title: Using family paradigms to improve evidence-based practice.
abstract: OBJECTIVE
  Evidence-based practice (EBP) describes clinical decision making using research, clinical experience, and client values. For family-centered practices, the client's family is integral to this process. This article proposes that using family paradigms, a family science framework, may help elicit and understand client/family values within family-centered EBP.
  
  
  METHODS
  This article describes the family paradigms framework: 4 classic paradigms of "closed," "random," "open," and "synchronous." Its applicability to family-centered EBP is proposed using augmentative and alternative communication examples.
  
  
  RESULTS
  A family-centered approach to EBP requires families to be an integral part of clinical decision making, but some families may need assistance in enumerating their views and values. Family paradigms (which consider how a family uses its resources of time, space, energy, and material in the pursuit of its goals of control, affect, meaning, and content) may be a way to elicit family values and preferences relevant to clinical decisions.
  
  
  CONCLUSIONS
  Family and client values can be incorporated throughout the EBP steps. Considering family paradigms may increase awareness and understanding of how families' views of their goals and resources affect clinical decisions. Further research is needed into both the processes and effectiveness of using family paradigms to conduct family-centered EBP.
authors.affiliation: University of Central Arkansas, Speech-Language Pathology Department, Box 4985, Conway, AR 72035, USA. mjchidecker@uca.edu
authors.forename: Mary Jo Cooley
authors.initials: MJ
authors.lastname: Hidecker
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Jones
authors.forename: David R
authors.initials: DR
authors.lastname: Imig
authors.forename: Francisco A
authors.initials: FA
authors.lastname: Villarruel
mesh_terms: D002648:Child; D003142:Communication; D003657:Decision Making; D055317:Evidence-Based Practice; D005190:Family; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011368:Professional-Family Relations; D011369:Professional-Patient Relations