'The human prerogative': a critical analysis of evidence-based and other paradigms of care in substance abuse treatment.
Present-day substance abuse treatment is characterized by a compelling demand for applying evidence-based interventions. Vehement discussions between policymakers, practitioners and researchers illustrate this clash of differing paradigms. The aim of this article is to situate evidence-based practice among the leading paradigms of care and to elucidate its implicit assumptions and potential implications. Evidence-based practice is inherent in the empirical-analytical paradigm of care and science, founded upon randomized and controlled studies. This paradigm is compared with the phenomenological-existential and the critical post-structural paradigm, which focus on elaborating the human potential and exploring individuals' subjective interpretations, and on criticizing social inequalities and striving for compliance with human rights, respectively. Evidence-based practice and the methodological rigidity in each paradigm are analyzed critically. We conclude that through the dialectical integration of these diverse approaches, evidence, existence/humanism and social emancipation can be combined for the benefit of the human prerogative of care.
Broekaert
Eric
E
Department of Orthopedagogics, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium. Eric.Broekaert@UGent.be
Autrique
Mieke
M
Vanderplasschen
Wouter
W
Colpaert
Kathy
K
D055317:Evidence-Based Practice / Q000379:methods*; D006808:Humanism; D006801:Humans; D008962:Models, Theoretical; D019966:Substance-Related Disorders / Q000628:therapy*