Using Family Paradigms to Improve Evidence-Based Practice Purpose 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. Method ... Viewpoint
Viewpoint  |   August 01, 2009
Using Family Paradigms to Improve Evidence-Based Practice
 
Author Affiliations & Notes
  • Mary Jo Cooley Hidecker
    Michigan State University, East Lansing
  • Rebecca S. Jones
    Private Practice, Holt, MI
  • David R. Imig
    Michigan State University
  • Francisco A. Villarruel
    Michigan State University
  • Contact author: Mary Jo Cooley Hidecker, who is now at the University of Central Arkansas, Speech-Language Pathology Department, Box 4985, Conway, AR 72035. E-mail: mjchidecker@uca.edu.
Article Information
Augmentative & Alternative Communication / Research Issues, Methods & Evidence-Based Practice / Viewpoint
Viewpoint   |   August 01, 2009
Using Family Paradigms to Improve Evidence-Based Practice
American Journal of Speech-Language Pathology, August 2009, Vol. 18, 212-221. doi:10.1044/1058-0360(2009/08-0011)
History: Received February 28, 2008 , Revised July 25, 2008 , Accepted January 24, 2009
 
American Journal of Speech-Language Pathology, August 2009, Vol. 18, 212-221. doi:10.1044/1058-0360(2009/08-0011)
History: Received February 28, 2008; Revised July 25, 2008; Accepted January 24, 2009
Web of Science® Times Cited: 1

Purpose 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.

Method 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.

Acknowledgments
This project was supported in part by National Institute on Deafness and Other Communication Disorders predoctoral fellowship NIH-NIDCD F31-DC05443 and postdoctoral fellowship NIH-NIDCD F32-DC008265. Jill Elfenbein, John Eulenberg, John Folkins, Ray Kent, Ida Stockman, Rana Al Khamra, Amyn Amlani, Johanna Boult, Sara Shogren Holcomb, David Medei, Diane Ogiela, Robin Roots, Greg Robinson, and Deborah Stuart provided critical comments and insights on earlier drafts of this article.
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