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Beneficial forms of [practice] demonstrated by clear evidence from
controlled trials.
Forms of [practice] likely to be beneficial. The evidence in favor of
these forms of care is not as clear as for those in category 1.
Forms of [practice] with a trade-off between beneficial and adverse
effects. Effects must be weighed according to individual circumstances
and priorities.
Forms of [practice] of unknown effectiveness. There are insufficient or
inadequate quality data upon which to base a recommendation for
Forms of [practice] unlikely to be beneficial. The evidence against
these forms of care is not as clear as for those in category 6.
Forms of [practice] likely to be ineffective or harmful. Ineffectiveness
or harm is demonstrated by clear evidence.
4. Commitment to Rational Practice
Competency-based management requires a commitment to objective
practice. In describing the ease with which competency-based practice
can be used, Bailes (2002) writes, “ ... [It] is not beyond your capability,
even if you do not engage in research. You do not have to perform
research; you can read the results of published studies [including manage-
ment] research studies, meta-analyses, and systematic reviews” (p. 1).
Bailes notes that the Internet permits access to various databases that allow
searches to be done quickly and efficiently. In clarifying the type of data
competency-based management looks for in its attempt to find best prac-
tices, Sackett, Rosenberg, Muir-Gray, Haynes, and Richardson (1996)
write that it “involves tracking down the best external evidence with
which to answer our practice [and management] questions” (p. 72).
In its position paper on the need for competent management in clini-
cal social work, the American Board of Examiners in Clinical Social
Work (2004) expresses its concern with the lack of research guiding prac-
tice, regardless of the discipline (i.e., clinical social workers, physicians,
psychologists, psychiatric nurses, counselors, etc.). The board argues that
scientific research in management is needed “to improve outcomes and to
increase our knowledge of what practices are being employed in the field
of clinical management, what findings are being disseminated and applied,
and which techniques might be adopted to improve the quality of
practice” ( Harkness & Poertner, 1989; Hensley, 2002 ) (p. 20). The Board
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