Problems of Evidence Based Practice in Community Based Services

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Abstract
An emerging orthodoxy regarding the definition and role of evidence based practice is identified and subjected to a constructive critique with particular reference to social and community health services for people who are intellectually (learning) disabled. It is argued that the orthodox approach to evidence based practice falters at every step, from the production of evidence to its use by practitioners. An alternative approach is suggested which distinguishes between macro, meso and micro types of evidence, and integrates information from these sources through the construction of practical realist theories that inform service provision through which the theories are also tested. A practical example based on current work on self-injury is provided.