Clinical practice offers the opportunity for the clinician to be a scientist-practitioner in the workplace. This, in turn, facilitates building practice-based evidence. But this can only occur if the effects of the interventions are objectively and systematically evaluated. To this end, single-case methodology is a valuable tool to implement an intervention in a scientifically rigorous manner and gather data on treatment effectiveness. It is possible to incorporate single-case methods into routine clinical practice by using a few simple strategies. This paper examines the ways in which single-case methodology departs from (a) routine clinical practice and (b) the familiar between-groups research design, such as the randomised controlled trial. It presents five practical strategies that will bridge the gap between routine clinical practice and single-case methodology. The Model for Assessing Treatment Effect is described as providing context for and a framework to self-evaluate the scientific rigour in clinical practice and benchmark service delivery.

This study evaluated a 3-day Schema Therapy (ST) training programme for trainee clinical psychologists. The training used an experiential model of learning, which was intended to encourage the transfer of knowledge and techniques from the learning environment into clinical practice. Using a mixed-methods approach, the training programme was evaluated in terms of: (1) self-reported changes in knowledge, confidence and willingness to use ST-informed techniques; (2) whether the training was integrated into clinical practice; and (3) the perceived barriers/facilitators to achieving practice integration. Participants – 17 of the 19 trainee clinical psychologists enrolled on the ST training programme – completed assessments immediately pre- and post-training. Participants were subsequently followed-up for reassessment 3 months after the training. Group- and individual-level analyses showed that most participants reported training-related gains in knowledge and confidence; these were largely sustained at follow-up, and were associated with post-training practice integration of ST concepts and techniques. Analysis of qualitative data identified factors moderating use of training in practice. Findings of the study have implications for future delivery and evaluation of training in cognitive-behavioural therapies.

Polypharmacy is a phenomenon of modern health care that can offer benefits in terms of patient outcomes. Known risks associated with so-called inappropriate polypharmacy can be reduced through good medicine management and appropriate use of clinical guidelines. However, we now see a growing literature highlighting additional risks to individual well-being and social functioning not recognised within these existing frameworks – the burden of polypharmacy and a problem of overprescribing. We need a new approach to defining and understanding inappropriate polypharmacy from a person-centred perspective. This paper discusses practice-based work exploring the impact of introducing generalist needs assessment for elderly patients with multiple chronic morbidities. The work suggests that generalist care offers something ‘different’ to current chronic disease management models, but highlights the need for formal evaluation to determine whether it is ‘better’. We call for new collaborative research between clinical and academic partners to address the question as to whether generalist care offers solutions to the problems of the burden of polypharmacy.

Within Primary Care, clients presenting with mental health problems are most likely to report the presence of an anxiety disorder. Referrals to mental health services can result in waiting lists due to the prevalence of individual models of intervention. A service delivery innovation to this organizational impasse has been White's group-based “Stresspac” approach. The current project attempted to increase the effectiveness of such service delivery via the application of practice-based evidence (PBE) guidelines. Clients completed a battery of psychometric tests prior to engaging in and on completion of a six-session group cognitive-behavioural intervention. A satisfaction survey was completed on termination of the group. Two groups were completed, the second of which was conducted using a PBE derived selection criterion. The application of the PBE selection criterion appeared to increase the effectiveness of the intervention provided, with clients in both groups being widely satisfied with the group approach. The active employment of PBE in the design and implementation of services appears to offer the opportunity for increasing the range, format and effectiveness of psychological interventions offered.