We revere evidence-based practice. But what if the evidence base itself is not inclusive?

Photo by Mario Gogh on Unsplash

Are you engaged in research? Take one of the projects you’re involved in…

  • Is the team lead a white person or a person of color? How about the rest of the team, who are you inviting on it?
  • Who are you studying; do they have a real say in the research agenda?
  • Who do you cite; do you actively search for and include scholars from underrepresented backgrounds?
  • Similarly, who do you invite to give presentations?

I’m talking to myself as much as I’m talking to you; there are so many areas where I should have been more inclusive (more on that later). This Wednesday/Thursday we hold a session (2 time zone options) to brainstorm small steps that we can already take to improve what we do.

Today, I wanted to talk about what motivated our team to organize this session: what we learned from our project on child trauma treatment guidelines.

Clinical practice guidelines are documents that inform clinical practice in several ways. They tell us what current evidence-based practice is, what the best trauma treatments are. They inform practitioners, prospective clients, professional associations, policy makers, program managers, regulatory agencies, and insurers, to name a few.

So they are important and influential. They can support equity and inclusion by means of their recommendations.

While doing an initial exercise of comparing recommendations across various guidelines, we got interested in children’s representation:

  • whether children had had a voice in the guideline process (as a ‘consumer’) and
  • whether their diversity of cultural backgrounds had been recognized and represented

The full – though short 😊 – commentary is available here (open access). Here is a quick overview of what we found: 


As far as we could tell from the 14 sets of guidance documents we considered, children or young people had not been actively involved in the development process of the guidelines:

They will have had a voice via the input from child-focused practitioners and researchers but we didn’t find reports of facilitated discussions or consultation with children and/or young people allowing their voice to be heard directly regarding proposed guideline questions, procedures or recommendations.

Cultural background:

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Go and collaborate

Child trauma researchers should collaborate more. That was one of the messages of the meta-analysis my colleagues and I recently published. Until now, researchers have conducted a number of interesting studies but these were relatively small and used a wide variety of methods and designs, which doesn’t permit robust conclusions. By combining efforts (see also the ‘data sharing’ page) much more could be known faster.

Our message is still relevant, but there are also some beautiful examples of collaboration. One was presented by Nancy Kassam-Adams at the European Conference on Traumatic Stress Studies. With three colleagues from the US and Australia she is building a large database from datasets of individual researchers: the Child PTSD Prediction Project. The data of  2500 children have been included so far (that’s already 25 times the usual N in a study…). It will enable researchers to answer questions about early risk and protective factors, and about trajectories of posttraumatic stress symptoms in children. Go and collaborate!