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Treatment interventions and findings from research: bridging the chasm in child psychiatry^*,

National Children's Bureau, 8 Wakley Street, London ECIV 7QE

Declaration of interest None.

^* This article is based on the Rutter Lecture, delivered on 22 April 1999, at the Faculty of Child and Adolescent Psychiatry Annual Meeting in Manchester.

See invited commentary, p. 420, this issue.

Background Along with all other branches of medicine, child and adolescent psychiatry is faced with the need to consider its evidence base and justify its activities accordingly.

Aims To consider critically the use of the term ‘evidence’, to suggest limits to the value of conventionally defined evidence and to point to possible ways forward to bridge the gap between research findings and clinical practice.

Method A review of the literature relating to the use of evidence-based methods.

Results The term ‘evidence’ needs to be used more widely than is conventionally the case. Substantial evidence exists from controlled trials, but there are barriers to its use.

Conclusions A move away from nonvalidated methods of intervention is both desirable and feasible. The use of qualitative methods of enquiry, both in situations where controlled trials are unlikely to be feasible and as adjuncts to quantitative methods, should be considered more seriously.

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