Knowing What We're Doing: Why Specification of Treatment Methods Is Critical for Evidence-Based Practice in Speech-Language Pathology

Abstract

Purpose: The purpose of this clinical focus article is to describe the conceptual framework of the multidisciplinary rehabilitation treatment taxonomy (RTT) and illustrate its potential use in speech-language pathology (SLP) clinical practice and research.

Method: The method used was a critical discussion.

Results: Current methods of defining and classifying SLP and other rehabilitation interventions maintain the "black box" of rehabilitation by referring to hours or days of therapy or using problem-oriented labels (e.g., naming treatment) to describe treatments, none of which reveal what is actually done to effect desired changes in patient functioning. The RTT framework uses treatment targets, ingredients, and mechanisms of action defined by treatment theory to specify SLP and other rehabilitation interventions with greater precision than current methods of treatment labeling and classification. It also makes a distinction between the target of treatment at which ingredients are directed and broader aims of treatment, which may be downstream effects explained instead by enablement/disablement theory.

Conclusion: Future application of the RTT conceptual scheme to SLP intervention may enhance clinical practice, research, and knowledge translation as well as training and program evaluation efforts.

Figures

Figure 1.

Enablement theory is concerned with relations among elements of the International Classification of Functioning, Disability and Health framework, shown by thin arrows among boxes in the figure. Treatment theory is concerned with the ingredients and mechanisms of specific treatment components, represented by open block arrows, that the clinician uses to achieve treatment targets, represented by italicized terms.