1. 1. Identifying and choosing your intervention – what, why and for whom?

1.1. An effective early support resource

Early Intervention is a Finnish information resource providing practitioners with details of effective early support methods aimed at children and their families. The purpose of the resource is to evaluate, coordinate and disseminate evidence-based know-how.

In this context, “early support” is used to describe a service that has been set up to promote mental health and well-being and to prevent problems in this area. The term “effective method” is used here to refer to evidence-based intervention methods that can be used to generate lasting, positive change for children and their families. Evidence is defined as scientifically and theoretically sound research results (for more, see Laajasalo & Pirkola, 2012, Jané-Llopis et al. 2010).

Early Intervention:

  • Offers reliable information on support methods available for children and their families
  • Establishes criteria for the meaningful evaluation of psychosocial intervention methods aimed at children and families
  • Features and endorses working methods that have been shown to be effective and that are based on sound evidence
  • Facilitates the adoption and implementation of these effective working methods by professionals working with children and young people
  • Helps line managers and local authority decision-makers to choose cost-effective and useful evidence-based methods for their local residents and to invest local training budgets in effective and safe methods

1.2. Who is Early Intervention for and how does it work?

Early Intervention is a resource aimed at all local authority and third sector staff working with families. The resource is designed as a platform for disseminating information and promoting awareness of the most effective interventions. It brings together reliable, comprehensive and up-to-date information on the best available working methods to allow professional practitioners and organisations to offer prompt, high-quality support to children and their families.

Practitioners committed to evidence-based practice must assess and apply the best available information and consider the needs and wishes of each individual client when selecting the most appropriate theoretical methods for use in their professional activities. Evidence-based practice is defined as the simultaneous, conscious and systematic use of more than one information source (www.hotus.fi).

1.3. Why is the Early Intervention resource necessary?

Professionals working with children and families may find it challenging to obtain up-to-date, concise and relevant information on the most effective working methods. Although research data tends to be readily available, practitioners often struggle to identify the best and most worthwhile methods that have also been shown to be the most effective and efficient.

When families turn to a service to seek support, the most important thing for them is to know that help will be available quickly and that the help offered will bring results. If parents feel that help is not readily available or that the support offered is not helpful to their situation, it can exacerbate the problem further (Marklund et al. 2010). As a rule, prevention is always best, in both human and macroeconomic terms. However, although preventive services offer potential financial benefits, there is evidence to suggest that accurately measuring the economic impact of preventive services is challenging (see for example Laajasalo & Pirkola 2012, Jané-Llopis et al. 2010).

1.4. Evidence-based and client-facing practice

All professional decision-making on mental health service design and provision, including the choice of working methods best suited to your local setting and regardless of whether they are offered for the purpose of promotion or prevention, should be based on high-quality, reliable data, such as scientific evidence. Evidence is based on scientific data evaluating the effects of the intervention or method in question.

In evidence-based practice, practitioners apply the best available, up-to-date data and methods in their day-to-day work. However, it is important to bear in mind that although it is important to ensure that your practice is based on solid scientific evidence, it does not mean that all evidence-based data and information is automatically relevant to all individual cases. You will need to assess whether the evidence-based information is relevant to your individual clients’ needs in consultation with the clients themselves, taking into account their opinions and motivations. The setting in which the client-facing work is delivered also influences the decision-making process (see www.hotus.fi; www.kaypahoito.fi).

In client-facing situations, your skills and experience, your capacity for empathy and your ability to identify and recognise problems play a key role in your practice. In evidence-based practice, you are also required to critically evaluate information and to balance and integrate into your practice all the information that is best suited to the individual client’s needs, in consultation with the client themselves. You will need to be open with your clients about the considerations your decisions are based on. Transparency is a key feature of evidence-based practice, facilitating service evaluation and your own ongoing professional development. Scientific data belongs to everyone, meaning that all evidence-based knowledge and information should be made available in the public domain.

Fig. 1 Evidence-based practice and decision-making as per the Hotus and Finnish Current Care Guidelines.

1.5. Other Nordic resources

When creating a set of criteria for the purpose of evaluating escientific evidence, our first priority was to undertake a thorough review of the relevant international literature and publications, evidence-based national and international databases and existing classification systems (see e.g. Flay et al. 2005; Jané-Llopis et al. 2010; Veerman & Yperen 2007).  In the early stages, we primarily focused our efforts on other Nordic experiences and evaluation systems. The Scientific Panel is responsible for determining what constitutes evidence for the purposes of this resource.

Across the Nordic countries, significant progress has already been made in disseminating evidence on  family support interventions Databases and other resources have been established to assess, produce and abridge scientific data so that it can be made available in a more accessible and user-friendly format.

In Norway, Denmark and Sweden, resources have already been put in place to promote effective, evidence-based working methods designed for use in child and family support services . Although they share many features and apply a number of the same criteria, each country has developed their own systems to meet their own particular requirements.

UNGSINN (Norway)