Building Empirical Evidence for Practice

1. Building Empirical Evidence for Practice Chapter 3

2. LEARNING OBJECTIVES • Understand the nature of evidence in social work practice • Understand the reasons for engaging in empirically oriented social work • Understand the essential components of building empirical evidence in practice 4. Understand the different means of collecting empirical information for practice

4. Clinical research can only be conducted as a partnership between research and practice. The goal is a bi-directional system with research informing practice and practice informing research THE RELATIONSHIP BETWEEN PRACTICE AND RESEARCH

5. THE RESEARCH-PRACTICE INTERFACE • Provides • A foundation of basic science knowledge • Collection of validated clinical tools • Supported by continuous infusion of research knowledge and tools RESEARCH PRACTICE • Provides • Clinical observations and outcome evaluation • Generation of hypotheses • Supported by ongoing communication between social worker and clients

6. As beginning generalist social workers, you will employ a practice model/method, which can be utilized when working with individuals, families, groups, organizations, communities and nations. This problem-solving process consists of six sequential stages or phases of treatment: The General Method

7. The General Method 4. Intervention 1. Engagement The General Method 5. Evaluation 2. Data Collection 3. Assessment and Contract Planning 6. Termination

8. 6 PHASES OF THE GENERAL METHOD • Engagement • Come up with plan to understand client’s system’s problems, issues, needs, strengths, and resources • Data Collection • Gather and prioritize information for understanding the client system problem in social context • Assessment and Contract Planning • Decide on pre-intervention data collection activities necessary to provide a baseline for evaluating change • Come up with a written contract that specifies the goals and objectives

9. 6 PHASES OF THE GENERAL METHOD • Intervention • Work toward identified goals and objectives; monitor goal accomplishment, track changes, and consider whether desired changes are occurring or whether the contract needs to be renegotiated • Evaluation • Analyze the accomplishment of goals and objectives; identify positive, negative, and unanticipated changes, and consider plans for termination • Termination • Revisit the change process and goal accomplishments, discuss maintenance of positive gains, plan an ending, consider context of future contacts

10. The General Method is Founded Upon EMPIRICISM Social Work is EMPIRICAL in the sense that its practice is based on scientific inquiry, observations and methods

11. Is everything common sense though? Based on your common sense of things…decide whether the following statements are TRUE or FALSE

12. People in a sad mood are less likely to help others than are people in a neutral mood. • False • Simply having other people around tends to make individuals perform better on easy tasks. • True • Male-to-female relationship violence is much more common than female-to-male relationship violence. • False • Women "fall in love" more quickly than do men. • False • Women "fall out of love" more quickly than do men. • True • Focusing on a person’s voice is a better way to detect whether someone is telling a lie than focusing on the person’s face. • False

13. From Sensory Experience to Empirical Practice • We use common sense regularly to validate our observations and experiences and the information we obtain from the world through our sense • Validating what our common sense tells us however, requires more advanced empirical inquiry • This requires concerted effort on our part

14. Historical Roots of Empirical Practice in Social Work

15. Mary Richmond: Social Diagnosis • For several decades, Richmond attempted to turn the practical but rough-hewn techniques and skills known as casework into a more systematic approach.   • After honing her ideas through workshops, lectures and articles, she put her ideas into a book; the first definitive text on casework. • Social Diagnosis, gave to the new field of social work an anchor in its quest for professionalism.

16. Ann Shyne 1948: Can planned short-term intervention be effective?

17. Florence Hollis 1964: Social Casework - A Psychosocial Therapy

18. Roots of Empirical Practice • Mullen & Dumpson 1972: • Evaluation of Social Intervention • Fisher 1973: • Measures for practice • Jayaratne & Levy 1979: • Document intervention outcomes • Gambrill 1999: • Importance of empirical evidence in practice • Rosen and Proctor 2003: • Defining the meaning of evidence and how best to apply it in practice

19. Cornerstones of Empirical Practice • Research and theory • Practice wisdom and values • Person of the practitioner • What client systems bring to practice situations Gilgun, 2005

20. Gathering Evidence to Support Theory and Research Empiricism: Acquiring knowledge through the senses To see, hear, touch, taste

22. Conceptual definitions Tell us what a concept means Cake: An edible concoction Operational definitions Tell us how to measure a concept Cake: The recipe is mixing 1 cup of flour, ¼ cup of butter, 1 cup of milk, 2 eggs and mixing and then baking at 400 degrees for 30 minutes Components of Empiricism

23. Components of Empiricism • Client system outcomes • Those conditions that best address change in client system needs given the presenting problem and resources • Interventions • Manipulations of an individual or societal environment that are performed for research purposes or physical procedures by which data are gathered and.

24. Program inputs Resources dedicated to or consumed by the intervention program and client system Money, staff and staff time, volunteers and volunteer time Activities What the program intervention does with the inputs to fulfill its mission and achieve client system goals and objectives Sheltering and feeding homeless families Components of Empiricism • Program outputs • Direct products of service activities • Counseling sessions conducted, interviews completed

25. Components of Empiricism • Use of logic models • A systematic and visual way to present and share your understanding of: • The relationships among the resources you have to operate your program, • The activities you plan to do, and • The changes or results you hope to achieve. • Logic Models are quite variable ranging: • From very simple to very complex • In Variety and Scope • Topic

26. Sample Logic Model: Simple

27. Sample Logic Models: Simple

28. Sample Logic Models: More Complex

29. Seek effectiveness information about interventions Ground practice efforts on prior findings that show intervention actions performed with specific client systems are beneficial and give predictable results Evaluate individually to prove results are a consequence of practitioner and client system efforts Subject interventions to rigorous, experimental evaluationsto determine scientific value and application Building Empirical Evidence in Practice Tips to Help You Build Conduct Empirical Practice

30. University of Michigan: :www.ssw.umich.edu/nimhcenter/ University of Tennessee: www.utcmhsrc.csw.utk.edu/ Portland State University: www.rri.pdx.edu/index.php University of Washington www.depts.washington.edu/sswweb/ioe/ Fordham University : www.fordham.edu IASWR www.iaswresearch.org/ SSWR sswr.org NASWwww.socialworkers.org/ Cochrane Collaboration www.cochrane.org Campbell Collaboration: www.campbellcollaboration.org. There are numerous online resources available to help you develop your skills as they relate to empirical practice Building Empirical Practice in Social Work

31. Steps to Building Empirical Evidence Practice • Identify the client system problems • Critically appraise the evidence • Formulate answerable questions 3. Search, gather, and critically examine the available evidence

32. Theory and Research

33. An explanation or model based on observation, experimentation, and reasoning, especially one that has been tested and confirmed The social work profession draws on theories of human development and behaviour and social systems to analyze complex situations and to facilitate individual, organizational, social and cultural changes.

34. Types of theory

35. All practice interventions and their evaluation processes are enhanced when based on explicit conceptual or theoretical frameworks All programs are based on some idea about which mechanisms contribute to client system change and why. Articulating the underpinning conceptual framework or theoretical beliefs about how and in what way the practice efforts are meant to help client system problems is essential for gathering and creating evidence-based best practice knowledge. Role of Theory in Social Work Practice

36. Theories of Practice

37. Research Scholarly or scientific investigation or inquiry Making Observations Using a Scientific Method

39. Ten Questions to Help you Make Sense of Research • Was there a clear statement of the aims of the research? • Is qualitative methodology appropriate? • Was the research design appropriate to address the aims of the research? • Was the recruitment strategy appropriate to the aims of the research? • Were the data collected in a way that addressed the research issue?

40. Ten Questions (cont) 6. Has the relationship between research and participants been adequately considered? 7. Have ethical questions been taken into consideration? 8. Was the data analysis sufficiently rigorous? 9. Is there a clear statement of findings? 10. How valuable is the research?

41. Critical Inquiry: Question, Question, Question Conduct and Evaluate Research by ASKING CRITICAL QUESTIONS OF IT

42. Popular Media Reports: Question it! • Soda causes obesity, researchers assert • Daytime TV tied to poorer mental scores in elderly • Political bias affects brain activity, study finds • More creative = more sexually active? • Spanking children fuels aggression, anxiety • The long & short of it -- Tall women aim high • Stop global warming: Become a pirate • Eating breakfast makes girls thinner • Kids' TV habits tied to poorer test scores ; TV -- any TV -- harms toddlers, study claims • ADHD treatment improves teens' grades, confidence • Eating pizza "cuts cancer risk" • Graffiti linked to obesity in city dwellers ; Researchers find no obesity, sprawl link • Breastfeeding fights arthritis

43. Critical Analysis: Questions to Ask • Is this information, claim, or evidence accurate? • What critical tests have been performed? • What biases are evident in results or to what extent are the results free of any bias? • What values are supported by the interventive strategy? • Have the results been replicated; if so, how and with what results? • How representative were the samples of participants selected? • Who is presenting the results and for what purpose? • What measuring instruments were used? Are these reliable and valid? • Are there vested interests apparent in presenting the conclusions being drawn? • Have any facts been omitted? • Are there any alternative explanations for the findings?

44. Evaluation An Essential Component of Social Work Practice

45. EVALUATION RESEARCH Evaluation is part of the continuous process of service delivery throughout the six phases of the General Method. Thinking about evaluation begins during the general method engagement phase when the social worker and client system first meet and begin exploring client system issues, problems, needs, strengths, resources, and goals. • Quality Assurance • Accountability • Goal Attainment

46. Evaluation Research • Enables practice decisions based on empirically-derived interventions that have documented their level of effectiveness and have been subjected to professional scrutiny. • Interventions are evaluated and subjected to some level of professional peer scrutiny. • Subjects practice interventions to empirically-based evaluation that documents progress and outcomes. Roberts, Yeager, & Regehr, 2006

47. Evaluation Research • Social Work is involved in carrying out evaluation research on a wide range of topics • Examples of projects include: • Follow-up evaluation of an alcohol service • Evaluation of support services for black and minority ethnic families • Evaluation of services for those with learning disabilities • Evaluation of social work education • Evaluation of a group for children whose parents have substance misuse problems

48. Common Strategies for Engaging in Practice Evaluation • Rapid Assessment Instruments • Standardized Measures • Client Focused Measures: • Client logs • Rating Scales • Goal Attainment Scaling System • Single Subject Designs