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INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 1
NADD Meeting Spring 2008
Partnerships to Integrate
Evidence-Based PracticeImplications for Social Work Education, Practice & Research
Joan Levy Zlotnik, PhD, ACSW
Institute for the Advancement of Social Work Research
www.iaswresearch.org
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 2
Institute for the Advancement of Social Work Research • Develop social work
research(ers)
• Translate research into effective practice and policy
• Translate practice issues into questions to be studied
– Strengthen the bridges between research and practice
– EBP efforts focus on defining, identifying, assessing, applying and evaluating…..
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 3
Why EBP?
EVIDENCE-BASED PRACTICEEVIDENCE-BASED/
RESEARCH-TESTED/EFFECTIVE PRACTICES
INFORMED CLINICAL DECISION-MAKING
How do we improve the capacity of providers to use research to best deliver care to consumers/patients?
How do we improve the uptake of practices demonstrated to improve consumer/ patient outcomes?
INTEGRATION INTEGRATION
EBP for Policy and Macro-practice Too
Chambers, D. (2007).
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 4
Why Evidence-Based Practice?
• Important for outcomes and accountability
– costs, replicability, standards, efficiency, quality improvement.
• Connect research to practice and policy
- usefulness, applicability, relevance, adoption.
• Important for effectiveness –
– what works – for whom –
• Make optimal practice decisions made on research
• Balance effective interventions with diversity -
– individual, culture and community.
• Ethical obligation to use what works
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 5
Definitions
• EBP is a process in which the practitioner combines well-researched interventions with (clinical) practice experience, ethics and client system preferences and culture - to guide and inform the delivery of treatments and services.
• EBP – specific practices• EBP – specific programs
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 6
Definitions
• Evidence-based practice is defined by the Institute of Medicine as the integration of best researched evidence and clinical expertise with patient values. (IOM Committee on Quality of Health Care in America (2001). Crossing the Quality Chasm. Washington, DC: National Academies Press.)
• "Evidence-based practices are interventions for which there is consistent scientific evidence showing that they improve client outcomes." (Drake et al., 2001, p. 180)
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 7
EBP Processes
• Developing Evidence
– Emphasize research with potential to “change practice”
– Produce findings applicable to current service delivery
– Involve clients/consumers/practitioners in research design and studies
• Disseminating Evidence
– Transportability
– Representativeness
• Adopting/Adapting Evidence
• Adherence, access and preference
• Health disparities
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 8
IASWR EBP Involvements Austin Initiative - Improving the teaching of evidence-based
practice – special issue of Research on Social Work Practice -- September 2007
Child welfare and evidence-based practice in the context of cultural competence - http://ssw.cehd.umn.edu/EBP-CulturalCompetence.html
NIMH – linking research and practice – Evidence-based behavioral practice – www.ebbp.org EBP – Family-centered health care – Health disparities Transporting Evidence-Based Practice to Community Settings
– Collaboration with NASW EBP and Care Coordination – Collaboration with the New
York Academy of Medicine
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 9
NIMH Initiative
Partnerships to Integrate Evidence-Based Mental Health Practices into Social Work Education and Research
Office of Constituency Relations & Public Liaison
Office for Special Populations
Division of Services & Intervention Research
Institute for the Advancement of SW Research
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 10
Purpose
• Develop strategies to expand and amplify existing activities integrating MH EBPs into social work education and research
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 11
Initiative Activities
• IASWR scan social work education and outreach to service providing organizations to identify current efforts to teach evidence-based practices in social work education
• Partnerships– Among social work organizations
– Between social work and NIMH
– Between a discipline and service providers
– Between a discipline/service providers/consumers
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 12
Invited Stakeholders• Assn for Baccalaureate SW Program Directors• Anxiety Disorders Assn of America• Council on SW Education• Group for the Advancement of Doctoral Education• Institute for the Advancement of SW Research• Mental Health America• Nat. Assn of Deans & Directors of Schools of SW• National Association of Social Workers• Nat. Assn of State MH Program Directors (& NRI)• Society for SW and Research• Substance Abuse and MH Services Administration• The St. Louis Group
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 13
April 2007 Meeting Agenda• School Perspective (supply)
• State Perspective (demand)
• EB Psychotherapy
• Existing Models at SW Schools• Culturally Appropriate Care
• National Workforce Development (SAMHSA)
• Stakeholder Perspective (employer)
• Consumer Perspective
• Roundtable Discussions
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 14
School & Agency Leverage Points
• Identifying and accessing EBTs
• Accepting and adopting EBTs
• Implementing EBTs in practice
• Evaluating effectiveness of EBTs
Proctor, E, Research on Social Work Practice (Special Issue) 2007
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 15
Promoting EBP Strategies and Challenges Curriculum
• Foundation and advanced research courses
• Standard practice curricula
• Advanced clinical practice electives
Life-long learning • Keep pace with new findings
• For non-responders or unknown areas
Field setting issues• Staff knowledge
• Limits for new training
• Limited resources
• Staff turnover
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 16
Program Models
UNIVERSITY OF MICHIGAN• Field Specific Collaboratives
Team students, faculty & agency to reduce implementation barriers
• Information Literacy CompetenciesLibrary developed website to assist practitioners
• Mini-Courses
For students and professionals, on EBPs
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 17
Program Models
NEW YORK STATE CONSORTIUM
STATE OMH AND DEANS & DIRECTORSSTATE OMH AND DEANS & DIRECTORS
School survey; Field focus groupsSchool survey; Field focus groups
Program development among five schools Program development among five schools syllabus, placement matching, field colloquiasyllabus, placement matching, field colloquia
Pilot ImplementationPilot Implementationcertificate and job referralcertificate and job referral
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 18
Program Models
UNIVERSITY OF SOUTHERN CALIFORNIA
Partner with LA Co. DMH to Transform Public MH Services
• FIELD UNIT TRAINING• Train students to implement EBPs
• Educational exchange for administrators & field supervisors
• Prime agencies for service innovation
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 19
OTHER MODELS
?????????????????????• Curricula inclusion• Community-based practice• Family/agency partnerships• Rural practice • Front-line staff • Access to EBP
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 20
Potential Action StepsPARTNERSHIPS FOR RESEARCH, EDUCATION AND
WORKFORCE DEVELOPMENT• Transfer info from workforce development in other fields (child
welfare/aging, etc.)• Encourage MH/SW ED state level partnerships
– Agenda setting– Conferences– Implementing services research agendas– Use academic library resources– Encourage faculty development at the national level – IASWR/NRI
summer workshops– Link to field education and teaching of EBPs– Certificate programs– SW guidelines across the educational continuum
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 21
Potential Action Steps
DOCTORAL EDUCATION IN SOCIAL WORK• Provide opportunities to learn about EBP, EBPTS and to
develop relevant research agendas.• Teach to use EBP process across fields of practice
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 22
Potential Action Steps
ENHANCEMENT AND SUSTAINABILITY • Conference grants to further address EBP issues,
strategies to educate faculty about culturally relevant EBP and EBTs, and promote partnership models and transfer from model projects
• National clearinghouse on sw relevant EBTs and EBP resources, strategies to use toolkits.
• National taskforce
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 23
Potential Action Steps
RESEARCH
• Systems level research to address organizational and structural issues to adopt and adapt EBP & EBTs
• Research on co-morbidity
• Agency/university research partnerships
• Translational research to link university, public health and mental health systems.
• Research workforce training program with rigorous methods that focus on dissemination and implementation into real world settings
• Encourage collaborative and participatory research models.
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 24
REACH-SW
• Curriculum enhancement tool to increase the use of empirical mental health research in social work practice.
• Field testing now
• Supported by NIMH Division of Services Intervention Research
– SBIR Phase I Contract: 9/2003 – 3/2004
– SBIR Phase II Contract: 9/2004 – 9/2008
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 25
REACH-SW Curriculum Tool
Objective: To support social work faculty in teaching students the lifelong skills needed to find, assess, and apply EBP approaches to social work practice in real-world settings.
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 26
Danya Cynthia Baker, Ph.D., Principal Investigator Nicole Owings-Fonner, M.A., Project Director Laurie Brockmann, M.P.H., M.S.W., Content Writer
NIMH Adam Haim, Ph.D., Program Official Denise Juliano-Bult, M.S.W., Program Chief, Systems Research
Program
Project Team
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 27
Advisory Panel Edward Mullen, D.S.W., Columbia University Enola Proctor, Ph.D., Washington University Wynne Sandra Korr, Ph.D., University of Illinois at Urbana-Champaign Mary Ruffolo, Ph.D., University of Michigan Betsy Schafer Vourlekis, Ph.D., University of Maryland Baltimore County
Content Development Resource Consultants Joan Zlotnik, Ph.D., A.C.S.W., Executive Director of IASWR Anita Rosen, Ph.D., Independent Consultant
Guest Editors/Contributors Edward Mullen, D.S.W., Columbia University School of Social Work Enola Proctor, Ph.D. , Washington University in St. Louis Phyllis Solomon, Ph.D., University of Pennsylvania Deborah Gioia, Ph.D., University of Maryland John Brekke, Ph.D., University of Southern California Haluk Soydan, Ph.D., University of Southern California
Project Team
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 28
REACH-SW Purpose
REACH-SW is designed to help faculty incorporate the application of EBP into their existing course content using an infusion model.
EBP content is incorporated into existing course materials, augmenting the faculty member’s expertise with ready-made resources to adapt to specific course content (e.g., student classroom activities, case examples, and assignments).
This approach is designed to help faculty bring an evidence-based approach into every course, rather than having to require new courses to cover this content or adding on content.
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 29
Approach
• REACH-SW supports social work faculty and programs in helping students to: Understand the importance, value, benefits, and limitations of
EBP approaches. Learn how to conduct EBP as a process (Gibbs 7-step model)
in real-world settings. Learn how to find, evaluate, adapt, and apply evidence-based
practices (or EBIs, EBT, etc.). Develop critical thinking skills as a “lifelong learner.” Increase scientific literacy.
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 30
Training Strategies
Three levels of training:
1.Individual Training
2.Training-of-Trainer
3.Faculty/Department-Wide Training
Or Just Do It!
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 31
Objective: To assess the effectiveness of the REACH-SW program and determine the added value of in-person training workshops.
N=36 social work faculty from around the nation All levels of education (BSW, MSW, DSW) Four research groups:
1. Self-guided (no in-person training; CD only)
2. Individual training
3. Training-of-Trainer
4. Control (no REACH-SW materials)
Evaluation (Currently Ongoing)
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 32
One-day pre-conference workshops at annual meetings of relevant organizations (CSWE, BPD, SSWR).
Regional trainings throughout the year.
Department-/faculty-wide trainings upon request.
CEUs available.
Technical Assistance and Ongoing Support Ongoing support (online technical assistance, booster
sessions, etc.) will be provided to those who have attended a training on an as-needed basis.
REACH-SW Trainings
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 33
Product and Training Availability
CD-ROMs will be available for purchase by summer 2008 Discussions underway to provide training/Faculty Development
Institutes at CSWE (October 2008, Philadelphia) Intend to offer if possible for BPD, SSWR Other types of training will also be available Social work educators from different regions of the country
and a variety of universities Develop REACH-SW trainers
Different “levels” of expertise in EBP Social work educators Operate as consultants to Danya Certified by REACH-SW “master trainer” and standardized certification
training process
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 34
•University of Texas at Austin•Methodist University•Virginia Commonwealth University•Southern University•Arizona State University•Florida Atlantic University•Florida State University•Springfield College•Southern Ct. Sate University•NC State University•University of Hawaii•Smith College•Boise State•University of North Carolina Wilmington•California State University Long Beach•Ohio State University•Portland State University•Missouri State University
• New York University• Bennett College for Women• University of Maryland at Baltimore• California University of Pennsylvania• Simmons College• University of Chicago• Loma Linda University• University of South Florida• University of Denver• San Jose State University• University of Central Missouri• Edinboro University• Savannah State University• Hawaii Pacific University• Hunter College• University of Minnesota• University of Tennessee• Hunter College
Participating Programs
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 35
For More Information
IASWR - www.iaswresearch.org
Partnerships to Integrate Evidence-Based Mental Health Practices into Social Work Education and Research
– http://charityadvantage.com/iaswr/EvidenceBasedPracticeSummary.pdf
NIMH - www.nimh.nih.gov
The Road Ahead: Research Partnerships to Transform Services
– http://www.nimh.nih.gov/about/advisory-boards-and-groups/namhc/reports/road-ahead.pdf
National Association of State Mental Health Program Directors Research Institute
(NRI-INC) – www.nri-incSubstance Abuse and Mental Health Services Administration – www.samhsa.gov
National Registry of Evidence-based Programs & Policies -
www.nrepp.samhsa.gov
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 36
For More Information
• Joan Levy Zlotnik, IASWR [email protected]
• Cynthia Baker, DANYA
cbaker @danya.com
• Denise Juliano-Bult, NIMH