NADD Meeting Spring 2008

INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH 1

NADD Meeting Spring 2008

Partnerships to Integrate Evidence-Based Practice

Implications for Social Work Education, Practice & Research

Joan Levy Zlotnik, PhD, ACSWInstitute for the Advancement of Social Work Research

[email protected]

http://www.iaswresearch.org/


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…..


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).


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


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


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)


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


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


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


Purpose

• Develop strategies to expand and amplify existing activities integrating MH EBPs into social work education and research


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


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


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


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


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


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-CoursesFor students and professionals, on EBPs


Program ModelsNEW 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


Program Models

UNIVERSITY OF SOUTHERN CALIFORNIAPartner 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


OTHER MODELS

?????????????????????• Curricula inclusion• Community-based practice• Family/agency partnerships• Rural practice • Front-line staff • Access to EBP


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


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



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



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.


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


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.


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


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


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.


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.


Training Strategies

Three levels of training:1.Individual Training2.Training-of-Trainer3.Faculty/Department-Wide Training Or Just Do It!


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 training3. Training-of-Trainer4. Control (no REACH-SW materials)

Evaluation (Currently Ongoing)


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


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


•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


For More InformationIASWR - 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.govThe Road Ahead: Research Partnerships to Transform Services– http://www.nimh.nih.gov/about/advisory-boards-and-groups/namhc/

reports/road-ahead.pdfNational Association of State Mental Health Program Directors Research Institute

(NRI-INC) – www.nri-incSubstance Abuse and Mental Health Services Administration – www.samhsa.govNational Registry of Evidence-based Programs & Policies -

www.nrepp.samhsa.gov


For More Information

• Joan Levy Zlotnik, IASWR [email protected]

• Cynthia Baker, DANYAcbaker @danya.com

• Denise Juliano-Bult, [email protected]

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NADD Meeting Spring 2008

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