Building Empirical Building Empirical Evidence for PracticeEvidence for Practice

Chapter 3Chapter 3

LEARNING OBJECTIVESLEARNING OBJECTIVES

1. Understand the nature of evidence in social work practice

2. Understand the reasons for engaging in empirically oriented social work

3. Understand the essential components of building empirical evidence in practice

4. Understand the different means of collecting empirical information for practice

THE RELATIONSHIP BETWEEN THE RELATIONSHIP BETWEEN PRACTICE AND RESEARCHPRACTICE AND RESEARCH

• 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

PRACTICEPRACTICERESEARCHRESEARCH

Provides•A foundation of basic science knowledge

•Collection of validated clinical toolsSupported by continuous infusion of

research knowledge and tools

Provides•Clinical observations and outcome

evaluation•Generation of hypotheses

Supported by ongoing communication between social worker and clients

THE RESEARCH-PRACTICE INTERFACE

The General MethodThe General Method

• 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

1. Engagement

2. Data Collection

3. Assessment and Contract Planning

4. Intervention

5. Evaluation

6. Termination

The General MethodThe General Method

6 PHASES OF THE GENERAL METHOD6 PHASES OF THE GENERAL METHOD

1. Engagement Come up with plan to understand client’s

system’s problems, issues, needs, strengths, and resources

2. Data Collection Gather and prioritize information for

understanding the client system problem in social context

3. 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

4. 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

5. Evaluation Analyze the accomplishment of goals and objectives;

identify positive, negative, and unanticipated changes, and consider plans for termination

6. Termination Revisit the change process and goal accomplishments,

discuss maintenance of positive gains, plan an ending, consider context of future contacts

6 PHASES OF THE GENERAL METHOD6 PHASES OF THE GENERAL METHOD

The General Method is Founded Upon The General Method is Founded Upon EMPIRICISMEMPIRICISM

Social Work is EMPIRICAL in the sense that its practice is based on scientific inquiry, observations and methods

Is everything Is everything common sense common sense

though?though?

Based on your common sense of things…decide

whether the following statements are TRUE or

FALSE

• 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

From Sensory Experience to Empirical PracticeFrom 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

Historical Roots of Historical Roots of Empirical PracticeEmpirical Practice in Social Workin Social Work

Mary Richmond: Social DiagnosisMary 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.

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

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

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

Roots of Empirical PracticeRoots of Empirical Practice

1. Research and theory

2. Practice wisdom and values

3. Person of the practitioner

4. What client systems bring to practice situations

Gilgun, 2005

Cornerstones of Empirical PracticeCornerstones of Empirical Practice

Gathering Evidence to Support Gathering Evidence to Support Theory and ResearchTheory and Research

Empiricism: Acquiring knowledge through the senses

To see, hear, touch, taste

Components of EmpiricismComponents of Empiricism

Conceptual definitions Tell us what a

concept means Cake: An edible

concoction

Operational definitionsTell us how to

measure a conceptCake: 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 EmpiricismComponents of Empiricism

Client system outcomesThose conditions that best address change in client

system needs given the presenting problem and resources

InterventionsManipulations of an individual or societal

environment that are performed for research purposes or physical procedures by which data are gathered and.

Components of EmpiricismComponents of Empiricism

Program inputs Resources dedicated to

or consumed by the intervention program and client system Money, staff and staff Money, staff and staff

time, volunteers and time, volunteers and volunteer time 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 Sheltering and feeding homeless families homeless families

Program outputs Direct products of service activities

Counseling sessions conducted, interviews completedCounseling sessions conducted, interviews completed

Components of EmpiricismComponents 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 complexFrom very simple to very complex• In Variety and ScopeIn Variety and Scope• TopicTopic

Sample Logic Model: SimpleSample Logic Model: Simple

Sample Logic Models: SimpleSample Logic Models: Simple

Sample Logic Models: More ComplexSample Logic Models: More Complex

Building Empirical Evidence in PracticeBuilding Empirical Evidence in Practice

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 evaluations to determine scientific value and application

Tips to Help You Build Conduct Empirical Practice

Building Empirical Practice in Social WorkBuilding Empirical Practice in Social Work

University of Michigan: :www.ssw.umich.edu/nimhcenter/University of Tennessee: www.utcmhsrc.csw.utk.edu/Portland State University: www.rri.pdx.edu/index.phpUniversity of Washington www.depts.washington.edu/sswweb/ioe/Fordham University : www.fordham.edu IASWR www.iaswresearch.org/SSWR sswr.orgNASW www.socialworkers.org/Cochrane Collaboration www.cochrane.orgCampbell Collaboration: www.campbellcollaboration.org.

• There are numerous online resources available to help you develop your skills as they relate to empirical practice

4. Critically appraise the evidence

Steps to Building Empirical Evidence PracticeSteps to Building Empirical Evidence Practice

3. Search, gather, and critically examine the available evidence

2. Formulate answerable questions

1. Identify the client system problems

Theory and ResearchTheory and Research

• 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.

Types of theoryTypes of theory

Types of theory Formal theory Informal theory

Theories of what social work is

Nature and Purposes of Welfare

Moral, political cultural objectives

Theories of how to do social work

Theories of Practice

Induction from particular situations

Theories of the client world

Social science Theories

Use of experience and general social meanings

Role of Theory in Social Work PracticeRole of Theory in Social Work Practice

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.

Theories of PracticeTheories of Practice

Problem-Based Theories Etiology of personal and social problems and factors that shape or constrain them

Theories of Intervention or Service Delivery

Processes, resources and activities used to achieve desired outcomes

Theories of problem-service matching

Interactional fit between client system needs and interventions

ResearchResearch

Scholarly or scientific investigation or inquiry

Making Observations Using a Scientific Method

Type of Research

Typical Study Question

Use of Theory Use of Hypotheses General Research Methods

Descriptive What are the characteristics of _____ e.g. a population group?

No theoretical basis required

Predicts expected results, but not hypothesized relationships between independent and dependent variables

Often involves counting, comparing characteristics of subjects

Explanatory What effects do ____ one or more independent variables have on ____ a dependent variable?

Tests theory by applying it to observations deductive method: how and why one or more variables have some effect on another variable

Findings will either support or not support specific hypothesized relationships between independent and dependent variables

Often involves finding correlational or causal relationships using comparison groups

Exploratory How do people in the ____ population view ____? Otherwise known as “Qualitative Research”

Builds theory from observations inductive method

Usually avoids hypothesizing results

Often involves open- ended interviews, “thick” description, and finding concepts within responses

Evaluative What effects did this program or intervention have? Components of both Explanatory and Descriptive

Tests theory which explains how and why program or intervention should result in effects

Findings will either support or not support hypothesized program or intervention effects

Often involves comparing subjects pre- and post- intervention; may also involve qualitative methods and multiple sources of data to confirm findings.

Ten Questions to Help you Make Sense of Ten Questions to Help you Make Sense of ResearchResearch

1. Was there a clear statement of the aims of the research?

2. Is qualitative methodology appropriate?3. Was the research design appropriate to

address the aims of the research?4. Was the recruitment strategy appropriate to

the aims of the research?5. Were the data collected in a way that

addressed the research issue?

Ten Questions (cont)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?

Critical Inquiry: Critical Inquiry: Question, Question, QuestionQuestion, Question, Question

Conduct and Evaluate Research by ASKING CRITICAL

QUESTIONS OF IT

Popular Media Reports: Question it!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

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?

Critical Analysis: Questions to AskCritical Analysis: Questions to Ask

EvaluationEvaluation

An Essential Component of Social Work Practice

EVALUATION RESEARCHEVALUATION RESEARCH

Evaluation is part of the continuous process of Evaluation is part of the continuous process of service delivery throughout the six phases of the service delivery throughout the six phases of the General Method.General Method.

Thinking about evaluation begins during the general Thinking about evaluation begins during the general method engagement phase when the social worker method engagement phase when the social worker and client system first meet and begin exploring client and client system first meet and begin exploring client system issues, problems, needs, strengths, system issues, problems, needs, strengths, resources, and goals.resources, and goals.

Quality AssuranceQuality AssuranceAccountabilityAccountabilityGoal AttainmentGoal Attainment

1. Enables practice decisions based on empirically-derived interventions that have documented their level of effectiveness and have been subjected to professional scrutiny.

2. Interventions are evaluated and subjected to some level of professional peer scrutiny.

3. Subjects practice interventions to empirically-based evaluation that documents progress and outcomes.

Roberts, Yeager, & Regehr, 2006

Evaluation ResearchEvaluation Research

Evaluation ResearchEvaluation 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

Rapid Assessment Instruments Standardized Measures Client Focused Measures:

Client logs Rating Scales Goal Attainment Scaling System

Single Subject Designs

Common Strategies Common Strategies for Engaging in Practice Evaluationfor Engaging in Practice Evaluation