Evidence-Based Practice

What is it & what do we do with it?

Barrett JohnsonCWDA Child Welfare Conference

Monterey, CAMay 29th, 2008

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What do we think EBP means?

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Some Definitions:EBP “is the integration of best research

evidence with clinical expertise and [client] values”

Sackett, Straus, Richardson, Rosenberg & Haynes (2000). Evidence-Based Medicine: How to practice and teach EBM (2nd ed.)

“It is the conscientious, explicit and judicious use of current best evidence in making decision about the care of individual [clients]”

Sackett, et al. (1997)

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Definitions, cont.Gilgun’s 4 ‘Cornerstones’ of EBP:1. Research and Theory2. Practice wisdom, or what we and other

professionals have leaned from our clients

3. The person of the practitioner (personal assumptions, values, biases and world views)

4. What clients bring to the situationGilgun, J.F. (2005). The four cornerstones of evidence-based practice in social work.

Research on Social Work Practice, 15(1).

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Definitions, Cont.Practice that is informed and ‘mindful’ of:

Best available research evidence;

Best Clinical Experience;

Client values and preferences.

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Evidence-Based Practice vs Evidence-Based Interventions/Treatments Evidence-Based Interventions or

Treatments refer to “the interventions or techniques (e.g. cognitive therapy for depression, exposure therapy for anxiety) that have produced therapeutic change in controlled trials.”

Kazden, A. (2008). Evidence-based treatment and practice. American Psychologist, 63 (3) p. 147.

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Evidence-Based Interventions/ Treatments Almost all of the evidence in CWS falls

under this category Not what the child welfare worker does,

but what other people do.

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Casework Practice

Domestic/Intimate Partner Violence: Batterer Intervention Programs

Domestic/Intimate Partner Violence: Services for Women and their Children

Home Visiting for School Readiness

Interventions for Neglect

Motivation and Engagement

Parent Training

Placement Stabilization

Prevention (Secondary)

Reunification

Substance Abuse (Parental)

Supervised Visitation (3 @ level 4: Effectiveness Unknown)

Trauma Treatment for Children

Youth Transitioning into Adulthood

CEBC Areas Currently

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2 Aspects to Consider:

Building evidence

Applying/translating the evidence that we have to practice

Building Evidence

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Building Evidence: The Research and Training NetworkResults so far: Four statewide symposia Established Research Agenda that has

been adopted by CWDA, CalSWEC and CFPIC

Aligned CalSWEC’s research and development grants to the agenda

REVISED Agenda currently under review

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Building Evidence Discussions

Divide into Safety, Permanence and Well-being:

Review the proposed Agenda Which are most important to you? Why? How might you think about studying this?

Translating Evidence

into Practice

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Translating Evidence: What we know

Most EB Interventions are not implemented

We have only begun to look at creating an atmosphere in the workplace for Evidence-Based Practice

The organizational Culture and Climate influence both of these things

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Translating Evidence: Some DefinitionsOrganizational Culture “the way things are done around here” The shared norms, beliefs and behavioral

expectations that drive behavior and communicate what is valued in an organization

Summary of definitions from:

Hemelgarn, Glisson and James. (2006) Organizational culture and climate: implications for services and interventions research. Clinical Psychology: Science and Practice. 13(1).

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Translating Evidence: Some DefinitionsOrganizational Climate “How it feels to work here” The agreed upon (i.e. not just individual)

perception of the psychological impact of the work environment

Summary of definitions from:

Hemelgarn, Glisson and James. (2006) Organizational culture and climate: implications for services and interventions research. Clinical Psychology: Science and Practice. 13(1).

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Translating Evidence DiscussionsDivide into groups: Review the definitions of culture and

climate What is the current culture of the CWS

agency about EBP? About EB Interventions?

What could you do to change this? How might the organizational climate

influence attitudes toward EBP/EB I? How might you change this?

What can we do for you?

For more information about EBP and training:

http://calswec.berkeley.edu/ www.cfpic.org

www.cachildwelfareclearinghouse.org