clinical social work research patience matute-ewelisane eugene shabash jayne griffin

Clinical Social Work Research

Patience Matute-Ewelisane

Eugene Shabash

Jayne Griffin

History of Clinical Social Work:

Prior to the 1960s, casework, informed by Freudian theory and ego psychology, was the central focus of the social work profession

In the 1960s, social work began to focus on community organizations, social program, policy design and social action

Social workers who engaged in individual treatment were accused of being agents of social control, of blaming the victim instead of the effects of oppression, poverty and trauma and of pathologizing the behaviours of marginalized groups

(Goldstein, 1996, p. 90)

History of Clinical Social Work:

Social Workers supporting individual treatment felt clients issues were being oversimplified and that clients needs were not being met

Social workers in direct practice felt alienated from the profession and worried about their acceptance as clinicians along side psychologists and psychiatrists

In 1971, the Federation of Societies for Clinical Social Work formed with the aims of establishing standards of practice and meeting the needs of direct practitioners

In 1972, The Clinical Social Work Journal was created

(Goldstein, 1990, pp. 90-91)

Definition of Clinical Social Work

Clinical social work: shares with all social work practice the goal of enhancement and maintenance of psychosocial functioning of individuals, families, and small groups. Clinical social work practice is the professional application of social work theory and methods to the treatment and prevention of psychosocial dysfunction, disability, or impairment, including emotional and mental disorders. It is based on knowledge of one or more theories of human development within a psychosocial context. The perspective of person-in-situation is central to clinical social work practice.

(http://www.socialworkers.org/practice/standards/clinical_sw.asp#definitions )

Definition of Evidence Based Practice:

Includes selecting, implementing and then evaluating interventions related to the client’s specified problems and goals, based upon the best available information or evidence of effectiveness….EBP requires the social worker to find reliable sources of information and then judge the quality of the information in order to inform selection of interventions.

(Vonk, E.M. & Tripodi, T. & Epstein, I., 2007, p. 91)

Clinical Social Work:

Assessment

Intervention

Evaluation

- Integrating research into Clinical Social Work Practice:

- We are going to explore how research can be implemented into each part of the clinical social work process

ASSESSMENT

Diagnostic assessment: the clinical social worker is supposed to accomplish 4 major tasks and then make a decision.

Gather information

Determines client’s eligibility

Prioritize client’s needs

Set intervention goals

(Vonk, E.M. & Tripodi, T. & Epstein, I., 2007)

RESEARCH INTERVIEW

Structure Content Interview schedule Environment Pretesting

USING AVAILABLE INSTRUMENTS

When What Who How


SYSTEMATIC OBSERVATION

Assess frequency of behaviours in various settings Can validate information provided by less structured means To see how well clients follow treatment plans To access the clinical process To evaluate treatment

SPECIFICATION AND RATING OF PROBLEMS AND GOALS

Listen Observe Operationalization


INTERVENTION

Clinical Social Workers can choose interventions with clients based on:

Previous training and practice experience

Treatment traditions and protocols of the agency where they are working

Research – Evidence based practice


Steps to Evidence Based Intervention Selection:

Specify the problem:

Severity

Duration/Frequency

Under what conditions is the problem likely to occur

Characteristics of the client involved

Client’s goals

Treatments that have been tried in the past, levels of success

2. Locate relevant research literature:

Systematic reviews (literature reviews)

Practice guidelines (treatment protocols or manuals)

Expert Consensus Guidelines

Independent search of available literature

(Vonk, E.M. & Tripodi, T. & Epstein, I., 2007, p. 92-94)

3. Assessing the level of Evidence:

Randomized controlled trials (RCT)- hypothesis tested with a large group of people

Quasi-experimental/non-experimental- describes statistical relationships between outcomes and interventions

Case studies/pilot studies – describes intervention techniques, clients, agencies

Practice based opinions and untested hypothesis

4. Assessing Measurement Accuracy, Reliability and Validity:

Measure Accuracy: the degree to which the process of determining the treatment’s effectiveness was free from error.

Reliability of measurement: the consistency that an instrument measures something

Validity of measurement: is the instrument measuring what it says it will measure?


5. Assessing the Empirical Relationship Between Invention and Outcome:

Determining the strength and predictability of the relationship between the intervention used and the results.

6. Assessing the External Validity:

Degree to which the results can be generalized

7. Assessing Internal Validity:

To connect the intervention to the desired outcome

8. Applying Appropriate Criteria:

Will the results be considered strong evidence or a hypothesis to undergo further testing?


9. Assessing the Utility of Intervention and Implementation Issues:

Is the intervention appropriate for this client, social worker (training), situation, agency?

10. Issues Related to the Intervention:

Is it specific?

Does it match the values and ethics of social work?

11. Issues related to the client:

Based on the client’s worldview, beliefs and values is the intervention a good fit for him/her?

12. Issues related to the Social Worker and Practice setting:

Does the social worker have the proper training to perform this intervention?

Is the intervention suitable for the practice setting? Cost?


EVALUATION

Evaluation is the last phase of clinical social work practice and informs about:

the degree treatment’s goals were achieved.

cost-benefit of treatment

further strategies: continue, modify or stop treatment

efficacy of particular treatment approach

Focus of Evaluation

Treatment evaluation: effectiveness and efficiency of social worker with the client

Program evaluation: practice setting effectiveness and efficiency of the whole program

Evaluation

Formative

Summative

Client Sensitive Evaluation

Objectives

Design

Confidentiality

Inform consent

Ethical dilemmas

Single Case Design

Single case design: working with a single client’s unit (person, family or group)

Use of single case design by itself

Use of single cases for aggregation

References

Goldstein, E. (1996). What is Clinical Social Work? Looking Back to Move Ahead. Clinical Social Work Journal, 24 (1), 89-104. doi: 10.1007/BF02189944.

Goldstein, E. (2007). Social Work Education and Clinical Learnings: Yesterday, Today and Tomorrow. Clinical Social Work Journal, 35, pp. 15-23. Doi:

10.1007/s10615-006-0067-z

Vonk, E.M. & Tripodi, T. & Epstein, I. (2007). Research Techniques for Clinical Social Workers. New York: Columbia University Press.

clinical social work research patience matute-ewelisane eugene shabash jayne griffin

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