NADD Meeting Spring 2008
Partnerships to Integrate
Evidence-Based Practice
Implications for Social Work Education, Practice & Research
Joan Levy Zlotnik, PhD, ACSW
Institute for the Advancement of Social Work Research
www.iaswresearch.org
jlziaswr@naswdc.org
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH
1
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
2
Why EBP?
EVIDENCE-BASED PRACTICE
EVIDENCE-BASED/
RESEARCH-TESTED/
EFFECTIVE PRACTICES
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
INFORMED CLINICAL
DECISION-MAKING
EBP for Policy and Macro-practice Too
Chambers, D. (2007).
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH
3
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
4
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
5
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
6
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
7
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/EBPCulturalCompetence.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
8
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
9
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
10
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
11
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
12
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
13
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
14
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
15
Program Models
UNIVERSITY OF MICHIGAN
• Field Specific Collaboratives
Team students, faculty & agency to reduce implementation
barriers
• Information Literacy Competencies
Library developed website to assist practitioners
• Mini-Courses
For students and professionals, on EBPs
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH
16
Program Models
NEW YORK STATE CONSORTIUM
STATE OMH AND DEANS & DIRECTORS
School survey; Field focus groups
Program development among five schools
syllabus, placement matching, field colloquia
Pilot Implementation
certificate and job referral
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH
17
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
18
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
19
Potential Action Steps
PARTNERSHIPS 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
20
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
21
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
22
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
23
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
24
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
25
Project Team
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
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH
26
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
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH
27
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
28
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
29
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
30
Evaluation (Currently Ongoing)
 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)
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH
31
REACH-SW Trainings
 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.
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH
32
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
33
Participating Programs
•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
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH
34
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-andgroups/namhc/reports/road-ahead.pdf
National Association of State Mental Health Program Directors Research Institute
(NRI-INC) – www.nri-inc
Substance 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
35
For More Information
• Joan Levy Zlotnik, IASWR
jlziaswr@naswdc.org
• Cynthia Baker, DANYA
cbaker @danya.com
• Denise Juliano-Bult, NIMH
djuliano@mail.nih.gov
INSTITUTE FOR THE ADVANCEMENT OF SOCIAL WORK RESEARCH
36