Evidence Based Practice Process SWK 632 AK LEND without Walls Friday, September 26, 2014 Mary Dallas Allen, PhD, MSW

Evidence Based Practices 2

Ethical Responsibility NASW Code of Ethics: 5.02 Evaluation & Research (a) Monitor & evaluate policies, program implementation, and practice interventions (b) Promote research & evaluation to contribute to knowledge base (p) Educate themselves, their students, and their colleagues about responsible research

Evidence Based Practice Process The conscientious, explicit, and judicious use of the best evidence in making decisions about human service assessment and intervention Integrates clinical expertise and takes patient/client desires, values, and needs into consideration (Sackett et al., 1997) SWK 632

Evidence Based Practice Process Research Evidence Practitioner Expertise EBP Client Attributes

Steps in Evidence Based Practice Question formulation Search for the evidence Critically appraise the relevant studies you find – hierarchy of evidence & determine which evidence-based intervention is most appropriate for your particular client Apply the Evidence-based intervention taking the patient’s/client’s wants / needs into consideration Evaluation and feedback

Question Formulation Question formulation – formulate a question based on what is known about a case or cases and what additional information is needed Ask important questions about the care of individuals, communities, or populations Challenge: Determining the level of specificity

Search for the evidence Use resources to identify evidence based intervention Agency for Healthcare Research and Quality SAMHSA’sNational Registry of Evidence-based Programs and Practices SAMHSA EBP Implementation Resource Kits for Mental Health California Evidence-Based Clearinghouse for Child Welfare OJJDP Model Programs Guide & Database Cochrane Collaboration Library Center for Evidence-Based Practice: Young Children with Challenging Behavior CDC: The Community Guide SWK 632

Critically evaluate relevant studies Two important questions: Was treatment outcome measured in a reliable, valid, and unbiased manner? Was the research design strong enough to indicate whether the intervention or something else explains the changes in client outcome? SWK 632

Research Hierarchy for EBP Level 1 - Systematic reviews and meta-analysis of RCTs and other well-designed experiments and quasi-experiments Level 2 - Multi-site replications of RCTs and other well-designed experiements Level 3 – RCTs and other randomized experiments Level 4 – Quasi-experiments Level 5 – single case experiments Level 6 – Correlational studies (anecdotal case reports; pretest- posttest studies without control groups; qualitative studies of client experiences during or after tx; surveys of clients or practitioners)

Determine the intervention most appropriate Quality of the evidence Are there important differences between your clients and those in the studies that produced the evidence? Do the interventions support the values of your clients / agency – is it a good fit? SWK 632

Apply the EBP May need training in the intervention Obtain readings on implementing it (treatment manuals) Identify colleagues who might be able to support you in the intervention ( those who are experience with it) Formulate (with the client) an individualized treatment plan that includes clear and measurable goals and integrates the context, values, and preferences of the client Issue: fidelity to the model SWK 632

Evaluation You and client will measure and evaluate progress in achieving the treatment goals Disseminate findings SWK 632

Evidence Based Practice Process Resources American Occupational Therapy Association Evidence-Based Practice Webpage: http://www.aota.org/Practice/Children-Youth/Evidence- based.aspx American Speech-Language Hearing Association Evidence-Based Practice Webpage http://www.asha.org/members/ebp/ Council for Exceptional Children Standards for Evidence-Based Practices in Special Education (2014) http://www.cec.sped.org/ SWK 632

Evidence Based Practice Process Resources American Psychological Association Evidenced-based Practice in Psychology webpage: http://www.apa.org/practice/resources/evidence/i ndex.aspx SWK 632