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? 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/EBP-CulturalCompetence.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

Danya NIMH Project Team 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 Content Development Resource Consultants 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: Individual Training Training-of-Trainer 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: Self-guided (no in-person training; CD only) Individual training Training-of-Trainer Control (no REACH-SW materials) Well over 100 faculty applied for only 36 spots Range of new/inexperienced to well seasoned teachers 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 Well over 100 faculty applied for only 36 spots Range of new/inexperienced to well seasoned teachers 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-and-groups/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