Social Work Research - Centre for Suicide Research and Prevention
Download
Report
Transcript Social Work Research - Centre for Suicide Research and Prevention
SOWK 6003 Social Work Research
Week 1
Dr. Paul Wong, D.Psyc.(Clinical)
Lecture 1
•
•
•
•
•
•
Overview of Course
Definition and Purposes of Research
Research and Social Work
Ways of Knowing
Evidence-based practice
Practice!
How I teach?
• Two major principles:
1. Based on a “"Tell me, I'll forget. Show
me, I'll remember. Involve me, I'll
understand" principle. Thus, I will do
some lecturing, you will have many
opportunities to discuss, practice,
interact during the lectures.
How I teach?
• 2. Principle of adult learning (Field, 1990):
– Become ready to learn when they recognize a deficiency in their
own skills and accept that they need to take action to remedy it;
– Want learning to be problem-based, leading to the solution of
particular problems facing the individual;
– Want to be treated as adults, enjoying the respect of the
instructor and of other learners, and to have the experience they
bring with them accepted as valid;
– Bring to the learning situation their unique mix of characteristics
such as self-confidence and self-image, learning style, and
personality.
Overview of the course
Please read the course outline
carefully
What is Research?
1 : careful or diligent search
2 : studious inquiry or examination,
especially investigation or
experimentation aimed at the discovery
and interpretation of facts, revision of
accepted theories or laws in the light of
new facts, or practical application of
such new or revised theories or laws
3 : the collecting of information about a
particular subject
Social work research is to…
• provide the practical knowledge that
social workers need to solve the
problems they confront;
• give the field the information it needs
to alleviate human suffering and
promote social welfare; and
• recognizing when particular
interventions for particular practice
situations have been supported by
adequate scientific evidence.
Besides research, there are other ways of
knowing our world:
E.g., How do you know food are better after being cook?
• Tradition – e.g., “The Chinese way of cooking include
steam, stir, fried, brew, etc”
• Authority – e.g., “Doctors recommended that we should
have your food cooked to well-done”
• Common sense e.g., “There are virus and germs in raw
meat”
• Popular media e.g., “Yan can cook shows that food taste
good after diligently cooked”
Using the Scientific Method to know something:
Questioning things and search for evidence as the basis
of making decisions
Key features:
a. everything is open to questions: knowledge is
provisional and subject to refutation
b. empirical: evidence based on systematic and
comprehensive observations
c. pursuit of objectivity through specified procedures
d. replication
Unscientific social work/psychology
practice:
E.g., Families and friends of suicide
•
•
•
•
Inaccurate observation
Overgeneralization
Selective observation
Ego involvement in
understanding
• Premature closure of inquiry
Evidence-based Practice
Why Evidence-based practice?
• increase understanding of health
pathologies that produce the foundation in
developing precisely targeted interventions.
• advancement in clinical research
methodologies that produce new evidence
for effectiveness of interventions
• global concerns over expenses of health
care (Huppert, Fabbro, & Barlow, 2006).
• implications over legal concern (Havighurst,
Hutt, McNeil & Miller, 2001).
EBM as “the integration
of best research
evidence with clinical
expertise and
patient values”
Components of Clinical Expertise
• assessment, diagnostic judgment, systematic case
formulation, and treatment planning
• clinical decision making, treatment implementation, and
monitoring of patient progress
• interpersonal expertise
• continual self-reflection and acquisition of skills
• appropriate evaluation and use of research evidence in
both basic and applied psychological science
• understanding the influence of individual and cultural
differences on treatment
• seeking available resources
• having a cogent rationale for clinical strategies
Patient characteristics, culture, and
preferences
• exploring “what works for whom”
• Patient characteristics: functional status, readiness to
change, and level of social support,
• Social factors and cultural background
• Familial factors
• Current environment context, stressors
• Developmental considerations
• Problem variations: Comorbidity and polysymptomatic
presenations
• Personal preferences, values, and preferences related to
treatment (goals, beliefs, worldviews, and treatment
expectations)
Evidence-based Practice
• de-emphasizes intuition, unsystematic
clinical experience, and pathophysiologic
rationale as sufficient grounds for clinical
decision making and
• stresses the examination of evidence from
clinical research. (Evidence-Based Medicine Working
Group, 1992)
Evidence-Based Practice in Psychology (EBPP)
(Levant, 2005)
• APA Presidential Task Force on
Evidence-Based Practice in 2005
• ‘ the purpose …to promote effective
psychological practice and enhance
public health by applying empirically
supported principles of psychological
assessment, case formulation,
therapeutic relationship, and
intervention (p. 5)
Evidence-based practice in Social Work
• The NASW Code of Ethics states that "Social
workers should critically examine and keep
current with emerging knowledge relevant to
social work and fully use evaluation and
research evidence in their professional
practice" (5.02(c)).
• This guideline also pertains to the ethical
mandate of informed consent, because
professionals need to know the evidentiary basis
for alternative practices and policies in order to
fully honor the informed consent principle
(Gambrill, 2003)."
Steps in evidence-based practice
1. Formulate a question to answer
practice needs;
2. Search for the evidence;
3. Critically appraise the relevant studies
you find;
4. Determine which evidence-based
intervention is most appropriate for your
particular client;
5. Apply the evidence-based intervention;
and
6. Evaluate and feedback
Level and Quality of Evidences
UK: 5 Levels of Evidence (Centre for
Evidence-based Medicine, University of
Oxford, 2009)
http://www.cebm.net/index.aspx?o=1025
A few key terms to remember:
•
•
•
•
•
•
•
•
•
•
•
Case-control study: Involves identifying patients who have the outcome of interest
(cases) and control patients without the same outcome, and looking to see if they had
the exposure of interest.
Clinical Expertise: refers to competence attained…through education, training, and
experience resulting in effective practice
Cohort study: Involves the identification of two groups (cohorts) of patients, one
which did receive the exposure of interest, and one which did not, and following these
cohorts forward for the outcome of interest.
Effectiveness: A measure of the benefit resulting from an intervention for a given
health problem under usual conditions of clinical care for a particular group.
Efficacy: A measure of the benefit resulting from an intervention for a given health
problem under the ideal conditions of an investigation.
Heterogeneity: In systematic reviews, the amount of incompatibility between trials
included in the review, whether clinical (ie the studies are clinically different) or
statistical (ie the results are different from one another).
p value: The probability that a particular result would have happened by chance.
Randomised controlled clinical trial: A group of patients is randomised into an
experimental group and a control group. These groups are followed up for the
variables/outcomes of interest
Sensitivity: The proportion of people with disease who have a positive test.
Specificity: The proportion of people free of a disease who have a negative test.
Systematic review: An article in which the authors have systematically searched for,
appraised, and summarised all of the medical literature for a specific topic.
Challenges in applying EBP in counseling settings
• Based on studies of clients unlike those
typically encountered in everyday life
practice;
• Lack of evidences over choices of multiple
evidences;
• Manualized brief intervention vs processoriented intervention
• Technicalization vs professionalism
• Use of RCT in clinical settings
• Knowledge, skills and attitudes (of you and
your supervisors/organizations)
In-class activities:
Complete Step 1 & 2 of EBP
1.
Form 3 groups:
a.
b.
c.
Use www.google.com
Use www.scholargoogle.com
Use www.campellcollaboration.org
2.
Search for evidence-based practice on ???
3.
Discuss “how that you found there can help
you practice an evidence-based intervention
for your client’s presenting problem”.
Homework
Repeat the in-class
activity with a real
problem that you
encounter at work using
the Cochrane
Collaboration and
Campbell Collaboration
References
Bulter, I. (2002). A code of ethics for social work and social care research. British Journal of Social
Work, 32, 239-248.
Evidence-Based Medicine Working Group (1992). Evidence-Based Medicine: A New Approach to
Teaching the Practice of Medicine. JAMA, 268(17):2420-2425.
Gambrill, E. (2003). Evidence-based practice: Sea change or the emperor's new clothes? Journal of
Social Work Education, 39(1), 3-23. Havighurst, C. C., Hutt, P. B., McNeil, B. J., & Miller, W.
(2001). Evidence: Its meanings in health care and in law. Journal in Health Politics, Policy and
Law. 21(2), 195-215.
Huppert, J. D., Fabbro, A., & Barlow, D. H. (2006). Evidence-based practice and psychological
treatment. In G. M. Reed & E. Eisman (eds.) Evidence-based psychotherapy: Where practice and
research meets (p. 131 – 152). Washington, DC: American Psychological Association.
Levant, R. F. (2005, July 1). Report of the 2005 presidential task force on evidence-based practice.
Retrieved June 20, 2008 from http://www.apa.org/practice/ebpreport.pdf
Lewis, J. (2003). Design issues. In J. Ritchie & J. Lewis (Eds.), Qualitative research practice : a guide
for social science students and researchers (pp. 47-76). London: SAGE.
McLeod, J. (2001). Qualitative research in counselling and psychotherapy. London: SAGE.
McNeece, C. A. & Thyer, B. A. (2004). Evidence based practice and social work. Journal of EvidenceBased Social Work. 1(1), 7 - 25.
Rubin, A. & Babbie, E. R. (2008). Research Methods for Social Work. 6th edition. Belmont, CA:
Thomson.
Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996).
Editorial: Evidence based Medicine: what it is and what it isn't. BMJ, 312, p. 71-72.
Willig, C. (2001). Introducing qualitative research in psychology : adventures in theory and method.
Buckingham: Open University Press.