Transcript Evidence Based Social Work Practice
Gallaudet University School of Social Work Edward J Mullen
9:00 – 10:30 Evidence Based Practice: Definitions, History, & Competencies 10:30 – 10:40 Break 10:40 – 12:00 Finding Evidence: Evidence-based Practices 12:00 – 1:00 Lunch 1:00 – 2:30 Resources & Curriculum Implications for Teaching & Learning 2:30 – 2:40 Break 2:40 – 4:00 Break-out Group Discussion: Applications to Classroom & Field Curriculum
Definitions ◦ ◦ ◦ ◦ Conceptual Frameworks Process Skills Question Types Evidence History ◦ ◦ ◦ Bridging Research & Practice in Social Work Evidence-based Medicine (EBM) Translating EBM into Social Work Contexts Competencies
How can EBP concepts, skills, & competencies be taught in the Gallaudet University School of Social Work Curriculum?
How can class and field teaching & learning be integrated around EBP?
How can EBP content be infused into current course syllabi?
How can EBP problem-based learning be fostered?
How can EBP critical thinking & EBP critical assessment skills be enhanced in the curriculum?
Evidence-based Policy Practice Evidence-based Management Practice Evidence-based Direct Practice
Evidence-based policy is concerned with problems about how best to achieve group or population goals.
◦ ◦ ◦ For children with mental health problems is it best to: provide remedial treatment services in residential treatment facilities Or in community-based programs that allow children to remain at home?
◦ ◦ ◦ Is it best to provide adults with severe and persistent mental disorders: sheltered work programs Or supportive services aimed at securing employment in the community?
Evidence-based management deals with problems about how best to organize, finance & implement services to populations.
How best to create & sustain an organizational environment so as to move the organization toward policy-based outcomes?
How best to create and sustain a learning based organization?
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Deals with problems of specific client units Problems are those of identifiable clients in need of some type of: 1.
Assessment 2.
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Intervention Prevention Evaluative service Questions have to do with here-and-now practice choices that must be made for specific clients
◦ ◦ EBP is integration of ◦ Best research evidence Practitioner expertise Client values Research evidence ◦ Practice relevant research from: Basic sciences Client-centered practice research about: Accuracy & precision of assessment tests & interview procedures Power of prognostic markers; Efficacy & safety of therapeutic, rehabilitative, & preventive regimens.
Expertise ◦ Ability to use skills & experience to rapidly identify each client’s: Unique psychosocial state & problems or needs Individual risks & benefits of potential interventions Personal values & expectations. Client values Unique preferences, concerns, & expectations of client that must be integrated into intervention decisions to serve client
Placing client’s benefits FIRST Practitioners adopt LIFELONG learning CONTINUALLY ASKING specific questions ◦ of direct practical importance to clients SEARCHING objectively & efficiently ◦ for current best evidence Taking appropriate action GUIDED by evidence (Gibbs, et al., 2003).
Best available research evidence Decision Making Client/population characteristics, state, needs, values, & preferences Resources including practitioner expertise Evidence-based Behavioral Practice Council, EBBP.ORG
Newest Trans-disciplinary View of EBP Evidence-based Behavioral Practice Council, EBBP.ORG
Professional decision-making process in which social workers & their clients systematically make intervention choices using practitioner expertise to identify: client conditions, needs, circumstances, preferences and values; best evidence about intervention options including potential risk & benefit likelihoods; contextual resources & constraints bearing on intervention options.
Intervention choices refer to action options about: how to assess client conditions & circumstances; how to provide services; how to evaluate the process & outcomes of services.
Clients can be individuals, families, groups, communities or large populations.
Best evidence includes findings from scientific studies as well as from other reliable sources considered to be of highest quality, strength, & relevance.
Using this decision-making process social workers themselves provide the selected interventions or they link clients to others who can provide the interventions.
Together with their clients, practitioners monitor & evaluate the process & outcomes of services provided making changes in response to what is learned & sharing this information with others to benefit future clients.
Ask well formed important questions about the care of individuals, communities, or populations.
Acquire the best available evidence regarding the question. Appraise the evidence for validity & applicability to the problem at hand.
Apply the evidence by engaging in collaborative shared decision-making with the affected individual(s) and/or group(s). Appropriate decision making integrates the context, values & preferences of client, as well as available resources, including professional expertise. Analyze change & adjust practice accordingly.
Assess outcome (process & intervention) & disseminate results.
Because the evidence-based process informs future questions & practice, it is useful to imagine it as a cycle: Five steps of evidence-based practice.
Assessment skills: Competency appraising client & community characteristics, problems, values & expectations, & environmental context Practitioner’s competency to assess own expertise level: to implement interventions outcomes of those techniques once implemented Process skills: Competency performing 5 EBP process steps : ask well-formulated questions acquire best available research evidence appraise evidence for quality & relevance apply evidence by engaging in shared decision-making with those who will be affected analyze change & adjust practice accordingly Communication & collaboration skills: Competency to convey information clearly & appropriately Competency to listen, observe, adjust, & negotiate as appropriate to achieve understanding & agreement on a course of action Engagement & intervention skills: Competency in motivating interest, constructive involvement, & positive change Competency in provision of EBPs which vary in degree of training & experience required
In Social Work (Gibbs – ◦ handout 5) Client Oriented Practical Evidence Search (COPES) In Medicine Patient Oriented Evidence that Matters (POEM) Patient (or Problem), Intervention, Comparison, Outcome (PICO)
Client Oriented ◦ Questions from daily practice, posed by practitioners, that really matter to client’s welfare Practical ◦ Concern problems that arise frequently ◦ Concern agency mission ◦ Knowing answer could impact decision Search Oriented ◦ Specific enough to guide electronic evidence search
Client characteristics Client problem What practitioner is considering doing Alternative course of action against which contemplated action is to be compared What practitioner seeks to accomplish
If delinquent youth Are exposed to A residential based program Or A community based program Will the former result in fewer delinquent behaviors?
If families of latency aged boys with conduct disorder Receive parent management training
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Or No formal training Will the former exhibit lower externalizing behavior problems?
If disoriented aged persons residing in a nursing home Are given
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Reality orientation therapy
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Or Validation therapy Which will result in better orientation to time, place, person?
If sexually active high school students at high risk for pregnancy Are given ◦ A problem exercise ◦ (Baby-Think-It-Over) Or Didactic information (material on use of birth control methods) Will the former have fewer pregnancies during the year?
Among adolescents at risk for pregnancy Will a sex education program that stresses abstinence
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Or One that provides birth control information Result in the lowest pregnancy rates?
If adolescents at risk for violence Receive school based violence prevention programs
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Or No formal violence prevention training Will the former display lower rates of violence and aggression?
Alzheimer’s disease or dementia Are administered ◦ Depression Screening Tests ◦ Or A Short Mental Status Examination Which measure will be the briefest,
If children & adolescents in my caseload Are administered a computerized brief depression scale ◦ Or Are screened by a staff psychiatrist Will the former detect childhood depression as frequently as the latter?
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If family members of children diagnosed with a learning disorder Meet in a support group to receive information and support from staff and other families What aspects of the support group will they find most helpful?
Among children who are cared for by a primary caregiver diagnosed as having a depressive disorder
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Compared with Children whose caregiver has no diagnosed mental disorder Will the former children be more frequently diagnosed as having a behavioral or emotional disorder?
If crisis line callers to a battered women shelter Are administered ◦ A risk assessment scale by telephone ◦ Or We rely on practical judgment unaided by a risk assessment scale Will the scale have higher reliability and predictive validity regarding future violence?
Background Questions ◦ ◦ What Causes AIDS?
Ask for General Knowledge about a Condition or Thing How Does Neighborhood Violence Affect Probability of Delinquency?
◦ Among children who are cared for by a primary caregiver diagnosed as having a depressive disorder compared with children whose caregiver has no diagnosed mental disorder will the former children be more frequently diagnosed as having a behavioral or emotional disorder?
Foreground Questions Knowledge to Inform Decisions or Actions ◦ Ask for Specific If children and adolescents in my caseload are administered a computerized brief depression scale or are screened by a staff psychiatrist will the former detect childhood depression as frequently as the latter?
◦ If adolescents at risk for violence receive school based violence prevention programs or no formal violence prevention training will the former display lower rates of violence and aggression?
Enhances quality of decisions about individual clients Fosters skills to: ◦ Gather and appraise client’s stories, symptoms, signs ◦ Incorporating values and expectations in alliance Fosters generic skills for finding, appraising, implementing scientific evidence Provides educational and self-directed life-long learning framework Identifies knowledge gaps leading to new research Provides common interdisciplinary language
◦ ◦ ◦ ◦ EBP moves practitioners away from authoritarian practices & policies EBP enhances opportunities to honor ethical obligations to clients & students EBP promotes transparency & honesty EBP encourages systemic approach for integrating practical, ethical & evidentiary issues EBP maximizes flow of knowledge & information about knowledge gaps Gambrill, 2003
EBP originated in medicine in 1990’s EBM has been transferred into other health disciplines over last 10-15 years EBP is now widely accepted in health disciplines A major factor stimulating EBP development is research showing that research findings flow into practice at an extremely slow pace: ◦ ◦ Uptake of scientific discoveries into clinical practice: 14% after 17 years (Balas & Boren, 2000) Only 15% of clinical practices based on evidence (IOM, 1985; Eddy 2005).
EBM was first introduced into American social work in late 1990’s (Gambrill 1999) Earlier models for integrating research & practice did exist (e.g., the empirical practice movement & scientific practitioner model) Evidence-based social work practice is, however, qualitatively different from these earlier efforts &, like EBM, has been seen as a paradigm shift The adoption of EBP has been facilitated by an increase in practice research as well as by mechanisms for evidence dissemination.
EBP is now required for accreditation of social work training programs Use of research evidence for professional practice is required by the code of ethics for social work
Acquiring evidence as 3 rd process step of EBP What are evidence-based practices (EBPs)?
What qualifies as “evidence”?
How are EBPs & EBP related?
How can EBPs & “evidence” be found?
Remember 5A’s which form process steps or skills of EBP (next slide) Recall that 2 nd step is ACQUIRING evidence needed to answer question ASKed in 1 st step.
◦ ◦ ◦ This step requires practitioners to conduct an evidence search to answer questions Translate question into search terms Search relevant evidence sources Best done with assistance of reference librarian
Because the evidence-based process informs future questions & practice, it is useful to imagine it as a cycle: Five steps of evidence-based practice.
Busy practitioners typically do not have time or skills to: ◦ Conduct searches for individual research studies which have examined their EBP question.
◦ Synthesize the research evidence from these individual studies Practitioners should first search for evidence summaries ◦ ◦ ◦ Evidence summaries are rapidly becoming available in online systems & clearinghouses These online systems/clearinghouses frequently do the work of: ◦ Locating research studies Systematically reviewing & summarizing study findings Assessing quality, strength, & relevance of evidence Publishing practice guidelines, model programs, best practices, or other forms of evidence-based recommendations ONLY in absence of evidence systems, summaries, synopses, or syntheses & ONLY WHEN EBP QUESTION IS IMPORTANT should practitioners conduct searches for individual research studies
Systems Summaries Synopses Syntheses Studies Reproduced from: Haynes, R Brian. 2006. Of studies, syntheses, synopses, summaries, and systems: the “5S” evolution of information services for evidence-based health care decisions. ACP Journal Club 145 (3):A-8 - A-9 .
EBBP.org
If evidence search is conducted of individual research studies practitioners will need to use their knowledge of research methods to critically appraise individual study validity & relevance If an evidence search is conducted of sources that have already summarized evidence then practitioners need to be able to critically appraise trustworthiness & relevance of those sources
◦ Efficacy studies : Many interventions of relevance to social work are now known to be efficacious based on efficacy studies Effects have been found in controlled research studies often under the best conditions with careful administration to control for possible confounds.
◦ This research not well-suited to testing if intervention will work in real world E contexts to test intervention under commonly experienced circumstances ◦ ffectiveness studies: Intervention may be efficacious but may not be effective Carried out in everyday
◦ ◦ ◦ ◦ ◦ ◦ ◦ Related terms Empirically supported interventions (ESIs) Empirically supported treatments (ESTs) Evidence-based programs (EBPs) Empirically Informed practices Practice guidelines Model Programs Best practices No single definition of EBPs Unlike EBP which is a well-defined process, EBPs are interventions considered to have some degree of research support When considering the use of EBPs or teaching EBPs important to investigate who is labeling intervention as an EBPs & what standards/criteria used
Interventions for which there is consistent scientific evidence supporting their use ◦ Assessment tools with good reliability, validity, sensitivity & specificity ◦ Descriptive measures of good reliability & validity ◦ Interventions showing that they improve client outcomes
Evidence-based practices ◦ Skills, techniques, & strategies that can be used by a practitioner individually or in combination Cognitive behavior therapy Systematic desensitization Token economy motivation systems Social skills teaching strategies Evidence-based programs ◦ Groups of practices that seek to integrate a number of intervention practices within a specific service delivery setting & organizational context for a specific population Assertive Community Treatment Functional Family Therapy Multisystemic Therapy Supported Employment
◦ ◦ ◦ Step 2 in 5A’s process = ACQUIRING evidence so when intervention decisions are made practitioners & clients are AWARE of evidence for alternate intervention choices Quality Strength, Relevance may be little evidence & choices made with this knowledge In step 2 EBPs may be found & these can then be critically appraised & considered by practitioners & clients in decision making
Research evidence Practice relevant research from: Basic behavioral & social sciences Client-centered practice research about: Accuracy & precision of assessment tests & interview procedures Power of prognostic markers; Efficacy & safety of therapeutic, rehabilitative, & preventive regimens.
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mpirical observation about relation between events This includes unsystematic observations of individual practitioners which can lead to profound insights but are limited because of potential bias & small sample sizes
Evidence alone is never sufficient for making practice decision Practitioners & clients weigh potential benefits & risks, inconvenience, & costs of alternative interventions & factor in client values & preferences In EBP there is a hierarchy of evidence for making practice decisions Different evidence hierarchies are proposed for different types of decisions Effectiveness of interventions (prevention, treatment, rehabilitation) Assessment (e.g., instrument validity, sensitivity, specificity, relevance) Risk assessment or prognosis Problem causation Describing conditions & experiences
A practitioner may wish to know whether one intervention has better outcomes than another
EBP has a hierarchy of evidence for effectiveness questions
N = 1 Randomized Controlled Trial Systematic Reviews of Randomized Trials Single Randomized Trials Systematic Reviews of Observational Studies Addressing Client Important Outcomes Single Observational Studies Addressing Client Important Outcomes Descriptive diagnostic studies Unsystematic clinical observation
EBSWP typically begins with assessment of client circumstances, condition, need, values, preferences.
Practitioner may wish to determine mental status of a client & formulate a question asking about reliability, validity, sensitivity & specificity of assessment instrument Evidence would come from: Cross-sectional surveys in which alternative measures are compared Reliability or validity studies Focus group designs & qualitative methods can be used with groups of clients to explore client values & preferences
causes of social problems that they Knowledge of causes can help diminish a client’s problem by Evidence could come from: Cohort or case-controlled studies Epidemiological research Case studies
Practitioners may encounter social problems that are likely to resolve themselves without intervention May work with groups where risk for development of social problem varies Some clients may be at high risk, others at a low risk for developing problem Evidence can come from longitudinal cohort designs
Practitioners may encounter social problems in their practice that could have been prevented if early signs had been measured & action taken In these circumstances can ask about what available screening measures for detecting early manifestations of social problems or early warning signs Evidence can come from cross-section surveys involving large populations Prevention questions can ask about outcomes of alternative prevention interventions Hierarchy of evidence for effectiveness questions applies to such prevention questions with preference for RCTs
Since 1970 many reviews of research findings about social work intervention outcomes Narrative reviews Systematic reviews including meta-analyses Since mid-1990’s many groups have conducted reviews & GRADED the quality, strength, & relevance of evidence These groups have graded, classified, and labeled interventions based on evidence & other factors These reviews & grading systems make ACQUIRING evidence feasible for EBP practitioners
Scientific Rating Scale This scale rates strength of research evidence supporting the practice Child Welfare Relevance Rating Scale This scale rates degree to which program or model was designed for families served within child welfare system Needed as some well-researched practices may never have been intended for child welfare applications & research upon which the scientific rating is made, may have little relevance to child welfare environments
Well Supported = 20 Supported = 29 Promising = 64 Evidence fails to demonstrate effect = 1 Concerning practice = 0
Classify psychotherapies into those for which there is: Clear evidence of efficacy = 31 therapies Some but limited support for efficacy = 25 less than limited support Criteria Replicated demonstration of superiority to control or 1, high quality RCT Clear description of intervention (e.g., manual) Clear description of client group
Robert Wood Johnson Foundation consensus panel
Identified 5 evidence-based psychosocial practices
for treatment of persons with severe mental illness
A form of intensive, social and medical, team based case management
Providing job and social supports to help individuals obtain and retain jobs in real-world work environments rather than in sheltered work environments.
Teaching families about the illness, treatments, options, and how to manage and provide support.
Educating patients/clients about their problems and how to deal with their problems
Providing effective treatments for individuals with both substance and mental disorders rather than limiting intervention to just one or the other disorder.
Therefore, they could be reliably taught and implemented Without clear manuals or guidelines they could not be replicated with reliability
Therefore, effects could be considered as due to interventions rather than other factors such as chance or passage of time
Outcomes were not trivial nor were they considered of little value to those receiving interventions Outcomes were reliably & validly established to have occurred
Possible bias of an advocate research group was offset by replication of outcomes by another research group
Practices standardized through manuals or guidelines.
Practices evaluated with controlled research designs.
Important outcomes were objectively measured.
Research was conducted by different research teams.
In 2010 Congress funded Teen Pregnancy Prevention Initiative $75 million is for funding replication of programs that have been proven effective through rigorous evaluation Mathematica Policy Research conducted systematic evidence review Criteria for study quality evidence search & evidence strength were used to rate each intervention found in Based on these criteria, OHA set standards an evaluation must meet in order for a program to be considered effective & eligible for funding as an evidence-based program
Quality Rating High, moderate, or low based on rigor & execution of research High rating RCTs with low attrition & no sample reassignment Moderate rating Quasi-experimental designs with well-matched comparison groups at baseline Certain RCTs that did not meet all high-rating criteria Low rating Quasi-experimental & RCTs not meeting criteria for high or moderate rating
Evidence of Effectiveness Rating Program had to be supported by at least one high or moderate-rated impact study showing a positive, statistically significant impact on at least one priority outcome (sexual activity, contraceptive use, STIs, or pregnancy or births), for either the full study sample or key subgroup (defined by gender or baseline sexual experience).
Programs rated high or moderate on quality & receiving a rating of effectiveness (above) were considered evidence-based (additional criteria used for funding) 28 programs met the funding criteria
Clinical Evidence (online journal) Ratings Interventions that are:
known to be beneficial likely to be beneficial
those where there is
trade off of benefits & harms depending on client circumstances & priorities unknown effectiveness unlikely to be beneficial likely to be ineffective or harmful
Historically most influential in establishing & disseminating Empirically Supported Treatments (ESTs) APA task force identified 18 treatments as “empirically supported” (e.g., cognitive behavioral therapy for panic disorder) & 7 as “probably efficacious” (e.g., exposure therapy for social phobia) (Chambless, et al. 1996) A later report listed sixteen ESTs that were then widely disseminated to training (Chambless, et al. 1998).
Clinical opinion Observation Consensus among experts representing the range of use in the field Systematized clinical observation Quasi experiments Randomized controlled experiments or their logical equivalents
1. Comparison with no-treatment control group, alternative treatment group, or placebo: a) in a randomized control trial, controlled single case experiment, or equivalent time-samples design and (b) in which EST is statistically significantly superior to no treatment, placebo, or alternative treatments or in which EST is equivalent to treatment already established in efficacy, & power is sufficient to detect moderate differences
2. Studies must have been conducted with: (a) a treatment manual or its logical equivalent; (b) a population, treated for specified problems, for whom inclusion criteria have been delineated in reliable, valid manner; (c) reliable & valid outcome assessment measures, at minimum tapping problems targeted for change; (d) appropriate data analysis
3 . E fficacious Superiority of EST must have been shown in at least 2 independent research settings (sample size of 3 or more at each site in case of single case experiments) If conflicting evidence, preponderance of well controlled data must support EST's efficacy 4. P 5. E ossibly efficacious One study (sample size of 3 or more in case of single case experiments) suffices in absence of conflicting evidence fficacious & specific Shown to be statistically significantly superior to pill or psychological placebo or to alternative bona fide treatment in 2 independent research settings If conflicting evidence, preponderance of well controlled data must support EST's efficacy & specificity
Practitioners are to be concerned with both efficacy & utility Generality of effects across: Varying & diverse patients, therapists, settings & interaction of factors Robustness of treatments across modes of delivery Feasibility which treatments can be delivered in real world settings Cost associated with treatments
Systematically developed statements to assist practitioner & client decisions about appropriate care for specific circumstances Professional organizations & governmental agencies have formulated practice guidelines for many conditions Guidelines prescribe how practitioners should assess & intervene with clients Sometimes guidelines are based on research findings Often research is not available guidelines are based on professional consensus Rosen & Proctor (2003) provide a comprehensive treatment of practice guidelines in social work
National Guideline Clearinghouse™ (NGC) is a public resource for evidence-based clinical practice guidelines http://www.guideline.gov/index.aspx
U.S. Preventive Service Task Force conducts scientific evidence reviews of a broad range of clinical preventive health care services & develops recommendations for primary care clinicians & health systems. These recommendations are published in the form of "Recommendation Statements.
“ U.S. Preventive Service Task Force
Busy practitioners typically do not have time or skills to: ◦ Conduct searches for individual research studies which have examined their EBP question.
◦ Synthesize the research evidence from these individual studies Practitioners should first search for evidence summaries ◦ ◦ ◦ Evidence summaries are rapidly becoming available in online systems & clearinghouses These online systems/clearinghouses frequently do the work of: ◦ Locating research studies Systematically reviewing & summarizing study findings Assessing quality, strength, & relevance of evidence Publishing EBPs, ESI’s, practice guidelines, model programs, best practices, or other forms of evidence-based recommendations ONLY in absence of evidence systems, summaries, synopses, or syntheses & ONLY WHEN EBP QUESTION IS IMPORTANT should practitioners conduct searches for individual research studies
◦ ◦ ◦ ◦ ◦ Acquiring evidence requires skills in using online search terms & strategies (handouts 7-13) Online review of OBO-SW “Evidence-based Practice: Finding Evidence” (handout) http://oxfordbibliographiesonline.com/view/docum ent/obo-9780195389678/obo-9780195389678 0043.xml?rskey=2Kk0JL&result=5&q = Online review of EBBP.org “Search for Evidence” module http://www.ebbp.org/training.html
Online review of Columbia University Musher Program EBP resources for finding evidence http://www.columbia.edu/cu/musher/EBP%20Reso urces.htm
CD-ROM review of REACH-SW “Finding Research Evidence” module (handouts) http://www.danya.com/reach/
Curriculum & Pedagogy of EBP Digital Resources for Teaching & Learning EBP in Social Work Curriculum Implications
EBM was developed in 1990’s as a curricular framework for training medical residents at Department of Medicine, McMaster University, Canada Training program was organized to teach residents: ◦ To develop an attitude of “enlightened skepticism” toward application of diagnostic, therapeutic, & prognostic technologies ◦ To be aware of evidence on which one’s practice is based, soundness of evidence, & strength of inference evidence permits ◦ To develop skills in what later was called 5A’s
The major text on EBM is focused on both practicing & teaching EBM
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( Evidence-Based Medicine: How to Practice and Teach EBM ) Suggested methods are based on collective experience of clinical teachers of EBM
“One solution for the problem of obsolescence of professional education is “problem-based learning” or “learning by inquiry”. That is, when confronted by a clinical question for which we are unsure of the current best answer, we need to develop the habit of looking for the current best answer as efficiently as possible.” – Struas, et al, 31.
Role model EBP Teaching practice using evidence
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Teaching specific EBP skills
(Shown in table on next slide for teaching clinical medicine residents)
“Standalone teaching improved knowledge but not skills, attitudes, or behaviour Clinically integrated teaching improved knowledge, skills, attitudes, and behaviour Teaching of evidence based medicine should be moved from classrooms to clinical practice to achieve improvements in substantial outcomes.” Coomarasamy, A., & Khan, K. S. (2004)
Much has been written recently about teaching & learning EBP in social work EBP is now required by CSWE Curriculum Policy & Accreditation Standards
Teach students to be lifelong learners Teach the skills & competencies of EBP Teach students what is currently known & not known about the efficacy & effectiveness of social work practices & programs Teach students to be knowledgeable & skillful with the empirically supported practices in their area of specialty Teach current practitioners new knowledge & skills through evidence based continuing education programs
Handout 14
Online Review of Oxford Bibliographies Online in Social Work (OBO-SW) & Public Health (OBO-PH) http://www.oxfordbibliographiesonlin
e.com/
Online Review of Columbia University Willma & Albert Musher Program Web Site: Evidence-Based Policy and Practice & Outcomes Measurement Resources http://www.columbia.edu/cu/musher /EBP%20Resources.htm
CD-ROM Review of DANYA International Research & Empirical Applications for Curriculum Enhancement in Social Work (REACH-SW) CD-ROM http://www.danya.com/reach/
Online Review of EBBP.org
web site http://www.ebbp.org/ Implementation Module
Online Review of Evidence based Practice for the Helping Professions web site http://www.evidence.brookscole.
com/
CSWE Curriculum Policy Statement Requires EBP Competencies Emphasis in CPS Fits with EBP Competencies but Need to Figure Out Where & How Competencies Can Be Integrated Into Class & Field Curriculum Faculty Needs Resources for Identifying ESIs for Inclusion in Curriculum Class & Field Instructors Need to be Supported in Efforts to Make EBP an Integrated Approach to Social Work Education