Irwin Epstein

Using available clinical information in practice-based research: mining for silver while dreaming of gold.

SUMMARY Social workers in health and mental health settings routinely collect and record enormous quantities of clinical information about clients, psycho-social interventions and client responses to these interventions. Despite its abundance and non-intrusiveness, social work researchers generally have ignored available clinical information, claiming that it is unreliable and subject to too many threats to validity to warrant serious consideration as a data source. Instead, many researchers have advocated “gold standard” experimental studies, employing standardized instruments and prospective data-collection. As a result, the research potential of retrospective studies based on available clinical information has been relatively unexplored and untested. This paper asserts that available clinical information can be converted into valuable retrospective, data-bases for practice-based research studies. Exemplars of such studies in health and mental health settings are provided as are guidelines for their conduct.

Lesbian, Gay, Bisexual, Sexual-Orientation Questioning Adolescents Seeking Mental Health Services

Summary Lesbian, gay, bisexual, and sexual-orientation questioning (LGBQ) adolescents have many of the same health needs as straight adolescents. In addition, they must learn to manage a stigmatized identity that may create confusion, anxiety, and emotional turbulence for them. Beyond stigma, LGBQ youth are often found to be at higher risk for substance abuse, violence, depression, suicide, and sexual health problems. Based on responses given by urban adolescents seeking mental health services to a clinical self-assessment questionnaire (Adquest), this article examines the relationship between sexual identity and risk factors related to safety, health, sex, substance use, family and friends, worries, and their desire to talk about these in counseling. Findings indicate that LGBQ youth are at higher risk than straights, and express greater desire to talk about substance use, health, their personal lives, and their friends. Mental health practitioners working with these young persons must properly assess and address their risks by creating a sense of community and safe environment for open discussion.

Promoting Harmony Where There Is Commonly Conflict: Evidence-Informed Practice as an Integrative Strategy

This article identifies dualisms in the continuing and sometimes acrimonious discourse concerning the relationship between social work practice and research. In so doing, it describes the epistemological assumptions of and differences between evidence-based practice, research-based practice, practice-based research, and reflective practice. In the spirit of the Hong Kong conference, the author extends McNeills concept of “evidence-informed practice” to suggest a more inclusive and harmonious conception of practice–research integration. The article concludes by considering what such a model might look like.

Research techniques for clinical social workers

IntroductionPart 1 Assessment 1. Research Interviewing and Questionnaires2. Using Available Instruments3. Systematic Observation4. Specification and Rating of Problems and GoalsPart 2 Selecting, Implementing, and Monitoring Intervention 5. Selection of Treatment Interventions6. Content Analysis7. The Development and Use of Forms for Client Self-Monitoring8. Qualitative Methods in Practice ResearchPart 3 Evaluating Treatment 9. Single-Case Designs10. Variations and Replications of Single-Case Designs11. The Use of Sample Surveys in Follow-up Evaluations12. Simple Group Designs for Use in Evaluation13. The Use of Data Aggregation and Analysis for Treatment Monitoring14. Research and Clinical Social Work PracticePostscriptIndex

Introduction: promoting and maintaining a reflective professional staff in a hospital-based social work department.

SUMMARY Promoting and sustaining a staff of reflective social work practitioners requires a supportive departmental structure and culture. Providing such support is a particular yet necessary challenge to social work administrators in the current health care environment. This article discusses an array of administrative strategies employed in one hospital social work department to promote reflective social work practice. More specifically, it describes the role of practice-based research in enhancing worker reflectiveness.

Specifying intensive case management: a multiple perspective approach.

Abstract“Intensive case management” (ICM) programs for people with serious mental illness are found widely throughout the United States. However, there is no standard definition or conceptualization of ICM. Despite these differences, ICM aspires to a set of common principles and core functions derived from the concept of continuity of care. This study attempted to identify the elements of ICM program theory by integrating information from the ICM literature with survey and focus-group data reflecting the perspectives of three distinct ICM respondent groups (researchers/administrators, program managers, and case managers). The findings suggest a strong consensus about the structural dimensions of ICM, but a moderate consensus about their operationalization. More generally, the results support viewing ICM as more “client oriented,” in contrast with conventional case management programs that are more “system driven.”

Social Work Practice with Pre- and Post-Liver Transplant Patients: A Retrospective Self Study

SUMMARY This paper describes a retrospective, practice-based research study of social work interventions with liver transplant candidates and recipients. This study is based on a retrospective chart review conducted to examine psychosocial risk factors, interventions and medical outcomes. Psychosocial interventions provided to patients and families before and after transplant will be described as well as their relationship to medical outcomes. Research Findings and practice implications will be discussed.

Development and Utilization of a Practice-Based, Adolescent Intake Questionnaire (Adquest) : Surveying Which Risks, Worries, and Concerns Urban Youth Want to Talk About

Summary This article describes an intake questionnaire (Adquest) that was designed, tested, and implemented, and later employed in clinical data-mining studies, by practitioners in an adolescent mental health program. The instrument is primarily a practice-based, clinical information-gathering and client engagement device. Consequently, it differs in significant ways from more research-driven Rapid Assessment Instruments (RAIs). Despite these differences, when aggregated and analyzed, Adquest data provides valuable psychosocial information about hundreds of vulnerable urban youth seeking mental health services.

The New York statement on the evolving definition of practice research designed for continuing dialogue: a bulletin from the 3rd International Conference on Practice Research (2014)

This Statement on Practice Research is a work in progress. It emerges out of deliberations from three international conferences on defining and operationalizing practice research. It seeks to capture both a process and outcome in which practitioners, researchers, service users, and educators collectively engage in a negotiated process of inquiry. One of the goals of this form of research is to place equal emphasis on improving practice and improving services. Practice research also seeks to rebalance the power relations in terms of integrating the voices of service users, service providers, service researchers, and instructors preparing future and current service providers. This third statement emerges out of the most recent international conference in New York City (2012) and continues the construction of the social science and social philosophy foundation of practice research. It seeks to expand the dialogue on practice research to include more international voices while also searching for linkages with the evolving process of defining the mixed methods approach to evidence-informed practice. This Statement provides a platform for the 4th International Conference on Practice Research planned for Hong Kong in 2017.

Creating and Sustaining a Practice-Based Research Group in an Urban Adolescent Mental Health Program

Summary This article describes the initiation, implementation, and accomplishments of a practice-based research group within a mental health program serving inner-city adolescents. Begun in 1995 and co-led by a program manager and a clinical social work practitioner, the group fosters and supports practitioner-driven research projects as part of a “reflective” organizational development strategy.