Mary C. Ruffolo

Teaching Evidence-Based Practice: Strategic and Pedagogical Recommendations for Schools of Social Work

Widespread adoption of pedagogical methods promoting evidence-based practice (EBP) could enhance the effectiveness of social work practice education. Schools of social work should ensure that faculty are trained in the methods of EBP; establish a committee responsible for tracking and implementing demonstrably effective instructional innovations related to EBP; provide continuing education courses that promote scientifically supported practices and that include a course devoted specifically to teaching the methods of EBP per se; reward faculty who model superior pedagogical skills in relation to EBP; provide extensive training in computerized bibliographic database searching and other information acquisition methods; incorporate problem-based instructional methods into all practice courses; employ skills-based in vivo assessments and other measures to ensure student-practitioner competency in EBP methods prior to graduation; emphasize specialty practice education to an unprecedented degree; and test for competence in specialty practice areas.

Support, Empowerment, and Education A Study of Multiple Family Group Psychoeducation

n this article we describe the results of a randomized trial (N = 94) that developed and evaluated a multiple family group psychoeducation interIvention (MFGPI) for parents/primary caregivers of children with serious emotional disturbance (SED) enrolled in community-based child and youth intensive case management programs. Through group problem-solving and interactive knowledge development activities, the MFGPI addressed the key components of social support, parent education,and parental empowerment. The structured group sessions used a professional/parent leadership model. Parents/primary caregivers were randomly assigned to one of two treatment conditions (intensive case management plus adjunctive MFGPI or “treatment as usual” intensive case management). Parent problem-solving skills, parental coping skills, perceived social support resources,and child behavior were measured at three points in time (baseline, 9 months, and 18 months). No statistically significant difference occurred by group condition for the key variables of social support versus problem-solving/coping measures; parents in both intervention conditions had significantly more individuals to help them out over time.Youth behavior in both conditions improved significantly over time as measured by the overall child behavior scores.Analysis of the time by intervention interaction suggested that parents in the group condition also reported significant improvements on child externalizing and internalizing behavior scores and several subscale behavior scores.

The challenges of implementing an evidence-based practice to meet consumer and family needs in a managed behavioral health care environment

SUMMARY This report describes a case study of how a managed behavioral health care organization used a community-centered model of planning to adopt and implement an evidence-based practice (EBP). The case study involved consensus building and decision-making processes to: (1) develop an implementation plan for adapting the EBP model, including a feasibility assessment to identify existing and needed organizational resources; (2) orient and train clinicians and key community stakeholders; (3) pilot test the EBP; (4) establish an ongoing evaluation plan to monitor fidelity to the model and track outcomes; and (5) develop a plan to sustain the practice. Using a community-centered planning process to bring evidence-based interventions into a managed, behavioral health care environment is time intensive but it promotes the critical steps necessary for sustainability of the EBP. The community-centered planning process allowed for systematic input from a wide rage of stakeholders, addressed the potential barriers to implementation, and allowed for the adaptation of the model within the realities of the current system. This approach to organizational change decreased resistance from staff and increased services to families in the organization.

Primary Prevention Programs for Children in the Social Service System

Providing effective social services for children and their families at high risk for substance abuse problems is a national concern. The paper presents the prevalence and incidence of children in need of social services due to child maltreatment, child poverty, parental incarceration, parental substance abuse, juvenile justice problems, child mental health and substance abuse problems, and homelessness. Next, the paper examines early childhood family education and family support approaches in primary prevention designed to meet the needs of these children. New research to understand developmental pathways that lead to substance abuse problems in these children is recommended.

Moving an Evidence-Based Intervention Into Routine Mental Health Care: A Multifaceted Case Example

Many evidence-based interventions fail to translate into routine care for individuals experiencing significant mental health disorders. Moving the evidence-based intervention from the controlled research settings to the broader mental health systems is an ongoing challenge for administrators and practitioners in the mental health delivery network. In the United States, the movement to bring evidence-based mental health interventions into the public mental health system to enhance consumer recovery and improve outcomes has been a major thrust of federal and state efforts over the past 10 years (IOM, 2006; New Freedom Commission on Mental Health, 2003; Michigan Mental Health Commission, 2004; U.S. Department of Health and Human Services, 1999). Using a multifaceted case example, this article will address one states efforts to implement an evidence-based intervention, Family Group Psychoeducation (FPE), into routine care for individuals living with schizophrenia and their families. The Consolidated Framework for Implementation Research (CFIR) (Damshcroder et al., 2009) guides the discussion of the dissemination efforts. This CFIR framework involves examining five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation

Integrating social work into undergraduate education through a community action and social change multidisciplinary minor

Social work education has a long and successful history of developing change agents through bachelor of social work, master’s of social work, and PhD programs, but these programs often create boundaries limiting the reach and infusion of social work perspectives. With rapid changes in social, economic, and political contexts, students from all academic concentrations need to understand how community action and social change improves society. Using systems and community practice frameworks, this article provides an in-depth case study of one university’s model of an undergraduate multidisciplinary minor bridging social work philosophy with other academic disciplines. We explore the model and its development, with specific discussion of the lessons learned in creating and sustaining a multidisciplinary minor, its effect on students, and its implications for social work.

One-Session Family Workshops for Bipolar Disorder and Depression

Family psychoeducational models have proved successful in outpatient settings, especially for families that include someone with schizophrenia. However, many families confronted with serious mental illness of a family member that have sought services from private practitioners or from acute care settings have not benefited from these psychoeducational models. There is a critical need to modify longer-term psychoeducational models into a brief intervention to address the needs of these families seeking services in these settings. A brief, two-hour, single-session family psychoeducational workshop was developed as part of a community outreach effort to reduce stigma, to increase links to community supports, and to assist families and consumers in coping with depression and bipolar illness. The rationale for a one-session, family psychoeducation workshop was based on three primary factors: limited professional staff time available to engage families under the current managed behavioral health care guidelines, a desire to engage the largest number of families of newly diagnosed patients, and perceived difficulty in getting many families to commit to ongoing group psychoeducational sessions. The strategy behind the brief workshop, implemented in 2002, is that by having an opportunity to learn about the illness, confront stigma associated with the illness, and receive hints about coping strategies, families would be more committed to participating in their loved one’s ongoing treatment intervention. In addition, the clinicians who designed the intervention hoped to improve identification of other family members with mood disorders by presenting information on how the illnesses manifest throughout the life cycle, from childhood to elderly populations. During the first hour of the twohour workshop, a PowerPoint presentation provides information on symptom identification, causes, prognosis, coexisting conditions, depression across the life cycle, suicide, medications, psychosocial treatments, neuromodulation treatments, exercise, nutrition, sleep, impact on family members, anger, coping strategies, and selfcare. In the second hour, the group is divided into breakout groups for more intensive discussion and problem solving. Each group is facilitated by a clinical social worker and focuses on issues identified by the participants, who briefly introduce themselves to one another and list the concerns that brought them to the workshop. Using a problem-solving framework, the participants’ concerns are addressed. The workshop was specifically designed to be a service and not a treatment intervention. A flyer announcing the group is distributed to clinicians in clinic settings, with additional flyers placed in waiting room areas. The flyer is also posted on a Web site that focuses on depression and bipolar disorder. Participants are not charged to attend the workshop. The brief, single-session family psychoeducation workshops have been offered since 2002. The development team secured human subjects approval for participants to voluntarily complete brief questionnaires before and after the intervention in an effort to focus on knowledge about the illness, the role of medication, and coping strategies. From fall 2002 until spring 2009, a total of 353 participants completed the questionnaires (35% were parents of a person with depression or bipolar disorder, 20% were partners, and 33% were persons with these disorders). In the preworkshop questionnaire, most participants (68%) indicated that they were not satisfied with the level of involvement that families have in the treatment of depression or bipolar illness, and about half of the participants did not believe that bipolar illness or depression is treatable. The postworkshop questionnaires indicated that participants found the information provided to be helpful (98%), with 78% indicating increased knowledge about stress reduction and coping strategies and 74% indicating that they had learned new strategies to prevent recurrence of severe symptoms of depression or bipolar illness. There was a significant difference (p<.001) between preworkshop and postworkshop measures on the importance of medication in the treatment of depression and bipolar illness, with more participants recognizing the importance of medication. The single-session workshop, which includes didactic and problem-solving components, appears to fill a critical gap in the service delivery system. Families and mental health care consumers actively search for information about depression and bipolar illness and ways to cope with these illnesses. The preliminary data suggest that a group setting with structured supports facilitates participants’ openness to learn from others and to gain an understanding about living with the illness. The pilot work suggests that a one-session family psychoeducation intervention helps families and consumers to better understand the illness and the importance of medications. It fills a gap in the treatment-focused delivery system by reaching out to families and consumers and providing a service that supports their goals of recovery. Mary C. Ruffolo, Ph.D., L.M.S.W. Laura Nitzberg, L.M.S.W. Katharene Schoof, L.M.S.W.

Exploring Challenges Faced by Students as they Transition to Social Justice Work in the “Real World”: Implications for Social Work

For students who are actively engaged in social justice efforts on their college/university campuses, the transition from a relatively easy platform for engagement to the “real world” can pose significant challenges and create new realities for negotiation. Little is known, however, about the nature of these transitions into post-graduate social justice experiences. Drawing on an open-ended survey of recent graduates (92 respondents, 50% response rate) from a social justice minor in a school of social work, we explore the ways in which respondents described their transitions into social justice work, focusing on a set of key challenges that emerged from our analysis and reflecting on the implications of these challenges for social work practice and future research. Understanding some of the challenges in making this transition will help social work and non-profit administrators to better support this population’s future volunteer, service, and employment needs.

From SSWR to Peer-Reviewed Publication: How Many Live and How Many Die?

The purpose of this study was to estimate how many presentations at the Annual Meeting of the Society for Social Work and Research (SSWR) are subsequently published in peer-reviewed journals. A 30% random sample of abstracts presented at the 2006 Annual Meeting of SSWR was reviewed. To determine publication status of the presentations, the authors conducted searches using Google Scholar, PubMed, PsycINFO, and Social Work Abstracts, in addition to reviewing faculty pages and curriculum vitae (CVs). The authors recorded information about the published articles including the journal title, impact factor, year, and authors. Forty-three percentage (95% CI = [34.5%, 51.9%]) of presentations were published in a peer-reviewed journal. Twenty-eight percentage (95% CI = [20.9%, 36.7%]) of publications were in a journal with an ISI Impact Factor (M = 1.32). The number of presentation authors was not associated with a subsequent publication. No differences were observed by type of presentation.

Examining Mental Health Service Needs in Pediatric Primary Care Settings

Abstract While integration of the primary health care system and mental health system is viewed as a way to improve early detection of emotional and behavioral problems in children and increase their access to mental health services, less is known about the extent to which parents bring concerns about their childs mental health to pediatricians. In this study, we assessed the mental health needs and service use of a diverse sample of 228 youth, ages 4-17, in pediatric primary care settings. The central research question examined whether parents who identify child mental health concerns talk about these concerns with pediatricians.