Micki Washburn

A pilot feasibility study of virtual patient simulation to enhance social work students’ brief mental health assessment skills

ABSTRACT This study presents preliminary feasibility and acceptability data on the use of virtual patient (VP) simulations to develop brief assessment skills within an interdisciplinary care setting. Results support the acceptability of technology-enhanced simulations and offer preliminary evidence for an association between engagement in VP practice simulations and improvements in diagnostic accuracy and clinical interviewing skills. Recommendations and next steps for research on technology-enhanced simulations within social work are discussed.

Outcome Benchmarks for Adaptations of Research-Supported Treatments for Adult Traumatic Stress

This article provides benchmark data on within-group effect sizes from published randomized controlled trials (RCTs) that evaluated the efficacy of research-supported treatments (RSTs) for adult traumatic stress. Agencies can compare these benchmarks to their treatment group effect size to inform their decisions as to whether the way they are adopting or adapting one of these RSTs is satisfactory or needs to be modified or replaced by a different intervention approach. These benchmarks also have potential utility for future implementation of research efforts about these RSTs that can assess what service provision conditions are associated with effect sizes that resemble the benchmarks provided in this study.

Virtual Patient Simulations for Brief Assessment of Mental Health Disorders in Integrated Care Settings

ABSTRACT This mixed-methods pilot investigation evaluated the use of virtual patient simulations for increasing self-efficacy and diagnostic accuracy for common behavioral health concerns within an integrated care setting. A two-by-three factorial design was employed to evaluate three different simulated training conditions with a sample of 22 Masters level behavioral health students. Results support engagement in virtual patient simulation training to increase students’ self-efficacy in brief clinical assessment, and support the use of virtual patient simulations to improve diagnostic accuracy. Results further indicate that virtual patient simulations have sufficient levels of usability and acceptability as a tool for developing brief clinical interviewing skills, and that participants found this method of instruction to be a valuable adjunct to traditional classroom or field based training. Future directions and next steps for the integration of technology enhanced simulations in clinical social services education are explored.

DBT Self-Help Application for Mobile Devices

DBT Self-Help is a mobile application serving as a companion to structured skills training in Dialectical Behavior Therapy (DBT). It is available for both Android and iOS and works on various mobile devices. This application affords users a private, easily portable way to access information and practice key DBT skill sets such as Core Mindfulness, Distress Tolerance, Emotional Regulation and Interpersonal Effectiveness. Although this app is affordable and contains a great deal of information, it can be difficult to navigate, especially for someone new to DBT concepts. The content is strong, but restructuring the presentation style would enhance clarity. This application is recommended for those already involved in a DBT-based program, and may be appropriate for those who wish to learn additional coping skills as an adjunct to other forms of treatment. Unfortunately, this app is not user-friendly enough to be easily followed by the average consumer wanting to learn new ways of managing uncomfortable emotions.

Assessing MSW Students’ Integrated Behavioral Health Skills Using an Objective Structured Clinical Examination

ABSTRACT Within the last decade, there has been a significant shift in the field of social work toward competency-based education. This article details the use of the Objective Structured Clinical Examination (OSCE) Adapted for Social Work Performance Rating Scale. We used the measure to evaluate specific practice competencies among students (n=33) participating in a professional workforce development program, funded by the Health Resources Services Administration Behavioral Health Workforce Education and Training for Professionals. We report on students’ performance and their views of the OSCE as an assessment measure and learning experience, and on the interrater reliability and consistency of the OSCE. Results can be used by other social work programs to inform the use of OSCEs to facilitate competency-based assessment.

Lesbian, gay, and bisexual (LGB) youth within in welfare: Prevalence, risk and outcomes

The purpose of this study was to estimate the population of sexual minority or LGB (lesbian, gay and bisexual) children and youth involved with the child welfare system, and to compare their health, mental health, placement and permanency outcomes to those of non-LGB youth. Data were drawn from the Second National Survey of Child and Adolescent Well-Being (NSCAW-II), a nationally representative sample of children who were referred to child welfare due to a report of abuse or neglect over a fifteen month period. This sample included youth ages eleven and older who self-identified their sexual orientation (n = 1095). Results indicate that approximately 15.5% of all system involved youth identified as lesbian, gay or bisexual, and that lesbian and bisexual females, and LGB youth of color are both overrepresented within child welfare systems. Although no substantive difference in risk factors, permanency and placement were found between LGB and Non-LGB youth, LGB youth were significantly more likely to meet the criteria for adverse mental health outcomes. Implications for child welfare practice and policy are presented, along with recommendations for future research in this area.

Within-Group Effect-Size Benchmarks for Trauma-Focused Cognitive Behavioral Therapy With Children and Adolescents

Purpose: This article provides benchmark data on within-group effect sizes from published randomized clinical trials (RCTs) supporting the efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) for traumatized children. Methods: Within-group effect-size benchmarks for symptoms of trauma, anxiety, and depression were calculated via the Glass approach and adjusted for sample size using Hedges’ g. Results: Overall TF-CBT and control group benchmarks are presented, as well as specific benchmarks for sexual abuse and mixed trauma, and whether included studies utilized intent-to-treat analysis. Discussion: Community practitioners can use these benchmarks as a comparison tool to evaluate whether the way they are adopting or adapting the TF-CBT intervention is satisfactory, needs to be modified, or should be replaced by a different intervention approach. These benchmarks also have potential utility for future implementation research on TF-CBT assessing which service provision conditions are associated with effect sizes approximating benchmarks provided in this article.

Benchmarks for Outpatient Dialectical Behavioral Therapy in Adults With Borderline Personality Disorder

Purpose: This article provides benchmark data on within-group effect sizes from published randomized clinical trials supporting the efficacy of dialectical behavioral therapy (DBT) for borderline personality disorder (BPD) in adults aged 18–65 years. Method: Within-group effect sizes were calculated via the Glass approach and adjusted for sample size using Hedges’s g then aggregated to produce benchmarks for symptoms commonly associated with BPD, such as self-harm, depression, and anger. Results: Aggregate within-group effect sizes are presented separately for treatment (DBT) and control (treatment as usual) groups and for interviewer assessed and self-reported outcome measures. Discussion: Community-based practitioners can use these benchmarks as a comparison tool to evaluate the ways in which they are adopting or adapting the DBT intervention and to determine if the intervention should be modified or replaced, given their unique practice setting and client population.

Teaching Note—Technology-Enhanced Clinical Simulations: Tools for Practicing Clinical Skills in Online Social Work Programs

ABSTRACT Technology-based simulations provide vehicles for social work students to practice clinical skills in online environments. This teaching note reviews 2 simulation tools educators may consider implementing in their training programs: virtual patients and Second Life. The current literature is presented discussing the use of these simulations in online learning programs. Suggestions for incorporating simulations into distance education programs are provided along with suggestions for future directions for research in this area. Educators are encouraged to examine these tools and further evaluate their feasibility, acceptability, and efficacy in building direct practice skills in online environments.

The moderating effects of ethnicity on key predictors of trauma in child welfare involved adolescents

Key predictors of trauma were examined using a multi-group analysis of a nationally representative sample of 716 child welfare involved youth ages 11-17. Results indicate that co-occurring clinical depression was associated with trauma across all racial/ethnic groups. Results also support that youths ethnicity moderates the relationship between gender, history of sexual abuse and sexual orientation and the development of trauma. Contrary to prior research, trauma was not significantly associated with substance abuse or having experienced out of home placement for all ethnic groups. Implications for policy, practice with child welfare involved adolescents and future research in this area are discussed.