Research on Social Work Practice

This article describes a 5-step model of intervention research. From lessons learned in our work, we develop an outline of core activities in designing and developing social programs. These include (a) develop problem and program theories; (b) design program materials and measures; (c) confirm and refine program components in efficacy tests; (d) test effectiveness in a variety of practice settings; and (e) disseminate program findings and materials. Last, using a risk and protective factor perspective, we discuss the adaptation of interventions for new settings and populations.

Objective: Increasingly, mental health care is provided within the general health care sector. Accompanying this significant change is the demand for evidence-based as well as cost-effective or cost-neutral care models. Method: The authors present a pooled analysis of three large randomized clinical trials in which social workers provide depression care in collaboration with patient navigators, treating physicians, and consulting psychiatrists to examine the effects of diverse depression interventions on symptom improvement among low-income minority populations with cancer or diabetes in public safety net care systems. Results: Pooled results find a significant intervention effect over usual care. Results also find stronger benefits of structured psychotherapy and or antidepressant medication (AM) over brief counseling and referral to mental health care. Conclusion: The rapid change in health care delivery underscores an urgent mandate for social work to significantly increase its comparative effectiveness clinical trial research and adapt its mental and health care education.

Objectives: The purpose of this article is to highlight the benefits of collaboration in child focused mental health services research. Method: Three unique research projects are described. These projects address the mental health needs of vulnerable, urban, minority children and their families. In each one, service delivery was codesigned, interventions were co-delivered and a team of stakeholders collaboratively tested the impact of each one. Results: The results indicate that the three interventions designed, delivered, and tested are associated with reductions in youth mental health symptoms. Conclusion: These interventions are feasible alternatives to traditional individualized outpatient treatment.

Objectives: This article describes the process of developing a culturally based family intervention for Spanish-speaking Latino families with a relative diagnosed with schizophrenia. Method: Our iterative intervention development process was guided by a cultural exchange framework and based on findings from an ethnographic study. We piloted this multifamily group 16-session intervention with 59 Latino families in a randomized control trial. Data were collected on family- and client-level outcomes, and poststudy focus groups were conducted with intervention participants. Results: Preliminary evidence indicates that the intervention is effective by increasing illness knowledge and reducing family burden. Conclusions: This work can provide a model for how to integrate cultural factors into psychosocial services and enhance interventions in real-world settings for culturally diverse populations.

Objectives: Recognizing the limitations of conventional frameworks for identifying evidence-based interventions, we sought to develop a comprehensive set of criteria that would have practical and policy relevance. Methods: We identify nine ideal attributes of a mental health practice (well defined, reflecting client goals, consistent with societal goals, effective, minimum side effects, positive long-term outcomes, reasonable costs, easy to implement, and adaptable to diverse communities and client subgroups). Using a case study approach, we applied these criteria to the Individual Placement and Support (IPS) model of supported employment. Findings: IPS generally satisfies all nine criteria, though the evidence is more limited in some areas. Conclusions: This framework provides a template that could be used to evaluate other social work interventions.

Relatively little attention has been paid to the dimension of time in the design of social work interventions. Critical time intervention (CTI), an empirically supported psychosocial intervention intended to reduce the risk of homelessness by enhancing continuity of support for individuals with severe mental illness (SMI) during the transition from institutions to community living, is a model that was explicitly developed to address a timing-specific need. After describing the model and summarizing research that supports its effectiveness, this article considers examples of other time-sensitive interventions in social work and related fields and speculates on some potential advantages to such strategies. Further attention to various dimensions of timing in the design and evaluation of social work interventions is warranted.

Twelve-month follow-up outcomes from a group-randomized trial (GRT) of a classroom curriculum aimed at preventing bullying and victimization among elementary students in the Denver, Colorado, public school system are presented. Twenty-eight elementary schools were randomly assigned to receive selected modules of Youth Matters (YM), a skills-training curriculum that targets bullying and victimization, or to a no-treatment control group. Linear growth models were fitted to five waves of data collected over 3 years to test the effect of the intervention on the rate of change in self-reported bullying and victimization. Participation in YM was associated with a 7% decline in bully victimization 1 year after the intervention ended. Practice and methodological challenges encountered in the investigation are discussed in the larger context of intervention research in school settings. Strategies to increase school-based intervention research by social work investigators are outlined.

In the United States, about 17% of adolescents meet diagnostic criteria for mental, emotional, and behavioral (MEB) disorders. Six million young people receive treatment services annually for mental, emotional, or behavioral problems. These problems affect one in five families and cost $247 million annually. Some strategies for preventing MEB disorders in young people have been developed, tested, and found to be effective in preventing the onset, persistence, and severity of psychological disorders, drug abuse, and delinquency. Unfortunately, tested and effective prevention policies, programs, and practices are not widely used. This article highlights recent advances in prevention science and describes some opportunities and challenges in advancing the use of science-based prevention in communities. The chapter concludes by exploring the potential role of social work education in developing a workforce ready to increase community access to effective prevention strategies.

Objectives: Approximately 25% of women are pregnant or postpartum when they enter prison. This study assesses a system-level intervention that prevented the separation of mothers and infants at birth, allowing them to reside together in an alternative community setting. Method: Longitudinal analysis of several state-level administrative databases compares the intervention (n = 48) group to the ‘‘treatment as usual’’ group (n = 36), over a 10-year period. Results: Preliminary analyses reveal few between-group differences and illuminate the presence of informal caregivers that were outside the scope of our data. Conclusions: Although 70% of the children remain legally attached to their mothers, further study is required to account for data limitations and to determine whether time to negative events differed between groups.

Police agencies across the country are struggling to respond to significant number of persons with serious mental illness, who are landing on their doorsteps with sometimes tragic consequences. Arguably, the most widely adopted approach, the Crisis Intervention Team (CIT) model, is a specialized police-based program designed to improve officers’ ability to safely and effectively respond to mental health crises. Conducting research on CIT is challenging; thus, the evidence base is limited. In this article, the author reviews the emerging literature, present a conceptual model of CIT effectiveness, and describe a study of CIT in Chicago. Findings from Chicago suggest that CIT is increasing linkage to services and reducing use of force in encounters with persons with mental illness. Lessons learned are discussed.

This commentary reviews three articles linked together by two themes (a) the use of cultural adaptation of evidence-based practices to reduce disparities in health and services delivery and (b) the importance of collaboration involving intervention developers, practitioners, and consumers when delivering services. Both themes illustrate a process of cultural exchange, enabling researchers to develop interventions that are more meaningful and acceptable to consumers; providers to develop a stronger therapeutic alliance with consumers; and consumers to develop greater understanding and acceptance of treatment process. Such exchanges lead to improved consumer outcomes and greater satisfaction with services. By serving as a culture broker or change agents, social workers can play a leadership role in the translation of research to practice.

The research reports by Boyd et al. and Herman et al. provide insights about intervention research with vulnerable populations that highlight often-neglected standards of evidence. This commentary describes linkages of nonspecific therapeutic factors critical to these outcome studies as illustrative of research to practice standards we must continually promote. Embedding intervention research with iterative links to service system and implementation research provides a framework for social work to chart future contributions toward closing critical translational gaps.

The challenging context of social work interventions require that most intervention studies will be derived from nonexperimental research designs. Two evaluation studies in this special issue employed nonrandomized designs to examine the efficacy of two programs—a police crisis intervention team designed to enhance officers’ responses to mental health crisis and a program for pregnant incarcerated women. Each is a laudable effort to examine important intervention outcomes in insular settings. The design and execution problems explicated in both studies are familiar to researchers who venture into such practice arenas. Disappointing outcomes, as in these two studies, can sometimes be attributed to the problems of nonequivalent comparison designs or to unanticipated events. Intervention researchers must also recognize that programs often fail to demonstrate differences and can even result in adverse outcomes.