How the periodic measurements could assist you in your ongoing work with Paula
The steps at the heart of single-system (subject) research are part of the everyday practice of social work. Each day social workers implement interventions to meet clients’ needs and monitor results. However, conducting proper single-system (subject) research entails far more than these simple day-to-day practices. Proper single-system research requires a high degree of knowledge and commitment. Social workers must fully understand the purpose of single-system (subject) research and the variations of single-system (subject) design. They must develop a hypothesis based upon research and select the right design for testing it. They must ensure the reliability and validity of the data to be collected and know how to properly analyze and evaluate that data. This assignment asks you to rise to the challenge of creating a proposal for a single-subject research study.
To prepare for this Assignment, imagine that you are the social worker assigned to work with Paula Cortez (see the case study, “Social Work Research: Single Subject” in this week’s resources). After an initial assessment of her social, medical, and psychiatric problems, you develop a plan for intervention. You also develop a plan to monitor progress in your work with her using measures that can be evaluated in a single-system research design. As a scholar practitioner, you rely on research to help plan your intervention and your evaluation plan.
Complete the Cortez Family interactive media in this week’s resources. Conduct a literature search related to the chronic issues related to HIV/AIDS and bipolar mental disorder. Search for additional research related to assessing outcomes and theoretical frameworks appropriate for this client. For example, your search could include terms such as motivational interviewing and outcomes and goal-oriented practice and outcomes. You might also look at the NREPP database identified in Week 1, to search for interventions related to mental health and physical health
Complete
a 5- to 7-page proposal/research plan for single-system (subject) evaluation for your work with Paula Cortez. Identify the problems that you will target and the outcomes you will measure, select an appropriate intervention or interventions (including length of time), and identify an appropriate evaluation plan.
Include a description of:
The problem(s) that are the focus of treatment
The intervention approach, including length of time, so that it can be replicated
A summary of the literature that you reviewed that led you to select this intervention approach
The purpose for conducting a single-system (subject) research evaluation
The measures for evaluating the outcomes and observing change including:
Evidence from your literature search about the nature of the measures
The validity and reliability of the measures
How baseline measures will be obtained
How often follow-up measures will be administered
The criteria that you would use to determine whether the intervention is effective
How the periodic measurements could assist you in your ongoing work with Paula
*reading Paula Case*
Social Work Research: Single Subject
Chris is a social worker in a geriatric case management program located in a midsize Northeastern town. She has an MSW and is part of a team of case managers that likes to continuously improve on its practice. The team is currently using an approach that integrates elements of geriatric case management with short-term treatment methods, particularly the solution-focused and task-centered models. As part of their ongoing practice, the team regularly conducts practice evaluations. It has participated in larger scale research projects in the past.
The agency is fairly small (three full-time and two part-time social work case managers) and is one of several providers in a region of approximately 50,000 inhabitants. Strengths of the agency include a strong professional network and good reputation in the local community as well as the team of experienced social workers. Staff turnover has been almost nonexistent for the past 3 years. The agency serves about 60–70 clients at any given time. The clients assisted by the case management program are older adults, ranging from their early 60s to over 100 years of age, as well as their caregivers.
To evaluate its practice approach, the team has decided to use a multiple-baseline, single-subject design. Each of the full-time case managers will select one client new to the caseload to participate in the study. The research project is explained to clients by the respective case manager and informed consent to participate is requested.
George was identified by Chris as a potential candidate for the evaluation. As a former science teacher who loved to do research himself, he agreed to participate in the project. George is 87 years old, and although he is not as physically robust as he once was, at 5 feet 9 inches tall, he has a strong presence. He has consistent back pain and occasional flare-ups of rheumatoid arthritis. His wife of 45 years passed away two summers ago after a long fight with cancer. After his initial grief, he has managed fairly well to adapt to life on his own. George entered the program after being hospitalized for fainting while at the grocery store. A battery of medical tests was conducted, but no specific cause of his fainting attack could be found. However, the physicians assessed signs of slight cognitive impairments/dementia and suggested a geriatric case management program.
An initial assessment by the case manager showed the need for assistance in the following areas: 1) personal care, 2) decrease in mobility, and 3) longer-term planning around living arrangement and home safety. The case manager also thought that George could benefit from setting up advance directives, which he did not want to discuss at that time. They agreed that the case manager could bring this topic up again in the future.
As part of the practice process, the case manager used clinical rating scales that were adapted from the task-centered model. At the beginning of each client contact, case manager and client collaboratively evaluated how well the practice steps (tasks) undertaken by client and/or case manager were completed using a 10-point clinical scale. Concurrently, they evaluated changes to the respective client problems, also using a 10-point clinical scale. George was able to actively participate in the planning and implementation of most care-related decisions. During the course of their collaborative work, most needs were at least partially addressed. Two tasks were completed regarding personal care, two regarding mobility, and three addressing home safety issues. Only personal mobility was still a minor problem and required some additional work.
After finishing the reassessment at 3 months, Chris completed gathering and evaluating the data for the single-subject design (SSD). As promised, she also provided George with the finished SSD findings. The following is an overview of the data that was collected for this case:
** please refer to file image for clear vision of chart below*
TABLE 1. TASK COMPLETION SCORES
WEEK: 1 2 3 4 5 6 7
Area:
Personal Care image 7 10 image image image image
Mobility image image image 2 N/A 10 image
Home Safety image image 10 10 10 image image
TABLE 2. PROBLEM CHANGE SCORES
WEEK: 1 2 3 4 5 6 7
Area:
Personal Care 3 3 8 5 8 9 9
Mobility 5 5 2 5 7 7 7
Home Safety 4 4 4 9 10 10 10
Reference: Plummer, S.-B., Makris, S., & Brocksen S. (Eds.). (2014b). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].
Read the following section:
“Social Work Research: Single Subject” (pp. 70–72)
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