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THE USE OF EVIDENCE IN MENTAL HEALTH PRACTICE: AN ANALYSIS OF PILOT STUDY DATA. PowerPoint Presentation
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THE USE OF EVIDENCE IN MENTAL HEALTH PRACTICE: AN ANALYSIS OF PILOT STUDY DATA.

THE USE OF EVIDENCE IN MENTAL HEALTH PRACTICE: AN ANALYSIS OF PILOT STUDY DATA.

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THE USE OF EVIDENCE IN MENTAL HEALTH PRACTICE: AN ANALYSIS OF PILOT STUDY DATA.

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  1. THE USE OF EVIDENCE IN MENTAL HEALTH PRACTICE: AN ANALYSIS OF PILOT STUDY DATA. Tracy C. Wharton, M.Ed., Doctoral Student, University of Alabama School of Social Work; MSc Candidate, Evidence Based Social Intervention, Oxford University Consistent with previous findings that training may provide some skills linking research to practice, data seem to indicate that practitioners with graduate degrees are more likely to self-identify as evidence-based practitioners than those who have undergraduate degrees. Similarly, respondents practicing in evidence oriented settings, such as medical settings, were less likely than those in other settings to respond negatively to evidence based practice models. Those in non-profit settings were much more divided on this issue, echoing the continuum suggested in the literature. Methodology & Analysis An internet based survey was used for this research. The survey contained 46-48 questions, depending on responses, including five open-ended questions. This study was designed to be a pilot study of the survey instrument which might be used in dissertation research. The survey was available on Survey Monkey from December 2007 to March 2008. A $1donation was made to the NASW Charitable Fund for each participant. Descriptive data was produced using SPSS for all variables, and crosstabs were used to examine the effects of variables on one another. Narrative data was coded using Atlas.ti, and an open coding scheme was used. Recruitment Snowball sampling was used for this research. Eighty-eight invitation emails containing the hyperlink to the survey were sent out by direct email. Forty handouts were given out in person at the SSWR conference. A week after the initial emails, reminder emails were sent. Reminders were sent again at one month. A copy of the invitation email was posted to the researcher’s Facebook page, and to the message board of two Facebook social work groups. This text was the same for all emails, posts and handouts. In an extensive review of the literature, one theme that emerged is that little, if any, literature addresses specifically how practitioners are accessing, interpreting, and applying evidence that is available to them and/or whether they are able to adapt information that may be contextually based elsewhere or in different populations. There was a notable dearth of information regarding how available evidence is actually interpreted and contextualized by practitioners, particularly given the current environment of global and instant access to information, not all of which is either applicable or even similar to the context in which the practitioner may be embedded (a concept known as “proximal similarity”). The purpose of this study was to pilot test a survey instrument to be used for the purpose of exploring this topic. Research questions framed the survey to explore views and barriers of social work practitioners related to the use of evidence and evidence-based practice. Plath’s model offers an integrated view of practice and environment, where factors are closely interrelated to one another. Findings from this survey seem to support the model. Factors that contribute to the personal, professional, political, and interpersonal domains of practice were endorsed by respondents, and seem to suggest that practitioners may use each of these domains as a contributing factor to practice decision making. Respondents regularly consume research, particularly by attending ongoing trainings and conferences. Most respondents search the internet for information regularly, through publicly available web sites such as WebMD and Google Scholar. Their work environments supported education and ongoing training. They are able to access peer reviewed research on the internet, as well as through other sources, such as print materials available through mail subscriptions or libraries. Comments throughout the survey indicated that access to research material and time to read that material may be barriers to some practitioners, although quantitative survey responses did not support this assertion. Data suggest low frequency of database access (such as the Cochrane or Campbell Collaboration databases). It is unclear the extent to which practitioners have the skills to identify peer-reviewed literature, and the extent to which they are able to access rigorously obtained information and screen out less valid material. Although respondents indicated that a significant number consider themselves as evidence-based practitioners, substantial numbers of them are not asked to justify their intervention choices by their supervisors. Responses to open-ended questions in this survey trended towards a mention of both positive and negative aspects of the EBP movement. There was an overwhelming indication that practitioners recognize expertise as something that comes from field experience, as well as research or education experience, and that research knowledge alone was insufficient to call oneself an expert in practice-related matters. Very few respondents aligned with the current procedural/process orientation currently being discussed in the social work literature. This is notable, as it suggests a disconnect between the academic discussion about EBP and the realities of implementation, where practitioners have a view that seems to be more technical than process oriented. Highlights from the results of the pilot study A total of 84 people went to the web page and initiated the survey, and a total of 61 people completed all primary questions, for a 73% completion rate. Response rates ranged from 61 to 84 people throughout the survey, as respondents were able to skip questions, return to them later, pause or quit the survey at any time. Respondents were 73% female, 88% from the USA, 77% white, mostly licensed practitioners of social work, with Master’s degrees (58%); 55% had no additional formal training beyond their degree, and 58% belong to a professional organization. • Research Questions • Since this is an exploratory study, research questions were framed that would allow for a broad exploration of gathered information, without expectations related to specific hypotheses. Research questions were based on findings from previous literature and the domains in Plath’s (2006) model (See Figure 1). • What do social work practitioners consider as “evidence” appropriate for practice? • What are the barriers that practitioners encounter in accessing research evidence? • Is their work environment oriented towards evidence-based practice? • What are the views of social work practitioners of evidence-based practice? “Evidence-based practice holds the social worker accountable for activities and funding; however, many times mental health cannot be measured that easily. It puts a huge strain on the practitioner to show results quickly. So… it’s a double-edged sword.” –anonymous study participant The researcher would like to acknowledge the support of the Center for Mental Health and Aging Summer Fellowship program, 2008.