Generating Support for Evidence Based Practices Discussion

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When treating clients, social workers must ensure that the evidence-based practice is appropriate for the client and the problem. Then, the social worker must get the client and other stakeholders to support the selected evidence-based practice. To earn that support, the social worker should present the client and stakeholders with a plan for implementation and evidence of the evidence-based practice efficacy and appropriateness. Social workers must demonstrate that they have carefully considered the steps necessary to implement the evidence-based practice, identified factors in the current environment that support implementation of the evidence-based practice, and addressed those factors that may hinder the successful implementation.

For this week’s Discussion, you will take on the role of the social worker in the Levy case study. You will choose an evidence-based practice and attempt to gain the support of both the client and supervisor. To do so, you will address its efficacy, appropriateness, and factors that may impact implementation of the evidence-based practice that you chose.

To prepare for this Discussion, review Levy Episode 2 (Transcript Provided.) Then using the registries provided in this week’s resources and the Walden Library, locate an evidence-based practice that you believe would be appropriate for Jake’s case. Then, review the Evidence-Based Practice kit for Family Psycho Education from the SAMHSA website from the resources. Note all the steps and considerations involved in implementing the evidence-based practice and which of these considerations apply to this case. Consider issues such as agency support, resources, and costs that might support or limit the application of the evidence-based intervention that you select.

By Day 3

Post an evaluation of the evidence-based practice that you selected for Jake. Describe the practice and the evidence supporting it. Explain why you think this intervention is appropriate for Jake. Then provide an explanation for the supervisor regarding issues related to implementation. Identify two factors that you believe are necessary for successful implementation of the evidence-based practice and explain why. Then, identify two factors that you believe may hinder implementation and explain how you might mitigate these factors. Be sure to include APA citations and references.

By Day 5

Respond to at least two colleagues by doing all of the following:

  • Identify strengths of your colleagues’ analyses and areas in which the analyses could be improved. Address his or her evaluation of the efficacy and applicability of the evidence-based practice, his or her identification of factors that could support or hinder the implementation of the evidence-based practice, and his or her solution for mitigating those factors.
  • Offer additional insight to your colleagues by either identifying additional factors that may support or limit implementation of the evidence-based practice or an alternative solution for mitigating one of the limitations that your colleagues identified.

Colleague 1: Katherine 

RE: Discussion – Week 2

COLLAPSE

  • Post an evaluation of the evidence-based practice that you selected for Jake.

The evidence-based practice that was selected for Jake is cognitive processing therapy.

  • Describe the practice and the evidence supporting it.

Cognitive processing therapy “is a twelve-session individual cognitive behavioral treatment for PTSD that teaches patients to recognize and challenge their own dysfunctional cognitions about traumatic events and current beliefs about themselves and others” (DeVoe et al., p 45).

CPT has two decades of research to support the intervention. Research has shown that this intervention helps to maintain gains for at least five years (DeVoe et al., 2018).

  • Explain why you think this intervention is appropriate for Jake.

This intervention is appropriate for Jake because Jake is having a hard time since coming home from war. He presents with many symptoms of PTSD and is having trouble maintaining those symptoms at home with his family and it is now affecting his home and family life. CPT helps to take the dysfunctional thoughts and helps them become more stable and realistic, which in turn reduces PTSD and depressive symptoms.

  • Then provide an explanation for the supervisor regarding issues related to implementation.

CPT uses a top-down cognitive treatment approach which can be hard if the client is not feeling that what they are experiencing is dysfunctional cognitively. Active participation by the client is an absolute must for this intervention to be successful.

“In a recent review of randomized clinical trials of PTSD treatment in military populations, Steenkamp, Litz, Hoge, and Marmar (2015) concluded that, although treatment may result in symptom reduction, many participants continue to qualify for a diagnosis of PTSD at the completion of intervention” (DeVoe et al., p 46).

  • Identify two factors that you believe are necessary for successful implementation of the evidence-based practice and explain why.
  1. Active participation is by far the most important aspect for successful implementation of the evidence-based practice because without participation the intervention is worthless.
  2. Also, making sure that the client is willing to reassess their own thoughts and feelings to help come to a conclusion that their thought process is dysfunctional, and a change is needed.
  • Then, identify two factors that you believe may hinder implementation and explain how you might mitigate these factors.
  1. “Concerns about the potential for exposure and homework exercises to trigger distress and higher likelihood of dropout have been raised by some investigators” (DeVoe et al., p 46).
  2. “…this population’s reluctance to engage in services, including concerns about confidentiality and stigma and perceptions that treatment will not be helpful” (DeVoe et al., p 46).

These factors can cause issues with implementation, but that should not discourage the use of the intervention. When it comes to the potential for exposure due to homework exercises, maintaining a good rapport with the client is essential and one way to decrease the increased chances of distress and dropout. If the client understands that they have someone they can reach out to this can create a safer environment for them. As for the reluctance to engage in services due to stigma and perceptions, that can be tough. Again established rapport will help to produce a therapeutic relationship that can keep the client in treatment and feel they are benefiting from the intervention.

References

DeVoe, E. R., Dondanville, K. A., Blankenship, A., & Hummel, V. M. (2018). PTSD Intervention with

Military Service Member Parents: A Call for Relational Approaches. Best Practices in Mental Health, 14(1), 40.

Colleague 2: Keshia 

Post a evaluation of evidence-based practice that you selected for Jake. Describe the practice and the evidence supporting it.

The evidence-based practice that I selected for Jake is (CPT),  Cognitive Processing Therapy.  According to the PTSD: National Center of PTSD this therapy teaches clients to refrain from negative thoughts and trauma. It involves talking with your provider about your negative thoughts. It is also suggested that completing short writing assignments help as well (PTSD, 2022). 

Explain why you think this evidence-based is appropriate for Jake. Then provide an explanation for the supervisor regarding issues related to implementation. 

Jake would be a good candidate for Cognitive Processing Therapy because he suffers from a psychiatric  disorder that was probably triggered from his past history from serving in the military and war in Iraq. I would advise the supervisor to be well trained on trauma-informed principles so that he or she may be able to properly implement this therapy to the client, also build an well organized culture of diversity, and equity and inclusion is important.  CPT is an evidenced-based treatment that has good sound research behind it. Therapist can have clients examine their thoughts by writing. Logical therapy looks at evidence on why clients draw negative conclusions about themselves PTSD, 2022). 

Identify two factors that you believe are necessary for successful implementation of the evidence-based practice and explain why.

In order for the the implementation of the intervention to be successful I feel the social worker should properly engage with their clients. By building that good rapport with your clients began to builds trust.  Secondly I feel the client has to be willing to put in the necessary work and efforts to produce the desired outcome. The therapist can assist only so much. 

Identify two factors that your believe may hinder implementation and explain how you might mitigate these factors.

Factors that could possibly hinder the implementation are 1.) Avoidance and trauma disclosure. The core PTSD symptoms is avoidance. Survivors with PTSD symptoms often avoid disclosure of traumatic experiences, and trauma reminders, and may be reluctant to seek help (Kazlauskas, 2017). 2.) Acknowledgment of survivors, negative attitudes towards trauma survivors in society result in avoidances help-seeking behaviors, The lack of acknowledgment of trauma and its effect results in inadequate health care policies on a national level (Kazlauskas, 2017). 

          I feel it is the role of the therapist or social worker to encourage our clients whom suffer with PTSD to seek help and don’t be ashamed to do so. During the implementation of the intervention you decide is appropriate for your client it would be important to properly engage with your clients, assess and review the information given regarding your client so you can develop the right strategies to intervene. By establishing that rapport with the client and building trust, your clients will become less reluctant to share information about their situation and seek the necessary help and resources provides by your therapist. 

References

Kazlauskas, E. Glob Health Action. (2017). Department of Clinical and Organizational Psychology, Vilnius University, Vilnius, Lithuania. Retrieved from. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC54960…

PTSD: National Center of PTSD. (2022). U.S. Department of Veterans Affairs. Retrieved from. htpps://www.ptsd.va.gov

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