This chapter focuses specifically on nursing research program vertical infrastructure. Vertical infrastructure refers to the pillars of the program: the foundation that provides the support to build other services. Three essential components are used to develop a solid nursing research program foundation that advances the scientific foundation of nursing practice and promotes integration of evidence-based practices. The three components are nurse researchers who coach or mentor clinical nurses in nursing research, intranet website resources, and a research departmental database. A successful nursing research program is contingent on having the right nurse researcher personnel who can move research from project inception to dissemination in peer-reviewed literature and translation into practice. Nurse leadership may benefit from educational programs or a business plan that includes the benefits of a nursing research program and information about how a specific nursing research program aligns with strategic goals.
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This chapter provides examples of programs and services beyond the foundational elements and global resources that can be used to overcome traditional nursing research barriers. It is assumed that at least one doctorate-prepared nurse researcher is available to facilitate research opportunities and educate nurses about research and evidence-based practice. Many clinical nurses fully understand their clinical roles but are completely unaware of opportunities and resources in nursing research within their hospital. Since contributions of nursing research are vital to the science and art of nursing and provide foundation for evidence-based practices, it is important to overcome the traditional cluster of barriers that include problems with nursing research visibility/priority, time and money, and research education. Nurses need confirmation that nurse leaders support research; when it is visible, it is valued. Moreover, nurses need time, education, and resources to complete rigorous research that leads to discoveries and answers to important clinical problems.
This chapter describes the relevance of critical thinking and the related process and philosophy of evidence-based practice (EBP) to cognitive behavior therapy and suggests choices that lie ahead in integrating these areas. Critical thinking in the helping professions involves the careful appraisal of beliefs and actions to arrive at well-reasoned ones that maximize the likelihood of helping clients and avoiding harm. Critical-thinking values, skills and knowledge, and evidence-based practice are suggested as guides to making ethical, professional decisions. Sources such as the Cochrane and Campbell Collaborations and other avenues for diffusion, together with helping practitioners and clients to acquire critical appraisal skills, will make it increasingly difficult to mislead people about “what we know”. Values, skills, and knowledge related to both critical thinking and EBP such as valuing honest brokering of knowledge, ignorance and uncertainty is and will be reflected in literature describing cognitive behavior methods to different degrees.
- Go to chapter: Integrating Theories of Developmental Psychology Into the Enactment of Child Psychotherapy
Child psychotherapy requires case conceptualization through the lens of developmental psychology in a multimodal approach to assessment, diagnosis, treatment planning, and clinical interventions. This chapter outlines a blueprint for therapists to provide treatment for children by integrating these fundamental principles while collaborating with the other people in the child’s life. The chapter guides the therapist through case conceptualization that integrates the most efficacious treatment interventions into the eight-phase template of eye movement desensitization and reprocessing (EMDR). Adaptive information processing (AIP) theory drives treatment with EMDR throughout the eight phases of that protocol and provides a template for case conceptualization and treatment planning. The use of the EMDR approach to psychotherapy is well documented and approved as evidence-based practice in Substance Abuse and Mental Health Administration (SAMHSA) and California Evidence-Based Clearinghouse for Child Welfare (CEBC).
This book provides the foundations and training that social workers need to master cognitive behavior therapy (CBT). CBT is based on several principles namely cognitions affect behavior and emotion; certain experiences can evoke cognitions, explanation, and attributions about that situation; cognitions may be made aware, monitored, and altered; desired emotional and behavioral change can be achieved through cognitive change. CBT employs a number of distinct and unique therapeutic strategies in its practice. As the human services increasingly develop robust evidence regarding the effectiveness of various psychosocial treatments for various clinical disorders and life problems, it becomes increasingly incumbent upon individual practitioners to become proficient in, and to provide, as first choice treatments, these various forms of evidence-based practice. It is also increasingly evident that CBT and practice represents a strongly supported approach to social work education and practice. The book covers the most common disorders encountered when working with adults, children, families, and couples including: anxiety disorders, depression, personality disorder, sexual and physical abuse, substance misuse, grief and bereavement, and eating disorders. Clinical social workers have an opportunity to position themselves at the forefront of historic, philosophical change in 21st-century medicine. While studies using the most advanced medical technology show the impact of emotional suffering on physical disease, other studies using the same technology are demonstrating CBT’s effectiveness in relieving not just emotional suffering but physical suffering among medically ill patients.
Cognitive behavioral therapy (CBT) with children addresses four main aims: to decrease behavior, to increase behavior, to remove anxiety, and to facilitate development. Each of these aims targets one of the four main groups of children referred to treatment. This chapter suggests a route for applying effective interventions in the day-to-day work of social workers who are involved in direct interventions with children and their families. An effective intervention is one that links developmental components with evidence-based practice to help enable clients to live with, accept, cope with, resolve, and overcome their distress and to improve their subjective well-being. CBT offers a promising approach to address such needs for treatment efficacy, on the condition that social workers adapt basic CBT to the specific needs of children and design the intervention holistically to foster change in children. Adolescent therapy covers rehabilitative activities and reduces the disability arising from an established disorder.
This chapter reviews the basic tenets of evidence-based practice (EBP), and discusses the potential applications of this model of practice and training for the field of clinical social work. It also presents some actual illustrations of its use. The chapter describes the major forms of clinical outcome studies: Anecdotal Case Reports, Single-System Designs With Weak Internal Validity, Quasi-Experimental Group Outcome Studies, Single, Randomized Controlled Trial, Multisite Randomized Controlled Trials and Metaanalyses that comprise the priority sources of information underpinning EBP. As the human services increasingly develop robust evidence regarding the effectiveness of various psychosocial treatments for various clinical disorders and life problems, it becomes increasingly incumbent upon individual practitioners to become proficient in, and to provide, as first choice treatments, these various forms of evidence-based practice. It is also increasingly evident that cognitive behavior therapy (CBT) and practice represents a strongly supported approach to social work education and practice.
- Go to chapter: Using Evidence-Based Practice to Enhance Organizational Policies, Healthcare Quality, and Patient Outcomes
Using Evidence-Based Practice to Enhance Organizational Policies, Healthcare Quality, and Patient Outcomes
This chapter discusses the evidence-based practice (EBP) paradigm and how it can be used to guide and improve organizational policies, healthcare quality, and patient outcomes. EBP is a problem-solving approach to the delivery of healthcare that integrates the best evidence from well-designed studies with a clinician’s expertise and patients’ preferences and values. Important components of clinical expertise in the EBP paradigm include: data gathered from a thorough patient assessment, internal evidence generated from outcomes management, quality improvement initiatives, and EBP implementation projects, and the evaluation of and use of available resources necessary to achieve desired patient outcomes. The chapter describes the difference between external and internal evidence, with an emphasis on how both types of evidence are important for changing institutional policies. It highlights the outcomes management and types of data collection systems that can be used to inform organizational policies.
- Go to chapter: Human Rights Issues and Research With Prisoners and Other Vulnerable Populations: Where Does Evidence-Based Practice Go From Here?
Human Rights Issues and Research With Prisoners and Other Vulnerable Populations: Where Does Evidence-Based Practice Go From Here?
This chapter discusses the history of forensic research atrocities. It promotes the use of National Association of Social Workers (NASW) Code of Ethics as a foundation for forensic research. The NASW Code of Ethics purports that social workers should promote and facilitate evaluation and research to contribute to the development of knowledge. This underscores both an ethical and a human rights obligation for the need for more prevention and intervention studies with incarcerated individuals. The chapter describes national and international responses to historic forensic research, and aims to build awareness of the need for new research to serve forensic populations and to increase familiarity with forensic research methodologies. The National Commission for the Protection of Human Subjects identifies three categories of research in prison settings: convenience research, prison-oriented research, and treatment-oriented research.
This chapter helps forensic social workers (FSWs) understand how to incorporate research into their practices. It clarifies the terms associated with evidence-based practice (EBP), and demonstrates three different approaches that FSWs can use in their practice settings. The chapter focuses on clinical interventions within forensic settings. It provides a brief summary and overview of some of the intervention models used in forensic settings with established empirical support, along with a discussion of their strengths and limitations. The chapter highlights commonly used forensic intervention models such as risk-needs-responsivity models, motivational interviewing, trauma-informed care, trauma-focused cognitive behavioral therapy, schema-focused therapy, and dialectical behavioral therapy. It concludes with a case example to illustrate how to use EBP in order to ensure that FSWs are providing interventions that are the best combination of art and science.