Evaluation, evidence-based practice, and research In recent years, greater interest in “evidence-based practice” (EBP) has become a prominent theme in the social work profession due to the need for justification for payment of services, as well as the need for methods of best treatment practice in social work. The role of professional ethics and values is an important source of evidence in the process of making decisions about evidence-based practice. Significant failures in making decisions occur when evidence is not used. These can include: ● Ineffective use of interventions. ● Interventions that do more harm than good. ● Continuing to use interventions instead of replacing them with better interventions. ● Failure to discontinue interventions that do more harm than good. Evidence-based practice (EBP) is the integration of best research evidence with clinical expertise and patient/client values. The purpose of EBP is to promote effective practice and to enhance public health by applying empirically supported principles of assessment, case formulation, therapeutic relationship, and intervention (Mount Saint Mary’s University, 2020). Evidence- based guidelines for best practice in the mental health profession should draw upon critical thinking, practice-related research, accountability, service to clients, informed consent, self-determination, and social justice as essential components of evidence-based practice. Evidence-based practice in social work focuses on evidence- based research in which clinical knowledge and client values are important considerations. Evidence-based practice implements the current state of knowledge and best practice strategies: etiology, causation, prevention, and treatment of a wide range of conditions using state-of-the-art methods. Evidence-based practice in social work utilizes the best available research evidence, along with professional wisdom and individual family values. The social worker should reflect on the following questions: ● Which treatment approaches and specific interventions are most effective? ● In what contexts and for whom? ● What are the indicators of effective social work practice using this method? ● How will results of treatment be measured? ● How can the assessment data be used to inform future work throughout the course of practice? These questions illustrate the close connection between critical thinking and the application of evidence-based practice. Of course, all social work practice must be individualized for the client based on the client’s specific needs and the most effective evidence-based methods to achieve his or her goals. All practice methods and techniques must be within the limits of the social worker’s training and experience, as outlined in ethical standards for competency. More about informed consent The issue of informed consent relates closely with one of the most important values of ethical mental health practice: self- determination. In order for informed consent to be valid, the following conditions must be met: 1. A person of legal age must give consent voluntarily. 2. The individual must be competent to refuse or to consent to treatment. 3. The client must be given thorough, accurate information about the service so she or he may weigh the benefits and risks of treatment. 4. Information must be given in a format that can be fully comprehended by the client based on age, cognitive ability, level of literacy, taking account of any disabilities, which must be accommodated.
The mental health profession has become more organized around the need for monitoring and assessing the effectiveness of interventions, policy initiatives, and program implementation. Improved services and outcomes for clients and enhancements increase credibility. Licensed mental health professionals should: ● Respect the dignity and protect the welfare of research participants. ● Be aware of applicable laws and regulations and professional standards governing the conduct of research. ● Monitor and evaluate policies, program implementation, and practice interventions. ● Promote and facilitate evaluation and research. ● Critically examine and keep current with emerging mental health practice research. ● Obtain voluntary, written informed consent, which includes: ○ No implied or actual deprivation or penalty for refusal, or undue inducement to participate. ○ Regard for the participant’s dignity, well-being, and privacy. ○ All information about the nature, extent, and duration of the participation and disclosure about the risks and benefits. ○ When the participant is incapable, provision of appropriate explanation to the participant, obtaining of permission to the degree he or she is able, and obtaining of written consent from the appropriate proxy. ● Never design or conduct evaluation or research that does not use informed consent procedures. ● Inform participants of the right to withdraw from evaluation and research. ● Ensure participants access to appropriate supportive services. ● Protect participants from unwarranted physical or mental distress, harm, danger, or deprivation. ● Discuss collected information only for professional purposes, with only those who have a professional concern for the information. ● Ensure anonymity and confidentiality of all participants and their data, and: ○ Inform participants of limits of confidentiality, measures taken, and when records will be destroyed. ○ Omit identifying information from reports unless disclosure is authorized. ○ When the possibility exists that others, including family members, may obtain access to confidential information, explain this possibility, along with the plan for protecting confidentiality as part of the procedure for obtaining informed consent. ● Respect each participant’s freedom to decline participation in or to withdraw from a research study at any time. ● Report evaluation and research findings accurately. ● Be alert to and avoid conflicts of interest and dual relationships with participants. ● Educate self, students, and colleagues about responsible research practices. One of the newest challenges for mental health practitioners is the issue of informed consent in e-therapy. Kanani & Regehr (2003) point out the following reasons: 1. Anonymity on the Internet makes it more difficult to determine the client’s mental capacity or visual or auditory capacity to comprehend the terms of consent. 2. It may be more difficult to determine legal age. 3. Potential conditions such as suicidal behaviors and eating disorders may not be suitable for online therapy. 4. There is limited empirical research available, thus limiting both the practitioner and client’s understanding of either the efficacy or the risks associated with e-therapy. 5. Internet identity issues place a greater burden on the practitioner to determine whether the client is legally and ethically able to consent.
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Book Code: SWTX1524
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