Researching EvidenceBased PracticeIn determining what evidence-based treatment tools toutilize with a client, it needs to be looked at what is most effective and whatwill work with this particular individual client. Thehistory of the client need to be taken into consideration as well as theircurrent situation. Another area which needs to be addressed is the ability ofthe agency to effectively implement the practice.
Areas which need to beconsidered are specialized training needed to implement, cost,strengths/weaknesses of the practice, and the overall measurement researchoutcomes. Client HistoryTiffani Bradley is a 16-year old heterosexual, Caucasianfemale (Plummer, Makris, & Brocksen, 2014). Tiffani has a history ofemotional, physical, sexual and psychological abuse in which she reports threeprior arrests for prostitution (Plummer, et al., 2014). Tiffani reports she hashad several treatments for sexually transmitted diseases and has for the lasttwo years been social isolated except for Donald, John “T”, other women whowere also being trafficked and those who paid to have sex with her (Plummer, etal., 2014). Tiffani reports feelings of low self-esteem/self-worth, fear, andanger (Plummer, et al.
, 2014). Tiffani reports she would like to complete herGED, obtain employment, and her own place (Plummer, et al., 2014).Evidence-Based PracticesBoston Consortium Model:Trauma-Informed Substance Abuse Treatment for Women: Boston ConsortiumModel: Trauma-Informed Substance Abuse Treatment for Women (BCM) is atrauma-informed substance abuse and mental health treatment which utilizes atrauma recovery and empowerment model of treatment (Substance Abuse and MentalHealth Services Administration (SAMHSA), n.d.
a). BCM addresses the correlations which can be found between a client’saddiction, mental health disorders, trauma, and sexual risk behaviors workingto develop positive coping skills with the client which will allow them to healfrom their trauma background (SAMHSA, n.d.a).
Areas of focus within thetreatment practice are: “alcohol and/or drug abuse, mental health needs,interpersonal violence, leadership, and effective assertive communication skills”(SAMHSA, n.d.a). The measurement outcomes for BCMtake into consideration substance useand related problem severity, mental health symptomatology, posttraumaticstress symptoms, HIV sexual riskbehaviors, and perceived power in one’s relationship (SAMHSA, n.d.a).
Inaddressing the area of substance abuse, the quasi-experimental measurementshowed a decrease after a six-month period, twelve-month and continuousdecreasing on recurring follow up (SAMHSA, n.d.a). The quasi-experimentalmeasurement outcome for mental health symptoms shows symptoms are beingreported in fewer instances over a twelve-month time period (SAMHSA, n.d.a).Posttraumatic stress symptoms measured a similar outcome with continueddecreasing symptoms (SAMHSA, n.
d.a). Those individuals who were at risk of HIVsexual risk behaviors also showed outcome measurements decreasing (SAMHSA,n.d.a). Say It Straight: Say It Straight (SIS) is a communication training programwhich teaches adolescents and adults empowering communication skills andbehaviors in order to increase their self-efficacy, self-awareness, social andpersonal responsibility (SAMHSA, n.
d.b). This evidence-based practice isdesigned to decrease negative behaviors such as: “substance use, eatingdisorders, bullying, violence, precocious sexual behavior, and behaviors thatcan result in HIV infection” (SAMHSA, n.d.b).
The process of this programconsists of role playing, body sculpting, journaling, and group discussion toassist the client in identifying the disempowering behaviors which led them towhere they find themselves currently (SAMHSA, n.d.b). The goal is to increasethe client’s integrity, compassion, courage, and resiliency (SAMHSA, n.d.
b). The measurement outcomes to determineif SIS is effective are: alcohol and/or drug-related school suspensions, intentionsto use assertive refusal skills, criminal offenses, communication skills, and intentionsto use assertive refusal skills in sexual situations (SAMHSA, n.d.b). SIS was measured pre-experimental as well asquasi-experimental. Each of these measurement outcome areas showed a decreasein behaviors, an increase in using effective communications skills such as theuse of “I” statements and an increase in utilizing assertive communicationskills to refuse in negative situations (SAMHSA, n.
d.b). Recommendations forTiffani’s TreatmentFactors which need to be considered prior to implementinga treatment program for Tiffani are: her substance abuse, the extensive traumashe has endured, lack of primary support system, and her need to develop positivecoping skills (Plummer, et al., 2014).
Social Work Skills. There are several social work skillswhich would need to be utilized with Tiffani. Tiffani may not feel like she hashad anyone really listen to her story of trauma as she had been arrested forprostitution and instead of being seen as a victim of human trafficking, shebecame further victimized by the judicial system (Plummer, et al., 2014). Itwould be important to provide Tiffani with active listening, empathy, and towork on building a rapport with her. In utilizing the social work skill ofactive listening, it would be inherent to summarize and to use reflection inorder to let Tiffani know that we are hearing what she has to say as well as toensure we are interpreting what she is saying correctly.
As her social worker,we need to utilize the social work skill of observation. Tiffani hasexperienced several years of trauma, both while living at home and upon leavinghome. It is important the social worker be aware of sudden changes in Tiffani’smood or behavior which may be a sign of something being triggered emotionallyfor her. Training ofEvidence-Based Practices.
BCM isa costly evidence-based practice in that the trainer requires $20,000 as wellas travel expenses (SAMHSA, n.d.a). The training consists of an on-site, 8-daytraining with all training materials included in the cost (SAMHSA, n.d.a). BCMis estimated to cost approximately $3,500 per client and this is contingent onother treatment systems such as mental health/substance abuse treatment(inpatient or outpatient) already being in place (SAMHSA, n.d.
a). SIS is more cost effective in that the practice is a 3-4-dayintensive training workshop in which agencies send their employees to aspecific location (Say It Straight, 2017). The cost of the training isapproximately $850 plus travel expenses per individual, however, one person cango through the Master SIS training and become a trainer for their agency (SayIt Straight, 2017). SIS can be implemented in schools, mental health orsubstance abuse treatment centers, detention centers, etc. National Registry of Evidence-BasedPrograms and PracticesAs a beginning researcher, I believe the registry would bebeneficial in acquiring evidence-based practices.
It took a few searches todiscover what I was looking for in the case of Tiffani, however, oncediscovering how to utilize the search engine effectively, I did find what itwas that I felt would be effective practice. The fundamental idea to using thisregistry is using key words on what it is that needs to be treated. Once finding an evidence-based practice I believe wouldbenefit Tiffani, this would increase my confidence in the knowledge that otherclient’s symptoms, substance usage, and negative behaviors have decreased byutilizing this treatment modality. In researching the practices, I noted therewere a few that did not provide much information regarding the outcomes orvalidity. These would have to be further researched prior to being implemented. Conclusion In deciding whatevidence-based treatment practice to use, we must be mindful of the cost neededto implement and continue to have the practice in place. If a practice is notcost-effective where it is able to be sustained over time, then other practicesneed to be considered.
In deciding what evidence-based treatment to utilize withTiffani, SIS would be an effective approach and treatment modality. This practicewould assist her with developing effective communication skills needed to empowerher to make more positive choices, develop self-efficacy, and increase her self-esteem.This treatment model would assist her in working through the trauma she has experienced.