The steps at the heart of single-system (subject) research are part of the everyday practice of social work. Each day social workers implement interventions to meet clients’ needs and monitor results. However, conducting proper single-system (subject) research entails far more than these simple day-to-day practices. Proper single-system research requires a high degree of knowledge and commitment. Social workers must fully understand the purpose of single-system (subject) research and the variations of single-system (subject) design. They must develop a hypothesis based upon research and select the right design for testing it. They must ensure the reliability and validity of the data to be collected and know how to properly analyze and evaluate that data. This assignment asks you to rise to the challenge of creating a proposal for a single-subject research study.
To prepare for this Assignment, imagine that you are the social worker assigned to work with Paula Cortez (see the case study, “Social Work Research: Single Subject” in this week’s resources). After an initial assessment of her social, medical, and psychiatric problems, you develop a plan for intervention. You also develop a plan to monitor progress in your work with her using measures that can be evaluated in a single-system research design. As a scholar practitioner, you rely on research to help plan your intervention and your evaluation plan.
Complete the Cortez Family interactive media in this week’s resources. Conduct a literature search related to the chronic issues related to HIV/AIDS and bipolar mental disorder. Search for additional research related to assessing outcomes and theoretical frameworks appropriate for this client. For example, your search could include terms such as motivational interviewing and outcomes and goal-oriented practice and outcomes. You might also look at the NREPP database identified in Week 1, to search for interventions related to mental health and physical health.
Submit 7-page proposal/research plan for single-system (subject) evaluation for your work with Paula Cortez. Identify the problems that you will target and the outcomes you will measure, select an appropriate intervention or interventions (including length of time), and identify an appropriate evaluation plan.
Include a description of:
The problem(s) that are the focus of treatment
The intervention approach, including length of time, so that it can be replicated
A summary of the literature that you reviewed that led you to select this intervention approach
The purpose for conducting a single-system (subject) research evaluation
The measures for evaluating the outcomes and observing change including:
Evidence from your literature search about the nature of the measures
The validity and reliability of the measures
How baseline measures will be obtained
How often follow-up measures will be administered
The criteria that you would use to determine whether the intervention is effective
How the periodic measurements could assist you in your ongoing work with Paula
SOCIAL WORK CASE STUDIES: CONCENTRATION YEAR
70
Social Work Research:
Single Subject
Chris is a social worker in a geriatric case management program
located in a midsize Northeastern town. She has an MSW and is
part of a team of case managers that likes to continuously improve
on its practice. The team is currently using an approach that inte-
grates elements of geriatric case management with short-term
treatment methods, particularly the solution-focused and task-
centered models. As part of their ongoing practice, the team regu-
larly conducts practice evaluations. It has participated in larger
scale research projects in the past.
The agency is fairly small (three full-time and two part-time
social work case managers) and is one of several providers in
a region of approximately 50,000 inhabitants. Strengths of the
agency include a strong professional network and good reputation
in the local community as well as the team of experienced social
workers. Staff turnover has been almost nonexistent for the past
3 years. The agency serves about 60–70 clients at any given time.
The clients assisted by the case management program are older
adults, ranging from their early 60s to over 100 years of age, as
well as their caregivers.
To evaluate its practice approach, the team has decided to use
a multiple-baseline, single-subject design. Each of the full-time
case managers will select one client new to the caseload to partici-
pate in the study. The research project is explained to clients by
the respective case manager and informed consent to participate
is requested.
George was identified by Chris as a potential candidate for the
evaluation. As a former science teacher who loved to do research
himself, he agreed to participate in the project. George is 87 years
old, and although he is not as physically robust as he once was, at
5 feet 9 inches tall, he has a strong presence. He has consistent
back pain and occasional flare-ups of rheumatoid arthritis. His
wife of 45 years passed away two summers ago after a long fight
with cancer. After his initial grief, he has managed fairly well to
adapt to life on his own. George entered the program after being
RESEARCH
71
hospitalized for fainting while at the grocery store. A battery of
medical tests was conducted, but no specific cause of his fainting
attack could be found. However, the physicians assessed signs of
slight cognitive impairments/dementia and suggested a geriatric
case management program.
An initial assessment by the case manager showed the need for
assistance in the following areas: 1) personal care, 2) decrease in
mobility, and 3) longer-term planning around living arrangement
and home safety. The case manager also thought that George
could benefit from setting up advance directives, which he did not
want to discuss at that time. They agreed that the case manager
could bring this topic up again in the future.
As part of the practice process, th
Locating Assessment
Instruments
Kevin Corcoran and Nikki 1-lozack
T
his c hapter nddr es.es how to locate inst r ume nts for oocial wor~ reseJr.:h
a nd p ract ice. T h is task m ay not seem too challeng ing, but it is. Locating
in,trument includes being familiar with a number of sou rces of men
surement in.)trumems and knowing what it is one \·ants to measure or
observe in t he first place.
To locate 3Jl instrum ent, the researcher mu’t know 1• hat he or she intends to mea
sure. This includes a well-defined construct or conceptual domain of study. fbe mea-
sureme nt too l is t he operation a.lizntion o f the v.tria b le, and it is impossible to locate an
•ppropria te mea1u rement u nless t h e resea rcher is certJin w hat is to be measu red.
Knowing what to obsen·e includes precise definitions of the independent and depen
dent vari,tbles. I nstruments often are .t>sociated with operationalizing the dependent
variables (e.g., m nl”i t al discord in a single-syste m design o f a couple in counseling, din-
teal depr~s;,ion in a
lly design, instruments intend to sy~tematically quan tify som e affeo, co gnit io n, o r con
duct in some e nvironment or setting and provide numerical estimates of affect, cogni ·
tion) or conduct.
Inst ruments also are useful in opc1·a tio nalizing independent va riables. I n experimc n
tal design>, this is considered a o1anipulation check. The reason for using a measurement
of the independent ,·ariables, as tl1e phr..se suggests, is to determine “hether the manip-
u latio n o f th e in dependen t 1•ar iablc was su c(.essful. Po t· exa mple, assu me th at the
rcsearchc t· is conduuiog a study comparing in -home counseling services to ca;e ma n
agement services. The researcher “ould want to be reassured rhat t h e coumcling group
was actually getting “cou nseli n g” fro m the cou nselor and that the case rn.Ulagemcnt
g roup wa> not getting some fo rm o f cou nseling fro m t he case mao.1gers. W ith o u t the
fonner,the researcher would not be certain that the counseling groups actually had •uf-
licient exposu re to tru ly be considered under the treatment condition of counseling. By
measuring t he independent va r iab le, the resca,·che r ca 11 also dete rmine whe th c,· expo
sure to some form of therapeu t ic relat ionship wit h the ca•c manager contam111ated the
com parison group. fo conduct a manipulation check hke this, the researcher mitht
decide to administe r the Workin g illhm ce Inventory (l torvath & Green berg, 1989),
which ascertains th ree elements of t h erapeutic relationsh ips: go•l orientn tion. t ask
65
66 Pt.n1′ I • Q uMml’t. n ·; c API’RUA<: uts: Fo u :.JOAtiONS Of Ot.rA Com CliON directedness, and bo nding. T WAL_SOCW6311_02_A_EN-CC.mp4 Single-System Studies Mark A. Mattaini ocial work practice at all system levels involves action leading to behav- ioral or cul tural change. The primary role of social work research is to provide knowledge that contributes to such professional action. vVhile descriptive resea rch about human and cultural conditions, as discussed elsc·where in this volume, can be valuable fo r guiding professional acti on, know ing how to most effectively support change is critical for practice. A central qu estion for social work research, therefore, is "what works" in practice, what works to address what goals and issues, with what populations, under wha t contextual conditions. While descriptive research ca11 suggest hypotheses, the only way to really determ in e howweU any fo rm of practice works is to test it, under the most rigorous conditions possible. Experimen tal research is therefore criti cal for advancin g social work practice. Unfon·tunately, only a small proportion of soc ial work research is experimental (Thyer, 200 I). Experiment al research is of two types, group experiments (e.g., randomized clinical trials [RCTs]) and single-system research (SS R, also commonly referred to as single case resealfch, N of 1 research, o r interrupted time-series experiments). Si ngle-system experi- mental research, however, has often been un deremphasi zed in social work, in part because of limited understanding of the logic of natural science among social scientists and wcial workers. SSR is experimental research; its purpose, as noted by Horner and colleagues (2005 ), is "to document causal, or functional, relationships between independent and dependent variables" (p. 166). The methodology has been used with all system levels-micro, mezzo, and macro-m aking it wid ely appl iCable for studying social work concerns. For example, Moore, Delaney, and Dixon (2007) studied ways to enha nce quality of life for quite impaired patients with Alzheimer's disease using singl e-system methods and were able to both individualize interven tions and produce generalizable knowledge from their study in ways that perhaps no other research strategy could equa l. In another example, Serna, Schumaker, Sherman, and Sheldon (1991) worked to improve family interactions in families with preteen and teenage children. The first several interven tions they attempted (interventions that are common in social work practice) fa iled to produce changes that generalized to homes. Single-system procedures, however, allowed them to rigorously and sequentially test multiple approaches until an adequately powerful intervention strategy was refi ned. (Note that Lhis would be impossible using group methods without under- mining the rigor of t he study.) 241 242 PART II • QUANTITATIV( APPROACHES: TYPES OF S TUDIES Turning to larger systems, single-system designs can be used, for example, to examine the relative effects of different sets of organizational
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