{"id":413,"date":"2024-02-05T00:23:16","date_gmt":"2024-02-05T00:23:16","guid":{"rendered":"https:\/\/swpro.org\/amymejias\/?page_id=413"},"modified":"2024-07-27T21:50:14","modified_gmt":"2024-07-27T21:50:14","slug":"course-evidence-for-practice-behavior-8-2","status":"publish","type":"page","link":"https:\/\/swpro.org\/amymejias\/competencies\/competency-8-intervene-with-individuals-families-groups-organizations-and-communities\/course-evidence-for-practice-behavior-8-2\/","title":{"rendered":"Course Evidence for Practice Behavior 8.2"},"content":{"rendered":"

Integrate MACRO-LEVEL evidence-based strategies with organizations and\/or communities<\/span><\/h3>\n

Below is an excerpt from “Empowering Change: Addressing Homelessness, Unemployment, and Substance Abuse Among Women in Hamilton County” by Connie Bradshaw, Kaitlyn Deaux, Madison Griswold, and Amy Mejias for <\/span>SOCW 612: Advanced Administrative Practice: Program Development, representing our examination of macro evidence-based practices. We used the social work knowledge<\/strong> and skills<\/strong> of needs assessment<\/strong> and program planning<\/strong> and development<\/strong>, as well as the social work value<\/strong> of service<\/strong>.\u00a0 The cognitive process<\/strong>\u00a0used were evaluating<\/strong> \u00a0and the affective process<\/strong> used was organization.\u00a0 <\/strong>The theoretical framework<\/strong> used was systems theory<\/strong>, which is focused on how all aspects of different systems are connected, including when it comes to social issues such as homelessness.\u00a0<\/span><\/p>\n

The full paper can be viewed here<\/a>.<\/p>\n

______________________________________________________________________<\/p>\n

Evidence-Based Practices<\/b><\/p>\n

Housing First Model<\/b><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 <\/span>Housing First is a homeless housing solution program that has existed since 1992 <\/span>(Padgett et al., <\/span>2016).\u00a0 The National Alliance to End Homelessness mentions that Housing First aims to provide permanent housing for the homeless but \u201c…does not require people experiencing homelessness to address all of their problems including behavioral health problems, or to graduate through a series of services programs before they can access housing\u201d.\u00a0 It continues to say that they offer supportive services to homeless individuals using the program, but that participation is not required (2022).<\/span>\u00a0\u00a0<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0A study from Canada on homeless women who had mental health issues, including substance abuse issues, being housed with Housing First showed that a high percentage, which was 75%, remained stably housed at a 24-month follow-up.\u00a0 However, despite being stably housed, this study did not show improvement regarding the individual impact on health and social outcomes, more than likely due to the lack of required treatments and services (O\u2019Campo et al., 2023).<\/span><\/p>\n

Permanent Supportive Housing<\/b><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0The National Alliance to End Homelessness (2016) states that Permanent Supportive Housing is \u201c…affordable housing assistance with voluntary support services to address the needs of chronically homeless people.\u201d\u00a0 A study by Dickson-Gomez et al. (2021) examined the different models of Permanent Supportive Housing and found little evidence that these models lead to improving mental health and substance abuse outcomes.\u00a0<\/span><\/p>\n

Evidence-Based Practice for Substance Abuse<\/b><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0<\/span>Research shows incentives as being an option to motivate those experiencing substance abuse to discontinue their usage. A study from 2003, which still has relevance because there is no recent research that could be found on incentives, examined voucher programs as incentives for managing cocaine dependence. With a voucher program, the patients receive vouchers that they can use for retail items if they meet therapeutic targets, such as passing drug screenings showing they have been abstaining from substances. This article mentioned that a study conducted by the University of Vermont showed a high retention rate and abstinence when implementing the voucher program with counseling, compared to those just being treated with counseling alone. The article mentioned that other studies yielded similar results (Higgins et al., 2003).\u00a0\u00a0<\/span><\/p>\n

Pay For Performance Programs<\/b><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 A study by Shepherd et al. (2006) focused on a \u201cpay for performance\u201d model of incentives but in this case for the counselors within substance abuse programs. In their controlled study, counselors were incentivized by their patients’ attendance in twelve counseling sessions. The probability of the patients completing five sessions was 59% compared to 33% when the counselors were not incentivized. The study also showed that when they were incentivized with $100 instead of $50, client retention also improved (Shepherd et al., 2006).<\/span><\/p>\n

Substance Abuse and Employment Treatment Programs<\/b><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Supported employment programs were initially designed for individuals with severe mental health disorders to find competitive employment (IPS Employment Center, n.d.). Individual Placement and Support (IPS) is an evidence-based version of supported employment whose principles include competitive employment, systematic job development, rapid job search, integrated services, benefits planning, zero exclusion, time-unlimited support, and worker preferences (IPS Employment Center, n.d.). IPS and supported employment studies have expanded to consider their effectiveness among individuals with substance abuse disorders. Lones et al. (2017) explored IPS for methadone maintenance therapy patients during a 12-month randomized clinical trial where 45 patients receiving treatment for moderate to severe opioid use disorder were placed in an IPS program or on a 6-month waitlist in Portland, Oregon. Results revealed that within 6 months, participants of the running IPS program were 11.0 times more likely to have a job and, within 12 months, were 2.6 times more likely to have employment than the waitlisted group (Lones et al., 2017). The waitlisted group had one individual employed within 6 months and 5 individuals employed at month 12 (Lones et al., 2017). While this study offered insight into the benefits of combining supported employment with substance abuse treatment, it was only a pilot study and will need to be repeated and expanded upon in larger studies to determine its effectiveness.\u00a0<\/span><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0Another evidence-based model of supported employment is Integrated Dual Disorder Treatment (IDDT), which combines substance abuse and mental health services to assist clients with comorbid disorders (Center for Evidence-Based Practices, n.d.). Beimers et al. (2010) studied 113 patients enrolled in IDDT programs in Ohio and collected data regarding their demographic and socioeconomic status, mental health and substance use, overall life functioning, work history and interest, and unemployment service use for twelve months. The researchers found that over 69% of clients with a substance abuse disorder became employed; over 85% of employed clients had used supported employment services for 30 minutes for one month or more (Beimers et al., 2010). This statistic provided promising support for evidence-based supported employment programs. Unfortunately, the researchers also documented that 43.4% of patients were employed for two months or less (Beimers et al., 2010). Further research is needed to determine the potential causes of this change and solutions for employment maintenance.<\/span><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Moreover, other study outcomes do not support using supported employment programs with unemployed individuals experiencing substance abuse. Another study by Frounfelker et al. (2011) explored enrollment in supported employment among clients with comorbid disorders. Utilizing SPSS, Frounfelker et al. (2011) compared demographic and clinical information and employment services engagement between clients at a psychiatric rehabilitation center in Chicago who use substances and those who do not. The 595 clients with a co-occurring substance use disorder were more likely to be homeless at admission and 52% less likely to be engaged in supported employment despite high interest (Frounfelker et al., 2011). If the client was homeless at admission, they were 79% less likely to be engaged in supported employment (Frounfelker et al., 2011). Although the researchers offered potential explanations for the lack of enrollment in supported employment by clients with substance use disorder, further research is needed to determine the cause.\u00a0<\/span><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0The information gleaned from the literature review will be considered in planning what the proposed program should include and which routes should be taken to accomplish the goal of helping clients with their homelessness, substance abuse issues, and joblessness. As an example, in beginning research and finding articles stating that Housing First was the evidence-based way to end homelessness, it seemed probable that the proposed program focus might need to change.\u00a0 However, after researching that various homeless programs were unsuccessful in improving substance abuse issues, it was confirmed that the original proposed program plan was appropriate.\u00a0 This is just one example of how to incorporate the research learnings in properly planning and implementing the proposed program.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Integrate MACRO-LEVEL evidence-based strategies with organizations and\/or communities Below is an excerpt from “Empowering Change: Addressing Homelessness, Unemployment, and Substance Abuse Among Women in Hamilton County” by Connie Bradshaw, Kaitlyn Deaux, Madison Griswold, and Amy Mejias for SOCW 612: Advanced … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":855,"featured_media":0,"parent":56,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"class_list":["post-413","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/pages\/413","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/users\/855"}],"replies":[{"embeddable":true,"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/comments?post=413"}],"version-history":[{"count":8,"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/pages\/413\/revisions"}],"predecessor-version":[{"id":903,"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/pages\/413\/revisions\/903"}],"up":[{"embeddable":true,"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/pages\/56"}],"wp:attachment":[{"href":"https:\/\/swpro.org\/amymejias\/wp-json\/wp\/v2\/media?parent=413"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}