SOCW6311 Creating a Single-System (Subject) Design Study

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Due 03/16/2019

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 a 5- to 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

References

Cocoran, K., & Hozak, N. (2010). Locating assessment instruments. In B. Thyer (Ed.), The handbook of social work research methods (2^nd ed., pp. 65-74). Thousand Oaks, Ca: Sage. (PDF)

Mattaini, M.A.. (2010). Single-system studies. In B. Thyer (Ed.), The handbook of social work research methods (2^nd ed., pp. 241-273). Thousand Oaks, Ca: Sage. (PDF)

Dudley, J. R. (2014). Social work evaluation: Enhancing what we do. (2nd ed.) Chicago, IL: Lyceum Books.

Chapter 9, “Is the Intervention Effective?” (pp. 236-244: Read from “Client Satisfaction & Effectiveness” to “Target Problem Scale”)

Laureate Education (Producer). (2013b). Cortez family [Interactive media]. Retrieved from https://class.waldenu.edu

Plummer, S.-B., Makris, S., & Brocksen S. (Eds.). (2014b). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

Read the following section:

“Social Work Research: Single Subject” (pp. 70–72)

Substance Abuse and Mental Health Services Administration. (2018) Evidence-based practices resource center. Retrieved from https://www.samhsa.gov/ebp-resource-center

https://www.nccpsafety.org/resources/library/samhsa-national-registry-of-evidence-based-programs-and-practices-nrepp

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A Meeting of an Interdisciplinary Team Paula has just been involuntarily hospitalized and placed on the psychiatric unit, for a minimum of 72 hours, for observation. Paula was deemed a suicidal risk after an assessment was completed by the social worker. The social worker observed that Paula appeared to be rapidly decompensating, potentially placing herself and her pregnancy at risk. OB Nurse Dialogue 1 I have not known the patient long, but it does appear that she is trying her best to deal with a very difficult situation. Pregnancies are stressful times for even the healthiest of women. For Paula to learn she is pregnant at 43—in addition to her HIV and Hepatitis status and her bipolar diagnosis—must be so overwhelming. Adding to this, she has come to her two appointments alone and stated she has no one to bring along with her. When I inquired about the father of the child, she said he’s a bad man and he won’t leave her alone. She seemed truly frightened of him and appears convinced he will hurt her. 00:00 Previous 00:43 Next OB Nurse Dialogue 2 Paula is most definitely a high-risk pregnancy, but that does not mean she can’t have a healthy baby. If she keeps up with her HAART medications and comes to her prenatal visits, there’s no reason this baby can’t be born healthy and HIV negative. My larger concern is with the pain medications she takes for her foot ulcers. There is a slight chance the baby will be born addicted to them. We would have to plan for a stay in the NICU if that occurs. While Paula clearly started to decompensate and exhibited some very risky behaviors recently, I think we should try and understand the stress she has been under. While it is not my place to tell the patient what she should do about a pregnancy, I don’t see that we would have to recommend termination. 00:00 Previous 00:52 Next Physician Dialogue 1 Paula is a complicated patient, and she presents with a complicated situation. She is HIV positive, has Hepatitis C, and multiple foot ulcers that can be debilitating at times. Paula has always been inconsistent with her HIV meds— no matter how often I explain the need for consistent compliance in order to maintain her health. Paula has exhibited a lack of insight into her medical conditions and the need to follow instructions. Frankly, I was astonished and frustrated when she stopped her wound care treatments and started to use chamomile tea on her foot ulcers. Even though we have educated her to the negative consequences of stopping her meds, and trying alternative medications instead, she continues to do so. 00:00 Previous 00:47 Next Physician Dialogue 2 As far as her pregnancy, if Paula doesn’t take her HAART medications religiously, she risks having a baby who is HIV positive. I am concerned about how she is going to care for a baby with her multiple medical issues. On the practical side, I wonder how she will physically care for this child. She has a semi-paralyzed right hand and walks with a limp. Additionally, when her foot ulcers flare up, she can barely put pressure on her feet. Newborns take a lot of time and energy, and I am not sure she has the capacity to handle the needs of an infant—let alone a toddler. I have not made any formal recommendations to Paula regarding whether to continue the pregnancy, but I have told Paula that, if she does decide to have the child, she must take her HAART medications every day. I explained that this is vital to her health and the health of her unborn child. 00:00 Previous 00:55 Next
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Running head: CREATING A SINGLE-SYSTEM

Creating a Single-System (Subject) Design Study
Name
Class
Date
Professor

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CREATING A SINGLE-SYSTEM

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Creating a Single-System (Subject) Design Study
The single-system (subject) design study (SSDs) is an effective tool for evaluating
interventions implemented by social workers for their clients. The empirical approach measures
the effectiveness of services the social worker provides to clients, and to guide future practice.
Taking repeated measurement of the target of intervention, in this case Paul Cortex, is an
important element of SSDs. Social workers implement the intervention, establish a timeframe,
establish a baseline, take repeated measurements, and interpret the results (Mattaini, 2010). They
must understand the purpose of single-system (subject) research and the variations of singlesystem (subject) design to meet clients’ needs and monitor results.
The Problem(s) that are the Focus of Treatment
Pala Cortez’s case is complicated. She has both medical and mental health issues. Her
diagnosis is HIV positive, Hepatitis C, bipolar, and she is pregnant (Laureate Education, 2013b).
Paula was recently admitted to the psychiatric unit for observation. After an assessment, Paula
was deemed suicidal and she appeared to be rapidly decompensating (Laureate Education,
2013b). She acks social support and is inconsistent in taking her HART medications which are
needed to prevent a diagnosis of full-blown aids as well as to prevent passing HIV to the fetus.
She has also stopped her wound care preferring the use of holistic medicines, but they are not
working, and her symptoms are worsening.
The OB nurse observed she was overwhelmed with her diagnosis and did not bring
anyone to her appointments. She is 43 years old with a complicated health situation and is
pregnant. Paula is scared of the Father of the baby. The nurse felt compassion for her situation,
but there is concern the baby will be born with HIV if the patient does not take her HART

CREATING A SINGLE-SYSTEM

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medications daily. The physician is less compassionate. His concern is the patients lack
...