EBP Exchange - UMB School of Social Work

Mass trauma is probably as old as civilization and seems to be accelerating because of marked political, geothermal, and population changes. Studying ways of helping to reduce the adverse traumatic impacts on mental health is difficult becuase the events are uncontrolled and the populations difficult to identify and reach. This paper discusses what research has been assembled to provide an evidence base for responding to mass trauma and offers insights into the kinds of data that social workers often need to harness in order to understand best practice in the many activities we conduct in nonclinical and uncontrolled situations.  http://www.nimh.nih.gov/science-news/2008/research-based-principles-may-help-improve-mental-health-recovery-following-mass-trauma.shtml

This very informative presentation begins with two great quotes: “All breakthrough, no follow through” (Woolf) and “Evidence based medicine should be complemented by evidence based implementation” (Grol).  Much of this work involves an update on the work to figure out how to implement evidence supported interventions in health settings.  the presentation also includes a section which seems like a bit of an aside, to me, but is intriguing–Grimshaw (the author) dismisses the “theories of change” model that has become so popular in American human services research [a concern previously raised, persuasively, by Julia Littel with regard to child welfare services].  This is clearly not a definitive treatment of the topic but worth a look.  Unfortunately, there are no references but they do refer you to a Canadian site that includes a great deal of information about implementing best practices in medicine.  The presentation is available at:  http://conferences.thehillgroup.com/conferences/di2007/dayone/01_Grimshaw.pdf

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is treatment used to address the biopsychosocial needs of children experiencing symptoms of post traumatic stress disorder (PTSD) or other internalizing and externalizing problems related to traumatic experiences in their life. Extensive clinical research trials have been conducted with children who have been sexually abused. Results suggest that over 80 percent of children receiving this short term therapy will have significant reduction in post traumatic stress symptomatology, depression, anxiety and other externalizing behaviors. Further, current research demonstrates this treatment is promising with children who are domestic violence survivors.  

Combining both trauma sensitive interventions and cognitive behavioral therapy, children and their parents receive knowledge and skills related to processing the trauma; managing distressing thoughts, feelings, and behaviors; and enhancing safety, parenting skills, and family communication. TF-CBT has been adapted to address the needs unique to Latino(a) populations, people who are hearing impaired/deaf, and for children who are experiencing traumatic grief. Although this therapy can be implemented in community based and private settings, it is contraindicated for children who have psychotic symptomatology and/or extreme conduct problems or risk behaviors. 

To find further information, citations which support this essay, and specific step by step instructions for each of the seven components of TF-CBT, printable scripts for introducing techniques to clients, and streaming video demonstrations of the therapy procedures you may visit www.tfcbt.musc.edu. Access to this website is free; however, you must register with a user name and password. The website is designed so that you can proceed at your own pace and use the learning experiences when it is convenient for you.

School of Social Work Dean Richard Barth recently presented “Findings from the National Survey of Child and Adolescent Well-Being (NSCAW): Clinical Lessons Learned” at the 21st Annual San Diego International Conference on Child and Family Maltreatment.

Click here to view the Dean’s PowerPoint presentation.