Evidence-Based Practice

When the National Family Preservation Network (NFPN) was founded 25 years ago, there were no standards for Evidence-Based Practice.  However, since its inception NFPN has supported evidence-based practice including one of the first child welfare programs demonstrating effectiveness through research: Intensive Family Preservation Services.

What is the definition of Evidence-Based Practice? The gold standard comes from the field of medicine with the Institute of Medicine defining it as:

  • Best Research Evidence
  • Best Clinical Experience
  • Consistent with Family/Client Values

Today all fields, including social work, have adopted standards for Evidence-Based Practice (EBP). More narrowly, the field of child welfare has a searchable registry of EBP available through the California Evidence-Based Clearinghouse for Child Welfare. The Clearinghouse uses a scientific rating scale of 1-5 to determine the level of research evidence and the following is a description of each level:

  • Well-supported by research evidence: Two rigorous randomized controlled trials (RCT), with sustained effect for at least one year post-treatment, and published in peer-reviewed literature
  • Supported by research evidence: One RCT, with sustained effect for at least six months post-treatment, and published in peer-reviewed literature
  • Promising research evidence: One study using a control group and published in peer-reviewed literature
  • Evidence fails to demonstrate effect: Two RCT studies have found the practice has not resulted in improved outcomes and published in peer-reviewed literature
  • Concerning practice: Multiple outcome studies suggest the intervention has a negative effect and/or risk of harm
  • Not able to be rated: Does not meet criteria for any other level and is generally accepted in clinical practice as appropriate and there is no known risk of harm

All ratings also require a written description of the components of the practice protocol and how to administer it, and the program must be replicable. The list of descriptions have been abbreviated; to view the complete descriptions visit http://www.cebc4cw.org/ratings/scientific-rating-scale/

The CEBC was launched in 2006 and has over 40 topic areas with over 300 programs plus a special section for measurement tools.  The complete list of topics is available here: http://www.cebc4cw.org/search/by-topic-area/.  Suppose that  you wish to find evidence-based programs for Trauma Treatment for Children and Adolescents.  Programs, beginning with the top level rating, are listed on one web page to allow a quick review: http://www.cebc4cw.org/topic/trauma-treatment-client-level-interventions-child-adolescent/.  You can then select a specific program to obtain a detailed report.

For a webinar overview of the CEBC, visit: http://www.cebc4cw.org/cebc-webinars/cebc-sponsored-webinars/looking-beyond-the-numbers/.The CEBC is not an exhaustive resource and it is not recommended for use as the sole source of evidence-based practice.

There are other evidence-based clearinghouses such as the National Registry of Evidence-Based Programs and Practices with more than 350 mental health and substance use interventions.  Programs listed must have a random control trial or control/comparison group study published in peer-reviewed literature. Programs are not rated effective or ineffective but are rated on the quality of research. Evidence ratings are based on outcomes. An outcome rating instrument is used to review each program with four levels of outcome ratings: effective, promising, ineffective, and inconclusive.  For example, entering “trauma” into “Find an Intervention” lists all of the reviewed programs and a color-coded rating for each outcome that was tested.

For more information on this registry visit http://www.nrepp.samhsa.gov/landing.aspx.

NFPN recommends checking EBP registries when EBPs are required by government contracts or when considering design and implementation of a new program.  If there is a program listed that could meet the need, it will save you a tremendous amount of time and resources.

Posted by Priscilla Martens

NFPN Executive Director

Q and A

The National Family Preservation Network (NFPN) receives inquiries on a regular basis. Here are some of the most frequent questions….and answers:

How can my agency establish effective family preservation services?

NFPN has conducted six research studies on Intensive Family Preservation Services (IFPS) with all demonstrating its effectiveness. The studies included both placement prevention and reunification services.   NFPN has also conducted three nationwide surveys of IFPS in the past 10 years. The studies and surveys tell us that key characteristics of effective IFPS programs include 24/7 availability of staff, low caseloads (2-4), brief duration (4-6 weeks), intensive services (40 hours or more of face-to-face contact), high rate of keeping families together (90% or higher at case closure), and an annual program evaluation.

A good starting place for developing an effective family preservation program is the IFPS ToolKit: http://www.nfpn.org/preservation/ifps-toolkit

For examples of state RFPs, standards, and annual evaluation reports, visit: http://www.nfpn.org/preservation/state-resources

A fidelity/quality improvement tool, CQI-IFPS Instrument, is available here: http://www.nfpn.org/preservation/cqi-ifps-instrument 

How can I find a reliable and valid assessment tool to meet the requirements of my agency’s government-contracted services?

The California Evidence-Based Clearinghouse for Child Welfare has rated 20 measurement tools. You can view the list of tools and ratings here: http://www.cebc4cw.org/assessment-tools/measurement-tools-highlighted-on-the-cebc/.

The Clearinghouse has given the North Carolina Family Assessment Scale (NCFAS) an “A” rating. The NCFAS scales measure family functioning. NFPN has conducted 6 research projects involving the assessment tools, all of them confirming the reliability and validity of the tools. A summary of research studies on the tools is available here: http://www.nfpn.org/assessment-tools/ncfases-scale-development-report

NFPN most recently released the Trauma/Post-Trauma Well-Being Tool (TWB). Designed for use with either the NCFAS-G or NCFAS-G+R assessment tools, the TWB tool assists workers to identify symptoms and indicators of trauma and the extent of healing following services. Detailed information is available here: http://www.nfpn.org/assessment-tools/trauma-assessment-tool

Is a web-based data entry system available for the assessment tools?

YES!   NFPN has worked with a developer, Integrated Imaging, to design a web database specifically for the NCFAS tools (NCFAS-G, NCFAS-G+R, and TWB). The web database includes demographics, reasons for referral, case plan forms, print/save features, research-caliber reports, and technical assistance.

Take a test drive by participating in a free web database demo scheduled for:

Wednesday, April 12, at 11:30 ET OR

Thursday, April 20, at 4:00 ET

Register by emailing Priscilla Martens, director@nfpn.org

For more details on the web database visit: http://www.nfpn.org/assessment-tools/ncfasgrt-database

Are there any videos or printed materials to train agency staff on father involvement?

NFPN has two videos on father involvement. Each video is part of a training curriculum on father involvement that also includes a manual, training script, handouts, and other resources.

Information on the Basic Fatherhood Training Curriculum Package is available here: http://www.nfpn.org/father-involvement/basic-training-package while information on the Advanced Fatherhood Training Curriculum Package is available here: http://www.nfpn.org/father-involvement/advanced-training-pack

Pricing begins at $150 per training package for up to 25 workers or $275 for both. To order contact Priscilla Martens, director@nfpn.org Note: the fatherhood training is not designed for use with fatherhood groups.

 

Posted by Priscilla Martens, NFPN Executive Director

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