How to evaluate a tailor-made social work intervention?:Some practice-based solutions with single-vase designs

Purpose: With the increased attention to the principles of evidence-based practice (EBP), social workers are challenged to adapt their daily interventions accordingly when treating clients. They usually work with individual clients, all with their own specificities. Single-Case Experimental Designs (SCEDs) can be used to inform a social worker about the effectiveness of an intervention at the individual client level. In everyday social work practice, however, it is difficult to meet methodological requirements of SCEDs to find causal explanations. A concern is that repeated measurements prior to an intervention are required in most situations. This study aims to provide researchers with alternatives to repeated measurement when using the logic of SCED to apply EBP in their everyday practice. Methods: In this study, we reviewed published single-case designs between January 1 and December 31, 2019, on types of SCEDs in the social domain, and how is dealt with baseline conditions. Results: SCEDs and quasi-experimental alternatives are hardly published in situations when baseline data are not available. Four underused quasi-experimental strategies that can be employed when repeated measurement during baseline is not possible are as follows: retrospective baselines, theoretical inference, multiraters, and triangulation with qualitative data. Discussion and Conclusion: The suggestions to work with single-case designs with quasi-experimental elements are meant to enable social workers to evaluate their interventions in a way that enhances mere narrative evaluations of the experiences of an intervention.</p

The developmental progress in social behavior of children with Autism Spectrum Disorder getting music therapy. A multiple case study

Background Music therapy is claimed to have a positive effect on the social behavior of children with Autism Spectrum Disorder (ASD). However, in most studies the target behaviors and the interventions are insufficiently defined and described. Also, it is often doubtful whether accurate research designs were performed to study the intervention to full satisfaction. Objective To answer the question whether the development of social behavior of children with ASD has improved during and after finishing the intervention of the ‘Papageno Music Therapy Program’ (PMTP). Method A multiple case study design was used, with a baseline and intervention phase. Ten children were observed over a period of 23 weeks. The social behavior was rated prior, after 10 weeks and at the end of the therapy by the Questionnaire for the Inventory of Social Behavior of Children (VISK), as well as on a weekly basis by the Social Behavior Questionnaire (SBQ). Results This study shows that during 20 weeks of music therapy sessions the development of the social behavior of children with ASD has accelerated. At least five children had a moderate improvement in the areas of ‘makes eye contact’, ‘is able to focus for five minutes on a game’, ‘is able to cope with changes’, ‘behavior has adapted to the situation’, ‘communicates verbally’, ‘is able to focus on something together’, ‘is able to take another person into account’ and ‘takes initiative’ from the SBQ. The largest progress, with three children showing a strong improvement, was found in the areas of ‘is able to focus on something together’ and 'takes initiative'. The findings on the social behavior were partly confirmed by the VISK scores. Additional statistical analyses of these aspects show a significant trend in the data that indicates growth that may be associated with the intervention phase. Conclusion This study confirms previous studies indicating that during music therapy the social behavior of children with ASD improves, compared to the developmental pace prior to therapy. Although this study was performed with a standardized intervention manual, a thorough description of the target behavior, and a rigor multiple case study design with a baseline and control condition, a larger study, preferably with an alternative intervention offered to a control group, is required to attribute the results more specifically to the PMTP and its elements

Longitudinal network structure and changes of clinical risk and protective factors in a nationwide sample of forensic psychiatric patients

In this study, we investigated network configurations of 14 Clinical risk and protective factors in a sample of 317 male forensic psychiatric patients across two time points: at the time of admission to the forensic psychiatric centers (T1) and at the time of unconditional release (T2). In terms of network structure, the strongest risk edge was between "hostility-violation of terms" at T1, and between "hostility-impulsivity" at T2. "Problem insight-crime responsibility" was the strongest protective edge, and "impulsivity-coping skills" was the strongest between-cluster edge, at both time points, respectively. In terms of strength centrality, "cooperation with treatment" had the highest strength centrality at both measurement occasions. This study expands the risk assessment field toward a better understanding of dynamic relationships between individual clinical risk and protective factors and points to the highly central risk and protective factors, which would be the best for future treatment targets

Predictive validity of the HKT-R risk assessment tool::Two and 5-year violent recidivism in a nationwide sample of Dutch forensic psychiatric patients

This study has examined the predictive validity of the Historical Clinical Future [Historisch Klinisch Toekomst] Revised risk assessment scheme in a cohort of 347 forensic psychiatric patients, which were discharged between 2004 and 2008 from any of 12 highly secure forensic centers in the Netherlands. Predictive validity was measured 2 and 5 years after release. Official reconviction data obtained from the Dutch Ministry of Security and Justice were used as outcome measures. Violent reoffending within 2 and 5 years after discharge was assessed. With regard to violent reoffending, results indicated that the predictive validity of the Historical domain was modest for 2 (area under the curve [AUC] = .75) and 5 (AUC = .74) years. The predictive validity of the Clinical domain was marginal for 2 (admission: AUC = .62; discharge: AUC = .63) and 5 (admission: AUC = .69; discharge: AUC = .62) years after release. The predictive validity of the Future domain was modest (AUC = .71) for 2 years and low for 5 (AUC = .58) years. The total score of the instrument was modest for 2 years (AUC = .78) and marginal for 5 (AUC = .68) years. Finally, the Final Risk Judgment was modest for 2 years (AUC = .78) and marginal for 5 (AUC = .63) years time at risk. It is concluded that this risk assessment instrument appears to be a satisfactory instrument for risk assessment

Influence of music therapy on coping skills and anger management in forensic psychiatric patients: An exploratory study

The effect of music therapy on anger management and coping skills is an innovative subject in the field of forensic psychiatry. This study explores the following research question: Can music therapy treatment contribute to positive changes in coping skills, anger management, and dysfunctional behavior of forensic psychiatric patients? To investigate this question, first a literature review is offered on music therapy and anger management in forensic psychiatry. Then, an explorative study is presented. In the study, a pre- and post-test design was used with a random assignment of patients to either treatment or control condition. Fourteen participants’ complete datasets were collected. All participants received “treatment as usual.” Nine of the participants received a standardized, music therapy anger management program; the five controls received, unplanned, an aggression management program. Results suggested that anger management skills improved for all participants. The improvement of positive coping skills and diminishing of avoidance as a coping skill were measured to show greater changes in music therapy participants. When controlling for the exact number of treatment hours, the outcomes suggested that music therapy might accelerate the process of behavioral changes

Exploring change in children's and art therapists' behavior during ‘Images of Self’, an art therapy program for children diagnosed with Autism Spectrum Disorders:A repeated case study design

(1) Background: ‘Images of Self’ (IOS) is a recently developed and evaluated art therapy program of 15 sessions to reduce difficulties in ‘sense of self’, ‘emotion regulation’, ‘flexibility’, and ‘social behavior’ of children diagnosed with Autism Spectrum Disorders (ASD). In this paper is explored whether change in the child’s behaviors corresponds to the therapist’s actions during IOS and 15 weeks later. (2) Method: In a repeated case study design, twelve children and seven therapists participated. Art therapists monitored their own and the children’s behavior by applying two observation instruments: the OAT (child behavior) and EAT (therapist behavior). Child behaviors during art making were - individually and as a group - compared with therapist actions at three moments during the program. (3) Results: Ten of twelve children showed a substantial or moderate positive behavior change considering all OAT-subscales at the end of the program and fifteen weeks after treatment. Improvement of ‘social behavior’ stood out. Halfway treatment art therapists most prominently showed support of ‘emotion regulation’, ‘flexibility’, and ‘social behavior’. Clear one-on-one relationships between changes in children’s behavior and actions of therapists could not be identified. (4) Conclusion: The study provides new insights in the AT-treatment process by monitoring children’s and therapists’ behavior. The art making itself and the art therapy triangle (child, art making, therapist) offer opportunities to improve verbal and nonverbal communication skills of the child

Exploring change in children's and art therapists' behavior during ‘Images of Self’, an art therapy program for children diagnosed with Autism Spectrum Disorders:A repeated case study design

(1) Background: ‘Images of Self’ (IOS) is a recently developed and evaluated art therapy program of 15 sessions to reduce difficulties in ‘sense of self’, ‘emotion regulation’, ‘flexibility’, and ‘social behavior’ of children diagnosed with Autism Spectrum Disorders (ASD). In this paper is explored whether change in the child’s behaviors corresponds to the therapist’s actions during IOS and 15 weeks later. (2) Method: In a repeated case study design, twelve children and seven therapists participated. Art therapists monitored their own and the children’s behavior by applying two observation instruments: the OAT (child behavior) and EAT (therapist behavior). Child behaviors during art making were - individually and as a group - compared with therapist actions at three moments during the program. (3) Results: Ten of twelve children showed a substantial or moderate positive behavior change considering all OAT-subscales at the end of the program and fifteen weeks after treatment. Improvement of ‘social behavior’ stood out. Halfway treatment art therapists most prominently showed support of ‘emotion regulation’, ‘flexibility’, and ‘social behavior’. Clear one-on-one relationships between changes in children’s behavior and actions of therapists could not be identified. (4) Conclusion: The study provides new insights in the AT-treatment process by monitoring children’s and therapists’ behavior. The art making itself and the art therapy triangle (child, art making, therapist) offer opportunities to improve verbal and nonverbal communication skills of the child