Creating A Single-System (Subject) Design Study
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 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
SOCIAL WORK CASE STUDIES: CONCENTRATION YEAR
Social Work Research:
Chris is a social worker in a geriatric case management program
located in a midsize Northeastern town. She has an MSW and is
part of a team of case managers that likes to continuously improve
on its practice. The team is currently using an approach that inte-
grates elements of geriatric case management with short-term
treatment methods, particularly the solution-focused and task-
centered models. As part of their ongoing practice, the team regu-
larly conducts practice evaluations. It has participated in larger
scale research projects in the past.
The agency is fairly small (three full-time and two part-time
social work case managers) and is one of several providers in
a region of approximately 50,000 inhabitants. Strengths of the
agency include a strong professional network and good reputation
in the local community as well as the team of experienced social
workers. Staff turnover has been almost nonexistent for the past
3 years. The agency serves about 60–70 clients at any given time.
The clients assisted by the case management program are older
adults, ranging from their early 60s to over 100 years of age, as
well as their caregivers.
To evaluate its practice approach, the team has decided to use
a multiple-baseline, single-subject design. Each of the full-time
case managers will select one client new to the caseload to partici-
pate in the study. The research project is explained to clients by
the respective case manager and informed consent to participate
George was identified by Chris as a potential candidate for the
evaluation. As a former science teacher who loved to do research
himself, he agreed to participate in the project. George is 87 years
old, and although he is not as physically robust as he once was, at
5 feet 9 inches tall, he has a strong presence. He has consistent
back pain and occasional flare-ups of rheumatoid arthritis. His
wife of 45 years passed away two summers ago after a long fight
with cancer. After his initial grief, he has managed fairly well to
adapt to life on his own. George entered the program after being
hospitalized for fainting while at the grocery store. A battery of
medical tests was conducted, but no specific cause of his fainting
attack could be found. However, the physicians assessed signs of
slight cognitive impairments/dementia and suggested a geriatric
case management program.
An initial assessment by the case manager showed the need for
assistance in the following areas: 1) personal care, 2) decrease in
mobility, and 3) longer-term planning around living arrangement
and home safety. The case manager also thought that George
could benefit from setting up advance directives, which he did not
want to discuss at that time. They agreed that the case manager
could bring this topic up again in the future.
As part of the practice process, the case manager used clini cal
rating scales that were adapted from the task-centered model.
At the beginning of each client contact, case manager and client
collaboratively evaluated how well the practice steps (tasks) under-
taken by client and/or case manager were completed using a
10-point clinical scale. Concurrently, they evaluated changes
to the respective client problems, also using a 10-point clinical
scale. George was able to actively participate in the planning and
implementation of most care-related decisions. During the course
of their collaborative work, most needs were at least partially
addressed. Two tasks were completed regarding personal care,
two regarding mobility, and three addressing home safety issues.
Only personal mobility was still a minor problem and required
some additional work.
SOCIAL WORK CASE STUDIES: CONCENTRATION YEAR
After finishing the reassessment at 3 months, Chris completed
gathering and evaluating the data for the single-subject design
(SSD). As promised, she also provided George with the finished
SSD findings. The following is an overview of the data that was
collected for this case:
TABLE 1. TASK COMPLETION SCORES
WEEK: 1 2 3 4 5 6 7
Mobility 2 N/A 10
10 10 10
TABLE 2. PROBLEM CHANGE SCORES
WEEK: 1 2 3 4 5 6 7
3 3 8 5 8 9 9
Mobility 5 5 2 5 7 7 7
4 4 4 9 10 10 10