Research That Matters (January 17 - 20, 2008)

Purpose: As Social Work moves toward a standard of practice defined by Evidence Based Practices (EBP), it is necessary to further understand how these interventions affect practice. While existing EBP may currently meet specific areas of client needs, there may be other problem areas that require attention. As more EBP are created and used, and these practices become more refined and better understood, will participants be able to have their needs met through multiple EBP? For example, despite documented gains in community tenure and reduced rates of institutionalization, Assertive Community Treatment (ACT) appears to have limited impact on social gains and life satisfaction. Moreover, ACT members have been found to have small social networks excluding their ACT workers. ACT is an EBP and is an individually based intervention that does not typically include group interventions for the clients. The Community Awareness Psychoeducation (CAPE) intervention was tested in combination with an ACT team to address these limitations.

Methods: CAPE is a psychoeducational group intervention that focuses on improving outcomes for participants, specifically decreased loneliness, increased functioning in everyday activities, and increased perception of functioning and coping. All 82 clients of a New York City ACT team were invited by agency staff and through flyers to participate in the CAPE groups. The CAPE groups included 12 sessions with each session lasting approximately one and a half hours. The sessions covered a proscribed psychoeducational curriculum with an emphasis on stress and coping, hope and resilience, and building self and community awareness as well as individual and community supports. Using an experimental design, 22 participants were assigned to either a CAPE group or a comparison waitlist for a future group. Primary outcome variables were social isolation and loneliness, community living skills and awareness of participants' mental health. Secondary outcomes were treatment plan adherence and substance use. Data was collected through the use of measurement scales at pre and post and analyses included descriptive statistics and t-tests. Results: Overall CAPE treatment outcome data suggested significant reductions in loneliness and isolation. Findings showed that the intervention in conjunction with ACT teams led to significantly improved participants' treatment outcomes at post-test, as measured by a reduction in social isolation (t=-4.975, p<.05) and increased scores on work readiness sub-scales (t=2.905, p<.05). Implications: Given the recursive cycles of relapse ACT clients' experience, social workers have struggled to increase positive social support and community integration, which would in turn reduce social isolation and increase community tenure. By combining two EBP, psychoeducation with ACT, it appears that these challenges can be met. The use of multiple or combined EBP may offer a wider range of positive outcomes for social work clients.