Research That Matters (January 17 - 20, 2008)

Background and Purpose: Increasingly, evidence based practice (EBP) has focused social work practitioners and researchers on the scientific examination and evaluation of the effectiveness of practice. The exponential growth of EBP has progressively affected the ability of social workers to engage in rigorous, scientific, efficacious practice for the betterment of individuals, families, groups, and communities. Fundamental to the success of any intervention is treatment adherence, which remains a significant issue that positively or negatively impacts treatment across all helping professions. While treatment adherence has been investigated for over fifty years in the medical field and other allied professions, the long established contributions of social work have often been overlooked. Increasingly, the profession of social work is investigating the importance and nature of this multifaceted concept. This symposium seeks to critically examine the unique strengths that social work brings to this issue by examining treatment adherence across four research investigations.

Methods: Four studies investigated several critical issues that impact treatment adherence. Each study was conducted by a social work researcher and investigated specific factors and predictors associated with adherence to medical and psychosocial interventions with one of the following population: children and adolescents with severe mental health issues, suicide attempters, persons with alcohol problems, or low income individuals accessing and receiving medical care.

Results: Each of the four studies suggest that success in treatment is inextricably linked with the development and implementation of interventions geared to improving participation and retention in treatment While similarities may exist in treatment adherence factors and predictors across studies, understanding the distinct factors associated with the populations and treatments can contribute most to efforts aimed at improving adherence. The profession of social work is uniquely positioned to identify, investigate and intervene to effectively address issues of treatment adherence.

Conclusions and Implications: Social workers should target both specific and general predictors of treatment adherence in the delivery of interventions and programs, including both individual-level and community level factors. Equally important is the provision of education and services that promote adherence, as well as the identification and monitoring of factors that may influence adherence rates. Clearly, it is important for health care professions, such as social work, to provide clinical treatment and services to individuals, families, groups and communities, but to do so without attention to adherence issues may significantly undermine our effectiveness. Social workers need to continue to add their unique perspective to the growing body of scientific literature on factors associated with treatment adherence.