Bina Rena, Barak Adi, Posmontier Barbara, Glasser Saralee, Cinamon Tali
The Louis & Gabi Weisfeld, School of Social Work, Bar Ilan University, Ramat Gan, Israel.
College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA.
Health Soc Care Community. 2018 Jan;26(1):e75-e84. doi: 10.1111/hsc.12479. Epub 2017 Jul 20.
Research on evidence-based practice (EBP) implementation in social work often neglects to include evaluation of application barriers. This qualitative study examined social workers' perspectives of provider- and organisational-related barriers to implementing a brief eight-session interpersonal therapy (IPT) intervention, a time-limited EBP that addresses reducing depressive symptoms and improving interpersonal functioning. Implementation took place in a primary care setting in Israel and was aimed at treating women who have postpartum depression (PPD) symptoms. Using purposeful sampling, 25 primary care licensed social workers were interviewed between IPT training and implementation regarding their perceived barriers to implementing IPT in practice. Data analysis was facilitated using a phenomenological approach, which entails identifying the shared themes and shared experiences of research participants regarding barriers to implementing IPT. Three themes emerged from the analysis of interviews: Perceived lack of flexibility of IPT intervention in comparison with more familiar methods social workers previously applied, specifically regarding the number of sessions and therapeutic topics included in the IPT protocol; insecurity and hesitance to gain experience with a new method of intervention; and organisational barriers, including difficulties with referrals, the perception of HMOs as health facilities not suitable for therapy, and time constraints. Addressing perceived barriers of social workers toward implementing EBPs, such as IPT for postpartum depression, during the training phase is crucial for enabling appropriate implementation. Future training should include examining practitioners' attitudes toward implementation of EBPs, as part of standardised training protocols.
社会工作中基于证据的实践(EBP)实施的研究往往忽视对应用障碍的评估。这项定性研究考察了社会工作者对实施为期八节的简短人际治疗(IPT)干预措施时与提供者及组织相关障碍的看法,IPT是一种限时的EBP,旨在减轻抑郁症状并改善人际功能。该实施在以色列的一个初级保健机构进行,目标是治疗有产后抑郁症(PPD)症状的女性。采用目的抽样法,在IPT培训和实施期间,对25名持有初级保健执照的社会工作者进行了访谈,询问他们在实践中实施IPT时所察觉到的障碍。使用现象学方法促进数据分析,该方法需要识别研究参与者关于实施IPT障碍的共同主题和共同经历。访谈分析得出了三个主题:与社会工作者之前应用的更熟悉的方法相比,IPT干预措施缺乏灵活性,特别是在IPT方案中的节数和治疗主题方面;对采用新的干预方法缺乏安全感和犹豫;以及组织障碍,包括转诊困难、将健康维护组织(HMO)视为不适合治疗的医疗机构,以及时间限制。在培训阶段解决社会工作者对实施EBP(如针对产后抑郁症的IPT)所察觉到的障碍,对于实现适当实施至关重要。未来的培训应包括将检查从业者对实施EBP的态度作为标准化培训方案的一部分。