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SW34010010 Kenneth Yeager 828 Lecture One Advocacy is what makes social work unique PTSD scores ICU nurses scored higher than Koreanera Vietnamera amp other war veterans 75 80 of people with substance abuse also have mental health issues when you figure out what you want to be and you do it you stop growing Get Bachelors take test for LSW Get Masters take test for LlSW Many professors in the Masters program will teach theoretical SW Get teachers who teach practical SW If you re any good at all you will end up being a supervisor If you re in SW you are in health care Goal for this class is to mesh practice and technology so that they make sense ASSIGNMENTS Onepage due week after next includes area of interest what to this date is my source of knowledge for this topic How do I know what I know Where would I look for new knowledge Where would I go for new knowledge Set up your Refworks account Annotated Bibliography 6 10 page paper doublespaced use bibliography topic is area of interest mentioned in first day of class Sometimes you are happier on the journey than by the time you get there About papers the references you put in validate your point of view Most people gravitate toward the news that reinforces their belief system rather than what challenges them Oh shit Where is Mr Smith SW34010010 Kenneth Yeager History amp Stages of EvidenceBased Practice We need to marry science and practice all major health practices use evidence based practice not all disciplines gravitated to it rapidly though What is the evidencebased process 1 Formulate a question 2 Search for Answers 3 AppraiseJudge the Evidence 4 Applying the Evidence a applying the research with consideration for the what the individual would like to have 5 Assessing the Outcome Do the readings that the syllabus has posted Third weeks readings and fourth weeks readings are accurate Weeks 5 14 are not set in stone Weeks twos reading will be posted 94 Lecture two ASK THE QUESTION you need a good question specific problems risks treatments tests desired outcome ACQUIRE THE EVIDENCE How to do a good literature review coming later this semester a good literature review starts with coming up with key words a lot of control over how to find the best research words has been lost through the use of Google real research is not able to use Googletype questionswording APPRAISE THE EVIDENCE How to think critically is the researchresult valid is the researchresult applicable to this case your client may have specific issues that have never been studied through they eyes of certain treatment methods APPLY how to blend research and clinical expertise ASSESS THE OUTCOMES SW34010010 Kenneth Yeager selfevaluation needs to be at least as critical as your efforts to appraise the evidence yes it is and should be a neverending cycle From Evidence to Practice there is a substantial difference between evidence and practice many times the treatment methods being practiced are not based upon the most resent and validated research found why do you believe that is information overload it is hard to make systemic changes to large organizations taking bureaucracy and red tape out of it individual practitioners do not have the motivation to make these changes not enough time to do all the research necessary millions literally millions of articles contradictory results found in seemingly validated research findings why different experiencesworldviews of clinicians research design method etc who was included in the study how was the research gathered small number study did not include enough patients to be substantially validated error uncritical acceptance the opposite of blending research and clinical expertise amp often does not result in the consideration of patientclient Early Intervention for Trauma when after a school shootingother traumatic event counselors go into the school soon after the event and set up counseling sessions for the students what they found was comparing students who had the immediate counseling versus those who did not there were not differences several years after the incident between the two kinds of people what they found was it canhas been more harmful to some kinds of people ie introverts forcing introverts to face issues without giving them time to process it caused greater harm to them 5 10 years after the traumatic event certain kinds of people who are more susceptible to traumatic events SW34010010 Kenneth Yeager for these people the attention caused by the debriefing solidified the event and made it more prominent and more traumatic being forced to process the event made people more traumatized by the actual event this doesn t show that it doesn t work for some people only that it is harmful for some kinds of people What can prevalence and incidence tell us about the context in which a problem exists What can prevalence and incidence tell us about how to intervene if something has a really high incidence rate then research can tell you when to intervene if there is a flatline incidence rate you would focus your attention there What can prevalence and incidence tell us about how to evaluate interventions if you re slowing down the incidence rate you should start saying I m going to take credit for the suicide rate going down if you re focusing on prevalence you would focus on that number going lower outcome setting how are you going to know that what you are doing is working conditions dictate much of this What is etiology cause in social work as should in most if not all fields it considers social factors environmental factors genetic factors etc What can etiology tell us about the context in which a problem exists knowing the cause gets you halfway there now you just need to know your options of how to intervene What can etiology tell us about how to intervene what areas of a person s life can we change if not age and gender possibly socioeconomic status focus on what you can change not what has already happened and you cannot changeeffect What can etiology tell us about how to evaluate interventions accepted way of saying look I can show you data that shows you how we have moved the needle on parenting styles SUICIDAL IDEATION AND SUICIDE ATTEMPTS IN CHILDREN AND ADOLESCENTS WITH BIPOLAR DISORDER what did they discover from this research SI suicidal ideation more likely to be caucasian SI more likely to be younger 105 vs 136 SA suicidal attempts associated with earlier illness onset SA associated with past physicalsexual abuse SW34010010 Kenneth Yeager concluded importance on early illness identification with depressed adolescents search for similar instances find reasons why young children are depressed concluded importance of specific assessment for suicide risk noted lack of studies focusing on issue not a lot of research on the link between bipolar disorder and suicidal ideationattempts noted lack of studies focusing on protective factors protective factors are as equally important as risk factors if not more important protective factors mitigate risk factors what are unique factors in a person s life that help them not become part of a certain statistics protective factors are harder to study they include resiliency religious views parental skills personality community support familial support noting two people who grew up with similar backgrounds but are taking separate routes in life the difference can most often be attributed to differences in protective factors Additional takeaways How did they do their literature review the actual search for their article that they did keywords used childhood children child adolescence adolescent pediatric youth bipolar mania suicid suicidal ideation selfharm selfinjur overdose wish to be dead die statistics regression analysis What are regression analyses linear multiple factorial etc estimating relationships between variablesessentially how much of a difference appears to be associated with X what is the likelihood that cause A will bring about effect A BOTTOM LINE purpose is generally predictive in nature CHILDHOOD MALTREATMENT AND PROSPECTIVELY OBSERVED QUALITY OF EARLY CARE AS PREDICTORS OF ANTISOCIAL PERSONALITY DISORDER FEATURES Overview looking for antisocial personality disorders in young children things that would show up when they are 20 years old they knew abuse histories by following families for 20 years what was the quality of their living environments SW34010010 Kenneth Yeager which one of these things was really the reason for antisocial personality disorder developing What did they discover abuse before age 18 years participants referred in infancy early clinical risk basically if the family was referred for some kind of service before the child was 18 months old they were much more likely to develop antisocial personality disorder this is a faulty find as there are many ways to approach this data comorbidity of substance abuse comorbidity two things happening at the same time comorbidity with major depression early clinical risk remained significant when substance abuse and major depression are controlled interesting childhood abuse did not when they say we controlled for something it basically means they removed it from the equation this means that when substance abuse and major depression were removed from the equation early childhood referral remained in the case this means that substance abuse and major depression alone were not able to be noted as singular causes of antisocial personality disorder Additional takeaways small N of individuals meeting ASPD diagnostic criteria so reporting is actually focused on a continuous measure of extent of ASPD features why is this important disentangling components of the environment is key in truly understanding etiology How research approaches addresses considers controls for etc associated variables is primarily rooted in the theoretical lens the problems is being viewed through medical model attachment theory evolutionary psychology genetics chemical imbalances substance abuse poor parenting poveny culture resmence etc SW34010010 Kenneth Yeager Every clinicianresearcheracademic field has something that guides their frame of reference You need to be aware of this in order to determine what is bias and what is truly statistically accurate and valid research Academic group think can be very prominent And very treacherous of course MATERNAL LIFETIME DEPRESSIVEANXIETY DISORDERS AND CHILDREN S INTERNALIZING SYMPTOMS Overview internalized symptoms rather than outward expressions of depressiveanxiety disorders a notecaveat small N of depressive and anxiety disorders in 6 11 year olds so reporting is actually focused on a continuous measure of extent of internalizing symptoms Go back and review their results and discussion sections specifically consider how they approached selecting and relating variables and attempting to control variables to identify root causes 918 Evidence Treatment Based Plans Individualized TreatmentMatching failure to document is malpractice Clinician ability to establish supportive therapeutic relationship was the ONLY STANDING key factor in determining the effectiveness of a therapeutic method The first steps to gaining a reliant and supportive relationship with a client is introducing yourself and building a relationship THERAPEUTIC RELATIONSHIPS ARE THE KEY TO SUCCESSFUL HELPING A CLIENT Therapeutic recapitulation of the primary family unlearning all the wrong rules that your family taught you screaming during arguments the louder person is heard and wins getting to know a client s family is important because client lie Early Engagment Program Participation Therapeutic Relationship Early Recovery Behavioral Change Psychosocial Change Assess readiness for treatment SW34010010 Kenneth Yeager hook them up with program therapeutic relationship cognitive change behavioral change out of this with adequate stay in treatment you get the outcome you want except when you don t get the outcome you want THERE S NO SUCH THING AS GOOD PHYSICAL HEALTH WITHOUT GOOD MENTAL HEALTH THERE S NO SUCH THING AS GOOD PHYSICAL HEALTH WITHOUT GOOD MENTAL HEALTH Treatment plan 1 Goal what you hope to accomplish 2 Objectives things that are designed to help you meet your goal 1 need to be measurable realistic and attainable 2 provide at least two objectives FOUR S APPROACH internet mental health website the cochrane library medline Education shapes your mind It you are equipped with the tools and you don t understand the research language While some time reading the plain language summary and reading the research language alongside it will prepare you to become a professional and for the Master s program 925 Speaking about the new life habits we are doing As social workers we will be taking things away from people constantly This exercise is to help us understand the process of losing something so that we better understand what we are asking our clients to do Primary process thinking and secondary process thinking Women learn this much faster than men SW34010010 Kenneth Yeager Learning social skills is learning secondary process thinking MIDTERM Due October 30 Email assignment to yeager5osuedu BEFORE MIDNIGHT Put NEWARK CLASS MIDTERM in subject line of email Because that is the night before Halloween and trick or treating is that night if you have kids that you need to be with for Halloween just email Yeager and he will excuse you from class He said that family is very important to him and he never wants to interfere with you spending time with your family He said this to the entire class Assignment for midterm Annotated Bibliography you are to search topics in one of three domains related to your topic Practice dealing with resistance practice special population approach eg abstinence vs nonabstinence based Theory role of spirituality in recovery theory basis comparing DSMIVR and DSMV or Policy public assistance dependent on drug screening payment for substance abuse treatment legalization of marijuana Within your selected domain you are to conduct a literature search and provide evidence informed sources outlining the current best practice and emerging knowledge and or conceptual frameworks Your literature review this is what the assignment is called will include the following Introduction Clearly articulate why you selected this topic and why this is of importance 1 paragraph this is the ONLY part of the paper that can be submitted in first person General Overview Describe the background and significance of your selected topic 1 3 paragraphs locally or nationally or worldwide why is this an important topic Who says so Data Sources include Journal articles books web pages expert consensus groups briefs and expert based reports must have a minimum of five resources this is the RefWorks section do not use newspapers or periodicals Newsweek these are secondary sources of evidence and cannot be used SW34010010 Kenneth Yeager they only quote and are frequently biased they are written for human interest and not for science this class is for science Conclusion The conclusion of your bibliography should outline the maior findings address the strengths and weaknesses of the evidence and make clear concise recommendations for further study implementation strategies or next steps Evaluation of Work You work will be evaluated by peers and the instructor each class member will review two bibliographies you will need to bring 3 printed copies to class and complete the bibliography evaluation sheet to be returned to the next class An introduction tell the reader what you are going to tell them Body tell the reader what you are telling them Conclusion tell the reader what you told them How to narrow topic for paper google terms and find the correct terms to use find big names involved with topic Peer Review Bring 3 copies of rough draft of paper next week for peer review PAY ATTENTION TO WHAT SOURCES YOU USE HE WILL GRADE YOU BASED UPON THESE STEPS FOR MAKING BIBLIOGRAPHY put Introduction General Overview Data Sources Conclusion Evaluation of Sources in bold titles before each section 1 Cover Page a no APA crap b no running headers etc 2 Introduction a describe why the information is important SW34010010 Kenneth Yeager 3 General Overview a b 1 3 paragraphs who else thinks this information is important You will provide sufficient detail as to why this is important include statistics 4 Data Sources a Go to university libraries homepage i right side select full text and article and narrow it by year only do recent relevant articles ii find articles and export to RefWorks account 1 this was slightly complicated so you could ask him to show you next class there s a good chance we ll do it again in class sometime iii go to list on refworks 1 open files and see all the articles you selected 2 to create bibliography a click create bibliography b chose APA 5th Annotated with Abstracts c click create bibliography d copy and paste sources to data sources section of paper 3 make sure to edit bibliography 5 Conclusion a b c d give important information major findings strengths and weaknesses of the evidence and recommendations he will deduct for different fonts and different font sizes he prefers Times New Roman 12 pt 1 3 paragraphs for conclusion 1002 How to find if an article is relevant or not look at doubleblind studies these are almost always reliable definitely more reliable than other studies HOW TO CRITICALLY APPRAISE AN ARTICLE must be able to select and appraise scientific literature CRITICALLY APPRAISING assess validity of data completeness of reporting methods and procedures conclusions compliance with ethical standards etc validity of data two kinds of validity SW34010010 Kenneth Yeager face validity does the data you re looking at actually say what it appears to be saying or are you fooled content validity did we do it right did we add this up right did we include all the variables of everything we know about this study is it complete are the conclusions clear TEN QUESTIONS TO ASK WHEN CRITICALLY APPRAISING A RESEARCH ARTICLE is the study question relevant does the study add anything new is there new research what type of research question is being asked is it a hypothesis a review about harm diagnosis was the study design appropriate for the research question if you re studying something that talks about prognosis or harm does it have the same relevant format that we discussed in class did the study methods address the most important potential sources of bias you will find this at the end in good studies you will find the strengths and weaknesses of the study it is usually in the weaknesses that you will find the bias of the study Was the study performed according to the original protocol was there deviation was the reason for the deviation stated does the study test a stated hypothesis were the statistical analyses performed correctly do the data justify the conclusions are there any conflicts of interest Data sets THE NORMAL DISTRIBUTION Properties bellshaped curve a symmetric unimodal with a mean of O y 50 of data fall on either side of the mean a 6826 fall within one SD 95 within 2 SD randomized sampling is not good because someone always gets left out it s no longer scientific as much as it is left up to chance What s under the curve Displaying Data Badly some rules for displaying data badly display as little information as possible SW34010010 Statistic Kenneth Yeager obscure what you do show with chart junk use pseudo3d and color gratuitously make a pie chart preferably in color and 3d use a poorly chosen scale s a this is a pure statistics week one of the statistics that we ll look at is the mean which is stats speak for the average you ve probably been thinking about this and working with it since you were a child a it will be pretty intuitive but we ll be comparing it to the median which you learned earlier in this class and that may not be intuitive at all a the second is the standard deviation the most common measure of the variability of data a this is a statistic that you ve probably had at some point but you probably haven t thought much about we ll think a lot about the implications of variability it s important both in research and in lite tinally we ll be talking about some statistics that you can use with categorical data variables like OB a BA gendenuu tinally we ll be talking about some statistics that you can sue iwth categorical data variables JECTIVES have a basic understanding of measures of centrality have a basic understanding of the way in which these statistics apply to social work and life CKGROUND most of you have probably been thinking about the mean and proportion since you were ten or so but you ve probably almost never thought about any measure of spread variability so we re including a bunch of thought activities that effectively look at spread in your life a this is actually an issue that you deal with constantly but you ve probably not thought about it quite this way a would you rather a friend who consistently made appointments or one who sometimes made them and sometimes missed them one who was always on time or one who was sometimes early and sometimes late why a how about a doctor s ottice how long do you keep this person as a friend friends you like are ones who are predictable reliable accountable these are all statistical terms l have been doing it my entire life wout tully realizing it Insurance Talk people with highend insurance most often keep their appointments people with lowend insurance most often losecancel their appointments we keep track of payer mix who shows up and who doesn t and we fill our clinics according to payer mix SW34010010 Kenneth Yeager up until 1998 you could put a person in a psych hospital and the average length of stay was 30 days a in 1998 there was a young lady named Errisa Duke Medical Center had intensely bad set of lungs got lung transplant antirejection medication the only one that Errisa could take was 1200 a pill and she had to take them the rest of her life the insurance company said that they could not pay this a law was passed that gave insurance companies the right to cap payments Insurance companies are able to dictate what they choose to pay for The mean in mental hospitals went from 30 days to 35 days 20 of addiction treatment centers and 20 of mental health centers closed a adult mental health appointment wait for initial visit is about 35 months but possibly longer What s the relationship between standard deviation and predictability standard deviation on the curve graph want small variation is you prefer predictability and stability LEVELS OF MEASUREMENT Interval category distance has meaning IQ score can calculate mean standard deviation Ordinal more or less groupings satisfaction or agreement high medium low education high school some college colelge quantitaive GET REST FROM SLIDE QUANTITATIVE DATA Descriptive standard deviation the statistical measure of the amount by which a set of values differs from the mean MOTIVATIONAL INTERVIEWING DARN v Desire Ability Reason Need CAT v Commitment intention decision readiness Activation ready prepared willing Taking steps a when you re working with people it is easy to get wrapped up in their drama SW34010010 Kenneth Yeager 1023 MEASUREMENT THEORY need to familiarize with terms this will be used in practice Scaling Core Ideas Validity how do you know what you are really measuring and what you think you are measuring Reliability are you measuring it fairly and equally The Theory of Measurement the process of observing and recording the observations you are collecting as part of a research e on validity are you measuring what you think you are measuring threats to measurement validity reliability and measurement error levels of measurement Construct Validity more than just measurement validity the approximate truth of a conclusion that your operationlization accurately reflects its constructs are you actually measuring what you think you are measuring is your operationalization an accurate translation of the construct does your programtreatment accurately reflect what you intended does your sample accurately represent your idea of the population of the interest are you measuring what you intended to measure Measurement Validity Types Construct Validity Translation Validity focuses on whether the operationalization ie measure is a good translation of the construct face validity are you measuring what you think you are measuring on its face does the operationalization look like a good translation of the content content validity do your measurements accurately portray what you are measuring operationalization is checked against the relevant content domain for the construct SW34010010 Kenneth Yeager may be difficult to determine all of the characteristics that constitute domain a systematic check of the operationalization against the content domain increases rigor Criterionrelated validity the performance of your operationalization ie measure is checked against come criterion predictive validity researchers ability to predict something it should theoretically be able to predict demonstrated by a high correlation between your measure and the criterion measure eg ls SAT score able to predict success in college ie college gpa concurrent validity research s ability to distinguish between groups it should theoretically be able to distinguish between results are more powerful if your measure is able to distinguish between two similar groups eg can a measure of empowerment distinguish between supervisors and employees randomized control study applies to this group that didn t get intervention first time does get it the second time while the group that did get the intervention the first time does not get the intervention the second time convergent validity degree to which the research is similar to converges on other research to which it theoretically should be similar demonstrated by high correlation of your measure with another measure of the same construct discriminant validity degree to which the research is not similar to diverges from other research to which it theoretically should not be similar demonstrated by low correlation of your measure with a measure of a theoretically opposite or dissimilar construct eg is there a low correlation between your measure of depression and a measure of wellbeing drug studies using sugar pills placebos and real medicine The Idea of Construct Validity theory what you think cause construct leads to what you think effect construct which leads to SEE REST OF SLIDE Threats to Construct Validity Interaction of different treatments could be a combination of treatments that were provided in a program use a control group SW34010010 Kenneth Yeager Interaction of testing and treatment measuring itself influences the outcome Restricted generalizability across constructs treatment only good for 1 outcome and not other measured confounding constructs and levels of constructs higher exposure to program or more session might work better social threats to construct validity hypothesis guessing by participants evaluation apprehension by participants experimenter expectancies conscious or subconscious What is validity a guess to how true or accurate your study or measurement is Reliability if you do it once and get an outcome what is the likelihood of you doing the exact same test again and getting the exact same outcomes how consistent are your measurements after several times of testing the same thing with the same test Levels of Measurement nominal numerical values simply name the attribute no ordering of values is implied numerical values are simply short codes for longer names eg color of your car blackf 6 red 2 2 silver 3 3 whitecream 4 3 ordinal attributes can be rank ordered distancesintervals between attributes have no meaning eg degree of satisfaction 1 dissatisfied 2 neutral 3 satisfied interval distancesintervals between attributes do have meaning eg temperature on a Fahrenheit scale ratios do not make sense eg 80 degrees is not twice as hot as 40 degrees SW34010010 Kenneth Yeager not meaningful absolute zero eg zero degrees F is not the absence of temperature ratio always a meaningful absolute zero allows construction of meaningful ratios eg weight zero pounds is the absence of weight 80 pounds is twice as much weight as 40 pounds ASSESSMENT OF PATIENTS WITH SUICIDAL BEHAVIORS Simply asking a person if they are suicidal does not absolve you of your responsibilities and does not constitute a full investigation What is a thorough psychiatric evaluation determine the presence or absence of signs and symptoms associated with specific psychiatric diagnoses identify specific psychiatric symptoms that may influence suicide risk including aggression violence towards others impulsiveness hopelessness agitation psychic anxiety anhedonia can t experience pleasure nothing s fun nothing feels good global insomnia and panic attacks Rather than asking Are you thinking of killing yourself you assess past suicidal behavior including attempts and selfinterest acts Have you ever tried to hurt yourself Have you ever visualized you killing yourself Where would you do it How would you do it Understand what the issues are and have been in the past that affected suicidal behavior Figure out the past issues that were influencing the patient at the time of attempt or consideration of selfharmsuicide What is the psychiatric history of the individual Any comorbid diagnoses what s the seriousness of the event Gauge the strength in spirituality Gauge the strength in stability Gauge the strength of relationships Find the strengths of the individual understand their culture and their personal or cultural or religious view of suicide Understand history of suicide in family members History of family depression SW34010010 Kenneth Yeager substance abuse physicalemotionalsexual abuse Does the individual have any chronic psychosocial stressors Financial problems Stability problems Job Loss Appreciate psychological strengths and vulnerabilities of client SPECIFICALLY INQUIRE ABOUT SUICIDAL THOUGHTS PLANS AND BEHAVIORS suicidal ideation have you ever wished that you would fall asleep and never wake up Qualitative Research DRIP data rich information poor Qualitative Research takes the quantitative research and makes logic and sense out of i t Qualitative Research the statistical data analysis techniques we have learned so far assume that your data consists of numbers this in turn drives the techniques of quantitative measurement qualitative research measures that which cannot be measured with numbers emotions driven by openended questions when you go in to do qualitative research you don t have all of your questions outlined you will begin with one single openended question what do you think is the most important reason the next question would follow based on the next natural question that follows with QLR you don t have a specific research question you are trying to answer you are looking for Emergent Themes Inductive Reasoning in QLR observation leads to pattern which leads to tentative hypothesis which leads to confirmation in QTR theory to hypothesis to observation to confirmation Margaret Mead QLR generates rich understanding of phenomena and of the lived experience that are not accessible via quantitative methods SW34010010 Kenneth Yeager highly flexible because data collection is ongoing and occurs simultaneously with data analysis allowing the research plan to be altered as needed can be less expensive than quantitative research rather than desiring a certain outcome you wait to see what you are actually researching until it comes out through the research thick description fact checking disinterested observer to insure that you are not finding certain themes due to bias CRITICISMS TO QLR lacks generalizability findings are so indepth as to be specific to the sample at hand however findings tell us what experiences can be like for some people subjectivity results are frequently based on the researcher s interpretation or judgment which are influenced by his or her values and individual biases however steps can be taken to minimize bias Statistics Section THE ANATOMY OF A METAANALYSIS remember that a metaanalysis is a statistical analysis of a set of studies systematic reviews often include a metaanalysis you can also find free standing metaanalyses that is they are not a part of a systematic review the goal of a metaanalysis is to provide both a comparative review of a set of studies and an overall summary of the effects of the study set metaanalysis can be bewildering when first encountered what follows are suggestions about the heart of the matter for any metaanalysis if you can get these figured out you will start to be a good metaanalysis consumer in general you need to know the types of studies included in the analysis the outcomes addressed the effect sizes used to compare studies first identify what types of studies are included in the metaanalysis and what outcomes are measured the gold standard is a randomized control trial welldone quasiexperimental design are also useful uses valid measures but is not controlled a less science next identify what effect sizes are being used to compare studies there are two general families of effect sizes used in MA SW34010010 Kenneth Yeager effect sizes based on categorial outcome data risk difference relative risk or risk ratio odd ratio effect sizes based on mean difference outcome data mean difference standardized mean difference most often Cohen s d or Hedge s g smoking average 17 shorter life expectancy for females 40 greater healthcare utilization studies that report odds ratio risk ratio or risk difference effect sizes have essentially reduced their expected outcomes to one of two levels for example program outcomes that are successful or unsuccessful program outcomes either produce positive benefits or no negative benefits FOREST PLOTS effect size data in systematic reviews and MA are often reported in graphs called forest plots each entry represents a finding from a single study boxes represent effect size estimates horizontal lines represent confidence intervals typically 95 a confidence interval that crosses the no differences indicates a nonsignificant finding diamond represents overall average effect size diamond width is a 95 confidence interval What I Learned Today Read the book Blink Malcolm Gladwell sexist START88 Workplace Programs to Build Resilience Individual Response to Workplace Stressor This lecture starts with You thinking about what life is going to look like for you in 10 years 1 question what is it that brought you into the field desire to help sense of accomplishment wellbeing the above options are typically the things which drive you into the field SW34010010 Kenneth Yeager what people are not telling you is that there are expectation which will be placed on you sometimes they are clear sometimes they are not there will be demands upon you you will find yourself in situations where your professional demand force you to make choices when you get out there practicing what you are going to face is lnputs high risk of patient acuity family expectations complexity of work you will have to document chart chart accurately because it might go to court or to a board have to document complex thinking work environment will be challenging overwhelmed in a violent situation few if any breaks the inputs tend to counteract the very things which brought you into the field these inputs may cause you physical distress question ability due to hard cases consider leaving healthcare Outputs stress anxietydepression absenteeism presenteeism the fear of what s going to happen if I m not at work compassion fatigue what comes when you fail to take care of yourself chronic illness Selfcare selfcare selfcare Consequences of a lack of selfcare vicarious trauma traumatic stress moral distress compassion fatigue STAR Interventions Redefining Quality how we take care of our patients SW34010010 Kenneth Yeager how we take care of each other how we take care of ourselves Resilience SelfAwareness knowing how much I can take Relationships Mindfulness being important to think about what you are doing and focus on it Purpose find purpose in your life SelfCare SelfAwareness the first principle is that you much not fool yourself but you are the easiest person to fool overconfidence this is going to end in disaster and you will have no one to blame but yourself What is Resilience Genetic Dispositions traditionally resilience has come to mean the individual s ability to overcome adversity and continue his or his normal development more recently and crossculturally Unger 2008 in the context of exposure to significant adversity whether psychological environmental or both resilience is both the capacity of individuals to navigate their way to health sustaining resources including opportunities to experience feelings of wellbeing and a condition of the individual s family community and culture to provide these health resources and experiences in culturally meaningful ways Resilience across Cultures Michael Ungar 2008 our Darwinian DNA utilizes soem negativeemotion mechanisms to help us pass our traits on to o spnng Cultivating Positive Emotion 3 to 1 Ratio What are we doing well How did you contribute When does the team come together Sharing positive comments with positivity you see new possibilities bounce back from setbacks connect with others and become the best version of yourself Positivity brings lower blood pressure 1 less pain 2 fewer colds 3 and better sleep 4 You re giving away your power when you place the responsibility for your life on them SW34010010 Kenneth Yeager Positive emotions lead to more novel thoughts activities relationships building enduring personal resources resilience skills and knowledge enhanced health survival and fulfillment Attachment an abundance of research shows that the perception that one has supportive others to turn to in times of stress ie perceived support buffers if you can have one good attachment you will live longer and be healthier and happier doing an act of kindness produces the single most reliable momentary increase in wellbeing of any exercise that has been tested find one wholly unexpected kind thing to do today or tomorrow and just do it Notice what happens to your mood Martin Seligman 2011 4am Friend is there someone you would be comfortable with calling at 4am to tell your problems loneliness is such a disabling condition Good attachment you are there for me when things go wrong How you respond does make a difference active destructive responding finding the bad in the good passive destructive responding not caring at all about their news passive constructive responding not making a big deal out of it active constructive responding reacting positively being interested caring about their news PostTraumatic Stress Disorder resilience and vulnerability Ayesha S Ahmed Three Good Things challenge notice 3 positive experiences in order to enhance your gratitude and positivity counteracts the negativity bias you can counteract the negativity bias If you try Luminosity for a year you won t get the enhanced performance that you get from simply focusing on the positive rather than the negative AMY
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