1. LINDSAY SHEPARD, MSW, MSC EBP STEP 1: POSING QUESTIONS FOR PRACTICE

2. OBJECTIVE To examine and practice EBP step 1, how to pose different question types using the PICO format

3. EBP STEP 1: PURPOSE You have a practice decision to make

4. EBP STEP 1: QUESTION TYPES What types of information might you need in practice? Descriptive (needs/protective factors/risk Factors) Assessment/Diagnostic tools Prevention effectiveness Intervention effectiveness

5. EBP STEP 1: QUESTION FORMAT You are interested in asking questions that are: Client-Oriented Practical Evidence-Seeking For that, we will use the PICO format…

6. EBP STEP 1: PICO FORMAT Population and Problem Describe client type/population Describe client problem Intervention Indicate the specific assessment tool or intervention, assessment or intervention type, OR ask about “best” Comparison Detail specific comparison tool/intervention, type, OR leave blank Outcome Specify the characteristics or outcomes you are interested in knowing about

7. EXAMPLES PopulationProblemInterventionComparisonOutcome Descriptive Example: Of adult, female victims of domestic violence is post- secondary education compared to secondary education or less a protective factor for re- victimization? Assessment Question Example: If aged residents of a nursing home who may be depressed or have dementia are administered depression screening tests or a short mental status examination which measure will be the briefest, most inexpensive, valid and reliable at discriminating between depression and dementia?

8. EXAMPLES PopulationProblemInterventionComparisonOutcome Prevention Question Example: If sexually active high school students at high risk for pregnancy are exposed to Baby-Think-It- Over or to lecture material on proper use of birth control which will result in fewer pregnancies during an academic year? Effectiveness Question Example: If aged persons who reside in a nursing home with symptoms of being disoriented are given reality orientation therapy or validation therapy which will result in better orientation to time, place, and person?

9. CLASS DISCUSSION Which question type do you think you will need the most in practice? Needs/Protective Factors/Risk Factors Assessment/Diagnostic tools Prevention effectiveness Intervention effectiveness We are going to concentrate our class efforts on Assessment and Intervention Effectiveness questions!

10. ASSESSMENT QUESTION TYPES : A) COMPARE AN ASSESSMENT TOOL TO NO ASSESSMENT B) COMPARE TWO ASSESSMENT TOOLS C) IDENTIFY THE BEST ASSESSMENT TOOL Safe and Healthy Families Examples: PopulationProblemInterventionComparisonOutcome For children seeking outpatient treatment for sexual behavior problems will a clinical interview and the Child Sexual Behavior Inventory or clinical interview alone be more reliable, valid, and cost-effective at identifying sexual behavior problems? Among children seeking outpatient treatment for traumawhat is the best, most cost-effective assessment tool for identifying Post- Traumatic Stress Disorder?

11. EFFECTIVENESS QUESTION TYPES : A) COMPARE TWO INTERVENTION B) COMPARE AN INTERVENTION TO NO INTERVENTION C) IDENTIFY WHAT IS THE BEST INTERVENTION? Safe and Healthy Families Examples: PopulationProblemInterventionComparisonOutcome For children seeking outpatient treatment for sexual behavior problems what is the most effective interventionfor extinguishing the problem behavior? Among children seeking outpatient treatment for traumais Trauma- Focused Cognitive Behavioral Therapy or non-directive play therapy more effective and timely at reducing symptoms of traumatic stress?

12. CLASS ACTIVITY With a partner, respond to the following scenario: You are a therapist at the Center for Safe and Healthy Families who just completed intake for a new client—a 15 year old, Caucasian male presenting with trauma exposure, symptoms of depression, and substance use. In preparation for framing your treatment plan, you wisely decide to consult evidence in your decision-making. How would you phrase an effectiveness question in the PICO format so that you might direct your evidence search?

13. IN YOUR GROUPS: Work on Group Posting 2: Provide a 1-2 paragraph case formulation of your client, including their basic characteristics, presenting problem(s), diagnosis, and any other relevant information. Then, provide two PICO questions, one regarding assessment for this client and the second, regarding treatment effectiveness. (See PICO Template on Canvas)