Studied by 40 peopleevidence-based practice
used to review, analyze, and translate the latest scientific evidence used to make informed decisions based on best available evidence considers patient preferences and values and clinician expertise
Goals of evidence-based practice
Increase the quality of treatment and increase accountability
6 steps of evidence based practice
Asses the situation Asking the question Acquire the evidence Appraising the evidence Applying the results Evaluate the outcome
Advantages of evidence-based practice
-better patient, provider, and institutional outcomes -the evaluation of research to understand the risks and effectiveness of a treatment -most likely to achieve goals -meet the needs of clients or patients -cost effective
Evidence-Based Practice Challenges
-sponsorship and resources -access to data and plan for measurement -inadequate EBP practice knowledge and skills -insufficient time
Evidence-based practice examples
building relationships adapting the enviorment developing social skills
Evidence-based practice matters because
specific to the client evaluates research to understand the risks and effectiveness of a treatment increases the quality of treatment
When policies go against evidence-based practices
patients are at risk of receiving outdated, possibly harmful medical advice and care.
Goal of Interventions
to take action that will make a positive change in the way someone thinks or behaves, to modify or prevent self-destructive behavior.
Interventions for kids
help children and young people to develop the skills they need to live happy, healthy, and successful lives.
FFPSA
Seeks to reduce entry in foster care, limit the use of congregate care, and to increase access to substance abuse and mental health services. (Texas department of family and protective services)
Goal of FFPSA
to prevent children from entering foster care by allowing federal reimbursement for mental health services, substance use treatment, and in-home parenting skill training.
allostatic load
physical wear and tear on the body due to chronic stress (get sick faster, more often)
PACES (protective and compensatory experiences scale)
relationships and resources provide the nurture and stability needed for success
Three Pillars of Trauma- Informed Care
safety, connection, managing emotions
Impact of Childhood Trauma
Physical disease, behavioral disorders and adult outcomes
Trauma
Person experiences a threat of death, serious injury to self, or threat to the physical integrity of self or another Affects whole self Overwhelms coping capacity
Safety
consistency, reliability, predictabiity, availability, honesty, transparency, include the child in decision making (where appropriate) (power, control)
Connections
between traumatized children and their care providers
normative community activities
traumatized kids associate adults with negative emotions
Connections -Brofenbrenner approach
attachment (positive emotional connection)
reciprocity (provision of necessary supports (scaffolding))
progressive complexity (developmental tasks become more complex as mastery develops)
balance of power (shift towards the child)
Managing Emotions
-orbitofrontal cortex(management and regulation of emotion)
-adult co-regulate (active listening, reflective skills, consciously labeling troublesome emotions)
-kids learn by calm adults, being present, and emotional literacy
Emotion Management for kids can be learned by
calm adults being present emotional literacy
Adults help co-regulate emotions
active listening, reflective skills, labeling troublesome emotions
Carol Gilligan (ethics of care)
supports moral action centers on interpersonal relationships and care or benevolence as a virtue
emphasizes the importance of response to individual
"what is just"
Ethics of Care
Motivation-care for those who are dependent and vulnerable
affirms the impotence of caring, emotion, and the body in moral deliberation
goes against the "justice perspective"
Four sub-elements of care
Attentiveness Responsibility Competence Responsiveness
Ethics of care advantages
humanizes ethics by centering thought on real people
can align with what we already do
focus our concern on those closest to us
Applied Care Ethics
Reproductive technology, Homosexuality and gay marriage, Capital punishment, Political agency, ect.
Care movements social programs
Universal health care, Pre-school education, Care for the elderly, Improved foster care, Adequate wages for care-givers, ect.
PACES Factors
-unconditional love -having a best friend -volunteering in community -being apart of a group -having a mentor -living in a home that is clean and safe, with enough food -getting an education -having a hobby -being physically active -having rules and routines
PACES
Protective and Compensatory Experience Scale
Harvard Brain Game
teaches us how trauma at a young age affects children's brain development (negative experiences result in an unstable brain)
Pair of ACES
combination of adverse childhood experiences and adverse community environments harder to deal with individual aces if the community is struggling
Acute trauma
One time
Complex trauma
varied types or multiple events
Chronic trauma
ongoing
Chapter 1 case
Tina was aggressive and always exposing herself in school, she was sexually abused and threatened by her neighbors son
Chapter 1 techniques
colored together, better regulated her stress system, better impulse control
Chapter 2 case
Sandy witnessed the murder of her mother and had to testify in court, Stan Walker was appointed to represent her
Chapter 2 techniques
gave her the drug clonidine (like he used for the boys in the group home), gave her complete control during their sessions where she played out the event
Chapter 3 case
Children released from the Branch Davidians cult in Waco, led by David Koresh, were never allowed to make decisions, divided by gender, trained with weapons
Chapter 3 technique
established a schedule and routine, built healthy relationships with adults, worked with many "therapist" with different personalities so each child could choose what they needed and build individual relationships with them, recapped each child's progress at night
Note
Flashcard