Professor Debbie Plath

This study examined parents¿ experiences of family-based interventions for the treatment of adolescents with anorexia nervosa (AN). Nine parents whose child¿s weight had reached the healthy weight range post-treatment were interviewed about their experiences of parenting a child with AN in either manualised family-based therapy (FBT) (n = 6) or non-manualised family systematic interventions (n = 3). The interviews were analysed using interpretative phenomenological analysis. Findings draw attention to the impact of AN on the whole family, the gatekeeping role of health professionals in accessing support and treatment, the value of externalisation, the prime importance of the therapeutic alliance between parents and clinicians, and the importance of tailoring treatment to the unique circumstances, values, and culture of each family. IMPLICATIONS Practitioners should be alert to the feelings of shock, guilt, and responsibility felt by parents of a child with anorexia nervosa and recognise the challenges faced by parents in accessing treatment and responding to their child¿s behaviour, alongside the demands of family, work, and other social roles. The quality of the parent¿practitioner therapeutic relationship influences parental perceptions of support and of the effectiveness of treatment. Regardless of the treatment model, parents respond well to therapists who express empathy, pay attention to building trust, respect, and activate the family¿s unique circumstances and values, offer support, explain the nature and purpose of the treatment, and provide feedback. From the parent perspective, practitioners are more effective if they clarify parents¿ value and belief systems and use these to engage parents with the treatment process.

Got It! is an early intervention programme for children with emerging conduct problems offered to families in schools. This article builds on prior research and reports on outcomes and experiences for a cohort of participants two years after programme completion. Strengths and Difficulties Questionnaire (SDQ) child conduct scores were obtained pre-intervention, and at three post-intervention time-points, and were used to map children's behaviour trajectories. Whilst statistically significant two-year post-intervention improvement was not found for the whole sample, qualitative parent interviews produced insights into experiences of children in different behaviour trajectory groups, including sustained improvement, no improvement and fluctuating child behaviour. The findings provide a better understanding of the role that Got It! can play in assisting families with young children with conduct concerns. The targeted group intervention appears to have a lasting impact for children who maintain a shift from the abnormal to normal behaviour bands. For the group of children who began and remained in the abnormal or borderline bands, however, Got It! also had a role to play in linking families with specialist follow-up services. The integration of Got It! within schools and the value of professional development and consultation for teachers is also indicated.

A questionnaire and in-depth interviews with 20 allied health clinicians generated data on key aspects of family-based treatment for adolescent anorexia nervosa that enhance recovery, processes that engage parents in treatment, and how and why clinicians modify or adapt the manualized Maudsley Family Based Treatment model. Findings indicate that clinicians support key principles in the Maudsley model, but that the approach is not implemented in the full, manualized form. Rather, aspects are integrated with clinicians¿ own clinical judgements based on assessment of the needs and capacities of families, cultural appropriateness, impact on family dynamics, and gains during early treatment.

This paper reports on findings from a national survey (n = 364) of social workers' views on what impedes and supports evidence-based practice (EBP) implementation. In contrast to some prior research, support for EBP was found to be strong among the social workers surveyed. Open-ended responses, however, reflected some reservations about the formalisation, relevance, usability and applicability of EBP in social work. A range of barriers to EBP implementation for social workers were identified at individual and organisational levels, which is largely supportive of findings from prior research. An interesting distinction was discerned between those respondents who preferred to engage in the whole EBP process themselves (locating, appraising and applying research) and those who preferred to adopt practice guidelines based on appraisal of research evidence by other experts. This finding has implications for the way organisations and the social work profession approach the implementation of EBP.

Qualitative findings on how evidence-based practice (EBP) is conceptualised and implemented in an Australian human service organisation are presented. The paper examines the application and relevance of the five-step decision-making model of EBP to the organisational context and also the position of standardised 'evidence-based programmes' in relation to EBP decision making. The case study has shown that the five-step model of EBP decision making is relevant to a human service organisational context, but that some modifications of the model would enhance its applicability and utility. First, it is proposed that the five-step model would be better conceived systemically to reflect the relational and contextual processes impacting on practice decision making in the teams and organisations in which social workers practise, rather than being confined to individual, clinical decision making. Second, a cyclic model is offered in order to capture a process of ongoing critical reflection, evidence gathering and programme modification as organisations develop and refine programmes to address priorities and improve client outcomes in complex and dynamic environments. © 2012 The Author.