The first steps toward narrowing the gap between research and practices are recognizing that one exists and educating oneself and others. Social workers must realize the benefits and eliminate the misconceptions surroundings evidence-based practice. In the Bradley episode the social worker combines her assessment of Tiffani Bradley’s individual situation with her knowledge of research to evaluate her supervisor’s recommended intervention. Now that the social worker has recognized a gap, she/he/they need to access potentially relevant information for a specific case and critically analyze for its applicability to that case. This week’s Assignment allows you to practice these critical next steps in the Bradley family case.
To prepare for this Assignment, review the Bradley family case study. Develop a list with 2-3 researchable questions that you could use to find evidence about the efficacy of 12-step programs or other treatments for substance abuse in adolescents. Then, using the resources provided, search for two evidenced-based interventions that would be appropriate for Tiffani Bradley. Be sure to consider quality of research, readiness of dissemination, replications, and costs.
Submit a 2-3 page paper that includes the following
Summaries of the two interventions and their respective research regarding effectiveness
Recommendations for Tiffani’s social worker that address the following:
Factors to consider when choosing between the two interventions
The social work skills that the staff would require to implement the intervention
The training required to implement each intervention
An evaluation of evidenced-based practice based on your reaction to the experience, in which you address the following question:
Would you, as a beginning researcher, have enough knowledge to benefit from researching evidence-based practices? Why or why not?
How might the research that you conducted increase your confidence in the intervention with Tiffani?
Is the information provided enough to make a decision regarding interventions? Why or why not?
Appropriate APA citations in your writing
The Bradley Family Case Study
Tiffani Bradley is a 16-year-old heterosexual Caucasian female referred to me after being arrested for prostitution. I worked with Tiffani at Teens First, a brand new court-mandated teen counseling program for adolescent victims of sexual exploitation and human trafficking. At Teens First we provide a holistic range of services for our clients. Tiffani has been provided room and board in our residential treatment facility and will meet with a number of social workers to address her multiple needs and concerns.
Tiffani has been arrested three times for prostitution in the last 2 years. Right before her most recent charge, a new state policy was enacted to protect youth 16 years and younger from prosecution and jail time for prostitution. The Safe Harbor for Exploited Children Act allows the state to define Tiffani as a sexually exploited youth and therefore the state will not imprison her for prostitution. She was mandated to services at our agency, unlike her prior arrests when she had been sent to detention.
Tiffani had been living with a man she has identified as Donald since she was 14 years old. She had had limited contact with her family members and had not been attending school. She described Donald as her “husband” (although they were not married) and her only friend. She had contacted her sister, Diana, a few times over the previous 2 years and stated that she missed her very much. Donald had recently sold Tiffani to another pimp, “John T.” Tiffani reported that she was very upset that Donald did this and that she wanted to be reunited with him. She had tried to make contact with him by sending messages through other people, as John T. did not allow her access to a phone.
During intake it was noted that Tiffani had multiple bruises and burn marks on her legs and arms. She reported that Donald had slapped her when he felt she did not behave and that John T. burned her with cigarettes. Tiffani has been treated for several sexually transmitted infections (STIs) at local clinics and is currently on an antibiotic for a kidney infection. Although she was given condoms by Donald and John T. for her “dates,” there were several “Johns” who refused to use them. It appears that over the last 2 years, Tiffani has had neither outside support nor interactions with anyone beyond Donald, John T., and some other young women also being prostituted.
Other members of the Bradley family include Tiffani’s 33-year-old mother, Shondra; Tiffani’s 38-year-old father, Robert; and Tiffani’s 13-year-old sister, Diana. Shondra and Robert have been separated for a little over a year and have started dating other people. Diana currently resides with her mother and Anthony, her mother’s new boyfriend. Shondra and Anthony abuse a variety of drugs, including marijuana and methamphetamine.
Robert also abuses a number of drugs and has recently been arrested for possession of crack cocaine. Robert has been arrested several times over the last 5 years: twice for domestic violence calls and twice for drug possession. He is currently in jail awaiting sentencing.
The goals Tiffani and I set in our initial sessions centered on helping her feel safe and secure in her new home and utilizing as many of the available resources as possible. Through individual and group counseling, Tiffani will have the opportunity to discuss her experiences prior to coming to Teens First, including what led to her relationship with Donald. A long-term goal I presented was to help her understand that Donald, the person who she maintained “is the love of my life,” had actually had a negative impact on her life. Tiffani listed some of her own long-term goals, including obtaining a General Education Development (GED) credential, getting her own apartment, getting a job, and reunifying with her sister.
During our sessions over the year, Tiffani gave a rather in-depth description of her childhood. At first Tiffani provided a family history that was filled with only happy memories. She remembered her life up to age 8 as filled with moments of joy. She remembered going to school, playing with her sister, and her mother and father getting along.
As we continued to meet, Tiffani shared what she remembered as a gradual but definitive change in the family dynamics around the time when she turned 8 years old. She remembered being awakened by music and laughter in the early hours of the morning. When she went downstairs to investigate, she saw her parents along with her uncle Nate passing a pipe back and forth between them. She remembered asking them what they were doing and her mother saying, “adult things” and putting her back in bed.
Tiffani remembered being woken up by noise several times after that and seeing her father and her uncle passing the pipe between them. Sometimes her mother was there and sometimes she was not. Often when her mother was not there, Nate would see her and ask her to come over. Her father would sometimes ask her to show them the dance that she had learned at school. When she danced, her father and Nate would laugh and offer her pocket change. Sometimes they were joined by their friend Jimmy.
For years the music and noise downstairs continued, later accompanied by screams and shouting and sounds of people fighting. One morning, Shondra yelled at Robert to “get up and go to work.” Tiffani and Diana saw Robert come out of the bedroom and slap Shondra so hard she was knocked down. Robert then went back into the bedroom.
Tiffani also noticed significant changes in her home’s appearance. The home, which was never fancy, was almost always neat and tidy. Tiffani noticed that dust would gather around the house, dishes would pile up in the sink, dirt would remain on the floor, and clothes would go for long periods of time without being washed. Tiffani remembered cleaning her own clothes and making meals for herself and her sister during this period. Sometimes Tiffani and her sister would come downstairs in the morning to find empty beer cans and liquor bottles on the kitchen table along with the pipe. Her parents would be in the bedroom, and Tiffani and her sister would leave the house and go to school by themselves. Tiffani was unclear if her parents were working or how the bills were paid. Often there was not enough food to feed everyone and she would go to bed hungry.
During one session, Tiffani described an incident of sexual abuse. One night she was awoken by her uncle Nate and his friend Jimmy in her room. Her parents were apparently out, and they were the only adults in the home. They asked her if she wanted to come downstairs and show them the new dances she learned at school. Once downstairs, Nate and Jimmy put some music on and started to dance. They asked Tiffani to start dancing with them, which she did. While they were dancing, Jimmy spilled some beer on her. Nate said she had to go to the bathroom to clean up. Nate, Jimmy, and Tiffani all went to the bathroom. Nate asked Tiffani to take her clothes off so she could get in the bath. Tiffani hesitated to do this, but Nate insisted it was okay since he and Jimmy were family. Tiffani eventually relented and began to wash up. Nate would tell her that she missed a spot and would scrub the area with his hands.
After this incident, others occurred, with increasing levels of molestation each time. Tiffani felt very bad about this, but had difficulty explaining why, even to herself. She was very afraid of everyone in her family except her sister Diana. She was also afraid that Diana might be subjected to the same thing.
The last time it happened, when Tiffani was 14, she pretended to be willing to dance for them, but when she got downstairs she ran out the front door of the house. Tiffani ran down the block to her school because, as she said, it was one of the few places where she felt safe. She said she was barefoot and in her pajamas and it was very cold. About halfway to her school, a car stopped, and a man inside asked her where she was going. When Tiffani replied that she was going to school, the man asked why she was going to school in the middle of the night. Tiffani did not want to tell him the whole story, so she told him that there was trouble at home and she just wanted to go to school early.
The man introduced himself as Donald and asked her why she did not go to her boyfriend’s house. When Tiffani said she did not have a boyfriend, Donald replied that if she had a boyfriend, she would have somebody to take care of her and keep her safe when these things happened. He then offered to be her boyfriend. Tiffani did not say anything, but when Donald then offered to give her a ride, she agreed and got in the car.
Donald took Tiffani to his apartment, explaining that the school would be closed for hours. When they got to his apartment, Donald fed Tiffani and gave her beer, explaining that it would help keep her warm. Tiffani did not like the taste of the beer, but at Donald’s insistence, she drank it.
When Tiffani was drunk, Donald began kissing her, and they had sex. Tiffani knew about sex from school and some of her girlfriends but she had never had it with anyone before. She was grateful to Donald because he had helped her get away from Nate and Jimmy. Donald had also told her that he loved her and they would be together forever. Tiffani was also afraid that if she did not have sex, Donald would not let her stay and she had nowhere else to go.
For the next 3 days, Donald brought her food and beer and had sex with her several more times. Donald told Tiffani that she was not allowed to do anything without his permission. This included watching TV, going to the bathroom, taking a shower, and eating and drinking.
Donald bought Tiffani a dress, explaining to her that she was going to “find a date” and get men to pay her to have sex with her. When Tiffani said she did not want to do that, Donald hit her several times. Donald explained that if she didn’t do it, he would get her sister, Diana, and make her do it instead. Out of fear for her sister, Tiffani relented and did what Donald told her to do.
Tiffani and I met over the course of a year for individual sessions. We talked often about her continued desire to be reunited with Donald. We discussed what Donald represented for her and why he was such an important part of her life. She often described him as the person who “saved” her and felt she owed much to him. She vividly remembered the fear she felt the nights Nate and Jimmy touched her, and she was convinced they would have raped her that last night. My efforts were to help her recognize that Donald was not a savior, but someone who did, in fact, rape her and then force her into prostitution. A lot of time and discussion went into changing this cognition around Donald and their relationship.
After about six months at Teens First, Tiffani said that she had a strong desire to see her sister and her mother, and I helped to arrange a family session at the agency. Tiffani and I talked about what her hopes were for the meeting and her intent for scheduling this session. Tiffani first and foremost just wanted to see them and hug them. She had not seen either of them in over two years and missed them very much. Tiffani also felt some anger toward her mother that she wanted to able to share in a safe environment. She said she felt that both her parents did not do enough to protect her and that they should have known better than to have let Nate and Jimmy into the house when they were not home. She also said she felt her mother should have tried harder to find her when she was with Donald. I wanted her to be realistic about the potential outcome of the meeting, so I did my best to explain that the session might not provide all of the answers she hoped for. We were aware, through a conversation with her sister that her mother was still using drugs, and we talked about how this might cloud her mother’s ability to engage in a substantial conversation.
In the family session, Shondra was very critical of Tiffani and her current situation. She ultimately blamed Tiffani for her current state. When Tiffani confronted her mother about the drug use and the lack of parental guidance and protection, Shondra denied ever having used drugs. She told Tiffani she was exaggerating and a liar and that neither she nor Tiffani’s father ever put her in harm’s way.
Throughout our time working together, Tiffani utilized all of the services at the agency and stopped trying to contact Donald. She had learned that he had actually gotten married to one of the other women that worked for him, and this made her very angry. She has passed her GED test and started working at a local fast food restaurant. She plans on applying to a community college and a fashion institute. (Plummer 17-19)
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