Assignment 1: Creating A Single-System Design Study

Assignment 1: Creating A Single-System (Subject) Design Study The steps

Construct a detailed proposal for a single-system (subject) research study based on a case scenario involving Paula Cortez. Your proposal should include the following components: a description of the problems targeted for treatment, the intervention approach with specified duration, a review of literature supporting your choice of intervention, the purpose of conducting the single-system evaluation, measures for evaluating outcomes, criteria for determining intervention effectiveness, and how periodic measurements will support ongoing work with Paula. Support your proposal with at least five credible references, including scholarly articles, frameworks, and evaluation methods relevant to HIV/AIDS, bipolar disorder, and research design.

Paper For Above instruction

Title: Creating A Single-System (Subject) Design Study The steps

The proposal for a single-system or single-subject research study focusing on Paula Cortez requires meticulous planning that integrates clinical assessment, evidence-based intervention strategies, and systematic evaluation to enhance her health outcomes. The complexity of Paula’s case—marked by HIV/AIDS, bipolar disorder, pregnancy, and social vulnerability—necessitates a carefully tailored approach that aligns with the principles of single-system research methodology.

Problem Identification and Focus of Treatment

The central problems targeting intervention include non-adherence to medication regimens, escalating paranoia, gestational health concerns, and psychosocial stressors. Paula’s history reveals inconsistent engagement with her HIV medication and psychiatric treatment, heightened paranoia, and unsafe behaviors, all compounded by an abusive relationship and pregnancy stress (Corcoran & Hozack, 2010). These issues threaten both her health and fetal wellbeing, warranting a focused intervention to improve medication adherence, reduce paranoia, and support her psychosocial needs during pregnancy. The specific target outcomes include increased medication compliance, decreased paranoia levels, improved mood stability, and enhanced coping skills.

Intervention Approach and Duration

To address these complex needs, integrated motivational interviewing (MI) combined with cognitive-behavioral therapy (CBT) strategies will be employed. MI facilitates intrinsic motivation for medication adherence and behavioral change (Dudley, 2014), while CBT addresses paranoid ideation and mood stabilization (Mattaini, 2010). The intervention will be delivered over a span of 12 weeks, with weekly sessions lasting approximately 60 minutes, allowing for ongoing adjustment based on Paula’s response. The intervention will be designed for reproducibility, with intervention protocols and session structures standardized and documented.

Literature Review Supporting Intervention Selection

Research indicates that motivational interviewing effectively enhances adherence to treatment among individuals with HIV/AIDS and co-occurring mental health conditions (Luborsky & McCarthy, 2012). Its client-centered approach fosters autonomy and engagement, essential for Paula’s non-compliant behaviors. Similarly, CBT has demonstrated efficacy in reducing paranoia and stabilizing mood in bipolar disorder (Reeves et al., 2019). Combining MI and CBT aligns with the goal-oriented, strengths-based practice models, which emphasize collaboration and empowerment. Additionally, literature from the National Registry of Evidence-Based Programs and Practices (NREPP) supports the use of integrated, multi-modal interventions tailored to complex cases like Paula’s, aiming to improve adherence and psychosocial functioning (NREPP, 2020).

Purpose of Conducting a Single-Subject Research Evaluation

The primary purpose is to empirically assess whether the intervention produces meaningful change in Paula’s medication adherence, paranoia levels, and overall mental health within a real-world clinical setting (Mattaini, 2010). Single-system design allows for detailed observation of individual responses over time, facilitating adjustments and ensuring intervention fidelity. It also provides evidence for replicability and scalability of effective strategies, contributing to practice-based evidence in social work (Dudley, 2014).

Measures for Evaluating Outcomes and Observing Change

Outcome measures will include standardized clinical assessments such as the Medication Adherence Rating Scale (MARS) for adherence (Corcoran & Hozack, 2010), the Paranoia Scale (Meyer & Mohr, 2018), and mood rating scales like the Young Mania Rating Scale (YMRS). Reliability and validity of these measures are well-established, ensuring accurate data collection. Baseline measures will be obtained in the first week, prior to intervention onset, through structured interviews and self-report questionnaires. Follow-up assessments will occur weekly during intervention sessions, with additional measures at post-intervention and at a three-month follow-up to evaluate sustained change.

Criteria for Intervention Effectiveness

Effectiveness will be determined by statistically significant improvements in adherence scores, reductions in paranoia severity, and mood stabilization, compared to baseline levels. Clinically meaningful change will be defined by established cutoff scores on the assessment tools—for example, a 30% reduction in paranoia scores and consistent medication adherence rates above 85%. Process data such as session attendance and engagement levels will also inform effectiveness, alongside qualitative feedback from Paula regarding her perceived progress.

Use of Periodic Measurements in Ongoing Work

Regular measurement intervals enable clinicians to monitor progress in real-time, quickly identify setbacks, and refine intervention strategies accordingly (Dudley, 2014). These data support collaborative discussions with Paula to reinforce progress or address barriers, fostering a strengths-based approach. Periodic assessments also provide tangible evidence of change, simultaneously enhancing Paula’s motivation and accountability. Utilizing a systematic charting of data aligns with single-system research principles, ensuring transparent evaluation of intervention impact and facilitating iterative practice adjustments (Mattaini, 2010).

Conclusion

Developing a robust single-system research proposal in this context involves integrating evidence-based intervention strategies with systematic measurement and evaluation. By carefully defining targeted problems, utilizing validated measures, and establishing criteria for success, the social worker can create a replicable, effective plan that enhances Paula’s health outcomes while contributing to practice-informed evidence. This tailored, data-driven approach exemplifies the therapist-researcher model, promoting continuous improvement and evidence-based practice in complex social work cases.

References

• Corcoran, K., & Hozack, N. (2010). Locating assessment instruments. In B. Thyer (Ed.), The handbook of social work research methods (2nd ed., pp. 65–74). Sage.
• Dudley, J. R. (2014). Social work evaluation: Enhancing what we do. Lyceum Books.
• Luborsky, L., & McCarthy, M. (2012). The role of motivation in treatment adherence. Psychotherapy Research, 22(4), 459-469.
• Meyer, B. J., & Mohr, P. A. (2018). Measuring paranoia: Scale development and validation. Journal of Psychological Assessment, 30(2), 89-102.
• Mattaini, M. A. (2010). Single-system studies. In B. Thyer (Ed.), The handbook of social work research methods (2nd ed., pp. 241–273). Sage.
• NREPP (2020). Intervention classification and evidence base for HIV and mental health. National Registry of Evidence-Based Programs and Practices.
• Reeves, C., et al. (2019). Cognitive-behavioral therapy for bipolar disorder. American Journal of Psychiatry, 176(3), 237-245.
• Tankersley, M., Cook, B. G., & Cook, L. (2008). Quality indicators in single-subject research. Education & Treatment of Children, 31(4), 523-548.
• Laureate Education. (2013). Cortez family [Interactive media]. Retrieved from Cortez Family website.
• Additional scholarly articles on motivational interviewing and outcome measurement in health-related behavioral interventions.