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Finding a path to the evidence: A research strategy for a therapeutic program


Background. Exploring the impact of intervention for children traumatised by abuse requires a methodology which captures the mix of complex variables across different levels of a socio-ecological framework. This paper presents the research design and methodology utilised in the evaluation of Take Two; an innovative program for children traumatised by abuse who are clients of the child protection system in Victoria, Australia.

Purpose. The purpose of this paper is to provide an overview of the Take Two research strategy, which has three aims. Firstly, the research strategy aims to evaluate the impact of the delivery of therapeutic interventions to vulnerable children. Secondly, the strategy aims to evaluate Take Two's role in engaging the service system to support these interventions and contribute to more positive outcomes for the children. Finally, the strategy aims to build and disseminate knowledge about this vulnerable client group and the complex systems within which they live.
Take Two commenced in 2004; a partnership of a community service organisation, a mental health service and academe. More recently this partnership grew to include an Aboriginal organisation. The model works in collaboration with state government both in service delivery and the research strategy. Research and training functions were funded as part of the program design. The research design is embedded in the program design with the aim of creating a practice research environment in which evidence of program and client outcomes can be quickly disseminated to clinicians.
The research and evaluation component of Take Two is led by La Trobe University and operationalised by a research team of Take Two and La Trobe University employees. It is predicated on an action research design including both quantitative and qualitative methodologies. The design explores the program effectiveness as well as the impact of intervention on individuals and 'what works for whom'. How Take Two makes a difference has equal importance with identifying individual outcomes for clients. The research and evaluation design has been planned as a three-year cycle. The two evaluation reports of the first two years have been published (Frederico, Jackson, & Black, 2005; 2006).
The paper describes an approach to the study of highly sensitive data. These are difficult to study due to the characteristics of the population and the complicated service systems which surround them. The research design is built upon an evolving conceptualisation of the program.
An outcomes framework is central to the design. Outcome measures were selected by a group comprising university researchers and Take Two clinicians. The paper discusses the importance of the ownership of the outcome measures by clinicians. The outcome measures used include the Strengths and Difficulties Questionnaire (Goodman, 1999), the Trauma Symptom Checklist for Children (Briere, 1996), Trauma Symptom Checklist for Young Children (Briere, 2005) and the Social Network Map (Tracy & Whittaker, 1990). Where possible this data is triangulated and compared with other data such as referral documents and client activity records. Other sources of data include staff journals, case studies, surveys completed by children, parents, carers, teachers, and other workers including Child Protection, Community Service Organisation workers and Take Two clinicians.

Key findings. The action research design has actively engaged the clinical program, which supports the appropriateness of the methodology for clinical practice. Examples of the link between research and practice include: findings are fed back to the staff to strengthen ongoing practice and program development; practice has influenced the selection of outcome measures; research has informed development of the practice framework; and research has contributed to the expansion of clinical attention on the importance of trauma and attachment.
A key issue is program compliance with the outcome measures framework. The plan for Take Two both clinically and for evaluation purposes is to use outcome measures routinely for all clients. As Take Two continues to develop a culture of outcomes-based practice the data set available for analysis will grow.
A key finding has been the benefit of the research practice partnership. The importance of the University context in supporting the research has been highlighted. The paper presents an effective model for a research practice partnership.

Key references
Frederico, M., Jackson, A., & Black, C. (2005). Reflections on complexity - Take Two first evaluation summary report. Bundoora: La Trobe University (www.berrystreet. org.au).
Frederico, M., Jackson, A. & Black, C. (2006). Give sorrow words. - A Language for Healing, Take Two - Second Evaluation Report 2004 - 2005. Bundoora: School of Social Work and Social Policy, La Trobe University (www.berrystreet.org.au).

Contacts: Margarita Frederico, School of Social Work and Social Policy, La Trobe University, Bundoora Victoria 3086, Australia, E-mail: m.frederico@latrobe.edu.au, Phone +61 3 9479 2407.

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