Role of Technology in Follow-Up for Mental Health Patients

Answer

• Role of Technology in Follow-Up for Mental Health Patients

   

  Table of Contents

  Abstract 3

  1.1 Introduction. 4

  1.2 Purpose Statement 5

  1.3 Rationale. 6

  1.4 Theoretical Framework. 6

  1.5 Research Question. 7

  1.6 Keywords. 7

  1.7 Report Structure. 8

  2.0 Literature Review.. 9

  Table 1 - Critical Review/Appraisal of Literature. 10

  2.1Thematic Review.. 13

  Roles of Social Workers dealing with Depressed Patients. 13

  2.3 The Role of Technology in Social Work. 16

  How effective is Technology Integration in Social Work. 16

  2.4 The Acceptability of Technology in Social Work. 16

  2.5 Client Follow-Up and Medication Adherence. 19

  2.6 Challenges Facing Technology Adoption and Integration in Social Work. 20

  Research Question and Objectives. 22

  Research Paradigm and Methodology. 23

  Research Methods. 24

  Reliability and Validity. 26

  Sampling. 28

  Research Ethics. 29

  Data Analysis. 32

  CHAPTER 4: CONCLUSION.. 33

  Reflexivity. 36

  Limitations. 37

  References. 38

   

   

   

   

  Abstract

  The role of technology in mental health treatment among social workers is highly undervalued. This trend is quite disturbing considering the immense effect it has had on other industries for the past few decades. In the wake of such interesting reality, the present piece proposes a qualitative research project which will help expose how technology can be leveraged to deliver desirable outcomes in social work. This research will be anchored on the systems theory which holds that the thoughts and actions of human beings are influenced by a broad range of education, family background, socioeconomic status, company, and environmental dynamics interworking as a system. The research will focus on answering the clinical question: Since technology is a valuable element of modern professional practice, how can social workers leverage desirable innovativeness to enhance outcomes when dealing with mental health cases? A review of literature points out that social workers have an active role when dealing with patients with depression and technology has immense impact in facilitating service delivery and follow-up process. The study will follow qualitative technique focus groups interview method to explore the relevance of technology in enhancing social work follow-up process for patients with depression. The sample will be obtained through snowball sampling method which is referral-based. Also, ethical concerns related to the study will be carefully examined and optimal solutions recommended to enhance smooth data collection, analysis, and presentation. The research limitations identified for this study include lack of true representation of the actual mental health population by the selected sample and possible recording inaccuracy on the impact of technology on mental health follow-up due to unpredictable depression triggers. The other limitation is that participants may conceal sensitive experiences during focus groups which would otherwise be revealed in an individualized interview session.

   

  Role of Technology in Follow-Up for Mental Health Patients

  CHAPTER 1: INTRODUCTION`

  1.1 Introduction

           Technology is among the most discussed topics in almost every area of modern life. This is evidenced by the interesting digital innovations that have transformed how people and organizations from all walks of life engage in their day-to-day processes. This disruptive trend has been in motion for barely five decades now yet its effects continue to baffle academicians, practitioners, and pundits alike. Inasmuch as the digital revolution is believed to have transformed healthcare practice, and public health at large, little can be said of its effects on social work. A rigorous exploration of the extant literature on this matter has shown that technology usage in this field is constrained within administrative processes (Saiod, vanGreunen, & Veldsman, 2017). Some of these processes include, research, service marketing, documentation (electronic data management), operations management (project management) information transmission across caregivers and agencies. For now, it suffices to highlight that the modern social service model has evolved into a gig economy; hence, a significant number of social workers use social media platforms and professional portals to reach clients independently (Smith, 2016). This trend explains why information and communications technologies are used for service marketing. Such a reality appears quite absurd given the fact that the digital revolution has improved how healthcare services are delivered to patients. As a matter of fact, technology is believed to have enhanced service quality in almost all industries by 10-20 percent, yet, its application in social work is devastatingly understated (Smith, 2016). In the wake of this reality, the present piece proposes a qualitative investigation of the role technology plays in social work, particularly during the follow-up of mental health patients. This project will improve the extant literature by discussing how the infrastructure can be leveraged to enhance processes involving practitioner-patient interactions.

          As mentioned, social workers have not embraced the digital revolution effectively. One of the greatest dangers of underutilization of technology in social work is the inability to improve practice experience and outcomes for both providers and patients. According to Barsky (2017), healthcare systems all over the world are struggling to reduce the high costs of care while enhancing quality outcomes, especially for low-income patients living in rural regions. Such individuals often spend a lot of resources in pursuit of care, which is often inaccessible and unaffordable due to long drives to care facilities, and high service costs. Also, the ageing population calls for innovative solutions in social work, especially since the number of patients suffering from mental health issues due to advancement in age are bound to outnumber the individuals offering such services. This reality is quite disheartening given the industry’s laxity in matters pertaining to technology. Furthermore, the current global COVID-19 pandemic has directly or indirectly affected the psychological health of significant portions of the population. So far, this phenomenon has accounted for over 8.85 million incidences and roughly 57,551 deaths in the United Kingdom (Berg-Weger & Moley, 2020). These figures imply that the number of people experiencing depression in the country has surged beyond anticipation. Furthermore, the restrictive measures implemented by the government have prompted a significant portion of the population to exist in isolation. Such circumstances are bound to trigger unwarranted mental health challenges and also impede access to services. Consequently, Berg-Weger and Moley (2020) urge social workers to leverage innovation to serve the highest possible number of people

  1.2 Purpose Statement

  Clearly, the low use of technology in social work would not be a problem if public health expenditure was bearable. Technology offers an avenue through which these obstacles can be removed (Smith, 2016). Remote practice allows social workers to serve more clients with limited resources (mainly time and operating capital). This way, the costs tend to reduce immensely. Also remote operations allow social workers to safely continue practice during the lockdown and restrictive measures associated with COVID-19. On this note, it is wise to argue that in-depth exploration of technology integration in social work will equip researchers, academicians, and practitioners with sufficient knowledge of its value and application. The present project aims at fulfilling such a noble goal to improve social work practice amidst the ongoing technological transformations. It seems fair to clarify that the use of a qualitative research design enhances this investigation’s value to people seeking in-depth understanding of the fundamental social work and technology integration concepts.

  1.3 Rationale

  I have been a technology enthusiast since the emergence of disruptive digital information and communication models in the modern world. My observations have resulted in the belief that such innovations can have positive impacts on human life when applied to solve particular problems. As an upcoming social worker, I am responsible for improving societal wellbeing through designing and implementing fast-forward solutions. The first step of this process is the exploration of how technology and social work interact in the enhancement of human life experience. A clear grasp of this unique relationship is bound to influence how I approach the practice once I obtain my professional certifications. It suffices to add that this project is the beginning of a long-term focus on the application of digital technology in social work practice. Furthermore, my report will add to the existing body of research since it focuses on an area that has been largely neglected by academicians and researchers across the globe.

  1.4 Theoretical Framework

           Theories are highly valuable aspects of social work as they define human behavior comprehensively. Concepts embedded in various frameworks such as psychodynamic practice, psychosocial performance, transpersonal relationships, and systems theory are among the logical guidelines that define social work practice (Green, 2017). As far as this project is concerned, the researcher will capitalize on the systems theory, which holds that human thoughts and actions are influenced by a broad range of dynamics which work together as a system (Green, 2017).

  Some of these factors include environment, company, socioeconomic status, family background, and education among others. For instance, a person from a low-income family is highly likely to engage in petty crimes compared to their counterpart in a high-income background. Similarly, an educated bipolar patient is more likely than an uneducated patient to understand and adhere to treatment procedures, especially when unfamiliar technology is involved. When placed into perspective, technology is undoubtedly a significant aspect of the modern social system for most if not all human beings on earth. As a matter of fact, the systems framework holds the belief that technology is beneficial to humanity with respect to service delivery and lifestyle improvement (Smith, 2017). This theory will be useful in determining whether technology facilitates positivity in the system for the betterment of mental health patients.

  1.5 Research Question

  1. Since technology is a valuable element of modern professional practice, how can social workers leverage desirable innovativeness to enhance outcomes when dealing with mental health cases?

  1.6 Keywords

  • Social Work
  • Technology
  • Digitisation
  • Electronic Social Work (e-social work)
  • Depression
  • Information Technology
  • Mental Health

  1.7 Report Structure

  • Chapter 1: Introduction
  1. Problem Statement
  2. Purpose Statement
  3. Rationale
  4. Theoretical Framework
  1. Research Questions
  2. Keywords
  • Chapter 2: Literature Review
  1. Social Work and Mental Health
  2. The Role of Technology in Social Work
  • Chapter 3: Methodology
  1. Research Design
  2. Sampling
  3. Data Collection
  4. Data Analysis
  • Chapter 4: Conclusion

  CHAPTER TWO: LITERATURE REVIEW

  2.0 Literature Review

         Keen evaluation of extant literature on social work and the use of technology to improve mental health patients’ experience and outcomes is vital in shaping the progress of this project. This literature review applies an inclusion/exclusion criterion, which is based on credibility and relevance. As far as the first is concerned, sources in this literature review include peer-reviewed articles found through professional databases such as PsycINFO, SocINDEX, EBSCOHOST, Google Scholar, and ProQuest.

  On the other hand, relevance was enhanced through selection of timely sources and thematic focus of studies. On this note, the review incorporates a broad range of secondary sources published between the years 2015 and 2020. These articles were screened to ensure that their content revolved around the following topics:

  • Principles of Social Work Practice
  • Social Work and Mental Health
    • Depression
    • The Roles of Social Workers dealing with Depressed Adults
  • The Role of Technology in Social Work
    • Technology Integration in Social Work
    • Patient Follow-Up and Medication Adherence

   

   

   

   

  Table 1 shows the details of the selected articles focusing on the role of technology in social work

  Table 1 - Critical Review/Appraisal of Literature

  Authors	Focus	Methods	Key Findings	Strengths	Limitations
  Barsky (2017)	Technology infusion in social work practice presents ethical challenges that necessitate effective policy response.	Critical assessment of the policy responses implemented by American organizations to resolve ethical issues arising from technology infusion in social work.	The challenges caused by technology have limited its integration rate in social work.	This report is based on real-life cases, so it offers a strong evidence for theoretical assessments.	The lack of a properly defined methodology compromises the value of this report, especially for studies seeking quantitative data.
  Berzin, Singer, and Chan (2015)	Social workers and other stakeholders should embrace technology to reap its fruits.	Literature review.	Information and Communications Technology has the potential to transform social work in the next decade.	In-depth review of current industry trends.	Lack of primary data collection and evaluation.
  Bullock and Covin (2015)	The focus of the research is on how communication technology can be integrated into social work practices.	The research applies data collection, graphical analysis and integration to ascertain the relationships between communication technology and social work	Technology is greatly aiding administrative and therapeutic processes in social work.   The impact of communication technology is magnificent, hence, can reshape social activities. The relationship is hence critical in improving processes.	The author’s decision to utilize various analytical tools enhances the paper’s credibility.	Over-reliance on literature reports prevents the researchers from affirming their findings through primary data.
  Carpenter-Song, Noel, Acquilano, and Drake (2018)	Technology usage among mental health patients is quite low	Qualitative survey	Industry stakeholders should invest in the development of innovative solutions that make it easy for mental health patients to benefit from modern technologies	Evidence-based outcomes.	Lacks feasible real-world solution to the present challenge.
  Hategan, Giroux, and Bourgeois (2019)	The human behavior theory offers a unique lens through which social workers can understand their patients.	Theoretical analysis.	Social workers can improve their service to clients by applying he human behavior theory.	This piece is relevant in the present project as it shows the factors that need be considered when creating interactive systems for social workers to serve their clients digitally.	This study has focused on the application of technology in a psychiatric setting. This specification limits the generalizability of study findings.
  Saiod, vanGreunen, and Veldsman (2017)	Focuses on the benefits and challenges of EHR to and organization which pertains to social work practices.	The research conducts interviews in organizational IT department to get views as to the interoperability of the system.	The research finds that EHR improves quality of data but also possess challenges as to the HCO interconnected	The study provides both sides of the coin hence leaving a dilemma as to the next course of action in healthcare outcomes.	Findings not applicable to social work.

   

   

   

   

   

  2.1Thematic Review

              Roles of Social Workers dealing with Depressed Patients

  Depression

         Depression is a mental health problem which is usually characterized by persistent decline in moods and chronic loss of interest in activities. This condition is caused by a broad range of factors including lifestyle deterioration, loss of loved one(s), genetic disposition, stigma, serious illness, medication side-effects, and other factors. In his insightful book, Gilbert (2016) argues that depression lacks a specific set of causes and thus it poses a significant challenge to the entire healthcare industry at large. A similar sentiment is shared by Cohen and DeRubies (2018) as they advocate for careful exploration of patient’s backgrounds prior to the treatment of depression. These arguments offer a clear picture of the unpredictable nature of this condition. The challenges posed by this mysterious condition are further affirmed in the statistical records reported in the recent years. According to recent reports recorded by Friedrich (2017), depression is a leading cause of disability across the globe. At least 3.4 percent of the total global populace has been diagnosed with this disorder in less than a decade. Such a mind-blowing figure implies that approximately 265,023,157 people in the world suffer from depression (Friedrich, 2017). In the UK, 69 million antidepressant drugs were dispensed in 2016 (Bell, 2018). 

  These figures are quite alarming when the number of social workers and psychologists in the country are taken into perspective. Keller, Hooker, and Jacobs (2018) found that the number of social workers in the country during the year was roughly 700,000 who are tasked with a wide variety of services to offer the general public while psychologists were around 105,000. Such a realization explains why Friedrich (2017) declares depression as the second leading cause of disability globally, after lower back pain.

  As a matter of fact, one cannot help but reflect on the huge number of depressed members of the society who cannot access care due to factors caused by inadequate supply of practitioners: some of these factors include high financial burden on the tax-payer, geographic inconveniences, and insufficient services. This labor supply problem is discussed comprehensively by Travis, Lizano, and Mor Barak (2016) who found out that most social workers in the child welfare settings complain of burnout due to the relatively few professionals in the industry. Social workers are faced with a colossal challenge which demands innovativeness to allow them to serve the ever-expanding patient base while reducing cases of burnout and occupation stress.

  2.2 The Role of Social Workers

  Like most if not all professional fields, social work is guided by a set of principles that are designed to promote standards and outcomes of practice. Beckett, Maynard, and Jordan (2017) agree that concrete values and ethics are crucial in the promotion of mental health in social work practice. According to these authors, social work principles are based on six key values including servitude, social justice, human relationships, integrity, competence, and dignity. A clear grasp of these principles helps decipher the roles played by social work practitioners in patients’ lives. With such knowledge researchers and policymakers are in a convenient position to explore innovative solutions that can be leveraged to enhance social work practice. Given the challenge faced by depression patients and the public health sector, it is obvious that social workers are expected to deliver high-quality services to the broader population without compromise. Not everyone who has depression will receive support from a social worker, but when they do, the duties of the social worker include identification of depressed persons, patient assessment (incorporates the creation and implementation of an action plan), helping people to cope with crises, connecting patients to vital resources/support, patient advocacy, and follow-up (Smith, 2016). As a social worker, one is expected to have immense knowledge of the behavioural factors that characterize mental health deterioration. Careful observation of a patient in the course of an appointment should allow the worker to generate accurate information regarding the patient’s health status. In their educative work, Travis, Lizano, and Mor Barak (2016) argue that depressed patients tend to show rather common traits such as loss of interest in activities of daily living, pessimism, and poor physical appearance. This knowledge should offer the practitioner the capacity to evaluate the patient’s needs, then come up with a rigorous action plan to resolve the issue. Commendable action plans tend to utilize simple tactics to gear the patients’ mind towards positive aspects of their lives. After all, change begins from within, so the practitioner should train his/her patient to develop positivity in thought and action. As soon as the program commences, a social worker is expected to keep tabs on the patient’s progress during and after the intervention. This part of the process usually involves the use of helpful clinical resources for education, recreation, and interaction with other people. For instance, valuable resources such as camping retreats involving depressed patients and their loved ones allow them to stay away from the routine environments that triggered the mental issue. As far as follow-up is concerned, it can be conducted via calls, emails, SMSs, or personal visits. This duty is quite relevant as it offers practitioners the opportunity to reduce unwarranted cases of stress-induced relapses, which are quite common among patients with mental health challenges such as depression (Fairburn & Patel, 2018; Carpenter-Song et al., 2018).

   

   

  2.3 The Role of Technology in Social Work

              How effective is Technology Integration in Social Work

  Technology use is a powerful tool in creating public awareness on mental health areas of concern and the services offered by social workers to manage the condition (Bullock & Colvin. 2015). The past two-to-three decades have ushered in an era of digitization, which has been characterized by the integration of information and communications technology solutions in to industrial processes. The healthcare sector is among the many that have benefited greatly from this revolution. In their reflective piece, Saiod, vanGreunen, and Veldsman (2017) allude that the United States Electronic Health Records system has improved healthcare for the past 12 years since it was first initiated. This project has managed to reduce healthcare-related errors by over 80 percent. Such an interesting performance is often linked to the fact that the information allowed practitioners from all levels of practice to have synchronized data which gave each of them sufficient grasp of a patient’s health history (Carpenter-Song et al., 2018).

              Since social work is closely linked to the healthcare industry, it is obviously bound to benefit from information and communications technologies innovations implemented in the industry (Hategan et al., 2019). The electronic healthcare record offers the first example of an intervention that continues to improve social work practice (Saiod, vanGreunen, & Veldsman, 2017). Prior to any treatment, a social worker goes through a client’s health record as well as the details of his/her family to define the root cause of mental health issue. Thus, advocacy for increased inclusion and access of technology simultaneously with digital literacy has contributed heavily to the social work effectiveness and efficiency.

  2.4 The Acceptability of Technology in Social Work

  According to Bullock and Colvin (2015), acceptance of technology is, therefore, a fundamental milestone that depends on the ease of use, the organization’s readiness to embrace technology, and staff training, experience, and attitudes. Besides these factors, the ability of the information system to reflect social work values is a key determinant of its adoption (Bullock & Colvin, 2015).

                Technology integration in social work goes beyond informing practitioners regarding the mental health history of patients. It is important to understand that information and communications technology is often praised for its ability to overcome geographic challenges that often affected inter-personal relationships (Carpenter-Song et al., 2018). This feature is quite useful in the modern social service sector considering the limited amount of resources available for the ever increasing number of depressed citizens. In a statistical exploration of the social work profession in the United States, Barsky (2017) asserts that the number of people accessing social service, especially children, is devastatingly low due to the cost-cutting measures developed by healthcare authorities as well as the limited number of people practicing social work in the modern age. As a matter of fact, Barsky approximated that a social worker in the United States is highly likely to have a population of over 1,000 patients that are in need of intervention (Barsky, 2017). Barsky’s (2017) findings are quite instrumental in this project since they are based on real-time feedback from existing social workers in the country. Given this reality, the integration of technology in social work ought to be inspired by this need. Keller, Hooker, and Jacobs (2018) embrace this notion by adding that social workers should resolve this issue by seeking solutions that will allow them to overcome the geographical barriers that make it hard for patients to access services. Bullock and Colvin (2015) support this by pointing out that rural areas have benefited highly from the incorporation of technology in social work. Due to the remoteness, rural areas experience a scarcity of clinical services, resources, and specialized professionals. Thus, technology enablers such as video conferencing, instant messaging, and emails enable social workers to render services to remote areas and avail counselling and assessment services to those with mobility impairments (Hategan et al., 2019).

  Bullock and Colvin (2015) come up with the technology adoption model (TAM) which evaluates the level of user acceptance to utilize technology in social work. The study reveals that the adoption level is dependent on the belief that the technology under consideration will improve their service delivery and work performance, the complexity of the technology adopted, and the actual use of the system. It was observed that the most appropriate technology is one that frees social workers of mental effort allowing them to venture into innovativeness and develop apt strategies to handle social issues. In the study, Bullock and Colvin (2015) also states that technology integration in social work practice is revolutionary. Technology reduces the amount of paperwork and leaves more time for social workers to interact with clients which automatically improves their efficiency in service delivery. For instance, electronic systems facilitate the mobility of social worker services without the need to have a bulk of papers containing client information (Hategan et al., 2019).

  Recent telecommunication inventions such as the infamous Zoom and Skype can be leveraged to allow these practitioners to serve masses within the limits of time rather than distance. It is well known that videoconferencing is a useful tool for people to hold meetings with multiple people at the same time. A social worker dealing with depressed patients can capitalize on the digital infrastructure to ensure that a huge number of patients are reached in a single session (Carpenter-Song et al., 2018). Furthermore, the group approach is quite relevant since it makes it possible for the patients to interact with each other, thus, allowing them to understand that they are not experiencing their problems in solitude. Thus, technological tools enhance collaboration with stakeholders for support in delivering social services at macro levels. Connection, coordination, and communication among stakeholders; regardless of their geographic location, makes planning and implementation timely and efficient (Bullock and Colvin, 2015).

  Technology may also be employed to enable service delivery through efficient case management, counselling, and support. Communication with clients also gets more efficient when technology is used to collect client information, pass information to the clients regarding their condition and enhance intervention activities to counter mental health concerns (Hategan et al., 2019). According to Bullock and Colvin (2015), the pressure of social service agencies to deliver results is continually mounting and computer information systems are constantly adopted to ensure effective services are delivered by social workers. In the same study to evaluate the role of communication technology in increasing social service efficiency, it is pointed out that the role played by social workers is undergoing constant evolution which compels workers to adjust swiftly to changes brought about by technology lest they are faced out of the profession.

  2.5 Client Follow-Up and Medication Adherence

  As a social worker, one is expected to keep tabs on his/her patients regardless of the communication barriers. Technology plays a pivotal role in ensuring that patients are in good hands during and after the treatment (Hategan et al., 2019). In their study on the challenge of integrating technology in social work, Berzin, Singer, and Chan (2015) recommend the employment of data entry portals which allow depressed patients to describe their experience on a daily basis for the time prescribed by their social work practitioner. Such tools might be developed as smartphone and computer software to allow patients from all walks of life to use them to describe their mental health status at any time (Bauer et al., 2020). Such solutions should have performance indicators which allow the practitioner to determine whether patients require further intervention or discharge from the program. Other communication options such as videoconferencing can also be leveraged in patient follow-up and medication adherence phase to facilitate smooth completion of the treatment programs (Carpenter-Song et al., 2018). When reflecting on this project’s theoretical framework, systems theory, one cannot help but acknowledge the fact that a stable system that incorporates technological infrastructure and human resource.

  2.6 Challenges Facing Technology Adoption and Integration in Social Work

              Unlike in most disciplines, the diffusion of technology in social work practice has been dishearteningly slow. So far, its application in this field has been limited to administrative duties such as documentation, marketing, and inter-professional coordination. This tendency is clearly reflected in a recent study by Barsky (2017): the researcher found that over 42 percent of social workers are skeptical about the use of digital technology in their practice. Opponents and sideliners argue that social work is a service-intensive field; hence, the incorporation of technology disrupts the value system. Their argument is grounded in the belief that interactions between providers and patients are bound to deteriorate when physical contact is alternated by remote communication. This kind of skepticism is further affirmed by Berzin, Singer, and Chan (2015) when they report that mental health patients with limited access to their providers disregard their treatment processes. Another common issue highlighted by both sides of this debate is the privacy challenge. Conventional knowledge holds that information systems are constantly vulnerable to malicious attacks which often jeopardize user data security. This too is believed to cause the low technology integration rates as well as the lack of interest in the same.

  Another challenge experienced in the integration and adoption of technology in social work is the inevitable decline of one-on-one interactions between professionals and their clients. Arguably, face-to-face interaction in social work is believed to create a rapport that is difficult if not impossible to duplicate under virtual engagement (Berzin, Singer, & Chan, 2015). Interacting with people, the community they live in and their immediate families creates an interface in social work that technology overlooks. Thus, it is difficult to create long-lasting actual relationships without face-to-face interaction. Consequently, Bullock and Colvin (2015) allude that technology is often perceived as cumbersome and shifts the role of social workers from helpers to bureaucrats.

  According to Bullock and Colvin (2015), the other challenge that compromises the extent to which technology is adopted in social services is end-user compatibility. Social workers hail from various generations with the younger generation developing apt techno savvy skills that are tasking to acquire for the older workers. With the integration of technology in learning institutions, the young generation is considered digital natives. Consequently, they are at ease with the use of technology to deliver services (Carpenter-Song et al., 2018). However, the utilization of software applications and digital technology among older workers is compromised due to digital illiteracy. This implies that social workers need to be educated on technological tools to be capable of documenting relevant client information electronically. Berzin, Singer, and Chan (2015) argue that technological applications developed for social work should also be user-friendly and easy to learn even for individuals that possess a basic level of competency. Their recommendation is grounded on the fact that simple applications have low learning curves which allow non-technical professionals to utilize them effectively and conveniently.

  CHAPTER THREE: RESEARCH PROPOSAL

  Aims

  • To identify the available technology applicable for carrying out follow-up for mental health patients.
  • To identify the extent to which technology has been embraced by social health workers in follow-up for mental health cases.
  • To review the impact technology has had on the efficiency and effectiveness of delivering mental health follow-up.
  • To make recommendation on how technology can be actively embraced to improve follow-up for mental health cases.

  Research Question and Objectives

  Since technology is a valuable element of modern professional practice, how can social workers leverage desirable innovativeness to enhance outcomes when dealing with mental health cases?

  The research intends to examine whether technology has been actively embraced in social work practice follow-up on mental health as a backing for more articulate and efficient means of reaching the patients and improving their outcomes. As part of the study, I aim to explore whether social workers who embrace technology in modern work profession enjoy increased innovativeness to improve mental health treatment outcomes than those who rely on the traditional management procedures.

  This explorative research, will commence by identifying the available follow-up technological options in practice. This will enable me to assess the most influential technological tool used in the follow-up process.

  In addition, this research will evaluate the extent to which social workers employ technology in the mental health follow-up procedures and the barriers to adoption of technology in the practice. This will help in determining whether technology is optimally used or if it is under-utilized, the test will help in proposing recommendations for widespread use.

  Also, this research will examine the level of expertise amongst social workers on use of modern technology. The technical expertise applicable to follow-up procedures will be specifically assessed to establish whether they are comfortable with the technology in use or there is need for further training that can improve patient outcomes.

  Research Paradigm and Methodology

  Ontological reasoning calls for the acknowledgment of social realities so that people can understand how different factors interact to influence human experience of life (Gerring, 2017). Ontological reasoning is concerned with answering the question of ‘what is there’ in real life (Amakiri & Juliet, 2018). Epistemological reasoning. on the other hand, is concerned with answering the question of ‘what knowledge is already available?’ and ‘how is it known?’ This study will adopt ontological reasoning in the qualitative research (Amakiri & Juliet, 2018). Ontological reasoning takes two stances, namely objectivism and subjectivism. Objectivism is the presentation of the real positions of phenomena and their meanings with the belief that there is a possibility of observing and understanding everything without interference by social factors (Amakiri & Juliet, 2018). Subjectivism, on the other hand, holds that the societal phenomenon under study and researcher are mutually dependent and interrelated (Amakiri & Juliet, 2018). This study will opt for subjectivism ontological reasoning in that the results derived on the impacts of technological incorporation in social work are dependent on the ability of the researcher to ask the right questions and make correct inferences. This implies that the researcher plays a key role in ensuring the study is a success (Amakiri & Juliet, 2018). In this sense, this concept justifies the researcher’s exploratory qualitative approach, particularly now that technology is a new phenomenon in the modern world, yet it is highly undervalued by stakeholders in the field of sociology. This implies that the feedback from technology incorporation in social practice will enable the researcher determine whether technology is good or bad for mental health follow-up and to what extent it facilitates or hinders service delivery.

  This research will utilize a qualitative design approach to explore relevant matters pertaining to the use of information technology in enhancing social work practice. This design is quite instrumental in the current context since it presents ICT usage in social work and depression management as a phenomenon that demands boundless exploration. First and foremost, it should be understood that the qualitative design often revolves around five key explorative questions, including ‘what’, ‘how’, ‘why’, ‘when’, and ‘who’ (Gerring, 2017). When taken into perspective, these questions are instrumental in exposing background information regarding a phenomenon and also unearth a detailed analysis of the study subject. It is also fair to add that the qualitative design research is commonly used when the issue under investigation is under-researched. Once sufficient information regarding a phenomenon is generated, researchers can effectively explore details through quantitative design approaches.

  This research will employ both qualitative of data collection method since it is an exploratory project. According to Paradis et al. (2016), while we appreciate that quantitative research entails collection and analysis of data, it is important, especially when testing the assumptions in the study. Quantitative research useful when attempting to deconstruct general fact and theories/concepts (Paradis et al., 2016). This can be achieved by conducting surveys using closed-ended questions and observations expressed in numbers (Gerring, 2017). Qualitative method will be useful for this study because it deduces an in-depth insight on the subject. This will be achieved through developing questions that are open –ended, literature reviews and describing observations (Paradis et al., 2016). It will also adequately acquire exploratory content recorded in the focus group meetings without sieving to suit the specific questions. Qualitative methods are also preferred over quantitative techniques because unlike the latter that deals with numerical data, qualitative techniques accommodate more comprehensive responses organized in themes (Paradis et al., 2016).

  Research Methods

  Qualitative research data can be collected through various means including interviews, questionnaires, observations, pundit analysis, surveys, and focus groups among other approaches (Paradis et al., 2016). Each of the mentioned approaches are effective in unearthing the qualitative aspects of social phenomena (Paradis et al., 2016). The proposed project will apply only the focus group method. This research will employ focus groups as the data collection method. Normally, focus groups usually involve guided discussion sessions among participants (Gerring, 2017). A typical focus group session involves qualified respondents and a moderator (usually the researcher) who uses a set of predetermined open-end questions to engage the members in conclusive discourse regarding the issues at hand (Paradis et al., 2016).

   As the name suggests, focus groups are used when specific information is required (Gerring, 2017). Besides, since participants will be responding as a group, it will enhance anonymity which would become a privacy and ethical concern under direct interview procedures (Busetto et al., 2020). Respondents will also acquire confidence to respond to questions as part of a group than when such questions are shot at them individually as in the case with interviews. Contrary to surveys where questionnaires are used, focus groups gather first-hand information from the participants, hence eliminate the bias of altering with data and imaginary content (Gerring, 2017).

  For this study, two focus group sessions will be carried out for data research. The sessions will help unearth data based on discussion points made by the sixteen participants, half of whom will be social workers incorporating technology in practice and the other half will comprise mental health patients who have benefited from the use of technology in treatment and follow-up process. The first session will involve the eight patients and the researcher as a moderator. Discussion for this group will focus on the selected mental health patients’ experience in social work. The team members will be asked to narrate their positive and/or negative experience with their social workers as well as how they believe technology could be used to improve the services meant for them. It should be understood that the entire session will be tethered around the question highlighted in the beginning of this section which will be comprehensively covered using follow-up sub-questions. The second session will comprise of the eight social work professional participants. Their discussion will be based on how they can utilize their clinical and technological resources to improve service delivery. It is fair to highlight that feedback from the first session will be instrumental in clarifying the challenges and opportunities available for social workers with respect to the integration of information and communications technology in social work related to adult depression treatment. Patients will provide information on the usefulness of technology in facilitating their mental health follow-up programs. The use of emails, video calls, phone calls, short message texts, and other affiliated technology to reach out to patients after their clinical visit will be analyzed for effectiveness in smoothing the follow-up process. The feedback will also entail the recommendations on how best technology can be applied for optimal outcomes as viewed from the mental health clients’ side.

   Also noteworthy is the fact that focus group sessions will be conducted via video-conferencing software. This approach will allow the researcher to not only adhere to the social distance protocols placed in the wake of COVID-19, but also engage respondents from different geographic background. Diversity is vital in expanding the researcher’s grasp of every theme under discussion. When reflecting on the use of this digital infrastructure to communicate with participants, one cannot help but acknowledge the fact that the process will shed some insight on how technology can promote communication between social work practitioners and their patients when geographic distance presents a challenge.

  Reliability and Validity

  In qualitative research, reliability infers to the stability of offered responses to multiple datasets coders (Leung, 2015). Reliability in qualitative research such as the current study can be enhanced by taking detailed field notes, transcription of digital files, and use of recording devices. Validity, on the other hand, refers the trustworthiness of the research which is achieved through its confirmability, dependability, transferability, authenticity, and credibility (Leung, 2015).

  Reliability of this research is focused on replicating the results if the same procedure is followed as many times as possible. It is difficult to achieve reliability in this study because of its analogy of stability, repeatability, and replicability of observations or results (Cypress, 2017). The reason it is difficult to assure of the research reliability is because human interactions and behaviors are dynamic and hence never the same (Leung, 2015). Observations and measurements can also be wrongly repeated hence arriving at different conclusions and findings from the ones obtained in this study (Cypress, 2017). To ensure reliability is increased, the research will focus on care and consistency in which the research practices are applied.

  According to Leung (2015), qualitative research contributes immensely to the primary care field irrespective of the level. In order to achieve internal validity, the layout of the methodology and result interpretation techniques must be rigorous (Cypress, 2017). Following a systematic and transparent research process is a key means of ensuring the validity of qualitative research is upheld (Leung, 2015). This implies that every research process from formation of the theory, study design, sampling techniques, acquisition of data, results reporting and analysis and the manner in which conclusions are drawn should systematic and transparent enough to be validated (Cypress, 2017). In this research, validity will be obtained through use of recording devices to ensure the content discussed in focus groups is not lost. This will ensure that the instrument used measures the impact of technology in social work follow-up for mental health patients accurately.

   Sampling

  Sampling is a unique phase of research projects as it allows investigators to define and approach the type of participants they require to attain their predetermined objectives. At the moment, there are only two recognized methods of sampling including probability and non-probability sampling (Taherdoost, 2016). According to Taherdoost (2016), probability sampling entails selection of participants randomly. Non-probability sampling on the other hand is the non-randomized selection of participants (Gupta, 2020). The participants are selected on the basis of a given criteria such as convenience. Non-probability sampling allows for ease of data collection than the more tasking and time-consuming probability sampling (Gupta, 2020). The probability sampling is often useful when seeking strong statistical inferences regarding a large group while non-probability sampling is highly convenient when the researcher hopes for systematic outcomes (Taherdoost, 2016).

  For the sake of this study, the researcher will use the snowball sampling technique, which is listed among non-probability sampling methods. Snowballing allows a researcher to reach a pool of participants through the primary contacts that he or she has. In this case, the present project’s researcher knows only three relevant participants, a depressed patient and two social workers working with depressed patients (Gerring, 2017). According to Kirchherr and Charles (2018), snow ball sampling utilizes a referral system where one interviewee refers the name of at least one potential participant to the researcher. The cycle continues and the sample grows like a rolling snowball until the required participant number is achieved (Kirchherr & Charles, 2018). The primary contacts will reach out to fellow patients and social workers (respectively) to ensure that participants reach the desired number. It is wise to clarify that the primary contacts will be informed through phone and one-on-one communication, then they will also apply a similar approach to recruit their contacts. Image 1 offers a graphical depiction of how the sampling process will be conducted:

  Image 1 – Snowball Sampling Approach

  This project will use a sample of sixteen male and female participants. Eight of   these respondents will include professionals in Social Work Practice who use technology in attending to their mental health patients and when carrying out follow-ups. This will enable the researcher to collect information on the effectiveness of technology in carrying out social work practice as the respondents will be able to present their individualized and professional experiences. Meanwhile, the remaining eight will include adult mental health patients working with social workers in the United Kingdom.

  Research Ethics

              This section will present the ethical considerations that will influence the research process.

  In research study, the appropriate ethical principles are applied to protect human subjects (Arifin, 2018). Qualitative research is deep in nature hence its ethical considerations resonate saliently, especially when vulnerable participant groups are involved as is the case with the current study (Arifin, 2018). The research participants will be confidential and shall not be exposed to inhumane activities. Most importantly, all participants will be required to give written or oral (recorded) consent before participating in the project. Approval will also be sought from the school of education and social care ethics committee. To obtain this approval, the researcher will complete a check-list to determine the risk level this research poses and the methods through which such risks can be kept at a minimum. Besides, the proposed research project will abide by the ethical standards present in the British Association of Social Workers Code of Ethics. The code of ethics guides researchers on protection of participants’ wellbeing, safety, rights, and stance (Arifin, 2018).

  The principle of respecting participants in this research will explore two fronts which include the fact that everyone must be treated as autonomous. This principle appreciates the fact that participants have a right to make individual decisions that they deem fit (Arifin, 2018). It is unethical to coerce a participant to agree to suggestions that are against their will and belief. Since this research will seek to address fundamental issues relating to health it therefore implies that individualized decision making is the best format of conducting research. This research will involve people who are in a position to exercise their autonomy in form of voluntary participation. It is common knowledge that people with diminished autonomy are incapable of making their own decision and even such decisions may be considered uninform (Arifin, 2018). The process of sampling and choice of participants will appreciate the principle of fairness and justice. The chosen population will not be victims of their vulnerabilities but people who are in a position to exercise their autonomy (Arifin, 2018). The reason we have chosen social work professionals using ICT is so that they can use the research to pinpoint gaps and suggest possible solutions based on best practices across the globe. Thus, participants are free to withdraw from the study while in progress or even refuse to take part in the research without affecting their social work or care follow-up in any way (Arifin, 2018).

  The other ethical concern arising from this research relates to confidentiality and anonymity of participants. According to Arifin (2018), interview environments should be managed such that the sessions, data analysis and findings disseminations are kept anonymous. In response, this research will adhere to the principle of beneficence to the extent that it aims to benefit others. The new information that will be gathered during this research will be useful to the general societal growth. The research will at no time aim to harm or hurt anyone since its cardinal principle is to ensure that technology is incorporated in dealing with mental health cases. The ultimate goal while conducting the research will be to maximize benefits intended for participants and reduce or eliminate any risk whatsoever that may befall them. Since the research methodology will involve adults who are healthcare professionals using ICT and the fact that there are no consumables or injectables, the participants will be freed from any physical harm that may arise during the study. The objective of achieving beneficence will be achieved through retaining the confidentiality of participants by concealing their identity and names throughout the research process (Arifin, 2018). However, participants may face distress when they are asked sensitive questions, especially if they relate to the phenomena that triggers their depression condition. Under such circumstances, the clients should be given some time off to calm down before continuing with the interviews. If they are incapable of going on, they should be relieved and the session carried out in their absentia.

  The study will also adhere to the ethical principle of informed consent. According to Burles and Bally (2018), although the research is non-obtrusive, the participants must be accorded the right to make informed consent through ensuring they have a thorough understanding of the data to be collected and the methods applied. This means that the participants should know that they will be undertaking the study as a group and that the information they share will be in the presence of others (Kaewkungwal & Adams, 2019). In order for the participants to make individualized and informed decisions, it will be crucial that they are provided with adequate information that relates to the study. An informed participant will make meaningful contribution to the study unlike their counterparts. It is then that they will be in a better position to make decisions that suit them (Arifin, 2018). Informed consent is obtained through a rigorous process where the researcher ensures participants gain an understanding of the research and the privacy and confidentiality of personal information they divulge during these discussions if they agree to take part in the study (Kaewkungwal & Adams, 2019). With this knowledge, the participants can make a decision to participate while acknowledging the full implication of the research. In order to avoid ethical issues, participants will be required to provide their informed consent forms in written form after their concerns and questions are addressed.

  Data Analysis

              There are various ways of scrutinizing qualitative data including content analysis, narrative evaluation, discourse assessment, framework analysis, and grounded theory (Gerring, 2017). Content assessment is the commonest approach used by researchers, and it involve thematic categorization and tagging of information to demonstrate the strength of particular themes. Discourse analysis often involves exploring what people say regarding social and cultural phenomena. This technique is strongly linked to narrative assessment since they both focus on describing the issues under discussion in the form of a story. The framework analysis approach usually relies on the use of coding frameworks such as the code frame to categorize themes based on their relevance and value to the issue under discussion. Lastly, the grounded theory is a practical approach which involves logical reflection and evaluation of collected data based on a predetermined theory which serves as an anchor for any findings that emerge in a project. Focus group interviews generate huge amounts of data. This research will, therefore, employ framework analysis to analyze data from the focus group discussions. The framework analysis will be conducted in a continuum manner from raw data accumulation to its interpretation (Koning et al., 2017). The data analysis procedure will follow five steps namely familiarization, thematic framework identification, indexing, charting and interpretation of mapped data. Themes are developed from the narratives provided by research participants and the research points/sub-questions used. The primary goal of this approach is to deliver raw insight on what patients and practitioners have to say regarding the integration of technology in social work relating to depression.

  CHAPTER 4: CONCLUSION

  Technology is identified as one of the key areas of concern in contemporary society. Digital innovations that evolve from technological applications have transformed the daily engagements among individuals, organizations, and all aspects of living. Although technology has penetrated almost all sectors, its application remains a going concern for practitioners, academicians, and society in general. With the digital revolution, it is expected that individuals will automatically embrace technology in their daily activities, however, it is not necessarily the truth. Instead, while some may be thriving in using technology as a tool of trade, others may find it daunting to learn and apply it in their fields of practice. In social work, it is established that technology is yet to take off effectively due to the need for human-to-human interactions as an effective way of reaching out.

  This study has capitalized on the existing gap in the use of technology in social work to examine its impact on follow-up programs for mental health patients. Some of the areas that technology can be used to follow-up mental health patients are through research, electronic data management, and the transmission of information from the social workers to their patients and vice-versa. Anchored on the systems theory, transpersonal relationships, and psychosocial performance, the study strives to utilize theories that comprehensively describe human behavior. The system’s theory upon which the research is built holds that dynamic factors such as education, family background, socio-economic status, company, and environment work together to define the actions and thoughts of human beings. A review of literature from articles dating between 2015 and 2021 is used to establish the existing knowledge on the use of technology and its impact in social work in general and mental health follow-up programs specifically. The literature is divided into two themes. The first theme focuses on the role of social workers dealing with depression patients. To build on this theme, depression is defined as mental health characterized by chronic loss of interest and decline in moods among patients. Causes of depression such as genetic disposition, side-effects of medication, severe illness, stigma, loss of loved ones, and deterioration of lifestyle are identified. Depression is also pointed out as a major challenge in the healthcare sector, especially with the fact that its exact cause is unknown. To enable patients to handle the depression menace, social workers are tasked with the role of promoting mental health based on dignity, competence, integrity, human relationships, social justice, and servitude principles of social practice. 

  The second theme focuses on the role technology plays in social work. Technology is established as a powerful public awareness tool in enlightening society on the areas of mental health concern and the availability of social works services to manage the condition. Digitization which has been highly characterized by the integration of ICT in the health sector has seen numerous people benefit from the prowess, effectiveness, and efficiency it delivers. Applications such as electronic health records document the health information of the patient, their family details, and mental health cause. This makes it easy to assist the patient when they return for services. However, technology is still at the teething stage in terms of acceptance in social work. Although digital literacy and technology access has been associated with a significant increase in efficiency and effectiveness of social work as they offer real-time feedback and enhance ease of attendance to the ever-increasing mental health population, it still faces the acceptance barrier among practitioners and patients. Adoption is dependent on whether the social workers consider it as an improvement to work performance and service delivery. This research will, therefore, establish the effectiveness of technology in follow-up programs and hence enhance its adoption as a tool of practice depending on the outcomes.

  The research proposal should demonstrate how the use of technology by social workers is proliferating. Technology has resulted in an expansion of social work, something that has made service delivery to patients easier. Various forms of technology can be used to transform the nature of social work and they include; online counselling, electronic social networks, telephone counselling, emails, and mobile apps. The use of technology by social workers can be expanded to include gathering, accessing as well as managing information about patients. The interaction between social workers and clients has been heightened by technology since it has created new ways through which social workers can deliver services to their clients, albeit remotely. Solutions resulting from the use of technology in handling patients with depression are a wide range to the extent that it can be used to address emergency concerns that probably do not necessarily require face-to-face meetings between the social workers and the patient. Besides, it can also be used to track and administer health protocols.

  Technology is devastatingly underused in the social work setting despite the disruptive effect it has had on various industries, including the healthcare sector. Such a reality calls for further investigation on how social workers can utilize available information technologies to improve the service they offer adult depression patients. The proposed project applies a qualitative approach to further expose the current situation since little information is available concerning this matter. The key limitation of this research approach is the lack of focus on a particular point. However, this limitation can be perceived as a strength since it allows the respondents to discuss matters that are relevant to this phenomenon. A broad discussion is permissible at this point because very few researchers have explored the interactions between technology and social work, let alone defining ways in which the former can be leveraged to augment national social care efforts against depression and other mental health issues.

  Reflexivity

              Qualitative research is carried out within a specific place and duration between the researcher and participants (Dodgson, 2019). The ability of the researcher to accurately describe the intersecting contextual relationship through the reflexibility process increase the credibility of the research findings and deepens the understanding of their work (Barrett, Kajamaa, & Johnston, 2020). Reflexibility, therefore, describes the responsibility of clearly and succinctly addressing the credibility issues that arise from qualitative research (Subramani, 2018). As the first comprehensive research work the researcher has undertaken in the field, it will equip the researcher with credible knowledge on the use of technology in social work as a follow-up tool for mental health patients. The study also reveals the hindrances to the overall embracing of technology in follow-ups instead of emphasizing face-to-face interactions that may be geographically or socially incapacitated. The study reveals the need to safeguard mental health patients who lack the mental capacity to make treatment or care decisions. With the power placed on social workers to determine which treatment method to use, the study also gave patients an opportunity to give quality feedback on the effectiveness of technology in terms of delivering services to them and the impact it has on their health outcomes.

  This research has broadened my understanding of mental health follow-up programs and enabled me to identify the patient as the center of service focus. I have also learned that although mentally ill patients have little to say about their treatment programs, their feedback is valuable and must be considered in practice. Previously, I figured that as a social worker, I am responsible for everything without any consultation. However, this study will reveal whether the patients are capable of increasing the value of technology application as informed individuals.

  Limitations  

  This study has limitations that make its findings to be considered precautious. The used samples are not representative of the general population of mental health patients because they differ on the level of mental illness. Also, due to the unpredictability of depression triggers, the impact of technology use may not be accurately recorded unless the patients are confined into a similar environment. Focus groups may also cause some of the participants to conceal their experiences.