The steps at the heart of single-system (subject) research are part of the everyday practice of social work. Each day social workers implement interventions to meet clients’ needs and monitor results. However, conducting proper single-system (subject) research entails far more than these simple day-to-day practices. Proper single-system research requires a high degree of knowledge and commitment. Social workers must fully understand the purpose of single-system (subject) research and the variations of single-system (subject) design. They must develop a hypothesis based upon research and select the right design for testing it. They must ensure the reliability and validity of the data to be collected and know how to properly analyze and evaluate that data. This assignment asks you to rise to the challenge of creating a proposal for a single-subject research study. To prepare for this Assignment, imagine that you are the social worker assigned to work with Paula Cortez (see the case study, “Social Work Research: Single Subject” in this week’s resources). After an initial assessment of her social, medical, and psychiatric problems, you develop a plan for intervention. You also develop a plan to monitor progress in your work with her using measures that can be evaluated in a single-system research design. As a scholar practitioner, you rely on research to help plan your intervention and your evaluation plan. Complete the Cortez Family interactive media in this week’s resources. Conduct a literature search related to the chronic issues related to HIV/AIDS and bipolar mental disorder. Search for additional research related to assessing outcomes and theoretical frameworks appropriate for this client. For example, your search could include terms such as motivational interviewing and outcomes and goal-oriented practice and outcomes. You might also look at the NREPP database identified in Week 1, to search for interventions related to mental health and physical health. By Day 7 Submit a 5- to 7-page proposal/research plan for single-system (subject) evaluation for your work with Paula Cortez. Identify the problems that you will target and the outcomes you will measure, select an appropriate intervention or interventions (including length of time), and identify an appropriate evaluation plan. Include a description of: The problem(s) that are the focus of treatment The intervention approach, including length of time, so that it can be replicated A summary of the literature that you reviewed that led you to select this intervention approach The purpose for conducting a single-system (subject) research evaluation The measures for evaluating the outcomes and observing change including: Evidence from your literature search about the nature of the measures The validity and reliability of the measures How baseline measures will be obtained How often follow-up measures will be administered The criteria that you would use to determi ...

1. The steps at the heart of single-system (subject) research are
part of the everyday practice of social work. Each day social
workers implement interventions to meet clients’ needs and
monitor results. However, conducting proper single-system
(subject) research entails far more than these simple day-to-day
practices. Proper single-system research requires a high degree
of knowledge and commitment. Social workers must fully
understand the purpose of single-system (subject) research and
the variations of single-system (subject) design. They must
develop a hypothesis based upon research and select the right
design for testing it. They must ensure the reliability and
validity of the data to be collected and know how to properly
analyze and evaluate that data. This assignment asks you to rise
to the challenge of creating a proposal for a single-subject
research study.
To prepare for this Assignment, imagine that you are the social
worker assigned to work with Paula Cortez (see the case study,
“Social Work Research: Single Subject” in this week’s
resources). After an initial assessment of her social, medical,
and psychiatric problems, you develop a plan for intervention.
You also develop a plan to monitor progress in your work with
her using measures that can be evaluated in a single-system
research design. As a scholar practitioner, you rely on research
to help plan your intervention and your evaluation plan.
Complete the Cortez Family interactive media in this week’s
resources. Conduct a literature search related to the chronic
issues related to HIV/AIDS and bipolar mental disorder. Search
for additional research related to assessing outcomes and
theoretical frameworks appropriate for this client. For example,
your search could include terms such as motivational
interviewing and outcomes and goal-oriented practice and
outcomes. You might also look at the NREPP database
identified in Week 1, to search for interventions related to

2. mental health and physical health.
By Day 7
Submit
a 5- to 7-page proposal/research plan for single-system
(subject) evaluation for your work with Paula Cortez. Identify
the problems that you will target and the outcomes you will
measure, select an appropriate intervention or interventions
(including length of time), and identify an appropriate
evaluation plan.
Include a description of:
The problem(s) that are the focus of treatment
The intervention approach, including length of time, so that it
can be replicated
A summary of the literature that you reviewed that led you to
select this intervention approach
The purpose for conducting a single-system (subject) research
evaluation
The measures for evaluating the outcomes and observing change
including:
Evidence from your literature search about the nature of the
measures

3. The validity and reliability of the measures
How baseline measures will be obtained
How often follow-up measures will be administered
The criteria that you would use to determine whether the
intervention is effective
How the periodic measurements could assist you in your
ongoing work with Paula
Required Readings
Dudley, J. R. (2014).
Social work evaluation: Enhancing what we do.
(2nd ed.) Chicago, IL: Lyceum Books.
Chapter 9, “Is the Intervention Effective?” (pp. 226-244: Read
from “Client Satisfaction & Effectiveness” to “Target Problem
Scale”)
Document:
Corcoran, K., & Hozack, N. (2010). Locating assessment
instruments. In B. Thyer (Ed.),
The handbook of social work research methods
(2nd ed., pp. 65–74). Thousand Oaks, CA: Sage. (PDF)
Copyright 2010 by Sage Publications, Inc.
Reprinted by permission of Sage Publications, Inc. via the

4. Copyright Clearance Center.
Document:
Mattaini, M. A. (2010). Single-system studies. In B. Thyer
(Ed.),
The handbook of social work research methods
(2nd ed., pp. 241–273). Thousand Oaks, CA: Sage. (PDF)
Copyright 2010 by Sage Publications, Inc.
Reprinted by permission of Sage Publications, Inc. via the
Copyright Clearance Center.
Plummer, S.-B., Makris, S., & Brocksen S. (Eds.). (2014b).
Social work case studies: Concentration year
. Baltimore, MD: Laureate International Universities
Publishing. [Vital Source e-reader].
Read the following section:
“Social Work Research: Single Subject” (pp. 70–72)
Tankersley, M., Cook, B. G., & Cook, L. (2008). A Preliminary
Examination to Identify the Presence of Quality Indicators in
Single-subject Research.
Education & Treatment of Children, 31
(4), 523-548
Social Work Research: Single Subject
Chris is a social worker in a geriatric case management program
located in a midsize Northeastern town. She has an MSW and is
part of a team of case managers that likes to continuously
improve on its practice. The team is currently using an approach

5. that integrates elements of geriatric case management with
short-term treatment methods, particularly the solution-focused
and task-centered models. As part of their ongoing practice, the
team regularly conducts practice evaluations. It has participated
in larger scale research projects in the past.
The agency is fairly small (three full-time and two part-time
social work case managers) and is one of several providers in a
region of approximately 50,000 inhabitants. Strengths of the
agency include a strong professional network and good
reputation in the local community as well as the team of
experienced social workers. Staff turnover has been almost
nonexistent for the past 3 years. The agency serves about 60–70
clients at any given time. The clients assisted by the case
management program are older adults, ranging from their early
60s to over 100 years of age, as well as their caregivers.
To evaluate its practice approach, the team has decided to use a
multiple-baseline, single-subject design. Each of the full-time
case managers will select one client new to the caseload to
participate in the study. The research project is explained to
clients by the respective case manager and informed consent to
participate is requested.
George was identified by Chris as a potential candidate for the
evaluation. As a former science teacher who loved to do
research himself, he agreed to participate in the project. George
is 87 years old, and although he is not as physically robust as he
once was, at 5 feet 9 inches tall, he has a strong presence. He
has consistent back pain and occasional flare-ups of rheumatoid
arthritis. His wife of 45 years passed away two summers ago
after a long fight with cancer. After his initial grief, he has
managed fairly well to adapt to life on his own. George entered
the program after being hospitalized for fainting while at the
grocery store. A battery of medical tests was conducted, but no
specific cause of his fainting attack could be found. However,

6. the physicians assessed signs of slight cognitive
impairments/dementia and suggested a geriatric case
management program.
An initial assessment by the case manager showed the need for
assistance in the following areas: 1) personal care, 2) decrease
in mobility, and 3) longer-term planning around living
arrangement and home safety. The case manager also thought
that George could benefit from setting up advance directives,
which he did not want to discuss at that time. They agreed that
the case manager could bring this topic up again in the future.
As part of the practice process, the case manager used clinical
rating scales that were adapted from the task-centered model. At
the beginning of each client contact, case manager and client
collaboratively evaluated how well the practice steps (tasks)
undertaken by client and/or case manager were completed using
a 10-point clinical scale. Concurrently, they evaluated changes
to the respective client problems, also using a 10-point clinical
scale. George was able to actively participate in the planning
and implementation of most care-related decisions. During the
course of their collaborative work, most needs were at least
partially addressed. Two tasks were completed regarding
personal care, two regarding mobility, and three addressing
home safety issues. Only personal mobility was still a minor
problem and required some additional work.
After finishing the reassessment at 3 months, Chris completed
gathering and evaluating the data for the single-subject design
(SSD). As promised, she also provided George with the finished
SSD findings. The following is an overview of the data that was
collected for this case:

7. Paula Cortez
Identifying Data: Paula Cortez is a 43-year-old Catholic
Hispanic female residing in New York City, NY. Paula was born
in Colombia. When she was 17 years old, Paula left Colombia
and moved to New York where she met David, who later
became her husband. Paula and David have one son, Miguel, 20
years old. They divorced after 5 years of marriage. Paula has a
five-year-old daughter, Maria, from a different relationship.
Presenting Problem: Paula has multiple medical issues, and
there is concern about whether she will be able to continue to
care for her youngest child, Maria. Paula has been
overwhelmed, especially since she again stopped taking her
medication. Paula is also concerned about the wellness of
Maria. Family Dynamics: Paula comes from a moderately well -
to-do family. Paula reports suffering physical and emotional
abuse at the hands of both her parents, eventually fleeing to
New York to get away from the abuse. Paula comes from an
authoritarian family where her role was to be “seen and not
heard.” Paula states that she did not feel valued by any of her
family members and reports never receiving the attention she
needed. As a teenager, she realized she felt “not good enough”
in her family system, which led to her leaving for New York
and looking for “someone to love me.” Her parents still reside
in Colombia with Paula’s two siblings. Paula met David when
she sought to purchase drugs. They married when Paula was 18
years old. The couple divorced after 5 years of marriage. Paula
raised Miguel, mostly by herself, until he was 8 years old, at
which time she was forced to relinquish custody due to her
medical condition. Paula maintains a relationship with her son,
Miguel, and her ex-husband, David. Miguel takes part in caring
for his half-sister, Maria. Paula does believe her job as a mother
is to take care of Maria but is finding that more and more
challenging with her physical illnesses. Employment History:
Paula worked for a clothing designer, but she realized that her

8. true passion was painting. She has a collection of more than 100
drawings and paintings, many of which track the course of her
personal and emotional journey. Paula held a fulltime job for a
number of years before her health prevented her from working.
She is now unemployed and receives Supplemental Security
Disability Insurance (SSD) and Medicaid. Miguel does his best
to help his mom but only works part time at a local supermarket
delivering groceries. Paula currently uses federal and state
services. Paula successfully applied for WIC, the federal
Supplemental Nutrition Program for Women, Infants, and
Children. Given Paula’s low income, health, and Medicaid
status, Paula is able to receive in-home childcare assistance
through New York’s public assistance program.
Social History: Paula is bilingual, fluent in both Spanish and
English. Although Paula identifies as Catholic, she does not
consider religion to be a big part of her life. Paula lives with
her daughter in an apartment in Queens, NY. Paula is socially
isolated as she has limited contact with her family in Colombia
and lacks a peer network of any kind in her neighborhood. Five
(5) years ago Paula met a man (Jesus) at a flower shop. They
spoke several times. He would visit her at her apartment to have
sex. Since they had an active sex life, Paula thought he was a
“stand-up guy” and really liked him. She believed he would take
care of her. Soon everything changed. Paula began to suspect
that he was using drugs, because he had started to become
controlling and demanding. He showed up at her apartment at
all times of the night demanding to be let in. He called her
relentlessly, and when she did not pick up the phone, he left her
mean and threatening messages. Paula was fearful for her safety
and thought her past behavior with drugs and sex brought on
bad relationships with men and that she did not deserve better.
After a couple of months, Paula realized she was pregnant.
Jesus stated he did not want anything to do with the “kid” and

9. stopped coming over, but he continued to contact and threaten
Paula by phone. Paula has no contact with Jesus at this point in
time due to a restraining order. Mental Health History: Paula
was diagnosed with bipolar disorder. She experiences periods of
mania lasting for a couple of weeks then goes into a depressive
state for months when not properly medicated. Paula has a
tendency toward paranoia. Paula has a history of not complying
with her psychiatric medication treatment because she does not
like the way it makes her feel. She often discontinues it without
telling her psychiatrist. Paula has had multiple psychiatric
hospitalizations but has remained out of the hospital for the past
5 years. Paula accepts her bipolar diagnosis but demonstrates
limited insight into the relationship between her symptoms and
her medication. Paula reports that when she was pregnant, she
was fearful for her safety due to the baby’s father’s anger about
the pregnancy. Jesus’ relentless phone calls and voicemails
rattled Paula. She believed she had nowhere to turn. At that
time, she became scared, slept poorly, and her paranoia
increased significantly. After completing a suicide assessment 5
years ago, it was noted that Paula was decompensating quickly
and was at risk of harming herself and/or her baby. Paula was
involuntarily admitted to the psychiatric unit of the hospital.
Paula remained on the unit for 2 weeks. Educational History:
Paula completed high school in Colombia. Paula had hoped to
attend the Fashion Institute of Technology (FIT) in New York
City, but getting divorced, then raising Miguel on her own
interfered with her plans. Miguel attends college full time in
New York City. Medical History: Paula was diagnosed as HIV
positive 15 years ago. Paula acquired AIDS three years l ater
when she was diagnosed with a severe brain infection and a
Tcell count of less than 200. Paula’s brain infection left her
completely paralyzed on the right side. She lost function in her
right arm and hand as well as the ability to walk. After a long
stay in an acute care hospital in New York City, Paula was
transferred to a skilled nursing facility (SNF) where she thought
she would die. After being in the skilled nursing facility for

10. more than a year, Paula regained the ability to walk, although
she does so with a severe limp. She also regained some function
in her right arm. Her right hand (her dominant hand) remains
semi-paralyzed and limp. Over the course of several years,
Paula taught herself to paint with her left hand and was able to
return to her beloved art. Paula began treatment for her
HIV/AIDS with highly active antiretroviral therapy (HAART).
Since she ran away from the family home, married and divorced
a drug user, then was in an abusive relationship, Paula thought
she deserved what she got in life. She responded well to
HAART and her HIV/AIDS was well controlled. In addition to
her HIV/AIDS disease, Paula is diagnosed with Hepatitis C
(Hep C). While this condition was controlled, it has reached a
point where Paula’s doctor is recommending she begin a new
treatment. Paula also has significant circulatory problems,
which cause her severe pain in her lower extremities. She uses
prescribed narcotic pain medication to control her symptoms.
Paula’s circulatory problems have also led to chronic ulcers on
her feet that will not heal. Treatment for her foot ulcers
demands frequent visits to a wound care clinic. Paula’s pain
paired with the foot ulcers make it difficult for her to ambulate
and leave her home. Paula has a tendency not to comply with
her medical treatment. She often disregards instructions from
her doctors and resorts to holistic treatments like treating her
ulcers with chamomile tea. When she stops her treatment, she
deteriorates quickly. Maria was born HIV negative and received
the appropriate HAART treatment after birth. She spent a week
in the neonatal intensive care unit as she had to detox from the
effects of the pain medication Paula took throughout her
pregnancy. Legal History: Previously, Paula used the AIDS Law
Project, a not-for-profit organization that helps individuals with
HIV address legal issues, such as those related to the child’s
father . At that time, Paula filed a police report in response to
Jesus' escalating threats and successfully got a restraining
order. Once the order was served, the phone calls and visits
stopped, and Paula regained a temporary sense of control over

11. her life. Paula completed the appropriate permanency planning
paperwork with the assistance of the organization The Family
Center. She named Miguel as her daughter’s guardian should
something happen to her. Alcohol and Drug Use History: Paula
became an intravenous drug user (IVDU), using cocaine and
heroin, at age 17. David was one of Paula’s “drug buddies” and
suppliers. Paula continued to use drugs in the United States for
several years; however, she stopped when she got pregnant with
Miguel. David continued to use drugs, which led to the failure
of their marriage. Strengths: Paula has shown her resilience
over the years. She has artistic skills and has found a way to
utilize them. Paula has the foresight to seek social services to
help her and her children survive. Paula has no legal
involvement. She has the ability to bounce back from her many
physical and health challenges to continue to care for her child
and maintain her household.