Transformative Self-Management (TSM): Participatory Action Research and Content Analysis PDF

Preview

Summary

PAR Study 1 ! Transformative Self-Management Transformative Self-Management: Participatory Action Research and Content Analysis PAR Study 2 ! Abstract In May of 2006, needs analysis at ACS, a constructivist clinic classroom in Orlando, Florida, demonstrated that students enrolled in a constructivist...

Description

PAR Study !1 Transformative Self-Management

Transformative Self-Management: Participatory Action Research and Content Analysis

PAR Study !2 Abstract In May of 2006, needs analysis at ACS, a constructivist clinic classroom in Orlando, Florida, demonstrated that students enrolled in a constructivist learning community needed comprehensive instruction in self-management. ACS offers instruction in 39 other topic areas. The problem was to provide meaningful, structured, and thorough instruction that correlated with required classroom learning. In 2007, sample TSM modules were tested with classroom learners to determine effectiveness and relevance to the learning needs of a population of college students and skilled professionals. An online learning product, Transformative Self Management (TSM), was designed, based on two years of intensive collaborative community inquiry, critique and dialogue. Extensive formative evaluation and surveying of students continued through May of 2008 when the learning product went online. A management and innovation project, described in this Capstone, details the implementation and evaluation of this online product, which will take place from August to December of 2008.

PAR Study !3 Acknowledgements Terri Lynn and Ryan Rabac, demonstrated perseverance, compassion, understanding, and make it all worthwhile. Helen Rabac provided lifelong encouragement and love. Jim Belcher contributed intellectual challenge, subject matter expertise, commiseration, and creativity. Heartfelt gratitude to Sydney Parent for professional mentoring and much needed prompting, re-assurance, and meticulous review. The ACS staff is diverse, creative, and committed. Todd Tippin, Frank Lovato, Cornelius Friendly, Ian Thomas Hart, and Robinn Halfacre are devoted and autonomous, and care about each other and the learners. It is difficult to imagine a more intelligent, enthused, and exemplary group of learners than those at ACS over the course of this project. Ryan Rabac has been a valuable source of guidance in computer technology and application. John Segers has been an invaluable rescuer from the dilemmas of using five computers to coalesce into one document. He is the heroic sort of character he portrays in countless Gilbert & Sullivan performances. Amber Dukes, who recently joined ACS, immediately put her whole heart and mind into all aspects of the clinic and TSM. Her contributions have been a reminder that dynamic, self-directed individuals will rise to the occasion if the challenge engages the fullness of being. Lastly, this capstone has blossomed at about the same time as a vividly colored

PAR Study !4 pink crepe myrtle in the back garden of our home. My father, John, who died during the last stages of this project, insisted that I acquire and plant that flowering tree. Now I know why.

Table of Contents CHAPTER 1: INTRODUCTION TO THE PROBLEM ………………………………… 6 Executive Summary …………………………………………………………………… 7 Problem Statement ...………………………………………………………………….. 9 Rationale and Significance ……………………………………………………… 11 Clients and Stakeholders ...…………………………………………………………… 12 Project Team Members...……………………………………………………………… 14 Research Questions …………………………………………………………………… 18 CHAPTER 2: LITERATURE REVIEW Introduction …………………………………………………………………………..

PAR Study !5 23 Online Learning Product Development and Testing ............................................. 24

Autonomy and the 3 Theory Bases of TSM ………………………………………

27 Qualitative, Action, and Participatory Action Research......................................... 30 Credibility of PAR ……..…………………………………………………………. 31 Discoveries……..…………………………………………………………………. 38 CHAPTER 3: METHODOLOGY Learner Analysis .……………………….………………………………………………… 41 Demographic Information…………………………………………………………. 43 Entry Level Knowledge/Skills.…………………………………………………….. 44 Additional Information on Education Levels............................................................ 45 Cultural Characteristics of the Target Population.................................................... 45 Special Populations………………..…………..………………………….……………….

PAR Study !6 48 Performance Objectives ...………………………………………………………………… 49

Self-Concept & Organization ………………………………………………….…….

49 Treatment Planning ………………………………………………………………….. 50 Motivation Enhancement Therapy …………………………………………………... 50 12 Steps Facilitation …………………………………………………………………. 50 Creativity: NLP, Jungian and Transpersonal ……………………………………….. 51 Neurocognitive……………………………………………………………………….. 52 Cognitive, Behavioral and Emotional Intelligence (EI)………………………………. 52 TSM …………………………………………………………………………………… 53 Project Deliverables ………………………………………………………………….......... 53 Learning

Theories

and

…………………………………………….57

Instructional

Strategies

PAR Study !7 Barriers and Risks …………………………………………………………………………. 62 Barriers ………………………………………………………………………………62 Risks ………………………………………………………………………………….64 Implementation Procedure………..………………………………………………………... 68 Media and Materials. ………………………………………………………………………..69 Project Timeline …………………………………………………………………………… 72 Collection of Data and Analysis …………………………………………………… 76 Budget..…………………………………………………………………………………….. 78

REFERENCES

PAR Study !8

CHAPTER ONE: INTRODUCTION TO THE PROBLEM Introduction In May 2006, at Addictions Counseling Services (ACS), a hybrid classroom/ clinic, audience analysis demonstrated that clients sought enhanced education in selfmanagement. A literature search highlighted the lack of an established methodology for participatory action research (PAR) that provides validity, credibility and opportunities for the generation and evaluation of quantitative results. The solution was to create a social constructivist learning-community to provide integrative instruction, blending evidence-based practice, content analysis and participatory action research (PAR). The ACS master instructional plan was converted into a 48-topic chart with 8 interventions organized according to analysis, design, development, implementation, and evaluation (ADDIE) phases with learning modules for each topic. After a one-year pilot, formative evaluation resulted in a learning design (LD) providing individualized learning

PAR Study !9 paths. Extensive surveys and continuous formative evaluation followed through May 2008. Results then identified self-management and creativity as key education objectives of students. An online interactive website and learning product, Transformative SelfManagement (TSM) was created and field-tested. Participants in the current project will include 30 students who will complete a selected portion of the learning product online, and 30 learners who will complete the same portion in the classroom. The Institute for Autonomy and Creativity Studies (IACS) has now been established to carry out educational objectives developed in the two year project to provide instruction to the general and professional public. IACS will build on the results of projects conducted since May 2006, as well as the capstone project to offer innovative and productive educational products in topic areas including nicotine addiction and smoking cessation, autonomy versus psychopathic domination, and creative self-organization. Executive Summary In May of 2006, the candidate sought to restore education to Addictions Counseling Services as an explicit practice rather than an added benefit of psychotherapy, in this case, substance abuse counseling. The plan was to create a hybrid clinic/ classroom, and to offer integrative therapeutic instruction, meaning psychotherapy and education would be openly integrated into treatment. The terms therapeutic instruction were meant to differentiate this educational approach from psychoeducation that had become, in practice, little more than patient education in diseases and disorders. This

PAR Study !10 decision was based on a needs analysis showing clients wanted educational lectures and small group discussions delivered in a classroom setting. The decision set in motion admission to the Western Governors University Management and Innovation program, and the instigation of an instructional design. This capstone follows two years of intensive participatory action research that included an instructional design (ID) and a learning design (LD). The ID was instituted two years ago and was fine-tuned during a one-year pilot project. The LD provides personal paths for achieving learning objectives and individualized module completion and tracking. ACS has activated an interactive website that features a 10 hour learning module, entitled transformative self-management (TSM). Amity College has been created to expand the instruction and learning design and to offer education to students drawn from the general and professional public. The college will offer residential and distributed education, as well as continuing education for licensed and certified professionals. The college merges the work done at ACS with creativity classes taught at a local community college into a consolidated approach to autonomy and creativity. The college is seeking to affiliate with accredited colleges and universities and to acquire internationally recognized memberships and affiliations. The educational project can be divided into three phases: ID, LD, and TSM. TSM is an educational product, which is now online and will be the subject of an August to December 2008 project. ID began in May of 2006, with preliminary decisions on the part of clinic management that after 17 years of very successful operation, with

PAR Study !11 success rates in the high 90 per cent range, changes were needed to keep pace with an influx of younger, college-educated clients. Historically, the clinic had attracted a blend of blue-collar workers, the underemployed, skilled workers, and professionals. The range was from dry wall installers to movie directors and attorneys. The ACS design, created in 1991, emphasized mastery of life direction skills through neurocognitive behavioral therapy combined with motivational enhancement and 12 Step facilitation. The clinical director/supervisor (CD/ S), trained as a research and development specialist, conducted an audience analysis and determined that demographics and learner characteristics would favor restoration of psychoeducation, peer counseling, and a classroom setting. Group sessions had been conducted with clients arrayed in a circle of chairs for five years. Audience analysis indicated clients wanted to be treated as students and seated, classroom style, at conference tables. It showed clients preferred lectures, reading assignments, tests, questionnaires, surveys, and small group discussions. In this document, the terms clients and students are interchangeable. The term learners connotes both usages. The goals of this capstone project are to build on two years of PAR, a one year ID and a one year LD, and a year of TSM to improve the online learning project, and to create an exportable methodology. The exportable methodology will not only be a model of online modular distributed education, but also a process for combining PAR and content analysis with appreciative inquiry (AI). Problem Statement

PAR Study !12 The purpose of the TSM project is to investigate the effects of an online learning product, Transformative Self-Management (TSM) on learners in a hybrid clinic/ classroom. Using Participatory Action Research (PAR) blended with content analysis in a social constructivist learning community, the project will determine if online learners demonstrate self-regulated learning at a level commensurate with classroom students. A self-regulated learning index, and content analysis, will express the results quantitatively so the findings can be expressed statistically. Since this is a PAR project, data gathering will emphasize problem identification, active learning, and problem solving. Student questionnaire responses, reflective journal entries, verbal expressions in focus groups, and portfolio submissions will be aggregated and presented back to learners in the form of bar charts, field notes, and summaries for community evaluation which will inform problem solving behavior. An extensive literature review indicated that there are no existing guidelines for melding PAR with content analysis, so another purpose of this project is to create an exportable methodology that can be applied to problems like nicotine addiction and psychopathic domination in future programs related to an educational institute that will be created following this capstone project. The problem is the need for an online learning product and the lack of a methodology for designing a product that combines PAR and content analysis. The general cause of this problem is the lack of specificity in PAR as it relates to instructional design, mixed, and quantitative methodologies. While suggestions for generating quantitative data abound, the employment of a social science derived, tested, and abundantly researched method, like content analysis, is a vastly superior fit. Given the

PAR Study !13 compendium of coded and thematic data elicited from reflective journals and questionnaires, as well as coded verbalized data recorded from field interviews, content analysis is a natural choice. ACS, the hybrid clinic/classroom, develops data weekly from three classes. Each class entails a lecture, completion of a Likert scale questionnaire, a survey, and a reflective journal entry. Once each class is completed, observations and case notes are written. Coding of significant terms, determination of common themes, and calculation of iterations or instances of contextual expressions lends naturally to content analysis, especially as it has been revised by Philip Mayring who provides a step-by-step processing guide. Needs analysis in May of 2006 indicated ACS learners wanted a lecture/small group discussion format that provides education on relapse prevention, neurocognitive, behavioral, and motivational coping skills, along with general education about selfdirection. In May 2007, after a one-year pilot project of an integrative therapeutic instructional design, learners sought increased collaboration in treatment planning/ tracking and evidence of personalized learning paths. Following a one-year pilot project of the learning design overlay of the instructional design, clients indicated that they wanted increased content on self-management and autonomy, and regular presentation of group and individual results during classes. Rationale and Significance The rationale for an online learning product resulted from the understanding that

PAR Study !14 ACS could not provide a comprehensive education in self-management in the classroom, given the need to present instruction in 39 other topic areas. The reasoning was that by providing online learning for students, ACS could concentrate on other topic areas and still meet client needs for self-management knowledge. Additionally, ACS could offer content in the area of creativity, Jungian Psychology, and spirituality. These content areas were all identified as desired by clients in the 2008 needs analysis. In the past, ACS planned sessions based on current learner needs and scheduled topics a few days prior to each class session. As part of the instructional design, ACS has a new system of topic rotation, indicating the current sequencing of topics, and still allows for substitution based on current needs. ACS did not have an online product that could be offered to learners as an incentive to finish personal learning plans and graduate expeditiously. Learners can now be assigned to complete the online module to reduce the required number of live classes that must be attended. This innovation has been remarkably effective in trials with qualified clients. ACS has state reporting requirements related to outcome analysis. The employment of content analysis paired with PAR will allow for far richer qualitative and quantitative outcome analysis. Since the ACS primary clinical outcome has shifted from self-direction to autonomy through transformative selfmanagement, the online module and blended methodology provide an excellent means of clearly expressing results. The number, ratio, and percentage of clients completing TSM and all other outcomes can be readily provided using this methodology.

PAR Study !15 Instructional Design Problem Statement Overview of the Problem Addictions Counseling Services (ACS) has been operating for 15 years in Central Florida and has consistently had positive outcomes in the range of +90%. Clients typically rate ACS as “superior in most or all aspects of treatment.” ACS does not, therefore, have a glaring problem that threatens to compromise good outcomes. Instead, ACS has the opportunity to redesign treatment in a manner that enhances existing strengths and responds to client learning styles and preferences, enriching the retention of educational content. The problem is to create an integrative model of psychoeducation based on self-efficacy principles employing instructional design (ID) to provide therapeutic instruction and recursive educational design cycles that result in constructivist learning, continuous motivation,and self-regulation. Background of the Problem ACS has an integrative treatment model emphasizing 12 Steps Facilitation, Motivational Enhancement Therapy and Cognitive Behavioral Coping Skills. This model is based on recommendations made by the Department of Community Medicine & Health Care of the University of Connecticut Health Center in the Project Match research project funded by the National Institute of Alcohol Abuse and Alcoholism. Project Match demonstrated that maximum positive outcomes result from an approach that “matches” client needs with therapeutic strategies. Many clinics have one theoretical orientation and clients are expected to comply with the clinic’s treatment philosophy, which is often applied dogmatically. In Central

PAR Study !16 Florida many clinics offer Cognitive/Behavioral Treatment with an Alcoholics Anonymous (AA) philosophical overlay. For those familiar with ID models, Cognitive/ Behavioral represents a merging of two distinct models. In practice this means clients are instructed to think about the dynamics of their substance abuse and to improve upon their past behavior. The AA overlay is often applied dogmatically to suggest that each client is “in denial” and must admit that she or he is “an alcoholic” or “drug addict” in order to successfully complete treatment. In some settings clients are assigned additional treatment sessions if they do not admit to being alcoholics. The author is familiar with cases in which clients assigned to 48-session treatment plans are re-assigned to 96 sessions to allow for time to grasp their own denial and admit to their alcohol or drug dependence. Miller and Munoz (2005) cite statistics that indicating “only 15% of men and 2% of women in the United States actually drink 12 drinks per week or more”. (p. 31) Other sources have estimated that among individuals in treatment nationwide, less than 30% are alcohol dependent.

ACS, by contrast, provides an integrative treatment approach, which blends three distinct models and provides experiential exposure to the AA philosophy by offering 12 Steps-style support groups between sessions. Clients are presented with the tools to determine for themselves the exact status of their alcohol or drug dependence. Clients are presented with an ensemble of instruments, charts and surveys and are guided to decide their place on a spectrum that ranges from occasional intoxicant to substance abuser to substance dependent. Given the number of local clinics that apply a cognitive/

PAR Study !17 behavioral/AA approach, ACS provides an alternative that emphasizes client autonomy and self-direction. This means another problem is addressed in creating the integrative therapeutic instruction model: the lack of variety, personalization and patient matching in Central Florida. The solution is to offer a clear alternative approac...