I recently tried to purchase the Beck Depression Inventory II (BDI II).
I was told that I needed to apply first to obtain the above and that only a PHd level would be able to purchase. They also told me that as an MSW, as long as I was supervised by a Phd, or a physician, that I would be able to directly use the Beck Inventory tool. Has anyone used this tool? If so, were you supervised? Did you use an intervention after the inventory, then measure depression sometime after the intervention? Any information on this subject would be helpful.

I posted your question to the CNSW listserv last night. I received two responses today.

Both social workers said they were able to purchase the BDI but had to provide a copy of their social worker license or license number. Neither was told they needed to be supervised. This may be because they are MSWs licensed at the specialist level.

One social worker said that the BDI questions were typical questions that a social worker asks during an assessment. The other said that her patients prefer the 7-item Beck Fast Screen (from the BDI II) which she said is quick to do and has good reliability and validity. It excludes somatic and performance symptoms that could be affected by medical conditions.

There are a number of surveys that assess for depression and other domains of functioning and well-being. An often recommended book that includes some of these is "Measuring Health: A Guide to Rating Scales and Questionnaires" by Ian McDowell, Claire Newell (ISBN: 0195103718). If you check for this book on Amazon, it will list several other books that also describe health and quality of life measurement tools.

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Originally posted by Beth Witten:
I posted your question to the CNSW listserv last night. I received two responses today.

Both social workers said they were able to purchase the BDI but had to provide a copy of their social worker license or license number. Neither was told they needed to be supervised. This may be because they are MSWs licensed at the specialist level.

One social worker said that the BDI questions were typical questions that a social worker asks during an assessment. The other said that her patients prefer the 7-item Beck Fast Screen (from the BDI II) which she said is quick to do and has good reliability and validity. It excludes somatic and performance symptoms that could be affected by medical conditions.

There are a number of surveys that assess for depression and other domains of functioning and well-being. An often recommended book that includes some of these is "Measuring Health: A Guide to Rating Scales and Questionnaires" by Ian McDowell, Claire Newell (ISBN: 0195103718). If you check for this book on Amazon, it will list several other books that also describe health and quality of life measurement tools.

BETH: Thank you for emailing my request out! I really appreciate it. Do you know what specialty the social workers had that obtained the BDI? I have an MSW and majored in mental health. I think I will try to obtain the BDI again. Part of my goal is to show management how we can save the clinic money by identifying those w/depression, and providing an intervention such as group therapy/something that will impact their mood, then measuring it again. Do you have any ideas on an intervention that I could use?? My premise would be that alleviating depression will result in better compliance....less hospitalization...thank you Beth...Jan

Jan, i think they require the MSW to be licensed. If I were you, i would discuss your intent with the nephrologist and submit to purchase it under his supervision. I like the Beck Medical Fast Track depression screening tool much better for our patients though, since it is designed for the medically ill and thus removes the somatic items such as sleep, energy ect which can confuse the scoring on our patients.

That's the kind of inventory we need at my unit-- what dialysis patient is ever 'full of pep?' Obviously dialysis patients aren't going to be as energetic as healthy people... and those questions just remind us that there's something seriously wrong with us.

I am a dialysis patient who is never ever depressed! I'm not saying that depressing things don't happen to me, because what could be more depressing than having to go to a dialysis unit 3x a week for the rest of my life, rain or shine, that does not have high professional standards!!

When I first met my SW, she commented that I was probably depressed now that I was on dialysis. I told her I wasn't depressed although the whole situation was very depressing. She insisted that I must be depressed, but was just in denial. I told her I was aware of the definition of denial and was not in denial.

The next week the SW was the speaker at our patient support group meeting and said that she would never believe someone who says they never get depressed. It sounded like she was describing me, hmmmm???

I would like to say that it would help a lot if SWs didn't jump to conslusions and lump all patients in the same category, although I would agree that most dialysis patients are depressed. But instead of investing in the Beck Depression Inventory for something you already know is a high statistic, why not
form an association of SWs and take on the dialysis companies and doctors who have no interest in your serving the dialysis patients in any capacity other than financial clerks. That would alleviate a lot of patients' depression right there.. don't you think?

I'm sorry that your social worker assumed that you were depressed when you weren't. If he/she would have asked you to complete a standardized survey for depression, he/she would have had those results rather than gut impression to go on. Everyone on dialysis is not depressed. Studies have reported depression at levels from 0% to 100%. It appears from studies done in the last 5 years or so that about 25% of patients have clinical depression. This is a large enough percentage to concern social workers since depression is linked with missed treatments, hospitalization, and death.

When I worked as a dialysis social worker, I let patients know that if they got depressed, it was understandable and not a "weakness." Many people feel stigmatized by mental health diagnoses. I'd tell them that depression drains energy so it's important to treat it so they could start setting goals and working toward meeting them so they could start enjoying life again.

Although you suggest that it might not be important to survey patients using a tool like the Beck, in today's dialysis environment, it is important for social workers, like other staff, to be able to describe a problem including how many people have it, to develop programs and interventions with the patient that target specific problems, and to measure how successful those interventions are in reducing costs of care for providers and burden of illness for patients so they can prove their value to decision makers who may know little about what a social worker can do.

You'd suggested that social workers band together. If your social worker doesn't know this, social workers can become members of the National Kidney Foundation's Council of Nephrology Social Workers. This organization offers annual conferences, educational materials, mentoring, a listserv for information and support, and several tools to help social workers enhance their clinical skills and advocate for themselves. CNSW continues to advocate with organizations and with the federal government for time to perform federally mandated responsibilities and appropriate task assignment. CNSW members who are members of social work advisory boards of major corporations continue to advocate on behalf of patients and social workers.

But social workers can't do it alone! You and other patients advocate for social workers to have time to spend with you. Let your administrator or nurse manager know that you have issues that require a social worker's help. Before doing this, talk with your social worker about what his/her training is, what his/her responsibilities are at your and any other clinic(s), and whether what the social worker is doing is what he/she would like to be doing. You may be surprised by what you hear. In my 25 years as a renal social worker I have seen caseloads double and in some clinics triple. Social workers who used to work in one clinic now cover many clinics with one-way travel time of up to 2 hours or more. I believe that if patients help social workers advocate for time during which they can help patients cope with kidney disease and treatment and improve patients' functioning and well-being, dialysis clinics and corporations will start to see greater need for patient access to social workers.