How is evidence integrated into the practice relationship between social worker and client? Studies suggest that at the practice level research is not consistently utilised. Evidence-Based Practice (EBP) has been hailed as a means of bringing practice and research together in a way that strengthens the empirical base of social work. Although EBP has had strong endorsement, it has also come under heavy criticism. This chapter explores these concerns in the hope of further clarifying the model. The need for an inclusive definition of evidence is emphasised giving rightful place to empirical research and to other forms of evidence. The need for a synthesis of evidence-based practice and critical reflection is also explored. Evidence must be used in a critically reflective way if it is to be used effectively. Finally, the language of “evidence-informed” is shown to more clearly articulate the components of the EBP process.
TopIntroduction
Experienced social work educators have come to understand that the reason why there are no textbook answers is because the problems practitioners confront are far too complex for simple solutions. The fact is that social work is an exceedingly difficult occupation….This does not mean that there is nothing that can be done to prepare aspiring social workers for the rigors ahead. It is just that there are no simple recipes to present to them. What can be done is to train them in ways of finding and applying the best available evidence when unfamiliar situations arise. (Barber, 2012, p. 192)
Social work is a very dynamic and demanding activity, and social workers become very practiced at what they do. The problems they address are widely varied and complex. In their daily work, they draw upon a vast array of resources, including personal strengths, formal education, and practice experience. But the question naturally arises as to what role evidence itself plays in social work practice? For our purposes, evidence simply means data upon which practice decisions can be made. What, then, constitutes good evidence, and how is it integrated or incorporated into the practice relationship between social worker and client?
In this chapter we will explore these questions.
TopLow Use Of Empirical Research Evidence
Perhaps rather surprisingly, a frequently recurring theme in the social work literature has been the low uptake of empirical evidence by social work practitioners. Osmond and O’Connor (2006) have surveyed a range of studies throughout the twentieth century which demonstrate that social workers rarely use research findings in their practice and conclude “there has been a growing body of research that suggests that theory and research are not routinely guiding social work practice” (p. 7). In their own small-scale investigation, social workers also “did not refer, consider, read or appraise any research during the observed data-collection period (18 months)” (p. 14).
Other writers have similarly pointed to studies which have consistently shown little use of empirical research by social work practitioners to inform their practice (Gray, Plath, & Webb, 2009, p. 2; Mullen, Bledsoe, & Bellamy, 2008, p. 325; Rosen, 2003, p. 201; Rubin & Parrish, 2012, pp. 203-204; Trinder, 2000b, p. 144). D’Cruz and Jones (2014) refer to a “general aversion to social work research” and state their aim to address some of the “fears and misconceptions” that exist among many social workers (p. 2).
Evidence-based practice (EBP) is a particular approach to the relationship between research and evidence, mandating the use of relevant empirical research where such exists. It is a topic to which we will return but there are some lessons to be drawn from specific studies of EBP that are relevant in this context.
Mullen and Bacon’s 2004 survey showed that practitioners seldom used research findings in practice decisions, were largely unfamiliar with EBP guidelines and manuals, and only rarely read reports of relevant research studies (Mullen, Shlonsky, Bledsoe, & Bellamy, 2005, p. 63). Most respondents in a study of field instructors agreed that EBP is a “useful” practice idea, but 43 percent indicated they only sometimes found and critically appraised the best scientific evidence, and seven percent did not do so at all (Edmond, Megivern, Williams, Rochman, & Howard, 2006, p. 385). In a survey of social work faculty in MSW programs throughout the United States, over 40 percent of respondents held that almost any form of research evidence was sufficient to justify an intervention as evidence-based. Only 25 percent of the survey respondents “defined EBP exclusively as ‘a process that includes locating and appraising credible evidence as a part of practice decisions’” (Rubin & Parrish, 2007, p. 417). And a study of social workers in Australia by Gray, Joy, Plath, and Webb (2014), although finding “largely positive and welcoming support for EBP” (p. 26), showed empirical research to be understood “predominately in generic terms or as a single source,” with only six percent of the respondents stating that they appraised a range of research to inform practice changes (p. 34).