How is evidence-based practice understood in social work?

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A little while ago, fellow elf Mike Clark wrote a blog on an Australian study on how policy makers use research evidence. This time we’re looking at a Swedish study on how social work practitioners, managers and policy makers understand evidence-based practice. The concept of evidence-based practice in social work has long been debated, with various academics arguing its relative merits for making complex decisions and exploring what could be included as ‘evidence’ for social work and social care (Forrester, 2010; Glasby & Beresford, 2006; Pawson et al, 2003; Webb, 2001).

However, despite the definitional and conceptual work groundwork that has been done for evidence-based in social work, not much research has covered how practitioners understand it or use it in practice. This Swedish study by Avby et al (2014) offers some useful insights into the levels and types of understanding that social work practitioners, managers and policy makers have, particularly for a UK context where there is a renewed expectation that social workers use evidence in their work, as outlined in a recent blog here. The authors state that their study aimed to

reveal how evidence-based practice (EBP) is viewed by people working in social work, and it focuses on what they talk about and how they talk about it.

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Political, managerial and frontline social work staff groups were asked about their understandings of EBP.

Methods

The participants from the study came from political, managerial and frontline staff groups in three Swedish municipality social work offices, one of which counted as a ‘metropolitan’ area. The offices were chosen as they were engaged in research on families and social deprivation.

Fourteen semi-structured interviews were undertaken with 6 people in managerial positions, 3 people in frontline social work and 5 people in political (policy) positions. The sample was comprised of six women and eight men between 31 and 61 years of age.

No explicit defintion of EBP was given during the interviews and the authors say that they took a ‘phenomenographic’ approach to interview and analysis, which they explain ‘is to reflect…understandings and not judge a statement as something right or wrong’.

Findings

The interview data showed five qualitatively different understandings of EBP, fitting into five main hierarchical practice categories:

  • Critical – reflective practice, challenging
  • Multifaceted – informed practice, knowledgeable
  • Instrumental – guided practice, developmental
  • Discursive – up-to-date practice, modern
  • Fragmented – traditional

At the ‘critical’ (or most developed) level, knowledge was appraised and contextualised, with practitioners being able discuss the complexity of EBP for social work.  The ‘multifaceted’ understanding was close to what is termed ‘evidence-informed practice’. At the ‘instrumental’ level, accredited tools, manuals and processes were cited, with the belief that ‘there is an optimal behaviour that can be achieved through a systematically organised environment’. The authors argue that this ‘rational’ approach is dominant in the Swedish social work system.

Despite the multifaceted understandings of EBP in social work among the study participants, they all ‘perceived a strong link between EBP and quality’, and in the ‘critical’ understanding

quality was expressed as an awareness of scrutinising work and justifying work to the benefit of clients.

Alongside evidence, emotion and interpretation were also seen as important influences for social work practice.

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Links were made between EBP and quality, with an emphasis on scrutinising practice.

Conclusion

Overall, the authors conclude that

Our findings suggest adherence to EBP has not yet been realised in social work…[and] point to the importance of acknowledging different ways in which EBP is understood to compose a supportive atmosphere for EBP to thrive and to realise a social work practice that utilises various knowledge sources, both research-based knowledge and practice-based knowledge, to the benefit of clients.

Limitations and strengths

The researchers produce a detailed and nuanced analysis and interpretation of the interview findings, using an intensive approach. The result is a helpful categorisation of types and quality of understandings of EBP across different professional groups within the social work policy and practice strata.

One of the main limitations, as the authors themselves note, is the small sample size. In addition there is the issue of uneven spread of respondent numbers across the policy maker, manager and frontline staff groups involved. Only three interviews were conducted with frontline staff, while six and five were conducted with managers and policy makers respectively. The paper did not indicate if there was any relationship between type and quality of undertanding of EBP and professional role group. A good understanding of the application of EBP is arguably most important for frontline staff, but it was hard to discern the results for this respondent group from the reporting. The reader is left wondering who had the ‘critcal understanding’ of EBP.

Summing up

Although this study was conducted in Sweden (which is arguably slightly behind the UK in its implementation of EBP in social work) with a very small sample of people, it nonetheless provides an important framework for mapping understandings of EBP and indentifies the elements of what appears to be the most complete understanding – ‘critical’. Given the renewed drive to embed knowledge-based practice in social work, it would be interesting to use the framework to investigate current understandings of EBP in the UK.

The research is also helpful in that it provides more support for the argument that social work practice should involve both research and practice based knowledge sources for making decisions with service users and carers. Importantly, it highlights the need for a supportive, learning atmosphere in social work teams for EBP ‘to thrive and to realise a social work practice that utilises various knowledge sources’.

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Social work practice should use various knowledge sources, both research-based and practice-based, to the benefit of service users.

Link

Avby, G., Nilsen, P. and Dahlgren, M.A. (2014) Ways of understanding evidence- based practice in social work: A qualitative study, British Journal of Social Work 44 (6) pp.1366-1383. [Abstract]

References

Forrester, D. (2010) The argument for evidence-based practice in social work Community Care, 18th June 2010 [Full Text]

Glasby, J. and Beresford, P. (2006) Commentary and Issues : Who knows best? Evidence-based practice and the service user contribution Critical Social Policy 26 (1) pp.268-284. [Abstract]

Pawson, R. et al (2003) Types and quality of knowledge in social care London: SCIE/Policy Press [Full Text]

Webb, S. (2001) Some considerations on the validity of evidence-based practice in social work British Journal of Social Work 31 (1) pp.57-79. [Abstract]

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Sarah Carr

Sarah Carr

Sarah is Associate Professor of Mental Health Research at Middlesex University. Sarah also runs an independent mental health and social care knowledge consultancy. She has a background as a senior research and policy analyst in mental health and social care, with a focus on service user participation, personalisation and equality issues, having formerly worked for the Social Care Institute for Excellence (SCIE). She is an Honorary Senior Lecturer at Institute for Applied Social Science at the University of Birmingham, an Honorary Visiting Fellow, Social Policy and Social Work at the University of York and a Fellow of the Royal Society of Arts. Co-chair of the National Survivor and User Network (NSUN) and a member of the editorial boards of the journals Disability and Society and Lancet Psychiatry, Sarah has a particular interest in social care and mental health issues and is a long term user of services.

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