Evidence-Based Practice and Social Work

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Evidence-Based Practice and Social Work C. Aaron McNeece, PhD Bruce A. Thyer, PhD ABSTRACT. The essential features of contemporary evidence-based practice (EBP) are outlined, with specific refere... nce to the applications of this model to various areas of social work, micro through macro. EBP is seen as a welcome addition to our field, representing a fuller and more comprehensive development of earlier and related positions such as em￾pirical clinical practice within social work, and the delineation of empiri￾cally-supported therapies within psychology. Social work should proactively adopt EBP as its preferred conceptual model, reorient BSW and MSW train￾ing programs along the lines advocated by EBP, and inculcate these princi￾ples into the delivery of social work services. This is seen as both a professional and ethical imperative necessary for the survival of the field. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: <[email protected]> Website: <http://www.HaworthPress.com> © 2004 by The Haworth Press, Inc. All rights reserved.] KEYWORDS. Conceptual model, evidence-based practice, social work From the recent attention that is given to evidence-based practice (EBP) in our academic journals, disciplinary meetings, and professional C. Aaron McNeece (E-mail: [email protected]) and Bruce A. Thyer (E-mail: [email protected]) are affiliated with the School of Social Work, Florida State University, Tallahassee, FL 32306. Journal of Evidence-Based Social Work, Vol. 1(1) 2004 http://www.haworthpress.com/web/JEBSW  2004 by The Haworth Press, Inc. All rights reserved. Digital Object Identifier: 10.1300/J394v01n01_02 7 organizations, an observer from outside the profession could easily be mislead into thinking that professionally trained social workers com￾monly use the current best scientific evidence available, rather than solely relying on practice wisdom, tradition, or “common sense” in de￾ciding how to assist a client. However, a closer look at the EBP litera￾ture is more likely to discover essays on why we are not doing evidence￾based practice (e.g., Gibbs & Gambrill, 2002) or arguments for why we should be doing it (e.g., Thyer, 1995, 2002a, 2002b) rather than descrip￾tions of how evidence-based practice is being used (e.g., Thyer, 2001). In a review of trends in knowledge development over the past quarter century, Reid (2002) concludes that “the increasing role of research in testing practice methods suggests that scientific methods may be gradu￾ally upstaging tests of time and consensus as a means of building core knowledge” (p. 16, italics added). His somewhat optimistic view of this trend views clients as “self-directing collaborators with knowledge and strengths” and social workers as having “new awareness of the limits of their expertise and knowledge” (p. 16). At least one school of social work, Washington University, has adopted EBP as its organizing framework (Howard, McMillen & Pollio, 2003). Many new social work books devote increasing attention to EBP (Corcoran, 2000, 2003; Mac￾donald, 2001; McNeece & DiNitto, 1998; Roberts & Greene, 2002; Springer, McNeece & Arnold, 2003; Thyer & Wodarski, 1998; Thyer & Kazi, 2003; Wodarski & Thyer, 1998). Nevertheless, adoption of EBP within the profession seems to continue at a slow pace, slower in some areas of practice than in others. WHAT IS EBP? One of the simplest definitions of EBP is that it is ‘treatment based on the best available science.’ One might make this somewhat less nar￾rowly clinical by changing “treatment” to “intervention.” The basic ele￾ments of EBP, according to Persons (1999, p. 2), is one in which, “The evidence-based practitioner: • provides informed consent for treatment. • relies on the efficacy data (especially from RCTs) when recom￾mending and selecting and carrying out treatments. • uses the empirical literature to guide decision-making. • uses a systematic, hypothesis-testing approach to the treatment of each case.” 8 JOURNAL OF EVIDENCE-BASED SOCIAL WORK This approach: • “begins with careful assessment. • sets clear and measurable treatment goals. • develops an individualized formulation and a treatment plan based on that formulation. • monitors progress towards the goals frequently and modifies or ends treatment as needed.” Although this is also a clinically-oriented definition, most of the elements could be modified to encompass many aspects of macro practice (e.g., community practice, administrative practice, and social policy practice.) Cournoyer and Powers (2002) use the term “client system” in their definition, rather than client. The essential concept of EBP is to rely upon the best scientific evidence that is currently available. It also involves providing the client (whether a person, a community, or an organization) with appropriate information about the efficacy of different interventions and allowing the client to make the final decision (Thyer, 2003). This is very different from the traditional practice model in which the social worker rarely looked for empirical evidence of treatment efficacy or presented treatment alternatives to the client. A more conservative (and perhaps more widely accepted) construction of evidence-based practice is found in the seminal textbook Evidence-based Medicine: How to Practice and Teach EBM by Sackett, Strauss, Richardson, Rosenberg and Haynes (2000) from which much of the following content is derived. Evidence-based practice can been defined as the integration of the best research evidence with clinical expertise and client values in making practice decisions. ‘Best research evidence’ means clinically relevant research from basic and applied scientific investigations, especially drawing from intervention research evaluating the outcomes of social work services, and from studies on the reliability and validity of assessment measures, and clinical expertise refers to our ability to use our education, interpersonal skills and past experience to assess client functioning, diagnose mental disorders and/or other relevant conditions, including environmental factors, and to understand client values and preferences. ‘Client values’ refers to the unique preferences, concerns and expectations each client brings to a clinical encounter with a social worker, and which must be integrated into practice decisions if they are to serve the client. [Show More]

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