Essays On Evidence Based Practice In Social Work
Select a specific research method and critically evaluate its usefulness to researching in/for social work.
It is not unusual for practitioners and students to become anxious about the prospect of undertaking social research. The reputation of research is difficult, mechanical and a tedious set of rituals that are linked to unappealing scientific or objective routines and tasks which ultimately result in remote, dry and even aloof as well as impenetrable, reports, books, and academic papers. Although challenging, most forms of qualitative research are accessible, rewarding, relevant, and at times, enlightening. Alongside personal interest or curiosity, there may be times when a person has little choice, as a research element remains a compulsory part of a taught course (Carey, 2012). Many of the core skills required for qualitative research will have been developed or mastered by many students and practitioners. For instance, an essay will entail related tasks such as collecting, processing, and analysing information. Furthermore, social work practitioners conduct interviews in assessments or write reports for funding panels or reports for court proceedings. Moreover, qualitative research is learned just as much through direct experience as through study and can help promote our imagination and sense of creativity or curiosity and the urge to know more (Shaw, 2012).
According to the Social Work Policy Institute (2010), social work research informs professional practice. Social work research allows the professional to assess the needs and resources of people in their environments, evaluate the effectiveness of social work services in meeting people’s needs, demonstrate relative costs and benefits of social work services, advance professional education in light of changing contexts for practice, and understand the impact of legislation and social policy on the clients and communities served. In the field of social work, practitioners must remain well-informed regarding any research advances in their respective areas. Advocates of evidence-based practice expect social workers to engage in practice informed by the best available evidence. Research studies conducted through the lens of qualitative studies provide important contributions to the social work knowledge base. In many cases, these studies can represent the best available research regarding emerging problems or application of evidence to diverse populations (Lietz & Zayas, 2010). Qualitative research continues to be a valuable approach in social work practice. In 1994, the Council on Social Work Education required that qualitative research methods be taught in all accredited bachelor’s and master’s level social work programs, a requirement renewed in the Education Policy and Accreditation Standards in 2002 and again in 2008 (Drisko, 2013).
A universal definition of does not exist. The literature of social science and applied professional fields, such as interpretive, naturalistic, constructivist, ethnographic, and fieldwork are variously employed to designate the broad collection of approaches that are simply qualitative research (Hunt, 2004). Qualitative research approaches allow researchers to connect with people in deeply personal ways that enable the persons being researched to express the rich meanings of their thoughts, actions, and events in their lives. The two main types of qualitative methods, in-depth interviews and observation, brings researchers into close contact with the lived experiences of the people being researched. These interactions frequently involve personal topics that can evoke powerful emotions for both the researcher and informants. These evocative situations provide researchers the opportunity to explore the deep meanings of the phenomena as well as develop new theories and understandings that have rich and nuanced dimensions. Therefore, the knowledge gained is not only information that passes through the central processors of the brain, but also arises from our hearts and deeply held emotions. Therefore, understandings gained via the engagement of heart and mind have an immediate potential to connect to the hearts and minds of audiences. This immediacy can be beneficial to persons who are members of social work constituencies such as maltreated children, poor people of colour, homeless families, people with mental illnesses and frail elderly who are disenfranchised from the political system and whose voices are regularly suppressed within the arenas where their fates are debated and shaped: public opinion, legislatures, and social service agencies (Gilgun & Abrams, 2002).
The commitment of qualitative social work practice to the empowerment of the disenfranchised population is commendable. Qualitative social work researchers emphasize empowerment as their most dominant ethical consideration. Yet, empowerment is often an exclusive ethical principle. The exclusiveness of the empowering research trend can be understood from two contemporary perspectives: the nature of social work and the lack of a specific code of ethics and training in ethics for qualitative social work researchers. Most social work is not basic research. Instead, social work is an ideology committed discipline in which practitioners and researchers have a duty to promote justice and improve welfare. The concept of empowerment allows social work researchers, particularly qualitative researchers, to work towards these goals via their research. Furthermore, by empowering research participants and related populations, social work researchers can bridge a gap that might exist between their value commitments as social workers and a lack of training on research ethics. Therefore, empowerment offers social work researchers the opportunity to be ethical according to current mainstream thinking in social work. The trend to emphasize empowerment in qualitative social work studies reveals merits and some limitations, as researchers often emphasize successful or resilient individuals within oppressed groups studied. The dual focus on resiliency and empowerment contributes to research participants as role models of successful coping within their communities. Simultaneously, it overshadows the stories of the multitudes of ordinary unfortunate members of these oppressed or disenfranchised populations. The target of most empowerment studies is to increase the social power of populations and not the research participants themselves, resilient or not (Peled & Leichtentritt, 2002).
A number of advantages have been documented about the use of qualitative methodologies for social work. For example, descriptive, inductive, and unobtrusive techniques for data collection are regarded as compatible with the knowledge and values of the social work profession. In circumstances where social workers are faced with issues and problems that are not amenable to quantitative examination, qualitative methods have been advocated. The social’psychological bases of qualitative research suggest that it is compatible with the person-in-environment paradigm of social work practice. Qualitative approaches are similar in method to clinical social work assessments, as clinicians rely on interviews to gather data on a client’s issues in the context of the environment. The clinician reviews a series of hunches and working hypotheses that are based on observations made through ongoing contact with the client. Qualitative researchers, like clinicians, are trained to investigate each case individually, without imposing preconceived notions or attempting to generalize to all clients having a particular problem. Qualitative researchers maintain field notes and documents on their research, just as clinicians maintain running accounts of contact with a client in the form of process recordings or case records. In studies of social processes of complex human systems such as families, organizations, and communities, qualitative methodology may be the most appropriate research strategy. Scholars of the family now extol the benefits of qualitative methodologies in gaining, or understanding, the dynamic processes, meanings, communication patterns, experiences, and individual and family constructions of reality. Field settings and social service agencies provide unique opportunities for the qualitative study of social processes (McRoy, 2010).
Qualitative approaches have the advantage of flexibility and, in-depth analysis, as well as the potential to observe a variety of features of a social situation. Qualitative researchers conducting face-to-face interviews can quickly adjust the interview schedule if the interviewee’s responses suggest the need for additional probes or lines of inquiry in future interviews. Moreover, qualitative researchers can develop and use questions on the spot which can aid in a more in-depth understanding of a respondent’s beliefs, attitudes, or situation. During the course of an interview or observation, a researcher is able to note changes in bodily expression, mood, voice intonation, and environmental factors that could influence the interviewee’s responses. This observational data can be especially valuable when a respondent’s body language runs counter to verbal responses given to interview questions. Nevertheless, qualitative methodology is not completely precise because human beings do not always act logically or predictably (McCoy, 2010).
Qualitative research is frequently based on the researcher’s interpretations or judgements. Interpretations are by nature very personal and influenced by the researcher’s own values and individual biases. These criticisms are considered subjectivity. Therefore, qualitative research findings cannot be replicated in the same way as quantitative results. For example, two qualitative researchers, one with a more pessimistic viewpoint and one with a more optimistic viewpoint, both studying the same phenomenon and interviewing the same individuals, may attain different conclusions because the interpretive process would be impacted by their dissimilar world views. However, it should be noted that a primary emphasis on designing rigorous qualitative studies helps to minimize researcher bias. Qualitative research findings do not generalize to populations beyond the sample. This is due to the subjectivity of the results and because they are so specific to the sample. Generalizability is not the aim of qualitative research because the goal of qualitative research is to develop a rich understanding of an aspect of human experience. As the aim of qualitative research is understanding rather than generalization, data collection continues as saturation occurs. Saturation occurs with relatively small sample sizes of 30, 20 or 10 participants (Krysik & Finn, 2013).
A risk of betrayal can result from the greater closeness, and consequent trust may develop between the researcher and participant in qualitative research. The risk of betrayal increases because of the characteristic use of smaller samples and the emphasis on the details of how people live their lives (Shaw, 2008). Qualitative research evokes consideration about confidentiality and the protection of participant identity. Ethical questions arise due to the special closeness that may develop between qualitative researchers and study participants. Since participant observation is a key methodology, the researcher must explain how he or she plans to address the issue of non-consenting members of the group. It is not unusual for qualitative researchers to investigate ‘hidden’ populations who engage in behaviour defined as deviant. Applicants studying individuals who may be subject to legal sanctions if their identities are revealed will need to specify procedures to ensure confidentiality (National Institute of Health, 2001).
Although time, budgetary, and other resource constraints may impact qualitative research, these constraints should not be allowed to undermine it. Other important considerations must be considered such as the data collection method, as well as, the human resources available to the project and their skills must be taken into account (Wilmot, 2005). Qualitative research can require an enormous amount of time and be extremely labour intensive. It can also produce results that may not be generalizable for policy-making or decision making, and many funding sources think it may be simply too expensive (Trochim, 2006). The democratization of social work research is one direction in which the politics of the research have moved centre-stage. The belated increase in the awareness of research funders that qualitative research makes an important and distinctive contribution to policy, practice, and strategic research poses new challenges to qualitative researchers to address ethical issues in a persuasive and original way when applying for funding (Shaw, 2008).
Qualitative methods are particularly suitable for use with people who are more comfortable responding in an interview format than to a standardized survey questionnaire. It has been suggested that the gender of respondents should be a consideration in selecting a research strategy because many women may prefer qualitative research techniques to quantitative approaches as they favour opportunities to discuss subjects in context. Additionally, some members of ethnic groups, low income populations, or people who are socially distant from the researcher are more likely to participate in the in-depth interviews characteristic of qualitative research than to complete a structured questionnaire or survey. To enhance the validity of results in research with diverse populations, research questions must be clearly constructed and must not be subject to different cultural interpretations. Moreover, due to the subjective nature of qualitative research, it is important for the researcher to continually engage in self-examination to be certain that his or her own biases and stereotypes are not influencing the interpretation of the findings. On the other hand, because qualitative analysis allows researchers to explore in depth all factors that might affect a particular issue, this strategy permits sensitive consideration of the complexities of human diversity (McCoy, 2010). Then again, when compared with surveys and experiments, qualitative research measurements normally provide more depth of meaning but have less reliability. Also, qualitative research results cannot be generalized as safely as those based on rigorous sampling and standardized questionnaires (Rubin & Babbin, 2009).
Prolonged engagement is used to reduce the impact of reactivity and respondent bias. It is assumed that a long and trusting relationship between a researcher and respondent gives the respondents less opportunity to deceive and is therefore less likely to withhold information and lie. Plus, lengthy interviews or follow-up interviews with the same respondent enables the researcher to detect distortion or the respondent to disclose socially undesirable truths. However, there are drawbacks to prolonged engagement as lengthy engagement can lead to bias if the researcher over-identifies with the respondent and lose his or her objective, analytic stance, or own sense of identity. The term for this narrative is going native. Notwithstanding, qualitative studies that lack prolonged engagement should be viewed with caution as some authors think that because qualitative inquiries emphasizes flexibility, the label ‘qualitative’ means ‘anything goes’. The most common example occurs when a researcher thinks that one brief open- ended interview with each respondent is satisfactory (Rubin & Babbie, 2009, p.233). Another decisive factor in whether the qualitative research report provides sufficient detail about the study’s contexts and participants is to enable readers in other situations to determine if the findings seem likely to apply to the contexts or populations with which they are concerned. Researchers using qualitative observation must fuse two paradoxical perspectives. The first is the emic perspective in which they attempt to adopt the beliefs, attitudes, and other points of view shared by the members of the culture being studied. The second is the etic perspective which means maintaining objectivity as an outsider and raising questions about the culture being observed that would not occur to members of that culture (Rubbin & Babbin, 2009).
In conclusion, it is true that many people dislike the thought of researching, yet it is also true that once research is initiated, it can be become addictive as the researchers thirst for knowledge is awakened. It is a positive attribute that quantitative research engages with hard-to-reach populations and offers insight in extremely complex and often hidden social problems. It gives oppressed populations a voice that can pave the way for social inclusion and social justice.
Professor Donald Forrester, in a new book, argues that the evidence-based model should be integral to all social work practice approaches
One of the most worrying aspects of the Baby P case was the failure of social work to be able to defend itself in the face of a firestorm of media criticism. In other professions individuals were held to account, but the entire profession of social work was judged and reformed.
This seems to be related to a more profound problem, namely whether we – the social work profession – can articulate and defend a convincing vision of what we do and the contribution that it makes. It seems that at present the answer to this question is sadly “no”.
The academic critiques of the current system – while they correctly identify bureaucracy and managerialism as huge problems – do not offer a vision of social work that appeals to politicians and policymakers.
The solution lies in three actions. First, investment in developing an evidence base to tell us what works for social work. Second, a commitment to using evidence-based ways of working (which may mean workers being expected to use specific approaches). Third, a focus on professional excellence in developing and delivering evidence-based approaches that recognises the time and skill required (as opposed to a belief that such approaches can be delivered as a cheap or simple option).
The idea that interventions should be based on evidence in social care has to be tempered by the fact that each individual and family is unique and it is difficult to specify approaches. But, in fact, this is true of many interventions – from prescribing medicines to teaching children to read. We would nonetheless expect professionals providing interventions to use those with the best evidence, rather than the one they like or “common sense”. It is difficult to see why social work should be different, and impossible to justify the failure of social work researchers to study what works or the failure of social work systems to use approaches based on evidence.
I would argue for interventions based on evidence from studies which compare one intervention with other ways of working (including normal service).
There have been many criticisms of this vision of evidence-based practice. One is that it can fail to be critical of social and political factors involved. For instance, cognitive behavioural therapy is an evidence-based way of helping people with depression but does not address the fact that depression is often created by social factors.
A pragmatic criticism is that EBP can too easily be used as a tool of central control.
Another consideration when using evidence-based approaches is the time and attention that needs to be spent controlling the quality of the intervention and the upskilling of practitioners to deliver it. All too often pilot projects fail to replicate their findings when rolled out to other settings. This is a key issue relating to the importance of excellence in the delivery of service.
I would argue, however, that a focus on delivering evidence-based approaches would provide the structure that social workers need to deliver excellent services. If we do not wrestle with these issues and develop our own form of EBP – one that can avoid simplistic and individualistic approaches and take seriously the complexities of delivering excellent practice – we will increasingly find an unsatisfactory and managerial form of EBP imposed upon us.
This is because – despite EBP being largely rejected by the social work community – policymakers, politicians and the public readily see the logic of a profession basing the work it does on evidence of effectiveness. They see that EBP adds a level of transparency and accountability.
Most importantly, EBP provides a fresh way forward for those interested in developing excellence in practice. For in contrast to the dominant, managerial approach – which focuses on bureaucratic collection of data on processes – EBP focuses on what happens when a practitioner meets a client and what the outcome is.
For this reason EBP is compatible with “reflective” and “relationship-based” approaches that are popular among social work academics. Indeed, almost all evidence-based ways of working rely on relationships and use reflection – and it is difficult to see why the public should fund relationship-based or reflective ways of working if we cannot show they make a difference. EBP needs to be integral to these approaches rather than seen as different to them.
Donald Forrester is director of the Tilda Goldberg Centre at the University of Bedfordshire
More details of Children’s Services at the Crossroads from the Russell House website
This article is published in the 24 June 2010 edition of Community Care magazine under the headline Invest in What we Can Prove Works