Best Practices
Theory and Research
Chapter 18
Current and Future Social Work
Practice
Best Practice
The Role of Evidence
• Practitioners require skill in accessing systematic
reviews and weighing the empirical evidence
according to the rigor of the research design.
• Choosing an effective and appropriate
intervention for a specific client or situation,
requires a review of the evidence that supports one
theory-based intervention over another.
• Research is the core of evidence-based practice.
Best Practices
The Limitations of Empiricism
• Though necessary, empiricism is not
sufficient to build knowledge.
• No array of statistical techniques can
produce cumulative knowledge.
• Empirical data become knowledge when
referred to theory for understanding.
Best Practices
The Role of Theory
• Theory, as knowledge, is a body of interrelated
proposition, statements, and concepts that have
been subjected to empirical verification.
• As part of the research process, theories become
self-corrective.
• The holistic property of theory (cause-effect)
moves the practitioner in an orderly and
conceptually consistent manner from declarative
knowledge (what is known-procedural knowing)
to enactment of a therapeutic process (doing-tacit
knowing).
Ways of Knowing
There are three basic ways of knowing:
1. Faith- knowing based on theological or
religious beliefs.
2. Reason-knowing based on rational discourse;
logic, argument, philosophical proof.
3. Science- knowing based on empirical evidence;
assumptions of linearity, probability, & ability
to measure an objective reality
Science As a Way of Knowing
• Scientific knowing differs from knowing based on
animal instincts and belief in ideology or magic.
• The scientific paradigm is based on trust in reason
(rules of discourse), logic, rigorous research
methodology, a belief in progress (new knowledge
builds on previous knowledge) and academic
freedom (pursuit of truth).
• Science adheres to standards against which
comparative evaluation occurs.
Science As A Way of Knowing
Continued
• Science holds that a large part of reality is
measurable and therefore capable of being
known.
• Science produces knowledge stated in such a way
as: (a) to make it comparative, (b) to prove or
disprove it, (c) to integrate it, (d) to generate and
test new knowledge.
• Knowledge is a set of ideas whose acceptability is
determined by the criteria of science.
Social Work and Science
• Social work has long subscribed to science as a
way of knowing.
• Those who subscribe to science as a way of
knowing, maintain that explanation/prediction
(cause-effect) makes prevention and intervention
possible.
• According to Polansky (1986) there is nothing as
practical as a good theory to guide action.
Theory As
Schools of Thought
• Theory and research work together to develop
schools of thought (multiple theories).
• Over time, social work has recognized that no
single theory, whether narrow (psychodynamic) or
grand (general systems theory) can guide practice.
• Generalist practice represents a paradigm shift to
open assessment and consideration of multiple
theories.
• The profession has gone from a paucity of theory
to a plurality of theory.
Multiple Theories
Decision Tree
• A plurality of theories creates theory choice.
• The decision tree helps practitioners navigate
different theories and the evidence for or against
them when selecting the best treatment option
from among available options for a specific case
or situation at hand.
• See case example on “Night Crying” in this
chapter.
• When practice is theory and evidence-based, the
practitioner asks what works, with whom under
what circumstances and at what cost.
Scientific Rigor
• Determining the relevance of research to
evidence is dependent on the methodology used to
conduct the research (Roberts & Yeager, 2004).
• Levels of evidence help practitioners select
treatment options based on the methodological
quality of the studies used to generate the
empirical evidence.
• The are four levels of evidence ranked by the rigor
of the methodology used.
Levels of Evidence
Designs
1. Experimental designs: random selection
(sampling) and random assignment to treatment
and control group; replicated;
2. Non-replicated experimental designs and
systematic reviews and meta analysis of
multiple, well designed controlled studies.
3. Quasi-experimental designs – comparison
groups in natural settings
4. Single subject and single group pre-post test
Comparison of Research
Methodology:
• Understanding scientific rigor requires familiarity
with the differences between quantitative and
qualitative research.See exhibit 18.1
• The two methodologies differ in design, sampling,
instruments, data gathering techniques, type of
data collected, inference, perception of reality,
variables (tested or generated) and how results are
reported.
Quantitative Methodology
Characteristics
• Quantitative research tests well-specified,
hypotheses concerning pre-determined variables;
deductive.
• Sampling is random and therefore representative;
findings may be generalized.
• Information is gathered in numeric form, using
valid and reliable instruments;
• Findings are produced using statistical procedures
and other means of quantification; usually
published as articles in professional journals..
Qualitative Methodology
Characteristics
• There are over 50 approaches to qualitative
research from numerous disciplines; inductive.
• Designs rely on participant observation, case
studies and the focused interview.
• Sampling is non-random; subjects are recruited;
studies cannot be replicated; findings cannot be
generalized.
• The researcher - the instrument of data collection.
• Data is non-numerical –field notes, audio tapes.
video tapes, photographs, documents/reports.
Qualitative Methodology
Assets
According to Padgett there are several good reasons
For engaging in qualitative research:
1. It is used in program evaluation (formative
research) and in activist research.
2. It is used when little is known about the topic
being explored or the topic is too sensitive
(taboo) and/or too emotional.
3. It is used when a researcher reaches an impasse
in data collection or interpretation using
quantitative methods.
Clinical Research
Evidence-Based Practice
• Evidence-based clinical research tilts toward
quantitative research and rigorous methodology.
• The focus in clinical social work is on outcome
efficacy; group analysis of clinical cases is
considered more rigorous than single subject or
single group designs. See chapter 6.
• What the clinician does is controlled through
empirically supported treatment protocols.
Evidence-based Practice
Policy, Advocacy, Management
• Policy, advocacy, management, and community
practice depends on program evaluation
(formative and summative research) to determine
program process and outcome effectiveness.
• In Macro practice, program evaluation has tilted
toward process (formative research) or qualitative
research methodology e.g. is the program being
implemented in the manner intended?
• Currently the emphasis is on summative/outcome
evaluation, i.e., results-oriented. Does it work?
Barriers to Evidence-based
Clinical Practice
• Choice, necessitates conscious decision making
based on criteria.
• Statistical significance may not equate with
clinical significance
• It is difficult to access systematic reviews of meta
analyses of multiple, well-designed controlled
studies; meta analysis cannot exceed the limits of
what is reported by primary researchers.
• It is difficult to implement empirically supported
treatments in everyday practice.
Barriers to Evidence-Based
Macro Practice
• Rigor in macro practice, has focused on
documenting needs and resources
• The standard of scientific rigor ( multiple,
replicated, experimental, controlled, studies) is
less feasible when applied to program evaluation
• The desired end-goals of most social programs are
value-determined in contrast to the more
scientifically-determined (cause-effect) outcomes
of clinical practice.
Barriers to Evidence-Based
Macro Practice: Continued
Factors, other than science, influence decisionmaking in macro practice:
1. Science documents needs/resources
2. Moral philosophy determines desired end-goals
of social policies and programs
3. Politics influences public or political support for
or against a program and its level of funding.
4. Economics Availability of funds and competing
interests for the same monies impact decisions.
The Argument for EvidenceBased Macro Practice
• Policy makers and program managers do improve
their practice when they use evidence to guide
their decisions.
• Evidence is an antidote to unfounded opinion
based on policies and programs that rely on
ideology, prejudice, or speculative conjecture.
• Evidence mitigates decisions based on personal
gain or organizational politics; evidence
promotes the common good.
• Grant Trend (RFPs): Evidence key in proposal
The Argument for EvidenceBased Clinical Practice
• Treatment choice is now a condition of competent
practice.
• Client’s benefit when practitioners are aware of
the availability of theoretically-sound and
empirically-verified diverse treatments.
• Client’s should be involved in making an
informed treatment decision based on a review of
available options; best practices.
Conclusions
Endings: Theory
• Social work has accepted a plurality of
theories
• A uni-theory, mono-theory or mega theory
have not come to pass.
• Social work has rejected practice devoid of
theory; whether based on relationship only
or empiricism only.
Conclusions
Endings: Methods
• Compared to ten years ago, the role of
generalist practice has become more clear.
• The profession has avoided adopting
generalist practice as a uni-method, monomethod, or mega-method.
• Generalist practice is a framework that is
both multi-theory and multi-method.
Conclusions
Endings: Polarizing Debates
• Polarizing debates (either/or positions) over the
importance of one theory or one method have
been replaced by discussions of the
appropriateness or lack of appropriateness of a
theory or method for the situation at hand.
• Divisiveness over theory focus ( pathology/deficit
vs. resilience/strength) has also diminished.
• Method and theory diversity are more aligned
with the multi-cultural and complex world within
which social workers practice.
Conclusions
Endings: Polarizing Debates
• Previous attempts to deny or exclude have been
replaced by the recognition that all theories and all
methods have equal value in themselves and
differential value in their proper or improper
application.
• The evidence-based movement, despite
differences over quantitative or qualitative
research methodologies, has strengthened the link
between theory, research, and practice.
Conclusions
Decision Tree
• The decision tree provides practitioners
with some assurance of competency
commensurate with their decision-making
responsibilities.
• As a tool, the decision tree adds precision
and proof of process when applying theory
and evidence to practice.
Conclusion
Competency
• By alternating chapters in clinical and macro
practice, the text provides the readers with skill
sets consistent with a range of system sizes:
individuals, dyads, families, groups, organizations,
and communities.
• The text shows the reader how to apply more than
one theory and more than one method to complex
data in the same case through case-specific model
building and the use of the decision tree.