Sample Paper on What Works in Social Work

What Works in Social Work

            Social work has been defined as a profession that promotes social change, problem solving, and the liberation of individuals to enhance their well-being (Mathews & Crawford, 2011). The concept of doing what works (also referred to by some as evidence-based practice) has increased in popularity in the last decade, from its evolution in the 1990s. This concept refers to the process through which a practitioner combines proper research, clinical experience, ethical considerations and clients’ background and preferences to guide and inform the delivery of assessment (Gilgun, 2005). This ensures that the decision chosen is well informed and has the highest probability of success. There is an increased interest in the evidence-based model, pointing to the likelihood of its increased significance in shaping professional culture for future generations (Webb, 2001).

The ‘what works’ concept has come to be very beneficial to the field of social work. It is seen as an essential component in contemporary practice. It is also closely linked with the concept of evidence-based practice because both methods rely on scientific research to aid wisdom and knowledge acquired in practice. However, evidence based practice is more strict on what constitutes evidence, explicitly requiring that for any information to be relied on as evidence, it has to be obtained from quantitative research and/or systematic reviews of randomized control trials (Mantzoukas, 2008). However, the focus of both approaches is similar in that they aim to make decision making more effective through the use of the best scientific evidence that is currently available for the scenario in review.

The method that has been employed the most in determining the success of the ‘what works’ approach is eventually the impact it has on the client. Since the client is given an opportunity to play a part in the eventual approach taken, the success of the approach can be measured by gauging the client’s reaction. The clients are also confident in the methods applied by the social worker. The worker is also given a chance to gauge whether clients are responding positively to the approach and change direction when necessary. This is the core of the ‘what works’ approach and is the measure of success of the model (Greene & Lee, 2011).

A central theme in the concept of ‘what works’ in practice is the use of the best available research knowledge to help in the determination of the course of action with the highest chance of being effective in the case in question (Drisko & Grady, 2012). This, however, must be combined with clinical expertise, which is crucial for the integration of all the available knowledge to come up with an informed decision. The success of this model is also hinged on the co-operation between the practitioner, the researcher, and the client to identify what works for various people and under what circumstances. Client input is also highly valuable since their specific preferences and unique background help to shape the course of action chosen.

Despite its apparent benefits, there has been a fair amount of criticism leveled against the ‘what works’ approach. One of the most prominent criticisms leveled against this model is that professionally acquired experience is every bit as valuable as formal research data (Glasby & Beresford, 2006). In fact, experience may even be more valuable. In addition, the over-reliance on a technical approach may cause a shift in priorities, for example by focusing on the application of research data regardless of its applicability in the specific context. The excessive reliance on science also seems to disregard the value of professional experience. These ‘certain’ approaches should only be fully relied upon in discrete components but the others require qualitative judgments (Taylor & White, 2000). Despite the seemingly growing appropriateness of the model, there also has not been a documented practice effort in which the model has been implemented and its results evaluated (Rosen, 2003).

One of the considerations regarding the implementation of this model is the definition of best practice. The ‘what works’ approach is merely a guideline in social work and its application may vary from case to case. For example, it is difficult to explicitly define the proportion of reliance on past research or experience that has been implemented in a case. Also, the mere fact that research has been considered is not proof that it was actually used to reach the final decision. It has also been argued that social workers act on not only the evidence available, but also on the expected circumstances and outcomes. This is shown by a tendency of social workers to rely on pre-existing inclinations when making decisions (Webb, 2001). Therefore it becomes difficult to determine the extent to which research data has been implemented in reaching the final decision.

The implementation of the ‘what works’ model is also influenced greatly by the various factors that come into play before a decision is made. Social work is a diverse field with many considerations which should be taken into account before an approach is chosen for implementation (Healy, 2005). For example, there may be a need for justification of the approach taken, and therefore this encourages use of this model. Political pressure therefore influences the use of this method. Other factors considered before coming to an eventual decision include resource constraints and personal values of the parties involved. Interpretation may therefore differ among various cases. Therefore, this is not a static model and is constantly changing due to the many factors involved (Webb, 2001).

A ‘what works’ approach is identified by the careful and specific application of best research evidence by social workers (Gilgun, 2005). Consideration of clinical experience and patient preferences is also evidence of the application of this approach.

The following is an implementation procedure outlined by Mullen, Bledsoe, & Bellamy (2008), though it is not necessarily applied in order shown:

  1. Converting information needs into an answerable question, which will be answered by research into existing literature.
  2. Research on the best and most appropriate evidence to answer the question formulated in the previous step.
  3. Critically assess the evidence for its viability, significance and relevance in practice.
  4. Integrate the critical appraisal with practical experience and client’s preferences and/or circumstances. The client’s views and preferences are incorporated to develop the treatment plan.
  5. Evaluate effectiveness and efficiency in exercising the previous steps and seek ways to improve on them next time.
  6. Teach others to follow the same process

This implementation model may vary according to the specific case in question and the practitioner has the freedom to change it to suit various situations. Measuring of the effectiveness of this model has been particularly challenging. Despite the almost universal acknowledgement that using evidence is beneficial, it is not clear whether the implementation of this approach improves the outcomes for the clients served by social workers in practice (Drisko & Grady, 2012).

The implications of the increasing adaptation of the evidence-based model have included increases investment of resources from Government. Research into this field is also increasingly being funded to cultivate evidence-based practice (Webb, 2001). The likely trend is that this model will become increasingly more significant and may even become a basic requirement for all social workers.

The emergence of the risk society paradigm is also an emerging issue in the field of evidence-based practice. Security and trust are becoming increasingly important for citizens. Individuals now demand more choice and responsibility. The effect of this much freedom is the increased likelihood of challenging expert opinion and professional judgment. There is increasing concern on exactly who can be trusted to satisfy the needs that people may experience in the present or future time (Webb, 2002). This is likely to be a great concern going forward and it is interesting to observe how this will shape up.

There are currently different theoretical approaches in addition to the concept of ‘what works’. These suggest a different view to the field of social work, which stresses on the importance of research evidence application in practice. One of these models is the authority- based model. Social workers adhering to this approach rely on quite different criteria, such as others’ opinions, anecdotal experience, and popularity or consensus (Gambrill, 1999). Another alternative theoretical approach is the intuition-based model. This relies on intuition gained from experience and introduces more autonomy in decision-making.

The strengths perspective is an alternative approach to social work commonly employed in contemporary practice. Since the focus of social work is essentially solving clients’ problems (Parton, 2000), it is therefore appropriate to focus on the clients’ strength in the seeking of a solution. This approach emphasizes the need for working with clients’ strengths. It is agreed that every individual has some strengths and capabilities. The strengths approach focuses on understanding clients from the point of view of their strengths. This approach has been found to be favorable because of its flexibility and its applicability in a wide range of cases (Greene & Lee, 2011). A central concept to the working of this approach is the partnership between the client and social worker, which enables the creation of opportunities for the clients’ strong points to be more evident.

The Payne’s theory concept is an alternative to the evidence-based model of social work in practice. This model suggests a three-way approach to social work. The three core areas that are focused on are therapeutic, social order and transformational views. It is argued that the three are different ways of dealing with the claim. The therapeutic approach suggests that in social work, there has to be constant interaction and mutual benefit between the workers and clients. Also known as reflectiveness, this helps social workers by giving them a deeper understanding of their practice while at the same time empowering clients to gain power over their lives. The transformational view chooses to see social work as a way to benefit the most oppressed people in society to gain control over their own lives. They seek to transform society for the benefit of the least-privileged groups since it is the role of society to make these transformations for their empowerment (Payne, 2013). Finally is the social order view, which sees social work as a crucial contributor to the maintaining of the fabric of society. It should be noted that each theory seeks to improve the others. These different dimensions exist merely to support each other, and the ‘what works’ approach may work best when applied to one of them. The Payne theory advocates for the combination of professional practice with social transformation and an interpersonal connection with the client (Cree, 2013).

The design and definition of ‘what works’ varies greatly with the practical implementation of the process. Some impeding factors contribute to differences in theory and practice. These factors are related to either the considerations involved in the evidence-based approach, practitioners’ preferences, or the approach employed in the use of information for decision-making. The factors cannot be easily altered due to their implicit nature. In addition, their discouraging influences on the implementation of the ‘what works’ model have not undergone studies in an attempt to reduce this negative effect (Rosen, 2003).

One of these factors is the pre-existing conceptions about solutions to situations that social workers may have due to prior experiences. Such knowledge is usually informally acquired and there may be a tendency to apply it in the professional context. This may be done subconsciously and is likely to disrupt the learning and application of professional habits in the course of their dealings with clients (Rosen, 2003). This works against the notion of applying scientifically correct knowledge in the course of social work, which should be guided by logic and rationality. Therefore, for the success of this model in practice, it requires the casting aside of prior lay knowledge in order to limit the transfer of inappropriate knowledge to a professional context (Rosen, 2003).

External limitations of the evidence may cause a discrepancy in the theoretical definition and the practical application of the ‘what works’ model. It is widely accepted that the use of research evidence, when available, is beneficial and should be implemented. The problem arises when this research is unavailable, contradictory, controversial or not applicable to the particular case in question (Godlee, 1998). Scientifically derived knowledge is also faced with the risk of uncertainty, even when optimal research methods have been used to obtain it.

The implication of the use of this data is that uncertain knowledge based on probability is applied to a situation where present circumstances differ from those used to acquire evidence. This poses the risk of an extremely high probability for error. When faced with such dilemmas, social workers are more likely to make their decisions based on practical experience rather than the research-based approach (Rosen, 2003).

Reliance on scientific knowledge for social work has been termed as dehumanizing, mechanical and insensitive to individual and cultural diversity (Rosen, 2003). The use of scientific research methods in social work is regarded as renouncing its core values of social justice on which it is intended for. Although this is advocated for in theory, its application in practice is seen as disregard for the human aspect of social work. This has been an obstacle for the implementation of the evidence-based model and eventually practitioners fall back to their practical experience.

The focus on the ‘what works’ approach is demonstrated by the benefits it presents to the various parties involved. One of the benefits is the involvement of the clients in the making of important practice decisions. The client is involved in the discussion on the practitioner’s findings and their recommendations for the course of action resulting from these findings. If no evidence has been found to support a specific method, the practitioner explains to the client their rationale for the selection of that method (Gambrill, 1999). Client involvement is beneficial because of its consideration of the client’s expectations, concerns and preferences, and its recognition that these views are every bit as valuable as those of the social workers and researchers (Gray, Plath, & Webb, 2009).

The usefulness of a focus on what works is also important since it backs up and provides practical experience with proof. It provides a logical reason for why a particular decision is made. In addition to this, new evidence is being generated each day and it is useful for the social workers to get to know about this information and apply it in their dealings with their clients. Problem-based learning has also been shown to help in keeping up to date with current trends (Gambrill, 1999).

The best application of the concept of ‘what works’ is one that enables the process to be as smooth as possible for all the parties involved. One of the methods through which this can be achieved is by availing of user-friendly tools to help in the identification, location, and retrieval of empirically supported interventions that are most relevant to the case in question (Rosen, 2003). This application would provide benefits for not only the social workers who get to increase their knowledge, but also for the clients, they serve, by providing them with the best possible services.

It is also important to note that the presence of research is not a substitute for wisdom and practical experience. For the successful application of this model, the employment of scientific research and its appropriateness for the situation must be critically analyzed before use. If necessary, the information should be supplemented or modified for the most appropriate usage based on the prior experience of the professional (Glasby & Beresford, 2006).

In addition to the above measures, the implementation and success of this model heavily relies on the availability of research information. Therefore, continuous evaluation of outcomes must be conducted and documented to increase the body of knowledge available for future use. In addition, relevant feedback on the effectiveness of the applications of the model should be availed since there is scanty information available on the effectiveness of the ‘what works’ model in practice.

In conclusion, the model of ‘what works’ is a massive step forward in the field of social work. It counters the classical models of intuition-based decision making and authority-based practice. Its emphasis on incorporation of scientific research evidence with practical experience and consideration for client values and circumstances is a beneficial approach to social work. In addition, it provides numerous benefits that can clearly lead to the evolution of the field of social work. Despite the general positivity around this model, there is concern regarding a lack of documentation on the measurement of its effectiveness when applied to the field of social work.

This model is definitely a work in progress with potential for future improvements. With its continued implementation in social work, it is guaranteed to evolve to a more mature model with more varied applications. It is therefore interesting to observe how this evolution will affect social work in future.

 

References

Cree, V. E. (2013). Social Work: A Reader. Routledge.

Drisko, J. W., & Grady, M. D. (2012). Evidence-based practice in clinical social work. New          York: Springer.

Gambrill, E. (1999). Evidence-based practice: An alternative to authority-based     practice. Families in Society: The Journal of Contemporary Social Services,80(4),        341-350.

Gilgun, J. F. (2005). The four cornerstones of evidence-based practice in social work. Research    on Social Work Practice15(1), 52-61.

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

Greene, G. J., & Lee, M. Y. (2011). Solution-oriented Social Work Practice: An Integrative            Approach to Working with Client Strengths. Oxford University Press.

Godlee, F. (1998). Applying research evidence to individual patients: evidence based case            reports will help. BMJ: British Medical Journal316(7145), 1621.

Gray, M., Plath, D., & Webb, S. A. (2009).Evidence-based Social Work: A Critical Stance.            Routledge.

Healy, K. (2005). Social Work Theories in Context: A Critical Introduction. Palgrave Macmillan.

Mantzoukas, S. (2008). A review of evidence‐based practice, nursing research and reflection:       levelling the hierarchy. Journal of Clinical Nursing, 17(2), 214-223.

Mathews, I., & Crawford, K. (2011).Evidence-based Practice in Social Work.SAGE.