Evidence Centred Practice Essay

From its roots, social work has always remained committed to its core value of empowering people faced with life challenges. In 1915, Flexner made a profound statement that social work lacked a research base to be identified as a unique profession, as it primarily implements knowledge from other professions (as cited in Cnaan & Dichter, 2008, p. 279). According to Greene (2001), social theorists have been trying to conceptualize a scientific framework that can be directly applied to social work practice. Research by Gitterman and Knight (2013) suggests that social workers must embrace research based methods in order to guide their practice. While research should be a framework that social work practice is based on, Greene (2001) identifies that it is important to combine empirical findings with a “reflective approach”, which accounts for the quality of the relationship that the client develops with the therapist. Social workers should adopt an evidence-guided practice approach as it helps rely on a scientific knowledge base, without letting our core value of empowering clients be affected.
Evidence-based practice in social work
Cournoyer argues that evidence-based social work practice involves identification and evaluation of practice effectiveness that can be the impetus to selection and
application of the appropriate service to the members of the target population (as cited in Gitterman & Knight, 2008, p. 70). This method allows for consistency, ethical practice and also holds us professionally accountable to the clients we serve. According to Cnaan and Dichter (2008), social work has geared towards enhancing quality of education by embedding research into curricular guidelines. Greene (2001) supports that there is a demand for evidence-based social work practice as it calls for social workers to think critically within a larger social context and be well informed with the evolving and dynamic nature of the profession. Evidence- based practice has more limitations than advantages in social work practice. Social work is a complex and diverse discipline. It is a challenging task to account for worker-client dynamics in a random assignment model or experimental design due to large sample sizes and variables like client’s daily struggles that are difficult to measure and control. Evidence- based practice adopts a linear relationship between research and application of practice. It is based on a premise that a specific intervention can be applied to produce a certain outcome. This cause and effect relationship cannot be applicable to social work practice as it is multi-disciplinary in nature (Cnaan & Dichter, 2008; Gitterman & Knight, 2008). Castonguay, Goldfried, Wiser Raue, and Hayes conducted an experiment in which cognitive behavioral intervention was compared with the quality of the therapeutic relationship and the clients’ engagement level. They found that quality of the therapeutic relationship was highly related to the clients’ progress than the technique that was used (as cited in Gitterman & Knight, 2008). Social workers work on establishing a two-way relationship with the client. If the focus remains solely on research, the equation between the two will be affected. Social work is seeking to incorporate a method where research can translate into practice effectively.
Evidence-guided practice in social work
Evidence- based practice forms the theoretical framework for evidence-guided practice, but allows flexibility wherein practitioners can attend to factors that would be hard to measure in a strict research method.
These factors include the relationship between the worker and client, the cultural and social context, the characteristics of the worker and the client. Evidence guided practice recognizes that while research can be used to choose the best technique to address the clients’ difficulties; the deliverance of this technique allows for the worker to be spontaneous, creative and genuine when dealing with the unique needs of the individual (Gitterman & Knight,
2008). Cnaan and Dichter (2008) describe two ways we gain knowledge: ‘Logico-scientific’ that is the type of professional knowledge that is taught to us through academia, and ‘narrative’ is a personal reflection of our experiences. The authors explain that each individual client and social worker create their own narrative using the guidelines that professional, scientific knowledge imparts. The incorporation of distinctive style has proven to work well with the core values of social work as it allows workers to help, engage and empower clients.
The limitation in evidence-guided practice lies in connection of theory, education and practice. Gitterman and Knight (2008) proposed that social work education must prepare students to value research findings and subsequently apply that in an effective way to the practice. The social worker needs to have the critical and reflective skills to move from theory to practice and be improvisational at any given time. Social work is constantly evolving as a profession, and research conducted in schools have to be responsive to the knowledge needs of the practitioners (Gitterman & Knight, 2008; Greene, 2001).
Empowering marginalized clients through evidence-guided practice Empowering marginalized clients who are coping with day to day life challenges has been a primary value that drives social work. Cnaan and Dichter (2008) have identified themes that social workers respond and some of these include: violence, crime, poverty, mental and physical illness and racism. This population faces stigma issues and is frowned upon by society. Social workers fight to advocate for justice and partner with or on behalf of their clients to encourage better choices and lead to desired outcomes. Clients should be active and informed participants in their desired goal to recovery. Research is the framework to which all practice should be based on. Evidence based- practice improves social work practice as it ensures consistency, ethical practice and accountability of professionals. Since Flexner’s argument in 1915, social work has been constantly evolving to define itself as a profession and has developed clear standards for practice with a scientific knowledge base. If social work leans were to lean towards purely evidence-based practice, it would lose its purpose as a creative and helping profession.
Gitterman and Knight (2008) state, “Prescriptive theoretical frameworks and evidence-based protocols may have the unintended consequence of rendering professional practice more rigid, devoid of spontaneity and authenticity, and less responsive to the ‘messiness’ of clients’ lives.” Worker-client dynamics are created by the worker meeting with the client and assessing needs. The worker needs to establish a trusting relationship and good rapport with the client so that the client is able to reciprocate and engage in a forthcoming and honest manner. This kind of relationship would be difficult to obtain in an evidence based framework. This would further subject clients to feeling stigmatized, dejected and disempowered. Conceptualization and application of scientific knowledge to action creates evidence guided practice (Greene, 2001). The Council on Social Work Education states that problems can be tackled when one is able to “distinguish, appraise and integrate multiple sources of knowledge” (as cited in Gitterman & Knight, 2008). This framework encourages social workers to be well informed, critical thinkers and respond effectively in a larger social context attending to variables that are otherwise difficult to measure using an evidence based practice. Evidence guided practice can adequately support marginalized populations. While maintaining the same consistency and ethical standards as evidence based practice, the guided approach allows flexibility for workers to use their unique interactional style to engage with the client. Social workers can assess the client based on verbal and non-verbal cues received. They can use existing knowledge and find relevance for the most suitable course of action that will best fit the clients’ needs. This approach will encourage the client to feel self-worth, respect and determined to change.