What is the place and meaning of ‘evidence-based practice’ in real world social work?

The practical application of evidence-based practice in the context of considering subjectivity and organisational priorities

evidence
Photo: aquarius83men/Fotolia

By Di Galpin, Andy Whiteford and Annastasia Maksymluk

Uncertainty is an inevitable aspect of social work practice, yet, the creation of certainty is a fundamental tendency of the human mind, and it is not just our perceptual system which automatically seeks to transform uncertainty into certainty. Government and wider society demand a high level of certainty from social workers, especially following high profile tragedies, and subsequent reports identifying ‘failings’ in practice.

As a response to such ‘failings’ the concept of ‘evidence-based practice’ (EBP) has proliferated in social work.

EBP is presented as a model of critical appraisal, designed to inform practice, where the practitioner has a relatively autonomous role in searching for, and critically analysing, research evidence to inform their decision making.  The latest guidance on the refreshed Professional Capabilities Framework (PCF) articulates this commitment and adds an additional expectation that social workers also generate ‘evidence’ to inform practice.

Whilst practitioners and educators strive to adhered to this principle it could be argued that the complexity associated with notions of EBP can be ignored at both a practical and philosophical level.

The role of subjectivity

Practitioners across allied professional groups are constantly called upon to manage uncertainty, ambiguity and complexity where there often seems to be a plurality of ways to understand what is happening in practice contexts.

From a philosophical perspective EBP appears to operate on modernist foundations, for example, seeking to adhere to methodological or analytic standards of rigour which demonstrate the reliability of a scientific approach, because this will provide clarity in establishing what is the ‘right’ knowledge by bringing together ideas into systematic, cohesive frameworks.

Within this approach the belief that by adopting it one can achieve a level of certainty is alluring, yet, arguably, unrealistic in social work practice, and indeed may lead practitioners into a false sense of security when making decisions based on EBP. Post-modernist frameworks are of benefit here to thinking about the multiple discourses at play in social work practices and understanding the dynamics between them – particularly concerning power.

This requires practitioner and academics to appreciate how objective knowledge is a contested concept which can lead to a fruitless search in complex situations for certainties that may not exist.

Peshkin (1988) provide an interesting perspective which extends and troubles the notion of objectivity by suggesting the ‘taboo’ of subjectivity stems from a misunderstanding of its potential role in EBP. It is our own subjective involvement in practice—not the precise replication of the event—which can provide strong theoretical insight.

However, we are somewhat conditioned as practitioners and academics to see subjectivity as a ‘contaminant’. Yet, subjectivity cannot be removed it – one can never get away from one self. As Alan Peshkin eloquently reminds us:

“Subjectivity is not a badge of honour, something earned like a merit badge and paraded around on special occasions for all to see. Whatever the substance of one’s persuasions at a given point, one’s subjectivity is like a garment that cannot be removed. It is insistently present in both the research and non-research aspects of our life. …  our subjectivity lies inert, unexamined when it counts .”

This subjectivity shapes and mediates our thinking and action in a whole range of ways. Therefore, it needs to be understood. Instead of trying to remove the garment and declare ourselves clean of subjectivity, it is important to acknowledge it and deeply analyse the reasons why the practitioner has approached decision making in a particular manner.

Evidence-based versus organisational context

Research from Scandinavia suggests while practitioners support the notion of EBP as the analysis of research to inform practice, it is rarely applied in a  conducive way to improve decision making.

This research found professional autonomy is not a given, suggesting the greatest barrier to practitioners engaging in EBP is the organisational context.

Five significant organisational issues were identified as impeding practitioners from adopting a more focused EBP approach:

  • No access to databases where they can search for, and evaluate research
  • Time constraints
  • ‘Organisational logic’ (predictability) prioritised over a ‘logic of care’ (unpredictability)
  • A focus on following organisational guidelines which aligns EBP with organisational logic to guide decision making
  • Financial considerations taking priority over research findings to inform practice.

The research concludes whilst social workers were not content with the current approach to EBP, they felt incapable of challenging it.

Is EBP at odds with real work social work?

Regardless of whatever EBP might, or might not be, it appears practitioners are currently expected to work within a model of EBP which might be more accurately conceptualised as operational based practice, where professional decision making is centred on meeting organisational need.

From this perspective the production, and application, of ‘evidence’ is the product of deliberate, conscious human design, which is amenable to a whole host of organisational, ethical and political requirements. Evidence is not value-free and we need to ask what values and processes currently underpin the discourse that surrounds and shapes EBP in education, research and practice.

From a logic perspective EBP provides a neat linear model of deliberated decision making. However, social work is rarely a logical, or a linear activity, dealing as it does with often complex and chaotic human lives, lives where meaning is constructed by a variety of individuals, and subjected to structural and organisational filters that heavily influence the practice of decision makers and the lives of those they work with.

The notion of EBP has provided the profession, regulators, educators and government with a seemingly straightforward response to improving decision making in complex cases. But the structural realities of practice continue to be ignored, as do the structural inequalities that exist in many of the lives practitioners work with.

Di Galpin is a social work academic lead at the University of Plymouth, Andy Whiteford and Annastasia Maksymluk are lecturers in social work at the university

10 Responses to What is the place and meaning of ‘evidence-based practice’ in real world social work?

  1. SB October 26, 2018 at 1:30 pm #

    Thank you for an interesting article. Perhaps the social work university syllabus should include the benefits of old fashioned common sense and the value of experience, either your own or that of others.
    During my training at university, and subsequently, I was not able to find any academic reference to provide an evidence base for these two essential skills and abilities.

    • Diane Galpin October 27, 2018 at 10:44 am #

      Thank you for reading and taking time to comment One thing I have notice is common sense is not as common one might think!

      • Felix October 31, 2018 at 2:01 pm #

        I completely agree Di. Common sense perspectives on disability have adversely impacted on AOP with disabled people for example. Qualitative research has been particularly useful in challenging ‘common sense’ perspectives and assumptions.
        Thanks for the interesting article.

    • Mohammed October 28, 2018 at 10:56 am #

      I do agree…

      Human beings as individuals and families, and their problems are complex and seldom (if ever) fit into any box. We as practitioners approach and help the person (s) resolve each issue using our own and their life and professional experience as well as the core concepts we all hold dear, eg a sense of equality, fair play, fair access to resources, sense of responsibility that comes with being a citizen etc. If we started to find research that fits the issues before we started doing anything we would hardly be able to achieve much in the timescales we have to work within these days. It’s often ‘get up and go’ from the onset – practical solutions to practical problems, psychological solutions to psychological problems.

      Someone whose value base says ‘love thy neighbour’ or that ‘a believer is one who does not go to bed on a full stomach while his neighbour is hungry’ does not need to read books upon books to understand the value of life – no taking of life, cherishing young lives of children, respect of lives of older people, the disabled, no discrimination, eradication of poverty etc.

      I think we have made helping / supporting people far too difficult and cumbersome then it ought to be.

    • Richard October 28, 2018 at 12:20 pm #

      Practice wisdom has been a central tenet of social work learning and, brings together theoretical understanding, common-sense (whatever that is) and the knowledge and experience of practising social work interventions. During my degree, lecturers were at pains to promote evidence-based practice but NOT to the exclusion of practice wisdom, rather that an effective social workers draws on all the knowledge available to them, including the service user experiences and knowledge to formulate and adapt the most practical and sustainable plans for interventions and support. Evidence-informed practice would be a better term, rather than ‘based’. ‘Based’ suggests the practice is determined by that evidence’s approach; however, ‘informed’ implies that the practition will draw on one or many approaches and add to and adapt to best fit the individual or collective needs.

      • Diane Galpin October 30, 2018 at 9:24 pm #

        Thank you for reading , and your comment, indeed practice wisdom is important.
        Thanks again.

  2. Kate Concannon October 31, 2018 at 8:46 am #

    Knowledge is power and people are the experts in their own lives – if we hold on to that, alongside sharing additional knowledge with people , knowledge from our toolkit’s, some of which may be evidence based, some of which may be practice wisdom then working with people and families can use EBP and knowledge from a range of sources and our assessments and plans will reflect this. There is no point to EBP if we’re not sharing this knowledge with the people we work alongside.

    • Diane Galpin November 6, 2018 at 5:37 pm #

      Yes, knowledge is power and it is important to recognise the fluidity of knowledge and its status. thanks for reading and commenting.

  3. Graham towl October 31, 2018 at 7:33 pm #

    Great article, thank you. The HCPC use the term Evidence Informed Practice on their standards related documentation. It seems to me that that more realistically reflects the relationship between evidence and good practice across health and care professions.

    • Diane Galpin November 6, 2018 at 5:36 pm #

      Indeed, and provides for a less certain approach. Uncertainty is something we all have to learn to live alongside, as it keeps spaces open for new learning. Thanks for reading and commenting.

Leave a Reply