By Al Murdach, LCSW (retired)
This column examines words that are currently significant for social work practitioners. These are words that can cause, or have caused, a major impact on the way social work practice is organized and carried out. Today’s word is: Evidence.
“Evidence” is currently a word much used in the profession. In fact, today all of social work practice, along with numerous other health and welfare services, is expected to be fully “evidence based” as much as possible. Evidence is defined as “facts that determine truth or validity.”
Of course in this sense, social work practitioners have always been urged to base their work on evidence. For example, early social work leaders such as Mary Richmond and Edith Abbott used data from interviews, surveys, social statistics, and expert testimony to guide their work, and criticized social workers who relied only on guesswork and sentiment to make their decisions. However, it is the type of evidence rather than evidence itself that is at issue today in the profession. Gone are the days, we are told, when social workers can guide their interventions by using the recommendations of our predecessors and the results of past successes.
Now our work must be solidly based on up to date “scientific” evidence, that is, data derived from controlled clinical trials, double blind studies and statistically proven methods. It is this information that determines the “best practices” which must always be used. Eileen Gambrill has famously stated that, while past social work knowledge was “authority based” (that is, derived from the pronouncements of past or present leaders in the field), modern social work can only progress if it is “evidence based.” Thus, past reliance on “practice wisdom” is now replaced by reliance on practice “verification.” Proof of “effectiveness” is now the standard of quality in the profession.
This is not necessarily a bad thing. After all, the clients of our services deserve the best possible treatment. At one time social work could coast on its reputation for quality service. This reputation was seriously challenged in the 1960s by a famous controlled study called Girls at Vocational High: An Experiment in Social Work Intervention, which found no significant difference in outcome between those students who received social work intervention and a control group which received no such services. Much hand-wringing occurred in the profession after the study’s publication (and subsequent public criticism of the profession in the news media). All of this furor resulted in strenuous efforts to focus attention on examining and improving the results of social work intervention rather than simply upgrading record-keeping to show that services had been delivered.
Today, however, there may be some danger that the profession has become, not merely focused, but obsessed by the need to base all of its results on so-called “hard data.” There is no doubt that social work services must be carried out by proven and tested methods, especially given the business climate that today dominates health and welfare efforts not only in this country but throughout the world. To gain funding and public support, the field has to constantly demonstrate not only its good and heartfelt intentions, but also its effectiveness and results. Nevertheless, it is obvious to anyone who has practiced our trade that decision-making in social work, as in medicine, nursing, teaching and a host of other service professions, is often grounded in the smart use of “soft data,, such as feelings, hunches, impressions, past experience, intuition, etc., combined with the smart use of “hard data” that informs and guides practice. Therefore, in our continued efforts to be “evidence based” we should never neglect the importance of improving our understanding of how best to use non-quantifiable data and indicators in order to improve our practice’s official numbers and results. This is especially true if we are to improve measures of customer satisfaction provided by our clients. After all it is no achievement to say, as does the old medical saw: “The operation was a success but the patient died.” We must strive to ensure both that we use the best methods and that our clients have benefited from our efforts.
