Evidencing social work practice the potential of practicebased
Evidencing social work practice: the potential of practice-based research Fran Crawford Angela Fielding Sabina Leitmann School of Occupational Therapy and Social Work Curtin University Centre for Research into Disability and Society Curtin Health Innovation Research Institute AASW Symposium for Mental Health Workers 280312 1
Acknowledgements n We thank the four social workers who generously gave their time and effort to participate in this study and so candidly shared their practice stories with us. n We also thank the Head of the Social Work Department at Sir Charles Gairdner Hospital who enthusiastically embraced the research project, helped steer the project’s approval by the Hospital’s Research Ethics Committee and provided for administrative support. AASW Symposium for Mental Health Workers 280312 2
EBP – differing trajectories n US – Education – Campbell – No Child Left Behind n UK – Medicine & NHS – Cochrane – Munro Child Protection Report n Social Work – Joel Fischer & scientific revolution AASW Symposium for Mental Health Workers 280312 3
Eileen Gambrill (2006) n Long-standing supporter and promoter of evidence-based practice in the US n EBP is the integration of best research evidence with clinical expertise and client values n EBP was created as a response to professionals not acting on research findings AASW Symposium for Mental Health Workers 280312 4
Tensions: What constitutes EBP Taylor and White (2001) acknowledge value of evidence to social work, health and welfare, also challenge some ideas and assumptions which underpin EBP: n q quest for certainty and assumption of the existence of certainty implicit proposal that there is but one form of rationality Moral/practical/political dimensions muted by technical/rational AASW Symposium for Mental Health Workers 280312 5
Stephen Webb’s questioning ‘validity’ of EBP n n n Presumes particularly deterministic version of rationality –not what happens in practice. Complex phenomena such as decisionmaking not rationally determined nor subject to ‘control’. Separating processes into ‘facts’ and ‘values’ undermines professional judgement and discretion in social work Unhelpful blend of scientism and managerialism AASW Symposium for Mental Health Workers 280312 6
Eileen Munro and reintroduction of professional judgement n Audit and inspection systems fails to make (google) n n n practice transparent. Mistaken emphasis on easily measured such as forms filled and meetings held. EBP undermines professional practice while legitimating a harsh managerialist ethos. Importance of regular critical supervision in social work AASW Symposium for Mental Health Workers 280312 7
Jane Gilgun’s Four Cornerstones Research and Theory Practice Wisdom Person of the practitioner What clients bring to practice situation Importantly, Gilgun views evidence as ‘provisional, meaning understandings are open to modification as new evidence unfolds’; and falsification as crucial: meaning a ‘willingness to seek information that challenges our own understandings and openness to contradictory evidence’ (2005, p 59). AASW Symposium for Mental Health Workers 280312 8
Overview of research n WA study: how skilled hospital social workers draw on multiple forms of knowledge for effective practice. n Four experienced hospital social workers: 10 cases in which they thought they were effective. n Researchers reviewed health records for social work entries n Qualitative design – in-depth interviews n Social workers talked about what knowledge they use in their practice; advice for new social worker. n Two ethics committees AASW Symposium for Mental Health Workers 280312 9
Publication n The interplay of evidence and knowledge for social work practice in a health setting Fielding, A, Crawford, F, Leitmann, S & J. Anderson International Jnl of Therapy and Rehabilitation (2009) 16(3): 156 -165 AASW Symposium for Mental Health Workers 280312 10
Key Points of Interplay Article n n divergent views - empirical and reflective approaches as to what constitutes evidence. Austn swers required to articulate forms of evidence shaping their practice. our study with health swers –they drew on empirical & reflective traditions in and for practice. active agents in making knowledge in situ as well as applying knowledge AASW Symposium for Mental Health Workers 280312 11
Evidencing through Narrative n The word narrative was not used; but it is what emerged across all interviews. n Feature of narrative is sequence and consequence: events are selected, organized, connected, and evaluated as meaningful for a particular audience (Riessman) AASW Symposium for Mental Health Workers 280312 12
Narrative Inquiry in social work n may be used to understand e. g. the nature of professional-client encounters; the tacit dimensions of practice; and categories of service such as ‘hospital social work’ that tend to be reified in much research. n (adapted from Wells, 2011: 12) AASW Symposium for Mental Health Workers 280312 13
Narrative Inquiry in social work may also be used to study aspects of development that may be otherwise overlooked; n the relational experiences at the heart of clinical social work n and the ways in which individuals negotiate social exclusion n n (adapted from Wells, 2011: 12) AASW Symposium for Mental Health Workers 280312 14
Elizabeth’s Story A Case Study of Effective Social Work Practice (pseudonym used)
I know I was effective that I know, I was effective. Social Worker discussing Elizabeth’s Case
Taylor & White (2001) n Social work is as much a practical-moral activity as it is a technical-rational one. n It is important to explore and debate the range of rationalities upon which social workers depend when they make their professional judgements. n Suggest social workers like all engaged practitioners make knowledge and in this they often use narrative. AASW Symposium for Mental Health Workers 280312 17
Second Interview at Interviewee’s Request in order to clarify n that ‘keeper of safe spaces’ was the one that worried me. AASW Symposium for Mental Health Workers 280312 18
Conclusions n Participants valued the reflective space of the interview. n The narratives demonstrated use of reflective and evidence-based knowledge, and the interweaving of skills and evidence from social work theories and models. n Next step is to facilitate a discursive exchange between the researchers and practitioners about the findings. We see this as a work in progress. AASW Symposium for Mental Health Workers 280312 19
References n Gambrill E (2006) Evidence Based practice and Policy: Choices Ahead. Research on Social Work Practice 16: 338 -357 n Gilgun J (2005) The Four Cornerstones of Evidence-Based Practice in Social Work. Research on Social Work Practice 15: 52 -61 n Riessman, Kohlman, C. (2005). Narrative in Social Work – A Critical Review. Qualitative Social Work, 4(4): 391– 412 n Taylor S & White C (2001) Practising Reflexivity in Health and Welfare: Making Knowledge. Buckingham, Open University Press n Webb, S. A. (2001) Some considerations on the Validity of Evidence -based Practice in Social Work British Journal of Social Work 31, 5779 n Wells (2011) Narrative Inquiry. New York: Oxford University Press AASW Symposium for Mental Health Workers 280312 20
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