Leaving Room For Change: Beyond Evidence Based Practice

Those of us in the social work profession have spent at least 4 years at university studying the intricacies of human behaviours, and thousands of hours analysing a myriad of models and theories that claim to provide the “solution” to people problems. Every model taught has undergone rigorous testing by suitably qualified professionals in order to prove validity, and to claim its stake in the world of “best practice” or “evidence based practice”.

We exit university feeling well equipped with an abundance of knowledge and an ability to adapt what we have learnt to any given client situation. Ethically, we’re bound to continue our professional development and keep ourselves up to date on the latest findings that add to, question or replace the strategies we were taught, and have started to use with our client groups.

prescriptiveHeading into the “real world”, we soon realize that the organisation (or its funding body) will regulate which models we will use with our particular client group. This may feel “prescriptive” for a while, but soon we’ll either be convinced, or told, that this is the latest and most effective evidence based method of intervention for your particular client group.  We may sprinkle in a portion of our own personality, and if particularly brave, insert a couple of our own ideas throughout the intervention process.  How and when this sort of “insertion of the worker’s own interpretation” occurs does not appear to be of much (if any) concern in overall evaluations.

The assertive among us may even go so far as to suggest CHANGE to some of the old “tried and true” strategies. But we’ll soon realize that we need a team of researchers and multitudes of clients willing to be guinea pigs, to provide that much-needed “evidence”. Time consuming. Probably cost prohibitive.  We’re probably already overworked and underpaid.  Perhaps it’s best to just stick to the existing  prescription.  After all, the “experts” have stated that all the research points to evidence that this works. Furthermore, organisational managers who have a management perspective (as opposed to a client perspective) start to adapt these models as “evidence”  to show they are following procedures which have a “proven” methodology. Models have measurements to gauge outcomes, and outcomes justify organisational spending.

Here comes the irony. Interestingly, we encourage our clients to embrace change. As social workers, we are often called “change agents”.  How then, can we justify a profession that is becoming “prescriptive” by the very nature of insistence on “evidence based practice”?

Now before I am bombarded by those proponents of evidence based practice who only read part way through a document – I urge you to read on.

changeBy no means am I inferring we do away with tried and tested models of intervention. Nor would the removal of “evidence” of effective practice achieve anything bar chaos. What I am suggesting is that “prescription intervention” has an inherent risk of the helping professional becoming complacent in his/her  practice. Take that complacency to its limits and we may well end up with workers who  place expectations on client responses. After all, if there is a generic “correct” model of intervention, then there must a generic “correct” client response.  Yet nothing could be further from the truth – we all know that client responses are as diverse as client circumstances.

So wherein lies the balance? The balance lies in perspective. It’s about how we view a particular model. The key is this – models are not meant to be prescriptive, they are a guide.  We value individual differences, so leave room in your practice to adapt, to be innovative, to be flexible according to your particular client needs and circumstances. Look beyond the prescription. Best practice is about best outcomes for clients.

Most of all, focus less on the need to be rigidly mindful on a model and start to use creativity, flexibility, authenticity, innovation and adaptability to ensure that any model of intervention remains relevant to client needs.  And if you think perhaps you’ve fallen into the trap of complacency, consider the need for some time out to regain that sense of wonder, intrigue and sense of justice you once had in your early practice years. Why? It is important for social workers to retain the ability to function effectively as a “change agent”.

Let’s just look at those words again – creativity, flexibility, authenticity, innovation, adaptability. A little outside your comfort zone? Not quite sure where these things fit into social work?   Let me remind you of Einstein’s quote “the definition of insanity is repeating the same thing over and over again and expecting different results”.  If you are not creative, flexible, innovative, authentic and adaptable in your own practice, then how can you empower your clients to make change?  If you adopt one particular “modus operandi” in your practice, relying solely on what has been presented to you as “evidence based practice”, then where will new ideas come from?  If you view one particular model as the generic answer to your client group’s issues, how will innovative new practices ever evolve?

It isn’t simply a case of sitting in the status quo of a current model and insisting on its merits because it has “proven results”, or because the company that pays your salary insists that you utilize a particular method. If you see a need for change, then speak out. Act on it. Find others in the helping professions and discuss their experiences.  After all, isn’t that what we encourage our clients to do?

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Veronique Moseley

Veronique Moseley is a Social Work Helper Contributor. In Australia, she has spent the last 20 years working in the areas of community development, stress management, adult education and facilitating creative partnerships. With a Bachelor of Social Work (UNSW) and experience in photojournalism and marketing, Veronique is passionate about highlighting the value of creativity, innovation and promotional skills in all areas of social work practice. She is co-founder of Behind The Seen, a preventative program for Australian emergency services personnel to help them and their families deal with the unique stresses they face. View all posts by Veronique Moseley

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