Is EBP New? February 9, 2007
Posted by rickbarth in Uncategorized.trackback
I have heard or read several comments suggesting that EBP is the flavor of the month or just a rehashed accountability or case evaluation or program evaluation strategy, from the past. I know that this question has been addressed by Eileen Gambrill, a couple of years back, if anyone wants to find that work. (Gambrill E.D. (2003). Evidence-based practice: Sea change or the emperor’s new clothes? Journal of Social Work Education, 39, 3-23. I am just lazy enough to want to write this short piece without going to find and read that piece and will hope that my ideas are fresh.
In short, the major difference that I see is that this is a worldwide and transdisciplinary movement. We are not alone–or just working with psychologists, as we did in purusing single subject design and goal attainment scaling or some other innovations. Whether we want it or not, we are part of a giant health services movement that we must be prepared to respond to. My first major involvement with EBP was working with a county in CA that had folded Child Welfare Services under their Health Department and every program had to meet the same EBP-driven standards. There are international resources (e..g, the Cochran Collaborative) which are very well funded and are having a significant impact. Certainly, some of the processes that Len Gibbs and others have developed for how to respond to cases within a EBP framework are very familiar and could be traced to many social workers who have built our capacity for scientific charity. What is VERY NEW, in my individual view, and is not going to lose or change flavor in a month, is the international infrascture in support of this direction of work, coupled with the IT infrastructure that makes the sharing of research information undeniably possible and, in some cases, very important. Also beyond the tipping point is the collection of ESIs that has emerged after three decades+ of development–including a series of interventions that have evolved from social and cognitive theory, which began to emerge in the 1960s as an important and influential explanation for behavior with practical applications. More generall, the explosion of health services research has called for a greater need to integrate findings to identify ESIs. The combination of additional ESIs with the ability to synthesize them and make the findings known to providers (and clients) is reason for me to believe that this is going to be a productive area for a long time.
After reflecting on the good presentations and discussions on Evidence Based Practice, I would like to share with you all these thoughts. I came to understand EBP in two levels: as a value and as a technique.
As a value, EBP is a desire of something that we should encourage and foster as much as possible. It is a way of bringing into realization the Code of Ethics that states “Social workers should base practice on recognized knowledge, including empirical knowledge, relevant to social work and social work ethics” (4.01, (c)). As a value EBP should be easily understood and accepted although the actuality of practice may not follow it. The reasons are multiple, some of which have been stated during the seminar. Furthermore, the very fact that research is a curriculum area is indicative that social work practitioners should not only think logically and use research methodologies for assessment purposes, deciding upon an intervention, and evaluating such an intervention, but that practice should be based as much as possible on knowledge, theoretical and empirical, based on the social and behavioral disciplines as well as on practice research, that is, the research done in the context of practice and on the components of practice such as population and problem analysis, intervention research, and interventions evaluation. In a classic article, Ernest Greenwood pointed out, about half a century ago, that while the disciplines can help us to understand personality, family, group, organization, institution, community, society, culture, what is normal and abnormal, problems and strengths, it is entirely up to social workers the development of a body of knowledge that can be called practice theory, that is, concepts, constructs, models, theories derived from the study of the reality of practice. This is precisely what practice research is all about. This also means that practitioners should be not mere knowledge users - as it was suggested and commonly understood - but as contributors to practice knowledge development.
But the core of the seminar’s presentations was focused on a technique - a set of procedures, language, means - for making possible a practice based on evidences supported by research. I find merits in such a technique, undeveloped as it is, but there have been previous approaches that approximate to EBP as a technique, such as E. Thomas’ ADEDA model (Analysis, Development, Evaluation, Diffusion, Adoption) derived from the Research and Development practice, or the research utilization model presented by the “Michigan trio”, Fellin, T. Tripodi, and H. Mayer, or the single case research model proposed by M. Bloom, J. Fischer, and J. Orme. As a technique, EBP has something to offer but it certainly needs more development, conceptual and procedurally, as well as evidences on its use, effectiveness, feasibility, perhaps cost. In other words, an evidence based EBP.
I certainly thank the presenters - as well as the organizers - for inducing us into a valuable reflection on practice, knowledge, research and related themes. I hope it continues on this and similar topics. We need it.
Regards,
Enrique Codas