ADOPTING AND TEACHING EVIDENCE-BASED PRACTICE IN MASTER'S-LEVEL SOCIAL WORK PROGRAMS

This article makes specific suggestions for teaching evidence-based practice (EBP) in the master's-in-social-work (MSW) curriculum. The authors use the model of EBP as it was originally conceived: a process for posing empirically answerable questions, finding and evaluating the best available evidence, and applying that evidence in conjunction with client characteristics and practitioner judgment. The authors suggest that EBP, in its original form, is both sufficiently well operationalized and flexible to serve as a primary paradigmatic component of social work education. Furthermore, EBP carries a series of distinct advantages for MSW education that have not been widely recognized to date. These include the provision of a structure for more explicitly recognizing client factors, bridging the micro–macro and researcher–clinician divides, and emphasizing the professionalism of MSW-level practice. Specific curricular components are proposed and discussed.     

Alcohol abuse

We reviewed 38 controlled studies of marital and family therapy (MFT) in alcoholism treatment. We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, (a) Al-Anon facilitation and referral help family members cope better; (b) Community Reinforcement and Family Training promotes treatment entry; and (c) the popular Johnson intervention apparently does not effectively promote treatment entry. Once the alcoholic enters treatment. MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. BCT also reduces social costs, domestic violence, and emotional problems of the couple's children. Future studies need to specifically evaluate: MFT with women and with minority patients, mechanisms and processes of change, and transportability of evidence-based MFT approaches to clinical practice settings.     

Newly Educated MSW Social Workers’ Use of Evidence-Based Practice and Evidence-Supported Interventions: Results From an Online Survey

ABSTRACT

Social work programs have increased evidence-based practice (EBP)-related curricular content; yet, it is unclear whether newer practitioners are successful in incorporating it into their practice. This study examines factors that influence the use of EBP among newly graduated social workers. We developed and implemented a Web-based survey that assessed individual, school, and agency factors that predict implementation of EBP among a sample of master’s of social work practitioners post-graduation. Multiple regression analysis resulted in five factors that were significantly associated with use of EBP: confidence with EBP; feeling that EBP is essential to practice; organizational culture emphasizes EBP; field placement/internship emphasizes EBP; and faculty emphasizes EBP. Findings suggest that individual and organizational factors may be more important in determining use of EBP than educational program factors alone.     

Postmodernism in marriage and family therapy training: doctoral students' understanding and experiences

The purpose of this study is to advance our understanding of how doctoral students perceive postmodernism's influence in the field of Marriage and Family Therapy (MFT). According to the literature, postmodernism has had a profound impact on many fields, including MFT. However, tracking of how postmodernism is actually being rendered in theory, research, practice, and training warrants investigation. This study utilized focus group interviews to investigate the perceptions of MFT doctoral students. Findings suggest that while participants are attracted to postmodern tenets, they also report feeling a mixture of liberation and excitement with confusion and fear regarding how postmodernism is influencing MFT models of therapy.     

Research Evidence and Social Work Practice: The Place of Evidence-Based Practice

This article will examine what evidence-based practice (EBP) is and is not. EBP will be defined and distinguished from other different, but related, terms and concepts. The steps of EBP as a practice decision-making process will be detailed and illustrated. The kinds of evidence EBP values and devalues will be discussed in several contexts. The administrative uses of EBP and its larger societal context will also be examined. A family therapy based example of doing EBP in clinical practice will show how it can be a real benefit to practice, but also points out some of its challenges and limitations.     

The fusion of culture and science: Challenges and controversies of cultural competency and evidence-based practice with an African American family advocacy network

This paper identifies interrelationships between evidence-based practice (EBP), radical structuralism, and culture, arguing that culturally-specific beliefs and norms should be integrated into evidence-based, cross-cultural partnerships within child and family service systems. A single case study of family advocate training in evidence-based practice is provided as an illustration of, and impetus for, the development of a format for use with community-based and ethnically-diverse parent/family advocates. The lessons learned from teaching evidence-based practice to a parent advocate in a particular child welfare service system are highlighted. The use of enhanced roles for social workers and indigenous social capital and resources, such as family advocates as allies, is recommended to help achieve a greater degree of accountability, cooperation, and core understanding in the use of EBP. By training racially-diverse foster parents as mental health advocates to work collaboratively with policymakers, community groups, and family participants, proponents of EBP will reach and benefit more diverse populations.     

Beyond Division: Convergences Between Postmodern Qualitative Research and Family Therapy

Starting from examples of postmodern research and therapeutic practice, we raise the question on the role of the research-therapy dichotomy within these approaches. The article aims to show the profound convergence between postmodern ethnographic research and constructionist, collaborative therapeutic approaches on a double, epistemological and practice level. First, we point out their converging development toward narrative and constructionist epistemologies. Second, an inquiry into the core features of these disciplinary activities' goal, process, and expert role reveals their profound convergence into a dialogical practice in which the boundaries between research and therapy are radically transgressed. We conclude by questioning the implications and acceptability of this convergence for researchers' and therapists' understanding of their practices.     

From the Editor—In This Issue

This article critically analyzes challenges that may influence whether evidence-based practice (EBP) enjoys more success than previous efforts to improve the integration of practice and research in social work education. Key challenges include: (1) alleviating disparities in how EBP is being defined by social work educators; (2) maximizing the feasibility of implementing the EBP process appropriately after graduation, while at the same time preparing students not to over-rely on authoritative publications that designate certain interventions as evidence-based; and (3) preventing evidentiary standards from getting softened to the point that EBP becomes a meaningless term, as any study, regardless of its methodological rigor, can be cited to justify deeming an intervention to be evidence based.     

Review of outcome research on marital and family therapy in treatment for alcoholism

This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better, and CRAFT promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics, and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate the following: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning.     

Identifying as an evidence-based social worker: the influence of attitudes,access, confidence,and education

This study explored United States-based social workers’ (N = 152) attitudes toward, access to, and confidence in engaging in evidence-based practice (EBP), the extent to which social work education prepared them to engage in EBP, and the factors that contributed to their identification as an evidence-based practitioner. Findings indicated that although practitioners had a positive attitude toward engaging in EBP, they were only moderately confident in doing so, rarely accessed evidence, and were only moderately prepared through their education. Believing that EBP should be implemented, more educational preparation, and positive attitudes contributed to greater identification as an evidence-based practitioner, areas that social work and continuing education should further support to enhance social workers’ EBP skills.     

Exploring MSW students’ and social workers’ orientation toward the evidence-based practice process

The aim of this exploratory study was to assess whether practicing social workers currently enrolled in Master Social Work (MSW) programs (hereafter referred to as MSW students) were more oriented to the evidence-based practice (EBP) process and more engaged in it than practicing social workers who are not currently enrolled in MSW programs (hereafter referred to as social workers) in the Netherlands. Data were collected from MSW students (n = 32) and from social workers (n = 341) using the EBP Process Assessment Scale. MSW students reported a stronger orientation toward the EBP process, more positive attitudes toward EBP, more familiarity with EBP and more intentions to engage in EBP than social workers did, however, they were less positive about the feasibility of implementing EBP in practice. These preliminary results suggest that there are grounds for optimism about MSW students’ acceptance of and engagement in the EBP process. Implications for social work education are discussed.     

TEACHING EVIDENCE-BASED PRACTICE AT THE BSW LEVEL: AN EFFECTIVE CAPSTONE PROJECT

Developing student competencies related to evidence-based practice (EBP) isbecoming increasingly important as an evidence-based approach to practicebecomes more salient in the field. Although there has been significant discussionin the literature about how to teach EBP at the master's level, there is farless discussion about such instruction in baccalaureate programs. This articledescribes an undergraduate senior capstone project, which, in partnership withinternship activities, developed students' familiarity with EBP concepts andimproved their abilities to search for and use interventions from the professionalliterature. Findings from a survey study of the project indicated that studentsfelt better prepared to use best practices and that the project enhanced theiroverall sense of competence as practitioners.     

Evidence-Based <Emphasis Type="Italic">Practices</Emphasis> Do Not Exist

The original process model of evidence-based practice (EBP) is described, and contrasted with the empirically supported treatments (EST) initiative which designated selected interventions as meeting some evidentiary benchmark (e.g., supported by two-well-designed randomized controlled trials). EBP does not utilize lists of ESTs, and designating a given psychotherapy as empirically supported is actually antithetical to the EBP decision-making process. Much of the resistance to EBP within social work may be attributable to confusion between EBP as it was originally conceived as a mutual decision-making process occurring between the clinician and the client, and the promulgation of lists of EST and the subsequent urging that social workers select their psychotherapies from such lists. The latter is not scientifically justifiable, nor does it taken into account other variables crucial to EBP, such as professional values, clinical expertise, client preferences and values, and available resources. EBP as it was originally conceived has much to add to the practice of clinical social work.     

Youth care workers' perspectives on and adoption of evidence-based practice

Despite increased emphasis on evidence-based practice (EBP), the limited implementation of EBP is a well-known reality. This research examines youth care practitioners' knowledge of, attitudes toward and adoption of EBP (N = 74). Additionally, the difference between EBP and empirically supported treatments (ESTs) is made. Findings show that some practitioner background variables are related to their knowledge of and attitudes toward EBP, but not to ESTs. Findings also provide evidence for current dissemination and implementation models that strongly emphasize the importance of good knowledge of and favorable attitudes toward EBP and EST by practitioners. Expanding the knowledge base of practitioners and positively influencing their attitudes toward EBP are two of the tracks for closing the gap between research and practice.     

Recent Social Work Practitioners’ Understanding and Use of Evidence-Based Practice and Empirically Supported Treatments

The aim of this study was to evaluate how CSWE’s 2008 shift placing more emphasis on research have affected newly trained social workers’ use of evidence-based practice (EBP). This qualitative study examined the educational and practice experiences of newly trained social workers and how those experiences influence the use of EBP and empirically supported interventions/treatments in the field. Thirteen newly graduated social workers were interviewed using a semi-structured interview. Twenty-three codes emerged from the interviews, with the most prominent theme being a sense of overall confusion about EBP. Other themes included lack of educational preparation, lack of agency resources, and prohibitive agency culture. Implications for social work education and practice are discussed.     

Evidence-based practice in occupational health: description and application of an implementation effectiveness model

Work-related muscuoloskeletal disorders (WMSDs) continue to represent the most costly category of occupational diseases. There is a growing body of literature regarding the causal nature of these injuries and effective intervention strategies. In this context, the consistent utilization of evidence-based practice (EBP) to address these problems can be viewed as one indicator of occupational health effectiveness. However, the routine integration of EBP remains elusive in occupational and physical therapy practice, including the occupational health arena. This article describes an implementation effectiveness model from the field of organizational management and applies it to the implementation of EBP within the occupational health practice arena. As a predictive or evaluative tool regarding implementation success, the model can assist clinic managers and clinicians in developing targeted approaches to EBP initiatives within any health care facility.     

Evidence-based practice in social work: perceptions and attitudes among Norwegian social workers

Although the concept of evidence-based practice (EBP) eludes precise definition, it is used as a trademark label to ensure that practice is based on science and thereby effective and of high quality. Proponents of EBP have proposed that both education and practice in social work should be transformed according to the principle of EBP. They attribute critical opposition to EBP to a lack of knowledge of what EBP is. In this article, we endeavour to clarify the concept and present results from a survey among social workers (N?=?2060) from Norway. The survey results show that although many have heard of the concept, few have precise knowledge about it. However, the more educated social workers are (master’s level), the clearer their opinions, both critical and non-critical. The results are discussed in relation to neo-liberal governance and development of social work.     

Implementing evidence-based practices and programmes in the human services: lessons from research in public administration

The development of evidence-based practice and programmes (EBP) has led to increasing interest in implementation issues in the field of human services, and specifically how to bridge the gap between scientific knowledge and actual practice. However, because EBP are usually connected with social policies, which are political, implementation problems arise concerning resource allocation, ethics and power. Such implementation problems in the field of public administration have been extensively researched. The aim of this paper is to investigate whether and how research into policy implementation in public administration may benefit ongoing research on EBP in the human services to understand, explain and manage common implementation problems. This paper is based on a broad review and comparison of the literatures on policy implementation in public administration and implementation of EBP in the human services. Analysis shows that human services could learn from public administration research to develop a broader theoretical approach for understanding and managing implementation of evidence-based practice and programmes.     

Clinicians' Experiences of a Podcast Series on Implementing a Manualized Treatment

The purpose of this qualitative study was to explore clinicians' experiences of using Podcasts to assist with implementing an evidence-based practice (EBP). Twelve clinicians, including eight student interns, at a human service organization were interviewed about their perceptions of using Podcasts about implementing an EBP called Grief and Trauma Intervention (GTI) for Children. Major themes included that the Podcasts were helpful, liked the short length, fit their learning styles, useful teaching tool, wanted more clinical content and more engaging material, and that administrative support was important for use. Technological difficulties were a major barrier to use. There were some differences in experiences of the Podcasts between post-masters professionals and interns. Podcasts may be a useful technology to help clinicians implement EBPs, and future research on Podcast use is warranted.