Use of evidence-based interventions in child welfare: Do attitudes matter?

Implementation of evidence-based programs in child welfare has progressed slowly, with the majority of services in child welfare settings lacking empirical evidence for effectiveness. In other settings, research has identified providers' attitudes about evidence-based practices (EBPs) as a potential barrier to adoption of EBPs. As little research has focused on the role of attitudes in influencing use after training in an EBP in child welfare, the potential for attitudes to impede implementation efforts in child welfare is unclear. This study addressed this question in a sample of 55 caseworkers and therapists randomly assigned to enhanced support to use an EBP following training or a training-only condition. Information on providers' use of the intervention after training and their attitudes about EBPs were measured for up to five time points. Results indicate that attitudes did not predict providers' use of the EBP, and attitudes did not change overall or in the enhanced condition that provided greater exposure to the intervention. Providers perceived of requirements to use a practice as more influential in their use than their openness to EBPs. However, those who were more open to EBPs were more likely to participate in implementation support after the training, suggesting that openness facilitates participation in activities that support use of a new intervention.     

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.     

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.     

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.     

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.     

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.     

A confirmatory factor analysis of the evidence-based practice attitudes scale in child welfare

Despite the emphasis on evidence-based practice (EBP) in child welfare services (CWS) as an emerging and inevitable trend, implementation factors such as child welfare worker attitudes towards implementing EBP have received little attention in CWS. Aaron's (2004) Evidence Based Practice Attitudes Scale (EBPAS) has been used in multiple studies across mental health and healthcare settings. However, it has rarely been used in CWS. A-Mid Atlantic State implemented the EBPAS in all child welfare jurisdictions to measure workers' performance. The purpose of this study is to examine the EBPAS applied in a large urban child welfare services setting using a confirmatory factor analysis. Based on prior literature, three models were tested: a four factor model, a five factor model, and a second order four factor model. The second order model provided the best fit to the data, suggesting the EBPAS can measure workers' global attitudes, as well as four attitude types, towards EBP in a CWS setting. This study validates the use of the EBPAS with child welfare workers. Implications for effective evidence based practice in child welfare are discussed.     

Evidence-based practice in group care: the effects of policy, research, and organizational practices

This article describes the effect of a province-wide vision of evidence-based and outcome-based services for children and youth and the challenges of implementing evidence-based practice (EBP) and evidence-based treatment (EBT) approaches within group care settings. The paper is based on the results of a survey of group care settings in the province of Ontario, Canada, which was designed to understand the factors affecting the use of EBP and EBT. The critical roles of policy, access to research, and organizational structure as they affect the frontline workforce were explored. The results identified key differences between programs who implemented an evidence-based approach and those who are struggling to do so. Differences in case management practices as well as organizational factors affect the program's ability to use an evidence-based approach.     

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.     

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.     

Reconsidering the ‘idea’ of evidence in evidence-based policy and practice

Evidence-based policy and practice (EBP) has become an important social work conceptual framework. Yet, the core EBP concept, the concept of evidence, remains ill-defined. I propose a modification of the concept of evidence as applied to EBP effectiveness questions. As a basis for this reformulation ideas about evidence are examined from cross-disciplinary and multidisciplinary perspectives including epistemology, philosophy of science, evidence-science, and law. I propose that for EBP effectiveness questions: (1) to be considered ‘relevant evidence’ an explanatory connection between an intervention and an outcome must be established rather than a mere association; (2) the EBP definition of ‘best available evidence’ should include total available evidence (rather than a subset) about effectiveness, causal roles (i.e., mechanisms), and support factors and be inclusive of high-quality experimental and observational studies as well as high-quality mechanistic reasoning; (3) the familiar five-step EBP process should be expanded to include formulation of warranted, evidence-based arguments and that evidence appraisal be guided by three high level criteria of relevance, credibility, and strength rather than rigid evidence hierarchies; (4) comparative effectiveness research strategies, especially pragmatic controlled studies, hold promise for providing relevant and actionable evidence needed for policy and practice decision-making and successful implementation.     

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.     

Research Articles in Australian Social Work from 1998–2007: A Content Analysis

Abstract

With the rise of evidence-based practice, there have been calls in social work for practice research that examines the efficacy of its interventions. For the present paper, the authors conducted a content analysis of all articles published in Australian Social Work in the period from 1998 to 2007 to examine the nature of published research and evaluation. Of the 313 articles, 138 (45%) reported on research findings. Of these, only six articles involved practice evaluation or testing of an instrument, but there were positive signs of a developing empirical research culture primarily utilising a qualitative approach or mixed methods studies. The authors suggest that there is a need for more research on social work interventions, a more conscious decision by the profession about its attitude to evidence-based practice (EBP), specific directions for research education, and greater rigour in reporting all types of research studies, but particularly qualitative studies.     

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.     

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.     

Field Instructors' Perceptions of Evidence-Based Practice in BSW Field Placement Sites

This exploratory study surveyed 17 BSW-level field instructors on their experience, beliefs, and perceived self-efficacy regarding evidence-based practice (EBP). The authors conducted focus groups concerning EBP in participants’ agencies and with BSW students under their supervision. Results indicate that although they felt positive toward EBP and reported moderate levels of perceived self-efficacy regarding EBP, implementation occurred in a piecemeal fashion, if at all. Factors identified to enhance EBP in the agencies include training, resources, supervision, matching EBP to client populations, and trust between administrators and staff members. According to our study, students’ experience with EBP in field settings could probably be facilitated by students' research readiness, collaboration between field instructors and faculty, access to university resources, and training.     

Use of evidence-based substance use treatment practices in Mississippi

Over the past decade, substance abuse treatment professionals have begun to implement evidence-based practices (EBPs) into the treatment of substance use disorders. There is a growing body of research on the diffusion of EBP in addiction treatment; however, less is known about individual state initiatives to implement EBPs among community providers. The current study aimed to evaluate the progress of an initiative of the Mississippi Department of Mental Health (MDMH) to increase the implementation of evidence-based substance abuse treatment practices by certified providers. In addition, the study examines potential barriers to implementing these practices. To accomplish this goal, we reported the findings of two surveys of Mississippi addiction professionals conducted in 2010 and in 2013.     

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.     

Evaluating a Teaching Module on Ethically Responsible Evidence-Based Practice Decision Making in an Advanced Micro Practice Course

ABSTRACT

This article adds to the growing body of literature on the use of evidence-based practice (EBP) in social work. Specifically, it examines a 9-hour EBP educational model designed to prepare MSW students for appropriate decision-making strategies in working with multicultural client populations. The model places emphasis on identification and application of critical thinking skills for micro- and mezzo-level practice in urban social work systems. It moves beyond traditional research approaches and emphasizes community-based and emic approaches for generating evidence appropriate for ethnic minority populations. Students’ written assignments (N = 80) demonstrated the model’s pedagogical value as a learning strategy for applying EBP. Students’ evaluations demonstrated the model’s value in sensitizing students to the importance of becoming ethically responsible research consumers.