Evidence-Based Practice
and Social Work
C. Aaron McNeece, PhD
Bruce A. Thyer, PhD
ABSTRACT. The essential features of contemporary evidence-based
practice (EBP) are outlined, with specific reference to the applicati
...
Evidence-Based Practice
and Social Work
C. Aaron McNeece, PhD
Bruce A. Thyer, PhD
ABSTRACT. The essential features of contemporary evidence-based
practice (EBP) are outlined, with specific reference to the applications of
this model to various areas of social work, micro through macro. EBP is
seen as a welcome addition to our field, representing a fuller and more
comprehensive development of earlier and related positions such as empirical clinical practice within social work, and the delineation of empirically-supported therapies within psychology. Social work should proactively
adopt EBP as its preferred conceptual model, reorient BSW and MSW training programs along the lines advocated by EBP, and inculcate these principles into the delivery of social work services. This is seen as both a
professional and ethical imperative necessary for the survival of the
field. [Article copies available for a fee from The Haworth Document Delivery
Service: 1-800-HAWORTH. E-mail address:
Website: © 2004 by The Haworth Press, Inc.
All rights reserved.]
KEYWORDS. Conceptual model, evidence-based practice, social work
From the recent attention that is given to evidence-based practice
(EBP) in our academic journals, disciplinary meetings, and professional
C. Aaron McNeece (E-mail: [email protected]) and Bruce A. Thyer
(E-mail: [email protected]) are affiliated with the School of Social Work, Florida
State University, Tallahassee, FL 32306.
Journal of Evidence-Based Social Work, Vol. 1(1) 2004
http://www.haworthpress.com/web/JEBSW
2004 by The Haworth Press, Inc. All rights reserved.
Digital Object Identifier: 10.1300/J394v01n01_02 7
organizations, an observer from outside the profession could easily be
mislead into thinking that professionally trained social workers commonly use the current best scientific evidence available, rather than
solely relying on practice wisdom, tradition, or “common sense” in deciding how to assist a client. However, a closer look at the EBP literature is more likely to discover essays on why we are not doing evidencebased practice (e.g., Gibbs & Gambrill, 2002) or arguments for why we
should be doing it (e.g., Thyer, 1995, 2002a, 2002b) rather than descriptions of how evidence-based practice is being used (e.g., Thyer, 2001).
In a review of trends in knowledge development over the past quarter
century, Reid (2002) concludes that “the increasing role of research in
testing practice methods suggests that scientific methods may be gradually upstaging tests of time and consensus as a means of building core
knowledge” (p. 16, italics added). His somewhat optimistic view of this
trend views clients as “self-directing collaborators with knowledge and
strengths” and social workers as having “new awareness of the limits of
their expertise and knowledge” (p. 16). At least one school of social
work, Washington University, has adopted EBP as its organizing
framework (Howard, McMillen & Pollio, 2003). Many new social work
books devote increasing attention to EBP (Corcoran, 2000, 2003; Macdonald, 2001; McNeece & DiNitto, 1998; Roberts & Greene, 2002;
Springer, McNeece & Arnold, 2003; Thyer & Wodarski, 1998; Thyer &
Kazi, 2003; Wodarski & Thyer, 1998). Nevertheless, adoption of EBP
within the profession seems to continue at a slow pace, slower in some
areas of practice than in others.
WHAT IS EBP?
One of the simplest definitions of EBP is that it is ‘treatment based on
the best available science.’ One might make this somewhat less narrowly clinical by changing “treatment” to “intervention.” The basic elements of EBP, according to Persons (1999, p. 2), is one in which, “The
evidence-based practitioner:
• provides informed consent for treatment.
• relies on the efficacy data (especially from RCTs) when recommending and selecting and carrying out treatments.
• uses the empirical literature to guide decision-making.
• uses a systematic, hypothesis-testing approach to the treatment of
each case.”
8 JOURNAL OF EVIDENCE-BASED SOCIAL WORK
This approach:
• “begins with careful assessment.
• sets clear and measurable treatment goals.
• develops an individualized formulation and a treatment plan based
on that formulation.
• monitors progress towards the goals frequently and modifies or
ends treatment as needed.”
Although this is also a clinically-oriented definition, most of the elements could be modified to encompass many aspects of macro practice (e.g., community practice, administrative practice, and social
policy practice.) Cournoyer and Powers (2002) use the term “client
system” in their definition, rather than client. The essential concept of
EBP is to rely upon the best scientific evidence that is currently available. It also involves providing the client (whether a person, a community, or an organization) with appropriate information about the
efficacy of different interventions and allowing the client to make the
final decision (Thyer, 2003). This is very different from the traditional
practice model in which the social worker rarely looked for empirical
evidence of treatment efficacy or presented treatment alternatives to
the client.
A more conservative (and perhaps more widely accepted) construction of evidence-based practice is found in the seminal textbook Evidence-based Medicine: How to Practice and Teach EBM by Sackett,
Strauss, Richardson, Rosenberg and Haynes (2000) from which much
of the following content is derived. Evidence-based practice can been
defined as the integration of the best research evidence with clinical expertise and client values in making practice decisions. ‘Best research
evidence’ means clinically relevant research from basic and applied scientific investigations, especially drawing from intervention research
evaluating the outcomes of social work services, and from studies on
the reliability and validity of assessment measures, and clinical expertise refers to our ability to use our education, interpersonal skills and
past experience to assess client functioning, diagnose mental disorders
and/or other relevant conditions, including environmental factors, and
to understand client values and preferences.
‘Client values’ refers to the unique preferences, concerns and expectations each client brings to a clinical encounter with a social worker,
and which must be integrated into practice decisions if they are to serve
the client.
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