Theory and Research by liaoqinmei

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									    Best Practices
 Theory and Research
          Chapter 18
Current and Future Social Work
           Practice
             Best Practice
         The Role of Evidence
• Practitioners require skill in accessing systematic
  reviews and weighing the empirical evidence
  according to the rigor of the research design.
• Choosing an effective and appropriate
  intervention for a specific client or situation,
  requires a review of the evidence that supports one
  theory-based intervention over another.
• Research is the core of evidence-based practice.
        Best Practices
 The Limitations of Empiricism
• Though necessary, empiricism is not
  sufficient to build knowledge.
• No array of statistical techniques can
  produce cumulative knowledge.
• Empirical data become knowledge when
  referred to theory for understanding.
             Best Practices
           The Role of Theory
• Theory, as knowledge, is a body of interrelated
  proposition, statements, and concepts that have
  been subjected to empirical verification.
• As part of the research process, theories become
  self-corrective.
• The holistic property of theory (cause-effect)
  moves the practitioner in an orderly and
  conceptually consistent manner from declarative
  knowledge (what is known-procedural knowing)
  to enactment of a therapeutic process (doing-tacit
  knowing).
            Ways of Knowing
There are three basic ways of knowing:
  1. Faith- knowing based on theological or
     religious beliefs.
  2. Reason-knowing based on rational discourse;
     logic, argument, philosophical proof.
  3. Science- knowing based on empirical evidence;
     assumptions of linearity, probability, & ability
     to measure an objective reality
  Science As a Way of Knowing
• Scientific knowing differs from knowing based on
  animal instincts and belief in ideology or magic.
• The scientific paradigm is based on trust in reason
  (rules of discourse), logic, rigorous research
  methodology, a belief in progress (new knowledge
  builds on previous knowledge) and academic
  freedom (pursuit of truth).
• Science adheres to standards against which
  comparative evaluation occurs.
 Science As A Way of Knowing
          Continued
• Science holds that a large part of reality is
  measurable and therefore capable of being
  known.
• Science produces knowledge stated in such a way
  as: (a) to make it comparative, (b) to prove or
  disprove it, (c) to integrate it, (d) to generate and
  test new knowledge.
• Knowledge is a set of ideas whose acceptability is
  determined by the criteria of science.
      Social Work and Science
• Social work has long subscribed to science as a
  way of knowing.
• Those who subscribe to science as a way of
  knowing, maintain that explanation/prediction
  (cause-effect) makes prevention and intervention
  possible.
• According to Polansky (1986) there is nothing as
  practical as a good theory to guide action.
              Theory As
          Schools of Thought
• Theory and research work together to develop
  schools of thought (multiple theories).
• Over time, social work has recognized that no
  single theory, whether narrow (psychodynamic) or
  grand (general systems theory) can guide practice.
• Generalist practice represents a paradigm shift to
  open assessment and consideration of multiple
  theories.
• The profession has gone from a paucity of theory
  to a plurality of theory.
            Multiple Theories
             Decision Tree
• A plurality of theories creates theory choice.
• The decision tree helps practitioners navigate
  different theories and the evidence for or against
  them when selecting the best treatment option
  from among available options for a specific case
  or situation at hand.
• See case example on “Night Crying” in this
  chapter.
• When practice is theory and evidence-based, the
  practitioner asks what works, with whom under
  what circumstances and at what cost.
              Scientific Rigor

• Determining the relevance of research to
  evidence is dependent on the methodology used to
  conduct the research (Roberts & Yeager, 2004).
• Levels of evidence help practitioners select
  treatment options based on the methodological
  quality of the studies used to generate the
  empirical evidence.
• The are four levels of evidence ranked by the rigor
  of the methodology used.
          Levels of Evidence
               Designs
1. Experimental designs: random selection
   (sampling) and random assignment to treatment
   and control group; replicated;
2. Non-replicated experimental designs and
   systematic reviews and meta analysis of
   multiple, well designed controlled studies.
3. Quasi-experimental designs – comparison
   groups in natural settings
4. Single subject and single group pre-post test
       Comparison of Research
          Methodology:
• Understanding scientific rigor requires familiarity
  with the differences between quantitative and
  qualitative research.See exhibit 18.1
• The two methodologies differ in design, sampling,
  instruments, data gathering techniques, type of
  data collected, inference, perception of reality,
  variables (tested or generated) and how results are
  reported.
     Quantitative Methodology
          Characteristics
• Quantitative research tests well-specified,
  hypotheses concerning pre-determined variables;
  deductive.
• Sampling is random and therefore representative;
  findings may be generalized.
• Information is gathered in numeric form, using
  valid and reliable instruments;
• Findings are produced using statistical procedures
  and other means of quantification; usually
  published as articles in professional journals..
      Qualitative Methodology
          Characteristics
• There are over 50 approaches to qualitative
  research from numerous disciplines; inductive.
• Designs rely on participant observation, case
  studies and the focused interview.
• Sampling is non-random; subjects are recruited;
  studies cannot be replicated; findings cannot be
  generalized.
• The researcher - the instrument of data collection.
• Data is non-numerical –field notes, audio tapes.
  video tapes, photographs, documents/reports.
      Qualitative Methodology
               Assets
According to Padgett there are several good reasons
For engaging in qualitative research:
1. It is used in program evaluation (formative
    research) and in activist research.
2. It is used when little is known about the topic
    being explored or the topic is too sensitive
    (taboo) and/or too emotional.
3. It is used when a researcher reaches an impasse
    in data collection or interpretation using
    quantitative methods.
         Clinical Research
      Evidence-Based Practice
• Evidence-based clinical research tilts toward
  quantitative research and rigorous methodology.
• The focus in clinical social work is on outcome
  efficacy; group analysis of clinical cases is
  considered more rigorous than single subject or
  single group designs. See chapter 6.
• What the clinician does is controlled through
  empirically supported treatment protocols.
     Evidence-based Practice
 Policy, Advocacy, Management
• Policy, advocacy, management, and community
  practice depends on program evaluation
  (formative and summative research) to determine
  program process and outcome effectiveness.
• In Macro practice, program evaluation has tilted
  toward process (formative research) or qualitative
  research methodology e.g. is the program being
  implemented in the manner intended?
• Currently the emphasis is on summative/outcome
  evaluation, i.e., results-oriented. Does it work?
     Barriers to Evidence-based
          Clinical Practice
• Choice, necessitates conscious decision making
  based on criteria.
• Statistical significance may not equate with
  clinical significance
• It is difficult to access systematic reviews of meta
  analyses of multiple, well-designed controlled
  studies; meta analysis cannot exceed the limits of
  what is reported by primary researchers.
• It is difficult to implement empirically supported
  treatments in everyday practice.
    Barriers to Evidence-Based
          Macro Practice
• Rigor in macro practice, has focused on
  documenting needs and resources
• The standard of scientific rigor ( multiple,
  replicated, experimental, controlled, studies) is
  less feasible when applied to program evaluation
• The desired end-goals of most social programs are
  value-determined in contrast to the more
  scientifically-determined (cause-effect) outcomes
  of clinical practice.
     Barriers to Evidence-Based
     Macro Practice: Continued
Factors, other than science, influence decision-
making in macro practice:
1. Science documents needs/resources
2. Moral philosophy determines desired end-goals
   of social policies and programs
3. Politics influences public or political support for
   or against a program and its level of funding.
4. Economics Availability of funds and competing
   interests for the same monies impact decisions.
   The Argument for Evidence-
      Based Macro Practice
• Policy makers and program managers do improve
  their practice when they use evidence to guide
  their decisions.
• Evidence is an antidote to unfounded opinion
  based on policies and programs that rely on
  ideology, prejudice, or speculative conjecture.
• Evidence mitigates decisions based on personal
  gain or organizational politics; evidence
  promotes the common good.
• Grant Trend (RFPs): Evidence key in proposal
   The Argument for Evidence-
     Based Clinical Practice
• Treatment choice is now a condition of competent
  practice.
• Client’s benefit when practitioners are aware of
  the availability of theoretically-sound and
  empirically-verified diverse treatments.
• Client’s should be involved in making an
  informed treatment decision based on a review of
  available options; best practices.
             Conclusions
           Endings: Theory
• Social work has accepted a plurality of
  theories
• A uni-theory, mono-theory or mega theory
  have not come to pass.
• Social work has rejected practice devoid of
  theory; whether based on relationship only
  or empiricism only.
            Conclusions
          Endings: Methods
• Compared to ten years ago, the role of
  generalist practice has become more clear.
• The profession has avoided adopting
  generalist practice as a uni-method, mono-
  method, or mega-method.
• Generalist practice is a framework that is
  both multi-theory and multi-method.
           Conclusions
    Endings: Polarizing Debates
• Polarizing debates (either/or positions) over the
  importance of one theory or one method have
  been replaced by discussions of the
  appropriateness or lack of appropriateness of a
  theory or method for the situation at hand.
• Divisiveness over theory focus ( pathology/deficit
  vs. resilience/strength) has also diminished.
• Method and theory diversity are more aligned
  with the multi-cultural and complex world within
  which social workers practice.
           Conclusions
    Endings: Polarizing Debates
• Previous attempts to deny or exclude have been
  replaced by the recognition that all theories and all
  methods have equal value in themselves and
  differential value in their proper or improper
  application.
• The evidence-based movement, despite
  differences over quantitative or qualitative
  research methodologies, has strengthened the link
  between theory, research, and practice.
             Conclusions
             Decision Tree
• The decision tree provides practitioners
  with some assurance of competency
  commensurate with their decision-making
  responsibilities.
• As a tool, the decision tree adds precision
  and proof of process when applying theory
  and evidence to practice.
                Conclusion
                Competency
• By alternating chapters in clinical and macro
  practice, the text provides the readers with skill
  sets consistent with a range of system sizes:
  individuals, dyads, families, groups, organizations,
  and communities.
• The text shows the reader how to apply more than
  one theory and more than one method to complex
  data in the same case through case-specific model
  building and the use of the decision tree.

								
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