association of directors of social work conference...

Association of Directors of Social Work

Conference Proceedings

Training, Standards and

Research

Making a Difference: The Role of

Evidence-Informed Social Work

Lesser Town Hall, Falkirk 26th April 2001

Contents

Page Acknowledgements 1 Introduction 3 Keynote Speakers The Use of Research Evidence in Public Services 7 Presentation overheads 11 Sandra Nutley What are the Barriers to Evidence-based Policy and Practice in Social Work, and how can they be Overcome? 34 Gill McIvor The Role of the Team Manager in Ensuring Effective Service Provision 43 Cathy Macnaughton Morning Workshops Criminal Justice Services 49 Gill McIvor and Allan Monteforte Youth Justice 51 Bill Whyte and Julie Ross Children and Families 52 Andy Kendrick and Cathy Macnaughton Children and Families: Looked After Children Services 53 Ranald Mair and Andrew Hosie

Inter-Agency Working in Community Care 54 Lisa Curtice and Frank Reilly Getting Evidence into Practice 55 Mary Marshall and Katrina Myers Afternoon Workshops Summary of Afternoon Workshops 59 Sam McLean, Moira Swanson, Philip Morgan-Klein, Margaret McConnachie, Alistair McDonald and Ray Pavey Appendices Appendix A: Morning Workshop questions 63 Appendix B: Afternoon Workshop questions 64

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Acknowledgements

This summary of proceedings of the ADSW conference Making a Difference: The Role of Evidence-Informed Social Work was only possible because of the involvement and advice of a range of committed and enthusiastic individuals. Their assistance was greatly appreciated. Thanks to: Sarah Carr, Information and Research Officer, National Institute of Social Work Lisa Curtice, Nuffield Centre for Community Care Studies, University of Glasgow Andrew Hosie, University of Strathclyde Dr Mike Hughes, Principal Research and Development Officer, Barnardo’s Andy Kendrick, University of Dundee Cathy Macnaughton, Team Manager, Falkirk Council Housing and Social Work Service Ranald Mair, Head of Geilsland Residential School, Church of Scotland Prof Mary Marshall, Director of the Dementia Centre, University of Stirling Margaret McConnachie, ADSW Training Standards and Research Group, and Inverclyde Council Alistair McDonald, ADSW Training Standards and Research Group, and Aberdeen City Council Gill McIvor, Social Work Research Centre, University of Strathclyde Sam McLean, ADSW Training Standards and Research Group, and South Lanarkshire Council Allan Monteforte, Team Manager, Dumfries and Galloway Council Phillip Morgan-Klein, Principal Officer of Research and Information, Falkirk Council Katrina Myers, Team Manager, Falkirk Council Housing and Social Work Service

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Dr Sandra Nutley, Senior Lecturer, University of St. Andrews Ray Pavey, Adviser, CCETSW/Topps Frank Reilly, Ayr and Arran Family Care Trust Julie Ross, Freagarrach Project, Barnardo’s Moira Swanson, ADSW Training Standards and Research Group, and West Dumbartonshire Council Raymond Taylor, ADSW Training Standards and Research Group, and Falkirk Council Bill Whyte, University of Edinburgh Thanks also to the Rowntree Foundation for kindly providing copies of Mike Hughes’ presentation which is published in the accompanying leaflet. For further information contact: Raymond Taylor Falkirk Council Housing and Social Work Service Brockville Hope St Falkirk 01324 501911 [email protected] Typeset by: Kate Adams [email protected] Co-edited by Raymond Taylor and Kate Adams

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Introduction

This report provides a summary of the proceedings of an important seminar organised by the Association of Directors of Social Work. The seminar, Making a Difference: The Role of Evidence-Informed Social Work, was addressed by a range of speakers who had stimulating and challenging things to say to all working within social work and social care. Dr Sandra Nutley of the University of St. Andrew’s referred to the lessons to be learned about evidence-based practice from across the public service. Professor Gill McIvor of the University of Stirling’s Social Work Research Centre provided an overview of what we know to be effective social work practice. However she reminded us that the issues that social workers have to deal with are often complex and contested and as a result research methods often reflect this complexity. She proposed that social work develop “a culture of curiosity” where research is routinely referred to, assessed for its relevance, and used appropriately to inform practice and policy. Cathy Macnaughton, a social worker and team manager from Falkirk Council, in outlining her involvement in a child care case concerning a baby born to a drug dependent mother, shared both the very practical problems faced by the workers involved in a demanding and sensitive area of practice whilst providing an analysis of three issues which require to be understood if we are to strengthen links between research and practice. These are: power and partnership, organisational and cultural issues and resources. Finally, Mike Hughes of Barnardo’s provided an entertaining overview of research published in 2000 which focused on the integration of research and practice. This has been published in a separate leaflet which accompanies these proceedings, by kind permission of the Rowntree Foundation. The event provided an opportunity for rich dialogue between practitioners, managers, researchers and representatives from SWSI, Topps, CETTSW and Audit Scotland. The publication of this report will, we hope, be a resource to practitioners, managers, researchers and policy makers. ADSW will also use it to promote wider interest in the topic of evidence-based social work. We are aware that only by achieving wider ownership of the research agenda at an organisational level will we be able to ensure the delivery of truly effective services. ADSW will do this by:

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• Insisting on the delivery of training programmes which make regular

reference to research into both the nature of social problems and effective intervention

• Stressing the need for social work staff to have critical appraisal skills in order that they can appraise the significance of research findings

• Encouraging greater partnership and collaboration between research commissioners, managers, and practitioners in carrying out research, and the all important tasks of disseminating findings and their implementation

• Encouraging local authorities, and other social work employers, to provide staff with access to relevant literature to ensure that they have up to date and relevant research available to them

• Working with the Scottish Social Services Council and Scottish Commission for the Regulation of Care to develop a culture where effectiveness research is of central importance to both occupational and service delivery standards

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Keynote Speakers

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Keynote Speaker

The Use of Research Evidence in Public Services

Facilitator: Dr Sandra Nutley The following overheads provide an overview of the key issues to arise from a range of public service areas that have endeavoured to engage with an evidence-based policy and practice agenda. There is much interest in this agenda following Labour’s declaration that “what counts in what works”, but as David Blunkett’s comment on homework research reveals, (overhead 2), this interest does not guarantee that evidence from research will always be welcomed. The presentation argues that there are at least four requirements for evidence-based policy and practice:

1. Agreement as to the nature of evidence. 2. A strategic approach to the creation of evidence and the

development of a cumulative knowledge base. 3. Effective dissemination of, and good access to, knowledge. 4. Initiatives to increase the uptake of evidence (in policy and in

practice). The ideas contained within the paper and presentation are a product of the ESRC Research Unit for Research Utilisation at St. Andrews and have been developed in collaboration with Dr Huw Davies.

Agreement as to the nature of evidence

The Cabinet Office documentation on evidence-based policy sets out a very broad definition of useful evidence, of which research evidence is just one type. The type of evidence that is required is shaped by the policy or practice questions that are asked. Where those questions relate to the effectiveness of various policy or practice interventions (‘what works’), this has tended to require evidence from experimental research methodologies. In health care there is broad agreement about an appropriate hierarchy of such evidence (overhead 7). In other public policy areas there is more disagreement about the nature of robust evidence, and this is particularly the case within social care.

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A strategic approach to knowledge creation

The problems set out on overhead 9 are widespread. In part these problems are due to the separation and isolation of the research and practice worlds. The lesson from across the public sector is that real progress can be made when researchers and users work in partnership on all aspects of the knowledge generation and adoption process. It is rare for strong and clear messages to emerge from initial research studies – promising leads need to be piloted, evaluated and developed in practice. This depends on forging effective partnerships between researchers and practitioners. Effective Research and Development (R&D) strategies are also dependent upon partnership working – see the example of National Education Research Forum (NERF) on overhead 12.

Effective dissemination/ access to

knowledge

There are frequently large time delays before evidence of effectiveness is implemented as standard practice. In health care these time lags can be up to ten years, even for low technology interventions, such as prescribing half an aspirin a day for those suffering from certain heart conditions. In response to these knowledge-practice gaps, the current emphasis is upon improving the dissemination of research evidence. Whilst this is necessary it is certainly not sufficient; a better push of the evidence needs to be combined with initiatives to increase the pull for that evidence.

Increasing the uptake of evidence

Much of the emphasis in this area has been focused on initiatives to change an individual’s professional practice (overhead 18). However, emphasising the individual ignores the importance of the context within which the individual has to operate (overhead 19). In social care a survey by the Centre for Evidence-based Social Services found that while professionals on the ground are keen to use research to improve their

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services, there are few opportunities to do so. This leads to the suggestion in overhead 20 that:

1. Specific changes in response to evidence need to build upon a contextual diagnosis of the reasons for current forms of practice.

2. General development of evidence-informed practice needs to target not only practitioners but also managers, organisational systems and organisational cultures.

Some examples of what both practitioners and managers in social care can do to take this agenda forward are set out on overheads 21 and 22.

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Overhead 1

The use of Research Evidence in Public Services

Sandra Nutley University of St. Andrews

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Overhead 2

The rhetoric

“What counts is what works.” (Tony Blair)

“Social science should be at the heart of policy

making …we need social scientists to help determine what works and why.”

(David Blunkett)

BUT “No one with the slightest common-sense could

take seriously suggestions by University researchers that homework is bad for you.”

(David Blunkett)

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Overhead 3

Things are happening

Education NERF & DfEE Centre for EBP&P Criminal Justice What works in probation, pathfinders in

Scotland

Social Care Scie, Cebss, Dartington, Centres of Excellence

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Overhead 4

Want to know more? What works? Evidence-based policy and practice in public services Edited by: Huw T.O. Davies, Sandra M. Nutley and Peter C. Smith: The Policy Press, 2000

• Within-sector reviews: - Health care, Education, Criminal Justice, Social Care

- Welfare, Housing, Transport and Urban Renewal Policy

• Cross-sector analysis: - the policy process; strategic approaches to R&D - methodological issues and the nature of evidence

- strategies for implementing evidence-based practice

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Overhead 5

Lessons from across public services Four Requirements for EBP&P

1. Agreement as to the nature of evidence. 2. Strategic approach to the creation of evidence; development of a

cumulative knowledge base. 3. Effective dissemination/ access to knowledge. 4. Initiatives to increase the uptake of evidence (in policy and practice).

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Overhead 6

Nature of evidence: UK government view

“Expert knowledge; published research; existing statistics; stakeholder consultations; previous policy evaluations; the Internet; outcomes from consultations; costings of policy options; output from economic and statistical modelling.” “There is a great deal of critical evidence held in the minds of both front-line staff … and those to whom policy is directed.”

UK Cabinet Office 1999

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Overhead 7

Hierarchy of evidence in healthcare

I-1 Systematic review and meta-analysis of two or more double-blind randomised control trials

I-2 One or more large double-blind randomised control trials

II-1 One or more well-conducted cohort studies

II-2 One or more well-conducted case-control studies

II-3 A dramatic uncontrolled experiment

III Expert committee sitting in review; peer leader opinion (e.g. narrative review) IV Personal experience

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Overhead 8

Suggestion one:

If we want EBP&P - we do need some agreement as to what constitutes EVIDENCE in what context.

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Overhead 9

Strategic approach to knowledge creation • Large gaps and ambiguities in knowledge base

• Lots of small, ad hoc studies

• Research that is producer rather than user driven

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Overhead 10

Twin Worlds: Management Practice problems

• Divergent -

– concerns, priorities, language, dynamics – conceptions of knowledge; time-scales – status • Leading to - – communication difficulties – mismatch between supply & demand – rejection; implementation failure

Research Practice

Research evidence

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Overhead 11 Moving away from linear models: Partnership Models for Evidence-based Practice

Knowledge

creation

Knowledge validation

Knowledge adoption

Knowledge dissemination and diffusion

Researchers &

Users

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Overhead 12

Strategy matters – NERF

• Create and agree research quality standards

• Devise methods for analysing research results and identifying gaps in knowledge

• Build capacity to identify longer term research requirements

• Common forum of academics, policy-makers and practitioners to set research priorities

• Co-operation of research funders to encourage coherence in allocation of funds

• Extend opportunities for teachers to participate in research

• Provide teachers with access to research findings

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Overhead 13

Suggestion Two:

Develop partnerships between researchers and research users - and create an environment which fosters and rewards such partnerships.

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Overhead 14

Dissemination/ access

• Policy: – Policy worlds and research worlds fail to connect…

• Practice:

– Significant ‘knowledge-practice’ gaps…

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Overhead 15

Existing Strategies Dissemination

• Accessible summaries of research which are targeted at appropriate audiences

Access

• Data-bases of individual studies

• Consultation with ‘experts’

• Non-systematic research syntheses

• Systematic research syntheses

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Overhead 16

Suggestion(s) Three:

(a) Systematic reviews offer effective shortcuts to evidence on what works (b) Pushing is not enough, need to develop PULL

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Overhead 17

Increasing the uptake Two related issues:

• Increasing the uptake of specific evidence-based recommendations • General development of evidence-informed practice

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Overhead 18

Changing Professional Practice

• Educational outreach/academic detailing

• Guidelines or other ‘prescriptions for practice’

• Reminder systems & client-mediated methods

• Linkage to performance indicators/targets

• Audit, accreditation and other inspections

• Continuing Professional Development

• Identification of exemplars - “beacons”

• Organisational change e.g. team working

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Overhead 19 Emphasising individuals ignores the context

Individual

Practice

Organisational structures &

culture

Peer values &

pressures

Tacit knowledge

Resources: Personal &

Organisational

Formal

knowledge e.g.

Research evidence

User demands &

pressure from stakeholders

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Overhead 20

Suggestion(s) Four:

(a) Specific changes in response to evidence need to build upon a contextual diagnosis of the reasons for current practice

(b) General development of evidence-informed practice needs to target

practitioners, managers and organisational systems and culture

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Overhead 21

What can I do? Practitioners

• Identify key areas where we need to know what works

• Become familiar with good sources of evidence

• Develop own research/ critical appraisal skills

• Ask questions about our own practice and record activity

• Become an advocate for EBP

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Overhead 22

What can I do?

Managers

• Debate what evidence-informed practice should look like

• Identify barriers to such practice

• Experiment: start small - pilot/ demonstration project in one area

• Coach and use evidence in supervision - value profession curiosity

• Build partnerships where appropriate

• Integrate EBP initiatives with wider service quality issues

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Overhead 23

Other Useful References Kendrick, S (2001), ‘Using all the evidence: towards a truly intelligent National Health Service’ Health Bulletin (59) 2, March (http://www.scotland.gov.uk/cmobulletin/hb592-00.asp)

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Keynote Speaker

What are the Barriers to Evidence-based Policy and Practice in Social Work, and how can they be

Overcome?

Facilitator: Gill McIvor

Introduction

This conference explicitly recognises the importance of social work practice being underpinned by research. With the concept of evidence-based or evidence-informed policy and practice becoming increasingly part of the parlance of social work practitioners and managers, it is easy to assume that the importance of research has long been recognised in the social work and social care fields. However, this is not so. When the Social Work Research Centre was established at Stirling University 15 years ago it was created specifically to promote social work research in the UK and its initial remit was explicitly evaluative in focus. The investment of resources in the creation of a centre for social work research was justified by the relative dearth of high quality research that was available to inform social work policy and practice. Research and evaluation had traditionally been little-used terms in the vocabulary of social workers and by the mid to late 1980s, evaluative research had had a limited impact upon social work policy and practice. A number of factors appear to have contributed to this state of affairs. Researchers (and especially academic researchers) were accused of addressing issues which were of limited relevance to day-to-day practice; of producing reports which were indigestible and obscure; and of failing to recognise the mechanisms by which, in organisations such as social work departments, policies and practices are developed and changed. Educators responsible for pre- and post-qualifying training likewise came under fire for failing to equip practitioners with an appreciation of research and its applicability to practice. Another factor which had arguably limited the usefulness of social work research was a widespread belief that social work practice emerged badly when subjected to a researcher’s gaze. It was more common, for example, for social work's lack of impact on delinquent activity to be alluded to, while more positive accounts of practice tended to be ignored.

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The emergence of evidence in social work

Over the last decade or so, and particularly in the last five years, increasing efforts have been made to identify ‘what works’ in various areas of social work practice. This interest in what works first gained some momentum in the criminal justice field where reviews of the research literature began to challenge the widely held but wrongly interpreted conclusion that ‘nothing works’ in reducing recidivism among offenders. These reviews suggested that a much more complex conclusion was warranted – that some things appear to help reduce offending among some offenders in some circumstances – and they also began to identify a number of broad principles that appeared to be associated with more effective intervention with offenders. Endeavours to identify what works have subsequently extended to other areas of social work practice as reflected, for example, by the ‘What Works’ series of publications produced by Barnardo’s. It is worth reflecting briefly on why the concept of evidence-based practice took hold relatively quickly in the criminal justice field, since the reasons it did so also provide pointers as to why research has often had a limited impact on social work policy and practice. First, in social work with offenders the purposes and intended outcomes of intervention are relatively easy to define. Although the precise objectives of supervision will vary from offender to offender, so as to reflect their underlying needs, ultimately the aim is to reduce the risk of further offending. This being so, it is perhaps easier in social work with offenders to identify whether or not and to what extent different interventions bring about the intended outcome, though that is not to suggest that the measurement of recidivism is, in itself, without problems (Smith, 2000). However, in comparison with other areas of social work, where the intended outcomes are more likely to be contested and may be more highly individualised, defining and measuring the outcomes of social work with offenders is a slightly more straightforward task. Second, much of the intervention that is undertaken with offenders employs relatively structured techniques which have specific outcomes associated with them and which therefore lend themselves more readily than less structured approaches to measurement and evaluation. Many of these techniques have been developed by psychologists and there are associated standardised measures available which enable an assessment to be made of how successful the intervention has been. For example, measures of aggression and impulsiveness can be employed to determine whether a programme aimed at enabling offenders to control their anger has been successful in this respect. Interventions with offenders therefore may lend themselves more readily to the types of evaluative methods that are traditionally assumed to be of sufficient scientific rigour to generate ‘scientific evidence’. Even so, it can be argued that

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reliance upon these interventions – and the theoretical models from which they are derived – produces an unhelpfully narrow approach to the supervision of offenders which ignores the socio-economic determinants of criminal behaviour and the broader context of offenders’ lives. Some have argued that by focusing upon – and even pathologising - the individual, these interventions divert attention away from practice that is aimed at empowering individuals, enhancing social justice and promoting their inclusion in society. Arguably, these methods have been embraced, particularly by probation services in England and Wales, both because they appear at one level to be effective in helping offenders to change, but also because the political climate demands that probation services demonstrate their effectiveness in reducing crime. The Effective Practice Initiative spearheaded by Her Majesty’s Inspectorate of Probation in England and Wales has been accompanied by increased centralisation of probation services through the creation of a National Probation Directorate and through the setting of performance targets, including those related to recidivism, that the Home Office expects the probation services to meet.

Barriers to an informed approach to practice

In a recent article in Community Care, Mark Watson, director of information at the National Institute for Social Work argues that the research world has largely failed to impact on social work practice. His assertion is supported by recent studies that have suggested that social workers tend to draw upon experience rather than systematic data about what is effective. There are a number of reasons why this might be so, including the failure of researchers to disseminate research findings in such a way that their implications for practice can be readily understood. The recent study by Barnardo’s of approaches to the dissemination of social work research identified a number of obstacles which impeded the successful integration of research into practice and offered a number of suggestions as to how the dissemination and implementation of research findings could be improved. Another factor that I believe has hindered the development of evidence-informed policy and practice in social work is the complexity and contested nature of the issues that social workers are required to engage with on a daily basis and, correspondingly, the necessary complexity of research that aims to capture the process by which they do so in a meaningful way. Social work does not, in the main, lend itself readily to the reductivist analysis required by the positivist position that aligns social work research with the scientific paradigm. This being so, evaluative research in social work will often fail to produce findings that provide clear pointers for policy and practice. The outcomes of social work practice may be difficult to measure and difficult to attribute to the intervention in question. Moreover, different stakeholders may have ascribed varying importance

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to different outcomes and may therefore have differing views about what constitutes success.

What is evidence?

Yet another factor which has limited the impact of research on social work practice has been the lack of clarity surrounding the status of evidence in social work and social care. In the wider scientific and medical fields, high standards of academic rigour are demanded before research studies are deemed to have generated reliable and valid evidence for the efficacy of a particular intervention or treatment. This usually means that an experimental design has been employed in which research subjects have been randomly assigned to an experimental group (which receives the treatment in question) or to a non-treatment control and the treatment outcomes of the two groups compared. If there is a difference in treatment outcome between the two groups and this difference is sufficiently large to reach statistical significance (that is, the probability of it having come about by chance is sufficiently small), then the difference is assumed to represent the effect of the treatment. Research studies that fall short of this methodological ideal (for example, by not employing a randomised experimental design) are usually considered not to provide a sufficiently robust test of the treatment under scrutiny. The relevance of this model of research to social work policy and practice has been challenged on a number of grounds. This includes a questioning of the feasibility of the experimental paradigm as a method of social work research. The majority of social work practice does not consist of self-contained interventions whose external context can be readily controlled; rather, service provision is more usually multi-faceted and the context in which it is delivered is complex and dynamic. Even where it is possible to identify an intervention that may lend itself to evaluation through the use of an experimental design, ethical questions are likely to arise in relation to the withholding of a potentially beneficial intervention from those who may benefit from it. In social work, quasi-experimental designs - which rely upon naturally occurring ‘comparison groups’ (for example those on a waiting list for a service) are more likely to be feasible, though their outcomes may be difficult to interpret and the reliability of the findings consequently reduced. The value of the scientific approach to social work research has also been questioned on the basis that the methods derived from it are predicated on a belief that human behaviour can be understood when divorced from its social context and from the meaning that people as social actors attach to their interaction with the social world. Instead, critics of positivist approaches would argue for methodologies and research processes which aim to capture the richness and diversity of personal experience as a means of better understanding the potential for social work to impact for better or for worse on people’s lives.

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For these and other reasons most social work academics have contested assumptions that the methods adopted to promote evidence-based practice in, for example, the health field will be applicable or relevant to the development of effective social work practice. The Cochrane Collaboration was established in the health care field to review and synthesise scientific research in that field on a systematic basis. In 2000 the Campbell Collaboration was formally established to undertake similar work in relation to social and educational interventions, being described as:

“…an emerging international effort that aims to help people make well-informed decisions by preparing, maintaining and promoting access to systematic reviews of studies on the effects of social and educational policies and practices.”

Those who have reservations about the role and focus of the Campbell Collaboration are concerned that the standards of scientific evidence that it may demand may exclude much of the knowledge generated, in particular, by social work practitioners and by the users of research and that this, in turn, will result in an increasingly mechanistic approach to practice which ignores the realities of social work in its social context. Webb (2001), for example, has recently argued that:

“…the emerging panacea of evidence-based work can have the effect of neutralising social work’s role in moral and political discourse and undermining its professional autonomy. It is not difficult to envisage that a stronger set of prescriptive policies will emerge thus tightening the straight-jacket further by insisting that evidence-based, cognitive-behavioural and evaluative practice combine to provide a uniform diet of interventions and training. This would represent a combined attempt to impose a planned rational order on the delivery of social work, despite contrary evidence suggesting that such order is impossible.”

Initiatives aimed at promoting evidence

informed social work

In recent years a number of other initiatives have been developed which have been aimed explicitly at enhancing the relationship between social work research and social work practice. I will describe each in turn very briefly - to provide an indication of the range and diversity of activity that is currently being undertaken in this regard. I should also point out that the list is by no means exhaustive, but instead is intended to convey a flavour of the types of initiatives that are currently underway.

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Making research count This is a network of university-based academics in England and Wales that provides tailor-made research support to social care agencies at the request of the agencies. This includes: • research-based workshops on ‘making sense of research’ • training on practitioner research and evaluation • the dissemination of research findings relevant to the provision of social work,

social care and health services across the service user groups • the publication of research briefings • the use of research to inform practice • annual conferences at national and regional level for senior managers, service

planners and others addressing the long term policy implications of new research findings

Research in practice This is another university-based initiative that is funded by 56 member agencies to disseminate key research evidence on childcare via written summaries and briefings, audio tapes, symposia and via a web site. A key underpinning assumption is that research evidence is most useful when harnessed to the professional experience and expertise of staff. Centre for Evidence-based Social Services This centre is based at the University of Essex and partly funded by the Department of Health. It works with 16 local authorities in the south west of England, running conferences and workshops on research evidence relating to a wide range of services and carries out research in partnership with member agencies. The Toronto Group This is a group of social care researchers who are committed to widening the debate about the nature and status of evidence in social work and promoting research as empowerment for service users. Social Care Institute for Excellence This institute is being established by the government for England and Wales. This will be a national resource which issues evidence-based good practice guidelines to social care professionals. It will, according to Mark Watson

“look at what research there is, then talk to users and carers to get their perspectives on what the research says. [It] will work in partnership with users and practitioners and will incorporate user and practitioner’s evidence and experience in the best practice guidance which will be aimed at the practitioner”.

Criminal Justice Social Work Development Centre This new Scottish Centre was established at the Universities of Edinburgh and Stirling at the beginning of this year. It is aimed at promoting research informed practice in criminal justice social work and juvenile justice by providing access to relevant material, by disseminating research in ways that can maximise its

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relevance to practice and by supporting research and evaluation activities by front-line practitioners and by managers in local authorities and the voluntary sector.

Conclusions

Initiatives of the type I have just described are testimony to the fact that the relationship between research, policy and practice in social work is both complex and contested. Each has been established to promote the role of research in the development of informed policy and practice though each does so somewhat differently, with different underpinning assumptions about the nature of evidence. The evidence base in most areas of social work is still currently rather thin. Although the volume of social work research has increased dramatically over the last 15 years most specific areas of practice continue to be supported by relatively few research studies. Even in the criminal justice field, where arguably, evidence-informed practice is most advanced, the principles which have been identified as underpinning effective work with offenders are, in actuality, derived from a relatively small body of studies and as such they are indicative rather than conclusive. Furthermore, many of these studies relate to interventions which have been undertaken with offenders in different jurisdictions and cultural contexts and it is by no means certain that they can be applied uncritically in the UK. Our understanding of what constitutes effective social work practice is therefore dependent upon further high quality research that can build upon that existing base. Further studies may challenge prior conclusions or serve to further consolidate and reinforce the emerging knowledge base that informs social work practice.

Practitioner and user involvement in

defining research needs

However, to ensure that research can contribute more meaningfully to policy and practice requires greater involvement of practitioner and of user service users in identifying priority areas for future research and contributing to different stages of the research process. The relevance of research to practice is likely to be enhanced if it engages with issues that are of concern to social workers and does so in such a way that the implications for practice can readily be distilled. Practitioners and managers are well placed to identify gaps in the existing evidence and knowledge and to assist in identifying the ways in which they might be filled. Involving users in this process can also ensure that research engages

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with issues of importance to them and in some circumstances can help to empower marginal groups who rarely have a voice.

Dissemination of research

No matter how relevant research is perceived to be in terms of the issues it seeks to illuminate or the questions it seeks to address, it is essential that it is disseminated in ways that can be utilised by practitioners, managers, service users and policy makers. Greater attention is therefore required to the dissemination of research in a variety of formats. Better dialogue between researchers and the users of research may help to identify how the key messages can be most effectively conveyed in a way that their implications for policy and practice can readily be identified and applied. It is equally important that research can inform practice in a way that is not overly prospective. The nature of social work and the issues with which it engages means that no two situations are ever likely to be the same. The research evidence will need to be considered alongside other factors and professional judgement exercised by practitioners in order that it might be appropriately applied. Practice that is underpinned purely by ‘evidence’ and that does not take account of individual circumstances and needs runs the risk of being mechanistic and less effective as a result.

Systematic reviews of the research

Whilst some individual research studies may produce data which can inform policy and practice, systematic reviews of the research literature around particular issues or methods of intervention are more likely to produce a firmer base of evidence from which practice can develop. Reviews of this kind consider the findings of an array of studies which may have different - and perhaps contradictory - outcomes and which may be associated with differing degrees of rigour. They therefore have the potential to identify areas of consensus or consistency from which firmer conclusions might be drawn about the effectiveness of practice and, similarly, can point to areas in which the evidence may be mixed. I also believe that a broad definition of ‘evidence’ is required if social work practice is to be informed by research evidence. Qualitative research which explores the social work process and how it is experienced by service users is likely to be as illuminating as more quantitative research focused exclusively upon outcomes. As Clark and Cornish argued almost three decades ago,

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“knowing that something has made a difference is very little use unless it has been identified”.

To draw again on a criminal justice example, knowing that probation supervision has brought about a reduction in re-offending is relatively meaningless unless we also know how it made a difference and why. Evidence-informed practice should not simply be a case of drawing upon the results of outcome studies to justify the use of one approach to intervention over another: it should also entail the integration of knowledge derived from a variety of sources. This requires practitioners to have a critical understanding and appreciation of research in order that they are able to distinguish what counts as good research evidence (in a very broad sense) and what is less convincing in this regard. An evidence-informed approach to practice therefore requires at the very least that practitioners and managers embrace a culture of curiosity in which research is routinely drawn upon, assessed for its value and relevance and used appropriately to inform policy and practice. Evidence-informed policy and practice should also ideally be reflected in the recognition of research as an integral aspect of practice in which social workers routinely gather information that can help to illuminate issues and that can assist them to evaluate their own practice. There is reason for optimism that research can make a greater contribution to the development of social work policy and practice than it typically has done to date. A commitment to evidence-informed policy and practice represents a commitment to improving the quality and effectiveness of services for the ultimate benefit of service users. Policy and practice that is informed by research evidence is more likely to be effective and to be responsive to the needs of service users than policy and practice that operates in an empirical vacuum. Academic debate will continue over the nature and status of evidence in social work. In the meantime I would encourage a broad definition of evidence which includes data derived from carefully controlled outcome studies where they are appropriate and feasible but which similarly embraces data obtained from other types of well-designed research. Researchers have a key role to play in assessing critically the quality of evidence, in disseminating this in accessible and usable formats to the users of research and in helping social work practitioners and managers to adopt a similarly critical and enquiring approach to policy and to day-to-day practice.

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Keynote Speaker

The Role of the Team Manager in Ensuring Effective Service Provision

Facilitator: Cathy Macnaughton

In this presentation I provide some views on promoting effective practice from a team manager’s viewpoint. I shall approach this by outlining one particular case which my team has worked on over the last two years, highlighting areas in which we've made conscious use of theory and current research, and pulling out some of the dilemmas and tensions which we've faced. This is a child care case, but I think that it raises issues of relevance for all areas of social work. I will then outline what for me are the key factors which influence the development of reflective and effective practice, and which impact on the integration of research and practice. The case I'm going to describe involves a baby who I'll call Janice, born to a mother with chronic drug problems, and born suffering severe effects from prenatal exposure to drugs. There had been long term involvement with an older child, and a pattern of neglect. By this time Janice was living with the extended family. First of all we had clearly failed to impact on the mother's lifestyle either to enable her to care for her older child, to prevent neglect of the older child, or to impact on the mother’s drug use and the serious harm that resulted to herself and to Janice. There was much room for improvement in our knowledge of 'what works' in intervening with chronic drug misuse, but there was also a need to keep in perspective what social work can hope to achieve when dealing with major social issues such as poverty and deprivation. Fairly soon after the birth we were faced with the first major decision in determining whether or not an emergency protection order was necessary. Clearly that involved an assessment and balancing of risks. I shall not provide details but suffice to say that the key issue was whether or not we could trust the mother to leave Janice in hospital. We were guided by legislation towards minimal intervention, and also to the paramountcy of the best interests of the child. Our judgement was that we could not be sure that the mother would not remove Janice from hospital; the baby would have been at extreme risk had she done so. There was a judgement to be made in a very emotive situation, and values and beliefs come into play not only for practitioners, but also for other key players such as Sheriffs and Children's Panel members.

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Even at this point it was apparent that the mother might not be able to care safely for Janice, and we were aware that we might need to find an alternative permanent family for her if her mother could not be supported in making significant changes to her lifestyle. We were very aware of the need to progress quickly towards either a successful rehabilitation or to an alternative permanent placement. I think it would be fair to say that we were influenced by core knowledge stemming from writers like Bowlby and Fahiberg about the importance of early secure attachments, and minimal changes of caregivers, and that this kind of knowledge is something that practitioners tend to use implicitly rather than explicitly. We also knew from experience that placement possibilities and outcomes diminish as children get older and more damaged by a lack of security. We were also propelled towards a clearer use of current thinking on concurrent planning, that is the progression in parallel of plans for rehabilitation and plans for permanence, so as to minimise changes and delays for children. A solicitor kept us very aware of the possible need to justify actions in court. We did therefore obtain, read and use work on concurrent planning. It was fortuitous that I was travelling up and down to Dundee and had access to the university library, and to some valuable assistance from University staff in obtaining material. We tried to follow a concurrent model as closely as possible throughout, and used this as a basis for presenting arguments to reviews, Panels and the court. Janice needed hospital care for nearly three months. There were no family members able to care for her, so firstly we enquired about whether there were foster carers able to work on a genuinely concurrent model; that is, to support rehabilitation but be prepared to offer adoption if it was unsuccessful. We had no carers trained or able to work in that way, but we did have foster carers who could meet her needs, and work towards rehabilitation or towards permanence. She was visited daily for 3 weeks prior to discharge. Clearly the quality of that resource was essential to a good outcome. The mother had only very sporadic contact initially, and none after Janice was six months old. Therefore the next major decision was when to move her to a permanent placement. We had to strike a balance between the best time for her, and the need to be certain ourselves that rehabilitation was not possible. We also had to be sure that we would not be prejudicing the outcome by acting precipitately. Although the move could have been at six months it was decided that it was too early. At nine months a freeing petition was lodged, and Janice was placed just before her first birthday. Attempts to timetable Panels, court, as well as needs of Janice and foster and adoptive carers probably suggest that we should have been bidding for a rail franchise! However, we then hit the vagaries of the court system, and there followed six months during which the adoptive carers went through the traumas of repeated adjournments before the freeing petition was finally granted. I have used this case experience as a basis and illustration of the following areas relevant to the development of reflective practice from a team manager’s view point. These are summarised under three main headings:

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1. Power and Partnership

1. Practitioners can often feel that they have a relatively powerless voice in a

debate about the links between research and practice. For true partnership to develop between research and practice there needs to be a truly equal relationship between researchers and practitioners.

2. It is important to use language that does not suggest blame, i.e. we should not

ask “Why don’t practitioners make better use of research?” but should ask “Why don’t practitioners and researchers work better together?”

3. Research should be connected to practice realities, and we need to value a

range of styles of research and evaluation. 4. Stronger local links between universities and agencies would help. 5. Practitioners need good access to research. IT development offers a real

opportunity here.

2. Organisational Culture

1. Managers can keep a focus on best practice by always asking “Why are we

doing this, what do we know, what else do we need to know and how can we find out?”

2. Reflective supervision at all levels is the keystone. 3. Team meetings can be used for practice development. 4. Practice teaching should be an integral part of practice. 5. Training – PQ and Advanced Award programmes are helpful but we must

recognise resource implications.

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3. Resources

1. If practitioners spend more time reading research they will spend less time

doing something else. This is obvious but needs to be said. 2. Also we need to be clear about what social work can hope to achieve, and that

it will not eradicate poverty, abuse or discrimination, and expectations and demands will be contingent upon political agendas.

Finally, what are the main things a team manager can do in their practice to promote reflective practice? A healthy learning environment needs to be fostered. At every available opportunity we need to ask the questions “Why are we doing this, what tells us that it is the best thing to do, and what else do we need to know to inform our decisions?” A fuller version of Cathy’s paper can be obtained from Raymond Taylor at the address on the acknowledgements page.

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Morning Workshops

Please refer to appendix A for a list of workshop questions.

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Morning workshop

Criminal Justice Services

Facilitators: Gill McIvor and Allan Monteforte

What did you discuss?

There is much written and spoken about the ‘What Works?’ agenda but it is recognised that this is probably better known as the ‘Principles of Effective Practice’. However there is a tendency to seek the headlines from these principles, and members of the workshop agreed that much more has to be done to understand all of the principles and the relation between them. There is a need to recognise the limitations about the level of effectiveness being declared within research. It was agreed that there has been a shift in the culture and receptiveness to research-based practice. Using research-based practice can increase stakeholders’ confidence in this area of social work: . Examples: • Assessment tools and processes e.g. Risk Assessment and Management

guidelines from SE, LSI-r and other assessment tools used to assess risk of re-conviction and to target resources

• Cognitive behavioural interventions, but be aware that this is not a panacea and that other structured interventions may need to be considered

• Considering issues of programme integrity; interventions planned and delivered as planned and changes (and reasons for changes) noted.

• Monitoring, evidence of PIs and other monitoring tools but a lack of extensive evaluation of work to complete the cycle of research and practice back to research

• Need to ensure practice is within a legal and ethical framework. There is still a tension between the social work role per se and the social work role with criminal justice

There is a need to widen our horizons to other areas of social work e.g. child care, domestic violence and mental illness.

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What did you conclude?

We would like to see: • Practitioner involvement in commissioning and undertaking research • The development of PQ in terms of research • The use of local research • Training in the use of research material • Wider access to research material Participants acknowledged that research was informing practice in criminal justice work; this has mainly been in North America. There is, however, a tendency to seek quick solutions rather than understanding what research says, including declared limitations and suggested actions for the future. Social work is also poor in recording an overview of activities; the why, what, and how of actions. In order to take research forward it was thought that this needed to be improved. Whilst National Objectives and Standards for Social Work Services in the Criminal Justice System have been in existence for some years, some stakeholders only appear to have a limited understanding of those objectives. . If one of our objectives has been to reduce custody, have we achieved that objective and if we have how do we know?

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Morning workshop

Youth Justice

Facilitators: Bill Whyte and Julie Ross


• Child care staff are unaware of relevant ‘what works’ research. A general lack

of youth justice research • Credible outcomes that can be used as evidence: what are they? • Supporting staff to become involved in research-based practice and reflective

practice, and the role of the practitioner and the manager within this • Use of standards based on models of practice and not losing sight of the

purpose of intervention, i.e. challenges for the organisation


• The general need for practitioners and managers to share experience, practice

and research across the country • More research required in youth justice creating a culture in the workplace

where consultation is supported in all aspects of work • Information can be generated easily but using it effectively requires

consultation • The need to improve research on longer term outcomes to inform effectiveness

of service

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Morning workshop

Children and Families

Facilitators: Andy Kendrick and Cathy Macnaughton


There was some difficulty in identifying areas where evidence-informed practice is in place. We did, however, acknowledge areas such as; the need for early intervention in early childhood leading to nursery provision; LAC materials; the value of keeping children in communities leading for example to Barnado’s Matrix project; the prevalence and impact of child sexual abuse. The gaps which were identified included: feedback from adoption re: long-term outcomes. The need to identify evidence from Europe rather than America. We queried whether practice in England and Wales was more clearly evidence-based for example, using resilience materials. We asked how effectively organisations used research, and what other structures impinged, for example, around child protection perhaps in an undeclared way. We asked how practitioner’s knowledge could be better disseminated. We also discussed whether evidence means certainty, and how robust/reliable different forms of research are.


There is a need to focus more on evidence informing policy and practice rather than individual practitioners. Research is only one informant of practice. There needs to be a commitment from the whole organisation to research. We should focus on points of critical decision-making, and ask who needs more knowledge and how do they and others get it? Standards need to be generated from the front-line rather than imposed from above. There is a sense from practice of no input to a standards agenda. We need better links between inputs and outcomes. There were queries re: LAC materials and education - will they help educational outcomes? Do they promote a sense of corporate parent? Does research address educational issues prior to accommodation? Practitioners have asked for standards re: fostering and adoption for a long time but the huge gap in resources puts more pressure on practitioners. How well-informed is the interface between research and standards, and do standards improve qualitative standards?

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Morning workshop

Children and Families: Looked After Children Services

Facilitators: Ranald Mair and Andrew Hosin


The core issue of why workers and agencies do not make extensive use of research: • Lack of ownership of the research agenda • Lack of agreement over the value base and political direction of outcome

based research • Feeling that research into child care and residential care has focussed more on

what has gone wrong as opposed to what is going well • Lack of time, space and resources to engage meaningfully in a reflective

process


• A need for a shift in culture and organisation to facilitate the development of

evidence-based practice • Research agendas need to be arrived at and pursued in consultation with front-

line staff and service users • A need for more debate over ‘outcomes’ and values • An improved resource base is necessary to create the space within which

reflective evidence-based practice can develop • Access to training and support

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Morning workshop

Inter-Agency Working in Community Care

Facilitators: Lisa Curtice and Frank Reilly


We discussed aspirations for joint working and acknowledged the lack of research in this area.


We identified a number of aspirations which we had in relation to joint working which were: • To create a smoother transition as they move between services • To create a shared vision for the development of community care services • The provision of high quality holistic assessments We aspire to pool not only budgets but also expertise • We need to identify not only what works but also what fails. It is not an easy

task to achieve this given the different IT systems which are in place in health and social work.

We also concluded that: • Given the role that Audit Scotland has in auditing health and social services,

might they be able to utilise research findings which will in turn influence service provision?

• There is a need for pre- and post-evaluation of joint working • There is a need for practitioners-researchers but they also need to balance

time and resources • In developing this research agenda we need to consider whose agenda to

prioritise. Is it the Scottish Executive’s, local authority’s health care trust or service users

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Morning workshop

Getting Evidence into Practice

Facilitators: Mary Marshall and Katrina Myers


• Multi-disciplinary work reconciling different professional’s research styles and

preoccupations • Problematic definition of outcomes: these may be different for each stakeholder • Concerns about user views not taking account of users who are on waiting lists

or otherwise not accessing assistance • Time: a shortage of time • Are government policy documents research based? • Identifying research funds which support our views • Knowing about research • Critically appraising research • We all have a research capacity and can collect data • New emphasis on standards • What happens to project write-ups and evaluations?


• In community care you cannot separate social work and health. There is a

need for joined up research for joined up work • It is hard to prioritise research in demanding jobs • Evaluation ought to be built into any new service • Research findings at several levels, potential conflicts with organisational

culture • There is a need for dynamic interchange between research and practice • Existing of research may steer work rather than the needs of users • We need to develop a research culture

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We felt it was possible to do things in management groups but that it was harder when cross-service or cross-Council. We noted the Durham partnership where schools and management collated information and the university helped them to analyse it. We searched for examples of measurement enabling rather than checking and thought this was the intention of LAC materials. We noted the gap between intention and outcomes, and that whilst social workers tended to like them, parents and children felt they were not involved and had little impact on day-to-day life.

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Afternoon Workshops

Please refer to appendix B for a list of workshop questions.

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Afternoon workshop

Summary of Afternoon Workshops

Facilitators: Sam McLean, Moira Swanson, Philip Morgan-Klein, Margaret McConnachie,

Alistair McDonald


The workshops focused on the issue of linking research and practice, and focused on the questions laid out in appendix B. The workshops identified those areas of social work where there is strong agreement on what constitutes effective social work practice. This is perhaps most systematically disseminated through qualifying and post-qualifying programmes. A great deal needs to be done however to create learning organisations where the culture encourages reading and reflection. Many participants in the workshops acknowledged that things are changing. In some agencies access to research and researchers is increasing. This may be because of direct involvement in particular research initiatives, easy access to research through NISW, the internet or departmental libraries. The collection and review of relevant research is increasingly more systematic. Managers and practitioners are more able to critically appraise research findings. Post Qualifying and Advanced Awards have played their part in encouraging these developments. Best Value with its emphasis on service evaluation and consultation, with staff and communities, encourages greater reflection and the identification of more effective models of service delivery. This reflection is crucial given the number of staff who feel that most of their time is spent fire-fighting. There are, however, areas of concern. First the wide variation between similar organisations; some appear to recognise the importance of evidence-informed social work to a far greater extent than others. Secondly, the variation within agencies; criminal justice is more evidence-informed than other areas of practice. The interest by frontline staff in research does not always permeate up through the organisation. Similarly, research findings are not always communicated down through large organisations.

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It was noted that some of the large scale structural changes in organisations may be driven by short term political priorities, and fashion, rather than an agenda which is informed by research.


• Organisational and team cultures are shifting and there is an increasing

awareness of the importance of research; there is however wide variation between and within organisations

• Evaluation of projects and new initiatives is becoming more routine in part to justify allocation of scarce resources. Through this practitioners are becoming more accustomed to evaluative methods

• Organisational change is often based on “hunches” and fashion rather than research

• In relation to multidisciplinary practice the issue of the relationship between values and what constitutes sound research cannot be ignored

• An increase in reading opportunities, and access to research, where this has happened, is welcomed

• There are enormous variations in the extent to which questioning and challenging are acceptable in teams and organisations

• Engagement of frontline staff is essential both in commissioning research of direct relevance to practice and ensuring the dissemination of research to staff at all levels in organisations

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Appendices

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Appendix A

Morning Workshop Questions

Getting Evidence into Practice 1. To what extent is Evidence-Informed Research already in place in this area

of service? (Be positive, or at least fair!) 2. What needs to be done to secure the research capacity to meet policy-

makers and practitioners need for evidence? 3. Credible evidence in Social Work?

- In which areas does credible evidence already exist? - Which areas require particular attention?

4a. Can, and should, the current “standards agenda” be used to promote

evidenced-informed social work? 4b. Given the current pre-occupation with the measurement of outcomes, what

role does performance management, and management information, more generally, have to play in improving social work effectiveness?

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Appendix B

Afternoon Workshop Questions

Linking Research and Practice In light of the presentation by Mike Hughes on ‘Linking Research and Practice’,* consider: 1 Is the delivery of services which are evidence-based realistic, desirable and

achievable? 2. What is needed within agencies to improve access to research literature? 3. How can we improve upon the way in which students, practice teachers and

policy makers currently use research? 4. Identify some positive examples of where the policy and practice

implications of research are being implemented. 5. In view of the conclusion from the Barnardo’s research that “decision

making is influenced by the prevailing organisational and team culture,” what needs to be put in place to achieve an organisational and team culture which is research minded?

*Please see the separate leaflet

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