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Chambers' Model of Informed Clinical Decision Making
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The implementation of evidence-based practice (EBP) as a professional model of practice for social work has been suggested as one approach to support informed clinical decision making. However, different barriers and processes have been identified that impact the use of EBP at individual, organizational, and systemic levels. This article describes...
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Citations
... Such barriers can inhibit changes in standard practices. Manuel et al. (2009) identified EBP barriers as lacking knowledge, skills, training, supervision, or monitoring around EBP implementation. Gray et al. (2012) found additional barriers, including resistance to agency culture or a negative or indifferent attitude toward EBP, possibly due to a poor understanding of the concept. ...
The aim of this research is to investigate school social workers’ attitudes to educational inclusion in regular classrooms regarding different variables. Using an attitude scale, we investigated 232 social workers from the UAE regarding age, gender, nationality, type of school, years of experience, and area of residence. Educational placement variables for different disabilities, and school accessibility, were also investigated. Gender, age, school type, and experience did not impact attitudes to inclusion, but nationality, residence, and educational placement did. Social workers reported that UAE schools are inaccessible to students with disabilities. Inclusive education provides better quality education for all and helps change discriminatory attitudes. Schools enable the development of social ties and interactions through a framework for first interactions outside the home. When students with different skills and experiences play and learn together, respect and understanding increase. School social workers can be the key to facilitating this.
... For practitioners that do have access to recently published journals, the lag time between generations of research findings and publications results in evidence can reach several years and is not necessarily useful for current practice (Thyer, 2004). Manuel, Mullen, Fang, Bellamy, & Bledsoe (2009) identified EBP barriers as including: lack of knowledge, skills, training, supervision, or monitoring around EBP implementation. The lack of resources like time, access, or funding overburdened staff. ...
... Some practitioner's inability to work with computers during EBP implementation and insufficient time at work to apply EBP was also cited as barriers. It was rated as the top barrier in this study, which is consistent with other studies conducted in similar social work settings (Manuel, Mullen, Fang, Bellamy, & Bledsoe, 2009;Cawood 2010;Mel Gray, Joy, Plath, & Webb 2012). ...
... Also the lack of authority for practitioners to make changes in practice was also listed as prominent barriers. These findings are consistent with other studies of its kind (Newman, Papadopoulos, & Sigsworth, 1998;Thyer 2004;Manuel, Mullen, Fang, Bellamy, & Bledsoe, 2009;Cawood 2010;Lee 2015;and Lundren et al., 2012). ...
... Treatment approaches that made their way onto one of the evidence-based practice registries based on research for treating one specific mental health disorder are often misleadingly promoted as an evidence-based practice for any condition. Critics of EBP have argued that it is too medicalized and attempts to separate the individual from their biopsychosocial reality while prescribing rigid interventions that do not honor client diversity, client preferences, the therapeutic relationship, or the practice wisdom of the social worker (Adams et al., 2009;Berger, 2010;Borntrager et al., 2009;Drisko & Grady, 2015;Goldstein et al., 2009;Magill, 2006;Manuel et al., 2009;Witkin, 2017). Others criticize the use of treatment manuals, citing the growing literature base supporting the effectiveness of the therapeutic relationship (Norcross & Lampbert, 2011). ...
This chapter is devoted to outlining the research literature of psychodrama and group therapy. Evidence-based practice trends and their impact on practice in the field of social work are described. Psychodrama is also framed within the research bases of the humanistic-experiential psychotherapies, creative arts therapies, and body- and movement-oriented therapies. While the quality and quantity of research available on the effectiveness of psychodrama are limited, current findings support its use to as a treatment for various mental health conditions. Shortcomings and critiques of research in psychodrama are included while indicating a need for higher quality psychodrama research studies. The research history of psychodrama’s founder, Jacob Moreno, is also described to provide insight on psychodrama’s historical relationship to research.
... Treatment approaches that made their way onto one of the evidence-based practice registries based on research for treating one specific mental health disorder are often misleadingly promoted as an evidence-based practice for any condition. Critics of EBP have argued that it is too medicalized and attempts to separate the individual from their biopsychosocial reality while prescribing rigid interventions that do not honor client diversity, client preferences, the therapeutic relationship, or the practice wisdom of the social worker (Adams et al., 2009;Berger, 2010;Borntrager et al., 2009;Drisko & Grady, 2015;Goldstein et al., 2009;Magill, 2006;Manuel et al., 2009;Witkin, 2017). Others criticize the use of treatment manuals, citing the growing literature base supporting the effectiveness of the therapeutic relationship (Norcross & Lampbert, 2011). ...
This open access book outlines the intersections between social work and the methods of sociometry and psychodrama. Different sections offer essential practice wisdom for both trauma-focused and trauma-informed experiential work for individuals, groups, organizations, and communities. This text enriches the understanding of various action-based approaches and highlights how to enliven social work practice. The chapters include clinical vignettes and examples of structured sociometric prompts with diverse populations, topics, and social work settings to enhance the understanding of group practice, individual practice, and community practice. It provides social workers and other professionals with dynamic tools to improve assessment, intervention, activism, and leadership. Strength-based practical tools are offered to readers, along with guidance for theoretical conceptualizations. This integrative book is an essential read for students, practitioners, leaders, and scholars within the fields of social work, psychodrama, the creative art therapies, group therapy, community organizing, and social activism.
... Experimentella studier i form av RCT är viktiga för att utvärdera metodernas effektivitet. Eftersom professionell expertis och klientens förutsättningar och behov utgör två av kärnkomponenterna i EBP behövs dock studier även kring hur professionella och klienter upplever det evidensbaserade arbetet Epstein, 2011;Gray et al., 2015, Heiwe et al., 2014Manuel, Mullen, Fang, Bellamy & Bledsoe, 2009). ...
Denna avhandling handlar om professionellt lärande och utveckling i
familjebehandlande socialt arbete. Mer specifikt fokuseras reflektion och
evidensbaserad praktik (EBP). Socialt arbete är en komplex och dynamisk praktik
vilket ställer krav på många olika förmågor hos de professionella. För att hantera
praktiken beskrivs reflektion ofta som ett viktigt verktyg. Reflektion är
betydelsefullt för erfarenhetsbaserat lärande, beskrivs som viktigt för att undvika
risker och misstag i praktiken och kan leda till ökad produktivitet. Trots dess
många goda effekter tycks tid och andra resurser för reflektion och reflekterande
praktik ha minskat till förmån för andra inslag för kvalitetssäkring. Ett exempel är
EBP som fått ökad uppmärksamhet under det senaste decenniet.
Evidensbaserade modeller har förespråkats för kunskapsutveckling baserad på
systematiskt prövad, vetenskaplig kunskap i socialtjänstens verksamhet. Till följd
har olika kunskapsformer ställts mot varandra i utformningen av praktiken och
forskningsbaserad kunskap beskrivs ofta som mer legitim och säker än
erfarenhetsbaserad. Samtidigt betonas både praktisk kunskap och
reflektionsförmåga som ovärderliga för en praktik som socialt arbete. Kritik riktas
även mot EBP och evidensbaserade modeller, till exempel därför att de används
för att driva standardisering av arbetet och kontroll av medarbetare för långt.
Evidensbaserade modellers ofta manualbaserade format kritiseras dessutom för
att reducera professionellas handlingsutrymme och möjlighet till eftertanke.
I avhandlingen studeras socialarbetares förståelse och användning av reflektion
samt vilken roll reflektion har för professionellt lärande och kunskapsutveckling.
Ett ytterligare fokus är organisatoriska förutsättningar för reflektion,
evidensbaserat arbete samt professionellt lärande och kunskapsutveckling. Det
empiriska materialet består av fokusgrupper med socialarbetare aktiva inom
familjebehandling. Socialarbetare med och utan utbildning i
föräldrastödsmodellen Family Check-Up (FCU), som i avhandlingen utgör
exempel på en evidensbaserad modell, deltog i studien.
xxi
Resultaten belyser socialarbetarbetarnas betoning av vikten av reflektion i
familjebehandlande socialt arbete. Reflektion beskrevs som ett verktyg för process
och progression i klientarbetet, som en skyddsmekanism för att hantera svåra och
emotionellt laddade situationer och som legitimerande i den professionella rollen.
Reflektion beskrevs även som viktigt för professionellt lärande och
kunskapsutveckling, både för att etablera lärande från erfarenhet och för att
integrera forskningsbaserad kunskap i praktiskt arbete. Trots dess
kvalitetsdrivande karaktär beskrevs minskat utrymme för reflekterande praktik,
inte minst tidsmässigt. Resultaten belyser också hur arbetet med FCU, som en
evidensbaserad modell, ansågs kräva reflektion samt att det kändes mer ”tillåtet”
att reflektera i FCU-arbetet varför det beskrevs som reflektionsfrämjande. Även
FCU-arbetet beskrevs försvåras av brist på tid. Organisatoriska förutsättningar
tycks därför viktigt för både reflektion och evidensbaserat arbete. För att skapa
goda förutsättningar behövs fördjupad förståelse för båda arbetsformerna, inte
minst hos beslutsfattare. Både personliga och externa faktorer är viktiga och måste
beaktas för att möjliggöra en evidensbaserad och reflekterande praktik.
... However, few studies have any ambition to use theories to explain their findings. Manuel and colleagues and Franklin and Hopson use implementation science and Brekke and colleagues translational science (Brekke et al., 2007;Franklin and Hopson, 2007;Manuel et al., 2009). These theories are used as a backdrop to investigate problems with implementation and knowledge dissemination. ...
... The analytical ambitions reflect the discourses and go from the frame of implementation science and EBP over to organisational learning and participation. Titles "Agency-university partnerships for evidencebased practice" (Bellamy et al., 2008) "Preparing social work practitioners to use evidence-based practice" (Manuel et al., 2009) "Opening the black box: ...
Since starting over a hundred years ago social work has been occupied with the division into academic and practical knowledge. A common theme in scientific journals of social work is how this gap can be understood and resolved. The initial purpose of this article was to carry out a systematic review to find out if and how the gap could be bridged. Because few independent studies could be found, the study instead took the form of a scoping review with more included articles. The results show concrete suggestions as to how to bridge the gap, but also three discourses with dissimilar problem definitions and solutions. The emergence of proposals such as the evidence-based practice and its diverse combinations, the formation of new institutions, and today’s globalisation triggers this fragmentation. The consequences are vast confusions of opinions and explanations which illustrate competing knowledge positions. The authors propose that researchers and practitioners should orient themselves in this landscape when building bridges between academia and practice. Instead of taking the research–practice gap for granted, they suggest that social work should relate more closely to these three discourses.
... First, factors such as managerialism, professional standards, practice accountability, and market-based approaches affected the practice of social work supervision (Falender and Shafranske, 2007;Noble and Irwin, 2009;Tsui, 2004). Evidence-based practice was seen as paving the way for the growth of competency-based supervision (Manuel et al., 2009;Palinkas et al., 2009;Stern et al., 2008). Competency is a cluster of knowledge, skills, and abilities that an individual needs in order to become an effective supervisor. ...
This article draws on research studies and journal articles to examine the historical development of knowledge in social work supervision. The findings highlight the process and details involved in supervision. In addition, organizational culture, empirical studies, cumulative knowledge, and contextual environment are of critical importance to the formation. In the future, supervisory practice will need to take account of the balance of administrative and educational functions of supervision, to create more opportunities for professional autonomy, and the demands of implementing evidence-based supervisory practice.
... Within medical social work, research on challenges related to EBP implementation is limited (Wike et al. 2014) and EBP is still a relatively new concept in social care (Manuel et al. 2009). The few studies that have specifically focused on medical social workers' attitudes show a low orientation towards EBP (Björkenheim 2007;Heiwe et al. 2013). ...
... Hence, in practice, EBP is still infrequently implemented within the field (Bellamy et al. 2006;Mullen and Bacon 2006;Rubin and Parrish 2007;Heiwe et al. 2013), even though some guiding models have recently been developed (Fugl-Meyer 2016). Because social work is conducted in a multitude of settings, each setting needs to be carefully studied to guide the successful implementation of EBP (Manuel et al. 2009). Social work conducted in healthcare settings is unique in many ways because of the context, therefore it is important to explore social work practice in these settings. ...
... Therefore, the perceived time issue described in this study must be considered when incorporating EBP into daily clinical practice. Manuel et al. (2009) emphasized the need to consider the real-world clinical complexities (e.g., context and culture) when implementing EBP. One of their suggestions for successful EBP implementation in social work settings is to apply a multilevel approach that would include increased collaboration (through partnership) with different organizations. ...
The aim of this study was to explore medical social workers’ perceptions of evidencebased practice (EBP), including factors relevant for the successful implementation of evidence into medical social work practice. Eight focus group interviews were conducted that included 27 medical social workers. Data were analyzed using qualitative content analysis, which resulted in two categories: “knowledge in practice” and “challenges in relation to the implementation of EBP” and four subcategories: “practice based on research evidence or experience”, “obtaining new evidence of practice”, “research and the social work context”, and “barriers and facilitating factors”. Participants tended to perceive EBP as theoretical and positivistic while perceiving their own knowledge as eclectic and experience-based. Although they perceived the relevance of research findings to their clinical practice, they expressed a need for support to translate research into policy and practice. They also reported that studies about their specific work were scarce. The medical social workers’ suggestion for the facilitation of knowledge exchange needs further investigation.
... Despite the growing interest in EBP, little empirical research has been reported examining EBP implementation in social work practice settings (Austin & Claassen, 2008;Gray et al., 2013;Manuel, Mullen, Fang, Bellamy, & Bledsoe, 2009). Moreover, much of the research into EBP implementation in social work to date has focused solely on the perceptions of social workers on EBP (Gray et al., 2013;Plath, 2014). ...
Purpose: This case study explores the views and attitudes towards Evidence-Based Practice (EBP) of social workers and staff working in a social work organization in the Netherlands that recently committed to EBP.
Method: Qualitative data were gathered from semi-structured interviews with 10 staff members and 12 social workers.
Results: Confusion about the meaning of EBP was a major theme among both social workers and staff and EBP was conceptualized in several different ways. Some respondents perceived EBP as using interventions for which there is scientific evidence that it is effective, i.e. Research-Supported Treatments (RSTs), other’s used a broader conceptualization that, besides scientific evidence, also takes into account professional expertise and/or client circumstances (EBP process). A strong preference for the EBP process as opposed to RSTs was another major theme among both social workers and staff.
Conclusion: The results suggest that organizations preparing for EBP implementation will need to increase both staff’s and social workers’ understanding of EBP by providing a clear explanation of the difference between RSTs and the EBP process.
... Moreover, it is important to point out that EBP is but one approach to supporting informed decision-making (Manuel et al. 2009). Two other prominent approaches include empirical clinical practice (ECP) and empirically supported treatment (EST) (Thyer and Myers 2011). ...
