Connecting Science to Intervention: Advances, Challenges, and the Promise of Evidence-Based Practice

Abstract

The popularity of evidence-based practice (EBP) in social work is contributing to renewed interest in developing, testing, and selecting efficacious interventions for diverse client groups and problems. This activity affords a unique opportunity for social work practitioners, educators, and investigators to make significant strides in connecting science to social intervention. The integration of science and intervention is an important, yet elusive, goal in social work practice and research. ADVANCES IN CONNECTING SCIENCE AND PRACTICE Early Efforts Discussion of the connection between science and practice is not new. In an oft-cited paper dating to the early 20th century, Flexner (1915) grappled with the question of whether social work was a legitimate profession. He also noted the relatively weak integration between research and practice that characterized early social intervention. Social work pioneers such as Jane Addams (1911) suggested that systematic data collection and information processing were critical aspects of effective individual-level interventions and community practice strategies. The persistence of early advocates and subsequent interest in the growing number of empirically based treatments for mental health and other problems in the mid-20th century set the stage for later efforts to link research and practice. The effects of social work interventions on client outcomes became a focal point in the discussion of science and intervention during the 1970s. Several reviews of the treatment outcome literature in social work revealed few effective interventions for clients (Fischer, 1976, 1978). These findings, accompanied by similar results in criminal justice and other fields (for example, Martinson, 1974), called attention to the inadequate methodology used in outcome studies and, in general, highlighted the fragile link between science and practice. The disappointing results from treatment outcome reviews contributed to the endorsement of the scientist-practitioner model, a framework first adopted by psychology at a 1949 conference in Boulder, Colorado (Raimy, 1950). The scientist--practitioner framework encouraged social workers to rigorously evaluate the effects of intervention with clients by using research strategies associated with single-subject design (Barlow, Hayes, & Nelson, 1984; Jayaratne & Levy, 1979). In the 1980s most schools of social work offered or required graduate-level research courses in single-subject design. Many readers will likely recall their classroom or instructional experiences in the study and application of this methodology. The fact that nearly all social work graduate programs allocated instructional time to convey the scientist--practitioner model to students was a testament to the importance relegated to the framework. Unfortunately, the combined effects of past efforts to connect science and practice were largely unsuccessful. Evaluations of the scientist--practitioner model revealed that relatively few practitioners engaged in systematic practice evaluation (Kirk & Reid, 2002). Many practitioners suggested that the principles associated with single-subject design inhibited their ability to engage in effective and sensitive practice with clients. Investigators also found that most practitioners did not consider empirical evidence when selecting interventions for clients (Rosen, Proctor, Morrow-Howell, & Staudt, 1995). Recent Developments Proactive and concrete steps to integrate science and intervention in the past 20 years have produced greater advances in connecting science and practice. In 1988 the National Institute of Mental Health (NIMH) appointed the Task Force on Social Work Research to lead an investigation of the status of social work research. The task force examined virtually all aspects of social work research, including the productivity of social work faculty, the apparent lack of federally funded social work researchers, and the nature of advanced research training in social work doctoral programs (Task Force on Social Work Research, 1991). …