Een Program Theory benadering voor het theoretisch onderbouwen van sociale interventies: een casestudie van vijf Nederlandse maatjesprojecten

Abstract

Een Program Theory benadering voor het theoretisch onderbouwen van sociale interventies: een casestudie van vijf Nederlandse maatjesprojecten Sociale professionals worden steeds meer gevraagd het professioneel handelen te verantwoorden. De sociale sector weet zich echter slechts marginaal te verantwoorden en te profileren als kenniseigenaar op het eigen domein. Het aantal sociale interventies dat theoretisch dan wel wetenschappelijk onderbouwd is, is beperkt. In de literatuur zijn verschillende benaderingen te onderscheiden die een antwoord beogen te geven op de vraag hoe en op basis waarvan een sociale interventie verantwoord dient te worden. In dit artikel geven we een methodebeschrijving van de “Program Theory” benadering en reflecteren we aan de hand van een casestudie op de praktische en wetenschappelijke meerwaarde van deze methode voor het theoretisch onderbouwen van sociale interventies. We argumenteren dat een Program Theory benadering vanuit de uitgangspunten van het kritisch realisme een waardevolle aanvulling biedt op de “evidence-based practice” benadering, die vooral inzicht geeft in de effecten van een interventie. Een Program Theory aanpak levert daarnaast een verklarende theorie over de effectiviteit van de interventie en neemt de werking van de praktijkcontext hierin mee door een interventietheorie “bottom-up” te ontwikkelen vanuit de praktijk en deze theorie tevens te onderbouwen met wetenschappelijke evidentie. Deze benadering biedt daarmee een collaboratieve leeromgeving voor professionals en onderzoekers, door de werking van mechanismen binnen een praktijkcontext te onderzoeken en te expliciteren. Doordat sociale professionals eigenaarschap blijven houden over hun eigen interventietheorie draagt de benadering bovendien bij aan de professionalisering en versterking van de kennisbasis van het sociaal werk.  Theorizing social interventions using a Program Theory approach: a case study of five Dutch buddy programmes Trust in the effectiveness of social work practice is rather limited. As a consequence, social workers are increasingly urged by policymakers and other societal stakeholders to justify their practices and interventions and to demonstrate their effectiveness. At the same time, the profession itself is calling for stronger knowledge-based practice. However, social workers justify their practices primarily by describing what they do (the “theory of action”) rather than referring to the theoretical assumptions or their effects (the “theory of change”). In other words, social workers marginally refer to the underlying theoretical mechanisms that explain why specific actions lead to specific consequences. Social interventions are usually accounted for by social workers based on intuitive, practice-based knowledge, and considerably less on the basis of scientific evidence and theoretical knowledge. Thus, social work needs a knowledge base that critically examines the underlying assumptions of the intervention and the impact of the social-political context. In addition, the breakthrough of New Public Management in the 1990s led to an increase in accountability processes in social work, with social workers increasingly steered and controlled by procedures, guidelines, regulations and strategic interests of the government. Work processes are monitored, measured and standardized. However, in practice, the effectiveness of interventions is considerably influenced by relational, contextual and normative factors. Different stakeholders have different perspectives on what effective social work is, and which information justifies and accounts for effective practices. In the literature, there is also an extensive debate about the methodological approach to theorizing social interventions and, more generally, to developing the knowledge base of social work. In the Netherlands, advocates of Evidence-Based Practice (EBP) dominate this debate. The increasing number of evidence-based social interventions in professional databases, such as the National Youth Institute and the Netherlands Centre for Social Development, demonstrate the influence of the EBP movement. However, it is questionable whether this approach leads to a better understanding of how and why social interventions work in practice, and whether it contributes to a more solid knowledge base for social work practice. Advocates of Critical Realism argue that the effectiveness of complex interventions is intertwined with the historically developed local context in which the intervention takes place, human agency (i.e. social interventions are developed, executed and pursued by people with their own motivations, identity, values, skills and goals) and social interactions between people and social systems. They contest the idea that this context and human factors can be comprehended by experimental research design. In this paper, we argue that a Program Theory approach, based on the principles of Critical Realism, is a valuable alternative to Evidence-Based Practice based on the golden standard approach. Research demonstrates that the Program Theory method can be used to develop and theorize complex interventions. A Program Theory delivers a narrative description of the intervention by describing the working method, context and the effects of an intervention and theorizing this description based on a combination of practical wisdom and scientific knowledge. Through a case study of five Dutch buddy programmes we demonstrate how a Program Theory approach can be used to theorize social interventions. A multi-method approach was used, combining a qualitative questionnaire, 10 focus group meetings with practitioners and volunteers and a scientific literature review. The practitioners struggled to define the effects of their interventions and the underlying mechanism which produced these effects. The researcher helped them to make connections between the theory of action and the theory of change by asking in-depth questions about their practices. A literature review was conducted to gather scientific knowledge on the effects and mechanisms of buddy programmes. The researcher translated this scientific knowledge into a practical guidebook, which the researcher and practitioners used to reflect on, theorize and improve the intervention theories developed. The case study shows that the approach offers a collaborative learning environment for social workers and researchers. The method provides social workers with a structure that allows them to critically reflect on the underlying logic of the intervention and its most important building blocks. This structure and the collaborative reflective process helped the social workers to write up an in-depth narrative description of their intervention logic, and to test and justify their theory based on insights and results from scientific research. In summary, the Program Theory approach helped the social work professionals to describe, theorize and evaluate social interventions by structuring their thoughts and actions and reinforcing their critical reflection. The collaborative approach enabled the professionals to remain the owners of their practice theory, and offered the researcher valuable insights into how the intervention worked and the influence of the context on the effectiveness of the intervention. Thereby, it offered insight into how social workers theorize their interventions in practice, the knowledge they use to justify their intervention theory, and the instruments that are helpful in this process. The researcher offered the social workers access to scientific research, and helped them to translate the findings of this research to their own practice setting, while the literature review contributed to a more sophisticated insight into the boundary conditions of an effective intervention by articulating the mechanisms of effective buddy programmes. In this way, social professionals were able to use scientific knowledge to theorize their interventions and to combine this with their own views and practical knowledge. The bottom-up process, the critical questions of the researcher and the insights from the literature review contributed to a more sophisticated insight into how and why the intervention worked in that specific practice setting. Furthermore, it offered an insight into the mechanisms that influence the effectiveness of an intervention and led to a more realistic view on what a buddy programme can and cannot achieve. Ultimately, this narrative and reflective process helped the social workers account for the effectiveness of their intervention. However, more research is needed to investigate whether and to what extent a Program Theory approach convinces policymakers to finance such interventions.