The mismatch between the map and the terrain—evidence-based social work in Sweden

Abstract

In this article we will give an account of the introduction of evidence-based practice (EBP) in Swedish social work. The Swedish development may serve as an example of what happens when the process is driven by bureaucracy with a strong public funding/back-up rather than by the academy. This is not to say that the Swedish case is unique, but rather that problems and controversies that are well established on the international arena are in Sweden framed in a very particular context. The most far reaching efforts to implement EBP in Swedish social work have been carried out by central bureaucracy. The introduction of EBP may be depicted as a top-down guideline project, with randomized controlled trials as the gold standard. Shortage of evidence paired with political pressure to implement EBP has to a certain extent also brought about dissolution of the basic concept. The article concludes with an elaborated assessment of how current conceptions of EBP relates to professional and contextual conditions of Swedish social work practice. We also address the issue of how to establish what adequate and valid evidence is by suggesting an approach that deviates from predominant evidence hierarchies and polarized extremes.