The idea of evidence-based practice in social care may sound relatively new but in fact it has a long history. Joseph Rowntree was writing about the need for rigor in assessing problems and designing solutions in the early nineteen hundreds, Mary Richmond in 1917 and Richard Cabot in 1933.

The first studies of the effectiveness of social work were undertaken in the 1930's in the United States. Since then there has been a steady build-up of results from well-conducted studies carried out in Britain and around the world. These have important messages for front line staff, managers and policy makers.

A good working definition of evidence-based social care is the following (freely adapted from 'Evidence-Based Medicine' by Sackett et al, 1996)

Evidence-based social care is the conscientious, explicit and judicious use of current best evidence in making decisions regarding the welfare of service-users and carers.

There are therefore, ethical, professional, and economic reasons for placing greater emphasis on the use of research in planning services; in sharing information with service users and carers, and in evaluating outcomes.

Types of research relevant to Evidence-Based Practice

If one accepts the view that work in the social services should be informed by current best evidence, the following kinds of research are relevant to this aim:

• Studies which compare patterns of service-provision and investigate which approaches appear to be most effective in reducing the effects of personal and social problems.
• Longitudinal studies [e.g. the National Child Development Study] which follow-up large samples of subjects, comparing groups which have and have not experienced particular life events and have or have not received particular interventions.
• Systematic, and narrative reviews which bring together scattered research findings. If interpreted with care these 'studies of studies' provide an excellent means by which busy staff can keep abreast of research trends and their implications.
• Qualitative studies based, for example, on interviews with service-users and carers which investigate patterns of satisfaction and dissatisfaction with different aspects of services.
• Studies of the nature, causes and development of social problems, e.g. what factors are responsible for children being brought into care? [A deceptively simple question.] What social pressures are associated with relapse in mental illness? What protective factors help slow loss of social skills in cases of dementia?
• Research from related disciplines is also valuable. The social care field has a dauntingly large remit and it is sensible therefore for practitioners and managers to draw on work from Psychology, Psychiatry, Sociology, Social Policy, and the Health Services field in general.

Organisational Implications of Evidence-Based Approaches

If evidence-based social service provision were to become a reality (rather than just a laudable aspiration) then we would expect to see the following changes in the way the social work profession organises itself and social workers go about their work:

• There would be in place a well-qualified workforce within which knowledge and experience are regularly up-dated by training courses which make regular reference to research both on the nature and development of social problems and on what is known at an empirical level about the effectiveness of different approaches designed to address them.
• There would be qualifying courses which, as a matter of priority, would address and review the literature on the effectiveness of services and equip students critically to appraise the results reported therein.
• The profession would nurture a system of staff supervision which regularly draws upon research to inform decisions made about cases and projects, and wherein questions such as 'so, why are we proceeding in this way?', and 'on what evidence?' would be seen as routine professional enquiries and not as a personal threat.
• Departmental meetings would regularly include references to research on what has been tried elsewhere, regionally, nationally and internationally, when services are being monitored or reviewed, or where departmental restructuring is in the offing, which it ubiquitously is, but often without benefit of supportive evidence for the changes envisaged and the value versus the costs involved.
• There would be a range of support facilities available to assist staff in their efforts to keep abreast of research relevant to their field, e.g. library facilities capable of delivering books and articles to enquirers, and able to distribute summaries of available evidence, with those in charge of them able to show that such services are regularly used.
• At an attitudinal level, there would be a workforce which takes some personal responsibility for acquainting itself with the empirical evidence on service-effectiveness, with a reasonably well-founded expectation of practical support from management for this necessary task.
• There would exist a range of collaborative arrangements between social services departments and local and regional universities and research institutes, so that each tangibly influences the work of the other, and within which each group of staff might unexceptionally be encountered on the corridors of the other pursuing common purposes.