A CRITICALLY REFLECTIVE APPROACH TO EVIDENCE-BASED PRACTICE: A Sample of School Social Workers

A CRITICALLY REFLECTIVE APPROACH TO EVIDENCE-BASED PRACTICE: A Sample of SchoolSocial WorkersAuthor(s): Michelle BatesSource: Canadian Social Work Review / Revue canadienne de service social, Vol. 23, No. 1/2(2006), pp. 95-109Published by: Canadian Association for Social Work Education (CASWE)Stable URL: http://www.jstor.org/stable/41669847 .

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A CRITICALLY REFLECTIVE

APPROACH TO EVIDENCE-BASED

PRACTICE

A Sample of School Social Workers

Michelle Bates

Abstract: Evidence-based practice has emerged as a significant trend in social work generally and within the field of school social work specifically. Generally understood as the effort to direct practitioners to base their interventions upon formal research, evidence-based practice is said to promise benefits to both clients and practitioners. Yet, despite pressure to adopt evidence-based practices, social workers have tended not to do so. Barriers to the implementation of evidence-based practice have been explored in the literature, but the perspectives of front-line school social workers have largely been overlooked. A small, qualitative study of practising school social workers in southern Ontario reveals their experiences of the promises realized and the tensions experienced in using evidence-based practice. Contrary to the literature that suggests social workers choose between research findings and practice wisdom, often favouring the lat- ter, the findings demonstrate that practising school social workers use both. The study uncovers the creative ways in which school social workers adapt evidence- based practice, challenge the definition of evidence itself, and use evidence- based practice as a source of power for themselves and their clients.

Abrégé : La pratique fondée sur les faits est dorénavant une tendance importante du service social en général et du travail social dans les écoles en particulier. Généralement défini comme l'effort d'amener les praticiens à intervenir en se basant sur des études officielles, la pratique fondée sur les faits est jugée pro- metteuse tant pour la clientèle que pour les praticiens. Pourtant, malgré les pres- sions à cet effet, les travailleurs sociaux ont eu tendance à ne pas adopter de tel- les pratiques. Les obstacles à leur mise en œuvre ont été étudiés dans la littérature, mais en faisant généralement fi du point de vue des travailleurs sociaux de pre- mière ligne dans les écoles. Une petite étude qualitative des travailleurs sociaux des écoles du Sud de l'Ontario traite de leur expérience - attentes remplies et tensions éprouvées - de la pratique fondée sur les faits. Contrairement à ce que

Michelle Bates received an MSW from McMaster University in June 2006. Her article was judged the winner in the journal's 2006 Student Manuscript Competition.

Canadian Social Work Review, Volume 23, Number 1-2 (2006) / Revue canadienne de service social, volume 23, numéro 1-2 (2006) Printed in Canada / Imprimé au Canada

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96 Revue canadienne de service social, volume 23, numéro 1-2

laissent entendre les écrits, à savoir que les travailleurs sociaux choisissent entre les résultats de la recherche et la sagesse de l'expérience, optant souvent pour celle- ci, l'étude démontre que les travailleurs sociaux en exercice dans les écoles choisissent les deux. Elle révèle les moyens inventifs qu'ont trouvés les travailleurs sociaux dans les écoles pour adapter la pratique fondée sur les faits, contester la définition de « faits » même et utiliser cette pratique comme source de prise en mains pour eux-mêmes et pour leurs clients.

EviDENCE-based practice has emerged amidst a number of socio- political and economic forces. Questions about the credibility, effectiveness, and efficacy of social work have preoccupied the field during the empirical practice movement of the last 40 years (Fortune 8c Proctor, 2001; Zlotnik, Biegel & Solt, 2002). Beginning in the 1990s, public cyn- icism concerning the welfare state and "expert systems" led many to doubt the validity of social work interventions (Drover, 1998). The public's reluctance to accept social work's authority has forced social work, like many other professions, to adopt evidence-based practice as a new mechanism of trust (Webb, 2002). Government cutbacks and a demand from funding bodies for accountability and efficiency have also necessi- tated the adoption and implementation of evidence-based practice. While some authors assert that social work has always been concerned with its legitimacy and effectiveness, Gray and McDonald (2006) suggest that evidence-based practice in particular is tied to neo-liberalism. In this context, evidence-based practice ensures that social workers provide high-quality services effectively (Goldman, Ganju, Drake, Gorman, Hogan, Hyde & Morgan, 2001). Larner (2004) asserts that evidence- based practice reflects a model of corporate accountability that Parton (2003) warns is an "attempt to rationalize and scientize increasing areas of social work activity" (p. 2).

The promises of evidence-based practice are seductive. Its support- ers claim that clients will receive better services (Schuerman, Soydan, Macdonald, Forslund, de Hoya 8c Boruch, 2002; Zlotnick et al., 2002) and achieve greater equity with professionals (Gambrill, 2001). Social work practitioners will reportedly achieve increased professional confidence (Howard, McMillen & Pollio, 2003), improved professional status and credibility (Fortune & Proctor, 2001; Taylor 8c White, 2001), enhanced job security and greater ability to secure funding (Franklin, 1999), and pro- tection from lawsuits (Howard et al., 2003; Raines, 2004).

Despite an increasingly available literature concerning evidence- based practice, dissemination studies reveal that social work practitioners have been neither accessing nor implementing the available evidence (Howard et al., 2003; Kirk, 1999). Barriers to the implementation of evidence-based practice include social workers' doubts about the applicability of research findings to practice settings (Howard et. al., 2003; Rosen, Proctor 8c Staudt, 2003; Schoenwald & Hoagwood, 2001), questions about



Canadian Social Work Review, Volume 23, Number 1-2 97

practitioners' ability to read and interpret research findings (Franklin, 1999; Gibbs 8c Gambrill, 2002; Mullen, 2002), practitioners' scepticism about research specifically (Barwick, Boydell, Stasiulis, Ferguson, Blasé & Fixsen, 2005; Hemsley-Brown, 2004; Jackson, 1999; Rosen et al., 2003; Rubin, 2000), and their reluctance to change generally, practitioners' lack of time to review the literature (Gilgun, 2005; Gira, Kessler & Poert- ner, 2004; Mufson, Dorta, Olfson, Weissman & Hoagwood, 2004), and ideological debates about the nature of social work and its incompatibility with positivist research (Aarons, 2004; Barwick et al., 2005; Gilgun, 2005; Gray 8c McDonald, 2006; Rosen et al., 2003).

Surprisingly, the voices of front-line social work practitioners are vir- tually absent in this literature. At the focal point where evidence-based practices are literally either used or not, social work practitioners are ideally positioned to inform and illuminate the possibilities and tensions surrounding their implementation.

Methods

This research sought to discover and elucidate the opinions of front- line, practising school social workers and their experiences with evidence-based practice. Four school social workers were recruited through school social work departments and a committee of professional school social workers. All participants held MSW degrees and RSW designa- tions. Two of the social workers were employed by Catholic school boards and the other two by public school boards. All of the participants worked within urban school settings in cities that ranged in size from 200,000 to 500,000 people. One social worker worked within a fairly affluent and culturally homogeneous community, and the remaining three in schools that represented economically and culturally diverse communities. One participant was a manager, and the remaining three participants were front-line practitioners. Their job assignments ranged from responsi- bility for one school to sérving a group of schools. Participants' experience as school social workers ranged from two to 2 1 years, and their experience with evidence-based practice varied: two were very familiar with evidence-based practice, and the other two described themselves as having a beginning understanding of what it entailed. Their employ- ers' organizational embrace of evidence-based practice varied as well. One board was silent, two boards were in the early stages of investigat- ing evidence-based practice, and one board had wholly endorsed its use. Although the sample size was small, it did encompass a range of social work positions and perspectives, and findings thus offer important ini- tial insight into school social workers' opinions of and experiences with evidence-based practice.

Face-to-face interviews lasting one to one-and-a-half hours, utiliz- ing a semi-structured interview guide, allowed participants to describe in




detail their thoughts about and experiences with evidence-based practice. All participants agreed to have their interviews taped and tran- scribed. A process of qualitative data analysis, based upon the grounded theory method, as oudined by Connolly (2003), was used. In the first level of analysis, coded meanings were identified through key words and phrases. Themes were then organized into conceptual categories. Con- cepts were identified that helped to explain the meaning of the data, out- lined the implications, linked research, or refined ideas and that were located and shared within all four interviews.

At the outset, it was aitficipated that themes would include a rejec- tion of the ideological basis upon which evidence-based practice is situ- ated and the difficulties of implementing scientific research. Instead, the analysis drew forward the benefits practitioners gained by using evidence-based practices and the tensions they experienced. It also high- lighted how participants were adapting the definition of evidence and the implementation of evidence-based practices, as well as using these practices and the inherent discourse to negotiate and claim power.

Benefits of using evidence-based practice as prescribed All of the social workers interviewed understood evidence-based practice to mean a way of practising that entailed adhering to specific techniques determined to be "effective" based upon formal research. Several benefits emerged from the participants' experiences of using evidence-based practice "as prescribed."

Every participant identified how evidence-based practices usefully informed and guided their activities with individual clients. These activities included the issues or problems that social workers explored, the questions subsequendy formulated and asked, and the interventions chosen. For example, one participant noted that, based upon research evidence of the relationship between a student's mood and school atten- dance, she asks parents and students about mood, and, if concerns are uncovered, recommends a mental health assessment by a physician.

Evidence-based practices were also used to guide the selection of group models and various protocols, as noted by two of the social workers. One participant described the lengthy process of reviewing the literature for group interventions for depressed teens. The group model was chosen based upon the strength of the evidence provided in the literature.

All participants indicated that using evidence-based practices provided them with a sense of certainty about their own practice. While acknowledging that practice involves intuition, participants appreciated the confidence provided by the evidence-based literature. Glisson (2002), discussing organizational issues, describes social service agencies' tech- nologies as "soft" because there is often no clear way of determining the




correct intervention. He identifies the temptation and push for certainty in these circumstances. Evidence-based practice, with its emphasis on certainty, may be understood as a method of decreasing the ambiguity inherent in social work practice situations.

Three of the four participants specifically stated their desire to know that what they did made a difference to clients. Using evidence-based practice was perceived as a means of ensuring that the interventions they were providing were effective. Witkin and Harrison (2001) suggest that evidence-based practice can provide answers to the demands of our "tell me what works" society. Taylor and White (2001) suggest that evidence-based practice can provide reassurance to the profession of the effectiveness of social work.

Enhanced professional credibility is one of the alluring promises made by the evidence-based practice movement (Gray & McDonald, 2006; Witkin & Harrison, 2001). All participants indicated that using evidence-based practice improved their professional credibility. One participant said, "If I'm a professional, then I would want to make sure that I have the evidence behind what I'm saying," Another participant sug- gested, "I think if I just kind of went by the gut, Fm not sure I would have the same kind of professional credibility." The other two social workers believed that using evidence-based practices would improve the profile of their department within the school board and would also create a higher profile and better public persona for all social workers.

Tensions arising from the use of evidence-based practices as prescribed

Despite these compelling benefits, participants in this study also revealed significant tensions arising from the use of evidence-based practices "as prescribed."

Rigidity versus flexibility Every participant was committed to ensuring that practice interventions fit the client. Valuing the need to be flexible with each client and respect- ful of her or his unique situation and individuality meant that these school social workers sometimes struggled with adhering to prescribed evidence-based interventions. One social worker observed, "If I treated every grade nine student the same, or all grade ten students the same, it just wouldn't work. Then it really wouldn't work." Another social worker observed, "That would be my caution for clients, right, is that we don't try to fit them for our programs, that we're willing to adapt our program to the needs."

Three of the four participants were also cognizant of the fit, or lack of fit, of evidence-based practices with their organizations or settings. "I mean, there might be things that I can't do, I can't operationalize,"




noted one participant. Yet another social worker shared, "So much of the research, and the stuff we do is around clinical issues, but we're not a clinical setting." Some authors note how treatments taken from a manual might not adapt well to individual client circumstances or different practice settings (Edwards, Dattilio & Bromley, 2004; Larner, 2004). Pentz (2004) makes note of the "reinvention" or "unplanned adaptation" of evidence-based practice to the real world setting. From some perspectives, these adaptations represent problems with the dissemination of evidence-based practice; from the perspective of social workers in this study, however, such adaptations may be valid and necessary.

Formal knowledge versus practice knowledge The distinction between formal knowledge and practice knowledge and the tensions that arise from balancing these two different kinds of knowl- edges were articulated by every participant. All of the social workers described how their practice knowledge, and that of their colleagues, guided their decision-making. The perception that formal knowledge is ascribed a higher value was revealed by one social worker, who noted somewhat sarcastically how nice it was when the literature substantiated what her experiences told her. Despite the benefits they identified of using formal knowledge derived from evidence-based practice, these participants continued to believe in the value of their practice knowledge. The tension between formal knowledge and practice knowledge is reflected in this social worker's comment: "I would hate to become so sin- gle-minded that I'm sitting in a meeting saying, well, based on the evidence that... / So I use both [practice and formal knowledge], and I'm not apologetic that I use both."

Sheppard, Newstead, DiCaccavo and Ryan (2000) make the distinction between practice knowledge and product knowledge. Within the paradigm of evidence-based practice, formal research, as a form of product knowledge, is elevated above practice knowledge. Gabbay, le May, Jef- ferson, Webb, Lovelock, Powell and Lathlean (2003), in their case study, note how participants strongly valued their experiential or practice knowledge and sometimes devalued the research literature. The social workers in the present study support Plath's (2006) observation: "social workers juggle the contradictions of positivist and interpretive para- digms and draw on both in daily practice" (p. 67). Not only did all of the participants in this study use both kinds of knowledge; they resound- ingly claimed the value of their practice knowledge.

Results versus improvement and change Evidence-based practice tends to focus upon the achievement of specific results, most frequently, in school social work, a reduction in mental health symptoms. All of the participants in this study expressed a




personal and organizational pressure to know that their interventions created positive change for their clients. What "counted" as relevant change, however, was a significant tension. Three of the four participants were steadfast in their acceptance of their clients' definitions of improvement and change, rather than relying on pre-determined outcomes. As one worker noted, "There's a lot more to it, and a lot more ways of trying to pull out whether you've made improvements."

This perspective is in keeping with critiques of evidence-based practice. Messer (2004) argues that, beyond reductions in particular symptoms, it is equally important to consider other treatment goals such as "attain- ment of insight, a sense of agency, a firmer identity, higher self-esteem, etc." (p. 582). Witkin and Harrison (2001) suggest that "medically pre- cise definitions of Outcomes' may be hard to reconcile with social workers' espoused views of taking into account all relevant aspects of a social situation" (p. 293). Plath (2006) notes that, given their concern with issues of social justice and well-being, social workers would find the concept of effectiveness more difficult to define.

Method/technique versus relationship Every participant noted that the relationship with the client was more important than the particular technique used. As one social worker stated, if "I wasn't using my good social work skills to deliver that information... then that evidence is not going to be very helpful." This state- ment underscores the belief that only in the context of a meaningful relationship with clients could evidence-based practices be shared and used meaningfully.

Within the literature there is an active debate as to whether positive change emerges from the relationship between practitioner and client, or is the result of the particular methods and techniques that practitioners use. Much of the evidence-based literature reports on the efficacy of particular approaches and techniques and supports the concept of a prescribed way of practising. Edwards et al. (2004) suggest that practitioners are resistant to the idea of research directing how to practise because the therapeutic alliance is often minimized - an argument supported by every participant in this study. However, Wampold and Bhati (2004) note that "there is compelling evidence that it makes more sense to think of elements of the relationship as being empirically supported rather than particular treatments" (p. 567).

Adapting evidence and evidence-based practice Social work practitioners in this research clearly articulated both the benefits and the tensions arising from their adoption of evidence-based practices. The study also uncovered the creative ways in which practising school social workers were adapting the definition of evidence and




evidence-based practices. Power relations surrounding evidence-based practice and the ways in which it is negotiated within certain contexts and claimed by social workers within their own practice were revealed.

Adaptations to local context

Placing an emphasis on fidelity and integrity, much of the evidence- based practice literature views it as problematic when front-line practitioners alter evidence-based practices (Mufson et al., 2004; Schoen- wald & Hoagwood, 2001). Contrary to the literature, every one of these practitioners saw adaptations to the local context as not only a necessity, but also an asset. As one worker commented, "I think that my model of intervention might stay fairly constant, but that I would be flexible within that model." Another social worker noted, "So we took bits of an evidence-based approach, [and] created our own."

Redefining evidence Numerous definitions of evidence-based practice can be found in the literature, most of which reflect a dependency upon knowledge derived from formal research. Gilgun (2005), however, advocates a broader definition of evidence: "evidence derived from sources external to individual clients, as well as evidence that emerges from interactions with clients, are relevant to social work practice" (p. 58). All of the participants in this study would agree. One social worker reflected, "When I first heard of it [evidence-based practice] I always thought that it was much more sci- entifically based... now I think evidence is just the situation at hand." Another social worker noted, "You might say, in my experience this has been helpful. Well, there's your own bit of research evidence, your own evidence-based practice that you have developed." The process of broad- ening and redefining evidence through the inclusion of different kinds of information, accessible to all practitioners, results in a demystifying of "evidence" as it is constructed within the dominant discourse of evidence-based practice.

Evidence and evidence-based practice as power The various social, economic, and political contexts that have given rise to the emergence of evidence-based practices have created a powerful paradigm, a political economy of evidence-based practice. Inter- estingly, all research participants talked about their different uses of evidence and evidence-based practice within different contexts. In this way, social workers are negotiating power through their definition of evidence and through their strategic use of both evidence-based practice and its language.

When participants talked about their use of evidence-based practices, they made it obvious how they were using them, and the definition




of evidence, very differently with different audiences. One participant said,

When I'm often relying on the research, the evidence, the lit and stuff. . .it's at this level, the managerial role where I'm fighting for a program, fighting for a resource to run a program. Advocating for that kind of intervention. Often when I'm saying things like, "in my experience, in my gut," it's when I'm involved in casework. So times I'm relying on the "lit" is when I'm looking for support at the Board level.

In other words, her definition of evidence held different currency depend- ing on her audience. Within organizational structures that are determining funding and service levels, formal knowledge is seen as more reliable and valid; therefore, the language of evidence-based practice is used to provide proof or support of the request for continued or additional service.

Participants also used the language of evidence-based practice with other service colleagues. Within this context, however, evidence-based practice represents the voice of authority or legitimacy, a premise supported by Plath (2006). One worker explained, "I mean, I like to be able to pull that when I'm in a meeting... I like to talk a little bit about how home instruction is often contraindicated in the literature because of blah, blah, blah and so it gives me some credibility." Another social worker noted how, when providing recommendations to staff, she has said, "I have some research to support what I'm saying." Alternatively, in the company of clients, social workers found the language of practice knowledge to be seen as reliable and valid, and used it within that context. As one worker said, "It's not like I'm going to say in a case conference, well, I can tell you 26 out of 30 times this works.' It's not like I pull the research out there."

Adopting evidence-based practices was also perceived by every participant as powerful rationale for justifying social work services. Like numerous authors (Carr, 2002; Howard et al., 2003; Plath, 2006; Pollio, 2002), participants were keenly aware of the correlation between evidence-based practice and funding for continued or additional services. One social worker was very blunt in her observation: "You can't do much these days without some evidence-based language or process." Another social worker said, "I think it always comes down to if you want to access funding, that a lot of that tends to be, is said to be, based on evidence- based practice."

In agreement with Zlotnik et al. (2002) and Fortune and Proktor (2001), all participants noted how the language of evidence-based practice was used to provide proof of the value of social work services. Because school social work is offered within a secondary setting, participants were acutely aware of the need to prove the value of their service and how it




supports the goals of the school board to retain students in school and to improve their academic achievement.

Discussion and implications These findings are important for individual social workers, for the broader field of social work, and for the current discourse of evidence- based practice. Appreciating school social workers' opinions and experiences with evidence-based practice leads to a greater understanding of the implications of this phenomenon for front-line practitioners, while revealing opportunities to challenge and redefine evidence-based practice. Rather than simplistically accepting or rejecting evidence-based practice, these school social workers are engaging in a critically reflective approach.

Contrary to the findings in much of the literature, social workers in this research study in fact supported and were taking up evidence-based practices. In many instances, they described benefiting from evidence- based practice as it informed their practice activities, provided feelings of certainty in implementing techniques, clearly delineated what worked and was effective, and enhanced their personal and collective professional credibility. That they found these promises of evidence-based practice to be actualized reflects the socio-political and economic pressures social work practitioners encounter to provide definable, effective, and accountable services. Evidence-based practice, with its emphasis on science, offers a sense of certainty about social work interventions because modernism "confers a sense of truth about that (scientific) knowledge" (Pärton, 2003, p. 7). However, by lessening reliance on professional judgment, evidence-based practice promotes a technical-rational approach whereby "social work becomes the application of rigorous research-based knowledge to practice" and threatens to erode what makes the profession of social work unique (Parton, 2003, p. 2).

Much of the mainstream evidence-based practice literature suggests that social workers have been ambivalent or reluctant to adopt evidence- based practices due to limitations in skills, time, and resources or due to their beliefs and attitudes. This study, however, in keeping with important critiques of evidence-based practice, confirms that social workers identify important tensions between the dominant discourse of evidence- based practice and social work practice values.

A key tension for social workers centred on the value placed upon formal knowledge and practice knowledge. In the literature, this tension is reflected in the epistemological debate concerning the definition of evidence and the over-reliance on positivist research as the primary source of knowledge. For the practising social workers interviewed in this study, the problem with the current discourse of evidence-based practice is that it reduces understanding of the complexity of human experience in the




real world, ignores the realities of practice settings, and negates the practice knowledge of social workers.

School social workers in this study indicated that they considered knowledge from their clients, colleagues, and their own practice to be evidence. By proclaiming their practice knowledge as valuable, social workers resisted the notion of a hierarchy wherein research knowledge is viewed as superior. Instead, these participants rejected the method- ological fundamentalism proposed by evidence-based practice (Staller, 2006) and have created opportunities to broaden the concept of evidence. Their attitude supports Plath (2006), who suggests, "reduction- ist approaches to evidence-based practice are less likely to yield useful guidance for social workers than a broad view of evidence for practice" (p. 64). Gould (2006) asserts that reliance on formal knowledge mar- ginalizes some perspectives and "distances practitioners from important sources of knowledge that are available" (p. 113). Parton (2003) believes that the " tacit and implicit

" knowledge of social work practition-

ers, which is grounded in and arises from practice situations, is the most appropriate form of knowing for the inherently ambiguous and uncer- tain situations with which clients and practitioners engage (p. 2). Plath (2006) cautions, "the future for evidence-based practice in social work lies in the resolution of conceptual tensions surrounding notions of 'evidence'" (p. 67).

Participants in this study noted the importance of adapting evidence- based practices to individual clients and to their particular practice settings. Although much of the evidence-based literature is critical of this kind of adaptation, these workers valued this approach as a way of sup- porting and respecting the individuality of their clients. Mufson et al. (2004) notes the absence in the literature of the adaptations required to integrate evidence-based practices into the field. In addition to challenging the suggestion that social workers are sceptical about research (Barwick et al., 2005; Hemsley-Brown, 2004; Jackson, 1999), this study also validates practitioners' perceptions about the limited applicability of empirical research (based on RCTs) to practice settings and the limitations of applying population-based studies to their individual clients (Staller, 2006). This study indicates that social workers' skills in assessing, implementing, and adapting evidence-based practices to their practice settings ought to be viewed as a unique and valued skill set. Additionally, more research based within practice settings needs to be undertaken.

While evidence-based practice has the potential to shape the practice of social work dramatically, these social workers revealed how they in fact used the current discourse of evidence-based practice to support their vision of social work practice. They used the language and per- suasive discourse of evidence-based practice with management and funding bodies to provide accountability for services provided, proof of the value of social work services, and rationales for continued or increased



106 Revue canadienne de service social, volume 23 , numéro 1-2

service levels. With colleagues, using the language of evidence-based practice provided the practitioner with the voice of authority and legitimacy. By using evidence-based practice in this manner, these practising social workers revealed how they negotiate power through their definition of evidence and through their subsequent strategic and creative use of both evidence-based practice and its language.

The debate about whether or not the practice of social work is a scientific or artistic endeavour, and the divide between research and practice, is longstanding. Critics have worried that evidence-based practice threatens to tip the scales in favour of science with the illusion of an objective, predictable practice world (Parton, 2000), devaluing and sup- pressing professional judgment (Staller, 2006) and reducing the caring associated with humanist, moral, and client-centred practice (Parton, 2000, 2003): all elements that define social work practice and make it unique. Despite tremendous internal and external pressures to adopt the technical-rational approach consistent with evidence-based practice, these practitioners have consciously held onto the humanist and artistic components of social work practice and were unapologetic in their endorsement of them. This study demonstrates how practising school social workers adeptly integrate both research and practice knowledge. As Johnsson and Svensson (2005) note, "in the interaction between these components social work knowledge is developed" (p. 426).

The literature has positioned social workers as either unskilled or resistant to evidence-based practices, and this study challenges that asser- tion. These social workers have not been passive in accepting evidence- based practice, nor have they been resistant. Instead, these practitioners have thoughtfully engaged in a critical analysis of evidence-based practice consistent with social constructionism. Johnsson and Svensson (2005) suggest that reflective practice "offers a rigorous way of thinking, without the stringency of evidence-based social work" (p. 425). Plath (2006) indicates that, when practitioners "value evidence gained from experience and understanding of contextual factors, as well as research evidence," they are more aligned "with the ethics, values and traditions of social work" (p. 70). Gray and McDonald (2006) believe that a critically reflective approach represents a "potential alternative to the imperative posed by evidence-based practice" (p. 16). Parton and O'Byrne's constructive social work offers an important alternative to evidence-based practice. Grounded in the theory of social constructionism, constructive social work "emphasizes: process; plurality of both knowledge and voice; possibility; and the relational quality of knowledge" (Pärton, 2003, p. 13), a practice perspective that the social workers in this study embody.

These school social workers have taken up and implemented what is beneficial about evidence-based practices, identified and resisted what is problematic, and creatively adapted them for the benefit of themselves and their clients. They provide an inside look into the enactment of a crit-




ically reflective approach to evidence-based practice. Parton (2003) defines "generative discourses" as "ways of talking and writing... that simultaneously challenge existing traditions of understanding and at the same time offer new possibilities for action and change" (p. 9). These practising school social workers have demonstrated a generative discourse by effectively adopting evidence-based practices without subju- gating practice knowledge and humanistic care and by using the power inherent in the dominant discourse of evidence-based practice while challenging it to be both broader and more inclusive.

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Documents

A CRITICALLY REFLECTIVE APPROACH TO EVIDENCE-BASED PRACTICE: A Sample of School Social Workers