Research:

What’s the Use? Brian Taylor

Professor of Social Work Ulster University

Social Care Workforce Research Unit, King’s College London, 14 Jan 2016

Los Angeles | London | New Delhi | Singapore | Washington DC

Brian Taylor Campbell Killick & Anne McGlade October 2015 £19.99 ISBN: 9781473908147

Understanding and Using Research in Social Work

Succinct focused and very well written with up to the minute insights on key issues. Excellent book.

-Mr Sean McEntee, Department of Social Work, Ulster University

Research - What’s the Use?: Outline

1. Drivers to use research 2. When & how to use research 3. Challenges in using research 4. Developing research use

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FIRST: A WORKING DEFINITION “Research” = Creating Generalisable Knowledge

• … gaining new insight into the operation of the natural world, needs, service operations, organisations…

• … developing a new theoretical conceptualisation or model of needs, change & helping processes…

• … testing a hypothesis about causes & effects, experimenting to measure effects of an intervention…

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1 Drivers to use research

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We need knowledge derived from research because: • Knowledge helps us to give the best

service to those who need it • Knowledge helps us to use scarce

public & charitable resources most effectively for those who need help

• Vulnerable people have a right not to be the ‘victims’ of untested & possibly harmful interventions, however well-intentioned

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IASSW: Global Standards for Social Work Education

“… knowledge and skills in the use of research methods, including ethical use of relevant research paradigms and critical appreciation of the use of research.” http://cdn.ifsw.org/assets/ifsw_65044-3.pdf p7

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Standards of care: Bolam test

“… not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art …” Mr. Justice McNair in Bolam-v-Friern Hospital

Management Committee 1957 2 All ER 118, [1957] 1 WLR 582

BUT ALSO ….. > 8

… now need a rationale:

• … professionals must be able to give a rationale such as research evidence or a theoretical basis for their views…

• Bolitho v City & Hackney Health Authority [1998] House of Lords AC232

• Increasingly important to use best evidence to inform practice 9

• Need “a fundamental step change in breadth, depth & quality of the UK research base in social work and social care”

• Economic & Social Research Council (2008) Strategic Adviser for Social Work and Social Care Research: Commissioning Brief, Swindon: ESRC BUT HOW?>

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2 When & how to use research

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Practice dilemmas E.g. As a social worker managing a

dementia service I have a small pot of money to spend. Do I buy: Hand massage service? Music therapy? Reminiscence materials? Reality orientation facilities?

What client benefits might I expect? 12

Programme management dilemmas E.g. I am a (social work) middle manager

responsible for recommending a parenting programme for implementation.

Which programme do I recommend? Laura Doyle [Action for Children SW] (2015) Preventing Family Breakdown: Interventions for preventing adolescents entering the public care system: Systematic narrative review (MSc dissertation project proposal). Ulster University

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The Evidence Informed Professional & Organisation: MSc dissertation proposals Ruth Kingston (Belfast HSC Trust, FCC team

leader) (2015) The Emotionally Intelligent parent: Do we need to consider this in our assessments?: Systematic narrative review

Carole Kirk (Northern HSC Trust, Social Work Training Team) (2015) Working with families where older people have experienced abuse: Systematic narrative review

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The Evidence Informed Professional & Organisation: MSc dissertation proposals Simon Darby (CLIC-Sargent SW at City Hospital

Belfast) (2015) Physical activity and the impact on late effects of teenager and young adult cancer survivors: Systematic narrative review

Elizabeth Tanner (Southern HSC Trust, Sensory Disability Team Manager) (2015) Interaction by health & social care professionals in the lives of individuals who are deaf-blind: Systematic narrative review

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Understanding & Using Research < What do you want to

know? What evidence would

answer the question? > What research designs

would best provide that evidence? >

How could this knowledge improve practice? >

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3 Challenges in using research

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Challenges in using research For individuals: What is research & how do I use this

knowledge to inform my practice? For organisations: How do we fulfil our responsibility to have

well-trained social workers? For the profession: How do we strengthen our credibility with the

public and other professions so as to deliver a more effective service to clients & families?

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What research knowledge?!?! “… There is an almost total lack of robust evidence available or given to social workers on what works in particular contexts. This weakness in analytics compromises both current … practice and the development of better approaches. …”

Kirkman, E. and Melrose, K. (2014) Clinical Judgement and Decision-Making in Children’s Social Work: An Analysis of the ‘Front Door’ System (Research Report DFE 323). London: The Behavioural Insights Team, Department for Education. [http://bit.ly/QTOkOZ]

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Fear of numbers

CARICATURE: I want to do a qualitative study because I feel more comfortable interviewing than analysing numbers; now the question that I want to study is to compare … [= measure = needs numbers!]

>> ESRC pilot to develop knowledge & skill in working with number in qualifying social work education

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Knowledge Building

Inductive research = exploring ideas that lead to an understanding or a model or theory Usually qualitative Builds on anomalies in deductive research

Theoretical reflection on ideas to create & connect concepts & models to be tested BY

Deductive research = testing ‘does it work’ by an experimental method Quantitative Builds on theory & inductive research

Richard Feynman, Nobel laureate in physics: ‘I spent a few years trying to invent

mathematical things that would permit me to solve the equations, but I didn’t get anywhere, and then I decided that in order to do that I must first understand more or less how the answer probably looks. … I had to get a qualitative idea of how the phenomenon works before I could get a good quantitative idea.” Feynman RP (1999) The Pleasure of Finding Things Out. Cambridge, MA: Helix (p18)

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Quantitative & Qualitative Paradigms Quantitative approaches emphasise

objectivity, rational argument and measurement to enable comparison

Qualitative approaches emphasise uniqueness of perceptions, social constructs, creating new conceptualisation

UUR APPROACH: Strength of method depends on type of research question

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Essential knowledge & skills for using research < Shaping an answerable, useful question Understanding types of questions & types

of research > Skills in identifying relevant research How do we appraise quality usefully? Synthesise & piece together knowledge jigsaw Apply knowledge to practice & decisions

An uncertain world! No panacea! 24

Major Research Designs *Survey = how prevalent is problem (condition) A = measuring difference between B and C = what correlation is there between D and E

*Qualitative = what are people’s real experiences of P = how to best conceptualise (model) Q

*(Quasi-)Experimental = does intervention X cause improvement Y

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Question IS NOT topic! E.G. stress amongst social workers How common is stress among SWs? = prevalence Q – survey

Does SW stress vary with age or client group? = correlation Q – survey

Conceptualising stress amongst SWs? = lived experience Q – qualitative

What interventions reduce stress among SWs? = effectiveness Q - (quasi-)experimental

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Eg HSC Trust case file survey 164 case files of total 215 open cases in 16+ teams Prevalence: 27% engaged in self-harming

Correlation of suicidal ideation with: male unemployed alcohol & drug misuse adverse childhood experiences higher number of placement moves older age entering care

Hamilton D, Taylor BJ & Killick C & Bickerstaff D (2015) Suicidal ideation and behaviour among young people leaving care: Case file survey. Child Care in Practice, 21(2), 160-176

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Eg Large scale survey DOES POVERTY CORRELATE WITH CHILD HOMICIDE? Relative poverty (4 measures) in 19 ‘Westernised’

democratic countries examined against rate of Child Homicide + 1/3rd Undefined causes of Death (to allow for suspicious cases) using WHO data

Child homicide did not correlate with relative poverty Overall child mortality did correlate significantly

with relative poverty [England and Wales 12th for child homicide rate;

Ireland 19th (1 = worst rate; 19th = best rate)] Pritchard C, Davey J & Williams R (2013) Who kill children? Re-examining

the evidence. British Journal of Social Work, 43, 1403-1438

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Eg Qualitative research to model

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Themes forming such as: ◦ A scale of physical needs does not equate to ‘need

for’ admission to care home ◦ Admission often arises in a crisis Eg person afraid to return home from hospital

◦ Fear of burglary and assault ◦ Fear of falling

Begin to form element of a model: ◦ Older person living along no longer has confidence

to continue doing so Taylor BJ & Donnelly M (2006) Professional perspectives on decision making about the long-term care of older people. British Journal of Social Work, 36(5), 807-826

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CRISIS Person living alone loses confidence

to continue

CRISIS Person living with a

family carer no longer able or willing

Health and social care staff assess risks and endeavour to maintain person at home if viable by raising confidence or meeting needs through improving informal supports or providing equipment or services

Recommend continuing to live at home

Recommend admission to institutional care

Older person with increasing needs

Eg Pre-post measure of outcomes

Time 1= on admission to day centre Time 2= Completion 16 week programme Perceived Stress Scale Schwartz Outcome Scale Gillespie D (2014) Service evaluation of the positive living programmes in day centres. Dissertation (MSc Professional Development in Social Work). Ulster University

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Eg Experiment for effectiveness Social work team leader of counselling team

set up following Omagh bombing 58 people with chronic post-traumatic stress

disorder resulting from traumas linked to terrorism & civil conflict 29 received immediate Cognitive

Behavioural Therapy (20 completed) 29 CBT after 12 week wait (25 completed)

Duffy M, Gillespie K & Clark DM (2007) Post-traumatic stress disorder in the context of terrorism and other civil conflict in Northern Ireland: randomised controlled trial. British Medical Journal, 334, 1147-50

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Building blocks for knowledge

Medical Research Council (2008) Developing and Evaluating Complex Interventions, London 33

1. Development Evidence & theory Model the process

2. Pilot feasibility Test procedures Test measures

3. Evaluation Measure Effect Understand

change process

4. Implement Disseminate Monitor

Prevalence of problem

4 Developing research use

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Where next for understanding & using research? Professional and public credibility Value knowledge to inform our helping Expect professional recognition as equals

We do not know it all & we can learn more Developing the profession: BOTH individual & organisational learning [Creating,] identifying, appraising,

synthesising, disseminating, implementing, applying knowledge

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Social Work Research & Continuous Improvement

Strategy (2015-2020)

http://www.hscboard.hscni.net/swresearch/ swresearchsistrategy@hscni.net

Employer responsibilities

1. Research culture 2. Infrastructure & capacity 3. Support knowledge & skills development 4. Opportunities for professionals to engage in research 5. Mechanisms for knowledge transfer 6. Partnership with universities, other professions etc. 7. Prioritizing research topics Health & Social Care Board (2014) Social Work Research and Continuous Improvement Strategy – In Pursuit of Excellence in Evidence-Informed Practice in Northern Ireland. HSCB: Belfast

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Culture + knowledge + skills + …

“… The aim is to build a research-minded organisational culture. This culture is one that recognises the important & necessary contribution that undertaking, understanding, critically appraising and applying evidence makes to improving outcomes for service users. This should be supported through a well-developed knowledge transfer process, making sense of what is best practice in services.”

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A profession embracing research?

“.. in the course of a lifetime career every social worker will undertake practice, and should also undertake some management or other leadership, do some teaching, engage in research in some way or other…” Séan Holland, Chief Social Work Officer (NI) at annual Ulster University meeting 2015 (subject to my memory errors!)

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Understanding & Using Research

We in social work need integrated initiatives to develop the culture, knowledge, skills, systems & infrastructure so as to understand and use research for the benefit of the clients and families whom we serve.

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Aims of the book:

1. Social workers as informed users of research

2. Social work as a research-minded profession

3. Employers of social workers recognising & acting on their responsibilities

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Los Angeles | London | New Delhi | Singapore | Washington DC

Brian Taylor, Campbell Killick & Anne McGlade October 2015 £19.99 ISBN: 9781473908147

Research: essential for the profession & possible to be

Understood & Used!

Succinct focused and very well written with up to the minute insights on key issues. Excellent book.

-Mr Sean McEntee, Department of Social Work, Ulster University