questions to scientific inquiry.
It Makes Sense to Me
Much of what we come to believe is supported by our own logical examination of the information we encounter in our daily lives. We ask ourselves if it makes sense to us. If we believe that homework was helpful to our learning in high school, then maybe we will believe that it makes sense for our clients to have homework between therapy sessions.
Sometimes we are convinced of a certain practice in social work because we were convinced of the logic of a service activity by someone. Perhaps it makes sense that we should involve the parents in the treatment of children because (a) we can learn more about the causes of the child’s behavior, (b) we can convey some knowledge to the parents that will help them improve the behavior of the child, and (c) the parents must be involved in the improvement of the child’s behavior for the service activities to work.
This basis for forming opinions is not founded on science, although any of them could be subjected to scientific inquiry. Instead, they are based on a particular logic that we embrace. But what if this logic is flawed? For many years, it was popularly believed in psychology that schizophrenia was caused by a form of parenting where the father was distant and the mother was controlling. This was the dominant belief among psychologists for a period of time, even though this theory was not supported by science. Finally, there were enough scientific studies to disclaim this idea and conclude that the brain of the schizophrenic is different. In other words, schizophrenics are the way they are because of genetics, not parenting.
Many new programs or services are sold on the basis that their practices make sense as a treatment for a given condition. But they do not become listed as evidence-based practices until they have been subjected to a sufficient amount of scientific studies. An example of a service that proved to make things worse was a program called Scared Straight. The idea of this program was that if at-risk youth were required to visit a prison where prisoners would tell them how bad prison life was, they would be scared enough to avoid a life of crime. This made a lot of sense to a lot of people, some of them important enough to ensure a good deal of funding for this program for a period of time before it was subjected to scientific study.
As you will see in a later part of this chapter, the evidence on the outcomes from this program suggested that at-risk youth who encountered this program were more likely to engage in criminal behavior than those who did not. So it was worse than being ineffective; it was making things worse.
It Is the Way We Have Done It
Social workers take jobs in agencies where they are taught how to deliver certain services. Their orientation program will include the collected opinions of staff and supervisors about how best to implement the service. Often social workers do not question these practices, nor do they subject them to scientific inquiry.
Should you, as a social worker, engage in practices that have been found to be effective and not to harm clients? Of course, you should! In fact, it is a requirement set forth in the Code of Ethics of the National Association of Social Workers (NASW). At a minimum, you should review the literature with regard to service practices for this purpose.
Several decades ago, there were far fewer publications revealing evidence about social work practices. With the enormous number of such studies today, there is no excuse for a social worker to ignore all this evidence. And if there is little evidence, it seems that you would have an ethical obligation to engage in the scientific study of your practices. You will learn how to do this in this book.
It Is Evidence-Based Practice
For a practice to be evidence based, it must have been subjected to various studies that revealed that it was effective with regard to a given outcome. For example, cognitive–behavioral therapy has been subjected to many studies that revealed it was effective in the treatment of depression.
Many human service agencies advertise that their services are evidence based. The social worker in these agencies should inquire into the basis for this statement. Can it be found on a legitimate list of evidence-based practices (some may refer to this as empirically supported practices)? Is there a list of publications that provide the evidence?
There is a chapter in this book that deals with this theme. For now, let’s be aware of what it means to have evidence as support for a service decision. It means that the evidence in support of this practice is greater than the evidence not in support of it, to lead a reasonable social worker to conclude that it is evidence based.
Avoiding Errors in Decision Making
There are several common errors in decision making when we avoid the spirit of scientific inquiry and the methods that support it. Among these errors to be discussed here are (a) incomplete information, (b) illogical reasoning, and (c) personal investment. Sometimes we make decisions without all the information we need. At other times we fall into the trap of a common method of illogical reasoning (i.e., a rationale that is not logical). Finally, we sometimes come to an opinion based on what will satisfy our ego investment in a situation (e.g., what will make us look better or gain more power).
Incomplete Information
A popular form of incomplete information is the cherry-picking of information to prove a point. This refers to the search behavior of only reporting the facts that support a given position and intentionally suppressing known facts that refute it.
Suppose you reviewed 12 studies on the effectiveness of a given form of therapy in the reduction of postpartum depression and found that only 2 studies show effectiveness but the other 10 fail to show that clients were better off because of this form of therapy. Which one of these are you most likely to report to others?
1 Would you report only on the two studies that showed effectiveness and declare this form of therapy to be an evidence-based therapy for the treatment of postpartum depression?
2 Would you report on all studies and conclude that the evidence, taken as a whole, fails to support the classification of this form of therapy as evidence based in the treatment of postpartum depression?
3 Would you report on all studies and conclude that this shows that this form of therapy is evidence based in the treatment of postpartum depression?
4 Would you report only on the 10 studies that failed to reveal success and conclude there is no evidence that supports this form of therapy for postpartum depression?
The social worker, as a social scientist, would select Option 2 above. There were far more studies with negative findings than positive ones. Unfortunately, some social workers, not embracing the spirit of scientific inquiry, would select Option 1, especially if the social worker has a personal investment in this form of therapy. Perhaps this is a form of therapy this social worker has been suggesting, and this revelation will be embarrassing.
Personal Investment
The personal investment in a given outcome was illustrated in the previous sentence. If you have been advocating for a certain action, you do not want to find evidence that suggests that it is a bad idea. If a certain kind of evidence has the potential to lead to the loss of your job, you will not want to embrace it.
A good issue to understand with someone is whether the information would normally be good news to that person or the kind that would not. In other words,
