As a newly qualified social worker in Australia, I was expected to be up-to-date with all the latest research right from the word go. When I returned home to the UK in the late 1990s, things were different. Teams had adopted case management practice and most couldn’t think about integrating evidence based practice into their heavy workloads.
My interest in linking evidence to day-to-day practice was rekindled when I became a manager at East Sussex county council and link officer for Research in Practice. In 2011, the Munro review and family justice review made clear the imperative for social workers’ expertise in assessment and intervention.
At the same time, East Sussex saw increasing numbers of children coming into care and being made subject to child protection plans. We were doing a lot of things right, including a clear emphasis on relationship based practice, but more had to be done. This thinking informed the development of a three-year programme, Thrive, which focused attention on building the knowledge and confidence of early help workers.
Part of Thrive included workforce development, focusing on training for social workers, early help workers and briefing for their managers. Social workers were asked to use their relationships with children and families to help create change through motivational interviewing and solution-focused therapy. These are goal-centred approaches in which the service user is encouraged to engage in “change talk” to increase motivation, for example by asking: “How might you like things to be different?” or “How does ______ interfere with things that you would like to do?”.
Practitioners were also trained in a protective behaviour approach. This is a safety awareness and resilience building programme, helping children and adults to recognise situations where they feel worried or threatened, and explores practical ways to keep safe. It also aims to identify support networks for times when we need someone to listen and help.
Staff responded positively to the training but told us that it had not helped to change their practice, so the job was only half done. We tried a different approach: teams now train over a period of weeks and get to grips with the theory, then bring real-life cases to training workshops, learn more, then embed it into cases they were working on. Once training is finished, learning surgeries continue to provide support. It’s still early days but social workers are starting to report that their practice is changing.
This approach also revealed that evidence based practice isn’t just about research. The building blocks for sound practice and effective interventions which are so often underplayed are drawn from experience and real-life observations.
For instance, a social worker might be worried about a child whose behaviour is disturbed when at school. A relationship is established with the family and followed up with extended observation. Using knowledge of attachment and close observation, the social worker now has evidence of the child’s experience at home and their emotional state which, in this case, might be a hypothesis that the child exhibits disorganised attachment. To avoid confirmatory bias, that hypothesis must be challenged, making sure that any intervention is the right one.
Mechanisms must be in place to ensure learning is applied in practice and to force social workers to think deeply and critically about any assumptions they have made. One way to do this is through group supervision. This uses the team’s deep well of knowledge and experience to develop an agreed case plan, underpinned by evidence based practice.
In East Sussex our learning has been enriched further by jointly investing adult and health sector resources into a team of psychologists, psychiatrists, nurses and social workers to offer specialist knowledge and treatment. They have expert knowledge in domestic abuse, sexual abuse, learning disabilities, mental health and substance misuse. Champions for each of the themes are appointed from frontline teams and after training they go on to offer consultations and share learning within their own teams.
For example, a social worker may become frustrated with a parent who repeatedly returns to a violent partner. The social worker can consult with the domestic abuse champion who would guide them in taking a holistic strengths and skills based approach, advise them on effecting change by identifying triggers and provide help with safety planning. As the work of our champions increases, more resources will be directed towards team-based learning and away from more traditional methods.
We’re also keen to tap into the knowledge of social work academics and are developing a research unit to answer real-life practice questions. We’ve established a pool of up-to-date research and practice tools in a single source on our website. A social work blog has been set up to spread learning about what practice works. And, I’m particularly excited about the development of a book club which offers a way of learning without repeatedly having to look at academic texts.
Once in place, evidence based practice doesn’t take any more time. Social workers are regularly seeing families on their casebook anyway. What it does do is increase the effectiveness of social work practice during these visits, making things better for vulnerable people. I have seen this in practice, working with a colleague who used motivational interviewing techniques to help a mother address her ambivalent feelings about her unborn baby. And I have spoken to young people who told me how the protective behaviour work they did with their social worker helped keep themselves safe.
