BOOK REVIEW - Evidence for Child Welfare Practice
By Bruce Leslie

Editor: Michael J. Austin

Publisher: Routledge, New York, 2010

Order: www.routledge.com

Some readers might think this book is 100 years too late, others might see it as a step in the right direction. At the beginning of the book the editor wrote "the purpose of this book is to provide a 'work in progress‘ that seeks to capture the micro (direct service) and macro (managerial) perspectives related to identifying evidence for practice within the practice domain of public child welfare." While most involved in the delivery of child welfare services would see themselves as practicing in a professional manner, concerns have been raised about the basis for decisions and the way these decisions evolve in practice.

The evidence-based practice (EBP) movement began in the early nineties when a group of physicians raised questions about how service was being delivered and what was being delivered. They wanted to ensure that practice was directed by the best available evidence, the service user and clinical judgment. This EBP model looks to move practitioners away from authority based practices and policies, to a more collaborative partnership with clients, incorporating evidence of effective services and the assessment of service impact (Gambrill, 2003). Evidence-based practice proponents seek to advance the weighting of research evidence in an egalitarian service process (Leslie, 2006).

The book, Evidence for Child Welfare Practice, seeks to answer the questions: 'What is best evidence?‘ 'What constitutes 'practice‘ in which evidence-based decision making is used in direct service, inter-agency collaboration and the management of organizational processes?‘ and 'Given the complexity of engaging in EBP, what is a reasonable timeline for implementation?‘

The chapters are heavily weighted towards highlighting 'best evidence‘ and the best evidence for ensuring its active use in practice. These two perspectives provide a wealth of information to address one of the key components of EBP – the research evidence. The other two – clinical judgment and the service user perspective – that need to be factored into an effective practice receive less attention.

While the editor admits that the authors addressed concerns that had emerged out of their service interests in the local San Francisco Bay area, chapter topics appear to have broad relevance to the field of child welfare: Understanding and Addressing Racial/Ethnic Disproportionality; Risk and Safety Assessment; Understanding and Measuring Child Welfare Outcomes; Implementing Evidence-Based Practice in Human Services Organizations; and Knowledge Management.

Each chapter highlights available evidence from American databases, exploring related perspectives, including a variety of findings and practice, organizational, and research implications. For example, in the first of the three chapters on child welfare outcomes, indicators related to safety, permanency and well-being are highlighted from the Children‘s and Family Reviews conducted in America that focus on the effectiveness of services. The meaning of the findings are amplified through the provision of the policy context that holds states accountable for these outcomes and a description of some of the benefits and challenges in this quality improvement process. The other chapters in this section describe findings from studies related to parental substance abuse and others that focus on the assessment of the impact of parent education.

The chapters promote positive research findings and raise methodological considerations in the building of an organizational knowledge management system. The early chapters form the content foundation that underpin EBPs and give rise to important considerations, addressed in the later chapters, in advancing evidence-based service in an organization. To facilitate such a system perspective in an agency, the authors review a series of inter-connected building blocks: agreement on the nature of evidence; a strategic approach to the creation of evidence and the development of a cumulative knowledge base; effective research access and dissemination processes; increasing use of evidence in practice and policy; and active organizational support. It is clearly recognized that an agency can facilitate or hinder EBPs at the front lines or in management.

The major components of an organizational culture that are seen to be supportive of EBP include clarity of mission and goals among staff, staff cohesiveness and autonomy, openness of communication and openness to change, low levels of job stress, careful attention to staff selection, training and mentoring, and the use of continuous improvement cycles.

Factors related to dissemination and utilization of evidence are highlighted from the perspectives of the individual practitioner, the organization, research, and communication. As with many authors of this topic, the consideration of client/service users‘ perspectives often receives less attention. This oversight is particularly important in child welfare services given that they are sometimes less cooperatively involved.

Shlonsky and Gibbs (2004), among others, recognize that the incorporation of service users‘ preferences in the development of the interventions in services like child welfare is not always possible. They see EBP as "a systematic process that blends current best evidence, client preferences (wherever possible), and clinical expertise, resulting in services that are both individualized and empirically sound."

These are key considerations in building an effective EBP and an area that needs further research. How are the significant findings of related studies utilized with this service user for this particular issue? What are the clinical expertise characteristics that facilitate the transmission and sharing of successful interventions?

It is also interesting to note that this book suffers somewhat from the same challenge as practitioners. How do you maintain an active up-to-date EBP in a field that is evolving and changing? One relevant example in the book is the reference to the consensus based risk assessment tool used in Ontario. This evidence is pre-Transformation based in a book published in 2010.

The chapter titled, "Evidence-Based Practice in the Social Services: Implications for Organizational Change" by Michelle Johnson and Michael J. Austin, provides important messages for agencies striving to create a culture of evidence-informed practice. They outline four key elements for creating organizational change that include: (1) engaging key decision makers (senior managers) who can influence change from within; (2) linkage of evidence-based practice initiatives to organizational goals and objectives; (3) dissemination of key findings; and (4) creation of learning sub-cultures. Examples of this include training curriculum that includes reference to current research evidence, staff meetings that embed in the discussion reference to existing evidence, and collaborative endeavours and research projects with local universities. The chapter highlights the busyness of workers who do not have time to wade through vast quantities of research articles to determine key practice issues. This chapter reaffirms the need for knowledge brokers for child welfare organizations.

Through the various chapters, the examination of EBP is seen to evolve from the promotion of individual study findings to descriptions of knowledge management – a much broader organizational and systemic feature. One author goes so far as to suggest, "it [EBP] is the key to maximizing productivity and promoting organizational sustainability" (p. 364).

This is a book worth reading. The front line practitioner gains insights into beneficial interventions, the manager is offered insights into advancing services and organizational culture, and the director is informed by organizational development strategies.

ABOUT THE AUTHOR

Bruce Leslie is the Manager of Quality Assurance at the Catholic Children‘s Aid Society of Toronto.

REFERENCES

Gambrill, E. (2003a) Evidence-based practice: sea of change or the emperor’s new clothes?, Journal of Social Work Education, vol. 39, no 1, pp 2-23.
Leslie, B. (2006) Evidence-based practice and decision-making in child welfare services. Child Welfare League of Canada Journal, Canada’s Children.

Shlonsky, A. & Gibbs, L. (2004) Will the Real Evidence-Based Practice Please Will the Real Evidence-Based Practice Please Stand Up? Teaching the process of Evidence-Based Practice to the Helping Professions. Brief Treatment and Crisis Intervention, Vol., 4(2), p 137 - 153

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