Social workers as research consumers

Whether you know it or not, your life is impacted by research every day. Many of our laws, social policies, and court proceedings are grounded in some degree of empirical research and evidence (Jenkins & Kroll-Smith, 1996).^[1] That’s not to say that all laws and social policies are good or make sense. But you can’t have an informed opinion about any of them without understanding where they come from, how they were formed, and what their evidence base is. In order to be effective practitioners across micro, meso, and macro domains, social workers need to understand the root causes and policy solutions to social problems their clients are experiencing.

A recent lawsuit against Walmart provides an example of social science research in action. A sociologist named Professor William Bielby was enlisted by plaintiffs to conduct an analysis of Walmart’s personnel policies in order to support their claim that Walmart engages in gender discriminatory practices. Bielby’s analysis shows that Walmart’s compensation and promotion decisions may indeed have been vulnerable to gender bias. In June 2011, the United States Supreme Court decided against allowing the case to proceed as a class-action lawsuit (Wal-Mart Stores, Inc. v. Dukes, 2011).^[2] While a class-action suit was not pursued in this case, consider the impact that such a suit against one of our nation’s largest employers could have had on companies, their employees, and even consumers around the country.^[3]

A social worker might learn about this lawsuit through popular media, news media websites or television programs. Social science knowledge allows a social worker to apply a critical eye towards new information, regardless of the source. Unfortunately, popular media does not always report on scientific findings accurately. A social worker armed with scientific knowledge would be able to search for, read, and interpret the original study as well as other information that might challenge or support the study. Chapters 3, 4, and 5 of this textbook focus on information literacy, or how to understand what we already know about a topic and contribute to that body of knowledge.

When social workers consume research, they are usually doing so to inform their practice. Social workers are often required by their state licensing board to complete continuing education classes in order to remain informed on the latest information in their field, which is generated by research. Social workers at public policy think tanks consume research to inform advocacy and public awareness campaigns. Regardless of the role of the social worker, practice must be informed by research.

Social workers as research producers

Innovation in social work is incredibly important. Social workers work on wicked problems for their careers. For those of you who have practice experience, you may have had an idea of how to better approach a practice situation. That is another reason you are here in a research methods class. You (really!) will have bright ideas about what to do in practice. Sam Tsemberis relates an “Aha!” moment from his practice in this Ted talk on homelessness. While a faculty member at the New York University School of Medicine, he noticed a problem with people cycling in and out of the local psychiatric hospital wards. Clients would arrive in psychiatric crisis, stabilize under medical supervision in the hospital, and end up back at the hospital in psychiatric crisis shortly after discharge.

When he asked the clients what their issues were, they said they were unable to participate in homelessness programs because they were not always compliant with medication for their mental health diagnosis and they continued to use drugs and alcohol. The housing supports offered by the city government required abstinence and medication compliance before one was deemed “ready” for housing. For these clients, the problem was a homelessness service system that was unable to meet clients where they were—ready for housing, but not ready for abstinence and psychiatric medication. As a result, chronically homeless clients were cycling in and out of psychiatric crises, moving back and forth from the hospital to the street.

The solution that Sam Tsemberis implemented and popularized is called Housing First—an approach to homelessness prevention that starts by, you guessed it, providing people with housing first and foremost. Tsemberis’s model addresses chronic homelessness in people with co-occurring disorders (those who have a diagnosis of a substance use and mental health disorder). The Housing First model states that housing is a human right: clients should not be denied their right to housing based on substance use or mental health diagnoses.

In Housing First programs, clients are provided housing as soon as possible. The Housing First agency provides wraparound treatment from an interdisciplinary team, including social workers, nurses, psychiatrists, and former clients who are in recovery. Over the past few decades, this program has gone from a single program in New York City to the program of choice for federal, state, and local governments seeking to address homelessness in their communities.

The main idea behind Housing First is that once clients have a residence of their own, they are better able to engage in mental health and substance use treatment. While this approach may seem logical to you, it is the opposite of the traditional homelessness treatment model. The traditional approach began with the client abstaining from drug and alcohol use and taking prescribed medication. Only after clients achieved these goals were they offered group housing. If the client remained sober and medication compliant, they could then graduate towards less restrictive individual housing.

Conducting and disseminating research allows practitioners to establish an evidence base for their innovation or intervention, and to argue that it is more effective than the alternatives, and should therefore be implemented more broadly. For example, by comparing clients who were served through Housing First with those receiving traditional services, Tsemberis could establish that Housing First was more effective at keeping people housed and at addressing mental health and substance use goals. Starting first with smaller studies and graduating to larger ones, Housing First built a reputation as an effective approach to addressing homelessness. When President Bush created the Collaborative Initiative to Help End Chronic Homelessness in 2003, Housing First was used in a majority of the interventions and its effectiveness was demonstrated on a national scale. In 2007, it was acknowledged as an evidence-based practice in the Substance Abuse and Mental Health Services Administration’s (SAMHSA) EBP resource center.^[4]

We suggest browsing around the SAMHSA EBP Resource Center and looking for interventions on topics that interest you. Other sources of evidence-based practices include the Cochrane Reviews digital library and Campbell Collaboration. In the next few chapters, we will talk more about how to search for and locate literature about clinical interventions. The use of systematic reviews, meta-analyses, and randomized controlled trials are particularly important in this regard, types of research we will describe more in Chapter 14.

So why share the story of Housing First? Well, we want you to think about what you hope to contribute to our knowledge of social work practice. What is your bright idea and how can it change the world? Practitioners innovate all the time, often incorporating those innovations into their agency’s approach and mission. Using scientific research methods, agency-based social workers can demonstrate to policymakers and other social workers that their innovations should be more widely used. Without this wellspring of new ideas, social services would not be able to adapt to the changing needs of their communities. Social workers in agency-based practice may also participate in research projects taking place at their agency. Partnerships between schools of social work and agencies are a common way of testing and implementing innovations in social work. In such a case, all parties receive an advantage: clinicians receive specialized training, clients receive additional services, agencies gain prestige, and researchers can illustrate the effectiveness of an intervention.

Evidence-based practice highlights the unique perspective that social work brings to research. Social work both “holds” and critiques evidence. With regard to the former, “holding” evidence refers to the fact that the field of social work values scientific information. The Housing First example demonstrates how this interplay between valuing and critiquing science works—first by critiquing existing research and conducting research to establish a new approach to a problem. It also demonstrates the importance of listening to your target population and privileging their understanding and perception of the issue. While their understanding is not the result of scientific inquiry, it is deeply informed through years of direct experience with the issue and embedded within the relevant cultural and historical context. Although science often searches for the “one true answer,” social work researchers must remain humble about the degree to which we can really know, and must begin to engage with other ways of knowing that may originate from clients and communities.

See the video on cultural humility in healthcare settings (CC-BY-NC-ND 3.0) embedded below for an example of how “one true answer” about a population can often oversimplify things and overstate how much we know about how to intervene in a given situation.

Formal and informal research roles

I’ve been teaching research methods for six years and have found that many students struggle to see the connection between research and social work practice. First of all, it’s important to mention that social work researchers exist! The authors of this textbook are social work researchers across university, government, and non-profit institutions. Matt and Cory are researchers at universities, and our research addresses higher education, disability policy, wellness & mental health, and intimate partner violence. Kate is a researcher at the Joint Legislative Audit and Review Commission in Virginia, where she studies policies related to criminal justice. Dalia, our editor, is a behavioral health researcher at RTI International, a nonprofit research institute, where she studies the opioid epidemic. The career path for social workers in formal research roles is bright and diverse, as we each bring a unique perspective with our ethical and theoretical orientation.

Formal research results in written products like journal articles, government reports, or policy briefs. To get a sense of formal research roles in social work, consider asking a professor about their research. You can also browse around the top journals in social work: Trauma, Violence & Abuse, Child Maltreatment, Child Abuse & Neglect, Social Service Review, Family Relations, Journal of Social Policy, Social Policy & Administration, Research on Social Work Practice, Health & Social Care in the Community, Health & Social Work, British Journal of Social Work, Child & Family Social Work, International Journal of Social Welfare, Qualitative Social Work, Children & Youth Services Review, Social Work, Social Work in Health Care, Journal of Social Work Practice, International Social Work, Affilia Journal of Women and Social Work, and Clinical Social Work Journal. Additionally, the websites to most government agencies, foundations, think tanks, and advocacy groups contain formal research often conducted by social workers.

Every time you are asking who, what, when, where and why, you are conducting informal research. Informal research can be more involved. Social workers may be surprised when they are asked to engage in research projects such as needs assessments, community scans, program and policy evaluations, and single system designs, to name a few. Macro-oriented social workers may have to conduct research on programs and policies as part of advocacy or administration.

Research for action

Regardless of whether a social worker conducts formal research that results in journal articles or informal research that is used within an agency, all social work research is distinctive in that it is active (Engel & Schutt, 2016).^[5] We want our results to be used to effect social change. Sometimes this means using findings to change how clients receive services. Sometimes it means using findings to show the benefits of programs or policies. Sometimes it means using findings to speak with those oppressed and marginalized persons who have been left out of the policy creation process. Additionally, it can mean using research as the mode with which to engage a constituency to address a social justice issue. All of these research activities differ; however, the one consistent ingredient is that these activities move us towards social and economic justice.