Aaron Rosen and Enola K. Proctor , Developing Practice Guidelines for Social Work Intervention

Journal of Sociology and Social Welfare, June, 2005 by Eric R. Hardiman

Aaron Rosen and Enola K. Proctor (Eds.), Developing Practice Guidelines for Social Work Intervention. New York: Columbia University Press, 2004. $62.50 hardcover, $29.50 papercover.

The influence of the evidence-based practice movement has begun to change the landscape of both social work practice and intervention research. Yet, despite increased attention to empirically-tested knowledge, front line practitioners continue to face significant challenges as they select and implement intervention strategies and struggle with decision-making processes. While few would argue with the value of offering services with solid empirical support, practice realities often make application difficult and cumbersome. Practitioner resistance to evidence-based practice is common, and many would claim that the gap between research and practice in social work has actually widened in recent years.

In response to these and other dilemmas, Rosen and Proctor's edited collection offers an ambitiously comprehensive look at the development of practice guidelines, conceptualized as a concrete tool for social work practitioners seeking to utilize an evidence-based approach. The case for practice guidelines is made in a logical and persuasive fashion, with an impressive group of social work scholars providing valuable contributions. The collection is organized into four sections: (1) precursors to practice guideline development; (2) needs and challenges; (3) responsiveness to diversity in populations and settings; and finally (4) practitioner, organizational, and institutional factors in the utilization of practice guidelines. Each section provides a refreshing blend of overview, analysis, critical discourse, and direction for the future. The book ends with thoughtful and cohesive essays from Rosen and Proctor.

Rosen and Proctor have wisely chosen a broad spectrum of authors to present multiple sides of the issues. Ever mindful of historical precedents and debates in allied professions such as medicine (where the practice guideline movement began), the editors have successfully articulated a cogent and persuasive argument. The level of attention to history and context is evidenced in the early chapters by Fraser, Gambrill, and Reid and Fortune who help the reader to understand current challenges and issues. Gambrill sets the stage in a particularly clear fashion by contextualizing the evidence based practice movement, distinguishing between evidence based practice and practice guidelines, and providing implications for the development of social work practice knowledge.

The various authors do not shy away from controversy, and the editors demonstrate an admirable ability to consider multiple viewpoints and divergent opinions. Easy solutions are not proffered; rather a spirit of discourse and critical engagement with the material is encouraged. One thought-provoking example is Thyer's call for an interdisciplinary rather than social work specific approach to practice guidelines. In a series of separate chapters, several authors (including Proctor, Rosen, Kirk, and Mattaini) grapple with how best to organize intervention knowledge. They offer an intriguing discussion of the relative benefits of using diagnostic or problem classification systems rather than taxonomies of the targets of interventions (advocated by the editors). These discussions, as well as those offered by Videka and others on ways to account for variability among setting, client, and population factors, are treated in some depth. Marsh also provides a thorough consideration of institutional theory and the multifaceted issues of professional authority, knowledge, and legitimation. These topics are often left out of discussions on evidence based practice.

After taking into account the range of perspectives offered here, the editors conclude by presenting a structured research agenda that will hopefully lead to the development and utilization of practice guidelines by social workers. The overarching message is one of optimism tempered with awareness of the need for ongoing reflection and critical dialogue. The editors clearly recognize the limitations and challenges, as well as the inherent strengths of the practice guideline approach. It is their willingness to tackle difficult tensions and issues that solidifies their primary argument. Successfully avoiding any urge to simplify the discussion, they provide a much needed focus and clarity to the issues. This book is certainly one of the best volumes on social work practice and research be published in recent times. Its only potential weakness lies in the relatively sparse attention given to issues of cultural competence and diversity. A short yet useful chapter from Zayas takes a step in this direction, but the editors have missed an opportunity to adequately link evidence based and cultural diversity issues and thus to enhance the field

Taken as a whole, the book is a major step towards resolving some of the challenges the social work profession currently faces. It offers an invaluable guide for practitioners and program administrators seeking to bring their practice efforts into a new era of accountability and effectiveness. Rosen and Proctor are to be commended for enhancing the level of discussion about evidence-based practice in social work and for offering a novel way to ease the divide between research and practice. They have compiled a fascinating and intellectually stimulating book that will be an excellent resource for both social work practice and research courses, particularly ones taught with emphases on evidence-based practice and critical thinking methods. Those interested in breaking the divide between research and practice, and seeking to advance the profession's commitment to knowledge development should read this book. It should also be required reading for doctoral students, faculty teaching practice courses, and social work practitioners.