The Challenges of Implementing Evidence Based Practice
A complicated relationship has been developing between professional ethics and evidence-based practice in social work within recent decades. On the one hand, it has been suggested that evidence-based practice can become a solution to practitioner application of ethical principles (Farley et al., 2009). On the other hand, there are also situations in which evidence-based practice that a practitioner is trying to implement comes in conflict with particular ethical principles.
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An example of such a situation is the intention of a practitioner to provide an intervention that has been confirmed to be effective and bring positive outcomes but has also been listed among undesirable or prohibited types of interventions by the organization for which the practitioner works. From the ethical perspective, a practitioner should commit to the organizational policy; however, the principle of following evidence-based practice also suggests that the intervention should be provided to meet the needs of targets.
At the same time, committing to evidence-based practice is exactly the method for practitioners to ensure that the decision-making processes are more ethical. This dilemma—to “go against the agency or managed care guidelines and provide the evidence-based intervention…or to ignore the findings and continue with business as usual” (Farley et al., 2009, para. 32)—illustrates possible barriers to implementing evidence-based practice, and these barriers deserve special attention.
The barriers can be divided into three groups: prevailing opinions, practice environment, and knowledge and attitudes (Farley, 2009). The first group encompasses barriers associated with established practices and authority. Even if a practitioner obtains confirmed scholarly findings that allow recommending how to improve certain policies or practices, he or she may find it difficult to implement them because of existing standards of practice. Professional training that is conducted inflexibly, i.e. without openness to adopting new practices and with teaching old ones only, strengthens these barriers, too. Moreover, even if an entire organization decides to employ new evidence-based policies or practices, it may be hard to go against established opinions, e.g. those of pharmaceutical companies.
The second group of barriers comprises practice environment complications, and the ethical dilemma described above falls into this category. Organizations sometimes impose strict regulations on their employees that limit access to adopting evidence-based practices. In these situations, social workers are encouraged to resort to advocacy (Farley, 2009), i.e. to attempts to deliver to the management or decision-makers that the proposed practices are beneficial.
In this context, advocacy refers to social workers’ functioning as a bridge between targets whose needs need to be met and people responsible for creating the environments in which appropriate interventions or care are delivered. Concerning the organizations’ perspective, they should establish incentives, including financial ones, for social workers to feel encouraged and motivated to adopt the evidence-based practice and to perceive their responsibility for the ultimate benefits for the targets and not the organization.
Finally, there are knowledge- and attitude-related barriers. Among social workers, one can often hear the opinion that there are constantly too many new things added to the procedures and policies, and the overload can significantly damage the adoption of evidence-based practice. Also, social workers may be unwilling to adopt something new if they do not fully understand the benefits of the proposed changes. All these barriers should be taken into consideration and addressed by both social workers and organizations that employ them to ensure positive outcomes.
Farley, A. J., Feaster, D., Schapmire, T. J., D’Ambrosio, J. G., Bruce, L. E., Oak, C. S., & Sar, B. K. (2009). The challenges of implementing evidence based practice: Ethical considerations in practice, education, policy, and research. Social Work and Society: International Online Journal, 7(2). Web.