Introduction
Social work is a broad and complex area of professional activities that embodies a wide range of decisions and responsibilities that predetermine the success of a social worker’s performance. Since the aim of social work is to improve people’s living conditions and provide support for the fulfillment of their needs, the professional in this field deals with highly challenging situations on a daily basis. Knowledge and skills are crucial for successful social work and are highly required as the obligatory qualification.
Indeed, the one who resolves social issues of the people has to operate with current research findings, legislature, and theoretical basis of the practice to provide the most accurate and relevant interventions for the clients. In this paper, the general overview of the importance of evidence-based practice will be presented. It will be followed by the discussion of the three levels of theories, including theoretical frameworks and perspectives, mid-level theories, and practice theories and models. After that, a more detailed analysis of some theory’s application in micro-and macro-practice. Finally, some concluding points and recommendations will be given in the summary.
Professional Knowledge Base
Professional knowledge is decisive for any type of work and is an obligatory requirement for a specialist in any field of activity. However, the extent, to which the intellectual abilities and expertise in the theoretical and practical aspects of the profession are important in social work, indicates the necessity to address the core elements of its knowledge base. The theoretical basis of social work practice is presented by a number of approaches, according to which one chooses a direction to the effective solution (Langer & Leitz, 2015).
The work with people’s problems and needs requires critical thinking and reflection; it is complicated due to the ambiguity of the possible decisions, on which the ultimate quality of clients’ lives depends (Marlowe, Appleton, Chinnery, & Van Stratum, 2015). The link between theory and practice in social work is created by evidence-based practice (EBP).
Therefore, when making a choice of the direction in which the work will be done, a social practitioner only utilizes “empirically-based treatment” that lies within the framework of EBP (Gambrill, 2007, p. 447). According to Drisco and Grady (2015), EBP is a decision-making process that requires a practitioner to “integrate the best research evidence available with their professional expertise and with client attributes, values, preferences, and circumstances” (p. 274). Moreover, the implementation of any intervention should be justified by the Code of Ethics that prioritizes the benefits of a client (Gambrill, 2007). Thus, evidence-based practice is the main direction in social work that grounds on the evidential proofs of the application of particular interventions which are validated by positive results.
The multifaceted practice of a social worker is bound to intervention choice, validation, and implementation, as well as direct delivery of the services to clients. The communication with people in treatment has been documented over the years, thus creating a scope of case records, which contribute to the EBP and the ethical validations of the work (Reamer, 2005). The access to the previously obtained practical experiences of the predecessors creates a competent assessment, planning, service delivery, supervision, and accountability of the work, which are of critical importance for ethically valid social practice.
According to Reamer (2005), prior documentation as an element of research provides “risk-management standards designed to enhance the delivery of services to clients and protect practitioners in case they have to defend themselves against ethics complaints” (p. 328). Therefore, theories and their practical implementation through the application of EBP construct a core professional knowledge base in social work.
Primary Social Work Theories
Any practical intervention in social service is based on a theory that predetermines the direction of thought and decision-making regarding the circumstances, values, and preferences of a client. The social work theoretical framework is divided into three levels of influence on practice, including theoretical frameworks and perspectives, mid-level theories, and practice theories and models. The first level embraces frameworks and perspectives, which are the broadest systems of ideas that shape the point of view on a particular issue.
For example, a practitioner might choose a person-in-environment perspective, problem-centered practice, or strengths perspective as a general framework, within which a cease will be viewed (Langer & Leitz, 2015). Although this level of theory might be used for practice settings, it still has some limitations, including the difficulty of measurement, challenging consistent implementation, and evaluation.
The second level embodies mid-level theories which are narrower than perspectives and provide an opportunity for a more specific application in a particular practice setting. These theories include crisis theory, cognitive theory, family systems theory, behaviorism, and others, which clearly define the direction in which a social worker should perform, thus providing more practical implications (Langer & Leitz, 2015). It is not difficult to define and assess the theories of this level in contrast to perspectives. However, they cannot be applied throughout practice settings.
The third level of social work theories incorporates practice models, which have a direct implication on the immediate application to work. While perspectives and mid-level theories are broad guides leading to practice, models provide immediate practical directions and “offer almost a how-to manual for social workers regarding what to say and do in specified client situations” (Langer & Leitz, 2015, p. 10). Such models as solution-focused brief therapy or motivational interviewing enhance consistent practice implementation and its evaluation but can be applied only to a particular population or setting.
Application of Theories to Micro Practice
Some of the overviewed theories have been applied in micro practice at the first field placement, which is Silverado Hospice in San Diego, CA. The micro practice is essential to social work and involves direct services provided for individuals and their families with regard to the particularities of a case (Austin, Anthony, Knee, & Mathias, 2016). Since the hospice is specializing in end-of-life care provision, social workers are required to apply cultural awareness, interdisciplinary knowledge, and a wide range of related skills to “address psychosocial needs of patients and their families” (Murty, Sanders, & Stensland, 2015, p. 12). The two theories that informed micro practice at Silverado include humanism theory and family systems theory.
Humanism theory prioritizes the self-worth and value of the life of every person (Langer & Leitz, 2015). This theory is widely used at the Silverado hospice in the work of social practitioners with each patient individually. The communication with each client is carried out in a manner that respects an individual’s dignity and human rights. Since the facility provides care for diverse populations, the variety of services meets the needs and requirements of every client. Respectful and supporting relationships with the residents of the hospice are key to the philosophy of the organization.
Families of the patients in end-of-life care units encounter significant psychological difficulties related to coping with the suffering of their loved ones and grieving after death. The task of a social worker is to address the needs of family members to eliminate adverse outcomes and foster healthy recovery after long-term treatment or loss (Curtis et al., 2016). At Silverado, family systems theory is applied in a manner that enables the inclusion of family members in the process of support in treatment according to end-of-life care. Extensive work with families allows Silverado staff to enhance the comfort of the patients, as well as provide support for the caregivers who are exposed to challenging psychological circumstances.
Application of Theories to Macro Practice
Social workers are expected to perform not only within the micro practice level but also in macro practice that incorporates activities and initiatives implemented within organizations and policies. According to Reisch (2016), the macro practice has emerged as an essential part of social work with the advances in globalization and organizational development. Therefore, it is critical for social practitioners to widen the scope of their influence and address global social issues with the help of communities and organizations. The following two theories informed macro practice at the Silverado hospice: critical theory and ecological systems theory.
The leadership at Silverado cooperates with large organizations of federal and state levels to implement social change on a larger scale. According to critical theory, the social workers at Silverado carry out services for each client in accord with his or her specific requirements, needs, and expectations without any oppression or discrimination (Langer & Leitz, 2015). The participation of the hospice in inter-organizational and national programs provides an opportunity to exemplify its achievements in the field of social work for the elderly and encourage others to do the same.
Ecological systems theory relates to the perception of the patterns in human behavior as a result of the influence of the environment (Langer & Leitz, 2015). Therefore, due to the fact that Silverado is often awarded for its achievements in the work with patients in end-of-life facilities, it is entitled to demonstrate its findings and practice implications. The hospice applies its achievements to change the environment to a more favorable one that enhances comfort for critically ill patients.
Evaluation of Approach
In conclusion, the professional knowledge base for social work is comprised of theories and research that form the basis for the practical implementation of service. While perspectives and mid-level theories provide broader directions for the choice of framework for future services, models supply step-by-step practical guidance for a social worker to apply in a particular setting. However, according to Adams, Matto, and LeCroy (2009), the EBP approach has its limitations related to the connection of EBP to its medical application. Also, one of the significant limitations of EBP is its high requirements for the practitioners’ skills in evidence retrieval, the development of which takes a lot of time and effort but obscures the speed of intervention implementation.
The approach utilized at Silverado is beneficial due to its high level of evidential support, orientation on both micro and macro practices, as well as the aspirations to meet the needs of everyone in the diverse population. However, the scope of influence of the organization on the community and other entities could be enhanced by the application of appropriate theories. Among the recommendations for the agency, it is suggested to employ the ecological systems theory in macro practice more broadly to initiate a shift in the national policies concerning equity in end-of-life services that would allow for non-discriminative support-oriented practice that has been successfully used at Silverado.
References
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Curtis, J. R., Treece, P. D., Nielsen, E. L., Gold, J., Ciechanowski, P. C., Shannon, S. E., … Engelberg, R. A. (2016). Randomized trial of communication facilitators to reduce family distress and intensity of end-of-life care. American Journal of Respiratory and Critical Care Medicine, 193(2), 154-162.
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