Evidence in action: a Thompsonian perspective on evidence-based decision-making in social work

Abstract

Evidence-based practice presupposes evidence-based decision-making. In the debate it is argued that a social work fashioned after evidence should be more rational, less authoritarian, and built on scientific knowledge, respect and ethics. Yet the empirical evidence that this idea works is weak. In fact, the difficulties met during efforts to implement evidence could be a sound reaction. Indeed, difficulties experienced could be a defensive organizational reaction to a new, disturbing technology. In this article, James D. Thompson's classical study Organizations in Action from 1967 is applied to evidence-based decision-making in social work. It shows, to date, that many problems have been given, at best, tenuous attention. It is argued that a focus on evidence will raise ambiguity and complexity levels within organizations, and that new professional specialists will emerge. Further, new constellations of power will appear, leading to a change of balance within the domains of social work.

Evidensbaserad praktik förutsätter evidensbaserat beslutsfattande. I debatten hävdas att ett socialt arbete som utnyttjar evidens utifrån vetenskaplig grund skulle kunna bli mera rationellt, mindre auktoritärt och med en utvecklad respekt för klienter. Det förekommer dock svaga empiriska bevis för att idén om en evidensbaserad praktik verkligen fungerar. I själva verket kan de svårigheter som förekommer att implementera idén vara en förståelig reaktion. Det kan nämligen uppstå defensiva organisatoriska reaktioner gentemot en ny oroande teknologi. I den här artikeln appliceras James D Thompsons klassiska studie ‘Organizations in action’ från 1967 på evidensbaserat beslutsfattande i socialt arbete. Det visar att många problem har fått begränsad uppmärksamhet i debatten. I artikeln argumenteras för att ett växande fokus på evidens kommer att öka osäkerhet och komplexitet inom organisationer och att nya professionella specialister kommer att träda fram. Dessutom utvecklas nya maktkonstellationer något som kommer att förändra balansen mellan aktörer inom det sociala arbetet.

Keywords:

• evidence-based practice
• decision-making
• organizational theory
• intervention
• implementation

Nyckerlord:

• Evidens
• Evidensbaserad Praktik
• Beslut
• Organisationsteori
• Socialt Arbete

Acknowledgements

This paper is based on research completed for the project ‘Modern Programme Evaluation’, sponsored by the Swedish Council for Working Life and Social Research (FAS). I would like to express my gratitude to two anonymous reviewers who have given important comments on earlier drafts of this article.

Notes

1. This influential article can be accessed at http://www.bmj.com/cgi/content/full/312/7023/71