Whatever the problem, the answer is "evidence-based practice"--or is it?

Abstract

What is the best program to hasten reunification? What practice will lead to more stable adoptions? What does the research support in serving drug-addicted parents? All good questions, whether asked by a busy worker struggling to match services with family needs, an administrator trying to meet federal Child and Family Services Review outcome levels, or a legislator wanting to maximize services for available dollars. Unfortunately the answer is a resounding, depends! The buzzword in child welfare today is evidence-based practice (EBP)-but that leaves the impression that the evidence in a given area of practice will point the way clearly to the desired outcome for all children and families and all agencies, public or private. Unfortunately, no one evidence-based program leads to faster reunification, more stable placements, or higher rates of recovery from addiction. Many programs and practices may affect these outcomes depending on a myriad of organizational and staffing issues. Managers and funders may promote EBP in the hope that they will save money and make services more effective, efficient, and accountable. All of those things are possible, but not inevitable. The body of literature is growing, but EBP in child welfare must also recognize the political and fiscal reality or context in which the program is implemented. EBP means using practices with demonstrated effectiveness. It also involves paying attention to treatment fidelity and generalizability and involving the consumer and organization (Gambrill, 1999). For example, research is clear that active, engaged family visitation (Farmer, 1996; Loar, 1998; Maluccio, 2000), accurate identification and remediation of parental issues (Fein, 1993; Hess, Folaron, & Jefferson, 1992), preparation for reunification (Warsh, Maluccio, & Pine, 1994), and aftercare support (Maluccio, 1999; Thomlison, Maluccio, & Abramczyk, 1996) are related to successful reunification. Imagine an agency has multiple data sources that point to a need to engage parents throughout the casework process. Managers and staff know that their case plans list stock services and are based on limited assessments. It is evident that families do not recognize the plan as a statement of their needs or capacities and often ignore the requirements. Supervisors are aware that visitation is infrequent and done at the convenience of the worker, rather than for the promotion of parenting skills or to strengthen parent-child relationships. Workers strive to achieve reunification seeing it as an end, not a point in a process that includes aftercare services. If this mythical agency chooses to enhance the practice of engagement, for example, as a partial response to the issues raised, implementation will require more than just a knowledge of the evidence linking engagement to positive outcomes. Everyone in the agency must be involved. It will require an assessment, usually a self-assessment, of agency operations. Is it only practice that needs to change, or are there other more fundamental issues to be addressed, like workload, staff qualifications, policies, and procedures? In engagement, EBP recognizes the need for workloads that allow workers to spend time with the family (U.S. General Accounting Office, 2003). EBP will not overcome structural issues like caseload size. Engagement also requires knowledge and skill on the part of casework staff. caseworkers who see their role as primarily regulatory or investigative may not understand that engagement is based on showing respect for clients' views and input or using open, honest communication to build trust (Yatchmenoff, 2002). A goal such as child permanence is reached through multiple tasks. Evidence is clear that concrete services need to be part of a reunification plan (Rzepnicki, Schuerman, & Johnson, 1997; Walton, Fraser, Pecora, & Walton, 1993). But if funds to restore utilities, purchase furniture, or provide transportation are hard to access or in short supply, workers will not be able to do what is needed-regardless of what the evidence says. …