How do you use evidence-based approaches with clients?

While I worked with a public relations agency using evidence-based approach was a powerful tool in our cocktail of communications solutions. We regularly sought expert views by commissioning research. Based on the knowledge generated we built our communication plans. I must add that it is misleading to take the so-called evidence we see in the media or cited by organisations as necessarily reliable because they are sometimes designed to suit a certain narrative and distorted. However, evidence-based approach is useful because it helps with proper mapping and targeting of solutions. It builds credibility too.

The evidence-based approach helps in better, well-informed, and effective decision-making by choosing reliable, tested, trustworthy solutions. Nevertheless, it is not necessary that all available evidence-based solutions/approaches will be effective or work in all situations. It is imperative to contextualize, adapt, and critically evaluate and examine these available pieces of evidence depending on the problem, target audience, geography, and other variables and factors.

In reflecting upon my 20 years in the field of social work, especially within my role as a psychotherapist and social work researcher, I have seen first hand the benefits of utilizing evidenced based practices to enhance my professional competence and effectively tailor clinical interventions to my client's clinical concerns. I attest to this article, that it is imperative that social workers utilize EBP to make sure they are approaching the needs of clients in an ethical way. EBP is backed up by valid research that solidifies the effectiveness of the clinical intervention that is utilized.

As someone that has utilized EBP as an individual/group psychotherapist, I have encountered such challenges through first hand experience. One of them is that I was often faced with a delicate balance of utilizing research based clinical interventions and the unique needs of my clients. EBP is vital for the efficacy of clinical services I provided, however I had to make sure that the EBP was tailored to the client's culture and preferences. It is important that flexibility is used when using EBP in order to be effective in clinical social work and in the field of social work in general.

One of the challenges of using an evidence-based approach is its very assumption that the practitioners are up to date and use the latest research evidence from around the world to make better decisions and implement better solutions, which is often not true. There is selection bias in selecting the evidence depending on the reputation of the scholar, institution, reach, and other variables. Besides, in the selection of evidence, the north-south divide is another concern where most of the solutions or evidence are generated by the scholars from the North for the South due to easy access to resources and other influences. Often suggested pieces of evidence are influenced by corporations, donors, and others who have vested interests.

I mostly access the pieces of evidence published in reputed peer-reviewed journals, websites, cross-references, and a few local pieces of evidence mentioned and suggested by peers, friends, and scholars. I appraise the evidence in totality from a holistic perspective apart from its relevance to the targeted audience. I also critically examine the solutions from a socio-political and economic perspective. One of the important components in appraisal is its rationale, relevance, and sustainability.

Throughout my social work career, as a researcher, psychotherapist and in other positions that I have held in the field, I have found that accessing and appraising evidence to be a vital part of my social work practice. I have always relied on utilizing various resources as the article suggested, especially books, academic journals etc. I also was able to utilize supervision as needed, mentors and experts to enhance my understanding and to refine my clinical skills.

I always try to understand the scope of evidence, balance and adapt the evidence with wider consultation with stakeholders who are directly going to benefit. Besides, I always try to share the evidence with the community for their feedback on what will work and what not. Another approach that I often follow is to blend the evidence with local knowledge and resources available.

I use a participatory approach to involve the client. Besides, I try to be conscious of clients' values, traditions, culture, norms, and voices. Listening to clients' opinions and ideas is foremost to involve them. It is always a good strategy to not impose your ideas but rather integrate their ideas into existing ideas (pieces of evidence) for better results and ownership.

As I reflect upon my own experience of utilizing evidenced based practices as a social worker, former psychotherapist and in other roles within the field, EBP is just one piece of the puzzle. In my own experience, it is my professional opinion that professional judgement, shaped by years of social work experience and my own values with an understanding of my client's unique needs and values. We must stress the importance of weighing the risk and benefits, limitations, strengths of applying EBP. It is vital that we engage our clients in a way that is backed by informed choices to serve clients.

I usually use a logical framework approach to monitor interventions. I use both qualitative and qualitative indicators to evaluate and monitor the performance indicators and progress. Some of the tools I use are theory-based evaluation, formal surveys, rapid appraisal methods, participatory methods, public expenditure tracking surveys, and cost-benefit and cost-effectiveness analysis depending on the need, resources, and time available, and the nature of the intervention.

As the article states it is vital to utilize evaluation and monitor your interventions for the clinical outcome of your clients. I always make it a priority in my work to seek feedback from my clients, colleagues to make sure that the interventions I use are appropriate and are ethically sound in my social work practice.