Rethinking the roles of families and clients in evidence-based practice

(Photo: Pixabay)

(Photo: Pixabay)

The principles which underpinned our approach to supporting Children and Parenting Support programs to implement evidence-based programs and practice as part of the Children and Families Expert Panel, had a large influence on how I presented evidence-based practice in the workshops we ran.

As mentioned in a previous post about evidence-based practice, evidence-based practice is generally described as a decision-making process that incorporates:

  1. The best research evidence
  2. The best clinical experience
  3. Family and client values. (see Figure 1)

Figure 1: Evidence-based practice (Source: Walsh, Rolls & Williams [2])

Figure 1: Evidence-based practice (Source: Walsh, Rolls & Williams [1])

When I presented it to the practitioners I made a couple of subtle, but significant changes (see figure 2). The first was fairly minor: “Best clinical experience” became, “Best practitioner wisdom and experience.” This was essentially changing the language to be more relevant to the family services we were working with.

The second change was much more significant. “Consistent with family and client values” become, “Family experience and insights.” This involves quite a different approach to families (or other people we work with). In the second version, families have a much more active role in contributing evidence. Rather than checking that a suggested approach or intervention is consistent with family values, the emphasis is on incorporating the experience and insights of families.

Figure 3: Evidence-based practice. (Adapted from Walsh, Rolls Reutz, & Williams [10])

Figure 2: Evidence-based practice (adapted)

Most of my work has been with bottom-up approaches to working with communities. They types of approaches (e.g., asset-based community-driven development) emphasise the importance of being community-led. It is not enough to just ensure our approach is “consistent” with the values of the people we work with, we need to actively involve them in planning and delivery. In suggesting some refinements to Collective Impact, Cabaj and Weaver [2] argue that there needs to be a great emphasis on “inclusive community engagement”.

The idea that those most affected by an issue should participate fully in attempts to address it (aka “Nothing about us without us!”) is a fundamental democratic and moral principle. (p. 5)

Likewise, Barnes and Schmitz [3] suggest that it is important to “view community members as producers of outcomes, not just as recipients of outcomes” (p. 36).

Family centred practice also emphasises valuing the expertise and experience of families. Scope (Victoria) Statewide Specialist Service [4] argue that:

Families are the experts with respect to their child and they can bring a great deal of information to a collaborative relationship with practitioners. It is important for practitioners to recognise this and ensure families have opportunities to share their expertise. (p. 16)

As suggested in the post about evidence-informed practice some approaches to evidence-based practice do place a greater role on the experience and insights of families and clients. For example, Nevo and Slonim-Nevo [5] suggest that:

Research findings should not override, or take precedence over, clinical experience and clients’ wishes, values and knowledge. Rather, empirical evidence is better regarded as one component in the mutual and constantly changing journey of client and practitioner. (p. 1178)

If family and community services are to truly value the experience and expertise of families, we need to update the definitions of evidence-based practice (and its visual representation) to ensure we recognise the important role of families, and their insights and knowledge, in planning and decision-making.

If you liked this post please follow my blog, and you might like to look at:

  1. Posts from the expert panel work in evidence-based practice
  2. What is evidence-based practice?
  3. What is evidence-informed practice?
  4. Bottom-up community development
  5. What is asset-based community-driven development (ABCD)?
  6. What are complex problems?

References

  1. Walsh, C., Rolls Reutz, J., & Williams, R. (2015). Selecting and implementing evidence-based practices: A guide for child and family serving systems (2nd ed.). San Diego, CA: California Evidence-Based Clearinghouse for Child Welfare. Available from http://www.cebc4cw.org/files/ImplementationGuide-Apr2015-onlinelinked.pdf
  2. Cabaj, M., & Weaver, L. (2016). Collective impact 3.0: An evolving framework for community change: Tamarack Institute. Available from http://cdn2.hubspot.net/hubfs/316071/Events/CCI/2016_CCI_Toronto/CCI_Publications/Collective_Impact_3.0_FINAL_PDF.pdf?t=1472581825369
  3. Barnes, M., & Schmitz, P. (2016). cenCommunity Engagement Matters (Now More Than Ever). Stanford Social Innovation Review(Spring), 32-39. Available from https://ssir.org/articles/entry/community_engagement_matters_now_more_than_ever
  4. Scope (Victoria) Statewide Specialist Service. (2005). Family-centred practice: an evaluation of an early childhood intervention service. Stronger Families Learning Exchange Bulletin, (7), 15-17. Available from http://content.webarchive.nla.gov.au/gov/wayback/20060820030608/http://aifs.gov.au/sf/pubs/bull7/scope.pdf
  5. Nevo, I., & Slonim-Nevo, V. (2011). The Myth of Evidence-Based Practice: Towards Evidence-Informed Practice. British Journal of Social Work, 41(6), 1176-1197. doi: 10.1093/bjsw/bcq149.

About Graeme Stuart

Lecturer (Family Action Centre, Newcastle Uni), blogger (Sustaining Community), environmentalist, Alternatives to Violence Project facilitator, father. Passionate about families, community development, peace & sustainability.
This entry was posted in Families & parenting, Strengths-based approaches & ABCD, Working with communities and tagged , , , , , , , . Bookmark the permalink.

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