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Evidence-guided practice: Integrating the Science and Art of Social workalex Gitterman & carolyn Knight

social work educators and practitioners have had an ongoing debate whether the profession is primarily a science or

an art. the pendulum has swung back and forth, with the current tilt toward scientific explanations and formulations.

evidence-based practice is the most symbolic manifestation of this tilt. the authors propose an alternative approach

to practice that integrates, rather than separates, the art and science traditions. evidence-guided practice incorporates

research findings, theoretical constructs, and a repertoire of professional competencies and skills consistent with the

profession’s values and ethics and the individual social worker’s distinctive style. major assumptions, as well as challenges,

associated with the model are identified. a case example illustrates major concepts of the model.

impliCations For praCtiCe

• social workers are encouraged not only to engage in

theoretically informed and evidence-based practice

but also to maintain their creativity, authenticity,

and flexibility.

From their very beginning in the settlement and char-ity organization society movements, and throughout the evolution of the profession, social work educa-

tors and practitioners have had an intense and ongoing internal debate: Is social work primarily a science or an art? The pendulum has swung back and forth. Its current tilt is toward scientific explanations and formulations, as reflected in the evidence-based approach to practice. We argue that the science of evidence-based practice versus the art of spontaneous practice is an artificial dichotomy.

in this article, the major tenets of evidence-based practice are first summarized, as are its advantages and limitations. We then describe an approach to prac-tice that integrates rather than separates the science and art traditions, an approach we intentionally term evidence-guided practice (egP). We use evidenced-guided rather than evidenced-informed because the term guided suggests that evidence is used to facili-tate professional action. ample opportunities also are available for social workers to use theory, professional experiences, and practice wisdom. We believe that the concept of guided has more of an action orientation than informed.

Evidence-based practice: major Assumptions

The concept of evidence-based practice actually origi-nated in the medical profession (sackett, rosenberg, gray, haynes, & richardson, 1996). The major prem-ise of evidence-based medicine has been that decisions for promoting health and treating illness should be based on the best available medical evidence (borry,

schotsmans, & dierickx, 2006; Cochrane Collabora-tion, 2010; gupta, 2009; taylor, 2012). evidence-based medicine has been defined as “the conscientious, ex-plicit, and judicious use of the current best evidence in making decisions about the care of individuals” (sack-ett, richardson, rosenberg, & haynes, 1997).

influenced by these developments in medicine, so-cial work scholars have advocated an evidence-based approach to social work practice (Corcoran, 2000; gambrill, 1999; gibbs, 2003; gibbs & gambrill, 2002; gossett & Weinman, 2007; Macgowan, 2008; rubin, 2007). evidence-based social work practice has been defined as the “mindful and systematic identification, analysis, evaluation, and synthesis of evidence of prac-tice effectiveness, as a primary part of an integrative and collaborative process concerning the selection of application of service to members of target client groups” (Cournoyer, 2004, p. 4).

evidence-based proponents argue that social work-ers should base their practice decisions on a critical re-view of available intervention strategies for a particu-lar client’s challenges and difficulties. The intent is to identify and employ those techniques that have been found to help an individual, family, or group with a specified problem. The social worker selects the most relevant, empirically verified approach. evidence-based practice also includes clinicians’ efforts to evalu-ate their intervention efforts (baker & ritchey, 2009).

advocates of evidence-based practice justify the ap-proach on ethical grounds, asserting that it encourages professional accountability to clients, as well as reflects the professional’s commitment to lifelong learning and competent practice (gambrill, 2007; hudson, 2009; Zlotnik, 2007). further, advocates argue that it encourages clients to be informed consumers of the services they receive, in contrast to traditional ap-proaches to practice that are viewed as “authority-based” (gambrill, 1999).

Gitterman & Knight | Evidence-Guided Practice: Integrating the Science and Art of Social Work

DrawbacksThe simultaneous focus on the individual, family, and/or group and wider social environment has come to define social work as a profession and distinguishes it from other helping professions. The early, diagnos-tic model of social work practice has been supplanted in social work education by an ecological approach that takes into account the myriad forces that shape human behavior. The worker considers forces within and outside of the client as sources of problems and targets for intervention.

since the professions of social work and medicine have different functions, social work’s renewed reliance on medical tenets is puzzling. The current evidence-based emphasis in social work is all the more perplexing since the medical profession has begun to rethink and refine its own evidence-based approach (avis & fresh-water, 2006; devisch & Murray, 2009; sestini, 2011). Critics note that evidence-based medicine ignores the needs of the individual patient (gupta, 2011; tannahill, 2008). Practicing physicians criticize evidence-based medicine’s narrow focus and its lack of attention to the range of variables that contribute to health and illness (Kumar, grimmer-sommers, & hughes, 2010). a more comprehensive definition of evidence-based medicine, promulgated by its earliest proponents, reflects this broader perspective: “evidence-based medicine is the integration of the best research evidence with clinical expertise and patient values” (emphasis added; sackett, richardson, rosenberg, straus, & haynes, 2010, as cited in oancea, 2010, p. 160).

The social work profession’s purpose is by definition especially broad: to improve clients’ social and psy-chological functioning; to enhance the transactions between people and their environments; and to influ-ence communities, organizations, and legislation to be more socially just (gitterman & germain, 2008). so-cial work takes place in a social context, embedded in, among other things, poverty, unemployment, oppres-sion, racism, homelessness, and community violence. Complex social problems do not lend themselves to narrow and discrete interventions that are the foun-dation of evidence-based practice (Walker, Koroloff, briggs, & friesen, 2007). The medical profession has begun to rethink its evidence-based orientation. We believe that social work, with its broader ecological fo-cus, must do the same.

Limitations of research. evidence-based practice proposes that specific interventions exist to solve most types of problems, and social workers can find and then use the most effective—the “best”—intervention. These two premises have a seductive appeal. in the real world of people with messy and overwhelming life stressors, a logical, orderly, and sequential formula-

tion is reassuring. it is understandable that one would be drawn to the idea that using technique X with Client Y with Problem Z will lead to the intended out-come. evidence-based practice assumes a linear rela-tionship between research and practice, when in ac-tuality the connections between theory, research, and practice are complex and often elusive.

evidence-based social work practice emphasizes studies that typically involve brief, cognitive, and skill-focused interventions (reid, Kenaley, & Colvin 2004). typically, these studies focus on intervention that affects individual change—whether the change is in thinking processes, emotional responses, or specific behaviors. The narrow focus of these interventions readily lends itself to testing and replication. but this does not mean that they truly reflect “best” practices, since less straightforward, harder-to-measure prob-lems and interventions are excluded (otto, Polutta, & Ziegler, 2009; Wampold & bhati, 2004). reid (2002, p. 277) captured the potential consequences of nar-rowing our professional perspective:

an intervention may be effective in reducing a problem of classroom behavior of a child in an inner-city school, but this kind of effective practice could be challenged on the grounds that social work resources might be better spent involving community members in changing a school that is chaotically managed and under-funded. such a school might not only produce an unending stream of classroom behavior problems but might be making a mockery of the very idea of providing decent education for the children attending.

focusing exclusively on discrete, measurable indi-vidual behavioral changes ignores the struggle people experience in dealing with and surviving day-to-day life challenges, struggles to which the social work pro-fession is committed to addressing. “[Clients] thrash or float through interventions without significant, lasting impact because they fail to engage the core of people’s lives—the chronic obstacles that bind one crisis to the next, the extreme experiences…that have become cus-tomary, the human relationships that may be as toxic as they are supportive, the unique context in which each person struggles to survive” (smyth & schorr, 2009, p. 5). Thus, evidence-based practice tends to be overly reductionistic and simplistic (Cnaan & dichter, 2008; steiker et al., 2008).

a separate body of research suggests that whatever model or intervention is used, the quality of the thera-peutic relationship is mostly responsible for positive or negative outcomes (smyth & schorr, 2009). for ex-ample, Castonguay, goldfried, Wiser raue, and hayes

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(1996) compared the impact of cognitive behavioral techniques on changing the distorted cognitions of depressed clients. The cognitive behavioral interven-tions were compared with two less clearly defined vari-ables: the quality of the therapeutic alliance and the clients’ emotional involvement with the therapist. The researchers found that these last two variables actually were more highly related with clients’ progress than the cognitive behavioral techniques under study.

There are more than 100 studies that support these findings (andrews, 2000). essentially, these studies indicate that effective therapeutic outcomes are more related to the quality of the relationship established between the worker and client, as well as the ability of a worker to be attuned and responsive to client com-munications; outcomes are much less related to spe-cific techniques, models, and protocols (duncan 2001; smyth & schorr, 2009).

further, the client is a partner in the therapeutic enterprise (duncan & Miller, 2000; smyth & schorr, 2009). by focusing solely on what the worker does and ignoring the client’s contributions, evaluation research designs lead to questionable findings that are of limit-ed utility. duncan (2001, p. 33) described the relevance of the client’s contributions:

Why should it be a surprise that the very factors that were operating in a client’s life before counseling also have crucial effect on the helping process? Clients, who are, for example, persistent, open, and optimistic, who, for that matter, have a supportive grandmother or are members of a religious community, are more likely to make gains in counseling.

finally, outcome studies are not neutral endeavors. Many are designed and implemented by proponents of the very approaches being evaluated. essentially, these studies may be affected by “investigator allegiance” (betts-adams, leCroy, & Matto, 2009, p. 171). fund-ing initiatives and availability, primarily defined by the federal government, as well as managed care re-strictions by and large determine what type of research will be valued and carried out. organizational, com-munity, and collegial pressures also significantly influ-ence design, measurement, and interpretation of data.

in addition, when practitioners undertake litera-ture searches to find relevant empirical data, they have no way of knowing whether a study’s findings are reliable, valid, and generalizable to their settings and their clients (tarrier, 2010). The fact that a jour-nal publishes a study is not sufficient evidence of va-lidity or reliability. Peer reviewers typically only re-view researchers’ summary presentation of data and rarely examine the raw data.

in a postreview of articles published in medical journals, altman (2002, p. 12) found “considerable evidence that many statistical and methodological errors were common in published papers and that au-thors failed to discuss the limitations of their findings and that the importance of findings were consistently exaggerated.” even if peer reviewers successfully re-jected invalid studies, altman (2002) further discov-ered that most papers ultimately found acceptance in other medical and scientific journals. evidence-based social work practices “can only be as good as the re-search on which decisions are to be made” (Margi-son, 2001, p. 174). The question remains, therefore, how much confidence can social work practitioners have in the validity and reliability of findings avail-able from outcome studies?

Inconsistency with contemporary practice. Per-haps most fundamentally, the realities of contempo-rary social work practice work against a purely evi-dence-based orientation. Most social workers simply do not have access to bibliographic databases and the peer-reviewed literature, both of which are required to practice from an evidence-based foundation (Knight, in press; gira, Kessler, & Poertner, 2004; ruffolo, sa-vas, neal, Capobianco, & reynolds, 2008). even if they did have such access, most practitioners lack the time to read and review such resources, given more im-mediate and pressing demands associated with their practice (osterling & austin, 2008).

despite the increased emphasis on teaching social work students about research, evidence continues to suggest that practicing social workers lack the skills and expertise necessary to operate from an evidence-based foundation (Knight, in press; lord & iudice, 2011; Mullen, bledsoe, & bellamy, 2008; staudt, 2007). finally, evidence-based practice does not take into ac-count the team-oriented, multidisciplinary nature of much of social work practice. Clients often simultane-ously receive multiple services, making it difficult to discern cause-and-effect relationships (bledsoe et al., 2007; soydan, 2007).

Evidenced-guided practice: major Assumptions

Various scholars have been actively seeking to build bridges between the art and science traditions, prefer-ring to use terms such as evidence-guided or evidence-informed practice (betts-adams et al., 2009; Klein & bloom, 1995; letendre & Wayne, 2008; Macgowan, 2003; nevo & slonim-nevo, 2011; Zayas, gonza-lez, & hanson, 2003). We intentionally use the term evidence-guided to refer to an approach to practice in which interventions are suggested, rather than prescribed, by research findings. This is more than a

Gitterman & Knight | Evidence-Guided Practice: Integrating the Science and Art of Social Work

semantic distinction. evidence-guided practice pos-sesses the same ethical advantages associated with ev-idence-based practice. however, it also recognizes the uniqueness of the individual and the inherent dignity and worth of the person. evidence-guided practice reinforces client empowerment and clients’ right to self-determination. finally, egP is consistent with the profession’s commitment to vulnerable populations and social justice, since it adopts an ecological view of client problems and worker interventions.

Attention to Range of Variables That Affect Intervention Outcomeevidence-guided practice encourages practitioners to be consumers of research and to rely upon best prac-tices. but it also requires practitioners to attend to the subtle, harder-to-measure variables that also influence intervention efficacy. as noted, these include, among others, the worker–client relationship, client and worker characteristics, worker skill, and practice and cultural context (Palinkas et al., 2009; Whaley & da-vis, 2007). Thyer (2010) argued, for example,

there are no such things as evidence-based interventions. there are research supported interventions…the phrase evidence-based practice refers to a ProCess of choosing one’s course of action, based upon an integration of many different factors, research evidence being one, but client preferences and values being another, professional ethics being a third, one’s own practice skills being a 4th, environmental resources being a 5th, etc. no one of these factors has primacy over the others, even the research evidence.

Thus, egP is inclusive, and it recognizes the range of variables that come into play in the effective help-ing relationship. evidence-guided practice means that social workers should attend to findings from outcome studies that have been validated and sufficiently rep-licated. Where egP parts ways with evidence-based practice is the recognition that the particular choice of technique to address client difficulties will hinge on the unique needs and desires of the individual client. The worker has to be prepared to be creative and come up with other strategies if those that have been found to be effective do not work with the particular client. tarrier (2010, p. 134) summed up the balance of at-tending to the individual and to the research base:

as a clinician i have to deal with patients as i find them with all the idiosyncrasies and heterogeneity that it involves.…to discharge [this responsibility] i need to be able to derive from the evidence base the best treatment for that patient as dictated by the

empirical research.…the researcher has established that a particular treatment works (or not) in general; the clinician is responsible for application of evidence to individual patients. (emphasis added)

unlike evidence-based practice, egP explicitly rec-ognizes relevant theory. Theories, as well as research, provide significant guidelines for practice. Theories about phases of individual, family, and group devel-opment; about ethnic/racial, religious, spiritual, and sexual identity development; about individual, family, and group behavior; and about how people change the structure of social workers’ assessments and suggest the direction that intervention may take (gray & Mc-donald, 2006; shdaimah, 2009).

While both theory and research findings about a broad range of variables are essential to social work practice, they are not sufficient. The application of theory and research to practice requires critical think-ing (gambrill, 2006). This is defined as the ability to define an issue/stressor/problem; to “distinguish, ap-praise, and integrate multiple sources of knowledge:” to formulate a tentative practice direction(s); to self-monitor, to self-reflect, and to “attend to professional roles and boundaries” (Council on social Work educa-tion, 2008, p. 3).

Attention to ArtistryTheory and research evidence provide a base for a dis-ciplined, scientific approach to engaging and helping clients. but social workers must also possess the au-tonomy and flexibility to improvise and to be sponta-neous. The worlds of theory and research are logical, orderly, and sequential. in contrast, the lives of people are confusing, disorderly, and contemporaneous. The very act of finding the connections among theory, re-search, and practice often requires a great deal of curi-osity and creativity (gitterman, 1991).

our needs for certainty and constancy can com-promise our natural curiosity and ability to tolerate ambiguity. Prescriptive theoretical frameworks and evidenced-based protocols may have the unintended consequence of rendering professional practice more rigid, devoid of spontaneity and authenticity, and less responsive to the “messiness” of clients’ lives.

in a particularly telling study, henry, strupp, butler, schacht, and binder (1993) examined clinicians’ behav-iors before and after they were trained in using manu-als to guide their interventions. The researchers found that those who followed these prescribed interventions demonstrated “unexpected deterioration in certain in-terpersonal and interactional aspects of therapy” (p. 438). The therapists reported that their spontaneity and intuition were curtailed, and clients felt “subjected” to treatment rather than engaged in treatment. The re-

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searchers further observed that “after training, thera-pists were judged by their clients to be less approving and supportive, less optimistic, and more authoritative and defensive” (henry et al., p. 439).

natural curiosity, a willingness to take a risk and follow hunches, and the ability to learn from mistakes and make more sophisticated mistakes are the sine quo non of artistry, as are the ability to “go with the flow,” to follow client cues, and to be transparent and genu-ine in our relationships with our clients. informality, spontaneity, and humor, when appropriate, provide a significant base for an artistic approach to engaging and helping clients.

social workers must each integrate professional methods, knowledge, and skills with their distinctive style and unique persona (Cnaan & dichter, 2008). Without this integration, clients often perceive social workers as mechanical and rote. When social work-ers rigidly adhere to prescribed interventions, they are unable to be authentically present or actively listen to clients’ verbal and nonverbal responses. Professionals must have the flexibility to follow clients’ messages and their own professional judgments. in fact, compe-tence, the capacity to self-monitor, and autonomy are precisely what makes a social worker a professional.

Practice Illustrationto illustrate an evidence-guided approach to practice, the authors drew on the group work modality, where the debate regarding the artistry and science of group work has been especially intense. group work is in-creasingly reliant on evidence-based manuals (Caplan & Thomas, 2003). Critics of the “manualization” of group work argue that control of the group rests sole-ly in the hands of the worker, which undermines the empowerment of members. further, the fixed agenda found in a manual artificially defines members’ needs as well as indicators of success. Perhaps most funda-mentally, the emphasis is on content—that is, what is in the manual—rather than on the process and mem-bers’ here-and-now interactions with one another and with the worker (gitterman, 2011).

Consistent with an evidence-guided orientation, however, group workers are beginning to recognize the benefits of evidence-based manuals (galinsky, 2003). a manual has the potential to sensitize the worker to the issues that may surface in the group and provide both the leader and members with a direction for work (galinsky, terzian, & fraser, 2006). further, clear ob-jectives and outcomes have the potential to enhance the overall effectiveness of the group intervention.

from an evidence-guided perspective, the group worker must be well versed in group work research, theory, and process in addition to the contents of the manual. for example, the social worker facilitating a

group must know that much of the driving force of the group experience is provided by the interplay of mem-bers’ feelings about the worker’s authority and feelings about becoming close to each other. in most instances, the preoccupation with the worker’s authority either precedes or occurs simultaneously with group mem-bers learning to trust and become close with each oth-er (bartolomeo, 2010; schiller, 2010). if the worker ex-pects to have her or his trustworthiness, authority, and competence tested in advance, the worker will have an easier time depersonalizing the testing and developing appropriate interventions.

to specifically illustrate this concept, consider the following scenario. Marcus is a social worker facili-tating an anger management group for adolescents who are required to attend because of their involve-ment with the juvenile justice system. Most have been charged with drug-related offenses and/or assault. Marcus is using an evidence-based manual that relies primarily on cognitive behavioral strategies. The man-ual includes 10 weekly lessons that teach members, among other things, possible sources of their anger, how to identify triggers, and techniques to manage their anger. each session of the group emphasizes a different lesson and builds upon the previous session. The manual is prescriptive in that each lesson is laid out in great detail, including suggested worker com-ments and required member activities. spontaneous exchanges between members and between the mem-bers and the leader are not addressed, implying that the leader should provide structure for each minute of the hourlong sessions.

in the first session, the six members of the group—all young men ages 15 to 17—are silent and appear to be hostile and disinterested. Marcus astutely recogniz-es that he cannot immediately jump into the manual’s “lesson” for the first session, which includes defini-tions of anger and what triggers angry responses in in-dividuals. if not addressed, members’ resentment and anger would lead only to an “illusion of work” (shul-man, 2009), in which they might go through the mo-tions of listening to Marcus’s “lectures” and engaging in the required activities without any real change in their thinking or behavior taking place. The challenge for Marcus is that his agency requires him to follow the manual, so he has to find a way to integrate the lessons included in the first session with what he sees right in front of him.

after explaining his role and the purpose of the group (evidence-based practice that enhances mem-ber commitment to the group), Marcus directly ac-knowledges members’ apparent anger about being in the group rather than starting with the lesson for the session. he makes this observation: “today we are sup-posed to talk about what anger is and what causes us

Gitterman & Knight | Evidence-Guided Practice: Integrating the Science and Art of Social Work

to get angry. given how you all are feeling about being here, i suspect you can tell me a thing or two about both of these issues!” This comment initially is met with hostile silence, but Marcus persists and observes, “i am wondering whether the group’s silence is a sign of members being pissed off about being here?” one of the members, Jonah, responds, “Yeah, man, this is bull—t. i don’t need no group. i just need to be left alone!” Marcus then observes, “Jonah is upset, and i bet he’s not the only one.” other members nod their heads in agreement. Marcus then says, “Perhaps we can start there, with you guys talking about the fact that you are angry that you have been made to come to this group when you don’t think you need it.” at this point, samuel, another member, volunteers, “i smoke a little dope some of the time. so what? it ain’t bothering nobody, so i don’t see why i have to be here!”

This group is well on its way to being a meaningful experience for the members, despite their initial un-willingness to participate. Marcus demonstrates that one need not choose artistry over evidence or vice ver-sa. Marcus’s skill as a group worker is apparent as is his understanding of group dynamics, individual member behavior, and the group worker’s role. he does not lose sight of the fact that he is operating from an ev-idence-based manual that depends upon a particular sequencing of content. Marcus is skillfully able to link the two—the process that is occurring in the here and now with the content that is outlined in the manual. Marcus reveals his critical thinking ability when he as-sesses what members’ behavior means and links their reactions to the intent of the session and purpose of the group in a meaningful and genuine way.

Marcus quickly realizes that he does not need to talk hypothetically about members’ anger and what causes it, as the emotion is right there, staring him (and others in the group) in the face. had Marcus ig-nored members’ actual feelings in favor of an academic discussion of anger and its causes, as dictated by the manual, he would have lost the group before it even started. as he acknowledges the young men’s feelings about the group, Marcus is following the lesson plan for the first session. but he is doing it in a way that has meaning for the members and capitalizes on their im-mediate, here-and-now reactions.

Implications for Social work Education and practice

evidence-guided practice requires that students be taught to think critically and to be self-aware. They also must be encouraged to employ the science of social work in a way that is genuine and reflects their uniqueness as individuals. social work education also must teach students to not just tolerate ambiguity, but embrace it.

social work education must do a better job of prepar-ing students to value research findings and use them in their practice. The solution to this problem lies not in simply throwing more research terms and statistics at social work students. evidence-guided practice should be presented and modeled in the practice courses. staudt, bates, blake, and shoffner (2003–2004), for ex-ample, have developed the systematic planned practice model (sPP). Consistent with egP, the emphasis in this model is on multiple sources of knowledge and critical thinking. “sPP is not an evaluation design, but rather a way of thinking about and conceptualizing practice so that evaluation becomes an integral part of practice…. Within the sPP framework, practitioners must make explicit their practice decisions, provide rationales for these decisions, and specify the practice implications of the decisions” (staudt et al., p. 71).

students themselves have recognized the value of learning about research concepts in practice courses (staudt, 2007). Presenting research material in meth-ods courses legitimizes its importance for practice and demystifies it for students. Yet, egP is more than the application of research concepts, as we have discussed. evidence-guided practice reflects an ecological per-spective and depends upon worker self-awareness, use of self, critical thinking, and a solid grounding in the-ory, each of which should already be an integral part of any practice/methods course.

in a different vein, egP requires support from em-ploying organizations and academic institutions in the form of access and time for social workers to consult the literature, particularly bibliographic databases. in addition, the professional literature needs to be pre-sented in a way that allows practitioners to easily and quickly grasp essential information (osterling & aus-tin, 2008; staudt, dulmus, & bennett, 2003). several recent developments in the field are promising. gary holden’s information for Practice website (http://ifp.nyu.edu/) is easy to use and practitioner friendly. it contains recent research relevant to contemporary social work practice and is available free of charge to anyone who logs on to the site. similarly, the Min-nesota Center for social Work research (http://www.cehd.umn.edu/ssw/research) regularly publishes a free newsletter that summarizes recent research and pres-ents it in a way that is accessible to practicing social workers. unfortunately, it is unlikely that most social workers practicing today are aware of these and other such resources that support egP (lord & iudice, 2011).

social workers are caught between agency mandates for documenting positive outcomes and what they have been taught about an ecological, client-centered approach in social work. The challenge is to encour-age agencies and funding sources to adopt this more ecologically focused approach to practice. evidence-

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guided practice provides practitioners with the tools necessary to employ research findings, and it has the added advantage of encouraging workers to take into account the range of variables that inevitably af-fect practice outcomes. borrowing from smyth and schorr’s (2009) discussion of what it takes to provide effective interventions, particularly to marginalized populations, the authors propose that egP adhere to the following principles:1. trusting relationships—between worker and client,

between client and significant others—are central to effective outcomes.

2. Clients must be active and informed partners in the social work endeavor.

3. Clear standards for practice must be balanced against flexibility in the face of client needs and circumstances.

4. The agency and worker must take into account and be prepared to intervene in the wider social environment.

5. Workers must be accountable for their actions and must continuously use research to guide their practice and refine and improve program design and delivery of services.

conclusion

We conclude with the suggestion that efforts to identify best practices must continue, but must be expanded to include the more subtle, hard-to-measure variables that we have identified. such research is not impossible to conduct, as the results of studies cited in this article in-dicate. What is required, however, is greater advocacy on the part of social work practitioners, educators, and researchers for financial and organizational support for a broader, ecologically based approach to research.

increased attention also needs to be devoted to iden-tifying how to get information to practitioners in a way that makes it easy for them to use. as noted, there are forums that already provide valuable information to guide clinicians in their practice, and more such sources are appearing all the time. however, these in-formation clearinghouses are only as good as the con-sumers who use them.

social workers must embrace scientific methods to guide their practice. They also must uphold their pro-fessional responsibilities and commitment to social justice and to a multidimensional view of clients and the challenges they face. and finally, they must hold on to their humanity, spontaneity, and passion for making a difference in people’s lives. evidence-guid-ed practice, as described in this article, allows social workers to do just that.

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Gitterman & Knight | Evidence-Guided Practice: Integrating the Science and Art of Social Work

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Families in society | Volume 94, no. 2

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Alex gitterman, edD, Zachs professor of social Work, University of Connecticut. carolyn knight, msW, phD, lGsW, professor, Uni-versity of maryland. Correspondence: alex.gitterman@uconn.edu; University of Connecticut, school of social Work, 1798 asylm ave., West Hartford, Ct 06117.

Authors’ note. We express our appreciation to professors Heller and Klein for providing suggestions to an early draft of the manuscript.

manuscript received: June 18, 2012revised: september 18, 2012accepted: october 2, 2012Disposition editor: Jessica strolin-Goltzman

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