Abstract
It is, for many reasons, a privilege to review Social Work Practice with Individuals and Families. This is a leading book, covering the evidence supporting the assessment and intervention across the life span. The editors have done a remarkable job in putting together a volume with a clear structure, based on contributions from authors with a closer understanding of the evidence informing the field of assessment and intervention. The book is intended to be a “foundation social work practice text with individuals and families for undergraduate and graduate students in social work programs” (p. xii). It reflects numerous competencies for accreditation required by the Council on Social Work Education.
Well organized and wide ranging in scope, the volume parallels a chapter on assessment with one on intervention for each of the following groups: children, adolescents, adults, the elderly, and families. The 10 chapters largely follow a similar structure that includes a history of the assessment of intervention with the group of concern, the current evidence, its limitations, and implications for practice. In order to meet students’ educational needs, each chapter starts with a concise text box presenting its purpose and rationale, how evidence-informed practice is presented, and the overarching question being addressed. The end of each chapter follows the same consistency of style: with a set of key terms, five critical thinking questions, and further online resources.
In Chapter 1, Michael E. Woolley positions the assessment of children in the context of social work ecological orientation and of the trend toward increasing the use of quantitative survey instruments in child assessment. We learn there are epistemological and ethical arguments for prioritizing children’s definition of the struggle. As they commonly report higher rates of severity of social and emotional problems than adult informants, the chapter strengthens the need for practitioners to include data based on self-report instruments. Steps for constructing reliable and valid assessment tools are being discussed.
In Chapter 2, Mary C. Ruffolo and Paula Allen-Meares present the key evidence-based interventions for children with emotional and behavioral problems. The interventions presented address complex problem areas, are multicomponent, and take place at the level of the individual children, family, and school/community. The status of empirical evidence for each practice is presented, alongside the main elements promoting positive outcomes.
In Chapter 3, David W. Springer and Tara M. Powell discuss criteria and strategies for selecting assessment scales, instruments, and screening inventories in ways that take into consideration the best available research, clients’ background, clinical utility, and treatment goals. Besides an informative overview of various tools, the authors engage in a very sensible examination of the limitations in assessment with adolescents. This section goes beyond the habitual concern for psychometric criteria (validity and reliability) into their applied value for assessing a population with multifaceted problems (e.g., issues of comorbidity and developmental particularities).
In Chapter 4, Craig Winston LeCroy and Lela Rankin Williams overview evidence-informed practices for intervening with adolescents. It includes a presentation of issues and problems facing adolescents and discusses promising programs of prevention, intervention, and treatment. The chapter includes besides a limited number of evidence-based interventions, other “probably efficacious treatments” (cf. “The Task Force Report on Promoting and Dissemination of Psychological Procedures,” 1995).
In Chapter 5, Elaine Congress examines various assessment models used in social work along its historical development (from a focus on psychosocial diagnostic, to the more recent tendency toward client-centered assessment models). It goes on to present sources of information, scales, and assessment tools including a useful culturagram. The chapter touches upon some of the social work concerns related to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition axes, in particular the unduly emphasis on medical disorders, at the expense of understanding the broader context or environment.
In Chapter 6, Bruce A. Thyer presents the sources for locating evidence-based interventions with adults. It starts by introducing the intricate process of establishing evidentiary standards for evaluating effectiveness of interventions (the work of Division 12 within the American Psychological Association). Then, the author engages in a clarifying discussion of main concepts (“evidence-based practice,” “empirically supported treatment,” and “practice guidelines”) and touches upon the discordant positions these notions generated among various professional communities. The chapter calls for social work programs to center the courses on the systematic reviews available on Campbell and Cochrane Collaborations and invites practitioners to proactively seek the evidentiary foundations of what they are doing.
Chapter 7, authored by Gregory J. Paveza, provides a systematic description of comprehensive geriatric assessment (CGA), a complex process that includes: an examination of the mental status, functional assessment, social and environmental assessment, nutritional- and health-practices review, medical history and treatments, and assessment of emotional well-being. The CGA is able to inform the care plan. It is argued that although evidence on the effectiveness of CGA is rather mixed and divided, a meta-analysis concluded that it enhances clients’ adherence to care recommendations.
Chapter 8, authored by Michael J Holosko, Jeffrey F. Skinner, Catherine A. Patterson, and Kimberly Brisebois, is organized according to three cohorts of evidence-based studies used in a review of interventions with the elderly. These are (i) conceptual/theoretical frameworks; (ii) effectiveness studies; and (iii) assessment of specified interventions and outcomes. A main argument is that practitioners need to inform their practice decisions also by an understanding of broader social themes/issues (e.g. demographic changes, shortage of trained personnel, the impact of new technologies, prevailing ageism, and social polarization). It is argued that operating very clear distinctions between micro/mezzo/macro levels may restrict social workers' ability to be effective.
In Chapter 9, Robyn Munford and Jackie Sanders look into the assessment of families from a social constructivist perspective and interrogate the power structures that shape social work practice. It is a thought-provoking chapter, arguing that approaches in family assessment are not politically neutral. It calls practitioners to inform their choices by a broader understanding of difference, which needs to go beyond a conventional local sensitivity to diversity and to embrace more global concerns such as unequal economic development, different constructions of human rights, multiple, and contested notions of well-being. The authors analyze assessment processes at the micro, mezzo, and macro levels of practice in ways that incorporate these above themes, values, and principles.
In Chapter 10, Cynthia Franklin, Catheleen Jordan, and Laura Hopson present evidence-based interventions that have been evaluated based on well-controlled experimental designs or strong quasi-experimental designs. Grounded in the understanding that assessment, treatment planning, intervention, and treatment monitoring cannot be seen in isolation, the chapter provides techniques for each element. Insightful implications for practice and principles for guiding action are systematically presented.
There are several emerging trends/new directions in social work, which one can infer based on the research evidence being presented in this book, in particular: (i) a move from a focus on individuals’ developmental history, to a “Person in Environment” system orientation; (ii) a move from a focus on problems—the “deficit-model,” to a strengths-based approach in both assessment and intervention; (iii) a move from long history taking—“history for the sake of history” (p. 271) to an emphasis of the relevant history and goal-oriented assessment; (iv) the repositioning of clients and families from passive recipients of interventions, to being actively involved in the change process; (iv) a move toward effective short-term interventions, rapid assessment, and treatment; and (v) preference for ongoing assessment and the integration of assessment with treatment. The book is also penetrated by a crosscutting concern over practitioners having to intervene with clients (individuals and families) who have multiple problems and co-occurring disorders, or facing social problems of structural nature. Overall, the research evidence presented supports ecological approaches in assessment/intervention and strengthens the theory base of social work as eclectic and interprofessional.
The book also touches upon several insightful issues likely to advance the field of assessment and intervention for the near future and, potentially to be included in a next edition, when evidence will add up: Why various interventions work? Why the transfer from research into practice (translational research) is not easy? What are the personal implications for practitioners undertaking evidence-based assessment and interventions (e.g., occupational stress, burnout, and vicarious trauma)?
This book is a great contribution for several reasons. First, it brings the evidence-based assessment closer to the center of the social work practice. Although generally acknowledged as essential, the development of evidence-based assessment remained rather marginal. This book is a timely contribution able to rethink this tendency and to shape the understanding of social work practice in a way that integrates assessment.
Second, this volume unfolds an impressive array of recent developments in social work with individuals and families. Reflecting the diverse epistemological foundations of the discipline, the book covers a wealth of explanations: from historical progresses in assessment/intervention, to the current status of evidence, various limitations, cultural dilemmas, tensions, and tendencies.
Overall, the volume makes a compelling case for (future) practitioners to internalize a mode of action informed by the best available research evidence, client values, and professional expertise and shaped by a critical awareness at the social and political context in which their actions are embedded. Grounding social work programs in readings like this creates the enabling circumstances for more informed, self-critical, and thoughtful processes of assessment and intervention.
In carrying out this impressive work, the editors and the authors had to handle at least two major challenges. One was given by the multidimensional nature of problems that families and individuals face. The second, by the apparently weak (internal) consensus on criteria for judging what is meant by “evidence-informed” assessments and interventions. A more consolidated introductory chapter would have been opportune for clarifying the concepts/the positioning or for opening up the debates on this rather contentious area. As it stands, the Preface does not do justice to the rich conceptual discussions on what qualifies as evidence and unsolved tensions between “evidence-based practice” and “evidence-informed practice” remain. On the other hand, authors are to be commended for handling this volatile terrain with professionalism: by avoiding unsupported claims and by making the level of evidence/empirical support explicit.
The book represents a rich and accurate text for informing teaching and learning in social work programs. It is wide ranging in scope, highly informative, well organized, and captivating in style. All authors did a remarkable job in balancing scientific rigor with accessibility in complex areas, where evidence, but also the needs and dilemmas accumulate at a fast pace.