A Historical Perspective on the Future of Innovation in Social Work

Summary of the ECP Movement

ECP was an orchestrated attempt to shift U.S. social work from a practice paradigm based on authority (e.g., standing and reputation in the field, conceptual appeal, and influence of proponents) to a practice paradigm based on empirical evidence (Okpych & Yu, 2014). The ECP movement was born out of crisis and opportunity. Formidable reports about the ineffectiveness of social work interventions, a political atmosphere that increasingly demanded demonstrated effectiveness and efficiency, and competition from fields that shared professional turf with social work threatened business as usual. At the same time, scholars trained in behaviorism entered social work with a new vision of grounding direct practice in rigorous empirical evaluation. Methodological innovations (especially single-system designs) developed in psychology and computing advances made it easier and faster to generate empirical evidence (Bronson & Blythe, 1987; Glisson, 1982; Hersen & Barlow, 1976). With the confluence of professional vulnerability and opportunity, several scholars in the early 1970s mounted the ECP movement. The end goal was to transform social work into a profession that was thoroughly grounded in empirical investigation. This meant that research production would increase, practitioners would preferentially use interventions that were backed by research (not tradition), and practitioners would routinely evaluate their interventions using systematic methods. Revolutionizing social work would require a sustained and coordinated effort to convince the field that the change was needed, develop new models of practice, disseminate these models, and cultivate enabling contexts that supported everyday implementation of the new models.

Although ECP was several years in the making, its origin can be traced to strategic meetings and conferences organized by social work scholars in the 1960s and early 1970s. Several scholars created generic practice models—templates for how practitioners would incorporate evidence into practice. The details of these models varied, but they all included steps of vetting empirical evidence, incorporating evidence into decisions about which treatment to use with particular clients, and systematically evaluating client response to treatment. This last part would not only track the effectiveness of the intervention but also inform the remainder of treatment. Some evidence-based practice (EBP) scholars argued that a small fraction of practitioners should receive additional research training, so that they could conduct rigorous research and contribute to the growing body of intervention research.

The movement was primarily disseminated through conferences, publications, and education in schools of social work. ECP has been described as an inside-out, bottom-up approach to diffusion and implementation (Okpych & Yu, 2014). Students trained in ECP methods in schools of social work were expected to spread ECP into the practice world and up through the ranks when they began their professional careers. Although activities such as modifying curriculum standards and developing instructional programs in schools of social work were central parts of the ECP movement, much less attention was devoted to anticipating or modifying the day-to-day practice contexts in which social workers operated.

Factors That Influenced the Impact of the ECP Movement

Although the ECP movement elevated the role empirical evidence in mainstream social work and was a forerunner of the EBP movement, it fell short of its goal of revolutionizing social work direct practice. Dr. Yu and I identified several factors that contributed to its decline (Okpych & Yu, 2014). The formula in Figure 1, adapted from the intervention science literature, is used to organize the factors that proved to be particularly important. Although we did not use this formula in our original article, it nicely frames some our main conclusions about ECP. I believe these factors will also play a role in the reach and penetration of an innovation movement, should one occur. Fixsen, Blase, Metz, and Van Dyke (2013) used the following formula to identify important factors that affect the implementation of new education interventions: effective intervention × effective implementation = improved outcomes. During a presentation in September 2015, Melissa Brodowski from the Administration for Children and Families modified the formula as follows: effective and usable interventions × effective implementation methods × enabling contexts = socially significant outcomes. I modified Ms. Brodowski’s version for the current article. The multiplication signs are used to suggest that the factors likely amplify one another, and that if one of them equals zero, then the impact of the movement is thwarted.

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Figure 1.

Factors influencing the empirical clinical practice movement.

First, the reach and penetration of the movement is influenced by the degree to which key stakeholders (i.e., groups that will later play a role in carrying out the movement) have a role in defining and shaping the movement. Without early investment, the movement and its objectives can feel like something that is created and imposed from the outside and does not reflect the interests and concerns of stakeholder groups. Not only will important contributions be missed, but stakeholders may be less willing to back the movement and put in the needed work to ensure its success. The second factor is the extent to which the technologies of the movement are useful and useable. That is, there must be viable and effective models for enacting the objectives of the movement. In the ECP movement, the technologies were models for integrating empirical investigation into practice. In the innovation movement, the technologies are arrangements and venues for creating new practice and policy tools. The third factor is the methods used to spread the movement and put the technologies into use. Diffusion and implementation are complicated by the fact that major organizing bodies in social work (i.e., around education, teaching, and research) operate autonomously and have different interests, and the practice field is variegated, diffuse, and nested in layers of bureaucracies. Effective strategies will need to identify the intended audience and create a plan of action for generating enthusiasm and facilitating implementation that addresses multiple levels (e.g., workers, organizations, larger systems). Fourth is the constellation of contextual factors, ranging from overarching policies to day-to-day work environments. The extent to which issues specific to these contexts can be anticipated and addressed will influence the spread of the movement and the use of its technologies.

The ECP movement was limited in all four factors, hampering its lasting impact on social work. In terms of stakeholder investment, support was lacking in both breadth and solidarity. The main stakeholders involved with defining and fleshing out the movement were a limited group of social work scholars (some of whom had practice experience). Importantly, the hundreds of thousands of practicing social workers, supervisors, and administrators were not major players in the movement’s development. Moreover, although the movement had a base of stalwart proponents, support was far from unanimous. Some scholars raised concerns that a strong emphasis on research evidence would devalue practice wisdom and expertise. The movement also spurred philosophical debates about what was considered legitimate research and evidence in social work. Limited involvement from players who would carry out ECP and contestation about the movement translated into a weak foundation of investment from key stakeholders.

The second factor of creating effective and usable technologies was also met with obstacles. There was a shortage of empirical research on interventions. With a knowledge base lacking both in volume and rigor, vetting empirical literature to inform practice decisions was in some cases a futile undertaking. Additionally, ECP advocates disagreed about the other major activity prescribed by the new practice models—evaluation of delivered interventions. Whereas some envisioned practitioners as rigorous evaluators, others argued that the demands of methods with high-internal control could raise ethical dilemmas. These disagreements splintered the effort to create coherent and cohesive practice models that were effective and usable.

The diffusion and implementation tactics, as well as formidable contextual barriers in real-world practice, also stymied the ECP movement. A major problem of an inside-out, bottom-up approach used to spread the ECP movement is that influence diminished in relation to distance from schools of social work. ECP was met with a mixed reception by schools of social work and was a faint whisper in the larger practice world. Each year a few thousand empirically oriented social work students graduated and entered organizations and work settings, occupied by hundreds of thousands of employees who did not buy into and were not equipped to carry out ECP. Even students who were well trained and enthusiastic about ECP found it difficult to implement once they left the confines of their social work schools and internships. Organizational structure and culture, resources and technology, and work tasks were organized around a mode of practicing that did not involve the routine incorporation of empirical investigation. Without concerted efforts to transform practice contexts to enable the uptake of ECP, these contexts were countervailing forces that desiccated the seed of ECP.

Given the challenges in garnering broad stakeholder investment, developing effective and usable practice models, diffusing and implementing ECP, and cultivating enabling contexts, the momentum of ECP movement had greatly diminished by the 1990s.

Implications for Innovation in Social Work

Since its inception, social work has had its fair share of innovators who developed new methods for addressing social problems. Should innovation now be elevated to a defining characteristic of the field? This is not a trivial question. Although there are certainly exceptions, emphasis in schools of social work and the practice field is placed on service delivery not innovation. Shifting from a field with innovators to a field that innovates would require a sea change in what we value and how we operate. In short, innovation would need to become a movement. How might factors that affected the rise and fall of the ECP movement play out in a social work innovation movement?

Perhaps the greatest hazard for an innovation movement would be if it followed the development and diffusion trend of ECP (first and third boxes in Figure 1). ECP was devised and animated by a small circle of social work scholars and then dispersed to professionals with little involvement or investment in the movement. With regard to an innovation movement, it is critical that wide representation of social work stakeholders be involved early in devising the enterprise. Although social work scholars can broach the idea, they cannot be the sole directors, orchestrating the vision and articulation of the movement. It needs to be a movement of shared vision, shared interest, shared contribution, and shared responsibility. Effectively organizing disparate knowledge that is dispersed across many groups and domains of the profession likely will be a source of innovation. Moreover, if innovation is to catch fire, stakeholders should see their priorities, concerns, and motivations reflected in the movement. Rather than being an inside-out, bottom-up approach to development and diffusion, it should be a movement with representation from multiple domains and levels of social work from the start.

Closely related to methods of diffusion are enabling contexts that promote implementation (third and fourth boxes in Figure 1). These include broad contexts such as federal and state policy and more local contexts such as characteristics of organizations in which social workers are employed and day-to-day working environments. Although ECP was aligned with political pressure for thrift and efficiency, the practice models were difficult to institutionalize in practice contexts that lacked the structures, resources, and human capital to integrate evidence into practice. Similarly, innovation certainly coheres with larger contextual forces such as an emphasis on accountability, discovering and using treatments that are backed by evidence, the Grand Challenges Initiative in social work, and so forth. A greater challenge for an innovation movement may lie in anticipating potential hindrances to innovation that are closer to the ground. For example, in schools of social work that are already pressed for time, how can innovation be meaningfully added to or integrated into curriculum? Understanding and using innovations demand a very different skill set than generating innovations. Will students be trained to use innovations, generate innovations, or both? Will developing innovations be a focus for all students or just some students (e.g., those who show an interest in or proclivity for innovating)? For example, should Bachelor of Social Work and Master of Social Work students engage in innovation before they have an adequate grasp of social problems and policy and practice responses? Might Doctor of Social Work programs, which tend to recruit students with rich-practice experience, be well-suited settings to focus on innovation? Similarly, many organizations in which social workers are employed are built around service and face resource and time constraints that can be prohibitive to innovation even when interest exists. These are just a few examples of contextual constraints. Anticipating likely obstacles and mapping out a plan for implementation in education, training, and employment settings is needed to create environments that are prepared to innovate. Engaging a broad range of stakeholders early on can help with formulating a reasonable map of hazards and plan for action steps.

If an innovation movement was to transpire in social work, another early task would be to develop models of where and how innovation would take place (second box in Figure 1). These are arrangements and partnerships that would function as the breeding ground for creating new options for addressing social problems. These may include arrangements such think tanks, retreats, institution–organization–community collaborations, class projects, and competitive grants, among others. Although innovation cannot be forced, it can be cultivated. An important task would involve experimenting with and identifying arrangements that show promise for developing new technologies and could serve as templates to be repeated across the field.

Closing Thoughts

Many individuals involved in social work would likely agree that innovation is a worthwhile pursuit, but institutionalizing innovation is a different undertaking altogether. The latter entails making a case that innovation should take a more central and perhaps defining role in social work. This would require moving pillars not just repainting the walls of the profession. We will need to change from a profession with innovators to a profession that innovates. This could take shape in myriad ways. For example, one possible approach is training all social workers as innovators, whereas another is developing innovation as a specialization in the field. In addition to fostering innovation, we would need to be thoughtful about the targets of innovation. As Albert Einstein once said, “If I had an hour to solve a problem, I’d spend 55 min thinking about the problem and 5 min thinking about solutions.” Serious consideration will need to be given not just to the problems themselves but which problems might be responsive to innovation efforts. In some situations, devoting resources to existing tools may do more good than diverting resources to coming up with new ones. To be sure, there will be many difficult decisions that the field would need to wrestle with if we decide to pursue innovation in earnest.