Reserch on social work interventions

This special issue addresses one of the profession's most pressing needs--evidence about the effectiveness of interventions in social work practice. Notwithstanding recent progress in the development of its research infrastructure, social work suffers a dearth--in both quantity and quality--of empirical studies of practice (Proctor, 2001). A recent study revealed that fewer than 14 percent of the research articles published in social work journals addressed the central issue facing the profession--the development of effective interventions (Rosen, Proctor, & Staudt, 1999). As the then-editor of this journal wrote when announcing this special issue, "Practice is the raison d'etre of social work. The purpose of social work is intervention. Social workers do not stop after studying a phenomenon, but do something about it: prevent ill health, change policy, influence organizations, assist families, or teach individuals coping skills. Why, then, do so many social work researchers stop with studying a phenomenon (descriptive research) rather than look at what social workers do and its effects?" (Fortune, 1999, p. 2) The credibility and effectiveness of our practice depends on the sufficiency of our knowledge about what works, under what circumstances, and for whom (McMahon, Reisch, & Patti, 1991; Task Force on Social Work Research, 1991). It is essential that the field increase its attention to intervention research. Thus, this collection of articles has particular importance. Each contributes new understanding about social work practice methods. Each contributes to our quest to discover "what works." The range of interventions reflects the breadth and variety of what we do--both prevention and intervention, with methods ranging from specific aspects of worker-client collaboration, to "packages" of component interventions (for example, family preservation "services," educational and prevention "programs"), to programmatic-level services (for example, shelters). Three articles demonstrate that our practice has enduring effects over time. This issue also addresses interventions' effectiveness in reaching not only ultimate outcomes, but also intermediate outcomes--that is, outcomes that reflect the worker-client relationship and contribute to the attainment of subsequent outcomes (Proctor, 1982; Rosen & Proctor, 1978). Littell's article addresses the intermediate outcome of client participation in treatment. The construction and testing of interventions in medicine and psychology is traditionally understood to begin with efficacy research, testing or validating interventions in relation to outcomes under relatively uniform and controlled conditions, with the primary focus on internal validity. Efficacy studies are and will remain important in an iterative process of knowledge development. Yet social work ultimately requires effectiveness studies--those that field-test interventions in relation to a variety of clients, settings, and practitioners so that issues of external validity are addressed. The articles published here are relevant to the diverse populations we serve. Each study reflects the complexity of real-world service settings--residential treatment settings, schools, shelters, and child welfare agencies. Moreover, Littell's findings indicate that clients must participate fully in these real-world services to attain desired outcomes. This issue's lead article reports on the effectiveness of a theoretically based and well-specified program targeting a significant public health concern among a high-risk population. Slonim-Nevo tested a cognitive--behavioral program designed to prevent HIV/AIDS among adolescents in residential centers and found the intervention to have a significant effect on participants' knowledge about HIV/AIDS, attitudes toward prevention, and coping with high-risk situations. Although the intervention did not affect all areas of targeted behaviors, it did have significant impact on the most important sexual risk activity--condom use in vaginal sex. …