Reconciling evidence-based practice, evidence-informed practice, and practice-based research: the role of clinical data-mining.

One can't talk about empowering social work without considering what disempowers social workers or how we disempower ourselves. One way is by constantly demeaning each other. Nowhere is the intramural practice of disparaging social work practitioners more pervasive than in the rhetoric of the evidence-based practice (EBP) movement. Alongside rigorously conducted research studies, one often finds disparaging references to practitioners' lack of critical thinking, the weakness of practice wisdom, and the dangers of interventions that have not first been tested via randomized controlled trials (RCTs) and meta-analyses. Practitioner disparagement appears to be both the raison d'etre and the sine qua non of EBP rhetoric. Having taught social work research for four decades, I am painfully aware, however, that the easiest and most self-defeating strategy for winning over "research-reluctant" students is to harangue them about how "soft headed" social workers are (Epstein, 1987). Instead of producing an appreciation of what research can tell us and what it can't or building on practitioners' concern for clients, a pedagogy grounded in disparagement only produces further research alienation--except, perhaps, in those few who go on to teach research and extend this unfortunate pedagogical practice for yet another generation. EBP RHETORIC AND ANTIPRACTITIONER BIAS Although disparagement of practitioners by researchers did not begin with EBP, I was reminded of it when I received my latest issue of Research on Social Work Practice. Vainly hoping to see a review of my most recent book (be careful what you wish for), I settled on Stoesz's (2010) review essay on Gray, Plath, and Webb's (2009) new "critique" of EBP Rather than dwell on the strengths and weaknesses of the book, Stoesz uses the opportunity to rail against social workers' sloppy record keeping, poor math skills, and seeking of "safe haven" in qualitative research and postmodernism. His catalogue of research calumnies is titled "Second-Rate Research for Second-Class Citizens" (Stoesz, 2010, p. 329). In his review, Stoesz righteously remarks, EBP represents a challenge to social work as a prescientific activity, a muddle of humanism, psychoanalysis, and most recently postmodernism. For proponents of EBP, little of social work, as it has evolved, makes much logical sense; its validity is based ultimately on the "authority" of practitioners as opposed to any independent rational assessment of efficacy. In the absence of evidence, social work is a grab bag of good intentions ... just as likely to inflict harm as benefit. (pp. 329-330) In the same issue, an invited article by Gambrill (2010)--perhaps the most prolific producer of pro-EBP and antipractitioner rhetoric--posits EBP as the "antidote to propaganda" and practitioner "palaver" in social work. Emphasizing the harm potential in social work services, Gambrill charges that social workers and those they serve are "bamboozled by false claims in professional journals and textbooks" (p. 303); that interventions not vetted by EBP methodology are "propagandistic" and "key in quackery, fraud and corruption" (p. 312); that criticisms of EBP are "propaganda ploys" and "distortions and misrepresentations"; and that EBP'S critics "have no concern for truth, only to create credibility and for guile and charm" (p. 304). By her logic, criticism equals "censorship." I cannot do justice to the prodigious effort (going back to Pope Gregory's first papal propaganda office in 1622), inflammatory language, and arguable logic that Gambrill (2010) invests in her representation of the dangers inherent in social work practices that are not guided by the EBP movement she champions. EBP is portrayed as a victim: "Distortion of the deeply democratic, participatory and transparent process and philosophy of EBP is an illustration of the power of propaganda to maintain authority-based decision-making" (Gambrill, 2010, p. …