The research-practice debate in a qualitative research context

I was gratified to see the rebuttals to my article Does the Glove Really Fit? Qualitative Research and Clinical Social Work Practice" (Padgett, 1998a). I would have been disappointed if it had not generated a response, and I welcome this opportunity to engage in a dialogue on qualitative methods and social work practice. Some of my colleagues - practitioners and researchers alike - have expressed mild surprise that my cautionary tale needed to be told. What is the issue here? they ask. Isn't it obvious that qualitative research methods and social work practice are two different endeavors? The critiques of Bein and Allen and of Heineman Pieper and Tyson attest to the continued advocacy of a position that I find troubling. I will address each of these responses separately and then return to my original argument and its viability in the face of these charges. Bein and Allen's rebuttal seems more focused on my characterization of social work practice than on the central premise of my argument. Indeed, their final paragraph expresses agreement with my main contention regarding the need to maintain a separation between the clinical role and the role of the qualitative researcher. We are left, then, with their assertions regarding my "outdated" and "sanitized" view of social work practice. Bein and Allen state that I have equated clinical practice with outdated images of private practice. My response to this is twofold. First, they seem to have ignored my caveat acknowledging the great diversity - theoretical, individual, and regional - in models of social work practice. Second, I was referring throughout to direct practice in social work, with the full knowledge that this is largely agency-based (with a smaller component of private practice as well). The fact that some social work practitioners work with mandated clients, with groups rather than individuals, and in naturalistic settings does not detract from the reality of social work practice today. I believe that my characterization is closer to this reality than Bein and Allen's. If anything, the pressures of managed care have placed even further constraints on the type of inductive and narrative approaches they claim are widespread. I do not like the current situation any more than Bein and Allen do, but I think it is misleading to argue that clinical practice takes place primarily in client's homes or other naturalistic settings and that it is stripped of the influence of psychological theories. Although social interventions and advocacy are at the heart of social work practice, assisting clients with depression and other serious mental disorders requires at least some accommodation with psychiatric treatments. To neglect these treatment options would be tantamount to malpractice. Have we discarded the "bio" and "psycho" from the "social" dimensions of client assessment and intervention? I hope not. Much of Bein and Allen's rebuttal is more of an idealized depiction (and an exhortation) of what social work practice should be rather than what it is. Relying on selective citations and anecdotal reports from their own experiences, Bein and Allen offer no convincing evidence to support their assertions. In any case, embracing a strengths- or solution-focused perspective does not diminish the importance of the clinical practice mandate. The movement in social work to focus on strengths must be placed in its proper context. Client strengths make sense only when addressed a part of a problem-solving intervention. Whether you believe that the problem is biological, psychological, or social in origin (or a combination of all of these etiological factors), social work practice derives its raison d'etre from that fact that vulnerable people and communities need help. Otherwise, there is no need for professional assistance. Even if one were willing to accept Bein and Allen's depiction of social work practice as the norm, I believe that my basic argument retains its validity. …