The Sage Handbook of Social Constructionist Practice. Группа авторов
this knowledge in their practice. This has led social service organizations to promote their services as evidence-based, resulting in the EBP label becoming a marketing tool used to communicate to potential clients that they will be receiving the best available services, backed by science.
From a social constructionist perspective, EBP's underlying assumptions, its widespread endorsement, claims, and politicization, generate some troubling issues. Although on the surface the idea of EBP seems laudable, to use the best available evidence in collaboration with the client to develop a treatment plan, its meaning in use and underlying philosophical foundation bears closer inspection.
Social construction encourages a problematizing orientation toward commonly held beliefs and concepts. Rather than accepting such concepts and beliefs as given or the way things are, social constructionists interrogate meanings, origins, use, and most important, benefits and harms. Social construction also encourages analysis from a relational perspective. When applied to EBP, a number of issues emerge. For example, I (Witkin, 2017) problematize the meanings of EBP, raising questions such as: Should early meanings of the concept – those attributed to the originators – be privileged? Is the meaning of EBP found in its definition or in how it is practiced? Is the concept of EBP static or does it change as social conditions change? Regarding application, I explore the difference between EBP use in practice versus its use in research, the latter being more circumscribed and uniform. Also related to application are the complexities of assessing whether an evidence-based treatment is appropriate for a particular client. EBP is a multidimensional concept derived from different kinds of inquiry with different research participants in different settings, presenting different problems, and using different measures. Ironically, when practitioners rely on summary evaluations from organizations like the Cochrane Collaboration, they are moving away from an evidence-based approach toward a more authority-based approach (Goldenberg, 2009). Consequently, applying the recommended procedure involves a leap of faith in the summarizing organization. The issue of what counts as evidence can also be viewed as a political issue. For example, Denzin (2009) asks,
[W]ho has the power to control the definition of evidence, who defines the kinds of materials that count as evidence, who determines what methods best produce the best forms of evidence, whose criteria and standards are used to evaluate quality evidence? (p. 142)
The response to these questions is inevitably political, subject to the vicissitudes of power relations within the context in which EBP is being applied.
From the EBP perspective, evidence is a form of knowledge. Such knowledge depends on the means by which it was generated. Therefore, research-based knowledge is most authoritative, trumping knowledge generated from other activities such as practice. From a social constructionist perspective, knowledge can be considered a status given to information. Its credibility will depend on the traditions of the knowledge community to which it is applied. Thus, for practitioners, knowledge generated within the context in which it will be used, and which is sensitive to client differences, is more relevant, robust, and useful. Moreover, it is generated within relationships and will reflect the dynamics of those relationships. Therefore from this standpoint, it is practice that should be the primary site of knowledge generation (Witkin, 2015).
Cultural Competence
Social work practice, like practice in related fields, is influenced by constructs that signify cherished value positions. One such construct is cultural competence. Within social work, cultural competence is primarily seen as expressing respect for cultural, ethnic, and race differences, and is therefore a critical dimension of practitioners’ knowledge and skill. This position has led to numerous training programs aimed at equipping practitioners with the requisite knowledge and skills to be competent in various cultures. The social constructionist informed social work practitioner acknowledges the value of sensitivity and knowledge of cultural and other forms of difference and their importance to relationship development; however, this is not synonymous with being ‘competent’ in a culture. In fact, for social constructionist informed practitioners the very notion of cultural competence is not assumed, but problematized, generating questions such as the following: What does it mean to be competent in a culture? How is such competence conferred and what privileges are given to its holders? What does this construct imply about culture (e.g., that it can be reduced to a set of competencies)? They also challenge the notion of cultural homogeneity and cultural inertia. People internalize and represent cultural values and ethos in different ways. Also, cultures are dynamic, they change over time. Finally, competency is an individualistic concept. As such it ‘underemphasizes the social, relational context of social work practice as the site where meanings are negotiated and realities generated’ (Witkin, 2017, p. 79). A social constructionist orientation could shift the practitioner's stance from cultural competence to ‘cultural humility’, from knowing the traits or qualities of a specific group to remaining open, curious, exploratory, and respectful of the myriad ways that clients have come to understand and express culture. For practitioners, a useful extension of cultural humility is narrative humility in which the idea of fully comprehending or mastering another's story is put aside in favor of ‘remaining open to their ambiguity and contradiction, and our own role in the story … how the story attracts or repels us because it reminds us of any number of personal stories’ (Das Gupta, 2008, p. 981). An important implication of this approach is that it extends beyond people perceived as culturally different to the conditions that influence and shape the stories we hear (Holstein and Gubrium, 2008).
Social Constructionist Informed Micro- Mezzo-, and Macro-Level Practice
Social construction, as applied in social work practice, is not a set of techniques but a way of foregrounding relational understandings. Social workers and their clients are understood as existing in a mutually influencing, meaning-making relationship. Micro practice is re-envisioned from the achievement of traditional goals of client behavioral change brought about by behavioral reinforcement, cognitive processing, or other clinical mechanisms to transformational change in which clients re-construct and experience themselves and their worlds differently through collaborative social worker–client relationships. Macro and mezzo practice is based in collaborative meaning-making about how problems and solutions to those problems will be understood. In this section we use practice examples to demonstrate these concepts. Because we view social construction as a sense-making framework rather than a prescriptive, method-oriented blueprint, we use the phrase ‘social constructionist informed’ social work practice. In this case, social construction is the guiding framework in the collaborative co-construction of problems and potential solutions. While there are practice models used within social work that are congruent with social constructionist ideas, for example, solution-focused (de Shazer and Dolan, 2012), possibility (O'Hanlon and Bertolino, 2013), and narrative (White and Epston, 1989), we focus more generally on how a social constructionist informed practice might guide social workers. Key social constructionist ideas that inform practice include that there is no inherent meaning in events, objects, or relationships; that meaning is applied to events, objects, and relationships; that meaning is controlled by language relationships; and that language and meaning are created in relationships (Hall, 2012).
No Inherent Meaning in Events, Objects, and Relationships
The above premise shifts social constructionist informed social work away from objective assessments designed to discover the truth of things into the realm of collaborative exploration in which meaning and understanding are explored and created relationally. Specifically, social workers are invited to adopt an open mindset in which assumptions of meaning are acknowledged. This position has been described in various ways by social constructionist informed scholars as looking with planned emptiness (Middleman and Wood, 1990), adopting a not knowing position (Anderson and Goolishian, 1992), and taking a curious stance (O'Hanlon and Beadle, 1999). This premise is most clearly seen in macro and mezzo social work through collaborative community and agency approaches (Wood and Tully, 2006) and in research through constructivist grounded theory (Charmaz, 2014) in which social workers seek to engage in collaborative and non-expert oriented ways of practice and research to reach agreed-upon constructed outcomes, collaborative change, and constructed meaning. In micro practice the premise