Research on Social Work Practice Does Not Benefit from Blurry Theory: A Response to Tomi Gomory.

Research on Social Work Practice Does Not Benefit from Blurry Theory: A Response to Tomi Gomory. The idea that casework needs a superordinate theory or theories is no longer tenable. The knowledge base of future practice will more likely consist of a variety of empirically demonstrated propositions from different perspectives, tied together by at least one major thread, i.e., their utilization leads to success in helping clients. Joel Fischer IT IS CERTAINLY AN HONOR for one's modest efforts to receivesuch concentrated attention from a scholar so gifted with a keenintellect and erudition er��u��di��tion?n.Deep, extensive learning. See Synonyms at knowledge.Eruditionof editors—Hare.Noun 1. as Professor Gomory. I was sorely tempted toform a simple one-sentence response to his critique, thanking him forhis analysis and urging the reader to give his arguments the attentionthey deserve. But I have known and respected the journal's editor,Professor Eileen Gambrill, for too long to disregard her graciousinvitation for a more detailed reply. It may help the reader for me toprovide some background as to how my article and Gomory's have cometo your attention. In 1998 I was invited to attend the annual Ohio StateUniversity Ohio State University,main campus at Columbus; land-grant and state supported; coeducational; chartered 1870, opened 1873 as Ohio Agricultural and Mechanical College, renamed 1878. There are also campuses at Lima, Mansfield, Marion, and Newark. College of Social Work National Symposium on DoctoralResearch, serving as a commentator for several of the dissertationspresented there. The dean of the College of Social Work, Dr. TonyTripodi, and the director of the PhD Program, Dr. Denise Bronson,invited me to give the keynote address keynote addressn.An opening address, as at a political convention, that outlines the issues to be considered. Also called keynote speech.Noun 1. for the following year'ssymposium. I was greatly honored by this opportunity. In 1998 thekeynote speaker was Dr. Enola Proctor, in 1997 Dr. Eileen Gambrill, andto be invited to follow in the footsteps of such illustriouspredecessors was in some ways the nicest professional recognition that Ihave ever received. I worked on my address, titled "The Role of Theory in Researchon Social Work Practice," during the following 12 months, andpresented it at Ohio State on April 12, 1999. I made the manuscriptavailable to selected individuals (e.g., social work doctoral programdirectors, members of various social work Internet Listservs, etc.), andin due course it appeared in the conference proceedings. I havepresented it at two international and one national conference and, basedon these dissemination efforts and feedback, revised it. I submitted itto the Journal of Social Work Education (JSWE JSWE Journal of Social Work Education ), under the prioreditorship of Dr. Paula Allen-Meares. It was critically reviewed andturned down, with a request that I revise and resubmit Verb 1. resubmit - submit (information) again to a program or automatic systemfeed backreturn, render - give back; "render money" it. I respondedto the reviewers' lengthy suggestions and submitted a revisionwhich was eventually accepted for publication. While I was patientlyawaiting its publication I attended an invitational conference on thedevelopment of social work practice guidelines practice guidelinesMedical practice A set of recommendations for Pt management that identifies a specific or range of range of management strategies. See Peer review organization, Practice standards. Cf 'Cookbook' medicine. held in May 2000 at theGeorge Warren Brown School of Social Work The George Warren Brown School of Social Work more commonly known as the Brown School of Social Work is one of the world's leading schools for the training of social workers, ranking 2nd (US News)and 9th (Gourman Report). at Washington University.Professor Gambrill was among the speakers, as was Professor Gomory towhom I was introduced. Professor Gambrill was Gomory's majorprofessor when he completed his PhD in social welfare at Berkeley. Weexchanged pleasantries and spent some hours together one evening,Professor Gomory, Professor Gambrill, Professor Stuart Kirk, and myself.It was a very enjoyable night--an hour browsing in a wonderful used bookstore, then a few beverages in a tavern talking. Two months ago Ireceived a request from Professor Gambrill, in her role as the neweditor of JSWE, asking for permission to delay the scheduled publicationof my blindly peer-reviewed article while Professor Gomory developed hisresponse to it, something she would invite him to do. I would in turn beoffered the opportunity to respond to his paper, and then he would reactto my response. This was to be a part of a new and ongoing initiativeProfessor Gambrill was undertaking as the Editor of the journal,intended to promote the critical analysis of published papers. I agreed,with some curiosity, not quite knowing what to expect. In due course Ireceived Gomory's paper, and I set about crafting my reply, whichbrings us to the present. On to some specifics! Antitheory? Moi? Yes, I am guilty of a prior essay appearing in this journal whereinI argued that social work education should not include theoreticalcontent in the BSW BSW Bachelor of Social Work (degree)BSW Bundesverband Solarwirtschaft (German Solar Industry Association)BSW BrettspielWelt (online gaming site)BSW Biblical Studies on the Web and MSW (MicroSoft Word) See Microsoft Word. curriculum (Thyer, 1994a). I stand by thatpaper and encourage interested readers to review its meticulously soundand irrefutable irrefutable - The opposite of refutable. reasoning. But I will not use valuable space toreiterate that paper here. If you e-mail me, I will send you a reprint.But, unlike Professor Gomory's first misrepresentation misrepresentationIn law, any false or misleading expression of fact, usually with the intent to deceive or defraud. It most commonly occurs in insurance and real-estate contracts. False advertising may also constitute misrepresentation. of my views,that paper did not extend the argument to educating doctoral students. Icertainly support teaching them theory, particularly empiricallysupported theories. You see, the BSW and MSW are professional practicedegrees, presumably pre��sum��a��ble?adj.That can be presumed or taken for granted; reasonable as a supposition: presumable causes of the disaster. based on scientific findings, but not themselvesacademic degrees like the PhD is at most universities. You can practicewithout recourse A phrase used by an endorser (a signer other than the original maker) of a negotiable instrument (for example, a check or promissory note) to mean that if payment of the instrument is refused, the endorser will not be responsible. to theory (many social workers appear to do soeveryday!), but theory can be quite useful in designing researchstudies. I myself have written a considerable number of theoreticalpapers (e.g., Thyer, 1987, 1988, 1992, 1993, 1994a, 1994b, 1997, 1999a,Thyer & Myers, 1997a, 1997b), which should belie be��lie?tr.v. be��lied, be��ly��ing, be��lies1. To picture falsely; misrepresent: "He spoke roughly in order to belie his air of gentility"James Joyce. any implicationthat I am somehow antitheoretical. My position in the paper ProfessorGomory reacted to is relatively simple: not all useful research is basedon some theory, and we in the academy should recognize this and stoppretending to be engaged in theory-testing research when we are reallynot. Just as finding one black swan disproves the contention that allswans are white, finding some examples of useful types of social workresearch that do not rely on formal theory disproves the contention thatall research must be theoretically based. My Selective Definition of Theory? Or the Profession'sDefinition? Gomory delicately suggested that I defined "theory" in adeliberately selective manner so as to buttress my position and that Imisunderstand what theory is. Perhaps he is right. I certainly haddifficulty understanding what Gomory means by theory, and I suspect thatmany readers do also. I cited widely used authorities in our field, thedefinition found in the National Association of Social Workers (1995)Social Work Dictionary, and the definition found in several social workresearch texts, including the prestigious Rubin and Babbie (1997), amongothers. I did not cull cullthe act of culling. Called also cast. the literature, blithely discarding points ofview at variance of my own. Rather the definition I address is preciselythat which most social workers really mean when they say"theory." Turn to textbooks on social work theory and you findthe kind of grand, encompassing accounts I spoke about in my paper. Someexamples are Roberts and Nee (1970), Greene (1994), Brandell (1997), andPayne (1997), each containing chapter-length treatments on grandapproaches such as systems, psychodynamic PsychodynamicA therapy technique that assumes improper or unwanted behavior is caused by unconscious, internal conflicts and focuses on gaining insight into these motivations.Mentioned in: Group Therapy, Suicide , cognitive, behavioral,ecological, humanism, existential, radical, psychsocial, functional,problem-solving, client-centered, symbolic interactionism Symbolic interactionism is a major sociological perspective that is influential in many areas of the discipline. It is particularly important in microsociology and sociological social psychology. , role,constructivism constructivism,Russian art movement founded c.1913 by Vladimir Tatlin, related to the movement known as suprematism. After 1916 the brothers Naum Gabo and Antoine Pevsner gave new impetus to Tatlin's art of purely abstract (although politically intended) , and Marxist theories. Do you, gentle reader, know whatGomory's definition of theory is? I certainly didn't after myfirst reading. I e-mailed him asking, "... would you be able togive me your sense of the term via email, as this may be an importantfactor in clarifying where you disagree with Verb 1. disagree with - not be very easily digestible; "Spicy food disagrees with some people"hurt - give trouble or pain to; "This exercise will hurt your back" my position." Hisresponse was "I guess the quote of Popper's that `we mustregard all laws and or theories as hypothetical or conjectural con��jec��tur��al?adj.1. Based on or involving conjecture. See Synonyms at supposed.2. Tending to conjecture.con��jec ; that isas guesses' (Popper, 1979, p. 9) about what is, is as good asany." I am sorry but this ambiguous definition is not as good asany, particularly the widely understood and accepted definitions Iprovided in my article. Payne (1997) summarizes this situation verynicely: There is also disagreement about what a social work "theory" is. Again, two positions exist, one broadly positivist, the other leaning towards postmodernism .... The positivist view is a strict application of scientific method. This argues that a "theory" is a general statement about the real world whose essential truth can be supported by evidence obtained through scientific method ... the process of theory development in positivist views comes from showing that an approach can work in particular cases, moving on to show that it does work in a series of cases, and then showing how it works.... In postmodernist views, the meaning of "theory" is looser. It is a generalisation which takes on three different possibilities: 1. Models describe what happens during practice in a general way, applying to a wide range of situations, in a structured form, so that they extract certain principles and patterns of activity which give the practice consistency. 2. Approaches to or perspectives on a complex human activity express values or views of the world which allow participants to order their minds sufficiently to be able to manage themselves while participating.... 3. Explanatory "theory" accounts for why an action results in particular consequences and the circumstances in which it does so. This is the positivist meaning of "theory." (pp. 34-35) See also Turner (1979): We frequently apply the word `theory' to describe such things as: basic tenets of practice; systematic formulation of ideas; approaches to theory; schools of thought or systems of thought; accumulated practice wisdom; post factum explanations of basic values; rather than the rigorous definition of theory usually used. (p. 4) So basically Professor Gomory (the postmodernist?) and I (therigorous positivist pos��i��tiv��ism?n.1. Philosophya. A doctrine contending that sense perceptions are the only admissible basis of human knowledge and precise thought.b. ) differ as to the meaning of theory. That seems tobe, as near as I can figure out, the basis of his argument. You know myview, and it is very likely similar to the one you understood. ForGomory, theory seems to imply all those things I specifically excludedfrom my use of the term--the underlying philosophy of science, models ofpractice, perspectives--and some others, including hypotheses,conjectures, and guesses. I submit that such an elastic use of the wordby Gomory renders the entire concept devoid of scientific meaning and,oddly enough, places Gomory in a particularly difficult position givenhis advocacy of falsificationism as a preferred method of inquiry. If bytheory you mean your underlying philosophy of science, model ofpractice, or perspectives, then how can you possibly falsify falsify,v to forge; to give a false appearance to anything, as to falsify a record. these viaempirical testing? It seems as if Gomory is advocating for a definitionof theory that cannot possibly be falsified. I concede that my ownpreferences for say, "realism" as an epistemologicalassumption, are axiomatic ax��i��o��mat��ic? also ax��i��o��mat��i��caladj.Of, relating to, or resembling an axiom; self-evident: "It's axiomatic in politics that voters won't throw out a presidential incumbent unless they think his challenger will , not supported by irrefutable proofs. Axiomsby definition are accepted givens and need no proof. If I acceptedGomory's view that if you have guesses that you bring to a study,or conjectures, or hypotheses, or an underlying philosophy of science,or the statistical assumptions of the t test, then I would by definitionhave to agree with him that all research involves theory in some way.But I was employing my definition of theory, not Gomory's. Hethinks my definition was parsed, selectively culled, and overlyrestrictive. I think it is a fair representation of theprofession's understanding of the term. Judge for yourself. I cangladly live with that. Who Said "Social Work Methods Are Atheoretical a��the��o��ret��i��cal?adj.Unrelated to or lacking a theoretical basis. "? Professor Gomory says that I endorse the statement that social workmethods are atheoretical. Sorry, not true. I have said that some areatheoretical (given the sense of the term I used and documented in mypaper). Here is another example: Take Habitat for Humanity Habitat for Humanity,nonprofit ecumenical Christian organization that enables low-income people to own affordable, livable housing. Headquartered in Americus, Ga., it was founded in 1976 by businessman Millard Fuller and his wife. (HFH HFH Habitat For HumanityHFH Henry Ford Hospital (Detroit, Michigan)HFH Heart Failure HospitalizationHFH Hemifacial Hyperplasia with Strabismus ), thatwonderful program that pairs poor people up with community volunteersand helps them build their own home. I am quite sure that if we queriedPresident Jimmy Carter or high officials within HFH about the behavioralscience theory underlying this social welfare intervention that we wouldbe met with bemused grins. These would develop into guffaws if we askedthem about the HFH psychosocial theory regarding the causes of povertyor the theoretical mechanisms on how home ownership benefits people.They would most likely inform us that HFH is based upon certainreligious beliefs (mostly) and perhaps common sense, practice wisdom,prior experience, and some other sources of knowledge. Behavioralscience theory would be conspicuous by its absence. Now picture the social work PhD student who conceives ofundertaking an evaluation of the HFH program. Perhaps she has plenty ofresources and time to conduct a randomized controlled trial A randomized controlled trial (RCT) is a scientific procedure most commonly used in testing medicines or medical procedures. RCTs are considered the most reliable form of scientific evidence because it eliminates all forms of spurious causality. . In theportion of the state where she lives, HFH can only provide homes to halfthe families otherwise qualified for the program, so to be fair thelocal HFH selection committee tosses a coin and randomly assignsequivalently needy families to receive a home or to not receive a home.The PhD student assesses the economic well-being, quality of life,health, and life satisfaction of all families qualified by HFH, andagain five years later, during which time half moved into their own home(one they helped build, about four years ago) and half did not. Assumetwo groups of about 50 families each. I contend that this randomizedcontrolled trial would be a marvelous exercise in program evaluation ofthe HFH intervention, and I would certainly encourage any PhD student toundertake such a study. One could test the hypothesis that the familieswho received a home had significantly higher economic well-being thanthey did five years earlier, as well as the hypothesis that the familieswho received a home were better off than the families who did notreceive an HFH home. This analysis could be repeated for other outcomemeasures (life satisfaction, quality of life, etc.). Given that the intervention is not explicitly based on some theoryof poverty (e.g., a Marxist analysis), and does not enjoy a genuinetheory of how it actually may work, I think it would be a dreadfulmistake to make the student pretend that she is testing some formaltheory. I can envision a faculty member enamored en��am��or?tr.v. en��am��ored, en��am��or��ing, en��am��orsTo inspire with love; captivate: was enamored of the beautiful dancer; were enamored with the charming island. of psychodynamics psychodynamics/psy��cho��dy��nam��ics/ (-di-nam��iks) the interplay of motivational forces that gives rise to the expression of mental processes, as in attitudes, behavior, or symptoms. asking the student to review the psychoanalytic significance of the"home" (symbolic of "mother"?), perhaps introduceelements of attachment theory or of transitional objects. Perhaps someelements of "self-efficacy" theory could be used to explainhow home ownership enhances life satisfaction, and undoubtedly there areeconomic theories that could come into play. But why bother? Thequestion being asked dealt with the possible effectiveness of the HFH inhelping poor people, not the validity or invalidity of any theory! Thuswe have illustrated the crucial difference between the purposes ofapplied and basic research. The validity of the particular theory inquestion will not be proven based on the results of the programevaluation. There will always be too many exculpatory exculpatoryadj. applied to evidence which may justify or excuse an accused defendant's actions, and which will tend to show the defendant is not guilty or has no criminal intent. factors to permitsolid conclusions regarding the validity of some underlying theory, butit is frequently the case that well-designed experimental studies candemonstrate the effectiveness and efficacy of an intervention. Why notsimply let the poor student evaluate the outcomes without being forcedto retrofit some spurious theory onto the project? Lord knows that theHFH and similar (most!) social welfare programs would benefit from thistype of systematic investigation. It would be exceedingly useful tolearn that the results were positive. It might help HFH solicitadditional funds and volunteers if you could show long-term positivebenefits among its clients. And it would be useful to know if theresults were negative--perhaps by isolating those families most likelyto not do well, the program would be in a better position to selectfuture recipients. Please note that this is not a perfect hypotheticalstudy. It did not involve a random selection of clients from theuniverse of folks needing home ownership. The sample size of 100 can befaulted because it was not 1,000, and of course a five-year follow-up isnot as stringent a test as a ten-year follow-up! Falsificationism--A Recipe for Disaster for Research on Social WorkPractice! The above section should illustrate the idea that social workersneed to move ahead with the selection of services in the absence ofperfect evidence. We need to know what psychosocial interventions seemto offer the most promising benefits to clients. Cognitive-behavioraltherapy Cognitive-Behavioral TherapyDefinitionCognitive-behavioral therapy is an action-oriented form of psychosocial therapy that assumes that maladaptive, or faulty, thinking patterns cause maladaptive behavior and "negative" emotions. (CBT (Computer-Based Training) Using the computer for training and instruction. CBT programs are called "courseware" and provide interactive training sessions for all disciplines. ) is a well-supported evidence-based psychosocial treatmentthat clinically and significantly helps clients meeting the DSM 1. DSM - Data Structure Manager.An object-oriented language by J.E. Rumbaugh and M.E. Loomis of GE, similar to C++. It is used in implementation of CAD/CAE software. DSM is written in DSM and C and produces C as output. criteriafor obsessive-compulsive disorder (OCD). Dozens of well-controlledclinical trials and dozens of single-subject studies bear this out, manydesigned and conducted by social workers. Most of these studies haveinvolved Caucasian clients, a few used African Americans. But bothgroups seem to respond well, as do both males and females. Suppose asocial worker has a new client from Mongolia with OCD. Being anevidence-based practitioner she consults the empirical literature andfinds to her dismay that there are no randomized controlled studies ofCBT for OCD with obsessive Mongolians! What is she to do? Should sheattempt to refer the client to a therapist trained in CBT, or perhapsacquire such skills herself? Or should this extremely large literaturebe ignored, because CBT for OCD has not been evaluated with Mongolians!The answer is obvious. We need to seek out the best evidence and notwait for perfect evidence. A psychosocial intervention psychosocial interventionPsychology A nonpharmacologic maneuver intended to alter a Pt's environment or reaction to lessen the impact of a mental disorder. See Attention-deficit-hyperactivity syndrome. support byseveral well-designed RCTs has stronger support than an interventionsupported by only one. One supported by a single RCT RCT Randomized Controlled TrialRCT Regimental Combat Team (infantry regiment with their own artillery, engineers, medical and tanks)RCT Rollercoaster TycoonRCT Randomized Clinical TrialRCT Rhondda Cynon Taff would be preferred(generally speaking) than one buttressed with a couple ofquasi-experiments. One with a single quasi-experimental study to back itup is preferred over one with a couple of pre-experimental ones, and soforth. Practitioners in applied fields like social work need to makedecisions about what to do now, and this by necessity involves relyingon less than perfect evidence. Falsificationism may well be the strongest approach to scientificinquiry regarding the validity of theories. I commend the lucid essay byPlatt (1964) for an engaging account of this method. But you may havefigured out from Gomory's essay that falsificationism can only tellyou confidently what does not work (or what is not true), but not whatdoes work. Consider how the evidence is portrayed. Should you use CBTwith OCD? "Well," the stern falsificationist says, "ithas stood up to a number of strict tests, and it has not failed themyet." "But does it work?" you enquire en��quire?v.Variant of inquire.enquireVerb[-quiring, -quired] same as inquireenquiry nVerb 1. . "Can'tsay. But it has not failed yet." "Should I use it with myMongolian client?" "Can't say, it's never beentested with Mongolians" "But what should I do with myMongolian client?" "Can't say." Contrast this with the approach Professor Gomory callsjustificationist (which I think corresponds to conventional scientificreasoning). Should you use CBT with OCD? "Well," the naivejustificationist says, "it has been subjected to a relatively largenumber of RCTs with generally positive results. It is widely cited inhandbooks and journal articles reviewing the scientific evidenceregarding the effectiveness and efficacy of interventions and thepsychosocial treatment of choice (e.g., Cohen cohenor kohen(Hebrew: “priest”) Jewish priest descended from Zadok (a descendant of Aaron), priest at the First Temple of Jerusalem. The biblical priesthood was hereditary and male. & Steketee, 1998;Franklin & Foa, 1998), and it has been endorsed by the OCDFoundation as a treatment of choice, based upon their independent reviewof the available evidence." "Is there any approach withstronger evidence to support its use, in lieu of CBT," you ask?"No" the justificationist answers. "But it has not beentested with obsessive Mongolians," you correctly note. "True,unfortunately. Eventually researchers may get around to that. But it hasbeen shown to be generally useful with other client groups it has beenused with, and since we have no particular reason to believe that OCD inMongolians differs appreciably from other groups, CBT would seem to bethe best place to start. You recognize, of course, that the designationof CBT as an evidenced-based psychosocial treatment is a provisionalone, always susceptible to review as new data comes in." "Whyyes, of course," you reply, "I learned that from some of themany elementary readings I had in my research classes while an MSWstudent." Turner makes this distinction nicely: "The clinician'sprincipal interest is in the utility of theory: what can it tell meabout this situation that will permit me to act effectively? It is,therefore, not knowledge for its own sake, but knowledge for use"(Turner, 1979, p. 3, italics added). Research findings viewed throughthe lens of the falsificationist cannot fulfill this function. It is arecipe for paralysis. It is also inherently self-contradictory, as areall radical skeptical arguments. Gomory is convinced that theoriescannot be proved to be true. He asserts this as a truth. But where isthe proof of this positive falsificationist assertion? If he is right,proof is impossible. If he has no proof how can he claim to be right?Philosophical debates like this can be amusing, but they are hardlyproductive since most of the issues involved are incapable of scientificresolution, and it was in that limited sense that the logicalpositivists labeled them as "meaningless," at least as definedby their "verificationist principle." The very term justificationist as used by Professor Gomory can bemisleading, to the extent that this implies a commitment to finding apositive outcome, outcomes that can be used to support or"justify" one's a priori a prioriIn epistemology, knowledge that is independent of all particular experiences, as opposed to a posteriori (or empirical) knowledge, which derives from experience. position. Good science consistsof conducting a study and being committed to accepting (and publishing)the results, regardless of whether they corroborate To support or enhance the believability of a fact or assertion by the presentation of additional information that confirms the truthfulness of the item.The testimony of a witness is corroborated if subsequent evidence, such as a coroner's report or the testimony of other or falsifyone's personally favored theories or interventions. On the Relative Value of Positive and Negative Knowledge Professor Gomory asserts that positive knowledge, for example,knowledge that helps choose social work interventions, is simply notpossible. For example, "A positive outcome of a test doesn'tprovide additional support" (p. 34), or "Nothing new islearned by positive results.... Positive results just confirm what youalready believe and can have no further inductive benefit. Real helpwould have been negative results" (p. 43). Talk to a social workpractitioner seeking guidance about how to provide effective care toclients, Professor Gomory, and ask them what they would find morehelpful--a well-designed outcome study with positive results, indicatingthat clients receiving a particular psychosocial intervention werehelped, or an equally well-designed outcome study with negative results,indicating that the intervention did not help clients. You will quicklyfind the relative utility to the field of falsificationist versusso-called justificationist approaches to research. The above is a social work recasting of a widely known critique ofPopper. Here is one example (O'Hear, 1989): The Popperian will say that the Popperian method aims at the truth. The critic will reply that the method aims at the truth only in the sense of ruling out false theories, and that it does not give any positive reasons for believing in the theories which have survived severe tests. To which the Popperian will agree, adding that we may still act on such theories in the hope that they are true. And the critic will say that he had hoped for more than a hope in science. Once again we are back where we started. (p. 41) You see, again this is a distinction between basic science andapplied studies. Although a positive outcome cannot be aid to prove thatthe theory predicting that outcome is true, a positive outcome in thecontext of an intervention study can provide guidance about useful waysto practice. As Gambrill (1983) states, a characteristic ofcompetency-based social work "is selection of assessment andintervention procedures based on the available evidence. We know moretoday than ever before about how to help people achieve their desiredoutcomes" (p. 3, italics added). Again, she notes that one of theconsiderations to be used in selecting intervention plans is whether"empirical literature supports selection in terms of efficiency,effectiveness comfort, and feasibility" (p. 227). Clearly, positiveknowledge, the selection of evidence-based treatments, is possible. "One cannot generalize at all beyond the observed data"(p. 32) is a particularly telling example of Gomory's negativepoint of view. I spent no inconsiderable in��con��sid��er��a��ble?adj.Too small or unimportant to merit attention or consideration; trivial.in amount of time learning therudiments of probability theory in order to have some legitimate groundsto make inferences from randomly chosen samples to larger groups. I alsolearned about the value of replicating findings in order to enhance ourconfidence in their generalizability. As a practical matter, socialworkers must generalize (cautiously) from the findings of flawedresearch studies in order to be guided in their practice. ProfessorGambrill, for example, pioneered testing the use of a behaviorally basedsystematic case management program for the natural parents of childrenin foster care. The positive results from this admittedly flawed studylead her to explicitly recommend this program. It was justificationallyconcluded that "It is clear that the project was successful inaccomplishing the objectives of moving a significant number of childrenout of foster home placement" (Stein & Gambrill, 1977, p. 509;see also Stein, Gambrill, & Wiltse, 1978). I note that this studydid not involve a placebo control group, a failing it shares with muchapplied research involving real life clients in agency-based settings(e.g., Baker & Thyer, 2000; Vonk & Thyer, 1999). Our field must rely on the best available evidence, not perfectevidence. No one has ever conducted a prospective randomized controlledclinical trial of the effects of smoking in relation to the developmentof lung cancer lung cancer,cancer that originates in the tissues of the lungs. Lung cancer is the leading cause of cancer death in the United States in both men and women. Like other cancers, lung cancer occurs after repeated insults to the genetic material of the cell. . Instead science relies on retrospective investigations,correlational studies, epidemiological data, surveys, public healthrecords, and similarly flawed data to construct an inescapableconclusion, that yes, indeed, smoking causes lung cancer. Similarlyimperfect evidence points to the causal linkages between alcohol use anddomestic violence; the availability of handguns and violent crime; andthe importance of education (e.g., high school graduation) to economicwell-being in later life. The flawed nature of the evidence related tothe latter issue has not prevented policymakers from taking steps to tryand deter dropping out of high school. If I were to dare introduce therecent Report of the Surgeon General The U.S. Surgeon General is charged with the protection and advancement of health in the United States. Since the 1960s the surgeon general has become a highly visible federal public health official, speaking out against known health risks such as tobacco use, and promoting disease on Mental Health and cite ProfessorSatcher's frequent pronouncements of the availability ofevidence-based treatments for a wide array of so-called mentaldisorders, I suspect that Professor Gomory would accuse me of relying on"authority" to buttress my claims. The reality is that thisnational report (edited by an MSW by the way) is indeed based on aconsiderable amount of empirical research, and the conclusions containedtherein are based on the overall quality of the data, not on thepersonal or professional status of Professor Satcher. Reference to theReport's findings is a shorthand version of citing a very largebody of primary literature. This is not an appeal to authority, but todata. I say this recognizing the shortcomings of the report--it is notperfect, but it is an advance (like the latest edition of the DSM). Applied disciplines like social work cannot wait, in the fullnessof time, for falsificationist research approaches to gradually weed outall the false, imperfect and ineffective interventions from ourarmamentarium ar��ma��men��tar��i��umn. pl. ar��ma��men��tar��i��ums or ar��ma��men��tar��i��aThe complete equipment of a physician or medical institution, including drugs, books, supplies, and instruments. . There is great value in less than perfect researchbecause it provides the beginnings of an evidence-based foundation forpractice in various areas. The American Psychiatric Association used thefollowing types of evidence (ranging in credibility from strongest toweakest) in developing its practice guidelines: (a) a randomizedclinical trial randomized clinical trial,n a clinical study where volunteer participants with comparable characteristics are randomly assigned to different test groups to compare the efficacy of therapies. , prospectively designed with double-blind assessments andtreatment and control groups; (b) a clinical trial, similarlyprospective, but lacking blind assessments or control groups; (c) cohortor longitudinal studies; (d) case-control studies, retrospective studiesof clients; (e) review with secondary data analysis, such asmeta-analyses; (f) qualitative reviews of literature lacking aquantitative synthesis of the data; and (g) other forms of evidence,such as textbooks, expert opinions, and case reports (Nathan &Gorman, 1998, p. 18). The American Psychological Association's TaskForce on Psychological Interventions used the following standards todetermine if a given treatment should be considered as empiricallywell-established: Is it supported by at least two good group designstudies conducted by different investigators? Was efficacy demonstratedby proving the experimental treatment superior to pill or psychologicalplacebo, or to an already established treatment? Did the therapists usetreatment manuals? Were the characteristics of the clients clearlydescribed? (Nathan & Gorman, 1998, p. 15). Such standards, whileadmittedly imperfect and perhaps too lax, provide the field with a placefrom which to move forward. Critics of these standards are urged tosuggest alternative scientific criteria to judge the evidentiary basisfor providing a particular psychosocial intervention. It is widely recognized that we must move forward within theconstraints of imperfect evidence in terms of making treatmentdecisions. Almost a quarter century ago Professor Gambrill authored amonumental handbook about behavior modification behavior modificationn.1. The use of basic learning techniques, such as conditioning, biofeedback, reinforcement, or aversion therapy, to teach simple skills or alter undesirable behavior.2. See behavior therapy. , containing over 1,000pages packed with recommended interventions. She took a decidedlyjustificationist point of view: "If the future holds as rapid anoutput of empirical studies on helping people to change their behavioras has the recent past, we should be blessed with increasingly effectivechange methods" (Gambrill, 1977, p. 1080, italics added). And shegoes on to laudably cite "the behavioral model of practice, whichdraws upon empirical literature to inform selection of assessment andintervention procedures" (p. 1082). Gambrill asked "Whyaren't programs that have shown themselves to be effective employedon a broader basis" (p. 1089)? I think that one culprit is thenotion that one must demand perfect evidentiary standards before makinga decision about how to proceed. Professor Gomory finds fault with handbooks such as mine (Thyer& Wodarski, 1998) and Gambrill's for overstating the evidencewith respect to the research support for various interventions. We arechastened for talking about anxiety, depression, drug abuse, autism autism(ô`tĭzəm), developmental disability resulting from a neurological disorder that affects the normal functioning of the brain. It is characterized by the abnormal development of communication skills, social skills, and reasoning. , thementally-retarded, `psychotic', stress, children's fears (allterms taken from Gambrill's (1977) Handbook, because this languagemay perpetuate the medicalization medicalizationSocial medicine A term for the erroneous tendency by society–often perpetuated by health professionals–to view effects of socioeconomic disadvantage as purely medical issues of these problems, and the use of theterm "disorder" may lead to the reification re��i��fy?tr.v. re��i��fied, re��i��fy��ing, re��i��fiesTo regard or treat (an abstraction) as if it had concrete or material existence.[Latin r of theseconstructs. Yet these are indeed the very issues that clients bring tosocial workers. Given an awareness of the lack of evidence regarding themedical etiologies for many of these conditions, writers such asGambrill and myself are very cautious about not reifying such terms andnoting that their use is merely convenient shorthand and contains noassumptions as to their `reality' as disease entities. What Is Not Empirically Researchable? Gomory oddly construes my statement in another publication (not theone published in this journal) that "empirical research has littleto say about those aspects of the world that are wholly subjective,immaterial or supernatural" (Thyer & Wodarski, 1998, p. 4),claiming "that this seems to leave out such common topics ofempirical research as subjective well-being, opinion polls about amultitude of topics, and cross-cultural studies on belief systems(including belief in magic) to just name a few that are not`empirically' researchable according to Thyer" (p. 35). WhatGomory actually leaves out is the sentence immediately following the onehe quoted from my book, "The study of these areas is the subjectmatter of other disciplines, such as philosophy or religion."Leaving out this following sentence is a curious omission, since itclearly limits my remarks to philosophical and religious issues, not toissues of science and social work. What is justice? What is the natureof God? Science can offer little assistance in resolving these matters.Of course we can do research on subjective matters like well-being,opinions, and cross-cultural studies. I have done so myself. What isessential for empirical research is that the phenomena in question bemeasured in some reliable and valid manner. When it comes to research onsocial work practice I cannot think of any topic that does not lenditself to empirical analysis using scientific methods. Even phenomenasupposedly based on supernatural or metaphysical explanations, likemagic or faith healing, are amenable to investigation, so long as theyare hypothesized to have measurable effects in the material world.Popular journals like The Skeptical Enquirer and The Skeptic routinelyreport the results of scientific research on such topics. I have nevercontended that science could not study such things. Gomory'sfailure to include the sentence immediately following the one he quotesseems much more of a example of contrived and selective citation thananything he suggested I was guilty of. That he knows he wasmisrepresenting my views is evident, since he cited another paper ofmine containing the following related statement--and surely a scholar ascareful as Professor Gomory would not miss such a crucial point: Many questions of great importance to our profession, such as the value base of social work, are simply outside the purview of scientific inquiry and other standards apply to the discussion of such topics apart from the conventional rules of scientific inference, standards such as those pertaining to religious beliefs, morality, and other philosophical convictions. Logical positivists are fully aware that many significant areas of our professional and personal lives should not be scrutinized through the lenses of science, but when the issues pertain to social work theory and the evaluation of our practice methods, then the role of controlled scientific investigations guided by the principles of logical positivism becomes a relevant factor. (Thyer, 1993, p. 6) Scientism sci��en��tism?n.1. The collection of attitudes and practices considered typical of scientists.2. The belief that the investigative methods of the physical sciences are applicable or justifiable in all fields of inquiry. is the view that the investigational methods used in thenatural sciences should be applied in all fields of inquiry and cananswer all questions of importance to the profession. I know of nosocial worker who holds such a view and I myself have explicitlyrejected it, as in the above quote, and more recently anotherpublication (Thyer, 2000, p. 10). On Solipsism sol��ip��sism?n. Philosophy1. The theory that the self is the only thing that can be known and verified.2. The theory or view that the self is the only reality. and Secondary Sources Contrast Schopenhauer's view (1969, p. 3, as cited by Gomory)"The world is my representation ..." with a current definitionof solipsism taken from Reber (1995, p. 737), "the philosophicalposition that holds that the only thing of which one can be certain isone's own personal experience and, by extension, that one'sexperiences represent all of reality--the outside world existing only asan object of one's consciousness." Linking Schopenhauer'sviews with the ancient doctrine of solipsism is not such a greatstretch. Yes, I confess to relying on secondary sources here--Gomory andReber. Moreover I admit to not having read Schopenhauer in the originalGerman. I also confess to not understanding what this section ofGomory's paper had to do with my essay on the role of theory inresearch on social work practice. On Atheoretical Interventions I cited Shapiro's EMDR EMDR Eye Movement Desensitization and Reprocessing to illustrate the common finding thatinterventions can be devised that are based on some underlying theoryand to have that theory subsequently proven to be false. The efficacy ofEMDR is irrelevant to the point (although it is likely a far weakerintervention that was originally claimed, e.g., Colosetti & Thyer,2000). I would think that Gomory would be applauding my falsificationistapproach, since I noted that EMDR theory has been subjected to severetests and shown to be invalid. Why is he criticizing me for making thatlegitimate claim? See, for example, Montgomery's review: Shapiro's rationale for EMDR does not appear to hold water either philosophically or empirically, but any new treatment, if empirically supported, would not require a theoretical grounding to be of utility. However, to date, EMDR has neither a sound empirical nor theoretical base on which to stand. (p. 68, italics added) Consider also MacCulloch and Feldman (1996, p. 571): "Thusfar, EMDR is a purely empirical treatment Empirical treatmentMedical treatment that is given on the basis of the doctor's observations and experience.Mentioned in: Enterobacterial Infections , developed by Shapiro almostserendipitously, lacking a theoretical framework or explanation"(italics added). Precisely my point. But if a treatment legitimately based on a particular theory isproperly applied, and the positive outcomes predicted by the theory donot emerge, two conclusions may be drawn--(1) the treatment does notwork and (2) the theory is invalid (false). It is possible to test thevalidity of a theory outside of the context of an outcome study of anintervention. For example, psychoanalytic theory asserts that theetiology of OCD has its origins in traumatic toilet trainingexperiences. It also asserts that psychoanalysis as a treatment shouldhelp clients with OCD. These two predictions can be tested separately.One could do an outcome study on psychoanalysis for OCD. Or one couldprospectively follow two groups of kids, those known to have experiencedtraumatic toilet training, and those known not to have had suchexperiences. If psychoanalytic theory were true, as these kids grew intoadolescence OCD would emerge in the former group and not the latter. Afailure to find this predicted result would be a step towards falsifyingor disconfirming Adj. 1. disconfirming - not indicating the presence of microorganisms or disease or a specific condition; "the HIV test was negative"negativemedical specialty, medicine - the branches of medical science that deal with nonsurgical techniques2. that particular theory--all outside of the context ofan intervention study. I was very pleased to find buried deep within the anatomy ofProfessor Gomory's paper his acknowledgement that the central themeof my paper is indeed correct! He agrees that doctoral advisorycommittees forcing students to include grand theory into theirdissertation research is silly, if it is not a legitimate integration.But he makes another serious mistake in his subsequent discussion of theBaker and Thyer (2000) article mentioned in my paper, when he says thatI have undermined "Professor Thyer's claim of no theoreticalorganization of the `intervention package'" (p. 42). If youthe reader will review my discussion of this paper, you will find thatnowhere did I state that this intervention was atheoretical. In fact Ispecifically said that it was based on operant operant/op��er��ant/ (op��er-ant) in psychology, any response that is not elicited by specific external stimuli but that recurs at a given rate in a particular set of circumstances. op��er��antadj. principles (whichqualifies as a theory in my view). What I did introduce in thediscussion of the Baker and Thyer (2000) work was to point out how thePhD student was forced by her advisory committee to include trulytangential tan��gen��tial? also tan��gen��taladj.1. Of, relating to, or moving along or in the direction of a tangent.2. Merely touching or slightly connected.3. and irrelevant theory, namely, the health belief model, inher dissertation. It would have been scientifically legitimate, in myview, if the committee had wanted more content on the theory behind casemanagement and more elaboration on operant theory, since these were whatthe intervention was really based upon. But this is not what happened.She had to include entirely unrelated theoretical content, content whichwas not used in the development of the intervention and was not testedin her outcome study. This was the practice I railed against. I ampleased that Professor Gomory would be similarly upset to see studentsbeing coerced in this manner. But I did not use Baker and Thyer (2000)as an example of an atheoretical intervention. Similarly, the reader can review what I said about the Vonk andThyer (1999) study. I said that the practitioners used many diverseapproaches to intervention. Because this "independentvariable" (student counseling services) was such a mishmash mish��mash?n.A collection or mixture of unrelated things; a hodgepodge.[Middle English misse-masche, probably reduplication of mash, soft mixture; see mash. ofinterventions (and some theories those interventions were based upon),Vonk did not construe construev. to determine the meaning of the words of a written document, statute or legal decision, based upon rules of legal interpretation as well as normal meanings. her quasi-experimental evaluation of the generaloutcomes of student counseling center services as a test of anyparticular theory. Gomory calls "eclectic short-termtreatment" a theory of treatment. I do not, particularly when thatshort term treatment is being provided by practitioners operating fromvarious, different, and competing perspectives. Short-term treatment perse does not provide either an etiological etiologicalpertaining to etiology.etiological diagnosisthe name of a disease which includes the identification of the causative agent, e.g. Streptococcus agalactiae mastitis. or an interventive theory forcollege student problems. The only thing that defines short-termtreatment is a focus on a small number of sessions provided within aspecific time frame (Dziegielewski, Shields, & Thyer, 1998). Suchpragmatic considerations do not constitute any kind of theory;short-term treatment may well be a model, but as I explained earliermodels are not explanations for the etiology of problems or of howinterventions work (i.e., a theory). Some of Gomory'smethodological criticisms of the Vonk and Thyer (1999) study may well betrue, but then we never claimed to have conducted a perfect evaluation,only one that advances upon those previously published. This is notself-aggrandizement, it is a fact used to justify the publication offlawed (like most) studies and is characteristic of the progressivenature of scientific research. We clearly discussed the limitations ofour design--lack of randomization randomization (ranˈ·d·m to immediate versus delayed treatment,using a nonprobability sample, the small proportion of clients seen, thesmall sample size, etc.--in the published article. Gomory'sreiteration of the methodological flaws in our study, flaws we ourselvesdiscussed, seems tangential to the possible role of theory in thisproject. If his point is to criticize quasi-experimental studies ingeneral as not capable of providing useful findings, such a perspectivefails to reflect the realities of field research and would exclude muchvaluable research from consideration by the profession (Cook &Campbell, 1979; Morgan, Gliner, & Harmon, 2000). Some Black Swans? Towards the end of his article Gomory contends that Thyer should be critiqued rigorously for his failure to fully and carefully engage with the essential scientific issues entailing philosophy and method as well as for suggesting that some members of the profession (i.e., students and direct service workers) don't have to think too critically but should simply apply pragmatic knowledge leaving theory, if at all necessary to the academics. I argue that Professor Thyer, due to his justificationary approach to science has not been able to see that efforts at finding proof, support, and credibility for his atheoretical research are doomed to failure because no such proof is possible. He seems to be unaware of the fallibilistic alternative which I have presented (he never discusses it in any of his writings), although he argues his position by claiming to know philosophy of science. (p. 47) Well, Gomory has certainly critiqued my work rigorously if notalways accurately. I may well have failed to engage fully and carefullyin the philosophical and methodological issues that Gomory raises.Although I am not a professionally trained philosopher of science, Icertainly have not ignored philosophical issues in my work and writings.In fact, one of my latest publications is an edited book on a philosophyof science (Thyer, 1999). I have outlined a philosophical position withclarity in a number of articles and chapters, some of which Gomoryhimself cites! The philosophical positions I advocate can certainly bechallenged--realism, materialism, determinism, positivism positivism(pŏ`zĭtĭvĭzəm), philosophical doctrine that denies any validity to speculation or metaphysics. Sometimes associated with empiricism, positivism maintains that metaphysical questions are unanswerable and that the only , empiricism empiricism(ĕmpĭr`ĭsĭzəm)[Gr.,=experience], philosophical doctrine that all knowledge is derived from experience. For most empiricists, experience includes inner experience—reflection upon the mind and its ,rationalism, operationism, parsimony par��si��mo��ny?n.1. Unusual or excessive frugality; extreme economy or stinginess.2. Adoption of the simplest assumption in the formulation of a theory or in the interpretation of data, especially in accordance with the rule of , scientific skepticism--as can myrejection of metaphysics, nihilism nihilism(nī`əlĭzəm), theory of revolution popular among Russian extremists until the fall of the czarist government (1917); the theory was given its name by Ivan Turgenev in his novel Fathers and Sons (1861). , teleology teleology(tĕl'ēŏl`əjē, tē'lē–), in philosophy, term applied to any system attempting to explain a series of events in terms of ends, goals, or purposes. , vitalism vitalism (vīˑ·tl·i·z , mentalism men��tal��ism?n.1. Parapsychological activities, such as telepathy and mind reading.2. The belief that some mental phenomena cannot be explained by physical laws. ,dualism, reification, circular reasoning, and scientism. Nor have Ineglected methodological issues (e.g., Royse, Thyer, Padgett, &Logan, 2001), having long written about and practiced a range ofresearch methods for the evaluation of social work practice, includingsingle-system research designs, pre-experimental designs,quasi-experimental designs, and true experiments conducted in thenomothetic nom��o��thet��ic? or nom��o��thet��ic��aladj.1. Of or relating to lawmaking; legislative.2. Based on a system of law.3. Of or relating to the philosophy of law.4. tradition. Gomory may claim that my positions are shallow(from the perspective of the professional philosopher) or simply wrong(they may well be), but they are defensible and most certainly theseissues have not been ignored by me, writing to the best of my abilitiesas a humble clinical social worker with evaluation interests. I do not see how he can contend that I suggest that social workpractitioners need not think critically about their work. Much of mycareer has been devoted to encouraging such critically reflectivethought. And I have even worked at promoting theory development andtesting. But one can think critically about issues other thantheory--that is what evidence-based practice is all about. What Gomorycalls "my" justificationary approach to science is not mine. Idid not invent it. It has been and remains the mainstream approach toprogram evaluation. Far from being unaware of the fallibilisticalternative, as Gomory claims, I have indeed written about it in thevery articles of mine which Gomory cites! Take for example the following(Thyer, 1993): The criterion of falsifiability has been recently summarized by Lett (1989): "It must be possible to conceive of evidence that would prove the claim for hypothesis false. It may sound paradoxical, but in order for any claim to be true, it must be falsifiable. The rule of falsifiability is a guarantee that if the claim is false, the evidence will prove it false; and if the claim is true, the evidence will not disprove it, in which case the claim can be tenatively accepted as true until such time as evidence is brought forth that does disprove it" (p. 154). Paradoxically, scientific methods of research are far better at demonstrating that a hypothesis (and ultimately the theory that the hypothesis is based upon) is incorrect than in proving that a particular theory is true.... At best in social science one may claim that the favorable results of a particular study (or clinical outcome) may be said to corroborate the theory the hypothesis was based upon. As the number of such corroborative studies grows, our confidence in the validity of a given theory may similarly increase. However, no matter how many such positive studies may accrue, the possibility always exists that tomorrow a more definitive (i.e. controlled) study based on another theory will be published which accounts for the findings of all the previous research, plus the results of the latest investigation. Logical positivists are thus modest in their claims, recognizing that all scientifically derived knowledge is tentative and susceptible to modification as further work is conducted. We can be relatively more certain about which theories are false, and only tentatively sure about which ones are true. Articles by Platt (1964) and Berkson (1989) provide excellent overviews of the role of falsifiability in this incremental approach to scientific progress. (pp. 14-16, italics in original) Or how about Thyer (1997): The extent to which a theory is falsifiable has long been held to be an important characteristic of its potential usefulness. Indeed, Sir Karl Popper ... contended for quite some time that disproving theories is a more valuable (and feasible) contribution to science than is trying to confirm them as accurate (Popper, 1959, 1963) (p. 65, italics in original).... As accurate data accrue, it becomes increasingly evident that a given theory is largely consistent with the facts or is inconsistent with them. In the former, the theory should be retained pending further testing by gathering new data. In the latter the theory should be discarded. (p. 80) Gomory says that I am unaware of the fallibilistic alternative, andhave never discussed it in any of my writings! He is incorrect in thisstatement. Absolutes (e.g., "never") are dangerous in science,Professor Gomory, since all it takes is one black swan to be provenwrong in one's contention that all swans are white. But I will notmake the mistake of discounting the balance of Gomory's analysis,his other published scholarship, or his personal capacities as aresearcher because he makes a few misrepresentations or outright errors.I have learned that no one who ventures into print is immune fromcriticism, and some of it justly points out honest mistakes. This is howall of us learn, as I most certainly did from preparing this response. Ifound Gomory to be a charming and engaging colleague when I met himearlier this year, and I look forward to another round of beverages withhim as we discuss these issues further. Gomory's vision is of "`autonomous social workers'who can decide through rigorous and open debate and tests what arebetter and worse policies and interventions." I doubt that debatewill help us decide. Proper tests might (I am immensely curious as tothe types of tests that Gomory believes are capable of providing usguidance). And when the empirical research summarizing the results ofsuch tests is reviewed, we end up with the beginning steps towardsevidence-based practice. Some psychosocial interventions have alreadybeen shown not to work. Others have been shown to be relativelyeffective. Social work education and practice should focus on thelatter. This may, or may not, involve theoretically driven research. Iftheory is legitimately involved, great. If it is not, then doctoralstudents and other researchers should not be forced into pretending thatit does. Both approaches are characteristic of science. Both have value.At present, theory-driven research exercises are much more highly valuedwithin academic social work than are atheoretical studies evaluatingoutcomes. This should change. Professor Gambrill (1993) says it well: Social work practice requires making inferences about the causal relationship between or among variables.... Problems in causal analysis arise when social workers do not use theories when they would be helpful and when they do use theories in areas in which they are inappropriate. (p. 235, italics added) Some Challenges for Gomory While I certainly do not wish to dictate the substance ofGomory's following rebuttal rebuttaln. evidence introduced to counter, disprove or contradict the opposition's evidence or a presumption, or responsive legal argument. , I think that if he attended to some ofthe following questions, the merits of his position(s) would become muchclearer to the reader. 1. Please provide a succinct definition of what you mean by"theory." 2. Please indicate the type of evidence (e.g., tests), if any, thatyou believe would justify labeling a psychosocial intervention asevidence-based. 3. Can you point to a single psychosocial intervention that youbelieve should be recommended to social workers as evidence-based withrespect to a particular type of client problem/situation? 4. 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