Professor Gary Rosenberg,
Mt. Sinai Hospital,
New York, N.Y.

 The varied worlds of social work, including practice, policy and research with individuals, families and communities demand the use of methodologies that are appropriate to both the question and the context. Research on outcomes can tell us more about the effectiveness of different interventions and may help to increase the efficiency of existing systems for monitoring the quality of care. Yet, as Professor Cheetham wisely recognizes, the changing goals of social policy can greatly influe nce social worker’s activities. Sometimes they are blamed for failing to achieve objectives which have recently been thrust upon them.

 Effectiveness studies can be helpful in achieving several related goals. These include increased understanding of the effectiveness of different interventions and the use of this information to make possible better decision making by policy maker s, planners, funding sources, social workers and clients, all of which hopefully result in improved services. The steps in moving from increased understanding to improved services are straightforward. We can use large databases to establish monitoring sys tems, identify variations in outcome in different areas and differences in procedures or interventions associated with differences in outcomes. And we can use meta-analysis if it will aid in summarizing large amounts of data. We incorporated the results o f these analyses into appropriate guidelines and then we use them for education and feedback to attempt to modify the behavior of social workers. 

One problem that Professor Cheetham correctly noted is that our early flurry of effectiveness research did not define what was being evaluated very well. In addition, few of these tests of social work’s impact had sufficient statistical power to detect small to moderate effect sizes. As Professor Cheetham points out, non-quantitative research approaches can generate valid data. Qualitative methods can provide a rich view of what has occurred.