Revista de Asisten]\ Social\, anul X, nr. 1/2011, 25-33 25 Measuring Effectiveness in Direct Social Work Practice Bradford W. Sheafor* Abstract. In many parts of the world social workers are increasingly expected to provide documentation of the effectiveness of their services. One useful approach to such documentation is to measure the amount of change clients experience relative to the issues in their lives being addressed with the social worker. This is one expression of the popular demand for evidence-based practice: evidence-based evaluation. While it is not possible to prove that a social worker�s intervention caused the change, empirical documentation of change can be shown to be associated with the intervention and the work of the social worker. This trend is somewhat controversial in social work and, indeed, there are advantages and disadvantages to efforts to quantify client change. In this article a process is described for conducting an evidence-based evalu- ation of client change when working in a direct service capacity, i.e., face-to-face intervention with individuals, families, and groups. In addition to the usual process followed in assessing and intervening to help change the client situation, additional steps in the process are to: 1) generate researchable questions that will inform the social worker�s actions with this client (formative research) or provide summary infor- mation about the practice outcomes (summative research) to inform future practice activities; 2) quantitatively measure change in the important variables related to the issue(s) being addressed; 3) organize the resulting data in a format that helps to interpret the client outcomes. Keywords: direct practice evaluation, evidence-based practice, measurement, single- -subject designs, empirical practice evaluation Introduction As social work has evolved, at least in industrialized nations, simply asserting that we are doing good when serving our clients is increasingly viewed with suspicion. When called upon to prove that our interventions make a difference for clients, social workers are often hard-pressed to uphold their claims of success-or defend against others� claims of our failures. How can we accurately determine if we are truly helping our clients? One approach is to ask the opinions of the clients who clearly have an important perspective on our work. However, there are serious limitations to client assessments of the social worker�s perfor- mance. Clients may not have an accurate basis of comparison to other service providers, * School of Social Work, Colorado State University, 119 Education Building, Fort Collins, CO 80523, USA, Tel.: (970) 4915654, E-mail: [email protected] B.W. Sheafor / Measuring Effectiveness in Direct Social Work Practice26 may base their judgments or disliking the social worker as opposed to assessing his or her competence in addressing the issues, and the client�s assessment may be subject to manipu- lation as s.

1. Revista de Asisten] Social, anul X, nr. 1/2011, 25-33 25
Measuring Effectiveness
in Direct Social Work Practice
Bradford W. Sheafor*
Abstract. In many parts of the world social workers are
increasingly expected to
provide documentation of the effectiveness of their services.
One useful approach to
such documentation is to measure the amount of change clients
experience relative to
the issues in their lives being addressed with the social worker.
This is one expression
of the popular demand for evidence-based practice: evidence-
based evaluation. While
it is not possible to prove that a social worker�s intervention
caused the change,
empirical documentation of change can be shown to be
associated with the intervention
and the work of the social worker. This trend is somewhat
controversial in social work
and, indeed, there are advantages and disadvantages to efforts to
quantify client
change. In this article a process is described for conducting an
evidence-based evalu-
ation of client change when working in a direct service
capacity, i.e., face-to-face
intervention with individuals, families, and groups. In addition
to the usual process
followed in assessing and intervening to help change the client

2. situation, additional
steps in the process are to: 1) generate researchable questions
that will inform the
social worker�s actions with this client (formative research) or
provide summary infor-
mation about the practice outcomes (summative research) to
inform future practice
activities; 2) quantitatively measure change in the important
variables related to the
issue(s) being addressed; 3) organize the resulting data in a
format that helps to
interpret the client outcomes.
Keywords: direct practice evaluation, evidence-based practice,
measurement, single-
-subject designs, empirical practice evaluation
Introduction
As social work has evolved, at least in industrialized nations,
simply asserting that we are
doing good when serving our clients is increasingly viewed with
suspicion. When called upon
to prove that our interventions make a difference for clients,
social workers are often
hard-pressed to uphold their claims of success-or defend against
others� claims of our failures.
How can we accurately determine if we are truly helping our
clients? One approach is
to ask the opinions of the clients who clearly have an important
perspective on our work.
However, there are serious limitations to client assessments of
the social worker�s perfor-
mance. Clients may not have an accurate basis of comparison to
other service providers,

3. * School of Social Work, Colorado State University, 119
Education Building, Fort Collins, CO
80523, USA, Tel.: (970) 4915654, E-mail: [email protected]
B.W. Sheafor / Measuring Effectiveness in Direct Social Work
Practice26
may base their judgments or disliking the social worker as
opposed to assessing his or her
competence in addressing the issues, and the client�s
assessment may be subject to manipu-
lation as social workers often are in a position to reward or
punish clients.
Another approach to worker assessment is to depend on
supervisors or managers in our
employing organization who may regularly evaluate our work
and base employment reten-
tion, salary increases, and promotions on the outcome. Yet, if
these assessments are to be
objective the organization must develop protocols for the
evaluation that may minimize
creativity and be more focused on efficiency (lowest cost for a
unit of service) than
effectiveness (client improvement). Social work practice, then,
becomes shaped by the
protocol and the activities rewarded by the agency, yet may
have limited relevance to the
clients being served.
Also, social workers should be responsible for assessing their
own work through their
informed professional judgments. A downside of self-

4. assessment is that for most social workers
the motivation for entering a helping profession is a passion for
contributing to the improve-
ment of the quality of life for the people served. With that
strong bias, the tendency is for
social workers to overestimate the improvement of clients
and/or their social functioning.
How, then, can social workers be responsive to the demands to
produce objective
evaluations of their practice effectiveness and still practice with
the flexibility of using
professional judgment to best serve clients? One approach is to
focus the measurement on
client change, rather than on direct judgments about the worker,
at least as one important
indicator of practice effectiveness.
Evidence-Based Practice
The growing demand for documentation of practice
effectiveness is part of a current
movement of social workers and other professionals. This
involves basing practice deci-
sions on systematic reviews of practice effectiveness and is
traced by an English physician,
Thomas Beddoes, who in 1808 argued for the systematic
indexing of medical facts and
increasing the publication of scientific research (Goodman,
2003). The popular term for
this movement, �evidence-based practice�, was introduced in
the medical profession in
Great Britain in the 1990s (Guyatt et al., 1992) and then spread
to other helping profes-
sions. Sometimes expressed under different terms (e.g.,
empirically supported treatment,

5. research-based practice), the basic intent of evidence-based
practice is that the art of social
work practice should be combined with the science of carefully
researched outcomes.
Gambrill (1999) has helpfully distinguished the difference in
these approaches. She depicts
evidence-based practice as interventions where the social
worker initially informs his or her
practice decisions from the professional literature versus
authority-based practice in which
the authority of the individual social worker�s knowledge and
judgment is the primary
source of practice decisions.
In the United States, for example, evidence-based practice has
become institutionalized
in the Educational Policy Statement associated with
accreditation standards of the Council on
Social Work Education (CSWE, 2008). These standards require
schools of social work to
demonstrate that they prepare their graduates with the
competency to �engage in research-
-informed practice and practice-informed research� (CSWE
Competency 2.1.6). Further,
the National Association of Social Workers (NASW) maintains
a website as part of its Social
Work Policy Institute that keeps an updated comprehensive list
of evidence-based practice
registries and databases
(http://www.socialworkpolicy.org/research/evidence-based-
practice-2.
html#EVP). Internationally, the highly respected work of the
Campbell Collaboration

6. Revista de Asisten] Social, nr. 1/2011 27
(http://www.campbellcollaboration.org/frontend.aspx) provides
evidence of effective in-
tervention approaches in specific practice situations that have
undergone evaluation through
rigorous protocols. The United Kingdom�s Social Care Institute
for Excellence also pro-
vides a very useful database at http://www.scie.org.uk.
For many social workers the term evidence-based practice has
become a concept used
in so many contexts that its meaning has been diminished. It is
useful to understand the
focus of evidence-based practice in three different phases of the
social change process:
assessment, intervention, and evaluation.
Evidence-Based Assessment: At the root of effective work with
clients is careful assess-
ment of the client and the client situation that is the purpose of
the social work practice.
We have considerable well-researched evidence about human
growth and development,
social interaction, family functioning, and the cultural
uniqueness of different population
groups to aid in understanding the clients with whom we work.
We are also having
considerable information about many of the social issues our
clients� experience (e.g.,
poverty, child protection, discrimination, mental illness,
physical disability, aging). This
evidence has been generated primarily through traditional forms
of research based on
application of the scientific method. Social workers clearly

7. must be skilled in evaluating the
literature reported in this research and able to make judgments
about its applicability to the
specific clients we are serving.
Evidence-Based Intervention: We are now beginning to develop
evidence about the relative
effectiveness of different intervention strategies or approaches
in work with specific client
groups or related to specific issues these clients are
experiencing. This �best practices� research
is largely based on meta-analysis research and suggests to social
workers the services that
are likely to be most effective is specific practice situations.
While not offering conclusive
evidence that any intervention approach(es) will be successful,
this evidence clearly helps
the social worker to give serious consideration to using the
documented best practices.
Evidence-Based Evaluation: Once the intervention has begun an
entirely different form of
evidence-based practice can be used to monitor the client�s
progress (or lack thereof) and to
draw final conclusions about the change experienced by the
client when the work is terminated.
As opposed to research based on the scientific method that is
based on carefully selected
control and experimental groups and the application of
(sometimes) sophisticated statistical
analysis, direct practice evaluation is largely focused on
tracking change during the time of the
intervention in the important conditions affecting the specific
individual, family, or small
group being served by the social worker. This approach is in its
�infancy�, or perhaps �early

8. childhood�, but shows promise for the social worker
documenting for clients, supervisors,
and especially for himself or herself the effectiveness of
services delivered to clients.
Pros and Cons of Evidence-Based Direct Service Evaluation
The emergence of evidence-based evaluation for direct practice
has not been without
controversy. On one side of the argument are those social
workers who consider the work
of this profession to be primarily an art form based on the
worker�s natural abilities for
building helping relationships and drawing on intuition and
practice experience or practice
wisdom. At the other extreme are those who view social work as
requiring much more
science at its base and contend that the direct practice
evaluation tools are too primitive to
provide useful data. Both views are partially valid, yet neither
perspective helps to answer
the larger concerns about the need to accurately assess our
practice outcomes.
B.W. Sheafor / Measuring Effectiveness in Direct Social Work
Practice28
More specifically, the ongoing arguments about the merits and
demerits of empirical
direct practice evaluation centred around the following issues.
� Depersonalization of the client. When specific client
conditions are measured
(e.g., depression, self-esteem, family relations) the focus of

9. practice moves to those
factors being measured and the client as a �whole person� is
neglected and the social
worker�s artistic expression in practice is minimized.
Countering that view is the
perspective that clients are involved with social workers to
address specific issues and
practice should be focused on addressing those issues and the
best evidence (science)
available should be brought to bear on those issues.
� Empirical evaluation is time consuming. One position argues
that social workers invari-
ably have heavy caseloads and time spent in activities other
than face-to-face interaction
with clients that deprives clients of a needed resource.
Especially when beginning to use
these evaluation tools it takes time to construct the study
designs and collect data,
although that time commitment decreases with practice.
However, if a social worker
learns what works and doesn�t work with his or her clients, in
time he or she becomes
both more efficient and effective thus making the up-front
investment of time payoff.
� The practitioner/scientist dilemma. Some question the utility
of expecting the social
worker to simultaneously be both a practitioner and a scientist.
Indeed, the thought
processes required for temporarily entering the lives of others to
develop empathy,
inspire hopefulness that change can occur, and achieve other
characteristics of effective
helping relationships is different than the need for the
researcher to stand back and

10. objectively observe the change that is occurring. Others contend
that developing empiri-
cal evaluations of practice does not require �rocket science�
and that professionally
educated social workers are surely capable of being both caring
with clients and being
objective in their evaluations. In fact, social workers are
expected to be both practition-
ers and scientists � whether depending on their traditional
impressionistic assessments
or increasing the objectivity through empirical assessments.
� Limitations of the evaluation tools. Some social scientists
contend that direct practice
evaluation is at such a preliminary stage of development that it
risks basing important
practice decisions on faulty evidence that is not powerful
enough to establish a cause and
effect relationship between the intervention and the client�s
situation. Few would argue
that measuring change in one client or client group can yield
information generalizable
to all other clients, or that it is possible to control for enough
external variables in the
client�s life, or that the measurements obtained are completely
accurate representations
of the factors being addressed. We can, however, identify an
association between the
initiation of our intervention and change in the client�s
condition as partial evidence of
the effectiveness of practice. When assessing client outcomes
we can provide a layer
protection to the process if empirical evaluations are considered
only one vantage point
for judging our clients� change. A useful concept for this check
and balance, triangula-

11. tion, is borrowed from the field of surveying and simply
suggests bringing at least three
different perspectives to the judgment. In addition to the
empirical evidence, for exam-
ple, the perspectives of the client, the client�s family members,
the client�s associates
such as teachers or employment colleagues, the social worker
and/or the worker�s
supervisor, and so on should be considered. When these
perspectives are in alignment,
the empirical data can be more trusted and provide more
specific information on degrees
of change.
Revista de Asisten] Social, nr. 1/2011 29
Steps in Conducting Empirical Direct Practice Evaluation
Many of the actions taken in direct practice evaluation are
identical to what one does in
practice when not undergoing this evaluation. The primary
differences are in formalizing
questions for which the answers will inform one�s practice,
using numerical measures of
change in the relevant client conditions, organizing the
measurements in a format that will
facilitate interpretation of the data, and adding the empirical
evidence to other perspectives
(i.e., triangulation) of the client�s situation. The following
steps capture the process.
Step 1: Analyze the practice situation. Practice begins with
understanding the client and
the client�s situation. As indicated above, the particular client

12. must be understood in the
context of his or her culture, gender, age, sexual orientation,
family constellation, and
other factors relevant to the practice situation. The practice
situation to be addressed, too,
must be fully understood and related to evidence about that
condition as found in the
evidence-based literature. These activities should occur
regardless of the form of evaluation
to be used.
Step 2: Generate Research Question(s). Sound empirical
evaluation forces the social worker
to be clear about the practice questions to be answered through
the empirical research and
the purpose for asking those questions. Usually this is to either
monitor what is transpiring
in the practice to inform what the worker does with the client
being served (i.e., formative
research) or to provide a summary at the point of termination to
report the changes the
client has made and to inform work with future clients (i.e.,
summative research).
Some questions relate to the client(s) being served. For
example, �To what extent does
Mrs. M�s level of depression change when the services of a
Hospice worker are provided?�
Or, �To what extent do the Johnson�s family relations change
when Jack (a foster child) is
placed in the home?� Or possibly, �To what extent do
members of a group perceive that
the outcomes they considered important were met through the
group experience?�
Other questions might be framed in a way to make judgments

13. about the effectiveness of
different intervention approaches or combinations of
approaches. For example, �To what
extent is the cognitive behavioural approach effective in
working with Mary in relation to
strengthening her self-esteem?� �To what extent is combining
the cognitive behavioural
approach with an assertiveness training group effective in
strengthening Mary�s self-es-
teem?� Or, �To what extent were the goals that Steven, his
teacher, and the social worker
established for the intervention attained?�
Finally, questions may relate to identifying the social worker�s
areas of strength and
weakness. A worker might ask �To what extent do my clients
perceive that they have
achieved their goals for each of the ten practice outcomes
expected to be addressed in this
unit of the hospital?� Or, a supervisor might ask �As viewed
by clients, to what extent is
each of the social workers on my unit successful in helping
clients achieve each of the ten
outcomes the workers are assigned to address?�
Step 3: Select tools for measuring client change. Perhaps the
most difficult part of
empirical practice evaluation is measurement. Some factors
social workers address are
tangible and already in a numerical format. For many other
client conditions, however, we
must have people rate the degree of pain, emotion, problem, or
other pertinent factors and
those ratings must reflect at least ordinal-level (ranking) data.
These measurements are
found in three distinct formats.

14. � Frequency counts. Often numerical data are already
maintained in agency records
such as a school�s count of the number of times a child is tardy
for his/her classes, or police
B.W. Sheafor / Measuring Effectiveness in Direct Social Work
Practice30
reports of the number of domestic violence calls to a household.
If data are not already
available, we may keep track of indicators of the issue being
addressed or we may help
clients keep such records. Keeping track of events such as
arguments among siblings or
bedwetting episodes for an older adult in a journal or on a
calendar can provide useful
information of patterns or trends. So long as the data are
truthful and consistently collected,
frequency counts can be accurate indicators of the intensity or
duration of a problem.
� Individualized scales. With a little practice, it is not difficult
for a social worker to
construct scales that measure an important factor in the practice
activity. Some factors are
best expressed in the client�s own words so that when the
degree of emotion or frequency
of feelings is measured over time, the client�s reference point
is revisited and the measure-
ments are consistent (Nugent, Sieppert and Hudson, 2001;
Bloom, Fischer and Orem,
2009). This �face validity� strengthens the usefulness of the
measurements. The terms that

15. anchor the numerical scores on each scale can also be indicated
by some language that is
commonly accepted in a culture. The essential characteristic of
these anchor points is that
they provide at least ordinal data (i.e., ranking) where each term
captures a progression of
the amount of the factor being rated. The anchor points may
also be symbols (e.g., for
children or people who are very ill � smiley/frowny � faces
with a progression of expres-
sions), thermometers showing amounts of the factor, or
numbers-although numbers (e.g.,
�Rate your degree of anger between 1 and 10�) without
anchoring terms or symbols tend
not to be very accurate.
Typically three to seven anchor points on any scale are
identified. Two factors should
be considered when establishing the number of anchor points.
First, how many degrees of
difference in the factor can the respondent accurately
differentiate? For example, children,
older adults, and people with a mental disability may have
difficulty in discriminating
between more than three or four points on a scale, while others
may have greater ability to
accurately identify differences. In general, more valid points on
a scale yield a greater
amount of data to help identify change. Second, should there be
an odd or even number of
points on the scale? Odd number scales are used most
frequently, yet they have the
limitation of the respondent selecting the midpoint and not
really considering if he or she
leans one direction or the other on that factor. An even number
scale forces a choice. When

16. creating a scale, the number of anchor points should depend on
nature of the factor(s) being
assessed.
� Standardized scales. At the most sophisticated level, a
surprisingly large set of
carefully developed self-rating scales has been developed in
relation to many factors that
social workers and their clients address (Corcoran and Fischer,
2009; Hudson, 1997).
Through rigorous psychometric testing the factor to be
measured is isolated from other
factors, usually 20 to 25 simple questions are selected to
represent dimensions expressions
of the concept, and an appropriate rating scale with anchor
points created. Through testing
with various population groups the reliability and validity of the
scale is established, the
standard error or measurement to be used in interpreting the
amount of instrument error
when analyzing results determined, and, in some cases, cutting
scores are established
indicating when clinical intervention is likely to be needed and
when the respondent is in
severe crisis. These are useful assessment tools and, in addition,
repeated application can
yield scores that track changes in the factor or condition the
client experiences.
Step 4: Select an appropriate tool for organizing the
measurements. The question(s)
asked in Step 2 will, to some degree, determine the format for
data organization. The social
worker equipped to select any of the following formats should
be able to compile measure-
ments for meaningful monitoring of the change during the

17. intervention or summing up the
Revista de Asisten] Social, nr. 1/2011 31
change at the point of termination. (Note: A more complete
description of these four tools
with examples of their application may be found in recent
editions of Sheafor)
� Service Planning Outcome Checklist (SPOC). The SPOC
involves the use of a check-
list at the initiation of service on which clients are asked to
identify items on a menu of
possible goals or outcomes that might be addressed. The menu
is created as a list of
the services an agency or a social worker typically offers.
Clients are asked to mark the
items they would like to address with the social worker and then
to select the two or three
highest priority items. While this format can be used with a
single client, it is most useful
when applied to groups of clients. With client groups, the
percent marking each item he or
she wants to address can be identified and the percent selecting
each item as a priority item
can also be determined. By adding together the two percentages
an Importance Index is
constructed and the items on the menu can be organized in order
of their importance to the
group.
When items are ordered by importance, the Importance Index
becomes a useful tool for
determining what to emphasize in the group sessions or

18. identifying what clients view as the
most important issues for them to address. At the point of
termination the clients are again
given the menu and asked to rate (usually on a five or seven
point scale) the degree to which
they believe they achieved each menu item. A mean score for
achievement, when compared
to the Importance Index, readily identifies areas where the
clients believe they were or were
not successful. If given to all of a social worker�s clients for a
period of time, this
information can lead the worker to evaluate where he or she
needs to strengthen his or her
practice competence.
� Task Achievement Scaling (TAS). Particularly when adopting
the task-centred ap-
proach (Epstein and Brown, 2002), but also when using other
practice approaches, social
workers and clients may agree on tasks or specific activities to
be completed between
sessions. By creating five-step scales of increasing success in
completing each agreed upon
task, it is possible to measure success in achieving each task.
For example, if a client
reaches step three (of five) in the task of obtaining rent-
subsidized housing, he or she has
achieved 60 percent of the task. When the client actually moves
into the housing (if that was
the final task on the scale), he or she would have achieved 100
percent of the task.
Assuming that more than one task is being addressed at any one
time, a percentage of
overall task accomplishment can be computed as an indicator of
the client�s overall task
achievement.

19. � Goal Attainment Scaling (GAS). As compared to the short-
term nature of tasks, social
work practice might be focused on achieving long-term goals. A
measure of practice
success, then, is the degree to which the client attains the
identified goals. Typically a
practice situation involves an effort to address three to five
goals. For example, working
with a child experiencing problems at school might reflect a
goal of enhancing self-esteem,
reducing anger outbursts with peers, and decreasing the
frequency of discipline referrals.
The child�s self-esteem might be measured by a standardized
or individualized scale, while
the other two goals could be reflected in numerical counts of
anger outbursts and discipline
referrals recorded by the client and/or teachers. In Goal
Attainment Scaling these factors
are measured early in the helping process and again when
service is terminated with
five-point scales reflecting change for each goal (Bloom,
Fischer and Orem, 2009; Kiresuk,
Smith and Cardillo, 1994).
Recognizing that all goals do not make an equal contribution to
client success, Goal
Attainment Scaling incorporates weighting the importance of
each goal to overall success.
Thus if a student�s self-esteem is viewed as critical for
improving his or her relations with
other students or avoiding discipline issues, the weights might
be 50 for change in

20. B.W. Sheafor / Measuring Effectiveness in Direct Social Work
Practice32
self-esteem and 25 for each of the other two goals. Then, when
the overall goal attainment
score is computed, the actual weighted change can be compared
to the possible weighted
change and an overall percent of change is completed reflecting
the differential importance
of the goals.
� Single-Subject Designs (SSD). The most well-known and
most versatile of the tools
for organizing measurement data are the single-subject designs
(also know as time-series
designs, single-case designs, or single-system designs). This
format allows the social worker
to visually track periodic measurements of one or more factors
being addressed in a practice
situation and, in some cases, to perform statistical analysis of
changes (Bloom, Fischer and
Orem, 2009). If anticipated change is not occurring, the social
worker and client can use
this information to determine if the service should be continued
or if a different intervention
approach should be used. Or, if the change is progressing in the
desired direction, to
reinforce what is being done and encourage the client to
continue with the intervention.
Typically social work practice begins with the identification of
factors in the client�s life
that the intervention is intended to help change. By developing
baseline measurements of
those factors, change can be traced by conducting measurements
of those variables on a

21. periodic basis. This baseline score is charted on the y-axis of a
grid and across the bottom
(x-axis) the dates the measurement was taken are noted. Thus by
connecting the points of
measurement, a simple line-graph of the variable(s) is created.
The usual procedure is to designate the baseline score(s) as the
A phase of the change
process, then labelling the measurements taken while each
intervention approach is being
used as the B, C, D, and so on phases. If more than one
intervention is used at a time, the
combination can also be identified. For example, if a cognitive-
behavioural approach
(B intervention) is the initial intervention and the client later
also enters an anger manage-
ment group (C intervention), while the two interventions are
simultaneous this would be
graphed as the B/C phase. Strength in this form of evaluation is
that the design can be
adapted to follow what occurs in practice. The goals are to
develop an empirical record of
what change is occurring in important client variables and to
determine if there is an
association between desired change and a particular intervention
approach of combination
of approaches.
Conclusion
Social work and other human services professions are
increasingly under pressure to
demonstrate that what they do truly makes a difference for their
clients. Our �professional
judgment� assertions that we positively affect client outcomes
may be correct, but clients,

22. taxpayers, agency boards of directors, and insurance companies
that contribute to paying the
cost of our services rightfully demand more objective evidence.
The call for �evidence-based
evaluation� is often resisted by social workers and it implies
inserting a scientific approach
into our practice activities for measurement to occur when the
social worker�s art of helping
is critical to the helping process. Our challenge is to provide
empirical evidence without
compromising the quality of services we deliver to our clients.
Clearly, social work is in the early stages of developing tools
for measurement of client
change that are not terribly invasive or demanding of the client.
In fact, these evaluation tools
are often resisted more by the worker than the client. Just as
most patients of physicians do
not resist having their blood pressure measured on a routine
basis and even want to know
the results, so social workers� clients are also interested in the
outcome of our empirical
measures. Also, relatively simple tools now exist for organizing
these measurements to
Revista de Asisten] Social, nr. 1/2011 33
increase the ability to analyze the patterns of change. It is quite
possible for the social
worker to find a middle-ground between being a scientist and a
practitioner in order to both
be flexible in servicing clients and, at the same time, measuring
client change.

23. References
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