by Robert S. Schachter, DSW, ACSW
(October 2000)

I was having breakfast the other day with a new member of the Chapter Board of Directors. This is someone I respect a great deal because of his deep sense of social work, the needs of people, and running an organization. He is the administrator for a large health care program employing many social workers and physicians.

He told me a few things. One is that it is very difficult to get the physicians in his own employ to respect and understand social work, even when social work has been designed to be a critical component of his program. Second, he finds it very difficult to get his social work staff to focus on, and articulate, the outcomes of their work.

In his role as administrator, he has the responsibility to communicate to his institution's superiors and to the program's funder, which happens to be state government, the value of what his staff are doing. What they want to know from him is "what happened as a result of the work that was done?" They want to know the outcomes.

Given that this is a particularly articulate person, he does his best to deal with this question. What is frustrating to him is that he has to struggle to get the information from his social work staff. He told me that it just seems that you can't get social workers to think in terms of their outcomes. Even when hiring people, there is little opportunity to select among applicants who demonstrate this ability.

A Valuable Workshop that Few Wanted

This whole conversation reminded me of a workshop NASW held several years ago called "Developing Outcomes Thinking for Social Work Practice". At the time the notion of framing health and social services in terms of outcomes was sweeping over just about every type of program, whether through managed care or government contracting.

We identified a former state mental hygiene commissioner who had just written a book on developing outcomes for government programs, and invited him to speak. We also invited a social worker who was working with the author to help her staff look at their work in terms of the outcomes that they wanted to achieve with their clients. At the workshop this social worker turned the ideas into very doable practice.

We thought it would be a valuable workshop and advertised it to the membership of NASW. In all, about 20 members attended. First off, I was surprised by the low turnout. My conclusion was that the topic was not what NASW members really wanted to hear about.

I thought at the time, and for a long time after that, even if NASW identified what some of us think might be important for social workers to know, it might not be what they want. In fact, when we more recently designed our continuing education program, this distinction informed our planning with the results showing in higher attendance.

The point for me in what was raised over breakfast that morning, is that NASW needs to re-visit this issue of relating practice to outcomes.

In the type of environment that we are in today and can expect for the future, the social work profession faces multiple challenges. NASW's role on behalf of its members is to be aware of those challenges and find ways to help position its members for some advantage. This can be daunting when the challenges are very large and are reflections of national, economically embedded trends.

Adding value to our work

In terms of employment, practice, and the quality of the workplace, we are developing a multi-pronged strategy. Several have to do with targeting employers and administrators, but it will not be easy to induce change on a system-wide scale. No matter what we achieve, however, I believe that the need for social workers to be able to formulate their work in terms of how it helps achieve the goals of the organizations that are paying for their services will continue to be there.

Translating practice into thoughts and communications about outcomes, both in the planning and in the attainment, will not go away.

To an important degree, social workers being valued will be related to this ability. So will survival. So will having opportunities to thrive.