Thursday, December 1
Social Work and the Return on Investment
It was an honor being asked to write an article for the NASW Illinois Chapter newsletter. Then I realized I actually had to come up with something to say to my peers who know the practice arena in Illinois far better than I do. I decided to write about return on investment, something that has been an important part of my professional agenda lately. I am often challenged when asked, particularly by non-social workers, what the value is or added worth of having social workers involved in our processes.I hope that the thoughts are relevant to practice here, and I so look forward to meeting my new colleagues and joining with old friends as I make my return to Chicago and Illinois.
When we think about today’s social work practice environment, it is absolutely imperative that we consider the ways in which our practices are able to produce changes we intend, to minimize undesirable outcomes, and to do so in an economically efficient way. Additionally (and no less important) is the impact of our practices on multiple stakeholder groups (i.e., clients, funders, other professionals, etc.) who either receive or are affected by our practice. In sum, we consider the total return on investment of the work we deliver.
While return on investment (ROI) is not a new concept (Chorptia & Regan 2009), its’ application in social work educational, research, and practice arenas is not so evident. In fact, in preparing this essay, a literature review of social work journals found very few published articles on the topic. This is unfortunate because in today’s tight economic environments where greater emphasis is placed on cost containment, use of evidence-based or evidence-informed models of practice have become goal- and results-oriented. It has become necessary for social work practitioners to be able to: (1) Speak clearly to the ways in which their practices will produce not just desired results, but (2) a positive return on the investments of time, monies, and human resources, and (3) are seen as valued by client/patient groups. This is no small order and deserves considerable attention in educational and training environments as well as in our practice settings. In this essay I will provide a few ideas offered as points of departure (not solutions) for our profession to consider in setting and advancing a strategic social work agenda. The goal here is to contribute to the resources that stimulate our collective professional energies for optimal client outcomes and professional rigor.
In its crudest definition, a return on investment assesses the efficiency of an investment against the costs of that investment. In contemporary social work and human and health practices, this is often operationalized as the ways in which evidenced-based practices are diffused or translated by trained professional in “real world” settings and used consistently to produce desired outcomes. The additional consideration of financial impact is added to this logarithm in ultimately weighing societal value for utilizing a practice or set of practices.
Arguably there are more astute articulations of the science that goes into actually calculating an ROI; however, these far exceed the capacities of this paper or the skill sets of this author. In fact, for the purposes of this essay we might argue that ROI can be framed simply as a clear articulation of three things: What practice(s) we do; Why we do that practice; and What differences (outcomes and financial) the practice(s) makes. The point I am trying to make here is that increasingly in competitive professional environments, we as professional social workers have a responsibility to speak not just about the good we do; it is also our responsibility to speak about the ways in which the good we do is purposive and considers investments of time, finances, and other resources if we are going to continue to be viable competitors in mental health, health, and human and social services. This is not just about re-languaging ourselves, but rather it goes to the very fiber of our professional commitment to social justice. The discourse on and practice of ROI must include an understanding of the ways in which our clients see, understand, and experience the impact of our work, not just the impact we believe we have our clients. These commitments to social justice actually move us into a closer alliance with meaningful societal returns that can be articulated in service outcomes as well as economic returns.
There are at least three areas we must address across the spectrum of professional practice in order for us to be able to competently incorporate this focus on ROI. This would include the academic training of students entering the profession, the development of practice and supervision models that incorporate ROI content, and advancing the theory and research on specific benefits of social work contributions.
The academic preparation of students—and by extension, the ongoing learning of social work academicians—will need to incorporate practices that speak to ROIs for clients and social work professionals. In their work examining the financial returns on specialty training for physicians, Weeks & Wallace (2002) offer contextual lessons for social workers to consider in developing practice-oriented learning environments (i.e., specialties) that are anchored to market forces, student desires and interest, and societal needs. Recognizing that many forces are beyond the control of educational institutions is not a panacea for ignorning these factors in advising students about the profession or for developing curricula that do not take into consideration the social, political, and economic realities of the practice environment. Social work learning models and the professionals our institutions produce must consider these factors in framing our educational platforms. Rigidly articulated competencies that are based on evidence-based practice (EBP) have mixed results in terms of translating to innovative and applicable scaled-up “real world” practice and should be critically examined in an ongoing process that includes the voices of those who will receive the services we implement, including the clients/patients and providers (Jacobson, Jones & Bowers, 2011).
Secondly, practice environments—although often constrained by practical matters of finances and limited staff—have to incorporate supervision and ongoing staff development that address ways to assess and incorporate return on investment thinking and practices. It is not enough to say we want it without finding ways to bring it into the practice setting.
Lastly, social work scholars have to produce knowledge that is directly relevant to social practice and not just resulting in “more research needs to be done” or based solely on randomized clinical trial (RCT) models as we know these have very dubious payoff in terms of translating the findings into good social work practice (Jacobson, Jones & Bowers, 2011).
There are undoubtedly many other factors that will challenge and perplex social workers (and other professionals) in taking on the questions of how to incorporate return on investment in their practices. However, without this focus it is likely the relevance and viability of our professional practices, and ultimately our profession, may be left to others to measure and evaluate. The consequences of this would likely not bode well for us or for the clients we value and serve daily.
Chorpita, B.F. & Regan, J. (2009). Dissemination of effective mental health treatment procedures: Maximizing the return on significant investment. Behaviour Research and Therapy, 47, 990-93.
Jacobson, J.M., Jones, A.L. & Bowers, N. (2011). Using Existing Employee Assistance Program Case Files to Demonstrate Outcomes. Journal of Workplace Behavioral Health. 26:1, 44–58.
Weeks, W.B. & Wallace, A.E. (2002). Financial returns on specialty training for surgeons. Surgery. 132, 795–802.
Darrell Wheeler, PhD, MSW, MPH, is dean and professor at Loyola University Chicago School of Social Work. Prior to taking this position, he was professor and associate dean for Research and Community Partnerships at the Hunter College School of Social Work. He is also on the doctoral faculty of the The City University of New York (CUNY) School of Public Health, The CUNY Graduate Center, and a member of the Center for Study of Gene Structure and Function at Hunter College. He currently serves on the editorial boards of Journal of Gay and Lesbian Social Services, International Journal of Men’s Health, and Journal of HIV/AIDS in Social Services. Dr. Wheeler is a fellow in the New York Academy of Medicine, and is a member of the American Public Health Association and the National Association of Social Workers (national Vice President 2009-2012).