After the NPM Wave

Evidence-Based Practice and the Vanishing Client

Abstract

Over the last two decades, a movement for Evidence-Based Management (EBM) has surfaced across the Atlantic world with pretensions of being a successor of New Public Management (NPM). In this paper, we focus on Swedish social welfare as an arena where persistent government attempts have been made to implement locally new evidence-based ideas, specifically evidence-based practice (EBP). In Swedish discourse, the meaning of “evidence-based” is contested. One interpretation maintains that best (and only accepta- ble) evidence comes from the use of randomized controlled trials (RCTs). Another inter- pretation maintains that evidence from research constitutes only one leg of a multi-factorial definition; that is, this view contends that RCT evidence should be considered along with experience of practitioners and clients (users). Although client participation was an important tenet in the incipient attempts to implement EBP, by using translation theory this article will show that later attempts have tended to ignore the client’s perspective. From this foundation, we address why client views and outlooks have been ignored in EBP implementation.