Background: In 2008 a Swedish governmental report pointed out that the social services in Sweden increasingly need to conduct their work based on an understanding of the effects of their services. The report stressed the development of evidence-based practice (EBP) as the long-term objective.

The Swedish National Board of Health describes EBP as “a deliberate and systematic use of the best available knowledge; the professional’s expertise; the person’s situation, experience and preferences”.

However, the Swedish social services have been relatively slow to implement EBP. Several reasons can be given for this, including lack of contact between the different levels (national, regional and local) and tensions between state authorities, researchers and professionals regarding how EBP should be pursued in practice.

Objectives: The objective is to examine: 1) the tension between the critical-appraisal approach and the guidelines approach with respect to how EBP ought to be conducted in the social services; and, 2) the argument based on paternalism. A critique sometimes raised against the EBP work carried out by the state authorities is that it is paternalistic because it promotes a top-down approach in relation to the professionals in social work.

Methods: Philosophical methods, such as conceptual analysis and argument analysis, will be used in order to explore the tensions and arguments. Conceptual analysis aims at clarifying and/or defining concepts. Argument analysis describes arguments and evaluates their validity and relevance.

Results and Conclusions: The tension between the critical-appraisal approach and the guidelines approach creates a dilemma for the practitioner. However, the practitioner’s dilemma can be managed by being able to respond to critiques directed against the two approaches. Even if it can be shown that the implementation of EBP in the social services has taken a top-down approach, it is important that professionals are not treated paternalistically.