In response to the new 'outcomes movement' in health care settings intentionally, social workers are increasingly expected to communicate their practice using the language of outcomes. Yet, little research has focused on the language that social workers use to describe their practice and how they identify appropriate interventions and link them to describe their practice and how they identify appropriate interventions and link them to clearly defined evaluative outcomes. This paper is part of a large programme of research exploring and identifying issues associated with social work practice in the Australian health context. Specifically, the paper draws on qualitative data from the first stage of the project that explores issues associated with customary social work practice. Findings from the paper suggest clear evidence of tensions and difficulties experienced by social workers in attempting to communicate the crucial expertise behind their practice and that practitioners have only rudimentary understanding of the concepts of outcomes and evaluation. A key challenge for social work research concerns how to encourage the profession actively to engage with the outcomes movement whilst maintaining the core principles and values of social work.