Risk Management Paradigms in Health and Social Services for Professional Decision Making on the Long-Term Care of Older People

Risk management systems and structures are developing rapidlywithin UK health and personal social services. However, therisk management strategies of organizations need to take intoaccount the conceptual frameworks used by professionals. Thisgrounded theory study used data from nineteen focus groups andnine semi-structured interviews (ninety-nine staff in total)to explore perspectives on risk and decision-making regardingthe long-term care of older people. Focus group participantsand interviewees comprised social workers, care managers, consultantgeriatricians, general medical practitioners, community nurses,occupational therapists, home care managers and hospital dischargesupport staff. Social work and health care professionals conceptualizedrisk and its management according to six paradigms that appearedto be in a state of reciprocal tension: (i) Identifying andMeeting Needs; (ii) Minimizing Situational Hazards; (iii) Protectingthis Individual and Others; (iv) Balancing Benefits and Harms;(v) Accounting for Resources and Priorities; and (vi) Warinessof Lurking Conflicts. The effective translation into practiceof risk management strategies needs to address the complex andoften contradictory issues facing health and social servicesprofessionals.     

Social worker decision-making in court

The current study aimed to explore the factors that influence how social workers make decisions and develop their decision-making skills in care proceedings, and to identify effective support and intervention to develop social worker decision-making skills. The study employed a mixed thematic approach across two phases of study: an initial inductive thematic analysis of responses to an online qualitative questionnaire and then a mixed thematic analysis of follow-up focus groups and interviews with social workers working in various social work roles within England and Northern Ireland. The findings identified a number of themes that help to understand the decision-making skills of social workers; thorough assessment skills, relationship-based anti-oppressive practice, being mindful of the lived experience of the child and using critical reflection to make complex decisions. Wider structural factors that support or hinder decision-making, particularly in respect of organizational support and management supervision were also identified. Social workers can be supported to develop decision-making skills through additional training, reflective learning and management support to develop their practice wisdom within this field.     

Goal Setting Process: Supporting Choice in a Feminist Group for Women with Alcohol Problems

ABSTRACT

Women who seek help for alcohol related concerns may have goals ranging from maintaining abstinence to moderating or simply monitoring their drinking. Facilitating a group when participants' goals vary is challenging but not impossible. The potential for slipping into the common stance of identifying abstinence as the most desirable goal can be avoided by sensitive group facilitation. This paper describes how a feminist group intervention employed the group process to support decision-making across a range of goal choices; it provides some guidance on how social group workers can assist in the difficult work of identifying, clarifying, and working toward self-selected goals.     

Challenges in Rural Social Work Practice: When Support Groups Contain Your Neighbors,Church Members,and the PTA

Rural social work occurs in unique practice environments with challenges and rare opportunities. Strong social ties, commonly found in rural communities and often missing in urban areas, can serve as sources of resilience for group members facing adverse life circumstances. Therapeutic formal and informal support groups, bolstered by this support and led by social workers in rural communities, can face numerous challenges due to locale, lack of transportation, and potential worker burnout. This article highlights ethical considerations rooted in a theme of rural group work while providing helpful hints based on the IASWG Standards for Social Work Practice with Groups.     

Business Social Responsibility: Perspectives of Businesses and Social Workers

ABSTRACT

This article compares the attitudes of social workers and business employees regarding the community involvement of businesses and the role of social workers in this involvement. The study, based on a structured questionnaire, was conducted in Israel and consisted of 316 participants from two cohorts: social workers and business employees. The principal findings show that social workers are more inclined than business employees to recommend that social workers increase their involvement in business social responsibility (BSR); business employees are more likely than social workers to advocate that the latter assume managerial functions; both groups support a low level of influence for social workers on decision-making processes and a role of exchange of knowledge rather than full partnership. The discussion addresses the implications of the findings for increasing social workers' involvement in BSR and cooperation with the business sector.     

Socratic Dialogue and Self-Directed Group Work: Strengthening Ethical Practice in Social Work

Socratic dialogue is a practical method of philosophical inquiry used to develop ethical and critical thinking among participants. On the other hand, self-directed group work is a practical intervention model based on social justice principles aimed at empowering service users and clients in social work and community work contexts. This conceptual article aims to reflect on a combination of the two models, arguing that group work interventions inspired by Socratic dialogue and self-directed group work may represent a way for social workers to develop a better ethical stance in their practice.     

Professional and personal hierarchies of ethical principles

We explore social workers’ perception of the importance and rank ordering of ethical principles. Do they have a generally agreed upon hierarchy of ethical principles? Do they apply similar hierarchies of ethical principles when facing different cases? Are their professional and personal hierarchies of ethical principles similar? The findings based on a structured questionnaire indicated that while social workers attach high importance to most ethical principles closely associated with social work, they do not hold a universal hierarchy of ethical principles. Social workers change their ethical hierarchies in different professional situations but there is no difference between their professional and personal ethical hierarchies. Implications for practice and education are discussed.     

On Getting over Oneself and Creating Space for All Voices in Group Work with Adolescents

As social group workers we may come to value all the trappings associated with becoming credentialed professionals, however there will always be moments in our groups when we cannot help but feeling like helpless amateurs. It is never easy to accept and hold on to these two contradictory states at the same time. Nevertheless, we must remain present and get over ourselves to create a space for all voices. This plenary discusses these and related ideas for hanging in there with our groups and illustrates groups that are struggling with issues including bias, bullying, grief, and trauma from individual change and social goals perspectives. Although adolescent groups are used as illustrations, the lessons herein are universal.     

Promoting Compassionate Concern in Social Work: Reflections on Ethics, Biology and Love

This paper challenges proceduralized, rule-bound approachesto ethics and considers how social workers and teams can developan attitude of compassionate concern and become more effectivein dealing with ethical problems in their day-to-day practice.It introduces the work of Humberto Maturana, a widely respectedtheorist, whose work has received little attention in socialwork. The paper argues that Maturana’s biology of cognitionprovides an approach to ethics that takes into account the spontaneousnature of everyday work in which social workers undertake theirethical actions. It stresses the importance of emotions, particularlylove, and considers the way in which ethical action is shapedby culture. It emphasizes the importance of engaging in reflectionon professional practices and team, professional and organizationalculture in order for social workers to improve their awarenessof ethical dilemmas and promote ethical practice. For thoseteaching ethics, this paper suggests an alternative to the rationalconsideration of moral dilemmas and proposes approaches to trainingthat can help social workers become more attuned and responsiveto ethical conflicts.     

伦理决策语境下的包容性增长研究

伦理决策与包容性增长具有内在的、不可分割的联系,在社会信任发生变化、传统工业文明的文化向现代商业文明的文化变迁、行政体制改革滞后的过程中,伦理决策有弱化的趋势。本文认为,在伦理决策语境下,包容性增长的路径表现为以政府为主导的政治伦理发展路径,以市场为依托的经济伦理发展路径和以社会为背景的生态伦理发展路径。     

Social work for vulnerable and marginalized people during COVID-19 in Japan

During the Coronavirus disease pandemic (COVID-19), working conditions became increasingly difficult for social workers, as they had to deal with new challenges and added workloads. This study describes the difficulties faced by social workers of the Self-Reliance Support System in Japan and clarifies the solution for each difficulty while conducting their duties to support vulnerable people during COVID-19. To this end, we conducted an open-ended questionnaire survey and an interview survey. The data were analyzed using qualitative coding. The results showed that the difficulties faced in consultation support work included supporting hitherto socially invisible groups such as sole traders and foreigners. Social workers also faced an ethical dilemma, as they could not provide support to clients who “did not try to solve their problems” or for whom “interventional attempts did not lead to counseling support” and who only sought benefits at the risk of becoming isolated and impoverished. Following this, consultants collaborated to resolve such difficulties while maximizing the use of various local resources. The study's findings clarify that it would be effective to understand the difficulties faced by social workers to obtain hints toward their resolution.     

Social work with children and families in Ghana: negotiating tradition and modernity

Ghanaian social workers practise in a poly‐ethnic nation comprising a multitude of different indigenous cultural practices and a modern urban sector largely divorced from a rural population adhering to customary law. This qualitative study explores how Ghanaian practitioners negotiate the contradictions between child welfare legislation and customary law. Data were gathered from semi‐structured interviews with 36 qualified social workers employed by the Department of Social Welfare and thematically analysed. The study found that legislative provision normalizes nuclear family forms and runs counter to customary law. Social workers are shown to struggle with the ethical dilemmas the law poses without being able to resolve them in a manner consonant with Ghanian workers' code of practice. The study makes recommendations for social changes to policy, practice and training.     

The parameters of prejudice: knowledge of ethics and age bias

This study examined two matters pertinent to social work practice: professional ethics and age bias among practicing social workers. Because social work ethics demand competent practice within one's area of proficiency, and because bias toward any segment of social work clientele impedes competent practice, prejudicial attitudes toward older people are problematic. This study found that age bias exists among practicing social workers (N = 367), with no discernible association between knowledge of professional ethical standards and age bias. The findings suggest a subtle and pervasive bias associated with work with older people. Positive bias was more prevalent than negative bias.     

Team-Based Learning Instruction for Responsible Conduct of Research Positively Impacts Ethical Decision-Making

Common practices for responsible conduct of research (RCR) instruction have recently been shown to have no positive impact on and possibly to undermine ethical decision-making (EDM). We show that a team-based learning (TBL) RCR curriculum results in some gains in decision ethicality, the use of more helpful metacognitive reasoning strategies in decision-making, and elimination of most negative effects of other forms of RCR instruction on social–behavioral responses. TBL supports the reasoning strategies and social mechanisms that underlie EDM and ethics instruction, and may provide a more effective method for RCR instruction than lectures and small group discussion.     

The Role of Family in Career Choices among Social Workers in China

Abstract

High turnover rate affects social work workforce development in China. Few empirical studies have been conducted to explore the factors that have influences on turnover intention among Chinese social workers. This study used data from China General Survey on Professional Social Workers to examine the influence of job satisfaction and family attitude on social workers’ career choices. The findings reveal that both job satisfaction and family’ attitude toward the profession have significant effects on social workers’ turnover intention. Family’s support or disapproval of the social work profession has moderate effect on the negative correlation between job satisfaction and turnover intention. The findings could be explained by the familyism culture of Chinese society and unique challenges of professional development experienced by social workers in China. Future studies should consider the influence of family to develop a more comprehensive research framework. Management in social service agencies should help family of social workers to learn and embrace the profession to gain their support of choosing social work as career.     

Supporting ethical use of electronic monitoring for people living with dementia: Social work’s role in assessment,decision-making,and review

Walking outdoors supports health and well-being, but some people living with dementia are at increased risk of getting lost and of harm while missing. Electronic monitoring can potentially play an important preventative role by enabling the person’s location to be continuously monitored by caregivers. However, there are considerable ethical concerns arising from electronic monitoring. This paper explores these thematically, drawing attention to its implications for autonomy and liberty; privacy; dignity; the rights and needs of caregivers and families; beneficence and nonmaleficence. Following from this, key questions for consideration in social work assessment are identified. The ethical issues necessitate assessment of the person’s unique circumstances and preferences and that of their caregivers, and careful ethical deliberation in decision-making. Social work can play an important role in facilitating inclusive assessment and decision-making, leading to consensus on intervening with electronic monitoring. The need for the ongoing review following implementation is discussed to track whether decisions need modification in light of the experience of usage. In conclusion, while legislative instruments and professional codes of ethics frame social work practice responses, there is need for a nuanced debate about ethical use of electronic monitoring and specific guidance to inform assessment, decision-making, and review.     

INTERPERSONAL SKILL TRAINING FOR SOCIAL WORKERS IN SMALL GROUPS

This study evaluates the effectiveness of a small-group training program aimed at teaching social workers those interpersonal skills necessary for effective practice. Participants were taught to deal with critical situations commonly encountered by professional social workers in their clinical practice. Modeling, overt and covert rehearsal, videotaped and verbal feedback, coaching, behavioral assignments, delegation of group leadership, and other small group procedures were utilized in the training program. Participants met in small groups offour to six members for 2-hour sessions each week over a period of 6 weeks. The results of the study indicated that, following training, the participants were significantly (p≤ .o1) more effective than the controls in dealing with both trained and untrained items on a behavior role-play test. Methodological limitations, implications for future research on small-group training of social workers, and training of group leaders are discussed.     

Empathy and professional attitude in social workers and non-trained aides

The purpose of this study was to investigate empathic communication and professional attitude in vocational groups representing different levels of professional training. A further aim was to elucidate some aspects of the impact of the clients. Four groups of professionals participated, three with degrees as social workers and one with only short professional training. Three groups worked with committed drug addicts, one group with somatically ill patients. The 110 subjects were tested with a video-test of professional attitude and empathic communication. Different response patterns were found in the different groups. The group with short training had the highest proportion of unprofessional responses. The group of social workers working with somatically ill patients showed the highest amount of empathic communication. Furthermore, there was a distinction among the kind of unprofessional responses used by the different groups. Hypotheses on the causes of these differences and implications for future research are discussed.     

Weaving cohesive identities: New Zealand women talk as mothers and workers

Abstract

This exploratory study examines the discourses which construct women as mothers and workers and explores the strategies the women use to weave these sometimes contradictory identities together. Discourse analysis was used to explore the talk of two focus groups of first‐time mothers, all New Zealanders of European descent in stable heterosexual partnerships with babies aged less than six months. The women deployed an intensive mother discourse which privileged their maternal role and positioned the babies as needing parental care and mothers as the natural providers of that care. However, they also felt the pressure of successful woman and economic rationalist discourses in which paid work is essential to wellbeing and good citizenship while motherhood is devalued. The women's decisions about re‐entering the paid workforce were characterised by conflict and constraint. The analysis focuses on the strategies of resistance that the women used to warrant their life choices, including constructing motherhood as a job, and deploying an independent mother discourse which serves to facilitate their striving for the best of both worlds. Also explored are some of the structural barriers that serve to further limit women's choices.     

A STUDY OF SOCIAL WORK PRACTICE WITH GROUPS

This paper presents the second stage of a study on group use in social work in Quebec. The first stage had identified 72 practitioners working with 130 client groups, and 60 of these workers participated in the second stage interview. The interview explored characteristics of social work practice with groups, and studied personal and organizational factors which may influence group use. The findings suggest group use in social work is characterized by a diversity of group goals, client populations and service settings. Most groups are small units formed by the worker. and their membership is closed during the duration of the group which is usually from 8 to 15 meetings. Structure varies, but most groups base program on discussion or structured exercises, and most workers assume a facilitator or therapist role. Despite these commonalities, there appear to be several distinct styles of practice which vary according to type of group goal, role of worker, and theoretical influences on the worker. These styles vary especially in the extent to which the worker takes a central leadership position or shares group tasks with members.