Independent Mental Health Advocacy: A Model of Social Work Advocacy?

ABSTRACT

Advocacy has received less attention in social work research than other aspects of social work practice. This paper draws attention to two tensions in social work advocacy; between worker-led advocacy and person-led advocacy, and between individual advocacy and system level advocacy. We argue that human-rights-based social workers must choose a person-led approach over a worker-led approach while advocating with both systems and individuals. This argument is made by drawing on findings of an evaluation of Independent Mental Health Advocacy (IMHA) in Victoria, Australia. It is shown that social work training had not prepared social workers for rights-based, person-led advocacy and that social workers in public mental health services were struggling to maintain the rights of people in their services even with assistance from IMHA.

IMPLICATIONS

• Independent Mental Health Advocacy (IMHA) is a model of advocacy influenced by social work theory and delivered in part by social-work-trained advocates.

• Social work training is not preparing social workers for person-led, human-rights-based advocacy.

• Public mental health social workers are struggling to maintain the rights of people in mental health services even with the support of external advocacy services.

     

Supporting the Well-Being of People with Mobility Disabilities Through Social Work Practice

ABSTRACT

The purpose of this insight generating study was to explore the viewpoints of people with mobility disabilities (PWMD) about ways for social workers to promote their well-being through social work practice. A qualitative participant action style methodology encouraged PWMD to voice their concerns and recommendations. Eighteen PWMD were interviewed, including nine consumers and nine social workers. Participants indicated from their experiences that social workers commonly are not sufficiently cognizant of the personal goals, perspectives, and health potentials of PWMD. Overall, they suggested that the social work practice approach for people with disabilities should become more holistic and proactive. Their recommendations are consistent with current ideas about best practice in the social work and disabilities literature and they reinforce the importance of making these ideas more widely practiced.     

Evidence-Based Practice: Current Issues and Future Directions

Abstract

Evidence-based practice approaches continue to increase in popularity in health and human service contexts in Australia and internationally. As social workers face pressures to evidence practice and justify outcomes, the limitations in applying an evidence-based practice approach to social work are confronted. The present paper identifies the features of evidence-based practice and notes the potential benefits and limitations of this approach in social work. Debates surrounding the nature of social work interventions, effectiveness and evidence are reviewed. The current context and climate influencing the use of research and other evidence in social work are discussed. The paper also considers the position of qualitative, interpretive and critical reflective approaches in relation to evidence-based practice. Issues for the future of evidence-based practice in social work are identified, including the need for the profession to examine more closely the relationship between critical reflective and evidence-based approaches to practice.     

Legal capacity and the mental health social worker role: an international comparison

ABSTRACT

New capacity laws have been introduced to many jurisdictions over the last decade. These laws have substantially changed the way in which mental health social workers and other professionals approach decisions about, and for, clients. Most notably, there is now an expectation that mental health social workers engage more in supported decision-making to prevent the need for substitute decision-making. This article describes the legal and policy drivers that have led to these changes in practice, with a particular emphasis on the significance of the United Nations Convention on the Rights of Persons with Disabilities (the UNCRPD) and the importance of recovery approaches in mental health services. It then uses selected literature to explore the efficacy of the laws and decision-making in this area. The second part of the article identifies the role that mental health social workers can play in supporting legal capacity, drawing from the authors’ experience and knowledge of mental health social work and law in four jurisdictions: Victoria, Australia; Ontario, Canada; England and Wales; and Northern Ireland. It is concluded that mental health and other social workers need to refine skills, knowledge and values to accommodate this paradigm shift in law, policy and practice.     

Raising the Titanic: Rescuing Social Work Documentation from the Sea of Ethical Risk

Abstract

One of the most contentious issues in social work practice concerns what should be written about people who access social work services, how comprehensively, and in what format social work assessments, interventions, and outcomes should be documented. The present paper describes a structured approach linked to an action research project that was undertaken by hospital-based social workers to identify and minimise problems associated with documentation in the medical record. The Social Work Ethics Audit provided social work staff with a risk-management tool that highlighted documentation as a key area of ethical risk. Through a process of evaluating existing recording practices, social workers were able to meet the challenge of improving social work recording in medical records, returning it to its proper place as a vital component of clinical and ethical practice rather than an administrative task submerged beneath competing priorities. It was anticipated that the social work documentation proforma that resulted from the ethics audit process would have applicability in other health care settings.     

Risk and Social Work Practice

Abstract

Risk assessment and risk management have emerged as central organising principles for an increasing number of health and welfare programs. As a consequence, the language, technologies and imperatives of risk have assumed considerable prominence in the practice of many social workers. The present paper addresses three significant and contemporary explanations for the rise of risk in the day-to-day work of many social workers. In the context of these approaches, the paper examines some of the challenges risk presents to professional and ethical social work practice. Four issues with particular meanings and impacts for social work are discussed, namely the priority of risk over need, changing professional roles, relocation of responsibility to individuals, and the culture of blame.     

Addiction Problems,Addiction Services,and Social Work in the Republic of Ireland

SUMMARY

The aim of this paper is to review policy and practice in relation to the management of alcohol and drug problems in Ireland, with a specific focus on the role of professional social work. There is a high prevalence of alcohol and drug problems in the caseloads of social workers that work within the statutory childcare and criminal justice services. Professional social work in Ireland is of comparatively recent origin and there are few social workers employed in specialist addiction posts or settings in Ireland. The profession as a whole, moreover, has not actively lobbied for a greater role in specialist services. While formal social policy on addictions has shifted in recent decades towards broad public health strategies, which reflect a pragmatic European perspective, the disease model from the United States of America continues to have popular appeal.     

Making Continuing Professional Development Relevant and Accessible in Regional Social Work

ABSTRACT

Continuing professional development (CPD) is an integral component of quality social work practice (Australian Association of Social Workers, 2013). Despite this, there is a lack of knowledge around the perceived needs and challenges of accessing CPD for rural and regional social work practitioners. This research explored professional development education needs and challenges for rural social work practitioners. The findings revealed an increase in complex cases in practice leading to the need for more training in mental health, legal aspects, and therapeutic interventions. Strong demand for CPD was evident, with a preference for face-to-face training instead of online modules. In the face of persistent challenges some innovative solutions were possible from a partnership between service providers, higher education providers, and the professional body to better meet the needs of the rural social work practitioners.

IMPLICATIONS

• Increasing complexity in rural, regional, and remote social work practice has placed extra demands on the knowledge resources of social workers.

• Continuing professional development (CPD) must be relevant and readily accessible to meet the needs of those who practice in these areas.

• Partnerships between agencies, higher education providers, and professional bodies, along with the use of technology can increase accessibility for rural, regional, and remote social workers.

     

Review of Australian Health Related Social Work Research 1990–2009

Abstract

Social workers form a critical component of the Australian health workforce. While their roles as practitioners are very strategic within the health system, less clear is their contribution to health research. This paper reviews the published record of social work research in Australian health from 1990–2009 in order to discern the patterns of the social work contribution to new knowledge in health. The results of this review indicate a tendency to focus on discursive commentary rather than empirical research as well as a less-than-expected focus on client studies. Given the rise of evidence-based practice, there are potentially serious implications for social work in terms of how it positions itself as a contributor to new knowledge within the health field.     

Ethical Dilemmas of Practicing Social Workers Around Psychiatric Medication

Abstract

It is acknowledged that social workers in mental health and other settings routinely experience client-related ethical dilemmas. Further, there is wide recognition of the potential impact of ethical dilemmas on social work practice with clients who use psychotropic medication. Little is know empirically, however, about the experiences of practitioners with these dilemmas. This article describes the results of a national survey of practicing social workers regarding the nature of ethical dilemmas they face related to their work with clients on medication issues. The results make it clear that social workers regularly confront a variety of ethical dilemmas in this type of practice. Many of these dilemmas are related to ambiguities around the knowledge base of practice, appropriate roles of providers, and basic personal and professional values. The authors present implications of these findings for social work practice and further research.     

The Evolution of Mental Health Care Policy and the Implications for Social Work

Abstract

The focus of this article is on the evolution of mental health care policy in the United States from the eighteenth century to the present. To the extent that social work practice enacts policy, this article focuses particularly on the ways 20th century social workers have reflected, interpreted, and forged mental health care initiatives and reforms. The article includes a discussion of how the cycles of mental health reform (moral treatment, mental hygiene, and community mental health) have influenced not only the roles but also the actual practices of social workers. The article concludes with a consideration of the impact of managed care on mental health policy and the implications for social work.     

Variations in Provider Capacity to Offer Accessible Health Care for People with Disabilities

Abstract

Since social workers are likely to practice in a range of health care settings, their training focusing on human behavior in the social environment could help providers develop strategies to improve access to care for people with disabilities. In this article, results from a comprehensive survey of providers about access to health care for people with a broad range of disabilities are reported. Results suggest that a minority of providers report difficulty serving people with disabilities. However, dentists and mental health/substance abuse providers are significantly less likely than other providers to report that they provide accessible services to individuals with disabilities. These providers are less likely to report having had training related to mobility impairments, providing mirrors at their facility, having an accessible door, or providing assistance with personal care needs, and are more likely to report that their building poses a barrier for people with disabilities. Social workers are well positioned to take a leadership role in working with providers and patients to improve access to health care for people with disabilities. A social work framework of understanding the individual in a social environment may be the most appropriate perspective for creating innovative strategies for addressing the complex, multidimensional needs of people with disabilities who experience limited access to care.     

Existential social work and the quest for existential meaning and well-being: A conceptual framework

ABSTRACT

The aim of this article is to conceptualize “existential social work.” A greater understanding of what existential social work means may enable social workers and those studying social work to see how its practice can reveal “the truth” about human existence and how they, as professionals, can enhance existential meaning and existential well-being among their clients. In such work, existential social workers have at their disposal tools such as the Frankl therapeutic approach to existential analysis (i.e., logotherapy) as well as spiritual-sensitive modalities (prayer and mindfulness). To interpret and understand apparent phenomena in the therapy is the ultimate goal with existential social work practices, thus providing clients with the opportunity to discover the meaning that exists in themselves. In addition, these practices pave the way for existential well-being.     

Minimising Coerciveness in Coercion: A Case Study of Social Work Powers under the Victorian Mental Health Act

The balance between care and control in mental health social work is one of constant tension. In the State of Victoria, Australia, the Mental Health Act 2014 gives coercive powers to social workers employed by public mental health services. These include the power to decide if a person needs to be assessed by a psychiatrist, to “take” a person using bodily restraint, to enter premises, and to search and seize a person’s belongings. This paper applies a doctrinal analysis to examine the law, then argues that the use of these powers by social workers, where safe, may be less restrictive than when they are used by police or paramedics. The exercise of these powers may be less traumatic and stigmatising to the people who are subject to them, and social workers may be both legally and ethically obligated to use coercion when appropriate.

IMPLICATIONS

• More social work literature on the coercive powers under mental health legislation is needed as well as more guidance on using these powers for social workers in practice.

• In some circumstances, these coercive powers may be better exercised by social workers than by other professionals.

• Social workers should carefully consider their legal and ethical obligations to use these powers in some circumstances.

     

Reflective practice in a process for the re-approval of ASWs: An exploration of some inevitable resistance

In this article a mental health trainer and a group facilitator explore the background to developing a new protocol to manage the re-approval of mental health social workers in an inner London borough. The new procedure involved social workers attending a series of small group sessions in which they were invited to present and reflect on their work with clients. The dynamics of these sessions and particularly some of the transferential material between group members and facilitator are explored here. The significance for mental health social work, post-qualifying learning and the possibilities of reflective practice is considered.     

School Social Work Information Systems (SSWIS): A Relational Database for School Social Workers

SUMMARY

After a review of their information management system, the Winston-Salem/Forsyth County School Social Work Office began a process to improve data collection and information management. The result was the creation of the School Social Work Information System, a relational database designed and developed by the school social workers themselves. This article reviews the process of evaluating existing systems, developing and implementing the new system, evaluation and continued development of the new system, and implications for further social work practice. This article is intended to provide the school social worker with the necessary information to develop similar systems.     

Applications of a Capability Approach to Disability and the International Classification of Functioning,Disability and Health (ICF) in Social Work Practice

Abstract

As disability rates increase more social workers will require greater preparation to practice effectively with individuals with disabilities. The Capability approach and the International Classification of Functioning, Disability and Health provide helpful tools for social worker training. The capability approach emphasizes the need to assess what individuals are able to do in their real-life environments (capabilities) rather than capacity or functional status. The ICF provides helpful disability-related terminology and an actual classification to assist social workers to develop appropriate interventions that facilitate capability development among individuals with disabilities. Using the capability framework with the ICF will contribute to improved understanding of disability among social work students and practitioners.     

Bringing Technology to School: An Online Resource Guide for the School Social Worker

SUMMARY

The Internet can assist social workers and other human service professionals to obtain information that may potentially benefit both themselves and their clients. There is little doubt among those who are familiar with the Internet that this electronic medium has revolutionized the way we communicate and access knowledge. This article provides school social workers and other human service professionals with links to resources that can be incorporated into practice by offering specific Web pages related to school social work practice.     

An interprofessional internship model for training master’s level social work and counseling students in higher education settings

ABSTRACT

The mental health needs of college students are steadily on the rise, which compels mental health service providers and educators to explore innovative ways to provide more collaborative, supportive, and interdisciplinary service models of practice and professional training. Graduate programs in social work and counseling are at the crux of producing internship training programs to help accommodate the influx of students with persistent mental health concerns across a variety of needs and cultures. This article describes an interprofessional internship program structured and designed to meet the clinical training needs of master’s level students matriculating in social work and counseling who aspire to provide mental health services in higher education settings. The interprofessional internship training model proposes an innovative interdisciplinary approach to field education which may result in positive training outcomes and learning experiences for social work and counseling students. This paper discusses the model’s emphasis on individual and interdisciplinary group supervision, objectives of the internship experience, internship site criteria, and professional and personal benefits to pre-service social workers and counselors. Recommendations for training and limitations of the model are provided.     

Developing Culturally Responsive Supervision Through Yarn Up Time and the CASE Supervision Model

ABSTRACT

This article explores a culturally focused supervision training program supporting Aboriginal and non-Aboriginal supervisors to provide cross-cultural supervision for Aboriginal staff within mainstream and Aboriginal community and human service organisations. The key features of the training program, Yarn Up Time and the CASE supervision model are a culturally respectful approach to cross-cultural professional supervision practice with the purpose of contributing to the development of culturally responsive supervision with Aboriginal staff and their clients. The article concludes with feedback from participants who attended the training and supports the future advancement of cross-cultural supervision practice and models in Australia.

IMPLICATIONS

• There continues to be a need for more culturally responsive supervision for Aboriginal staff and for non-Aboriginal social work practice with Aboriginal people.

• Yarn Up Time and the CASE model is a culturally appropriate approach for supervising Aboriginal staff and non-Aboriginal social workers’ supervision of social workers’ practice with Aboriginal communities.

• Social work supervisors need to be able to use an effective cultural supervision model to support Aboriginal staff in Yarn Up Time.