Hospital social work in Sweden and the UK: Access to chances of physical health and well-being

In Swedish and UK practice, interest is developing in social work's contribution to tackling service users' unequal chances and experience of physical health. This is through alleviating disadvantaged social conditions such as relative poverty which service users face and which are associated with health inequalities. Ready access to social work services is an essential preliminary if service users are to gain the material and social resources services can provide, to alleviate their adverse social circumstances and thereby improve their health prospects. However, despite hospital social work's well-established position, its significance as an access point for services has tended to be marginalized. Drawing on a comparative account of Swedish and UK practice featuring two action research projects, we explore how hospital social work is a key point of access to services for service users experiencing profound disadvantage. We analyse major barriers to such access, notably the underfunded nature of hospital social work, discriminatory procedures, and unequal professional service user power relations. Nevertheless, the action research projects show how these barriers may be breached to some degree, enabling service users as patients and carers to access resources which contribute to more equal chances of health and well-being in ill-health.     

Promises and Pitfalls: Involving Service Users and Carers in Social Work Manager Education

Partnership working occupies an increasing amount of social work managers' time and budget, requiring skills and abilities not always developed previously within social work programmes. Much discussion around partnership working centres on building collaborative inter-agency and inter-professional relationships with less emphasis on the need to ensure good working relationships with service users and carers, despite their being the ultimate recipients of the process. This article explores efforts to develop a focus on service users and carers within a module for social work managers as part of post-qualifying (PQ) social work education. It documents a process where, initially, service users and carers provided personal testimonies of being recipients of services and then subsequently occupied more authoritative roles within teaching, to the current position when they are again less actively involved.

In describing these developments it explores possible reasons why involving service users and carers within this module has proved challenging. The article acknowledges that there is relatively limited literature about the involvement of service users and carers in PQ education. It suggests that lessons learned from involving service users and carers in qualifying social work training cannot directly be transposed to the post-qualifying context.     

Social Exclusion and Social Work: Questions for the Future

This paper describes the experiences of students and service users and carers participating in the Staffordshire University Skills Lab Programme. Two focus groups were held: one with first year social work students and one with service users and carers to explore their views. Qualitative analysis identified key themes that were part of the students' and the service users and carers' experience of the skills lab. The skills lab was very positively rated overall. Several recommendations for improvement will be addressed for future years.     

Editorial

In recent years the imperative to involve service users and carers at every level of care, service and policy development has been extended to include involving users and carers in the training of health and social care professionals. Guidance on how this is to be achieved in practice is, however, limited. This paper describes work undertaken to explore how an Approved Social Work Programme in the north of England could involve service users and carers more fully and develop an integrated approach to service user and carer involvement in this and other social work programmes. Following a review of the literature in this area, the results of a series of meetings with individual and groups of service users and carers are presented, together with a survey of ASW programmes. It then goes on to consider the implications for service user and carer involvement in the new social work degree.     

Learning from service users’ involvement: a research about changing stigmatizing attitudes in social work students

Abstract

Stigmatizing attitudes can create barriers to forming partnership with service users and to developing people’s empowerment. So, social work education must help students overcome their stigmatizing attitudes. A useful strategy for bringing about changes is service users’ and carers’ involvement in social work education, providing students with direct exposure to stigmatized people in roles that emphasize their humanity and strengths, rather than their deficits. The present study assessed the impact of a one-day meeting with service users and carers members of self-help and mutual-aid groups on freshman social work students. Students completed an adapted version of Attitudes to Mental Illness Questionnaire before and after the meeting, and answered several qualitative questions. Data comparisons suggest that after face-to-face contact with service users and carers, social work students showed reduced stigmatizing attitudes. Implications for further research and social work education are discussed.     

Role-played interviews with service users in preparation for social work practice: exploring students’ and service users’ experience of co-produced workshops

Abstract

Within a Theory and Practice of Social Work module, prior to embarking on practice placements, social work students practised professional communication skills with people who had used social work services. They undertook role-played interviews with service users about real issues, which had led individuals to seek assistance in the past. Using principles of co-production, the workshop was developed in partnership with members of the University’s social work service users and carers’ group. Care was taken to safeguard service users’ well-being, as well as developing an effective learning opportunity. Drawing on evaluations by students and feedback from service users, this paper discusses the process of planning and delivering the workshops, as well as perceived outcomes for both groups. Findings indicate that students valued the opportunity to engage with service users, gaining key learning about their own practice skills. Service users described a boost to self-esteem through contributing to students’ learning. The workshop provides an example of how service user involvement in social work education has evolved from a primary focus on sharing personal testimonies to active participation in student skill development. It underlines the importance of investment in service user involvement to achieve an appropriate context for such projects to develop.     

Building Capacity for Service User and Carer Involvement in Social Work Education

Requirements set out for the social work degree and post‐qualifying framework specify the involvement of service users and carers on a number of levels. Research indicates that service user and carer involvement can benefit students, professionals and service users and carers themselves. To keep up with demands placed on service users and carers by higher education institutions and other social work bodies, the issue of capacity needs to be addressed. This paper describes a programme (Getting Involved) designed by Skills for Care to build capacity to participate among service users and carers new to social work education. It describes the experience of piloting the programme in Dorset by a team at Bournemouth University consisting of service users and carers and staff from the Centre for Post‐Qualifying Social Work. Getting Involved is a welcome development and the outcomes of the pilot have been extremely positive for all involved. The process of undertaking and evaluating the pilot raised issues concerning setting up programmes, project management, service users and carers as co‐researchers and sustainability. These are discussed in terms of our experience and how they link with the literature. Lessons learnt and implications for similar work in the future are highlighted.     

Mental health social work in Northern Ireland and the Republic of Ireland: challenges and opportunities for developing practice

Drawing on their experience of mental health social work in Northern Ireland and the Republic of Ireland, the authors examine the impact of current legislative and policy change in both jurisdictions. The paper applies Lorenz's theoretical framework to develop a comparative analysis of how global and country specific variables have interacted in shaping mental health social work. The analysis identifies linkages between factors and indicates similarities and differences in mental health social work practice. The paper highlights emerging discourses in this field and explores the impact on practice of developments such as de-institutionalisation, community care, and ‘user rights’ versus ‘public protection’. The article concludes with a review of key challenges facing social workers in both jurisdictions and identifies opportunities for developing mental health social work in ways that can positively respond to change and effectively address the needs of mental health service users and their carers. The analysis provides an opportunity to evaluate Lorenz's theoretical framework and the paper includes a brief critical commentary on its utility as a conceptual tool in comparative social work.     

Assessment as the Site of Power: A Bourdieusian Interrogation of Service User and Carer Involvement in the Assessments of Social Work Students

The centrality of service user and carer involvement in social work education in England is now well established, both in policy and practice. However, research evidence suggests their involvement in student assessments is underdeveloped and under researched. This study focused on the positioning of service users and carers in relation to other stakeholders involved in the assessments of social work students in England. Using narrative research methodology, 21 participants, including service users, carers, social work students, social work employers and social work educators, were offered a semi-structured individual interview. Participants’ narratives revealed different power relations among those involved in social work students’ assessments and a lack of confidence among service users and carers in making failed assessment recommendations. The paper concludes by arguing the case for social work educators and service user organisations to provide joint training to support service users and carers in their role as assessors of social work students.     

Outcomes focused user involvement in social work education: applying knowledge to practice

Abstract

This paper discusses an innovative approach connecting service user and carer involvement (SUCI) in social work education to social work practice. The research team, comprised service users, carers, social work students and module leader, worked collaboratively democratising the research process. At the University of Dundee, a core social work module facilitates students to spend 15 h with a service user and/or carer (host) gaining a unique insight into their everyday lives. During this time, hosts and students discuss two policy practice questions, responses to these questions are generating annual qualitative data, with study findings being disseminated at local and national level. The experiential learning students acquire from spending time with their host becomes the site of knowledge creation through involvement that is applied to practice. This paper reports on the narratives emerging from the longitudinal data (2012–2015, n = 90) on the changing landscape of social care in Scotland and the dissemination of project findings. We explore the intersection where the voices of service users and carers, student learning and social work practice coalesce. A model of outcomes focused SUCI is introduced as a template for meaningful, sustainable and outcomes-focused SUCI in social work education.     

Service users and carers’ involvement in social work education: lessons from an English case study

Within the larger context of the search to improve social work practice in Europe, this article presents a case study of a UK innovation in social work education with the potential to radically change social work practice. Following governmental requirements, Anglia Ruskin University has introduced systematic involvement of service users and carers in the training of a new undergraduate degree since September 2003. The conceptual and value base, the structure, staffing, and main activities are outlined; the main achievements and obstacles are highlighted. Mindful of the danger of slipping into tokenistic involvement, the project has included an action research evaluation component exploring the views of all the project's stakeholders thus establishing the project as an evidence-based educational innovation. The findings highlight the value of service users and carers’ involvement on the qualifying social work degree, of the action research design of the evaluation, and the steps needed for the cultural change required for such an involvement to become more comprehensive and embedded in the degree.     

‘Providing a Link with the Real World’: Learning from the Student Experience of Service User and Carer Involvement in Social Work Education

Social work has long placed an emphasis on involving users and carers in the education of practitioners, an emphasis driven by service users and carers themselves, the value base of social work, and by policy and legislation from successive governments and regulatory bodies. Recent changes in regulation and professional standards in social work suggest a continuing commitment to service user and carer involvement. This paper argues that in order to ensure a sustainable commitment, there needs to be greater evidence of the value and purpose of such involvement. Whilst there is a considerable body of literature on this issue in social work education, little focus is on any impact on current and future practice of social work students. The paper discusses a research project addressing this issue from the perspective of social work students. Findings suggest that the involvement of service users and carers in their training was perceived by students as overwhelmingly positive, should be enhanced and that they believed that these experiences were taken forward in their practice. The paper also identifies key points that could inform best educational practice.     

The terrors of night and the arrows of day. Social workers' processes in the aftermath of murder

This paper provides extended extracts from interviews conducted with three social workers interviewed for a study enquiring into social workers' experiences of stress. For the purposes of this study, experienced practitioners were asked to recall a time that stood out for them in their minds as causing them stress. They were asked to describe the experience, to say how it had affected them, how they responded to it and what they had found helpful and unhelpful when attempting to deal with the experience. The three participants quoted in the paper all talked of their involvement with service users who had killed others. They describe personal and organisational responses to the murders and tell of internal processes and responses from others that were found to be helpful and unhelpful. The 'haunting' quality of such experiences is apparent throughout accounts, as is the relevance of psychodynamic theory and concepts. The importance of creating and using a therapeutic space in which it is possible to have ideas about how such stress can be thought about is emphasised.     

The Fount of All Knowledge: Training Required to Involve Service Users and Carers in Health and Social Care Education and Training

A modified Delphi study was carried out in order to obtain consensus regarding the content of a university training course to involve service users and carers at all stages of the health and social care educational process within a higher education environment. Telephone interviews were carried out with service users and carers, educationalists and leaders in the field of service user and carer involvement to generate curriculum ideas. A questionnaire was developed from their responses and sent to a purposive sample of 65 people (24 service users and carers, 28 health and social care educationalists and 13 leaders in the field of service user and carer involvement). Fifty‐five statements were generated with consensus being reached on 46 (84%) statements. Mismatches between service users and carers, educationalists and leaders in the field were explored. Key themes to be included in the curriculum were identified. This paper demonstrates that the best training is not imposed upon service users and carers by academics or others who think they know best; rather, that service users and carers themselves can play a leading role in identifying their training needs and devising strategies to ensure these needs are effectively met.     

Involving Service Users in Social Work Management Education: What Makes it Meaningful According to the ‘Experts’?

Course leaders have adopted a relatively cautious approach to involving service users and carers in Post-Qualifying (PQ) social work management education programmes in the UK, looking for opportunities in which it ‘makes sense’ for them to be included. Whilst there is, to a certain extent, the belief that involving service users and carers in PQ social work education is ‘a good thing’, it has proved challenging to implement. This research study sought to explore, through interviews with ‘experts’ in the field, why this process had proved so challenging. A term which emerged during the research was the importance of ‘meaningful involvement’. The research explored what ‘meaningful involvement’ might mean for managers, for academics and also for service users and carers; what it looks like and how might it take forward the understanding of and the preparation for PQ social work management education.     

The Caring Experience: Learning about Community Care through Spending 24 Hours with People Who Use Services and Family Carers

This paper describes a teaching and learning initiative developed in a UK social work programme that has involved carers, service users, academic social work staff and practitioners. Post‐graduate student social workers spend 24 hours in agreed periods with family carers or people who use social work services. The paper explains the origins of this initiative, rooted in a model of service user and carer involvement established over a number of years within the social work programme at the University of Dundee, Scotland. The development of this teaching and learning method is outlined and an account is given by a family carer describing their experience of being involved in the programme. Findings from the evaluation of this first year of operation are reported.     

Living with dementia in rural and remote Scotland: Diverse experiences of people with dementia and their carers

There is a lack of research into people's experiences of using services as dementia sufferers themselves, or because they care for someone with dementia, in rural areas. This article explores their experiences in the context of rural Scotland, drawing on data gathered from both people with dementia and their carers. Our research suggests that understanding the nuanced and co-constituted experience of dementia in rural communities is a pre-requisite for improving service provision. The paper explores the way in which participants linked their experiences to their spatial location in rural areas. Our findings suggest that participants used a narrative of idealised rurality which linked together interwoven and overlapping social networks, a physical relationship with place and a sense of self sufficiency. However, the participants’ stories also highlighted the diversity in experiences as service users between places, suggesting a disjunction between the generalising narrative of the rural idyll and their particular situations. These findings extend the literature on rural mental health issues and on the experience of dementia in particular, in turn helping to inform place and person centred policies.     

Grassroots Networks: A Model for Promoting the Influence of Service Users and Carers in Social Work Education

We examine a process for involving service users and carers in a social work programme in Scotland and include the perspective of a service user involved in the development. We note the extent of service user and carer involvement within Scottish social work education. The Dundee system involves a regulated process of academics liaising with service user and carer groups in the locality, so that the expertise of service users and carers informs and influences social work qualifying training. The model is built on current ideas surrounding communication networks that work in non‐hierarchical ways. The paper emphasises the importance of basing a system on shared values and overcoming tokenistic approaches to involvement.     

‘She Knew What was Coming’: Knowledge and Domestic Violence in Social Work Education

Social Work educators are aware that within any class of social work students there are likely to be students with first-hand experience of domestic violence. The Writing Stories project was designed to engage students with social policy learning using experiential accounts. An unintended outcome of the project was the disclosure of students' experience of domestic violence. The accounts of violence offer an interesting juxtaposition with the formalised academic story of violence. This paper, by drawing on the concept of banality, aims to uncover how knowledge is presented in those stories and what challenges this may pose for educators. Feminist research highlights the need for researchers to enable women to tell their stories. Social work values also stress that service-user experience should be central to theorising and knowledge production. However, within an educational relationship these stories also need to be examined for how they can both provide a basis for knowledge and compete with, clash or resist other forms of knowledge. The key argument is that neither the formal, academic forms of knowledge, nor the experiential should be privileged. Instead, it is by working across a spectrum of epistemological methods that practice is best contextualised.     

Teaching and learning: an exchange of knowledge in the university among students,service users,and professors

The education system's responsibility for social workers to be is a central argument in the academic arena. The purpose of the article is to present an innovative perspective about social work education promoted for several years in the Catholic University in Milan. The education experience with students, social workers to be, gave life to a particular workshop ‘Social Work Orientation’ characterized by different and innovative activities. The experience presented focuses on relational principles such as empowerment, peer facilitation, involvement of service users, and facilitation, following the idea that teaching and learning could be a simultaneous process. Revealing is the experience of ‘service users as professors’, a meeting day in the university between students and service users, a sharing of life stories and relationships. The future social workers learn from the service users, accustoming themselves to considering the service users as people able to cope with their life situations even before enrichment with all the professional tools. The feedback collected about this experience (from students, service users, and professors) shows that the possibility to experiment from the beginning in this approach facilitates the students to become social workers oriented to empowerment and relational processes.