Consent and Informed Consent: Their Ongoing Evolutions in Clinical Care and Research on Humans

The dual concepts of 'consent' and 'informed consent' continue to have three evolutions. The primary evolution of consent in the patient–physician relationship began in Great Britain in 1767 in the British case, Slater v. Baker and Stapleton , in the judge-made law of consent. The term 'informed consent' within the patient–physician relationship entered the judicial lexicon in the 1957 California appellate case, Salgo v. Leland Stanford Junior University . In its second evolution within research on humans following the Nuremberg trials that included experimental atrocities on humans, there is a key focus on clarifying the purpose of research and specifying the reasons for the need for an even more extensive risk disclosure to individuals considering volunteering for study participation. This second evolution continues with the further refinement of the Declaration of Helsinki and, within the USA, a focus on the Belmont Report . In its third evolution in research in the social science, there has been a recognition of problems with informed consent to questionnaire research. When questionnaires involve patients with moderate or severe posttraumatic stress disorder or abused individuals, there needs to be intense consideration focused on how to best protect the participants with these conditions during the questionnaire study.     

Informed Consent as Process: Problematizing Informed Consent in Organizational Ethnographies

This article examines the implications of informed consent in organizational ethnographies, where the research site is a bounded and formal institution that has its own sets of rules which govern action and membership. While there is considerable scholarship on the issue of ethics in ethnography in general, very little has been written about informed consent in organizational ethnographies where researchers often simultaneously observe managers, “studying” up according to Nadar, and employees referred to as “studying down”. Organizational researchers tend to discuss ethics in terms of obtaining informed consent for individual interviews or in terms of access to an organization as a research site. This essay examines ethical dilemmas experienced in fieldwork studying participatory work arrangements in a Mexican garment firm. By discussing practical issues of gaining access, problems of maintaining access and consent, and concerns of how gatekeeper consent affects subordinates, I problematize the practice of obtaining informed consent in organizations. I argue that thinking of informed consent as an on-going process that requires an active reflexivity on the part of the ethnographer will help researchers to navigate the ever-shifting web of power dynamics present in organizations.     

Teaching Reflective Social Work Practice in Health Care: Promoting Best Practices

Reflection on case material is traditionally believed to promote better clinical practice; recent neurobiological understandings explain why reflection consolidates learning and allows professional heuristics to develop. Here, we describe a practice in context (PIC) framework that requires reflection on the contextual and decisional aspects of a case and further reflection on potential changes for use in similar cases in the future. We analyze cases using the PIC framework to identify themes related to the use of self to identify potential best practices. The framework is shown to function to promote reflection at all levels of practice; published cases provide “role-modeling” for students, while also creating data for analysis of best practices.     

Informed Consent: Provider Responsibilities in Psychotherapy

Abstract

When a psychotherapist and patient meet for the first time, there may be a multiplicity of assumptions on both sides about expectations and goals. This paper describes that crucial relationship and the work that must take place in order that a patient gives a relatively informed consent about the therapeutic process. Due to the many variables and unknowns, there is no such thing as an absolute informed consent in psychotherapy. A relatively informed patient, however, is one who is better prepared to enter into a therapeutic alliance. These important concepts are illustrated with case examples.     

The Diagnosis of Mental Disorders in Clinical Social Work: A Review of Standards of Care

Licensed to diagnose and treat mental disorders, clinical social workers have begun to develop and practice professional standards commensurate with their status as the nation’s largest provider of mental health care. Against the backdrop of malpractice claims and awards, this paper reviews the extant standards promulgated by our professional organizations, regulatory bodies, health-insurance and managed-care entities, and the courts to synthesize standards of care for the diagnosis of mental disorders. The limited available evidence suggests that clinical social workers merit congratulations and concern as we rise to the challenge of addressing those standards in education and practice.     

Digital Exclusion: Potential Implications for Social Work Education

QAA Subject Benchmark 5.9 requires social work students to demonstrate the ability to have a critical understanding of the social impact of ICT, including an awareness of the impact of the ‘digital divide’. In the twenty-first century, the implications of digital exclusion may become increasingly relevant for the social work profession with its values of empowerment and anti-oppressive practices. As governments and organisations move closer to the provision of online services, the social worker may find themselves addressing the disempowerment of service users and carers disconnected from a virtual welfare state. The concern is that Benchmark 5.9 does not go far enough, that the full significance of this requirement may not be sufficiently realised and a greater awareness urgently called for.     

Social Work Practices for Young People with Complex Needs: An Integrative Review

The aim of this integrative review is to investigate research of social work practices for adolescents and young adults with complex needs. The research questions are: What are the major themes in studies of practices for young people with complex needs? How do studies suggest that complex needs can be met in ways that are beneficial for young people? A young person with complex needs is in this review defined as an adolescent or young adult who, due to mental ill-health in combination with different types of social vulnerabilities, is receiving assistance from multiple welfare services. Searches were conducted in seven databases. These searches resulted in a sample of 1677 records, published 2007–2016, which in the screening process were reduced to 24 publications, all peer-reviewed articles. The participants in the studies in the articles consisted of young people, parents and professionals from mainly Anglo-Saxon countries. The articles were analyzed with qualitative summative content analysis. Three empirically generated themes were found in studies of work practices targeting young people with complex needs: collaboration-, relationship- and empowerment-oriented practices. In conclusion, the practices contain a wide variety of features, but with the joint aim of acknowledging young people’s needs. The results can be used by practitioners and policymakers to further the development of services for youth with mental ill-health and social vulnerabilities, who use multiple welfare services.     

Critical Thinking in Social Care and Social Work: Searching Student Assignments for the Evidence

The ability to think critically would appear to be a defining feature of competent social work practice. Yet the way practitioners develop critical thinking and how it is taught and assessed within educational establishments is unclear. This paper explores one key aspect of the learning process; the way critical thinking might be evidenced in the transition from Further Education to Higher Education. The assignments produced by students undertaking the HNC in Social Care and year one students at the initial stage of the BA Social Work programme in Scotland were examined. The findings suggest that students working in social care environments and year one students on the BA Social Work course were able to evidence some critical thinking; however, it was generally quite minimal and limited to certain categories. Whilst there are likely to be diverse opinions within Scotland as to how the new four‐year honours degree in social work is implemented in terms of teaching, assessment and learning, a valuable opportunity may be missed if critical thinking is not a core feature and meaningfully aligned to students' experiences at Further Education and Higher Education.     

Preparing Social Work Graduates for Digital Practice: Ethical Pedagogies for Effective Learning

ABSTRACT

Debate has arisen in social work about the value of online education, with proponents providing examples of innovative approaches to online teaching and those against it citing the need for face-to-face interactions to suitably teach and assess social work skills. At the same time, social workers are increasingly making use of social media, websites, online databases, email, and text messaging services for work with clients. Consequently, social workers must be adequately prepared to make use of online technologies in their practice. Drawing on examples of online interactive activities used at two regional universities and informed by Chi’s conceptual framework of cognitive processes of learning, this article argues that learning via information and communications technology (ICT) helps prepare graduates for emerging digital practice and should be an integral part of social work education. Further, ICT enables educators to monitor the levels and quality of student rehearsal of practice skills and knowledge in interactive learning experiences helping promote competent practice, grounded in social work values.     

The Social Care Work Portfolio: An Aid to Integrated Learning and Reflection in Social Care Training

The focus of the paper is on the use of a specifically designed portfolio in social care training as an aid to both integrated learning and reflection. Integrated learning is achieved through the use of discrete sections in the portfolio which require students to discuss their practice placement agencies from perspectives that demonstrate their understanding of subjects such as theories and practices of social care, psychology, social policy, legal studies. Reflection, which is considered a core element of social care training, is examined as a learning tool. A model for the promotion of reflection is presented to help students gain new perspectives on their learning experiences. Criteria for the assessment of both integrated learning and use of reflection are discussed. Some comments of students, recorded during the evaluation process, are presented as evidence of their learning through the use of the portfolio model.     

Child Care “Packaging” Among TANF Recipients: Implications for Social Work

This article reports the results of a study that examined the ways in which current and recent TANF recipients assembled or “packaged” their child care arrangements among formal and informal providers. The findings are drawn from in-person, in-depth interviews with current and former welfare recipients. The study found that most of the respondents used multiple providers within the category of informal child care for reasons including availability, the use of a network of social acquaintances as a problem-solving resource, the need to accommodate irregular work hours, and personal trauma that contributed to a distrust of strangers in formal settings. The findings can affect the efficacy of practice with TANF recipients by contributing to social workers’ understanding of the context of decision-making regarding child care.     

Innovating Practices to Prepare Students for Graduate School: Lessons From a Social Work MOOC

This article describes the implementation of a massive open online course (MOOC) developed by a school of social work and piloted in the incoming 2016 MSW class (N=397). Using implementation science as a framework, we describe the MOOC as an intervention for preparing students for graduate school and share findings from the pilot evaluation. We argue that MOOCs can represent an innovative approach for other schools of social work, but our lessons learned suggest that they also require resources, time investment, organizational support, and understanding of the implications for students and the school. Future questions for research include examining the long-term benefits of MOOCs to students, their broader application, and the cost-benefit analysis for schools interested in developing MOOCs.     

Social Development and Minimum Standards in Social Work Education in South Africa

This paper evaluates how well South African minimum standards for social work education, known as Exit Level Outcomes, are aligned to a social development paradigm. Developmental social work is a relatively new approach in social work education internationally, and this article can therefore provide lessons for other countries using this paradigm in an education model based on national minimum standards.

The complexities and difficulties of using a minimum standards approach in education are discussed and the policy context for the development of these standards in South Africa is explained. The use of a social development framework for the analysis is motivated in relation to its relevance to the social context. Nine criteria for a social development perspective were drawn from the literature to form an analytical framework. A content analysis using this framework was done on the minimum standards.

The results show that the minimum standards are generally aligned with social development principles that drive national priorities, but a few significant gaps exist, which are outlined and discussed. This article attempts to grapple with the complexities of using these minimum standards to drive both curricula related and extra curricula activities in social work education in South Africa