Being a service user and a social work academic: balancing expert identities

Abstract

I am a service user and academic working in a university social work department. My hybrid identity allows me to draw on different types of knowledge in all aspects of my work, including: academic, practice and experiential wisdom. Service user involvement is mandated across social work education but the scope and breadth of different kinds of participation is developed in diverse ways across university contexts. This article affirms the value of service user involvement in health and social care education, exploring its positive impact on students. When lecturers share personal experience of using services alongside practice and academic wisdom in the course of teaching, sometimes the value of experiential knowledge is doubted and its influence dismissed. I examine the importance of experiential wisdom in social work education, specifically when it is embedded in an academic role in a university social work department, and consider how it can be respected and valued. The parallel experiences of involving peer support workers in mental health services, who use their knowledge of recovery to mentor other service users, are then briefly examined, together with reflection of the concerns across mental health with professionals sharing their experiential wisdom with the people that they support.     

Book reviews

This paper addresses a number of issues concerning the future prospects for social work and mental health in England and the implications of these for social work education. In particular the significance of interprofessional practice and education will be examined and these will be located within the wider context of the social work contribution to mental health services. The experience of social work in promoting the interests and involvement of service users and carers and of working within a holistic model will also be recognised. The particular value of the social work contribution to mental health in both mental health and non-mental health settings is emphasised and attention is paid to how this could be strengthened and extended in the light of the opportunities for positive and creative developments offered by the introduction of the new 3-year degree. These will include the development of shared learning with other professional groups and the need to prepare social work students for practice within a rapidly changing world.     

Developing Advanced Practitioners in Mental Health Social Work: Pedagogical Considerations

Advanced social work practitioners in mental health services daily face the challenges of working alongside the more powerful professions of psychiatry and psychology. Advanced post-qualifying programmes in mental health social work equip practitioners with the knowledge, skills and expertise to confidently work alongside both psychiatrists and clinical psychologists in multi-disciplinary teams. This includes training in empirical research methods, which are used to develop the evidence base for psychiatry and psychology, although social work practitioners find this particularly challenging. This paper explores the importance of research methods teaching in the development of advanced practitioners in mental health social work. Using learning theory to explore possible reasons why practitioners find it so difficult, it offers some solutions which may enhance the learning and teaching of research methodology to experienced social workers.     

Allies in Learning: Critical-Reflective Practice On-line with Allied Mental Health Practitioners

This paper is a reflection in action using personal examples of student feedback to guide teaching. In 2003, a post-graduate course was developed at Victoria University in New Zealand for occupational therapists and social workers employed in the mental health services. The aim of the programme is to provide opportunities for on-the-job learning while recruiting and retaining a skilled allied mental health workforce. The programme is publicly funded for students as part of a national workforce development strategy for mental health professionals. In this article, I reflect upon my first year as co-ordinator of the programme in 2007–2008. Due to my background as a social worker and my familiarity with social work theories of practice, I focus on my theories of teaching from a social work perspective while returning to reflect on themes for the student cohort as a whole. The programme is delivered using distance methods supported by nine days of on-site learning throughout the academic year. A problem-based learning (PBL) approach delivered on the Internet platform, ‘Blackboard’, enables students to study from their workplaces. The conceptual model of teaching evolved is a process of ‘creative attunement’ to the learner's world. I conclude by providing examples of the key elements of my teaching/learning model as a ‘work in progress’.     

Personal reflection and experience of a Fulbright Scholar: teaching a mental health course in Vietnam’s changing culture

This paper documents the experience of developing and teaching a course on mental health for undergraduate social worker students during a semester in Vietnam. Social work is a profession at the early stages of development in Vietnam, requiring much curriculum development. There are over 40 universities with undergraduate social work education programs, but few of the faculty have had training or experience in practicing social work. The paper will summarize the main reasons for developing such a course given the current state of mental health need and services in a changing culture, as well as the current state of professional social work education and the newly established profession of social work. The author describes the contexts underlying the course—the status of social work and social work education in Vietnam, the context of mental health and mental illness in Vietnam, and curriculum adaptation to the cultural context. From this experience, the lessons learned about the role of cross-cultural critical thinking, cultural knowledge, and other strategies will be discussed about teaching a subject like mental health internationally.     

Navigating stormy waters: Challenges and opportunities for social work in mental health

The reforms driven by the National Mental Health Strategy have created both opportunities and challenges for social work as a profession. This paper examines the rapidly changing context for practice in mental health, including policy change, and developments in the education and training of the mental health workforce. Key practice issues identified for social work include: (i) the need to establish a viable paradigm for practice; (ii) a more positive response to the challenge of evidence-based practice models; (iii) a national agenda for education and training; and (iv) the importance of working collaboratively with consumers and families in a way that values their human rights and the lived experience of mental illness.     

The pursuit of socially modifiable contingencies in mental health

The effort to understand the meanings of the well-demonstrated linkages between mental health and one's locations in the social structure has commanded a great deal of research attention over the past half century. Following a brief consideration of my early efforts to make a contribution in this regard, some recent and ongoing work is summarized. In concert with important work by others, these findings support the conclusion that differences in exposure to social stress represent a much more critical contingency in mental health and substance use outcomes than has generally been assumed. In addition, reported results indicate that the lifetime experience of multiple adversities is quite common among young people in South Florida and, presumably, elsewhere and the likelihood that the compelling linkage observed between cumulative adversity and risk for psychiatric and substance disorders is causal in nature. It is suggested that the development of interventions in the service of stress prevention or reduction should command a greater proportion of the attention of researchers and interventionists.     

An Experiment in Overseas Field Instruction

This paper reports on a study that examined the knowledge needed for practice in community mental health and the primary source for this knowledge. Differences were found in knowledge areas needed for practice in community mental health settings when contrasted with practice in more traditional mental health agencies. The most frequently indicated source of knowledge for social work roles in community mental health was on-the-job experience. Courses in social work schools were not a primary source of knowledge for the many nonclinical roles undertaken by social workers in community mental health.     

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.     

A research agenda for the black middle class: work stress, survival strategies, and mental health

In this article we discuss the social position of the black middle class and two forms of work stress that appear unique to this group: token stress and social rejection. We outline a research agenda for studying: (1) the relationship between these stressors and mental health in the context of the work environment, and (2) the type of strategies that appear especially efficacious (or problematic) with regard to these problems. We begin the paper with a contextual discussion of the black middle class. We then offer a set of theoretical predictions about the relationship between work stress and mental health among middle class African Americans. We conclude the article with recommendations for future research, and we identify the implications of the research agenda for social policy efforts to diversify the workplace.     

高职教师心理健康现状及应对策略

通过对全国高职院校教师的工作状态、职业压力及心理健康状况的抽样调查和研究,结果表明,目前高职院校教师的工作状态不佳、职业压力较大,身心健康不容乐观;工作状态、职业压力和心理健康两两之间存在显著正相关,职业压力与工作状态对心理健康都有显著的影响作用,职业压力对心理健康的影响有一部分是通过工作状态来实现的。在此基础上,文章提出了建立面向高职教师心理健康的社会支持系统、EAP系统等应对策略。     

Culturally responsive social work practice with D/deaf clients

ABSTRACT

D/deaf individuals are often marginalized in our society. A lack of cultural understanding among social workers serving this population, coupled with communication barriers, inconsistent access to interpreters, or misperceptions of culture, adds to the potential for further marginalization. D/deaf individuals seeking mental health and social services live in a unique cultural context with which social workers may not be familiar and experience persistent issues surrounding access to mental health and social services. This article reviews some useful best practices, cultural points to be aware of, and suggests some strategies for providing culturally responsive social work when working D/deaf clients.     

Exploring Knowledge through Peer Tutoring in a Transitional Learning Community: An Alternative Way of Teaching Counseling Skills to Students in Social Work Education

This article is a critical review of Crossing Bridges, a Department of Health training pack for those working with 'mentally ill' parents and their children. The author argues, on the basis of both personal and professional experience, that although the pack pays lip-service to the significance of structural factors, the training resources are primarily rooted in an individual and family-focused pathology model of mental illness. Three arguments are put forward for the necessity of a wider framework: the significance of shame and stigma to those experiencing mental distress and their families; the predominance of understandings of mental illness that translate social phenomena into individualised problems, notably genetic explanations and attributions of risk and dangerousness; and the contribution of motherhood to the experiencing of mental distress in women. Initiatives within the mental health survivor movement are highlighted as examples promoting positive images of mental distress, and the implications of the issues raised for social work education are considered. The article concludes that efforts to help the children of 'mentally ill' parents, not to mention the parents themselves, must incorporate wider strategies to promote openness, respect, acceptance and ultimately, social inclusion, of those who experience mental distress.     

COMMENTARY (12 YEARS ON) ON ‘THE CONTRIBUTION OF OBSERVATION TRAINING TO PROFESSIONAL DEVELOPMENT IN SOCIAL WORK’ BY JUDITH TROWELL AND GILLIAN MILES

This article aims to stimulate discussion about relationships between the lives of professionals and of service users. The idea is that when parallels are explored and developed, power dynamics between professionals and social workers are reduced, the quality of interaction and work with service users can be improved, and professionals can also be helped in overcoming difficulties in their own lives. I start with an outline of my own personal background and highlight my development throughout, including my emerging identity as a Buddhist. I discuss a case study involving ‘Sally’ and her family and our work together while I was a social work assistant in a Children and Family's team. I try to show the interconnections between the different difficulties that we faced and how that informed my work. I look at some of the benefits, pitfalls and boundaries of working from the point of view that service user and professional are both working to overcome their problems. I also interweave interactions I had at the time with Carlos, a drug user friend in a crisis and the impact he had on me. Because I include my own situation I have called this article a ‘case experience’.

Throughout I refer to Buddhist and psychoanalytic thinking and particularly to agreement between the two around ideas that inner‐resistance is the main barrier to personal evolution. I argue that faith is the key to unlocking resistance, and that faith should be understood as the development of a belief within people that they are able to progress rather than be destroyed in the face of inevitable problems.     

Consensus or contention: an exploration of multidisciplinary team functioning in an Irish mental health context

Multidisciplinary teams (MDTs) are conventionally recommended in mental health care literature as an important way to offer holistic treatment provision to patients. This study aims to explore multidisciplinary teamwork in contemporary mental health settings, particularly what aids and hinders the process of multidisciplinary teamworking, and the social work contribution in such teams. In order to attain an in-depth exploration of these phenomena, a single case study design was employed. Within this design, data were generated through semi-structured interviews and structured observation of a mental health MDT in Ireland. These data were analysed using interpretative phenomenological analysis. The research highlights how the concept of mental illness is contested within this MDT, with the medical model dominant within an environment of fluid working arrangements. Professional role blurring and stereotyping were found to impact the division of labour on this team, with role negotiation found to be an integral part of retaining a professional's practice identity. This research raises concerns for social work's capacity to function within mental health MDTs in Ireland, and highlights ways in which social work educators might respond in order to empower Irish social workers to meet the challenges of mental health multidisciplinary teamworking.     

Mental health in vietnam and the move to incorporate social work: A mixed methods study of staff perceptions and expectations

In 2010, Vietnam established social work as a profession. As part of their strategic plan, the government aims to incorporate social work into existing hospitals and health care facilities in the country, including psychiatric hospitals and mental health care centers. This paper, based upon survey and focus group data from 194 people working in three major mental health facilities in Hanoi, explores direct care staffs’ perceptions of this historic incorporation of social work, with a particular eye to the benefits and challenges of the transition. Results show most staff members thought social workers would provide great support to the many unmet needs of their largely underserved and impoverished patients. They also viewed social workers as a potential resource to the treatment team by reducing work overload. Existing staff, however, were less attuned to the clinical functions of social workers in mental health settings, often equating social work with community development and social movements. Some were concerned about social workers taking on their tasks; others about new social workers being hindered by the professional hierarchy in which doctors were placed at the top. Successful integration of social workers will hinge on strong support from policy-makers and leaders of mental health systems.     

Learning from Mental Health Lived Experience and the Influence on Students’ Practice

This study explored how learning from mental health lived experience influenced Australian social work students’ practice during their first fieldwork placement. Involvement of mental health consumers in social work education is gaining momentum, yet little is known about how this type of learning informs students’ practice. Ten social work students participated in semistructured interviews and one focus group. Findings suggest that learning from lived experience promoted social work practice that honoured the expertise of mental health consumers and privileged personal recovery. Factors such as organisational culture and supervisor attitudes were found to mediate the students’ attempts to privilege lived experience.     

A case for psychodynamic social work

Abstract

Psychodynamic casework is not as popular in social work theory and practice as it once was. It is considered by some to be impractical, unscientific, and not suitable for those customarily receiving a social work service. Task-centred casework, behavioural approaches, the newer psychotherapies, and family therapy have all taken over as major paradigms of social work method. This is especially so, I think, for the social worker working in a psychiatric setting, where many clients stay only for a short time and where emphasis is placed on assessment and short-term intervention.

In this paper I shall argue that a psychodynamic approach in social work is still relevant; that it is important for its humanizing qualities, for understanding and working with people with severe problems and for, perhaps, helping us to locate the position of social work vis-a-vis other mental health professions. I shall do this by focusing on a particular case I had as a social work student on placement in a psychiatric day hospital.     

The personal is political: a feminist reflection on a journey into participatory arts-based research with sex worker migrants in South Africa

ABSTRACT

This article offers a personal reflection of my journey into participatory arts-based research with sex work migrants in South Africa. It begins by sharing some background information of how my own experience as a migrant woman, and my layered (sometimes conflicted) identities, have continued to shape and influence much of my scholarly work, including my commitment to engaging in research that supports (or at least tries to support) social justice. Through this article, I offer an example of how the ‘personal is political’ is entwined in feminist values of research and engagement. Those who experience the issues under investigation must be considered equal partners in research processes. Collaborative forms of knowledge production can support social justice, particularly if efforts strive to shift the centre from which knowledge is traditionally generated and disseminated.