Case Work in Social Work: Exploring the use of Reflective Letters in the Intensive Family Support Services

This paper begins by reviewing the current policy context of ‘evidence based interventions’, a term littered in social work literature and more recently working with complex families in Wales. This study demonstrates the application of practice of a range of workers located in the Integrated Family Support Services (IFSS) in Wales in the context of reflective letters utilising motivational interviewing (MI) techniques. As part of the MI method, which is used as a model for practice in the IFSS, the consultant social worker, alongside other practitioners, uses a range of tools including the use of reflective letters and narrative principles. These letters are evidence themselves of the work and therapeutic conversations that happen during sessions within the family home, and with various family members. This paper draws on 14 samples of reflective letters from current practice in Wales and explores and considers their application to practice and areas for further development.     

Integrating a Family-Centered Approach into Social Work Practice with Families of Children and Adolescents with Disabilities

Abstract

This article identifies a family-centered practice construct for working with children and adolescents with disabilities and their families. The experiences of these families have shifted considerably over the past 30 years. A legislative and historical context provides the basis for an understanding of present policies and practices that influence current approaches to service delivery. Though family-centered practice is emphasized in various practice settings, there is still a need to integrate this philosophy into social work practice with children and adolescents with disabilities and their families. In order to enhance the ability of the social worker to integrate this construct into practice, a framework for exploring the experiences of children, adolescents and families is provided. This framework provides an overview of factors related to the individual child, the family and siblings for the social worker to consider when working with these families. The social worker's role as collaborator, advocate, team member and family resource is highlighted.     

Integrating a family-centered approach into social work practice with families of children and adolescents with disabilities

This article identifies a family-centered practice construct for working with children and adolescents with disabilities and their families. The experiences of these families have shifted considerably over the past 30 years. A legislative and historical context provides the basis for an understanding of present policies and practices that influence current approaches to service delivery. Though family-centered practice is emphasized in various practice settings, there is still a need to integrate this philosophy into social work practice with children and adolescents with disabilities and their families. In order to enhance the ability of the social worker to integrate this construct into practice, a framework for exploring the experiences of children, adolescents and families is provided. This framework provides an overview of factors related to the individual child, the family and siblings for the social worker to consider when working with these families. The social worker's role as collaborator, advocate, team member and family resource is highlighted.     

‘Lady,Leave My Culture Out of It!’ An Interview With Nada Miocevic

Nada Miocevic is a social worker and family therapist who trained at Zagreb University in Croatia and at Melbourne University in Victoria, Australia. She completed her training in family therapy in 1975 at the Bouverie Centre, Melbourne. Since migrating to Australia in 1967, her work with migrant and refugee families has taken her throughout Australia and overseas. Currently she is in private practice. Her work involves conducting training courses in supervision and supervision of supervision, as well as her continuing work with families who experience long‐term illnesses.     

The Social Worker as Transdisciplinary Professional: A Reflective Account

The transdisciplinary key worker model requires early childhood intervention professionals to make radical adjustment in their respective scopes of knowledge and practice. Focused on the author’s brief experience in a key worker role, the article highlights challenges and contradictions that arise when health and welfare professionals are expected not only to exchange knowledge, skills, and expertise, but also to perform each other’s work. Two contextual, reflective accounts of the reasons why social workers should be cautious in task transfers in transdisciplinary teams are given. The article renews support for social workers playing professionally appropriate roles in early childhood intervention teams in ways that can protect best service delivery to children with disability and their families.     

A Journal of Family Social Work conversation with Monica McGoldrick,LCSW

Monica McGoldrick and Judith Siegel converse about Monica’s decision to become a social worker, her interest in families, key people who influenced her along the way, and the inspiration for her work on ethnicity in family therapy.     

Using a real case scenario in teaching social work with children and families in different practice settings

Transforming classroom knowledge into practice competency is particularly challenging in social work with children and families. It involves complex, competitive practice approaches and different service settings with procedures and norms influencing a child’s wellbeing. The paper presents the content, application, and evaluation of a module based on a case scenario which considers the limitations and achievements of social work with children and families in different settings. A mixed-method approach was applied to this review process. Students were given an evaluative questionnaire based on the theoretical framework of experiential learning whereupon they wrote reflective essays describing their learning experience. Case method contributes to the acquisition of reflective, integrative, and stimulating knowledge. The participation level contributes to the students’ satisfaction during such learning. Students have learned that families with multiple and complex needs require a holistic approach that separate systems and services cannot provide. This way of learning, with certain limitations, allows activation and an intensive learning experience for large groups of students relevant for a number of social work schools.     

Interpersonal justice: the importance of relationships for child and family social workers

There is still much to learn about what it means to be a child and family social worker. Child and family social workers have a job that often entails making difficult decisions regarding vulnerable children and families in collaboration with other professionals, under stressful conditions in an increasing cost-restrictive climate with diminishing resources. The organisational justice framework has primarily been used to ascertain employee’s perceptions of fairness and can be used to explain a variety of organisational behaviours. Here, it was used qualitatively as a framework to structure the research aims of exploring the lived experience of child and family social workers. The results suggest that the relationships’ social workers have with their peers and managers are significant components to how they manage emotions involved with practice.     

The Family,The Statutory Worker and the Therapist Working Together for Change

Myths have developed for some therapists and statutory workers that have prevented or interfered with their forming a satisfactory working relationship. In such a climate, families tend to remain confused and disempowered and become more dependent on the authority of the legal and statutory system. This paper describes work with one particular family and a local Community Services, Victoria social worker, where these issues were addressed in a way that allowed the workers to be clear about their roles and enabled the parents to resume their responsibility for parenting. The emphasis in this article is on practice issues.     

The Intrusiveness of Home-Based Work on Family Life

This research is intended to ascertain factors related to intrusion of home-based work into the life of the family, and identify the relative impact of characteristics of the home-based worker, his or her family, and the business on intrusions. Logistic regression was used to examine three types of intrusions. Seeing clients at home more than once a week is almost exclusively a function of the characteristics of the work; receiving telephone calls daily and frequently sharing space are functions of the characteristics of the work and of the worker. Understanding the nature of intrusions can help advise families contemplating home-based work and help home-working families find a balance between family demands and work.     

Family support in practice: voices from the field

This paper revisits core family support messages for social work practice in working with children and families, linking to findings from high-profile child protection cases in the UK and the Republic of Ireland. Drawing on a comparative study where these identified practice messages were explored through the lens of testimony of family support workers in the UK and Ireland, these core messages are examined. Operating with hard-to-engage children and parents, we hear how families and family support worker colleagues now view the core functions of child and family work across both jurisdictions (Ireland and England). The authors argue that by naming a more detailed set of practices that are deemed as most useful by families, based on the benefits and challenges of intensive family support work, key messages arise that have major resonance for social work and multiagency practice into the future. A basic message from this study is that valuable lessons on engagement and intervention with families can be drawn for professionals by examining the practice elements of this group of paraprofessionals in the child and family arena. This paper adds to debates on the role of support and intervention in social work and family support work.     

Lone mothers and paid work: the ‘family-work project’

When a mother starts work, her daily life changes in various ways: time, money, relationships, quality of life, and well-being are all subject to modification and potentially greater uncertainty. This is also true for her children, who must adapt to changed circumstances and perhaps play a different role within the family as a consequence. Sustaining work and care over time means that the situation of being a working family must become part of the everyday and regular practice of the family, and this actively involves all family members. This article explores this concept of a ‘family-work project’ through a qualitative longitudinal study of British lone mothers and their children, starting as the mothers took up work and following the families for four to five years. The research captured the experiences of the families as they negotiated the demands of sustaining employment while living on a low, but complex, income.     

Lost in Translation? Embracing the Challenges of Working With Families From a Refugee Background

This article describes the difficulties a mainstream family therapy service experienced in working with families from a refugee background. The experience of six therapists and five bicultural workers, who are also the referring agents, was captured in focus groups, and the reflections that emerged shaped a four‐part approach for working with families from a refugee background. Live consultation, either by the family therapist or bicultural worker, is suggested as a way to marry the expertise of family therapists who are not cultural ‘insiders’ with the ‘lived experience’ and cultural expertise of bicultural support workers. The process of reflecting on therapeutic failure resulted in several principles for working therapeu‐tically with families with a history of refugee trauma, unmet resettlement needs and family relationship challenges. These include maintaining a flexible approach to therapy, ascertaining a clear understanding of the referral context, defining an explicit therapeutic contract from the first session, being mindful of the important role that language plays and terminating therapy if it is contra‐indicated.     

The practice of systemic reflexivity

What does it mean to practise systemic reflexivity? Much has been written on reflective practice but less is known of the practice of systemic reflexivity. This paper is a contribution towards expanding on what is known of the practice of systemic reflexivity. In this endeavour, a contextualising narrative of how ideas of the practice of systemic reflexivity merged within the systemic field is followed by an exploration of reflective practice and systemic reflexivity, using McGilchrist’s approach of interpersonal neuroscience. The purpose is to demonstrate how the two concepts of reflective practice and systemic reflexivity combined could enhance social work practice. However, this is not to deny the current literature that we have on reflection and reflexivity, but there is a need to continue creating space to widen dialogue in this area as a way of keeping the ideas alive and generating alternative ways of working with the two concepts.     

Mindful of the Intersession Break in Family Therapy: The Time to Think Experiment

The Time to Think Experiment researches the experience of clinicians, consumers, and families of an intersession break, which has been used historically in various models of family therapy training. This qualitative pilot study explores the experiences of 21 clinicians, 19 consumers, and six family members using this break for reflection, across the domains of family and couple therapy, individual therapy, group work, and supervision in a mental health service covering the whole age range. Using a phenomenological design, the analysis included narrative, thematic, content, and comparative techniques. The paper considers the impact of privileging reflection in the therapy process, in a climate where models, work cultures, and general lifestyles may not encourage it. Using the intersession break to create space to ‘be’ in the therapy process is one way to integrate mindful and family therapy practice. The emerging themes of an intersession break to promote a richer and deeper therapy experience, and the apparent shift of responsibility for change from clinicians to consumers is discussed.     

‘Riding the Wave’: Working Systemically with Traumatised Families

This paper draws on the authors’ clinical experience as family therapists, working predominantly with families who have experienced trauma such as sexual abuse, physical abuse and neglect, to demonstrate that taking a systemic trauma‐informed approach is a powerful therapeutic modality that can facilitate positive outcomes for all family members. The paper discusses the impact of trauma on relationships, and then outlines a rationale for a trauma‐informed, systemic approach with those traumatised families who are, at times, challenged by excessively heightened behaviour and emotional dysregulation. Drawing from parenting research, it includes a discussion of the place of parent work and how this can be integrated with systemic family work. Key constraints and considerations are highlighted followed by a discussion of key interventions the authors have found useful in building a clinical framework for this work, including what is critical for the therapeutic process. While working with traumatised families is complex and challenging, offering a safe place for families to be in the presence of each other's pain and ‘ride the wave’ of emotions can be a powerful path to recovery.     

‘Sitting on the Mourning Bench’: Mental Health Workers and an Elderly Client

Abstract

The present article documents the experience of a first year social work student on fieldwork placement in an Aged Persons Mental Health Service. The student was part of a team providing service to a long-term client of the service when he was diagnosed with a life-threatening illness. The student's compassionate response to the client raises questions about grief and professionalism, which she explored through a journal and in discussion with her supervisor and other team members working with the client. As part of their reflective practice, the student, her supervisor and the client's mental health workers formed a collective to document their experience and present a staff education session. This article is the outcome of these processes and explores important grief issues in Aged Psychiatry and demonstrates the valuable contribution made by a student to the work of the team in the rich learning environment of a fieldwork placement in aged psychiatry. It is published with the kind permission of the client's next of kin.     

Conceptualising ‘The Relationship’ in Intensive Key Worker Support as a Therapeutic Medium

Across various welfare and justice systems, intensive key worker support is a model of working considered effective for individuals and families identified as having multiple and complex needs. The high profile ‘troubled families’ programme in England is the most recent prominent example of such a model. The key worker role is to assess an individual’s needs, carry out support planning, provide and/or co-ordinate the delivery of supportive interventions and complete care plan reviews. This requires the key worker to work on a one-to-one basis with individuals which, in turn, demands the ability to form effective relationships. In this paper and using evidence from a number of studies, I look at how the key worker-client relationship is developed and maintained. I examine the skills, processes and communication strategies that allow key workers to engage clients, build relationships and drive change. I also explore the notion that the key worker-service user relationship is itself a ‘therapeutic’ medium and is therefore a productive practice in its own right. The paper suggests that while key workers might not be trained therapists or counsellors, they might be equipped to address some emotional challenges that individuals with complex needs face and build therapeutic relationships with them.     

Love in Times of Cholera: Systemic Reflections on Supporting Families Through the Journey(s) of Illness

This paper is the result of our increasing interest in the experience of illness in families and the concomitant reflections on how best to therapeutically support these families through this process. This interest led us to reflect on the nuanced way in which language establishes a play with the experience of illness, a play that can amplify or reduce its effects. Such an interplay in turn led us to consider the valuable role that family therapists have in helping families and treating practitioners to create a safe space for conversation about illness. Further questions are also explored in relation to whether there is a role for family therapists in facilitating the interface between our clinical practice with clients and the wider treating medical community. And, if so, what shape would such an interface take? Considerations at this level would include the anticipation of psychological reactions to diagnosis of chronic and life‐threatening illnesses, in particular the importance of ‘normalisation’ of the psychological reactions to such chronic and/or life threatening diagnoses; the complex dynamics emerging from the interface between the effects of illness in the subjectivity of the ill person and the grief experienced by the other family members; different family members’ narratives of the illness; relevant community contexts; and, lastly, ways to help the family members and/or the ill person navigate the medical system including the use of second opinions, cyberspace information, and other systems in their ecology, such as the spiritual dimension. Some aspects of children's narratives of illness are also identified. The paper has been organised around the dialogue that the authors had around one of their clinical cases.     

DIFFICULTIES IN HOLDING THE ROLE OF THE OBSERVER

This is the second of two linked papers on learning from infant and child observation in social work qualifying training (linked with Linnet McMahon & Steve Farnfield ‘Too Close In Or Too Far Out’). A former student reflects on her own observation experience. She considers the anxieties aroused and their containment, which became possible initially through reflection in the seminar group and ultimately through her internalisation of the reflective process. She discusses the value of her learning in subsequent practice in palliative care.