Regulation and Risk in Social Work: The General Social Care Council and the Social Care Register in Context

The 2000 Care Standards Act led to the setting up the GeneralSocial Care Council (GSCC) as the new governing professionalbody for social workers and other social care employees in England.¹The GSCC published national Codes of Practice for social carestaff and their employers in 2002, whilst 1 April 2003 saw theintroduction of the Social Care Register. The stated aim ofthese developments is to protect the public, improve the qualityof care offered by social workers and increase public confidencein the profession. However, such intentions disguise the increasein regulatory control that the GSCC and social care employershave gained over the workforce—intrusions that have metrelatively little criticism. By locating these developmentswithin a broader social context, one in which risk and its managementare at the forefront of contemporary social policy and practice,this paper argues that underlying the debate is a climate offear and distrust in which there is a tendency to view peopleas either vulnerable, dangerous or both. Such a degraded viewof the subjects of social work also pertains to social workersthemselves, who are simultaneously seen as assessors of risk,at risk and as a risk.     

Social Workers and Policy- Practice: The Role of Social and Professional Values

ABSTRACT

Although policy practice is regarded as an essential component of social work, the actual involvement of social workers in policy practice is apparently very limited. This article presents the findings of a study that seeks to explore the role of social and professional values in support by social workers in Israel for engagement in policy practice and their actual involvement in this type of practice. The findings indicate that socioeconomic orientations and professional values have an impact on social worker's perception of policy practice and the degree to which they are actually involved in the social welfare policy process. In particular, it was found that attitudes toward social justice played a major role in the social worker's perceptions of, and involvement in, policy practice.     

Mental Health Problems and Behavioral Disruptions in Nursing Homes:

This paper describes a study that examines knowledge of mental health problems and management of behavioral disruptions by social workers in nursing homes. Since a significant number of nursing home patients have mental health problems (estimates range from 50 to 80 percent) which present behavioral disruptions, this knowledge is critical. Results indicate that social workers are not prepared to provide needed services because they do not have adequate knowledge about the management of behavioral disruptions or the identification of mental health problems of nursing home patients. Recommendations are that social workers employed in nursing homes should have gerontological training and that national policy changes are needed to develop guidelines for qualifications of nursing home social workers. Nursing homes are not meeting the needs of older adults with mental health problems when social workers do not have the knowledge needed to provide nursing home services.     

The Work Experiences of Social Workers: Factors Impacting Compassion Satisfaction and Workplace Stress

Abstract

In 2015, over 6,000 licensed social workers in 13?US states responded to an online survey regarding perceptions and feelings about their work, as well as numerous personal and practice issues. Specifically, this study examined participants’ levels of compassion satisfaction and workplace stress, and then determined through multivariate analyses what demographic factors, behavioral and physical health problems, practice issues, fields of practice, and workplace environment issues impacted these two variables.

The findings indicate that participants demonstrated high levels of compassion satisfaction, with a wide range of workplace stress levels. Workplace environment issues had the greatest impact on both variables, with social workers’ mental health problems, physical health status, and certain demographic factors such as race also influencing them. Over 82% of respondents expressed agreement that they were glad that they chose social work as a profession. The results appear to demonstrate that despite being a potentially stressful occupation, licensed social workers tend to experience significant emotional satisfaction from their work. On the other hand, the results also highlight the need for further research to determine how to enhance support for social workers in the workplace in order to not only reduce workplace stress, but also to increase compassion satisfaction.     

Shaping the Future of Mental Health Policy and Legislation in Northern Ireland: The Impact of Service User and Professional Social Work Discourses

This paper explores the complex interrelationship between serviceuser and professional social work discourses and provides acritical commentary on their respective contributions to therecent review of mental health policy and legislation in NorthernIreland. The analysis indicates that dominant trends in mentalhealth care, as mediated through service structures and institutionalidentities, have tended to prioritize the more coercive aspectsof the social work role and reinforce existing power inequalitieswith service users. It is argued that such developments underlinethe need for a ‘re-focusing’ debate in mental healthsocial work to consider how a more appropriate balance can beachieved between its participatory/empowering and regulatory/coercivefunctions. Whilst highlighting both congruence and dissonancebetween respective discourses, the paper concludes that opportunitiesexist within the current change process for service users andsocial workers to build closer alliances in working togetherto reconstruct practice, safeguard human rights and developinnovative alternatives to a traditional bio-medical model oftreatment.     

Stress and Pressures in Mental Health Social Work: The Worker Speaks

Two-thirds of councils with social services responsibilities(CSSRs) took part in a UK survey of mental health social workers.A one in five sample of front line workers was drawn, and 237respondents completed a questionnaire and diary about theirwork context and content, and their attitudes to their work,their employer, mental health policy and the place of mentalhealth social work in modernized mental health services. Thequestions, that called for free-text responses, were completedin detail and at length. This paper reports the results of aqualitative analysis of these responses using NVIVO software.The paper is structured around the themes emerging from theanalysis: pressure of work; staffing matters; job satisfactionand well-being; recruitment and retention issues; and beingvalued. The conclusions are that the social workers value faceto face contact with service users, and that their commitmentto service users is an important factor in staff retention.The most unsatisfactory aspects of their work context arisefrom not feeling valued by their employers and wider society,and some of the most satisfactory from the support of colleaguesand supervisors. Without attention to these factors, recruitmentand retention problems will remain an unresolved issue.     

An Inclusive Approach to Knowledge for Mental Health Social Work Practice and Policy

As the integration of health and social care services progressesin the mental health sector, there is concern that mental healthsocial workers are disadvantaged, relative to health professionals,because they cannot identify the knowledge base for their practice.This paper argues that this concern is partly the product ofassuming that the knowledge base has to be premised upon randomizedcontrolled trials. Instead, it proposes a non-hierarchical frameworkbased on that developed in health research in Canada by Upshurand colleagues that generates a typology of knowledge whichis congruent with the main forms of inquiry that are relevantto mental health social work practice. The framework recognizesthe contribution of randomized controlled trials to the knowledgebase but also validates knowledge drawn from qualitative, epidemiological,practitioner and user knowledge. It is argued that the frameworkprofiles a wider knowledge base than that promoted by conventionalevidence-based practice, and also could be a basis for futuredevelopment of the research agenda in mental health social work.     

Room to move? Professional discretion at the frontline of welfare‐to‐work

Outcomes of social policies have always been mediated by the discretionary agency of front‐line staff, processes which nevertheless have received insufficient attention in policy evaluation and in the social policy literature more broadly. This article takes the case example of the policy reforms associated with the Australian government's welfare‐to‐work agenda. Drawing on two discreet research projects undertaken at different points in the policy trajectory, the practices of social workers in Centrelink – the Commonwealth government's primary service delivery agency involved in welfare‐to‐work – is examined. Centrelink social workers have been and remain one of the core groups of specialist staff since the Department's inception in the late 1940s, working to improve the well being of people in receipt of income security. Their experiences of the recent past and their expectations of the future of their professional practice as welfare reform becomes more entrenched are canvassed. In summary, the discretionary capacity of the Centrelink social workers to moderate or shape the impact of policy on income security recipients is steadily eroding as this group of professionals is increasingly captured by the emerging practices of workfare.     

On Teaching and Applying the Law in Social Work: It is not that Simple

Summary The teaching of welfare law to social workers has recently beenthe subject of critical scrutiny. Concurrently the relationshipbetween social work practice and the law, the place that legislationshould occupy in daily working practice, has been openly debated.This paper, based on our teaching and practice experience anda small evaluation exercise, criticizes the principal positionstaken in the debate on that relationship. It also evaluatestwo approaches to teaching law to social workers. We argue thatteaching law to social workers and using legal knowledge andprovisions in practice is not as simple and straight-forwardas some commentators allege. Rather, we argue that, for socialworkers to learn and apply the law effectively, both teachinglaw and any subsequent application of this knowledge must beconsidered in a conceptual frame of practice dilemmas whichconfront every practitioner and create role conflict, uncertainty,ambiguity, and insecurity.     

Social Work and End-of-Life Care

Abstract

This paper reviews the professional literature with respect to the social work profession's involvement in end-of-life care. The search process was conducted by entering key words in various combinations to electronic databases. Eligible articles were required to address one of the following: roles and activities of social workers in providing end-of-life care; core principles valued by social workers in the provision of end-of-life care; and barriers to provision of effective end-of-life care. The literature from 1990 through July 2004 was searched most rigorously. Based on this review, suggestions for where the profession of social work should focus its energies are offered. These key areas include focusing on generating empirically-based knowledge for practice and policy analysis and developing a system of social work education that addresses the unique knowledge and skills needed to participate in end-of-life practice as competent and informed professional practitioners. Current initiatives with regard to critical areas are summarized.     

Tracing the contours of postmodern social work

Summary Postmodern ideas and the ferment of debate generated by themcontinue to influence and challenge social work policy and practice.Recent discourses within the social science literature haverarely acknowledged earlier contributions concerning the developmentof social work in the context of the debate between modernistand postmodernist epistemology. This paper examines some ofthe links between earlier and more contemporary ideas, and inso doing highlights their complementary nature and the potentialcontributions they offer to the shape and texture of socialwork in the future as it seeks to define itself in a postmodernworld. Examining these debates in this way enables them to beperceived as helpful resources for social workers to draw upon,rather than choices from which to exclude. It is therefore possibleto begin to map the contours of changing practice as it evolveswhilst understanding something of its origins, traditions andconnections. This paper concludes by recommending a broaderintellectual panorama and less allegiance to opposing theoreticalpositions by social work policy makers and practitioners whofeel constrained to choose between either postmodernist or modernistepistemology.     

Perspectives on Social Care Practice in Romania: Supporting the Development of Professional Learning and Practice

This paper examines the authors’ experiences of developingand delivering training for workers in social care servicesin Romania, through a European Union PHARE¹ funded project.The authors use their experiences to draw on the past and currentpractices of those social workers who were participants in thetraining and to explore their understanding of the emergingissues and themes for social work in Romania. There is alsoan exploration of the potential opportunities for the furtherdevelopment of professional social work learning and practicewithin Romania. The case is made that learning and developmentof social workers could be supported through the encouragementof participatory networks and ‘communities of practice’.     

Primary Health Care Workers' Views about Social Work

Summary SUMMARY A comparison of the views about social work held by 188 primaryhealth care workers—118 GPs, 31 health visitors and 39district nurses—working in the same teams is presentedhere.^* The study focussed particularly on their perceptionsof social workers, their role and performance. The data indicatea general acceptance of the social work role, but a lack ofknowledge of or extensive criticism about, social work performance.Significant differences of view emerged about social work training,role and clients, indicating occupation is a significant factorin perceptions held. In particular, the client group predominantlydealt with appears to have had an impact on perceptions. However,views about social work performance did not differ greatly,suggesting the influence of occupation on perceptions shouldnot be overstated.     

Bilingual Social Workers in Mental Health Service Provision: Cultural Competence,Language, and Work Experience

Many agencies actively recruit bilingual social workers. This study presents the reactions of 10 Chinese bilingual social workers to the expectations and demands of their agencies. The study employed a qualitative design with a phenomenological approach. The participants’ responses provide insight into how they manage ethnic and cultural mental health issues in Chinese populations. This study aims to improve social service delivery for clients with limited English proficiency by identifying effective, culturally competent services. The findings suggest that when hiring bilingual social workers, it is just as important for them to be culturally competent as it is for them to be an ethnic or language match with the client base. Having all of these qualities will result in staff members who can provide more effective services by making accurate diagnoses and identifying appropriate treatment plans. In addition to employing bilingual social workers, it is important to maintain good supervision as this will allow supervisees to have a unique perspective on what is involved in providing effective delivery of services to clients with limited English proficiency. Implications for research, practice, and policy are discussed.     

Medicalization of Social Workers in Mental Health Services in Hong Kong

Correspondence to Dr Kam-shing Yip, Associate Professor, Department of Applied Social Studies, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong. E-mail: ssksyip{at}polyu.edu.hk Summary Medical dominance is a crucial problem in social work practicein mental health services. This paper is an examination of theresponse of social workers to medical dominance in mental healthservices in Hong Kong. To explore the process and the effectsof medicalization of social workers, sixty-three social workersin various areas of mental health service settings were interviewed.Their reaction and daily performance in facing medical dominancewere analysed and evaluated. The findings show that facing medicaldominance was a common occurrence for social workers in variousmental health services in Hong Kong. Conflict existed betweenthe rationalization of medical knowledge by medical professionals,and social work rationalization of social work knowledge bysocial workers. The process of medicalization consisted of fivestages: ignorance of medical dominance, confronting medicaldominance, compromise with medical dominance, acceptance ofmedical dominance and internalization of medical dominance.The findings also show that medicalization was influenced bythe organizational and team context.     

Social Work and Child Mental Health: Psychosocial Principles in Community Practice

Correspondence to Steven Walker, Senior Lecturer, School of Community Health and Social Studies, Anglia Polytechnic University, 2nd Floor, Ashby House, Brook Street, Chelmsford, Essex CM1 1SQ, UK. E-mail: s.walker{at}apu.ac.uk Summary The increased prevalence, complexity and earlier onset of childand adolescent mental health difficulties, has prompted governmentinitiatives to reconfigure current provision for this clientgroup, their parents and the carers who try to support them.Social workers have an important part to play in respondingto the needs of these individual children and families. A residual,care management role is not adequate in these circumstances.This paper describes the development of social work in childand adolescent mental health, and suggests that a synthesisof psychosocial principles and community practice, offers theoptimum social work model of assessment and intervention. Sucha model embraces the most useful aspects of psychodynamic theoryin the context of practice consistent with anti-discriminatory,children's rights and partnership principles.     

Reassessing a Theory of Professional Expertise: A Cross-National Investigation of Expert Mental Health Social Workers

This paper presents the findings from a cross-national studyof expert mental health social workers in Melbourne, Australiaand San Jose, California, USA. In this study, expert socialworkers were selected based on a peer-nomination process andthey were invited to participate in two-hour focus group interviewsin which they described memorable practice situations. Detailedaccounts of these practice situations were gathered from nineteenAustralian and American expert practitioners employed in community-basedmental health settings. The study findings corroborate manyof the dimensions that are explicated in a theory of professionalexpertise developed by Fook et al. (2000). Further, the findingsdescribe the skilful and ethical comportment of these socialworkers in the context of often complex and challenging practicesituations. Narrative accounts are used to demonstrate the distinguishingdimensions and features of expert practice described by Fookand her colleagues, especially when providing services to peoplewith chronic mental illness. In-depth articulation of practiceexpertise using cross-national data enhances social work researchand pedagogy by providing important exemplars that inform morefully the development of empirically based practice theories.     

Physician-Assisted Suicide and Midwest Social Workers: Where Do They Stand?

ABSTRACT

Physician-assisted suicide (PAS) is explicitly legal in five states and by court decision in one. Legislative bills have been introduced in other states including Minnesota, Iowa, and Wisconsin. This quantitative study was designed to understand Midwest, hospice and palliative care at end-of-life social workers’ attitudes toward PAS, preferred terminology, perception of preparedness for the implementation, and awareness of PAS legislation in their state. Sixty-two social workers from Minnesota, Iowa, and Wisconsin completed an anonymous online survey. The results indicated that over one-half of the participants supported PAS legislation and is consistent with previous research on social workers across the country. While there was a range of perceived preparedness for implementation, a majority felt moderately to very prepared. Professional and personal values as well as professional experience influenced their perceived preparedness. Few social workers had accurate awareness of PAS legislation in their state or had attended workshops/events for further education or as a policy advocate. To practice competently and advocate at all levels of practice, hospice and palliative care at end-of-life social workers’ need to understand their own attitudes and values toward PAS and pursue additional education around this ethical issue.     

Female genital mutilation: implications for social work

This article examines the different aspects of female genital mutilation (FGM) which is more commonly known as "female circumcision." It also discusses the Women-at-Risk Program in Canada, mental health issues, and Canadian laws and bans on this practice. Implications of FGM for the social work are also addressed. FGM is a global issue, occurring across different cultures and ethnic groups. It is estimated that between 85 and 14 million women have been mutilated worldwide. There are three forms of FGM: circumcision, excision, and infibulation. Despite the many serious risks arising from these procedures, the practice still continues for reasons that are often based on myths, tradition, and beliefs that religion requires it. Females can suffer from severe consequences of FGM. Various fields, which address health needs, however, failed to recognize the physical and psychological impact of the practice, and have not effectively trained health workers to confront this issue. Putting an end to FGM requires a global action from professionals in mental health, social work, medicine and nursing to challenge laws and lobby for new policies; advocate for the human rights of women and children; negotiate for changes in the health care system to address the needs of women have been mutilated; and create educational literature, thus, increasing awareness on FGM.