Translating knowledge into practice: using simulation to enhance mental health competence through social work education

ABSTRACT

Simulation-based learning (SBL) is an innovative experiential teaching method where students and instructors interact with a simulated client to foster students’ holistic competence in practice. Considering the context of North America where social workers are the largest service provider in the field of mental health, it is critical for educators to enhance competencies in students during the social work program. Guided by competency- and simulation-based, adult learning frameworks, this paper illustrates the development and integration of a range of educational activities into a treatment-focused advanced mental health course in the social work curriculum. We conclude by discussing how SBL enhances students’ mental health competence and provide recommendations when developing SBL in the mental health curriculum in social work education.     

Mutual Benefits: Developing Relational Service Approaches Within Centrelink

Abstract

The machinery of income support can have considerable influence in people's lives, creating opportunities for social work but also tensions: access to vulnerable people, but not always on their terms. This paper argues that the challenge to social work is about more than holding on to professional discretion. It considers how social workers can influence service delivery approaches to work more relationally, pursuing a more equal involvement of clients, and recognising the complex interactive context of social and community life. The authors trace the development of such an approach within the Australian Government human services delivery agency Centrelink in Logan, Queensland, and briefly consider a parallel innovation in Newcastle, New South Wales. The authors suggest that grounding a large institutional social service agency in the realities of client and community experiences has mutual benefits, creating a more humanising, cooperative space, and displacing inefficient and sometimes tragic cycles of misunderstanding, confrontation, and disconnection.     

Psychotherapeutic care for sexually-victimized children – Do service providers meet the need? Multilevel analysis

ObjectivesSurprisingly little is known on the decision to refer sexually-victimized children to psychotherapy. Previous research on service provisions for victims of child maltreatment has analyzed the impact of case characteristics, like child or caregiver functional levels, lack of social support, and socioeconomic status. Findings, however, show that the decision to provide services is not only needs-driven, but also affected by external factors like provincial legislation, institutional policies, and the availability and accessibility of services. By analyzing characteristics behind the decision to refer sexually-victimized children to psychotherapy at the case and institutional level, we aimed to disentangle the complex interplay of factors driving this decision.MethodsThe data for this analysis were drawn from the first nationally-representative agency survey on reported child sexual victimization (CSV) in Switzerland. Over a 6-month data-collection period, 165 child protective services, 87 penal authorities and 98 agencies in the health and social sector documented a total of 911 incidents of CSV. Multilevel logistic regression was applied to analyze factors at both the case and contextual level.ResultsThe main finding was that the severity of consequences was strongly associated with the probability of psychotherapeutic service referrals (OR = 10.4; p < 0.001). However, one bias was identified at the individual level: sexually-victimized children born in Switzerland were more likely to be referred to psychotherapy than immigrant children. Institutional disparities in the decision to refer a sexually-victimized child to psychotherapy were large (median OR = 3.83), with penal authorities referring significantly fewer cases to psychotherapy than specialized agencies in the health and social sector. What exactly was driving the difference between psychotherapy referral in different types of agency remains largely unexplained.ConclusionsFuture research should invest in scrutinizing contextual factors of child protective service decisions. As we operationalize the need for psychotherapy as proxy-rated consequences of victimization, routine screening for mental health needs using standardized measures for children in contact with child protection agencies should be implemented, to help frontline workers to identify the psychotherapeutic needs of victimized children.     

A therapeutic social work team in practice

In 1996, as a result of interagency collaboration between social services and health, Leeds Social Services Department brought together three groups of social workers undertaking therapeutic work into a centrally managed team. Continued inter-agency working together has ensured that the Therapeutic Social Work Team has become an established service for children and families. This paper describes the work of the team by focusing on four areas: the context of interagency collaboration, therapeutic work in the child protection process, managing different theoretical approaches in one team, and evaluating practice.     

Liability and the Internet: Risks and Recommendations for Social Work Practice

SUMMARY

Use of the Internet for counseling and information services has increased dramatically in the last five years. Although the Internet may benefit consumers by helping them secure needed services and resources, social workers and social service agencies who provide counseling over the Internet need to be aware of the legal risks associated with its use. Among the most salient concerns that need to be addressed are client confidentiality and privacy of records, appropriateness of treatment services, and the duty to warn others of harm that a client might pose to them. This paper looks at these legal concerns in light of appropriate Social Work practice and recommends methods to abate the risks that might occur when Internet counseling and service is provided.     

Technology and School Social Work Services: Introducing Technology in an Alternative School

SUMMARY

The public school system, one of the largest human service institutions in our nation, is continuously engaged in a struggle to balance the needs of a growing and diverse population with continuing threats of budget cuts. Under these conditions, it becomes even more critical that school social workers understand and appreciate the role of technology in delivering and evaluating services. To assess the effectiveness of school social work services, evaluation will have to be planned for, and systems of data collection and processing will have to be conducted on an ongoing basis.

This paper outlines the process whereby school social workers in a local school district proceeded to introduce technology into their service delivery regimen. Secondly, the paper shows how such technology was, and may be, used to evaluate the services provided by school social workers in an alternative school.     

Cyber Counseling for Queer Clients and Clinicians

Abstract

As the Internet grows, so does its use by mental health professionals and by clients seeking mental health services. Drawing on his own experience as an example, the author describes how the Internet can enhance clinical practice. Social service professionals can utilize the Internet to provide a supportive forum for patients grappling with issues of self-identity; facilitate communication between therapist and client; provide community education about mental health issues; provide referrals to local social service professionals; market a private psychotherapy practice; and provide patient billing, scheduling, and record keeping.     

Social Workers’ Preparation for Child Protection: Revisiting the Question of Specialisation

Abstract

Child welfare work is a key field of practice for social work graduates and for graduates of a growing range of disciplines. In the present paper, the authors drew on a survey of 208 child welfare workers and interviews with 28 senior personnel in child and family welfare agencies to analyse perceptions of the educational preparation of social workers and other human science graduates for this field of practice. The findings indicated that child welfare workers and employers are ambivalent about the value of social work and other generic social science and human services programmes as preparation for tertiary or statutory child protection practice, which involves investigation, assessment, and intervention in child abuse and neglect. The authors argue that the social work profession must better balance generic and specialist aspects to prepare graduates for practice in specialist fields of high social work involvement, particularly in tertiary child protection work.     

Social work guanxi: a reflexive account of the social work relationship in the Chinese context

ABSTRACT

In a guanxi-driven acquaintanceship, the worker, the client, and the community are tied together more closely than they are in mutually agreed-upon service contracts. This paper re-examines the contemporary boundaries in the social work relationship, especially in Asian nations such as China, where ‘relationships’ are generally translated and perceived as ‘guanxi’. The indigenisation of social work must be managed with care when translating from West to East. Drawing from the experiences of community development projects in rural Hong Kong, this paper discusses how guanxi among social workers, clients and other stakeholders in Chinese communities might challenge the professionalism of social work and breach the boundaries of social work relationships.     

Mending the gaps in social work education and research: two examples from a Swedish context

ABSTRACT

The gap-mending concept is an analytical tool that helps teachers and researchers in social work to reflect upon what, in their practice, increases, maintains or mends gaps between professionals and service user groups. The article suggests a theoretical background on how gaps in social work practice can be challenged. This includes theories about power and recognition. It then moves on to describe the development of gap-mending strategies in research and education at the School of Social Work at Lund University. Lund University was one of three partners that took the initiative to the international network PowerUs that has focused on gap-mending strategies in social work education. The authors have been working over 10 years in collaboration with service user participation in the education of social workers and in different research projects. In the article, they give examples of gap-mending practices and of challenges that they have faced. The first example is an experimental course that has been given since 2005 where social work students study together with students from service user organizations in a university course. The second example is an attempt to combat homelessness in several Swedish municipalities. Supported by researchers, the development project has been a collaboration between homeless groups, politicians and social workers.     

How do you solve a problem like Maria? Family complexity and institutional complications in UK social work

ABSTRACT

This paper draws on UK data from an international, comparative project involving eight countries. The study examined how social workers’ conceptions and definitions of family impact on the way they engage with complex families, and how social policies that frame social work context impact on the way social workers engage with families. Focus groups were held in which social workers from four service areas (child welfare, addictions, mental health and migration) were asked to discuss a case vignette. Several factors were embedded in the vignette to represent a realistic situation a social worker may come across in their day-to-day work. Social workers clearly identified the complexity of the family’s situation in terms of the range of issues identified and candidate ‘causes’. However, typical first responses were institutional, looking for triggers that would signify certainty about their, or other agencies’ involvement. This resulted in a complicated story, through which the family was disaggregated into individual problem-service categories. This paper argues that understanding these processes and their consequences is critical for exploring the ways in which we might develop alternative, supportive professional responses with families with complex needs. It also demonstrates how organisational systems manifest themselves in everyday reasoning.     

Power and Child Protection: The Need for a Child Welfare Service Users' Union or Association

Abstract

This paper reports a study in which parents who had received child protection intervention set out to develop a “Service Users' Guide” to help parents newly receiving intervention better understand and cope with the process. The study took place in Ontario, Canada between 2004–2009. Ninety-five parents took part in 13 focus groups and 20 individual interviews. A mix of Participatory Action and grounded theory methods were used to enable parents to develop their service uses guide. As the study progressed it quickly became evident that the biggest issue parents face when receiving intervention is an imbalance in power between themselves and workers. This paper describes the problems this power imbalance causes for parents and presents a potential solution suggested by parents themselves – the development of a child welfare service users' association or union. Parent's ideas about why this association is needed, how it could function, and the benefits it might bring, are discussed. The paper concludes by reviewing the benefits a service users' association might bring not only for those receiving child welfare intervention, but all social work services.     

Challenging implicit bias: preparing students to practice with African American families

ABSTRACT

The disparity of African American families in the foster care system is a concern in the field of child welfare services and the social work profession. African American families experience unique challenges related to discriminatory practices and implicit biases in the child welfare system and by mandated reporters. To address these inequalities, state and local agencies have implemented prevention and intervention services to support minority families. Additionally, child welfare agencies have invested in professional development training for their workers to alleviate possible intolerant practices. This article describes implicit biases and considers how they could contribute to the disparity of African American families involved in the child welfare system. Furthermore, the article presents approaches to help social work students to identify and challenge their implicit biases to support culturally sensitive practices while working with African American families. It concludes with implications for social work education.     

Social work and technology: Challenges for social workers in practice: A case study

Abstract

Social Work is just beginning to consider the full impact of technology on practice. In this paper the experience of social workers working in Centrelink, the Australian Government's service delivery organisation, is explored in the context of Centrelink's increased reliance on technology to deliver its services to six million Australians. The results of a survey that indicated nearly one half of Centrelink's social workers have received no formal training in how to use the technologies they rely so heavily on in their work are considered, as is the role of the social workers who are working as a part of Centrelink's call centre network. It is argued that social workers need to be careful not to confuse means and ends when it comes to utilising technology as a part of their practice.     

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.     

Performance measurement in child protection

Abstract

The increasing use of performance measurement by government means that child protection services are under pressure to demonstrate effectiveness in protecting children from harm and efficiency in the use of public funds to help children and families. From a policy perspective, the way performance measurement is conceptualised and implemented can have major consequences for service delivery. This paper examines key issues raised in the literature about performance measurement, the context for its introduction in child protection, how the concepts of effectiveness and efficiency are dealt with, how client outcomes are defined, and assumptions about ‘good performance’. An overview of performance measurement in child protection in Australia is provided. The paper argues that a critical approach to performance measurement in child protection can contribute to improved service delivery to clients.     

The experience of teaching and learning in social work. The teaching of young child observation: A historical overview

This paper describes the setting up in 1989 of the Tavistock/CCETSW course in young child observation for social work tutors and practice teachers, against the background of the immense pressures on social workers, particularly in the field of child protection. The paper summarises the potential learning from young child observation, and its contribution within social work training. It outlines the issues which faced the social work trainers as they went on to introduce and teach observation on their courses, and draws on an evaluative study in which the members of the course participated, giving their views on the value of observation training.     

Independent Mental Health Advocacy: A Model of Social Work Advocacy?

ABSTRACT

Advocacy has received less attention in social work research than other aspects of social work practice. This paper draws attention to two tensions in social work advocacy; between worker-led advocacy and person-led advocacy, and between individual advocacy and system level advocacy. We argue that human-rights-based social workers must choose a person-led approach over a worker-led approach while advocating with both systems and individuals. This argument is made by drawing on findings of an evaluation of Independent Mental Health Advocacy (IMHA) in Victoria, Australia. It is shown that social work training had not prepared social workers for rights-based, person-led advocacy and that social workers in public mental health services were struggling to maintain the rights of people in their services even with assistance from IMHA.

IMPLICATIONS

• Independent Mental Health Advocacy (IMHA) is a model of advocacy influenced by social work theory and delivered in part by social-work-trained advocates.

• Social work training is not preparing social workers for person-led, human-rights-based advocacy.

• Public mental health social workers are struggling to maintain the rights of people in mental health services even with the support of external advocacy services.

     

Triage and Ethics: Social Workers on the Front Line

ABSTRACT

This article highlights the results of an international qualitative study examining the impact of terrorism and other disasters—both human-made and natural—on social work agencies and their labor force. The study was conducted with focus groups of social workers in health care and social service settings. The major research question concerned the impact of disaster—both natural and human-made—on agencies and social work practitioners. Focus was placed on the ethical dissonance experienced by social workers under pressure to prioritize how services and resources are distributed to those in need.     

The geriatric social worker and his self-awareness

Abstract

Hospice and palliative care services have become an established part of Australian health care in the last decade. Multi-disciplinary teams are usually a feature of such services and social workers are common members of such teams. Yet the exact extent of their use and role in these programs has not been investigated previously. The author conducted a survey of 53 social workers working in such programs and at the same time, another questionnaire was also sent to service directors in all 134 Australian programs about their utilisation and perception of social workers. This article reports the results of both surveys. The results show that a third of the programs employed social workers, but the social workers themselves reported a number of difficulties: nurses are often the dominant occupational group and role-blurring amongst team members is common. The findings are discussed in terms of their implications for the social work profession.