Training together--part two: An exploration of the evaluation of a shared learning programme on dual diagnosis for specialist drugs workers and Approved Social Workers (ASWs)

This paper describes a formative approach to evaluating a shared learning training course for ASWs and drugs workers on dual diagnosis. It uses a four-stage approach to evaluation in an attempt to explore issues relating to curriculum content, training methods and design, learners' satisfaction with the training and outcomes in respect of practice. It also draws upon a recent review of interprofessional education undertaken by the British Education Research Association (BERA) to explore to what extent interactive methods of learning are employed through the training delivery as a means of fostering improved interprofessional collaboration that can be transferred from the training environment to professional practice. The paper concludes that although limited in its generalisability and the extent to which changes in practice can be attributed to the training, the training providers have learned some useful lessons about how to maximise the value of a shared learning approach in promoting collaborative working between ASWs and drugs workers.     

Substance Use Training Experiences and Needs: Findings From a National Survey of Social Care Professionals in England

For more than 30 years there have been calls in the UK to improve training for social workers in relation to substance use. Yet very little research has explored what training practitioners have received or what their training needs are. This study sought to establish practitioners' experiences of previous training in substance use and identify their current training needs. An online survey was disseminated to 3,164 practitioners in adults' (AS) and children's (CS) social care and 12 vignette-based focus groups were also held. Of the final sample of 597, more than a third of social workers had not received any training and a further fifth only received between one and four hours. Other social care staff fared worse. Overwhelmingly, respondents said that substance use knowledge and skills were very important to their practice but their professional education had not prepared them well. They identified a number of training needs including ‘how to talk to people about substance use’ and ‘the types of intervention and treatment available’. Most social care professionals report not being adequately prepared for working with substance use, particularly basic knowledge and skills which would help them to conduct assessments and signpost people to specialist substance services.     

Managing Risk in Community Care of Older People: Perspectives from the Frontline

Abstract

Since the mid-1980s, Australian governments have focused on expanding community and home-based services for older people. This has led to increased levels of dependency, vulnerability, and complexity to be managed in the community. Consequently, aged care services have had to develop mechanisms for regulating and managing these increased risks, and risk management has become more central to the practices of professional workers in this field. This paper reports on some findings from a large-scale study that explores the way risk management policies have been translated into practice by community-based services in Victoria, Australia. Drawing on interviews with 18 frontline and management professionals employed in community aged care, we found that these workers were wrestling with a diverse and new range of institutional risks beyond those encountered in the actual delivery of frontline care. We found that these workers experienced “risk” in four different contexts, which often created demands for contradictory or conflicting responses. Here we examine these “contexts of risk practice”: professional workers' relationships with their clients, relationships with other service providers, the unregulated nature of the home as a work environment, and community expectations about the management of risk. Despite tensions that frequently arose, workers expressed strong professional commitments to their clients and were motivated to find positive resolutions amid competing interests. We conclude that tensions experienced by workers were embedded in the structural dimensions of institutional relationships and the systematic absence of shared understandings of “acceptable” risks in the community care of older people, rather than in the failure of professional agency.     

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.     

Refusing to Listen: Are We Failing the Needs of People with Alcohol and Drug Problems?

This paper argues that social work education in the UK has persistently failed to equip its social workers with the knowledge to work effectively with people with alcohol and drug problems. In spite of continuing criticism of the profession's unwillingness or inability to engage with substance use issues, social work education has failed to respond to the calls for better training on this subject, even when specific guidance has been issued about course content. This results in a failure to meet the needs of our service users as well as social work staff who remain frustrated at their inability to intervene. The paper explores the historical and current debate about social work training in relation to alcohol and drugs and identifies the barriers to its inclusion in qualifying and post‐qualifying (PQ) curricula. Finally it offers a strategy for improving social work training as well as an overview of programme content requirements.     

Mental Health Professionals' Exposure to Clients with Problematic Internet Experiences

ABSTRACT

This paper examines clients' exposure to problematic Internet experiences among a national sample of 2,098 social workers, psychologists, marriage and family therapists, and other mental health professionals. This analysis finds that mental health professionals are working with clients experiencing a range of problems related to Internet use. However, these professionals have generally not been exposed to training or information in the professional literature on the topic of working with clients with problematic Internet experiences. We identify several areas in which additional training is needed and review practical implications for mental health professionals.     

‘Listen: This Really Happened’: Making Sense of Social Work Through Story‐telling

The use of guided critical reflection and analysis is increasingly popular in the education and training of social workers, especially when students embark on their practice learning opportunities. This paper explores the use of structured story‐telling in tutorials as a way of helping students make sense of social work practice. By focusing on a narrative shared with a tutor group, the argument will be made that tutorials are important places to ‘monitor’ the self (and others) in social contexts, and are helpful places for students to identify their personal values and how these might link with their future professional selves.     

Approved Social Work Training in Northern Ireland: Using Research to Examine Competence‐based Learning and Influence Policy Change

This article reports on how research activity helped describe and analyse ASW (Approved Social Worker) learning experience as well as acting as a catalyst for change and development in policy and practice in Northern Ireland. The paper contextualizes the study by outlining the legislation, the main features of the ASW role and the approach to ASW training in Northern Ireland, and by reviewing the literature on the efficacy and value of competence‐based learning. While the findings do not provide conclusive evidence that a competence‐based approach is inherently more effective than previous courses, they do indicate that candidates who were trained in this way were moderately more satisfied than those who had participated in non‐competence based programmes. The research also highlights the importance of the interrelationship between training, practice experience and support in developing and sustaining competence. The paper concludes with a review of the recommendations arising from the study and an analysis of the developments in training and regulations relating to practice experience and re‐approval of ASWs since publication of the research. The study is of contemporary interest given the proposed changes to the role of ASWs/Mental Health Officers in the context of the reviews of UK mental health law.     

An interprofessional internship model for training master’s level social work and counseling students in higher education settings

ABSTRACT

The mental health needs of college students are steadily on the rise, which compels mental health service providers and educators to explore innovative ways to provide more collaborative, supportive, and interdisciplinary service models of practice and professional training. Graduate programs in social work and counseling are at the crux of producing internship training programs to help accommodate the influx of students with persistent mental health concerns across a variety of needs and cultures. This article describes an interprofessional internship program structured and designed to meet the clinical training needs of master’s level students matriculating in social work and counseling who aspire to provide mental health services in higher education settings. The interprofessional internship training model proposes an innovative interdisciplinary approach to field education which may result in positive training outcomes and learning experiences for social work and counseling students. This paper discusses the model’s emphasis on individual and interdisciplinary group supervision, objectives of the internship experience, internship site criteria, and professional and personal benefits to pre-service social workers and counselors. Recommendations for training and limitations of the model are provided.     

Assessing Fitness to Practise and Managing Work‐based Placement

This article describes the experience of Nottingham and Birmingham Universities in partnership with workers from Advocacy In Action and shows that service‐users, carers and other eligible citizens can and should be involved in deciding fitness for practice and in the managing of that practice, and that such involvement enhances the student experience and lays the foundations for partnership working in the professional arena. The users and citizen stakeholders of social services are a valuable resource in respect of all aspects of service planning, delivery and control. In respect of social work education, their involvement is too valuable an opportunity to miss and we look forward to further exciting partnerships in the field of practice learning.     

Substance Use and Disabilities: Experiences of Adults' Social Care Professionals and the Implications for Education and Training

This paper draws on data from a national survey of social workers and social care practitioners in England undertaken in 2010–2011. It focuses on practitioners working in services for adults with either learning or physical disabilities and, in particular, their experiences of responding to alcohol and other drug use among their service users. Based on secondary analysis of survey and focus group data from the earlier study, the paper outlines the extent to which workers in these areas of practice encounter alcohol and drug problems and discusses the key challenges this poses for them. The findings show that between 4% and 10% of adults' practitioners' service users have alcohol and drug problems depending on the nature of the disability. Regardless of the type of disability, practitioners reported difficulties in talking about substance use with their service users as well as identifying tensions around life-style choice and risk management. They also reported the need for education and training in a number of areas. Social work education and subsequent training in working with substance use problems needs to be available to adults' practitioners and it needs to address the specific issues and needs in different areas of social work practice.     

Localising Social Work: Lessons Learnt from a Community Based Intervention amongst the Bedouin in Jordan

This paper presents an example of local social work practice in Jordan in the health field. It draws on a research study on Bedouin health in the North Eastern Badia. The project developed, implemented and evaluated a training intervention developed in partnership with a range of providers for improving local social work practice. Evaluation methods used included a pre and post test, focus group discussions and students' field notes. Findings revealed the significance of promoting culturally competent practice to respond to local health and social needs. Students and practice assessors agreed that the training interventions were an effective way to implement theory into local practice in relation to Bedouin society. This training intervention is an example of developing local social work practice as a way of responding critically to social inequalities.     

Provider Preparedness for Treatment of Co-occurring Disorders: Comparison of Social Workers and Alcohol and Drug Counselors

Substance use and mental health disorders remain significant behavioral health concerns in the United States and other Western nations. Nearly half of the 20.3 million adults with substance use disorders in the US have a co-occurring mental illness . Despite growing research support, integrated treatment by providers with expertise in both mental health and substance use is critically lacking. As part of a co-occurring disorders (COD) training initiative in the USA, this study investigated providers' (n = 438) past training, current COD service provision, and future training needs. Specifically, we examined the extent to which social workers were prepared to treat individuals with COD compared to alcohol and drug counselors. Unsurprisingly, social workers reported receiving significantly more mental health related training, while alcohol and drug counselors reported more substance use related training. Alcohol and drug counselors reported significantly more COD-specific training including general COD, psychopharmacology, COD treatment, and relapse prevention. Social workers were significantly more likely than alcohol and drug counselors to report wanting more training in substance use disorders and culturally-specific intervention techniques. These findings suggest that tailored training and licensure changes are needed to enhance social workers' capacity for competent COD treatment.     

Building Relationships with Aboriginal People: A Cultural Mapping Toolbox

Abstract

This article describes a cultural mapping tool developed specifically for working with Aboriginal people experiencing mental health problems. The tool has broad scope, drawing from ecological and systems approaches. It will assist social workers to understand cultural and family obligations and build relationships with Aboriginal service users. Students learning about cultural diversity have expressed concern about asking culturally-sensitive questions. Australian human service workers typically state they feel inadequate in addressing Aboriginal culture in their practice approaches. The three components of the cultural mapping toolbox, (a) the social and emotional wellbeing cluster map, (b) the community and cultural diversity map, and (c) the migration map, provide social workers with a way of supporting a culturally connected lifestyle in contemporary society.     

Continuing professional development after qualification--partnerships,pitfalls and potential

Social work educators, employers and policy-makers have increasingly recognised the importance of continuing professional development. The UK social work qualification (DipSW) provides a broad base of practice skills, knowledge and values. However, increasingly complex work, frequent legislative and policy changes, research findings and challenges of working in a societal context of increasing change and diversity all contribute to the necessity of developing strategies for continuing professional development which adequately equip social workers. Such education cannot be alienated from social workers' employment context, and thus needs to remain mindful of employers' needs while concurrently maintaining academic rigour. This paper explores the development and delivery of a year-long post-qualifying training course run collaboratively between West Sussex Social and Caring Services and University College Chichester. It places some of the experiences of tutors, candidates and Training and Development Officers within the wider context of social work education, training and the delivery of social care. In exploring some of the contradictions and tensions experienced it seeks to further understand the challenge of delivering effective training in an increasingly complex and fragmented arena. Finally, it considers possible future developments, mindful of future changes in UK social work education.     

Practice Learning and the Development of Professional Practice

The development of professional practice is based on practice learning, yet there is no consensus about its definition. The currently evolving use of the term ‘practice learning’ provides us with an opportunity to consider the nature of learning for professional practice at initial entry through to post qualifying stages of development. A number of streams of thought are influencing the understanding of practice learning and we aim to consider some of these and how they inform those involved in supporting and guiding practice learners at different stages of their professional development.

In presenting our conceptualisation of practice learning we argue against oversimplified dualities of classroom‐based academic learning concerned with theory and workplace‐based practice learning concerned with practice. Additionally we make explicit the career‐long nature of practice learning which is as embedded in continuing professional development as it is in the requirements for qualifying programmes.

Having established what we mean by ‘practice learning’ we consider the impact of organisational learning theory on the management of practice learning. The consideration of the characteristics of organisations which learn leads to a brief examination of approaches to teaching and learning which promote knowledge creation in a way which is meaningful to practitioners. We will argue that the development of understandings of organisational learning and knowledge creation should become part of the knowledge base for those supporting and guiding practice learners, in addition to the traditional knowledge base of adult learning theory.

Before exploring the nature of practice learning it would be helpful to consider briefly what we mean by professional practice for which practice learning is preparing people.

Professional practice in social work is a complex set of activities which involve direct work with service users, and their families, as well as work with other professionals and agencies. A range of knowledge and skills are used with a firm value base which recognises diversity and oppression as key elements in UK society.

Such professional practice is learned and developed in a range of ways over time through training, practice, understanding, analysis and reflection. However, the nature of just what practice learning is and where it occurs has become a focus of debate in the UK as a result of recent developments in initial professional education and training for social work.     

Work-based Supervisors: The Neglected Partners in Practice Learning

The introduction of the Degree in Social Work programme in 2003 prompted considerable diversification in arrangements for practice supervision, teaching and assessment. A small scale exploratory study was undertaken into a model which utilises work-based supervisors, working in tandem with off-site practice teachers who are primarily responsible for the assessment of student social workers. The study focused on exploring the experiences of work-based supervisors and off-site practice teachers working to this model. The findings pointed to increased anxiety and confusion about roles amongst work-based supervisors and off-site practice teachers. Work-based supervisors described themselves as the ‘neglected partners’ in the learning process, taking on most of the work, but with limited recognition, reward or status. Work-based supervisors valued the new range of professional development opportunities to support them in their role but had difficulty in accessing these due to other professional commitments.     

Notes on contributors

Ethics is a central area for professional education in social work. The main educational strategies for the ethics component in social work programmes are often a combination of explicit attention to principles and implicit grounding in practice examples (such as ‘case study’ vignettes). These approaches equip students to recognise and respond to the complexities of ethics in practice. However, they may also encourage students to understand ethics as ‘rules of conduct’, in which there are ‘correct answers’ that can be learned and applied. This paper advances the view that it is more helpful to consider ethics as a ‘framework for thinking’ about the means/ends relationship in practice. It is argued that, as a consequence, the goal of ethics education should be to enable student social workers to grasp the inherently moral nature of practice and the ambiguities that follow from this. Such a position points to the paradox of social work education, that it involves teaching about things that cannot ‘exist’ separately from their being created in action. To explore this paradox in teaching ethics, the paper considers inductive approaches in learning as a way of responding to the ambiguities that are inherent not only in the subject but also in the experience of professional education.     

Social Workers Can e-Learn: Evaluation of a Pilot Post-Qualifying e-Learning Course in Research Methods and Critical Appraisal Skills for Social Workers

Social workers are increasingly encouraged to become research minded and integrate research findings into their practice. However, there is a paucity of high-quality accessible training for social workers in research methods and critical appraisal skills. We developed an e-learning version of an MSc degree module to widen access to this kind of training and this paper presents the findings of an evaluation of a pilot of this e-learning course. To test the effectiveness of the e-learning environment in delivering research methods and critical appraisal skills training to social workers in comparison with a classroom group, we adopted a mixed methods approach which comprised concept mapping exercises, semi-structured interviews and evaluation questionnaires administered to the e-learners (n = 3) and a classroom comparison group (n = 12). Our analysis of the students' concept maps revealed no conspicuous differences in the quality of student knowledge changes that were a consequence of the mode of teaching delivery. The e-learners met the learning outcomes of the module to the same extent as the classroom group and were highly satisfied with the mode of delivery. Although this was a small pilot, it provided tentative evidence that social workers can use e-learning to develop evidence-based practice skills.     

Using child welfare assessments and latent class analysis to identify prevalence and comorbidity of parent service needs

Data collected through Illinois's Integrated Assessment (IA) program—an assessment and service coordination program incorporating clinical assessments of both parents following a child's placement in foster care—offers a unique opportunity to examine the service needs of parents within a family context. Between January 2007 and June 2010, integrated assessments were completed with 4089 families in which at least one parent participated in the assessment. Utilizing these data, this study employs a Latent Class Analysis approach to identify the patterns of service needs of parents with children entering foster care. Latent class models were generated for mothers and fathers who participated in comprehensive family assessments based on identified service needs. Models revealed “low need” and “high need” classes among both mothers and fathers. A distinct class characterized by substance abuse needs emerged among fathers and a similar class among mothers was characterized by both substance abuse and mental health needs. A mental health needs class was identified among fathers while a similar class among mothers was characterized by both mental health needs as well as trauma symptoms. In examining the distribution of classes among families where both parents were present, the largest groups of families were those in which both parents fell into the “low need” classes, those in which the father fell into the “low need” class and the mother fell into the “substance abuse and mental health” class, and those in which both the mother and the father fell into the “substance abuse” classes. Implications for case assignment practices, father engagement, and addressing comorbid service needs are discussed.