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.     

Beyond Social Constructionism: Critical Realism and Social Work

Summary Theories within the social and psychological sciences continueto shape social work practice. However, recent debates withinthese sciences on the shortcomings of ‘social constructionism’,and the attempt to overcome them through a critical realistposition, have so far failed to capture social work's attention.This paper provides a critical overview of these theoreticaldebates, highlighting the shortcomings of social constructionismfor social work. The critical realist challenge to social constructionism,as articulated by the British philosopher Roy Bhaskar, is consideredand its relevance to social work formulated in terms of a returnto ‘depth’ in practice.     

Notes on Theory and Practice in Social Work: a Comparative View

Please address reprint requests to Robert van Krieken, Department of Social Work, University of Sydney, Sydney, New South Wales 2006, Australia. Summary There are still a number of problems surrounding the relationshipbetween theories of social work practice and that practice itself.This paper examines the factors underlying those problems andemphasises their roots in the failure to examine the diversityof social work theories and practices. We refer to one attemptto resolve the problems—the distinction between ‘practicetheory’ and ‘theory of practice’—pointout some difficulties with it and suggest an alternative, three-folddistinction within theorising: between (a) materialist socialtheory, (b) strategic practice theory and (c) working concepts. As an example of how those distinctions can be used, we thenbriefly discuss the work of Oskar Negt and its introductioninto the Dutch welfare context, as it was the issues raisedby that which stimulated the ideas in this paper. We concludeby arguing that only this kind of perspective on theorisingcan produce ideas which are of real use to progressive socialwork practitioners.     

Keeping Social Work Honest: Evaluating as Profession and Practice

Correspondence to Ian Shaw, School of Social and Administrative Studies, University of Wales Cardiff, 50 Park Place, Cardiff CF1 3AT Summary The central argument of this paper is that social work needsa radical alternative to existing options for evaluating practice.Social workers at present are offered three choices. They areinvited to choose between applying research, conducting researchor adopting specific forms of empirical research-based practice(for example Everitt et al., 1992; Thyer. 1993; Fuller and Petch,1995). We touch briefly on reasons why we believe none of these optionsprovides an adequate grounding for social work, referring especiallyto the growing call for social work to find new purpose throughan empirical, research-based practice. If alternative approachesare to be persuasive, they must be fashioned from the materialsof a new approach to research on social work practice—‘one that is exploratory rather than confirmatory, buildinga model of evaluation from the practitioners' own accounts ratherthan superimposing an ideal model’ (Elks and Kirkhart,1993, p. 555). The major part of this paper is taken up withevidence from research of this kind. The model of evaluatingin practice with which we conclude the paper is simultaneouslytrue to social workers' accounts of their practice, while offeringa critical starting point for evaluating and refashioning thatpractice.     

The Effectiveness of Attached Social Workers in the Management of Depressed Women in General Practice

Summary Following early reports of the feasibility and usefulness oflocating social workers in general practice (Collins, 1965;Forman and Fairbairn, 1968; Cooper, 1971) the number of attachmentsto general practice has increased markedly over the last decade(Gilchrest et al., 1978). Although there have been a numberof accounts of the increased co-operation between health carestaff (Clare and Corney, 1982) there has been a dearth of objectiveevaluations of the advantages these schemes bring to generalpractice patients. This paper describes the design, executionand outcome of a clinical trial of social work carried out ondepressed women in general practice aged 18–45. It focuseson the social workers' activities and the clients view of help:more detailed information is described elsewhere (Corney, 1981).     

On the Nature of Practice

Summary In this paper an attempt is made to draw a distinction betweenthe notion of the practical and the technical. Reference ismade to Aristotle's concept of Phronesis and the related thoughtof the German philosopher, Hans-Georg Gadamer. The purpose ofthis is to retrieve a sense of social work practice which recognizesit as a form of practical, moral engagement, and not primarilyas a matter of technique.     

Towards an Alternative Model of Social Groupwork

Summary This paper arose from our disagreement with some of the suggestionsin an earlier article in this journal (Brown et al., 1982).Before and since, we have both worked in and studied numerousexamples of groups of a type which, according to Brown and hiscoauthors, scarcely exists in British social work practice.This paper explains what we believe to be the actual significanceof the type of group work we refer to as ‘self-directed’,together with our view of its place within wider social work,community work, and groupwork practice. We also give examplesof such groups and conclude that their proliferation would enableworkers to go beyond the alleviation of individual distressinto the achievement of external change.     

Can We Afford not to Develop Social Work Practice?

Summary This paper outlines the main arguments for resources to be directedtowards developing practice methodology and skills. A reviewof recent research literature indicates that there are a groupof cases which take up much social work time and resources butthat this work lacks professional expertise and effectiveness.Outcome research in related fields is also reviewed. A synthesisof these studies' conclusions suggests that social workers couldbe effective though the essential skills are rare. The implicationsof these findings for the focus and nature of social work trainingare discussed.     

Modernity, Postmodernity and Social Work

Correspondence to Prof. David Howe, School of Social Work, University of East Anglia, Norwich NR4 7TJ. Summary For so long in search of a common base, there are early signsthat social work's intellectual outlook is fragmenting. Theunity that was once sought in both theory and practice as wellas policy and organziation is being abandoned. A child of modernity,social work now finds itself in a postmodern world, uncertainwhether or not there are any deep and unwavering principleswhich define the essence of its character and hold it togertheras a cohernt enterprise. The article outlines some of the characteristics of modernityand postmodernity, relating them to the rise of social work,its formation within modern society, and its current conditionin what many observers believe is a postmodern world. Thereare three ‘visions’ within which people look toleam the ’truth‘ of things, including matters offact and matters of value: those centred in God's word (revelation);those centred in the minds of men and women (reason); and thosede-centred and dispersed withing language, meaning and culture(relativism).     

The Reprofessionalization of Social Work: Collaborative Approaches for Achieving Professional Recognition

Correspondence to Dr Karen Healy, School of Social Work and Applied Human Sciences, Education Building, Level 7, The University of Sydney, Australia. E-mail: k.healy{at}social. uq.edu.au or Dr Gabrielle Meagher, Political Economy, School of Economics and Political Science, The University of Sydney, Australia. E-mail: G.Meagher{at}econ.usyd.edu.au Summary Contemporary practice theories assume that social workers havethe capacity to enact their work as a thoughtful, analytic andcreative activity, and that these capacities are, or shouldbe, recognized and supported in human services organizations.However, emerging evidence from the front line of social servicespractice suggests that, despite public policy rhetoric emphasizingservice quality, the practice environment is characterized bya lack of support for, if not outright hostility towards, professionalsocial work. In this paper we will consider how the social workprofession can collectively improve the recognition of theirwork as professional activity. We discuss the deprofessionalizationof social services work and analyse collaborative strategiesfor achieving recognition, specifically the formation of professionalassociations and trade unions. We will focus our discussionon emerging convergences between new professionalism and thenew political unionism. Finally, we consider how these new developmentscan enhance the industrial and cultural recognition of humanservices work.     

Beyond Retroduction? -- Hermeneutics, Reflexivity and Social Work Practice

Correspondence to Susan White, University of Manchester, Department of Social Policy and Social Work, Williamson Building, Oxford Road, Manchester Summary Over the last three decades qualitative research methodologieshave been in the ascent within social science. Yet social workevaluation studies have tended to be quantitative in nature,conventially relying upon the generation of criteria againstwhich interventions are retrospectively judged. The generationof such criteria inevitably depends upon pre-suppositions, whichin themselves go unresearched. As a consequence the .sense makingactivities on which social work interventions depend are renderedimmune from critical analysis. This reflects a broader tendencyfor social work to cling to naive realist epistemologies, whichare arguably obsolete within the interpretive paradigm in whichits activity is properly located. By examining the debates withininterpretive social science, this paper argues for an approachto social work assessment which avoids the pitfalls of naiveobjectivism and the nihilism of anarchic relativism, whilstretaining creativity, imagination and hope.     

Social Work Assessment Processes in Work with Ethnic Minorities-the Doshi Family

Summary The authors describe a framework for assessment which they developedin a book on practice theory (Curnock and Hardiker, 1979). Thisframework was used by them to guide the practice described withthe Doshi family and to analyse the social work processes involved.This paper concludes with an evaluation of the practice.     

Evaluating Social Work and Medical Practice with Black and Ethnic Minority Groups Using the Clinical Audit Model

Correspondence to Kish Bhatti-Sinclair, Department of Social Work Studies, University of Southampton, Highfield, Southampton SO17 1BJ, UK. Summary This paper is based on the External Audit-Ethnically SensitivePractice (EA-ESP) project which was undertaken within six primaryand secondary health care settings. This project is used asan example of how the clinical audit model can be used to monitorand review health and social work practice in the UK. The paperexamines quality, compares approaches to evaluation, and suggeststhat audit can be a useful tool for agencies in obtaining userand staff views on many areas of practice but in particularon equal opportunities, anti-racism and anti-oppression. Attentionis drawn to audit within broader evaluative and review approachesalready employed by social work academics and practitioners.The issue of quality and how it can be measured is consideredthrough an analytical comparison with approaches which employaction research and other evaluative means in the process ofreview. Audit is explored in the context of a growing need for the developmentof monitoring and review systems which provide evidence to supportand develop professionalism within social work. External auditis explored and compared to internal audit. Finally, the needfor the development of quality services in anti-racist and anti-oppressivework is highlighted and it is suggested that audit can be acost-effective and efficient way of achieving this.     

Learning from a Murri Way'

Summary Under the modernist project indigenous social welfare work approacheshave been silenced and relegated to the periphery as deficittheory and practice in the landscape of social work. This positioninghas promoted the belief that indigenous expertise and cultureis only of relevance for culturally-sensitive practice. Rejectingthis view, I utilize the findings of a study of intra-grouphelping amongst Aborigines and Torres Strait Islanders—a‘Murri way’—to argue that social work theoryand practice has much to learn from indigenous peoples aboutthe interpersonal helping process. I call for recognition ofa space of possibility between indigenous and non-indigenouspractitioners that the indigenous telling creates. This is aspace in between these players who do not share a common understanding,a space where players may participate in a dance of difference(dialogue) to help map a common space of understanding.     

The Social Work Task in an Acute Psychiatric In-Patient Unit

Summary This paper reports the results of monitoring all admissionsfrom a prescribed geographical area to an acute psychiatricin-patient unit for a six month period. Members of the hospitalsocial work department assessed all admissions and selectedapproximately one-half of these for high social work input Demographicdata for the whole subject group is examined and compared tothe high input group. The case review system outlined by Goldbergand Fruin (1976) is used to describe the clients' social problemson admission, as well as the social work task, in terms of practicalservices and other social worker activities. These findingsare compared to those of Goldberg et al. (1977) who examinedthe social work task in an area office social services departmentintake team. Despite differences in demographic profiles ofthe two groups and consequently differing social problems, thesocial work task in both settings was found to be similar. Inboth studies 53% of clients were offered some practical (althoughdifferent service) and the most common social work activitieswere found to be assessment, information and advice, and mobilizingresources.     

At the Edge of the Frame: Beyond Science and Art in Social Work

Correspondence to Dean Emilia E. Martinez-B raw ley. School of Social Work, Arizona State University, PO Box 871802, Tempe, Arizona 85287–1802, USA. Summary The central argument in this article is that social work hasalways been a practice at the fringes. The phrase is used inits best sense and in at least two meanings: (1) that socialwork has been at the edges of the mainstream of scientific discourse,not because of any intrinsic deficiency in the profession butbecause of the nature of the practice; (2) that, in the postmodernsense, social work has been a collage where science, art, rationalityand intuition, systematic and asystematic knowledge meet. Inthis latter sense, this article proposes, social work can representa very desirable convergence of paradigms that needs to be acknowledgedand celebrated. Perhaps the most significant contribution ofpostmodernism is that it accommodates this possibility.     

Non-Statutory Mental Health Social Work in Primary Care: A Chance for Renewal?

Correspondence to Malcolm T. Firth, Honorary Research Fellow & Senior Psychiatric Social Worker, 'DEAL', Department of Psychiatric Social Work, 12th Floor, Mathematics Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. E-mail: malcolm.firth{at}mhsc.manchester.nhs.uk Summary The current status of evidence-based practice in the field ofmental health has led some to question the potential for innovationif social work practice is organizationally proscribed or reducedto a dogged adherence to methodological orthodoxy. Conversely,social work's value base is esteemed disproportionately to itsevidence base. Changing service contexts in the UK, particularlythe emergence of Primary Care Trusts as gatekeepers and commissionersof health and social care services, are providing opportunitiesfor social work to develop a new presence and purpose. The authorsdescribe their work in a small-scale service based in primarycare that anticipated these opportunities, by a retrospectivestudy of 120 cases. A new evidence base that derives directlyfrom practice is suggested as a way forward for social workeducation and training, as well as for service and professionaldevelopment.     

Beyond Power Discourse: Alienation and Social Work

Correspondence to Michael Lavalette, Department of Sociology, Social Policy and Social Work Studies, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool. E-mail: M.Lavalette{at}Liverpool.ac.uk Summary This paper argues for the relevance of the Marxist concept ofalienation to the development of an emancipatory social workpractice. As the concept has often been misinterpreted withinthe social work literature to refer primarily to a psychologicalstate, the first part of the paper seeks to establish the materialbasis of the theory as developed by Marx, and identifies fourkey aspects of alienation—from the product of labour,from the labour process, from our ‘human nature’and from our fellow human beings. Alienation theory is thenapplied to the experience of both social workers and serviceusers and it is argued that the notions of loss of control (inthe case of social workers) and powerlessness (in the case ofservice users) have greater explanatory power, and provide afirmer basis for a radical practice, than currently fashionablepower discourses, derived from postructuralism, which oftenmirror the individualism of the New Right approaches they seekto challenge. Finally, examples are given of the ways in whichthe concept of alienation might contribute towards the developmentof a new, emancipatory social work, central to which is likelyto be the development of more collective approaches.     

Social Work, Liberty and Law

Correspondence to Professor John Williams, Department of Law, University of Wales, Aberystwyth, SY23 3DY, UK. E-mail: jow{at}aber.ac.uk Summary The relationship between law and social work is complex. Doeslaw assist practitioners to promote rights, or is it confinedto ensuring accountability and regulating practice? This articleexplores law's role, and its limitations, in promoting liberty,or more accurately ‘constitutional liberty’. Doeslaw provide practitioners with liberty-based values capable,if necessary, of legal enforcement? The paper argues that thereis no simple answer; law impacts on social work in differentways and there is little consistency across and within clientgroups. However, it concludes that law is one of the tools thatsocial workers can use to promote liberty.     

Social Work Education: Tackling The Theory--Practice Dilemma

Summary The integration of theory and practice has long been a topicfor debate and concern amongst social work educators. A longitudinalparticipant observation study of one cohort of social work studentsconfirmed that the ideal of theory—practice integrationwas also high on their own list of self-established priorities.Students' efforts towards attaining this goal were also hamperedby the perspectives which they themselves brought to bear ontheir training. Attempting to resolve the conflict between theirown perspectives and their perceived demands of professionaleducation students appealed to and reconstructed afresh variousmodels of theory application endorsed both by social work educatorsand practitioners. These models, however, are essentially contradictoryand pose serious problems for the development and maintenanceof social work standards.