Finding the right connections: Peer support within a community‐based mental health service

Gray M., Davies K., Butcher L. Finding the right connections: Peer support within a community‐based mental health service This article reports on a qualitative study that examined the organisational enablers and barriers to implementing peer support work in an Australian, rural, community‐based mental health service. Interviews with 19 peer and non‐peer staff were conducted to identify attitudes towards peer support and whether there were organisational values, practices and strategies that might support the implementation of peer support. The findings revealed that peer support workers were valued for their ability to build trusting connections with clients and to accept client choice in a non‐judgemental way. However, peer support workers tended to ‘fill service gaps’ within intensive, administrative case‐management environments. These findings highlight the importance of an organisational‐wide approach to integrating peer support, where the responsibilities for adopting new ways of working fall to all staff, not just the peer support workers themselves. Key Practitioner Message: ? Practitioners placed high value on the peer support workers on their teams due to their unique personalised engagement with clients; ? The roles of peer support workers were poorly understood by team members; ? Organisational integration of peer support principles could improve the way all staff engage with clients to reflect a recovery orientation.     

Matching Practice Skills with Client Problems

Abstract

Despite the increasing pressure to measure social work practice skills and relate those activities to client outcomes and treatment costs, relatively little social work research has been devoted to the development of social work process instruments. The recent development of the Practice Skills Inventory has provided practitioners with a useful tool for measuring the frequency with which practitioners employ specific categories of common social work intervention skills. However, it is important to demonstrate that social workers employ these practice skills differentially depending on clients' presenting problems. The current study of 281 experienced MSW practitioners demonstrates that they, indeed, emphasize supportive, therapeutic, case management and insight facilitation skills differentially depending on the problems experienced by their clients. Implications for practice and evaluation research are addressed.     

Exploration of Choice for Older People with Daily Care Needs: Scottish Professionals’ Perspectives on Self-Directed Support

ABSTRACT

This article explores The Social Care (Self-Directed Support [SDS]) (Scotland) Act 2013 developments, influence’s on individuals informed choices for care decisions and implications for direct practice situations. The article discusses perspectives from 18 professionals and front-line care workers interviewed in Scotland on SDS policy changes. Barriers included attitudes on dependence, power and control, shortage of direct client contact time, clients becoming “employers,” and reductions in the number of qualified social workers. Some recommendations included allowing social workers freedom of creativity, sharing and application of practice experience. Findings revealed an outcome-focused, person-centered approach was utilized to support an independent living environment.     

Advance Care Planning in the Delivery of Adult Protective Services

ABSTRACT

In ensuring the safety and protection of older adults from abuse and exploitation, adult protective services (APS) workers face a variety of situations involving serious illness and end-of-life conditions. Many older adults encountered in APS will present with one or more chronic conditions that may warrant discussion of advance care planning with clients and their families. This study surveyed APS workers (n = 508) in 21 states regarding encounters with end-of-life situations and the practice of future care planning. Results revealed that three-fourths of APS workers encounter clients with serious illnesses and about two-thirds do discuss planning in advance for care. More than one-half of the respondents indicated client incapacity and refusal to address future care needs as barriers to discussing planning in advance for care. Recommendations to enhance advance care planning among APS workers are discussed.     

Activation,Public Employment Services and their Clients: The Role of Social Class in a Continental Welfare State

This article fills a gap in the existing literature by investigating how public employment service (PES) staff actually deal with their clients under a continental regime of activation. The results reported here are based on interviews both with PES staff and their unemployed clients in Germany. We argue that due to its Bismarckian origins as an insurance‐based system of ‘unemployment protection’, Germany's system of unemployment compensation is attractive not only for the marginalized, but also for core workers. As a result, PES staff deal with clients from very heterogeneous class backgrounds. We demonstrate that social class is a significant factor in client outcomes, and that earlier research has perhaps overemphasized the role of frontline staff as ‘street‐level bureaucrats’. While staff do have considerable power, the result of the encounters between the administration and clients also depends on the capabilities of the clients, which, in turn, are strongly related to social class.     

Social Workers' Implementation of Client Participation: What Factors Make the Difference?

ABSTRACT

Client participation is both a value and a strategy in social work, involving clients in decisions influencing their lives. Nevertheless, the factors encouraging its use by social workers in social services have received little research attention. This article reports on a study drawing on Goal Commitment Theory to examine, for the first time, four categories of variables that might predict its implementation: background variables (intervention method, age, experience, education, supervision); personal resources (self-esteem, mastery); organizational variables (superiors' support, organizational commitment); and situational factors (previous client participation, perception of client participation).

A sample of 661 Israeli social workers completed questionnaires. Hierarchical regression analysis and t-tests revealed that intervention method, mastery, superiors' support, and both situational variables contributed significantly to explaining the variance in client participation. Moreover, social workers valued client participation significantly more than they used it. The implications for researchers and professionals in social services are discussed. Proper training could increase social workers' awareness of client participation and provide tools for implementation. Policy makers should set standards for its use and evaluation, and require its inclusion in all interventions. Further research investigating clients and managers of social services could provide a broader picture of the factors impacting client participation.     

Utilizing a Required Documentation Course to Improve the Recording Skills of Undergraduate Social Work Students

ABSTRACT

Baccalaureate social workers respond to documentation and record-keeping demands of regulatory organizations that oversee or fund social service agencies. Learning to accurately document client needs, progress, and service delivery outcomes is important in ensuring that clients are receiving effective services. Despite the importance of documentation skills, many undergraduate social work programs do not provide sufficient curriculum content on client record keeping. The authors report the results of a study that examined changes in baccalaureate social work students’ perceptions of their documentation skills after completing a required documentation course. The sample size included 101 students at pretest and 97 students completing the post-test. Statistically significant findings show students perceived an increase in knowledge in three areas of documentation: 1) formats, 2) content, and 3) writing skills. The authors discuss implications for social work education and practice.     

The Intersubjective Action of Case Advocacy and Engagement in a Working Alliance

This article presents a viewpoint for explaining the positive associations between case advocacy and the engagement in a working alliance of low‐income single mothers at‐risk for physical abuse of their children. Utilizing narrative vignettes from a qualitative study about clinical social workers’ experiences in engaging this population, the article suggests that client/worker partnerships in case advocacy enhanced opportunities for client/worker mutuality and for worker capacities to experience and communicate empathy to their clients. Theoretical constructs from Daniel J. Stern’s infant research and neuroscience are then applied to suggest an intersubjective framework for understanding what occurred.     

Compassion Fatigue and the Adult Protective Services Social Worker

Compassion fatigue is a relatively new term that describes the symptoms that are experienced by social workers and other helping professionals who work with clients experiencing trauma. This article defines the concept of compassion fatigue and relates compassion fatigue to Adult Protective Services (APS) social workers. It is proposed that APS social workers may be susceptible to the deleterious effects of compassion fatigue due to the nature of their work and environment. Suggestions for avoidance of compassion fatigue are also discussed, including self-care strategies and the need for continuing education regarding this phenomenon.     

Client Violence Against Social Workers at Homeless Assistance Organizations in South Korea

This study examined the essence of client violence that social workers encounter at homeless assistance organizations in South Korea. Based on 149 self‐administered questionnaires in 29 homeless assistance organizations in Seoul metropolitan areas, the study verified that client violence against social workers was prevalent. More than 70% of respondents experienced physical violence from their clients; 78.5% reported emotional violence; 53% reported property damage. This study also found that client violence emerged differently according to gender and types of agencies in the field. The results suggested that effective prevention strategies against client violence should be encouraged to maintain valuable human resources and to create a safe workplace in the field of social work.     

Client Perspectives in a General Practice Attachment

Summary In this study, 50 clients of social workers in an attachmentscheme were interviewed and their views compared with the assessmentsmade by the social workers. The results were very favourablefor the attachment; the clients were well satisfied with theservice given and the majority of clients felt that they hadbeen helped, especially with their emotional problems. However,there was much disagreement between the social worker's assessmentand that made by the client, especially regarding the type andnumber of problems helped.     

Social Worker Supervision with Novice and Experienced Workers

ABSTRACT

This empirical study compares the perceptions of social work supervisors about the needs of novice and experienced social work supervisees. The respondents, 211 supervisors in public welfare agencies in Israel, provided novice workers more supervisory time in 6 of the 8 content areas examined: administrative matters; inspection and control; inter-organizational communication; client issues; job-related tensions; and personal tensions. Projects in the community were given priority to experienced rather than novice supervisees, and professional development was regarded by the supervisors as equally important for novice and experienced workers. Comparisons were also made between the actual and preferred supervisory time allotment.     

“They Kill People Over Nothing”: An Exploratory Study of Latina Immigrant Trauma

Abstract

This article presents findings from an exploratory, mixed methods study to: (1) Ascertain whether Latina immigrant clients of a healthcare clinic for uninsured patients suffer a higher rate of PTSD compared to the citizen population at large and (2) Explore whether factors unique to immigrants, such as surviving human smuggling, would predict PTSD. Two validated instruments were deployed with clients who agreed to be screened (n?=?62). Ten percent of U.S. women are expected to develop PTSD in a lifetime, a total tripled by immigrant women in this study. Women who scored high on the PTSD CheckList for Civilians (PCL-C) reported victimization from sexual assault, robberies and loss of friend/family member to violence, though no single assault predicted PTSD. Qualitative data, however, revealed that violence in countries of origin influenced decisions to immigrate. Among the avenues for future research identified by this study are (1) exploration of methods for linking Latina immigrants to mental health services, (2) determining the effects of smuggling violence on immigrants, and (3) Evaluate additive effects of multiple traumas.     

Social Workers Talking to Clients: A Comment

Summary I read Baldock and Prior's article with interest in view ofthe shortage of studies examining day-to-day practice in socialwork, but the authors' analysis leaves me reflecting uneasilyupon the state of uncertainty into which social work has fallen.The authors conclude by describing as ‘skilled’,practices which they say resulted in confusion for clients andwhich only apparently reflected social work principles. We arenot told whether the authors checked their analysis with workersor clients and it is possible that the clients were not as confusedas we are led to believe, given their long term contact withthe workers. If, however, the picture is an accurate one, shouldit really be described as representing skilled social work?Baldock and Prior do so but neglect to examine the ends towardswhich interviewing skill should be directed in social work.The result is a strangely ambiguous statement about practice,particularly in the light of research findings on effectivenessand client satisfaction, and one which offers little scope forcomplacency.     

Spiritual Assessment and Latter-Day Saints: Establishing the Preliminary Validity of Spiritual Eco-Maps

ABSTRACT

Few spiritual assessment approaches have been validated with Latter-Day Saints (LDS), in spite of the importance of religion to this culturally distinct population and its burgeoning growth. Drawing on the concept of social validity, this mixed-method study validates a qualitative spiritual assessment approach—spiritual eco-maps—using a geographically diverse sample of social workers (N = 100), all of whom had at least 5 years of direct practice experience with LDS clients. These individuals were asked to identify: a) the degree of cultural consistency, strengths, and limitations of the spiritual eco-map at a conceptual level; and 2) how the questions designed to operationalize the approach might be improved to be more valid, relevant, and consistent with LDS culture. The results suggest that spiritual eco-maps are consistent with LDS culture as long as they are operationalized appropriately. Toward this end, a culturally valid question protocol is provided along with suggestions for administering the instrument in a culturally competent manner. Spiritual eco-maps may be particularly useful in settings where a quick, visually oriented assessment that focuses on clients’ present relationships is indicated. Future research might build upon the present study by assessing the validity of spiritual eco-maps with both community and client samples.     

Being the Only One: Finding Connection through the Shared Experience of “Otherness”

ABSTRACT

There is a noticeable paucity of clinical resources that help clinicians of color to name and navigate the multitude of challenges in working through racial, cultural, and power differences in psychotherapy with White clients. African American therapists rarely receive adequate preparation for clinical practice in identifying, addressing, and working through transference and countertransference reactions in racially mixed dyads. The author highlights the challenges she faced early in her career with addressing racial and sociopolitical differences as an African American female clinical social worker providing individual psychotherapy to her older White male client whose traumatic experience focused on racial issues.     

Open Records: The Client's Right to Partnership

Summary Many Social Services Departments have opened their files totheir clients or intend to do so. This reflects the incomingtide of concern about citizens' rights and client participation,but what effect might the opening of records have on the practiceof social work? The paper summarizes the findings of a small scale study inwhich a team of social workers opened their case recording toa selected number of clients. The workers’ and clients‘views of this process are described, along with the implicationsfor practice. The study suggests that a focus on shared recordingcan begin to alter the kind of work done by the social worker,helping to promote a partnership between the worker and theclient. Finally, the paper argues that a policy of client access enforcedonly as a right is prone to sabotage or a fall into disuse.A seven point training programme is outlined in order to helpsocial workers use Open Records as an opportunity to promotea partnership in their work with clients.