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.     

Equal or individual treatment: contesting storylines in needs assessment conversations within Swedish eldercare

This article examines the role of care managers and their work in putting policy into practice in micro-interactions with older people in Swedish eldercare. The care managers assess the individual needs of older people, and decide what type of social care and services will be given. Dilemmas in care management are often related to the gap between needs and resources. The aim was to study the positioning of care managers within different storylines advanced in needs assessment conversations. Positioning theory was applied to study discursive practices and discursive strategies within Swedish eldercare. Audio-recorded needs assessment conversations among care managers, older people and their relatives at care planning meetings in connection with hospital discharge were analyzed. Two overall positions were identified for care managers—as ‘professional experts’ and as ‘organizational representatives’—allowing the care managers to maneuver within two contesting storylines: ‘distribution of scarce eldercare resources based on the principles of eligibility and equal treatment’ and ‘older people entitled to eldercare according to their own perceived individual needs’. For social work, the results showed the importance of discussing how care managers might move towards exercising greater professional autonomy, becoming less dependent on their position in the organization.     

Transitioning from ‘outside observer’ to ‘inside player’ in social work: practitioner and student perspectives on developing expertise in decision-making

ABSTRACT

This paper reports on a six-year qualitative study of social workers’ perspectives on factors influencing decision-making in children and families social work in England. Data collected between 2010 and 2016 reflect frontline practice during a period of substantial change and reform in UK social work. This paper builds on an earlier analysis with data from all three stages of the study capturing the lived experiences of practitioners ranging from student social workers to qualified advanced practitioners in management roles. Data from 9 focus groups comprising 51 participants were analysed using grounded theory. Data analysis generated four representative categories: developing agency in the social work role; troubling emotions; transitions in the development of expertise and the impact of organisational cultures in children and families social work services. An emerging theoretical framework is presented. This identifies the significance of transitions and threshold concepts in the development of the social work professional from the role of students as ‘outside players looking in’ through to the expertise of qualified practitioners as ‘inside players’ within organisations. Recognising periods of liminality, transitional learning and uncertainties in developing decision-making expertise may be of significant benefit to social work education and the profession.     

Social Care Work in the Recent Past: Revisiting the Professional/Amateur Dichotomy

Abstract

The present article challenges the received wisdom of the distinctiveness of professional social work in Australia and its dichotomous juxtapositioning against work undertaken by those without formal social work qualifications. Findings are presented from a qualitative study of Australian Catholic sisters’ experiences of social care work in the recent past, based on indepth interviews with sisters who collectively worked in a variety of fields from the 1950s to the time of writing. Sisters’ accounts of work with marginalised people reveal many similarities with the values and principles of social work. This suggests a blurred line between “professional” social work and “amateur” social care work. In an era of reconsideration of many certainties, Australian social work could profitably reflect on its commonalities with, and differences from, practice domains outside professional social work.     

The Implications of Disability Protests for Social Work Practice

Abstract

This article examines the demands which have been made in the over 800 US protests this author has analyzed. Some demands are cross-disability, meaning they could apply to people with all types of impairments; these include demands for rights and accessibility in all domains. Other demands are disability-specific: they apply to people with specific types of impairments, ranging from mobility impairments to developmental disabilities. Many demands have been related to services, which can be either cross-disability or disability-specific. The paper examines the implications of these demands for social work practice. These include that disability be de-stigmatized by practitioners, that people with disabilities have choices, that they have control over their services, and that all aspects of social work practice be accessible to people with any type of disability.     

The Extent and Nature of Practitioners,Encounters with Alcohol and Other Drug Use in Social Work and Social Care Practice

This article considers the extent and nature of social work and social care practitioners' experience of working with service users whose lives are affected by the problematic use of alcohol or other drugs (AOD). It draws on the findings of a national study of ‘working with alcohol and drug use’ which was conducted in England in 2010–2011. The study reported here comprised an online survey of front-line practitioners (n = 597), complemented by 12 practitioner focus groups and interviews with 21 key informants from participating local authorities and substance use treatment services. This paper focuses primarily on data from one element of the survey. Findings indicate that the great majority of staff encountered service users who are affected by AOD problems at some level, although there were differences between groups of practitioners in the extent and nature of AOD problems for different groups of service users. The differential experiences of staff according to their client groups underlines the need for education and professional development not only to provide training on working with AOD but to ensure that training is contextualised and relevant to practitioners across the range of social work and social care services.     

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.     

Sticks and Stones Can Break Your Bones

Summary

Utilizing the narratives of 54 youths and 88 child welfare professionals, this article explores the experiences and lives of gay and lesbian youths in child welfare agencies in three cities—New York, Los Angeles, and Toronto—who have been subject to verbal harassment and physical violence within those systems. The author additionally explores the multiple layers of verbal harassment and violence in both the youths' families and in the foster care system, offering recommendations to social work practitioners interested in creating gay and lesbian affirming environments.     

Harnessing Resistance in Interventions with Young People

This article draws on the findings from the qualitative phase of a New Zealand longitudinal study concerning vulnerable young people’s transitions to adulthood. The young people, aged between 12 and 17 at the time of the first interview had sustained exposure to harm (abuse, violence, addictions, disengagement from school and mental health issues) and were clients of statutory and non-governmental services including: child welfare services, juvenile justice services, remedial education services and mental health services. Qualitative interviews explored young people’s experiences of services, their key transitions, their coping capacities, and the strategies they used to locate support and resources to mitigate the effects of harmful events and environments. There were three stages to the qualitative phase of the study; this article draws on the interviews from stage one and two. It explores the idea of resistance which emerged as a key theme in the data analysis. Three thematic clusters are presented: the nature of young people’s resistance; practitioner responses to resistance; and harnessing resistance in interventions. The article concludes with a discussion of how social workers and other practitioners can understand resistance and build more responsive and meaningful relationships with vulnerable youth.     

Investigating the organizational everyday: a critical feminist approach

ABSTRACT

This article considers the possibilities and limits of applying institutional ethnography, a feminist theoretical and methodological approach that contributes to collective projects of investigating and transforming social life. Elaborating on the approach, the article reports on an ethnographic exploration of visual artists’ experiences and struggles in Canada's art world – a project that started from the standpoint of practising visual artists, examined their work and relations, and explicated practices and logics of art and valued work conditioning their lives. Speaking back to formal or text-based investigations of particular institutions, the article grapples with how to engage in research that more fully reveals the ‘social,’ attending to everyday life, to the ‘life work’ that people do, and to social forms that are threaded through intersecting, localized intimate and institutional spheres.     

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.     

Books Received

Abstract

The generic nature of social work assists social workers to fulfill, variety of tasks and roles, in a range of settings. Social work train in provides workers with a broad range of knowledge and skills, as well as an ability to be both flexible and adaptable across a given range of situations. Such a ‘launching base’ is essential for all social workers, particularly those who work in the resource-starved remote area sector.

Through the author's own insights and experiences on the remote setting of Saipan, a small island located in the western Pacific Ocean this article examines some of the unique personal and professional challenges that confronted him during his stay on Saipan. These accounts are later transposed generally to an exploration of their implications for practitioners who work, or are contemplating working in a remote area.     

The Expansion of the Peer Adviser Workforce: Opportunities and Challenges for Social Work

ABSTRACT

Peer adviser roles are becoming an increasingly common—and celebrated—aspect of agencies where social workers are located. This article reports on a qualitative research study exploring the experiences of staff within a homelessness outreach service in which three peer advisers (people with a lived experience of homelessness) commenced employment. Drawing on action research principles, the study explored the experiences of the peer advisers and the broader team following the introduction of the peer adviser roles. Themes identified include, realising the skills of peer advisers, defining the role, taking a “whole of team” approach, and reflecting on power. This study demonstrates that the introduction of peer adviser roles into human service organisations is a promising strategy for creating services that are more likely to respond effectively to the needs of service users. However, social workers need to be aware of the pitfalls of tokenism and the devaluing of experiential knowledge.

IMPLICATIONS

• Peer advisers in health and welfare agencies add significant benefits to an agency’s capacity to respond to the needs of service users.

• The introduction of the peer workforce is aligned to social work values of service user empowerment and the valuing of experiential knowledge.

• In order to avoid tokenism, the introduction of peer adviser roles should be supported by both the attitudes and actions of other staff members, as well as organisational support structures.

     

Becoming,Being and Having Been: Practitioner Perspectives on Temporal Stances and Participation across Children’s Services

This article is based on a study of the changing meanings and experiences of citizenship and participation for young people in transition from primary to secondary school. One of the primary concerns of the study is to better understand how different professional practices impact upon young people’s uptake of participation and adoption of civic identity. To gain some insight into this area the article first looks at the contexts in which participation work is developing and the interrelationships between these developments across children’s services. How different practitioner’s conceptualise participation is tied into different assessments of young people’s or children’s capacity. Recasting questions of capacity as dialogues across differing temporal stances can offer practitioners new ways to reflect upon the power negotiations within their relations with young people. The key role temporality plays in configuring power relationships and transactions is explored as it arises within practitioner life history interviews. The shifts between temporal stances that young people experience as they interact with different practitioners are illustrated through fieldwork data.     

Experiential careers: the routinization and de-routinization of religious life

This article develops the concept of experiential careers, drawing theoretical attention to the routinization and de-routinization of specific experiences as they unfold over social career trajectories. Based on interviews and ethnographic fieldwork in two religious communities, we compare the social-temporal patterning of religious experience among newly religious Orthodox Jews and converted Muslims in two cities in the United States. In both cases, we find that as newly religious people work to transform their previous bodily habits and take on newly prescribed religious acts, the beginning of their religious careers becomes marked by what practitioners describe as potent religious experiences in situations of religious practice. However, over time, these once novel practices become routinized and religious experiences in these situations diminish, thus provoking actors and institutions in both fields to work to re-enchant religious life. Through this ethnographic comparison, we demonstrate the utility of focusing on experiential careers as a sociological unit of analysis. Doing so allows sociologists to use a non-reductive phenomenological approach to chart the shifting manifestations of experiences people deeply care about, along with the patterned enchantments, disenchantments, and possible re-enchantments these social careers entail. As such, this approach contributes to the analysis of social careers and experiences of ??becoming?? across both religious and non-religious domains.     

Stumbling towards oblivion or discovering new horizons? Observations on the relationship between social work education and practice

What should social work education be training students for? What should the relationship be between social work education and practice? The first half of this article cautions that social work education, as currently constituted, may 'unfit' people. Principally, this is because social work practice, as envisaged by employer interests, has not been subject to the same critical scrutiny as social work education and has come to dominate perceptions of the training task. The dangers that follow from this position are outlined. The second half of the article proceeds to explore the contribution that practice teachers and tutors can make to enable practitioners to remain confident, credible, critical and creative in this practice environment. The article concludes with some observations on the future as envisaged in the proposals to modernise social services and to create a General Social Care Council.     

Reshaping to serve evolving communities: Addressing immigrant needs in the library

Abstract

Libraries face evolving communities and must constantly reorient themselves to serve new needs. This article examines the impact of emerging immigrant communities on library services. It discusses the emergence of library services to immigrants and the diverse faces of these services, which may include foreign language collections, access to technology and connections with local services, as appropriately determined through community analysis. The Atwater Library and Computer Centre in Montréal, Québec is examined as a case study of community analysis informing service reorientation. This article will be useful for organizations working with immigrants or community service providers confronted with changing demographics.     

Spiritual Competence: What It Is,Why It Is Necessary,and How to Develop It

Various professional standards underscore the importance of providing effective services to all people, including those from diverse religious backgrounds. Yet despite these standards, studies have repeatedly found that most social workers receive little training in navigating this aspect of diversity during their graduate educations. To address this lack of training, the present article discusses a concept that is foundational for effective service provision with spiritual clients from diverse religious backgrounds—spiritual competence. More specifically, this article outlines what spiritual competence is and why it is important in therapeutic work, and then offers a number of strategies for developing spiritual competence. As such, this article helps equip practitioners to provide more ethical, effective services in a nation characterized by increasing religious diversity.     

User and Carer Experiences of International Social Care Workers in England: Listening to their Accounts of Choice and Control

Abstract

This paper develops a typology of people using social care services’ preferences for care workers and satisfaction with social care services from a large multimethod study that explored international recruitment to the English social care sector (home and health care, including residential homes). We developed this typology with two questions in mind: (a) what led to satisfaction of care and (b) what led to preference and satisfaction with workers? Data were collected from face-to-face interviews with 35 people who were using social care services and carers (2007–2009) and these data were used to develop the typology. Using the theoretical concept of homophily, we explored contentions that people might prefer to receive care and support from individuals resembling themselves. We observed that preferences for care workers and satisfaction with social care services may be linked, but highlighted that the concept of meeting a preference is personal to the individual. The implications of users’ preferences for certain care workers at a time where policy is promoting greater consumer-led care or self-directed support are discussed.     

Embarking on self-directed support in Scotland: a focused scoping review of the literature

This article presents findings from a focused scoping review of the published literature on self-directed support (SDS), the term adopted by the Scottish Government to refer to its policy to improve social care outcomes and choices for people using publicly funded services and to distinguish it from personalisation, the term more commonly used in England, and from consumer-directed-care and cash for counselling. The review was undertaken to inform an evaluation of the early adopters of SDS, funded by the Scottish Government 2009–2011, and was updated with later literature. It focused on the evidence base available to inform the Test Sites' (pilot local authorities) efforts to reduce bureaucracy or ‘red tape’ for people choosing their own social care and support; the available evidence about leadership and training to support these changes and about the use of specific transitional funding to ease the process of implementation. The findings of the literature review around these three themes are presented and discussed. The article concludes with a discussion of the potential for such focused literature reviews to inform policy-makers, researchers, and social work practitioners across Europe of the options available when seeking to combine rapid yet rigorous approaches to evidence.