Social Work and Complex Care Systems: The Case of People Hospitalised with a Disability

Health and hospital system reforms prioritise efficiency. However, initiatives can impact on people with new or existing disabilities who require time to maximise functional independence. With greater demands for shorter hospital stays social workers face increasing pressure to facilitate discharge. This paper reports findings from research identifying factors contributing to extended stays for adults with disabilities. We sought to better understand patient characteristics and discharge planning challenges by analysing a clinical dataset of 80 patients and qualitative interviews with five experienced hospital social workers. Three key factors are identified: issues around rehabilitation services; assessment and planning for community care; and availability of and access to discharge options. Strategies to reduce length of stay are reported. We argue that building collaborative partnerships and working across multiple, complex systems and disciplines are vital to ensure these patients access appropriate community-based resources within the current health reform environment.     

Child protection decision-making

The effects of interagency collaboration on risk assessment in child protection practice were analysed in respect of the decision-making processes in child death inquiries. Universal features in the assessment of risk as identified in psychological literature were applied; in particular, the concepts of ‘groupthink’, the ‘certainty effect’ and ‘group polarization’. It is suggested that case conference decisions are inherently more risky than those taken by professionals with individual responsibility because of the way in which cases are framed in terms of losses.     

A Multivariate Indicator to Compute Middle Class Population

Social Indicators Research - Monitoring progress towards the Sustainable Development Goals by 2030 requires the global community to disaggregate targets along socio-economic lines, but little has...     

‘What Was I Thinking?!’ Rhetorical Questions as a Technique to Identify and Explore Impasses in Therapy

Rhetorical questions emerging spontaneously in consultations can be used as a tool for developing self‐reflexivity and exploring the therapeutic alliance in the process of therapy with couples and families. This paper presents a technique based on the enunciation of rhetorical questions, which can point to an impasse in the process of therapy and contain a key to its resolution. The technique focuses on the distinctive feature of rhetorical questions as convening a paradoxical injunction: a question not intended as a question, while uttered as such. The technique in four steps is illustrated by examples from therapy, supervision, consultation, and self‐supervision. Its focus is the interlink between the therapeutic relationship and the process of therapy and it is informed by a second‐order cybernetics approach, dialogical practice, and the systemic literature on emotion. The technique can help develop curiosity in working with families, lead to unforeseen developments, and touch on prejudices not made explicit in previous therapeutic encounters. Whether we are acting as supervisors, therapists, or clients, the creation of a ‘secure enough’ context for rhetorical questions becomes critical to allow freeform exploration.     

An Analysis of Student Satisfaction: Full-Time vs. Part-Time Students

This paper examines how full-time or part-time status affects students’ level of satisfaction with their degree programs. For our analysis, we obtained data from a survey of graduate students. The survey was conducted at a public university in Spain from 2001 to 2004. The decision to undertake paid employment while studying emerges as one of the key determinants of student satisfaction. In particular, our findings indicate that students who hold a part-time job while studying are more likely to express less satisfaction with their college experience.     

Changing symbolic and geographical boundaries between penal zones and rural communities in the Russian Federation

The article examines the processes involved in the integration of the USSR's secret places into mainstream rural society in the Russian Federation. Taking the example of one rural district in the Volga-Ural region that has been the site of a large prison complex over a period of ninety years, the article examines how economic changes and local government and penal reforms have eroded the boundary that marked off the penal region from the rural district in which it was located. Using interviews and social surveys conducted among the local population, the article examines the extent to which the opening of the penal sub-region has led to changes in the symbolic boundary between the communities in the rural raion. The article concludes that although new spaces of active government are being produced in rural Russia, these are not necessarily the basis for the emergence of new common identities among the people living in them.     

Theory,practice and use of self in the open dialogues approach to family therapy: A simple complexity or a complex simplicity?

In the family therapy literature there is increasing interest in the dialogical approach, particularly as it becomes well‐grounded in psychotherapy research. One embodiment is ‘open dialogues’, which has developed over a 30‐year period in Western Lapland, Finland. This paper outlines my experience of visiting Keropudas Hospital in Tornio, Finland, the birthplace of open dialogues. It explores the seven theoretical principles of open dialogues, associated elements of clinical practice, and the therapist use of self. The author utilises these aspects to reflect on dialogical moments through words and images based on three conceptual themes, which illustrate the relevance of open dialogues for family therapy practitioners and their contexts.     

Championing the interface between mental health and child protection: evaluation of a service initiative to improve joint working in northern Ireland

The importance of establishing effective inter‐agency working between adult mental health services and child care services in order to safeguard children has been repeatedly identified by research, policy, inquiries and inspection reports. This article reports on the evaluation of an initiative in one health and social care trust in Northern Ireland that aimed to facilitate joint working and so improve service provision and protection for children and families. The Champions Initiative involved identifying a Champion in each multidisciplinary community mental health team and in each family and child care team that would have responsibility for providing information, promoting joint working and identifying any obstacles to better cooperation. The evaluation of this Initiative assessed levels of experience, training, confidence, understanding and awareness in the Champions and their team members at baseline. The Champions and their Team Leaders were then followed up after six months to obtain their qualitative views of the impact of the initiative. The results include comparisons between mental health and child care staff, and crucially, views about whether the initiative has had any impact on working together. This study also generated recommendations for further service development in this complex and important area of practice. Copyright © 2010 John Wiley & Sons, Ltd.

‘Identifying a Champion in each multidisciplinary community mental health team and in each family and child care team’

Citing Literature

Number of times cited according to CrossRef: 15

• Kerry McVeigh, The Think Family Social Work Assessment: outcomes of a family-focused initiative using The Family Model, Advances in Mental Health, 10.1080/18387357.2020.1825969, (1-15), (2020). Crossref
• Billie Lever Taylor, Liberty Mosse, Nicky Stanley, Experiences of social work intervention among mothers with perinatal mental health needs, Health & Social Care in the Community, 10.1111/hsc.12832, 27 , 6, (1586-1596), (2019). Wiley Online Library
• Lelia Fitzsimons, The role of champions in promoting family focused practice across adult mental health and children's services, Advances in Mental Health, 10.1080/18387357.2019.1661783, (1-10), (2019). Crossref
• Nicky Stanley, Khatidja Chantler, Rachel Robbins, Children and Domestic Homicide, The British Journal of Social Work, 10.1093/bjsw/bcy024, 49 , 1, (59-76), (2018). Crossref
• Sanne Rumping, Leonieke Boendermaker, Doret J. Ruyter, Stimulating interdisciplinary collaboration among youth social workers: A scoping review, Health & Social Care in the Community, 10.1111/hsc.12589, 27 , 2, (293-305), (2018). Wiley Online Library
• Robin Mason, Janice Du Mont, Maeve Paterson, Ilene Hyman, Experiences of child protection workers in collaborating with adult mental health providers: An exploratory study from Ontario, Canada, Children and Youth Services Review, 10.1016/j.childyouth.2018.02.005, 86 , (271-276), (2018). Crossref
• Andani Thakhathi, Champions of Change and Organizational Development: A Return to Schön and Typology for Future Research and Practice, Research in Organizational Change and Development, 10.1108/S0897-301620180000026007, (265-306), (2018). Crossref
• Phillip Tchernegovski, Andrea E. Reupert, Darryl J. Maybery, How do Australian adult mental health clinicians manage the challenges of working with parental mental illness? A phenomenological study, Child & Family Social Work, 10.1111/cfs.12426, 23 , 3, (381-389), (2017). Wiley Online Library
• Eeva Timonen-Kallio, Juha Hämäläinen, Eila Laukkanen, Interprofessional Collaboration in Finnish Residential Child Care: Challenges in Incorporating and Sharing Expertise Between the Child Protection and Health Care Systems, Child Care in Practice, 10.1080/13575279.2016.1158153, 23 , 4, (389-403), (2016). Crossref
• Barry Luckock, Jane Barlow, Chris Brown, Developing innovative models of practice at the interface between the NHS and child and family social work where children living at home are at risk of abuse and neglect: a scoping review, Child & Family Social Work, 10.1111/cfs.12228, 22 , S4, (62-69), (2015). Wiley Online Library
• Joe Duffy, Gavin Davidson, Damien Kavanagh, Applying the recovery approach to the interface between mental health and child protection services, Child Care in Practice, 10.1080/13575279.2015.1064358, 22 , 1, (35-49), (2015). Crossref
• Estela Arcos, Ximena Sanchez, Maria Cecilia Toffoletto, Margarita Baeza, Patricia Gazmuri, Luz Angélica Muñoz, Antonia Vollrath, Social protection systems in vulnerable families: their importance for the public health, Revista de Saúde Pública, 10.1590/S0034-8910.2014048005131, 48 , 3, (398-405), (2014). Crossref
• Oi Ling Wong, Integrative Family and Systems Treatment with Parental Mental Illness: A Hong Kong Chinese Family, Contemporary Family Therapy, 10.1007/s10591-014-9298-2, 36 , 2, (242-249), (2014). Crossref
• Peter Sidebotham, Rethinking Filicide, Child Abuse Review, 10.1002/car.2303, 22 , 5, (305-310), (2013). Wiley Online Library
• Jane V. Appleton, Peter Sidebotham, Child Protection and Mental Health, Child Abuse Review, 10.1002/car.2220, 21 , 3, (153-156), (2012). Wiley Online Library

Volume 21 , Issue 3 May/June 2012

Pages 157-172     

Mentoring Siblings of Gang Members: A Template for Reaching Families of Gang Members?

Mentoring has become a popular model of intervention to reduce the risk of offending, and has been proposed as an effective tool to tackle the risk of gang membership. This paper reviews the existing literature on mentoring and reports on a qualitative evaluation of a mentoring programme targeted at young people ‘at risk’ of gang membership in an English city. The study highlights important issues around these interventions. Although we found it a useful way to engage otherwise hard‐to‐reach families, important limitations remain: their potential labelling impact and their limited impact in isolation from other more ambitious measures.     

Rights discourses in relation to education of people with intellectual disability: towards an ethics of care that enables participation

In this paper we argue that human rights approaches for intellectually disabled people have failed to recognise the complexity of rights claims made by and on behalf of this group. Drawing on a research project into discourses of education for intellectually disabled people in the Eastern Cape, South Africa we discern three rights discourses; namely, rights to full participation, rights to special services and rights to protection. These draw off a social model, a medical model and a protective model, respectively. We note that these discourses may be set up in contestation with each other. However, we argue that they can be seen as complementary if viewed within an ethics of care that enables participation. Within this conceptualisation, participation is viewed within relations of care but is subject to a critique that examines the role of context and disciplinary power in constructing dependency.