On Reflection – a Social Work Journal Club Chat for 3/10/13 8pm BST #swjcchat

24 09 2013

For the next Social Work Journal Club chat, I’ve chosen this article “Critical Reflection : Reflecting on Learning to be Reflective” by Helen Hickson and published in 2011 in “Reflective Practice : International and Multidisciplinary  Perspectives”. I’ll write up a summary and some questions next week some time but in the meantime, this is the abstract where Hickson writes:

In this paper, I explore reflective practice literature and the elements of critical reflection, and I reflect on my experiences of learning and using a critical reflection approach to better understand a significant incident. This reflective paper is written from my personal perspective as a social worker using Fook and Gardner’s model of critical reflection to provide a framework to reflect, explore and learn from my own experiences. The Fook and Gardner approach to critical reflection encourages deconstruction and analysis of a personal or professional experience to understand the different assumptions, relationships and influences embedded within it and how it affects our practice. As new understandings emerge, the individual is able to reconstruct this incident and develop new techniques to deal with a similar incident in the future.

I hope it will be an opportunity to discuss how we use reflection in practice (and while studying) and what it means to practice improvement generally.

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Building Wellbeing and Resilience in Social Work Students – a recap

20 09 2013

Here’s the log of the chat from 19/9/13 – thanks to all who joined in. I’ll put up a new paper next week and next chat will be Thursday 3rd October at 8pm BST





Building Wellbeing and Resilience in Social Work Students – Some thoughts

15 09 2013

This week, this article received the most votes and it’s timely as we come to a new term ahead for social work students.

The article is called “Enhancing Wellbeing in Social Work Students : Building Resilience in the Next Generation” written by Louise Grant and Gail Kinman and published in 2012 in Social Work Education.

I’m going to summarise some of my own thoughts from reading this article but encourage people to read it for themselves and join  me and hopefully, others to discuss it and some of the issues arising from it this coming Thursday.

 

What is ‘resilience’?

The paper starts by looking at what ‘resilience’ is. Clarify a couple of meanings which include being able to work through stress and negative life events and not only recover from them but use them to build personal ‘meaning’ or overcoming ‘challenges’ in ones life. I can’t say I’m completely satisfied with these meanings as there’s an implication that one can only gain resilience by experiencing stressors or negative life experiences.

They go on to discuss the nature of resilience in social work practitioners and whether ‘resilience’ is a quality which makes them less likely to ‘burn-out’.

Resilience is useful, they say, in social work because it is a stressful profession. Resilience is what protects the mental health of social workers themselves when they work in this field. Again, I’m not sure the definitions we have entirely convince me in this argument as I think there are many factors that can protect against burnout and they aren’t all dependent on qualities or internal struggles of individual professionals.

The article leans on Lord Laming’s report which argued that social work training

“is to help develop the emotional resilience to manage the challenges they [social workers] will face in dealing with potentially difficult families”

I’d be interested in other people’s views about this. Personally it moves me uncomfortably into a them/us range almost blaming ‘difficult’ families for stressing out poor social workers. I am not unsympathetic but wonder if we have to be a bit more brutal in demanding support from employers rather than relying on the individual or blaming people who need to use social work services.

The article says

“the Task Force [Social Work Task Force] expressed serious concerns that many social workers are not sufficiently resilient to survive their future career. In order to address these concerns, social work educators in the UK have been tasked with reviewing the criteria governing entry requirements to courses and with developing the curriculum, in order to enhance the resilience of trainees”.

The first thing that springs to my mind is the progress of the Frontline programme which seems to promise ‘leadership’ and hothouse 5 week training programmes and I do wonder how this meshes with the evidence in this paper.

The paper goes on to look at what ‘training for resilience’ might look like in practice. What qualities build in to ‘resilience’ and is this happening in social work courses at the moment?

 

What makes someone ‘resilient’

The authors of the paper explain how they tried to identify the competencies that would make students ‘resilient’.

They say

The competencies examined were emotional intelligence, reflective ability, empathy and social competence

The research involved 240 students on undergraduate social work courses and they were sampled by online questionnaire. We can explore whether this is the best research method or simply the easiest one later if we want to appraise the paper critically. It isn’t clear how many universities were surveyed so I am assuming there was only one – and it’s interesting that only undergraduate and not postgraduate students were asked. There are some holes in the method as a result.  69% of students who completed the questionnaires were in their first year with 39% in  second year. Presumably the rest were further into the course. The average age of respondents was 33.7.  They used specific scales to measure the competencies identified. The unsurprising results were that students who scored as having more emotional intelligence, social confidence, better reflective ability “tended to be more resilient to stress”.  Resilience as defined here indicated “more psychologically healthy”.  The research therefore indicated that these competencies should be built into social work training courses.

 

As an aside, I wonder how much they can be developed in post-qualification training too and whether we should consider this in the ‘compressed’ curriculum methods of ‘Step Up’ and ‘Frontline’.  The article looks at each of the competencies explored and I’ll run through them.

 

Emotional Intelligence

This is about being aware of one’s emotions and being able to regulate them. There is research that evidences a link between high emotional intelligence and physical and psychological health.  The authors state that high emotional intelligence is one of the strongest connections to resilience in social work students.

Can it be ‘taught’? I’m not sure. Something to discuss maybe.

 

Reflective Ability

As the authors state “our study … found reflective ability to be an important predictor of wellbeing, in that trainee social workers who are better able to reflect on their thoughts, feelings and beliefs, who are more able to consider the position of other people and who can use their reflective abilities to communicate effective with others tended to be more resilient to stress and to be more psychologically healthy”

I’m a great fan of refining reflective ability through social work training as it is a skill which can be practised and needs time to develop. Being questioned and having strong supervision is vital but so is the need and ability to question ones self and to be open, constantly to learning and improving practice.  This is something that it is vital is built into social work training courses and built in well.

 

Empathy

The authors say

“Empathy is a core element of helping relationships: it has strong positive effects on service users’ physical, mental and social wellbeing and it also engenders feelings of personal accomplishment in helping professionals”.

But what is ‘empathy’? Is it being able to imagine someone else’s life and experiences from their point of view? The authors say it is more than this and indicates a more holistic understanding of empathy where ‘over-empathising’ with service users can possibly lead to greater distress for the professional. It’s an interesting point and I’ll be interested to hear what others think about this and how we define empathy.

They say

“Our findings highlight the need to raise awareness at an early stage of social work training that, although a certain degree of empathy is needed in order to acknowledge and accept what their clients think and feel, clear emotional boundaries are required. This is to ensure that empathetic concern does not lead to empathetic distress”.

 

This is something I’ll admit I’ve found difficult over the years and have needed to train my own mind in.  Can we ‘teach’ empathy? It’s an interesting one that is occupying health and social care greatly at the moment. Personally, I’d link it to reflective practice but will be interested to know what others think.

Social Competencies

The authors use this term to discuss communication skills, self-confidence and the ability to be assertive when required. I can’t help thinking, perhaps, mischeviously of the Frontline ‘leadership leadership leadership’ blurb.

The authors say that there isn’t necessarily much focus on these communication skills as there may be an assumption people entering the helping professions may have them already but

“our study found considerable variation in the level of social confidence amongst social work trainees, some formal input is required to enhance social competence and foster feelings of confidence in social settings”

They also go on to say that social support is one of the greatest protective factors against stress in the job.

 

So how can these be taught?

The authors explain some of the things they have done to try and promote these skills among their own undergraduates. They have developed ‘Wellbeing days’ for social work trainees and included the following topics.

Mindfulness

Mindfulness or awareness of the moment without judgement, has long had a role in managing psychological problems and building resilience. It has been used extensively in stress management settings and there are various online tools, from the Mental Health Foundation and other organisations which have some packages to help promote it (I’ve personally tried both of these and would recommend them).  The paper reflects on the use of workshops to develop mindfulness practices and skills in students.

 

Peer coaching

This was introduced during the Wellbeing Days at the university and they were taught some ways of implementing it.  It’s not something I’ve had a great deal of experience of but the paper explains that it helps students manage stress and gives some of the students more space for reflection.

 

Reflective supervision

This is something I do have a lot more experience of. The university ran a workshop on this but to be honest, I’d expect all students on placement to have experience of this with their practice educators. I know, as a practice educator, I spent a lot of time developing reflective supervision skills and ensured my student was well supported to use supervision reflectively.  I’m not convinced ‘workshops’ are needed but they can’t do any harm.

 

Thinking Skills (CBT techniques)

The Wellbeing days built in workshops on CBT to introduce students to it’s principles. When I was at unversity, we did a four week (full time during the summer between the first and second year) counselling skills course which included CBT skills. I imagine this is some kind of reflection on that. I am all for communication and ‘thinking’ skills being taught but not sure a workshop or two is sufficient.

 

Self-awareness and action planning

This was another workshop at the Wellbeing days at the university which students were invited to consider how they respond to stress individually. They were also asked to develop plans in how to work on those issues as individuals. Personally, I would group this with reflective practice.

 

Conclusion

The authors explained that 200 students participated in their ‘wellbeing days’ and those students found them useful and felt they have increased their skills.

 

I think there are some really useful parts of this paper which can guide some social work training but I can’t help but have a few wobbly doubts about it. The input came from one university, mostly first year social work students and all undergraduates. I think in order to have a better understanding of resilience in social work students, I’d like to see a broader initial base. It seems like it was a research project carried out without much complexity.

As for the wellbeing days, they sound both interesting and useful – and students enjoyed them but to really understand about whether they have increased the resilience levels of students, we’d need to understand how those students progress into practice.

 

Questions

These are some questions I’m suggesting for the social work journal club chat on Thursday but if you have others or different ones, these aren’t exclusive – just a way of thinking for a start

1. What do you understand as resilience?

2. Is resilience inherent or can it be taught? Do you have to experience adversity/stress to understand it?

3. Is this (training resilience) happening in social work courses at the moment?

4. Does it need to be taught/nurtured post qualification?

5. What do we think about the issues that the authors say make up ‘resilience’ – would we add anything?

6. What will be impact of ‘fast track’ social work training have on the development of resilience?

7. What do we think of ‘Wellbeing days’ and workshops? Is it an effective way to ‘teach’ resilience?

8. What do we think of the paper in general and the research methods which lead to it?

 

I’m sure I’ll add others during the week but please feel free to join in!





Enhancing Wellbeing and Building Resilience in Social Work Students – Social Work Journal Club Chat 19/9/13 8pm BST #swjcchat

11 09 2013

After the pretty conclusive vote, the next Social Work Journal  Club chat will be around this article “Enhancing Wellbeing in Social Work Students : Building Resilience in the Next Generation” by Grant and Kinman and published in Social Work Education (Vol 31 Issue 5) in 2012.

I’ll do a summary and post some questions around the article early next week if you do want to join me @swjcchat next Thursday.

I hope it will be particularly relevant as students start/return to universities and I would think there are some broader issues of building resilience in practice so it’s not confined to an issue for students!

We could also look at the different ways that social work training embed resilience and if they do so it would be good to have some examples. Of course, academics currently teaching are also welcomed. Actually, everyone is!

Hope to see some of you next Thursday 19th September at 8pm – 9pm for the chat.





Choose a paper for next #swjcchat discussion 19/9/13 8pm

1 09 2013

When we would usually be scheduling the next chat for the Social Work Journal Club on 12/9/13, I’m actually busy that evening (I know, it happens – not very often mind!) so I’m postponing it a week. Sorry. But all the more time to read more articles.

I have found two open access articles that seem interesting and want to ask you, kind and enthusiastic people, to help choose what you would like to read and discuss on Thursday 19th September at 8pm BST. Also, do leave me a message if the time and day of the week don’t work well because I can definitely look at moving it after the next one. I work Mon-Fri 9am – 5pm and won’t be able to do Monday evenings but other than that, I can be quite flexible. Also, if anyone wants to host a chat, please let me know and I’ll happily add you as an administrator to post here.

So these are the papers – as it’s September and we have a new term starting soon

A) “Enhancing Wellbeing in Social Work Students: Building resilience in the Next Generation”  Grant and Kinman 2011 Social Work Education

Abstract

The need for social workers to be resilient is widely emphasised. Although enhancing resilience in social work trainees presents a challenge to educators, they are nonetheless responsible for developing professionals who are able to cope with the emotional demands of the job. This paper argues that building resilience in the future workforce should be a key element of social work education. However, as little is known about the competencies and support structures that underpin resilience or the extent to which resilience protects the wellbeing of trainees, an evidence-based approach is required to inform curriculum development.

Recent research conducted by the authors of this paper has highlighted the protective nature of resilience in social work trainees. Emotional intelligence and associated competencies, such as reflective ability, aspects of empathy and social confidence, were found to be key predictors of this important quality. The important role played by social support from various sources was also emphasised. The present paper summarises this research, and presents interventions based on the findings that have the potential to promote resilience and wellbeing in social work trainees. Also considered are ways in which the curriculum might be further enhanced to provide trainees with an internal ‘tool-box’ of strategies that will help them manage their wellbeing more effectively in their future career

This could lead to some interesting discussions about resilience generally in social work and ‘fast track’ social work training.

B) Stigmas and Silos: Social Workers accounts of care for people with serious mental illness and cancer  Sinding, Watt, Miller et al Social Work in Mental Health 2013

Abstract

The purpose of this study was to better understand the processes of care for people living with serious mental illness who are diagnosed with cancer, from the perspectives of social workers. Interviews were conducted with 11 social workers at a multisite acute and tertiary care centre in Ontario, Canada. Analysis showed how patients diagnosed with serious mental illness were channeled to mental health services and their cancer-related concerns discredited, and how care was compromised by the compartmentalization of mental and physical health care. The study also revealed that relationships between patients and their families were often repaired or reactivated by a cancer diagnosis, and health care providers’ empathy and resources mobilized. Theories of stigma are used to deepen study findings and to highlight the significance of social workers’ actions in creating health care environments that are less disabling for people diagnosed with a mental illness. The vital roles social workers play in clinical coordination and in ensuring care equity—and the factors that impede these roles—are discussed.

This is a Canadian study but I think the issues are relevant across the world around stigma related to mental illnesses and people’s access to health services. I think it could lead to a far broader discussions about stigma and place of social work to challenge it.

In the future please to feel free to suggest articles you find. I am restricting it to articles that anyone can access and don’t need to be paid for or Athens Access for.

I’ll close the ‘voting’ next Sunday.





Social Work, Professionalism and Boundaries #sjwcchat Discussion 29/8/13

29 08 2013

This is the chat log from the Social Work Journal Club chat on 29/8/13. Many thanks to all who participated and read from afar.

I’m going to be out on 12/9/13 so the next chat will be 19th Sept. Keep an eye on the site and I’ll keep reviewing papers and policy as they pop up and I’ll do another ‘select a paper to discuss’ early next week so we can all choose something for the next time!





About Boundaries and Social Work/Social Care – Social Work Journal Club Chat 29/8/13 8pm

28 08 2013

The article for the chat tomorrow at 8pm can be found here. It is published in the open access online journal ‘Social Work and Society’ and is called “Setting and Crossing Boundaries: Professionalization of Social Work and Social Work Professionalism” and is written by Catrin Heite from the University of Zurich. It’s the first time we’ll have been out of the UK in terms of discussing an article and I hope it’s as interesting to others as it is to me!

I’m interested in boundaries and power in social work. Boundaries between social workers and people who use services. Boundaries between practice educators and students. Boundaries between social work managers and social workers. Boundaries between social work academics and social work students. There are all different interpretations and some fluidly but I think, in an age where social media can break down some barriers, it’s worth reflecting on which ones need to be maintained and why.

Heite looks at the boundary between ‘professional’ and ‘non-professional’. This is an issue in social care too where I have seen some hierarchical pandering to the increased ‘professionalisation’ of social work. Does social work need ‘professionalisation’ – is it a matter of status or will it actually make the work we do better? The craving of social workers to be ‘respected’ like nurses/teachers/doctors – (I’m not convinced yet that they aren’t,  but I think the profession has a collective inferiority complex where it becomes obsessed by ‘status’)  is that real or imagined slight? ‘Noone likes social workers’ really? Have we seen some of the press nurses have been getting recently – but back to the article.

Some of the language in the article isn’t terribly ‘user friendly’ so I’m going to sum up some of my thoughts in response to it.

Heite starts by looking at what ‘boundaries’ are. Boundaries are artificial contructs which we create to provide some order and a sense of hierarchy and power. She says

The boundary classifies, categorizes, sorts, normalizes, includes and excludes, privileges and de-privileges, allocates rights and removes them; the boundary is an expression of power relations and governance, and a medium for their maintenance

So around boundaries we have issues of power and who has it and who doesn’t. I’m not sure I’m entirely convinced on this 100%. Power is at the heart of the reason for boundaries but it isn’t always people in ‘power’ who create and maintain them. Sometimes the fact that people with power can’t maintain boundaries is an abuse of their power.

Heite talks about how professionalisation creates a boundaries between those who are ‘in’ and those who are ‘out’.

Professionalization and the securing of the status of profession is a process of defining the boundary between profession and non-profession by agreeing upon definitions of reality and by disputing and acquiring status and monopolizing resources. This involves claiming, and recognizing, that a certain field of occupational action is a professional field or is in need of professionalization

She goes on to say

Boundary-setting is efficient in defining what a profession is and is not, debarring other occupations from a certain professional realm, monopolizing this occupational area, and also claiming professional authority over a sphere.

so an interesting question arising from this text is around what ‘social work’ is? Does it exist as a ‘profession’. We have, over decades, seen the hiving off of different tasks of ‘social work’ yet we have (at the moment and I assume only temporarily, a generic training route). My idea of social work is very different from someone who works in child protection and again from someone who works in care management or leaving care team or fostering and adoption. Is it one profession?

How different is (or should be) social work from social care work? When I started in the field people who worked in residential care were called residential social workers regardless of training and background. Weren’t they doing ‘social work’? No, now it’s a ‘protected title’ but who does it protect? Has hiving off ‘social work’ as a ‘profession’ weakened ‘social care’?

Heite turns to look at the history of social work and relates it to the ‘women’s movement’. Social work is, she says a ‘female profession’ and as she terms it ‘the social question’.

It is concerned with the boundaries between normal and deviant, integration and disintegration, as well as with those vulnerable and disconnected people who have to survive at the boundaries of society.

She touches on the professions routes from the Christian charities in the 19th century and the increasing involvement of middle-class women in the ‘social question’ through initially voluntary and then vocational work.  An interesting point she touches on which is increasingly relevant is the place that the image of the ‘deserving’ v ‘undeserving’ poor had in the mind of those middle class ‘helping’ professionals.

Unannounced visits to the home and questions asked of neighbours about the family being supported, among other means, represented techniques for the bourgeois monitoring of proletarian lifestyles, in the sense of disciplinary interventions across class boundaries. In this way, the class-specific power dynamics between bourgeois and proletarian women found in the context of the invention and professionalization of social work a new location for moralizing, disciplining and monitoring

I expect social workers today may feel uncomfortable with this – I do – but I can also see there’s an aspect of these attitudes that roll over in making decisions about how people live their lives and spend their money. How people from working classes have much more involvement with ‘social services’ than those who are middle class. There is, perhaps a hang over and the move of social work into a profession creates further divides (I have to wonder about the ‘elite’ Frontline ‘fast-trackers’ moving into ‘leadership’ and how this builds higher boundaries and makes me ponder what social work is? Is it just about education/training?)

So what makes a profession?

Heite looks at how knowledge, theory, science (and social science) created a knowledge base for social work which creates a profession of it.  She looks at the move from vocational to professional in social work which is interesting in itself.

She says

The perception of professional work both as intellectual, science-based, ethically consolidated, autonomous, self-controlled, and also as engaged, impassionate, emotional and dedicated is a feature that is difficult to calibrate when demarcating the boundary between profession and non-profession.

We can calibrate when we are assessed on these issues – you are either ‘qualified’ or not. You are either ‘registered’ as a social worker (here in the UK) or not. But what about people who are registered and not doing a job that requires a social work qualification (me, for example) or people who are qualified but working in an ‘unqualified’ post. There are always differences but there is a boundary that is set clearly in terms of registration/regulation of social workers.

Heite looks at the move from the mid 1970s towards the professionalisation within social work and of social work.

She relates social work as work on the boundaries – boundaries between ‘functional’ and ‘non-functional’ between ‘normal’ and ‘deviant’. I think we have to look at the scale of work done by social workers to understand better but it’s interesting to think what makes someone a ‘user’ of social work services. It isn’t always as clear cut and depends very much on the issues. Certainly in the team I used to work in many people had parents who received social work services and we were simultaneously providers of services and receivers of services as family members.

Perhaps more of those barriers are fading yet, it is vitally important to hold on – not to maintain professional status but to protect those who have less power.

It’s interesting that Heite says

“the boundary” offers a theoretical, analytical, practical and political perspective for social work as a science and a profession. As shown above in addressing the analytic notion of the boundary, the boundary not only deprives and excludes, but also moves players to take action against these deprivations and to disregard them, and to transform and shift boundaries.

So those with power have the ability to set and to move those boundaries and that’s an important issue to remember. Whose boundaries are they and who are they for? Who do boundaries protect? Personally, I think as someone with power, I need to create and maintain boundaries to protect those I work with. Is that a patriarchal assumption I’m making to make me feel better or ‘more distant’ from those who use the services I provide? Maybe but maybe not. I’d justify it by saying that while I have power, the relationship I have with people I work with has to address that. That’s why I think the issue is the same with lecturers and social work students, practice educators and students.

Heite emphasises that boundaries create professionalism.

Socio-pedagogical professionalism can thus be understood as a means – varying in content and full of contradiction – of dealing with boundaries: supporting and enabling, but also monitoring and disciplining.

I’d hope, like Heite does, that these boundaries enable and support rather than push hierarchy and power on to people.

– Questions

So some questions to think about if you do want to join for the chat tonight

-What is social work? How does it differ from social care work? Where is the boundary?

-Has professionalism improves social work delivery?

-Who is professionalism ‘for’?

-Are boundaries useful? How are boundaries useful?

-Do boundaries make hierarchies better or worse?

-Should boundaries come down? Whose decision is it?

-How has more fluid communication (like social media) effected boundaries?

-Are boundaries between academics/practice educators and students different from boundaries between people who use services and professionals by their nature?

I’m sure there are many other questions I’ll think of and please join me and add your own!