Perspectives of a nurse, a social-worker and a psychiatrist, regarding patient assessment in acute inpatient psychiatry settings : a case study approach

This case study explores what informs and organizes the assessment of patients, as undertaken by a nurse, a social worker and a psychiatrist in public, metropolitan, acute mental health service settings. The research data are the transcripts of in-depth interviews with three experienced practitioners, one from each of the three disciplines. The analysis draws on Foucauldian concepts: discourse as constructed through practices of discipline and the gaze. We explored examples of taken-for-granted assessment practices and their interplay with discourse. The findings suggest that participating practitioners use language in assessment in ways that support the powerful discourses of the professional disciplines. The competing discourse of management, associated with industry and economics, is evident in hospital admission processes, dictating the times and places of assessment. Professional and management discourses both effectively marginalize the perspective of another player in assessment, the patient.

Gatekeeping or redressing social exclusion : expectations on social work educators in relation to incarcerated students

Until recently, the author was in Scotland, where professional registration in social work extends to students and involves criminal record checks prior to acceptance into a course of study. She is now teaching at Deakin University in Australia, which places a high priority on making higher education available to persons and groups who have traditionally been excluded, both through the provision of courses through off campus (distance education) study mode and an innovative and culturally sensitive mode of provision for indigenous Australians. One result of our attempts to redress social exclusion is that, on occasion, we discover that some of our students are incarcerated. There are important logistical issues which may emerge as a consequence of accepting prisoners into a program of social work education. However, it would seem that the inclusion of prisoners is symbolic of a fundamental difference in philosophy with programmes of social work education in countries where there is a strong expectation that social work educators act as gatekeepers to the profession, especially in respect of students with criminal convictions. This in tum reflects an expectation among social work educators in Australia that it may be more appropriate for professional associations or registration bodies to determine whether or not a graduate with a criminal record is suitable for employment as a professional social worker. In some settings, a prior criminal record is not a barrier to being an effective service provider, as well as international differences in understandings of the social work role and employment
destinations of social work graduates.

The multiple relationships between the discipline of social work and the contributions of Michael White

Michael White, the Australian narrative practitioner, died in April this year. Given White trained in social work and has had a large impact on many social workers, it is timely to investigate the opaque relationships linking White and his work with his discipline-of-origin. The present examination proceeds in three steps. First, a schematic outline of White’s intellectual influences and achievements is set out; second, the alignments, as well as tensions, between White’s work and his discipline-of-origin are considered; and, third, it is argued that White was informed by, and went on to produce a body of work that further informed, the contesting spirit that is the wellspring of the discipline of social work. This conclusion is reached mindful of the fact that White remained antagonistic to the role played by the professions in general and that he did not identify with the title ‘social worker’ in particular.

Using vignettes to evaluate the outcomes of student learning : data from the evaluation of the new social work degree in England

This paper reports the use of vignettes as a methodology to analyse the extent to which the new social work degree programmes enabled students to develop their analytical and reflective capabilities. Two vignettes, which focused on children and families and adult social care respectively, were developed for the study. Students were asked to respond in writing, from the perspective of a social worker, to a standard set of questions at the beginning (T1) and end of their degree programme (T2). Considering the responses to all questions across the two vignettes, a series of scales was developed to measure the key themes which had been identified by qualitative analysis. These included ‘Attention to process of relationships’ and ‘Social/structural/political awareness’. Responses were also rated as ‘descriptive’, ‘analytic’ or ‘reflective’.

Students from six universities in England participated. From an original sample of 222 students, it was possible to match 79 T1 and T2 responses. Analysis of variance demonstrated statistically significant increases in nine of the 11 themes and increases in ratings for analysis and reflection.

In conclusion, vignettes can be used to produce both qualitative and quantitative data in respect of changes in students’ acquisition of knowledge and skills over time.

Professional supervision : a workforce retention strategy for social work?

Retaining social workers in the workforce is a significant challenge and a considerable amount of research has focused on identifying and examining the reasons why social workers choose to leave the profession. This paper presents findings collected as part of a small-scale exploratory study into why some social workers have chosen to remain in the social work profession for many years and who consider themselves to be passionate about their careers. In particular, the paper focuses on the potential of effective professional supervision as a factor that can facilitate social worker workforce retention. Supervision was mentioned by all participants in the study as being important for their wellbeing, either throughout their social work career or at particular points along the way, and supervision was also cited as one of the reasons they were still social workers. On the basis of this research, the authors argue that regular professional supervision can increase the retention rate of social worker employees; and it is, therefore, false economy not to allocate sufficient resources for effective supervision.

An evaluation of the effect of an educational intervention for Australian social workers on competence in delivering brief cognitive behavioural strategies : a randomised controlled trial

Background Broad community access to high quality evidence-based primary mental health care is an ongoing challenge around the world. In Australia one approach has been to broaden access to care by funding psychologists and other allied health care professionals to deliver brief psychological treatments to general practitioners' patients. To date, there has been a scarcity of studies assessing the efficacy of social worker delivered psychological strategies. This study aims to build the evidence base by evaluating the impact of a brief educational intervention on social workers' competence in delivering cognitive behavioural strategies (strategies derived from cognitive behavioural therapy). Methods A randomised controlled trial design was undertaken with baseline and one-week follow-up measurement of both objective and self-perceived competence. Simulated consultations with standardised depressed patients were recorded on videotape and objective competence was assessed by blinded reviewers using the Cognitive Therapy Scale. Questionnaires completed by participants were used to measure self-perceived competence. The training intervention was a 15 hour face-to-face course involving presentations, video example consultations, written materials and rehearsal of skills in pairs. Results 40 Melbourne-based (Australia) social workers enrolled and were randomised and 9 of these withdrew from the study before the pre training simulated consultation. 30 of the remaining 31 social workers (97%) completed all phases of the intervention and evaluation protocol (16 from intervention and 14 from control group). The intervention group showed significantly greater improvements than the control group in objective competence (mean improvement of 14.2 (7.38-21.02) on the 66 point Cognitive Therapy Scale) and in subjective confidence (mean improvement of 1.28 (0.84-1.72) on a 5 point Likert scale). On average, the intervention group improved from below to above the base competency threshold on the Cognitive Therapy Scale whilst the control group remained below. Conclusions Social workers can attain significant improvements in competency in delivering cognitive behavioural strategies from undertaking brief face to face training. This is relevant in the context of health reforms that involve social worker delivery of evidence based psychological care. Further research is required to assess how these improvements in competence translate into performance in practice and clinical outcomes for patients.

Assessing financial competence

Some people have cognitive impairments that may reduce their capacity to manage their own financial affairs. The legal decision to limit a person's right to manage his or her own finances depends, in part, on an assessment of financial competence. Currently, tribunals and courts may receive information from a variety of different sources (e.g., family members, general practitioner, psychologist, social worker etc.) and have to reconcile this information in order to make guardianship decisions. The first aim of this article is to critique contemporary methods, procedures and practices for assessing financial competence. The second aim is to suggest a standard assessment framework that could be employed by tribunals and courts to help them evaluate the status of a person's financial competence.

C'mon guys! A program to facilitate father involvement in the primary school environment

This article is written to provide a case study example of a program developed to encourage fathers' engagement with their children in the primary school environment. C'mon Guys! was delivered in a Primary School in Victoria, Australia (unnamed to protect the privacy of the participants). The article begins by first describing the community in which C'mon Guys! was offered and goes on to outline the literature related to aspects pertinent to the program such as father involvement in the lives of children at school, and the role of the social worker in facilitating this type of groupwork in the school setting. Next, the aims of the program are discussed with particular reference to its design, social learning theory, systems theory and groupwork principles and processes. The outcomes of C'mon Guys! are then discussed noting the limitations of the program as well as identifying the extrinsic and intrinsic benefits for the children, their fathers and the community.

Swapping roles or swapping desks? When experienced practitioners become students on placement

The social work education literature on the preparation of students for their first practice learning placement, and the support needs of such students once in placement, tend to include implicit assumptions that the students being placed are novice practitioners, with little experience of working in social welfare agencies. Although there are some students for whom these assumptions are undoubtedly correct, another common phenomenon is that practice experience often leads to practitioners enrolling in professional degrees to qualify as a social worker. As credit for prior work experience in social welfare settings has only recently become possible for Australian social work students, we routinely work with aggrieved students who believe they should be exempted from placements, some of whom subsequently find the transition from experienced practitioner to student on placement somewhat difficult. This paper reports on a study which sought to explore the specific needs of experienced practitioners who become social work students on practice learning placements, with the aim of developing procedural recommendations for the placement and support of such students in the future. One of our findings was that several of the students continued to identify as practitioners, albeit in a different agency or programme from their normal place of employment, rather than take on the student identity. The implications of this for the development of practice learning opportunities for students who are experienced practitioners will be discussed.

Urban social insurance and worker satisfaction in China: Implications for India

This paper draws on a unique survey of urban employees in Jiangsu that was designed to assist analysis of workers' satisfaction with the urban social insurance scheme in China, and sheds light on whether workers in the urban non-state sector are satisfied with the level of social insurance coverage and whether their perceptions compare favourably with workers in the state-owned sector. It also discusses the globalisation and social protection debate in India and draws implications for the Indian experience from both our perception research and China's experience with urban social insurance reform more generally.

A factor-analytic study exploring the factors of co-worker cohesion

Despite the applied importance of cohesion within organisational settings, researchers have yet to reach consensus about the dimensionality of group cohesion, and therefore appropriate tools for its measurement. The way that cohesion has generally been conceptualised has changed over time, but the measures appear not to reflect the underlying theory. This deficiency has impeded attempts to explore the relationship between co-worker cohesion and group performance (Beal et al., 2003; Mullen & Copper, 1994). Given inconsistent findings from previous factor analyses of cohesion, the present study employed exploratory means to help clarify the factor structure of cohesion within the workplace. Potential participants were recruited via the researchers' social networks. This snowballing technique led to 236 participants completing the online questionnaire. Exploratory factor analysis revealed four first-order factors of team commitment, friendliness, interpersonal conflict and communication that collectively accounted for 55.17% of the variance shared among the 75 cohesion items. Subsequently, a single higher-order factor was extracted which accounted for over half of the co-variation among the first order factors. This higher-order factor seems to reflect a general cohesion factor, as it was loaded by a diffuse collection of items, including those from the four lower-order factors as well as items that failed to load onto these lower-order factors. While there were similarities between these results and those of previous studies, the present factor structure did not map perfectly onto any of the existing conceptual models of cohesion. This finding highlights the need to incorporate some alternate factors that have previously been given little consideration.

Building the capacity of family day care educators to promote children’s social and emotional wellbeing : an exploratory cluster randomised controlled trial

Background: Childhood mental health problems are highly prevalent, experienced by one in five children living in socioeconomically disadvantaged families. Although childcare settings, including family day care are ideal to promote children’s social and emotional wellbeing at a population level in a sustainable way, family day care educators receive limited training in promoting children’s mental health. This study is an exploratory wait-list control cluster randomised controlled trial to test the appropriateness, acceptability, cost, and effectiveness of “Thrive,” an intervention program to build the capacity of family day care educators to promote children’s social and emotional wellbeing. Thrive aims to increase educators’ knowledge, confidence and skills in promoting children’s social and emotional wellbeing.
Methods/Design: This study involves one family day care organisation based in a low socioeconomic area of Melbourne. All family day care educators (term used for registered carers who provide care for children for financial reimbursement in the carers own home) are eligible to participate in the study. The clusters for randomisation will be the fieldworkers (n = 5) who each supervise 10-15 educators. The intervention group (field workers and educators) will participate in a variety of intervention activities over 12 months, including workshops; activity exchanges with other educators; and focused discussion about children’s social and emotional wellbeing during field worker visits. The control group will continue with their normal work practice. The intervention will be delivered to the intervention group and then to the control group after a time delay of 15 months post intervention commencement. A baseline survey will be conducted with all consenting educators and field workers (n = ~70) assessing outcomes at the cluster and individual level. The survey will also be administered at one month, six months and 12 months post-intervention commencement. The survey consists of questions measuring perceived levels of knowledge, confidence and skills in promoting children’s social and emotional wellbeing. As much of this intervention will be delivered by field workers, field worker-family day care educator relationships are key to its success and thus supervisor support will also be measured. All educators will also have an in-home quality of care assessment at baseline, one month, six months and 12 months post-intervention commencement. Process evaluation will occur at one month, six months and 12 months post-intervention commencement. Information regarding intervention fidelity and economics will also be assessed in the survey.
Discussion: A capacity building intervention in child mental health promotion for family day care is an essential contribution to research, policy and practice. This initiative is the first internationally, and essential in building an evidence base of interventions in this extremely policy-timely setting.

Does workplace social capital buffer the effects of job stress? A cross-sectional, multilevel analysis of cigarette smoking among U.S. manufacturing workers

Objective: To investigate whether workplace social capital buffers the association between job stress and smoking status. Methods: As part of the Harvard Cancer Prevention Project's Healthy Directions—Small Business Study, interviewer-administered questionnaires were completed by 1740 workers and 288 managers in 26 manufacturing firms (84% and 85% response). Social capital was assessed by multiple items measured at the individual level among workers and contextual level among managers. Job stress was operationalized by the demand-control model. Multilevel logistic regression was used to estimate associations between job stressors and smoking and test for effect modification by social capital measures. Results: Workplace social capital (both summary measures) buffered associations between high job demands and smoking. One compositional item—worker trust in managers—buffered associations between job strain and smoking. Conclusion: Workplace social capital may modify the effects of psychosocial working conditions on health behaviors.