Innovative Approaches to Involving Service Users in Palliative Care Social Work Education

Service user involvement in social work education is now a firmly established concept in UnitedKingdom.As a result, it is common practice for service users to occupy central roles the education and training of social work students and staff in both qualifying and postqualifying programmes. This paper describes an initiative, undertaken inNorthern Ireland, which compares two methods of user involvement employed with undergraduate and postqualifying social work students. In both situations the students firstly observed discussedDVDexcerpts of narratives from people affected by cancer and secondly observed live facilitated interview with a 25-year-old male service user who shared his experiences being diagnosedwith cancer at a young age.Understanding the social work role in palliative care is crucial as all social workers, regardless of practice context, will have some degree involvement in helping individuals and families to address end-of-life care issues. paper compares the findings of evaluations from two student groups which may help inform social work educators about the effectiveness of different teaching methods used achieve meaningful and effective user involvement with seldom heard groups.

User perspective on palliative care services: experiences of middle-aged partners bereaved through cancer known to social work services in Northern Ireland

This qualitative research study explores experiences of partners bereaved through cancer, who were resident in an urban area of Northern Ireland and who had been service users of the social work services. Data were collected in 2004 from 10 individuals who participated in semi-structured interviews. Emergent themes were identified using thematic content analysis and findings analysed under four categories: cancer journey; impact of bereavement; process of adjustment and change; and experience of support services. Opportunities to facilitate communication were not always maximised, often resulting in poor bereavement outcomes. Although hospices undertook bereavement risk assessment, participants were unaware of its use and queried its accuracy without service user involvement. The most cited informal support was family and friends, although such help was time-limited. Service user feedback regarding social workers was generally positive; however, there was a lack of knowledge about their role in palliative care. Post-bereavement adjustment was influenced by the quality of social networks, the responsibilities of lone parenthood, and challenges to life values and core beliefs. A framework for palliative care social work has been recommended based on research findings.

Evidencing reflective practice in social work education: Theoretical uncertainties and practical challenges

Reflective practice has become an increasingly influential idea in social work education and, in the UK context, it has recently been acknowledged as key to ensuring that social workers are better equipped to engage in complex decision making and effective practice. However, there remains a lack of clarity about how this concept is defined and operationalised in teaching and learning and there has been little systematic empirical examination of its utility in facilitating professional development. Drawing on research with undergraduates at Queen's University Belfast, this paper aims to develop understanding of students' experience of reflective practice. The results suggest that agency systems that have become over-reliant on rules and procedures present formidable obstacles to learning both at an individual and at an organisational level. The paper argues that the relationship between how reflective practice is taught and how it is enacted in practice needs to be better understood if such obstacles are to be overcome. The paper concludes by considering the implications of the findings for developing reflective practice in social work education and practice and highlights the challenges that need to be addressed if reflection and critical thinking are to become more firmly embedded within agency systems and practice cultures.

Bolivian health and social care professionals' experiences of decision-making in oncology and palliative care

In the UK, end-of-life care strategies recommend patients and families are involved in decision making around treatment and care. In Bolivia, such strategies do not exist, and access to oncology services depends on finance, geography, education and culture. Compared to more developed countries, the delivery of oncology services in Latin America may result in a higher percentage of patients presenting with advanced incurable disease. The objective of this study was to explore decision-making experiences of health and social care professionals who cared for oncology and palliative care patients attending the Instituto Oncológico Nacional, Cochabamba (Bolivia). Patients were predominantly from the Quechua tradition, which has its own ethnic diversity, linguistic distinctions and economic systems. Qualitative data were collected during focus groups. Data analysis was conducted using Interpretative Phenomenological Analysis. Three interrelated themes emerged: (i) making sense of structures of experience and relationality; (ii) frustration with the system; and (iii) the challenges of promoting shared decision making. The study uncovered participants' lived experiences, emotions and perceptions of providing care for Quechua patients. There was evidence of structural inequalities, the marginalisation of Quechua patients and areas of concern that social workers might well be equipped to respond to, such as accessing finances for treatment/care, education and alleviating psychological or spiritual suffering.

Reflecting on Psycho-Social Domains in Social Work: Towards a Model of Enabling Others (Monograph Version with ISBN)

This monograph develops a model of reflexivity for social workers based on the work of Derek Layder. It examines psycho-biographical, interactional, institutional, cultural and economic factors and how they enable and constrain social work practice.

Empowering the Shamed Self: Recognition and Critical Social Work

Summary: This article provides a review of the contribution of Axel Honneth’s model of recognition for critical social work. While Honneth’s tripartite conceptualisation of optimal identity-formation is positively appraised, his analysis of the link between misrecognition, the experience of shame and eventual sense of moral outrage, is contested. Drawing on a range of sources, including the sociology of shame, Honneth’s ideas about the emotional antecedents of emancipatory action are revised to guide critical social work with misrecognised service users.

Findings: The intellectual background to Honneth’s recognition model, emanating from leading German philosophers, is described and its application to social work set out. Even so, Honneth’s model is found to be deficient in one primary regard: its assumption about the emotional antecedents to quests for withheld recognition is misapprehended. In particular, the argument in this article is that the ubiquitous emotion of shame, which Honneth argues flows from misrecognition, must be carefully addressed through the medium of relationship, otherwise it might lead to repressed shame and frustrated attempts at social struggle. To this end, a social work process is delineated for dealing with shame, following episodes of misrecognition.

Applications: Honneth’s model of recognition, along with revised ideas about how to recognise and manage shame, is incorporated into a conceptual framework for critical social work practice. With this renewed understanding of the impact of shame, following misrecognition, social workers should be better equipped conceptually to enable service users to take action for empowerment.

Delivering Social Work Education on Case Reviews and Inquiry Reports: An Exploratory Study of Students' Perspectives in Northern Ireland

It is self-evident that we live in the age of inquiry where the negative impact of risk has been examined through numerous formal processes. In the wake of such scrutiny, there have been repeated recommendations for better training of the professionals charged with safeguarding the welfare of vulnerable individuals. Yet there has been very little examination of how student social workers, in particular, evaluate this training. This exploratory study responded to this gap through a mixed-methods design centring on the views of qualifying and post-qualifying social work students attending courses within two regional universities in Northern Ireland. The study found that, in the main, the cohorts responded favourably to certain aspects of the curriculum and how they were delivered. That said, the emotive nature of the case review and inquiry reports was inadequately addressed in the classroom and was not processed afterwards through a psycho-social framework. In effect, students were often left with residual anxieties that potentially hampered learning. On the basis of the findings, the study calls for further research into this highly significant area of professional competence.

The executive committee of the Greek Professional Association of Social Work in an age of austerity: examining its response

This paper explores the response by the Greek Association of Social Workers (SKLE) to Greece's current economic crisis. Socioeconomic conditions in Greece have deteriorated rapidly since the imposition of a Structural Adjustment Programme as a condition of the loan Troika provided to Greece to address its class-based public debt crisis. Interviews were conducted with SKLE Executive Committee members to examine SKLE's response in the context of newly raised inequalities. Research results show that SKLE recognised the negative consequences to both service users and its members. However, SKLE continues to reformulate its strategy mostly as a social partner. SKLE's previous strategy entailed amongst other things the analysis of policy proposals and participation in welfare related government committees. This strategy is no longer relevant because decision-making powers have been transferred to transnational bodies. This paper elaborates on these findings and discusses the barriers that prohibit SKLE from differentiation of its strategy. Although the research is country specific, it has implications for the broader global debate because professional associations must reformulate their strategies for better serving of both their constituents and the collective good based on the social justice mandate of the profession.

'If we do not cut social spending, we will end up like Greece': Challenging consent to austerity through social work action

'If we do not cut social spending, we will end up like Greece'. Establishment politicians and media figures use this new ideological mantra throughout the Western world to frighten people into consenting to further neo-liberal restructuring along with cuts in social spending. This phrase and other ideologically laden assertions hide the real causes of the Greek public debt crisis. This commentary challenges the dominant discourse by contextualizing the Greek case within the larger global neo-liberal restructuring processes and then, drawing upon Gramsci's concept of the organic intellectual, proposes ways that the members of the Professional Association of Social Workers (PASW) can engage in a war of ideas and action, as organic intellectuals, to delegitimize the dominant discourse, which seeks consent for social spending cuts and further neo-liberal restructuring of society. © The Author(s) 2013.

Relationships matter: social worker relationships with young children

This paper reviews the recent policy developments designed to improve social workers' relationships with children and the barriers to establishing these.

Enabling Others in Social Work: Reflexivity and the Theory of Social Domains

This paper sets out a framework to structure reflexivity in social work practice. Based on the thinking of the sociologist, Derek Layder, it comprises five domains that impact on the individual and social life, namely: (i) psycho-biography – referring to a person’s unique experience throughout the life-course; (ii) situated activity – highlighting the impact of every day social interaction; (iii) social settings – addressing the role of organizations in social life; (iv) culture – covering the influence of attitudes, beliefs, tastes and ideas on symbolic meaning; and (v) politico-economy – alluding to the ramifications of political and economic forces on people’s lives. It is contended that power circulates throughout each domain as an enabling and constraining force. The paper then outlines a process for using the reflexive framework in ‘enabling’ activities such as practice learning, supervision, mentoring and coaching. By applying the framework in these contexts, it is argued that social workers can reflect critically on their role and develop emancipatory forms of practice.

Challenges to undertaking randomised trials with looked after children in social care settings

Background: Randomised controlled trials (RCTs) are widely viewed as the gold standard for assessing effectiveness in health research; however many researchers and practitioners believe that RCTs are inappropriate and un-doable in social care settings, particularly in relation to looked after children. The aim of this article is to describe the challenges faced in conducting a pilot study and phase II RCT of a peer mentoring intervention to reduce teenage pregnancy in looked after children in a social care setting.

Methods: Interviews were undertaken with social care professionals and looked after children, and a survey conducted with looked after children, to establish the feasibility and acceptability of the intervention and research design.

Results: Barriers to recruitment and in managing the intervention were identified, including social workers acting as informal gatekeepers; social workers concerns and misconceptions about the recruitment criteria and the need for and purpose of randomisation; resource limitations, which made it difficult to prioritise research over other demands on their time and difficulties in engaging and retaining looked after children in the study.

Conclusions: The relative absence of a research infrastructure and culture in social care and the lack of research support funding available for social care agencies, compared to health organisations, has implications for increasing evidence-based practice in social care settings, particularly in this very vulnerable group of young people.

Risk, Recovery and Capacity: Competing or Complementary Approaches to Mental Health Social Work

Mental health social workers have a central role in providing support to people with mental health problems and in the use of coercion aimed at dealing with risk. Mental health services have traditionally focused on monitoring symptoms and ascertaining the risks people may present to themselves and/or others. This well-intentioned but negative focus on deficits has contributed to stigma, discrimination and exclusion experienced by service users. Emerging understandings of risk also suggest that our inability to accurately predict the future makes risk a problematic foundation for compulsory intervention. It is therefore argued that alternative approaches are needed to make issues of power and inequality transparent. This article focuses on two areas of practice: the use of recovery based approaches, which promote supported decision making and inclusion; and the assessment of a person’s ability to make decisions, their mental capacity, as a less discriminatory gateway criterion than risk for compulsory intervention.

‘Making it real’: evaluating the impact of service user and carer involvement in social work education

Service user and carer involvement (SUCI) in social work education in England is required by the profession’s regulator, the Health and Care Professions Council. However, a recent study of 83 HEIs in England reported that despite considerable progress in SUCI, there is no evidence that the learning derived from it is being transferred to social work practice. In this article we describe a study that examines the question: ‘What impact does SUCI have on the skills, knowledge and values of student social workers at the point of qualification and beyond?’ Students at universities in England and Northern Ireland completed online questionnaires and participated in focus groups, spanning a period immediately pre-qualification and between six to nine months post-qualification. From our findings, we identify four categories that influence the impact of service user involvement on students’ learning: student factors; service user and carer factors; programme factors; and practice factors; each comprises of a number of sub-categories. We propose that the model developed can be used by social work educators, service user and carer contributors and practitioners to maximise the impact of SUCI. We argue that our findings also have implications for employment-based learning routes and post-qualifying education.