ATHROFA GOGLEDD DDWYRAIN CYMRU, WRECSAM

 

 

PREPARING FOR PRACTICE IN WALES

 

THE SOCIAL WORK PROCESS

(ENGLISH LANGUAGE VERSION)

IOLO JONES DEBBIE WILLIAMS

This workbook was produced through funding by CCETSW Wales (Care Council for Wales by now) and The University of Wales, Bangor. It was written and designed by NEWI staff, Plas Coch Campus, Mold Road, Wrexham LL11 2AW

The video was produced in partnership with: Elaine Davies, Cen Williams, Criw Pobl Ifanc, Just us, Save the Children, Gwasanaeth Ieuenctid Conwy, Andy Cheatham, Cwmni Barcud, Dave Mosford, Elin Llwyd Morgan, Iolo Williams, Sioned Hickey . Copies of the video are available from the social work department at NEWI

PREPARING FOR PRACTICE IN WALES

INTRODUCTION  
WORKBOOK AIMS  
LEARNING OUTCOMES  
SOCIAL WORK PROCESSES
ANTI-DISCRIMINATORY PRACTICE
PCS MODEL
ACCESS, REFERRAL AND ALLOCATION
THE WELSH LANGUAGE IN CONTEXT
INITIAL CONTACT
WELSH PEOPLE AND WELSH SPEAKERS
BLACK PEOPLE
PEOPLE WITH A DISABILITY
PEOPLE WHO ARE GAY OR LESBIAN
VALUES, ATTITUDES AND ANTI-DISCRIMINATORY PRACTICE
ACTIVE LISTENING AND EMPATHY
GATHERING INFORMATION
ASSESSING
WHERE TO BEGIN WITH A NEEDS ASSESSMENT?
RISK ASSESSMENT
PLANNING
REVIEWING
ENDINGS
EVALUATION
REFLECTIVE PRACTICE
BIBLIOGRAPHY

Preparing For Practice in Wales

 

Introduction

The production of this learning pack was made possible through joint funding by CCETSW Cymru (now the Care Council for Wales) and the University of Bangor. The impetus for the project came from the general lack of bilingual learning materials available for social workers in training and the collaboration and enthusiasm generated by a time limited project led by Elaine Davies (The Development of Bilingual Provision within the Dip SW 1999-2000). Elaine Davies (author of ‘They All Speak English Anyway" 2001) has been at the heart of the development and promotion of linguistically sensitive practice within social work in Wales for the past decade. She provides the introduction to this material at the beginning of the video, this will set the scene for the need to adopt a linguistically sensitive approach to social work practice in Wales. The video should be watched now as an introduction to the Preparing for Practice in Wales Workbooks.

Video Trigger 1: Introduction by Elaine Davies

 

The workbook Preparing for Practice in Wales 2: Social Work Processes is designed to be used with the accompanying video and its partner workbook Preparing for Practice in Wales 1: Values, Ethics and Social Work. This workbook will use some of its own case studies and commentaries in conjunction with exercises related to the video. The rationale for using this video to cover two modules is to enable you to understand the interrelationship between ‘values’ and ‘social work processes’. The video and the workbooks set social work within its holistic context. Social work is a complex activity in which you will often have to manage conflicting dilemmas and challenges. As you embark on your training, or continue to develop in your practice, you will be encouraged to continually develop your understanding of your self and your own values (what they are and where they have come from). When you are exploring social work processes questions of values and ethics constantly emerge to challenge your practice. The aim of both workbooks is to enable you to understand that social work operates on a number of different levels.

 

This workbook will cover some of the key issues faced by social workers practising within the context of social work in Wales. However, these issues are not exclusive to Wales and can be applied to other contexts; for example, the issue of language sensitivity forms an important part of the context for any social work practice. This workbook should be used as an introduction to social work processes. You are encouraged to use the bibliography and suggested reading to explore many of the ideas and themes further.

Workbook Aims

The workbook aims to develop your knowledge and understanding of the process of social work within an anti-discriminatory and systematic framework

Learning Outcomes

By the end of the workbook it is expected that you will be able to

Social Work Processes

Working with people can often seem a very nebulous activity. The complexity and diversity of some of the issues that service users and their families often face can challenge even the most experienced of practitioners. Faced with having to manage these tensions it is not surprising that social workers sometimes have problems identifying where to begin. Social work has often been criticised for being vague and woolly. Adopting a systematic approach helps social workers avoid getting ‘lost in the situation’ and becoming vague and woolly (Thompson 1996, Milner and O’Byrne 1998, Coulshead and Orme, 1998).

A systematic approach is an approach that breaks down a seemingly unwieldy whole into its component parts so that the various parts are then better understood and negotiated. The end result of dealing with a large task in a systematic way is that in the end the whole is achieved more comfortably and in an orderly fashion. To use an analogy- turning an overgrown patch of ground into something resembling a nice summer garden can seem daunting even to the best motivated of gardeners. However approaching the work in a systematic manner can assist in the overall project. In terms of the analogy, a systematic approach to gardening might involve:

Alternatively students returning to higher education may find writing an assignment very daunting. However by approaching the task in a systematic manner the task is made more manageable. Systematic students might

Most readers will therefore be familiar with the process of approaching tasks in a systematic manner, and will be aware of the advantages of doing this in that it makes a large and seemingly impossible task more possible and manageable. Milner and O’Byrne (1998) however strike a note of caution in respect of attempts at the neat packaging of such a complex task as working with people. They suggest that human service work is increasingly being turned into a technical activity in which the worker follows strict guidelines, procedures, frameworks for assessment and competence based systems. Milner and O’Bryne (1998) argue that at its extreme this can be at the cost of a proper focus on the ethical and values based principles that should underpin working with people.

Whilst a systematic approach can be criticised, there are undoubted advantages in adopting such an approach. Firstly, for service users it should create a greater transparency. For social workers and other professionals involved it should promote greater clarity in multi-disciplinary practice because in a systematic approach roles are agreed and tasks are allocated according to a formalised plan. A systematic process therefore brings a degree of coherence to work, as it lessens ambiguity and confusion. A systematic approach serves to order and manage change, it promotes clearer, more honest working relationship and is in general evaluated more positively by service users than less structured approaches (Bonta 1998). In addition, research into effectiveness has shown that interventions with clear aims and objectives have more successful outcomes than less clearly defined and structured approaches to working (Vennard 1996).

A systematic approach must recognise however that working with people cannot always follow a neat linear process (Milner and O’Byrne 1998, Thompson 1996). Changes in circumstances or new information may necessitate a reassessment of a particular case. An over reliance on a linear process could prevent new information from being assimilated appropriately

Several models for systematic practice have been suggested. Pincus and Minahan (1972) suggest a systematic approach based on scientific principles. They suggest that workers should approach the task of intervening in people’s lives in a scientific way. In their model, working with people consists of:

Pincus and Minahan (1972) describe the process of working with people in a very medical way, with the worker undertaking a detailed assessment before prescribing the appropriate intervention. Sutton (1994) suggested that workers should undertake a systematic approach with the acronym ‘ASPIRE’ in mind.

The acronym refers to the stages of

AS assessment

P Planning

I Implementation

RE reviewing

Similarly Thompson (1998) promotes a systematic model that involves assessment

intervention, review, termination and evaluation. The model is presented in a diagrammatic form that stresses the iterative nature of his model:

 

Assessment

Intervention

Review

Termination

Evaluation

(Thompson 1998, p.305)

In this workbook the Social Work Process will be discussed as a process comprising of the following eight stages:

Evaluation Access, Referral and allocation

Ending

Initial Contact

Review

Information gathering

Planning

Assessment/ Risk Assessment

Our systematic model is represented by a circle to draw attention to the importance of seamlessness in practice, the different stages can often overlap and interact with each other across the circle.

Each stage in the Social Work Process will be discussed separately and the key issues pertinent to the stage will be outlined and explored. However, the foundation for effective social work practice begins with the need to adopt and incorporate an anti-discriminatory perspective.

Anti-Discriminatory Practice

Since the late 1980’s there has been an increasing awareness of the impact of oppression and discrimination on clients and communities (Thompson, 2001, Brown, 1998, Langdan and Day, 1992). Over the past decade anti-discriminatory practice has emerged as a major focus underpinning social work policy, theory and practice. Thus, for social workers in training, and those already in practice there is a need to develop and maintain an understanding of why an anti-discriminatory practice approach is important and the ways in which we can work at countering discrimination and oppression. As citizens in a multicultural society with many different aspects of diversity, we will bring to our learning and our practice a wide range of differing experiences. Gender, class, language, age, ethnic group, amongst other social factors, have combined in influencing and shaping our own social identity, understanding and experience of the world that we live in.

Talking about discrimination and addressing issues of oppression can raise many challenges and provoke many questions for us. As Pugh (1996) highlights: "anti-discriminatory practice confronts all of us with knowledge about our more or less favoured positions in society" (p.119).

The comments below illustrate some of the initial thoughts, or responses that social care professionals might have when beginning to think about oppression and discrimination

Each of these statements will now be discussed further:

Statement One: But I am not prejudiced! Some of my best friends are gay/black!

It is hoped and expected that social workers would not be intentionally prejudiced. Indeed part of the motivation and determination that you may have in choosing a career in social work may be because you have seen or directly experienced some of the inequality and injustice that exists in our society. We need to explore the way in which discrimination operates to gain a greater understanding of how we, as ‘products’ of our society, are likely to have been influenced by society’s prejudices. Having gay, or black friends is not proof of a lack of prejudice. Thompson (2001) provides a useful tool in his PCS analysis model to explain the complex nature of how inequalities and discrimination operates and affects the lives of individuals, groups and communities.

Thompson’s PCS Model identifies three interlinking levels that reinforce discrimination and oppression within society, these are:

P = PERSONAL: Personal or psychological: An Individual’s thoughts, feelings, attitudes and actions.

C = CULTURAL: Our shared ways of seeing, thinking, comic humour, shared values, and conformity to social norms.

S = STRUCTURAL: Structural, network of social divisions, institutional.

If we use the example of sexuality to explain these different levels, on a personal level a social worker within a team is returning from a late call out for the Emergency Duty Team. She asks her colleague to not call her out again that evening as she has guests for dinner. It is already 7.30pm so her colleague in an attempt to be good humoured says "I hope that your husband is a good cook!". To which the social worker replies "Partner, and actually my partner is another woman!". The worker had not intentionally been discriminatory, but our world is often basically understood in terms of what we see to be the ‘norm’. There are dangers in that in that ‘norm’ is often interpreted as normal. However, assuming the world in heterosexist terms potentially excludes the real and lived experience of at least 10% of the population who are gay or lesbian. On a cultural basis, if we look at the media and consider the extent to which gay people and couples are either invisible or misrepresented within television we have an understanding of the subtle messages that are culturally reinforced. Then finally on a structural basis, there are a number of ways in which either on an organisational, institutional or legal basis that gay or lesbian people and/or couples are discriminated against. Although new adoption legislation is due to be revised, until recently gay couples were unable to jointly adopt a child. Similarly there has been much dismay at the continuing Section 28 legislation (Local Government Act 1988), which states that a local authority shall not intentionally promote homosexuality or publish material with the intention of promoting it.

 

Exercise

Based on Thompson’s PCS model, think of another aspect of diversity and identify how discrimination is reinforced at the different level

PCS Model

Statement Two: I know all about oppression because I am a woman

Everybody is a member of a variety of different social groups; we may belong to different groups, some of which may come into conflict with one another. Being a woman does not in itself make women experts on what it is like for all women. Indeed, traditional feminism has come under much criticism for ignoring black women’s issues and interpreting the world from a white middle class perspective Thus, a black female client may prefer and think that she has more in common with a black male worker, than a white female one. .

Statement Three: What if I say the wrong thing? I can’t cope with all this political correctness!

There has at times been much confusion and misunderstanding around issues of anti-discriminatory practice, and particularly what is understood as political correctness. The effect of this has been two fold:

The use of language is particularly important. As Pugh has argued, language is much more than a means of expression, but is the ‘product and carrier of social culture’ (1992). Language can be seen as both reflecting and reinforcing inequality (Thompson, 1998). This has been particularly evident in the way in which language has often reflected the world in masculine terms (for example, chairman, policeman, and so forth.) It is important to not feel too worried about ‘saying the wrong thing’, otherwise you will find yourself not contributing, or saying anything at all. Remember, though that we will all inevitably make mistakes, but it is what we do with those ‘mistakes’ that counts. Countering discrimination is an integral part of reflective practice and we need to continually reflect on our practice and consider the way in which it may be seen and experienced as discriminatory.

Exercise

Think of the many different groups that you are part of (class, ethnic, linguistic, political, family, social and so on).

How important are each of these groups to you?

What does it mean to you to belong to each of them?

Consider what your identity or role within each group is?

Does this create any conflict between the groups and your role?,

ACCESS, REFERRAL AND ALLOCATION

There are a number of important factors that need exploration before any contact between a service user and a social service agency occurs. Accessing information about services is fundamental to ensuring all people within the community know about services provided and how to access them. Important considerations include:

How services are advertised? Are leaflets available bilingually? Are their leaflets in other languages (ie other community languages commonly spoke within the area). Are leaflets available in other forms such as on tape, or in larger print for people with hearing loss or those who have visual impairment?

How welcoming is the reception? What messages are given by the appearance and planning of the reception area. English only leaflets and posters can be interpreted by service users as ‘No welsh spoken here!’; in the same way that other material might reinforce ideas and stereotypes about ethnicity, gender and sexuality.

Where services are advertised? Leaflets and posters in social services reception areas are only useful for people who know where the office is and already have some idea already about what social services do?

 

Exercise Developing an Information Strategy List as many potential venues where social services should advertise what they do (leaflets and posters). Remember that there are limited resources so try and prioritise your information strategy and link it to specific client groups. If you wish choose a specific client group and plan a strategy for getting information to this specific group

Unless accessing services is planned and provided within an anti-discriminatory framework at the pre-contact stage, then any attempts to operationalise social work on anti-oppressive principles is likely to fail before it has even began.

Use the following case study to explore issues relating to referrals and allocations. At this point readers are referred to Scene Two of the video that accompanies this workbook. This scene involves a supervision session between a newly qualified worker and their Team Leader. Watch the video scene carefully- to the point just after the Social Worker has been allocated the case and the young people begin to discuss their experiences of meeting their social worker.

 

Video Trigger 2:: Allocation- the case is allocated What issues arise in relation to the allocation of this case? How important is language, should attention be paid for instance to class/race or gender issues during allocation or is language the most important factor. ?

 

Commentary

A number of issues arise in relation to the allocation of the case of Mrs Jones and Mrs

Mair Williams, not least of all the discriminatory attitude and action of the manager about language and age. The mangers uses phrases such as "taffs" and "coming out of the woodwork" which suggests he holds some prejudice about Welsh speaking clients. The worker puts up some arguments against her taking the case, but appears powerless to challenge the manager. There may be a number of other issues that you have picked up from this scenario, ie issues of gender and power. It could also be argued that the fact that the hypothetical department has only one Welsh speaking member of staff is an example of discrimination at an organisational and planning level. To enable effective provision of services organisations should be working towards ensuring that the language resources of staff meet the language needs of the community (ie if 50% of the local population are bilingual Welsh speakers, and the organisation only employs 10%, there is clearly going to be significant constraints on how, and to whom the organisation can provide a service to). The assumption that ‘They All speak English Anyway" has been highlighted by Davies (1994, 2001). This argument is being put forward by the manager, who is ignoring some of the key issues about language choice. Traditionally many bilingual service users have not received a service in the language of their choice for a variety of reasons that will be explored in the following section – The Welsh Language in Context. In addition, whilst the manager recognises that there is a policy of allocating Welsh speakers to Welsh speaking staff, this "policy" is being ignored. This may give rise to several issues in relation to how tokenistic anti-discriminatory and anti-oppressive policies can be at times. The allocation of this case gives rise to a number of ancillary considerations, which you might wish to consider in light of the issues highlighted in the values workbook accompanying this workbook. Parallel issues arise in relation to allocation procedures in general. If Mrs Jones were black for instance, would allocating a black worker be more important than allocating a welsh speaking one?, and similarly are there gender related issues which should be as, or even more important when making allocation decisions? The fundamental issue in exploring these questions is does a social worker have to reflect the same identities of the service users to be able to understand and work effectively with them? Is this so for every case? If not what are the key skills and qualities that social workers need?

The Welsh Language in Context

As a result of the1536 and 1542 Acts of Union Wales became part of England ruled by the English monarchy. The use of the Welsh language in the public sphere in Wales was prohibited. This remained the case well into the late 20th century. The1847 report on the state of education in Wales- (a report often termed the treason of the blue books) highlighted the attitudes towards the welsh language and its speakers:

"The Welsh language is a vast drawback to Wales and a manifold barrier to the moral progress and commercial prosperity of the people. It is not easy to over- estimate its evil effects" (Report known as Brad y Llyrau Gleision: The Treason of the Blue Books, cited in Davies, 1994)

The English language was promoted as the only "proper" medium of communication within Wales. It is therefore, not surprising to find that the 1870 Education Act- the act that established the principle of universal education for all, made no reference to the teaching of the Welsh language at all. In addition to the invisibilisation of the Welsh language, more direct and practices were employed to further stigmatise the language and its speakers. In schools, where the use of the Welsh language was also prohibited, the " Welsh Not" was used. This involved hanging a wooden plaque inscribed with the letter ‘WN’ around a child caught speaking Welsh. This then passed to the next child caught speaking Welsh until whoever had the ‘WN’ at the end of the day would be beaten.

The campaigning work of the Welsh Language Society in the 1970’s has lead to significant changes in attitudes towards the Welsh language and Welsh speakers. There have also been legislative changes, the passing of the first Language Act in 1967, then a subsequent act in 1993. The later act was intended to put the Welsh language on an equal footing with the English language in Wales. However, the exact wording of the Welsh Language Act 1993 remains unambitious in that Welsh was to be equal with English as far as it is…"appropriate under the circumstances and is reasonably practicable". In addition the act applied only to the public sphere, the private and voluntary sectors were omitted from having to provide a bilingual service. As a result of these limitations, there has been a growing campaign for a new Welsh Language Act, which fully equalises the status of Welsh language with that of English language in Wales across all provisions.

Language is not just a means of communication it is also the system by which a person constructs their identity and their understanding of the world. As Pugh explains " language is the bridge that links us to the social world, but more than that it constructs identity through its use; in one sense we find out and create who we are through language" (Pugh, 1996, p.40). Effective communication is an essential component in the delivery of good professional practice in social work (Lishman, 1994). A Welsh speaker is likely to have a much more confidence and to be able to more effectively express themselves in their ‘first’ language as opposed to their second or learnt language. There are times when bilingual speakers struggle to find an equivalent word that fits both there languages, at times it is impossible. For example the word ‘hireath’ has a meaning in Welsh that many people would argue has no comparable meaning, or translation into English (its nearest translation would be ‘a desperate longing for’).

The way in which language reflects meaning and constructs relationships can be illustrated in the use of the words "chi" and "ti" in Welsh- words which are equivalent to the words "vous" and tu" in French. "Chi" and "vous" refer to the formal you, whereas "tu" and "ti" refer to the informal you. These are examples of cultural and linguistic rules about which word you should use and when. Using "vous" or "chi" establishes a relationship with the other person, which is far more formal than would be the case if "tu" or "ti" was used. The informal addresses are most often used with children or people who we are familiar with, the formal address are reserved for the more formal, or respectful addresses. Older people could interpret the use of "ti" as disrespectful, in the same way that they may prefer to be called by their formal second name (ie Mrs Jones), rather than Mair.

In modern Wales the legacy of the past continues and discrimination and oppression of the welsh language still exists. Whilst there is significant regional variation, despite the 1993 Welsh Language Act, Welsh often continues to be given secondary status. The fact that it was excluded from public administration for over 400 years has meant that it developed as a language of informal rather than formal communication. The Welsh Language therefore largely developed as an informal means of communication within the closer communities, a language traditionally associated as being the language of the hearth (home) and chapel. Pugh suggests that " the most remarkable feature of this language is its continued existence, a testament to the tenacity of language and an indicator of the significance that language can have for an oppressed group" (1994, p.432).

There is less of a strong history of the Welsh language being used, or being expected to be used in formal settings, Welsh speakers may not expect or demand a service in Welsh. The historical suppression of the language and negative representations of the Welsh language and its speakers as inferior, continues to have an impact and Welsh speakers are often reluctant to "make a fuss" , or be seen as awkward by requesting a Welsh speaking service.

At this point readers are directed to the next video section featuring young people discussing their thoughts and feelings about meeting their social worker for the first time. This is followed by a scene involving the social worker going to visit Mrs Jones at her home. Watch this section of the video and discuss the following questions:

 

Video Trigger 3: Young people talk about meeting their social worker for the first time and the social worker visits Mrs Jones at home. How easy was it for Mrs Jones to express her wishes to the social worker How might Mrs Jones and the social worker feel if she had asked for a Welsh speaking social worker.

Commentary

It is important to consider how Mrs Jones felt when approached by the social worker on her doorstep. An offer is made for a bilingual officer but to fully understand the nature of social work in a Welsh context it is vital that the conversation between Mrs Jones and the social worker is placed in the preceding historical and political context. In relation to Mrs Jones, she may not specifically request a Welsh service either because she genuinely does not mind- which may be the case or because:

being awkward

At this point it will be necessary to view again the comments of the young people about meeting their social worker for the first time. View this section of the video again and consider the question below:

 

Video Trigger 3 -: The young people’s comments revisited based on the young people’s comments about initial decisions, consider the key aspects of good practice in working with young people and indeed all client groups.

 

Commentary

Much of the young people’s comments relate to pre-contact concerns and having some power to decide how and where they will meet. A social worker who does not allow a person to have some say in deciding when and where a contact will take place is unlikely to be laying strong foundations for future involvement.

INITIAL CONTACT

In relation to initial meetings Coulshed and Orme (2000) identify four aims, these are:

  1. To exchange information- note the word exchange
  2. To secure a treatment alliance- working in a manner so that the dis-empowered become more powerful
  3. To convey a sense of hopefulness
  4. To demonstrate to the service user some of the ways in which the worker and the service work
  5. Clearly however a fifth aim must be

  6. Identifying the "problem" or focus for future contact.

Exercise

Consider what issues need to be considered in Planning an initial meeting (e.g. what information do you need from the referral, can you find out any more information?)

Arranging the meeting place (ie where, when should it be? What are the advantages and disadvantages of a home visit)

 

 

Commentary

The following is by no means comprehensive but these are some of the issues we identified. In planning an initial meeting the social worker would need to consider

In arranging the meeting place the social worker would also need to consider

Exercise

What expectations and images do members of the public have about Social Services and social workers? What fears and anxieties might they have?

Commentary

Social workers are still seen by many as powerful and unpredictable (Coulshead and Orme1998). General fears about social workers are often reinforced by media representations of the profession and centre around some of the following ideas and assumptions:

Exercise Choose one aspect of diversity based on one of the following potential client groups (or a group you identify yourselves- this could be people that you are currently working with, or worked with on placement)

Welsh speakers, Black People, People with a Disability, Lesbians, Gay Men Care Leavers, Young Offenders, People with mental health problems, People with a learning disability, Drug users…..

  1. What stereotypes exist in relation to this group? The use of language can often reinforce ideas and images about people. How does discriminatory language describe your chosen group (ie what abusive terms, phrases or ‘jokes’ describe this group)?
  2. What effect does such stereotypes and language likely to have on the service user individually and collectively as a group?
  3. What fears might this group have about approaching social services?
  4. How might you adopt an anti-oppressive approach to address some of these issues?

Commentary

You are likely to have identified many issues dependent on your chosen group. Did the number of abusive phrases and terms surprise you? The above exercise should have helped you to begin to explore ideas about discrimination and its impact. However, it is important to not focus solely on one particular aspect of diversity. Often people experience multiple forms of oppression, a person’s social location is made up of many aspects of their identity (ie their class, age, sex, race, gender, language, sexuality and so on The experience of a black working class young offender living in Brixton, is likely to be very different than a black middle class ‘professional’ Newsreader living in Chiswick). Lena Dominelli (1998) describes this as double jeopardy.

A number of key factors that potentially increase peoples fears and anxieties about approaching social services are explored below in relation to welsh people and speakers, black people, people with a disability, people who are lesbian or gay.

Welsh People and Welsh Speakers

People who live in smaller communities may be concerned about their visibility, gossip may spread quickly if somebody sees going into social services office, or a social worker is seen calling their house. Users may be concerned about whether they will be able to get a service in Welsh and how they might be seen if they ask for a Welsh speaker. Service users could feel awkward asking and the result could be concerns about making oneself understood. The issue of sensitivity to the Welsh language is often considered to be important only in certain parts of Wales. As the 1991 census figures below show however- significant numbers of Welsh speakers reside in part of Wales that are traditionally considered less Welsh speaking e.g. Glamorgan. The consequences of this is that there are still a large number of people for whom a welsh language provision may be important in these areas albeit their visibility may be less.

Area

Population

As percentage of whole population

Clwyd

71,405

18.2%

Gwynedd

138,413

61%

Powys

22,871

20.2%

Glamorgan

130,000

9%

Dyfed

144,988

43.7%

Elaine Davies (1994) identifies 5 core principles underpinning anti-oppressive practice in Wales:

(Davies, 1994, p.60)

It is important to realise that non-Welsh speaking practitioners are often in positions where they can actively promote linguistically sensitive practice as much as their welsh speaking colleagues. Being sensitive to language is not an issue just for Welsh speaking practitioners in the same way that challenging racism, or sexism is not just an issue for black people, or women.

Black people

Black people may often be hesitant about approaching services for a variety of reasons. Some of these issues might be worries or concerns that their immigration status will be questioned, when it is more likely that they are second or third generations Black Welsh, or Black British (Modood, 1997) Based on their previous experiences of racism they may feel uncomfortable about approaching services - How they will be received? How can I make myself understood (ie they don’t speak my language)? What will happen to them next? What will people think of me and my family – (service providers and people within their own community)? Are there any services that will meet their specific needs anyway? How much will it cost? Services for black people have also often been based on misconceptions and some taken for granted assumptions ie "They all look after their own don’t they? (SSI 1998).

People with a Disability

Issues of accessibility are often fundamental for people with a disability. For example: Does the office have a ramp rather than steps? Are their interview rooms accessible for wheelchair users? Is information available in large print? Are sign language interpreters available? How will I be treated when I get there? Will I be treated like a child? Access and information services need to be designed and developed to ensure people with a disability are able to receive the information and advice that they may need, but that more essentially this is in a way that does not leave them feeling further stigmatised and marginalized.

People who are Gay or Lesbian

People who are gay or lesbian also have fears about approaching social services. ‘Heterosexism’ is often assumed as the norm – for example social workers may assume that a person’s partner is a person of the opposite sex, or that if an older female couple are living together this is because it is convenient and they are friends or sisters. People who are gay or lesbian may have concerns that their relationships will be either ignored, or not acknowledged as an important part of their lives in the same way that heterosexual relationships are acknowledged. They may worry that services are not designed to cater appropriately and sensitively for their needs (ie is there a double bedroom (with a double bed) available for two older men, or two older women? Other issues about records and confidentiality for people who have not shared their sexuality within their family or friendship groups- are also significant particularly in smaller communities and concern over having to "come out" yet again comparative stranger and how they might react.

Values, Attitudes and Anti-Discriminatory Practice

All of the issues explored above relate to issues of values, attitudes and anti- discriminatory practice. When a service user does finally meet their social worker-the social worker needs to be especially aware of how their own values and attitudes might affect the way they interact with a service user. As stated by CCETSW, one of the main requirements for newly qualified social workers is that they have been able to demonstrate "The Values Requirements" for practice. The first of these values requirements states that…

"In order to achieve the award of the Dip.SW, students must demonstrate in meeting the core competences that they: Identify and question their own values and prejudices, and their implications for practice;"

(CCETSW 1991paper 30 p.14)

The Care Council for Wales replaced CCETSW Cymru in October 2001 and is currently revising the requirements of what will become a three-year degree qualification; however the significance of values will remain fundamental. In relation to Mrs Jones it would be vital for the social worker to explore what stereotypes exist for them in relation to Welsh people? Older People? and Women?

Active Listening and Empathy

Meeting service users and attempting to offer assistance or attempting to empower someone to achieve his or her own ends is not a passive process that anyone can do. It involves the careful development of specific skills in communicating and engaging with people. Two specific but generically important skills are

  1. Being genuinely empathetic
  2. Actively listening

1. Being Genuinely Empathetic

According to the Oxford English Dictionary empathy is the power of identifying oneself mentally with a person or object.

"Empathy is a continuing process whereby the counsellor lays aside her own way of experiencing and perceiving reality, preferring to sense and respond to the experiences and perceptions of her client. This sensing may be intense and enduring with the counsellor actually experiencing her client’s thoughts and feelings as powerfully as if they had originated in herself" (Mearns and Thorne 1988, p39)

However, ‘empathy’ is not unproblematic. As Trevithick explains being empathetic "describes an attempt to put ourselves in another person’s place, in the hope that we can feel and understand another person’s emotions, thought, actions and motives (2000,p.81). Although Prins (1986) warns of the dangers of trying to gain too close an understanding of dangerous and bizarre behaviour (in such instances it is truly dangerous to try to enter a world of deeply disturbed thoughts and feelings) in relation to much of social work practice, empathy remains a core skill. In attending to the service users’ emotional, physical and spiritual needs social workers enhance and promote the development of effective personal relationships and assist service users to identify their own thoughts and feelings accurately. Practitioners demonstrate empathy by perceiving and responding to clients’ feelings with sensitivity and understanding. This demands of the worker considerable skills in relation to active listening and genuiness, and forms a central component to establishing rapport and developing service user's confidence in our personal and professional integrity

2. Active Listening

Active listening is the skill of showing concern and giving verbal and non-verbal feedback to demonstrate involvement in the others’ narrative. Active listening involves the following

Giving your full attention to the person Sitting squarely Having an open body posture Leaning slightly forward The use of appropriate and sensitive eye contact Having a relaxed (though not too relaxed) demeanour Use of affirming nods Smiling Semi-verbal prompts The use of humms Being aware of non verbal communication Using a third ear- to pick up recurrent themes, gaps, sudden changes of topic

Actively listening and showing empathy are by no means easy skills albeit to a certain extent all people will be familiar with their basic deployment. Smith (1986) in discussing listening skills and in particular poor listeners, alerts us to key features of poor listening and divides poor listeners into 3 categories

 

Pretend listeners- not really listening, they just know some of the movements

Limiting listeners- they are hearing what is being said but not totally listening to how it is being said, when, is it being repeated, what are the themes? Good listening is about more than hearing it is about listening on several levels- emotionally, verbally, linguistically

Self-centred listeners- whose own needs are inadequately met so only things relevant to them are heard

In the next video clip- scene two, Mrs Jones has managed to assert her rights and been allocated to a Welsh speaking social worker who has invited her into the office for a meeting.

Video Trigger 4 & 5 -: The young people talk about meeting their social worker and the new social worker meets Mrs Jones. Consider the following:

  1. To what extent does the social worker demonstrate active listening skills and use of empathy.
  2. How could the social worker have improved their listening skills? What issues might arise in relation to cross-cultural interviews?

 

Commentary

The social workers use of active listening and empathic skills are quite limited though some examples are evident. A good introduction by the social worker supported by an open body posture. The worker correctly identifies the clients nervous state and offers reassurance in case Mrs Jones was nervous on account of being seen coming to social services or worried that it was a sign of personal failings. The interview is progressing well but the interruption occasioned by the ringing of the workers mobile phone is especially distracting and insufficient time has been allocated to the meeting. The worker is far better at active listening than offering empathy- there are no comments recognising how the service user is feeling other than her initial nervousness in coming to the office. In relation to communicating with service users it is interesting to consider the work of Argyle (1975) According to Argyle (1975) people rely far more on non-verbal cues than verbal cues to assess how committed a person is to their concerns. Argyle also noted that if verbal and non-verbal cues are in conflict, people rely on the non-verbal cues a lot more. Because non-verbal signals are often only slightly conscious to us- the issue of addressing pre-existing prejudice is all the more important if appropriate care and concern is to be transmitted on both the verbal and non-verbal level during an interview. In all our communication and contact with service users it is vital that we are conscious of our own professional jargon and avoid using it. The Social Services Inspectorate in 1991 conducted a survey entitled "Getting the Message Across". They circulated a questionnaire listing a number of words used within social work to service users and asked them what they thought they meant. The meanings given by service users (outlined below), whilst in one sense humorous, contain poignant messages about how many of the words and their meanings which we commonly use and take for granted within our own professional language; have a very different interpretation and meaning for service users.

Voluntary agencies - people with no experience/ volunteers

Maintain- mixed it up with maintenance from court

Sensitive- tender and sore

Encompass- a way of finding directions

Agencies- second hand clothes shops

Common- cheap and nasty

Eligibility- a good marriage catch

Allocation process- being offered re-housing

Function- a wedding do

Format- you wipe your feet on it at the front door

Gender- most did not know this word

Criteria- most did not know this word

Equitable manner-did not know this term Networks- no one had heard of this word Advocacy- some thought it was a court proceeding that occurred if they did not agree with assessment.

The avoidance of jargon is especially relevant when providing a service in Welsh as it has already been noted, the language has primarily developed along informal lines, and generally the Welsh speaking population is unlikely to be fully confident with formal technical Welsh terms. This is not to state that the use of technical terms should not be encouraged, but to state that in the context of a social work interview it is vital for the service user to follow, that which is being proposed.

In relation to cross cultural communication and language sensitivity, Thompson states "language...plays a significant part in the construction and maintenance of discriminatory and oppressive forms of practice" (Thompson 2001, p32). The way in which language reflects and constructs existing forms of power and dominance has been well documented by a number of feminist writers (Spender, 1998, Cameron, 1990, Coates 1993), in the way that language often reflects the world in masculine terms, i.e. ‘chairman’ is a common example. Similarly, as Thompson (1998) highlights the use of the word "penetration" as opposed to "encapsulation" to describe sexual intercourse constructs the sexual act and the world in masculine terms. Language can create and reinforce an able bodied world by the use of idioms such as "making great strides", "walking tall" "stand on you own too feet" "stand up for yourself". (Keith 1989).

Another potential and significant barrier to effective communication is the way in which an Anglo-centric frame of reference is often unconsciously adopted. Communication style varies from culture to culture. An example is the prominence given to verbal/ non-verbal cues. Ekman, Friesen and Ellsworth (1972) observe the bulk of non-verbal communication is culture bound e.g. looking into eyes is considered a sign of caring and attentiveness in USA and UK, in Native American cultures however it can be rude and intimidating. Also in the USA people often express quite deep personal info quickly, but Native Americans avoid this. Professional social work practice that emphasises distance can also be insensitive. Dubois & Miley (1998) note that Asian service users expect social workers to share personal information as well if a relationship is to flourish. This also is a feature identified by Pugh in relation to rural social work, "social workers in rural areas often find that clients wish to ‘place’ them, that is to establish who they are and where they come from (2000, p.32).

Kochman (1983) reports that in many Western societies peoples talk dispassionately because science and the idea that the truth exists independent of our emotions about it heavily influence the Western mode of thinking. Hence debate is unemotional or cold. This is not true of many cultures where belief and thought and emotion go hand in hand. It is vital therefore for the social worker to understand the nuances of the verbal and non-verbal communication styles of the cultures within which they are working. Failure to develop this understanding is often behind discriminatory practice. The over-diagnosis of schizophrenia and other mental health problems amongst members of ethnic minorities is considered to be at least partly due to misunderstanding the nuances of communication by Western Psychiatrists (Owusu-Bempah & Howitt, 2000)

Video Trigger 4& 5 - The Just us group note what’s important in first contacts At the end of the video clip involving the social workers’ first contact with Mrs Jones, service users make comments in relation to the communication skills social workers need to employ. Consider these messages from young people, based on these comments and your own thoughts and ideas about how you would want to be treated as a service users draw up ‘checklist’ of good practice in communicating and developing an effective professional relationship

 

 

 

 

 

 

 

 

Commentary

Are these young people asking for anything unreasonable? The young people talk about the difficulties they have had making themselves understood and how information is misunderstood. The importance of promoting and continuing to develop an honest and meaningful relationship between worker and service user is essential to all stages of the social work process. Fundamentally, as Trevithick notes "to understand another person, and their world of meaning, we need to start by acknowledging our ignorance of that person and their social world" (2000, p.53).

GATHERING INFORMATION

Styles of questioning

A significant issue in relation to the task of gathering information is that the kind of data or information that is collected is very much shaped by the questions that are asked. The questions we ask are not random, but a selected range of the possible questions in a given situation. As Milner and O’Byrne point out "theory shapes the questioning, which, in turn leads to sets of data being produced because our very questions construct their own answers" (1998, p.53). For example a cognitive theorist may ask one set of questions whilst somebody who describes themselves as more psychoanalytic could ask a whole different set. In any situation hundreds of questions could be asked, however the questions we do end up asking reflect our preferences, ideas and theories.

Taylor and White (2001) identify two broad approaches towards social work which are based on either realist or relativist approaches. According to these authors realists are those who believe..

"that there exists a real world out there, independent of us as knowers, but which can nonetheless come to be known by objective and dispassionate observation of it" (2000, p. 40).

Kvale (1996) describes realists as miners who subscribe to the mining approach in working with service users

"The interviewer digs nuggets of data or meaning out of a subject’s pure experiences, unpolluted by any leading questions" (Kvale 1996 in Taylor and White, 2001 p.40)

The alternative position is held however by a group who are termed as relativists. This group would believe that there is no objective reality that exists independently of the views of the knower. They would argue that because of this it is vital to start the task of social work with the client’s own definition of their situation. Tucson, Smale and Statham comment:

"A worker can either take the role of an expert who, from the outside, understands the service user, the user’s problems and what might be the best option; or she can work alongside the person and other significant people to arrive at a mutual understanding of the problem and negotiate who might do what to help, or who might best influence behaviour seen as undesirable or self-damaging" (2000, p.132).

In light of the realist/ relativist debate there are three approaches to asking questions when gathering information- the questioning, procedural or exchange approach. These approaches represent ideal types, however, it is important to remember that no interview, or contact with a service users, is ever likely to be confined exclusively to the one approach.

Questioning approach – is usually adopted by a social worker that approaches a case with a particularly focused frame of reference whether appropriate or not. The presenting problems are analysed in terms of this frame of reference and the social worker is seen as the expert, ‘diagnosing’ the client’s behaviour and problems. An example of this approach might be a social worker committed to some psychodynamic techniques whose focus is on developmental issues during childhood. The questions asked would reflect this preference and information would be gathered on the developmental stages in an individuals’ lift

Procedural approach- although it is similar to the questioning approach, this approach involves little use of self by social worker. It focuses on the use of a standardised procedure, usually involving a set number and sequence of questions for assessment, or review. Again the worker has the power and dictates the conversation and the questions will usually reflect an overall preconceived understanding, not necessarily explicit, of the issues involved.

Exchange approach- in this approach social worker and service users are seen as having valid perceptions of the problems and issues and work together at possible solutions. An exchange approach is more likely to be encompass an anti-oppressive approach with most service users because it works within the client’s own frame of reference. Brandon (1991) notes that within the exchange approach neither social worker nor client..

" tries to manipulate the other to win control. Instead they move gently towards sharing information and respect for each other’s position. They are humble, rather than arrogant, aware of what they do not know rather than what they know" (Brandon,1991 in Smale, Tuson, and Statham,2000 p.132)

In the questioning approach there is very much the Dr/Patient type relationship. The relationship between social worker and service user is that of expert to novice with the worker as expert. In the procedural approach the worker is in the role of bureaucrat and there exists a mechanistic relationship. In the exchange approach the client and worker are more equal, the relationship could be described far more as a partnership.

The questions that are asked will vary depending on the relational style adopted by the social worker with the client or service user.

Exercise Consider each of the three approaches described above.

 

  1. For each of these approaches list the advantages and disadvantages from the following perspectives:
    • A service user
    • A social worker
    • The organisation

2. Consider a variety of social work situations (i.e. enquiring about home-care, a child protection investigation, application for a Blue Car badge, working with drug users,..) and state which approach is likely to be the most appropriate and why?

Commentary

Questioning Approach One of the disadvantages with a questioning approach is that it is closed viz new ideas. Certain issues have already been decided and are usually not open to debate. An example is a social worker orientated towards psychodynamic approaches. Information is not received neutrally but rather the worker who interprets it assumes the expert role. It is possible therefore that cross-cultural issues maybe ignored because the whole assessment is to a certain extent pre-judged. It is therefore possible for questioning and a relational style such as this to be experienced negatively and oppressively. The style is unlikely to be conducive to the enabler/ facilitator role more typical of community care tasks.

Advantages exist however in that the approach avoids giving credibility to risky ideas and behaviours e.g. when the starting theory is about morality. For example when working with those who have harmed children the issue of whether it is appropriate to sexually abuse or physically assault children is likely to be one that will be subject to pre-judgement by the worker. The view that it is legitimate behaviour would not be accepted and would probably be tentatively challenged even at an early stage in intervention because leaving matters unchallenged, from the onset can create immediate risks and problems at later stages.

Procedural Approach. A disadvantage of the procedural approach is that it can be experienced as cold and unhelpful, procedures are often based on "norms" so such an approach does not lend itself very well to variation. However to a certain extent it is also true that a procedural approach has the advantage of stopping or reducing bias and error because questions are standardised and to a large extent the questioner is taken out of the equation. Procedural approaches are systematic and from an organisational perspective ensure standardisation.

Exchange Approach. The exchange approach is based on the assumption that a true and frank exchange can take place, - it assumes no power differences, or where they do exist that they can be ignored. The exchange approach is, like the others, based on the presumption that an exchange can take place- however, this is not always the case, for example, a service user experiencing extreme mental health difficulties may be unable to engage in such an exchange. The exchange approach is also very open-ended which opens up the possibility of bias and it is somewhat ‘idealistic’ in a legislative, bureaucratic climate. On the other hand it is a democratic approach in that it allows the knowers to define reality, in doing this it avoids cultural bias and respects self-determination. In the context of community care it might be considered that an exchange approach would best meet the requirements of anti-oppressive practice. It allows the service user a clear voice in the process of social work and recognises how oppressive decisions can be made if only the voice of the worker is heard. In relation to some elements of social work however a questioning approach might be deemed more appropriate. An example of this might be in relation to work with sex offenders or perpetrator’s of domestic violence where the social worker cannot be neutral in their assessment of such damaging and injurious behaviours. A procedural approach- in guaranteeing due process, might be better suited for routine assessments e.g. for Blue Car Badges for people with a disability.

Types of questions

Whatever style of questioning is used the types of questions used will be of equal importance. Experienced questioners have made use of what has become the 5 ‘wh’s’ approach to questioning- that is to ask questions which focus on the what, why, when, how, where and who. Kipling (in Hargie 1987) rhymed about these tools in the following manner

I keep six honest serving men

They taught me all I knew

Their names are What and Why and When

And How and Where and Who

(Hargie 1987 p.62)

Caution needs to be exercised with why questions however as they tend to be difficult to answer and can be accusatory in tone. Apart from this Kadushin (1990) describes four other forms of potentially unhelpful questions

  1. Leading or suggestive questions
  2. Too many yes/no questions
  3. Garbled or unclear questions
  4. Double or multiple questions

The value of using open- ended questions is significant for social work practice. Open-ended questions allow service users to explore themes and generally promote dialogue, in comparison closed questions tend to offer a range of ready-made responses based on the theme, or issue chosen by the questioner. For example to ask "Do you like to read books or watch television?" is likely to illicit a ‘yes’ or ‘no’ response, and we remain unclear about whether they like both equally, or just one of these. An open–ended question would ask "What do you like to do in your spare time?" is likely to gain a much fuller response based on the person’s own interests and activities rather than our own assumptions about what people might do in their leisure time.

Managing Silence

In asking questions to gather information a social worker will also need to be able to manage silences. Silences can be experienced as ‘difficult’ and challenging to an inexperienced social worker. Kadushin (1990) notes how professionals tend to be anxious about continued silence and see it as signalling a failing interview:

"It is no surprise then that inexperienced interviewers tend to feel uncomfortable with silences and tend to terminate them prematurely. It takes confidence for the interviewer to let a productive silence continue" (1990, p.87).

Silence does not necessarily indicate the end of an interview, it can mean any, or a combination of the following:

The person has said enough

They are taking time to think

They have remembered something and withdrawn

They have shared difficult material or are about to and need time to reflect

They are feeling angry

They are being resistant

They want to avoid the issue/topic

Silence needs careful interpretation and respect. If we are in touch with the ‘interview’ we will know when it is appropriate to fill or end a period of silence. The longer we work with people, the more confidence we will develop in knowing and understanding their use of silence and so too they will begin to interpret our use of silence.

video clip 6 should be referred to at this point. in this clip the social worker has gone to visit Mrs Jones and her mother at their home and is asking questions in order to conduct an assessment. watch the video scene and then answer the questions below:

 

Video Trigger 6 –: The social worker interviews Mrs Williams

  1. Identify what questioning style does the interviewer adopt?
  2. What types of question are asked?
  3. Would you reframe any of these?

 

Commentary

The social worker asks a series of open questions and seems to adopt a fairly useful "exchange approach" to interviewing Mrs Williams. Mrs Williams is encouraged in her narrative by the social worker’s use of verbal and non-verbal cues. At the beginning of the interview the social worker notes a tendency by Mrs Williams’ daughter Mrs Jones to answer questions for her mother. This can be a feature of all working with vulnerable adults and children. Family and friends maybe so concerned about getting their message across that they take over the conversation and answer on the service user’s behalf. Here the social worker attempts to ensure that Mrs Williams is given an opportunity to speak for herself by asking Mrs Jones to make some tea. By doing this, the social worker is seeking to empower Mrs Williams and ensure that the assessment is based on her needs, potentially as well as considering other family needs.

Directing questions

Whatever questioning/ interviewing model is favoured however- it is probably important for the social worker to have in mind the kind of people that could be approached for information. In terms of social work theory it might be useful to consider from a systems approach which systems influence a particular case. To explore information gathering further consider the exercise below

Exercise : Jane Jones (46) is in a relationship with Gwyn Roberts (33). They have been Together for 12 years and have three children Joni (8) Iwan (5) and Josh (1). This family have come to your attention due to an anonymous phone call saying the children were being neglected because the mother was always drinking. On checking service files you find a referral was made about the children 2 years ago from the school- at that time there were concerns about Joni’s behavioural and emotional development arising out of his withdrawn and seemingly depressed nature in school. At that time enquiries were made but following a home visit where the children were found to be well cared for and happy, the case was closed. You make a home visit to the family home. Jane Jones is in when you call and happy for you to come in. The children again seem happy and content, Gwyn Roberts is not in however- he is at work away- you learn he is a road Engineer and works away quite a bit. Jane Jones assures you everything is ok and although there have been occasions when she has been drunk, and says she does not have a problem and the issue is neighbours who resent the fact they are from England. The children seem to you to be happy enough. Where could you get information from to initially assess this situation? What rules would guide your approaches to sources outside of the family?

Commentary

A range of agencies and individuals could be contacted for information, but the manner in which this is done is important. As part of the requirements under the Data Protection Act (1998) service users should be aware and consent to you contacting other agencies that they might be involved with (i.e. Health - GP, Health Visitor, CPN, drugs worker, Education- school teacher, Police etc). Agreement should always be attempted. Only in circumstances where there is a likelihood of significant harm to self or others can the need to obtain consent be overrode.

Exercise : Returning to the case of Mrs Williams

  1. Where might you go for further information?
  2. How should this be pursued, if at all?

 

Commentary

Clearly a number of sources could be approached- GP, neighbours- but in this case, given the remit of the role and meeting- it may not be appropriate to go beyond Mrs Williams and Mrs Jones. Nevertheless, this might change if Mrs Williams showed signs of being abused or mistreated. The importance of protecting ‘vulnerable adults’ is increasingly being addressed by local authorities who are now likely to have an equivalent set of procedures for managing ‘adult abuse’, as has been long established in child protection.

ASSESSING

Assessment is the gathering together of all the available information and the drawing of tentative conclusions. Social work assessments vary and can assess a wide range of circumstances and events for example:

The ability of parents to care – A Children and Families Social worker

A person’s mental health state – An Approved Social Worker

The ability to live independently- Community Care Social Worker

The likelihood of re-offending – A Youth Offending Officer, or Probation Officer

In general all assessment assess "needs" be they protection, health, care or criminogenic respectively in the above cases Braye and Preston Shoot (1995) highlight how the community care system ignores how difficulties are caused by structural deficiencies in the system. They suggest that an emphasis on individual needs masks common social needs and obscures the problems that arise for groups of people from the operation of social norms and policies. It is vital therefore that a full assessment takes account not only of people’s individual needs but also of some of the forces that have given rise to some of the needs. For example the National Assessment Framework (NafW 2000) for assessing children in need seeks to address three domains

A Child’s Developmental Needs

Parenting Capacity

Family and Environmental Factors

The inclusion of the later domain is seen as particularly significant in locating families within the context of wider environmental factors

Exercise

Think of a situation where you, or your family might be assessed by a social worker:

  1. What kind of general needs would you want the social worker to address their assessment?
  2. How would you like the assessment to be carried out? (i.e. what information do you want from the social worker, how do you want them to relate to you)

Commentary

You’d probably want to : 

Know why the social worker was there and the purpose of the assessment

Feel that you are being listened to

Be seen not solely in terms of your ‘need’ or problem

Feel that the social worker was aware of your strengths- what you can do

Be able to express your views and be shown respect and treated like an adult

Be treated in a sympathetic, friendly manner

Not be seen as a ‘failure’ and personally responsible for all your problems

Feel that the social worker has some understanding of the stresses there have been in your life.

As discussed in the section on initial contact, being ‘in need’ still has many negative connotations. In Western societies any form of dependency is still considered a negative thing and this perception might be considered an inevitable consequence of the philosophy of self-determination and individualisation- issues that can be explored further in the values workbook A holistic understanding of the needs of an individual is at the core of good assessment practice. A "needs led" approach is a very specific form of assessment which assesses what the client needs as opposed to fitting clients into existing resources. To explain further consider John’s needs in a case where he is constantly truanting from school and his social worker and family are at their ‘wits end’. A resource based assessment might conclude that John’s needs are to attend school (as this is the established resource for providing education). However, a needs based assessment would identify that what John needs is an education. Attending school is one way of addressing this need, but potentially this need could be met in a variety of different ways (i.e. home tuition, early admission to a college etc..) Similarly if Mrs Jones cannot get upstairs to bed as she has lost mobility her needs are not for a chair lift and frame, but rather for the ability to get to bed or toilet, needs which might be addressed in many ways other than a chair lift or frame. Needs based assessments differ from resource led assessments in that they are far more creative, participative, and less closed in defining solutions to issues of concern.

Bradshaw (1972) identifies 4 types of need that could exist in a given situation:

Felt Needs- anything a person feels they need

Expressed Needs -what people are prepared to say they need- similar to wants, felt needs may not be expressed

Normative Needs- defined by experts against a standard

Comparative Needs- relative to others also defined by experts

In order to explore these different types of needs, consider the case example below and answer the questions that follow.

Exercise

Mr Conway is 83 years old. He was admitted to hospital recently with a urinary infection that has now been treated. He had been referred to the hospital’s social workers because he feels he will find it difficult to manage at home. The consultant wants Mr Conway discharged quickly so that other patients may use his bed. Mr Conway’s wife died 6 months ago, so that he now lives on his own. A married daughter (Ms Brown) lives nearby and had visited him two or three times a week to help with cleaning and shopping. She is separated from her husband and is experiencing some strain in managing her full-time job and running a home with 3 teenage children. She has only one brother who lives in Canada. Ms Brown has told the hospital social worker that it would be better if her father went into a residential home. She is concerned that he is at risk to himself at home, because he has had several falls and tends to let saucepans or kettles boil dry on his stove.

Mr Conway has said that he would prefer to go home but reluctantly acknowledges that it may be better for his daughter’s sake if he went into residential care. His main friends are a couple living next door. They have told Ms Brown that he could manage at home physically but has recently seemed depressed, lacking concentration and interest in himself. As Mr Conway’s social worker you are aware that your department has a policy not to provide home care if the cost is likely to be over a specified limit. In such instances service users are required to enter residential care. You are aware however that some older people have been able to remain at home with home care paid partly by your department and partly by the service user. You are concerned that Mr Conway will suffer however as he has no private funds.

In light of the work of Bradshaw:

  1. Identify the different needs that are evident?
  2. Which of these needs should be responded to?

 

Commentary

In undertaking an assessment there will have to be some agreement as to which needs are going to be met. Are all felt needs going to be met or just expressed needs? Similarly should needs be defined in normative or comparative terms. Felt and expressed needs are client led but comparative or normative needs are professionally defined- in such a situation the question is which definition ought to take precedent?

There are complications to adopting an assessment process that responds solely to felt or expressed needs. These can arise because there are considerations other than the service user there are political considerations about what should be given to whom and when there are resource issues which require decisions about prioritising needs and deciding which needs should be met and by whom. Hence whilst in the context of social work assessment can be needs led, it is rarely needs determined, and whilst it can be User led is cannot necessarily be user determined. Accordingly in the practitioner’s guide to the Community Care Act para 3.35 it states  "ultimately…having weighed the views of all parties, including his/her own observation, the assessing practitioner is responsible for defining the user’s needs"

Where to begin with a needs assessment?

Maslow (1952) proposed that there was a hierarchy of needs, which each person had to navigate. He categorized human needs as follows

Self-actualisation needs

Esteem needs

Belonging and love needs

Safety needs

Physiological needs

Maslow argued that lower order needs are dominant until satisfied- a point that has some intuitive support if you consider food. Only when the needs had been met could the individual reach their full potential and be self-actualised. He was one of the first writers to analyse human needs and to relate the meeting of needs to human growth and development. Nonetheless his work is open to contradiction in that it is not necessary to meet the needs in a sequential order to fully self-actualise, as witnessed by artists starving for their art.

Towle (1965) identifies four types of needs:

Physical needs

Emotional and developmental needs

Contact/social needs

Spiritual needs

All of which need to be met for full participatory existence. In order to explore these four types of needs further the assessment scene with Mrs Williams should be watched again and the questions below explored.

Video trigger 6 – re watch this scene: the assessment interview with Mrs Jones and Mrs Williams.

 

Considering the work of Maslow and Towle- what needs are evident in Mrs Williams case?

Commentary

The social worker rightly assesses some of the needs in this case, ensuring from the outset that Mrs Williams is able to express her own needs. Several needs emerge from this conversation- such as

-to be able to go to the toilet -to have housebound and social mobility - to have social contact -a number of physical issues that relate to health needs

Need is defined in the Practitioners Guide to the Community Care Act as shorthand for

"the requirements of individuals to enable them to achieve, maintain or restore an acceptable level of social independence or quality of life, as defined by the particular care agency or authority"

The standard used is therefore of the "normative" type identified by Bradshaw’s typology. Therefore although many organisations state that the focus of assessment is the service users own needs, there is an acknowledgement that the needs of others are as, or even more, important at times (e.g. in probation practice it could be argued that it is societies needs which are paramount- the need to be protected from harm and re- offending, even if the service user disagrees). In social work there are normative needs that outweigh individual claims or felt needs. In the case of Mrs Williams, normative factors will influence which of the needs that are identified will be responded to and what form that response will take.

The emphasis on assessment as a process rather than a one off event has been noted by Challis and Davies (cited in Milner and O’Byrne, 1998). In their study of assessment decisions they found that there was a likelihood that new information was interpreted to accommodate existing assessments and the only time cases seemed to be re-assessed was when a new worker took over a case. Otherwise new potentially dis-confirming evidence was often ignored or re-interpreted by workers with the common reaction being to state that the existing assessment was correct, but just that it needed time to work.

Risk Assessment

Risk assessment has acquired an importance over the past two decades for three main reasons:

Kemshall define risk as "the chance or probability that an undesired event, behaviour or action will result" (Kemshall, 1997 p.102)

It is important to remember that taking risks can be positive and a risk free life would stifle enjoyment (e.g. going on a plane, or even getting out of bed in the morning ). We all take risks and we develop and grow as a result of taking risks, embarking on a Social Work Course is potentially risky for a variety of reasons. Risks can take many forms- they can be physical, psychological, social, financial or sexual.

Exercise Consider an activity, venture that you are thinking of embarking on (i.e. moving house, changing jobs, moving in with someone, having laser treatment on your eyes, starting IVF treatment..)

  1. List the potential risks?
  2. Identify the category they come under (physical, psychological, social, sexual, and financial)?
  3. How likely are they to happen?

  4. What do you ‘risk’ by not taking the risk?

As the exercise above should illustrate issues of risk are a complex and unavoidable part of everyday living. Curtailing someone’s right to take risks or intervening to address issues relating to risk raises complex ethical issues in social work. As this can often be in conflict with one of the core social work values ‘self-determination’.

However social workers may have to act on perceived risks and seek further information without the client’s consent, or engage in compulsory interventions in either one of three situations:

When there is a clear risk of significant harm to others.

When there is loss or restriction of insight and risks are identified

When we have a duty of care, and or protection and risks are identified

The concept of risk comprises two elements. These are the likelihood of a negative event occurring and the degree of harm that would result. If the two issues of likelihood of harm and degree of harm were to be plotted- the following matrix would be produced-

On each criteria for intervention the greater the likelihood or degree of harm the more likely that intervention will be required.

High

likelihood


Low/Low degree of harm High

The probabilities produced in each quadrant refer to the probability that some form of intervention will be required to manage risks.

Risk assessment is the process for assessing the likelihood that a future (usually) harmful event will occur and the degree of harm that would result . Based on the assessment an intervention strategy or risk management plan might then be devised.

There are three recognised ways of assessing risk- they are the clinical, actuarial and anaclastic approaches.

CLINICAL

A clinical approach is based on personal intuition, experience and skills. The worker uses their own acquired knowledge to assess the risks in a particular situation

Monahan (1992) have reported extensively on the fallibility of risk assessment in this manner. They have conducted a number of risk assessment exercises, one famously with a number of professions were it was found that those doing risk assessment on a daily basis were less likely to predict risks from case studies than those less experienced in formal assessments. Clinical judgement has also been called into disrepute as a result of what became know as the Baxtrom cases in the USA. The Baxtrom patients were people kept in secure settings in 1960’s America because they were deemed too dangerous to be released. When an appeal court decision led to their almost immediate release, follow up studies found a very low incidence of negative outcomes, suggesting that the original risk assessments had been very wrong.  Whilst this does not suggest that good risk assessments cannot be useful, it highlights the tendency for clinical judgements to over predict risk than to under predict risk. This has obvious ramifications in terms of self-determination and civil liberties.

ACTUARIAL

In the case of actuarial assessment- information is gathered on a subject or situation and then this information is compared with previous experience and research to produce a statistical rating of the likelihood that the case is similar to previous cases. Such approaches are very much in vogue in the insurance industry where individual driver’s insurance premiums are calculated based on risk factors such as age, gender and driving record, etc. Actuarial approaches have the advantage of being more neutral than clinical approaches, they are less open to individual interpretation or bias. Regardless of who interviews a person, the assessment of risk should be the same. The disadvantage of such an approach is that even if the situation led to a high statistical risk prediction, say 90%- the score has more group than individual validity as a score of 90% cannot tell you whether the individual in front of you is one of the risky 90%, or the safe 10%.

ANACLASTIC

The third approach is called the anaclastic approach and it combines actuarial and clinical judgement. An actuarial score is used to guide rather than dictate judgement, with clinical assessment being retained but informed by statistical evidence. Bonta (1994) found that anaclastic assessments can assess risk better than clinical or actuarial data alone.

In making risk assessments Brearley (1982) suggests 5 steps be undertaken

Identify everyone involved

Be specific about risks

What are the hazards? (what are the existing factors that introduce or increase the possibility of an undesirable outcome, and the level of harm)

What are the strengths? (what factors reduces the possibility or likelihood of harm and the level of harm)

What don’t you know?

Exercise Refer back to the case of Mrs Williams and her daughter Mrs Jones. Using the Brearly framework identify what risks if any exist in this situation, and how you would go about addressing these issues.

 

Commentary

The risks in this case might be considered less immediate than a child protection incident. There are some physical risks associated with Mrs Williams being alone in the house but the real risks seem more related to the psychological long-term well being of Mrs Williams, Mrs Jones and the wider family.

Meetings. Conducting needs and risk assessments might often involve convening meetings with more people present than just the service user and the social worker. Often a multi- disciplinary meeting will be required in order to pool information more effectively and share the decision-making and planning process. In the following video scene the young people’s group "Just us" talk about meeting their social workers. Watch this video and consider what is said about meetings

 

Video Trigger 7 What issues and themes emerge for social workers from listening to these service Users

 

You are likely to identify a number of key themes involving issues of power and participation.

PLANNING

Any intervention will be unfocussed and unclear without a plan. A plan is a written statement identifying the objectives and goals for a specified period, it forms an agreement between service user’s, their families, practitioners and any other significant people involved . The plan will outline the identified needs and establish how the needs will be met and by whom. In statutory settings a plan is often referred to as a Care Plan. In many circumstances a number of different people (both within the family and practitioners) will be responsible for a variety of different aspects of the ‘Care Plan. Social Workers often play a key role as co-ordinators of the care plan, by overseeing the plan and continually reviewing its effectiveness in meeting the service users needs. It is unlikely that a care plan can addresses all the needs that might be identified in any one case, or often any needs to everybody’s maximum satisfaction. Unmet needs should also be recorded within any plan. This is essential both on an individual and an organisational basis, as it seeks to highlights areas for future planning and provision; particularly with regard to issues of anti-discriminatory practice. It is vital that workers and users are creative in exploring plans to address needs and do not try to fit people into existing services. Social workers creativity and flexibility may often be constrained when as care managers they have limited power to purchase services outside an approved list of services and providers. Nevertheless, ‘Direct Payment’ options are beginning to be increasingly used and offer service users the potential to be more in charge of developing their own creative care packages. Care planning, however, involves planning

What is to be done

When it is to be done

How it will be done

Who is responsible for doing it.

It involves consideration of the following

Aims- a broad statement of intent

Objectives- a specific action statement of what you want to have achieved

Inputs- a description of the resources you will use, or are available- this involves considering the systems involved that could be called upon

Process- a statement of how the resources will be used and when they will be reviewed

Outputs- what you expect to happen

Outcomes- the impact you expect this to have

Aims….….objectives……..inputs……..process……..outputs……..outcomes

A good plan therefore involves consideration of all of these issues and in a good plan the objective and output will be the same. Two examples of plans are presented below using the format outlined. One is for a summer garden, the other is a plan to help an offender avoid re-offending.

Example 1 After completing the first year of your social work course you want to catch up on work you haven’t done in the garden and have somewhere to enjoy and relax in

Aim: To have a pleasant summer garden

Objectives: To plant a display of bulbs and daffodils by Wednesday

Inputs: Bulbs, fertiliser, water, time, effort, money

Process: Drive to local gardening shop on Saturday morning and select and buy bulbs, Sunday/ Monday- prepare ground, Monday evening- put bulbs in ground, water and feed. Then wait

Outputs: Bulbs planted, psychological contentment

Outcome: Daffodils and tulips, compliments from neighbours, somewhere pleasant to sit

Example 2 -John is an offender with a drink problem that has been assessed as being directly related to his offending

Aim: to help John stay offence free

Objective: To reduce John’s alcohol consumption by 30-50% within the next 3 months

Input: A weekly programme of individual work for John, sessions to be 1hour per week, to be delivered by the case worker plus a referral interview with the specialist alcohol agency

Process: John to catch bus to office every Thursday for 6pm group. John

will then engage in cognitive behavioral work on gains and losses of alcohol use for John and learn the necessary coping skills in order to reduce his dependency.

Output: John’s compliance with the programme expectations including attendance each week and the completion of given tasks. John’s drinking to have reduced by 30-50% within 3 months.

Outcome: No known re-offending during this 3-month period. John is happier and not in jail. Office statistics look good!

A key part of effective planning is that the agreed objectives are identified as SMART Specific Measurable Appropriate Realistic Time orientated

In order to explore the planning process and the objective setting process further consider the exercise below:

Exercise Identify an issue that you want to address. It could be to exercise more, diet/ eat Less, walk the dog more. Set out a plan of action using the key terms of: aims, objectives, inputs, process, outputs, outcomes, making especially sure that the objectives set are SMART objectives.

Commentary

A common problem is that objectives are not smart enough and can be made smarter by refining them. It is important to consider whether the objective you have set could be even smarter. As well as setting SMART objectives it is vital that the process to meet the objectives is as clear as possible. Both case examples outline the process clearly however, the process can often be broken down further into more manageable steps. These could form the basis for sub-objectives of the main objectives. The following example demonstrates this where each stage of the process could have been seen as separate mini objectives

Client’s name: Mr Jones

Date: 6.6.01 Mr Jones can walk unsteadily and is very sociable but is afraid of going out walking since a fall.

 

Aim: Mr Jones to go out a lot more

Objective: By the end of the intervention Mr Jones wants to be able to

        1. go to the local spar shop unaided twice a week
        2. Meet Friends in the pub twice a week

Input: volunteer, one journey out of the house every day by Mr Jones

Process:

1st Step: Mr Jones will go to the Spar shop accompanied by his helper, Sarah, and then return home.

2nd Step: Mr Jones will go to the Spar shop accompanied by his helper, Sarah, and return home on his own with a little shopping, to be met there by Sarah.

3rd Step: Mr Jones will meet his helper. Sarah, half way to the Spar shop. She will then accompany him the rest of the way. After buying his shopping Mr Jones will return home, unaccompanied, to be met there by Sarah.

4th Step: Mr. Jones will walk unaccompanied to the Spar shop and meet Sarah there. After doing his shopping she will accompany him to the club next door. He will meet his friend there and have a game of dominoes. They will return home together.

5th Step: Mr. Jones will go to the Spar shop unaccompanied and do a little shopping. He will then go unaccompanied to the British Legion and meet Sarah and his friend there. After a game of dominoes he will go home with his friend.

6th Step: Mr. Jones will go unaccompanied to the Spar shop and get some shopping. Afterwards, he will go unaccompanied to the British Legion and meet his friend there for a game of dominoes. Afterwards he will make his way home. Sarah will pop around later to see if everything went well.

7th step: Mr. Jones will go unaccompanied to the Spar shop and get some shopping. Afterwards, he will go unaccompanied to the British Legion and meet his friend there for a game of dominoes. Afterwards he will make his way home.

Output: Mr. Jones able to walk to shop and to British legion unaided twice a week Outcome: Mr Jones is happier and more confident in his walking.

Exercise Looking at the issues you identified in the previous exercise- identify the process you need to undergo to achieve your own SMART objectives.

 

 

Commentary

You should go through your smart objectives making sure that each objective could be quantified in terms of being specific, measurable, achievable, realistic and time limited. Ask yourselves the following questions in relation to each of your objectives: S - is this objective as specific as I can make it?

M - how will I measure it? - "I will know when I have achieved the objective when…" is it possible to reach the objective,

A - is it achievable?

R - is the objective a realistic one for me?

T - have you set a time limit on the objective?

Key value principles should underpin the planning process. These principles are considered at some length in the Values workbook accompanying this workbook. These key principles are

Partnership and Empowerment

Respect for self-determination- (subject to risk considerations)

Minimum intervention

 

In respect of any plan of action social action is important. Although it could be argued that a social action approach is not easily accommodated within the statutory social services definitions of care the practitioner’s guide to the Community Care Act also makes clear that the individuals needs are to be seen in their proper social contexts

 

In order to consider matters relating to planning further, watch the video section relating to the planning process and answer the questions that follow

Video Trigger 8: Watch the video section entitled "planning" where the social worker and Mrs Williams and Mrs Jones plan for the future.

  1. What do you notice with regards to how the care plan is negotiated and targets set?
  2. Is the process of planning followed- if not where might improvements be made?

Commentary

In this case the social worker systematically works through needs, empowering the client to devise solutions to their issues and state their preferences, rather than imposing his own preferences and solutions. He keeps a mind on cost, resources and service constraints and offers his own knowledge when appropriate. However, there is a lack of clarity in making the objectives SMART in relation to how they will proceed over the next few weeks.

REVIEWING

Reviewing intervention is an essential part of ensuring that we are monitoring and

checking that we are on course and as such forms part of systematic practice:

Although reviewing is often associated with meetings, there are a number of other ways in which reviewing occurs, for example:

You might want to take some time to go through one of your case files to review developments over the past few weeks, or months.

Review can also be a discussion in supervision with a Practice Teacher.

Review should also be an integral part of any dialogue/discussions with service users about the services that they receive or need

In this way review should be seen as an evaluation of everyday practice, something that is being done continually. There are key times when we should think about reviewing, some of these are:

When there appears to be a significant change, for example a carer becomes

ill, or has to go into hospital

When it is thought that a service is no longer needed we need to clarify and agree this through a review

As part of a legal/statutory requirement, for example children who are looked after should have regular reviews at specific times

When feeling like we are stuck- you might be feeling that nothing is getting better , or that services haven’t helped

When transferring a case to another worker, (as student social workers on placement you will have to transfer cases before your placement finishes)

When there is disagreement between either professionals involved and the service user or their family

In order to consider the issues relating to reviewing further- watch video scene 10 entitled "reviewing" and consider the questions that follow

Video Trigger 9: The Social Worker and Mrs Williams and Mrs Jones review

  1. Try to identity examples of good practice in the reviewing of services for Mrs Jones?
  2. Can you identify anything within this review that could be improved?
  3. Who else would it have been useful to invite to this review?

Commentary

The social worker allows the service users to describe their experiences of the service they have received and to make observations as to any changes they would like to make. The social worker does not automatically inform the service users that the changes will occur, instead he agrees to pass on their concerns and see what he can do to enable the changes to happen. However, the social workers potentially breaches confidentiality when he refers to other people that the care workers see before coming to Mrs Williams’ home. The importance of confidentiality is discussed at some length in the Values Workbook. In addition to this, by describing the care assistants using the term "girls" the social worker is using discriminatory language.

ENDINGS

Endings are important because so many service users have experienced painful, abrupt and sometimes traumatising endings in the past. Providing a good ending gives an opportunity for a person to work through issues to do with endings, moving on and saying ‘goodbye’.

Shulman (1984) has identified several processes in the endings, which are similar to the bereavement process

Denial Anger Sadness Depression Resolution

Endings should be planned and prepared for from the beginning and should not be as devastating or traumatic as bereavement often can be. For example one social work student working with a young person who had experienced many changes in carers and social workers, helped the child to realise where they were up to by drawing a picture of two people in a boat, they set off from one island and were rowing to another – each week the boat nearer to the other island and waiting at the island was a new social worker.

Ford and Jones (1987) consider there to be four main tasks to be completed at endings

Ways of preparing for endings involve extending time between contact visits and or decreasing the time spent on such visits. It is good practice to have a planned date to work towards and when transferring a case to introduce the new worker at least once.

Video Trigger 10: The Manger puts pressure on the social worker to close the case

Consider the scenario where the social worker is meeting the manager in respect of closing the case of Mrs Williams, in what ways are the manager requests inappropriate?

Commentary

The manager is clearly putting pressure on the social worker to close the case. The worker resists the pressure but at the end is the one to lose out having to take on even more cases. Again the manager appears to lack understanding and sensitivity towards Welsh speaking service users. Dominelli (1995) refers to ‘Dumping’ as one the of the tactics that can be used to avoid dealing with discrimination, this is evident in this case. Dumping occurs when one person is identified as having responsibility for addressing oppressive practice instead of the issue being seen as a team issue. The result is that the worker is professionally compromised, he feels unable to close the case, and under pressure to take on more work. A team and wider organisational response to this issue might lead to more sustainable anti-oppressive practice by trying to ensure that new appointments have a Welsh-speaking requirement. Although, this is recognisably not always so easy to put into practice, as there is a shortage of social workers in general; nevertheless, at an organisational level such issues need addressing.

 

Video Trigger 11 At the end of the video- ‘Just Us’ offer guidance to social workers: They are the answers given when young people who have had contact with social services were asked to finish the sentences beginning: "Social workers should…" "Social workers shouldn’t…" After watching this section of the video:

  1. Consider what themes emerge in relation to social work processes and values?
  2. What ‘kind’ of social worker do you want to be?
  3. What might be some of the barriers that are likely to get in the way of this?

EVALUATION

Evaluation, is the often neglected final stage of social work processes. Evaluation can be a social workers own reflection and evaluation of their work, but it also involves consultation, information gathering and research about service user’s experience about the quality, effectiveness and range of services provided. It is a vital way of clarifying our effectiveness from a service user’s perspective and should help us gain a greater understanding of ‘what works’. Thus, enabling organisations to direct their resources into the services that are likely to be the most effective and well received. As Thompson notes " evaluation involves examining our practice and so that we can learn from our mistakes and build on our successes" (1998, p.304)

When does it occur?

As an ongoing process: Evaluation can be an on-going process, social workers often in quite an informal way gather service user’s views about the services they receive. Such on-going consultation is important as it means that changes that can be implemented that will directly benefit the service user whilst they are still receiving a service.

When services have terminated: The information that is gained from service user’s who no longer receive a service, is particularly valuable for two reasons. Firstly, it can provide an overview that encompasses the whole ‘process’ from initial contact to the end of social work involvement. Secondly, and perhaps more significantly, service user’s who are no longer receiving a service will feel free to give ‘honest’ answers. For example asking parents whose children are on the Child Protection Register what they think of the services whilst their children’s names are still on the Register is likely to gain one of two responses. They may worry or feel that being ‘honest’ and providing criticisms about the department will effect the outcome of whether their children remain on the Register. Or they may be ‘locked’ into what can only be a traumatic experience and not be able to rationalise any of the situation very clearly.

What does it involve?

Evaluation can take many different forms, including the following,

Informal feedback to social workers about services (service users will often make such comments with out social workers needing to illicit this).

Questionnaires

Focus Groups

Informal feedback is important because it is often spontaneous and ‘honest’, though this will to some extent depend on the relationship established between the social worker and the service user. However, without clear processes for such information to be disseminated and acted upon ‘informal’ feedback can often get lost. Thus, processes for the gathering of formal feedback (i.e. through questionnaires and ‘focus groups’) are particularly important.

Good Practice in Evaluation

Evaluation is a form of ‘research’, and as such a number of key value based and ethical considerations need to be addressed. In undertaking any evaluation you need to be conscious of and address some of the following issues:

Differences in Power: Acknowledge power differences in any evaluation from the onset. Pro-actively encourage ‘user participation’ and ownership in evaluation projects from the onset. This can involve social workers ‘letting go’ of some of their power and control and ‘sharing’ the research agenda. By ‘letting’ service users decide what the research focuses on and getting them to devise the questions, we are more likely gain information about what service user’s think is important from the beginning.

Representatives: Ensure that a user’s perspective is gained form all users, and potential users. There is often a danger that we only seek the views of the most accessible user’s, and potentially leave out important ‘groups’ (ie the homeless, minority language users, service users who are traditionally seen as ‘difficult’). The importance of consultation with potential users is significant, as it can help us look at some of the potential barriers to people using social services. For example if a Family Centre wants to encourage more men to use it, the responses gained from a questionnaire to existing users (predominately female) is not likely to give us as much useful information as actually asking men what might they want from a Family Centre.

Accountability and Reporting back: If we ask people their opinion about our services, then the very least we can do is report back to them and let them know what we found. Evaluation though should go further than this, and if we are going to seek user’s views then we also need to be clear about the extent (often dependent on limited resources) to which there is going to be any change in service delivery as a result of this.

Getting Messages to the top: For organisational change to occur there often needs to be some action taken at management level. Thus, as practitioners committed to effective and meaningful evaluation of service we needs to ensure that there are effective systems for mangers (right up to Directorate level) to ‘hear’ and respond to what service users have to the say. The messages from practitioners at the ‘coal face’ are also important and need an effective route up the management hierarchy.

Exercise : Either

Think of a service user group that you are familiar with and design a questionnaire that seeks their views about the services they receive. You might want to design the questionnaire so that it provide both tick box answers (ie by using yes or no response, or a Likert scale) and some space for them to write their own responses.

OR

Think of a project that is going to be set up (ie a Teenage Parent group, a Toy Library, a Lunch Club) you want to gain an understanding about how best it could meet peoples needs, devise a questionnaire to distribute to potential users

REFLECTIVE PRACTICE

Utilising knowledge gained in academic learning and learning through practice is important because within social care practitioners often face unique and challenging

Situations. No academic course could ever hope to cover all the possible scenarios a practitioner might face, nor transfer every possible piece of knowledge that may be required. Academic learning is useful in knowing how to deal with these situations, but practitioners also need to be able to apply and refine skills in order to further their professional expertise. Therefore it is argued in this workbook that neither knowledge nor experience are enough on their own. Practitioners need the skills to apply learning and to learn from experience in the workplace as their careers develop.

One way in which such learning can take place is through reflective practice. In the context of professional education reflection has a specific meaning, relating to a deliberate process of thinking about experience in order to learn from it.

Boud, Keogh and Walker (1985) consider that reflection in the context of learning is a general term for those activities in which individuals explore their experiences in order to lead to new understanding and appreciations.

Boyd and False (1983) suggest that reflective learning is about the process of examining and exploring practice issues in terms of how they impacted on the self and how the practice may have been experienced by and influenced by others. Several educational theorists and philosophers have analysed the processes of reflection in learning (Boud et al 1985, Schon 1992 , Mezirow 1981 , Habermas  1977 and Van Manen 1977). Three key stages can be identified from their writings to make up reflective practice

The first stage of reflective processes is often triggered by an awareness of uncomfortable feelings and thoughts. 

This arises from a realisation that the knowledge, skills or values that were being applied were not sufficient to that unique particular situation. There may be feelings of dissatisfaction, unhappiness, discomfort or uncertainty . In describing the sensation Schon (1992) refers to the ‘experience of surprise’, whilst Boyd and Fales (1983) refer to ‘a sense of inner discomfort’.Reflection is not prompted only by negative states however. 

Often it may be promptedby more positive states, such as a sense of achievement or having done a job well.The second stage of reflection involves a critical analysis of the situation, which isconstructive and includes an examination of both feelings and knowledge of how thesituation has affected the individual and how the individual has affected the situation.It is important to focus upon positive feelings about the experience, and to deal withnegative feelings which could obstruct a rational consideration of the events. 

The knowledge used in that situation needs to be illuminated and importantly this mustinclude academic, moral and personal, as well as empirical knowledge. Sometimes this process can be undertaken in isolation, but also at times it can be undertaken withothers, who can provide more independent feedback upon which the practitioner canreflect further.The third stage is the development of a new perspective on the situation. 

The outcomeof reflection, therefore, is learning. This may include the clarification of an issue, thedevelopment of a new attitude or a new way of thinking about something, theresolution of a problem, a change in behaviour or a decision. The changes may bequite small or large. 

For reflection to make a real difference to practice, it isimportant that the outcome includes a commitment to action. Action is the final stageof the reflective cycle and will result in a changed way of working or thinking about asituation.David Kolb (1984) suggests that reflection is a skill, and because of this, it canbe learnt. Kolb (1984) suggests that reflective practice is the end result of a four stageprocess that he sets out as follows:

  1. Individuals have concrete experiences
  2. During and after the experience individuals observe and reflect upon what is going on or has happened.
  3. As a result of looking (observation) and thinking (reflection) people learn new
  4. general and specific skills, knowledge and attitudes which arise from the situation.

  5. After individuals have developed these ideas and abilities, they start to test the ideas and skills in new situations (Kolb, 1984).

TYPES OF REFLECTION

Schon (1992) distinguishes between two types of reflection; reflection on action and reflection in action

Reflection on action is the retrospective analysis and interpretation of practice in order to uncover the knowledge used and the accompanying feelings within a particular situation. The practitioner may speculate on how the situation might have been handled differently, and what other knowledge would have been helpful.

Reflection on action occurs after the event and therefore contributes to the continuing development of skills, knowledge and future practice.

Reflection in action is the process whereby the practitioner recognises a new situation or problem and thinks about it while still acting. Although the issues may not be exactly the same as on previous occasions, the skilled practitioner is able to select and remix responses from previous experiences, when deciding how to solve a problem in practice.

It is recognised that you need certain attitudes and qualities to learn through reflection. Developing skills for reflection, and using reflection in learning, takes time and energy. Motivation and commitment are therefore essential. Open-mindedness is also necessary to enable the individual to recognise personal biases and to be receptive to new ideas

By adopting a systematic approach within a reflective orientation a practitioner can begin the process of responding to service users in a way which is both personally satisfying and developmental for the worker, and experienced as empowering and effective by the service user.

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