Tag: research

Learning about Learning

This week, on a day off from the full-time work, I took a day back at the university to attend a couple of workshops they set up for postgraduate students. I was wondering beforehand if this had been something of a luxury. Unlike my previous job, I don’t get any days off for study leave (welcome to the NHS!) anymore so all the leave I take is annual leave and I am a bit short on AL this year due to the changes in job where the dates didn’t quite line up.

So despite my reservations about whether it would be better use to sit in a library, I went to the workshops to learn with a mixed group of doctoral and post-doctoral students about learning techniques.

The first session was about speed reading, or as the tutor told us, repeatedly, better reading. He was right. Noone really teaches you how to read effectively after the first few years in primary school unless there is a specific reason or at least, that was my experience.

We started with some fun activities, testing our reading speed and the importance of understanding that memorising (as we did in reading comprehension tests at school) and understanding is vast.

In some ways, I expected a lot of what he said to be obvious, but it really wasn’t. I can say that I have a few more ideas about how I read (and have been reading) and how I can be more effective in reading through information more quickly but also making sure the notes I make about what I read are better (this might be counter intuitive about learning in a class about reading but it is what I took from it).

While I came away eager to practice new techniques, I thought that it was probably, for me, anyway more about reading efficiency than reading speed. How can I get the information I need from a text in the quickest way that ensures I remember and record (if necessary) what I have read. One of the key techniques that I want to practise is about extending my peripheral vision when I read so that I read more ‘at once’. This was something I hadn’t considered before learning about it.

The second half of the day was about mind-mapping. I probably wouldn’t have signed up for it if it hadn’t followed on from the morning because the speed reading was what I had been most interested in.

I’ve tried a bit of mind-mapping, particularly on software (iThoughts if anyone is interested – I’ve tried a few and that’s my favourite) and thought if there is a ‘way’ to mindmap, it might be useful to know. I used it when I wanted to gather my ideas in a different way.

Fortunately, this is how it was presented to us. This isn’t a panacea. It won’t make you cleverer or quicker or more imaginative, but it is a tool that can help with taking notes and recording information in a clearer way. I tend to doodle a lot and make notes with lots of arrows in them, so it could be the method I didn’t realise I wanted. I hadn’t thought of mindmapping to summarise or take notes.

Having attended the course, I’d say that learning from someone who knows, is useful. I have tried any number of mindmaps since the training. The next morning, at work, I arrived and drew my day’s to do list as a mindmap (which I then had to explain to a colleague who was intrigued), it took no longer but it was visually more pleasing – although that is not the point.

What has been more useful were my brief attempts, over the weekend, to link up the speed reading and mindmapping and creating a ‘mindmap’ notes of book chapters and articles. I’ve been able to jot mini-mindmaps after chapters of a book I am reading, (have been trying to speed read!) so I remember what the key points are. I’ve used post-its or pieces of printer paper which I have then popped into the book at the required chapter or scanned and saved with the paper on Mendeley entries. For the first few I’ve done, I’ve written some more conventional notes afterwards, using the mindmaps to test if I have learnt or remembered more or at least, noted down the key useful points and I think it may work as a technique when I need to remember things I have read.

I’m still at the early stages of this. I am mindmapping everything. As we were told though, it’s often about practise and getting better at it. It may not change the way I learn and think in the long run, but it was an enjoyable session that helped me think differently. And I think it helped when I went back to work as well because this isn’t just about helping my learning at university but also at work.

Even if I don’t persist with mind-mapping as a note-taking technique, at least I know a bit more about it and why I would reject it which is a better place to be. As for the speed-reading, I can’t see any situation that won’t be useful so I’m going to continue to practice and if I do get better, I might write up more about the specific techniques. It is good to have a day out from the usual though, particularly if we are able to challenge our own thinking.

Paper Review: Ethical considerations in social work research

Ana M. Sobočan, Teresa Bertotti & Kim Strom-Gottfried (2019) Ethical considerations in social work research, European Journal of Social Work, 22:5, 805-818, DOI: 10.1080/13691457.2018.1544117

Introduction

This is a paper whose aim is to place is looking at the ethics of research through a specific social work lens. What is it that might make social work research and the ethical considerations of it, different from other types of research in other fields. Although there are books devoted specifically to this (Morris, 2006, D’Cruz and Jones, 2013, Hardwick and Worsley 2011 and many others) it is a useful introduction to some of the key tensions and considerations which exist in the field. Not least, for me anyway, because it comes from a perspective of authors from Slovenia, Trento and the United States where most of my reading has been UK-based.

Methodology

In terms of methods, this is more of a piece combining literature relating to research ethics with some of the literature about social work research. Referencing BASW (British Association of Social Work) Code of Ethics and the IFSW (International Federation of Social Workers) Statement of Principles, it pulls apart from of the considerations that make social work research ethics different from research ethics, by adding an additional layer of professional responsibilities and values rather than by removing anything.

It does this with two case study examples illustrating where the values of a social worker as a professional may be at odds with the purity of the research process. In these two examples they are focusing on two particular ‘research values’ and explaining where the conflict could potentially arise.

Context

The examples they give as ‘case study’ type relate to the principle of nonmaleficience. This basically means that the researcher should not cause any harm, obviously not intentionally but unintentionally as well through their research with people. The authors draw on this fundamental principle of bioethics where there may be medical treatments involved and extrapolate to social work where there may be ‘harm’ that isn’t easily identified.

In their example, they refer to research in the field of child protection where there were potentially sensitive issues discussed but the research was around understanding the quality of services delivered from the view of families who received services.

This research was carried out in a focus group and this presented some stresses regarding the role of confidentiality and the use of a group setting where sensitive issues were discussed.

The dilemma identified stemmed from the formation of self-help and support group between people who were the ‘research subjects’ during the focus groups. Should the professional stop these conversations where those who were using services were providing advice and support to each other, talking about how they ‘managed’ poor services and provided useful help within the group? Or should they return the conversation and the group focus to the research questions?

The researcher in question moved the focus back to their research and away from the emergent discussion about how participants may help each other, but the authors leave us with the question about whether this was a misuse of power on the part of the researcher who is also a social worker?

The second case given relates to a social worker/researcher whose roles potentially overlap. On the one hand, the social worker is the ‘agent of change’ but the role as a researcher is to document what is.

In this case, the social worker was researching same-gender parented families. The researcher had personal experiences in this area which is what had led them to the research and in order to aid conversation and discussion, told the participants, so they knew they were speaking to someone who intrinsically supported their families and relationships.

In some conversations, the researcher, on listening to some of the challenges and discrimination faced, was faced with the dilemma of whether they advocate for the families who are ‘research subjects’. Would that change the focus of the research so that some stories became stronger if they were to give a view that might help the family?

These were some of the dilemmas that the authors saw as stemming from the dual role of social work practitioner and researcher.

Key Learning

By presenting case studies, the authors invite us to ask questions about potential ethical dilemmas across social work research, and to explore how these issues may be addressed in writing about social work research, for example, in papers that are published. How do we establish that the research has benefited the participants and social work itself rather than provided a professional stepping stone for the author? This is a useful challenge to reflect on as I make my way through research in the field.

The authors looked at the role of social justice in social work research which had taken place and how often it may have been referenced in studies over the years. They are particularly interested in the role that virtue ethics may play in research with researchers, particularly in social work, exploring their motivations behind the research and ensuring the research is beneficial to participants who are not seen as a means to an end.

The paper asks that universities who train novice researchers from the first steps, engage with ethics by ensuring the language is ethics is central because language feeds attitude.

They present models they have considered about how to review ethical impact, particularly looking at some generic ones which they transpose to a social work framework. The authors then demonstrate how the dilemmas presented in the case studies might work through these frameworks.

Reflection

I enjoyed reading this paper as it was clearly written and easy to follow. I enjoy reading about ethics anyway and placing research ethics within a social work context was immediately useful to me so it may have made my perception of interest stronger.

Some of the issues raised about ethics are specific to research. How do we choose research and subjects? Sometimes this is an individual decision, sometimes it relates to funding availability but it should have a purpose that serves the aims of the profession in terms of growth.

I enjoyed the case study examples as well, they were easy to follow in any context and not specific to social work in a particular area but they made the examples clearer.

Use in Practice

As I am increasingly moving into a different stage of research, this has provided practical contexts for me to reflect on how I design research to ensure that social work principles and standards are embedded in the design from the start, but it is also providing me with a template, through the models given, to review the research but also some of the work we might do on a day to day basis when we try to gather feedback or run QI-type projects, of being aware of any potential harm that may be caused.

It also reminded me of the need to look beyond some of the UK texts I usually turn to and broaden my understanding of professional literature internationally.

Conclusion

This was a useful paper both in terms of research ethics, where it is most relevant but also worth considering some of the points in a more general exploration of social work ethics and how we make decisions about priorities in a work role.

Reflection: On Linking Practice, Research and Writing about It.

After a month or so of writing on this site, after a couple of false starts over the years, I thought I’d reflect a bit on what I’ve learnt through writing and how my research work, day job and additional writing are coming together.

I have tried to develop more of a discipline with the writing. Whether this will see me through the next three years (or so) to completion of my doctorate or not, I don’t know but what I do know is that writing is easy when you are on a roll, but it needs to be a discipline in order to make it a habit. I have never been one for self-help books, especially, but it was a book I read that emphasised the point which, thinking about it, is obvious (which I guess is the same for many self-help books) that to write when you don’t feel like writing, is the toughest part.

It’s also incredibly easy to stop writing. Yes, it’s about creating a habit but it doesn’t always develop naturally through habit and just a day or two of a lapse, makes it much harder to re-start.

I tend to work towards deadlines. One of the hardest things I’ve found about moving to a research aspect of a degree rather than a taught part is the flexibility of deadlines and knowing this in my head. I’ve bought myself (I did this last year as well) an A4 day to view diary with monthly plans at the front and while I’m a big fan of digitalisation, this diary sits on my desk and I make notes about what I have done and am planning to each day. I have the next few months mapped out and whilst that may and is likely to change, I have set myself clear expectations.

My ‘research diary’ as such sits on OneNote but having a paper version allows for other notes and is particularly helpful for setting myself deadlines. The problem with deadlines is the disappointment when you fail to meet them but while trying to build a discipline, I’m also trying not to be too hard on myself.

Along that line, the writing has been on the basis that I will review one paper a week and one book a week. I have deleted one post I published because I was told (and this was correct) that I had fatally misinterpreted an acronym used in the research paper which had completely changed its meaning. This was a very useful lesson to me about assumptions made, on my part and on the part of those who write for us. I am also not sure if I will be able to keep to that pace. I read a lot anyway, and a lot of the books I am reviewing, are books I’ve read over the last few years but having the discipline of trying to write regularly can be helpful, when it doesn’t involve too much pressure. It’s that balance between discipline and self-criticism that one has to walk, especially if you are particularly tired or stressed from work on one day.

While I want to succeed, I often have to prioritise work on a day to day basis and trying not to feel guilty when I spend days doing not-work, not-study things is also a focus.

I write because I want to practice writing. I am not looking at ‘hits’ or developing a loyal readership as I know I am quite selfishly choosing topics which are interesting to me. I choose papers I have found useful, either for my studying or for work. There is a paper that I read recently, that I thought was really poor and a book that I thought didn’t set out what it intended to. Generally, all the papers and books I have written about, I’ve found useful, helpful and well-written. I may need to develop more confidence before confronting the critical although that is a useful skill as well and one I will try to work on.

Often the last few years, I’ve had more division between my part time study and full time work. I had some study days generously granted by my employers and I brought some of the additional reading I had done into the workplace in exchange, including developing some additional mental capacity training which was rolled out. As I moved into a different job, the links are becoming easier to create because I am doing social work and studying about doing social work. It’s not always intrinsically linked because the areas of social work are different (long story) but what it has done is made me far more aware of the breadth of social work and the value in not compartmentalising the profession into ‘mental health’, ‘child protection’, ‘dementia’, ‘learning disabilities’. The ‘social work’ runs deeper and needs to run deeper than the topic. However, it has become more difficult to separate the time between work and study. I’ve had to actively use more leave which has an impact on the time to rest. This, I hope, will improve but it is a worry.

The other area I have become more aware of is the links and divisions between research and practice. Practitioner research happens and is happening. I am evidence of that. But in order for the profession to grow, it needs to happen far more. This isn’t about battle lines drawn between academia and practice. If anything, I have seen those are increasingly unhelpfully divisive, but we need to make space for more conversations and more conversations with the people who aren’t used to having these conversations – about how we can work together and how we can draw in more user and carer voices.

So I will try and continue as far as I can with the writing, as long as it helps me to learn. I keep telling myself that if I stop now, what I have learnt has already been worth the time (and financial) investment. I may move to one review post and one more flexible post, whether it’s posting links, an update on where I am going or how I use the various tools I use (I am currently on my fifth reference manager). Thank you for joining me.

Research in Social Work – January 2020 links (Open or Free Access papers)

When I started writing at the beginning of the year, I thought I’d compile a summary of links each month about news and research, but it became a bit too much to compile, and this is, fundamentally a hobby for me.

So, I’ve decided instead to highlight each month some open access papers that I’ve found useful, interesting or have bookmarked for later, that others might want to read because we all want accessible research information and the more we read, the more we understand what is worth reading. So here are a few for February – they aren’t always new, but they will be new to me!

This paper in Social Work Education (May 2019) looks at how critical reflection is taught in social work courses specifically in relation to working with older people.

This issue (2018) of the British Journal of Learning Disabilities is open access (most aren’t) so is worth browsing and includes (among other interesting ones) this article which is a study on what is it link to move house for people with learning disabilities.

This is a free access review of literature about trauma-informed care in inpatient mental health services (2013) from the International Journal of Mental Health Nursing which is a useful way to get a broader view of the topic at the moment.

On a slightly different tack, Critical Social Policy have an open access article from January 2019 on ‘Raising Critical Consciousness in the struggle against poverty’. Nice of them to make it free! Seriously though, we need to speak about poverty and the impact it has on our work at every level.

And Practice – Social Work in Action, has this article about decision-making of AMHPs which is a useful read from 2019.

Although this is not ‘my’ area of social work, this paper in Qualitative Social Work from December 2019 with birth mothers’ accounts of the impact of the removal of their children on their future lives has impact for all of us in the sector.

This 2017 paper on the role of trustworthiness in social work from Australian Social Work is definitely something I found helpful in my consideration of how we carry out ethical social work.

Paper Review: Human Rights : Its Meaning and Practice in Social Work Field Settings

This post refers to the following paper :

Julie A. Steen, Mary Mann, Nichole Restivo, Shellene Mazany, Reshawna Chapple, Human Rights: Its Meaning and Practice in Social Work Field Settings, Social Work, Volume 62, Issue 1, 1 January 2017, Pages 9–17, https://doi.org/10.1093/sw/sww075

Introduction

As I have covered Australian and British social work papers, I thought I’d turn to the United States with this one and while I have read and learned about human rights in the context of English mental health and mental capacity legislation, the ability to see where the global human rights debate is, was appealing. It has been useful to look at where research is focused in the US where the role of social work has some distinct differences and the cultural context may not be as similar as we sometimes assume.

Context

The research study which was carried out involved interviews with social work students and and ‘field supervisors’ who are experienced social workers as might be obvious, who are supervising students in their initial training placements.

The paper starts with a literature review which covers social work and the role of human rights in social work settings. This has the UN Universal Declaration of Human Rights in 1948 as the starting point but diverges by looking at some of the additional principles to cover, what they describe as ‘population-specific’ conventions including the Convention on the Rights of the Child and Principles for the Older Person which grew up subsequently. There is also reference to some of the work which has linked human rights with social work in a broader context and where human rights practice crosses with social work. This includes the role of advocacy in social work and an interesting distinction between case-based advocacy and cause-based advocacy. There is also reflection on the role of community based social work as human rights in practice.

It was interesting reading through a UK lens where obviously the European Convention of Human Rights doesn’t figure but also where the UK-based literature on human rights and social work would not have been as relevant to the article. This is very much my ‘little England’ view and a literature review is never going to be comprehensive. However, it also introduced me to a broader understanding of human rights, encouraging me to read further and put my focus on UK human rights into a better global perspective.

Methodology

One thing I noticed in this study which was helpful (to me, as a novice researcher) was that the authors explicitly stated their research questions which were

“What means do social work students and their field supervisors attribute to the concept of human rights as it relates to their work in field settings?” and “How do social work students and their field supervisors describe human rights practice in their own agency meetings?”

Having the research questions clearly established helps with appraising the research which takes place and helps understand decisions made regarding research design.

In this case, the authors took a phenomenological approach. These terms can sound like a different language intended to detach academic world but it only means that it is looking at the experiences of people who have them from their viewpoint. It is not an ‘objective’ study but that would not have been unsuitable for the research questions which are asking about how the participants experience and understand human rights in their practice and so phenomenology fits well.

The study was carried out through online questionnaires. Online surveys were sent out to students and supervisors and they were open for responses for two months. There were, in the end, 35 student participants and 48 supervisors. There was a mix of students on different programmes (Batchelors and Masters) and mix of gender and race which was established in the results. The average age of students was 20 and the average age of supervisors was 45. I noted this only because I can’t imagine the average age of UK students would be so low. So another notable difference.

The survey contained a mix of open-ended and structured questions.

Results

The researchers divide the outcomes into seven themes in terms of identification of human rights issues relevant to practice and five themes under which they described their own practice or observation of practice.

In terms of the human rights overlap with social work, the most common theme identified was poverty, in addition to this was discrimination, participation, self-determination, autonomy, violence (right to live free from violence where violence is expanded to mean abuse), dignity, respect, privacy (including confidentiality) and ‘freedom and liberty’.

Poverty identified reflected the resources that link to access to housing and healthcare. This obviously has a different context where healthcare is mostly on an insurance basis but presented another layer of the economic and social human rights which occupy the social justice element of social work and embed social work as a human rights profession.

The interesting point the researchers made about discrimination was that students primarily focussed on discrimination faced by LGBTQ+ groups whereas the supervisors more often referred to cultural competencies and gender based discrimination.

The themes of participation, self-determination and autonomy emphasised the right to have the means to determine ones’ own destiny, including refusing or discounting professional advice.

The group of supervisors who referred to ‘freedom and liberty’ were non-descriptive. It is an interesting expression of a more abstract concept as a right.

In terms of practice and how they saw human rights expressed within the agency there were five themes determined. These were advocacy, service provision, assessment and relationships.

Advocacy was reflected in both individual practice with clients and in terms of challenges within organisations. The researchers distinguish themes of case advocacy versus cause advocacy. Cause advocacy was more heavily emphasised by students. Service provision included areas like psychoeduction and providing direct support to groups of people that had specific needs. I’m not sure of case management as human rights but that might be about my prejudices and understanding of the term rather than the way it is meant by the participants.

Assessment was seen as a human rights engaged activity as a process in order for ‘needs and wishes’ to be met. I think this may be a bit tenuous at best because I prefer ‘conversations about needs’ to ‘assessments’ but that might be my issue with the language. Sometimes, assessments need to be assessments. Do they always lead to resources that are necessary? Perhaps not.

The relationship was interesting as it was presented as being key to human rights in practice including the honesty and transparency of the connection. For the purposes of the paper, treating people with dignity, care and in a way that is free from discrimination were part of the relationship.

Key learning for practice

There were a couple of interesting elements that I took from this paper. It was fascinating to read about human rights from a non-European perspective. It made me itch for more exposure to international research. Struggling to match human rights in principle to work that social workers apply on a day to day level can be a challenge and this research addresses this by asking about both conceptual and practical visions of human rights.

The language of human rights was measured in the research and it can make us think about the language we use in practice. Do we talk about assessments meeting wants and needs or about assessments as processes to be completed? Do we distinguish and action both case and cause advocacy? We might not be able to to both but do we recognise it when we do it.

One of the things I thought I could do as a result of this, was self-audit some of the small actions and conversations I have and records I write in each week, meetings I attend and consider how human rights legislation and principles are enacted in practice.

Reflections and gaps

I enjoyed reading this paper and enjoyed particularly seeing the process of a research project including research questions being described. Of course, the study was based on students and practice supervisors. It would have been interesting to see the outcomes if it had been practitioners at various stages of their careers. The different areas of practice were not also clearly differentiated so it wasn’t clear how many worked with adults or children and in what settings, for example. This might have produced further interesting results. It was a relatively large sample (I thought) and the survey was an interesting way of collecting data, particularly large tracts of data but I wondered about how useful (or different) interviews might have been.

Conclusion

One of the things that struck me (and possibly the authors as well) was the lack of reference to race and discrimination on the basis of race and culture particularly by the students who were interviewed. This was something I wondered about in terms of teaching within social work settings as well. The authors speculate that this might align with gaps in the teaching curriculum although discrimination in the LGBTQI+ community was more heavily referenced by students.

Poverty came up as a strong theme in discussion but in practice it wasn’t always clear how this was challenged and addressed. This is more about where some of the cause advocacy might focus, perhaps.

Book review: Developing Research Questions

This review refers to

White, P. (2017). Developing research questions : a guide for social scientists. 2nd ed. Basingstoke England ; New York: Palgrave Macmillan which is available to buy on Amazon here (non-affiliate link). I was not paid to write this and bought the book myself.

Introduction

This is a book which I picked up quite early in my ‘research journey’ and I picked it up because it was one of a number on a reading list. It was written by Patrick White who is a lecturer in the Department of Sociology at the University of Leicester.

Content

This is a book that is best suited to the beginning of a research project as you start out. It’s focus is entirely the start of the process and how to build both effective research questions but while doing that, identify the key areas to focus on when starting with a topic and trying to narrow it down. As well as focussing on the process of defining a clearly focussed topic with an answerable research question, which is the starting point in terms of the aims of the book, it also covers aspects of this including what a good research question looks and sounds like.

For experienced researchers this is probably more than they need but it helps to clarify some of the confusion which can start at the beginning of a project when you have an idea but want to make from it, questions that are not just interesting but answerable.

When I bought the book, I read through it start to finish, which probably isn’t necessary, but I also tried the suggested exercises as I went, saving my initial thought processes into my research diary to return to and to help me understand and then reflect on my thinking early on in the process.

White gives frequent examples, which are taken from a range of disciplines, about what might make a good research question and the different types of questions one can ‘ask’ or at least, identify in research. It is written very much from a social science perspective and as that is where I am coming from, I’m not sure how translatable it is but it makes sense.

Summary

This is a book very much aimed at novice researchers but it highlights the importance of clarity of purpose in research from the very start in the building of research questions that might well be dipped into from people at different stages of their careers. As well as an explainer of types of questions in the context of research questions specifically, and how ‘answerable’ they need to be, the book covers broader areas around research design and levels of evidence, information required to answer them.

Starting from a premise that literature reviews, lead to identification of areas in need of research in order to justify the research questions being asked, White writes, taking a logical order to offer clarity in the face of what can be an surplus of information and studies and cleverly helps the reader find a path through the jungle of information to read the end goal.

While the focus is clear in the title of the book, there are some excursions into later stages of the project including whether and how one manages to answer the given research questions and use of hypotheses and what ‘counts’ as evidence and linking evidence to claims which can help to answer these questions.

This is a practical text which refers to the answerability of a question which can depend on time, resources and level of research projects. Each chapter ends with exercises and has chapter bibliographies for further reading. Personally, I found the earlier exercises in particularly, helpful in narrowing down some of my initial thoughts.

Key strengths and gaps

I enjoyed this book. The strength was in the narrowness of it’s aim, in a way. I have other books which talk about research processes from start to finish but this was focussed solely on identifying research questions which work. It is a cross disciplinary book which a focus on social sciences and the research methodologies used predominantly in social sciences.

There are some useful conceits introduced, or were for me in any case, including the ‘literature funnel’ which models broad reading across a topic, through a funnel of contemporary issues, debates and findings to establishing a relevant and useable research question.

One of the suggested exercises was to reduce your topic to 140 characters. It can provide focus but it was other similar exercises that allowed me to think about things in different ways.

Of course, many of the issues raised in this book which will very familiar to experienced researchers so this is a book aimed at novices and primarily aimed at novices in universities with access to libraries and wide ranges of reading materials.

The examples given are from across social sciences and some of the exercises might not be useful. I like the key points which were set out at different points and above all, it is clearly written and concise which only works to its benefit.

Use in practice

I’ve mentioned this previously but this was one of the most useful books I found around methodology towards the start of my research. ‘Research questions’ can be frightening and establishing a good mix between pertenant and manageable is not always easy, especially if it is a first time research project. It might be that these are the things you learn early in university careers but if not, I’d recommend finding this book.

As well as clarity of scope and purpose, it has some useful glossaries of research terms which help when learning the different professional language needed to become a researcher. Even if you are not doing the research yourself, some of the exercises and background information about types of questions can be useful in appraising and understanding the research of others and identifying distinguishing research questions in papers that you read to keep up with the subject area in which you are working.

Conclusion

I both enjoyed reading this book and found it useful. It is a short text and it is written with a style that is conversational and therefore not too intimidating. It has provided an additional confidence in understanding what might make research both good and logical. It has definitely helped me along my journey.

Paper review: Health and social care practitioners experiences of assessing mental capacity in a community learning disability team

This paper, authored by Daniel Ratcliff and Melanie Chapman, was published in the British Journal of Learning Disabilities 2016 Vol 44 (4) p329-336

Introduction

This is an article which is very much located outside the ‘social work research’ space although it is occupied with a topic which is very much in our areas of interest, indeed, my own research is focussed on the Mental Capacity Act and ways of assessing it so there may be a tilt towards articles in this area. And this one has been enormously useful.

The premise of the paper is to look at the experiences of different professionals when undertaking the assessment task. It’s interesting to note that the study was undertaken by one practitioner (Ratcliff) and one academic (Chapman) working together. This adds another layer of interest to the paper and its analysis.

Methodology

The study was very much located within the qualitative space, exploring the experiences of eight professionals, from health and social care backgrounds, using semi-structured interviews which were then analysed using thematic network analysis.

All those interviewed worked within a community learning disability team and had done for at least seven years. In terms of professional breakdown, there were three nurses, a physiotherapist, a speech and language therapist and two social workers. All of the team members worked in the same team and had received the same in-house training.

The data, which was the transcribed interviews, was analysed using thematic network analysis. Thematic analysis looks at identifying common themes which emerge from the data and the researchers focussed on networks within the data which linked to the themes identified.

Context

The paper starts with a brief literature review relating to the current situation regarding the use of the Mental Capacity Act (2005) in England and Wales. It identifies, from previous research, that there are known variations in the quality of work around use of the MCA in practice including gaps in knowledge and lack of confidence in implementation of knowledge and that despite training, this had not, seemingly, led to improved practice.

The Mental Capacity Act (2005) while being generally acknowledged as a positive move in legislation relating to those whose capacity to make specific decisions may be doubted, has led to continuing conversations, over 10 years after implementation (which was in 2007) about the lack of embeddiness in health and social care services. The Act is used in all areas of health and social care practice (apart from under 16s) but it has been particularly used relating to adults with cognitive impairments, whether permanent or temporary. In terms of social work practice, this is most commonly identified in work with adults with learning disabilities and work with older adults where deteriorating cognitive functioning may be identified, for example, with some dementias.

Key learning points

The study identified five significant themes which emerged from the thematic analysis of the interviews.

  • Systematic barriers to assessment
  • Capacity assessment as a challenging process
  • Person-specific challenges
  • Protective practices
  • Protection of a fundamental human right

Basically, there were organisational and structural issues in place which might impede quality assessments. This could be about the workload pressure of staff or the ethical tensions between organisational need and outcome of specific assessments, particularly noted around attitudes towards risk

…there was service level pressure to ensure that risks of harm to individuals were limited as far as possible, thereby conflicting with the practice of positive risk taking and allowing capacitious individuals to make unwise decisions.

p332

There was also an expression that a ‘capacity assessment’ could take time and effort to ensure it was carried out in the best way, particularly with involvement of carers. While the legislation explicitly encourages family involvement it can be more challenging when there are differences around the decisions made.

Practitioners raised the challenge of difficult decisions where it was not a straightforward outcome but where there might be a different interpretation, for example, relating to specific decisions.

Participants noted that joint decision-making was helpful and support from other colleagues in thinking through the processes. They also said more specific guidance could be helpful.

There was a general positive response to the impact the MCA had made on practice. It had put into legislation, some of the importance of emphasising the individual and their human rights. There was a feeling it had improved practice and the rights of people who used the services they provided.

The researchers identified a ‘global theme’ which enveloped the data collected as ‘freedom to act versus restrictions on action’. Without understanding more about the coding process, I relate this back to the initial title, which summarises the experiences of those using the MCA in this setting.

Reflections and gaps

The study is acknowledged to be a small-scale study which has taken place within one team where professionals have worked with the same organisation and often with the same people (they have all been in the team for a minimum of seven years). This means there may be a further risk of extrapolating from this data where practises and the culture of the team and organisation may have embedded and reflected on the responses.

Language, attitudes and values can be shaped by the organisation as well as the individual attitude. The study does not reflect (possibly because it is not different and the same size was so small they could be identified) if the professional background of the interviewee was a factor in reflecting the differences.

It is useful to see practitioners directly involved in research, particularly noting the interviews were carried out by the practitioner. It would have been useful, although this might be for a longer piece, to know if he had links to the team in which the research was taking place. It makes no difference to the outcomes, but it an interesting context in which to place the research.

Use in practice

It is good to see an example of research of practice taking place involving a practitioner and academic working together, particularly as the issue is one that can have an impact on the way teams work.

There were a number of issues identified in the study that I can take with me to practice. One is about the usefulness of support. Often this can be looking at supervision and training but the key that this piece draws out is those informal conversations with colleagues, highlighting a need which emerges from the paper, for a consideration of peer groups among professionals. Personally, I’m wondering if there is a scope for multidisciplinary peer groups which a focus on learning from each others’ practice and reflecting on potential improvements in practice together, in my work setting.

Training is necessary for legal literacy but use of training can vary. It is worth considering how understanding and knowledge can be on a continuous basis rather than a snapshot in time. I come back to the peer support groups and wonder whether this is an aspect that can improve.

The paper talks about the need for organisational changes to ensure that there is sufficient time to ensure that work can happen in the best environment. This could be written about any aspect of health and social care and isn’t something we can often change as individuals. There is an aspect about usefulness of templates and examples which might be able to be shared to make the decision-making better informed. Perhaps sharing some model anonymised good practice examples which are referenced with up to date case law and research. Sometimes the time spent searching for new information can be saved if it is well-disseminated.

Conclusion

This is a useful study and a useful paper in all. As someone who has developed an interest both in how the MCA is used and understanding different research methodologies, it has been an interesting piece. The research is clearly explained and the gaps identified.

I think while the literature review is well-presented, the sample size is small but produces some useful content which reflects some of the previous research in the field. The commentary around the piece including the themes identified, in some ways seems more useful than the specific data. It is very useful to see practice-focussed research. I’d like to see more about any differences between professionals and how that links to attitudes to the legislation as well as the experiences of people who have differing levels of post-qualification experience.

Saying that, the paper is useful, particularly as the researchers identify explicitly, the potential use in practice. It does leave us begging a lot of questions for more research in this area though.

Book review: Research and Evaluation for Busy Practitioners : A Time-Saving Guide

This is a review of Research and Evaluation for Busy Practitioners by Helen Kara first published by Policy Press in 2012. I have a copy of the first edition so I have reviewed that but there is a second edition available.

Introduction

This book is written by an independent researcher and writer, Helen Kara, who has written a number of books about research. This book fills a space because it is very much aimed at practitioners who are employed in ‘non-research’ roles, like, well, social workers but by no means only that, who are thinking of starting research and/or evaluation projects in a work setting. Through writing the book, Kara interviewed 20 different professionals who contribute. The writing is interspersed with key ‘advice’ quotations which stand out from the text. I have to say my favourite one was

You don’t have to read the unreadable

p35

Research is useful, doing research is an important professional skill and using research evidence is necessary to stay current in work environments. However, not all research is good research and critical analysis needs to accompany the reading/writing/doing of research, just as it does in practice environments.

Context

The place this books inhibits is partly about a guide to research for non-researchers and partly taking people who are confident and experienced practitioners and putting them in a ‘research’ space.

I found the most useful part of the book was the tone. Often, and I have read a lot of ‘how to research’ and ‘beginning research projects’ books which are entirely aimed at first year undergraduates or at least, early stage postgraduates.

While I have an MA in social work, and for that, I needed to complete a dissertation, it was entirely using secondary data and as part of a qualifying course, research methods and methodology was not emphasised beyond the immediate need and the push to make things as easy as we could for ourselves in getting through the degree programme.

Kara is able to speak to people like me. I am not new to my subject (in this case, social work) but having qualified in 2000, I have not been used to the language of academia. There is a particularly useful glossary at the back of the book which gives very short, one or two sentence definitions for research terms which will be second nature to those within academia but can increase the distance for those on the outside. Often, in many sectors of work, knowing the language and the terms is such a key part of understanding what is being said and how to say things. Finding the common language is key and that’s where I’ve found a lot of this book incredibly useful.

Key points

This book, as the title says, takes the busy practitioner who has a job alongside research, through the process of defining what project it is that will be undertaken, looking for research questions and better defining the tasks and best way of gathering data to answer the questions, gathering the data, including use of interviews, focus groups and quantitative data sources. Then glances through data analysis and dissemination.

These are all the same key points that would be made in many research texts for those who are new to research. What sets this book apart is that it is not aimed at academics or students. There is a useful pragmatism and an acknowledgement that perfect isn’t possible in a messy world with competing priorities. I had never read, for example, the distinction between a document review and a literature review or thought about why designing a research project on the basis of what is most feasible is not a ‘get out of jail free’ card but an entirely legitimate approach.

Kara touches on all the key parts of research, including research ethics and involving people who use services you might be working in including a breezy nod to the importance of being a practitioner in the development of emancipatory research and action research as well as an explanation of the difference between them.

Use in practice

The whole book is very much built about being able to use its contents in practice but for me, the key take-aways, apart from the additional knowledge of research and the language it uses to sometimes create a veil of mystery around the work of researchers, has been a re-stating of the idea that research doesn’t sit in a box distinct from practice. It is a challenge to integrate research into practice until you realise what you are doing anyway is using a lot of research skills, particularly if you are involved in audits and evaluation work.

As practitioners we have interviewing skills, skills to manage groups, skills to discern quality of evidence provided. These are all research skills.

There are some handy practical tips as well, such as managing information, making notes and keep track of references which has been immediately useful. The book also addresses issues such as funding and allowing time (or not) for research alongside work, often full-time.

One of the areas which is probably a bit outside the scope of the book that I think I’d have liked to see more of, was less about the doing research which is very robustly covered and a bit more about using the research evidence in practice and tying research into practice contexts, particularly when there isn’t time or support to carry out full research projects. Some more examples of the small projects which have to run alongside work would be useful.

Saying that, I found this an incredibly useful resource and it is a clearly written text which occupies a gap in the market and as such I’d definitely recommend it.

Summary

This was a book which spoke to me because it catered to a professional, skilful audience who are just not in synch with the language of academia and some of the skills of research. Although one of the key takeaways that I found particularly helpful was the idea that often use the same skills that are needed to undertake research and evaluation, in a work environment but don’t always recognise them as such. We have conversations (interviews.. ), we write assessments (reports), we analyse information which is provided to us and determine the output based on evidence.

Being spoken to, as this book does, as a skilful and knowledgeable professional who just wants to know more about how to do research in a work environment which may not always be supportive, rather than as an 18 year old undergraduate who is at university for the first time, is a great relief.

I have read a number of Kara’s books, which no doubt I will return to at other times but if you fall into the category of ‘wanting to start research but not really sure of some of the things that everyone takes for granted’ this is a perfect place to start. Even in the third year of the studies, I found it a refreshing.

We need research in practice and we need to undertake research in practice. We need to understand the basis of evaluation work and need to speak the language of evaluation and research to thrive in a professional context and this book is a great start.

The book can be bought here (I’ve linked to the second edition on Amazon – this is not an affiliate link – although I may add some later, I will always state explicitly when I use affiliate links).

Paper review: The Mental Health Act Assessment Process and Risk Factors for Compulsory Admission to Psychiatric Hospitals – A Mixed Methods Study

This post refers to ‘The Mental Health Act Assessment Process and Risk Factors for Compulsory Admission to Psychiatric Hospital : A Mixed Methods Study‘ – Wickersham, A, Nairi, S, Jones R and Lloyd-Evans, B. Published in British Journal of Social Work in April 2019.

Introduction

This paper presents a mixed method study using data from mental health act assessments followed by interviews with AMHPs (approved mental health professionals), s12 doctors and some AMHP managers in a focus group.

A Mental Health Act Assessment is a formal process in England and Wales, which relates to the provisions of the 1983 (as amended 2007) Mental Health Act. It is the process by which a person can be compulsorily detained in a hospital which is registered to provide care and treatment. An application for detention is made by an AMHP (who is a social worker, nurse, occupational therapist or clinical psychologist who has received additional specialist training and is approved by the relevant local authority) and it requires the recommendation of two doctors, at least one of whom should be independent (the other can be the treating psychiatrist or can be a GP) and who has preferably received additional training under section 12 of the Mental Health Act.

This process is commonly known a ‘sectioning’ a person.

Methodology

The study is described as ‘mixed methods’ because it integrates elements of quantitative and qualitative research methodologies. The researchers took a range of data from AMHP reports following Mental Health Act Assessments and the information held on electronic databases within the trust to analyse some characteristics and outcomes of people who were assessed under the Mental Health Act within a specific time period. 150 records were analysed, including retrospective case record audits of which 146 were included. The researchers noted that there were fewer, and less complete records for assessments which had not resulted in detention which meant they covered a longer period in order to ensure some were included.

Only assessments which took place in the community were included and anyone who was recalled on a CTO was excluded.

Some of the characteristics identified or used to differentiate included what, if any, diagnosis the person assessed had, whether the reason for assessment was due to concerns about risk of harm to self and/or others and whether a ‘lack of capacity or insight’ was noted (I’ll come back to this).

Then the researchers undertook semi-structured interviews with 4 AMHPs, 4 section 12 doctors and ran a focus group with 3 AMHP service managers. These were subject to thematic and content analysis.

My first thought was that it was a small group of interviews and that it might reflect a lack of balance in the importance of each conversation but the number of AMHPs within one trust is small so as a representative sample of 53 AMHPs employed it was a fair percentage.

The paper refers to the outcome of the study being discussed with the AMHP leads and involving ‘a research colleague who has lived experience of using services and working as a peer support worker in the participating trust’ but that just begged a few more questions in my view.

Context

This study took place in one London trust. It is described as an ‘inner London trust covering two local authorities’ which, for anyone who knows London mental health, narrows it down to one trust. I had to try to stop myself being distracted by this because I was an AMHP in one of those boroughs, in that trust, so kept thinking of people I used to work with, but that’s not the best perspective from which to start reading a paper in a neutral manner. However, it does emphasise the truism that we don’t read papers in isolation of our own experiences and knowledge of situations. So while, in one sense, I am trying to move away from that and read the paper as if I had no idea where it was and who might be being interviewed, I am also able to acknowledge the role that self, and background knowledge always plays when we read papers and research.

The aim of the study was to focus on potential increases in the level of detentions and to look at any barriers to alternatives to admission or what might or might not influence decisions to detain someone under compulsion which is an extreme action regarding the deprivation of liberty of another person in the context of state infringement of the human rights of another person.

Key learning points

Some of the themes identified will be familiar to those who have worked in this field for any length of time. One related to the potential difficulties caused by not having three professionals assess at the same time. A doctor may make a recommendation and this can be followed up by an assessment with a doctor and an AMHP attended at the same time. One of the issues identified was that the first recommending doctor may be influenced to recommend detention, as the paper states

‘ one doctor suggested that, as the first to do an assessment, it can feel safe to recommend detention and pass responsibility to the second doctor’

p12

This was followed by the further discussion that the AMHP and second doctor may be influenced by the first recommendation.

Issues were raised as well about the individual different in attitudes, experience, knowledge and confidence with understanding risk thresholds which can be key to the outcome. Personality and unconscious bias may play a role in the outcomes of assessments.

One of the key themes to emerge, unsurprisingly, was that the impact that lack of alternative options to admission, made on the decisions to detain. If there were no places in crisis houses, capacity in crisis resolution teams, day services that met the needs of the person who required support, family and informal support in place, it could have a significant impact on the outcome and decisions made. Lack of access to substance misuse services may also have an impact on some decisions.

It may also be about the assessing team not knowing what the alternatives are for that person. One of the key pieces of learning the researchers emphasise is the potential difference in outcome when someone has a member of their community team present, or a family member or someone who knows the individual. This can help to identify both options and the lack of suitable options.

There were some issues raised around poor operational processes including the role of inpatient services. This included poor discharge planning which led to hasty readmission and poor continuity of care between community and inpatient teams. There were some additional factors which might be more relevant in the type of area it is, around access to support for people who are non-UK residents. This is an area which may include some people who are visiting the area.

Reflections and gaps

The paper identifies some of the difficulties in identifying data in the assessments considered for inclusion and reflects that out of the 150 assessments analysed, 22% had missing or incomplete AMHP reports.

The identification of ‘lack of capacity or insight’ as one of the categories in which the assessments were sorted, indicates to me a lax approach to the term and use of ‘capacity’. I never want to see the term ‘lack of capacity’ in any document that doesn’t refer to what the lack of capacity is for. I accept this is my pedantry, but is if it ‘lack of capacity to consent to an admission to hospital for assessment or treatment’ it wouldn’t take many more words to say so and these phrases add to the general misconception around capacity and/or insight, that it can be applied broadly, or maybe it’s me not understanding the implicit suggestion that this is specifically capacity to consent to admission.

The sample size is local to one trust so the findings can’t necessarily be used to evidence situations in other geographical areas. The interview sample sizes are small which can attribute far more importance to one or two, what might otherwise be, throw-away lines. That doesn’t mean that the importance of what is said isn’t valuable. It is, but it needs to be recognised in the context of the sample of assessments and the sample of interviews.

The involvement of management staff was key to understanding some of the context in which the study happened and the management team reviewed the data which was prepared for inclusion but that does offer a consideration about any self-imposed restraints that those interviewed might have felt in terms of criticism of the organisation, given that the sample size was so small. However, saying that, there was a fair bit of criticism for the organisation coming through but it may have been a factor.

The study only looked at community assessments because the focus was on avoiding hospital admissions. This meant that the voices of those who are detained in hospital and views of inpatient teams are lost. It is possible, especially with longer admissions, that some inpatient staff may have built up a different perspective about blockages and this aspect was intentionally lost. That is due to the limitations of the study rather than a lack of thought in the process.

This is research which is about the outcomes of Mental Health Act Assessments and the process of completing them. The study was focussed on professional views and records. There was a researcher who was there to review, who had lived experienced and the purpose of this research was to present a professional perspective but I wonder if there are more gaps around involving people who have experienced detention, in the processes of research and using social work research as empowerment. I know there are other studies which have and are doing this so it does feel like an unfair criticism but I felt it would be remiss to ignore it totally.

Use in practice

So what does the paper tell us that we can use in practice? The key headline and of course, this may be increasingly difficult in the face of cuts in services, is the importance of having someone who knows the person being assessed, present as part of the assessment, whether that is the care coordinator, or a family member or person who works with them through a third sector organisation.

It is also preferable to have the assessing team carry out the assessment at the same time. Often this is not lacking because there is an intention to make the process more challenging but due to availability of staff who are more frequently pressed by competing needs. It is useful to point to a study which evidences this as a factor.

The other aspect is to keep pushing for better options around prevention. This isn’t something that everyone can change but we can keep advocating and shouting for improved services which lead to better outcomes . I don’t know how much difference this makes when it is a factor that is far bigger than the individual practitioner, team or even organisation but it always needs to be referred to and having the evidence to do so is helpful.

Conclusion

This was a very useful paper to me in a lot of ways. It helped to show the way that mixed methods can be used effectively and how they can form a cohesive approach to understanding a problem. The outcomes and concerns raised were ones I recognised and I suspect will be recognised by those of us working in this space. Did I learn new things? Possibly not, but I found I have evidence to back up some of the assumptions made and that is key to pushing changes and improvements. If organisations can be presented with evidence linking the lack of capacity in the service, to involve people who know the person being assessed in the assessments and show that this leads to more admissions and therefore more cost, it may be a trigger to change systems.

And even if it isn’t, it allows us to talk about about what we see with more authority.

Reflecting on ethics and social work practice

We all think we act ethically. Whatever the context, we are able to justify our actions to ourselves. As part of my research, I am interested in understanding the different ways that we interpret values, as well as our personal values and where they come from, the professional values which are more explicitly expressed. I have done some reading about this but wanted to write about the thoughts I have had rather than referencing particular articles and books which have led to my thinking. This is not the ‘academic’ way to write but I think by expressing these thoughts and where I am at the moment, I can take my ideas through as more of a ‘work in progress’.

Personal ethics

What makes us who we are? We draw our values from our biographies – our upbringing. Thinking of this, as someone who was raised in a religious background, part of my ethical make up is very much based on my living and learning about Jewish culture, heritage and history. I took religious studies (because it was compulsory) in my school and it was exclusively learning about the Old Testament, Talmud, Mishnah and the other, more recent commentaries and debates. There is a Jewish tradition of ‘argument’ which I don’t think I understood fully, as being ‘different’ until I left home and studied philosophy, including philosophy of religion, at university. There is no one line that can’t be improved by arguing it out.

This was around how my ethics were formed and why I moved away from religion after school as well. I disliked hypocrisy and the religion that birthed me and raised me is couched, like many, I suppose but don’t know better, in contradictions that didn’t make sense to me.

How could religious people, who really believed and had faith, be (objectively in my child-like eyes) be ‘bad’ people. Surely, the purpose of religious codes of ethics is to teach people to be ‘good’ but then going to the religious services and hearing the same people gossip about who was wearing the nicest clothes/house and who was going through relationship difficulties etc, didn’t strike me as a ‘good’ thing.

While the religion no doubt, formed a basis of personal values, this was augmented by experiential knowledge. I saw that people who told webs of lies, got caught out. I knew that when I was mean or did things that did not link with my personal ethical code, I felt guilty which was not a feeling I enjoyed. There was a selfishness in my personal ethical values and there still is. I don’t want to feel bad about myself so I try not to do things that will make me feel bad. This isn’t altruism, it’s selfishness. I think it’s possible to extrapolate this to my working life as a social worker. I went into this line of work because I want to make the ragged edges of state intervention in the most personal and difficult moments of that person’s life to be as gentle and as clearly explained as possible. It won’t always be possible to soften the pain and it isn’t always my job to do so but it is my role to make the interaction with social work as straightforward and as clear as I can. When I do ‘good’ pieces of work, which make someone’s life easier or less harsh, I go home feeling better.

Saying that, I don’t know if my values are the ‘right’ ones. Indeed, to many people they would not be. I am sure I do make many mistakes of judgement that can have hideous or painful consequences and fundamentally at work, in a resource and time-limited world, I have to prioritise some work over other work. Which means prioritising some people over others. That is why my values are important to my work.

Professional ethics

When we learn to practise our trade, specifically with other people who will not, for the most part, choose to be in a room with us and will not have a choice of which social workers they are allocated – although there are areas of social work outside statutory settings, and those who may have more scope – there are few people who would decide, if all options were available, to engage with social work (fostering and adoption may be an exception).

I tend to see this as an additional responsibility as our role is very much linked, intrinsically to the power we wield with an ID badge around our necks. We can be representatives of The State or The Agency including those of us working in the third sector. Our professional forebears were the religious communities, the benevolent societies, the ‘saviours’ of those who had fallen on bad times or misfortunes. This is the root of social work and it is very much key to the way we need to interpret our roles today and how we are perceived. This power relationship with people who work with us is unavoidable. We cannot work ethically if we do not acknowledge our power. I have written about this previously but it is the core of what social work ethics are.

Looking at the definition of social work and the way that ethics interact with practice, we have this from the International Federation of Social Workers as a definition:

“Social work is a practice-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people. Principles of social justice, human rights, collective responsibility and respect for diversities are central to social work.  Underpinned by theories of social work, social sciences, humanities and indigenous knowledge, social workengages people and structures to address life challenges and enhance wellbeing. The above definition may be amplified at national and/or regional levels.”

International Federation of Social Workers (accessed 26/12/19)

And this from the British Association of Social Workers’ Code of Ethics

Ethical awareness is fundamental to the professional practice of social workers. Their ability and commitment to act ethically is an essential aspect of the quality of the service offered to those who engage with social workers. Respect for human rights and a commitment to promoting social justice are at the core of social work practice throughout the world.

British Association of Social Workers (accessed 26/12/19)

Of course, I moved immediately from this to the ‘social justice’ phrase, I’ll come back to human rights later, but I think, I try to adhere to this. But if there’s something this last electoral cycle has taught me, it’s that my interpretation of ‘social justice’ is something that is specific to me. I think I am committed to social justice but don’t we all? This is part of my concern about the way that professional ethics are held up as being something specific to social work – my hope and, to be fair, my experience is, that many nurses, doctors, occupational therapists and psychologists I work with are committed to these values, as much, if not more than social workers.

What is it about this definition that specifically makes it about social work? Promoting social change and development? How do I do that in my role with individuals? Do I do this? Am I a social worker at all, or am I someone who undertakes social work tasks that actually can be trained. Am I paid for the tasks I complete or the learning and experience I have in order to make decisions about how to prioritise my tasks? When I undertake a social work task, am I making different decisions to another social worker? In that case, why is ‘my’ social work decision-making better or worse?

We need to be able to broaden and not restrict social workers to those who define social work ethics narrowly. I know I believe I work ethically. but anyone would say that if asked – and if they wouldn’t, they shouldn’t be anywhere near a person who needs social work interventions.

Lipsky’s Street-level bureaucracy first published in 1980, reflects on the importance of the power left in the hands of individual practitioners, like social workers and the impact the those ‘small’ decisions of prioritisation can have on practice and impact on individuals who have far less power in the world which is defined by actions and interactions with organisations that hold power. Any social worker who feels disempowered should pick up a copy of this book where much of it still holds true, despite talk of levelling hierarchies.

I don’t have an answer to what it means to practice ethically and the influence that professional ethics and our understanding and interpretation of these ethical standards, but I am interested in the way that these values and ethics, impact on our practice. Will a person get a different service to someone who interprets their professional responsibilities in a different way from me? How do our conscious and unconscious biases come into play?

I’m going to veer into politics briefly here and say that Corbyn doesn’t believe he’s ever been anti-racist in his life. Ask the majority of the British Jewish community and they might have a different opinion. Is this about understanding unconscious bias, perhaps? This is why we always need to question our own values and ethics and be constantly challenged on the biases we may not be aware we have.

Organisational ethics

This is a difficult one to see, sometimes from the outside, especially if you haven’t had experiences in different organisations. Most large organisations will be able not reel off lists of values that they claim to live by. I went for an interview at an NHS trust (I didn’t get the job) about a year ago and I was asked, in the interview, what the trust values were – I hadn’t remembered, so I invented some of the usual ones, like involvement, excellence, integrity – because they can be a bit ‘cut and paste’ but how do organisations evidence ethical practice, especially large organisations? From the view of the service user/patient, it will be the impact of the individual member of staff.

From the member of staff working within the organisation, it’ll be their immediate manager and possibly more senior management staff. But one part of an organisation can have very different values to another. One ward of a hospital can have a different ethical approach to another ward next door. It might be about interpretations of guidance and policies, it might be about individual interpretations of values in practice. This is why good governance processes are essential within a well-run organisation.

How does this inform and change our practice as social workers? It’s about the value placed on professional development, supervision, training needs and space to reflect and understand how to improve our practice. It’s about the value placed on the voices of people who use services and how well-embedded co-production is, beyond a tick box which needs to be completed to meet a need.

Good governance is something that perhaps isn’t something that comes into our focus as social workers in direct practice but it is the key to establish an organisational culture that works.

Final thoughts

I have no answers. The thing I learnt in my studies of philosophy is that sometimes the value of questions isn’t finding answers, as there may be no answers, but it is asking the right questions in order to aid enquiry. And this leads me back to the previous post about research questions. Currently, I think I’m where I want to be with some of my questions but when I go to work tomorrow with the aim of ensuring ethics guide my practice, I’ll not ever know if I am getting it right or not.

Social work is not a profession which has sufficient confidence to challenge itself regarding the fundamental ethics of some of the practices that have persisted, although some of it happens around the edges. While I hope this will inform some of my research work, I hope that I don’t ever end a day or a week, without thinking, how did I ensure that I thought about the actions and priorities I took and considered this within an ethical framework, whether utilitarian, Kantian or virtue ethics.

We have to understand the decisions we make, ethically, in the context of the decisions we don’t make but we have to know that our values can never be pure, perfect or altruistic. We wobble and we need to know, for the sake of those who rely on us, how to wobble less.

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