Transcript Social Work and Human Services Curriculum

SOCIAL WORK ACTIVISM:
Resistance from the frontier
Social Work Activism
Resistance from the Frontier
Lyndal Greenslade
PhD Candidate
School of Human Services and Social Work
Griffith University
Why this topic?
Professional Reflections
 Social workers are committed to social justice
activism
 Social workers are experiencing difficulties
practicing social justice Activism within
contemporary welfare organisations
 Social workers report feelings of distress when
they are unable to pursue social justice Activism
for their clients
Activism in social work:
A proud history
“Action indeed is the sole medium of
expression for ethics”
- Jane Addams
Activism in social work ethical
documents
 Activism is enshrined in the Codes of Ethics of
member countries of the IFSW
 The Codes of Ethics use proactive language:
“Act to change”
“promote”
“challenging injustice”
“engaging in action”
Social Work - A unique perspective
 In comparison with the Codes of Ethics of
five professions in the Allied Health field in
Australia, social work is unique in its focus
on the active pursuit of social justice
 Further, many Codes of Ethics and Practice
Standards state that they take precedence
over employers’ policies and procedures
Why research social work
Activism?
 Limited amount of research exploring Activism
 What does exist conceptualises Activism as a form of
macro practice (eg: engaging in critical discussions,
advocating for client groups, collaborating with others and
joining existing issue groups)
 Call for more research into Activism to explore possible
incongruence between professional and organisational
demands
Chui & Gray, 2004; Andrews & Reisch, 2002; Gray et al, 2002; Abramovitz,
1998; Dietz Domanski, 1998; Pritchard, 1998; De Maria, 1993; Healy, 1993;
Wagner, 1989; Reeser &Epstein,1987; Hearn, 1982; Evans,1975.
Activism in practice: why is it so
hard?
Incongruence between social work professional values and
contemporary welfare ideologies, which have seen:
 a dominance of technical practice models and an
accompanying loss of structural, activist approaches
 a concealing of activist activities, for fear of reprisal
should more open forms of radical practice be attempted
Andrew & Reisch, 2002; Wagner, 1989
Organisational-Professional
Conflict
 Research informs that conflict between the social work
professional Code of Ethics and Organisational policy and
procedure is wide spread
 Research reports that such conflict is more prevalent in
statutory workplace settings
Aronson & Smith, 2009; McDonald & Chenoweth, 2009; Collins, 2008; Ferguson
& Lavalette, 2006; McAuliffe, 2005; Jordan, 2004; Lonne et al, 2004; Hough,
2003; Jones, 2001; Postle, 2001; Fook et al, 2000; Bell, 1999; Balloch et al, 1998;
Banks, 1998; Dominelli & Hoogvelt, 1996Reeser, 1996; Jones & Novak, 1993.
Voices from the Field
I think that I did at one time actually believe that I could
change the world. Now I do the best in my sphere of
influence and hope that how I treat others will make a
difference in how they treat others.
Andrews & Reisch, 2002, p. 21
For the people from 1999 on, it's the only system they
know. So we talk in the field about the new generation of
social workers - like '99 to now - being real compliance
technicians not social workers, right?
Aronson and Smith's, 2009, p. 6
Causes of organisationalprofessional conflict
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role conflict
loss of services
chronic under resourcing
loss of professional expertise
increased accountability and surveillance
the domination of evidenced based practice
loss of client time
increased paperwork
Aronson & Smith, 2009; McDonald & Chenoweth, 2009; McDonald et al, 2008;
McDonald & Marston, 2006; Abramovitz, 2005; Banks & Williams, 2005; Healy,
2002; Postle, 2001; Jones, 1993; Bell, 1990.
Ethical Dilemmas on the rise
 Findings from several studies attested to the rise in ethical
dilemmas, as social workers attempt to implement their
professional values in environments that are incongruent
with these values and increasingly hostile
Aronson & Smith, 2009; McDonald & Chenoweth, 2009; McDonald et al, 2008;
McDonald & Marston, 2006; Abramovitz, 2005; Banks & Williams, 2005; Healy,
2002; Postle, 2001; Jones, 1993; Bell, 1990.
Voices from the Field
One would hate to see all the things that were best about
social work jettisoned, but I think, honestly, the demands
on time in terms of sheer numbers means that a large
percentage of the social work element has been jettisoned.
Postle, 2001, p. 20
The underlying rationale is that this is a business, and to
stay in business, social work needs to provide a service to a
customer in assisting them to eventually have an economic
outcome.
McDonald & Chenoweth, 2009, p. 154
What happens when we can’t practice
what we believe in?
Research reports a range of negative impacts:
 Severe stress, emotional exhaustion, impaired mental
health, frustration, depression, insomnia, withdrawal, anger
and despair
 Fearful of repercussions should workers attempt to
challenge their employers
Huxley et al, 2005; McAuliffe, 2005, Regenhr et al, 2002; Gibbs, 2001; Jones,
2001; Postle, 2001.
Voices from the Field
Social work agencies need to remember just how
stressful social work can be and, when an employee
shows clear signs of stress, the question should not
be: 'What is the weakness in this employee?', but what
is the weakness in this organization that allows this to
happen?
Thompson et al, 1996, p. 663
What do we do?
Research reports a range of responses to organisational
professional conflict:
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Staying and ‘coping’
Breaking down and leaving
Whistle blowing
A new field of research identifies a different approach RESISTANCE
Aronson & Smith, 2009; McDonald & Chenoweth, 2009; Abramovitz, 2005;
Huxley et al, 2005; McAuliffe, 2005; Pockett, 2002; Baines, 2001; Gibbs, 2001;
Jones, 2001; Postle, 2001; Drake & Yadama, 1996
Covert Activism
 A small number of studies identify covert activist
strategies employed by social workers to resist
organisational policy and procedure which is
incongruent with our professional ethics
 These strategies are covert due to the fear of
reprisal and the belief that overt Activism will not
work
Aronson & Smith, 2009; McDonald & Chenoweth, 2009; Abramovitz, 2005;
Huxley et al, 2005; McAuliffe, 2005; Pockett, 2002; Baines, 2001; Gibbs, 2001;
Jones, 2001; Postle, 2001; Drake & Yadama, 1996
Borrowing from sociology:
Workplace resistance
• Major field of study in sociology
• Minor field of study in nursing and human resource
management
• Birth of ‘covert’, ‘everyday’ and ‘informal’
resistance in the 1980’s/90’s
• Minimal use of the concept in social work research
Hollander & Einwohner, 2004; Peter, 2004; Fleming & Sewell, 2002; Prasad &
Prasad, 2000.
Covert workplace resistance in social work
practice
Micro activities to advance the needs of the client:
 acting in opposition to organisational directives
 looking the other way when client's did not comply with
directives
 ‘creatively’ filling out forms and over stating a client problem to
promote their access to services
 being 'flexible' with rules and laws
 case by case 'rule bending'
 No studies explore the experience of utilising covert workplace
resistance for social workers
Aronson & Smith, 2009; McDonald & Chenoweth, 2009; Abramovitz, 2005;
Baines, 2001
Voices from the Field
I’ve decided to stick with the job for a while to see how it all pans
out. I’ve no intention of keeping my mouth shut!
McDonald & Chenoweth, 2009, p. 157
We become very creative in our efforts to gain services. We don’t
lie, we just creatively manage to try to get our folks what they need.
Abramovitz, 2005, p. 182
We may be doing some things that violate the rules or the law. It
happens. Believe me it happens. We put ourselves on the line.
Whatever it takes.
Abramovitz, 2005, p. 182
The time is ripe
 Resurgence of interest in Radical practice
 Our professional values are radical and
revolutionary in contemporary welfare ideologies
 ‘macro’ radical activist strategies may be less
appropriate/successful in contemporary settings
Is covert workplace resistance a form of
contemporary Radical practice?
The Research study
Theoretical Perspectives:
• Critical Theory
Methodology:
• Qualitative, feminist research
• Critical Reflective practice
Methods:
• Semi-structured narrative interviews
(Email Facilitated Reflective Dialogue)
• Manual theme analysis and interpretation
• Critical analysis and recommendations
Participant criteria and Recruitment
 Qualified social workers with eligibility for AASW membership
 Current or recent past (2 years) employees of a statutory welfare
organisation
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State Child Protection Services
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State Corrections Services
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State Mental Health Services
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State Hospital Services
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Federal Income Service (Centrelink)
 Recruited through advertisements in key social work
publications, informal networks and online social
networking sites
The research questions
 How do social work practitioners utilising covert
resistant strategies within statutory welfare
organisations define their professional identity?
 How do social work practitioners utilise covert
resistant strategies within statutory welfare
organisations to challenge organisationalprofessional conflict?
 What is the experience of utilising covert resistant
strategies within statutory welfare organisations for
social work practitioners?
Research outcomes
 Insight into the behaviours and experiences of social workers
working in contemporary statutory organisations
 Insight into potential incongruence between professional and
organisational demands
 Identify potential strategies for reducing incongruence between
professional and organisational demands
 Inform discussion on the relevance of activist practice methods
in challenging contemporary welfare practice and the role of
Social Workers as agents of change
A final thought ….
“Tactics mean doing what you can with
what you have”
Saul Alinsky
Interested in participating?
[email protected]
GRAPPLING WITH ETHICS &
EVIDENCE WITHIN A
SEMI-REGULATED INDUSTRY
Reported and un-reported
complaints about problematic or
unethical practice
Research Symposium: Social Work PhD Research
Grappling with ethics and evidence
within a semi-regulated industry:
Reported and un-reported complaints about
problematic or unethical practice
Deborah Sauvage
Griffith University
School of Human Services and Social Work
Friday 6th November 2009
Trust and integrity in helping professions
• “There is a long-standing tradition dating back
as least as far as the Hippocratic Oath, that the
integrity and trustworthiness of the practitioner
is assured by the profession and can be
assumed by the consumer/client”
(Gabriel, 2005, p.73)
The problem
•
There is historical evidence of reported cases of
impaired practice and harm
•
an unknown rate of unreported harm
•
Psychological services are often provided in
power-laden, unwitnessed interactions
•
Creates significant difficulty in establishing
factual evidence
•
A compassionate, humane system of regulation
is needed for such a complex industry
A taboo topic
• Taboo topics such as “professional
misconduct”, “incompetence”, “unethical
practice”, and “sexual exploitation” can provoke
many strong reactions
• These can include shock, anger, denial,
numbness, minimisation, dissociation, blame,
stereotyping, vigilante responses, anxiety,
confusion, distress, sadness, despair, and
many others…
Cases of Harm
• 100+ years of discourse about harm and complaints e.g
• - 1906 Sabina Speilrein’s diary (client)
• - 1999 “John Brown” (practitioner)
• 2009 Tribunal Transcripts UK Social Workers
• Acute impacts on health of clients and practitioners,
including suicides. (evidenced by published cases and research eg. Nachmani & Somer, 2007,
Gabriel, 2005, Disch & Avery, 2001, Pope & Vasquez, 1998, Pope and Vetter 1991, Luepker, 1989, Schoener et al,
1989; Quadrio, 1994, Dawson, 1994 ; Boeckenhauer et al 1998 ; Middleton, 2004, Callinan et al, 2000, 2001;
Celenza 2008, Celenza & Gabbard, 2007, Brown, 1999, Hedges, 1999 )
Solutions?
• Is licencing and regulation part of the solution?
• If so, what model of regulation should we use in
Australia?
• We need to ask those who have been involved
The research problem
• Natural justice, or “the right to be given a fair
hearing and the opportunity to present one’s
case…and a decision by an unbiased decision
maker” (AASW 1999, p28) is not assured for all in a
semi-regulated industry.
The research problem (con’t)
• Only those using the occupation title
‘psychologist’, or ‘psychiatrist’, or
‘psychiatric nurse’ are required to be
registered, and subject to formal complaint
avenues.
• Occupation titles of ‘counsellor’,
‘psychotherapist’, ‘social worker’, ‘case
worker’ and ‘welfare worker’ etc are not
subject to statutory licensing or registration.
The research problem (con’t)
• Practitioners can get an ABN to register as a
business in private practice, even without having
to provide proof of qualification or ‘blue card’.
(Australian Government, 2009).
• Even if complaints about fair trading by those in
private business are made, these are only
actionable within the jurisdiction of legislation
governing registered health professionals.
•
(see www.fairtrading.qld.gov.au)
What does overseas research tell us?
• In the US, half of respondents to a national survey of
psychologists in 1991 reported they had assessed or
treated at least one patient who reported sexual
involvement with a previous therapist
(Pope Sonne & Holroyd, 1993).
• In the US, half of the respondents to a survey about
social workers in private practice in 2004 reported
treating clients who had had sexual involvement with a
previous therapist
(Hutchinson-Mittendorf & Schroeder, 2004).
What does overseas research tell us? (con’t)
• When sexual involvement occurs within a therapeutic
relationship it results in reported harm in 80-95% of
cases (Pope Sonne & Holroyd, 1993).
• Harm so serious that it resulted in suicides, multiple
attempted suicides, hospitalizations, and 80% did not
recover from the effects of the sexual involvement
despite subsequent treatment (Pope & Vetter, 1991).
• Despite the seriousness of harm, complaints were
only lodged in 12-15% of cases (Pope & Vetter, 1991, Hutchinson-Mittendorf
& Schroeder, 2004).
• An analysis of 894 complaints to the NASW in the US
found that over a third of complaints made to the
NASW were not accepted for adjudication, some of
these due to what appeared to the author to be prejudging of cases without hearing (Strom-Gottfried, 2003).
What does Australian research tell us?
Paucity of research indicates there is much that we
do not know about:• the number of unregulated providers, their training
and their activities
• the prevalence of harm or problematic outcomes
• The level of knowledge of ethical practice standards
and commitment to ethical codes
• The rate of complaint within small and large
government and non-government organisations and
regarding those in private practice
• The manner of response to complaints
• Feedback from consumers about services and
manner of response to complaints
What does Australian research tell us? (con’t)
• Workforce mapping research with a 9% return rate
(577 replies) out of a population of 6000 counsellors
and psychotherapists who held voluntary membership
of professional associations, indicated that a quarter of
these counsellors reported that they do not follow an
ethical code, and only 40 % of these counsellors were
university trained (Schofield 2008b, Pelling, 2005).
• 3% of surveyed advertised counselling Psychologists
reported that although they are members of the
Australian Psychological Society, they do not follow an
ethical code (Pelling, 2007, p.213).
• Quadrio (1994,p.189) published case studies about sexual
abuse by therapists, and reported serious concerns
about “closed ranks, collusions, and conspiracies of
silence” in complaint procedures.
How will this research project add to the
literature?
• “One important group which was not formally
consulted about the models of self-regulation was the
consumer group” (Schofield 2008, p.96) .
• There is a current agenda regarding regulation (Council of
Australian Governments, 2006, 2009, Schofield, 2008, Cumming, 2008).
• For the first time in Australia, a research project can
contribute recommendations about regulation and
complaint management systems based on input by
those involved in decision-making and those whose
lives have been affected.
Who should be asked for further data to
address gaps in previous research?
1.
Complainants
2.
Respondents
3.
Third parties - includes subsequent therapists
whose client told them of a past problematic
experience with a counsellor, as well as members
of relevant organizations eg. ethics officers, ethics
panel members, investigators, policy makers,
legislators.
What should be asked?
- Research questions 1.
How do complainants, respondents and third parties
describe, reflect on and understand their past
experience of a decision making process regarding
complaints?
2.
What do the perspectives and experiences of
complainants, respondents and third parties indicate
about dynamics of structural and relational power
associated with complaints?
3.
What specific changes need to be made by the
industry to effectively address the needs of various
parties involved in complaints?
Conduct of the study
• No known finite population, purposive,
snowball methods will be used to recruit up
to 30 (7-10 from each of the three groups)
• In-depth semi-structured qualitative
interviews
• face-to-face and email facilitated reflective
dialogue (McAuliffe, 2003, McCoyd, 2006)
• personal narratives and reflections in
hindsight about the experience of decision
making processes
Limitations
• Small sample – results not generalisable
• Data saturation unlikely with three sub- groups
• Self-report of retrospective reflections are highly
subjective and subject to inaccuracy
Ethical protocols
• No identifying information required from participants
apart from name (required for the consent form)
• The identity of others involved in complaints is not to
be stated by participants
• No identifying information in transcripts or findings
• No details about potentially identifiable incidents,
professions, organisation, location, or timeframes
• Broad Australia-wide sample population
Preliminary findings
- #1 an unreported complaint • About an unregulated professional – counselling role
• Described by complainant as “creepy”; “having very
close intense relationships with young men (clients)”;
“giving moral advice”; “patronising”; “would divulge
things to me about clients that just weren’t
appropriate”; told client “god would solve her
problems”; “grooming behaviours”; ”strong gut
instinct” ; “interrogating them in front of
others…asserting power of what he knew about them
every time instead of just saying hi”; ”coming out of
session with arm around clients back”; “moral
guardian”, judging female clients’ sexual behaviour
and giving inappropriate relationship advice; failing to
intervene in serious situations appropriately;
“extremely high opinion of himself”.
Preliminary Findings
- #1 an unreported complaint • “I had no idea whether there was any sort of ethical
review or whether his performance management
crossed over lines of ethics or behaviour or
procedures. I had no idea whether the (organisation)
really gave a damn. Like really, because they clearly
didn’t give a damn about certain other things at the
time. There were whole piles of other issues going on”
• “privacy” of unwitnessed, unsupervised sessions a
barrier to these matters being dealt with.
• Need an external body, to oversee patterns in
“hearsay” complaints in absence of client report
Preliminary findings
- #1 an unreported complaint • No formal complaint reported but verbal “blacklisting” of the
practitioner due to many informal reports from clients.
• another worker made complaint; practitioner made a countercomplaint, observed by others as a threat to all.
• “I don’t know what procedural method she would have had to
deal with him because he was one of those people who would
almost have you in court the next day if you said something
negatively about him.”
• “the way I felt about it, (was) conflicted most of the time, not able
to really seriously voice my true opinion ever, genuinely, and the
problem was that I had not much evidence, really, apart from my
feelings, and some reports, about this person”.
• could not directly ask clients to complain, fear of implications
Preliminary findings
- #2 a reported complaint • About an unregulated professional – casework role
• Described by complainant as about “almost criminally
negligent practice”, “systemic abuse” of clients,
associated with “character failings”, as well as
imposition of damaging beliefs of practitioner
• Complaint made complainant in exit interview
• Was validated and acted on promptly
• Practitioner removed from that role, given other duties
• Complainant had safe person to talk through the
issues with away from work
Preliminary findings
- #2 a reported complaint • Stressed need for “validation of concerns” without
“vigilante” response against respondent
• Need for clear knowledge of practice standards and
how to supervise these
• “acres of red tape”, “naming and shaming” not needed
in complaint management; Need a “relational
response” in order to maximise “conditions for growth”
• Proposed a “pink card” licencing system to be required
for all “helping and caring roles” in Australia, similar to
blue card, so background checks can occur
Questions and comments
Interested in the project?
Deborah Sauvage
[email protected]
(07) 33821201
AN EXPLORATION OF
HYPNOSIS IN THE
AUSTRALIAN CONTEXT
AN EXPLORATION OF HYPNOSIS IN THE AUSTRALIAN CONTEXT
JUDITH ANNE MERARI-LYONS (PhD)
The thesis comments on hypnosis within the Australian Context
Definition
Research question
Hypothesis
Research objectives
Target population
Methodology
Definitions
Findings
Relevance to Social Work
Definition of Hypnosis
1: Hypnosis is a natural, altered state of
consciousness. The state of hypnosis is
distinctly different from a person’s normal
state of consciousness.
2: Each person is unique and therefore
their response to the hypnotic Trance
State will also be unique (Erickson, 1985 &
Yappko, 1995)
Research Question
In a therapeutic context Is Hypnosis well
utlized as an intervention tool in Australia?
Hypothesis
Hypnosis is well utilized
Or
Hypnosis is not well utlized
Research Objectives
1:To explore if religion and myth influence the
use of hypnosis in Australia
2: To explore what theoretical frameworks guide
practice in Australia
3: To understand how hypnosis is utlized in
Australia
4: To explore and define any barriers to the use
of hypnosis in Australia
5: To understand what the real or perceived
differences are between lay and professional
practitioners
Target Population
1: Lay population
2: Legal professionals and police
3: Medical professionals, allied health
professionals (i.e., psychologists, social
workers, occupational therapists) working
in drug and alcohol, mental health, nursing
professionals working in the above fields
as well in general care, private
hypnotherapists and psychotherapists.
Defining Hypnosis/Myths and Facts
To tease out the myths and facts a questionnaire containing 7 key
questions was devised after an extensive analysis of the
literature. They are:
1: What myths and legends, if any, are you aware of about hypnosis
practice in Australia?
2: In your opinion does religion influence who uses hypnosis in
Australia?
3: From your experience what are the prevailing theories influencing
hypnosis practice in Australia?
4: In your view what are the main uses of hypnosis?
5:Do you consider hypnosis to be under-utilized in the Australian
clinical practice arena? If yes please explain why in your view?
6: What are the barriers, if any, to utlizing hypnosis as a best
practice in the Australian context.
Social context of the Study
The history of hypnosis
Regulation of the industry including counsellors
& psychotherapists
The Introduction of Medicare rebates for people
accessing a mental health plan via their GP to
see registered professionals working privately
within allied health ie Social Workers and
Psychologists/ Occupational Therapists.
Methodology
Literature review
Impressions & Informal discussions
Review of the Australian and State Regulation
Research Design & Data Collection: Ethics and
interviews
Problems encountered
Open ended Questionnaires
Definition of hypnosis
Findings
Overall:
The lay population was consistently influenced by religion.
The lay population were not interested, or concerned if they have any factual knowledge about hypnosis –
blind faith factor.
The legal profession and the police ( the most responsive group of participants) highlighted a healthy
skepticism , pragmatic approach due to fear of contamination of evidence – but they were the participants
most likely to support and engage a hypnotherapist for clients.
The theories in general about hypnosis were not well known by any participants
All participants had a sound knowledge of what hypnosis can be used for
The legal profession were the strongest voice in supporting registered practitioners with tertiary
qualifications to work with clients. Where as the lay population did not mind either way.
The health professionals across the country showed the most interest in participating but were frequently
stopped by management from participating.
Practicing psychotherapist & Hypnotehrapists did not participate
Erickson is the most well known theorist
Findings
The overall findings indicate that the health practitioners
who did participate focused on the uses of hypnosis for
stop smoking; weight; stress reduction; mental health
issues such as phobias and anxiety.
All participants thought hypnosis is under utlized in
Australia
The barriers were noted as lack of empirical evidence/
evidenced based studies, the dominance of the medical
model, rules of evidence, qualifications and training
All participants had tried or were fascinated by hypnosis
at some point in their life.
Those who had tried it found it successful and those who
were fascinated were planning to attend a session in the
future.
Relevance for Social Work
Why not?
Working with trauma/ prisoners
Relaxation techniques- stress reduction techniques
which derive from hypnosis
Private Practice- Clinical Social Work
Brief interventions
Further research – i.e. evidence based
Hypnosis is one tool in the tool kit of many and requires
a sound psychosocial and bio psychosocial assessment
Caution - use as a tool in mental health patients if a
psychiatrist agrees and is supportive and a thorough
assessment has been done, and the practitioner has
training in the use of hypnosis