Transcript the paper in full - Centre for Social Work Practice

Innovations in Social Work Practice Education:
Utilising Relationship Based Social Work
The potential significance of the
supervisory relationship in
practice education
Dr Michelle Lefevre
University of Sussex
5.6.14
The focus of this presentation
• What the supervisory relationship is nested within
• Why the relationship might matter
• What can go well/go wrong
• What Practice Educators need to be attuned to
• How PEs might support themselves/be better supported by their
agencies
2
Complex networks of supervisory
relationships (1)
PE/WBS
Student
Tutor/University
3
• Potential for
splitting/
projection
• Fantasies/
prejudices
• Phantasies
• Transference,
countertransference
Complex networks of supervisory
relationships (2)
• Power, status
and influence
• Whose voice
counts?
• Valuing and
respect
• Fears or trust
• Alignments
• Cracks
4
Tutor
PE
WBS
Student
Complex networks of supervisory
relationships (3)
What is enacted
between the
supervisor/student is
influenced/reflected by
others around them
Peers
(Mattinson, 1975).
Where are the
family/individuals
positioned and how are
they understood/helped
within the supervisory
relationship? (systemic)
5
Team
Uni
Supervisor
Student
Nests: containment or impingement?
National policy &
practice context
University
Agency
PE/WBS
Student
Service
user
6
So, what is the importance of the
supervisory relationship in these
networks?
• Technical considerations are important
• But good PE also associated with emotional and processoriented factors (Doel et al, 2004)
• PE can be the reflective container for students’ responses to:
- complex, challenging, distressing client situations (Ferguson,
2011; Munro, 2011)
- anxiety and drop in confidence from being a learner and being
assessed (Salzberger-Wittenberg et al., 1983)
7
Earlier models of supervision in PE
• Early quasi-therapeutic models focused on internal world (e.g.
Taft, 1950; Hamilton, 1954).
• Students concerned about boundaries and intrusion (Kadushin,
1974)
• Role systems (Wijnberg & Schwarz,1977) more egalitarian and
collaborative; Growth in understandings of power and antioppressive practice
• Downside: PEs wary of considering the more affective, processoriented and interpersonal components of their interaction with
students and of students with service users (Bogo, 1993)
8
What have students said about the
importance of the relationship?
(Lefevre, 2004)
• 2004 written survey, qualitative & quantitative data
• Sample: 72 students who were undertaking a qualification
programme in social work, either MSW or DipSW level, England.
• Undertaken 2 weeks after they had received their final report
from the practice teacher
• 44 completed the survey (61% of sample frame)
• 17 were in first placement, 27 final placement (reviewed both
placement experiences)
• No demographic data
• Limitations: influence of feelings about recent PE assessment
9
Positive words and phrases used by
students to describe rel with PE (1)
• 78 words reflected positive aspects of the relationship.
- ‘supportive’ appeared 34 times, used by 48%
- ‘friendly’ (13 times); ‘helpful’ and ‘good’ (11); ‘positive’ (7); encouraging’,
‘relaxed’ and ‘understanding’ (6); ‘informative’, ‘respect(ful)’, ‘warm’ and ‘open’
(5).
• 26 of these denoted a supportive relationship:
- ‘kind’, ‘nurturing’, ‘caring’, ‘warm’, ‘rewarding’, ‘friendly’, ‘considerate’, ‘fun’,
‘sensitive’, ‘encouraging’, ‘approachable’, ‘understanding’, ‘accommodating’,
‘trusting’, ‘confidence-giving’.
• Some reflected a person-centred approach by PE:
- ‘empathic’, ‘congruent’, ‘valued’.
10
Positive words and phrases used by
students to describe rel with PE (2)
• 16 suggested a relaxed learning environment:
- ‘comfortable’, ‘informal’, ‘flexible’, ‘easy-going’ or ‘laid-back’
• 28 indicated a relationship with an anti-oppressive and
collaborative approach with dynamics of empowerment, respect,
mutuality, fairness and transparency:
- ‘good communication’, ‘a sharing of ideas’, ‘an equal relationship where
anything could be discussed’ and a sense that they were ‘learning together’.
- This resulted in students feeling ‘listened-to’ and ‘included’ and that they
were part of a team.
11
More negative words and phrases (1)
• 47 words indicated negative dynamics in the relationship:
- ‘strained’ (3); ‘demanding’, ‘distant’, ‘stressful’, ‘unhelpful’ (2).
• 16 signified a lack of support, warmth and friendliness:
- ‘unapproachable’,‘unvalued’, ‘uncomfortable’, ‘distant’ ‘impersonal’.
• 2 students felt negative because the practice teacher was overfriendly and supportive
• Some indicated tension in the relationship:
- ‘strained’,‘inflexible’, ‘wary’, ‘prickly’, ‘awkward’, ‘stressful’, ‘unpredictable’,
‘tempestuous’; ‘worrying’ about the practice teacher’s mood; ‘on a rollercoaster
ride’.
12
More negative words and phrases (2)
• 12 related to the practice teacher’s availability, such as
• ‘always busy’, ‘rushed’, ‘stretched’, ‘basic’, ‘bare minimum’; low priority, a
burden or nuisance.
• For 13 the relationship was oppressive
- an ‘unconstructive’, ‘confrontational’ even ‘degrading’ relationship in which
they felt ‘domineered’, ‘bullied’ and ‘controlled’.
- their ‘self-confidence and self-esteem plummeted’; they ‘never knew whether
[they were] right or wrong’; ‘not listened to’; left to ‘get on with it’.
- Stereotyping: ‘Presumptions were made but questions never asked’.
- One described the practice teacher as ‘Very racist’.
• 1/3 indicated transference and counter-transference
13
- ‘Mother and son (I was the son)’.
Students’ perceptions of whether and
how the relationship had an impact on
their learning and development
• 90% believed that the relationship with their practice teacher had
had either ‘a lot’ or ‘a bit’ of an impact on their learning and
development
• When asked ‘how’, the theme of supportiveness dominated (31
statements)
• A lack of support experienced in the relationship negatively affected
respondents’ development
• Worries that over-supportiveness was also unhelpful
• Where PEs lacked competence, this caused the student to feel
negatively about the relationship
14
Whether and how the relationship
affected the effectiveness and accuracy
of the assessment (1)
• 77.5% rated the relationship as having impacted the effectiveness
and accuracy of the assessment
• A collaborative and trusting relationship enabled a fuller picture of
their competence to emerge, resulting in a fairer, more accurate
and more transparent assessment process.
• 4 believed that the way power had been mishandled in the
relationship had adversely affected their assessment
15
Whether and how the relationship
affected the effectiveness and accuracy
of the assessment (2)
• 4/5 suggested correspondence between feeling positive
about the relationship and believing the assessment to be
effective and accurate
• 6 questioned whether their positive relationship with PE
made it less fair because of bias or reluctance to challenge
• Half of the 9 who had a negative relationship felt it had an
impact on the effectiveness and accuracy of the PE
assessment
• But 3 others still felt they received a fair assessment
16
What influenced the development of the
student’s relationship with their PE
17
• How much student felt listened to/heard by the practice teacher 83.1%
• How much student felt respected and valued by the practice teacher
80.3%
• Trust/safety (or lack of) 74.6%
• The way in which critical feedback was given 66.2%
• The practice teacher’s capacity to provide emotional support 66.2%
• How much student felt the practice teacher showed them warmth 63.4%
• Issues in the power relationship 50.7%
• The practice teacher’s availability due to agency pressures 43.7%
• Personal stress on the part of the practice teacher 38%
• Personal stress on the part of the student 36.6%
• Transference/counter-transference 31%
• Issues of race/gender/age/class/disability/sexuality 23.9%
So what can we take from this?
• Powerful feelings are generated in practice learning, e.g. anxiety,
vulnerability, under-confidence, powerlessness, hope,
dependence
• These have a foundation in the relationship between the student
and the practice teacher.
- Relating to the roles they inhabit
- Each others’ expectations of these roles
- And how they each embody these roles
18
Unhelpful if processes go all one way
STUDENT
PRACTICE EDUCATOR
• Learner
• Teacher
• Recipient of
• Cared for
• Child
19
One
way
assessment
• Assessor
• Carer
• Parent
This model implies a striving for
reciprocity
STUDENT
Learner
Assessee
Cared for
Child
20
MUTUAL
PRACTICE
EDUCATOR
Both learning
Self & other evaluation
Mutual caring &
recognition of other
Adult
Teacher
Assessor
Carer
Parent
This improves both learning and
assessment
• Supportive experiences are also significant to perceptions of the
accuracy and fairness of the PE assessment
• More trust meant they were more willing to expose fallibility and
be open to critical feedback
• So assessment based on the fullest of information
• An ongoing constructive looping process between formative and
summative assessment, maximizing learning opportunities.
• The reverse was caused by ‘expectations clash’, uncollaborative,
non-transparent approach to assessment
21
Crucial to consider developmental
stages and needs of each
Student
• Some vulnerable/anxious and
more dependent at the beginning
• Psychodynamic model allows for
stage of nurturing (horticultural)
• So student has time to ‘grow up’
• But not to ‘full independence’ but
aiming for Fairbairn’s ‘mutual
dependence’ & resilience (ongoing
needs for learning & support)
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Practice educator
• What stage is PE at in
supervisory career?
• What might stop them
supporting?
• What is the nature of their
own practice context?
• How much learning/ nurturing
are they receiving?
• How resilient?
So what are the implications for
Practice Educators?
Agency
PE/WBS
• The need for the
agency to contain the
PE, who contains the
student, who contains
the service user
Student
Service
user
• The student learns how
to do this experientially
for their own practice
But PEs need workplace
environment that supports them
• PE can’t be supportive in an unsupportive environment
- ‘Emotional responsiveness and capacity are not
merely a product of individuals, but are powerfully
influenced by collective and contextual processes,
including workplace, professional and socio-cultural
factors’ (Morrison, 2007, p. 253).
• Enhanced self-awareness, rigorous self-reflection and a
context for practice which facilitates this are required:
- To be able to practise well, social workers have to be
employed in an organisation that supports them and
their professional development (Munro, 2011, p. 105)
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The role of the organisation and
PE
• If workers don’t feel safe, they won’t separate from
the office or car (Ferguson, 2011)
• Workers need a ‘container’ (the organisation) to
hold/make bearable these overwhelming feelings
and create a safe reflective space – PE does for
student (Bion, 1962)
• Supervisor aims to understand and name students’
feelings and needs by receiving them herself –
counter-transference?
What the student can then experience
• Repeated experience of an attuned response in supervision leads
students to feel what is happening to them is understandable
• It makes their experience bearable and nameable
• So uncertainty and anxiety become more manageable
• This generates higher level emotional and cognitive development in the
student and an ability to ‘hold’ the client
• Although containment originally comes through the relationship, this
process is internalised and the student learns to do it for him/herself:
→ reflective practice
Practitioners who were more able to
reflect are more:
• Committed to conceptualising and developing their practice
• Able to explore alternative perspectives
• Able to embrace and engage with uncertainty, complexity and risk
• ‘Mindful’ and ‘whole-hearted’ when engaging with practice
• Responsive, responsible, relational and empowering regarding
partnership with service users
• Able to critically scrutinise their affective responses to encounters
so that they become another source of knowledge (Ruch, 2011)
What happens when the supervisor
does not act as a container
• The emotions don’t go away; instead:
- This developmental construction process is impaired
- Thoughts and feelings remain unprocessed and fragmented
• Not only is the student left with unbearable anxiety in the moment but she
does not learn how to reflect effectively on or in action (Schon, 1983).
• Supervision in PE does not become either a support or a transformatory
experience
• Unhelpful defence mechanisms develop,
- e.g. Menzies-Lyth (1998): ‘the liver in bed nine’ - detachment
- Engaging more in routine and procedural tasks
- Burn-out, illness
Process reflection (1)
• Psychodynamic theories
- Defences against unbearable anxiety
- Splitting/ project
- Transference/counter-transference
- What is happening between us in the here and now?
- How might this reflect what is happening with the service
user?
- How might it relate to students/PEs’ usual patterns?
29
Process reflection (2)
Transactional analysis
Games People Play (Berne, 1964) - ego states
30
- Parent critical/nurturing
- Parent critical/nurturing
- Adult
- Adult
- Child free/rebellious/
adaptive
- Child free/rebellious/
adaptive
Process reflection (3)
Drama Triangle (Karpman):
Victim
Rescuer
31
Persecutor
Self-awareness
• Professionals are every bit as capable of repression,
splitting, projection and transference as service users.
• PEs are every bit as capable of repression, splitting,
projection and transference as students…..
• What patterns have you noticed?
• What feeling states/processes are you most likely to
accuse others of? They may be yours…..
32
Developing resilience in SW students
(drawing on Beddoe et al, 2011; Grant & Kinman, 2011)
• Decline in well-being in NQSWs; retention is decreasing
• Students will need skills to enable them to ‘thrive and survive’ in
practice careers - both personal qualities and readiness to
manage self and emotions in the turbulent workplace
• How may PE support students’ personal dispositions so that
hopefulness, altruism, empathy, optimism, coping and personal
robustness may be nurtured?
• It is a multi-systemic process. Students have a personal
responsibility for their own self-development but the
organisation/PE has to be safe and containing to promote this
How the organisation and
supervision may help (2)
• Promote development of students’ clear professional identity with
an understanding of what this role realistically will involve
• ‘Identity building’ work, to explore and articulate :
- Who am I with this new professional identity?
- What do I believe in?
- What are my aspirations?
- What will I stand up for?’
• Demonstrate professional ethics and qualities
- You demonstrating nurturing, compassion, authority, respect,
self-awareness and strong boundaries
How the organisation and
supervision may help (3)
• Supporting students developing coping strategies and maintaining
appropriate work–life balance
• Recognising personal journeys and motivations and the need to
process these (e.g. ‘rescuer’, need to be liked).
• The importance of clear personal and professional boundaries
• Mindfulness and other awareness enhancing techniques (e.g. yoga):
- Can help students manage stress & cope more effectively with their own
emotional states and highly charged emotional states of others
- Can help facilitate students’ active listening, promote self-awareness and
enhance critical reflection
- Can support students to develop their capacity for deep reflection and
enhance their emotional intelligence
How the organisation and supervision
may help (4)
• Using CBT techniques to help students manage guilt, worry, blame
(Grant & Kinman, 2011)
- Identify how thinking errors and negative automatic thoughts may
prevent students from thinking constructively and non-blamingly about
work situations
• Action planning
• Primary appraisal: the student makes a conscious evaluation of an event
such as a harm or a loss, a threat, or a challenge.
• Secondary appraisal takes place when the student asks himself or herself,
‘What can I do about it?’ - evaluating the internal and external resources
available to them that have the potential to buffer stress reactions (Bakker et
al., 2004).
• Develop realistic goals that are not too easy or too difficult to achieve.
Peer Coaching among PEs to develop
their own reflective practice
• Peer coaching draws on Grant & Kinman’s (2011) work on resilience
• A collaborative relationship to facilitate development of skills through feedback,
reflection and self-directed learning in a safe dyadic space
• Helps PEs identify personal strengths as well as perceived weaknesses, so
promotes self-awareness and facilitates reflection on their practice of PE
• Benefits social-emotional development and improved interpersonal skills such as
active listening, questioning and probing, for each PE.
• Exercise A: Coach helps coachee to adopt a solution-focused, rather than
problem-focused, approach to difficulties they may encounter in PE
• Exercise B: Coach asks coachee to identify ‘Sparkling Moments’ - times in their
work when they felt particularly successful and satisfied. Explore what made this
situation satisfying, and consider how to maximise such opportunities in future.
Some questions to ponder
• How well do you feel you are able to offer this kind of
containment and promotion of reflective, resilient practice
through your supervisory style? (appraise current capabilities)
• What might get in the way of you doing this better? (looking for
blocks or skill gaps)
• What strategies could you develop to improve your own practice
(and that of your organisation, too, if possible)?
References
• Beddoe, L., Davys, A. & Adamson, C. (2011): Educating Resilient
Practitioners, Social Work Education: The International Journal, Advance
Access DOI:10.1080/02615479.2011.644532
• Bion, W. (1962) Learning from Experience. London: Heinemann.
• Bogo, M. (1993) ‘The student/field instructor relationship: the critical
factor in field education’, The Clinical Supervisor, vol. 11, no. 2, pp. 23–
36.
• Doel, M., Deacon, L. & Sawdon, C. (2004) An Audit of Models of Practice
Learning in the New Social Work Award,
http://www.practicelearning.org.uk/
• Ferguson, H. (2011) Child Protection Practice. Palgrave Macmillan
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References
• Grant, L. & Kinman, G. (2011): Enhancing Wellbeing in Social Work
Students: Building Resilience in the Next Generation, Social Work
Education: The International Journal, Advance Access:
DOI:10.1080/02615479.2011.590931
• Hamilton, G. (1954) ‘Self-awareness in professional education’, Social
Casework, vol. 35,pp. 374–377.
• Lefevre, M. (2005) 'Facilitating Practice Learning and Assessment: The
Influence of Relationship', Social Work Education, 24:5,565 — 583
• Mattinson, J. (1975) The Reflection Process in Casework Supervision.
London: Tavistock Institute.
• Menzies-Lyth, I. (1988) Containing Anxiety in Institutions: Selected
Essays, Volume 1. London: Free Association Books.
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• Morrison, T. (2007) Emotional Intelligence, Emotion and Social Work:
Context, Characteristics, Complications and Contribution, British
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• Munro, E. (2011) The Munro Review of Child Protection:Final Report.
http://www.education.gov.uk/childrenandyoungpeople/safeguardingchild
ren/protection/b00219296/munro
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• Salzberger-Wittenberg, I., Henry, G. & Osborne, E. (1983) The
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