Transcript To what extent do experiences of using services or caring for someone influence the perspectives and practice of social work students at Queen’s University Belfast? Damien.

To what extent do experiences of
using services or caring for
someone influence the
perspectives and practice of social
work students at Queen’s
University Belfast?
Damien Kavanagh
School of Sociology, Social Policy and Social Work
Queen’s University Belfast
N. Ireland
About me
• A Dad and Partner
• Mental health experiences within myself and my
family
• Mental Health Social Worker
• Pre-employment checks and disclosure – ‘Risk?’
• Background in (passion for) mental health peer
advocacy
• Graduate student (MRes)
• I am nervous
Aims of enquiry
• To identify and explore the levels of health and
social care service use, and caring responsibilities,
among social work students at Queen’s University
Belfast.
• Investigate the prevalence of client and carer selfidentification among a population of social work
students.
• Investigate the level of self-identification and
disclosure among social work students.
Aims of enquiry
• Identify whether and to what extent the social
work students perceive clients and carers as
‘other’ than themselves.
• Consider whether a relationship exists between
the policy, practice and identity issues involved.
• This study also sought to explore whether future
social workers presume that the people they will
work with and support are vulnerable or
oppressed.
Northern Ireland Context
•
•
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•
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1.7 million population
Legacy of the conflict
Sectarianism
Increasing diversity
Integrated service - issues
Community and Voluntary Sector
Unionism / Loyalism
Nationalism / Republicanism
‘Belfastism’
Terminology and language
Challenges in defining categories (McLaughlin,
2009).
Service user: someone who has used or uses
services in Health and Social Care.
Caregiver: someone who has or has had an ongoing emotional or practical interest in the
wellbeing of a service user.
Social context
• Society emerging post-conflict.
• Disability issues were not the main concern.
• Conflict issues were and are not the main
concern for many disabled citizens and
caregivers.
• Social Work part of an integrated Health and
Social Care setting.
Legislative context
• The Special Educational Needs and Disability
Order (SENDO) 1 September 2005.
• Extended Disability Discrimination Act 1995 to
ensure equal opportunities in Higher
Education.
• Section 75 of the Northern Ireland Act 1998
(aka Good Friday Agreement).
• Duty on public bodies to promote equality of
opportunity.
Disclosure
• Disclosure is the responsibility of the student,
as a personal decision.
• Unclear how students may be facilitated in
addressing barriers to self-disclosure within
context of personal choice.
• Notion of ‘process’ in a fluid ecological
context, as opposed to single event.
Identity
• Fluid discourses, subjectively significant
experiences and categorisation (Chapell et al,
2003; Goffman, 1958)
• Individual agency and power imbalances (Clark,
2006)
• Opportunities for identity redefinition (Foucault,
1994)
• ‘Otherness’ and professional socialisation, denying
personal experiences (Clouder, 2001)
Identity
Evidence-informed practice and objectivity in
context of humanity and subjectivity (Wiles,
2011)
Disability as a medical, personal tragedy (Oliver
and Sapey, 2006)
Fear of disclosure and unfitness to practise
(Wray et al, 2005)
Citizen involvement
• Citizen leadership increasingly central to social
work education (Farrow and Fillingham, 2011)
research (Rose, 2008; Kavanagh et al, 2012),
policy and practice (Duffy, 2008).
• Service users and caregivers involved in design
and delivery of curriculum and regulation of
workforce.
• Helps reduce distance between experience and
interpretation (Beresford, 2007).
• Potential for over-involvement (Rose, 2008).
Social work as an entity
• Multi-disciplinary, integrated nature of health
and social care and marginalisation of social
work (Judd and Sheffield, 2010).
• Regulatory requirements, heightened
accountability as ‘surveillance’ of workers
(McLaughlin, 2010).
• Target and performance driven philosophy
(Heffernan, 2006).
Higher Education
• Structural and institutional norms which differ
from students’ culture and values (Reay et al,
2010).
• Internships compound this with organisational
norms (Hughes et al, 2007).
• Diversity of and micro-political nature of
internship settings exacerbate issue (Dutton
and Worsley, 2009).
Methodology
Sample
• Phase one: Initial purposive sample across
BSW (Bachelor of Social Work) undergraduate
program (n=122).
• Phase two: Convenience sample of a priori
criteria – those who self-identify as service
user, caregiver or both.
Methodology
Data collection
• Mixed method – Phase one survey (using
Personal Response System)
• Phase two semi-structured interviews.
• Interview and survey schedule.
• Informed consent.
Analysis
• Subjective experiences warranted inductive
approach.
• SPSS and thematic framework.
Results and analysis
Gender
Frequency
Percentage
Male
15
13.5
Female
96
86.5
Total
111
100
Table1: Frequency of survey participants by gender
Disabled students
Disability
Frequency
Percentage
None
101
91.0
Physical impairment
1
0.9
Hearing impairment
2
1.8
Sensory impairment
1
0.9
Learning Disability
6
5.4
Total
111
100
Table 2: Frequency table of cohort by disability, as disclosed.
As a future social worker do you
regard service users as different from
you?
Frequency
Percentage
Yes
51
47.2
No
57
52.8
Valid Total
108
100
Table 3: Frequency table of cohort’s views regarding service users.
Please indicate if you have ever used
or are using services beyond Primary
Care.
Frequency
Valid Percent
Yes
60
55
No
49
45
Valid Total
109
100
Table 4 : Breakdown of service use beyond primary care.
Self-identification and otherness
Used/using services
View service users as different
Total
beyond primary care
Yes
No
Yes
25
32
57
No
23
25
48
Total
48
57
105
Interviews
• Available sample = 20
• Actual sample = 6 social work students
Future practitioner profiles
• ‘Rita’ : Initial child protection social work assessment in respect
of her own children. Past and current experiences as a carer for
her father, who lives with physical support needs.
• ‘Stephanie’: Prior use of cancer services. Present experiences as
a consequence of having used these services, in terms of the
physical and emotional effects of treatment .
• ‘Rose’: A caregiver for her brother, who lives with an intellectual
disability.
Future practitioner profiles
• ‘Barbara’: Child and Adolescent Mental Health Services
in respect of her son. Lived experiences of a parent
who lives with alcohol addiction.
• ‘Anna’: Someone living with epilepsy in addition to
experiences as a child and adult with a parent who
lives with alcohol addiction.
• ‘Ursula’: Experienced sexual abuse as a child, and ongoing mental health needs who made use of
counselling services in relation to these experiences.
Experiences of living in and leaving local authority care.
Questions
• Influence on how they perceive themselves.
• Influence of how others perceive them.
• How their experiences have influenced their
approaches to social work.
• Their readiness to disclose their experiences in
a public setting.
Labelling, otherness and sameness
“Now that I’m a social worker I don’t want to give
too much away.... I view my illness and how it
shaped my life differently.... I remember the first
day .... thinking, ‘What are people going to think
about someone on crutches? I need to get off
crutches before I go on placement’. ... I was
always conscious that it was about me feeling
different from other people, and that all came
from being sick.”
‘Stephanie’
Self-labelling
“I made the realisation that I’m a carer and not
just a family member. I could see people
around me answering differently.... my life
experiences are different from everyone
else’s.... It’s more than being a sister; I don’t
know any of my friends who would be
mothering their 16 year old brother.”
‘Rose’
Sameness
“I think it’s important to think through past
experiences and be aware of the potential
impact on people. I’m no different from
anyone else.... Our lives are basically the
same as the people we are going to be
offering support to. We’ve just been a bit
luckier with the circumstances, and I think
that’s the only difference.”
‘Barbara’
Language
“It’s all about the words that you use. People are
in contact with social services for a reason,
but it’s always ‘service user vulnerable’, not
‘service user strong’. It’s about the pathology
of service user status and experiences, people
need to practice thinking about people in a
different light, as experts on themselves.”
‘Ursula’
Balance and Fluidity
“I have grown as a person ... I am a professional
and I bring my life experiences. I will not deny
these; they’ll not be put in a box. .... I now
know the other side of the relationship.... I
always check how I think about things; it’s
about personal and professional safety.”
‘Ursula’
Disclosure
Reinforcing good practice.
“My family and my Gateway experience was a
more positive experience and I would be more
willing to share this. I wouldn’t be though if it
had been a bad experience.”
‘Rita’
Disclosure
Social justice and advocacy.
“Yes, when I have to stand up for them when
someone makes a remark....I felt hurt and
insulted, but now that I’m on the social work
course I’m trying to handle situations better....
I don’t want him (brother) to be an object or
subject to be talked about.”
‘Rose’
Disclosure
Access to accommodations, institutional and
personal.
“I did, mostly for support materials and to
increase my accessibility. The previous
University didn’t ask and I didn’t tell them. I
had friends from school with me who
supported me.”
‘Anna’
Disclosure
Ownership and protection of experiences
“I said a couple of sentences but didn’t say too
much detail about it. I think that if you bring
your life experience and once you put it out
there someone else owns your personal
information.”
‘Ursula’
Other emergent themes
• Experience-informed practice, linking experience
to interpretation.
• Positivity and expertise.
• Balanced approach to negotiating multiple
identities within a context of fluidity and
professionalization.
• Institutions facilitating service users and
caregivers on the program to contribute to
learning.
• Fitness to practise.
Limitations
• My lived experiences and potential bias. Regular
reflections in supervision assisted.
• Possibility of desirable responses from interviewees.
• Limited sampling frame in context of academic
timetable. The good grace of students and teaching
staff facilitated this.
• Challenges in migrating data from the Personal
Response System to SPSS.
• Survey - level of non-response for each question.
• Interview sample limited from the point of view of
gender, as no males were recruited for interview.
Conclusions
•
Subjective interpretations of user and carer self-identification exist. Who owns
disclosure?
•
The extent to which this cohort of students perceive service users and carers as
‘other’ than themselves is also significant.
•
Variances in perceptions of experiences, ranging from presumed vulnerability to
presumed strength, hope and opportunity (Sakamoto and Pitner, 2005).
•
Sensitivities to the concept of holding blurred and fluid identities as human beings,
as opposed to binary relationships between lived experiences and professional
work practice (Chapell et al, 2003).
Conclusions
• Disclosure underpinned by a critical tension between
individual agency and professional socialisation (Clark,
2006).
• Pertinent questions about social work education and
practice as a potentially and paradoxically oppressive forum
for practitioners with lived experiences, and whether or not
meaningful supports exist for these people (Webber and
Robinson, 2011).
• Further research explicitly in relation to the concept of
‘otherness’.
A final word on Northern Ireland .....
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