Does Service User and Carer involvement in social

Does Service User and Carer involvement in social work education promote person-centred social work practice? An examination of student discourses. Dr Eleni Skoura-Kirk Senior Lecturer in Social Work New Directions Conference 26 th and 27 th August 2015

Research area l Long-standing interest and involvement in service user and carer involvement in social work education. l Committed yet wanting to promote critical approach. l Gap in the knowledge of impact of service user involvement in the practice of students.

Working title l Does Service User and Carer involvement in social work education promote person-centred practice? l “Person-centred” refers to empathy, nonjudgmental approach, use of self. Also want to capture issues of power, ADP and AOP. l Driven by the idea that SUI can have an impact on the attitudes and values of students and their practice (levels 2 a and 3 a Robinson and Webber, 2013).

Impact on values, attitudes, beliefs. l “The development of knowledge and skills can be learned, and assessed for competence, more readily than values. We still feel we are there to shape the value base…” (Baldwin and Sadd, 2006, p. 351) l “We want to try to identify and nurture empathy in social work students- empathy, not sympathy. ” (Bob B. , in Skoura-Kirk et al, 2013, p. 566)

l “An important question in this area, and a subject that warrants rigorous research because of its relevance to all professionals working with people, is whether these ‘attitudes’ and ‘abilities’—such as empathy or the ‘professional use of self’—can be taught on training courses, including social work courses” (Erera, 1997 cited in Trevithick, 2003, p. 165).

How? l 2 nd year BA module focusing on the service user experience- one cohort of students (28 gave consent). l Wanted to examine the way in which the students’ written discourses around “service users” and “carers” might have shifted after SUI input during the module. l Discourse analysis approach. l Ethical approval by FREC.

Discourse Analysis l Professional discourses shaping relationship between social worker/ service user (Krumer. Nevo et al, 2011) l Social Linguistic Analysis: understand how social phenomena- decisions, organisations, identities- are produced by specific discursive actions and events on the part of particular actors (Phillips and Hardy, 2002, p. 23; l Links to work by Potter and Wetherell (1987) and Billig et al, (1988), i. e. idea of interpretive repertoires, ideological dilemmas and subject positioning.

Data l Initial written statements on ‘I think a service user is…” “I think a carer is…” l Student reflective essays at the end of the module. l Students’ Assessment of Practice Tool (APT) end of their placement, end of the academic year. l Focus group to discuss initial findings.

Initial findings- statements “A service user is…” Themes Examples 1) In need of support and guidance Vulnerability Crisis 2) Emancipation/ empowerment Facing oppression, bias, exclusion An individual A person just A source with rights, a like me/ a of learning voice human being 3) Narrow/ oppressive Dependent on government funding A patient in hospital or resident in care home 4) Complexity/ tensions Partnership/force Difficult but also inspiring Uses services Part of a caseload that could be taking up time that could be used more positively elsewhere

Theme 4 l “A service user can be challenging, difficult, negative but can also be inspiring, positive and a life changing experience for those that encounter them. ” l “Someone with whom we work collaboratively with, in most situations, however occasionally we force ourselves on them. ”

Initial findings- essays (26) l Use of emotional words when ‘processing’ the experience of SUCI in the classroom, i. e. “surprised”, “challenged”, “I began to notice some areas of instability in myself”, “very shocked”, “I felt ashamed”, “sobering thought”. l Lightbulb moment? “ I was narrow minded”, “superficial”, “an eye-opener”.

Initial findings- essays cont. l Followed by examples of how their practice might be different (i. e. recognising the control element of domestic abuse in future cases). l However, essays part of formal assessment/students following guidance, so writing what they feel markers want to hear? Links to broader expected social work discourses?

Initial findings- APTs (12) l Clear evidence of use of person-centred and empowerment discourses. l Service users are present, i. e. they are constructed through lively examples of practice, rather than relegated to initials and jargon. l Practice dilemmas and conflicts explored in the students’ writing.

Initial findings- focus group (11) l Narratives explored and questioned: ‘real’ and ‘valid’. Word ‘concrete’ used, i. e. clear perspective linked to best social work practice. l Critical incident in classroom/disclosure: strong, lasting reactions, links to risk. l Emotional impact of narratives- need for building/teaching resilience. l Deep awareness of power of language and conflicts with practice environments, .

Examples- what is real? 118…we can all sit here with case studies and reason it on a 119 piece of paper but it doesn’t mean anything to me, cause in my head it still is a story 120 and I don’t think it’s real but until I hear someone talking about their own personal 121 life, that’s where I kind of have that emotional connection.

Examples: negotiating the subjective 131 F I think, I think the danger of it though is like, what [Alice] was saying, also about if 132 your experience of domestic abuse and then if you see someone come in and then if 133 you get the perspective of the service user that comes in, you shouldn't take it on 134 face value that is the experience. 135 ((General murmurs of agreement)) 136 Because there was one particular experience that actually made me quite angry?

Examples: emotional impact 99 D and as I say, learning them on the module, it doesn't always bring up thoughts 100 that feelings from your personal life but listening to a service user discussing it, 102 maybe young lady really affected me personally and made me identify issues that 103 that I’ve got to deal with 104 Eleni Mmmhmm 105 D and go forward with and it was really interesting and really helpful. 106 Eleni Mmmhmm, it's interesting, yeah, that the emotional impact is something I’m seeing at 107 the essays. 108 A ((Murmurs agreement)) 108 D I actually cried at that lecture, I did.

Example: ideological dilemma 967 remember going in on the first day of this placement and going into like a handover meeting and 968 everyone referring to the Room 1, Room 2, Room 3 and I thought: I am never, ever going 969 to get into that mode of referring to them as room numbers, I think that’s just so taking away 970 the individual perspective and I did it the other day because the unit’s completely full and I just 971 couldn’t remember this person’s name off the top of my head and I referred to them for the 972 room and I could feel myself inside thinking: What have I just done?

Initial comments on these findings l Person-centred, anti-oppressive discourses present from the start, seem to be ‘refined’ across the course and to inform direct practice. (Interpretive repertoires) l Emotional, relational discourses employed by students. l Conflicts when their person-centred discourses are to be applied on placement. (ideological dilemmas)

Reflections/challenges/way forward l Discourse analysis can feel very slippery and vague- how to ensure robust research with direct, tangible outcomes? l Discourse analysis can benefit social work research, theory and practice, as it can promote critical thinking and practice approaches. l On practical level, changes to the module: more theory, space to reflect and dialogue model.

Contact: l Dr Eleni Skoura-Kirk School of Public Health, Midwifery and Social Work eleni. skoura-kirk@canterbury. ac. uk 01227 767700 ext 3886

References l Baldwin, M. and Sadd, J. (2006) Allies with Attitude! Service Users, Academics and Social Service Agency Staff Learning How to Share Power in Running Social Work Education Courses, Social Work Education, 25 (4), pp. 348 -359. l Krumer-Nevo, M. , Weiss-Gal I. and Levin, L. (2011). Searching for Poverty-aware Social Work: Discourse Analysis of Job Descriptions. Journal of Social Policy, 40 (2), pp 313 -332 l Phillips, N. and Hardy, C. (2002) Discourse Analysis: Investigating processes of social construction. Thousand Oaks, Sage. l Potter, J. and Wetherell, M. (1987) Discourse and Social psychology: beyond attitudes and behaviour. London: Sage.

References l Robinson, K. and Webber, M. (2013) Models and Effectiveness of Service User and Carer Involvement in Social Work Education: A Literature Review, British Journal of Social Work, 43, pp. 925 -944 l Skoura-Kirk, E. , Backhouse, B. , Bennison, G. , Cecil, B. , Keeler, J. , Talbot, D. and Watch, L. (2013) Mark my words! Service User and Carer involvement in Social Work Academic Assessment, Social Work Education, 32 (5), pp. 560 -575. l Trevithick, P. (2003) Effective relationship-based practice: A theoretical exploration, Journal of Social Work Practice, 17 (2), pp. 163 -176