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Slide 1: Teaching and learning communication skills in social work education Marie Diggins Better knowledge for better practice i
Slide 2: Teaching and learning communication skills in social work education First published in Great Britain in June 2004 by the Social Care Institute for Excellence (SCIE) Social Care Institute for Excellence 1st Floor Goldings House 2 Hay’s Lane London SE1 2HB UK www.scie.org.uk © Social Care Institute for Excellence 2004 Cartoons © Harry Venning, The Guardian, and Angela Martin as featured in the Scope publication A lot to say: A guide for social workers, personal advisors and others working with disabled children and young people with communication impairments. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 1 904812 08 2 Marie Diggins is Practice Development Manager at SCIE The right of Marie Diggins to be identified as the author of this work has been asserted by her in accordance with the 1988 Copyright, Designs and Patents Act. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, or stored in any retrieval system of any nature, without prior permission of the publisher. Produced by The Policy Press University of Bristol Fourth Floor, Beacon House Queen’s Road Bristol BS8 1QU UK www.policypress.org.uk Printed and bound in Great Britain by Hobbs the Printers Ltd, Southampton. ii
Slide 3: Contents Acknowledgements 1. Introduction 1.1. What this resource guide is about 1.2. Who this resource guide is for 1.3. How this resource guide can assist in teaching and learning communication skills 1.4. How to use the resource guide Signposts to new ways of working 2.1. Learning aims and outcomes 2.2. Standards 2.3. Assessing communication skills 2.4. Evaluation of teaching and learning communication skills 2.5. Service user and carer involvement 2.6. The relationship between practice and academic settings, including quality assurance 2.7. Applying theory 2.8. Writing skills 2.9. Transferability across practice settings and from training to doing 2.10. Learning from, about, and with other professionals Changes in social work training 3.1. Key documents 3.2. Implications for teaching and learning communication skills 3.3. Supporting initiatives and opportunities 3.4. Parallel development in health Key messages from service users and carers The SCIE research review Teaching and learning communication skills in social work education – a summary 5.1. Conclusion and challenges for the future The SCIE practice review Teaching and learning in social work: Communication – a summary 6.1. How are communication skills currently taught and how are they delivered? 6.2. How do you distinguish and differentiate between core transferable skills and specific skills, including technical skills? 6.3. What is the breadth and depth of skills training needed to perform the range of duties and tasks for beginning practice and for qualifying level? 6.4. How do you identify the underpinning principles and values of communication for all categories of social work delivery? v 1 1 2 2 2 4 4 4 5 6 6 6 7 8 8 8 9 9 10 11 11 13 15 16 17 18 18 19 20 2. 3. 4. 5. 6. iii
Slide 4: Teaching and learning communication skills in social work education 7. Practice examples 22 51 52 54 References and source material Appendix A: Summary of methodology Appendix B: The SCIE practice review Teaching and learning in social work: Communication – full text iv
Slide 5: Acknowledgements This project was funded by the Department of Health and Welsh Assembly. We are grateful for the support provided by all the members of the project reference group: • Janet Bakht, Student Social Worker, Anglia Polytechnic University • Claudia Bernard, Senior Lecturer in Social Work, Goldsmiths College University of London • Anna Fairtlough, Lecturer in Social Work, Goldsmiths College University of London • Jeanette Harding, User Trainer-Consultant • Elisabeth Hunter, Practice Manager, Mental Health of Older Adults and Practice Teacher Coordinator, London Borough of Lewisham • Ruth Jordan, Senior Lecturer in Social Work, Institute of Health and Community Studies, Bournemouth University • Kate McMullen, Policy and Research Officer, Scope • Rachel Norrington, Social Worker, Community Mental Health Team, London Borough of Lewisham • Louise O’Connor, Lecturer in Social Work, Bromley College of Further and Higher Education • Pauline O’Loughlin, Principal Social Worker, St Christopher’s Hospice • Tamara Van Coolenburg, Student Social Worker, Anglia Polytechnic University We thank the members of academic teams that undertook the research and practice reviews. The practice review team from Brunel University for Teaching and learning in social work: Communication (2003, unpublished, London: SCIE) was as follows: • Cathy Aymer, Senior Lecturer in Social Work and Director of Social Work Studies, Brunel University and Director of the Centre for Black Professional Practice, Brunel University • Adam Dinham, Lecturer and Tutor in Social Work, Brunel University • Annabel Goodyear, Lecturer and MA Course Leader in Social Work, Brunel University and a member of the Centre for Child-Focused Research • Dr Toyin Okitikpi, Lecturer and Course Leader in Social Work, Brunel University and a member of the Centre for Black Professional Practice, Brunel University • Bryony Randall, Research Assistant The research review team for Teaching and learning communication skills in social work education (2004, London: SCIE) was: • Bernard Moss, Principal Lecturer in Social Work and Applied Studies and Learning and Teaching Fellow, Staffordshire University • Sally Richards, Lecturer in the School of Health and Social Care, University of Reading • Gillian Ruch, Lecturer in the Division of Social Work Studies, University of Southampton • Pamela Trevithick, Senior Lecturer in the School for Policy Studies, University of Bristol v
Slide 6: Teaching and learning communication skills in social work education With: • Linda Lines, Open University • Oded Manor, formerly Middlesex University A special thanks goes to Scope and Jenny Morris for allowing SCIE to use illustrations from their publication A lot to say: A guide for social workers, personal advisors and others working with disabled children and young people with communication impairments, and to Angela Martin who produced the cartoons. We would also like to thank Harry Venning for giving permission for SCIE to include a selection of cartoon strips from the Clare in the Community series, which regularly features in The Guardian. Particular thanks goes to the administrators, Lynette Bolitho and Zoë Elford, who have supported us throughout the project. vi
Slide 7: 1 Introduction 1.1. What this resource guide is about This resource guide is about teaching and learning communication skills in social work qualifying education. It is intended to be a resource for all of those involved in teaching and learning on the new social work degree. Learning to communicate in a professional manner in a variety of contexts with people from a diverse range of backgrounds can be difficult, but it is a fundamental skill without which it is difficult to perform many other social work tasks or, perhaps, the social work role at all. Communication not always, but sometimes, takes place in difficult and challenging contexts. Finding a way to engage with someone who avoids all contact with social care agencies is not easy; nor is explaining to someone that you have concerns about their parenting skills or to a carer that their son is experiencing a mental health crisis and needs urgent admission to hospital. Communicating with people with different communication needs to yourself can also pose challenges if you do not speak the same language or know enough about their specific mode of communication or preferences. For qualified or student social workers who are communicating with service users, carers or other professionals, or for students in simulated situations such as role play carried out in front of peers and teachers, these circumstances can conjure up a variety of uncomfortable emotions. Embarrassment, anxiety, fear and uncertainty are but a few of those emotions described. It should be of no surprise, then, that when asking for volunteers for a role play people rush to the back of the queue. 1
Slide 8: Teaching and learning communication skills in social work education 1.2. Who this resource guide is for This guide is primarily for programme providers of the social work degree, including Higher Education Institutions (HEIs), practice assessors as agency-based educators and service users and carers involved in the planning and delivery of the social work degree programme. It may also be of interest to: employers, in particular, those offering practice learning opportunities; practice learning organisers; student social workers; and other people involved in skills development, for example, training officers. and share their work. In 2006 SCIE will undertake a further review of the work undertaken in teaching and learning communication skills during the first of the degree courses from 2003-05. This resource guide: • identifies general principles of teaching and learning communication skills in social work training up to qualifying level; describes and reviews the range of what people are doing and drawing on in social work education prior to the introduction of the new degree; acts as a springboard for further research that people might want to undertake; provides opportunities for key stakeholders to share and comment on the curriculum process once the degree programmes are underway; provides links to other relevant sources of information. • • 1.3. How this resource guide can assist in teaching and learning communication skills The information from literature and practice reviewed for inclusion in this guide has necessarily been drawn from teaching and learning on qualifying social work courses that precede the new degree. Identifying and reflecting on the experience and knowledge gained from what has gone before should assist programme providers in their planning, delivery and evaluation of teaching and learning on the new programmes. Communicating with adults, children and those with specific communication needs is a very broad and encompassing curriculum area, and this guide focuses on general principles underpinning teaching, learning and assessing communication skills. This guide has been published to coincide with the onset of the first of the new degree programmes. The guide offers a starting point for ongoing dialogue with and between key stakeholders. The Social Care Institute for Excellence (SCIE) will continue to support the process of sharing and recording the developments that take place as the degree programmes progress. SCIE will provide practical support and encouragement to those who wish to publish • • The following areas will not be covered by this guide, but may need further attention: • the guide does not cover specific or technical communications in any detail or communication skills in specific contexts, including where there are cultural or language differences (these may be the focus for future work by SCIE); the guide does not draw on materials from nursing, medicine and other allied professions (again, this may be the focus for future work by SCIE). • 1.4. How to use the resource guide The content of this guide is drawn primarily from the findings of a SCIE research review and practice review. These findings are presented in a number of different ways to enable readers to decide how much detail they 2
Slide 9: Introduction need at any one time, moving easily between sections of the guide for more detailed information as required. There are reference and electronic links (in the online version) that point to additional supporting text, and examples found elsewhere in the guide and from other publications and websites. The guide’s key messages are articulated as signposts to new ways of working (see Chapter 2, p 4), and are a commentary on the key themes arising from combined findings from literature and practice. The messages and questions that are set out are intended to stimulate further discussion and action by those involved in teaching and learning communication skills. A summary of the SCIE research review can be found with references and electronic links to the full text version. There is also a summary of the SCIE practice review with the full text available in Appendix B of this guide (p 54). If you would like to see examples of teaching, please see Chapter 7, which is a description of teaching and learning resources that were mostly identified during the SCIE practice review (p 22). Details of how this resource guide was created can be found in Appendix A (p 52). 3
Slide 10: Teaching and learning communication skills in social work education 2 Signposts to new ways of working 2.1. Learning aims and outcomes The SCIE practice review found uncertainty about how and where best to teach and learn communication skills. There was confusion about whether academic or practice settings, theoretical or experiential approaches, were more appropriate. While setting learning aims and measuring learning outcomes is familiar work to HEIs, extending these appraisal skills beyond ‘classroom’ learning may be new, just as demonstrable learning outcomes may be new to practice agencies. However, learning aims and outcomes can be best achieved if they are explicit and are extended outside of the university classroom to include the practice environment and the work of the practice assessors. While the increased number and range of practice learning opportunities is welcomed, this new environment is potentially complex. HEIs and their practice agencies will be most effective if they can specify learning aims and outcome measurements for academic and practice settings. What service users and carers value in their communication with social workers will help in developing standards locally. • The SCIE practice review illustrates the standards of communication that service users and carers expect from social workers (‘Key messages from service users and carers’, p 13). The development of the National Occupational Standards (NOS) in England drew on service user and carer consultation and is set out in the Statement of expectations from individuals, families, carers, groups and communities who use services and those who care for them, Appendix D, NOS, 2002 (www.topss.org.uk). • Other sources of information about the standards that service users and their carers expect from services and service providers can be found in the following publications: • A lot to say: A guide for social workers, personal advisors and others working with disabled children and young people with communication impairments (Morris, 20021). The good practice guide for support workers and personal assistants working with disabled people with communication impairments (written by disabled people using Scope services in Essex and in partnership with consultants from the Essex Coalition of Disabled People,20022). The standards we expect: What service users and carers want from social services workers (Harding and Beresford, 19963). 2.2. Standards Clear learning aims follow on from clear standards. Social care standards take account of the views of people who use services and their carers. The standards of communication skills expected of student social workers, laid down by HEIs and Care Councils for Wales and Northern Ireland, will need to reflect this aim. Practice assessors should be as mindful of the views of people who use services and their carers in this as in any other aspect of their professional work. • • 4
Slide 11: Signposts to new ways of working • Raised voices (Wilson and Francis, 19974). • Breaking the circles of fear: A review of the relationship between mental health services and African and Caribbean communities (The Sainsbury Centre for Mental Health, 20025). See also the General Social Care Council (GSCC) Codes of practice for employers and social workers (20026) and Care Councils for Wales and Northern Ireland, which include both specific and related standards about communication and communication skills (www.gscc.org.uk, www.wales.gov.uk, www.ni-assembly.gov.uk). the client speaks and appreciate the need for a male or female interpreter. Interpreters need to be trained and qualified. There is nothing worse than having someone try and explain procedures and rights when they do not have either fluency in a particular language or training around issues that are very personal and need to be dealt with sensitively.” (Newham black and ethnic minority community care forum, from Harding and Beresford, 1996, p 213) “Sensitivity in communication needs to be extended to record keeping. Some groups reported that ‘What is written in files can be brutal’.” (Newham black and ethnic minority community care forum, from Harding and Beresford, 1996, p 223) “… it’s kind of more than just information that’s needed [by staff], it’s also a kind of training on skills of negotiation with the system, you know, for people to be able to use the language that will get them the things they want….” (The Sainsbury Centre for Mental Health, 2002, p 475) “Don’t panic when we express feelings. Often it is useful to sob, shout, scream, shake or shiver. We appreciate being listened to and encouraged. We want space to do that without disturbing other people.” (MIND guidelines, from Harding and Beresford, 1996, p 203) “Young people don’t feel listened to. This is partly because they choose to talk when there is no one to listen, and sometimes in a way that makes listening difficult. Being asked how things are for you, how you feel about what’s happening, suggests some commitment.” (WHO CARES TRUST, from Harding and Beresford, 1996, p 203) “Listening should be done with insight and sensitivity: staff should be able to discriminate between over-complaining and a muted cry for help.” (National Pensioners Convention, from Harding and Beresford, 1996, p 203) “Black and ethnic minority communities value staff who understand their religion and culture; staff who can communicate with them in their own language; staff who can deal with any communication barriers by acting promptly and getting interpreters when required, can find out which language 2.3. Assessing communication skills Building the confidence of students in communication skills was seen in the practice review as a key element in teaching and learning for beginning and qualifying level practice. Students described this as reaching a state of “feeling ordinary” and having “confidence” in communication skills. However, self-reporting on achieving a level of “feeling ordinary” or feeling “confident” is not enough. Some markers to help establish who is a confident practitioner, for example, being prepared, being reflective or, indeed, an over-confident practitioner, are probably helpful. Otherwise, these are difficult notions to capture without measures, particularly as the SCIE practice review noted discrepancies of 5
Slide 12: Teaching and learning communication skills in social work education perception between students and other stakeholders. Service users, carers, HEIs and agencies expressed concerns about students’ written skills whereas students did not. There are a number of questions that arise from the SCIE practice review findings relating to assessment of communication skills, and which HEIs and their partner agencies could ask themselves: • Is it better to assess communication skills separately or as part of other learning outcomes? • Is it better to assess competence through written or observational methods? • Should academics share their role of assessor with practice assessors? full text version and electronic guide can be found on www.scie.org.uk). The benefits of this involvement include: the availability of more immediate feedback and a true sense of the impact on the recipient of the student’s communication skills; material to reflect upon in supervision and academic assignments; a focus on individual learning objectives; and a contribution to the overall appraisal of the student’s learning. Students’ emphasis on learning communication skills by putting them into practice strongly indicates that user and carer involvement should be part of practice settings as well as the classroom. Inviting users and carers to become part of the learning and assessment of student communication skills in practice settings has very obvious benefits. Service users and carers can give feedback on the range of communication modes used by the student, for example, written (including recordings on file), verbal, telephone, use of interpreters and so on. Feedback can be given directly to the student or via a third party, that is, the practice assessor in a situation acceptable to the service user/carer. The benefits of this involvement include: the availability of more immediate feedback and a true sense of the impact on the recipient of the student’s communication skills; increased material to reflect upon in supervision and in academic assignments; a focus on individual learning objectives; and a contribution to the overall appraisal of the student’s learning. 2.4. Evaluation of teaching and learning communication skills The combined findings from practice and research are that evaluation tends to be concerned with satisfaction with the process and method of training, rather than individual and collective learning through learning aims and with outcome measurements. Shifts in thinking about practice learning, skills laboratories and learning resource centres offer the chance to try out new ways of teaching and learning, including evaluating outcomes. 2.5. Service user and carer involvement One of the degree requirements is service user and carer involvement. While this is a moral imperative, it is also a pragmatic one, recognising involvement as a strong lever for improving social care. Although not the prime focus of this guide, nevertheless, no respondents discussed the involvement of users in the planning of courses when asked what factors in planning might help improve teaching. SCIE has produced a companion resource guide to this, called Involving service users and carers in the social work degree7 (a 2.6. The relationship between practice and academic settings, including quality assurance The SCIE practice review identified a ‘fault line’ between practice settings and college, as noted above in the confusion about ‘where, when and how’ to teach communication skills. Some respondents understood the need for closer collaboration and expressed “goodwill and commitment” to achieving this. Putting goodwill and commitment into action will involve filling in the fault line with shared, explicit standards, aims and outcome measures that apply to both settings. Review findings 6
Slide 13: Signposts to new ways of working demonstrate that teaching, learning and the assessment of communication skills needs to take place in the academic setting, in the agency and in the relationship between the two. Students consider the practice placement as a place to get experience but not a place to learn: this observation from one academic illustrates the importance for HEIs and practice assessors in ensuring that students understand that the application of theoretical understanding to practice situations is equally important in both the classroom and practice setting. There are several examples in this chapter of the guide of how this strengthening and clarification of the independent and collective roles can be expressed. Further possibilities include: • Two initiatives which offer HEIs, social care agencies and service users opportunities to train students and practitioners collaboratively: learning resource centres, which can assist organisations in creating the organisational-development and critical-mass approaches as a supportive precondition for practice learning, both for students and for the workforce; skills laboratories, which are the responsibility of programme providers but could draw on the expertise of service users and practitioners to offer rehearsal opportunities to students, particularly in communication skills (SCIE Position paper 2, A framework for supporting and assessing practice learning, www.scie.org.uk). • Contracts made between HEIs and their partner agencies should contain explicit criteria and standards laid down by the HEIs about what they want for their students, how they want them to receive this, and how this teaching and learning process will be evaluated. An example of how HEIs might achieve this in a systematic way would be a practice assessment handbook agreed by the HEIs, agencies and practice assessors. • The application of theory to practice might indicate poor practice. Closer collaboration will mean that programme providers are more involved with social care agencies’ practice standards. Some programme providers already have ‘whistle-blowing’ protocols, which focus on the role of students who encounter poor practice. However, this approach usually concentrates on the consequences for the student’s learning. Agreements and practice codes at organisation level would be more effective. The effect on standards is a concrete example of how mutual benefits, built on shared responsibilities, can be achieved through practice learning (SCIE Position paper 2, A framework for supporting and assessing practice learning, www.scie.org.uk). 2.7. Applying theory The research review found that the theoretical underpinning of teaching and learning of communication skills is underdeveloped, with little in the literature to assist educators to teach and students to learn effectively. The practice review found that there were few attributed teaching models mentioned in the review. Egan’s SOLER model8 was the only one to be mentioned more than once, indicating a continued emphasis on the teaching of counselling skills as a basis to communication skills in social work. The literature, however, does not give a full picture of what is happening in current and emerging educational practice, and this can be demonstrated by some of the practice examples given in Chapter 7 (p 22) that demonstrate theoretical underpinnings to teaching and learning. It is important that, as the degree programmes progress, more educators disseminate the work they are undertaking in teaching and learning communication skills. More evaluative accounts from key stakeholders will assist educators and students and give a more accurate picture of what actually happens in practice. 7
Slide 14: Teaching and learning communication skills in social work education 2.8. Writing skills Writing skills were identified clearly as a concern by all stakeholders with the exception of students. Attention to writing skills particularly for a younger intake of students who it is anticipated may have a lower skills base could represent a resource implication for HEIs and agencies. The Department of Health Requirements for social work training in England9 include a requirement on providers of social work education to ensure that “in addition to the university’s own admission requirements for the degree, all entrants have achieved at least Key Skills level 2 in English and mathematics”. Also, the requirement that providers must “satisfy themselves that all entrants can understand and make use of written material and are able to communicate clearly and accurately in spoken and written English”. Therefore the new degree status of qualifying social work education may go some way in establishing that entrants to training will have the necessary written skills required to begin an academic course of this standard, regardless of their age. However, the standard of written skills expected from students at all stages of recruitment and training should be explicit and measured to avoid confusion about what is acceptable practice, and to avoid negative resource implications. • the original learning must be in place and understood; the learner must be able to see and understand the connections between the original learning and the new learning; there must be sufficient opportunity to try out this new learning in practice. • • See also Practice example 9, Social work skills: A practice handbook, the University of Bristol, which gives a further example of what is needed to transfer learning (p 42). 2.10. Learning from, about, and with other professionals Renewed interest in communication is in part related to the exposure that social work has received in the mass media in recent years. Independent inquiries into adult and child homicides raise crucial issues about lack of communication, both with services users and within and among different professional groups. It is imperative that educators ensure that teaching and learning includes the necessary communication skills needed to work across adult and childcare services. Service users and carers emphasise the need for social workers to be able to communicate effectively, verbally and in writing, with other professional groups, in order to be able to access services that they need, and to avoid repetitive questioning from the various professionals involved in people’s lives. Evidence from the practice review suggests that social work programmes prior to the degree were already paying attention to interprofessional education, with more opportunities planned for the new degree. Interprofessional learning and working in partnership will be covered more fully in a forthcoming SCIE social work education resource guide, dedicated to this area of teaching and learning. 2.9. Transferability across practice settings and from training to doing Effective professional communication with children, adults and those with particular communication needs requires the ability to transfer learning across a range of practice settings and from training to doing. In their study of transfer of learning, Cree and colleagues10 suggest the following factors need to exist for transfer of learning to be able to take place: 8
Slide 15: 3 Changes in social work training Preparing and putting into place the new three-year degree programme in social work, at the same time as phasing out the current Diploma in Social Work qualification, posed an enormous challenge for those involved in the education of social workers. It may be helpful for everyone involved in the new social work degree to be knowledgeable about the background to its introduction and, above all, its main purpose. At the time of writing, this guide refers mainly to the degree requirements in England. The degree requirements for Wales are set out in the National Assembly For Wales Requirements for an award of a degree in social work11. These requirements were developed in partnership with the social care sector in Wales to reflect the key principles for the reform of social work training in Wales set out by the Minister for Health and Social Services in June 2001. They underpin the Assembly’s objective of improving standards through the introduction of degree-level training. The requirements are part of the overall ‘Qualification framework for the degree in social work in Wales’ and are reflected in the Care Council for Wales’ ‘Approval and visiting of degree courses in social work (Wales) Rules 2003’ as the required standard of proficiency in relevant social work. For detailed information go to: www.wales.gov.uk/ In England, the consultation paper on A quality strategy for social care (DH, 200013) signalled the introduction of the changes. It included the modernisation of qualifying training for social workers in its proposals to support quality and continuous improvements in social care. The registration by the GSCC of all social workers and students under the 2000 Care Standards Act from 2003 is also part of this strategy. The thrust of all the new arrangements is that service users and carers get high quality social work services in terms of both processes and outcomes. Thus the changes, including service user and carer participation in training, are the means to the ends of improving experiences and outcomes rather than ends in themselves. Issued under the 2000 Care Standards Act, the Requirements for social work training in England9 specify “what providers of social work training must do”, covering the entry, teaching, learning and assessment requirements for the degree courses. The national occupational standards for social work (TOPSS, 200213) and the Benchmark statement for social work (QAA, 200214) form the basis for the assessment of competence at the end of the programme and the award of the degree. Taken together, the requirements, standards and benchmark statement comprise the prescribed curriculum for the degree. The emphasis is on practice with academic learning to support it. To this end, students will spend at least 200 days gaining experience and learning in practice settings. For detailed information and access via the Internet, go to: www.dh.gov.uk/ 3.1. Key documents Listed below are a number of key documents and web links that give detailed information about the changes in social work education and the initiatives that are being implemented to support this process: 1. A quality strategy for social care (DH, 200012): the process of change in social work education began with this consultation paper and included the 9
Slide 16: Teaching and learning communication skills in social work education modernisation of qualifying training for social workers in its proposals to support quality and continuous improvement in social care. 2. 2000 Care Standards Act (www.legislation.hmso.gov.uk/acts/ acts2000/20000014.htm): the registration by the GSCC of all social workers and students under this Act is a component of the quality strategy for social care above. 3. The Department of Health have a dedicated website for social work education with updates and further information about requirements for training and assessments; entry requirements; and teaching, learning and assessment requirements: www.dh.gov.uk/ 4. The Practice Learning Taskforce was established in 2002 to work with statutory, voluntary, private, user and carer-led organisations and with HEIs to help secure sufficient quality, quantity and diversity of practice learning and assessment opportunities for social work students (www.practicelearning.org.uk). 5. Performance indicator: the provision of social work practice learning will be a performance indicator for local authorities, which takes effect in 2004. Local authorities are being asked to provide the Department of Health with the number of practice learning days currently provided for Diploma in Social Work students, as part of the Performance Assessment Framework for social services departments. This information will be used to develop targets against which the Department of Health will monitor performance in local authorities. This new monitoring is an indication of the importance attached to the successful delivery of the new degree (www.dh.gov.uk/). 3.2. Implications for teaching and learning communication skills The changes to social work education have direct implications for teaching and learning communication skills: • The social work degree and the current recruitment drive to attract and inspire young people to enter social work both suggest a younger intake of students. HEIs anticipate an increased need to cover basic communication skills for younger, less experienced, students. An increased emphasis on practice learning will require more rigorous systems and standards for teaching, learning and assessment of communication skills within practice settings. See Dick et al (200215). This report was commissioned by the Scottish Executive as part of the reform of social work education in Scotland. The literature review presents a summary of the current thinking, knowledge practice and research on practice learning within professional education, with particular attention paid to the area of social work. In particular, it consolidates the literature in three areas: theories of practice learning, methods of practice learning, and the use of e-learning strategies in conjunction with practice learning (see the document in full at www.scotland.gov.uk). The focus on practice learning opportunities, including the increased number of student days in practice settings, requires a shift in thinking about the types of opportunities and the range of practice assessors: The centrality of practice learning to the creation of confident and relevant social work professionals is recognised within the degree. The need to reform the way practice learning takes place and its aims have also been part of the development of the new qualification. The degree is committed to practice learning opportunities that include the • • 10
Slide 17: Changes in social work training primacy of users’ experiences and an understanding and experience of collaborative working with other professions. Achieving these goals requires a shift in perception from individual assessors of individual students to a workplace where every social care worker sees practice learning as their business. The costs of students in the workplace can be set against the benefits of extending learning and raising standards across the workforce16 (SCIE Position paper 2, A framework for supporting and assessing practice learning, www.scie.org.uk). The new emphasis on teaching and learning through practice is closely linked to another of the degree requirements of ‘learning from, about, and with other professionals’. Communication skills are likely to be a prominent part of such collaborative practice learning. (See Whittington, 200317 and www.dh.gov.uk/) focus for the degree. The laboratories could draw on the expertise of service users and practitioners to offer rehearsal opportunities to students, particularly in communication skills. They provide an environment for the development and assessment of social work students’ skills at each stage of the integration of learning between ‘field’ and classroom settings (www.dh.gov.uk). 3.4. Parallel development in health The Department of Health (England), Universities UK, the Health Professional Council (HPC), the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC) have prepared a joint statement setting out guiding principles relating to the commissioning and provision of communication skills training, and the required support for healthcare students, at pre-registration and undergraduate level. The NHS Plan for England (DH, 2000) stated that by 2002 it will be a precondition of qualification to deliver patient care in the NHS that an individual has demonstrated competence in communication with patients. In addition, reports highlighting failures in health and social care systems, such as the Kennedy Report (The Bristol Royal Infirmary Inquiry, July 2001), The Cancer Plan (DH, September 2000), the Health Service Ombudsman’s Report for England (2002, Annual Report, 2001-02), and the report from the Victoria Climbié Enquiry (Lord Laming, January 2003), reinforce the need for improved communication skills for all health and social care staff. Ensuring that healthcare students are suitably prepared for their first post is only the foundation on which they will continue to build during their careers. Developments in specialist communication skills, improving the skills of existing staff and induction programmes for all healthcare staff are being developed by the National Health Service University (NHSU) in partnership with experts, patients and local health communities. This 3.3. Supporting initiatives and opportunities Two of the government initiatives to support practice learning are of particular relevance to teaching and learning communications skills through practice. They offer ways to strengthen the relationships between employers and programme providers, and to promote practice learning in practice agencies. • Learning resource centres offer organisations the opportunity to develop practice learning for students and for the workforce. Ten pilot centres will be established in 2003/04, a further 15 in 2004/05 and by 2005/06 there will be 50. The initiative will be overseen by TOPSS England: www.topss.org.uk • Skills laboratories are the responsibility of programme providers who have been provided with pump-priming funding for 2003/05 to enable programmes to realign their present arrangements for delivering social work training to a more practical 11
Slide 18: Teaching and learning communication skills in social work education will build on the work of others, including the regulatory and professional bodies. The NHSU will develop programmes for developing and improving specialist communication skills that are likely to cover both health and social care. The health guidelines are available at: www.dh.gov.uk/ 12
Slide 19: 4 Key messages from service users and carers “When people not used to speaking out are heard by those not used to listening real changes can be made.” (John O’Brien, mental health worker) Social workers who are good at communication: • are courteous • turn up on time • speak directly to service users, not carers or personal assistants • don’t use jargon • ‘open their ears’ and ‘think before they talk’ • listen and ‘really hear’ and accept what carers are saying • explain what is happening and why • do what they say they are going to do and don’t over-promise • • say honestly when they can’t help are patient and make enough time to communicate with disabled service users 13
Slide 20: Teaching and learning communication skills in social work education • recognise the loss of dignity people experience when approaching social services for the first time – the ‘cost’ in this – and respond sensitively • don’t assume anything about a user’s abilities simply because of a disability • understand the importance of privacy, peace and quiet and users’ and carers’ choice of meeting place • know that closed questions can be easier for service users with communication difficulties to answer • check out that they’ve been understood • find a mode of communication that works • remember that young people may prefer to talk while doing something else • build trust, empathy and warmth • work in organisations that help them to do all these things. Many of the points made here echo statements that were made during a detailed consultation that took place as part of the development of The national occupational standards. These statements can be found in the Statement of expectations from individual, families, carers, groups and communities who use services and those who care for them (www.topss.org.uk). For details of how these statements specifically link to The national occupational standards for social work please see www.topss.org.uk13 For more information on ‘simple skills’ that can make a difference, see A lot to say: A guide for social workers, personal advisors and others working with disabled children and young people with communication impairments1 and The good practice guide for support workers and personal assistants working with disabled people with communication impairments2, two communication skills resources both produced by and available free from Scope (www.scope.org.uk). You can also find out more about A lot to say by going to Chapter 7 and looking at Practice example 4 (p 30). 14
Slide 21: 5 The SCIE research review Teaching and learning communication skills in social work education – a summary The theoretical underpinning in relation to the teaching and learning of communication skills is underdeveloped. For example, there is little coherence in the literature to assist educators to teach effectively, and little coverage of students’ different learning styles. These differences are reflected in the divergent range of models identified by the Brunel Practice Review (2003)18, and also in research undertaken by Marsh and Triseliotis (1996)19. In light of the requirements of the new degree in relation to teaching and learning communication skills, several aspects require particular attention: • there is an absence of literature that addresses service user involvement in – and perspectives on – the teaching and learning of communication skills; • greater focus is needed on the importance of transcultural communication skills given the limited literature and research in this area; • encouragement needs to be given to enable practitioners to contribute to teaching/learning in all aspects of practice, particularly those areas such as transcultural communication skills, where there is a serious lack of literature and research; • there is scope for more work to be done on the teaching and learning of specific communication skills associated with specific theoretical approaches; • the lack of a ‘common language’ means that greater rigour is needed when using such terms as generalist, specialist and advanced practice skills, micro-skills and macro skills, interventions and so on; the processes involved in teaching communication skills require as much attention as the content of the teaching; evaluative studies which focus on the teaching and learning of interviewing and listening skills suggest that the improvements made in simulated settings do not automatically transfer to practice settings with service users. The integration of communication skills training with practice learning is seen as crucial here; the increasing use of computer-based programs and skills laboratories is described in the literature, but the limited evaluation of such resources suggests that they are best used to support face-to-face teaching rather than as ‘stand-alone’ training in communication skills; the relative paucity of evaluative literature indicates that there is an urgent need to develop a robust methodology, particularly with regard to defining and measuring the effectiveness of communication skills with service users. • • • • 15
Slide 22: Teaching and learning communication skills in social work education 5.1. Conclusion and challenges for the future In light of the requirements of the new degree, the teaching of communication skills needs to be seen as a priority in social work education. Although this report has not been able to identify from the literature reviewed a unified body of knowledge on which such teaching programmes can be based, it has highlighted those aspects that need further attention. Firstly, there are two significant aspects of the literature review generated by the Centre for Reviews and Dissemination (CRD) search that were not possible to review within the parameters of this research project (www.york.ac.uk). However, they may be the subject of further examination by SCIE: • the literature on teaching and learning of communication skills in other sectors such as medicine, nursing and allied health professionals; • the literature on improving communications skills of users. Secondly, it is recognised that there is far greater expertise in existence than is reflected in the literature. The findings of the SCIE practice review (2003)16 indicate that there is a considerable amount of innovative practice being undertaken in this field that is, as yet, barely covered in the literature. It is hoped, therefore, that this report can serve as a catalyst to educators in two ways: by encouraging educators to write for publication about their knowledge and experience on this aspect of education, and to address the gaps in existing knowledge by undertaking research in the areas identified in the report’s key messages. Thirdly, the theoretical knowledge base that underpins the teaching and learning of communication skills needs to be made more explicit, adopting the same academic rigour used in other areas of social work research and practice theory. The review was enriched by the international scope of the articles provided by the search, but the transferability of much of the material to the UK context is far from straightforward. Furthermore, more research is needed on the transferability of communication skills teaching and learning from the university to practice contexts, and across different settings and service user groups. If these challenges can be met, there is the potential for the teaching and learning of communication skills in social work to be built on firm foundations – an essential prerequisite for effective teaching, learning and practice. Copies of the full report of this review, Teaching and learning communication skills in social work education, Knowledge review 6, can be found at www.scie.org.uk. 16
Slide 23: 6 The SCIE practice review Teaching and learning in social work: Communication – a summary This practice review addresses the area of communication skills with children, adults and those with particular communication needs, although it is, of necessity, a general review within its remit and further research could focus more specifically on each group identified. The work reviews current practice in teaching and learning of communication skills in social work from the perspectives of all the stakeholders: academics, practice assessors, students, service users (including adults and children) and carers. 17
Slide 24: Teaching and learning communication skills in social work education 6.1. How are communication skills currently taught and how are they delivered? • Current provision centres primarily around dedicated modules in communication, taught using an experiential learning approach, and focusing on verbal and nonwritten forms of communication. There is a concurrent commitment to the integration of teaching and learning in this area across other non-dedicated elements in courses. • However, these tend to emphasise generic communication skills around interviewing, drawing on counselling models, especially Egan’s8. • There is no explicit emphasis on specific skills and where they are mentioned, they are understood in terms of skills for specific settings and client groups rather than as micro-skills. • A growing area is in the teaching of communication skills interprofessionally and for interprofessional purposes, although there is a focus here on skills which are common across professions rather than on a range of topics including integrating communication skills across different professional models. • Communication skills have already been given central importance, both explicitly and implicitly, and the planned increase in communication skills teaching is broadly welcomed. Nevertheless, while many of the skills identified in the benchmarks and embedded in The national occupational standards are evident in current practice, there appear to be two crucial gaps: first, between current practice and the new language for describing it (benchmarks and national occupational standards); and second, between an emphasis on very general foundations for communication skills and a new focus on their concrete practice and how it is done. 6.2. How do you distinguish and differentiate between core transferable skills and specific skills, including technical skills? • There are two key strands emerging: on the one hand, there is some resistance to any proliferation of specific, especially technical, skills training. Instead there is a clear emphasis on core skills training which is regarded as subsequently transferable. It is anticipated that this will equip students for a breadth of situations in practice for which it is impossible explicitly to prepare. On the other hand, there was the view that there should be more in the way of specific skills training, particularly technical skills, so as to promote communication with groups with particular communication needs. For example, several respondents regretted that they did not do any training on working through translators, or with those with hearing impairments. • While respondents suggest that the academic setting should provide a good grounding in core communication skills, including (and increasingly) written and interprofessional skills, the place for specific skills training remains unclear. 18
Slide 25: The SCIE practice review Teaching and learning in social work • Some respondents argued for more specific skills training in the academic setting, others that the extent and range of this training is most useful when it is carried out in a particular user group and reflects that setting’s needs. • A third group argued that specific skills training should be a concern only for postqualifying learning. • There is a clear absence of consensus regarding definitions of ‘core’, ‘specific’ and ‘technical’ communication skills. This appears to be linked to gaps in knowledge about theories of communication skills, and their teaching, learning and assessment. The research review may throw some light on the breadth and depth of the extent and use of theoretical knowledge in practice. and beginning level on the other. These levels are seen as largely identical. The analysis reflects this failure of distinction. • Of all the skills identified as necessary for qualifying and beginning level, those contributing to the performance of a ‘professional’ role were most prominent. These include the development of highlevel specific written skills such as report writing, courtroom skills, and selfawareness in the social work role. The acquisition of professional identity is therefore central. There is an issue as to how the professional role of the social worker is best maintained. Skills specific to the social work profession and the organisational and statutory requirements of the job are seen as growing out of and founded on ‘core’ communication skills, without which no amount of specialist training in procedure could equip the student for the beginning of practice. The ‘specific’ skills of practice are regarded as peripheral to the task of teaching and learning at beginning and qualifying level, although they are often acquired in placements. • 6.3. What is the breadth and depth of skills training needed to perform the range of duties and tasks for beginning practice and for qualifying level? • There is little distinction in the data drawn between qualifying level on the one hand, 19
Slide 26: Teaching and learning communication skills in social work education • At the same time, a key issue is the relative youth and inexperience of the new intakes. There is a concern that current social work teaching and learning assumes a degree of professional and organisational competence in communication skills, which may no longer be there. The anticipated implication is that a micro-skills focus may emerge on skills like ‘attending meetings’ and ‘using the telephone’. • Related to this is a stress on the importance of building up students’ confidence in communication skills as a key element in teaching and learning for qualifying and beginning level. consensus, based on (a) the identified CCESTW/GSCC core social work values and (b) adult learning principles deriving from community work and community development (for example, empowerment, partnership, sustainability). • However, the clarity of an established value base appears to make it taken for granted and most respondents were unable to be sharply critical about precise meanings and implications of principles and values identified. Some respondents suggest that learning about communication should start with teachers revisiting their understandings of social work values and principles in order to internalise the thinking, which has so thoroughly fed into social work’s distinctive value base. 6.4. How do you identify the underpinning principles and values of communication for all categories of social work delivery? • Generally speaking, social work as a discipline benefits from a relatively wellestablished base of values and principles, about which there is a good deal of 20
Slide 27: The SCIE Practice review Teaching and learning in social work education: Communication What also emerges is the view that values and principles cannot be taught, only learnt, and that this represents the learner’s transition from ‘the personal to the professional’. It is suggested that this takes place best where it is modelled in the culture of the department and setting within which students learn, and specifically through supervision and tutorials where that learning is drawn out and made explicit. 21
Slide 28: Teaching and learning communication skills in social work education 7 Practice examples The practice examples here are intended to provide examples of some of the existing practice in the field in order that it may be learnt from and disseminated to others involved in teaching and learning communication skills in social work. The examples here have been selected using varying levels of shared criteria or viewpoints to reflect: • what respondents perceive to be ‘good practice’ (identified as innovation, experienced learning effectiveness and feasibility); • user participation; • other key stakeholder participation, for example, practice partners; • • acceptability; do-ability/do-able/feasibility/applicability in everyday practice; sustainability over time and place. • None of the examples included have been evaluated for the purposes of the research underpinning this guide, and their inclusion should not be understood as endorsement of the example given. Rather, they are intended to contribute to and inform the teaching and learning practices of others and to contribute to peer dissemination of good practice in social work education. Practice example 1 Title Knowing yourself: A foundation for professional practice (1996) Compiled and edited by Christina Stern with Roger Clough, Lancaster University Description Knowing yourself: A foundation for professional practice is a written resource based on the observation that self-awareness is a key starting point for the acquisition and deployment of effective communication skills in social work. It arises out of an experience of teaching around communication skills and selfawareness as ad hoc, and is derived from a course that the author had been teaching for some time when the written resource was conceived. It represents the attempt to bring all the many and various communications and self-awareness materials collected over the years together into one place. The book takes a service user perspective by focusing on social workers’ selfawareness as a crucial starting point for communicating in a dialogue with users. It also takes into account student feedback on an earlier module which suggested that students needed more time and opportunity to practise skills. 22
Slide 29: Practice examples The book is divided into eight sections: The self as a social worker; The origins of self; The current self; The helping self; The thinking and feeling self; Self view of others; Others’ view of self; and Self in relation to power and authority. The sections consist of exercises, prefaced by explanatory notes, which allow the student to explore an aspect of the self. Some of the exercises are intended to be done alone, some in pairs, and some in groups of varying sizes. Most of the exercises can be done in more than one of these combinations. The book makes use of symbols throughout, either as ‘sign-posting’ devices – for example, to draw attention to ‘General aims’ and ‘Specific objectives’ – or to point out links and context – for example, ‘Some theory’, ‘Further reading’ and ‘Links to practice’. The book contains 177 pages of exercises and is not intended to be worked through systematically. As the book was first written in 1996, some of the text and references are now inevitably somewhat out of date. However, the tutor continues to adapt and select from the book according to changes taking place in social work and according to the needs of the particular student group in any given year. All practice teachers involved in student placements have access to the workbook and it has become a tool for facilitating the integration of university and practice curricula. The workbook has also been widely requested by local agencies, and is used by the probation service local to Lancaster. The author feels that a crucial aspect of the success of this workbook is the tutor’s ability to create a safe environment in which students can learn, as the material covered can often be very sensitive. Therefore the tutor keeps to issues, debates and third party behaviour in the first term and a half, only moving on to work on the self in the second half of the second term. Ground rules about confidentiality always apply, and in some cases feedback will be invited on the process, rather than the content, of small group discussions. Student feedback on the exercises in the book is very good, although students always want more time working in this area. User participation in planning, delivery and evaluation Some of the exercises were designed by individual service users and user groups. Other key stakeholder participation in planning, delivery and evaluation Nobody other than practice teachers employed by key stakeholders have used material from the book with students on placement. Feedback has been positive. Learning aims and outcomes Student and practice teacher feedback is very good in respect of identified personal growth and change in the student. However, students always want more time and opportunity working in this area. Assessment of learning Students are required to write practice essays and reflective pieces of work drawing on (among other things) the use of self and the impact of self on others. Scores in these pieces of work have been consistently good to very good. 23
Slide 30: Teaching and learning communication skills in social work education Integration between university and practice curricula Exercises continually draw on the links between theory (classroom teaching) and the practice curricular. Many cross-curricular areas are covered. Feedback/evaluation Student feedback on the exercises in the workbook is very good, although students always want more time working in this area. Reference Stern, C. and Clough, R. (1996) Knowing yourself: A foundation for professional practice, Lancaster: Lancaster University. Further information available from Christina Stern, Lancaster University (c.stern@lancaster.ac.uk www.lancaster.ac.uk). Practice example 2 Title Service-user assessment of students, University of Nottingham Description This is a module called ‘Users’ and carers’ perspectives in community care’. It is aimed at 2nd year students on the MA route as part of the ‘Adults’ pathway. What is distinctive about this module is that it is planned, delivered and assessed by users and carers, who are paid for their services. The module thereby operates in partnership with a local organisation ‘Advocacy in Action’, who have a long and trusted relationship with the university. The course is delivered in six workshops, each lasting for one day. The last two are assessment days. Students give a presentation of their life history, bearing in mind the communication skills they use. Some assessors will have cognitive impairment or be non-readers. Students must take account of these issues in their presentations. The grading is a percentage mark, based on the service users’ judgement on how well the students have been able to engage in the themes of the module through their presentations. There is also a proportion of the mark awarded in recognition of the overall contributions of students to the module, judged by service users over the entire module. In 2001 and 2002, the final mark awarded was moderated by the coordinating tutor. For 2003, this tutor has been a part of the teaching team and will therefore be part of the assessment process itself, with no consequent need for moderation of the marks. Students report that they enjoy this module, and do well on it. It consciously aims to raise the power dynamics of communication with service users, hence the importance of them directing the assessments. The course material is enhanced by sharing the experiences of the service users, 8 or 9 people for each module, and has included rough sleepers, asylum seekers, prostitutes, people with learning 24
Slide 31: Practice examples disabilities, people with mental health problems, ex-offenders, older people, carers, and so on. User participation in planning, delivery and evaluation The module has been entirely planned and delivered by a service user-led group, with the active involvement of a member of university staff ensuring that practical and financial issues are addressed. Evaluation is carried out separately by the user group and within the university; the outcomes of these evaluations form the next stage of planning. Learning aims and outcomes The module learning aims are as follows: “The aim of this module is that students will be able to grasp the significance of the perspectives of service users and carers within community care. It is argued that social workers have historically not understood that users and carers are first and foremost people, with unique experiences and narratives. Through a process of experiential learning, the module will demonstrate that an understanding of these users and carers as people is an essential prerequisite for successful social work practice. The common theme of the module will be the shared humanity of social workers, service users and carers”. The learning outcomes are as follows: “By the conclusion of this module, students should be able to: 1. Demonstrate an understanding of the relationship between past and current life experiences for service users. 2. Demonstrate acceptance and humility in respect of services users’ anger and pride, and commitment to the positive action and change that enhances and promotes service users’ ability to reclaim and take charge of their own lives. 3. Present an aspect of their life story to a mixed group of service users, carers and students. 4. Communicate in ways which are meaningful and respectful for people with a wide range of communication requirements, including both people with learning disabilities and with language disadvantages.” Assessment of learning As noted above, the module is assessed by the service users. The grading is a percentage mark, based on the service users’ judgement on how well the students have been able to engage in the themes of the module through their presentations. There is also a proportion of the mark awarded in recognition of the overall contributions of students to the module, judged by service users over the entire module. In 2001 and 2002, the final mark awarded was moderated by the coordinating tutor. For 2003, this tutor has been a part of the teaching team and will therefore be part of the assessment process itself, with no consequent need for moderation of the marks. Integration between university and practice curricula The module is part of the formal university academic curriculum. As yet, this has not been mapped against the Department of Health Requirements, The national occupational standards for social work, or the Subject benchmarks for social work. 25
Slide 32: Teaching and learning communication skills in social work education Feedback/evaluation The results of the university feedback process for the past two years are included below. Students have an evaluation form to complete, which contains a number of questions that ask for narrative comments, alongside a section that invites them to evaluate their overall experience. This includes four possible outcomes. 2002: Excellent 2001: Excellent 7 5.5 Good 6 Good 4.5 Satisfactory 0 Satisfactory 1 Poor Poor 0 0 This is among the most positive feedback given to any academic module, an impression reinforced by comments in the narrative section attesting to the power of the experience for students. Feedback and evaluation from Advocacy in Action has been similar in nature. This is particularly gratifying as this is far from being a standard academic module, in delivery or assessment. Further information available from Mark Lymbery (Mark.lymbery@nottingham.ac.uk, www.nottingham.ac.uk). Practice example 3 Title Effective communication with children and adults, London Metropolitan University Description The module specifically focuses on communication and requires practical demonstration of skills as well as knowledge of theory. It builds on a body of literature surrounding social work interventions with children, vulnerable adults, their families and interagency working. The module is taught primarily through workshops and group work, with some presentation combined with practical exercises. It also makes use of outside experts and service user involvement. There is also use of video materials and a particular emphasis on the use of case studies to ‘bring alive’ some of the issues in a practice-oriented way. The main areas explored are: • paradigms and the social contexts of communication; • methods for direct practical work with children and adults, for example, play, art therapy, story-telling; • achieving best evidence guidance – formal investigative interviewing; • communication issues relating to disability; • communication issues relating to ethnicity; • professionals having a voice – whistle blowing. Students are strongly encouraged to develop skills in building up evidence for the views they take and the interventions they subsequently propose. Skills are 26
Slide 33: Practice examples practised in the writing of ‘mock’ reports and papers in response to some case studies. There is also a commitment throughout to being child-focused and to developing the skills to communicate at levels of interaction appropriate to the child’s age and understanding. In this way, issues in developmental psychology are explored, consolidated and integrated. User participation in planning, delivery and evaluation Service users are involved in a number of the sessions relating to disability (physical and mental health) and also young people. They are also involved in the assessment process. An interpreter is also involved in one session. Other key stakeholder participation in planning, delivery and evaluation Experts are included, for example, a specialist foster carer presents communication issues relating to looked-after children and a playwright presents a drama about the Victoria Climbié Inquiry. Learning aims and outcomes Learning Objective 1: Demonstrate a critical and systematic understanding of the application of theories of communication to social work practice. Learning Objective 2: Analyse and evaluate a range of communication methods essential for communication with children and adults. Learning Objective 3: Demonstrate with confidence the key skills required for effective communication with children and vulnerable adults. Assessment of learning Students devise and role play a communication exercise in small groups. Presentation is to tutors and service users. This is audio recorded and includes a written plan (20% marks). An essay of 3,000 words tests students’ comprehensive understanding of theories of communication and includes a critical evaluation of learning from the role play (80%). Integration between university and practice curricula Key Role 1: Prepare for, and work with, individuals, families, carers, groups and communities to assess their needs and circumstances. (Unit 2) Work with individuals, families, carers, groups and communities to help them make informed decisions. (Unit 3) Assess needs and options to recommend a course of action. Key Role 2: Plan, carry out, review and evaluate social work practice, with individuals, families, carers, groups, communities and other professionals. (Unit 4) Respond to crisis situations. (Unit 5) Interact with individuals, families, carers, groups and communities to achieve change and development and to improve life opportunities. (Unit 7) Support the development of networks to meet assessed needs and planned outcomes. 27
Slide 34: Teaching and learning communication skills in social work education (Unit 8) Work with groups to promote individual growth, development and independence. (Unit 9) Address behaviour, which presents a risk to individuals, families, carers, groups, communities and the wider public. Key Role 3: Support individuals to represent their needs, views and circumstances. (Unit 10) Advocate with, and on behalf of, individuals, families, carers, groups and communities. Key Role 4: Manage risk to individuals, families, carers, groups and communities. (Unit 12) Assess and manage risks to individuals, families, carers, groups and communities. Key Role 5: Manage and be accountable, with supervision and support, for your own social work practice within your organisation. (Unit 17) Work within multi-disciplinary and multi-organisational teams, networks and systems. Feedback/evaluation Evaluation is through the module monitoring form but also throughout the module in each session there is a time for feedback in the learning sets. References Axline, V. (1990) Dibs in search of self, Harmondsworth: Penguin. Bray, M. (1992) Poppies on the rubbish heap: Sexual abuse: The child’s voice, Edinburgh: Canongate Press. Cairns, K. (2002) Attachment, trauma and resilience: Therapeutic caring for children, London: BAAF. Cattanach, A. (2001) Play therapy: Where the sky meets the underworld, London: Jessica Kingsley Publishers. CROA (Children’s Rights, Officers and Advocates) and Department of Health (2000) Total respect: A resource pack for listening and communicating with young people, London: CROA [available from CROA, Cambridge House, Cambridge Grove, London W6 0LE, tel 020 8748 7413, e-mail mail@croal.freeserve.co.uk]. Davis, N. (1990) Once upon a time: Therapeutic stories, Nancy Davis Publications [revised edn, self-published, available from 9836 Natick Road, Burke VA 22015]. Fever, F. (1997) Who cares? Memories of a childhood in Barnardo’s, London: Warner Books. Fitzgerald, J. and Bilton, K. (1996) Listening to children: The issues, London: The Bridge Childcare Development Service. Home Office (2001) Achieving best evidence in criminal proceedings, London: The Stationery Office. Kadushin, A. (1995) Social work interview: A guide for human service professionals, New York, NY: Columbia University Press. Lishman, J. (1994) Communication in social work, Basingstoke: Macmillan. Milner, P. and Carolin, B. (eds) (1999) Time to listen to children: Personal and professional communication, London: Routledge. NSPCC (1997) Turning points: A resource pack for communicating with children, London: NSPCC. NSPCC (2001) Two way street: Communication with disabled children and young people, London: NSPCC. 28
Slide 35: Practice examples O’Neale, V. (2000) Excellence not excuses: Inspection of services for ethnic minority children and families, London: SSI, DH Publications (PO Box 777, London SE1 6XH [free], e-mail doh@prologistics.co.uk). Russell, W. (1988) The wrong boy, London: Black Swan. Ryan, T. and Walker, R. (1997) Life story: Work, London: BAAF. Schon, D. (1995) The reflective practitioner: How professionals think in action, New York, NY: Basic Books. Thompson, N. (2002) People skills, Basingstoke: Palgrave. Thompson, N. (2003) Communication and language, Basingstoke: Palgrave. Wilson, C. and Powell, M. (2001) A guide to interviewing children, London: Routledge. Books for direct work with children Althea (2001) When Uncle Bob died, Bradfield: Happy Cat Books. Bruzzoni, C. (1994) My friends, Kingston upon Thames: b small publishing. Bruzzoni, C. (1996) My family tree, Kingston upon Thames: b small publishing. Bruzzoni, C. (1999) All about me, Kingston upon Thames: b small publishing. Children’s Legal Centre (2004) At what age can I? Updated guide to age based legislation affecting young people, Essex: Children’s Legal Centre. Green, J. (2002) What do we think about racism?, Hove: Hodder Wayland. Ironside, V. (2001) The huge bag of worries, Hove: Hodder Wayland. Jackson, M. (1994) Our family tree, London: Evans Brothers – Books for Children. Masurel, C. (2002) Two homes, London: Walker Books. National Deaf Children’s Society (2003) You choose; and Secrets, London: National Deaf Children’s Society [available from National Deaf Children’s Society, 15 Dufferin Street, London EC17 8UR, tel 020 7490 8656; minicom 020 7490 8656; email ndcs@ndcs.org.uk]. NSPCC (1998) Child Witness Pack. Peak, A. and Rouf, K. (1989) My book my body, London: The Children’s Society. Pickering, F. (2000) Hitting and hurting, London: The Children’s Society. Rouf, K. (1989) Mousie, London : The Children’s Society. Rouf, K. (1989) Secrets, London: The Children’s Society. Stickney, D. (1997) Water bugs and dragonflies, London: Geoffrey Chapman. Striker, S. and Kimmel, E. (1979) The anti-colouring book, Scholastic. NSPCC (1997) Turning points: A resource pack for communicating with children, London: NSPCC [this pack has a wealth of practical resources]. UNICEF (2002) For every child: The UN Convention on the rights of the child, London: Red Fox. Vail, B. (1999) Ricky has a problem, Lyme Regis: Russell House Publishing. Varley, S. (1982) Badger’s parting gifts, London: Picture Lions. Websites To give a voice to children who are looked after: www.anationalvoice.org National Association for the Protection of Children and Vulnerable Adults from Abuse: www.anncrafttrust.org Children’s rights website: www.article12.org Asylum Aid: www.asylumaid.org.uk Children’s Rights, Representation and Advocacy Service: www.croa.org.uk Website to support older people who have suffered abuse: www.elderabuse.org.uk A mental health service user organisation: www.hearing-voices.org National Deaf Children’s Society: www.ndcs.org.uk 29
Slide 36: Teaching and learning communication skills in social work education Website for people with learning disabilities: www.peoplefirst.org.uk Website for people under 25 with mental illness: www.sane.org.uk Website of the Inquiry into the death of Victoria Climbié: www.victoria-climbieinquiry.org.uk An organisation which provides computer programmes to facilitate communication with young people involved with social services provision: www.viewpointorganisation.co.uk Support group for children and adults who have experienced crime or abuse: www.voiceuk.clara.net Website for people with disabilities: www.youreable.com Videos Home Truths (1999) Leeds Animation Workshop, 45 Bayswater Row, Leeds, LS8 5LF, tel 0113 248 4997, e-mail: law@ledsanimation.demon.co.uk In Safe Hands (2001) Save the Children/Refugee Council Resource Pack to support work with refugee children Let’s Be Clear Home Farm Trust training video Technology for deaf children (2003) NDCS Two Way Street (2001) Training video and handbook about communicating with disabled children and young people, NSPCC Sounding the Alarm (1998) Barnardo’s, Information Officer, Barnardo’s, Tanner’s Lane, Barkingside, Ilford, Essex, tel 0208 550 8822 Towards Safer Care (2000) DH, video and guide Further information available from London Metropolitan University (www.londonmetropolitan.ac.uk). Practice example 4 Title A lot to say: A guide for social workers, personal advisors and others working with disabled children and young people with communication impairments (2002) By Jenny Morris, London: Scope Description This guide offers advice and information to social workers, Connexions personal advisers and others working with children and young people who have communication impairments. It will be of use in a number of settings – health, social services, education, and private and voluntary sector agencies. It is aimed at professionals who are not specialists in communication impairments, but who have responsibilities to assess the needs, and seek the views of, this important group of children and young people. Drawing on the expertise of both those who work with young people with communication impairments, and young people themselves, the guide: • summarises what gets in the way of communicating; • offers practical advice about getting to know how someone communicates and how to find out their views; • identifies how you can help someone maximise their communication potential; 30
Slide 37: Practice examples • lists the resources available to those working with this group of young people; • provides information on the legal framework concerning communication, and identifies sources of funding. User participation in planning, delivery and evaluation The guide was written in collaboration with young disabled people who have communication impairments. Social workers and speech and language therapists were consulted on a draft. Other key stakeholder participation in planning, delivery and evaluation A lawyer provided advice on the section in the guide about legal entitlements (which covers entitlements for both those aged 16 and below and for those over 16). Learning aims and outcomes This is intended as a resource for all those who come into contact with disabled children and adults who have communication impairments. It will help to both communicate with this group of service users and also to ensure that communication needs are appropriately assessed, reviewed and responded to. Assessment of earning Integration between university and practice curricula. References A list of resources, references and relevant organisations is given in the guide. A companion guide, written by disabled people, was published at the same time entitled The good practice guide for support workers and personal assistants working with disabled people with communication impairments (2002). Both guides are available free from Scope, tel 020 7619 7341, e-mail: information@scope.org.uk Practice example 5 Title ARTiculation Description Rationale “I would like to pretend that the programme sprang from a vision about how you could use youth arts to work with disaffected young people, but I have to admit it took root in a more prosaic way than that. It was trying to get away from bad practice. If you’ve been to a conference where young people have been brought along as walking case studies, to talk about their personal experiences to show how things have got to change, then that’s one conference too many in my view. These are young people who have been exploited enough already. The first time I sat on a panel I wasn’t very good at it, so I don’t see why we should expect young people to be. That’s really why we started looking for a better way of involving young people and allowing them to have a voice, because it is vital that they do find their own voices and have the chance to influence the services that are supposed to be there for them. Then you have a chance of providing a service that is good for them.” ARTiculation is a 12-month rolling programme that enables young people aged 1623, who access NCH projects, to participate in high quality arts provision. NCH 31
Slide 38: Teaching and learning communication skills in social work education service users include: care leavers, young carers, young people with disabilities, black and minority ethnic young people, young refugees/asylum seekers and young offenders. ARTiculation is designed to enable these young people to explore and present their views and opinions about issues that impact on their daily lives, in an imaginative and constructive way, to key politicians, policy makers, employers and social services providers. ARTiculation comprises: the Annual Youth Arts Weekend, creative consultation, rehearsals and performances, an integrated project, accreditation and staff and artists training. “ARTiculation is a model of provision that fills a gap in current provision for young people and provides a useful stepping stone; ARTiculation involves a method and setting that sustains the engagement of vulnerable young people and facilitates the development of confidence and self esteem, enhanced self image, motivation and a range of personal, social and pre-vocational skills.” “The programme posits young people as responsible, important young adults whose views and abilities are respected (rather than young people with problems and difficulties). As a result, participation can have a profound impact on how young people view themselves, others and the world.” (“Now I’m a somebody”, CATR, University of Manchester) “Challenging disadvantage and discrimination is the keystone of this programme. By giving some of the most vulnerable and excluded young people the opportunity to explore and express their views and opinions to policy makers, business leaders, service deliverers and service user groups, we hope to give them the opportunity to challenge those policies or practices which bring about or compound their disadvantage.” (Amanda Allard, NCH Policy Officer) User participation in planning, delivery and evaluation ARTiculation developed from the Youth Arts Weekend, Sheffield University, in 1999, and the subsequent pilot performance programme. Since then, with the initial financial support of the Lloyds/TSB Foundation, over 400 young people from NCH projects across the UK have participated in the Youth Arts Weekend and more than 50 young people, from as far afield as Inverness and Plymouth, have come together to make theatre that gives them a voice. They have performed in front of over 4,000 people in places like the House of Commons, the House of Lords, Social Care Institute for Excellence (SCIE) and the Association of Directors of Social Services (ADSS) Annual Conference. The audiences have included practitioners, policy makers and key decision makers in social services, education and juvenile justice. Young people are actively involved in the evaluation of the annual Youth Arts Weekend and take responsibility for the planning and support of the next. Additionally, young people from each of the first three years came together to evaluate the programme and make recommendations about its future. Young people were involved in a 12-month research study by NCH and a year-long evaluation by the University of Manchester. 32
Slide 39: Practice examples Other key stakeholder participation in planning, delivery and evaluation • HQ Arts – youth arts organisation specialising in work with marginalised and disaffected young people • NCH support staff • NCH research unit • NCH Policy Unit • NCH Children’s Services • Centre for Applied Theatre Research, University of Manchester Learning aims and outcomes The video is intended to be used as a resource to raise awareness of how youth arts can be used to support the personal, social and political development of young people. Through discussion, reflection and demonstration of the process engaged in by the young people, we want to demonstrate the power of an arts-based approach and its effectiveness in engaging vulnerable and marginalised young people. It also advocates using creative models of consultation to get young people’s voices heard within large organisations. Assessment of learning Integration between university and practice curricula. Reference “Now I’m a somebody”, CATR, University of Manchester. Further information available from HQ Arts Ltd: info@hqarts.com or NCH, 85 Highbury Park, London N5 1UD (www.nch.org.uk/). Practice example 6 Title ‘Social Work Challenge’, City College Norwich Description ‘Social Work Challenge’ is a student-led learning day focusing on the key communications challenges to social workers across a range of settings. The session lasts for one day. Students are divided into small groups and asked to identify the challenges to social workers in communicating and engaging with a particular client group. As part of their challenge the students look at the skills necessary, the knowledge required and the techniques that are appropriate. Each group is assigned an agency or organisation that they visit in order to research, gather information and gain insights into what the issues for communication in that setting are. The agencies involved are: • the Unthank Centre (social services) – a children and families centre that do group work and direct work; • the Sensory Support Unit (social services) – working with people with impairment; • People First (independent self-advocacy organisation) – working with adults with learning difficulties; • City Police Station – they have an officer dedicated to working with minority ethnic groups. The students decide within their groups who will take ‘lead’ responsibility for investigating different aspects of the challenge as they emerge, and part of the task 33
Slide 40: Teaching and learning communication skills in social work education focuses on their working as a team to draw together their individual findings. Students are advised to use the library to conduct a literature search for background materials and are encouraged to use Internet resources and make contacts with various bodies that may be of help to them and their challenge. Typically students have contacted bodies such the Race Equality Centre, Disability Group and a Refugee Support Group. As well as learning about the issues about communications in a range of settings, students also develop communication skills in the course of the challenge: they learn about working in groups, planning, researching, delegating, writing, engaging and negotiating. Students consolidate their specific and general learning in presentations that they make to each other. Time is dedicated in the day to thinking about and planning their presentation that takes place the following week. Presentations address both specific issues about communications in the setting with which they have worked and general ones about their experience of communicating to meet the challenge. Students typically use videos, role plays, flip-charts and graphic materials in their presentations which, themselves, contribute to the specific communication skill of presenting in public. The ‘Social Work Challenge’ is part of a module in ‘Communication and engagement’, which lasts for one term. The ‘challenge’ takes place therefore within a wider context and links between them are actively made. Other sessions in the module include: • • • • • • • • • • Introduction to communication Modes of communication Models of communication Barriers to communication and engaging Interviewing skills Working with challenging behaviour Assessment Assertiveness Challenging Report writing and writing skills. User participation in planning, delivery and evaluation At People First the service users decide when and how they will use the students’ visit. The request for them to offer this opportunity is discussed in their team meeting. At the venues there is no user participation. Other key stakeholder participation in planning, delivery and evaluation As above, currently only the People First organisation plan, deliver and evaluate their own contribution. Learning aims and outcomes • Understand components of effective communication with different individuals, groups and communities – recognising and responding to different needs. • Demonstrate awareness of barriers to communication with a range of users/carers, for example, people with sensory impairment, physical difficulties, older people. 34
Slide 41: Practice examples • Demonstrate effective communication with people for whom English is not their first language. • Identify and demonstrate effective communication with organisations, agencies other then social services. • Demonstrate effective communication with individuals and communities and seek to reduce risk and need. Assessment of learning Assessment of the learning for this module is through an academic assignment undertaken by the students during their first placement. It is based on their first direct observation. Integration between university and practice curricula The assignment is used to help the students make direct links between the academic content of the module and the direct practice. The placement experience is also supported by one day a week in college during the placement, where relevant issues are explored and further links encouraged. Feedback/evaluation The students undertake a detailed evaluation exercise of the module at the end of the term. In the evaluation for the last three years it is interesting to note that a few students specifically mention this exercise in their feedback on ‘Methods of teaching’, but the majority of the students do not. It happens at the beginning of the term. References There are two key texts for this course which the students are encouraged to purchase: Thompson, N. (1996) People skills: A guide to effective practice in the human services, Basingstoke: Macmillan Press. Williams, D. (1997) Communication skills in practice, London: Jessica Kingsley. This is supplemented by a reading list of about 20-30 other texts which is updated annually, for example: Aldridge, M. and Wood, J. (1998) Interviewing children: A guide for child care and forensic practitioners, Chichester: John Wiley. Beveridge, M., Conti-Ramsden, G. and Leudar, I. (1997) Language and communication with people with learning disabilities, London: Routledge. Bolton, G. (2001) Reflective practice: Writing and professional development, London: Paul Chapman Publishing. Bourg, W., Broderick, R., Flagor, R., Kelly, D., Ervin, D. and Butler, J. (1999) A child interviewer’s guidebook, Thousand Oaks, CA: Sage Publications. Brammer, L. and MacDonald, G. (1999) The helping relationship: Process and skills (7th edn), Boston, MA: Allyn and Bacon. Brearley, J. (1995) Counselling and social work, Buckingham: Open University Press. Brill, N. (1998) Working with people: The helping process (6th edn), New York, NY: Longman. Bull, P. (2002) Communication under the microscope: The theory and practice of microanalysis, London: Routledge. Caldwell, P. (1996) Getting in touch: Ways of working with people with severe learning disabilities and extensive support needs, Brighton: Pavilion Publishing. 35
Slide 42: Teaching and learning communication skills in social work education Caldwell, P. and Houghton, M. (2000) You don’t know what it’s like: Finding ways of building relationships with people with severe learning disabilities, autistic spectrum disorder and other impairments, Brighton: Pavilion Publishing. Caldwell, P. and Stevens, P. (1998) Person to person: Establishing contact and communication with people with profound learning disabilities and those whose behaviour may be challenging, Brighton: Pavilion Publishing. Canter, D. and Alison, L. (eds) (1999) Interviewing and deception, Aldershot: Dartmouth Publishing Ltd. Csoti, M. (2000) People skills for young adults, London: Jessica Kingsley. Csoti, M. (2001) Social awareness skills for children, London: Jessica Kinsgley. Doherty-Sneddon, G. (2003) Children’s unspoken language, London: Jessica Kingsley. Drake, R. (1999) Understanding disability policies, Basingstoke: Macmillan. Egan, G. (2002) The skilled helper: A problem management and opportunity development approach to helping (7th edn), Pacific Grove, CA: Brooks/Cole. Ellin, J. (1994) Listening helpfully: How to develop your counselling skills, London: Souvenir Press. Ellis, R. (2002) Communication skills: Stepladders to success for the professional, Bristol: Intellect Books. Ellison, L. (2001) The adversarial process and the vulnerable witness, Oxford: Oxford University Press. Fine, S.F. and Glasser, P.H. (1996) The first helping interview: Engaging the client and building trust, Thousand Oaks, CA: Sage Publications. Goodwin, R. (1999) Personal relationships across cultures, London: Routledge. Gudykunst, W.B. and Ting-Tooney, S. (eds) (1996) Communication in personal relationships across cultures, London: Sage Publications. Hargie, O. (ed) (1997) Handbook of communication skills, London: Routledge. Hayes, J. (2002) Interpersonal skills at work, Hove: Routledge. Hewett, D. (ed) (1998) Challenging behaviour: Principles and practices, London: David Fulton Publishers. Hopkins, G. (1998) Plain English for social services, Lyme Regis: Russell House. Hough, M. (1998) Counselling skills and theory, London: Hodder & Stoughton. Hough, M. (2001) Groupwork skills and theory, London: Hodder & Stoughton. Kadushin, A. (1997) The social work interview: A guide for human service professionals (4th edn), New York, NY: Columbia University Press. Killick, J. and Allan, K. (2001) Communications and the care of people with dementia, Buckingham: Open University Press. Klein, M., Chen, D. and Haney, M. (2000) Promoting learning through active interaction: A guide to communication with young children who have multiple disabilities, Baltimore, MD: Paul Brookes Publishing. Lindenfield, G. (2000) Managing anger (revised edn), London: Thorsons. Lishman, J. (1994) Communication in social work, Basingstoke: Macmillan. Livingstone, S. (1997) Dealing with anger (revised edn), St Alberta, Canada: S.L. Discovery Consulting Services Ltd. Madonik, B. (2001) I hear what you say, but what are you telling me? The strategic use of non-verbal communication in mediation, San Francisco, CA: Jossey-Bass. Manthei, R. (1997) Counselling: The skills of finding solutions to problems, London: Routledge. Maple, F. (1998) Goal-focused interviewing, Thousand Oaks, CA: Sage Publications. Memon, A. and Bull, R. (eds) (1999) Handbook of the psychology of interviewing, Chichester: John Wiley. Miller, W. and Rollnick, S.(1991) Motivational interviewing, New York, NY: Guilford Press. 36
Slide 43: Practice examples Milne, R. and Bull, R. (1999) Investigative interviewing: Psychology and practice, Chichester: John Wiley and Sons. Morris, J. (2002) A lot to say!, London: Scope. Noon, J.M. (1999) Counselling and helping carers, Leicester: British Psychological Society. O’Rourke, L. (2002) For the record: Recording skills training manual, Lyme Regis: Russell House. Potter, C. and Whittaker, C. (2001) Enabling communication in children with autism, London: Jessica Kingsley. Prince, K. (1996) Boring records? Communication, speech and writing in social work, London: Jessica Kingsley. Seden, J. (1999) Counselling skills in social work practice, Buckingham: Open University Press. Sutton, C. (1994) Social work, community work and psychology, Leicester: British Psychological Society. Swift, T. and Robertson, I. (2000) Effective interviewing skills, Leicester: British Psychological Society. Taylor, B. (1995) Helping people change, Boston Spa: Oasis Publications. Thompson, N. (2003) Communication and language: A handbook of theory and practice, Basingstoke: Palgrave. Thompson, N., Bates, J. and Bevan, D. (1999) Stress matters: A personal guide, Birmingham: Pepar Publications. Weisberg, N. and Wilder, R. (eds) (2001) Expressive arts with elders: A resource (2nd edn), London: Jessica Kingsley. Williams, D. (1997) Communication skills in practice, London: Jessica Kingsley. Williams, D (2002) Writing skills in practice: A practical guide for health professionals, London: Jessica Kingsley. Wilson, C. and Powell, M. (2001) A guide to interviewing children: Essential skills for counsellors, police, lawyers and social workers, London: Routledge. Further information available from Bridget Macdonald, c/o Flo Watson, City College Norwich (www.ccn.ac.uk). Practice example 7 Title Lets talk about sex and relationships: Working with children and young people who are looked after Description Rationale Many young people tell us that they really want to talk to someone whom they can trust about sex and relationships. Good quality information on sex and relationships enables young people to develop self-esteem, to explore values, attitudes and beliefs and also to make informed decisions about their behaviour, personal relationships and sexual health. Consequently, they are able to develop social skills, including assertiveness and negotiation, which can also be used in other aspects of their lives. However, many looked-after children and young people who are looked-after may have experienced many traumatic events, including neglect and sexual, physical and 37
Slide 44: Teaching and learning communication skills in social work education emotional abuse, often perpetrated by their parents and carers. Some young people will have experienced violence and sustained attacks; some may go on to perpetrate further violence against others and through self-harming. This may distort their understanding of sex, sexuality and personal relationships, resulting in low self-esteem and inappropriate sexual behaviour. Their damaging experiences may mean they lack the necessary skills and confidence to negotiate and sustain positive personal relationships. Young people who are looked-after often miss out on education on sex and relationships, either at home, in care or at school, because of their disrupted experiences. The UK has the highest rate of unintended pregnancies in western Europe and, in some areas, up to one in four teenage young women leaving care have a child, or have one soon after leaving. They have often themselves suffered poor parenting, have no appropriate role models and have received little or no preparation for parenthood. We found that those working in the field are still apprehensive about working on sex and relationships with young people in their care, particularly in residential settings, often because they fear allegations of misconduct from the young people, and/or disciplinary proceedings. They want to be clear about their role, able to maintain professional boundaries, and able to develop the knowledge, skills and confidence to do this work. A range of professionals who work with young people have told us that they want training on sexual health, sexuality, delivering informal sex and relationships education, parenting and childcare skills, unintended pregnancies, legal issues, confidentiality, contraception, reproduction, abortion, and sexually transmitted infections, including HIV. As well as working with young women, they are also keen to develop effective work with boys and young men, with young people from diverse religious and cultural backgrounds, and with gay, lesbian and bisexual young people. Let’s talk about sex and relationships is about communicating about sex, sexuality, relationships and sexual health with children and young people who are lookedafter, and is targeted at the wide range of professionals working with this group: social workers, foster carers, residential social workers, Looked After Children nurses, children and family teams, leaving care teams, family placement teams, Connexions advisers, learning mentors, school (health) nurses, genitourinary medicine clinic staff, health visitors and so on. The training promotes a multidisciplinary and partnership approach to working in this field. The course is part of a larger project initiated and developed by fpa (formerly the Family Planning Association) and the National Children’s Bureau 2001-03, and funded by the Department of Health (Teenage Pregnancy Unit). The outputs of this project were: a training manual called Let’s make it happen: Training on sex relationships, pregnancy and parenthood for those working with children and young people who are looked after (S. Mackie and H. Patel-Kanwal, fpa/NCB, 2003); a Training the Trainers dissemination programme across England; and an evaluation report. User participation in planning, delivery and evaluation The course was piloted with Kensington, Chelsea and Westminster children and families teams in 2000, and all comments fed into the final design of the course. fpa runs the course 38
Slide 45: Practice examples across England as part of its training function, and all participant evaluations are incorporated into the ongoing improvement of the course. To develop this training we worked with many sources, but very closely with research with young people themselves, done by: • Young parents in public care: Pregnancy and parenthood among young people looked after by local authorities (J. Corlyon and C. McGuire, NCB, 1997). • Barnardo’s and Southampton Social Services sexual health and looked-after children project (1997-2000). • Sexual health, teenage pregnancy and looked after young people: A resource for professional working with young people in or leaving care (D. Haydon, Barnardo’s, 2003). Other key stakeholder participation in planning, delivery and evaluation The course, and the training manual, of which it is part, has been developed with an expert multidisciplinary steering group; there was a full evaluation report in December 2003. Learning aims and outcomes Specific learning aims and outcomes have been developed for each training course. You should refer to the training manual for further details. The training manual describes in detail the various methods used in the course. Integration between university and practice curricula This training manual can support students in their practice-based learning. Feedback/evaluation This training manual has been peer reviewed and the course within it has been evaluated in writing and verbally by course participants. References Mackie, S. and Patel-Kanwal, H. (2003) Let’s make it happen: Training on sex relationships, pregnancy and parenthood for those working with children and young people who are looked after, London: fpa/NCB. Corlyon, J. and McGuire, C. (1997) Young parents in public care: Pregnancy and parenthood among young people looked after by local authorities, London: NCB. Haydon, D. (2003) Sexual health, teenage pregnancy and looked after young people: A resource for professionals working with young people in or leaving care, Barkingside: Barnardo’s. Further information available from Teenage Pregnancy Unit, 580D Skipton House, 80 London Road, London SE1 6LH (MB-Teenage-PregnancyUnit@doh.gsi.gov.uk). 39
Slide 46: Teaching and learning communication skills in social work education Practice example 8 Title Open Learning materials, Anglia Polytechnic University Description In company with many universities and colleges, Anglia Polytechnic University (APU) has been delivering its part-time course through supported Open Learning for around five years. The part-time course was originally delivered as a taught course, but it was found that this did not meet the needs of the students on the course, many of whom are in full-time employment and have other commitments in addition to their study. The supported Open Learning mode of delivery was developed in conjunction with the Open Learning Foundation, who also supported a professorship in Open Learning at the university at the time. Open Learning at APU is supported by the development of a range of Open Learning materials, including some focusing on communication skills in social work. The course materials, which students work through in their own time, consist of: • A 26-page resource file consisting of worksheets for students, describing both practical and paper-based exercises. • A 162-page workbook (plus appendices) which provides extensive theoretical input interspersed with exercises. This workbook is organised around four sessions: ◗ professional relationships and communication skills ◗ core communication skills in various social work contexts ◗ barriers to interpersonal and interprofessional communication in social work ◗ recording in social work. The thinking behind the development of the Open Learning materials focuses on the following teaching and learning needs: • giving students activities which they could do on their own, in their own time, and in self-managed learning groups; • enabling students to draw on their own experiences; • directing students to further reading. The course is assessed through a written assignment in two sections. The first section consists of a response to the question ‘What are good communication skills and how can they be developed and improved by social workers?’. The second consists of the student’s learning journal, or extracts from it. The word limit for the whole assignment is 4,000 words, with a recommended minimum of 2,000 words devoted to the first section. The course convenor reports very good feedback from students. Even students who are already working in social care have been surprised at how much there is to communication, and how much there is to learn about something which they had previously approached in an instinctive way. Teaching and learning of communication skills appears to fit particularly well with Open Learning because communication is something that is going on all the time and can be learnt ‘while sitting on a bus’, unlike some other curriculum areas. Many 40
Slide 47: Practice examples of the exercises and worksheets included in the module materials explicitly involve learning in just such an ‘everyday’ and real life context, such as observing body language during conversations and practising different ways of greeting people. One of the knock-on benefits to arise from the development of materials for this module is that many of the exercises and activities initially intended for the parttime students were then found to be appropriate to use with the full-time students. In having to think creatively and develop activities around communication skills which people could do in their own time, and which drew on their own experiences, the module leaders were able to extend this good teaching and learning practice into the full-time course. User participation in planning, delivery and evaluation A user/carer representative has been appointed on each of the APU sites to work one day a week on developing user and carer involvement in all aspects of the curriculum. It is also planned to involve users/carers in evaluating the communication skills of applicants as part of the admissions process. Other key stakeholder participation in planning, delivery and evaluation See Integration between university and practice curricula below. Learning aims and outcomes 1. Demonstrate an understanding of the range and significance of interpersonal verbal, non-verbal and symbolic communication. 2. Recognise and anticipate potential barriers to communication in social work, and demonstrate an understanding of the range of creative responses which may redress the power imbalance within a professional social work relationship. 3. Describe the core interviewing skills required in a range of social work settings. 4. Identify the skills that promote effective interprofessional communication. 5. Describe the nature and purpose of social work records and demonstrate an understanding of how accuracy may be maximised in the context of the worker’s own experience, values and prejudices. 6. Demonstrate an awareness of how effective communication skills within a professional social work relationship should be used to promote people’s strengths and their rights to choice, privacy and confidentiality, while respecting and valuing uniqueness and diversity. Assessment of learning The course is assessed through a written assignment in two sections. The first section consists of a response to the question ‘What are good communication skills and how can they be developed and improved by social workers?’. The second consists of the student’s learning journal, or extracts from it. The word limit for the whole assignment is 4,000 words, with a recommended minimum of 2,000 words devoted to the first section. Integration between university and practice curricula Communication skills will be included in the practice curriculum (within a module entitled ‘Principles and skills of social work’ and so practice teachers representing a wide range of agencies will be involved in the assessment of students’ communication skills in practice. Feedback/evaluation The course convenor reports very good feedback from students. Even students who are already working in social care have been surprised 41
Slide 48: Teaching and learning communication skills in social work education at how much there is to communication, and how much there is to learn about something which they had previously approached in an instinctive way. Further information available from Clare Seymour, Anglia Polytechnic University (c.v.seymour@apu.ac.uk). Practice example 9 Title Social work skills: A practice handbook (2000) By Pam Trevithick, University of Bristol, published by the Open University Press, Buckingham Description This textbook has a section on communication skills in social work. The work is based on lectures taught to social work students at the University of Bristol from 1989-99. The overriding principle of the book focuses on the important relationship between theory and practice. The author argues that there exists a gap in the number of texts specifically addressing social work skills, and that where texts exist these do not draw on theory to inform practice in sufficient detail. One important principle underpinning the book is that where there is a difficulty communicating, it is the task of the professional – in this case the social worker – to address this difficulty. In addition, the author argues that it is only with a sound theoretical understanding in relation to communication skills that effective, transferable communication skills can be developed. The motivation for this text was to provide a resource for ‘bewildered’ students and practitioners. The book is aimed at both students and practitioners. It is divided into two sections. The first section looks at ‘the theoretical underpinnings to practice’, including an overview of psychological theories. This explores looking at the use of theory and research to underpin practice and includes specific terms used in social work, and how to evidence effectiveness in listening, communication and assessment skills. The second section explores ‘how these theoretical concepts relate in practice’, and identifies 50 skills ‘used within social work on a regular basis’. These are grouped under the following chapter headings: • • • • basic interviewing skills; providing help, direction and guidance; empowerment, negotiation and partnership skills; professional competence and accountability. The author also states that “other core skills are included, but not described separately. These include communication, interviewing, observation, listening, assessment and decision-making skills”. This is not a ‘workbook’ of exercises. Rather, it describes a particular skill and the kind of social work context in which it might be useful, often referring the reader to other texts. The author frequently uses examples from practice, drawn from her 42
Slide 49: Practice examples experience as an academic/practitioner. These examples sometimes take the form of a transcribed dialogue (always anonymised) as a way to illustrate the skills described. In relation to her role as an academic, the author used the same format described in the book in her teaching of social work skills, including communication skills. The book analyses interventions on three levels: ‘basic’, ‘intermediate’ and ‘advanced’ level skills. For example, under the general heading entitled ‘Basic interviewing skills’, the author breaks these 20 skills into five separate sections. One section, on ‘Sticking to the point and probing deeper’, includes a description of ‘prompting’ and ‘using self-disclosure’ as important communication skills. Or again, the section on questioning covers the use of ‘open’ and closed’ questions’, ‘what’ and ‘circular’ questions, and describes how these skills might be used effectively in different practice settings and with different service user groups. The author reports that students find it easier to relate skills to particular approaches and theories when they are explicitly broken down in this way, and in the programme she delivers she works from core or basic skills through to advanced skills. While the book does not provide exercises, it illustrates the use of skills through a dialogue format or through the use of practice examples. Its primary aim is to provide a handbook that students and practitioners can refer to easily, and in ways that enable them to reflect on ‘what we are doing and why’. It is also intended to be a resource for academics and practice assessors – a text that social workers and students can refer to when something goes wrong, or when something goes well, in order to learn from that experience and to understand why something might have happened in a particular way. The book has been translated in Spanish and Korean, and is currently being translated into Chinese. It is also on the syllabus of social work courses in Australia, North American universities and West Africa, as well as being used in universities throughout the UK and the Republic of Ireland. Reference Trevithick, P. (2000). Social work skills: A practice handbook, Buckinghamshire: Open University Press. Further information available from: Pam Trevithick, School for Policy Studies, University of Bristol (www.bristol.ac.uk/sps). Practice example 10 Title ‘Learning and observation’ module, BA Social Work, University of Sussex/ University of Brighton Planned by Cath Holmstrom, Gill Johnston and Pat Le Riche Description This module is taught in the first term of the BA Social Work on the Sussex University campus. The overall aim of the teaching is to provide an introduction to study skills to support students as they make the transition into higher education. This module informs all aspects of learning in the first year of the programme. Two concepts will provide the main focus: the development of identity and the use of observational learning. 43
Slide 50: Teaching and learning communication skills in social work education Identity development provides a theme for all the Sussex modules at Level 1 of the BA. In the first term the emphasis is on personal identity, moving on to professional identity in the second term and interprofessional identity in the third term. The shadowing experience, which takes place towards the end of the first term, provides a bridge between aspects of personal and professional identity. Exploring aspects of identity will provide the focus for developing study skills for individual and collaborative learning. In groups the students explore a range of study skills such as reading and writing for a purpose, making notes and referencing. They are helped to make use of a range of resources such as electronic sources and the libraries on both the Sussex and Brighton campus. The second key concept, the use of observational knowledge and skills, explores the use of observation in the process of shadowing social workers. Within the module there is an active approach to observational learning using a range of teaching and learning strategies. These include practising observational skills in and outside the classroom, exploring observational theory and learning how to record observations. Students will also be introduced to the characteristics of ethical observation as a ‘case study’ in anti-oppressive practice. Learning aims and outcomes Our overall expectation in planning the module is that students will be active participants in the learning. They will be helped to develop skills in independent and collaborative study so that they can take greater responsibility for their own learning. The detailed aims of the module are to lay the foundation for successful study at degree level by: • providing a preliminary exploration of the concept of identity as an introduction to the study of social work; • introducing a range of study skills that will promote independent and collaborative learning at university level; • introducing a range of library and computer-based resources; • introducing the use of observational learning as part of the process of shadowing social work practitioners. At the end of this module students will be able to: • demonstrate an initial understanding of the concept of identity as a personal and professional issue; • describe the ways in which groups can be used to develop collaborative learning strategies; • complete a library-based project with other members of the student group; • demonstrate an understanding of how observational skills and knowledge can contribute to shadowing social work practitioners. Assessment of learning The assignment will consist of a learning and observation record. The three parts of the record are: 1. An individual annotated bibliography on the subject of identity. 2. A description of the work of the learning group in preparing the bibliography. 44
Slide 51: Practice examples 3. An account of the student’s initial understanding of some of the ways in which observational learning can be used in shadowing professional practice. Feedback/evaluation Throughout the module the students will be encouraged to evaluate their own and others’ contributions to learning. Self and peer evaluation will be a key element of ‘learning to learn’. The module will be formally evaluated at the end of the term but formal and informal feedback will be sought on an ongoing basis. Further information available from Pat Le Riche, University of Sussex (p.leriche@sussex.ac.uk). Practice example 11 Title Court skills training, Brunel University Description The importance of court work in many social work settings has been associated in the literature with high levels of anxiety among social work students about their readiness and capacity for the communication skills required in this context. Court skills training is provided in order to give students some practice in a range of the required skills and to prepare students for the practical communication issues around forms of address, procedures and roles in the court arena, body language and delivery of key messages under pressure. This skills learning takes the form of an interprofessional one-day training. The court role play is undertaken in courts local to the university. Preparation begins a week in advance when students are given mock court reports, statements and other case materials derived from those used to train Bar School students. Students are also provided with information about the structure of the court system and plans of courtroom lay-outs with explanatory notes. The day is divided into two halves: the first half consists of a presentation, video case study and discussion groups to unpack and explore child protection issues. After a meal break there is a briefing to outline the case materials, identify issues in the cases and allocate the various roles undertaken within the court setting, with students taking on the role of a magistrate, solicitor (parent/client, prosecution, defence), witnesses, guardian, and so on. Other students may act as ‘shadows’ and observe their counterparts without the pressure of ‘performing’, although ‘shadows’ and ‘performers’ may swap roles in order to experience the role play from both perspectives. In this way the day focuses on interprofessional communication skills as well as skills for the court setting in particular. A key aspect of the court skills day is that it includes students interprofessionally from a range of social work, health and education disciplines including: 45
Slide 52: Teaching and learning communication skills in social work education • • • • social workers health visitors school nurses teachers. The day is facilitated by tutors from across these disciplines. Following role plays, students are encouraged to reflect on their experiences and feelings and to identify issues and key learning points for communication in two ways: • as an aspect of working within a court setting; • in terms of interprofessional issues such as shared or conflicting values and perspectives. User participation in planning, delivery and evaluation None. Other key stakeholder participation in planning, delivery and evaluation Feedback from practice assessors in social work informed the need for this training. Learning aims and outcomes To enable students to reconcile differing practice models and to enable students to acquire basic skills in child protection and court work. Assessment of learning None. Integration between university and practice curricula Feedback from practice assessors in social work informed the need for this training. Feedback/evaluation Student feedback has been positive. References Arcock, A. and White, R. (1998) Significant harm, Croydon: Significant Publications. Department of Health (1995) Child protection: Messages from research, London: The Stationery Office. Further information available from Annabel Goodyer, Brunel University (www.brunel.ac.uk). Practice example 12 Title Interprofessional social work, Hull University Description The interprofessional social work focus in this course aims to address the issues surrounding community care, networking, collaboration, community and partnership, which have again come to the fore in social work practice, and to do so from an integrated and practice-focused perspective. 46
Slide 53: Practice examples This is an interdisciplinary module involving social work students and student nurses looking at communication skills across the two professions and from the perspective of their service users. The module is divided into three parts: the first part, involving social work students and student nurses, looks at theoretical frameworks and the underpinning knowledge of communication; the second part introduces the active involvement of service users and carers who facilitate seminar groups and teaching on the module; and the third part is an action enquiry learning case study. Part One: Theory Social work students and student nurses look at the theoretical frameworks underpinning communication skills in their professions. They examine interpersonal helping skills and other aspects of communication including: the nature of communication; models of communication; how to engage and sustain communication in practice; ‘core skills’: assessment, interviewing, writing, verbal and non-verbal skills. This module aims to introduce and elicit the key communications parameters and leads to the practice of theories, models and skills in the second part. Part Two: Practice Part Two is the application of the ideas explored in Part One and involves service users and carers. Service users and carers take an active role in the design, assessment and teaching of the module. Service users and carers act as facilitators to a small group of students in a series of seminars that look at various aspects of communication. Although a tutor is at hand in each seminar group to ensure safety and to act as overseer, their presence is designed to be non-intrusive because the focus is the practical application of the ideas taught in Part One. Part Three: Assignment The module is assessed through a case study which students examine and develop responses to within groups. Both the social work students and student nurses are given the same case study to work with, and although they try to find information that relates to their respective specialist areas, the emphasis is on interprofessional aspects of the communication issues in working together. Informed by the action inquiry learning approach, the attempt is to foster collaborative working between the different disciplines both through the issues thrown up and the processes by which they are arrived at. Further information available from University of Hull (www.hull.ac.uk). Practice example 13 Title Community role play, Staffordshire University Description Community role play is a mix of drama, role play, observation, reflection and assessment conducted over the course of about six weeks as part of a first year module entitled ‘Core skills for social workers’. 47
Slide 54: Teaching and learning communication skills in social work education This role play was developed in the late 1990s by a tutor who had trained as a family mediator. The rationale behind the development of this role play was that social work training can often appear to be geared to the gathering of information, but that communication skills are intrinsic to this process and can be learnt through the experience of ‘trying out’ the tasks and skills involved in it. The tutor sets up a role play based on the story of two families that are designed to involve as wide a range of social work situations and settings as possible. Scenarios not only involve family and childcare issues, but also relationships between partners, friends, colleagues and agencies. Students are cast within the role play as social workers, users (both adults and children), carers, family and friends, colleagues and other professionals. Although individual students do not necessarily sustain the same role throughout the six weeks, the same characters continue throughout and their choices, dilemmas, problems and challenges are followed for the duration. Students are encouraged to play as many roles as possible and it is their actions within the role play that form the basis of students’ reflection and discussion which focuses on aspects of communication as well as on other social work skills. While the story rolls over from session to session, the tutor will stop the role play at various points in order to encourage students to reflect on key issues which arise. The specific benefits of this extended role play include: • students experience continuity in a developing scenario, very much as they would in practice; • students can develop a character in more detail than they might be able to in a one-off role play, enabling them to consider in more depth the various factors contributing to particular behaviour and to stay with difficult feelings in a safe way; • students experience the multi-layered nature of social work processes and the various agencies involved; • issues of identity and self-awareness are developed in a real-life yet safe environment, for example, a student’s ethnicity or gender might affect the way they behave when playing a particular role; • students gain practical experience of information gathering, report writing, advocacy, negotiation and many other communication skills through the exercises which are part of the role play. The feedback on the role play is very positive and students are encouraged to take risks. They feel they get a lot from it. An important aspect of supporting this work is the tutor’s creation of a safe environment in which students can work. This is aided by the fact that the tutor may take on roles in order to ‘model’ them. Students report that seeing a tutor taking risks makes them feel more comfortable doing so themselves. The whole process, while having a clear teaching and learning focus, is conducted in a relaxed atmosphere of enjoyment, as the tutor feels that students get more out of their experience in such an atmosphere. 48
Slide 55: Practice examples User participation in planning, delivery and evaluation At present, none. However, with the new social work degree plans are being made to involve service users and carers in some aspects of the role play to help sharpen the service user and carer perspective. Learning aims and outcomes The module aims to help students make links between theoretical underpinning knowledge and simulated practice, in order to help them be better prepared for practice learning. By encouraging them to enter into the roles they are playing, the staff team hope that students will have greater insight into the issues being explored. Assessment of learning There is no formal assessment of the community role play. Informal feedback on how students are engaging with the exercise is given by the module tutor. When out on practice, students are encouraged to discuss with their practice assessor some of the issues which were raised in the role play. Integration between university and practice curricula Students are encouraged to discuss their experiences of this role play with their practice assessor when out on placement. Feedback/evaluation The feedback on the role play is very positive and students are encouraged to take risks. They feel they get a lot from it. Reference Moss, B. (2000) ‘The use of large group role play techniques in social work education’, Social Work Education, vol 19, no 5, pp 471-83. Further information available from Bernard Moss, Staffordshire University (www.staffs.ac.uk). Practice example 14 Title The Video Suite, Plymouth University Description The Video Suite is a technology for the teaching and learning of communication skills with social workers which uses a video laboratory in a range of ways to replay recorded role plays to rehearse, pause, refocus and replay aspects of practice in a non-direct way. Students work in groups of about 14 in a specialist video laboratory where they role play interventions that are video-recorded by the other students. They can use the technology to focus on particular people and events and to stop and play at their choosing. In this way they are able to play back and go through video recordings of their own and each others’ practice in order to self and peer review the work done. Areas of particular focus in this process are: • • • • why a student has chosen a certain method; how different methods might have been deployed; reflection on theoretical perspectives underpinning action; effectiveness of the communication style and outcome. 49
Slide 56: Teaching and learning communication skills in social work education The emphasis is on the service user and the ‘social worker’ in the role plays is usually filmed from behind in order to focus on the user’s responses and communications. In this way the focus is not on self-confrontation but on learning about communication skills experientially and by peer review. A key aspect of the device is that role plays are observed by the other students from an adjacent room where they can comment as the role play proceeds without disturbing the work. The video laboratory was originally devised for the university counselling service as a tool for non-direct intervention with students. It draws on Shuman’s perspectives on communication that suggests that communication is necessarily concerned with contact, interaction, transaction and relationships. The technique is used throughout social work courses to focus on: Level One Counselling skills Types of questioning and interviewing Level Two Putting feelings into words Exploring others’ feelings Group situations Explaining the role and purpose of involvement Common obstacles Groups’ and individuals’ relationship with the worker In particular the technique is used in preparing students for placement. Integration between university and practice curricula In particular this technique is used in preparing students for beginning practice/practice placement. Further information available from John Lewis, University of Plymouth (www.plymouth.ac.uk). 50
Slide 57: References and source material 1 Morris, J. (2002) A lot to say: A guide for social workers, personal advisors and others working with disabled children and young people with communication impairments, London: Scope. Essex Coalition of Disabled People and Scope (2002)The good practice guide for support workers and personal assistants working with disabled people with communication impairments, London: Scope (www.scope.org.uk). Harding. T. and Beresford, P. (1996) The standards we expect: What service users and carers want from social services workers, London: NISW. Wilson, M. and Francis, J. (1997) Raised voices, London: MIND Publications. The Sainsbury Centre for Mental Health (2002) Breaking the circles of fear: A review of the relationship between mental health services an African and Caribbean communities, London: The Sainsbury Centre for Mental Health. GSCC (General Social Care Council) (2002) Codes of practice for employers and social workers, London: GSCC. Levin, E. (2003) Involving service users and carers in the social work degree, London: SCIE. Egan, G. (2002) The skilled helper: A systematic approach to effective helping, Pacific Grove, CA: Brookes/Cole. DH (Department of Health) (2002) Requirements for social work training in England, London: DH. 10 Cree, V., MacAulay, C. and Loney, H. (1998) Transfer of learning: A study, Edinburgh: The Scottish Office Central Research Unit. National Assembly for Wales (2003) Requirements for an award of a degree in social work. DH (Departmant of Health) (2000) A quality strategy for social care, London: DH. TOPSS (2002) The national occupational standards for social work, Leeds: TOPSS. QAA (Quality Assurance Agency) (2002) Benchmark statement for social work. Dick, E., Headrick, D. and Scott, M. (2002) Practice learning for professional skills: A review of literature, Edinburgh: Scottish Executive. Kearney, P. (2003) A framework for supporting and assessing practice learning, SCIE Position paper No 2, London: SCIE. Whittington, C. (2003) Learning for collaborative practice with other professions and agencies to inform the development of the new social work degree, London: DH. Brunel Practice Review (2003) ‘Communicating with children, adults and those with particular communication needs’, unpublished practice review, London: SCIE. Marsh, P. and Triseliotis, J. (1996) Ready to practise? Social workers and probation officers: Their training and first year in work, Aldershot: Avebury. 11 2 12 13 3 14 15 4 5 16 17 6 7 18 8 19 9 51
Slide 58: Teaching and learning communication skills in social work education A Appendix A: Summary of methodology The key stages in the research and development work undertaken to produce this guide are summarised below. 1. An initial scoping exercise Conversations with academics, practice assessors, social work students, front-line managers in social care, newly qualified workers and service users, with some preliminary reading, provided the framework for the resource guide development and determined the specific requirements of a SCIE practice review. 2. SCIE research review Teaching and learning communication skills in social work education by P. Trevithick, S. Richards, G. Ruch and B. Moss • This review of the literature on the teaching and learning of communication skills in social work education was commissioned by SCIE, in collaboration with the Social Work and Social Policy Learning and Teaching Support Network (SWAPltsn). The purpose of the review was: • to identify the key messages concerning the teaching and learning of communication skills on social work qualifying courses/training programmes, in order to facilitate effective practice with a range of client groups; and A search of electronic databases was conducted by the Centre for Reviews and Dissemination (CRD) at the University of York, using search terms agreed by the working group that undertook the review. This generated a vast literature of 8,023 records, mostly relating to communication skills for health professionals. Only the 61 records relating to the teaching and learning of communication skills for social care professionals were included in the review, with additional material identified by hand searching key journals and from group members’ personal libraries. The review focuses on two main areas: • the theoretical underpinnings for the teaching and learning of communication skills; • how communication skills are being taught and to what effect. 3. SCIE practice review SCIE commissioned a practice review, Teaching and learning in social work: Communication, by A. Dinham, C. Aymer, T. Okitikpi, A. Goodyer and B. Randall (2003), unpublished, London: SCIE. The full findings of the review can be found in this guide in Appendix B, p 54. The practice review was carried out over three months using mixed methods, consisting of a survey using semi-structured interviews with academics, focus groups with other stakeholders, and small-scale case studies using web searches, semi-structured interviews and • to enable social work educators to reflect these messages in the design and delivery of social work programmes. 52
Slide 59: Appendix A focus groups to build up a portfolio of examples of practice. The practice review investigated practice in teaching and learning and assessment of communication skills in social work from the perspectives of all the stakeholders: academics, practice assessors, students, adult and child service users and carers. 4. Drawing on related resources SCIE research and practice review reports provide the main text for this guide with additional material as referenced. Other closely related SCIE publications that appear in this work and that are available separately are Involving service users and carers in the social work degree (SCIE, 2003) and A framework for supporting and assessing practice learning (SCIE Position paper 2, www.scie.org.uk). 5. Reference group Representatives of key stakeholder groups were brought together early in the project to advise and comment at key stages in the resource guide development. Group members were able to give their individual professional or service user view but also contributed a collective dialogue between key stakeholders. 6. Consultation and quality assurance The research and practice reviews were subject to an internal SCIE and external independent assessment process. Consultation on the final draft of the resource guide was undertaken with reference group members, the Practice Learning Taskforce, authors from the research and practice review teams and our sponsors from the Department of Health and Welsh Assembly. 7. Dissemination and implementation Copies of the resource guide and information about how to access the electronic guide have been sent to all HEIs offering the degree in social work in the UK. Further copies have been circulated to local authority training managers in England, post-qualifying courses in Practice Teaching, service user training organisations and links to the electronic guide are cited on the SCIE website (www.scie.org.uk), SWAPltsn (www.swap.ac.uk) and the National Organisation for Practice Teaching (www.nopt.org). SCIE will maintain contact with key stakeholders after publication to assist with the implementation of the materials. The interactive links on the electronic resource guide/website will be used to aid and monitor implementation. 8. Evaluation and review When the first of the degree courses has been completed, SCIE will review teaching and learning communication skills and this will include an assessment of the use and value of the resource guide. 53
Slide 60: Teaching and learning communication skills in social work education B Appendix B: The SCIE practice review Teaching and learning in social work: Communication – full text This practice review addresses the area of communication skills with children, adults and those with particular communication needs, although it is, of necessity, a general review within its remit and further research could focus more specifically on each group identified. The work reviews current practice in the teaching and learning of communication skills in social work from the perspectives of all the stakeholders: academics, practice assessors, students, service users (including adults and children) and carers. Findings are presented first by question, where academics’ views are predominant, and then by all other stakeholders, to ensure that their views are strongly voiced. The practice review was undertaken by a team of academics from Brunel University. The researchers did not provide respondents with their definition of communication skills as it was felt that respondents’ own definitions (implied or explicit) would be interesting in themselves in indicating the range of perspectives across social work educators. For example, some respondents reflected on the definition of ‘skill’, one arguing for a distinction between a technical ‘act’ – for example, sensitive direct work with children – and a ‘skill’, which is putting that act into practice appropriately. For purposes of initial analysis, however, the researchers used as a working definition the QAA benchmark standards for communication skills required in social work practice, which state that: … honours graduates in social work should be able to use C&IT methods and techniques for a variety of purposes including professional communications, data storage and retrieval and information searching. (3.2.1, QAA, 2002) These “do not attempt to define professional competence at qualifying level” (1.4, QAA, 2002), but rather to define the range of communication skills required. They are expressed in the National Occupational Standards (NOS) in terms of practice competences (many of which ‘embed’ communication skills, although some refer to them explicitly, for example, in 16.1, “Maintain accurate, complete, accessible and up to date Findings by question 1. How are communication skills currently taught and how are they delivered? Overview Respondents were asked to give an overview of what communication skills are taught at their institution and to give a description of the teaching and learning methods used. 54
Slide 61: Appendix B records and reports”, and part 3 of ‘Specific areas of practice’ in each NOS, ‘Values and ethics’, which states “recognise and facilitate each person’s use of language and form of communication of their choice” and “maintain trust and confidence … by communicating in an open, accurate and understandable way”. We prefer the benchmark statements for these purposes as they are more immediately accessible as working definitions. The benchmarks require that graduates “should be able to communicate clearly, accurately and precisely (both orally and in writing) with individuals and groups in a range of formal and informal situations” (3.2.3, QAA, 2002). A comprehensive list of required standards is given: • Make effective contact with individuals and organisations for a range of objectives, by verbal, paper-based and electronic means. • Clarify and negotiate the purpose of such contacts and the boundaries of their involvement. • Listen actively to others, engage appropriately with the life experiences of service users, understand critically their viewpoint and overcome personal prejudices…. audience for which these have been prepared. • Make effective preparation for and lead meetings in a productive way. Communicate effectively across potential barriers resulting from differences. • In summary of this section, the researchers offer a brief initial analysis of how the practice review measures up to the benchmarks as a starting point. There are three key trends in what is being taught and learnt about communication in social work: dedicated teaching; dedicated teaching specific to social work pathways; and non-dedicated learning which is integrated. The most common pattern of teaching and learning of communication skills is the inclusion of a dedicated communication skills module early in the course, or a strong communication component within an early module about methods, skills and practice. The trend is that this is then followed by further, often more specialised, communication skills, which tend to be associated with particular client groups, and addressed within teaching of specific pathways, for example, children and families, mental health, and community care. A complementary trend lies in the attention paid to the development of communication skills through its integration across modules. As one respondent put it, “we would make a distinction between teaching and learning” in this respect; in other words, while the explicit teaching in communication skills might be restricted to one module or part of a module, respondents were keen to emphasise that the continued practice and formative assessment of these skills throughout the course was equally important as part of the students’ development of adequate communication skills. • Use both verbal and non-verbal cues to guide interpretation. • Identify and use opportunities for purposeful and supportive communication with users within their everyday living situations. • Follow and develop an argument and evaluate the viewpoints and evidence of others. • Write accurately and clearly in styles adapted to the audience, purpose and context of the communication. • Present conclusions verbally and on paper, in a structured form, appropriate to the 55
Slide 62: Teaching and learning communication skills in social work education Themes There are a number of key themes arising from the data relating to what is currently being taught regarding communication in social work, as follows: 1.1. Dominance of interviewing and interview skills The most common skill to be identified in the teaching of communication is interviewing. While this is often undefined, in many cases respondents go on to identify particular contributory or ‘sub’-skills, including listening, questioning (in particular, asking open questions), non-verbal communication and empathy. These were also the kind of skills most likely to be identified in students’ responses, wherein the focus group suggested that interviewing was the most prevalent communication form they have learnt. 1.2. Neglect of written communication skills There is a clear emphasis on verbal and nonverbal (other than written) communication teaching and learning in current practice. However, where written communication was mentioned, respondents tended to express anxiety about lack of attention to this area, and academics and practice teachers felt that students need particular support with their written skills. Indeed, there was serious concern among all the groups about literacy levels, with the exception of the students group, who did not raise it. This suggests that they do not see this area as problematic, while other stakeholders do. In addition, questions of disability, including learning disabilities such as dyslexia, were notable by their absence in the responses and this may be an area for future research in the practice of teaching and learning of communication skills. 1.3. More communication skills training in new degree Where information was given about the changes planned for the new degree, most respondents stated that the communication skills module on the Diploma in Social Work would be expanded or a new dedicated communication or interpersonal skills module was planned, and/or that there would be greater focus on skills training. Specific themes reported within the changes planned for the new degree include: • increased user involvement, with users coming in to deliver teaching and also being involved with assessment; increased interprofessional teaching – both teaching in mixed groups with other human services students, and teaching about interprofessional communication; increased assessment by observation as well as written assessment; • • • increased use of observation and shadowing, that is, students shadowing experienced social workers in practice. The issue of interprofessional communication emerges as a key theme. Some respondents mentioned that there was already teaching in this particular area, and several stated that teaching of communication in this area would be increased in the new degree. 1.4. Experiential learning principles Overall, there was a strong emphasis on experiential teaching and learning, reflected in the strong showing of participative activities such as role play, video work (students being videoed and observing themselves and each other) and small group work. Typically, respondents described sessions beginning with a short period of tutor-delivered theory or background, followed by exercises and role plays in small groups, with feedback. Where direct input from tutors was mentioned, however, all respondents emphasised that this was kept to a minimum – one respondent described them as ‘mini-lectures’. 56
Slide 63: Appendix B Few attributed models were mentioned, but among these, Egan’s SOLER model (2002) was the only one to be mentioned more than once, indicating a continued emphasis on the teaching of counselling skills as a basis to communication skills in social work. Although the standards do not explicitly require this, several of the requirements could usefully draw on such skills. 1.5. Usefulness of (child) observation in developing communication skills Observation was referred to by several respondents as not only a place where communication skills with children could be developed by observation, but also to introduce the idea of not ‘hiding behind the social worker role’ and communicating through listening, staying neutral and ‘using your senses’. Observation skills can be used in a variety of contexts and not just infant observation which is a highly contextualised activity, for example, in interviews, observing practice assessors practice. See Practice example 10, ‘Learning and observation’ module from Sussex University, where observation is used as the basis for developing professional identity (p 43). 1.6. Make effective contact with individuals and organisations for a range of objectives, by verbal, paper-based and electronic means There was no systematic approach to teaching and learning about ‘making effective contact’ that distinguished between individuals and organisations or different objectives. Nevertheless, evidence was found that many of the skills needed for doing so are embedded in curricula, for example, counselling, networking, advocacy and interviewing. It appears, however, that much of this needs to be thought through against the benchmarks and NOS in an explicit way. In terms of modes of communication (‘verbal, paper-based and electronic’), there is an emphasis on verbal communication. Nevertheless, paper-based communication skills are reported in terms of ‘report writing’, ‘written communication’, ‘recording’, and ‘writing letters’. Electronic means are also referred to in terms of ‘IT skills’ and ‘telephone work’. The impact of disabilities, including learning disabilities such as dyslexia, is not addressed in the responses. 1.7. Clarify and negotiate the purpose of such contacts and the boundaries of their involvement Again, many of the skills underpinning this benchmark appear to be evident but are not specifically linked in a systematic way. For example, respondents report teaching and learning about ‘listening/attending’, ‘questioning’, ‘summarising’, ‘reflecting’, ‘responding’ ‘frames of reference’, ‘clarifying’, and ‘checking out’, all of which are key in achieving the benchmark. 1.8. Listen actively to others, engage appropriately with the life experiences of service users, understand critically their viewpoint and overcome personal prejudices… While there is evidence of teaching and learning about ‘listening actively’ (see above), there is little that links explicitly with ‘engage appropriately with the life experiences of service users…’. Responses include ‘working with difference and diversity’, ‘political/social context of social work’ and ‘adapting skills to users’ situations’ (practice teachers’ focus group), each of which can be seen to contribute to the benchmark but not in a clearly defined way. 1.9. Use both verbal and non-verbal cues to guide interpretation Significantly, respondents refer specifically to ‘non-verbal communication’ as a key skill, and this is supported by reports of other related skills being taught and learnt, for example, ‘self-awareness’, ‘rapport building’ and ‘communication through art and play’ (practice teachers’ focus group). Verbal cues are also addressed in current teaching and learning in terms of ‘questioning’, ‘feedback’, ‘clarifying’ and ‘checking out’, but, again, not clearly drawn out. 57
Slide 64: Teaching and learning communication skills in social work education 1.10. Identify and use opportunities for purposeful and supportive communication with users within their everyday living situations Practice teachers in particular identify ‘adapting skills to users’ situations’ as key and academics refer to related skills, for example, ‘working with difference and diversity’. 1.11. Follow and develop an argument and evaluate the viewpoints and evidence of others Again, there is little that explicitly links to this benchmark, but respondents do report using critical skills in teaching and learning which might develop these capacities, for example, the writing of a ‘reflective essay’, and use of video and peer review to reflect on self and practice. 1.12. Write accurately and clearly in styles adapted to the audience, purpose and context of the communication Writing skills are raised as a concern for all groups except students. Teaching and learning is reported which seeks to address this skill, for example, ‘report writing’, ‘written communication’, ‘recording’, and ‘writing letters’. Questions of adaptation are not addressed except in as much as different modes of writing are referred to (for example, ‘report writing’ and ‘recording’), and there is a reference to ‘adapting skills to users’ situations’ (practice assessors’ focus group). 1.13. Present conclusions verbally and on paper, in a structured form, appropriate to the audience for which these have been prepared See above. In addition, it is noteworthy that no explicit reference is made to the ways in which academic essay writing is used to support the development of competence in this area, although presumably this is a central tool for doing so. This is a question that should be addressed with the assessment review. 1.14. Make effective preparation for and lead meetings in a productive way No direct evidence was found of teaching and learning about communication in ‘meetings’, although there are references to ‘working in teams’ and ‘role play’ where it might reasonably be expected that such skills could be addressed. 1.15 Communicate effectively across potential barriers resulting from differences Respondents refer to ‘adapting skills to users’ situations’ (practice assessors’ focus group) and ‘working with difference and diversity’. 2. How do you distinguish and differentiate between core transferable skills and specific skills including technical skills? Overview Respondents were asked what they considered to be core transferable and what specific skills, what criteria they would give for identifying them as such, and what skills were taught under these categories. The understanding of ‘core’ skills here follows the NOS and the range required by the NOS and QAA benchmarks for qualifying level (to begin to practice). ‘Core’ skills here are regarded as transferable in the sense that they are a base line required for qualification to practice across all social work settings and user groups. These include an understanding or awareness of the communication process (information to be transmitted, mode of transmission, destination of information, receiver, receipt, decoding). Core also refers to knowing about the difference between verbal and non-verbal modes, active listening and awareness of self in the situation (Okitikpi, 2003). They stand in juxtaposition to ‘specific’ skills that we regard as those skills which emerge as important or necessary within particular settings or user groups during placements or upon taking up employment post-qualifying. They may include ‘technical’ skills, which are skills associated with methods 58
Slide 65: Appendix B and techniques of communicating, especially where there are particular communication needs. The data shows that this understanding is shared with respondents where a distinction was drawn. Nevertheless, the most striking finding from the responses was that little distinction was drawn between ‘core’ and ‘specific’ skills. Where definitions are offered, they fall into three categories: respondents who suggested that communication skills may be seen variously as core or specific depending on the context in which they are deployed; others who identify ‘specific’ skills as those used in working with a particular client group; and a number explicitly stated that there was no such distinction either in practice or in theory. 2.1. Variety of responses – what is a skill? A key theme lies in the sheer range of responses given. There was little consensus as to definitions of ‘core’ or ‘specific’ skills. Responses to the question of what the respondent would give as the core skills for social workers ranged from ‘measurable and discrete skills’ such as ‘writing reports’ to more general or ‘subjective’ ones such as ‘immediacy’, ‘conveying respect’, and ‘knowledge of social context’. These areas correspond to those found in the literature that relate to knowledge rather than to skills acquisition. Additionally, many responses could be seen as describing collections of skills rather than clearly identifiable discrete skills. As one respondent put it, empathy might be defined as a skill for some purposes, but “it’s really a bundle of micro-skills”, of which many would also appear elsewhere among the responses, for example, ‘listening’, ‘non-verbal communication’, and ‘not using jargon’. Similarly, the range of skills identified as ‘specific’ was also diverse, ranging from ‘use of information and communications technology’ to courtroom skills and working with conflict. However, around half of the skills identified as ‘specific’ are also defined as ‘core’, indicating a lack of clarity of definition. The pervading evidence is twofold: that the idea of ‘specific skills’ is either seen to denote ‘core skills taught at a deeper level’ or that specific skills are seen as ‘skills which are pertinent to a specific client group’. 2.2. Emphasis on interpersonal skills and skills for personal development ‘Core’ skills appear to be regarded as those which support direct interpersonal work and personal development, namely ‘listening’, selfawareness, empathy, choosing appropriate forms of communication for users’ needs, questioning, non-verbal communication, and awareness of diversity and difference. This is particularly true from students’ perspectives wherein all the suggested core skills are ones used in direct interpersonal communication – except ‘observation’, which was identified as core in the development of communication skills. The importance of personal development was also indicated in an emphasis on ‘assertiveness/ confidence’. This emphasis was reflected vividly in one institution’s plan to introduce ‘personal and professional development groups’ as an innovation for the new degree, taking students through all three years and involving tutor and peer assessment of behaviour, self-presentation and so forth. This would appear to be a development of the idea of practice seminars as a space for considering the theoretical and feelings level implications of placement, which already are fairly common. 2.3. Emphasis on communication learning in placement A pattern of experiential and participative teaching and learning methods was also apparent in terms of how core skills are taught and their transferability identified and practised. However, a large proportion of respondents also stated that in terms of transferability, the most important teaching, learning and/or assessment of communication skills took place on placement. The balance between assessing in placement and in the academic setting emerged in this context as an important issue. One view is 59
Slide 66: Teaching and learning communication skills in social work education that it is inappropriate to assess performance of communication skills in a university setting because they are very practice-focused skills and university is theory-focused. This is a rather worrying idea that fails to take into account what is known in the literature about the relationship between theory and practice (for example, Schon, 1995). Another view that emerges is that institutions should not formally assess core communication skills as a matter of principle because they are ‘difficult to quantify’, and the emphasis should be on students’ learning ‘in a relaxed environment’. These responses may indicate gaps in educators’ knowledge about assessment and learning of communication skills and this could be a key area for further study. 2.4. Overlap between core skills and values Some of what is reported as ‘core skills’ appears to refer to items that could be described as social work values (see discussion of values, below). Elements such as ‘selfawareness’, ‘awareness of diversity/difference’, ‘conveying respect’, ‘confidentiality’, ‘working to empower users’, and ‘aiming to equalise the relationship between user and social worker’ are all identified as communication ‘skills’. 2.5. Transferability Where the issue was addressed, core skills were generally identified as being by definition transferable, and particular emphasis was placed on the importance of teaching core skills as transferable. For example, one respondent suggested that the absence of pathways within the course at their institution “ensured transferability [of core communication skills] by the absence of guiding students in any particular direction”. At the same time, there is some concern, especially among students, that it is sometimes assumed that skills are being transferred where this may not automatically be the case. Another respondent noted that drawing attention to the transferability of skills in the teaching of core skills was particularly important because it makes students aware of the skills they already possess and raises their confidence, which itself is crucial for communication. 2.6. Technical skills Some respondents said that they felt there was room for more specific communication skills training – working through interpreters and British Sign Language were the two most commonly identified technical skills in this category. However, current teaching and learning of technical skills appears to be very limited. The key factors restricting the level of technical skills training are identified as time and resources, although the difficulty of choosing which specific skills to teach was also an important concern. As it stands, the level of teaching of specific skills was often described as ‘touched upon’ or addressed at a ‘theoretical’ level – students were given information about where to go for resources and support in a situation where specialist techniques would be required. Where these specific technical skills are specifically taught, this is in the form of oneoff sessions with specialists either from within the institution or, much more often, from an outside speaker, usually a specialist practitioner and sometimes a service user. The frequency of these sessions was, however, often described as ‘erratic’, and very often respondents stated that whether such specialist teaching was given depended on the students’ own interest or experience. 3. What is the breadth and depth of skills training needed to perform the range of duties and tasks for beginning practice and for qualifying level? Overview Although it is recognised that the benchmark statement “does not attempt to define professional competence at qualifying level…” (1.3, QAA, 2002) it is again, used here (3.2.3, QAA, 2002) as a working definition of ‘skills training needed’. This is because it describes in 60
Slide 67: Appendix B a clear and explicit way the expectations of communication skills in practice at qualifying level. In identifying current practice in teaching and learning it has been possible, to some extent, to grasp the breadth of existing practice. In this question, respondents were asked for their perceptions of what is required, what can be used as a measure against what is actually required in the benchmarks (and embedded in the NOS). The researchers regard the question of the depth of skills teaching and learning, as addressed in the benchmark statement (3.2.3, QAA, 2002), to be incomplete for their purposes: “Honours graduates … should be able to communicate clearly, accurately and precisely…”. No other clear and explicit statements are known of the depth to which communication skills are expected to be taught and learnt. Respondents’ understandings of ‘depth’ therefore are reported below. The distinction between ‘beginning’ and ‘qualifying’ level is that there is the point at which candidates begin to be social work students and go out to placements (‘beginning’), and the point at which they qualify as practitioners (‘qualifying’). Again, the researchers have been interested to investigate respondents’ understandings of this distinction and to relate this to the question of depth in terms of how ‘depth’ changes between these levels. There are a number of key themes arising from the data relating to breadth and depth at beginning and qualifying level, as follows: explicitly stated by some respondents, that there is a particular issue around the quality of social workers’ written communication skills at qualifying level. While this is obviously a fairly long-standing concern, the findings of recent enquiries such as the Laming Report (2003) may have brought this to the forefront of people’s minds. Nevertheless, it is notable that no respondents raised this in relation to dyslexia or learning disability, and this may suggest a lack of addressing this issue in current teaching and learning practice. This may be a matter for further research. Another area relating to the findings of the Laming Report is that of interprofessional communication. Again, while responses to Question 1 show that teaching in this area is already established in many institutions, the frequent reference to the need for competence in communicating as a professional across professional settings and values at qualifying level shows the prominence of this area of concern at this time. 3.2. Anticipating a different intake Academics anticipate an increasing need to cover ‘basic’ micro-skills such as walking into a room, introducing oneself, using the telephone, or taking messages, as intakes of much younger students on the new degree are expected to be starting from a lower skills base. One member of a teaching faculty suggested that “sometimes people want to go a bit too deep”, that is, address theoretical or conceptual issues, before they have ensured that skills such as these have been mastered. It was also noted that a younger student body would be likely to have less social care experience. As one respondent put it, competent beginning level social workers would ideally have more experience, but “experience is not something you can teach”. Specifically, the respondent reported that younger students are likely to have less experience of working with different client groups and identifies a gap in training in this respect. But “there aren’t any books on how Themes 3.1. Writing and interprofessional skills Of the skills explicitly identified as necessary at this level, the most frequently mentioned was written communication. While this also appears as both a core and a specific skill in Section 2, the frequency of its appearance in response to this question reflects the feeling, 61
Slide 68: Teaching and learning communication skills in social work education to talk to teenagers or old people” – the only way to learn this, he argued, is by experience. A key role of the university setting, therefore, was seen as building up students’ confidence to prepare them for real-life situations. Literacy was again a particular and increasing concern in relation to this issue. One faculty member suggested that, while social work has long been committed to widening participation, there is nevertheless a limit to what a social work course is able to provide in terms of basic literacy, although many of the students coming on to social work courses need support in this area. Another respondent stated that “you can’t now rely on an Access course as a guarantee of sufficient written skills”. While the widening participation agenda is widely supported, there is also frustration that teaching time is taken up in raising students’ literacy levels for the beginning of practice. It is interesting, and of fundamental importance, that no respondents raised the issue of dyslexia in this regard, despite evidence of increasing incidence and a new legislative requirement in the 2001 Special Educational Needs and Disability Act (SENDA). 3.3. Bureaucratisation Another area of frustration is the perceived increase in bureaucratisation in the social work profession. One tutor specifically stated that one of the hindrances to a more ‘substantial’ level of competence at qualifying level was ideology; he argued that “the current agenda means that social work is being driven towards becoming a task-led, outcome-driven profession”. The emphasis on outcomes over processes was identified by more than one respondent as constraining a desirable level of skills training by the beginning of practice – as one respondent put it, “good teaching of communication skills in particular needs attention to process as well as outcome”. The ‘increased bureaucratisation’ associated by respondents with this outcome-driven approach was seen to be focusing on skills such as filling in a particular form, rather than dealing with human situations. There was significant feeling that “currently social work training produces bureaucrats”, although it was also felt that this was more a product of practice and policy emphases than academic agenda. This bureaucratisation was seen to be to the detriment of the development of creative problem-solving skills, the ability to make the most of chance encounters, and the development of more in-depth counselling skills. As one tutor reported, “there’s lots of legal and structural knowledge to get through before the student can roll up their sleeves, get down on the floor and talk to a five-year-old”. There was some frustration that, for students, placements can be sanitised ‘light weight’ versions of the ‘real thing’, giving them a false impression of what life as a social worker will be like, particularly if they go on to work in statutory settings. One student told her group that she is leaving the UK and going to work in Australia, after graduating less than a year ago, because of her frustration at having done nothing but care proceedings since qualifying. The tutor commented, “What are we training them in communication skills for if the job is purely bureaucratic?”. 4. How do you identify the underpinning principles and values of communication for all categories of social work delivery? Overview Only a small proportion of respondents were able, unprompted, to distinguish between values and principles, a large number asking for clarification on the distinction, although they do appear to be strongly embedded in the collective and individual consciousness of respondents. A consensus about values and principles which emerges from the data, despite an inability to pin it down explicitly, supports this. Clark (2000) suggests that “There is no dependable consensus about what type of concept, principle or precept merits the implied high status of a social work value and there are different views about the specific character of social work values”. Any 62
Slide 69: Appendix B definition of values is therefore going to be inherently controversial. Nevertheless, Clark, along with Banks (1995), suggests that there are four essential elements that between them accommodate the insights contained in statements about social work values: • the worth and uniqueness of every person; • the entitlement to justice; • the claim to freedom; • the essentiality of community. although it is proposed here that principles are the practical expression of the ontological category of values. In other words, principles may be said to operationalise values. It is beyond the remit of the practice review to conduct a fully critical account of the literature on this matter. Suffice it to say for these purposes that what emerges in the practice review is an understanding of values as those which are given by CCETSW (or the General Social Care Council [GSCC]). Our probing revealed that respondents were unable to define these values closely or to relate them to practice implications. Our conclusion is that the value base for communication skills teaching and learning is taken for granted and, in the process, that much of their sharpness of meaning is lost or muddied. Anti-discriminatory practice (ADP) is identified as the major value underpinning social work communication and social work overall while, in terms of principles, user perspectives and using students’ own experiences in learning are identified as central. A key trend is in the explicit identification of the values underpinning communication, including ADP, with the former CCETSW values, although their relationship to principles is rarely elucidated. A ready-made bundle of values such as these, while arising out of the social work community originally, therefore seems to have lost much of its immediacy in terms of everyday application to the practice of teaching and learning. Values seem to be referred to frequently although their practical implications remain undefined. The maintenance of a ‘social work value base’ is also identified as important in the context of increased emphasis on interprofessional learning. The different value bases of the professions within the human services (social work, health visiting, teaching, occupational therapy, general practice, psychology, psychiatry and counselling) is raised by several respondents, and the need for social work to maintain its unique focus in teaching and learning emphasised. These rather heady categories, it may be argued, find at least one expression in the former Central Council for Education and Training in Social Work (CCETSW) statement of values, which is used here as one benchmark for the purposes of this review. They are: • Identify and question values and prejudices and the implications for practice. • Respect and value uniqueness and diversity and recognise and build on strengths. • Promote people’s right of choice, privacy, confidentiality and protection while recognising and addressing the complexities of competing rights and demands. • Assist people to increase control of and improve the quality of their lives, while recognising that control of behaviour will be required at times. • Identify, analyse and take action to counter discrimination, racism, disadvantage, inequality and injustice, using strategies appropriate to role and context. • Practice in a manner that does not stigmatise or disadvantage either individuals, groups or communities. These statements do little to account for any distinction between values and principles, 63
Slide 70: Teaching and learning communication skills in social work education Another important strand lies in the ways in which social work has drawn on a variety of other disciplines and procedures while nevertheless maintaining a distinct values ethos of its own. These influences include psychology and counselling, psychosocial and socio-psychological perspectives, anthropology and sociology, political science and social policy and youth and community work, including community development. One respondent who emphasised counselling values as important in underpinning his teaching, did so “while recognising that it’s not a counselling course”. These discourses are seen as ‘appropriated’ by social work and given expression in terms of social work values. Notable by its absence, however, is any discussion of the ethnocentricity of a social work value base that ‘appropriates’ from other Western academic and philosophical disciplines without reference to the practice realities of social work with black and minority groups, including asylum seekers and refugees. This point may also apply to other ‘centrisms’ around gender, sexuality, age and disability. The practice review found no evidence of teaching and learning of communication skills that takes this on board in terms of the values underpinning that teaching and learning. It is suspected from anecdotal evidence that some of this thinking is there but conclude from the practice review that it may not be ‘on the surface’ of many courses in relation to communication skills. There are a number of key themes arising from the data relating to what is regarded as ‘core’ and ‘specific’, as follows: Twelvetrees, 1982). This is frequently related to principles such as drawing on students’ own experiences, students taking responsibility for their own learning, and peer learning. These modes of learning are understood to encourage the sustained internalisation of skills as approaches and as ‘deep knowledge’. Some difficulty is recorded around the principle of participation in the academic setting where tutors identify the difficulty of balancing between acknowledging and challenging students’ own values. One tutor described her perspective on it thus: that values cannot be taught, but that the task of the social work teacher is to raise students’ awareness of their own values and beliefs. She identified two strands to this: first, that “this is OK – everyone is entitled to their beliefs”, but also, that this will, not just may, have an impact on how they communicate with others, and that this may require the learning of new behaviours. A similar perspective on the place of students’ own beliefs was given by a tutor who felt that more could be done to help students to make “the transition from the personal to the professional”, involving the principle of putting one’s own issues aside and putting the client’s first. This perspective placed more emphasis on the second strand identified above, stressing the need for awareness that social work happens in a particular context with particular goals, and therefore social workers take up particular professional roles in these contexts. 4.2. Values and principles in daily life Many respondents emphasised the principle of using students’ own experiences in learning. Others added to this by identifying the principle of using real-life examples in case studies and so forth, to avoid ‘distancing’ from the subject. One tutor also described trying at every point to ‘bolt on’ what is being taught to students’ experiences, so that they have their experiences valued, and then encourage them to reflect on this. Themes 4.1. Adult learning principles and students’ values A large proportion of respondents explicitly refer to the importance of using ‘adult learning principles’ in teaching and learning about communication. These appear to be derived from community work where adult education is recognised as a major force for community development (Freire, in 64
Slide 71: Appendix B 4.3. Tutor modelling The role of the tutor is seen as particularly important by tutors themselves in relation to this question. Several tutors emphasise that they and their colleagues try to implement the principles of ADP, respect for the individual, honesty and so on at an interpersonal level with students and at an institutional, or at least departmental level, as well as in the teaching and learning situation. As one tutor put it, the principles underpinning communication arise from “the culture of the department’” and are themselves based on “communication and consensus between the staff group”. 4.4. Students’ own communication needs As well as attending to the values and principles underpinning the communication skills that social work students are taught, some respondents also explicitly mentioned the principle of supporting students who have particular communication needs. One tutor identified, for example, ensuring access for students with hearing impairment. Another noted that, due to the specific kind of intake at their institution, there was a commitment to the principle of helping those for whom English is not a first language, and the UK not their culture of origin. 4.5. Critical thinking, reflection, and issues with competencies While it is found that, generally speaking, increased attention to skills training is welcomed by respondents, it is also the case that there is a tendency for the focus on identification of competencies to produce a ‘tool-box’ approach. This is seen to compromise awareness of context in their students. Similarly, a significant minority of respondents felt that there had been a ‘withering’ of the principle of supervision of students, partly as a result of the emphasis on competencies. She suggested that supervision encourages reflection, which she felt has been neglected, but noted that “they were coming back to” the new standards as a key part of learning about communication. 4.6. Social justice The issue of inequality and social justice was also prominent in the responses, and feelings ran high on this issue. One tutor, identifying respect for the individual as a key value, went on to clarify that this was not just based on human rights principles, but because the user is subject to processes of social injustice and discrimination that precisely dehumanise. A key skill in social work is therefore to attempt to communicate in the context of that discrimination and oppression. Related teaching and learning principles include the valuable learning experience to be had in playing the part of user in role play – to attempt to feel what it is like from users’ perspectives. Similarly, it is felt that learning should take in the role of the social worker as an agent of change at levels beyond the immediate situation of the user, in other words at an organisational and social level. This would also include what the respondent identified as ‘radical practice’, which he noted “is rarely taught or discussed now”, involving giving the user the role of change agent him or herself, and communicating to them their capacity to take on this role. Communication skills for such approaches are distinctive and conceive of communication in a ‘different way’ – as emancipatory and powerful. These are seen as key principles and values that are distinctive to social work. 4.7. User involvement, ADP and critical thinking Anti-discriminatory and anti-oppressive practice feature very strongly in the responses to this question, and several tutors identify this as something increasingly neglected as a principle – there is even concern that it might ‘fall off the end’ in the new curriculum. For example, one tutor noted that while ADP was ‘still there’ in the NOS, it was less explicitly so, and that ‘user involvement’ was the new buzzword. This respondent felt “why not stick with ADP?” because “it covers everything”. On the other hand, some respondents do not single ADP out as a principle in teaching because “it can become a ‘hat’ that students 65
Slide 72: Teaching and learning communication skills in social work education put on”, rather than something that pervades their practice as a whole. It was also noted by a couple of respondents that, while crosscultural anti-discrimination was now well established as a value and principle, some other areas of discrimination, such as discrimination on the grounds of sexuality or of disability, were being neglected. It is also noted that from a number of perspectives, user involvement is not a new discourse, although its explicit recognition in a clear language of its own underpins a valuecentred and principled approach to the involvement of users. 4.8. Child-centred principles While there were very few values and principles identified as unique to specific client groups, the maintenance of a child-centred perspective is identified as a matter of value and principle. The notion of partnership is identified as even more important when working with children. 4.9. Empowerment A principle that was strongly emphasised across stakeholders was that of empowerment. This was seen as particularly important by users with disability who expressed their need to have their ability to speak for themselves facilitated and respected. Tutors also recognised the empowerment of users to communicate effectively as an important principle in the teaching and learning of communication. One emphasised the importance of recognising that users might be discriminated against precisely because of their lack of communication skills. He stated that “If you’re a good communicator you can get a lot of information out of people, but this is irresponsible unless you’re doing it with them, with agreed outcomes, and passing on these communication skills to them”. 4.10. Difficulties and dilemmas While the majority of respondents describe the values and principles they identified as universal, many added that the relative emphasis on certain values and principles would vary across work with different client groups. In particular, certain client groups or settings might make the application of values and principles of communication less obviously achievable. A key issue in applying values and principles underpinning teaching and learning of communication is identified as resources. This is seen to put pressure on the size, make-up and frequency of seminars, lectures and tutorials, the practice teachers’ time and energy and the students’ need to set time aside for reflective learning when their circumstances require them to work in order to maintain themselves financially. 5. What are the range of teaching and learning opportunities that can be incorporated into the preparation for and in practice settings? Overview Although one tutor states that “students just have to go out and get on with it”, most respondents describe preparatory and placement-based teaching and learning to some degree or another. The Department of Health Requirements for social work training in England state that providers must “Ensure that all students undergo assessed preparation for direct practice to ensure their safety to undertake practice learning in a service delivery setting”. Respondents’ understanding appears to be that teaching and learning is taking place primarily in the academic setting, although a significant number of respondents also identified learning (which they distinguish from teaching) as taking place in practice. There is the suggestion that the focus for the teaching of communication skills lies in the academic setting only because this is where most of the ‘formal’ assessment happens and the award is made. This fails to take into account the assessment role of practice teachers. In addition, teaching and learning are understood as rather ‘formal’ activities and it is likely that opportunities for teaching and learning outside academic departments are somewhat 66
Slide 73: Appendix B underestimated in the responses because they are (wrongly) not understood as ‘learning’ (Jackson; Brown; McGill). In the academic setting, tutors report that all teaching and learning is seen as practicerelevant, although it is not always described as such. Some courses make use of practice assesors and users in the seminar room specifically to think about the practice setting, allied with tutorial sessions in which students are encouraged to make explicit their learning. This is reflected in an emphasis on supervision in the placement, although links between theory and practice often remain underdeveloped because the three-way relationship between practice assessor teacher, tutor and student is difficult to sustain creatively under the respective pressures of the roles. Nevertheless, there is no shortage of goodwill between these parties, all of whom tend to emphasise the importance of the relationship for teaching and learning between universities and practice settings. In addition, the newly formalised role of shadowing in the new degree (as opposed to learning in an ‘apprenticeship’ model as is current in placements), is highly rated, although most institutions plan to start this with the introduction of the new degree and there is as yet little experience of this role to draw on. Observation, role play and case study are much more widespread, and most institutions report an emphasis on such practice-focused learning across their courses. Elsewhere, student respondents suggest that role play can feel ‘artificial’ and ‘staged’, and there is some concern that this can compromise the usefulness of such exercises. The community role play described in Practice example 13 (p 47), however, suggests, on the contrary, that students find role play extremely useful and “get a lot from it”. These different perspectives may indicate differences in approach and environment that might fundamentally affect the experience of role play and there is literature that discusses the elements of successful exercises of this kind. It may be a matter for future research to look more closely at factors contributing to a positive role play experience for students, including in terms of learning impacts and outcomes. Examples of a range of role play experiences and formats and a discussion about their impact on learning can be found in Practice learning for professional skills: A review of literuature15 . Another key learning mode is the use of the peer group in preparation for practice. Some courses make use of this approach currently (for example, see Practice example 14, the Video Suite at Plymouth University (p 49). Responses suggest that this is likely to be taken up more widely. For example, a student mentoring scheme, running parallel to observations and in-placement shadowing, is planned in some universities, drawing on the experiences of second or third year students. Overall, there is the feeling that, however good the preparation, there is “no substitute for practice”. Themes 5.1. Personal and professional preparation for practice A number of respondents describe a specific module in the area of ‘Personal and professional preparation for practice’. Such modules usually take the form of student-led seminars and address the students’ personal experiences of professional learning, very often through the identification of personal issues and difficulties the student might encounter, and address learning needs and the drawing up of learning contracts, sometimes with attention to different learning styles. They also address issues around professional conduct and interprofessional communication. The most striking aspect of these modules is the emphasis on general preparation (focusing on self-awareness and confidence, for example), rather than on practical issues in communication such as conduct at core groups, case conferences and team meetings or the negotiation of learning agreements and use of supervision. This may reflect a focus on general skills associated with ‘approach’ and 67
Slide 74: Teaching and learning communication skills in social work education transferability. If so, it suggests that this is contrary to a focus in the new degree on practice-focused learning. 5.2. The academic setting/placement relationship The centrality of the relationship between practice assesors and teaching institutions is also a key theme, whether explicitly identified or implicit in responses. Many respondents identify a good relationship with placements as central to good communication skills training, both in preparation for and in placement. Where it is strong, practice assesors are involved in teaching sessions at the university, feeding into curriculum development and assessment and, in one case, working on practice-related academic research alongside academic teams in practice settings. However, while the vast majority of respondents were positive about the learning opportunities available on placement, one tutor argued strongly that experiences of practice placements can be thoroughly detrimental to students. She argued that the link between theory and practice, crucial to the development of effective communication skills, was not being made, and indeed that on placement “students learn that they don’t need theory”. She also had little confidence that good skills training went on in placement, arguing that “[the students] pick up bad habits”. 5.3. The usefulness of role play The question of the usefulness of role play as preparation for practice generates a lot of discussion, especially among the student respondents. While there seemed to be a general feeling that role play is “useful to a certain extent”, there is some feeling that it can feel very “staged”. However, where role play is not formally observed or assessed, it is felt to be less intimidating as an exercise and students overwhelmingly report feeling better able to learn in this environment. 5.4. Shadowing and observation The question of the value of observation is also prominent among responses. The requirement of shadowing as part of the new degree is particularly welcomed among tutors, and students’ responses reflect this. There is consensus that the opportunity to observe a variety of practitioners at work, and thereby observe a variety of personal styles, would be extremely useful in the development of students’ own communication skills. Similarly, it is felt that students themselves benefit from being observed and assessed on placement. This is happening fairly frequently by means of informal and indirect observation throughout the placement from all or several staff members, rather than by means of direct observations from a single practice assessor. Overall practice assesors and students reported feeling that this less formal approach to observation makes for a better learning environment. 5.5. First placements: voluntary and community work The choice of first placement is identified as particularly important in terms of the development of good communication skills. Work in the voluntary sector and community work are picked out as particularly useful. One tutor reported that at her institution, the first placement is always in a voluntary setting, where communication skills are prioritised and crisis pressures on time and resources are often less pronounced. Some institutions describe community work modules as a kind of introductory placement, wherein students produce a community ‘profile’ or ‘resource file’, which requires students to go ‘out into the community’ before they begin a service provision role. Another tutor described an explicit emphasis on communication skills during the first placement, through the preparation for placement and through the input of the practice assessor, on the principle that, as she put it, “if they can’t communicate they won’t get off the starting block”. 68
Slide 75: Appendix B Findings by stakeholder While key themes and messages emerge across the data, they represent predominantly the views of academics who have been the primary stakeholders in the practice review. The review has sought also to represent the views of other stakeholders through focus groups. The practice review therefore also highlights the views and experiences of a range of specific partners in teaching and learning in social work education who have responded from their particular perspectives. These are: • • adult users users with learning disabilities and their carers Southwark and Lambeth, South London, social services children and families users in a North London borough. 1.1. Adult users were largely dissatisfied with their experience of social workers’ communication skills, although they also felt that social workers are well intentioned, genuinely concerned to help, and honest, and that many of the deficiencies in communication are a result of organisational pressures. 1.2. Complaints arose in two key areas: the failure to communicate purpose and approach; and the failure to intervene and respond imaginatively to the users’ realities. 1.3. In terms of purpose and approach, users were concerned that social workers do not communicate the reasons for their actions, their thinking or their expectations. The group particularly asked for written notes of all meetings, especially home visits, to be taken and shared with clients after the event. 1.4. In terms of imaginative intervention, the group felt that social workers are poor in some basic areas of communication such as responding to calls, dealing with basic enquiries adequately, appearing to respect people, appearing capable of getting the right balance between being hands-on and handsoff, and sympathetically understanding the realities of people’s lives. In addition, users felt that they were uninformed and uninvolved for much of the time. 1.5. Although this group represented a crosssection of social work settings and client groups, a key message arose in the area of children and families where there was a strong sense that social workers’ communications indicate that they are interested only in the child and not in the wider family system. This was consolidated by the view that social workers misinform and over-promise, giving assurances that are unmet. 1.6. These issues arise in the context of a recurring theme for adult users – the poor level of communication within social services and • users with physical disabilities and their carers • users who are children/young people • carers • • practice assesors students. The review does not specifically address the views of academics here as they are so fully represented in the remainder of the review (although the views of the other stakeholders here are also incorporated into the body of the review). In this way the research seeks to highlight the particular views and experiences of other stakeholders in the teaching and learning of communications skills and to make clear specific issues arising for each group. It is hoped that this may set the perimeters for consolidating strengths and addressing areas of weakness and concern. 1. Adult users This focus group consisted of adult users who do not have physical or learning disabilities and who are not otherwise involved with social work. The group contained 15 participants equally split between family centres in 69
Slide 76: Teaching and learning communication skills in social work education the lack of cooperation and coordination within the service. People reported that they generally find themselves repeating the same problem to different people. This causes a great deal of distress, anger and frustration and a sense of bewilderment with the service. 1.7. They nevertheless made a clear distinction between workers in statutory departments and their experience of social workers in community-based organisations. Social workers in community organisations were seen as more likely to respect and value them and provide an acceptable service. They were also seen as much more likely to provide continuity of personnel. 1.8. People also felt that, in initial conversations, more sensitivity needs to be shown towards clients. In their view, the reactions and attitudes of people in social services departments (including social workers) in first conversations was casual and this was seen to frustrate the making of a trusting working relationship. 2. Users with learning disabilities and their carers 2.1. A key message from this group was the importance of social workers being patient when communicating with users with learning disabilities. While one respondent stated that his social worker had always seemed to be in a hurry, and that this “wasn’t very good”, another spoke very positively about her social worker who had time to sit down, have a cup of tea, and chat with her. 2.2. Some respondents also felt that social workers have assumed that because of their learning disabilities, they lack the ability to make choices for themselves. The group identified the most important social work role as listening to what activities a user might want to get involved with, and follow this up as best they could, rather than imposing activities on them that they might not be interested in. Thus, it was strongly felt that social workers should “let you speak up for yourself”, for example, in reviews, rather than assuming they are not able to contribute directly, and speaking for them. Related to this was the importance of social workers being skilled in communicating with other services and advocating for users. This was seen as central in helping them get involved with activities, go on holiday, get a job or go to college. The role of advocate was seen as central, therefore, to the users’ social experience and development. 2.3. Some participants also identified a difference between the way they were treated as children, and the way they were treated once they became adults. One respondent reported that when he was a child (under the age of 18) his social worker had been very “bossy” but that when he turned 18 this stopped and the adult services social worker treated him much more as an equal. At the same time, others reported feeling that social workers had continued to talk to them as though they were children, even when they became adults. 2.4. For users with learning disabilities who are entering adulthood, a key issue arose about help with filling in forms and writing letters. These skills are crucial at this stage when clients begin to be more independent in running jobs and home life, and some felt that this was overlooked. This was related to the need to listen carefully to what a user wants to say, and making sure that what is written accurately reflects their views. 2.5. ‘Kindness’ and warmth were also qualities strongly emphasised by respondents. One male respondent specifically stated that he would feel more comfortable with a female social worker as he felt they were “kinder”; he felt that men were “too hard”. 2.6. Users also identified the importance of the environment in which they met and spoke to their social worker as important. For example, one respondent described very positive experiences of her social worker spending time with her at home. Nevertheless, what was emphasised above all was that it should be users’ choice where they meet their social worker, and whether they come into their 70
Slide 77: Appendix B home or not. “Peace and quiet” were identified as particularly important when working with this group of users to help their concentration. 3. Users with physical disabilities and their carers 3.1. Perhaps the most important key message to come out of the focus group with users with physical disabilities was the need for social workers to be patient, and to devote sufficient time to working with users in this group. While users understood that time constraints were often forced on social workers by their heavy workload, participants felt that they had experienced some extremely bad practice. For instance, one participant described an annual review that had only lasted five minutes, during which he had been given no opportunity to express a view. Even where the relationship between the individual user and social worker was felt to be very good, lack of time impaired good communication. 3.2. It was reported that social workers often speak to users’ key workers or personal assistants, rather than to the user him or herself. Speaking to the user directly was felt to be of vital importance. It was noted that professionals tend to speak to the carer, but members of the general public are more likely to speak directly to the user. 3.3. The participants in this focus group had little or no verbal communication. Therefore, they reported that it was much easier for them to respond to closed questions, and suggested that this was a simple skill that social workers could develop when working with users with communication impairments. A specific strategy was to break topics down into smaller parts, using closed questions to offer the service user a sequence of options so that communication could be built up. 3.4. ‘Checking out’, identified as an important skill by other groups of respondents, was seen as particularly important by this group. It was felt that in some cases social workers assume that something has been understood by the service user where this might not be the case, and that time and attention needs to be devoted to ensuring that the service user understands what has been said and decided and that responses have also been understood clearly. 3.5. While some of the participants could read, it was suggested that letters could be audiotaped for service users without literacy. Another option was e-mailing letters to service users, rather than sending them in hard copy. This would help to ensure that letters came directly to the service user. One user reported that she does not see letters that come to her from her social worker, and that information from these letters comes through to her via carers. Hence the need for social workers to check that communication has happened is not only important in an interpersonal situation, as described above, but also in terms of formal written communication. 3.6. In addition to some of these ‘technical’ barriers to effective communication, the group also identified some ‘attitudinal’ factors. Courtesy was identified as crucial in aiding communication. It was seen as particularly important that social workers convey respect in their interaction with users, and while experiences were mixed, several participants reported positive experiences in this respect. 3.7. Further, the keeping of appointments, or apologising and giving a reason when appointments have to be cancelled, was seen as a crucial part of treating the user with courtesy, particularly where meetings require a great deal of organisation in terms of transport and personal assistance. It was felt that, particularly where users were in residential care, failure to keep appointments amounted to discrimination. 3.8. Another skill required to support courteous and successful communication, and also requiring time and patience, was preparation for the required communication, including good research before the meeting. Participants identified the importance of reading the user’s files well before the meeting, not just as the meeting is about to begin. This would avoid the kind of situation 71
Slide 78: Teaching and learning communication skills in social work education arising, as reported by one participant, where a social worker began an annual review unaware that the user was profoundly deaf. Further, it was seen as important that users were given adequate notice of the date of their annual review, so that they too could prepare for it. 3.9. It was also suggested that it would be useful if the social worker could meet the service user before an annual review takes place. Here the social worker could identify the user’s specific communication needs and the way in which they communicate, and so that trust could be built up between the social worker and the user. 3.10. There were three values or principles that were felt to be of most importance when communicating with users with physical disabilities. The first was being nonjudgemental, and not assuming anything about a user’s abilities simply because of a disability. The second was that of building a relationship of trust with users, because without this, the user may be reluctant to communicate fully with the social worker. The third important principle, again reflecting that identified by several other groups, was that students training to be social workers need to have as much experience of working with people with disabilities as possible, as part of their training. 4. Users who are children/young people 4.1. Young people expressed their view of deficiencies in social workers’ listening skills, saying that they need to “open their ears” and “think before they talk”. Women were seen as being better listeners. 4.2. Another crucial issue was the need for social workers to explain to young people what is happening, discussing situations with them, and letting them have a say in what happened. For example, some children reported that the first time they had heard about the possibility of their going into care was in court. There was widespread experience of decisions having been made without consultation with or explanation to the young person. 4.3. The need for children to have a say in less dramatic circumstances was also expressed. For example, it was felt to be important that social workers took an interest in the child’s own taste and preferences when, for example, choosing activities. This issue is related both to the idea of ‘communication through action’ and to that of having respect for the child as an individual. 4.4. When asked about good experiences with social workers, the young people often mentioned things like “doing things with you”, “playing football”, “taking you out”, and so forth. While this might not strictly be regarded as communication, it does indicate that for these young people, actions often speak louder than words, and a way to initiate and sustain good communication is to participate in activities they enjoy with them. 4.5. As with the adult users’ and carers’ focus groups, a common complaint was that social workers “say they’ll do things that they don’t do”. Generally speaking, this ‘following up’ was felt to be an extremely important and neglected element of communication between social workers and young users. 4.6. When asked what they would like from their social worker, one young participant stated that he thought they should “check in” more often. Regular visits were felt to be important, or just a telephone call to see how the young person was. There was a sense that lines of communication between social workers and young people were often cut off or inactive for long periods of time, which made the young people feel frustrated and abandoned. 4.7. The communication of warmth and genuine care was also felt to be crucial to building the relationship between social worker and young person. 4.8. There was a perception among many young people that social workers regard what they are doing as ‘just a job’ – “they are getting paid for doing a job so they don’t really care”. Again, this suggests that social workers need to communicate commitment 72
Slide 79: Appendix B and genuineness as part of their work. A young person’s social worker might be one in a long line of professionals that the young person has been in contact with. Social workers need to be able to anticipate and prepare to be able to tackle user assumptions in a useful way that helps to gain an insight into the relationship. 4.9. There was some debate within the group as to the best way of training and selecting social workers to be able to communicate with young people. Some participants stated that social workers needed to go to college and pass exams – one younger participant said they needed to be “brainy”. Invited to explain this, he referred to the facilitator, and the facilitator’s direction of the group in listening to one person at a time. 4.10. Many participants said that they felt that social workers judged them on the grounds of what was in their file. Several stated that some things in their file were not true. Another stated that when she had been allowed to see her file, the many positive comments in it boosted her confidence. Overall there was some anxiety that young people should be allowed to see their file, and that the information in it should be agreed upon. 4.11. After the focus group, one of the facilitators, who had noticed one of the participants doodling some graffiti during the session, asked him if he would draw his ‘tag’ on the flipchart. Other participants also volunteered to do this with their own, and there was general chat about the tags, what they mean, where they might be and so on. This incident was important because it demonstrated that these young people may be communicating through other media, such as graffiti or art more generally, and that social workers might be able to use this as part of their communication with young people. 5. Carers 5.1. In this focus group, carers tended not to focus explicitly on communication skills per se. Rather, what they described were desirable principles and outcomes which, in order to be implemented successfully, need to be underpinned by good communication skills, or values which need to be expressed through good communication skills. 5.2. A key theme was that, while there is a perception of poor communications practice among individual social workers, these are seen to be the result of systems and organisational structures. For example, the lack of time social workers have to spend with carers not only means that there is simply less opportunity to communicate, but also that carers feel they are not being treated with respect and care, which inhibits the development of a good relationship. 5.3. Listening was once again identified as a crucial skill. Carers specified that social workers need to listen “and really hear” and accept what carers were saying. In addition, workers need to “check back” to make sure that they have understood what has been communicated to them. 5.4. A strong theme was the need for social workers to respond to carers’ needs and requests more quickly. Indeed, “getting in touch in the first place” was identified as a particular difficulty – the accessibility of social services in general was an important issue for this group. 5.5. Communication between social workers and interprofessional communication was felt to be crucial in providing a good service to carers. The keeping of good, accurate records, and the keeping of these records so that they could be referred to by other workers or at a later date, was felt to be extremely important. There was some frustration that, particularly now with the opportunities opened up by IT, social workers seem to have to replicate work and ask the same questions repeatedly which is seen as a result of inadequate record keeping. 5.6. The perception that social services operated on an issue-by-issue basis, rather than responding to the individual in a consistent and holistic way, was another organisational barrier to good communication. 73
Slide 80: Teaching and learning communication skills in social work education 5.7. A related group of problems was grouped under the heading ‘honesty’. Carers found it frustrating when social workers said they would respond, or that they would do something, and nothing then happened, leaving the carer themselves to chase it up. One carer described the phrase ‘we’ll get back to you’ as “the famous last words” in this context. Again, problems and obstacles at an organisational level were identified as part of the problem here. 5.8. However, it was also felt that social workers needed to have the personal communication skills to be able to say honestly when they could not help with a problem, but to be able to refer the carer on to other appropriate sources of help and support. 5.9. Another central issue was that of communicating respect and care for the carer themselves. This consisted in particular of addressing the carer’s own needs as well as the user’s. One carer said “my social worker did a brilliant assessment for my daughter, I couldn’t fault it, but there was absolutely no assessment of my needs”. For example, it was suggested that social workers need to address whether carers want to carry on being carers at all, rather than assuming that they would. It was also felt to be important that social workers recognise the loss of dignity people experience when approaching social services for the first time – the ‘cost’ in this – and respond sensitively. 5.10. The principle of treating the carer as expert in their own situation was identified as crucial in the successful communication of respect between social worker and carer. The principle of partnership was also identified as important. There was a perception that social workers tend to come across as arrogant or behave as if they are ‘superior’, although they may not intend to but rather are ‘naïve’ about a carer’s situation. 5.11. It was felt that carers often were not given the information they need in order to make the most of their abilities. The expression ‘need-to-know’ basis was used, and again this was identified as something coming ‘from on high’ – it was felt that social workers were worried that the more information carers were given, the more demands they would make, both in terms of time and financially. 5.12. There was a need for clear, accessible written information for carers. Carers described many of the forms they have to fill out as ‘difficult’, and felt that they needed more support with this. One carer also described the experience of being given a 25page leaflet in response to his enquiry about benefits, in which the information he needed was ‘buried’ in the final paragraph. 5.13. One carer identified the need for social workers to be taught ‘psychology of perception’, and be taught awareness of the various ways in which a situation might be perceived, rather than making assumptions. 5.14. On the whole, carers did not feel it was necessary for social workers to have a wide range of specialist communication skills. However, it was felt to be important (a) that social workers were aware when users were able to communicate but not directly – for example, where they could communicate through their carers, and to make the effort to engage with that, and (b) that social workers referred to specialists, particularly medical specialists, when necessary. Overall, a need for good background knowledge of the user and carer’s situation (related to good record keeping), together with a basic understanding of the particular needs of the user (for example, that there are degrees of learning disability, or that people without hearing may communicate in different ways) was felt to be important to support communication. 5.15. The use of jargon, primarily in written communication but also in spoken communication, was criticised across the board. One carer described her experience with social workers over the years as “like learning a foreign language”. Carers did feel that, with the increased opportunity for carers to become involved at an organisational level, they were able to challenge social workers where unnecessarily complex or technical language was used. While they recognised the 74
Slide 81: Appendix B usefulness of jargon as a short-hand between professionals, they felt it was important for social workers to use language appropriate to a situation. 6. Practice assessors 6.1 In terms of what is taught and learnt, . practice assessors’ main perception is that there is a range of key core skills that students will already have acquired by the time they get to placement. They also identify the importance of confidence and ‘emotional maturity’ for readiness to learn in practice. The main skills identified are interviewing and report writing. As these appear high on the list of skills taught in the academic setting it appears that practice assessors and academic tutors share this understanding. 6.2. Specific and technical skills are regarded as secondary and no specific teaching and learning is identified as necessary. Nevertheless, it is recognised that such skills may be important in certain settings and with certain client groups. The emphasis here is on learning through experience in placement, rather than teaching in academic settings. 6.3. This also raises a key question about assessment. Practice assessors overwhelmingly suggest that the assessment of communication skills is challenging for two main reasons: first, that such skills are amorphous and subjective; and second, that the act of assessment is dangerous to the demonstration of effective communication skills as it becomes artificial. 6.4. The relationship between practice assessors and the teaching institution is central. Practice assessors are not always clear about their role in relation to the academic setting and there is considerable concern about this, even where academic institutions are providing workshops and other support to the practice teachers with whom they work. This concern pervades both at the level of teaching and learning and at the level of assessment, for the reasons described above. 6.5. Practice assessors identify some ways in which the teaching and learning of communication skills on placement can be supported by teaching institutions. For example, profiling of students’ individual learning needs and specific knowledge of the curriculum are seen as important. 6.6. A lack of clear distinction between core and specific skills is also a key issue for practice assesors, as is the case across the research. Nevertheless, practice assesors do identify a small number of technical skills that they feel are important. These are British Sign Language, Makaton, communication through play, and communication through art. These skills, rarely identified as being taught in teaching institutions, are identified as the kind of specific skill that should be taught in practice, although only where the setting or client group demands it. There is no expectation among practice assesors that specific and technical skills should be taught in the academic setting. 6.7. A range of principles underpinning good communication were identified which reflect the practice assesors’ own day-to-day experiences. A key concern is what they describe as ‘working with reality’, including acknowledging frustrations inherent in the work, and setting realistic aims and expectations both for users and for workers. These principles are also related to the aims in communication of empowering users, being aware of power differentials, and of breaking down institutionalisation where possible. 7. Students 7.1. The students’ responses across the range of research questions indicate a strong awareness of and concern with the establishment and maintenance of the social worker role. In particular, they indicate a strong awareness of the importance of interprofessional communication skills. 7.2. At the same time, students share with academics the perception that there is a range of core skills which are key to social work and the respective skills they identify overlap with their academic teachers’. This is unsurprising since they are currently studying on Social Work courses and responses are likely to reflect that learning. Nevertheless, students’ own 75
Slide 82: Teaching and learning communication skills in social work education identification of core skills does not reflect the concern with written communication that is raised by both tutors and practice assessors. 7.3. At the same time, they also make little of learning in placement in an explicit way although a great deal is implied about their view that it is in practice settings that they pick up practice-useful communication skills. 7.4. While students have a very user-centred sense of values and principles, the principles they identify also suggest an emphasis on the extent and limitations of the social worker role. For example, one of the strongest statements of principle to emerge is that of “speaking for the client but not actually doing everything for them”. 7.5. Students also describe the need to “know what’s happening for the user”. This means making sure that they have done sufficient research into the background of the user’s case, to have good knowledge of the situation in advance of face-to-face communication. It would also manifest itself in appropriate selfpresentation, including dressing in a way that makes the user feel most at ease. This raises the question ‘How will they get to know this?’. What if it is a name badge that makes the service user most at ease? 7.6. Students also suggest that shadowing is good preparation for practice. There is consensus that the opportunity to observe a variety of practitioners at work, and thereby observe a variety of personal styles, would be extremely useful in the development of, and building confidence in, students’ own communication skills. 7.7. Students, along with tutors and practice assessors, emphasise the importance of learning communication skills by putting them into practice – as one student put it, “there’s only so much you can learn from text books”. 7.8. Nevertheless, on the question of assessment, there is concern that the academic setting has a preference for assessment in the written mode, while assessment of communication skills is more properly the concern of placement emphasising verbal and non-written modes, which are seen to come more naturally to practice settings. A fault line is identified between these settings and their concomitant modes of assessment, and it is unclear how the gap can be bridged in such a way that students do not experience learning about communication as fractured. 7.9. In particular, there is a general feeling that, while observation and role play is “useful to a certain extent”, it can feel very “staged”. There was some doubt as to whether this can effectively reflect students’ competence in communication. Bibliography Banks, S. (1995) Ethics and values in social work, Basingstoke: Macmillan. Clark, C.L. (2000) Social work ethics: Politics, principles and practice, Basingstoke: Macmillan. Egan, G. (2002) The skilled helper: A problem management and opportunity approach to helping, Pacific Grove, CA: Cambridge Brooks/Cole. Laming, H. (2003) The Victoria Climbié Inquiry: Report of an inquiry, London: The Stationery Office. Okitikpi, T. (2003) ‘Communication skills in social work education’, Paper presented to staff team at Brunel University, unpublished, London. QAA (Quality Assurance Agency) (2002) Benchmark statement for social work. Schon, D. (1995) The reflective practitioner: How professionals think in action, Aldershot: Ashgate/Arena. Twelvetrees, A. (1982) Community work, Birmingham: BASW. 76
Slide 83: Also available from SCIE Resource Guide No 2 Involving service users and carers in social work education Better outcomes for service users and carers are fundamental to the recent reforms in social work education. The Social Care Institute for Excellence (SCIE) is supporting the new degree in social work by providing a series of reviews and guides on the best way of educating and training social workers. This Resource guide outlines ways of involving service users and carers in all aspects of the design and delivery of the social work degree programmes. It focuses on how partnerships between higher education institutions (HEIs) and service user and carer organisations can be developed and sustained. It covers the values, principles and practicalities of participation, outlining a range of approaches to creating active and purposeful partnerships. Paperback 210x297mm • 48 pages • ISBN 1 904812 07 4 • March 2004 Full versions of all SCIE publications, including titles on social work education, are available on the SCIE website and in print from SCIE. Further details are available from: Social Care Institute for Excellence 1st Floor, Goldings House 2 Hay’s Lane London SE1 2HB Tel: 020 7089 6840 Fax: 020 7089 6841 www.scie.org.uk 77
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