Reflective practice: luxury or necessity for social workers?

Judy Cooper discovers that plans to train more social workers in therapeutic approaches could be thwarted by rising caseloads and overspends in children’s services

A good craftsman doesn’t produce hundreds of items and social work needs to be seen as a craft, not a conveyor belt.” Stuart Hannah, a former social worker and now psychotherapist, believes this is the fundamental reason to increase therapeutic approaches in day-to-day social work.

Yet such approaches have almost disappeared from frontline social work. They have instead become embedded in more specialist fields such as mental health, play therapy and specialist children’s homes.

This, says Andrew Cooper, professor of social work at the Tavistock Clinic and the University of East London, is because since the 1980s and 1990s social work has been more about care planning than providing care itself.

However, therapeutic approaches are making a comeback, under the banner of reflective practice. Indeed, in the past two years Lord Laming’s recommendations and the Social Work Task Force report have highlighted the need for social workers to engage in more reflective practice.

Cooper agrees that, among frontline social workers and “well-functioning” agencies, “there is a recognition that relationship-based work is the vital element missing from most social work practice”.

One of the first things Peter Lewis did, after being appointed as director of children’s services at Haringey, was to send his social work staff on reflective practice courses at the Tavistock Clinic.

Cooper adds that most social workers are crying out for the ability to undertake more reflective practice. “There is a sense of frustration and hunger for the time and the tools to undertake relationship-based work which they believe is effective and which they came into the profession to do. Instead they are spending all their time filling in ICS forms.”

Political obstacles

But it seems that, even when politicians are convinced of the need and provide funding, politics can still get in the way. In 2006 the Scottish Government’s Changing Lives review of social work emphasised the need for more reflective practice. As part of this finding, the Scottish Institute of Human Relations (SIHR) was funded for three years to provide courses for social work managers on how reflective practice could improve the management and supervision of frontline social workers.

Satisfaction rates were all above 80% and, although outcomes were difficult to measure in such a short time, anecdotal reports suggest a greater feeling of confidence and ability to solve problems.

Ray Pavey, SIHR development manager who evaluated the scheme, says there were 300 people on courses in the three years and interest among councils was high.

But after the Scottish National Party took power at Holyrood the scheme languished because it had been championed by the former Labour administration.

Currently, however, the biggest obstacle to reflective practice becoming more widespread in frontline social work in England comes from the twin attack of tightening budgets and increasing referrals.

Tim Loughton, shadow children’s minister, says: “If we had a hugely well-qualified social workforce then we could have the luxury of engaging in reflective practice. But we have a lack of well-trained staff and the caseloads of those we have are too high, and that is likely to remain the case for the foreseeable future. It’s an aspiration and desirable but it’s not do-able at the moment.”

The Local Government Association’s recent report on the cost of Lord Laming’s recommendations after the Baby P case found that to train social workers in reflective practice theories and allow them the time to practise them would cost each local authority £13,588 a year for each frontline team. But when children’s services budgets are facing overspends and increasing referrals it seems that even such a relatively small sum will be impossible to find.

But Hannah claims that, unless reflective practice is considered a necessity rather than a luxury, children’s services will be prone to more high-profile failures.

Objectivity

“The volume of the work and its impact means, as a social worker, you feel stressed and overwhelmed. Then you begin to overly identify with children in need or with the parents. It becomes hard to hold on to your objectivity and stand back,” he says.

“Reflection is hardest when you are anxious and I don’t think I’ve met many contained, non-anxious social workers in the past five years. Since Baby P it’s all about professional survival and covering backs.”

Cooper agrees that reflective practice should be an essential part of social worker decision-making.

“People get stirred up by child protection work. For example, if someone is forced to look at slides of abuse it is painful for them to see. Unless they can reflect about how upset and angry they feel they will be unable to manage their feelings in relation to the work and decisions they need to make.”

 

Case study: Sarah McLinden, Independent social worker: ‘The course had such an impact on my practice’

Sarah McLinden is an independent social worker, specialising in complex case work for London boroughs, and expert witness in parenting assessments.

“I feel on some level that I’ve always engaged in reflective practice,” she says. “But doing courses in therapeutic approaches puts flesh and bones on what I used to do instinctively.

“For example, at the end of a case I used to think about an outcome and wonder whether I could have done something better. Now I think about the dynamics between the child and the parent and the dynamics between myself and the child and the parent and use key theories to assess what went on.

“Something like the theory of containment I was never aware of, but it’s so key to assessing parenting. It’s particularly helpful in those cases where you can’t put your finger on what’s wrong.

“I find it most useful when dealing with adolescents and small children. Adolescents often withhold their feelings. Reflective practice allows me to think about the detail of what they’ve told me alongside how they’ve acted and how they might be dealing with anxiety and anger.

“Similarly with observing small children. If, for example, they repeatedly try to fix things or break things, you can get an idea of how a situation is impacting on them.

“I don’t think I’ve ever been on a course which has had such an impact on my practice.”

 

Elements of reflective practice

● The role emotion plays in decision-making.

● Patterns and pictures – finding the evidence for gut feelings.

● Confirmation bias – reluctance to abandon a pre-formed opinion.

● Attribution error – attributing other people’s behaviour to personality traits rather than the context.

● Hindsight error – overestimating how obvious a problem appeared.

Source: Community Care Inform: Guide to analytic and intuitive reasoning


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