Communication Skills Training for Practice: the Ethical Dilemma for Social Work Education

1
Communication Skills Training for Practice the
Ethical Dilemma for Social Work Education

• Sally Richards - University of Reading
• Gillian Ruch - University of Southampton
• Pamela Trevithick - University of Bristol

2
Outline

• Communication skills training findings from the
  SCIE Knowledge Review
• Communication in contemporary practice settings
• Ethical dilemmas for social work education
• Equipping our students to communicate effectively
  in the real world

3
Communication Skills TrainingReview Findings

• 86 texts fully reviewed
• North American and European social work
  programmes
• Emphasis on interview skills
• Absence of coherent theoretical framework
• Diverse approaches to learning and teaching
• Limited evidence on the transfer of learning to
  practice

4
Communication Skills TrainingShared Assumptions

• Social work is about helping people in
• difficulty. This requires social workers to
• engage with service users as individuals
• demonstrate genuineness, empathy and respect
• attend and listen in order to understand
• problems and needs
• use self as a tool.

5
Contemporary Practice

• Managerialist culture
• Surface not depth explanation of difficulties
• Understands users through administrative
  categories
• Emphasis on procedures and performance management
• Intervention is task focused and time limited
• Lack of professional support and supervision.

6

• I hadnt been in the bath for about two
  years. Id been sitting on the loo, the wash
  bowl is handy, and washing myself down. My
  doctor asked me would I like to have a social
  worker to see me at home. I said, oh yes. I
  thought Id like to talk to them and ask them if
  they could advise me. I only wanted advice. I
  got a phone call from the Social Services but all
  he would say to me was have you got 16,000 in
  the Bank? Have you got 16,000?. In the end, I
  came off in loads of tears and he said to me you
  see your doctor hasnt told me your financial
  circumstances.
• Ann aged 80-84, At Risk

7
Contemporary Practice

• Managerialist culture
• Surface not depth explanation of difficulties
• Understands users through administrative
  categories
• Emphasis on procedures and performance management
• Intervention is task focused and time limited
• Lack of professional support and supervision.

8

• If I had more time, more space in my diary,
  there are a lot of people like Mr R that Id
  like to spend some time with. Just to make sure
  that he really does want whats happening to him,
  that he really has come to terms with the
  disability And hes now losing his home, and we
  have not the time to address that. One would hope
  that the rest home will give him space to talk
  about that, because they have more time, but (the
  staff) arent skilled in counselling. At some
  point, all (older people) need is somebody to
  listen to them, to say something like its OK,
  its alright to be sad about losing your home.
  Whether they will actually say that or not I
  dont know. It would be nice if we had, because
  we havent the time to do it. I wish we did
  because its really the most interesting bit of
  the job is that kind of work.
• (Social Worker Older Persons Team)

9
Contemporary Practice

• Managerialist culture
• Surface not depth explanation of difficulties
• Understands users through administrative
  categories
• Emphasis on procedures and performance management
• Intervention is task focused and time limited
• Lack of professional support and supervision.

10
Ethical dilemmas for social work education

• Our perspective
• As social work academics, we are not equipping
  students for the real world
• The real world is ethically problematic

11
Equipping students for the real world

• What communication skills should we teach?
• Should we teach skills that are framed to fit a
  managerialist approach?
• Should we teach skills that effectively engage
  with service users and carers, and in ways that
  recognise their rights and needs?

12
A managerialist approach

• What might this look like in terms of
  communication skills?
• Teaching techniques that keep communi-cation
  efficient and narrow e.g. closed, time limited
  and constrained forms of questioning
• Ignoring underlying problems, causes or
  complexities
• Individualising problems and their solution
• Conceptualising people and their problems in
  terms of categories e.g. according to levels of
  risk or diagnoses

13
A managerialist approach (cont)

• Focusing on information and explanations that
  support without question agency/government policy
  and practice
• Failing to teach students how to use supervision
  in ways that can improve communication.
• Outcome driven evaluations of effectiveness of
  skills teaching which disregard the service
  users experience and other process oriented
  issues

14
Skills that effectively engage with service users
and carers, and that recognise their rights and
needs?

• What might this look like in terms of
  communication skills?
• Asking questions in ways that enhance peoples
  understanding and capacity to make connections to
  the wider picture
• Asking questions that explore the meaning given
  to experiences and how these relate to peoples
  needs, expectations and quality of life

15
Rights and needs of service users and carers
(cont.)

• Teaching those communication skills that bring
  service users and carers together to seek
  collective solutions to shared problems
• Locating communication skills as a tool for
  autonomy, choice and empowerment (Jordan 2004
  5). This may involve putting our knowledge and
  skills at the disposal of service users and
  carers (e.g. teaching assertiveness skills)
• Communicating in ways that inspire hope and
  possibility and that convey our commitment and
  concern

16
What can we do?

• Embrace the opportunities provided by the new
  degree
• Embrace the opportunities provided by government
  policy re. consumer choice, empowerment,
  partnership
• Link current developments to a coherent knowledge
  framework

17
What can we do? (cont.)

• Review how best to teach all skills, particularly
  communication skills
• Undertake more research on the transfer of
  communication skills to practice
• More generally, undertake more research on
  intervention skills (not just CBT), emphasising
  in this research the views of service users,
  carers and practitioners on effectiveness