Ms Ang Bee Lian, 24 April 2015
Recently, I asked Mrs Ann Wee what question she might set for an exam question for Social Work today if we were to have a chance to answer it. She did not reply with a question but her response reminded me of the importance of understanding the roles of each profession that interfaces in the helping relationship with clients. Clients often need the help of a few professionals, be it the social worker, the psychologist, the doctor, the nurse, the counsellor or the special needs teacher, just to mention a few. As the emerging theme of collaborative practice becomes more recurrent, it is good to revisit the role of each profession in helping the client. After all, most literature on collaborative practice use inter-professional work, working together, joint working, working in partnership and inter-agency working and multi-disciplinary working almost sometimes interchangeably and so we must consider its important role in collaborative practice.
One might be tempted to run ahead and try to determine the knowledge and skills needed for good collaborative practice and how to help social workers to be competent in these. But it may be useful to take a moment to think about the context in which collaborative practice started to emerge as a theme. We can then explore how to better prepare students for inter-professional collaborative practice. We may arrive at a point where we realise that the role of the practice teacher is pivotal in facilitating inter-professional practice learning. And the question that follows then is how practice teachers can be prepared for the role and how they can be supported to facilitate inter-professional practice learning.
Social workers here practice within a constantly changing environment. It is one with challenging social problems and a developing framework of policies and legislation for families in distress, social care, health and early intervention not unlike elsewhere. Recent developments for us include the Mental Capacity Act, the introduction of legislation to better protect vulnerable adults, the increase in step-down and home and community based care for older persons and the mandating of pre-divorce filing advisory for marital dissolution with young children. These areas add to the existing ones that call for collaborative practice.
New or experienced social workers alike will increasingly be asked to develop their collaborative practice with service users and carers and with other professionals in order to improve services for patients, clients and users as well as to improve the outcomes from intervention. The call is for practitioners in social care, health and related sectors to work more effectively together in line with current developments in policy and practice. But what is collaborative work or inter-professional practice? It is about building genuine partnerships between professionals, and with service users and carers in planning and service development and providing care. And what are the groups where professionals working together make a marked difference to the well-being of the client than each working singularly? Invariably, we will say that it is particularly important when we work with older people, people with mental health needs, children and families in distress and people with learning disabilities.
Collaborative practice can occur within and between professions or occupations, in uni-professional and multi-professional teams, within and between agencies, and when working in partnership with service users, carers and even communities. In good social work practice, we know that the need for personalised services and the responses to the circumstances, strengths and aspirations of particular children, adults and families will require professionals to work in partnership. It is about working with people to find the solutions and to achieve the desired outcomes and to work collaboratively with other agencies and disciplines to ensure coordination of services and support. However, this does not happen intuitively. Having systems and processes will facilitate this but is in itself not sufficient. These outcomes require that collaborative working is grounded in inter-professional learning. It is about working across professional, organisational and agency boundaries. Social workers and other professionals need to understand and be prepared for collaborative practice.
Generally, social work students will share that they are not prepared for the range, nature of and approaches to inter-professional practice learning although they may recognise its importance. Most lecturers may mention it but students will say that they do not have exposure to modules that are taught inter-professionally with mixed student groups, using a range of teaching and learning strategies including interactive methods and involving service users. But this of course is the ideal.
Such opportunities are difficult to create as they depend on the relationships between the professions within the institutions of higher learning, relationships with agencies, availability of placements and context. But where they exist, students value the experience they gain and learning about the different ways in which professions are deployed during their placements in the statutory and voluntary sectors. This not only helps them to learn about the roles of other professions, but also the roles of social workers. Students gain from these opportunities too when practice teachers are deliberate in discussing what inter-professional and inter-agency working involves.
Opportunities in inter-professional and inter-agency work such as in the examples of the National Family Violence Dialogue Groups and the National Committee on Youth Guidance and Rehabilitation are good for reflecting on working across professions, agencies and systems. Lessons gleaned from such opportunities include having clear aims, a recognition of the roles of all the people involved in the particular service, an understanding of the power differentials and strengths of different partners and the techniques involved in bringing people on board in different ways. There are two main aims in preparing students for inter-professional and inter-agency collaborative practice. One aim is to help students understand the perspective of different professions and the second is to learn about shared approaches to working in a team which includes confidentiality, roles and boundaries. And in the case of working in multi-professional teams, practice teachers can do well to ensure students in social work do not feel that they are in a lesser profession.
No matter how limited these learning opportunities are for collaborative practice, they do exist and we have to ensure that students have the opportunity to work alongside and with other professions. Perhaps we can devote more attention to better prepare students in the university for effective inter-professional practice before their placements. These can include lectures on working together, sharing information, policy issues and organisational structures, how to overcome problems and structures, what to expect from different organisations and the challenges and dilemmas of practice.
To venture further, we can consider how to include older people and those with learning disabilities in the process of learning about inter-professional work. Clients or service users can talk about their perceptions of social work and how they wish to be treated. But to facilitate such occasions to move towards learning about inter-professional work requires effort from practice teachers. One way to structure this is to explore cross learning or joined up learning through a range of modules with students from other professions. In the areas of child and adult protection and increasingly in social care, inter-professional work will begin to feature as a topic in itself.
Social work is practised in a variety of settings and the roles which social workers fulfil, the tasks they undertake and the way in which they deliver a service is very much context dependent. Confidence and clarity regarding their professional role and identity is important and necessary before inter-professional relationships can be successful.
It is good if inter-professional learning at placements and in the classroom can be in the curriculum. To do this well, practice teachers will want to be prepared for the facilitation of inter-professional learning and working as this is an area that is “caught” more than “taught”. Ideally, the learning occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of service and care.
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MS ANG BEE LIAN
Director-General of Social Welfare