Contributions of Professional Social Work – Some Reflections and Contemplations
Professor & Head, Department of Social Work, Bharathidasan University, Khajamalai Campus, Tiruchirappalli – 23. Email: pon.
In his recent book entitled -What is professional social work?-, Malcolm Payne portrays the now classic analysis of social work as a discourse between three aspects of practice: social order, therapeutic and transformational perspectives. He gives a clarion call to social workers to analyse and value the role of social work in present-day multiprofessional social care. He also explores social work’s struggle to meet its claim to achieve social progress through interpersonal practice. Payne specifically addresses some specific issues and concerns such as practical ways of analysing personal professional identity, understanding how social workers embody their profession in their practice with other professionals, detailed analysis of current and historical documents defining social work and social care, analysis of values, agencies and global social work. His work has stimulated social workers, students and policy makers in social care to think again about the valuable role social work plays in society (Malcolm Payne, 2006). Professional social workers have a strong tradition of working for social justice and refusing to recreate unequal social structures. This means going beyond state sponsored practices which merely cater to individual needs. Social work maintains this radical kernel with the objective of transforming society as a whole. Today, many social workers internationally have strong connections with social and political movements for the emancipation of the oppressed. The main tasks of professional social workers are case management (linking clients with agencies and programs that will meet their psychosocial needs), medical social work, counseling (psychotherapy), human services management, social welfare policy analysis, community organizing, advocacy, teaching (in schools of social work), and social science research. Professional social workers work in a variety of settings, including: non-profit or public social service agencies, grassroots advocacy organizations, hospitals, hospices, community health agencies, schools, faith-based organizations, and even the military. Other social workers work as psychotherapists, counselors, or mental health practitioners, normally working in coordination with psychiatrists, psychologists, or other medical professionals. Additionally, some social workers have chosen to direct the focus their efforts on social policy or academic research towards the practice or ethics of social work. While the emphasis has varied among these task areas in different eras and countries, some areas have been the subject of controversy as to whether they are properly part of social work’s mission. (Wikipedia). While celebrating the over 100 years of professional social workers’ contributions during March 2001, the then NASW President Ruth W.Mayden mentioned “Across the nation, the contributions of social workers are being recognized by agencies, community leaders, and government officials. This is a wonderful opportunity for us to acknowledge the work of these excellent professional social workers-work that often is unnoticed and overlooked. For these social workers, we take the month of March to say thank you and to celebrate these caring and skilled professionals who have helped individuals, families and communities throughout our country and abroad.” In fact, it is said that March is National Professional Social Work Month. When I read about these things, my heart started aching to realize that professional social workers in India, even after over 7 decades of existence, still do not get this kind of a public recognition and encouragement. In U.S.A, The National Association of Social Workers (NASW) is the largest and most recognized membership organization of professional social workers in the world. Representing 150,000 members from 56 chapters in the United States and abroad, the association promotes, develops and protects the practice of social work and social workers. NASW also seeks to enhance the well-being of individuals, families, and communities through its work and advocacy. Although membership is generally not required for licensure, NASW survey data give a rough idea of how social workers are employed in the US. According to NASW: Nearly 40% of NASW members say that mental health is their primary practice area. The health sector employs 8% of NASW’s members, and 8% practice in child welfare or family organizations. Six percent of NASW members say school social work is their primary practice area, and another 3% work primarily with adolescents. (NASW, 2005) These figures are significantly confounded by the fact that NASW members are primarily licensed practitioners working in the clinical arena, and the fact that many social workers in the field do not actually hold a degree in social work. NASW is usually concerned with issues like licensing, reimbursement, etc., that are not relevant to child welfare practice, for instance. Private practice was not part of the social work profession when it began in the late 1800s. It has been controversial among social workers, some of whom feel that the more lucrative opportunities of private practice have led many social workers to abandon the field’s historic mission of assisting disadvantaged populations. The private practice model can be at odds with the community development and political activism strains of social work. (Wikipedia). The Making of a Professional Social Worker As a social worker, one carries an important role in helping the community. Social workers are a special class of workers in that their work demands a lot from them — physically, mentally and emotionally. They are there to assist various people with different kinds of problems. Some of these problems include unemployment, substance abuse, housing and shelter concerns and domestic problems. Social workers are the first people to respond in times of crisis. They are the first to offer guidance, support and services in broad and varied ways. Hence, their job is definitely not an easy one. To become a social worker, here are some things to keep in mind: 1.Training. Social Work operates on a wide field, which means that you can either get into a family career, a child career, a community career or a counseling career. If you are interested in becoming a social worker, the job demands you to have a social degree, such as a Bachelor’s Degree in Social Work, to be able to enter the field. If you are already a degree holder in nursing, psychology, behavioral science or sociology, for example, some agencies will only require you to get training as a Social Worker. This should be enough to complement your credentials. 2.Attitude. Most of the time, it would seem as though social workers do their work voluntarily, even to the extent of opening up their own homes to those in need. Because this is the case, becoming a social worker requires a selfless attitude, first and foremost. An effective social worker must also have committed energy to do this kind of work. He must have this mindset of putting others first before one’s own needs. 3.Organizational skills. A social worker must also have excellent problem solving skills, discipline, a knack for time management, and good communication skills, as social workers will often act as liaisons and consultants for their wards. They must be competent team players since they will also need to coordinate and work together with different agencies. Many social workers work closely with other charitable organizations, government agencies, schools and hospitals. 4.Exposure. When you already a degree holder, your next step is to get into actual training by doing a lot of voluntary work. Exposure is very important to a social worker’s effectiveness and you can only gain this by going through different community care groups, residential homes and similar agencies. The training you will achieve doing this will help you figure out your strength as well as your weaknesses, thus giving you a better understanding of how you can use your skills in helping others. Social work is a job that can be extremely challenging, heavy and stressful. But there are still plenty of people interested in becoming social workers because the bottom line is that this job also has plenty of rewards when it comes to finding a purposeful life. Social Workers have become vital contributors in our communities over the last century. They can be found working in schools, hospitals, community mental health centers, correctional facilities and some are even members of Congress. Professional social workers are the nation’s largest providers of mental health and therapy services in both rural and urban areas. Social workers provide an important service by being able to coordinate both counseling services with community and environmental resources The skills social workers bring to the situation are:
social analysis – to help people understand
social catalyst – to help people achieve change for themselves
social action – working through social relationships to sustain change This can be achieved on the individual level, with the family and local community or at a national/global level.
Every profession, undoubtedly, contributes to the welfare and development of the society. In fact, every -profession’ if it wants to be recognized as a -profession’, is expected to contribute significantly to these two major areas in my opinion. The credibility and respect which a profession enjoys in the society is directly linked to the significant contributions it makes to the general well being of different sections of the society, particularly, the needy and deserving sections on the one hand and on the other, its significant contributions to the growth and progress of the society to higher and more desirable standards and quality of living. For example, people have no difficulty in recognizing the medical profession as a -profession’ and respecting the medical professionals as -professionals’ because they are able to see the tangible contributions of the profession especially the secondary and tertiary levels of preventive interventions (identification of diseases, treatment and rehabilitation) to their well being and progress even though they may not directly see and appreciate the intangible contributions such as health promotion, preventive and social medicine. Hence, at this juncture when professional social work education and practice in India are really at the crossroads and faced with innumerable dilemmas, we need to seriously consider and take stock of the significant contributions which trained social workers, thousands of -qualified’ social workers who have gone through the portals of various Universities, Institutes and colleges spread all over the nation, during the past more than 7 decades of professional social work’ in India.
With my over two decades of professional experience in the field, when I seriously reflected and analyzed the existing conditions of social work profession in our country and compared them with other well established and highly respected professions (some of them may be even of a fairly recent origin), one important thing occurred to my mind. That is, it is not just the contributions made by a profession to the society, but rather, the main thing is whether there is a systematic and regular documentation of the contributions qualitatively and quantitatively. For example, the contributions of medical professionals are regularly and systematically documented by way of reports, monographs, books and scientific articles published in reputed and properly indexed professional journals. This is a very crucial area in which I strongly feel that we, the social work professionals have not concentrated much and that is probably one of the main reasons for the lack of social recognition and proper status of the social work profession in India. We must realize that building the credibility of a profession is akin to the building up of the image and credibility of an individual person, a very long term process and it happens only in an incremental fashion. For example, the medical profession enjoys such a high level of recognition and respect because of several decades of documentation and sharing of valuable information about the profession’s contributions. So, if we would like to work towards building up of our profession’s credibility and social image and thereby enhance its status, we need to start paying more attention to this vital aspect of systematic and scientific documentation of our profession and professionals’ contributions to welfare and development. It is never too late or it is better late than never.
Professional Social Work and Welfare
In spite of the existence of social work education and the profession itself for the past more than seven decades, still in India, majority of trained social workers are found working in social welfare agencies. Social workers are employed in orphanages, destitute homes, family counseling centres, de-addiction centres, child care centres, old age homes, rehabilitation centres and the like. Quite a large number of social workers do work with grass root level NGOs, voluntary organizations and other community based organizations but the fact is, they are actually involved in some narrow area of -welfare’ such as child care, youth welfare, welfare of the aged, welfare of women etc. In other words, the professionally trained social work manpower in the NGO sector predominantly has not been used to its full potential in carrying forward the development agenda. However, social workers have undoubtedly contributed significantly to the planning, implementation and evaluation of various welfare schemes (both governmental and non-governmental or philanthropic).
Professional Social Work and Social Development
Due to some reason or other, professional social workers’ direct involvement in the area of social development is far from the expected level. Somehow, a large proportion of trained social workers seem to be happy and contented with some job in welfare agencies probably because, in my opinion, it is less risky, less challenging and less problematic. I think too many of us, social work professionals, have remained far too long in our own little comfort zones. But, undeniably quite a few social workers are more daring and bold enough to get actively involved in the development sector. Some have established prominent NGOs and are doing excellent work but their work is known only to the funding agencies and the local community which they are serving. However, in the development sector also, there is a blurring of the professional identity of social workers since professionals from other disciplines such as agriculture, rural development, town and country planning, development economics and even persons with entirely different background such as law, education, commerce and other subjects are also doing a lot of work in specialized areas such as sanitation, micro-credit, organic farming, cost-effective housing and other technologies etc. Some of them have even become very prominent and received national level and international level recognition, awards and other distinctions.
Professional Social Work Contributions in India
In India, Professional social workers work in various settings such as community development, human resource management, clinical social work and correctional settings. They also work at various levels of management. There are very senior top management professionals, middle level functionaries and even lower level employees. We even have prominent burocrats and senior administrators of different departments who are professionally trained and qualified. Prof.Armaity Desai had served as the Chairperson of the University Grants Commission, the apex body for higher education in India. Prof.K.V.Ramana was the Vice-Chancellor of Andhra University. Currently, Prof.S.V.Sudakar is serving as the Vice-Chancellor of B.R.Ambedkar University, Srikakulam, Andhra Pradesh. We have very senior officers such as DIGs, Directors of Government Departments and Corporations, CEOs of Industries and Corporate Hospitals (Mr.K.R.Gangadharan is the Director of Heritage Hospital, Hyderabad and Dr.Mrs.Shanthi Ranganathan, Director of TTK Hospital, Chennai), District Collectors and Secretaries to the government (those who went on to clear their Civil Services Examinations like Mrs.Gariyali), Directors of very prominent and huge national level NGOs such as Dr.S.D.Gokhale of CASP, Pune. Besides, we have hundreds of thousands of trained social workers working in various capacities in the government departments, boards, corporations, the print and electronic media houses and NGOs. Apart from these, we have a huge number of social workers working as lecturers, research associates and professors in countless number of colleges, universities and institutes all over India. Another large chunk of professionals are found in the NGO sector, unidentified and not properly recognized, at every nook and corner of the country. Quite a few occupy very senior positions in INGOs such as Action Aid, Oxfam, Save the Children, Clinton Foundation, just to name a few. Interestingly, we even have some prominent social activists such as Medha Padkar, Mendhupurkar and Nandita Das.
Social Work in Community Development Field
In the field of community development, right from the inception of the Community Development Programme in 1952, professional social workers have been playing very active roles in different capacities. In some states, many qualified social workers have been functioning as BDOs, Project Officers of DRDA and even as Chief Community Development Officers in Slum Clearance Boards (such as Dr.C.J.Paul in Tamil Nadu). Besides the hundreds of social workers who are found in grass root level NGOs have been contributing significantly for the cause of rural, tribal and urban development. Quite a few have founded their own NGOs and are doing tremendous work in their own respective project areas. Clinical Social Work Contributions
Even though medical social work has not yet been recognized duly in India, we know that in many well established and reputed hospitals and medical colleges such as St.John’s Medical College, Bangalore, Lokmanya Thilak Hospital, Mumbai, Christian Medical College, Vellore, professionally qualified social workers have been doing a tremendous job of offering a variety of psycho-social interventions for the patients and their families. In fact, some institutions even have full-fledged departments of medical social work. Medical social workers contribute to the team by making home visits, psycho-social assessments, counseling and other professional interventions and even follow up services.
The role of social work in the field of mental health in India has been growing in terms of importance and even it has been fully integrated and recognized in premier institutes such as NIMHANS, Bangalore, PGI, Chandigarh, Institute of Mental Health in Ranchi and many other places. In this area, the lead role, undoubtedly, has been played by the Department of Psychiatric Social Work, NIMHANS, the first of its kind in India in existence for over for several decades. In fact, NIMHANS was the first and foremost institution to offer a Two Year Specialized Clinically-oriented Psychiatric Social Work Training. Now, hundreds of psychiatric social workers trained in NIMHANS and other institutions have been working in Psychiatric Hospitals and Nursing Homes all over the country and even overseas.
In developed countries, current and potential future contributions of social workers to health practice are considered at the three levels of direct service to patients, influence on the processes and procedures of the health setting and influence on its future planning and service development. The capacity of U.S.A. and U.K. social work to contribute at these levels is compared in the light of their contrasting relationships to the health system. U.S.A. social work in health care is practised as employees of the health setting or as private practitioners and contains the majority of U.S.A. social workers. It remains a specialism that sustains a major body of published work, commitment to knowledge-building, standard setting and performance review, and a psycho-social orientation shared by a growing number of medical and nursing professionals. Its approach to the health system is that of the pursuit of professional credibility in the secondary setting by adopting the professional-technical practice model of the clinician. U.K. social work since the early 1970s has been committed to generic education and practice and to the development of its own primary setting in social services departments which now employ almost all U.K. social workers. Area team social work in these departments, typified by statutory work with the most deprived sections of the population, has become the dominant culture of British social work, with implications for the occupational identity and career prospects of those social workers who are outposted or attached to health settings but no longer employed by them. British social work and its management now approach the health system from a position of organizational independence which should strengthen their capacity to influence the health system. The cultural differences between social work and medicine, however, are experienced more keenly than ever as many social workers adopt a socio-political practice model that is at odds with the professional-technical model of the clinician. Provision of social work services to the health system has become a questionable priority and raises the issue of whether much of what is now termed “health care’ could more appropriately be termed “social care’ and provided in a primary social work setting to which medicine and nursing would make their “proper contributions’ (Huntington, 1986). Role in Human Resource Management
One of the unique aspects of professional social work training is the specialization called Human Resource Management (the erstwhile Personnel Management and Industrial Relations). As a matter of fact, off late, there is a huge demand among candidates seeking admission to MSW programme for the HRM Specialization, probably due to the enormous employment potential in IT Sector and other industrial sectors with so much of globalization going on. This trend has brought with it a dire need to change the focus of what we do as social workers in the HR field. As rightly brought out by senior social work educator Godwin Premsingh in his paper in the present volume, addressing the need to move or transform from industrial social work to corporate social responsibility.
Correctional Administration and Social Defense
Professional social workers’ role in correctional institutions has still not been given due recognition in India until now. However, social workers are found in voluntary organizations working in the area of social defense such as Kiran Bedi’s Navjyoti India Foundation. There are many social work professionals working as law enforcement authorities in different capacities and ranks of the police departments and prison departments of many states. Professional social workers function as trainers in various Regional Institutes of Correctional Administration. Quite a few social workers also pursue their studies in law and are either involved in their own practice or get involved in organizations working for the protection of human rights and social justice related advocacy work.
Research Contributions Since the inception of professional social work training in India, research has been a part and parcel of social work training and practice. Almost all schools of social work or departments of social work have -social work research methodology and statistics’ as a core course which is compulsory for all students and even have a mandatory requirement of completing a research project and submission of a thesis / dissertation. Besides, many institutions have research degree programmes such as M.Phil and Ph.D programmes. Every year, thousands of MSW students and M.Phil / Ph.D research scholars have been doing research studies on various issues relating to different specialization areas. Most of these student research projects are not published and hence the wealth of valuable information are not shared with fellow professionals and with the public as well. Social work teachers also carry out research projects funded by the UGC and other agencies. In the current volume, another senior social work educator Umesh Samuel has thrown some light on Significant Quantitative Research Contributions by Professional Social Workers in India. Quality professional documentation Quality documentation is a must in the modern world. Essentially, quality documentation is the type of documentation where a physical process or activity is conveyed through the medium of writing by having it noted down in a document of some kind. This is a necessity due to several reasons. Most importantly, it allows errors to be isolated and successes to be replicated. Documentation also helps you to guard against the risk of potential litigation. Competence, accountability and documentation To be competent as professionals, social workers need to communicate effectively with individuals and groups. Accountability means that a social worker must be prepared to answer to others, such as clients, Council and employers, for their actions and the responsibilities that are inherent in their positions. Accountability cannot be delegated. As part of accountable practice, social workers must document/ record the care that is given, changes in care and scope of practice and delegation decisions. Quality professional documentation is the cornerstone of effective communication. It is also an integral part of accountable practice.
What is quality professional documentation? Producing quality professional documentation is only one step in the process of providing quality care. The documentation must also be read, noted and actioned.
What are the benefits of quality professional documentation? Quality professional documentation generates genuine benefits for the client, the professionals and the organisation.
Quality professional documentation benefits clients by: ensuring the client is consulted and included in care planning and that their decisions are recorded supporting continuity of care by allowing another social worker to safely take over the client’s ongoing care
Quality professional documentation benefits the Service providers team by: providing reliable, accurate and complete information for safe and effective care and treatment. Quality professional documentation benefits the social workers by: giving clear and dependable instructions, highlighting their unique contribution to client care, increasing professional credibility by recording clinical judgement, delegation decisions and critical thinking, involving them in a structured reflective reasoning process. Despite the common misconception that record – keeping is a waste of valuable care-giving time, quality professional documentation saves time because less energy is spent searching for information or instructions. Conversely, poor documentation wastes time due to lost, incomplete or misleading information.
Quality professional documentation benefits the organisation/ employer by: providing complete and reliable data to justify financial expenditure and resource allocation such as staffing levels and equipment facilitating research, auditing and quality improvement processes.
Employers and quality practice settings Employers and social work professionals share responsibility to create practice settings that support quality professional documentation. Employers can assist the social workers to meet the standards by: maintaining a documentation system that promotes pertinent sharing of information among team members while protecting client confidentiality, providing an appropriate physical environment, reliable equipment, ample storage and quick retrieval processes factoring sufficient time for staff to produce quality professional documentation into workload and staff ratio calculations and developing documentation policies, procedures and forms in conjunction with social work staff regularly monitoring and evaluating the quality of documentation.
Professional misconduct and documentation
The following are examples of documentation practices that may constitute professional misconduct (this is not an exhaustive list): failure to keep records as required inappropriate destruction of documentation falsification of a social work qualification or job application falsification of clinical records including administration, observations and incident forms. This may include: – documenting care that never occurred or occurred at another time – signing a document that is known to contain false or misleading information – falsely signing for care when it was actually carried out by another person
Documentation standards Seven key standards must be met for -quality professional documentation’. It must be: F.A.C.T.U.A.L. Focused on the client Accurate Complete Timely Understandable Always objective Legible 1. Focused on the client Documentation must be personalised to reflect the client’s needs, values and rights and their involvement in care decisions. Recording clients’ comments supports understanding of their needs 2. Accurate Documentation must give a true and clear picture of the client’s perspective of their health and wellbeing, the plan of care, the care provided and the effects of that care.
3. Complete Documentation must include all relevant information. Records should be more comprehensive, in-depth and frequent if the client is very ill or exposed to high risk. To identify how often and how detailed documentation should be, consider: the complexity of the client’s needs the degree that the client’s condition, care or treatment puts them at risk the employer’s policies and any legal requirements that apply in the practice setting if an unusual event has happened, such as a transfer, refusal of care, accident or error.
4. Timely Documentation must record all significant events as soon as possible, to reflect the client’s current status. Update changes in a client’s care plan as soon as possible. A chronological entry, that is information recorded during or immediately after an event, reduces the likelihood of errors or misunderstandings and is more reliable than information recorded later which is based on memory.
5. Understandable Documentation must be written in plain language and, if abbreviations or symbols are used, must be well understood. Remember to use the full word if the meaning could be misinterpreted, especially when referring to drug administration times or doses. Correct spelling and punctuation aid understanding.
6. Always objective Documentation must be based on clear and unbiased statements. Avoid unfounded conclusions or value judgements andmeaningless or vague phrases such as -up and about’ or -usual day.’Disparaging remarks which criticise clients can bias other staff’s perception of the client.
7. Legible Documentation must be easy to read and decipherable. If you make an error, draw a line through the entry and include your signature, date and reason. Do not delete computer-based entries but -strikethrough’ it.
Social justice is increasingly being seen as the organizing value of social work. First, the profession must consider what “social justice” is and why it is being considered the organizing value for social work. Furthermore, what is an organizing value? The term comes from Wakefield (1988a, 1988b), who has written one of the most definitive statements about social justice in social work, particularly in regard to clinical social work. He described the “defining function” or primary purpose of a profession as its “organizing value,” in the sense in which the organizing value of medicine is curing disease; of education, learning; and of law, legal justice.
The main difficulty is, social workers’ professional contributions are enmeshed with the contributions of other related professionals such as psychologists, counselors, rural development graduates, rehabilitation workers, nurses, occupational therapists, voluntary social workers etc. There is a lack of clear cut boundary with reference to the professional domain of social work. Off late, we find that many other professionals such as graduates of women’s studies, counseling and guidance, youth development or welfare, rehabilitation science, entrepreneurship development, to name a few, also claim that they are also doing -social work’. Even administrators, planners and policy makers find it extremely difficult to accept the distinct identity of professional social work. Hence, it is the need of the hour for social work professionals to come together to take stock of the situation and seriously consider undertaking systematic and proper documentation of their contributions to different sectors and at different levels. If we fail to address this crucial need at least at this point of time (already, it is rather too late), the future cadres of trained social workers are likely to be faced with very serious problems in getting employment and there are chances of the profession losing its credibility and as a result, may lose the very identity (if at all there is any) of being a -profession’.
Bjorvell C, Wredling R, Thorell-Ekstrand I. 2003, -Improving documentation using a nursing model-, Journal of advanced Nursing, 43(4), pp.402- 410.
College of Registered Nurses of Manitoba 2003, Fact sheet documentation. Winnipeg, Canada.
College of Nurses of Ontario 2002, Nursing documentation standards. Toronto, Canada.
Forrester, K. & Griffiths, D. 2001, essentials of law for health professionals. Harcourt, Sydney, Australia. Huntington,J (1986), The proper contributions of social workers in health practice, Soc Sci Med.; 22(11):1151-60. Nursing and Midwifery Council (UK) 2004,Guidelines for recordsand record keeping. London, UK.
Nursing Board of Tasmania 2003, Standards for nursing documentation. Hobart, Tasmania. Nurses Board of Western Australia 2004, management of patient information and documentation guidelines. Perth, Australia.
Payne, M (2006), What is Professional Social Work?, Lyceum Books, Inc.; 2nd Edition, Chicago
Queensland Nursing Council 2000, Code of practice for midwives. Brisbane, Australia.
Toowoomba Health Service District, Nursing Documentation, Queensland Health, 2005
www.ifsw.org/cm_data/IFSW_Bestinterestpaper0901.doc Brown, Janet , The Importance of Documentation in Quality Management Systems, http://ezinearticles.com/?The-Importance-of-Documentation-in-Quality-Management-Systems&type=sv&id=2427135 http://www.qnc.qld.gov.au/assets/files/pdfs/information_sheets/sop_framework/Framework_information_sheet_03_Professional_documentation_standards.pdf.