Funder by the Department of Human Services Auspiced by Our Community

A CONSUMER'S GUIDE TO SOCIAL WORKERS

Social workers have a strong academic background in understanding people within the social contexts of their lives.

From their studies they have learned about social theory and social research. Ideally, their academic and practical preparation also gives them a background in social justice and issues to do with quality of life for those of us who have less.

At a pragmatic level, social workers in a clinical mental health context are trained to assess our social needs and develop systems to make sure people have access to their finances, housing, clean clothes, support from family if we want it, and access to communication. This is the profession that is trained to provide support for home to hospital and hospital to home transitions, for example.

These days, sometimes the work of social workers will overlap with the role of generic case workers, which is why so many social workers end up as case workers in clinical services in Victoria.

One of the interesting things about social workers is that many of us will never cross their path, while others will find that they seem to appear everywhere as we try to find a way through a maze of services (some of which we want and many of which we do not).

Many of the settings in which we encounter social workers have little (or should have little) to do with our 'mental illness'. Often we interact with social work at the time of greatest distress, such as when we are dealing with child protection.


Qualifications & registration

In order to be a qualified social worker, students need to complete a recognised and registered undergraduate course in social work, generally of four years duration. Courses in community development do not qualify you as a social worker but much to many consumers' joy the tide has turned and community development is coming back into the social work curriculum.

Many social workers are members of the Australian Association of Social Workers. The AASU promotes the social work profession, oversees ethical and professional standards, and advocates "for the pursuit of social justice and changes to social structures and policies in order to promote social inclusion and redress social disadvantage". It's important for consumers to realise that mental health social workers make up only a small fraction of the total number of social workers working in Australia.


History

It can be useful for us to understand a bit about where social workers are coming from as without this understanding they can be viewed as little more than a pain in the proverbial; bossy, lacking empathy, trying to make us do things we do not want to do, and even taking our children away from us.

Up until the mid 20th Century social workers were called almoners, describing someone (usually related to organised religions) whose role it was to give goods and money to the poor.

The emergence of the term social worker was an attempt by almoners to distance themselves from organised religion and to professionalise. This meant study, a developed job description, qualifications, registration and professional status.

Over the years this new professional power has grown and social workers joined the ranks of clinical groups competing for authority, not only in the mental health sector but across the mainstream health and community sectors as well.

Social work is now undoubtedly seen as a profession with its own body of knowledge, standardised educational qualifications, registration and professional status. Its professional status has been hard won and is vigorously protected by the Australian Association of Social Workers.

The profession fills that space where the consumer's life line crashes into the social world; where our lives, families and 'illness' meet the institutions of the state such as social class, sexual preference, the media, the family, religion, and education.

All of this translates into social workers (like other clinicians) gaining power over those of us whose lives rotate around issues of poverty, homelessness, Centrelink, pensions, the dole, joblessness, hopelessness, issues with child rearing, criminality, racism, ethnicity, drugs, alcohol and 'mental illness'.


Education & training

Social work education can differ enormously from school to school.

During initial university preparation, some schools run a very structural study in critical sociology. In such a school, social workers look in depth at the institutions of society and the way they so tightly control how we live and relate, endowing some of us with more than our fair share of economic, social and educational capital, and leaving others severely disadvantaged.

Social workers trained in this school will often see the central tenet of their practice as social justice and will understand how they contribute to the injustice that their 'clients' experience. The individual is not so much the central point but rather the community, the school, the town. So their interest is in systemic advocacy. This is a politically idealist approach.

Other schools of social work concentrate on traditional interpersonal work with people who seek help to solve social problems in their lives.

Within mental health, the academic schools which follow a more classical approach produce more conservative graduates with a different set of competencies and expectations. This is an area dominated by the medical model and all that this entails, including the traditional orthodoxy of diagnosis, treatment, and prognosis.

Training for social workers is a combination of generic theory and practice followed by short periods of time learning about specific areas of work, such as social work in mental health or social work in child protection.

Social work education does not spend a lot of time concentrating on mental health social work, with some schools still only giving a two-week elective on mental health. It's doubtful that competency can emerge from this. Of course, most of the real learning is done on the job.

One of the things graduating social workers learn is the hierarchy within mental health workforces. All the bravado of the professionalised social worker breaks down in the reflection of the power of psychiatrists.


Good practice/bad practice

Social workers work with individuals and families with the intent of improving the capacity of 'the neediest' to connect with society or protect vulnerable children or 'empower' people.

Very often the people who enter social work do so with good intentions but uninformed views about some of the fundamental concepts that will inform their future practice. There is a social work adage that they don't do things for people; rather they enable people to do things for themselves. Consumers know that this is very rarely true and, despite their claims to the contrary, that social workers are often disempowering.

Some of this is revealed in the language used - the words 'case management', for example. How can we possibly be 'empowered' and 'managed' by social workers at the same time?

Although social workers, at their best, can be a wonderful resource, the sanctions they control scare many of us into pretending we are doing things we are not.

If we or our family are working with a social worker from any jurisdiction we might expect four things:

  1. Competency. We need our social workers to know all the systems they crisscross intimately. We hope they have contacts and understand all the laws, regulations and precedents that will affect our lives and those of our families. Unfortunately, particularly in some of the most difficult areas, there is extraordinary level of turnover of staff. Experienced social workers often choose to move on from the most challenging environments, leaving the very difficult environments to young clinicians who are often out of their depth, despite professional supervision.
  2. Communication that is both good and fair. We wish it wouldn't happen but we know we will be spoken about behind our backs. But we would appreciate someone letting us know when plans are being made for us. We rely on social workers to push through the jargon and tell us the truth. It's also important that our Advance Directives are recorded, kept competently filed, and utilised when we ask for that.
  3. Understanding power inequity. A common consumer saying about social workers is, "There goes the pink twinset brigade." This might be a bit naughty (not to mention bad for mutual respect) but it does help to provide us with some precious insight into power. It is a comment about social class, privilege and the fact that our social workers usually don't come from the same social class as many of their clients.
  4. Passion. Sometimes the social workers who are admired most are those who go in to battle for us, who push the boundaries of professionalism, who talk and think and act just a little bit like us, who recognise and fight against injustice in all its guises.

Whenever consumers organise consumer-run educational opportunities for clinicians and trainees, the groups that seem to consistently understand why it's vital are invariably occupational therapists, social workers and psychiatric nurses.

This gives us hope for the future!

It's also worth noting that social work academics routinely ask consumers to co-teach entire social work units in mental health. We get good feedback from undergraduate social work students who simply love to talk about the issues of greatest importance to both them and us.

However, there is a process of cynicism and a tendency towards institutional ways of behaving that seems to pervade new social workers once they start work. This can have a devastating effect on both their own job satisfaction and their effectiveness. A lack of political knowledge about how large organisations work, combined with a clash of ideals seems to leave new social workers critically questioning what practice is all about and fomenting discontent.

Despite this, consumers do encounter some extraordinary, reflective, sensitive, caring, questioning, sharing social workers, many of whom are working on educating the next generation of clinicians.

Our support goes out to these people because, particularly the public system, it is a tough place to survive and thrive whilst still maintaining the gentleness and generosity we also admire.


Complaints

The Australian Association of Social Workers (see the help sheet titled Accreditation & Registration) can investigate complaints against a member, though it's worth noting that that it is not compulsory for everyone practicing as a social worker to be a member.

Associations and colleges representing clinicians in mental health, including the AASW, are generally as anxious to get rid of rogue practitioners as we are - though we might just have a very different definition of rogue!


Rebates

Consumers with a GP referral may be eligible for counselling by social workers under the Federal Government's Better Access Scheme. Social workers participating in this scheme are required to provide short-term, goal-oriented, focussed personal resources for us.

It's important for anyone contemplating counselling from a private social worker, or anyone being advised by a GP to get some social work counselling, to gain a more detailed understanding of the possibilities and restrictions that apply. Some further information about Medicare rebates is provided in the help sheet titled How money (or lack of it) affects a consumer's choices.