Decision-Making and Relationship Competence When Reporting Suspected Physical Abuse and Child Neglect: An Objective Structured Clinical Evaluation.

Mandatory reporting of suspected child abuse and neglect highlights the challenges between the ethical and legal obligations of social workers and the need to maintain the therapeutic relationship with the client. The ability to bridge this tension is paramount to ensure continued psychosocial treatment and the well-being of children. This paper discusses a study to determine the decision-making factors of social work students and practitioners when facing a suspicion of child abuse and neglect, how they justify their decision to report or not report to child protection services, and the current and future relationship repair strategies used with simulated clients during an objective structured clinical evaluation (OSCE). Nineteen BSW, MSW, and experienced practitioners (N = 19) underwent an OSCE with one of two child maltreatment vignettes, physical abuse or neglect. Fisher's exact test was used to examine participants' historical and current reporting behaviors. Independent samples T-tests, Cohen's D, and qualitative content analysis was used to examine participants' decision making and relationship repair strategies when faced with suspected child abuse and neglect. Results showed that six participants discussed the duty to report during the OSCE while 13 participants did not. Participants' who discussed and did not discuss the duty to report during the OSCE articulated clear reasons for their decision and identified relationship repair strategies in working with the client. A sub-group of participants who identified the child maltreatment but did not discuss the duty to report, provided more tentative and complex reasons for their inaction and next steps in working with the client. All participants demonstrated a degree of competence and critical reflection in the OSCE, with integration for future learning. These findings are discussed and implications for future practice are offered.

Responding to COVID-19: New Trends in Social Workers' Use of Information and Communication Technology.

COVID-19 changed the context for Information and Communication Technology (ICT) use globally. With face-to-face practice restricted, almost all communication with clients shifted to ICTs. Starting in April 2019, we conducted semi-structured interviews with social workers from four agencies serving diverse populations in a large urban centre, with the aim of exploring social workers' informal ICT use with clients. Approximately 6 weeks after the cessation of face-to-face practice in March 2020 due to COVID-19 measures, we re-interviewed social workers (n = 11) who had participated in our study. Second interviews were based on a newly developed interview guide that explored social workers' use of ICTs with clients in the context of COVID-19. Analysis of transcribed interviews revealed that the context of COVID-19 had generated two main themes. One, a paradigm shift for social workers was characterized by (a) diverse ICT options, (b) client-driven approach, and (c) necessary creativity. The second theme entails the impact of this transition which involved (a) greater awareness of clients' degree of access, (b) confidentiality and privacy, and (c) professional boundaries. We discuss these themes and sub-themes and present implications for practice and research in a Post-COVID-19 world.

Honoring the Voice of the Client in Clinical Social Work Practice: Negotiating with Epistemic Injustice.

Epistemic injustice occurs when therapists implicitly and explicitly impose professional and institutional power onto clients. When clients have a diagnosis of schizophrenia, this very fact further complicates and highlights the power disparity within the helping relationship. Inspired by the work of critical philosopher Miranda Fricker on epistemic injustice, and using critical theories of language and knowledge, this article analyzes audiotaped session transcripts between a client with a history of psychosis and a social worker in an outpatient mental health agency. Findings illustrate two main discursive interactional patterns in everyday clinical social work encounters: (1) how the therapist's utterances claim disciplinary power and construct the client's testimony in alignment with an institutional agenda, while pre-empting the client's lived experience; and (2) how the client, though actively resisting, is managed to perform the identity of being a mentally ill person. The authors close with suggestions of how to avoid these mishaps and work toward epistemic justice in mental health practice.

Suicide risk assessments: Examining influences on clinicians' professional judgment.

Professional judgment in complex clinical situations such as the assessment of suicide risk encompasses a multifaceted cognitive understanding of the substantive issues, technical expertise, and emotional awareness. This experimental design study investigated the degree to which the previous work-related experiences of clinicians and their preexisting emotional state influence professional judgment regarding acute risk in patients presenting with suicidal ideation. Experienced social workers and social work students conducted suicide risk assessments on 2 standardized patients performing in scenarios constructed to depict individuals presenting with suicidal ideation. This study revealed significant variations in clinical judgments of practitioners assessing suicide risk. While scores on standardized risk assessment measures were the strongest predictor of judgments regarding the need for hospitalization to ensure the safety of the patient, other influences included clinician age and levels of posttraumatic stress symptoms. Mental health clinicians and organizations that employ them should be aware of possible individual influences on professional judgments related to suicide risk.

Social media and social work education: understanding and dealing with the new digital world.

Accompanying the multiple benefits and innovations of social media are the complex ethical and pedagogical issues that challenge social work educators. Without a clear understanding of the blurred boundaries between public and private, the potentially limitless and unintended audiences, as well as the permanency of the information shared online, social work students who use social media can find themselves in difficult situations in their personal and professional lives. In this article, we present three scenarios that illustrate issues and complexities involving social media use by social work students, followed by a discussion and recommendations for social work educators.

Stress responses and decision making in child protection workers faced with high conflict situations.

INTRODUCTION: The assessment of children at risk of abuse and neglect is a critical societal function performed by child protection workers in situations of acute stress and conflict. Despite efforts to improve the reliability of risk assessments through standardized measures, available tools continue to rely on subjective judgment. The goal of this study was to assess the stress responses of child protection workers and their assessments of risk in high conflict situations. METHODS: Ninety-six child protection workers participated in 2 simulated scenarios, 1 non-confrontational and 1 confrontational. In each scenario, participants conducted a 15-minute interview with a mother played by a specially trained actor. Following the interview, the workers completed 2 risk assessment measures used in the field at the time of the study. Anxiety was measured by the State-Trait Anxiety Inventory at baseline and immediately following the completion of each interview. Physiological stress as measured by salivary cortisol was obtained at baseline as well as 20 and 30 minutes after the start of each interview. RESULTS: Participants demonstrated significant stress responses during the 1st scenario, regardless of whether the interview was confrontational or not. During the second scenario, the participants did not exhibit significant cortisol responses, however the confrontational interview elicited greater subjective anxiety than the non-confrontational scenario. In the first scenario, in which the workers demonstrated greater stress responses, risk assessment scores were higher on one risk assessment tool for the confrontational scenario than for the non-confrontational scenario. CONCLUSION: The results suggest that stress responses in child protection workers appear to be influenced by the novelty of a situation and by a parent's demeanor during interviews. Some forms of risk assessment tools appear to be more strongly associated than other with the workers' subjective and physiological stress responses. This merits further research to determine which aspects of risk assessment tools are susceptible to the emotional elements of intake interviews.

Supporting front-line practitioners' professional development and job satisfaction in mental health and addiction.

Substantial organizational change in many health institutions has eliminated profession-based departments and replaced them with program management structures. This article aims to explore practitioners' perceptions of their professional work in a large urban centre for addiction and mental health that has undergone such change. Seventy-six practitioners from six professions participated in focus groups that were transcribed and analyzed. Practitioners' perceptions about their professional competence, performance, development, and job satisfaction were affected by three interrelated factors: available supervision from experts who validate practitioners' subjective work experiences and provide population-specific knowledge for effective interventions; teams that provide a home base and support through positive interpersonal relations, collaboration and informal feedback; and organizations and managers who provide assistance and training while expecting quality performance and productivity. Effective clinical and organizational leaders manage tensions between providing supportive environments and expecting accountability throughout the workplace.

The influence of clinicians' previous trauma exposure on their assessment of child abuse risk.

Research has identified high levels of trauma exposure and PTSD in professionals responsible for assessing children at risk for abuse. An important question arising is the influence of stress and trauma on professional judgment. This study examined the association between critical incident exposure, PTSD and workers' judgments of child risk. Ninety-six child protection workers participated in 2 simulated clinical interviews and subsequently completed standardized risk assessment measures. Workers reported high levels of exposure to critical events in the workplace and high levels of traumatic stress symptoms. Number of prior critical events encountered was negatively associated with assessment of risk. Level of traumatic stress symptoms was negatively associated with risk on one, but not other measures of risk. It is concluded that standardized measures for assessing a child's risk of abuse may be influenced by previous exposure to critical workplace events and levels of traumatic stress in workers.

Walking the tightrope: using power and authority in child welfare supervision.

Recognizing the importance of understanding the way in which supervisors in child welfare perceive their administrative responsibilities and use power and authority, an exploratory study was conducted. Supervisors in child welfare agencies in urban and rural settings participated in focus groups and discussed the impact of macro and micro factors on their performance. Policy changes, including using new approaches to child welfare and organizational culture had a major affect on the way they offered supervision. At the micro level, their use of power was related to elements in their relationships with frontline workers and their own professional development. Implications for child welfare practice and for new and experienced supervisors are presented.

Changing times: understanding social workers' motivation to be field instructors.

Renewing the profession of social work is historically dependent on social work practitioners volunteering to be field educators for students placed in their agencies. During the past decade, with massive funding cuts to social and health services and changes in professional practice, the availability of field instructors has been threatened. This article reports on social workers' motivations to become field instructors. The findings from qualitative interviews with 20 social workers randomly selected from a range of field agencies indicate that current organizational culture has a powerful influence on social workers' motivations to volunteer to become field instructors. The implications of this shift are discussed in relation to rejuvenating the profession of social work. Collaboration among organizations, professional associations, and schools of social work at the local and national level is critical.

The different faces of intimate violence: implications for assessment and treatment.

Current research about violence in intimate relationships suggests that at least two qualitatively distinct types of violence exist. This new knowledge challenges the dominant conceptualization of intimate violence as solely a manifestation of patriarchal male dominance. Following a review of the research and analysis of illustrative clinical examples, a conceptual framework is presented that assists couple therapists in answering three salient questions: What type of violence am I most likely to be working with? How can I assess the differences between types of violence? And how might I proceed with treatment for different types of violence?

The impact of hospital restructuring on social work field education.

Hospital restructuring has had a dramatic impact on social work practice and field education. In a qualitative focus group study of nine educational coordinators responsible for educational programs in teaching hospitals with 25 to 100 social workers each, four main themes emerged: (1) difficulty managing field education when the actual change experienced in restructuring hospitals was far less progressive and systemic than the hospital missions espoused; (2) a struggle to maintain stable student programs when change was unpredictable; (3) the importance of support, reciprocity, and advocacy from the university; and (4) the need to be creative in delivering the educational program while undergoing organizational change.