Recent articles on user and carer involvement in education

[Jill Anderson]

Here are the abstracts of three recent articles:

 

Tew, J., Holley, T. & Caplan, P. (2012) Dialogue and Challenge: Involving Service Users and Carers in Small Group Learning with Social Work and Nursing Students, Social Work Education: The International Journal, 31 (3), 316-330

Abstract
This paper examines the rationale for service user and carer involvement in professional education and reflects on an initiative in which social work and nursing students undertook a sequence of joint learning in relation to mental health theory and practice. Central to this initiative was the promotion of opportunities for dialogue, both between students from different professional disciplines and between students, service users and carers. To enable this, much of the learning took place in small groups facilitated by either a service user or a carer.
Evaluation of this initiative indicated that, for the majority of social work and nursing students, learning from this shared experience had a major impact on their professional development. However, a small but significant minority found it hard to enter into a dialogue with others on a basis of equality and a sharing of their human as well as their professional experience. Some students indicated that they would have preferred a focus on acquiring more specialist professional knowledge and skills. This raises important issues in relation to the changing expectations of professionalism and professional education—and what really makes someone ‘fit for practice’.

 

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Joe Duffy, J., Das, C. & Davidson, G. (2011): Service User and Carer Involvement in Role-plays to Assess Readiness for Practice, Social Work Education, DOI: 10.1080/02615479.2011.639066

 
Abstract
 
Service user and carer involvement in social work education is now well established since its inception as a compulsory requirement in the social work curriculum in the United Kingdom in 2003. Since then, there have been many examples of how such involvement has been approached by education providers. Nevertheless, one of the key obstacles and challenges in this field continues to centre on the need to achieve non-tokenistic user involvement which cements the engagement of service users and carers at the heart of social work education. This paper describes one such initiative where service user and carer colleagues in a university in Northern Ireland have been actively involved in the
assessment of first year social work students’ preparation for their first period of practice learning. The paper presents the background to this initiative explaining how the project unfolded; the detailed preparations that were involved and the evidence gathered from evaluations undertaken with the students, service users and carers, and academic colleagues who were all involved. We believe that the findings from this project can contribute to the advancement of existing knowledge in the field in exploring and recommending creative methodologies for user involvement in social work education.

 

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Joe Duffy & David Hayes (2012): Social Work Students Learn about Social Work Values from Service Users and Carers, Ethics and Social Welfare, Available online 31 January.

 

Abstract
 
Teaching on social work values is centrally important in social work education as a core aspect of underpinning knowledge in preparing students for practice. This paper describes an innovative project occurring within the first year of the degree in social work, where service users and carers have assisted students with their understanding of social work values. The positive contribution of
service users and  carers in facilitating students to make links between theory and practice is now well documented. Applying this user perspective to the educational domain of values, however, is relatively uncharted territory given the challenges that have traditionally accompanied the teaching of values. Importantly, this paper describes the ‘value talk’ which occurred when first year students sought further meaning from service-user and carer groups in their community settings following classroom teaching on values. The paper not only discusses the detailed preparations involved in the project but also the learning which resulted, drawing on the evaluation findings from the students
and participating groups. Whilst the findings show that the students’ understanding of social work values has been most significantly influenced by the contributions from service users and carers, it is recognized that further research is needed to monitor the longer term impact on social work students’
practice after they qualify.

[Dave Smith]

Very interesting and useful - thanks Jill!  The issues for me is that as we are a charitable organisation (www.hafal.org) we do not always have the access required to such articles.  However, my project (Expert Patient Trainer, see  http://www.hafal.org/hafal/EPT.php) is an exciting and viable resource for those working in Higher Education particularly in the Social Care, Health and other related disciplines.

We have achieved fantastic results working alongside most of the larger Welsh Universities involved in training our future GPs, Mental Health nurses, Social Workers and both private and public healthcare staff.  We have developed a varied range of training sessions suitable for whole day trainings, guest lectures on University Degree programmes and have facilitated a full day national conference (all this achieved by service users within the first 2 years of our 3 year project).  The project attracted significant funding from Comic Relief which was 'match-funded' by Hafal, the principal mental health organisation in Wales.

 

In 2010 we were asked to develop a core unit to enable The Welsh Government to offer training to all care coordinators in Wales to facilitate a transition from the old CPA method of Care & Treatment Planning to the new ways of supporting secondary mental health service users to 'Recovery' through the implementation of The Mental Health (Wales) Measure 2010.  We are now part of a wider team led by Lincoln University's Ian McGonagle and our current task is to facilitate the training of a wider network of trainers from the statutory bodies who will then, in turn, train their colleagues in order to make a smoother transition for staff working under the new legislation to perform their duties to the very best of their abilities.

 

The absolute value of skilled, qualified trainers who have used mental health services is now having a far reaching impact at the highest level in the nation of Wales.  In the past Wales has attempted to facilitate the wide body of expertise held by mental health service users and has issued vast guidance documents such as 'Stronger In Partnership' and the aptly named 'Stronger In Partnership 2' but because of a lack of imagination, creativity and sheer determination so much 'good intention' has failed.

 

One of the key drivers for change will be the 'thorny issue' of how we recompense such expertise ('experts by experience') for their unique resources which are, in the main, their experiences of the mental health system whether good, bad or indifferent.  We must find useful ways of engaging with what might be called our 'customer experience' in order to drive quality in our staff, commisioning, procedures and further systems if we are to see 'Recovery' within our practice.  In turn if our Mental Health Services can achieve 'recovery' we will then see far wider evidence of recovery in our client group.

 

Within Wales this is now attainable.  New Mental Health legislation has placed a thorough duty on those who both operate and staff our services to embrace and deliver Recovery Orientated Services to the end user.  Welsh Government is now involved in developing a new Mental Health strategy for Wales which will be the first to seek a wider remit, that of 'Mental Health & Wellbeing' for the whole of the Welsh population.  

 

One might say that there has never been a better time to be suffering mental distress in Wales.  The scene is now set, the play is written, the actors are in rehearsal.  Curtains go up on June 6th, 2012.  It might not be an absolute sell-out on opening night but this 'show' has the potential to run and run!  

[Jill Anderson]

Thanks so much Dave for sharing all this useful work - will email you separately re the articles.  Best wishes, Jill

[julie gosling]

Dave your work sounds great - love to hear how you are progressing it

[Jill Anderson]

Here is another thought provoking recent article, which is freely available online:

“Recovering our Stories”: A Small Act of Resistance

Lucy Costa, Jijian Voronka, Danielle Landry, Jenna Reid, Becky Mcfarlane, David Reville, Kathryn Church

Abstract

This paper describes a community event organized in response to the appropriation and overreliance on the psychiatric patient “personal story” within mental health organizations. The sharing of experiences through stories by individuals who self-identify as having “lived experience” has been central to the history of organizing for change in and outside of the psychiatric system. However, in the last decade, personal stories have increasingly been used by the psychiatric system to bolster research, education, and fundraising interests. We explore how personal stories from consumer/survivors have been harnessed by mental health organizations to further their interests and in so doing have shifted these narrations from “agents of change” towards one of “disability tourism” or “patient porn.” We mark the ethical dilemmas of narrative cooptation and consumption, and query how stories of resistance can be reclaimed not as personal recovery narratives but rather as a tool for socio-political change.

Download here

[julie gosling]

Yes Jill - I thought this article was absolutely wonderful when I read it last month - the notion of a voyeuristic consumption of service-user experience as 'tourism' or 'porn' is spot on - although I believe it is possible to actively engage hearers in what a student some years back described as 'face-to-face-nowhere-to-hide confrontation'

We have used three strategies at the University of Nottingham over the past twenty years of 'story-telling:'

- we require a structured critical reflection after any personal presentation which must incorporate cognitive and empathic understandings, links to theory, links to the hearer's own personal and professional experience, an understanding within the political context of oppression and colonisation of experience, a summary of the learning from all of this and a written commitment to future practice

- we engage learners in follow-on exercises to stimulate discussion and enable them to question values and practice on both an individual and an organisational level

- at the end of the five week module, the students (MA/BA mixed group) must present back to their peers and to their service-user tutors a 15 minute presentation of a part of their own human experience that has impacted on their understanding of power and powerlessness - this receives an academic mark towards their final degree from the service-user tutors (no university input in this module) and the marking framework, developed by our group focuses on their personal honesty, willingness to share, ability to make empathic and relevant links with the service-user experiences previously shared with them, considerations of oppression and privilege, creativity, communication skills and a clearly defined commitment to future practice, based on their learning from their own and our stories.

The final critical reflection on this process reveals how students come to deeply understand the process of laying oneself bare for others to receive and pass judgement on - it is a powerful and sometimes quite world-changing experience for students which many later come to comment stays with them throughout their professional practice.

Spin-offs from this have been countless examples of personal resolution and healing within learners own lives, and a deep bonding and culture of tolerance and compassion that seems to embed itself in the student group once they have witnessed each others personal testimonies. 

It also has to be said that presentations over the years have been imaginative and moving - we have been transported back to school memories within a giant cardboard classroom, eaten Taiwanese breakfast sitting cross-legged on the floor, raveled ourselves in a silken sequined web of second generation migrant identity, blown up the balloons of deflated, pricked, burst or bullied voices within a relationship, and learned to Irish dance!

All this learning and sharing together - within those true liminal 'growing spaces' where difficult knowledge can be fully explored - is far removed from the shallow consumerist experiences that the authors warn against.  We too have told our stories with 'anger, pride and power' - we have reclaimed our identities and politicised our experience where it has told of oppression - and I believe we have engaged the hearers within a truly human space where deep learning has been allowed to blossom and change inspired.

I recommend the article as a really good read - it resonates wholly with concerns we too have addressed over the years - and it deals with the issues head on  - much power to the story tellers - long may the stories be heard, understood and acted on!