Lay or/and professional: Those who are affected by the issue from the public

1. Lay or/and professional: Those who are affected by the issue from the public

In some contexts, we all are potentially excluded, marginalised and powerless. In many cases, we are (not) the experts. As a professional, it is important to develop an awareness of the historical (re)configuration of one's professional identity and public mandate. Part of this awareness is also to think through how history impacts how society at large and the citizens as potential service users perceive specific health and social services and how we recognise the life knowledge and capacities of "lay" people. When dealing with such complex issues, in situations of vulnerability, we can reach out to those affected, raise our voices, and require change. Complex issues enable public involvement in politics and make it possible to deal with them democratically (Marres 2005).  

Is there a stigma attached to requiring and getting social support/services, or is it considered a right and entitlement of all citizens? How might this impact the (democratic) practice of social and health services, and how to deal with this? What are the burning issues that call for the creation of devoted public consisting of actors from different social worlds?

Case study (Belgium): Reflexivity in representation efforts in participative anti-poverty policymaking and practice development: a historical perspective on the rhetoric of self-advocacy organisations of people in poverty

A historical study of the rhetoric of self-advocacy organisations of people in poverty in Belgium reveals the necessity to employ reflexivity in shaping a politics of representation in policy and practice development (see Degerickx et al., 2022). The study focused on how, since the 1990s, a paradigm of participation has gained prominence in anti-poverty policymaking and social work practice development in Europe, implying that people in poverty should participate as equal citizens in political decision-making processes. Based on a historical case study, questions were raised about who actually participates in such processes. Relying on a set of ideas of the French philosopher Jacques Rancière to theorise different notions of participation, the study identified four different understandings of participation that can emerge in social policy and social work practice development: (1) consultation with an emphasis on harvesting testimonies of people in poverty without their involvement in framing collective concerns, (2) inclusion as part of an emancipatory project to include people in poverty in the social order, (3) confrontation in which poor and non-poor stakeholders are committed to debating the issue of equality in the process and in our societies, and (4) mobilisation in which poor and non-poor stakeholders actively engage the broader society in the development of anti-poverty policies and strategies. The study's main researcher, Heidi Degerickx, currently works as the coordinator of the Network Against Poverty in the Dutch-speaking part of Belgium, where she is actively involved in shaping the politics of participation and representation. The central question she addresses concerning each of these approaches is whether participatory efforts produce moments of democracy in which a power shift actually takes place and might lead to a more socially just and equal society. As such, a plea has been made for an "ignorant" or reflexive position of social work and social policy actors: "giving voice" is not enough, and they need to create organisational and institutional circumstances for and with people in poverty for such political participation. It requires the opening up a democratic space in which the values of equality and dissensus are embraced and an awareness of the complexity and uncertainty of such participatory ventures.

2. Example of innovative practice (Belgium):

As an attempt to make masters students in social work at Ghent University aware of their own normative value orientations as future professionals, a course called 'Socio-spatial social work' has been designed in which students are expected to immerse themselves in the complex realities in the surrounding neighbourhood of the faculty building. The course originated when it became clear that there was absolutely no synergy between the Faculty of Psychology and Educational Sciences and the surrounding environment – a multi-faceted quarter of the city of Ghent in which social high-rise housing complexes are historically crowded together and a growing concentration of societal problems is looming, due to extreme forms of poverty and precarity, hidden homelessness, ageing, substance abuse and an increasing number of citizens with mental health problems. There is a lack of resources and public provisions near these public high-rise buildings. In this sense, the social housing towers form an isolated zone in the broader social fabric of the city. The students are asked to work on issues that matter to citizens and community-based professionals in the neighbourhood. They are required to imagine they need to develop meaningful work in such complex and dynamic community arrangements in which structural and local conditions give rise to a concentration of social problems that interfere with the lifeworld of citizens living there. 

Part of the task is to adopt a socio-spatial professional orientation that takes a stance with framing problems in the neighbourhood, formulates relevant questions, and reflects professional strategies that can be meaningful in relation to residents and the wider environment. The students are challenged in revisiting their own normative value orientations, the norms and habits they have internalised due to their often privileged positions (related to housing, mobility, income, …), and due to the expectation they have to navigate ethically and politically in the complex community arrangements while making their assignments. 

One group of students worked, for example, on the formal organisation of housing companies but eventually, amongst other things, organised a survey among their fellow students in the Faculty to explore their own assumptions and knowledge of social housing and the high-rise neighbourhood. They were shocked about the results since they discovered that most students had operated with the norm of middle-class private ownership, in line with the Belgian housing order. 

Moreover, students are expected to write papers as their final product, present their findings, and do meaningful projects for and with the neighbourhood's residents and professionals. 

3. SAOL Project

Social work educators in Ireland and other parts of the world have had a mixed history of engagement with service users in the curriculum. Often this resulted in limited or tokenistic.

Service user engagement with women in recovery from addiction: learning from an Irish social work module component

Introduction
In response to the increasing need for raising the sensitivity of social work and health care students for the live experience of service users, it has become important to embed service user involvement in core curriculum content and delivery. In our example, we have used the guiding questions of the RPP involving six packages of focus to describe our experience.

3.1. CONTEXT

There is a quasi-legal expectation in Ireland that social work educators involve service users in programmes, as stated by the profession's Irish state regulator (CORU):

The curriculum must be guided by evidence-informed professional knowledge relevant to current practice and the philosophy and core values associated with the profession, with evidence of input from all relevant stakeholders, including service users and employers (Social Work Education Board, 2019, p8).

The context for the partnership stemmed from the acknowledgement that women who have drug use issues or are in recovery from addiction are often overrepresented in child welfare and protection processes. Hence, there was a need to take a more trauma-informed approach to how social work students learn about this intersection.

3.2. MOTIVATION

We were motivated to choose as partners some more or less homogenous group of users which face a serious social stigma. As our school has had a good previous collaboration with an established NGO that seeks to support women who experience addiction problems, we decided to start a partnership with the women through this organisation. 

The research evidence highlights how women with addiction problems who are in recovery face issues of social stigma and exclusion which are informed by problematic assumptions about the causes of these problems. For this reason, women with these problems face difficulties in having their experiences and voices heard (Agterberg et al., 2020). Many of the service users have also had negative interactions with social workers. Therefore the co-designed partnership approach set out to help empower the women by allowing their voice to be amplified through their involvement in teaching and assessment. 

A reflective approach was viewed as particularly important in light of the suggestion by Nelson (2012, p. 26) that social workers may find engaging in anti-discriminatory practice 'especially tricky if working with service users who engage in illegal activities like drug taking.' This underpinned this initiative in conjunction with concerns that social workers may feel inadequate when working with drug use issues (Loughran, Hohman, & Finnegan,2010). 

Learning objectives

From the academic teaching team, four aims were formulated: 

• To enable service users to co-design the teaching content and methods.
• To enable service users to be involved in student assessment methods.
• To better prepare qualifying students to understand the views and needs of service users generally, specifically women who have addiction problems and encounter child welfare and protection services.
• To help empower women who have experienced problems with addiction by allowing their lived experience to be shared with the social work students. It was also hoped that through this process, some of the women's own negative perceptions and experiences of social workers could be shifted/changed.

CORU (standards-of-proficiency-for-social-workers.pdf (coru.ie)_

References: Agterberg, S., Schubert, N., Overington, L., & Corace, K. (2020). Treatment barriers among individuals with co-occurring substance use and mental health problems: Examining gender differences. Journal of substance abuse treatment, 112, 29-35.

Nelson, A. (2012). Social work with substance users. London: Sage. 10.4135/9781446288849

Loughran, H., Hohman, M., & Finnegan, D. (2010). Predictors of role legitimacy and role adequacy of social workers working with substance-using clients. British Journal of Social Work, 40, 239–256. 10.1093/bjsw/bcn106

3.3. PARTNERS

The partners invited to RPP were four types- the university-based teachers/researchers, the women/service users, the NGO organisation- SAOL Woman's Project and the social work students.

The co-coordinating (university-based) teachers/researchers had pre-existing relationships and were already well established with the NGO through educational outreach and community development - these were at the centre of the community participatory research approach. This is acknowledged as an important asset, as researchers are seen to have a track record which facilitates collaboration (Greenlick and Freeborn, 1986).

The women can, in some way, be described as a homogenous community of service users with specific histories of addiction problems. They have selected themselves from the broader community/organisation to provide the teaching. This is a particularly important group with these intersecting identities and needs (women/addictions).

The students were already very familiar with reflective practice and convinced that 'through reflection as social workers we can change how we think, feel and behave to meet the needs of service users and carers better' (Knott & Scragg, 2013, p. 54). 

SAOL is an experienced NGO committed to education and inclusiveness and was very enthusiastic about developing the assessment initiative. The Director checked to see if service users would be interested. To support the initiative, SAOL were prepared to provide any additional counselling or support that engagement with this project might demand. This was an important condition for research ethical approval. Its role is described in Ways and Strategies.

References:

Loughran, H. & Broderick, G. (2017) From service-user to social work examiner: not a bridge too far, Social Work Education, 36:2, 188-202, DOI: 10.1080/02615479.2016.1268592

3.4. ONE'S OWN POSITION

As educators who embrace a critical and radical positioning, we were keen to promote social justice, apply a partnership approach, address stigma and discrimination and give voice to the lived experience of the SAOL service users. While we thought we were attending to power differentials, it became evident that for our service user partners, this was not always their experience. For them, the power differential became problematic, and they sought to 'claim back' their power within the process. 

This was demonstrated during Covid-19 when teaching input by the SAOL service users was reduced. They challenged what they perceived to be the "tokenistic nature" of their involvement with the students, demanding more meaningful input or withdrawal from the teaching program. This triggered a complete review and re-evaluation of the nature of SAOL's involvement. The result was the reintroduction of additional teaching hours and a new co-designed video assignment for the students that the service users helped to design and jointly grade. This case study suggests that there may be a tendency to invite those who are "easiest" to engage with, which typically means highly educated, neuro-normal, verbal, trained, extrovert individuals (Locock et al., 2022). As social work educators and researchers, we must challenge these embedded stereotypes of "vulnerability" and recognise that vulnerability is a two-way process and that we are also vulnerable within participatory processes.

Link to: Why intersectionality matters for social work practice in adult services - Social work with adults (blog.gov.uk)

Reference: Charter, M.L. (2021). "Exploring the importance of feminist identity in social work education." Journal of Teaching in Social Work 41, no. 2 (2021): 117-134.

3.5. APPROACHES AND STRATEGIES

Planning and delivery of the teaching module and the assessment of the students were co-produced between social work academics, students and the group of service users. 

Before introducing the service-led assessment, the Director of the SAOL Project and the university lecturer agreed to design and deliver the module. The already established partnership between the service and the university lecturer and the direct involvement of the Director of the service in the provision of the module greatly facilitated the process.

Following discussion, it was agreed that conducting research on the process would provide much-needed insight and service users themselves wanted the process to be recorded in some way. It was their view that writing about their involvement might have a better chance of influencing social work education in the future, and most of them were motivated to help social workers to understand drug use and its impact on service users (Loughran and Broderick, 2017).

Brainstorming, initial discussions, and decision-making took place prior to the delivery to agree on the content of teaching, which included lectures on: 

• Poverty and Life Course Perspectives on Addiction
• Domestic Violence, Child Protection and Addiction
• Working in Partnership: Using a Trauma-Informed Approach to Addiction

A core aspect of the curriculum focused on the concepts of empathy, compassion and trauma as experienced by service users in the context of their growing up, parenting, adult lives, and environmental and social factors that helped explain their problems with addictions. 

Service users then designed a case study reflecting their own experience for use in teaching with students. This presented issues of the cycle of abuse and addiction and how this could be broken. For example, this included strategies for working with parents and children at risk. Importantly, these issues were placed in wider contexts, such as societal bias, stigma, shame, use of language, power and control, and labelling. It was emphasised that preventative approaches were necessary if harm and risk were to be addressed.

Student assessment

The student's learning is assessed using a written assignment based on the case study developed by the service users and a reflective group video project: students make a 5–10-minute video describing their key learning. 

The written assignment is co-graded by the social work academic module coordinator and the Director of the NGO. The video assignment is co-graded by the social work academic module coordinator and the service users. A feedback workshop is also convened between the service users and the social work students.

Links to: Service user integration into social work education: lessons learned from Nordic participatory action projects - PubMed (nih.gov)

References: Loughran, H., & McCann, M. E. (2015). Employing community participative research methods to advance service user collaboration in social work research. The British Journal of Social Work, 45(2), 705-723. https://doi.org/10.1093/bjsw/bct133

Loughran, H. & Broderick, G. (2017) From service-user to social work examiner: not a bridge too far, Social Work Education, 36:2, 188-202, DOI: 10.1080/02615479.2016.1268592

3.6. FOLLOW UP ACTIVITIES

Our aspiration in the Irish case study was that lessons learned, skills acquired, and experiences of empowerment would be lasting and repeatable. In particular, we expected service users to experience a sense of growth and confidence in their abilities and how these positively affect their lives.

We expected there may be opportunities for partnership results to be disseminated to broader communities of service users, students and academic communities. These opportunities should be planned and delivered using the same principles of co-production used in the project itself. In particular, the dissemination methods should be appropriate and sensitive to the needs of service users in terms of language, style and transmission of ideas through face-to-face and virtual platforms. 

A positive outcome would be for service users to find the confidence to gain qualifications and skills in teaching and learning where they become more permanent partners in delivering important dimensions of social work education and professional training.

Links to: Co-production - Social Work England

Reference: MacDermott, D., & Harkin-MacDermott, C. (2020). Co-producing a shared stories narrative model for social work education with experts by experience. Practice, 32(2), 89-108.

Hatton, K (2017) A critical examination of the knowledge contribution service user and carer involvement brings to social work education, Social Work Education, 36:2, 154-171, DOI: 10.1080/02615479.2016.1254769

As an exercise, try to reflect on each package. You can either first choose the reason WHY (problem to be solved, task to be delivered) and the CONTEXT, or you can select a group which you would like to empower or support to be more heard or to reach a better position in some community or even in your school. Use questions you find relevant to your intentions, modify them, or create your own. For reflection, you can use the relevant parts of this Practice guide. We also recommend reading the more detailed material O1, O2 and O3, available here.