Output 3

In the past few decades, scholars in the fields of health and social care have increasingly called for a reflexive professionalization of their respective fields (Fook, 2016; Gillings, 2000; Mann et al., 2009). Since its early conception, reflexivity has been considered both an approach to practice and a form of professional learning (Schön, 1983). Therefore, reflexivity has not only been integrated in health and social care practice, but is also widely acknowledged as a central part of higher education training and internationally adopted in professional accreditation standards (Thompson & Pascal, 2012).

The growing emphasis on reflexivity has been explained as a response to current socio-political changes and their impacts on the fields of health and social care. For example, Kessl (2009) contextualizes the ongoing search for reflexive social work in transformations of our welfare systems and the challenges these transformations pose. This includes: the increasing reproduction of social inequality and precarity, the privatization of public services, a shift away from structural and change-oriented towards individualized responses to complex problem scenarios, and a potential reduction of professional autonomy by a combination of factors, like the pressure to frame the relationship between professionals and citizens in managerial terms as that of service providers and users/consumers (see also Ferguson & Lavalette, 2006; Garrett, 2019; Marston & MacDonald, 2006). Other scholars have theorized the turn towards reflexivity as a response to overtly technical approaches to social work practice and knowledge. Such technical approaches emphasize methodic and procedural knowledge, and risk to obscure the presence and value of ‘multiple knowledges’ in health and social care including the ‘practice wisdom’ of the professional and the ‘life knowledge’ of service users and ‘experts by experience’ (Morley, 2008; Taylor & White, 2001).

The increasing recognition of reflexivity as a central part of professional practice and professional development has led to a wide but complex body of academic work on how we should understand the concept of reflexivity. Scholars draw on various theoretical perspectives and use different terminology (e.g., reflexivity, reflectivity, reflective practice and critical reflection) to refer to sometimes similar but sometimes very different ideas on what a reflexive professional or profession entails. As such, and very similar to the concept of participation, the notion of reflexivity has become conceptually ambiguous and may take very different forms in practice, research and education (D’Cruz et al., 2007; Fook et al., 2006). For example, some scholars argue that reflexivity is as a skill that individual professionals must acquire so they become more objective, effective and accountable problem solvers, whereas others advocate for more critical approaches that consider reflexivity as necessarily oriented towards social justice and as an attitude of inquiry into the power relations that are at work when we construct knowledge about social problems and about service users (Van Beveren et al., 2018).

The conception of reflexivity that is used in this project, starts from a positioning of social work as a practice-based profession and academic discipline that is concerned with a social justice orientation and that is aimed at combating social inequality (see IFSW, 2014; Kessl, 2009). This entails that reflexivity requires a commitment to the participation of citizens as service users (Urek, 2017; Degerickx et al., 2021). It furthermore implies that reflexivity is not only a personal and pedagogical professionalization process, but must also take into account the organizational, policy and socio-political circumstances in which professionals operate and service users are expected to ‘participate’ (Garett, 2019). More specifically, we integrate in our conception of reflexivity a personal, interpersonal and socio-structural dimension (see Van Beveren et al., 2018).

• At the personal level, reflexivity refers to a critical interrogation of one’s professional assumptions and of the process of constructing professional knowledge and how power is at work in it (D’Cruz et al., 2007; Taylor & White, 2001).
• At the interpersonal level, reflexivity refers to the process of constructing knowledge about clients and their experiences together with clients in a relational and dialogical process (Parton & O’Byrne, 2006).
• Finally, at the socio-structural level, reflexivity refers to connecting personal and interpersonal reflections on professional practice with more structural and political analyses of personal problems, placing these problems within their historical, socio-political, and socio-economic contexts; combining a stance of analysis and critique with a commitment towards social transformation (Bay & MacFarlane, 2011; Brookfield, 2009; Fook, 2016; Van Beveren et al., 2022). 

Below, we discuss various case studies that report on how partners in the project engaged with the challenge of educating students in health and social care to become reflexive professionals that include in their reflexivity a commitment to citizens as service-users. 

Case example 1: Developing supervision as a safe space for stimulating reflexivity (Czech Republic)

Several case studies from the Czech Republic examined reflexivity as a process of professional development and, emphasizing the personal and interpersonal dimensions of reflexivity, related it to the practice of supervision, which is identified as a platform where reflection can occur. A first case addressed educators’ views on reflection and the specific ways they promote reflexivity among their students in the master-level educational program ‘Management of health and social organizations’. A thematic analysis of seven in-depth interviews with educators revealed that educators want to take a student-centered approach, have an interest in professional growth and learning, and apply different methods when promoting reflection in students. They described their relationship with students as a partnership and saw their role as facilitators. More specific topics that were mentioned by the educators were the importance of student selection for the program, students' feedback, and creating a safe space for reflection where students can share their insecurities, opinions, and remarks. A second case study from the Czech Republic drew on experiences with offering supervision to the preachers of the Brothers church to elaborate on the importance of creating a safe space as a central condition for reflexive learning during supervision. The case indicated that a safe supervision environment was especially needed given the spiritual dimension of the preachers’ work. Some of the participants expressed a fear of the supervision being too personal and of being misunderstood and evaluated by peers. Using a neurological perspective, the case also illustrated that, during supervision, students can be in a state of openness and curiosity and can be present, listen and learn, and can be in a state of feeling threatened, which leads to frustration and takes away opportunities to learn and listen. A major insight from the case is that, in order to stimulate reflexivity in students, supervisors need to find a balance between creating safe spaces to discuss insecurities and pushing students to deal with uncertainty and mistakes without entering a state of frustration and helplessness (see also theme 5. Ambiguity, risks and mistakes). 

Case example 2: Critical reflexivity in social work education: thinking ‘rhetorically’ about poverty (Belgium) (see Van Beveren, Roets, Buysse & Rutten, 2022). 

A Belgian case study focused on an educational project in which master students in social work reflected on the topic of social work practice in relation to poverty by critically engaging with Renzo Martens’ (2008) artistic documentary ‘Enjoy Poverty’. The educators used a rhetorical approach to reflexivity, which means that students were asked to focus on the various discourses that professionals, service users, policymakers and society at large use to construct knowledge about poverty and people in poverty and on how these discourses impact on how we deal with the issue of poverty. One of the main findings of the case study is that almost all students assumed self-critical positions (personal level) and reflected on the power of the professional to decide what problem definitions of poverty are more legitimate than others. Many students combined this self-critical position with a plea for relational reflexivity (interpersonal level) and argued that instances of ‘othering’ of people in poverty can be reduced if professionals actively and willingly listen to the ‘knowledge by experience’ of the service users. This led to a complex discussion about the role of professional expertise when trying to develop participatory social work practice. Students argued that social professionals need to deal with the challenge of having ‘trained incapacities’: they need to take the risk to act and to do this from a specific (professional) way of seeing (being trained), but must simultaneously recognize the possibility of alternative views and courses of action (having incapacities). In addition, the case study illustrated that it is crucial that students extend their reflexivity from the personal and interpersonal to the socio-structural level,  where inward-focused reflexivity (i.e., how did I do wrong?, how can I do better?) is extended to the broader sociohistorical, political and economic contexts in which professionals develop their practice. Indeed, several students reflected on the dominant societal discourses of activation, individualization and responsibilisation in relation to poverty and discussed how social work practice can both reinforce and challenge these discourses and the socio-economic systems they sustain (socio-structural level).

Critical questions for reflexivity

• What does it mean to create a ‘safe space’ for reflection and supervision in educational and professional contexts (while still allowing for professional growth and learning)? How can we create a professional climate of trust and understanding and simultaneously recognize that social professionals are characterized by different social positions, genders, racial, religious,... backgrounds?
• How can we support students/professionals to integrate reflections about their concrete interactions with service users with wider reflections about the sociohistorical, political and economic contexts in which these interactions occur? What strategies can we use to develop reflexivity as both a pedagogical practice (professional and personal development) and a political practice (relation of our practice to the socio-political and economic status-quo)?