Clifford Casey IASW 2013

EDITORIALBy Monica Egan

It was with great sadness that the social work community learned of the untimely death of Mary Allen in June. It is still hard to believe that this creative and lively person is not still among us. She had given so much to the profession and still had so much to give as instanced by her most recent book which was published just shortly before her death and referred to by Marie Therese Mulholland in the Obituary which she wrote for this edition of the Irish Social Worker.

Mary wrote an article for The Irish Social Worker in 2008 and it is reprinted here in front of her obituary as a tribute to her memory and in recognition of the tremendous contribution she made to Irish social work particularly in the area of feminism and social work. It is heartening that her legacy will continue in the articles she has written and her two published books and among the many students she trained both as a lecturer and practice teacher.

The last day for social workers who were already qualified to register with CORU, The Health and Social Care Professionals Council, was May 31st 2013. It is too early to say yet what impact registration will have on the profession. Overall people have welcomed registration and particularly the Code of Ethics to which each social worker must adhere. Siobhán Walsh’s research for her Master’s Dissertation is very timely as it examines the perspectives of mental health social workers in relation to CORU’s Code of Ethics for social workers. In general she notes that “the participants generally considered the code as useful to their practice.” However fears were expressed and there were differing views as to whether the guidance nature of the Code of Ethics facilitated or impeded its use. Only time will tell.

The Code of Ethics is also referred to in the next article by Barry Higgins where another timely theme is examined which is the role of standards in social work. He does this by analysing the time which social workers have available for working with their clients and “balances this against the standards of practice required.” There is much discussion about standards at present particularly in light of many of the HIQA (Health and Information Quality Authority) reports into various services. It is important in these discussions to keep in mind what Barry Higgins says as part of the Conclusion of his article, “Whilst standards are essential, they won’t in themselves ensure outcomes.”

There have been articles in previous editions discussing strengths based approaches to social work. Patrick Clifford and Briege Casey examine these approaches in relation to working with homeless people. This is followed by Edel Bourke’s article based on her study of rural social work through an examination of the experiences of rural child protection workers.

Social workers and psychologists often work closely in services in Ireland. Séamus Ryan, Kiran Sarma and

Michael Byrne examine referrals from social workers to psychology departments. It was a great pity that more social workers did not respond to their on line survey. Only 51 people responded out of a total of 486 to whom the survey was sent. They point out that this might well be because of busy caseloads and work commitments. It is important however that social workers make time for research so that the profession is well informed in relation to its practices. Referrals to other professions can be key when working with some clients and families so this study has particular relevance.

Social workers often complain that they get very little positive feedback about their work. The articles by Mia de Faoite and Fr. Peter McVerry certainly are high in their praise for what social workers do. Mia de Faoite’s story, maybe it would be better called an address or letter to social workers, is a brave and courageous one, giving as it does a personal and honest account of her time working in prostitution. She shows very clearly how she was influenced by a social worker to make changes to her life. Her message is a very strong and powerful one showing that one person in their work can make a huge impact on someone’s life. I would like very particularly to thank Mia for submitting this to The Irish Social Worker for publication.

Fr. Peter McVerry, a strong advocate for better services for vulnerable people, in his address to the Irish Association of Social Workers Conference last May and published here, also like Mia de Faoite, speaks of the impact that social workers can make on the people with whom they work. Particularly striking is what he says of social work as the profession that most deserves the name of being a caring profession. A social worker is not a technician he says but is “reaching out to people who are lonely, people who are hurting inside.”

A key role that social workers play is as an advocate for their clients/service users and their families. They also often request independent advocates for their clients/service users. The final article will therefore be of interest to social workers as it shows according to Anna Visser “that social justice advocacy is alive and kicking in Ireland.” Anna Visser presents the Advocacy Initiative’s new study Mapping of Social Justice Advocacy in Ireland and some of its findings. It is heartening to note that advocacy in Ireland is “very diverse with activities ranging from insider strategies to protests and public awareness campaigns.”

I have edited The Irish Social Worker since 2006 and the time has come for me to hand over to others. The profession is now a registered profession and I think it is only right that registered social workers now take up the baton. A registered profession is quite different to an unregistered one. Different issues, different challenges will arise. The Irish Social Worker going forward should and will reflect that changing world. It should therefore be edited by those who are involved with and fully understand that changing world. As I am no longer working in that world and indeed have been lucky enough

to get the opportunity to change to another sphere of work, it is only fair that those who are and will be working as registered social workers, take over from here.

I would like to take the opportunity to thank all the contributors for their articles and book reviews. I have enjoyed reading people’s contributions and have enjoyed the email correspondence I have had with so many of you.

I would like to thank the staff in the office and the printers who bore with last minute deadlines and indeed broken deadlines. I would like to thank the Executive of IASW for all their support over the years not only as Editor of The Irish Social Worker but also during my time as President of the Association.

It is my hope for both The Irish Social Worker and the IASW that they both grow in strength as the profession moves into new and exciting times.

Feminist social Work: myth, reality or remote Possibility?By Mary Allen

introductionShared commitments to the inherent dignity of each individual as well as the value of diversity, the appreciation of the ‘person-in-environment’ and commitment to ‘empowerment’ might suggest that feminism and social work would be natural allies (Barretti, 2001:266/267). On the other hand, it would be somewhat of an understatement to say that the social and legal environment in which social work finds its origins as a profession, was not an egalitarian world for women. Skehill (1999) in her analysis of the historical discourses which influenced the development of social work in Ireland, cites much original material which articulates the patriarchal attitudes to women in the early years of the twentieth century. One example of this is a quotation from a Catholic guide for social workers and others, which is explicit in its understanding of the relationship between the sexes, where the role of the woman in the family is to be “subject to the authority of the husband” (Kerr, 1927:33, cited in Skehill, 1999:77). Such ideological influences were not however limited to gender discourses in the new Irish State (Rojeck, 1988:79). The dominant influence of Mary Richmond’s (1922, 1917)”psychological” tradition over Jane Addam’s (1930, 1910) “collectivist” approach to social problems has led, in the US and elsewhere, to a continuing and consistent emphasis on the individual as a focus for social work interventions (Leonard, 1975). The central discourse of these influences was the importance of the family and the role of women and social workers (primarily women) in supporting the family, a family model which was explicitly based on an exclusively heterosexual male breadwinner model. A good example of the role of professional social work in reinforcing this discourse is Florence Hollis’s guidelines to social caseworkers assessing marital conflict, amongst which she lists: “does the woman show ….comfortable acceptance of support from her husband, a preference for staying in her home rather than working if she has young children, the absence of a marked need to dominate or be aggressive and a preference for a masculine type of man?” (Hollis, 1949, quoted in Miles, 1981:14).

the language oF social Work theory Growing in such explicitly “gender blind”, (Dominelli, 1992:88; Rojek, 1988:94) and patriarchal soil, it is hardly surprising that the influence of feminism was slow to gain recognition in mainstream social work theory and practice. Analysis of journal contents can give one a sense of where the issue of gender lies in professional social work’s official consciousness. Quam and Austin (1984) found that less than 7.2% of the articles published in eight major social work journals from 1970 to 1981

were devoted to women’s concerns. A follow up study by Nichols-Casebolt et al. (1994) which reviewed 462 articles published in 12 journals between 1982 and 1991 found that less than 10% of all articles focused on women’s issues. Barretti (2001) carried out a systematic review of 17 significant social work journals published in the USA between 1988 and 1997 in which she found that articles about women and women’s issues increased steadily from 8.6% in 1988 to a high of 13.5% in 1994 and 1995. However, Affilia: The Journal of Women and Social Work, alone published 40% of the 567 articles on women, with Social Work publishing 5.8%, and each of the other journals publishing 5.8% or less (p.274). Baretti also found that articles written from a specifically feminist perspective decreased significantly between 1988 and 1997 (p.287).

Grice-Owens’ (2002) content analysis of the language used in the “premier” Journal of Social Work Education for the years1998-99, found a picture of “subtle, systemic, cumulative and preponderant gender inequity” (p.152). Such a contemporary negative judgement however must be counterbalanced with the publication, since 1986, of the journal Affilia: The Journal of Women and Social Work. While the existence of a social work journal which deals explicitly with feminist issues in social work might signal a ‘resistance’ to the gender imbalance found in the studies discussed above, Barretti (2001) suggests that the establishment of such an explicitly feminist journal may well have inadvertently exonerated the mainstream journals from systematically incorporating feminist and women’s issues, and consequently resulted in marginalizing these issues even further (p.289).

Feminism and contemPorary social WorkThat fifty years of feminist analysis and activism has had an impact on the social work discourse is suggested by the number of publications which explicitly address its application in social work (Payne, 2005:2510). Names like Dominelli, (2005, 2004, 2002, 2000, 1992, 1991), Orme (2002, 1998). Brook and Davis (1985), Sands and Nuccio, (1992), and Fook (2002), amongst others, have been influential in the social work lexicon. The most popular general theory and practice textbooks used by mainstream Irish training programmes, (e.g. Payne, 2005, Adams et. al, 2002 ) all have at least one section devoted to feminism, anti-oppressive or critical practice.

Feminist social work, sometimes associated with the Marxist critique of radical social work (Orme, 1998:219), can more accurately be said to mirror the liberal/radical/socialist/postmodern divisions within the wider feminist tradition. Liberal strategies for change were initially attractive to social workers as they offered attainable and more immediate solutions to women’s problems within an individualistic framework (Orme,1998:221; Freeman, 1990). The Marxist tradition challenged the individual focus of social work interventions such as casework with its consequent pathologising of women

(Orme, 1998:222). The radical separatist approaches which grew out of the analysis of sexual politics (Millet, 1977) locating the sources of women’s oppression in the patriarchal system, were of limited value to women as both service users and workers, who did not have either the opportunity or the inclination to pursue personal or political separatism (Orme, 1998:222; Hudson, 1989:75). The socialist feminist approach (Wearing, 1986, Dale and Foster, 1986) recognises both class and gender as dual forces which contribute to the oppression of women as both workers and service users. It is from this tradition that the most enduring and fruitful contributions to woman centred and feminist social work praxis have emerged.

socialist Feminist social WorkWithin the feminist social work lexicon, pride of place is usually given to the work of Dominelli writing alone or with others. In their co-authored work Feminist Social Work, Dominelli and McLeod, (1989) set out a very optimistic and energetic challenge to the profession. Acknowledging that the feminist movement was undergoing a time of fragmentation in the eighties (p.19), and claiming that feminist practice had by then already made a significant contribution to both the identification of social problems and the practice areas of community action, counselling and statutory work (p.10), they outline how feminism could continue to influence this practice. Using the gender analysis developed by feminists, they identify the way in which women are pathologised in the search for solutions to poverty and problems such as child abuse and neglect. In their consciously “egalitarian” all inclusive approach, their work both reflects and contributes to the development of anti-oppressive practice (Dalrymple and Burke, 1995; Mullaly, 2002).

Despite the optimism of this seminal text, Dominelli, writing in 1992, 2002 and as recently as 2004 , concedes that feminism is largely limited to the areas of voluntary and community work and considers statutory social work to be largely unaffected by feminist analysis. Writing as she does after the “cultural and linguistic turn” of postmodernism, Dominelli roundly rejects many of its critiques of feminist social work, particularly the charge of “essentialism”, arguing that social work transcends the “fragmented individual identities” posited by post modernism (Dominelli, 2002:8).

social Work and Postmodern FeminismSands and Nuccio (1992) are less dismissive of the value of postmodern feminist ideas and they explore their implications for social work practice. Pointing to the pervasive use of ‘either/or’ binary categories such as generalist versus specialist, macro versus micros, research versus practice, they suggest that social work can learn from postmodernism that categories can co-exist and overlap as ‘both/and’. As with other feminist writers they also draw attention to the ‘political dilemma’

(p.493) of advocating on behalf of ‘categories’ of clients based on race, gender, age.

Commenting on feminist social work practice at the end of the twentieth century, Van Den Bergh (1995) traces a shift in the themes which appear in the practice literature since the 1960’s. She outlines the implications for this shift in emphasis by integrating the concepts of subjective knowledges which will be found in partnership ‘community based’ practice relationships- communities which are not geographically or demographically bound, but defined by common experiences and shared meanings. Social work’s traditional person-in-situation and ecological traditions are transformed by feminist ‘standpoint’ theories such as those of Stanley and Wise (1993), and from these perspectives, the work of narrative therapists such as Michael White (2007, 2000, 1995,1990, 1989), become appropriate methodologies by which the marginalized ‘silenced’ voices can move from the margin to the centre.

is Feminist social Work Possible?In two small scale studies, White (2006, 1995) examines the possibility of feminist practice and identity in social work. Her 1995 findings reaffirm the difficulties identified by Dominelli (2002, 1992), Hudson (1989) and Featherstone (2004) for feminist practice in statutory social work settings, identifying the issue of power as the problematic in developing a sense of commonality with other women. She concludes that it is the constraints of the statutory context which are crucial to the construction, or even the possibility of, feminist social work practice.

In a later study, White (2006) explores the possibility of a feminist social work identity with 20 British female practitioners. Only two of her sample described their stance as ‘feminist’ in relation to addressing the interests of women, while the majority identified their approach as that of ‘anti-oppressive practice’ (p.83). She argues from this that the mainstream literature which advocates for the existence and value of a specific feminist social work identity is not supported by the evidence, emphasising the constraints placed on social work by its statutory role and responsibilities in ‘state social work’, paying particular attention to the impact of ‘managerialism’ on contemporary developments in British social work. Accepting that the battle has been lost in relation to incorporating what she describes as an ‘unrealistic version’ of feminist social work into mainstream practice settings, she argues for ‘being in’ but ‘against managerialism’. Being against managerialism is possible she argues, by adopting an approach to feminist social work similar to that of Dominelli (2004, 2002), which resembles closely the ‘eclectic ’all inclusive approach of anti-oppressive and anti-discriminatory practice. Despite specifically addressing the British statutory context, the increasing emphasis on managerialism in the Irish system makes White’s arguments relevant for Irish social work practice.

resistance to Feminist PracticeHudson (1989) and Featherstone (2004) provide some insights into the complex reasons why the statutory sector (and particularly the child care sector) has proved to be so resistant to feminist theory. Hudson suggests that social workers see the claims of feminist groups as a threat to their authority and expertise, and result in their being caught in the dilemma of wanting to work with their own authority and power and yet wanting to build bridges with women’s groups (p.82). The skewed gender ratios within social work management, whereby a predominantly female profession is managed and led by predominantly male managers (Christie, 2007; Payne, 2005:252; Orme, 1998:218), answerable to a male dominated political and civil service system (CSO, 2007, 2006), might also helpfully have been taken into account in Hudson’s analysis. This is a dilemma that is not likely to be resolved in the near future!

Featherstone (2004) is much less optimistic or enthusiastic than either Hudson (1989) or Dominelli (2004, 2002) about the potential or actual contributions of feminist insights to the practice of social work. Writing in the context of social work involvement with family support (2004:166-169), she identifies the commonality of gender as the motivation for what she refers to as “something called feminist social work”, and concludes that it quickly “ran aground”. She traces this failure to the conflict between the wish of feminist social work to de-emphasise women’s identity as mothers and wives, (as for example in the work of Brook and Davis (1985)) and to the reality of social workers’ roles in the lives of women as mothers. The attempt to coalesce the needs of women with those of children, and to assume a mutuality of interest between female workers and their female clients, is not she suggests, well thought out. It requires a “sanitized” notion of mothers and mothering and their relationship with their children which does not reflect the complexity of women’s actual experience and does not allow for consideration of women’s “ambivalence” towards their role as mothers. A similar critique of the relevance of feminist analysis in the face of the needs of children who may be neglected or rejected by their mothers has been made by Wise (1995) who claimed that feminist social work in a statutory setting was “a fantasy”.

Feminist social Work in the neW millenniumIt can be concluded from this review of some relevant literature, that feminism has had a mixed reception and a somewhat limited impact on the practice of social work. While Dominelli, (2004, 2002) and Domenilli and McLeod (1987), Payne, (2005:252) and Orme, (2002) are undoubtedly correct to suggest that feminist critiques, along with anti-racism, have challenged the dominant models of social work, these alternative models are still marginalized within mainstream social work (White, 2006; Dominelli, 2004:55.) Similarly, women’s role in the higher echelons of social work management is still as elusive as

in other professions (Christie, 2007; CSO, 2007; Payne, 2005:252; Orme, 1998:218). Nevertheless, it is true that feminist analysis and the consciousness of the impact of one’s gender subjectivity on access to power and resources have had an influence on the academic world and on social work education, particularly in relation to domestic violence and child sexual abuse (Dominelli, 2002:21).

The work of Mullender, (1996), Kelly (2005, 1996, 1995, 1994, 1988.), Hester and Radford (1992, 1996) and Humphreys (2000) on these issues, have changed the parameters of the debates and practice in these areas. Despite the pessimistic findings of Grice- Owens (2002) and Barretti, (2001) discussed above, there is another discourse within the profession. Payne (2005:254) suggests that there is a well-developed feminist social work analysis. Social workers constantly refer women to ‘feminist women only’ spaces and organizations such as Women’s Aid Refuges and support groups and would no doubt advocate for their continued existence if this were threatened. While this may suggest a convenient co-existence rather than an incorporation, this co-existence may hide more subtle influences emerging within social work theory as it responds to the influences of the postmodern wave of feminist thought and to sociology’s critical theory. One example of these influences is ‘critical social work’ theory.

social Work and critical theoryCritical social work practice can be said to have grown out of the radical social work tradition of the 1960s and 1970s, and has “merged” along the way with feminist and anti-racist and other anti-discriminatory practices (Payne, 2005:227). Radical practice, as the strand of social work theory which drew its inspiration from Marxist theory, is, by definition, materialist and structuralist. Like feminist social work, radical social work did not find a ready home in mainstream social work and has also been influenced by the “cultural turn” of postmoderism. Now with the influence of postmodernism and empowerment practices, it has begun to re-emerge as critical social work theory (Fook, 2002, Mullaly, 2000).

Fook (2002) makes a helpful distinction between the contribution of postmodernism, which is essentially an epistemological theory, and radical, structural and feminist theories, which as “moral theories” provide guidance about how society “should be”. Recognizing the difference between these disparate theoretical views of reality and of social relationships, Fook (2002:16) suggests that “we need to combine both types of theorising in order to begin to understand our complex world”.

Critical theory could be said to “meet” postmodernism, when it recognises that knowledge does not just reflect “empirical reality”, but is actively constructed by those studying this knowledge. Therefore the role of reflection and analysis underscores the importance of communication processes.

conclusionHas feminism therefore simply disappeared into critical or anti oppressive theory and practices? Can it be said that postmodern thought has contributed to this annexation, while at the same time, statutory social work settings and the effects of managerialism ensure it is effectively silenced? Has the increasing (and valid) concern with involving men in social work practices made feminism unfashionable and apparently redundant? In a profession in which the majority of both practitioners and service users are female, (NSWQB, 2007; Payne, 2005; Grice-Owens, 2002; Skehill, 1999; Orme, 1998), the disappearance of an explicit and clearly articulated gender analysis should perhaps cause greater concern to practitioners, researchers and educators than is presently the case. It would appear that social work needs to be clear to what extent a feminist perspective has been incorporated into wider cultural discourses and demands, and whether such incorporation serves it well.

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Adams, R., Dominelli, L. & Payne, M. (2002) Eds., Social Work: Themes, Issues and Critical Debates. Basingstoke: Palgrave Macmillan

Barretti, M. (2001) Social Work, Women and Feminism: A Review of Social Work Journals, 1988-1997, Affilia, 16: 266-294

Brook, E. & Davis, A. (1985) Women, the Family and Social Work. London: Tavistock

Christie, A. (2007) The Gender Profile of the Social Work Profession in Ireland. Paper presented at the IASW Conference, May 2007. Dublin

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CSO (2007) Equality in Ireland 2007. Dublin: Stationary Office

Dale, J. & Foster, P. (1986) Feminists and State Welfare. London: Routledge & Kegan Paul

Dalrymple, J. & Burke, B. (1995) Anti-Oppressive Practice: Social Care and the Law. Maidenhead: Open University Press.

Dominelli, L. (1991) Women Across Continents: Feminist Comparative Social Policy. New York: Harvester Wheatsheaf

Dominelli, L. (1992) More Than a Method: Feminist Social Work, in K. Campbell (Ed.) Critical Feminism: Argument in the Disciplines. Buckingham: Open University Press

Dominelli, L. (2000) Empowerment: Help or Hindrance in Professional Relationships? in D. Ford and P. Stepney (Eds) Social Work Models, Methods and Theories: A Framework for Practice. Lyme Regis: Russell House Publishing

Dominelli, L. (2002) Feminist Social Work Theory and Practice. Basingstoke: Palgrave

Dominelli, L. (2004) Social Work: Theory and Practice for a Changing Profession. Cambridge: Polity

Dominelli, L. (2005) Social Work Research: Contested Knowledge for Practice in R. Adams, L. Dominelli and M.Payne (eds), Social Work Futures, Crossing Boundaries, Transforming Practice. Basingstoke: Palgrave Macmillan, 223-236

Dominelli, L. and McLeod, E. (1989) Feminist Social Work. Basingstoke: Macmillan

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Hester, M. and Radford, L. (1992) Domestic Violence and Child Contact Arrangements in England and Denmark. Journal of Social Welfare and Family Law, 1: 57-70

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obituaryDr Mary Allen

We wish to pay tribute to Mary Allen who died in June 2013, aged 60. Mary will be known to many of you as a colleague, lecturer and champion of human rights. Most of you will be familiar with Mary’s in-depth

knowledge of intimate partner violence and its impact on women and children. Mary pioneered the development of training for A&E, maternity, medical staff and the mental health sector.

Mary graduated in Social Science from UCC. She worked initially with Community Development projects in Zambia, Kenya and Brazil. Mary undertook post graduate studies in UCD and obtained her professional social work qualification. She was offered a social work post at St James’s Hospital and became the Deputy Head of the Department. Joan Cronin, a colleague and friend of Mary from the St James’s days, said at Mary’s memorial service: ‘Mary was a natural innovator and leader and this reflected in her work with Threshold, HAIL, Daisy Housing Association, the National Women’s Council, Women’s Aid and the Dublin Women’s Therapy Centre. Mary was a feminist in the true sense of the word. Her feminism came through in her social work practice, her research and her teaching. She had a questioning intelligence, which challenged institutional assumptions and her knowledge of Irish Social Policy was enviable. ‘

While Mary was working in St James’s Hospital she began to conduct research into para suicide and domestic violence and was seconded to the training unit in Women’s Aid. She joined the Board in 2007 and became chairperson where she remained until shortly before her untimely death.

Mary moved to a lecturing post in the School of Applied Social Science at UCD in 2002, where she completed a PHD. She assumed the role of Director of MSocSc (Social Work) fulltime programme initially prior to directing the parttime MSocSc(Social Work) programme. Given the broad range of social work experience which Mary brought to the post, she was particularly equiped to lecture on a number of topics – intimate partner violence, ethics, counselling, social work skills, grief and loss and supervised many dissertations over the course of her stay at UCD. Mary was passionate about her topics and frequently engaged in ‘lively’ debates with colleagues. She collaborated with colleagues in research within the Irish context and also with partners in Europe and USA which led to a number of ground breaking publications. She published two books in recent years - ‘Journeys to Safety. Using Narrative Therapy to support abused women’ (2011) published by Jessica Kingsley,London and ‘Social Work and Intimate Partner Violence’ (2013)

published by Routledge. She worked on her last book while struggling with her illness. Her committment and dedication to the topic did not allow health issues to detract her from her mission. Mary has been described as an ‘inspirational lecturer ‘ by former students . They greatly appreciated her ability to relate theoretical concepts to practice issues, drawing on her extensive social work experience. She managed her teaching committments despite suffering the effects of her illness. In addition to her afore mentioned teaching expertise, Mary was a warm, generous , supportive and entertaining colleague. We miss her so much.

Throughout her career Mary was an active member of the IASW and was a member of the Board of the NSWQB. She was passionate about her profession and the development of the profession. Mary was also known to have a great sense of humour and was a great tennis player. She was a great mentor and colleague and will be missed by all who knew her. Mary has left a legacy of work that has influenced practice and will continue to shape practice into the future.

Mary is survived by family, friends and colleagues and will be sorely missed.

Ar dheis Dé go raibh a anam dilis.

Marie Therese Mulholland

Past President IASW

adult mental health social Workers’ PersPectives oF thE CORU CODE Of PROfEssiOnAl COnDUCt AnD EthiCs fOR sOCiAl WORkERsBy siobhan E. Walsh

introductionRecent media has highlighted cases of professionals being held accountable for inappropriate practices; a psychiatrist assaulting Gardaí (Irish Times, 2013), a solicitor allegedly stealing from clients (Limerick Leader, 2013) and a UK social worker being involved in an inappropriate relationship with a service user (Community Care, 2013). The above incidents suggest that professionals need to be held accountable for their actions and this is why there has been a move by Governments in many countries to introduce closer regulation of professionals. An intrinsic element of such regulation and accountability are professional codes of conduct and ethics.

Professional codes of conduct and ethics have developed significantly across many caring professions internationally (Osmo and Landu, 2006; Banks, 2004). Social work in Ireland is no exception to this. Ireland has moved to statutory registration with CORU through the Social Work Registration Board (SWRB) and adherence to CORU’s Code of Professional Conduct and Ethics for Social Workers (herein referred to as CORU’s code of ethics) is mandatory for all social workers on the register. This is a significant change for social workers in Ireland, as statutory registration means that it is the first time that social workers are legally held accountable for the standard of their practice and behavior both within and outside work.

This article presents the findings from a Masters in Social Work (MSW) thesis examining adult mental health social workers’ perspectives on CORU’s code of ethics and its usefulness in their practice. This article is adapted from a study that was conducted as an MSW thesis at University College Cork (UCC), to include some but not all of its findings. This article focuses on a few key findings and the full study is available from the author (details below). The purpose of this study was to 1) investigate the literature on social workers’ perceptions of professional codes of conduct and ethics, 2) explore adult mental health social workers’ perspectives of the usefulness of CORU’s code of ethics, 3) discover what facilitates and impedes the use of codes of ethics in practice.

The research process has three components; an in depth literature review, a short questionnaire as an information sheet and six semi-structured interviews. This study is timely considering the recently lapsed statutory registration deadline and the binding nature of the CORU’s code of ethics upon social workers. The

key findings from the literature review, interviews are explored and discussed. Finally, recommendations and conclusions are made.

coru’s code oF ethicsThe CORU code of ethics is a fourteen page document that was introduced in 2011. There are five key social work values that inform the code are 1) respect and inherent dignity and worth of persons, 2) pursuit of social justice, 3) integrity and professional practice, 4) confidentiality in professional practice, and 5) competence in professional practice. There are twenty-three duties which are assigned to maintaining these values. There are also two appendices, one which help with ethical decision making in practice and another which gives ethical procedures for undertaking research.

There are two types of professional codes of ethics, guidance codes and prescriptive codes. CORU’s code is a guidance code as it provides a list of principles to assist the professional in practice; it does not tell the professional what to do in particular situations. Thus allows the code to be interpreted in different ways in different situations. Guidance codes are popular in Europe. Prescriptive codes have an exhaustive list of duties and detail exactly what professionals are to do in situations. They are popular in the USA. As CORU’s code is a guidance code, the literature referring to prescriptive codes was not reviewed.

key debates on the useFulness oF ProFessional codes oF ethicsThere were two key areas within the literature that related to the usefulness of codes of ethics in practice detailed below.

1) guidance to PractitionersOne of the strongest arguments around the use of professional codes is that they contribute to or encourage ethical conduct. However, it is also argued that a professional code cannot be expected to be solely responsible for ethical conduct (Asquith and Rice, 2005; Hugman, 2003; Clark, 1999; Banks, 1998a). Codes act as a moral compass for critical reflection and self-awareness (Osmo and Landau, 2006). However, a code’s ability to be a moral compass in ethical dilemmas relies greatly on practitioners being aware of them (Banks, 1998a; Banks, 1998b), understanding how to use them in practice (Johns and Crockwell, 2009; Osmo and Landau, 2006; Hugman 2003) and selecting them over agency policy or procedures (Doel et al., 2010). Dean and Rhodes (1992) state that professional codes play an important and useful role in educating practitioners by encouraging discussion surrounding ethics and ethical practice. However, codes need organisational support to be effective (Manning, 1997).

2) Protection of the Public and Professional RegulationProtection of the public through professional regulation, resulting in an increase in trustworthiness and confidence from the populace, is a benefit of professional codes (Banks, 2004; Clark, 2000). This professional regulation only works where professionals are held accountable, and is presented as both a positive and negative use of professional codes within the literature.

Professional codes have been used by other professions to regulate themselves. The CORU code of ethics however, is enforced by a regulatory body weighted in favor of the lay person in conjunction with professionals. Johns and Crockwell (2009) and Wiltkin (2000) argue that where professional codes are not regulated solely by the profession, they may be more concerned with punitive measures for the practitioners than protection of the public. Clark (1999) considers that codes are used where Government and managers need to ensure practitioners are accountable to their ‘political masters’, follow procedures outlined, and act within budget. Thus, protection of the agency rather than practitioners or public is ensured. This can result in practitioners becoming more cautious in their practice due to the fear of punishment (Doel et al., 2010; John and Crockwell, 2009; Witkin, 2000; Banks, 1998a).

Factors that imPede and Facilitate the use oF ProFessional codes oF ethicsSome argue that professional codes are simply aspirational (Petrire, 2009; Beckett, 2009). However, others consider that they are essential in professions such as social work and their importance in ethical conduct is vital (Dean and Rhodes, 1992). Doel et al. (2010) contends that understanding and competence in ethics is necessary and can only be achieved through education. It is considered that the best way to improve ethical conduct and the way that professional codes are used is by ingraining them in education (Doel et al., 2010; Johns and Crockwell, 2009; Hugman, 2003; Clark, 1999). This can be built upon by using them in the supervision of all social workers (Fine and Teram, 2009; Dean and Rhodes, 1992). This can be supported through general agency support, consultation with peers in the agency environment regularly (Doel et al., 2010; Osmo and Landau, 2006; Witkin, 2000) and ensuring codes become part of reflective practice (Fine and Teram, 2009).

Doel et al. (2010) recognise that professional codes should be developed by ethically engaged practitioners to ensure their applicability; a bottom-up approach. Hugman (2003) adds to this by stating that it is essential for professional codes to be reviewed regularly by engaged professionals. Overall, measures can be put in place to increase the use of professional codes. However, it is the responsibility of the social worker to stay ‘morally vigilant’ (Doel et al., 2010; Osmo and Landau, 2006; Hugman, 2003).

Factors that impede the use of professional codes include: contravention with policy and procedures (Gallina, 2010; Asquith et al., 2005); heavy workloads (John and Crockwell, 2009); lack of agency support, lack of knowledge and understanding (Doel et al., 2010; Osmo and Landau, 2006; Hugman, 2003, Witkin, 2000); feared as a tool to penalise social workers (Fine and Teram, 2009; Clark, 1999) and it is noted that if they are viewed as a hostile set of rules they will fail (Doel et al. 2010).

adult mental health social Workers’ PersPectives on the coru code oF ethicsSix social workers in adult mental health were interviewed in-depth about their perspectives on the CORU code of ethics and its usefulness in practice. All the participants consented to take part in the study and for the data to be used in publications and presentations. All the names below are pseudonyms. The data was collected in early 2013 just before the end of the ‘grand-parenting’ period for practicing social workers. All the study participants were aware of the CORU code of ethics and three core themes arose from the content analysis: 1) perspectives of the CORU code of ethics, 2) The usefulness of the CORU code of ethics, 3) What facilitates and impedes the use of the CORU code of ethics in practice?

theme one: PersPectives oF the coru code oF ethics.All the participants were positive about the introduction of the CORU code of ethics.

“I was delighted when I saw it” (Pat)

“I would see it as a helpful thing.....I think it’s a good thing” (Ron)

“I’d see it as a vital ....needed” (Anne)

However some of the participants were anxious about its introduction.

“it [the CORU code of ethics] makes me nervous....like what if somebody challenges my practice under one of the duties” (Michael)

Overall, participants’ perspectives concurred with the international literature, which states that professional codes of ethics are generally positively accepted by professionals (Clark, 2000). However there is an underlying anxiety that it will be used to challenge their practice. Professional codes of ethics are generally instigated and monitored by the profession (Butler 2002). However, the CORU code of ethics is unlike many other professional codes, as it was not instigated solely by the profession and will be monitored by CORU. This may have influenced the level of nerves around its introduction.

theme tWo: the useFulness oF the coru code oF ethics in PracticeAll participants considered themselves to have a good knowledge of the CORU code at the time of interview. This may be partly due to the researcher forwarding copies of the code to all participants in advance of the interview. Overall, the participants considered the CORU code of ethics to be useful. This is demonstrated below.

1) Guidance to PractitionersAll participants noted that the CORU code of ethics was useful in guiding their practice.

“[the CORU code guides social workers in] the key things that they need to comply with in terms of the practice, what knowledge they need to have, what skills they need to have and what kind of ......ethical standards need to underpin everything”. (Barry)

The use of professional codes for guidance is one of the strongest arguments for their introduction, stating that codes contribute to, or encourage, ethical conduct (Dean and Rhodes, 1992). This has been confirmed as one of the strongest uses for the CORU code of ethics by these participants.

Half of the participants considered the guidance nature of the code, rather than a prescriptive code, as a key factor that facilitated its use in practice. The other half viewing this as something that impeded its use. Those that considered the guidance nature as facilitating their practice stated

“it still gives a little bit of room for manoeuvre. I think it’s probably a positive thing ‘cause there are no kind of black and whites” (Ron)

The other half of the participants considered the non-prescriptive nature of the code as something that impeded its use in practice.

“It’s the woolly language... it doesn’t really tell you, when you really go to look for guidance on it, it gives you the general spiel but it doesn’t really tell you the specifics....maybe it could be improved, a bit clearer, more directive.” (Anne)

Participants noted that some duties conflict in particular situations and no specific guidance is given what do when this happens.

“say a female service user is involved in a relationship where there’s domestic violence.......but you have to respect her personal relationship [referring to duty 3 of the CORU code of ethics] yet try to encourage her to get out [referring to duty 9 of the CORU code of ethics].... but then you are disrespecting her choice to have a relationship with X...what do you do?” (Michael)

This quote highlights the participants’ uncertainty of what to do where duties collide. This may be largely because this participant considers that the code should give more prescription than guidance.

It is noted that the CORU code of ethics does offer a practical tool in deciding what to do in a specific situation in Appendix A, ‘Suggested procedure for ethical decision making’. The participants such as Michael above who considered that they did not know what to do when duties collided did not mention Appendix A. It is noted that some of the participants referred to Appendix A as facilitating their use of the code in practice.

“one of the things that really attracts me about the code is the sections, the Appendix A...which gives…how you would deal with an ethical dilemma and I think that is a very useful guide, and I think it’s a very practical guide ‘cause we never had anything like that” (Pat)

It is evident from the above that there is a divide in what the participants want from a professional code of ethics; some wanting guidance and others wanting prescription.

2) Protection of Clients and Professional RegulationAll participants noted that the code was useful in offering protection to clients:

“Its key thing is to protect the public you know and I suppose you know there could be rogue practitioners out there” (Barry)

This was generally seen as a positive thing by the participants:

“Competence has affected clients and I think everyone is hoping that the code will kind of address that” (Joan)

Although the protection for clients and general accountability of professionals was seen as a positive use by participants, all participants were acutely aware that their practice could be challenged:

“I also recognise that on day two of registration, someone could just decide to make a complaint about me ......, we are working with an awful lot with people who are on the margins of society or who are very vulnerable. You know we run higher risks [then other professionals], that they mightn’t like a service” (Pat)

The above comments highlight the element of anxiety from practitioners that their practice would be challenged. When probed about such underlying fears, the majority were uneasy about the complaints procedure and what that would entail for them:

“What if somebody challenges my practice under one of the duties. I would just be nervous because it’s open

to so much interpretation that it could go either way” (Michael)

Clearly the CORU code of ethics can be interpreted in different ways and this adds to the anxiety for social workers that their practice can be challenged. John and Crockwell (2009) recognise that this can result in practitioners becoming more cautious in their practice due to the fear of litigation. CORU have yet to establish their complaints process. From 2005-2010, the Northern Ireland Social Care Council received 132 complaints against social workers this equates to only 1% of the total social work registrants (Northern Ireland Social Care Council, 2010). All complaints including those against social care workers amounted to just 1.7% of all registrants, of which 83% were closed at preliminary investigation stage (Northern Ireland Social Care Council, 2010). In this period a total of 6 registrants (social care and social workers) were removed from the register, 3 were suspended and 5 received admonishment of five years (Northern Ireland Social Care Council, 2010). These are similar to complaint figures in the UK and it is considered that Ireland may follow a similar trend. On this basis, it is considered that investigations are very low and serious action even lower.

theme three: What Facilitates and imPedes the use oF the coru code oF ethics in Practice?The strongest theme to emerge that facilitates or impedes the use of the CORU code of ethics in practice is education. Education is recognised as being necessary for understanding and being competent in ethical decision-making (Doel et al., 2010). Education as training, workshops and examples of uses of the CORU code of ethics, was a theme discussed by almost all participants as beneficial to their use of the code.

“Well maybe if CORU did, once we’ve all registered now, if they rolled out some sort of training on it, it would be beneficial. If there was training on the code I’d definitely go and we could then thrash out different examples under the headings [referring to the duties]” (Michael)

“[referring to training] I think like workshop kind of thing which might even inform us” (Anne)

It is clear from the above comments that the participants are open to and recognise the importance of education in understanding and using the CORU code of ethics in their practice. This is also linked to the fact that some of the participants are looking for more direction from the code, which it is not intended to give. Understanding this point and the use of ‘Appendix A’ is something that could be developed in such training.

discussionOverall, it was clear from the above that the participants generally considered the code as useful to their practice. The majority saw it as beneficial, needed and helpful. However, throughout the study there was an underlying uneasiness from some participants who were happy about the code’s introduction but were nervous about its use to challenge their practice. This underlying uneasiness may be attributed to participants’ fears of their practice being challenged, although they all considered that they abide by the code already. This uneasiness may have come from their perception that social workers are more open to be challenged than other professionals. This is due to the vulnerable nature of the clients and furthermore because the profession walks a fine line between social control, justice and care.

All participants articulated that the protection of clients was a key use of the code in their practice that they welcomed. In terms of professional regulation, all participants were happy with this. However, there were underlying fears around the procedure, the possibility of their own practice being challenged and what this may entail for them as a practitioner.

Overall, education was also seen as a key factor in facilitating the use of the code of ethics, with many participants stating that they would like education/training around how to use and interpret the code.

One of the most contentious findings of this study is the factor that split the participants equally. Half of the participants considered the guidance nature of the code as something that facilitated its use, the other half considered it as impeding its use. The participants that considered guidance as facilitating its use, stated that it recognsies the complexities of social work practice and it does not try to put people in boxes. It further recognises that there are no black and whites in practice when making decisions. The other half of the participants want more direction from the code, stating that it did not give any specifics and particularly where duties or values collided, it did not offer any assistance.

It is noted however that the CORU code of ethics does not give a prescription of what to do in individual situations nor does it intend to. It simply intends to guide practitioners in their decision making. Doel et al. (2010) recognise that the understanding and competence of professionals in the use of professional codes of ethics is essential to their success and use. The way for this to be best achieved is through education and training (Doel et al. 2010). This is something that the participants identified as facilitating the use of the CORU code of ethics. Due to the limited sample of this study, care should be taken in generalising from the findings.

recommendationsThere are a number of recommendations that this researcher wishes to make based on this study.

Further research into the perceptions of Social Workers of CORU’s code of ethics and its usefulness in their practice is needed. It is necessary to try and further reduce the gap in research, to ensure the code is understood by practitioners and overall for the benefit of the profession. A larger scale study on the adoption and use of the code by social workers in all areas of social work practice in Ireland would be valuable.

It has been established from the literature that the best way to improve ethical conduct and the use of professional codes of ethics is through improving the practitioners understanding of the code, which in turn increases their use of the code (Clark 1999). This understanding could be achieved through education (Doel et al. 2010; Hugman, 2003; Clarke, 1999). This leads to two further recommendations.

Firstly, for trainee social workers: CORU’s code of ethics and ethical decision making should form a fundamental component of all professionally qualified courses and examination should be held in same (Johns and Crockwell, 2009). The earlier trainee social workers learn to understand and use CORU’s code of ethics the less fear they will have around its use. Fear is something that can lead to overtly cautious practitioners (Johns and Crockwell, 2009).

Secondly, training should be carried out with all registered social workers. This could take the form of focus groups with case examples. This would improve practicing social workers’ understanding of the code as a guidance code, its use and potentially reduce their fears. Training would also give practitioners more ownership of the code and improve their use of same (Doel et al., 2010; Fine and Teram, 2009; Osmo and Landu, 2006; Clark, 1999).

Finally, it is important that all codes of ethics are reviewed and updated (Doel et al., 2010; Fine and Teram, 2009; Clark, 1999). This should be carried out in a hands-on way by social workers. Similarly to the suggested training above, this could include focus groups. The inclusion of social workers in a potential review in a more active way may allow them to view CORU’s code of ethics less like a set of rules they must follow or a tool for litigation (Doel et al., 2010; Fine and Teram, 2009; Osmo and Landu, 2006).

conclusion This study emphasised that professional codes of ethics are beneficial where practitioners have a good knowledge and understanding of how to utilise them. Where they are not understood they can result in fear and overtly cautious practice. This recognises the importance of training and educating social workers and trainee social workers in how to interpret and use CORU’s code of ethics in practice. At the end of the study, this researcher agrees with the words of a participant who in referring to CORU’s code of ethics state that it is

“a starting point, this is a huge step in the right direction, I’m extremely happy with it but there are things that need to be tweaked” (Pat)

It is this researcher’s opinion that the biggest ‘tweak’ that would encourage the use of CORU’s Code of Professional Conduct and Ethics for Social Workers is for practitioners to be supported in its use through education, training and further research.

reFerencesAsquith, M. and Rice, K. (2005) ‘Social Work Ethics- Practice and Practitioners’, in New Global Development, Vol. 21 No1, (10-17).

Banks, S. (2008) ‘Critical Commentary: Social Work Ethics’, in British Journal of Social Work, Vol. 38 No6, (1238-1249).

Banks, S. (2004) Ethics, Accountability and Social Professions, Palgrave MacMillan, New York.

Banks, S. (1998a) ‘Codes of Ethics and Ethical Conduct: A view from Caring Professions’, in Public Money and Management, Vol. 18 No1, (27-30).

Banks, S. (1998b) ‘Professional Ethics in Social Work- What Future?’, in British Journal of Social Work, Vol. 28 No2,(213-231).

Banks, S. And Gallagher, A. (2009) Ethics in Professional Life, virtues for health and social care. Palgrave Macmillan, New York.

Beckett, C. (2009) ‘Realism as an Ethical Obligation: Engaging with Practice Realities, Not Just ‘Virtuous Words’’, in Ethics and Social Welfare, Vol.1 No3, (64-68).

Butler, I. (2002) ‘A Code of Ethics for Social Work and Social Care Research’, British Association of Social Workers, in Vol.32 No2, (239-248).

Clark, C. (2000) Social Work Ethics; Politics, Principles and Practice, Palgrave, Hampshire.

Clark, C. (1999) ‘Observing the Lighthouse’, in European Journal of Social Work, Vol.2 No3, (259-270).

Community Care (2013) ‘Social Worker Struck Off for inappropriate relationship with teenager’ [Internet] Community Care, UK. Available online from

http://www.communitycare.co.uk/articles/05/04/2013/119069/social-worker-struck-off-for-inappropriate-relationship-with-teenager.htm (access on the 16th April 2013).

CORU (2011) Code of Professional Conduct and Ethics for Social Workers, CORU, Dublin.

Dean, R. and Rohdes, M. (1992) ‘Ethical-Clinical Tensions in Clinical Practice’, Social Work, in Vol. 37 No2, (128-132).

Doel, M., Allmark,P., Conway, P., Cowburn, M., Flynn, M., Nelson, P. and Tod, A. (2010) ‘Professional Boundaries:

Crossing a Line or Entering the Shadows?’ in British Journal of Social Work, Vol.40,(1866-1889).

Fine, M. and Teram, E. (2009) ‘Believers and Skeptics: Where Social Worker Situate Themselves Regarding the Code of Ethics’, in Ethics & Behaviour, Vol.19 No1, pp.60-78.

Gallina, N. (2010) ‘Conflict Between Professional Ethics and Practice Demand: Social Workers Perceptions’, [Internet] Journal of Social Work Values and Ethics, 7(2). Available online at http://www.socialworker.com/jswve/fall2010/f10conflict.pdf (accessed 29th June 2012).

Hugman, R. (2003) ‘Professional Ethics in Social Work: Living with the Legacy’, in Australian Social Work, Vol. 56 No1, (5-15).

Irish Times, (2013) Psychiatrist who bit Garda, [Internet] Ireland, Irish Times. Available online at http://www.irishtimes.com/news/crime-and-law/psychiatrist-who-bit-garda%C3%AD-to-be-sentenced-next-month-1.1340994 (accessed on the 16th of April 2013).

Johns, A. and Crockwell, L. (2009) ‘Reflecting on the Use of the Code of Ethics in SW Practice: A Newfoundland and Labrador Perspective’, The Journal of Social Work Values and Ethics, 6(2), available online from http://www.socialworker.com/jswve/content/view/122/68/ (accessed on the 3rd April 2012).

Limerick Leader (2013) Local Solicitor Suspended over missing money, [internet] Ireland, Limerick Leader. Available online from http://www.limerickleader.ie/news/leader-local/limerick-solicitor-suspended-over-missing-money-1-4532472

Manning, S. (1997) ‘The Social Worker as Moral Citizen: Ethics in Action’, in Social Work, Vol. 42 No 3, (223-230).

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Osmo, R. And Landau, R. (2006) ‘The Role of Ethical Theories in Decision Making by Social Workers’, in Social Work Education, Vol. 24 No 8, (863-876).

Petrie, S. (2009) ‘Are the international and National Codes of Ethics for Social Work in the UK as Useful as a Chocolate Teapot?’, in Journal of Social Work Values and Ethics, Vol. 6 No 2, available online from

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Reamer, F. and Shardlow, S. (2009) Ethical Codes of Practice in US and UK: One profession, two standards, The Journal of Social Work Values and Ethics, Vol. 6 No 2 available on line http://www.socialworker.com/jswve/content/view/120/68/(accessed on the 29th March 2013).

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acknoWledgementI would like to take this opportunity to thank all the participants of this study for sharing their knowledge and experiences. I also wish to thank Kenneth Burns and Robert O’Connor for their advice and support.

about the authorSiobhán E. Walsh is a Children in Care Social Worker working in the Midwest. She has a keen interest in ethics in practice and human rights. She is a recent graduate of University College Masters in Social Work programme. She can be contacted at siobhanerica_walsh@hotmail.com.

ThE EvOLuTIOn Of sTAnDARDs In sOcIAL wORk pRAcTIcE: In search of the mIssIng lInk.By Barry higgins

introductionThe following statements are just some of the many concerns identified in the Report of the Independent Child Death Review Group in 2012 in relation to the care provided to some of the 196 children who had interacted with the child care system1:

‘Complete and total disregard for the fostering regulations’. ‘Children First guidelines were not followed’. ‘Very scant records’. ‘No care plan’. ‘Not acceptable practice in terms of children who are in the care of the state’. ‘Failure to ensure that there was professional support available’. ‘Complete lack of planning regarding this young person’s care’. ‘No comprehensive risk assessment’. ‘No evidence that there was any contact between the social worker and this young person’. ‘Level of case work recorded was poor’. ‘No direct engagement with this young person’. ‘No referral made’. ‘Allegation of physical abuse was not followed up’. ‘Failure to consider and provide for the welfare of this young person’. ‘Legal and child protection formalities were not adhered to’. ‘This young person was failed by a system designed to protect children’.

Concerns such as these are quite factually based, and one would be drawn to conclude that the social workers involved were practising in a negligent manner. Indeed, if a social worker is negligent, they should be held accountable. There is, however, a broader context that also deserves our consideration. This article analyses the work hours that are available to social work clients, and balances this against the standards of practice required2. The figures provided throughout this report are used judiciously and at times conservatively. They are based on experience, peer review, research and reports3.

1 Dr. Geoffrey Shannon and Norah Gibbons (2012) Report of the Independent Child Death Review Group. Government publications, Dublin. All of the cases, irrespective of cause of death, helped to inform the findings of ICDRG report.

2 Children First: National Guidance for the Protection and Welfare of Children; National Standards for the Protection and Welfare of Children for HSE Children and Family Services; National Standards for Foster Care; National Standards for Children’s Residential Centres; National Standards for Special Care Units; Child Care Act, 1991; Children Act 2001; Child Care (Placement of children with relatives) Regulations 1995; Child Care (Placement of children in Residential Care) Regulations 1995; Child Care (Placement of children in foster care) Regulations 1995; Code of Professional Conduct and Ethics for Social Workers Bye-Law 2011.

3 “Workload Management Data Analysis, January 2005, Area 7” (Social Information Systems Ltd.)

Work hours availableThere are 222 working days in a year when annual leave, public holidays and weekends are accounted for4. In-service training is an important component of agency policy, and three days per year is a conservative estimate of the expectations placed on social work staff. A further two days may be accounted for in terms of mandatory area and management meetings [Days remaining: 217]. With seven hours in a working day5, there are 1519 work hours per annum. When basic monthly commitments are deducted [Supervision & Team Meetings], there are 1464 work hours remaining6.

Administration is a massive component of the social work task (telephone calls, assessments, reports, care plans, forms, case notes, letters, referrals, emails, filing), and a social worker will engage in an average of 3½ hours of administrative duties per day7 [Work hours remaining: 704.58]. Most of these tasks are mandatory, as recognised in various standards and legal requirements. Office visits, professionals’ meetings, case conferences, strategy meetings, child-in-care reviews, access visits and various other meetings may account for anywhere between 3-6 hours per week; and up to twice this if in Court [Work hours remaining: 520.59]10. Travel time for all of the above comprises anything from 1-4 hours per week on average if a social worker uses their own vehicle, and anywhere up to twice this if reliant on public transport [Work hours remaining11: 428.512].

The values so far depict individual worked time, and it is important to acknowledge that social work is a team process. Certain tasks require co-working support; for example, joint home visits/meetings. In addition, peer support and debriefing are essential components when working with risk, abuse, anxiety, conflict and aggression13. Thirty minutes per day is a basic estimate for the above tasks [320 work hours remaining]14.

4 365 – 104 (weekends)= 261 – 29 (annual leave) = 232 – (9+1) (public hols +GF)= 222

5 Since July 2013, the working week has increased by 2 hours. The figures used in this report are based on pre July 2013 figures.

6 5 hrs per mth x 11 = 55

7 Some days, social workers will spend all their time on admin, or may spend a full day at meetings. 3½ hours is given as an average figure for admin over time.

8 3.5hrs x 217days = 759.5hrs; 1464hrs-759.5hrs= 704.5hrs [for 20 cases: 843 hrs; 1464 – 843 = 621]

9 4hrs x 46 wks (adjusted for leave) = 184hrs; 704.5hrs-184hrs= 520.5hrs [for 20 cases: 621 - (184+11%) = 417]

10 These are average figures, and a social worker may have days that a fully devoted to admin, or fully devoted to meetings etc.

11 Based on own vehicle use

12 2hrs x 46wks = 92 hrs; 520.5 – 92 = 428.5 [for 20 cases: 417 – (92+11%) = 315]

13 There are of course very many pleasurable moments in social work, however, the emotional states listed must be acknowledged in the context of the need for peer support.

14 30mins x 217 days = 108.5hrs; 428.5 – 108.5 = 320 [for 20 cases: 315 – 108.5 = 206.5)

case PrioritisationWith a caseload of eighteen, the average direct contact time available for children and families is one-and-a-half hours per month15. The reality, however, is that time is not spread evenly between each family on a caseload. Cases are typically categorised as high, medium or low priority; the level being determined by the nature of the risk and the complexity of family need (mental health issues, addiction, deprivation etc). A social worker may have an average of four high priority, ten medium and four low priority cases. All eighteen cases will have met the threshold for social work intervention; where a child’s welfare or safety has been impacted; often by neglect, and/or physical, emotional or sexual abuse. High priority cases may involve, for example, teenagers with high-risk behaviours; children exhibiting sexualised, aggressive or self-harming behaviours; or children at imminent risk of abuse or neglect. It may take several months of intensive work to stabilise a child/family situation such as this. When they have stabilised, these cases are often re-classified as medium priority. Low priority cases are often characterised by ‘welfare’ issues; where parents may be struggling to manage, or where family stressors are a cause of significant distress to a child.

With the introduction of DRM in some areas (Differential Response Model), many of the low priority ‘welfare’ cases are now being re-directed away from social work departments, and towards community support services. This model has a lot of merit, though in order to be effective, the necessary community resources must be in place. With the move to registration and greater accountability, public safeguards may also need to be extended to clients of DRM, as the workers who engage directly with these families are not necessarily social workers, and are not, therefore, accountable to the public under the Code of Professional Conduct and Ethics for Social Workers Bye-Law 201116. Whilst DRM may result in an improved service for the low priority cases referred to it, it does not necessarily follow, however, that there is a corresponding improvement in service for the remaining families on a social worker’s caseload. On the contrary, many social workers are now required to carry a higher proportion of high and medium priority cases.

At any given time, four to six cases will usually require significant and immediate intervention. Most clients move through cycles of crises, and a social worker has to prioritise these families on an ongoing basis. If just four of these cases required one hour of direct contact per week, or if some of this time was spent on tasks, over and above those already accounted for, this would leave

15 320hrs / 12mths = 26.66 hrs per month total client time. For 18cases = 1.48 hours per client per month [for 20 cases: 206.5 / 12mths = 17.2 hrs per month total client time = .86 hrs per month, 51.6 mins]

16 They may at some level be supervised by a social work practitioner; however frontline workers will only be accountable under the 2011 Code if they are registered social workers.

approximately eleven minutes per week for the remaining 14 families on a caseload of 1817.

This may not be an issue for some families, who may not require intervention on a monthly basis. The difficulty arises, however, when the pattern is repeated month after month. As a result of more urgent cases, some of the medium and low priority cases are routinely de-prioritised; and some families can drift for long periods of time without receiving any service. Some families will not complain; they may not want social work involvement, and may not, therefore, be demanding that standards be met. Other clients do want a service, particularly children; and some are let down.

When a case has been de-prioritised repeatedly, these clients may receive a brief intervention; just enough to ensure that no major crisis is occurring. This, however, is more to do with monitoring risk than responding to it, let alone pre-empting or preventing it. Often a social worker will experience considerable relief when they finally make contact with a family, when they learn that no one has been hurt; or worse. There is now a ‘clean slate’ in terms of the child’s safety, and the family may be deprioritised again. Allied professionals (GPs, teachers etc) can become frustrated with social workers in situations like this, where no real intervention seems to be taking place.

missing link 1: Vulnerable children and families are legally entitled to have their needs met, though seldom have the motivation, desire or capacity to demand their rights in this regard. Ensuring theses rights needs to be service led, and as such, an outcomes approach must be incorporated into regular case load reviews to ensure that clients are receiving an adequate service.

The estimates of time used so far, derive from an analysis of the time spent on cases that have been worked, i.e. the higher priority cases. As such, they are not an indicator of the time required to complete all core tasks for every family on a caseload18; which would be significantly higher. Indeed, a 2005 consultancy report on the child and family service in Dublin North observed that “for many staff a handful of clients can occupy significant proportions of time”. This observation was followed with a question: “Does this mean that workers have many cases on their caseload that they have not been able to do much work with?” 19 Unfortunately, the report does not provide an answer to this question.

case load allocation Process The figure of eighteen cases per social worker derives more from the number of children requiring allocation, than it does

17 26.66 hrs per mth for all cases – 16 hours [4 cases x 4hrs per month] = 10.66hrs / 4wks = 2.66 / 14 cases = .19 = 11.42mins

18 Travel time, for example, is only allowed in these calculations for the visits carried out on the cases actively being worked, and does not, therefore, allow for the time that would be required to carry out home visits to all clients on a case load.

19 “Workload Management Data Analysis, January 2005, Area 7” (Social Information Systems Ltd.)

from the number to whom a service can be provided. In 2006, fifteen was widely regarded as an average caseload. From the corporate point of view, the organisation may look good when cases are allocated; and to a degree, it is a legitimate attempt to mitigate the risk to as many children as possible within the resources available.

However, with each additional case allocated, there is a subtle effect that occurs, which impacts on a social worker’s capacity to respond to all the families on their caseload. By separating out the social work role in terms of (i) core tasks, and (ii) direct contact; it becomes apparent that with each additional case allocated, the quantity of core tasks increases, while the remaining time available for clients is not only reduced, but is also divided between a greater number of families.

missing link 2: With each additional case, the average contact time available per family decreases exponentially. It does not therefore follow, that by allocating a case, a child is safer.

To illustrate this point, if a caseload were to increase from eighteen to twenty, using the above figures, the average direct contact time per month would be reduced from 90 minutes to 56 minutes per family20. In this calculation, an increase of just two cases reduces the time available to clients by almost a half. This steep reduction begins as soon as case number two is allocated, and it may go some way to help understand the challenges that social workers experience as their caseloads increase, where often times social workers are left bewildered by the fact that they can’t get to what are basic tasks.

additional tasksTime is a finite resource in any given year. It is therefore essential to recognise the impact of additional management/agency requirements on the time remaining for clients. Management requests are normally issued with priority status (i.e. they are not optional and have clear timeframes attached). These may include such matters as: duty systems; statistic requests; file audits; discussion documents; reading and implementing new policies and procedures; or the implementation of action plans. Some management tasks are also optional-but-essential agency functions, for example, participation on committees, or ‘acting-up’ for a Team Leader whilst carrying existing caseloads. These tasks may seem quite reasonable when taken in isolation; indeed, there may be very reasonable notice provided in terms of these expectations. However, whilst the impact of these tasks may be imperceptible on a day-to-day basis, it must be recognised that there is a very real impact on clients in any given period.

20 An additional two cases will increase the administrative tasks, meetings and travel times by 11%, while the time remaining for clients is reduced by 11%, due to the larger number of cases.

missing link 3: Each additional management/agency task takes time away from existing core social work functions.

Some policy decisions can have similar effect. Coinciding with the transition to the new Child and Family Support Agency, it seems that some social work departments face corporate re-location from their community based Health Service Executive (HSE) premises. An example may be seen where plans have been progressed to relocate all social workers in Dublin North City from their HSE community based centres, to a single office complex. Such cost saving measures are often justified on the basis of ‘synergies’ they will purportedly produce. However, the reality on the ground is that social workers will be further removed from the families they serve. The increase in commuting time, for example, will result in less time available for the client.

missing link 4: Strategic change does not always acknowledge the impact on clients. All policy decisions should be child and family proofed in order to ensure that any new policies do not have an adverse impact on the safety and welfare of children. Such a proofing mechanism would require an independent appeals process.

dutyOne of the additional tasks referred to above, the ‘duty system’, is a management response to long waiting lists and shortage of staffing. In addition to their allocated caseloads, social workers are often expected to work one week in every X number of weeks with families who are on the waiting list. In the absence of resources, this may seem like an inspired way to manage risk, though it has to be realised that there is a cost to the clients on the social worker’s caseload. If a social worker is required to work one week in every four months on duty, the average contact time available per family is now just 60 minutes per month on a caseload of 18 and 25 minutes per month on a caseload of 2021.

As noted already, however, time is not spread evenly across a caseload. To return to the scenario where just four families are in active crisis and require significant and immediate intervention, there is now just 2 minutes contact time remaining for each of the other 14 families per week22.

The scenarios discussed above are not exhaustive, and other local arrangements can include, for example, the questionably named ‘buddy system’, wherein a social worker is paired with a colleague, and each is tasked with responding to any emergencies on the other’s caseload when their ‘buddy’ is not available due to leave etc. This is a significant additional level of responsibility, and further reduces the time available to one’s own allocated clients.

21 320hrs per year – (35 x 3) = 215 / 12 / 18 = 60 mins [for 20 cases: 206.5 – (35 x 3) = 101.5 / 12/ 20 = 25mins]

22 215 hrs p.a./ 12 = 17.92 hr p.m. – (4 cases x 1hr x 4 wks) = 1.92hrs / 14 cases = .137 = 8.22mins / 4 = 2mins 5 seconds.

imPact oF high caseloadsEven if they aren’t in a position to respond, social workers are not permitted to refuse cases, return cases, or refuse tasks. The process, however, is slightly more disquieting than that. The pressure in the system has created a situation where social workers are told that there is enough time to meet all the requirements; that they just need to manage their time better and prioritise. They will be told that everyone else has the same number of cases, or that some people actually have more23. They may be told that additional expectations are just for a short time; that they will be reviewed; that it’s about sharing the responsibility or assisting colleagues; or the most emotive reason of all, responding to children at risk.

Many social workers become ill with the sheer stress and nausea of the unachievable expectations placed upon them. They are responsible and accountable for ensuring the safety and wellbeing of vulnerable children; some of whom they don’t have the time to see. They are responsible for mandatory tasks that they do not have the time to complete. If a social worker takes five days sick leave in any given year (whilst also working a duty system), there is now just 15 hours available to allocate to the four priority cases per month, with zero contact hours available for the remaining 14 families24. Significant overtime is regularly worked in order to complete essential tasks. When overtime is recouped, however, the situation returns to the way it was, and can only be accounted for in terms of core tasks not being completed25. Furthermore, if a family refuses to engage, or is not at home when the social worker calls, that is their allocated contact time gone for that month. There is no more time available; not unless it is taken from someone or something else. It is perhaps not surprising then, that ‘the evidence shows that children are not being adequately included in child protection work. A persistent criticism in reports of inquiries and reviews into child deaths is that people did not speak to the children enough’26. If a social worker chooses to prioritise seeing their clients, then the time must be taken from some other core and mandatory task.

In the UK, Professor Munro’s Final Report on child protection (May 2011) stressed the importance of professional relationships in improving outcomes for families27; and the International Federation of Social Workers (2010) states that social workers should spend

23 See Higgins, B. ‘Caseload Management and Battered Worker Syndrome’, Irish Social Worker, Summer 2010

24 215 hrs – 35 hrs = 180 hrs p.a. /12 = 15 hrs per month.

25 Notwithstanding the enormity of the administrative task, the average number of administrative staff to social workers is probably in the order of one administrative staff to every 15 social workers. These administrative staff are similarly overwhelmed by the tasks facing them.

26 The Munro Review of Child Protection, Interim Report: The Child’s Journey, February 2011, P.39

27 The Munro Review of Child Protection: Final Report: A Child-Centered System, Professor Eileen Munro, May 2011

70% of their time in direct work with clients28. For a caseload of 18, this would equate to 5 hours per family per month29. If the current time available was spread evenly across all 18 families [which it is not], social workers would still only be achieving just over one third of this (one fifth if working a duty system).

missing link 5: It is through the relationship with clients that trust is built, knowledge formed, and positive change effected. By increasing the direct contact time over a sustained period, the likelihood of positive outcomes increases. By contrast, high case numbers, which result in a fire-fighting approach, are less likely to achieve sustainable change.

the ‘r’ WordIf we truly want to safeguard children at risk in the community, it is essential that we understand and respond to the resource issue fully. In 2006-7, Norway and the State of Queensland, Australia, had similar population sizes to Ireland in 2011, with similar numbers of child protection referrals and children in care (Healy & Oltedal, 2010)30. Norway had 3,040 staff in front-line child welfare services, and an additional 3,333 workers in 26 regional response and consultation teams (Ibid). In Queensland, there were 1,585 workers employed in its child protection and family support services (Ibid). Ireland, by contrast, has an estimated 860 child welfare and protection social workers31.

To compound matters further, there has been a 10.5% rise in the 0-17 population in Ireland since 200632; and during this period, the total number of welfare reports has risen by 24.3%,33 while the number of child protection reports has increased by 51.3%34. Notwithstanding exemptions under recruitment embargos, and assurances of additional social workers following the Ryan Report, many social work teams are currently running seriously

28 Children and Families Special Interest Group/IASW, A Call for Change Discussion Document, 2011, P.7

29 222 working days = 1554 hrs per annum. 70% of 1554 hrs per annum = 1088 hrs / 12mths / 18 cases= 5.03

30 Healy & Oltedal, 2010: 226, cited in Burns, K. & Christie, A. ‘Employment mobility or turnover? An analysis of child welfare and protection employee retention’, in Children and Youth Services Review 35 (2013) 340-346.

31 Burns and Christie provide this estimate in their 2013 paper, noting: “This is an approximate number as the HSE was unable to provide the authors with the number of social workers working in child welfare and protection in Ireland.” (‘Employment mobility or turnover? An analysis of child welfare and protection employee retention’ in Children and Youth Services Review 35 (2013) 340-346.)

32 The 0-17 population increased from 1,036,034 in 2006 to 1,148,687 in 2011; Central Statistics Office (CSO 2012a). Profile 2: Older and Younger.

33 From 12,715 to 15,808

34 From 10,453 to 15,818

below capacity; with maternity35 and other posts not being filled. This is a reality that HIQA has identified, time and again: “Overall, the LHA did not have the resources to ensure that all children were placed with foster carers who had the capacity to meet their needs” (2013).36

The current economic climate adds pseudo-legitimacy to the ‘working within resources’ mantra; however, even when the economy was booming, standards were not being met. Then, as now, the focus has been on restructuring, reconfiguring and reforming. That is not to say that review and reform37 are unnecessary; indeed there have been many improvements made as a result. However, by focusing exclusively on reform, attention is deflected away from the agency in terms of its clear responsibility under the Child Care Act 1991,38 to ensure that it meets the needs of vulnerable children and families.

This requirement is not qualified in terms of the resources available; indeed, resources are not mentioned anywhere in this legislation. Notwithstanding this, the HSE has often made qualified commitments to address deficiencies: “Dublin North West is committed to ensuring in line with best practice that all foster carers are reviewed in accordance with the standards within the resources available”; “Dublin North West is committed to fulfilling its statutory obligation that all foster care households are assigned a link social worker within the resources available.”39 It is quite astounding that the HSE can qualify its legal responsibilities in this manner; and more so that HIQA accepts these qualifications.

missing link 6: In order to safeguard children and families, in line with the Standards of Practice, we have to accept that significant additional resources are required, and we have to ensure they are put in place.

The reality on the ground is that standards are not being met in direct proportion to the lack of resources. This has been masked to a considerable degree, at both micro and macro level. The former has been outlined above, in terms of the over-allocation of cases. The latter is evident in terms of the periodic movement and re-organisation of resources, in a ‘robbing Peter to pay Paul’ manner. This turns the Standards into a moving target; and makes it

35 With regard to maternity leave cover, if one were to infer a policy from practice, it would be to sit it out and wait for the worker to return. This places the cost of covering maternity leave on vulnerable clients, rather than on the agency which has the responsibility to meet client needs.

36 HIQA: 21/2/13 Report on the Inspection of the HSE Dublin North West Local Health Area Fostering Service, in the HSE Dublin North East Region

37 This includes professional training, where the focus may be placed on providing social workers with training in order to ensure that they respond appropriately.

38 Sect 3(1): “It shall be a function of every health board to promote the welfare of children in its area who are not receiving adequate care and protection”

39 HIQA: 21/2/13 Report on the Inspection of the HSE Dublin North West Local Health Area Fostering Service, in the HSE Dublin North East Region

increasingly difficult to get a true sense of the extent of the resource issue. Elements of this approach are evident in HIQA’s 2013 inspection report, wherein it observes that “116 children in foster care (32%) had only been assigned a designated social worker three weeks prior to inspection.” 40 HIQA’s reports provide a snapshot of just one aspect of the child protection service at a time. It does not, however, identify the other parts of the service that may be de-prioritised as a result; nor does it identify the capacity of these social workers to respond to these children’s needs.

The frightening thing about the majority of HIQA inspections of social work services is that they are generally announced inspections. Time has been afforded to focus existing minimal resources on certain checkbox items, sometimes at the expense of other areas. Significant overtime is frequently worked in advance of inspections, however, this time has to be recouped. The snapshot presented to HIQA, which still falls short, is often a prepared and polished version of the day to day reality.

illusion, delusion and disillusionWe have become so accustomed to the smoke and mirrors, that it’s very difficult to penetrate the blinkered reform and perform illusion. Rather than address the issue of resources, social workers are instead advised on how better to organise their time, their assessments, and their case notes etc., or required to attend training on such matters as understanding neglect. This is notwithstanding the fact that social workers are often highly skilled, and, out of necessity, highly efficient.

The cracks continue to spread; and they are not the type that let the light in. In this regard, it seems that a lack of trust has developed within the Court system, wherein Guardian ad Litems (GALs) are being appointed with greater frequency. This is currently a growth industry, with many social workers leaving the HSE to become GALs. In many ways, a social worker’s job is similar to that of a GAL; a key difference being, however, that a GAL has the autonomy to identify what a child needs, irrespective of whether the resources exist41. A social worker, by contrast, can only seek to meet a child’s needs within the resources available.

This has created a vicious circle that has spiralled out of control. Because the resource issue has not been sufficiently addressed, millions and millions of euro is being taken from the child care budget to pay legal and GAL fees, which might otherwise be spent on improving services for children and families. The problem is not with the GALs or the legal system – they are protecting and ensuring the rights of the children who come to their attention.

40 HIQA, 14/2/2013, Inspection of the HSE Dublin North West Local Health Area Fostering Service in the HSE Dublin North East Region

41 They are not, however, charged with the task of meeting these needs – this is the social worker’s role.

missing link 7: Trust in the system will only be earned if the system is adequately resourced. In this regard, the onus is on the new Child and Family Support Agency to restore confidence in the system.

This has created a two-tier system, where children before the Courts are likely to receive a prioritised service over those who are not. This may also be the case where a child requires specialist services, or indeed, a service which is not considered an entitlement, such as Aftercare. The impact of under-resourcing is also evident in the area of fostering, where the lack of sufficient social workers has meant that the HSE cannot recruit sufficient foster carers to meet the need for placements. This is one of the main reasons for the massive growth in private fostering agencies in recent years. These services are generally of excellent quality, though come at a considerable cost42.

The lack of fostering resources has a serious impact in terms of some children being left in unsuitable placements; children being placed outside of their communities (indeed, sometimes outside of their county); and unnecessary placement moves, where financial approval for private foster care is generally only granted for short-term placements (exceptions to this may include cases before the Court)43.

missing link 8: There are no real consequences to the HSE as an agency, where it fails to meet the necessary standards to ensure the safety and wellbeing of children and families.

HIQA have the authority to close a hospital or a residential home; however, in the case of child protection, there is no alternative service that people can be referred to. In terms of ensuring compliance with the standards, HIQA are quite limited in terms of the consequences at their disposal. They also seem sensitive to the fact that, more often than not, social workers are not practising in a negligent manner, even where standards have not been met44. Only when there are real and significant consequences for the agency, will sufficient resources

42 Private fostering agencies would undoubtedly argue that they provide good value for the money they charge; and in many circumstances they do. In terms of budgets, however, the cost represents a significant addition to the agency’s current expenditure.

43 Any potential foster carer recruitment campaigns need to be backed up with the necessary additional social workers to assess, train and support any new applicants they hope to secure. Otherwise other mandatory aspects of the service will suffer, or applicants will remain on a waiting list for assessment.

44 Where a social worker is negligent, this would undoubtedly be identified and addressed by HIQA.

be assured to meet the standards of care required45. Now with compulsory registration, there is a very real possibility that the impact of under-resourcing may be transferred onto the individual social work practitioner. Indeed, social workers are the only level within the organisation that are directly accountable to the public, through CORU. The agency itself shows little liability. Senior managers, who hold responsibility for determining how resources are used, both in general and in individual cases, are not accountable to the public for the decisions they make.

Post-registration social WorkRegardless as to the number of cases allocated, a social worker may now face legal sanction if they do not adhere to the standards of care required by the Code of Professional Conduct and Ethics for Social Workers Bye-Law 201146. This places social workers in a bind, as the Agency’s approach to managing risk requires it to allocate as many cases as possible. The Agency has a duty to all children in need, and as such, its independence in terms of determining appropriate caseloads may be compromised. If a social worker retains a case that they are unable to work, they may be held in breach of the Code for failing to provide a service to that family.

To this end, any assurance that a social worker might receive from their employer, in terms of safeguarding their professional accountability, may not be worth the paper it’s written on (if written at all). The law is very clear on the matter of standards; and no agency or social worker has the authority to pick and choose which parts of the Code they will adhere to. Any commitments to introduce standardised caseload ‘weighting’ systems will have to ensure that the mechanism is responsive to changes within a caseload, and is fully calibrated to the expectations of the Code and the relevant Standards. Otherwise, it may simply result in a new tool for validating excessive caseloads.

Section 7(d) of the Code may provide social workers with some leverage in this regard, wherein it states: “If there is a conflict between this Code of Professional Conduct and Ethics and a registrant’s work environment, the registrant’s obligation is to the Code”. This may give social workers some degree of legal authority to prioritise their clients’ needs over those of the organisation. However, there is no mechanism by which a social worker can proactively invoke this authority; and any attempts to refuse or return excessive cases may result in disciplinary

45 It would be counterproductive to directly impose financial penalties on the HSE/Child and Family Support Agency, as like the situation with GALs, there would be even less resources available for services. However, if the Department of Finance, for example, were to face steep financial sanction for the failings of the Department of Children’s ‘Child and Family Support Agency’, there may be greater impetus to ensure that the requisite resources are made available to safeguard and support children and families.

46 From 31/5/13, all social workers in Ireland must now be registered with CORU, the agency responsible for protecting the public by regulating health and social care professionals.

procedures against a social worker. As such, a social worker may have few options but to draw on existing policies, however effective, in order to address matters such as excessive caseloads (e.g. grievance procedure). Such action on the part of a social worker could result in clients being returned to the waiting list, and whilst this would be unpalatable, for some of these families it may increase their likelihood of receiving a service, as their needs can be seen, identified and responded to.

missing link 9: Independent child and family social work monitors are required, with the authority and independence to adjudicate on caseload numbers, irrespective of any competing agency pressures47.

conclusionThe real cost to clients is not always considered when applying a business model to social services; and significantly, the impact of resource deficits are not easily demonstrable on a day-to-day basis. Time is often considered open-ended, infinite; and there is a general perception that by continuous prioritisation, all tasks will be completed. This could only be true if the tasks themselves were finite. However, as soon one case in crisis is managed, there is another waiting to take its place; if not from the social worker’s current caseload, then from the waiting list. Indeed, social workers are often left feeling disillusioned when they see the number of tasks that they haven’t managed to respond to in any given month; notwithstanding everything they may have achieved. No social worker enters into child and family work to neglect vulnerable children. The fact that this happens, as evidenced in many reports, is equally likely to be an issue of resources as it is to be one of negligent practice.

missing link 10: Any enquiry, review or report into the care that a client receives from a social work service, must consider the context in which the practitioner was working48. To neglect this dimension is possibly to neglect a key contributory factor to the outcomes being investigated; and therefore to overlook the correct response required to improve practice and prevent malpractice.

For social workers, it is a juggling game, and the more balls that are in the air, the greater the risk of some of them falling. On the ground, the situation is like giving an assembly line worker clear guidance regarding quality and safety; whilst at the same time turning up the speed of the conveyor belt. Just as you begin one task, there’s something new in front of you, demanding your undivided attention. The core difference, however, is that social

47 To this end, it would be essential to ensure that caseloads remain static for sufficient time to offer clients a service. Otherwise there is a risk that clients will be allocated and de-allocated, revolving door style, in response to the agency’s need to prioritise the most pressing cases as a result of insufficient resources.

48 Caseload numbers, priority cases, miscellaneous duties etc.

work clients are people, not products, and they are entitled to be treated in accordance with the Standards and laws prescribed.

Whilst standards are essential, they won’t in themselves ensure outcomes. At the Agency level, the situation is akin to having 25 vaccines to inoculate a target population of 100+ children. The current approach has been to dilute the vaccine in the hope of protecting as many children as possible within the resources available. This, however, reduces the vaccine’s effectiveness; and there are still some children who don’t receive an injection. Under the new regulations, these vaccines can no longer be watered down. In the absence of any additional resources, an alternative response might be to reduce the target population. This is where DRM comes in. This has the effect of reducing the 100+ target population, by sending 25 children to receive a ‘differential’ vaccine; one which is not regulated by the Medicines Board.

The only other pragmatic response might be to increase the hours in a social worker’s week. This has recently been achieved through the Haddington Road Agreement, yielding almost three extra weeks work from every social worker. This is notwithstanding the fact that most social workers are already working well in excess of their weekly requirement, in a job that requires stringent work-life balance boundaries due to the high personal impact of the work. Burn-out levels are high, which may account for the relatively high turnover of social workers in some areas. Sometimes the pressure and risk level is so high, that the only safeguard for social workers has been to avail of sick leave, or to transfer to another area or team.

With professional registration complete, standards of care have become non-negotiable. In the absence of the necessary resources from the State, the unintended consequence of this may be significantly higher numbers of vulnerable children returning to the waiting list. Through the Code, Social workers are now the legal custodians of the Standards, and they must ensure that their professionally registered name is only permitted to be used for cases where they have the capacity to respond. To this end, social workers need to develop a new language; a new way of defining their limits, in order to be able to meet their commitments.

To return to the opening statements, it seems apt to acknowledge that most social workers enter into child protection work with the aspiration that they will make a difference in children’s lives. More often than not, and against a backdrop of considerable resource deficits, social workers, in partnership with allied services49, have managed to keep the overwhelming majority of children safe. It is also the case that many standards have not been met along the way, and in many regrettable circumstances, children and young people, who were previously known to the child care system, have died.

49 Such as GPs, Gardaí, schools, crèches, PHNs, mental health services, parenting programmes, addiction support services, home help, family support, pre-school and after-school clubs, and a vast array of highly committed community services.

The Child and Family Services have evolved to this point for a reason – as a society, we believe that children and families should receive a minimum standard of care. This evolution has taken place in principle, though has yet to be effected in practice. The standards of care cannot be achieved with just one loaf and fish; and social workers are fresh out of miracles on the ground. If the resource issue is permitted to remain a ‘no go’ area, what is really being said is that the safety and well-being of children and families is valued only in theory, and not in practice. If this is permitted, we will all have to take our share of the responsibility for each HIQA report that exposes deficits, every inquiry that highlights deficiencies, and any future Child Death Review Group that reports on deaths.

author’s note:This article is written in the spirit expressed by the current Minister for Children, and the CEO designate of the new Child and Family Support Agency, who have both advocated open and honest acknowledgement of the issues and challenges facing the system. In order to respond effectively to these challenges, it is important to have a thorough understanding of the system. I hope this paper will add to a greater understanding of the challenges facing social work practice, in the hope that the very real needs of vulnerable children and families may be more accurately understood, identified and responded to.

This article necessarily focuses on child and family social work practice, and there is not sufficient scope to explore the very real challenges facing fostering social workers, Team Leaders, Principal Social Workers, Area Managers, CEOs, or indeed clients. All of these people work immensely hard, in what are very trying circumstances. In addition, social work client groups may vary from region to region; particularly with regard to areas of disadvantage, and as such, some issues may be more or less relevant as a result.

Whilst respecting their anonymity, the author would like to express deep gratitude to those who offered assistance and feedback with this report; any errors or omissions remain the sole responsibility of the author. Indeed, errors are certainly possibly in terms of the mathematics used throughout this report. In such event – and whilst not seeking to escape culpability – I proffer that the paper is written in good faith, in an attempt to capture some of the subtle, dynamic and elusive qualities of child and family social work practice; aspects of which are highly relevant in terms of identifying the correct response to ensure positive outcomes for vulnerable children and families. The author would very much welcome any feedback/contributions which may clarify matters further.

about the author:Barry Higgins is the current Chair of the Children and Family Special Interest Group of the Irish Association of Social Workers.

Feedback, comment or debate in relation to the opinions expressed in this article may be posted on the IASW Facebook page.

strengths-based aPProaches in assessment PracticeBy Patrick Clifford and Briege Casey

‘The fundamental premise is that individuals will do better in the long run when they are helped to identify, recognise, and use the strengths and resources available in themselves and their environment’ (Graybeal, 2001)

Concepts such as building a good therapeutic relationship (O’Farrell, 2006) and using core conditions (Rogers, 1958) are commonly included in training programmes for those who work as helpers in the caring professions. In addition, evidenced based strategies and techniques such as motivational interviewing (Miller and Rollnick, 2002), strengths-based approaches (Cowger, 1994. Graybeal, 2001), solution-focussed approaches (Sharry, 2001, deShazer, 1988) and many other interventions have been adopted from modern psychology for use in a range of helping relationships. This paper focuses on the use of strengths based approaches when working with people who are homeless and argues that that the practice of identifying and maximising clients’ strengths are central to the helping relationship. However, this paper also posits that the assessment and support planning tools currently used by many service providers in this sector do not sufficiently embrace strengths-based approaches. While there are many useful assessment and support planning initiatives in evidence, this paper argues that the current assessment process places too great an emphasis on clients’ problems and deficiencies and therefore may inadvertently reinforce the powerlessness of the client. With reference to a case study, personal workplace experiences and evidenced-based research, the paper will outline limitations in the current assessment and support planning process and present additional interventions which may better facilitate client empowerment.

An increasing amount of research points to the benefits of adopting a strengths perspective which acknowledges the unique skills and abilities of persons who do not fit neatly into categories and who create solutions where none previously seemed possible (Graybeal, 2001). Hill (2008 p107) states that focussing on clients’ strengths is at the very core of social work values; claiming that “Social Workers are ethically bound to enhance the capacity of people to address their own needs.” Min (2011) proposes that a client-centred integrative approach is essential to assist clients in making full use of their strengths and resources, and to cope better with and overcome their problems. Saleebey (2009) asserts that the strengths-based perspective is not only good basic social work practice but that interventions based on uncovering peoples’ goals and strengths affirm the right to self-determination and the wellbeing of homeless individuals.

While these authors promote the benefits of a strengths-based perspective, researchers also argue that deficit-based assessment practices provide obstacles to client empowerment and can generate an unequal power balance in the client-helper relationship. Cowger (1994) claims that much of social work assessment literature including assessment instruments is overwhelmingly concerned with individual inadequacies. Similarly, Hill (2008) warns against a problem-centred approach which often arises from a needs assessment and is evaluated on its successes in addressing social problems. Weick and Chamberlain (1997) believe that if the social worker focuses on the client’s problems, he/she may neglect the client’s strengths and former success in rallying against these problems.

There exists the potential that the client may be participating in the assessment on a very stressful day, possibly even experiencing hunger, a trauma, or any one of a host of negative emotions. In addition, the client may never have sought any help before and be feeling shame or guilt for even having to ask for help. In such an instance, Graybeal (2001) asserts that the questions the practitioner asks are critical. A set of questions therefore that exclusively focuses on issues, behaviours and experiences which collectively combined to place a person on a journey to homelessness, may “reinforce the worst of external conditions and internal experience” (Graybeal, 2001 p240).

As an example of a client whose life experiences and strengths were not and could not be uncovered within the confined framework of our present assessment and support planning structures, we would like to present the case of ‘Ellen’, a 29 year old mother of two children, both now in foster care. Ellen presented for supported temporary accommodation and her assessment documents had recently been completed at another service. The section on mental health revealed that Ellen sometimes experienced suicide ideation and she continued to suffer from depression, often triggered by memories of being abused as a child by a member of her extended family. The drug use assessment disclosed that Ellen had struggled with polydrug use for many years. Ellen was now somewhat stable but on relatively high doses of methadone. Ellen had experienced a long term relationship with an abusive partner which was now over. This period resulted in isolation for Ellen as she lost not only her children, but contact with most of her siblings and significant friends. The completed formal assessment also revealed that Ellen was feeling very low and was being prescribed anti-anxiety medication from her clinic doctor. Ellen had not seen either of her two daughters for over a year having lost supervised access visits due to a chaotic lifestyle and inconsistent attendance.

This rather bleak picture told only part of Ellen’s story. During subsequent keyworking, it emerged that Ellen is the second oldest child in a large family. When her mother died, Ellen and her older brother were thrust prematurely into parental roles due to her father not coping. This situation endured for some years thanks to

Ellen’s strengths and skill set with the result that her two youngest siblings often referred to her as their “Mam”. Ellen also talked with some pride about managing to run and maintain a household with her two daughters for four years despite the presence of a violent and unstable partner.

Though the additional information came to light in the course of contact between client and keyworker, it is the contention of this paper that knowledge of this kind should be gained more readily and consistently from homeless clients. Though solution-focussed questions (deShazer, 1988) are seen as an effective strategy within the therapeutic relationship, there are many instances where this method of eliciting client’s strengths can be incorporated into assessment frameworks and processes. Through the introduction of carefully selected solution-focussed type questions into appropriate sections of formal assessment documents, the strength and resources of the client can be brought directly into the language of the client’s support plan.

A useful resource for guidance on incorporating strengths-based approaches into the assessment process is the Additional Assessment Information from a Strengths Perspective (Graybeal 2001). In this document, Graybeal demonstrates how traditional needs assessment can be transformed through the inclusion of additional information derived from using solution-focussed interviewing. For example, a practitioner gathering information on a client’s problem history can combat what Graybeal (ibid) calls “the relentless pursuit of pathology” (p235) by asking “exception questions” such as ‘When was the problem not happening?’ or “miracle questions” (deShazer, 1988) that can help provide for the client and helper a vision for when the problem is solved. Similarly, while current assessment protocols regarding the substance abuse history of a client will often collate information regarding patterns of use, drug habits, drug choices and consequences of use, a helper utilising a strengths-based approach might include questions that would uncover and explore periods when the client used less substances or enjoyed periods of abstinence. By using such techniques, the narrative of the assessment is expanded and the additional information can provide options, possibilities and solutions hitherto obscured by the narrow focus of traditional assessment approaches.

This paper does not advocate for wholesale abandonment of our current models of assessment. McMillen, Morris and Sherradan (2004) argue that the best social work practice has always maintained a dual focus on both problems and capacity building. It should be acknowledged also that some current models of assessment appear to value client collaboration and a strengths perspective with regard to assessment and support planning. For example, many assessment questions require clients to respond with quite comprehensive answers and helpers are instructed to document clients’ own responses. Contemporary assessment tools also facilitate clients’ aspirations

in questions that for example, discover which family members the client would like included in their housing plans, or which supports they might require in the future. Similarly, questions such as those that seek clients’ preferences for future employment and training, and sections that prompt discussions on supportive family relationships are congruent to strength-based principles. Therefore, despite the shortcomings of the assessment and support planning structures that are discussed in this paper, it would seem then that the concepts of client empowerment and collaboration underpin most holistic frameworks in contemporary practice.

The primary concern of this paper is the level of attention paid by the assessment tools to the strengths and resources of homeless clients. This paper argues that while most holistic assessment tools may allow opportunities for client collaboration and empowerment, many fail to incorporate sufficiently a strengths-based approach. Consequently, the assessment process may cause helpers to overlook their clients as people with strengths, talents, and a capacity to contribute effectively to improving their situation. Such omissions can hinder a helper in partnering a client and can stifle the energy of the client at the formation of their support plan. In order to address these shortcomings, this paper has proposed that solution-focussed questions be incorporated into assessment literature. Graybeal (2001) posits that assessments should include meaningful questions that seek to discover hidden strengths or hold the seeds of solutions to problems previously seen as insurmountable

This paper acknowledges the ways in which practitioners and helpers across the entire sphere of social work have benefited from the adoption of evidenced-based strategies and techniques. Helpers to homeless individuals owe much to the valuable knowledge and insights that have emerged. Nevertheless, practitioners often experience feelings of dismay when welcoming familiar faces time and time again. For those who have been homeless for an extended period of time, the goal of breaking the cycle of homelessness is daunting. It is the contention of this paper that a strengths-based approach is crucial in homeless settings because it can engender hope while tapping into the client’s potential. This paper has acknowledged that noteworthy initiatives are occurring in strengths-based support planning practices. Nevertheless, the paper asserts that the methods currently used for assessing clients contexts and for recording client goals/support planning is almost exclusively problem saturated; a collection of needs to be addressed and not a comprehensive reflection of an individual with capacity and strengths. The solution-focussed questions proposed in this paper (Graybeal, 2001) represent an additional option that can aid solution-focussed workers in their assessment practice.

reFerencesCowger, C.(1994), ‘Assessing client strengths: clinical assessment for client empowerment’, Social Work, 39, 3, pp. 262-268, CINAHL Plus with Full Text, EBSCOhost, viewed 9 January 2013.

deShazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: W.W. Norton.

Graybeal, C., (2001). Strength-Based Social Work Assessment: Transforming the Dominant Paradigm. Families in Society: Journal of Contemporary Human Services. 82 (3).

Hill, K., (2008). A Strength-Based Framework for Social Policy: Barriers and Possibilities. Journal of Policy Practice, 7 2-3, 106-121.

McMillen, J.C., Morris, L., & Sherradan, M. (2004). Ending Social Work’s Grudge Match: Problems versus Strengths. Families in Society: The Journal of Contemporary Social Services [Online]http://www.casbrant.ca/files/upload/roundtable08/Day2/1_ Agency _ Updates_Contd/Section_7_-_Ottawa/Additions/Ending_Social_ Work%27s _ Grudge_Match,_Problems_Versus_Strengths,_MCMillen,_Morris,_Sheraden.pdf Downloaded 16th January, 2013.

Miller, W.R., & Rollnick, S. (2002). Motivational Interviewing: Preparing People for Change. Guilford Press. New York.

Min, T., (2011). The Client-Centred Integrative Strenghts-Based Approach: Ending Longstanding Conflict between Social Work Values and Practice. Canadian Social Science. 7 (2) 15-22.

O’Farrell, U. (2006). First Steps in Counselling. 3rd Ed. Veritas.

Ribner, D.S., & Knei-Paz, C., (2002). Client’s View of a Successful Helping Relationship. Social Work. 47, 4 [Online] http://moodle.dcu.ie/mod/resource/ view. php?id=259864 Downloaded 10th January, 2013.

Rogers, C. R., (1958). Characteristics of a Helping Relationship. Journal of Personnell Guidance, 37 6-16.

Saleebey, D. (2009). The Strengths Perspective in Social Work Practice 5th ed.

Boston, MA: Allyn and Bacon.

Saleebey, D. (2006). The Strengths Perspective in Social Work Practice 4th ed Boston: Pearson Education.

Walter, J. L., & Peller, J. E. (1992). Becoming solution-focused in brief therapy. New York: Brunner/Mazel.

about the authorsPat Clifford BA is currently a student at Dublin City University’s Certificate in Homeless Prevention and Intervention programme and is employed as a Project Worker at Novas Initiatives Mount Brown Dublin 8, a low threshold facility accommodating homeless women. He can be contacted at patrick.clifford@novas.ie.

Dr Briege Casey EdD, MSc, BA, RNT, RPN, RGN is Co-ordinator for the Certificate in Homeless Prevention and Intervention programme and is Director of Teaching and Learning at the School of Nursing and Human Sciences, Dublin City University. She can be contacted at this address or email briege.casey@dcu.ie

social Work in rural areas: exPloring child WelFare Practitioners exPeriencesBy Edel Bourke

introductionOver the last 20 years in Ireland, a number of inquiries have taken place into child protection practices (Skehill, O’Sullivan and Buckley: 1999, The Roscommon Childcare Case: 2008, Report on the Kilkenny Incest Investigation: 1993). Many of the families to which these inquiries refer lived in a rural area. While their rural location is not identified as a contributory factor per se, there are a number of themes throughout the findings and recommendations which suggest that social workers’ ability to protect the children involved was impacted indirectly by their remote locations. For this study, the following inquiries were examined:

• the Roscommon Childcare Case: Report of the inquiry team to the health service Executive (Gibbons, Harrison, Lunny, & O’Neill: 2008) The family who were the subject of this inquiry lived in a rural area adjacent to a small town, described by the inquiry team as a ‘pocket of deprivation’.

• kelly: A Child is Dead (Keenan: 1996) Family lived on a small farm in East Mayo.

• West of ireland farmer Case: Report to the panel of inquiry (North Western Health Board: 1998) This family lived on an isolated farm near a small village in Co Sligo.

• Report on the kilkenny incest investigation ( Mc Guinness :1993) This family lived on a small farm in Co. Carlow for 5 years, following which they moved to a townland nearby, described as ‘less isolated’.

• Monageer inquiry (Brosnan: 2009) Family lived in a small village in Wexford, with a population of less than 1,000.

Furthermore, despite the development of rural social work as a field of research internationally (Pugh and Cheers: 2010), there remains a complete gap in empirical knowledge pertaining to Ireland. Studies carried out in Ireland on social work practices appear to pay little attention to the urban or rural setting in which they are based, leading to the assumption that setting has little or no impact on how social work is practised. Internationally however, rural social work has a well-established body of research in Australia, Canada and US, and is growing steadily in the UK and Western Europe (Ginsberg: 1998, Green: 2003, Martinez-Brawley: 1998, Mayer:2001, Pugh:2010).

literature revieW

i. Social and Political ContextWhile the term rurality may conjure up idyllic notions, the reality of people’s lives is more complex. According to Curtin et al, “the prettiness of the rural scene often belies the reality” (1996: 62). “There is a tendency to regard rural living as idyllic or ‘problem-free’ or the existence of problems is contested by ideologies which romanticise rural life and the rural environment” (Cummins:2004:61). O’Brien (2013) commenting on the most recent census 2011 data and the largely hidden tracts of deprivation which have emerged in rural Ireland since the economic downturn, points to specific rural counties ravaged by unemployment and lack of opportunity.

In their analysis of childcare inquiries carried out in the UK, Reder et al (1993) suggest that social and political context impact greatly on how child protection was practised. They point out to the tension between two opposing views, “the view that family’s right to private life is a sacrosanct civil liberty and the view that the state must continue to monitor and intervene into many facets of life” (1993:16). This tension will no doubt impact on the public’s willingness to report child protection concerns, and maybe particularly so in rural communities where referrers may be more identifiable.

identiFication oF Families at riskSociologists point out that as a feature of rural Ireland, the invisibility of rural communities can create a barrier to supporting families at risk (Cummins: 2004, Curtin et al: 1996). A general theme in the international research is that geographic isolation can create a situation where particular problems, and indeed children at risk, go unnoticed (Curtin et al: 1996, Cummins: 2004, Pugh & Cheers: 2010). This issue was highlighted in two of the Irish inquiries outlined above where there are examples of children doing heavy manual labour outdoors, which it appears went unnoticed, (Report on the Kilkenny Incest Investigation, Kelly: A Child is Dead).

Working With isolated FamiliesThe capacity to reach rural families is hindered further by logistical challenges once a child at risk has been identified. According to Curtin et al “with the decline of rural populations and the consolidation of land holdings, this had often led to considerable distances between households and in many instances, isolation of rural communities” (1996:62). This physical separation is thought to contribute to an invisibility of social problems, in particular poverty (Curtin et al: 1996, Cummins: 2004). Cheers et al suggest that issues like child abuse and neglect are “hidden and unreported…family and domestic violence remains largely out of sight” (2007: 148).

logistical challenges oF rural social WorkThe logistical challenges in providing a service over a large geographical area, a feature of social service provision in rural Ireland, was noted throughout international literature (Ginsberg: 1998, Turbett: 2009, Belanger and Stone: 2008) Travelling long distances to visit families undoubtedly causes a drain on resources. Rural working conditions were noted in the Roscommon Childcare Case as having an impact on service delivery. They outline specifically “the challenge in rural areas to provide…targeted family support services…where the population and indeed the staff are dispersed” (Gibbons, 2008: 78). In addition, the capacity to see children alone, widely acknowledged as an essential part of the assessment process, where the family live long distances from social work offices, will no doubt be compromised.

saFety imPlications oF rural WorkersIt is remarked that higher social visibility in rural areas, for both workers and service users poses a greater safety risk (Pugh: 2007, Green: 2003, Buckley et al: 1997). Rural visiting has been identified as a potentially dangerous practice which often takes place in very isolated areas, carried out by lone workers. Literature also addresses the implications of increased visibility of potential referrers. Green (2003) refers to this and the fear of reporting suspected child abuse due to possible retaliation from perpetrators. There is also the perceived stigma attached to availing of certain social work services which will have a negative impact on engagement, particularly in a rural area.

resource imPlications For rural social Work PracticeThe international literature emphasises the point that specific and additional needs of rural communities, due to poor infrastructure, non-existent public transport and limited employment opportunities, are not adequately recognised by ‘mainstream’ social work (Ginsberg: 1998, Pugh and Cheers: 2010, Belanger and Stone: 2008). Riebschleger goes so far as to suggest that rural people “should be considered an at-risk or diverse group based on their high rates of poverty, lower life opportunities and stigmatised social status” (2007:210). There is as yet little recognition in Ireland of the additional resource implications for providing social services to dispersed rural populations.

ii. Dual RelationshipsAn overarching theme throughout the literature is the prevalence of dual relationships, how workers manage the intricacies of living and working in the same community (Pugh and Cheers: 2010, Pugh: 2007, Martinez-Bradley: 1998). The inevitability of dual relationships in rural settings challenge what Pugh (2007) regards as “that absolutist conception of confidentiality

and undermine assumptions of objectivity and neutrality in professional stance” (2007:1405).

generalist PracticeOne of the longstanding themes of rural social work literature internationally is how workers are required to develop extra skills to meet the varying needs of the community. This body of research identifies rural workers as ‘generalist’ practitioners encompassing both personal and community level interventions. To compensate for the lack of accessibility to specialised services for the client, the worker would fulfil the task of case manager, counsellor, policy implementer and community worker (Pugh: 2000, Ginsberg: 1998, Pugh and Cheers: 2010). Mayer expands further on the demands made on rural workers. “Further attributes such as flexibility, adaptability, presenting as conservative initially, willingness to take on tasks outside the actual job description, creativity, skilled telephone counselling and persistence, take on new meaning in the context of little or no secondary referral points” (Mayer:2001:98). While these skills are not exclusive to rural social work, they are adapted in a way which acknowledges the distinct social dynamics of rural communities.

Other issues raised in international literature were the extent to which rural context impacted negatively on professional development. Access to further training, poor supervision and stimulation from other professionals for lone workers were all cited as possible reasons which limited professional development for rural workers.

methodologyThis small scale qualitative study was carried out using a phenomenological approach (Crotty: 1998), to gain insight into the lived experience of participants. The overall aim of this study was to explore the experiences of rural child protection workers. The author wanted to gain insight into the day to day practical benefits and challenges of working in a rural community and also the broader implications such an environment has on social work practice. The specific research questions were:

• How does providing a service over a large geographical area impact on service delivery?

• How does working and living in the same small community impact on practices?

• How do social workers manage the potential overlap in professional and social relationships which may develop in such small communities?

• Are there additional safety implications for workers visiting families in isolated areas?

For the purposes of this study, The author relied on the definition used by the Central Statistics Office to define what we termed rural. Accordingly rural communities were defined as a group of people living in an area, be that countryside or small town, with a population of 1,500 or less. In the 2011 census in Ireland I, 741,363 people

were registered as living in a rural area, accounting for 38% of the whole population (CSO: 2012:13).

A sample of eight social workers were recruited for the study through two locations one in the rural west, another in a large urban area. They all had worked in a rural area for at least six months. The sampling strategy employed was purposive and convenient. All interviews were digitally recorded and transcribed. Data was analysed using a coding system (Alston & Bowles: 2003). Findings were then reviewed in the context of international literature and empirical research and presented thematically. An application was made to the School of Social Work and Social Policy for ethical approval and was granted prior to participants being contacted and the being carried out.

Some limitations of the study should be noted. As the sample size is small, issues outlined are illustrative rather than representative, beginning the process of exploring what is a very complex issue.

Findings and discussion

Impact of Logistical Challenges on PracticeUnsurprisingly, issues relating to physical geography offered the greatest challenge to rural practitioners who took part in this study. Participants felt that physical distance from families inhibited the development of relationships with families, the frequency with which they could see children, the extent to which they could respond to crisis as they arose and generally impacted negatively on the level of service they provided to families. This was articulated by several participants:

“you can’t call out unplanned as you might if they were living locally…there are families you need to get to, it’s just about having the time” (Interviewee No 1).

“There are times of the year when road conditions are bad and you just can’t get out to families” (Interviewee No 5).

“that Christmas with the really bad snow…one of the children I was working with was signed into care…I was expected to bring him to a foster family and it literally took hours to get there…in the middle of nowhere…I had three skids with the teenager in the car, he ended up having to push me out of the ditch…so unprofessional…so dangerous…that wasn’t putting my safety or that of the child first” (Interviewee No. 1).

Simple practical issues such as being able to locate a house in a rural area were also noted. The importance of home visiting is well established in literature as a significant safeguarding measure in the protection of children (Ferguson: 2011, Reder et al: 1993). The risk inherent in this challenge appeared to weigh heavily on participants. While they reported that they were

supported by their employers to visits families as often as they deemed appropriate, there were no additional resources offered to do so. It was the expectation of the organisation that this would be done within existing resources, regardless of the location of the family, resulting in overtime being accumulated for which the worker received no remuneration. The challenge of providing a service over a wide geographical area is noted throughout international literature (Pugh and Cheers: 2010, Buckley et al: 1997, Ginsberg: 1998, Green: 2003). This is also identified in the Roscommon Childcare Case (2008) as a factor which influenced how the family in question were supported.

access to servicesAdditionally, this study found that from the perspectives of the social workers interviewed, the families’ ability to access services was inhibited by their isolated locations. Most participants felt that while rural areas were as well, if not better serviced than urban areas, uptake of services by families at risk was often low. One participant spoke of how this can reflect negatively on the family-

“it can reflect badly on the family, because they aren’t engaging, but they aren’t engaging for very valid reason” (Interviewee No 5). According to another participant, “if a family don’t live in the town, and don’t have transport, you need to figure out how to get them there…without the services the cases really fall apart” (Interviewee no. 3).

The manner in which family support services adapted the way they worked to reach families which were isolated or reluctant to engage was also highlighted. Participants provided some creative examples where services used information technology to reach these families , or simply were willing to go the extra mile (both literally and metaphorically) in an effort to provide support where they felt it was needed. However while these measures were successful in some cases, there continued to be a difficulty in enabling families who were deemed most at risk to engage in services. Again there is strong evidence of this throughout the literature (Buckley et al: 1997, Ginsberg: 1998, Pugh and Cheers: 2010, Belanger and Stone: 2008). Access to services is exacerbated by poor infrastructure and public transport services, characteristic of Irish rural communities (Curtin et al: 2007). The difficulty of access was particularly felt by families in attending court. As the court system currently operates, held at different locations and different days, families may find themselves travelling up to 150 kms to attend. However due to the lack of empirical research generally into how the Irish family law courts operate, more thorough evidence for this is lacking.

child Protection in rural communities: identiFying children at riskOne of the more complex and concerning questions to arise from this study was how rural communities perceive and engage in child protection, as recounted by this small sample of social workers. This study suggests a reluctance by members of the public, both professionals and community members, to make referrals in relation to children they are concerned about. The reasons for this are unclear. Some participants felt that traditional views in relation to family life and right to privacy persisted in rural communities:

“a cultural thing…there’s more secrecy in rural areas” (Interviewee No. 5), “it’s a very Irish thing, that families are families” (Interviewee No.4), “people see the family as very private thing…people are still nervous about butting into family life and it’s probably more so in a rural area” (Interviewee No. 3) “I think it’s just very traditional…people mightn’t want to get involved” (Interviewee No.1).

Others felt that increased likelihood of being identified as the referrer and potential repercussions acted as a deterrent:

“there are a only a few neighbours to report in rural areas so it’s easier for people to identify who made the report” (Interviewee No. 4),” people are more reluctant, worried that families would find out and fear what repercussions are in reporting” (Interviewee No. 2), “referral from neighbours are very rare…because they are very nervous” (interviewee No. 3), “ I definitely think in rural areas they don’t want to rock the boat, they don’t want the hassle from families” (Interviewee No 1) .

There is evidence to support both views within existing literature. Arnsberg and Kimball’s (2011) suggestion that the family holds a unique position in Irish rural communities seems to be borne out in this study. This is reinforced by international literature which argues that there is a slower pace of change in rural communities in terms of moving away from traditional beliefs and values (Riebschleger: 2007, Pugh and Cheers: 2010). Furthermore, Irish studies on rural communities show that there is reluctance, at community and parish level, to acknowledge the social problems which exist in rural communities, perhaps preferring instead to preserve a more idyllic notion of rural life, to the detriment of its inhabitants (Curtin et al: 1996, Cummins: 2004). Again this has consequences for those working with families experiencing issues like poverty and social exclusion. In addition, there is evidence to suggest that increased likelihood of being identified also plays a role preventing professionals and members of the public from making a referral (Pugh: 2007, Green: 2003). Participants felt strongly about professionals, primarily teachers but

also public health nurses, who they believed failed to report concerns. It was felt this was a feature of small rural schools where parents and teachers had close relationships. Whatever the reason, this has huge implications for the extent to which children experiencing significant levels of abuse and/or neglect go undetected. Whether this is unique to rural communities or also occurs in urban areas is beyond the scope of this study to establish. A similar issue was raised in childcare inquiries where children who are being neglected or abused go unnoticed (Kelly: A Child is Dead, Report on the Kilkenny Incest Investigation). Respondents spoke of the way in which remoteness of some rural locations can keep evidence of child abuse and neglect invisible to the outside world. Limited interactions with neighbours and school friends increased the risk for these children. This was reflected by several respondents:

“It’s easier to get away with things in a rural setting…social workers are less likely to do an ad hoc visit” (Interviewee No 5), “it’s quite easy for a lot to be going on in terms of abuse and neglect and nobody being aware” (Interviewee No 1) “I would say a lot of families slip through the net because of their rural location” (Interviewee No 8).

The ability to identify and respond to these children was an on-going challenge for the participants of this study and arguably increases their dependence on other professionals such as teachers and nurses to be more vigilant and active in reporting concerns. As outlined above however, professionals in themselves may be compromised in rural areas through the dual role dynamic.

saFety imPlication oF rural social Work PracticeThemes in international literature which identified the extent to which lone working is a feature of rural social work, and the safety implications of this, were also highlighted in the current study (Pugh: 2007, Green: 2003). This was evidenced by participants’ examples of instances where their personal safety was at risk. One respondent gave an example whereby a client she perceived to be very dangerous became aware where the workers elderly parents lived. Workers spoke about “never being switched off” such was the potential to meet a client. Participants spoke of how acutely aware they were of how far they were from their office or nearest Garda station. While risk to safety is a feature of all child protection work, this is compounded by the isolated areas in which rural workers find themselves.

interagency collaborationThe potential to develop positive relationships with other agencies arose as one of the main benefits of rural child protection social work. This is facilitated by the fact that other services were based in the same building or

in very close proximity. While there were exceptions to this, participants felt that they had the opportunity to get to know a smaller pool of professionals which facilitated good child protection practice. They noted this was particularly true of local Gardaí, with whom they worked closely. Again evidence of this is also found in international literature (Pugh and Cheers: 2010).

managing boundaries and relationshiPs in rural communitiesMost significant for respondents was the impact of their work on their personal life. Respondents overwhelmingly felt that they were more visible in a rural community and more vulnerable to negative responses from decisions they made. Additionally, there was evidence of workers’ personal time being intruded upon, for example, by neighbours or relatives coming to their family home to express concerns about a child. The interconnectedness of relationships in rural communities led to ethical dilemmas for workers in how information was received and to whom it is referred. This was thought to be true for other professionals also - “you get a lot of local teachers working in schools they attended themselves…you just don’t get that in a city or town…it would be a predicament they need to rise above” (Interviewee No 2). The ability of staff of smaller schools to get to know parents made it more difficult to refer formally. It was clear that community dynamics were at play with regard to how various professionals fulfilled their child protection remit. This study reinforced similar findings of international studies which suggest overlapping relationships are more prevalent in rural communities and workers individually were required to develop strategies to manage this (Riebschleger: 2007, Martinez Brawley: 1990, Mayer: 2007, Green: 2003). Respondents felt that their own families were also susceptible to negative repercussions from clients. Both individual workers and management had developed strategies for managing the impact of overlapping relationships. Cases would be allocated to workers who did not have any pre-existing relationship with the client and lived a considerable distance away. Workers managed situations by discussing with clients, at the outset, how boundaries, confidentiality and social situations could be managed. However, this issue continued to have a significant impact on their lives. International studies suggest these situations are best resolved with the input of authorities governing social work practice (Martinez Brawley: 1990, Mayer: 2007).

service Provision in rural communitiesOne of the most significant themes throughout international literature is the lack of specialised services in rural areas and the response of workers who become what is now termed ‘generalist’ in their practice, that is, workers develop a broad skill base to compensate for the lack of services (Ginsberg: 1998). However, it appears

from this study that rural Ireland is well serviced in terms of family support and this ‘generalist’ notion was not supported in the current findings. Services in rural areas appeared to be quite highly regarded, and met the needs of families, as far as possible, regardless of their isolated location. In fact workers who had experience of both urban and rural areas felt that rural areas are on the whole better serviced.

conclusionThis study suggests that context matters a great deal for the child protection workers who participated. Furthermore the experiences of some rural practitioners in Ireland are similar to those working in other jurisdictions. The logistical challenge of providing a service over a large geographical area, the resource implications of this and ensuring clients’ access to services are among the most significant challenges. It appears from this study that the responsibility for managing the additional resource implications of providing a service, in particular the additional time required for travel, falls to individual workers to manage rather than at organisational structural level.

One of the more unexpected findings of this research is the impact of the social context in safeguarding children. While identified in international literature, social and political context, specifically the prevalence of traditional views of the family, seems to have a significant impact in how practitioners safeguard children. This study provides further evidence of the additional safety implications for workers found in international studies.

While participants outlined a number of challenges, all acknowledged the benefits of working in a rural area. The emergence of generalist practice among rural workers elsewhere due to a lack of specialised services was not borne out in this study. Issues in relation to staff retention, again a feature of rural practice elsewhere, was not a feature with the social work departments referred to in this study. Stable well-established teams were the norm rather than the exception. However some concerns were expressed that this was a result of limited employment opportunities elsewhere rather than a preference for rural child protection work.

This study clearly indicates the specific challenges of rural social work require further exploration. How rural and urban context impacts practice needs to be acknowledged in social work education. In particular the issues of managing relationship dynamics in rural communities, increasing the visibility of children at risk and the skills to practice child protection in a rural community all require consideration by workers, those who educate them and the organisations of which they are a part. Without acknowledging some crucial differences in rural practice, these issues cannot be addressed, impacting negatively not only on the worker but also the families they serve.

reFerencesAlston, Margaret, Bowles, Wendy (2003) Research for Social Workers: An Introduction to MethodsNew South Wales: Allen & Unwin.

Arensberg, Conrad and Kimball, Solon (2001) Family and Community in Ireland Ennis: Clasp Press.

Belanger, Kathleen & Stone, Warren (2008) The Social Welfare Divide: Service Availability and Accessibility in Rural versus Urban Counties and Impact on Child Welfare Outcomes. Child Welfare 87 (4):101-124.

Brosnan, Kate (2008) Monageer Inquiry Report Presented to Ms Mary Harney T.D. Minister for Health and Children and Mr Dermot Ahern T.D. Minister for Justice, Equality and Law Reform. Dublin.

Buckley, Helen, Skehill, Caroline & O’Sullivan, Eoin (1997) Child Protection Practices In Ireland: A Case Study Dublin: Oak Tree Press.

Central Statistics Office (2012) This is Ireland: Highlights from Census 2011, Part 1 Dublin: Stationary Office.

Cheers, Brian, Darracott, Ros, & Lonne, Bob (2007) Social Care Practice in Rural Communities Sydney: The Federation Press.

Crotty, Michael (1998) The Foundations of Social Research: Meaning and Perspective in the Research Process Australia: Sage Publications.

Cummins, Patrick (2004) Poverty and Social Exclusion in Rural Areas: Characteristics, Processes and Research Issues. Sociologia Ruralis 44 (4): 60-75 Curtin, Chris, Haase, Trutz & Tovey, Hilary (1996) Poverty in Rural Ireland: A Political Economy Perspective Dublin: Oak Tree Press in association with Combat Poverty Agency.

Ferguson, Harry (2011) Child Protection Practice Basingstoke: Palgrave Macmillan.

Gibbons, N. (2010) Roscommon Childcare Case: Report of the Inquiry Team to the Health Service Executive Dublin: Department of Health.

Ginsberg, Leon H (1998) Social Work in Rural Communities 3rd Edition Alexandria: Council of Social Work Education.

Green, Rosemary (2003) Social Work in Rural Areas: A Personal and Professional Challenge Australian Social Work 56 (3): 209- 219.

Keenan, O. (1996) Kelly: A Child is Dead. Interim Report of the Joint Committee on the Family. Dublin: Department of Health.

Matinez-Brawley, Emilia E. (1998) Community-Oriented Practice in Rural Social Work In: Ginsberg, Leon H. (Ed) Social Work in Rural Communities 3rd Edition Alexandia: Council of Social Work Education.

Mayer, Angela G Krieg (2001) Rural Social Work: The perceptions and experiences of five remote practitioners. Australian Social Work 54 (1) 91-102.

Mc Guinness, Catherine (1993) Report on the Kilkenny Incest Investigation Report presented to Mr. Brendan Howlin T.D. Minister for Health by South Eastern Health Board May 1993. Dublin: The Stationery Office.

O’Brien, Carl (2013) Rich Land Poor Land. The Irish Times 5th January 2013: 1-2.

Pugh, Richard & Cheers, Brian (2010) Rural Social Work: An International Perspective. Bristol: Policy Press.

Pugh, Richard (2007) Dual Relationships: Personal and Professional Boundaries in Rural Social Work. British Journal of Social Work 37(8): 1406-1423.

Reder, Peter, Duncan, Sylvia and Gray, Moira (1993) Beyond Blame: Child Abuse Tragedies Revisited London: Routledge.

Riebschleger, Joanne (2007) Social Worker’s Suggestions for Effective Rural Practice. Families in Society 88(2): 203-213.

Skehill, Caroline, Eoin O’ Sullivan and Helen Buckley (1999) The nature of child protection practices: An Irish Case Study in Child and Family Social Work 4 (2) pg 145-152.

Turbett, Colin (2009) Tensions in the Delivery of Social Work Services in Rural and Remote Scotland. British Journal of Social Work 39: 506-521.

acknoWledgementThe author wishes to thank Trish Walsh, School of Social Work and Social Policy, Trinity College, Dublin for all her encouragement and support both in supervising her thesis and in completing this article.

about the authorEdel Bourke worked for a number of years as an aftercare worker before completing the Masters of Social Work in Trinity College Dublin earlier this year. Edel is currently working as a child protection social worker with the Health Service Executive.

theory oF Planned behaviour as a Predictor oF reFerrals to Psychology dePartments From social Workers in ireland: a multiPle regression analysisBy séamus Ryan, kiran sarma and

Michael Byrne

Competing Interest Statement: The authors have no support from any organisation for the submitted work, no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, and no other relationships or activities that could appear to have influenced the submitted work.

summaryThe important role of social workers in referring clients to Psychology remains under-researched. A multiple regression analysis found the theory of planned behaviour predicted 16% of variance in referral rates by social workers.

introductionReferral behaviour plays an integral part in the process of providing healthcare interventions. The decision-making processes used by health care professionals when making referrals to other professionals may be partly explained by existing theoretical models.

The theory of planned behaviour (TPB; Ajzen, 1991) is a predictive theoretical model that has been applied to clinical decision making. TPB predicts that three factors influence a person’s behavioural intention: the person’s attitude toward the behaviour, the subjective norms, and the person’s perceived control over the behaviour. For example, if a person has a positive attitude towards making referrals, perceives that others also make referrals, and has a sense of control over the referral’s execution, that person is hypothesised to be more likely to make a referral if an opportunity arises.

The TPB has been applied to GPs’ referrals to mental health services in the UK. Russo et al. (2011) found that the three TPB factors collectively explained 35% of the variance of intention to identify and refer individuals at ultra-high risk for psychosis. Each TPB factor significantly predicted intention. Subjective norms represented the strongest predictor of intention. This finding indicated a good fit with the TPB model.

Social workers’ referral behaviours have also previously been partially explained with reference to the TPB. The referral behaviour of oncology social workers to hospice care services in the USA has been found to

be significantly correlated with the attitudes of social workers towards hospice philosophy and care (Becker, 2004).

JustiFication For current studyThe referral process between social workers and psychologists is of key importance as social workers are amongst the most frequent agents of mental health and psychological referrals in the USA (Gant et al, 2009). However, the needs and expectations of social workers regarding referrals to Psychology services has yet to be explored within an Irish or a UK context. Previous research in Ireland has focused on the needs and expectations of other professionals when referring to Psychology services, such as the requirements of GPs (Byrne, 2007; Ni Shiothchain & Byrne, 2009). This research with Irish GPs explored accessibility to psychologists, ease of referral, management of referrals, level of care provided to clients, range of clients seen, level of care provided to clients, and communication (written/verbal). However, these previous studies were descriptive rather than inferential or predictive. The current study aims to extend previous research to explore the referral behaviour of social workers and child care staff to Psychology services in Ireland. The current study also aims to test a predictive model of referral behaviour. It is hypothesised that the self-reported rate of referral behaviour of social workers and child care staff to Psychology services in Ireland over the previous 12 months can be partially predicted by the three factors in the TPB (attitudes towards referrals, subjective norms, perceived behavioural control).

method51 Health Service Executive (HSE) staff participated in an anonymous online survey. 45 social workers and 6 social care/child care workers participated. The total number of staff invited by email to participate was 486, which consisted of staff from HSE departments in each HSE region nationally. The response rate was 10.5%. Recruitment was undertaken by initially contacting the Principal Social Worker in HSE departments throughout Ireland. Social Work departments were invited to email the online survey to all members of staff, and to subsequently notify the researcher of how many staff members were sent an email invitation. Ethical approval for the study was obtained from the Ethics Committee of the School of Psychology, National University of Ireland, Galway.

An online questionnaire was developed to measure the outcome variable (referral behaviour) and the three hypothesised predictor variables. A copy of the questionnaire may be obtained from the authors upon request. A questionnaire previously used to evaluate GP referrals to Psychology services (Ni Shiothchain & Byrne, 2009) was adapted for use in the current study with a social worker population. ‘Referral rate’ was operationalised as the self-reported number of referrals directly made by a participant to Psychology

departments over the previous 12 months. The predictor variables were measured as follows:

‘Attitude towards referral’ was measured using eight questionnaire items, with each item consisting of a five-point Likert scale. These items were as follows: past referral restrictions due to waiting lists; past referral restrictions due to lack of confidence in Psychology; accessibility to Psychologists; contact levels with Psychology post-referral; level of care provided by Psychology; range of clients seen by Psychology; level of oral communication received from Psychology; level of written communication received from Psychology.

‘Perceived behavioural control’ was measured using five questionnaire items, with each item consisting of a five-point Likert scale. These items were as follows: ease of referral procedures to Psychology in general; ease of routine referral procedure; ease of urgent referral procedure; knowledge of services provided by Psychology.

‘Subjective norms’ were measured using a five-point Likert scale item which measured the influence of colleagues’ referral behaviours over the participant’s referral behaviour.

Statistical analysis of the data was undertaken using ‘Statistical Package for the Social Sciences 20’ (SPSS 20). Cronbach’s alpha coefficients were computed to determine the internal consistency of the two predictor variables (Attitude towards referral, Perceived behavioural control) which consisted of two or more questionnaire items. A multiple linear regression analysis was undertaken to evaluate the explanatory value of the three predictor variables in predicting rates of referral.

results

ReliabilityMissing data points were replaced with the mean score for the questionnaire item from which the data point was missing. Three outliers of 3 standard deviations or greater from the mean were also replaced with the mean score. Reliability computations were carried out. Internal consistencies were satisfactory for the two variables consisting of two or more questionnaire items. The Cronbach’s alpha reliability scores were greater than 0.8 for both ‘Attitude’ (α = .89) and ‘Perceived behavioural control’ (α = .81).

descriPtive statistics & correlationsThe mean number of referrals made to Psychology by respondents over the previous 12 months was 3.78 (S.D. = 3.40), with a range of between 0 and 10 referrals made. No predictor variable significantly correlated with ‘Referral rate’. The factor with the greatest degree of correlation to ‘Referral rate’ was ‘Attitude towards referral’ (r = -.21, ns). All variance inflation factors (VIF) were below 10, and all r < .8. This indicated that no multi-collinearity was

present (Myers, 1990). Please see Table 1 for a summary of correlations and descriptive data.

table 1: Descriptive data and correlations amongst variables.

Referral rate

Attitudes Perceived behavioural control

Mean (SD)

Referral rate 3.78 (3.40)

Attitude towards referral

-.21 26.29 (6.91)

Perceived behavioural control

-.01 .78* 12.96 (3.26)

Subjective norms

-.13 -.43* -.36* 2.78 (1.19)

(Note: N=51, *p<.01).

multiPle linear regression analysisA multiple linear regression analysis was undertaken, with three TPB factors entered (attitude, perceived behavioural control, subjective norms). This produced a significant F-ratio, accounting for 15.9% of the unique variance in the outcome variable (F(3,47) = 2.95, p<.05), with ‘attitude’ (β = -.62, t = -2.80, p<.05) being the only significant predictor. The statistical power of the study was .71, close to the recommended power level of .8 or greater (Cohen, 1992). Table 2 provides a summary of the multiple regression analysis undertaken.

All statistically redundant variables were subsequently removed from the regression model as recommended by Field (2009, p.213). A new regression analysis was undertaken involving only the ‘attitude’ predictor variable. This single-factor model was found to explain only 4% of the variance, and was non-significant (F(1,49) = 2.24, p = ns). As a sole predictor variable in this model, ‘attitude’ was not a significant predictor of ‘referral rates’ (β = -.21, t = -1.50, ns).

table 2: Theory of Planned Behaviour as a predictor of Referral rates.

Δ R² B SE B β t

Model: Theory of Planned Behaviour .16

(Constant) 8.53 2.81 3.03

Attitude -.30 .11 -.62* -2.80

Perceived behavioural control .40 .22 .38 1.80

Subjective Norms -.72 .42 -.25 -1.68

(Note: *p<.05).

discussionThe findings provide evidence to support a model which hypothesises that the self-reported rate of referral behaviour of social workers and child care staff to Psychology services in Ireland over the previous 12 months can be predicted by the TPB. The multiple

regression analysis found that a predictive model including all three TPB factors produced an F-ratio which was significant, and explained 16% of the variance of referral rates. This regression model resulted in a significantly better prediction of referral behaviour than that provided by chance, but it should be noted that staff attitudes to referrals was the only significant predictor variable within this model. However, when staff attitudes towards referrals was analysed as a stand-alone variable, it was no longer a significant predictor of referral behaviour.

The predictive value of this overall model was hypothesised at the outset in the context of previous research on referral rates to Psychology amongst GPs. Russo et al. (2011) found that the three TPB predictor factors explained 35% of the variance in GP referrals for patients at ultra-high risk for psychosis in the UK. The reduced level of variance (16%) explained by the TPB factors in the current study may be as a result of different predictor factors being at work when social workers and child care workers are making referrals versus GPs. In order to ascertain which factors are of particular importance to social workers and child care staff when making referrals to Psychology in an Irish or UK context, further exploratory qualitative research with this population may also prove useful for theory-building.

limitationsLimitations to this study were identified which may also have impacted upon the findings of this study. The sample size of 51 participants was small, and this restricts the generalisability of the findings beyond the study sample to the general population of social workers and child care staff in Ireland. The statistical power of the study was 0.71. Cohen (1992) recommends a power level of .8 in order to detect significant effects of a model. In order to reach this magnitude of power, the current study would have required a sample size of 72 participants. The current study e-mailed participation invitations to 486 HSE staff in an effort to reach this power level. The small sample size can be partially explained by the small overall potential population of social workers working within a relatively small country such as Ireland. Additionally, there was a low response rate of 10.5% to participation invitations. This low response rate may have been due to the lack of a direct incentive for staff to complete the questionnaire. This may have been particularly important in the context of the heavy caseloads often associated with the busy working environments of HSE social work departments. The low response rate also raises the question of whether or not there may have been a self-selection bias involved in relation to those participants who agreed to take part in the study. Any future research would require a bigger sample size in order to increase the power of the research findings, which might be facilitated by using a larger overall population to sample from. In addition, an increase in the response rate might reduce the potential for self-selection bias.

The lack of a reliable and validated questionnaire for measuring predictor variables was a limitation. The Cronbach’s alpha level for the scales measuring ‘Attitude’ and ‘Perceived behavioural control’ showed internal consistency levels above .8. However, a single questionnaire items were used to measure ‘Subjective norms’. A reliable multi-item measure for this predictor variable was not included in the current study. Any future study in this research area would benefit from the use of a questionnaire which included multi-item questionnaire measures for ‘Subjective norms’, with demonstrable Cronbach’s alpha levels of .8 or greater.

conclusionsThe factors predicting referral rates to Psychology amongst social workers and child care staff remains an important research area, as this population represents one of the most frequent referral agents to Psychology services. However, this area also remains under-researched. This study found that three factors in the theory of planned behaviour, when taken as a whole, predicted 16% of the variance in referral rates to Psychology. However, each individual stand-alone factor was not a significant predictor. Future research in this area would be enhanced by increased sample size, improved response rate, and reliable questionnaire measures. Future research could also explore alternative theoretical models and factors which may predict referral rates, in addition to the model hypothesised at the outset of the current study. Qualitative research involving interviews with social workers and child care workers may prove beneficial in this regard.

reFerencesAjzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211.

Becker, J.E. (2004). Oncology Social Workers’ Attitudes toward Hospice Care and Referral Behavior. Health Social Work, 29(1), 36-45.

Byrne, M. (2007). GPs want access to psychology services. Forum, 24(9), 57-59.

Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155-159.

Field, A. (2009). Discovering Statistics Using SPSS, 3rd Edition. London: Sage.

Gant, L., Benn, R., Gioia, D., & Seabury, B. (2009). Incorporating integrative health services in social work education. Journal of Social Work Education, 45(3), 405-425.

Myers, R. (1990). Classical and modern regression with applications (2nd ed.). Boston, MA: Duxbury.

Ni Shiothchain, A. & Byrne, M. (2009b). What do GPs want from mental health services? Irish Psychiatrist, 10(1), 42–44.

Russo, D.A., Stochl, J., Croudace, T.J., Graffy, J.P., Youens, J., Jones, P.B., & Perez, J. (2011). Use of the theory of planned behaviour to assess factors influencing the identification of individuals at ultra-high risk for psychosis in primary care. Early Intervention in Psychiatry.

about the authorsSéamus Ryan is a Trainee Clinical Psychologist, School of Psychology, Clinical Psychology Programme, National University of Ireland Galway, 2nd Floor, Woodquay Court, Galway, Ireland.

Kiran Sarma is a Senior Lecturer, School of Psychology, Clinical Psychology Programme, National University of Ireland Galway, 2nd Floor, Woodquay Court, Galway, Ireland.

Michael Byrne is a Principal Clinical Psychologist, HSE West, Psychology Department, Primary Care Centre, Golf Links Road, Roscommon, County Roscommon, Ireland.

Corresponding Author:

Email: seamusryan@hotmail.com

Best Contact Address: Dr Séamus Ryan, School of Psychology, Clinical Psychology Programme, National University of Ireland Galway, 2nd Floor, Woodquay Court, Galway, Ireland.

my storyBy Mia de faoite

I was prostituted on the streets of Dublin mainly the Burlington Road for nearly six years. Prostitution, the purchase of another human being for sex, is not and never has been the purchase of sex, because neither I nor any of the other women stand on the street or in the brothels with our genitalia and our mouths and throats in neatly wrapped packages which you could borrow and return to us in 20 minutes. No, I had go with them, you had to talk to me first, my mind was present the whole time. You always have to buy the person before you gain access to their body. So you must ask yourself one question, do you believe that people have the right to buy other human beings? When I ask anyone this question, of course they say No but when I ask them do you believe that people have the right to buy other human beings for the purpose of their own sexual gratification?, they sometimes hesitate, I understand where this hesitation comes from, because they think “well if they are offering it”, what’s the problem, two consenting adults, a business transaction!! I say no, this question requires a yes/no answer, you either believe it or you don’t, end of. I stood on that street selling myself but I always knew they had no right to buy me. There are many reasons why women find themselves in prostitution and all of them have nothing to do with feeling empowered and even if they did feel delusionally empowered, I don’t care if she is offering herself up in a gold bikini on a silver platter in the pent house suite of the Berkeley Court, no one actually has the right to buy her, period!!

I never believed when I stepped out onto that street that it would not only own me within a short space of time but that it would take from me everything I thought I once was. What I didn’t realise was that I had entered a paradox that so very few of us escape from. I am one of the lucky few.

Society assumes many things on the issue of choice but it forgets two things, one it presumes that we see the world the same way as everybody else, which we don’t and two your ability to see choices becomes extremely compromised by the effects of trauma and disconnection from normality itself and that’s if you ever had any choices to begin with. The women I stood alongside placed such little value upon themselves, I know that mainly by how they treated me, they thought I was of much more value because of my accent, my appearance and the fact that I was educated. They were extremely protective of me for this reason. Their loyalty to me never faltered and I now feel a strong sense of responsibility to ensure their voices are heard.

Life on the street is so complex as we led quite difficult and complex lives that I would never be able to explain them in just one article but there are two issues I would like to address, the first of these issues is rape. Rape does become part of the job, so much so that we don’t really use the term rape, we don’t have permission to,

we might allude to it but then it’s ignored and the subject is changed, many become desensitised to the pain of others, because if you acknowledge someone else’s pain, you may just have to acknowledge your own, and we don’t have anywhere to place or deal with that pain, so some bury it, some use substances to forget it, some disconnect from it and unfortunately some accept it as routine.

Every prostituted woman I have ever met has a rape or sexual assault CV and here is mine.

Myself and my friend were subjected to a vicious gang rape by 8 men and I have never seen the world the same way since. As for my friend, she died, her drug use spiralled out of control and she died alone from an overdose about 3 months later. It might have been heroin in her arm the day she died but I know what really killed her. Today I am her voice.

My next rape was a year or so later by a lone offender off the Burlington Rd. The next I’m not sure if I can call it rape, it happened the same night, I was sitting on the ground on the street after the attack, my money and my phone had also been taken, just sitting disorientated and alone, with an aching body and a struggling mind, when a regular of mine pulled up, he got out of the car, picked me up and offered to drive me home. I told him what had happened and he even stopped and bought me a coffee but just before we reached my home, he pulled in and reminded me that I had no money to pay him. He was a taxi driver but that I could sort him out, I didn’t even argue, I just leaned back and let him. So what do you call that, someone who has sex with a woman they know has been raped about an hour or so beforehand?

My last rape was by two young men, high on cocaine, one watched while the other did it but to me he is just as guilty. You see, when you set up the conditions for rape, it will happen. We as prostituted women are a prime target for any man who wants to fulfil the sexual fantasy of rape. Only with us they can do it for real and get away with it and both society and the laws that govern it have a major role in keeping it that way, and it will remain un-punishable while it remains legal to buy another human being in the first place.

People ask me how many men. I was bought by 4-5 offenders, 2-3 nights a week, at least 45 weeks of the year for nearly 6 years and that is an equation that I will never do in my head. I was no “sex worker”. I was a trapped mind who lived in a body that no longer belonged to me, in fact I was a disconnected, drug addicted, walking rape victim, we all were.

the analytic truthProstitution and sex trafficking are intrinsically linked, you have one because of the other. We are connected both prostitutes and trafficked women, although that initial introduction may be different but we are connected because we are bought, used, exploited, humiliated and raped by the same offenders and that connection can

never be broken by anyone, at any time, in any country. The trafficked women now work alongside Irish women in the brothels and on the street. I, myself stood alongside a trafficked woman for 18 months. She was my closest friend and I have never seen a woman so broken down. I used to think as bad as I felt, as disconnected and lonely as I was, at least I got to go home at night. Their stories are horrific, often being gang-raped into submission, threatened and beaten on a regular basis; some do not even have command of the English language and have no sense of where they are. They are moved around constantly. The trafficked women are very popular here. Most offenders are well aware that they could be trapped, but there is something exotic about the foreign women. They are more vulnerable, less likely to challenge them, and I personally feel there is an added kick for offenders, getting the use of another man’s slave.

In the last 3 years alone, 32 children, the average size of a class room, have been rescued from sexual slavery in Ireland, dragged to this country where their young minds and bodies were irrevocably damaged forever. I am so fortunate that my nightmares no longer keep me up at night but the nightmares of those children and the children still trapped here do, so I ask you, who pays the ultimate price under tolerating regimes?

There are some who say they are happy to be there, I never met one but there are a few out there. I find it reprehensible to put the rights of a few before the human rights of the most vulnerable. The liberty of a few should never come before the freedom of so many, because any time in history that has happened human dignity has been removed and freedom lost and you don’t have to believe me, you only have to look at the appalling state of Amsterdam. Now acknowledged as the liberal revolution that back fired with disastrous consequences, but I ask you who is paying for those consequences? The social experiment that failed, but at whose expense did it fail? So be a liberal, but please never be a liberal at the expense of human dignity.

In the end, I, myself did not just make a choice to leave or decide one day that I had had enough, although my mind was struggling badly and my body was drained completely. I had no idea how or if I could ever escape prostitution. Heroin had become my lifeline, it shut out my thoughts and feelings about what had become of me and the cruel events that had happened. Remove it and I didn’t believe my mind could cope. I had a teenage daughter to look after who was struggling with her own illness and my priority was to remain as strong and as sane as possible for her sake.

In the summer of 2010 my daughter needed some in-patient care. In the first week or so she had met a social worker and for some reason took to her, which was unusual as my daughter is quite guarded about whom she lets in. You see, my daughter and I had lived a very isolated and lonely existence, apart from a few good friends she had, we never saw anyone and nobody wanted to know us. I was her full-time carer and only

ever left her side to go to the Burlington Rd. Because of this we had formed a tight bond, and an unhealthy attachment to each other, and it was us against the world, so to speak.

After a couple of weeks the social worker asked me to drop into her office, which I did with the usual guarded front but what I didn’t realise was that I was about to be asked a few questions nobody had ever asked. Her first words to me were “your daughter’s a lot stronger then you think”, then she said “but I want to know, what is life like for you?” “What is it like to be a mother and watch your daughter struggle and feel helpless? And what’s it like to be out there at night, all alone?” These questions scared the life out of me at the time because they were deep; they were powerful, too powerful for me to answer just yet. I left her office very quickly but I couldn’t stop thinking about them and I had seen compassion in her eyes that I had never seen before. I’d only ever been met with judgement but what I didn’t realise was that I had just met the person who would change the course of my life forever.

I returned to see her after a few days, I began to talk and she listened. Over the next few weeks we built up a strong relationship, she helped me make sense of things I just couldn’t. I found myself talking about things I had never talked about with anyone. I’d let her in because I knew she understood why and how we had come to be where we were. She was a strong voice for my daughter and organised an out-patient programme for her, but mostly she just believed in us and believed that we were both strong enough to get out of this existence. After my daughter was discharged, she asked me one final question, “Do you now trust me enough to let me make a phone call on your behalf?” and I said yes.

I walked off the Burlington Road on the 10th October, 2010 and although I didn’t know if I was strong enough to make it, I knew looking down that street for the last time that I’d never be back, for I now had someone who believed in me and who could place me in the safe hands of others who would and did. I have managed to rebuild my life with the help and support of many but it would not have happened if I had not met this incredible woman, who without doubt has to be one of the most compassionate human beings I’ve ever met. My daughter has grown into a strong young woman and with pride she named her second daughter after the social worker who gave us back our life.

Prostitution is, was and always will be an absolute affront to human dignity and I know that because I have lived and witnessed it. Sweden didn’t do a radical thing or a controversial thing. Sweden just did the right thing in the name of freedom, justice and equality. Norway and Iceland followed and now it is Ireland’s turn and we must not let an opportunity to evoke a social change for the greater good pass us by for our government does not have the right to continue to let tragic lives become absurd. It is now time that we formally remove the female body from the market and reclaim human dignity.

To finish; one’s life has value so long as one attributes value to the life of others. That is my wish for my country, that it attributes value to the lives of the trafficked, the coerced, the displaced, the isolated, the damaged, the addicted, in essence the haunted majority of which I was once one.

With much respect and admiration to you all for the work that you do, often tough, challenging and sometimes it may feel a little thankless but please know that there are so many of us out there who just wouldn’t be where we are but for the work that you do, and I, for one am so very grateful.

My sincere good wishes,

Mia de Faoite,

Survivor of Prostitution,

Philosophy student at NUI Maynooth.

address at the irish association oF social Workers’ conFerence may 2013By fr Peter Mc Verry

What keeps you going? That’s a question I would love to get the answer to. It’s a question that I am frequently asked myself. But despite the frustrations of inadequate services, bureaucratic demands and uncomprehending officials, the answer for me is that the little you can sometimes do for homeless people means an awful lot to them. Homeless people frequently remark how something you did for them, or said to them, or arranged for them had a significant impact on them, even though I may have thought nothing of it at the time. The sense that you are making an important difference in the lives of people, a difference which may not otherwise happen, is its own reward. Your vocation is hopefully even more fulfilling than mine. The difference you can make in the lives of people, sometimes people in severe difficulties, is enormous. To see a young child, whose life is a misery, transform into a happy and contented child in a foster home, or to help a family in difficulties to cope and re-establish relationships within the family, is an extraordinary gift which you can sometimes offer. But I don’t want to romanticise your job. Like my own, there are many frustrations, many failures. I know the staff in our hostels for under-18s often complain that they spend more time filling out forms than working with the young people themselves. The demands of bureaucracy can be soul-destroying. Your successes in making a difference in the lives of people rarely get acknowledged, your failures may end up on the front page of the national papers. The large workload that many of you have only increases the frustrations of your job – to bring this country up to the same level of social work activity as in Northern Ireland would require us to recruit another 2,000 social workers. How can you work effectively with 25 cases or more on your books? I have seen some of you spend all day in the family courts waiting on your case to be called, or much of the day arranging and supervising access visits for parents whose children are in care. How can you be there for 25 families with multiple children and multiple problems? Some of the decisions you make may be more influenced by lack of resources or services than by the needs of the people you work with. I have seen children taken out of care homes where they are happy and settled, and placed in homes where they are unhappy, in order to save money. That is not your fault, but it must be your frustration. Those who make the decisions may have different priorities, and be under different pressures, than those of you on the ground. Yet, despite all that, you make an enormous difference to the lives of those you work with.

What exactly is that difference which you make? What is the hardest part of being homeless? I often thought that the hardest part of being homeless was not having a bed for the night, having to find a doorway, or derelict

building, or even worse, going into an emergency hostel. But it’s not. You can get used to that, it’s not comfortable, but you can get used to it. And then I thought, it’s being hungry or cold by day and night. But it’s not. And then I thought it must be the boredom of every day, nowhere to go, nothing to do. But it’s not. What is the hardest part of being homeless? We had a young guy living with us. When he was about 18, he left us and went to live with his girl-friend. After about a year they split up and he went on to the streets, as he had nowhere else to go. A couple of months later, he threw himself into the Liffey. To his dismay, he was rescued and brought to hospital. I went up to see him in hospital and he said: “Peter, I can’t go on living like this.” “Living like what,” I asked him. “I can’t go on living knowing that nobody cares.” And that’s the hardest part of being homeless, to know that if you disappeared off the streets of Dublin, nobody would even notice. Your life has no value, no significance to anyone else – you have totally lost your self-esteem, your sense of your own value, your dignity. And so what are we doing working with homeless people? Yes, we can give some of them accommodation, drug treatment, counselling, but what we are really doing is to give them the message that they are just as important, just as valuable as anyone else. And if we are not giving them that message, we might as well pack up and go home, as the rest isn’t worth it.

And when they have left us, perhaps for a few years, and return to say hello, what is it they thank us for. Not so much for getting them accommodation, or helping them to get off drugs, but they will say something like: “Thanks for being there for me when I needed you.” What they remember and what they value most was the relationship, a relationship in which they felt important, in which they felt they were cared for, in which they were not being judged. Many homeless people talk to me about their social workers, past or present. Which social workers do they talk about? They talk about the social worker who cared, who was kind, who made them feel like a person, not a client. I hate when our staff talk about homeless persons as clients, the term client depersonalises them and shifts the focus from the person to the job. Those on the margins, who make up a large percentage of the people you work with, often feel excluded, their problems may be overwhelming and they may feel, with a lot of justification sometimes, that society doesn’t really care. That sense of exclusion, that society doesn’t care for them, creates a frustration that leads to resentment, and unfortunately, you may become the focus of that resentment. Of course they want a solution to their problems, but they want more than just a solution. They want to feel that somebody cares about them. And you may be the only somebody involved in their lives. And so, what is important is not just what you do, but how you do it. It doesn’t cost money to show you care but it requires much more than money – it requires a strength of character which is not overwhelmed by the demands of bureaucracy or the pressure of overwork. It requires a spirituality of living in the present moment. The past is history, the future has not yet come, all that matters is the

present moment and those we are relating to here and now.

I often find myself in a situation where I am trying to balance the accounts or trying to think of something to say to a group at 9.30 the next morning in the Gresham, and someone comes in who wants to talk. Half of me is listening to them, but the other half is focused on what I am doing, or shortly have to do. My body language is telling them that they are not that important to me. And when they are gone, I regret not having given them my full attention. It is extraordinarily difficult to give your whole attention to the person in front of you but that is what many of those you, and I, work with want most of all. And nothing communicates how much we care as giving someone some of our time and all of our attention. And so, your work, like mine, is all about relationships. Tonight, many homeless people will be offered a bed for the night in Camden Hall. People who are drug free are dumped into a room full of active drug users, people who were sexually abused as children are dumped into a room full of strangers. Yes, it gets them out of the cold, out of the rain, but it is destroying their dignity. What is the message that homeless people are getting? The message is that this is how society values you, this is what society thinks you’re worth. People are employed to do a job, to allocate beds to homeless people and they do that job with great efficiency. But doing their job with great efficiency is actually damaging homeless people, destroying their self-esteem. It’s not the fault of those who are employed to allocate beds to homeless people, but I use that example to illustrate that in our job, doing the job with great efficiency is not enough. We cannot allow ourselves to get swallowed up by the system, to be absorbed into the system, we must maintain our ability to criticise the system, to challenge it , we must remain angry when the system or bureaucracy prevents us doing what is most important, namely caring.

We all have difficult jobs, the danger of burnout or disillusionment always accompanies us. What is it that prevents us burning out or becoming disillusioned? It has to be job satisfaction. Without the belief that your work and mine is making a difference to the lives of vulnerable people, sometimes people who hurt, I imagine it is difficult to go on. Of all the “caring” professions, yours is the profession that most deserves that name. If I am sick, I go to a doctor or nurse. I don’t really mind if they care about me or not, I just want them to make me better, though of course it is nice if they show an interest in me. But “caring” is at the heart and centre of the work that you do. You are not a technician finding solutions to problems – you are reaching out to people who are lonely, people who are hurting inside and while your caring may not and often cannot heal that hurt inside, it can at least make it a little more tolerable. In our work, perhaps we can never achieve what we would like to achieve. That young man who threw himself into the Liffey, what happened to him? 18 months later, he succeeded in killing himself. I do about one funeral a month, it is usually a young person who has died by overdose or suicide.

We cannot work miracles and cure every ill. But we must keep on caring, with the conviction that that caring is important and makes a difference in the lives of those we work with. When we engage in peoples’ lives, we cannot control the outcome, but we can control the input. And so I hope that today, when no doubt you will share your frustrations and problems in trying to do the job you want to do, you will also be reinforced in your conviction that what you are doing is a vocation, that what you do has a value that cannot be measured in quantitative outcomes, that what you do makes a difference to the lives of those whom you encounter.

research shines neW light on social Justice advocacyBy Anna Visser

“Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has.” Margaret Mead

Social justice advocates the need to strive to influence policy to create a more inclusive and equitable Ireland. Often this work is done quietly and without fanfare. With this new research we wanted to shine a light on the diverse range of advocacy being carried out across the country and celebrate the many successes that can go unnoticed.

The Advocacy Initiative’s new study ‘Mapping of Social Justice Advocacy in Ireland’ reveals that social justice advocacy is alive and kicking in Ireland, but faces significant challenges in 2013 and beyond. For the first time this research shows the breadth and depth of social justice advocacy in Ireland; who is doing it, how they are doing it and what strategies are most effective for change.

The research was carried out in two phases. The first used a postal survey of a representative sample to measure the breadth of advocacy, while the second utilised an online survey of organisations identified in Phase 1. This was complemented by five case studies of effective social justice advocacy by a range of organisations. The Initiative is grateful to the authors of the research Candy Murphy and Patricia Keilthy of CMAdvice Ltd., for all their work.

The authors discovered that 39% of non-profit organisations surveyed are engaged directly in social justice advocacy, the majority doing so at local level followed by 30% at national level. “This was an interesting figure for us, as often we see advocacy through a national lens. This shows that there is a lot of activity at a local level that is quite different to the work being done nationally,” stated Anna Visser, Director of The Advocacy Initiative.

The advocacy being done across Ireland is very diverse with activities ranging from insider strategies to protests and public awareness campaigns. There is a 50/50 split between internal and external advocacy with the same for unplanned and planned. However planned advocacy is on the rise, with 44% conducting information and awareness raising work, 19% focusing on policy implementation and 18% on developing new policy. Public awareness activities were identified as the dominant activity followed by networking, participation in local committees and lobbying.

Of those organisations not doing any social justice advocacy the reasons varied, with the majority stating it wasn’t relevant to their work while 12% stated it wasn’t a role for their organisation, 11% put it down to a lack of resources and 19% said it was due to lack of expertise in the area.

The main targets of advocacy were identified as the general public followed by local committees and City and County Council structures, while the key methods to mobilise the public were information meetings and media engagement. Two thirds reported doing more around social media focusing on raising awareness in the external environment.

“When we asked respondents about the policy making processes in Ireland today the picture that emerged was not a particularly positive one. 84% stated said it was fragmented, 89% disagreed that values underpinning policy making was explicit, just over half said there was no evidence base in decision making and 68% believe there are few specialists in the process. In addition, over the past 3 years for most people their workload has increased and become more difficult, particularly in rural areas and for those working in community development and social services,” Ms. Visser stated.

Half the respondents have a system in place to monitor their impact leaving a large gap in those not monitoring their advocacy work. Ms. Visser commented:

“There was a sense of a lot of change happening which had accelerated over the past few years. One of the main things was the need for evidence based data which puts pressure on organisations to present hard data. Many found this created competition within the sector and made it much harder to gain traction on issues that cost money.”

One of the key ways identified to respond to the challenges was to collaborate with other Non-Governmental Organisations (NGOs). Of those involved in collaborations 71% rated it as a positive experience.

Other responses included focusing more on evidence gathering, linking specific policy issues to broader social justice agendas, more economic analysis and relying more on rights based approaches.

As part of the research five case studies of effective social justice advocacy were presented in the study and at the recent 3rd Knowledge Exchange Forum. Two of the studies were chosen from Phase 2 that had indicated a willingness to participate in the study as examples. The remaining three were selected to reflect a wider range of themes and approaches. The organisations involved were the Irish Heart Foundation, Migrant Rights Centre Ireland, Doras Luimní in co-operation with Crosscare and Nasc, Gay + Lesbian Equality Network & Rialto Rights in Action Group.

The following key findings emerged from the case studies:

1. A well thought out advocacy campaign and related strategy is essential. This should involve clear intermediate goals within a longer term vision with agreed outcomes, underpinned by values of equality, human rights and community development.

2. Be ambitious, but keep the message simple and appeal to human interest and concern.

3. A key element of an effective advocacy campaign is to empower those affected to be their own advocates through training and professional support.

4. How you win a campaign is as important as what you win. A positive win lays the foundation for future wins – and a certain level of pragmatism is often required.

5. It is important to be reasonable, constructive and professional when dealing with decision makers and to build relationships of trust. Appealing to the best in politicians and public servants can be helpful-their sense of fairness.

6. Recognised and proven international models and frameworks should be harnessed whenever possible.

7. Collaboration across regions and organisations can provide compelling evidence that the identified problems are systemic.

8. It is important to seize opportunities and to adapt to changes in the external environment when they arise, e.g. a new government, new Minister, changing economic conditions.

9. Being able to measure the impact of an advocacy campaign is important in terms of accessing further funding.

Resources are required to run effective, professional campaigns and to effectively engage clients, the media and public opinion in the campaign. All the case studies were strongly focused on ‘internal’ advocacy strategies as this approach was considered to be most effective. They all illustrate how an effective campaign must manage the potential tensions between internal/external elements of the campaign. Sometimes a too forceful

media/public campaign can be counterproductive. However, they also demonstrate that strong linkages between public campaigning and achieving policy change. Effective public campaigns can play a key role in mobilising policy makers to address policy gaps and weaknesses and in achieving positive changes to services.

From this study a number of recommendations were identified, which will be investigated by The Advocacy Initiative which includes:

• Explore with relevant organisations, possibly through Knowledge Exchange Forums, what is meant by ’social justice advocacy’ and assess the extent to which definitions are consistent and clear across the non-profit sector and among recipients of such advocacy. (See for example Geller, S.L. and Salamon, L.M. (2007) for a discussion on possible confusion regarding what ‘non-profit advocacy’ means). Based on this, work increase public understanding of the term and of the objectives of such work along with identifying and exploiting opportunities for collaboration among social justice advocacy organisations in making the case for social justice in Ireland.

• Carry out further work on what constitutes ‘effective’ advocacy work and ‘responsive’ recipients of such advocacy, including identifying the specific skills needed by non- profit organisations in carrying out effective ‘internal’ and ‘external’ social justice advocacy and support the provision of training in such skills, including training in planning, organising and running effective advocacy campaigns.

• Draw particularly on the findings from the case studies by exploring with social justice advocacy organisations what the key elements of a ‘professional’ advocacy campaign are and the possibility of drawing up guidelines on how to run an effective ‘insider’ campaign aimed at changing public policy and to compliment this with an effective public campaign. This work could also be used to develop evaluation tools for measuring the impact of different types of social justice advocacy.

• Explore with policy makers the views that respondent organisations have expressed here on how the policy making process operates in Ireland and elicit their opinions on what constitutes ‘effective’ social justice advocacy.

• Utilising the Knowledge Exchange Forum, explore further the development of effective linkages between local and national level advocacy and related policy issues and identify the particular needs of organisations engaged in social justice advocacy at a local level, including holding regional meetings of the Forum.

• Support social justice advocacy organisations in gathering hard evidence to underpin their work, in developing effective systems for measuring

its effectiveness and impact and in utilising such evidence to achieve policy change.

• Repeat the current surveys in 2-3 years’ time to identify trends and to test the representativeness of the current findings. This future survey could also provide an opportunity to explore sub-sectorial classifications of the non-profit sector which may be more relevant in an Irish context than the UN/Johns Hopkins University “functional-structural” classification system used in the current study.

• Support the greater use of social media as an advocacy tool by non-profit organisations.

• Utilise the actions recommended above to explore the opportunities and challenges involved in achieving greater collaboration and shared learning among organisations carrying out social justice advocacy.

These recommendations reinforce and further develop many of the proposals made in the 2010 report for The Advocacy Initiative by Montague and Middlequarter and provide supporting evidence for the work being carried out under the Initiative. In particular our findings provide further evidence on the need: to better define advocacy, to develop common tools and processes for evaluating the effectiveness or otherwise of social justice advocacy, to carry out research into the advocacy methods and approaches that are proving to be most effective and to improve the knowledge and skill levels of social policy advocates to face the growing challenges of today’s environment. Our results also highlight a growing recognition of the benefits of approaching such challenges in a collaborative manner and make a number of recommendations as to how best The Advocacy Initiative can support such work.

The forum, attended by over 70 social justice advocates focused on what works in social justice advocacy and gave an opportunity to share experiences and learning with others. You can read the full report and view photographs and cartoons from the event on our website at: http://goo.gl/3Fr2q.

The Advocacy Initiative is a three-year community and voluntary sector project that promotes understanding, awareness and effectiveness of social justice advocacy in Ireland. Our aim is to create conditions for stronger social justice advocacy which will strengthen policy responses to existing and emerging challenges in addressing poverty and social exclusion. If you would like to get involved in any capacity, please fill out the simple form on our website www.advocacyinitiative.ie under ‘Get Involved’.

about the authorAnna Visser is the Director of the Advocacy Initiative.

book revieWtitle: the solution-focused helper: Ethics

and Practice in health and social Care by

trish Walsh (2010) Open University Press.

249 pages

Review by Barry Higgins, Social WorkerWalsh begins by tracing the development of Solution-Focused Therapy from its esoteric origins, to its current use in an array of health and social care settings. It becomes evident that solution-focused therapy has not only evolved, it has cross-pollinated with many different forms of practice, producing many interesting hybrids. There is solution-focused therapy, solution-focused practice, solution-focused helping, solution-focused methods, solution-focused principles, solution-focused philosophy.

Walsh shines a solution focused light on five broad areas: multicultural working, learning disability services, elder care, palliative care and community development. Walsh goes into considerable detail on the broader context of each of these areas, before drawing in the solution-focused dimension. This can be a little cumbersome for the eager solution-focused reader, who may wish to delve straight into the ‘good stuff’. Whilst she does refer to solution-focused issues along the way, it is in the latter part of each chapter where Walsh really explores the solution-focused dimension.

A clear benefit of such an approach is that the reader/practitioner receives a really good summary of the broad theoretical knowledge bases that inform their practice as a whole. A possible drawback is that there is less time available to focus on the multitude of interesting solution-focused ethical and practice issues that can arise in the various settings reviewed.

Many of the ethical and practice issues discussed throughout the book also present as general to the health or social care setting being explored, rather than related to solution-focused practice per se. Notwithstanding this, Walsh’s stated aim is to stimulate practitioner awareness of the theoretical bases they draw on in their practice, the ethical dimensions of their practice, and the possibilities that Solution-Focused principles can offer; and in this, she succeeds. Walsh also references a very comprehensive array of solution focused studies, which will certainly provide the reader with food for thought on ways in which solution-focused methods may be incorporated into their work.

book revieWtitle: Child sexual Abuse and the Catholic

Church: Gender, Power and Organisational

Culture by Marie keenan (2012) Oxford

University Press. isBn 978-0-19989567-0.

355 pages.

Review by Keith O’Reilly, Principal Social Worker - Keith.oreilly@cuh.ie Marie Keenan approaches this comprehensive and exhaustive work from the perspective of the researcher and the practitioner, in her respective roles in University College Dublin and as a Social Worker and Psychotherapist. She brings a wealth of clinical experience in her work with people who have experienced and perpetrated sexual abuse. She has also brought this experience to bear in informing her doctoral research on Catholic clergy who sexually abused children.

In this book, the author attempts to contextualise the issue of child sexual abuse within the Catholic Church. As a Social Work practitioner who has worked with children and adults who have experienced sexual abuse, as well as those who have sexually offended, I found this book to be a significant addition to the discourse on the problem, particularly as much of the commentary is initiated by the media in a way that is not always well informed or seeking to educate.

Keenan clearly sets out from the outset how the book will be structured, by delineating it into four distinct parts. Part One considers the context of the issue of sexual abuse within the Catholic Church, including the organisational culture, and information provided by nine research participants , all of whom clerics who have sexually abused children. Part Two devotes three chapters to conceptualising sexual abuse with the author adopting a social constructionist stance in considering the relationship between the individual, the social and the linguistic in bringing about and understanding certain phenomena such as child sexual abuse. The final part devotes attention to the Irish context, benefiting from the wealth of information brought forward by the Ryan and Murphy reports and using this information to attempt to understand the manifestation of the abusive behaviour by clerics from a systemic perspective. The concluding section attempts to synthesise some of her findings with a view to an alternative model of Catholic Church emerging that honours compassion ( for both those who experience and perpetrate abuse).

When one considers the problem of child sexual abuse in the Catholic Church, apart from the behaviour itself, and the associated impact that it has had on the child, one is also struck by the generally inadequate response to complaints, and in some cases, attempted silencing

of those coming forward, which has served to protect the power and authority of an institution, as opposed to honouring the rights and needs of individuals. Many have argued that this response from the hierarchy has served to alienate its followers more than the behaviour itself. From the outset, Keenan seeks to consider the culture that operates within the Catholic Church and asserts that some of the factors that contributed to a climate whereby men could sexually offend also made it possible for the hierarchy to mishandle complaints about the behaviour of the clergy for whom they were responsible. This is a most welcome analysis as it serves to go beyond the ‘few bad apples’ argument that can permeate debates on the issue. She refers to ideas within narrative therapy and social constructionism such as those espoused by Michael White to hypothesise that sexual exploitation and boundary breaking is more likely to occur within a closed organisation where individuals are trying to meet their personal, professional, social and sexual needs within the boundary of one organisation. Historically, fraternisation by clerics among those from the non-clerical world was not encouraged, leading to a somewhat closed environment, lacking perspective. A picture may have thus emerged of a system that was above the law.

She devotes some time to interesting discussion about the issue of celibacy and to what extent that may have had an associated effect on the problem of child sexual abuse within the Catholic Church. For example, she refers to the Church’s teaching on sexuality; specifically that sexual expression can only be realised within the boundary of heterosexual marriage for the purpose of conception, and any other sexual thought, word, desire and action outside of this boundary constitutes a mortal sin on the part of the transgressor. Opposing views are put forward relating to the significance of the celibacy issue, but there seemed to be more common ground in challenging the notion that forced celibacy among clerics was a positive way of expressing one’s sexual identity and the possibility that chastity may bestow a sense of superior character on the celibate person was highlighted. Such a belief system can be exacerbated by the emphasis in clerical training and education on deference to authority and adherence to centralised power structures, rather than encouraging independent thinking and ethical responsibility.

Keenan attempts to consider how the Catholic Church can remedy the organisational failings so evident in various government reports. She expresses concern that there has been an over emphasis on policies and procedures as a means of addressing the problem in the absence of considering the systemic factors already highlighted that create an environment conducive to abusive behaviour. Interestingly, she challenges the notion that rather than being ‘light’ on clerics who offend, their former colleagues and leaders in fact show extreme anger to these men in way that makes their lives ‘almost intolerable’. While this anger may at times be appropriate, Keenan argues that when not attended to in the proper forum; it can contribute to an unhelpful public discourse.

Based on her research, she states the case for a new, more critical theology accompanied by structural reform with particular emphasis on the greater inclusion of laity. She also highlights the need for a reformulation of the status of women in the Catholic Church, inter – religious dialogue and teaching of sexuality. She advocates the adoption of transformative justice approaches in conjunction with criminal and civil law proceedings as a means of being therapeutic to the person who has experienced sexual abuse, as well as encouraging responsibility and accountability on the part of the person who sexually offends with a view to prioritising the safety of children in the future.

While this book considers the problem of sexual abuse in the Catholic Church, it is much more than that. It provides very rich information and analysis in the areas of organisational culture, offending behaviour, therapeutic approaches and social commentary. The author’s systemic conceptualisation allows insights to develop which helps the reader to consider the issue from a wider, multi-faceted perspective. I would not concur with some of her suggestions, for example that the poor handling by the Church hierarchy was primarily down to errors of judgment, rather than cover up, as recent Government commissioned reports have highlighted the steps taken by those in power to withhold information, and silence those who came forward in a way that indicated that they were aware of the meaning of their actions. However, this thought provoking book succeeds in hugely engaging the reader and provides hope that this problem can be addressed meaningfully in the future.

Clifford Casey IASW 2013

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