‘Nothing about Us without Us’: the Voices of People with Lived Experience in Practice Education and Post-Qualifying Social Work

Introduction

The voice and perspective of People With Lived Experience (PWLE) is essential to social work practice; to support good practice, challenge inadequate practice and thereby contribute to the improvement of social work intervention (Tanner, 2017; Westwood et al., 2017). These authors concur with most of the literature that student social workers are well served by learning from PWLE. These contacts are described as the ‘pivotal link’ (Westwood et al., 2017, p. 856) for learning about essential social work skills. However, they go on to conclude that this can diminish post-qualification as service delivery and resource management is prioritised. Indeed, Branfield et al. (2007) highlight diminishing interest in learning from PWLE post-qualification.

Formal inspections can increase the focus on the experiences of PWLE for social workers, and Westwood’s article seeks to explore the use of a mobile App to capture ‘in the moment’ PWLE feedback (Westwood et al., 2017). This method of gaining feedback can be seen internationally (Celedonia et al., 2021). However, these articles to some extent ignore the power dynamics evident in collecting feedback in this way. Indeed, as IMPACT members (the service user and carer group at the University of Worcester), we would emphasise the importance of longitudinal feedback, from the beginning to the end of social work involvement, rather than capturing a snapshot moment. Other research continues to emphasise the importance of PWLE feedback (Wilkins and Forrester, 2021) and discuss some attempts to gain feedback after each meeting. This is particularly prevalent in the family therapy field (Sundet 2017).

There has been a paucity of research into the use of PWLE in the post-qualifying education of social workers. Agnew and Duffy (2010) conducted a positively evaluated, small-scale study into the use of PWLE in educating palliative care social workers. A study by Farrow and Fillingham (2012) articulated some key messages in involving PWLE in social work manager training. First, they identified a need for post-qualifying programmes to be developed with the involvement of PWLE, alongside employers, at a regional, sub-regional and local level. However, there is a dearth of literature to suggest this is occurring. Secondly, a theme emerged about the pressures of managerialist cultures in social work. Whilst PWLE involvement was viewed positively, there was little evidence to suggest that it changed these cultural practices due to the demands these managers were facing. However, it was acknowledged that differing groups of learners are unique and will respond in different ways. Finally, the article referred to the complexity of managing the expectations of PWLE, alongside those of the managers. Issues of professional identity emerged, whereby managers felt their expertise was being threatened and negated.

According to research by YouGov in 2021, the vast majority of social workers value Continuing Professional Development (CPD) and most find it improves their practice, but four in ten do not have time to do it. The survey found that 83 per cent of the social workers saw the value of CPD, whilst 76 per cent said it kept their practice up to date and 69 per cent said that it improved their skills as a social worker. Time was the biggest barrier to undertaking learning and development, whilst almost a fifth said they were not supported by their employer to carry it out.

However, a study by Webber and Robinson (2012) revealed views from qualified staff who did not see the relevance of having people they work with every day involved in their ongoing training. There was some resistance to power sharing by the qualified staff interviewed, and even a view that PWLE as trainers would represent a dilution of quality in professional standards. By way of contrast, most of the pre-qualifying research (Anghel and Ramon, 2009; Unwin et al., 2018) generally points to students developing different perspectives, developing empathy and receiving a ‘non textbook’ critique of the world. The sharing of power leads to new constructs in students’ minds, and there is also the serendipitous spinoff of PWLE benefitting personally from playing such valued roles.

Further emerging themes from the literature identified the necessity to design meaningful and planned engagement of PWLE in both pre- and post-qualifying education, and a need to measure the effectiveness of involvement in bringing about change. If input from PWLE is recognised as an important part of pre-qualification training, why does it largely disappear post-qualification? In meetings we have had, both with current Practice Educators (PEs) and social workers aspiring to be PEs, the lack of PWLE involvement in post-qualifying training was seen as a surprising anomaly in need of correction. Barriers were stated to have difficulty accessing/lack of knowledge of how to find suitable PWLE to meet specific training needs.

We know that the input of PWLE in pre-qualifying teaching can enhance students’ learning (Anghel and Ramon, 2009; Tanner et al., 2017; Unwin et al., 2018; Rooney et al., 2019). Our aim was to extend this impact and value into practice education and beyond whilst also modelling a co-production approach, with PWLE being involved on an equal basis with academics and practitioners through the planning, delivery and evaluation stages.

This led to our engagement, as PWLE, in the PE Professional Standards Stage 1 course from its infancy through to an evaluation of PWLE teaching input, both during the course and after. This approach offered a planned delivery and both post-teaching feedback sessions and the ongoing collation of longitudinal feedback from social workers training to be PEs.

PWLE involvement at the University of Worcester

Social Work England (SWE, 2022) suggests that all social work practitioners should regularly ask users with lived experience of social work for feedback. It suggests asking a variety of people for feedback on different areas of their practice, through formal or informal discussions, through letters of recommendation, supervision or even complaints (!) and suggests that the key thing to remember is that feedback should be used constructively and with an understanding of that person’s viewpoint, followed by reflection on how it can help the development of working styles and practices. PWLE involvement in the ongoing Social Work CPD is not, however, mandatory, and one of the findings from the recent West Midland Teaching Partnership ASYE (assessed and supported year in practice) Participation Project (WMTP, 2022) was that local authorities absolutely saw the value added by PWLE but found it difficult to access PWLE to be involved in training qualified Social Workers.

At the University of Worcester, it is recognised that feedback is one of the most important tools for learning on placement. PWLE must be at the core of this learning. Although students in both the BA and MA Social Work courses are asked to provide three instances of structured feedback for their e-portfolios, they are encouraged to seek feedback at every appropriate opportunity to demonstrate their learning. However, only three pieces are required to be included in the e-portfolio.

The PE will be responsible for collecting at least two sources of feedback, mainly from direct practice, usually direct observations. The student is responsible for collecting one piece of feedback for the e-portfolio and is encouraged to be as creative as possible in gaining feedback. Each piece of feedback should be jointly planned in supervision beforehand with a discussion about the relevant method and how it is going to be used. The PE feedback should be completed without the student being present so that the person with lived experience does not feel inhibited in expressing their views, though it is important to acknowledge that there may still be difficulties owing to the PE’s unequal power relationship. If there are any gaps in evidence with regard to skills or value base, then this is the PE’s opportunity to gain more information on the student’s direct practice.

For each of the three pieces of feedback, student social workers are specifically asked to consider issues regarding engagement of the PWLE; how consent was achieved, and the reasons why a particular method of gaining feedback was chosen. Moreover, student social workers are asked to reflect on the experience. This reflection is underpinned by ‘Fundamental Requirements’ developed by a past member of IMPACT (University of Worcester, 2021). These are that the gaining of feedback from PWLE should be based on guiding principles such as confidentiality, reassurance that comments made during feedback will not affect the service they receive, clarity about the process and choice of how and when feedback will be gathered and the opportunity to either decline the request or indeed amend comments at a later date. Respect for the service user or carer at all times is a fundamental requirement. Osborne, cited in Rooney et al. (2016), further adds that it is important that student social workers be aware of the expectations of the PWLE in this process (and be able to manage these), and be able to accept and reflect on the value of ‘raw’ (verbatim) comment from PWLE.

Before going on placement, students have a session with PWLE that seeks to embed these considerations and to help them to think creatively about how to gain meaningful feedback. Students are also encouraged to gain longitudinal feedback wherever possible—from the beginning to the end of social work involvement. Between 2015 and 2019, as a consequence of PWLE input into teaching centred on preparing students for their practice placements and feedback to students via the quality assuring of e-portfolios post-placement, there was a steady upward trend in the quality of feedback and in the thought and creativity put into methods for gaining it. However, it was notable that despite the PE gaining two items of PWLE feedback, there was a gap in how the PEs were prepared for this task, and that PWLE involvement was somewhat lacking in this preparation. This led to our involvement in the planning for the new PEPS1 programme, which is now in its second year of delivery at the university.

PEPS1 input and reflection

The Practice Educator Professional Standards (PEPS Stages 1 and 2) is a programme, which enables qualified social workers to support and assess the capability of student social workers in the workplace (BASW, 2022).

It seemed a natural progression to us to be involved in this ongoing social work training as we had already participated in the assessment of student social workers’ portfolios. Helping trainee PEs to prepare student social workers for practice, therefore, had a double pertinence. Nevertheless, was this presumptuous of us? Was ‘nothing about us without us’ enough justification? (Charlton, 1998; UN Convention of Human Rights, 2017). Reassurance came from the Practice Education Curriculum that stresses the importance of the involvement of PWLE: 

Understanding of, and critical engagement with, the experience of people with lived experience of social work, including uses of culture and discrimination and social justice … (para 4.4.1 xi). (BASW 2022)

The Professional Capabilities Framework (PCF) domains reinforced this:

Encourage students to self-evaluate and seek service user and carer and work-based colleagues’ feedback to develop their performance (Values statements 1,4,6,7; PCF 1). (BASW 2022a)

Despite the rhetoric, it was still a daunting step for us to take. However, our previous involvement at the University of Worcester and the consequent building of sound relationships between us as PWLE and academics gave us the confidence to participate when we were invited to do so. 

The messages we wished to convey to the trainee PEs were based on the fundamental requirements discussed earlier but were enhanced by our understanding of post-qualifying social work as we had experienced it in times of crisis, stability and safeguarding situations. We wanted to make a real difference in the development of the workforce by emphasising the need to communicate creatively and intelligently with PWLE when obtaining feedback. Students only need to provide one-third of the feedback, but PEs provide two-thirds and are possibly better placed to get ‘raw’ (verbatim) PWLE feedback, which provides such valuable learning opportunities. The ripple effect of having PWLE involved with PEPS not only helps to train the students but also helps to inform the trainee PEs’ own professional practice. This was highlighted in student feedback for PEPS1, following the delivered teaching:

QUOTE 1: SOCIAL WORKER (female, adult services): ‘This has increased my perspective and knowledge on being creative and sensitive when gaining my feedback from PWLE’

QUOTE 2: SOCIAL WORKER (female, children’s services): ‘I am now more aware of the challenges of PWLE providing feedback. Good ideas from Anne and David’

QUOTE 3: SOCIAL WORKER (male, adult services): ‘This has changed how I will approach gaining feedback now. I intend to brief my service users and carers before the student arrives’ (*note to reader: quote adjusted to ensure anonymity of the social worker)

QUOTE 4: SOCIAL WORKER (female, children’s services): ‘This has helped me to remember the human aspect of social work’, ‘I hadn’t thought of longitudinal feedback before. We tend to just send a comment and complaints form out at the end of contact’.

The above quotes are pertinent in relation to the identified themes raised earlier in terms of challenging that managerialist approach to social work practice (Quote 4), the unique expertise of PWLE, what this brings to teaching and learning (Quotes 1 and 2), and finally (Quote 3) how PWLE input changed the planning of a placement to ensure meaningful PWLE feedback was gained; this by the involvement of PWLE in a co-productive way with the social worker/trainee PE prior to a placement starting. Interestingly, we received no negative comments about our involvement, reinforcing the message that the involvement of PWLE was valued and should be integral to the planning and delivery of post-qualifying training. Barriers, real or imagined, can be overcome.

Being involved with PEPS has also enabled us to reflect on our own abilities. We can even use our own vulnerability as a positive factor in helping to train the social care workforce and we hope that it has a two-way effect of nurturing resilience. Using our lived experience as a force for change helps to redress feelings of anger and powerlessness. The feeling of ‘doing with’ and not being ‘done to’ is empowering. When practitioners actively seek the views of PWLE, experts by experience become active members of the service they are receiving and not just passive recipients of it. 

We have also been enabled to build on our IT skills as much of our initial involvement was by video conferencing. It is a good way of making the best use of time but has taken some getting used to and has highlighted some training needs for the university to act upon. Despite this challenge, our involvement online, and post-COVID in the classroom, has provided lively, engaging and mutually thought-provoking discussions with social workers aspiring to be PEs.

Conclusion

Continuous professional development is mandatory for qualified social workers and the voice of PWLE remains central to this development (SWE, 2022). The voice of PWLE is seen as an integral part of pre-qualifying training but is less present in the post-qualifying framework of social work practice. We have attempted here to outline and evidence the importance of PWLE involvement in post-qualifying training. Of particular note is that this needs to be carefully thought about and planned based on the true principles of co-production and on well-developed relationships between academics/trainers and PWLE.

How to embed the voice of PWLE in all its guises, together with the wisdom and humanity that comes with it, is understandably a challenge. Local authorities and voluntary sector organisations employing social workers all have their targets, key performance indicators and budgets to consider. The result is that PWLE tend to become marginalised within the managerialist structure, to be ‘done to’ and not ‘to learn from and with’. The nature of post-qualifying social work practice is innately complex, and learning extends well beyond a two- or three-year training period. The voice of PWLE should be seen as a vital and integral part of this process.

Author Biographies

Anne Duddington is a full-time carer for her son who has a severe learning disability and complex health and care needs, requiring ongoing social work input from children’s services through to adult services. His inspiration, as well as his vulnerability due to lack of speech and mental capacity, especially in safeguarding situations, is the impetus for her work with a local charity and consequent involvement with statutory services to enable carers and people with a learning disability to fulfil their potential and to have a strong and effective voice leading to change. She has been a member of IMPACT since 2010.

David Gowar is a musician and ex-music lecturer who also spent eight years as a residential social worker. He has an MA in Social and Political Science from Cambridge University and was invited to become a member of University of Worcester service user and carer group (IMPACT) in 2013 to share his experience of domestic abuse, post-separation abuse, false allegations and institutionalised prejudice. He has received compensation and numerous apologies for errors made by Children’s Services over a ten-year period but has nevertheless become alienated from his youngest daughter. He is a passionate advocate for change in the way male victims of domestic abuse and coercive control are treated by legal and human services professionals. 

Kay Wall is a Senior Lecturer at the University of Worcester. She has a social work practice background grounded in working with both adults and children who offend; and is a strong advocate for the re-establishing of social work values into this practice area. She has service user experience in the social work field of adoption.