I also work
with people who are being discharged from hospitals (both general hospitals and
psychiatric hospitals) and arrange and plan services that might be needed to
support them at home or, when necessary, arrange placements in nursing or
residential homes.
I'm also an
Approved Mental Health Professional (AMHP). This is an additional and specific role I have under the
Mental Health Act (1983) that means that I have certain powers and duties with
respect to making applications for someone who might need to be subject to
compulsory hospital admissions or treatments for mental health disorders.
It is seen
as a very important role because I have powers to potentially commit someone to
hospital for up to six months.
That's a very simplistic explanation but a more detailed and precise
explanation would probably go on for another 5000 words! So sometimes my role
at work is to carry out these specific assessments and commit someone by
compulsion for mental health assessment or treatment.
(In general, this is not something that an American social worker would have the authority to do. The laws for involuntary commitment to a mental health institution vary from state to state; however, even the psychiatrist in the emergency room tends to only have the authority to hold a person up to 72 hours involuntarily. To be able to hold a person for a longer period, the psychiatrist would need to obtain a judge's approval. Source: Encyclopedia of Mental Disorders)
I am also
able to apply to a magistrate's court for a warrant to enter a property if we
would not otherwise be able to access the person whom we are concerned about.
For these particular assessments, as the AMHP, I would arrange them and
coordinate the doctors (I need two doctors’ recommendations to make the
applications), ambulance, police presence (if necessary) and liaise with the
hospital regarding bed availability.
In order to
undertake the role of an AMHP you have to undertake an additional postgraduate
level course and keep up regular training annually (in addition to that which
you need to complete as a registered social worker).
I am also a
Best Interests Assessor (BIA) which is another specific statutory role under
the Mental Capacity Act (2005) and that allows me to carry out particularly
specified independent assessments of people who lack capacity and make
decisions about the appropriateness or not of detaining someone in a
residential care home or hospital if they lack the capacity to make a decision
to be there and are being 'deprived of their liberty'.
What are the aspects that you find most rewarding
in your work?
Without
doubt, the best thing about the work is when you are able to discharge someone
and feel that they no longer need the service that we offer. Because I often
work very closely with individuals and their families we get great satisfaction
from seeing the improvement and seeing that we can see people move on.
And what are the parts that you find most
challenging?
I hate using
the compulsory powers that I have to remove someone from home and detain
him/her in the hospital for an assessment or treatment. It can be very
distressing, particularly if we need the support of the police.
I often
think it's not what I thought I'd be doing when I decided to become a social
worker but I only do that if I am absolutely sure that it needs to be done and
of course, we are bound by the law in the way that we can (quite rightly) act
but even if you know the alternatives will be tragic, it is still horrible to
have to do that.
Moving onto another topic, you had once mentioned
(in an offline talk we had) that social workers in the U.K. are not permitted
to provide therapy in a private practice mode as they are in the U.S. - Could you expand on that?
I should
perhaps explain a little better what I meant in our previous discussion. Social
workers can do some kinds of therapies but they would be expected to do
additional specific training and be registered by a regulator as such.
Qualifying
as a social worker or registering as a social worker does not give an
individual 'enough' to have a private practice. I do know some social workers
who have gone on to undertake specific training in psychoanalysis but they
practice as therapists on the basis of their subsequent training and not by
virtue of being 'social workers'.
It isn't so
much a rule against providing therapy so much as a rule that the social work
qualification alone is not 'enough'. If you consider that clinical
psychologists need many years of study and a PhD to practice, a 2 years masters
course in social work which is a generic course is not going to be enough.
What type of additional training would a social
worker need to be qualified to provide therapy in the U.K.? (See Social Work Licensing Part I and Part II to see requirements in the U.S.)
It is a
completely separate training 'route' to be a counselor in the U.K. You can do
that as well as being a social worker but you don't have to be a social worker
to do that. I believe it's a three year path to that qualification as well.
There are
shorter courses that we might do to provide specific training in specific
aspects of counseling such as CBT specifically or systemic therapy but for
'going it alone,' you have to do the full program.
How would you define the role of a social worker
in the U.K.? (In the U.S., social workers typically provide varying degrees of case management and/or therapeutic interventions depending on setting and specific role.)
As for the
role of social work in the UK beyond 'therapy,' it is massive. Case management
is primarily what we would do in adult services in the public sector but there
are broader roles in settings like hospices where there would be more
therapeutic input (with additional training). I have never worked in children’s
services so I can't comment specifically about what they do.
Another question I have in this area is whether
the additional training rule applies for social workers throughout Europe or
does each country within Europe set its own rules?
Different
countries have different set ups as far as social work is concerned. As far as
I understand, there is a similar set up in the Republic of Ireland. I believe
that social work in Europe tends to be much more closely linked to public
sector work in Europe than it generally seems to be, to me, in the States.
To us, the
thought of there being a 'private' social worker seems very unusual. We do though have laws that allow
freedom of movement and recognition of qualifications across Europe so a
Portuguese qualified Social Worker would be able to work in the UK, just as I
would be able to work in Greece or Italy (theoretically anyway).
An additional interesting difference between how
things are in the social work field in the U.S. vs. the
U.K. is that you had mentioned having to study various laws every few years.
Could you please expand on that – what types of laws and for what reason?
The legal
update training mainly relates to my roles as an Approved Mental Health
Professional (AMHP) and as a Best Interests Assessor (BIA) because those are
specific statutory functions.
For the AMHP
role, I have to complete at least 5 days of training per year regarding legal
updates. In the BIA role, there is an expectation of 3 days for legal updates,
as well as regular workshops and forums for both roles.
This is
because, particularly with the AMHP role, we have a function which impacts
significantly on an individuals' human rights and when we act to apply for the
detention of a person we have to be very clear on the legal terms by which we
can do this.
Case law
develops very quickly so we need to be up to date.
Often the doctors rely on us
to know the law and advise them about this. We have to be re-approved every 5
years and this involves a legal exam. The laws specifically are the ones
relating to Mental Health and Mental Capacity.
Moving onto another topic, you recently wrote a
post about wanting to see some sort of social media forum created for social
workers throughout the world. Could you recap what you were envisioning and how
people could get involved?
It's in its very
early stages but I see Online Technology 4 Occupational Therapy as a
model and particularly their virtual learning exchange http://ot4ot.com/world-ot-day-2011-
I'd love to see a similar project for social work and copying shamelessly from
their name, I set up a SW4SW site.
There isn't
much there yet, but I'm currently using it to test different software packages
to see if I can find what I like and to establish a forum to share ideas which
anyone is welcome to join at http://www.sw4sw.net/forum/
I don't
really have any great desires to 'run' it but I would like to see more
discussion and innovation in collaborative working for the benefit of social
work knowledge and education.
If someone
else wants to pick up the idea and run with it, I'd be more than happy but I
thought, rather than wait for someone else to come along, why not try and get
started and at least find a place to have these discussions.
Finally, let's talk a bit about your blog. When did you first start it and do you have any specific aspirations?
The first
post in my blog was in November 2007 but I only really started writing
regularly in April 2008. I had absolutely no aspirations. I remember being
really excited by getting 12 views in the first few months. I think I had fewer
than 10 views in the first 4 months.
For me, it
was about creating the type of blog I wanted to read. I read blogs but at that
point there were very few social work blogs and I couldn't find any other UK
social work blogs so I started to write one.
Also, you have chosen a rather unusual name @monstertalk
and avatar (see cute hamster above). Could you share with us how and why you
came up with these?
Ah yes.
Well, we need to work backwards on this. The name of the blog came first
'Fighting Monsters' and it is from the Nietzsche quote 'Be careful when you
fight the monsters, lest you become one' - it is an adage that has long stuck
with me from my first work in mental health but I've related to it in different
ways.
We used to
joke that those who work in mental health sometimes are not the most 'well
adjusted' people in the world. I took the quote as a warning to myself that I
should always be aware of what the 'monsters' that I am fighting are - namely
the stigma and distress of mental illness and a warning that I shouldn't become
a part of the problem rather than the solution.
Remember
when I started writing the blog, I wasn't expecting an audience and was writing
for myself. That's very apparent if you look at my early posts.
The Twitter
name @monstertalk was an attempt to link the name to the blog although I guess
many people see me on Twitter and have no idea the blog exists - it was my very
basic attempt at 'branding' (I've been reading blogs about blogging for too
long!) - but it is memorable!
As for the
hamster, well, being anonymous, I can't put a picture of me as an avatar. I had
various cat avatars for a while but then I wanted to be different. That hamster
is one that belonged to one of our foster kids and I think it's quite a cute
picture!
Photo Credits: Scenes of London by My husband (who has asked to be anonymous)
Sept 12, 2011 addendum: cb has closed down both her monstertalk twitter account and fighting monsters website.
Sept 30, 2011 addendum: cb wrote a Goodbye post on her site. I've included a copy of this within the comments section for your viewing because her site will only be open for a short time.
(affiliate link), he defines unlearning as:
by Irvin Yalom?
