• Identifying and responding to alcohol misuse in memory clinics: current practice, barriers and facilitators

      Thake, Anna; Wadd, Sarah; Edwards, Kim; Randall-James, James; University of Hertfordshire; University of Bedfordshire; South Essex Partnership NHS Foundation Trust; Bedford CMHT for Older People (Emerald, 2015-05-18)
      Purpose – The purpose of this paper is to explore current practice, barriers and facilitators to identifying and responding to alcohol problems in memory clinics. Design/methodology/approach – A questionnaire sent to professionals in 55 memory clinics in England, Wales and the Isle of Wight and two focus groups with professionals from three memory clinics in England. Findings – Only 1/35 clinics that responded to the questionnaire was using a standardised alcohol screening tool but all attempted to gain some information about alcohol use. Without screening tools, practitioners found it difficult to determine whether alcohol use was problematic. Barriers to identification/intervention included cognitive impairment, service-user being “on guard” during assessment, presence of family members/carers, time constraints and a perception that brief interventions were not within the remit of memory clinics. Facilitators were obtaining visual clues of problem drinking during home visits and collateral information from family members/carers. Research limitations/implications – Focus group participants were recruited through convenience sampling and a small number of professionals took part. This means that the findings may be subject to selection bias and limits the generalisability of the findings. Practical implications – Memory clinics should provide guidance and training for practitioners on how to intervene and respond to alcohol misuse. Further research is required to determine the most effective way to identify alcohol problems in people with cognitive impairment and how to deliver brief alcohol interventions that take account of cognitive deficits. Originality/value – This is the first study to examine alcohol screening and interventions in memory clinics and identifies a need for guidance, training and further research.
    • Alcohol screening in people with cognitive impairment: an exploratory study

      Randall-James, James; Wadd, Sarah; Edwards, Kim; Thake, Anna (Taylor & Francis, 2014-12)
      Objective: Alcohol misuse can coexist with and/or contribute to the development of cognitive impairment in the older adult population but continues to be underestimated and undetected in older people. This study aimed to examine the feasibility and acceptability of routine screening for alcohol misuse in a small sample of older people with cognitive impairment receiving services in memory clinics. Methods: This study employed a qualitative and exploratory design, using a convenience sample of individuals attending a memory clinic in England. Ten service users older than 65 with a diagnosis of cognitive impairment (i.e., mild cognitive impairment or dementia) took part in the study. Individuals who met inclusion criteria were invited to take part in an hour-long interview, which included the interviewer administering the alcohol screening tools. Interview transcripts were analyzed using thematic analysis. Results: Participants were able to engage with the screening tools and could, with assistance, complete them in a collaborative and timely manner without distress. All participants reported that these tools were acceptable as part of the clinic assessment. Administering the screening tools was not time-consuming or difficult, making their use feasible within the memory clinic setting. While there were some challenges (e.g., arithmetic, recall, language problems), these challenges could be overcome with the aid of the person administering the screening tool using standardized techniques for assessment administration. Conclusions: Routine screening for alcohol misuse in older people with cognitive impairment receiving services in memory clinics is feasible and acceptable. The process of completing alcohol screening tools with older adults receiving services at memory clinics may increase awareness of the potential impact of alcohol on cognitive functioning and provide practitioners with an opportunity to educate service users about the ways that their drinking is affecting their memory. Several techniques to facilitate completion of screening tools were identified. Future research should evaluate the reliability and validity of alcohol screening tools with older people through corroborating screening results with other assessment methods.
    • Women Against Fundamentalism: stories of dissent and solidarity

      Dhaliwal, Sukhwant; Yuval-Davis, Nira (Lawrence and Wishart, 2015)
    • The recruitment, assessment, support and supervision of lesbian, gay, bisexual and transgender foster carers: an international literature review

      Cosis-Brown, Helen; Sebba, Judy; Luke, Nikki (University of Oxford, 2015-02)
      Electronic databases and websites covering the international literature were used to identify 20 published papers (covering 19 studies). Those identified were from the UK, USA and Australia. Comparisons across countries are subject to limitations of different cultures and services. Most of the research exclusively about LGBT foster care, rather than research that merges fostering and adoption, has developed in Australia where, in contrast to the USA and UK, adoption is rarely the chosen option for permanence for children in public care. Studies identified for the review were published since 1996 and were all written in English. Most of the studies focused exclusively on the perceptions of established foster carers’, less often on perceptions of social workers and one included young people’s perceptions. The studies used a range of methodologies from in-depth interviews and focus groups to larger scale surveys using questionnaires. Study samples ranged from 1 to nearly 400. No studies were identified in the review that included interventions subjected to evaluation using comparison or control groups. Most studies adopted a retrospective design, seeking the perspectives of established carers.
    • The role of the supervising social worker in foster care: an international literature review

      Cosis-Brown, Helen; Sebba, Judy; Luke, Nikki (University of Oxford, 2014-09)
      Foster carers play a central role in providing family based care for foster children. Enabling, developing, and supporting foster carers to care for foster children in a way that provides security, stability, love and a strong sense of identity and belonging involves foster carers themselves being professionally supported, both emotionally and practically. This literature review focuses on ‘social work support’, and more particularly the role of the supervising social worker in providing that support and supervision. The discrete role of what we are refer to for the purposes of this literature review as the ‘supervising social worker’ (known by many others terms across the world), to provide supervision and support to foster carers, is a relatively recent development. Alongside the professionalisation of foster care, there have been changing views of the relationships and duties of supervising social workers and the introduction of criteria for supervision and inspection of fostering services. The expectations of the supervising social work role are set out in Standard 21 of the Fostering Services: National Minimum Standards in England (Department for Education, 2011). The supervising social worker acts as the conduit between the fostering household and the fostering service, and is distinct from the role of the foster child’s social worker. The role of the supervisory social worker is complex since it encompasses both the support and supervisory aspects of work done with the foster carer. For example, if a child protection matter is raised by a foster child’s social worker, then the supervisory nature of the relationship between the foster carer and their supervising social worker becomes more prominent whereas when a foster carer experiences a family bereavement, the support relationship may take over. Foster carers report consistently that this relationship is very important to them and it has been shown to be a factor in the recruitment (in terms of the beliefs of potential carers about what support will be available) and retention of carers (Sebba, 2012). It is therefore of interest that the supervising social worker role has attracted little research or scholarly attention, perhaps because of the lack of well-developed models of supervising social work. This review of the international research addresses the topic of the role of the supervising social worker. Foster care is considered in its broadest terms, including family and friends (kinship) foster care. The review was undertaken in order to consider the following three questions: What do supervising social workers do, and what are the components of supervision and support they offer foster carers? What contributes to effective supervision by social workers of foster carers? Does the quality and/or quantity of support and supervision offered to foster carers by supervising social workers impact on: outcomes for foster children; stability of placements; retention of foster carers? Electronic databases and websites were used to identify 22 studies (24 related papers) from the UK, US, Canada and Australia. Comparisons across countries are subject to limitations of different cultures and services. Studies identified for the review were published since 1996 and were all in English. Fourteen of the 22 studies focused exclusively on foster carers’ perceptions, the others focusing on social workers, caseworkers, foster family resource workers, fostering service managers and in one study young people, usually in addition to foster carers. The studies used a range of methodologies from in-depth interviews and focus groups to larger scale surveys using questionnaires. Study samples ranged from 7 to nearly 2000 with only five studies reporting on data from samples of fewer than 30 participants. No studies were identified in the review that included interventions subjected to evaluation using comparison or control groups. Most studies adopted a retrospective design.
    • Finding the right match: a survey of approved adopters’ experiences of agency support in the linking and matching process

      Dance, Cherilyn; University of Bedfordshire (University of Bedfordshire, 2015-03)
      This research study was commissioned by Adoption Link to explore approved adopters’ experiences of agency support in their search for a child or children who they felt able to parent. The impetus for the research came from Adoption Link’s awareness, as a result of contact with their users and posts on various adoption forums, of some level of dissatisfaction with the ways in which processes for linking and matching were operating for approved adopters. By way of setting the scene for the study findings, this introduction looks briefly at the policy background as it relates to linking and matching in adoption; the current situation, particularly in England, regarding the numbers and profiles of waiting children and approved adopters; provision of adoption agency services and how links and matches are achieved. It is important to note that much of what is covered in this introductory section applies to England only. While there is some shared legislation across the four countries of the UK , each implements elements of distinct legislation and policy in relation to looked after children and adoption and up to date statistics for Northern Ireland, Scotland and Wales are rather difficult to come by. Although the policy context in different parts of the UK might be distinct, adoption practice in relation to children in care is similar. The focus here on England is in part pragmatic – because information about the situation in England is easily available and in the public domain –it also reflects the fact that the majority of responses to the survey reported were from adopters in England and space precludes a detailed discussion of the similarities and differences between countries.
    • Learning from the research process: discussing sensitive topics as a cultural outsider

      Manders, Gary; Galvani, Sarah (Taylor & Francis, 2014-11-19)
      This paper explores the sensitivities and cultural complexities of engaging in research about substance use with a Sikh Punjabi community in England, from the perspective of cultural outsiders. The objective of the research was to explore the feasibility of developing a Community Alcohol Support Package (CASP) within the community, where existing alcohol service provision was felt to be limited, using ethnographic research methods. Tensions between a strict religious prohibition against drinking and a cultural acceptance of a heavy drinking culture created the conditions for the research and its particular challenges. This paper reports on the process of conducting the research and the transferable lessons for social work teaching and practice. Two key methodological challenges are highlighted together with reflections on how they were addressed: first, the problem of engagement and negotiating access to the community in focus; second, the challenge for outsiders of tuning into the socio-political context of the community and the power dynamics within it. Overcoming these challenges required high levels of sensitivity to the concerns of the community, while maintaining research integrity, and demonstrable openness and honesty in the course of developing research relationships. The lessons for social work education and practice are discussed.
    • Protecting asylum seeking children on the move

      Kohli, Ravi K.S. (Université de Poitiers, 2014)
      This paper considers the ways that children seeking asylum can be assisted to make sense of movement in their lives as forced migrants, and to find a sense of “home” in a foreign country after arrival, even if their stay in that country is temporary. It explores the proposition that movement happens in three dimensions – as geographical displacement, as the passage of time, and as psychological and maturational change. While acknowledging the utility of using the 1951 Refugee Convention as a defence against children’s persecution, the paper suggests that the 1989 UN Convention on the Rights of the Child offers a wider framework for considering asylum seeking children’s life-long well-being. Within the UNCRC’s design, an example of a Guardianship service in Scotland is used to track movement across three domains of practice – when processing an asylum claim, providing welfare, and regenerating social networks. The paper considers that offering protection is not just a shield against persecution, but also an embrace that makes children feel “at home”.
    • The importance of practice learning in social work: do we practice what we preach?

      Domakin, Alison (Taylor & Francis, 2015-04)
      This paper reports on themes identified from focus group discussions with practice educators, in which they articulated concerns about factors that limited their work with students on placement. Four key themes are identified from analysis of the data: (1) The absence of workload relief for agency based practice educators; (2) A lack of knowledge about the academic curriculum in qualifying social work programmes; (3) A sense of isolation from universities placing students with them; (4) Concerns about the quality of practice learning experiences they could provide to students. Expressions of guilt and anxiety were a prominent feature of the focus group discussions. Almost all the practice educators felt that their work in this role was not good enough. They were concerned about standards and missed opportunities to work developmentally with students who may be at risk of failing, or conversely to stimulate those who were more able. The findings suggest that universities should consider whether practice educators are sufficiently connected with other parts of the social work education system to fulfil their role.
    • Community awareness raising on child sexual exploitation: possibilities and problems

      Dhaliwal, Sukhwant; D'Arcy, Kate; Thomas, Roma; University of Bedfordshire (Emerald, 2015-01-12)
      Purpose – A number of reports on child sexual exploitation (CSE) have pointed to the importance of community awareness raising as a preventative measure, a means of extending the reach of CSE services and widening the scope of social responsibility to protect children. However, little has been said about how to undertake such activities; how to do this well and the potential pitfalls to avoid. The purpose of this paper is to draw out critical questions about the notion of community and highlight what can be learnt from historical debates about multiculturalist practice. While the paper does not focus solely on ethnic minority communities, the authors do take stock of pertinent points from that literature in relation to issues of engagement, power and representation and applicable learning for awareness raising around CSE. In the second half of the paper, the authors consider the issue of awareness raising within communities. The authors draw on the limited literature on community awareness raising in CSE, contextualising this with reference to relevant learning from other pertinent bodies of work, to reflect on implications for practice. Design/methodology/approach – This is a conceptual paper based on a review of various bodies of literature. The first half reviews the literature about community, community engagement, and multiculturalism as policy and practice. The second half draws evidence from the literature on forms of awareness raising on CSE and other sensitive social issues to discuss implications for practice arising from the authors’ reflections on the literature. Findings – The review produces three key findings. First, the need to transfer historic insights into the limits of “community” and multiculturalism and apply these to the emergent field of CSE. Second, despite theoretical distinctions between “community” and “society”, evidence from the literature suggests that the term “community” is being applied more generally to refer to a wide range of events and practices. Third, the authors conclude with some points about what may work well for CSE professionals developing work in this field; that is, clear aims and objectives, nuanced approaches and targeted messages. Research limitations/implications – This is an under-researched area where there are currently no published evaluations of community awareness raising interventions for CSE. Effective evidence-based strategies for engaging communities are urgently needed for CSE prevention work to be extended in positive ways which protect those affected. Originality/value – This paper is original in drawing insights from historical debates about multiculturalist practice to inform thinking on community awareness raising on CSE. It makes a valuable contribution by bringing together insights from a number of distinct bodies of literature in ways which can inform practice.
    • A framework for the analysis of the social processes in the adoption of disabled children

      Bunt, Sarah; University of Bedfordshire (Sage, 2013-03-22)
      Summary: There is a dearth of literature on the adoption of disabled children within the UK, and that which has been published is somewhat dated and often characterised by largely empiricist approach, which is perhaps surprising in view of the fact that the study of adult disability has benefited so greatly from an understanding of the social processes involved. Cousins (2009), for example, has suggested that disabled children are profoundly disadvantaged in the adoption process by the negativity associated with the social construction of disability. Findings: This article seeks to develop a framework that provides a theoretically informed and multidimensional approach to the understanding of the adoption of disabled children. It does so by drawing on Layder's delineation of different levels of analysis. This entails examining wider macro features that influence adoption processes, right through to the micro interactions between adopters and adoption agencies. The article also applies Bourdieu's concept of the habitus to assist in our understanding of how individual agents internalise the messages around them, which can influence and mediate their actions in adoption. Application: This framework indicates that adoption outcomes for disabled children can only be understood within wider social processes, which can affect not only individual adoptions themselves, but also the practice of adoption generally. This has implications for both research and practice, for if, on the one hand, it provides a more comprehensive framework for the conduct of research, and it also potentially enables practice to be informed by wider considerations other than those occurring in the immediate context of the adoption.
    • Child maltreatment: how can friends contribute to safety?

      Allnock, Debra; University of Bedfordshire (Emerald, 2015-01-12)
      Purpose – The purpose of this paper is to present the findings of a study of support received by 60 young adults who experienced sexual, physical or emotional abuse and neglect in childhood. It is focussed on the support provided by friends in particular, and draws out relevant learning for child sexual exploitation (CSE). Design/methodology/approach – In all, 60 young people completed a questionnaire, complemented by a two hour follow-up interview to explore experiences of formal and informal support in disclosing abuse. In total, 13 young people were recruited on the basis of their prior participation in a larger, associated study of child abuse and neglect, with the remainder recruited via open invitation. Findings – There is rich information in the interviews about the ways that friends provided support to participants. Friends provided practical, moral and emotional support. They intervened to keep their friends safe. They offered emotional “escape” and a conduit to adults who could help keep them safe. Importantly, friends recognised that participants were in distress even when they did not know the participants were being abused. Practical implications – The results highlight that friends have a crucial role to play in helping children to keep safe and to feel safe, provided that they are equipped with information and knowledge of how to respond and where to seek help. Originality/value – The paper is original in considering the role of friends within a community safety framework. In addition, the study sample is larger than other studies of its kind, and considers a wider variety of child maltreatment experiences than previous studies, making clear links to CSE.
    • Social work and foster care

      Cosis-Brown, Helen; Middlesex University (SAGE, 2014-02)
    • No one noticed, no one heard: a study of disclosures of childhood abuse

      Allnock, Debra; Miller, Pam (NSPCC, 2013)
      This report describes the childhood experiences of abuse of 60 young men and women and how they disclosed this abuse and sought help. These young people experienced high levels and different kinds of violence, including sexual abuse and family violence. It is often asserted that young people who experience abuse do not talk about it. The face to face interviews for this study show that a majority of young people did attempt to disclose their abuse to at least one person although this information was not identified in the surveys for this study. Eighty per cent – 48 of the 60 young people we spoke to – attempted to disclose the abuse before they were 18 years old. Some of these disclosures led to protective action and some did not. Research has suggested that sexual abuse is unlikely to be disclosed – and yet 38 of the 44 young people (86 per cent) who suffered from sexual abuse did disclose during childhood; 66 per cent attempted to disclose when the abuse was happening. However, just like many high profile cases, not all of these disclosures were “heard” or acted upon. Young people generally made more than one disclosure. Of the 203 disclosures in childhood that were made, 117 disclosures (58 per cent) were acted upon by recipients. Suffering from abuse is a distressing experience. It should be no surprise that disclosures that were ignored, denied or badly handled added to the negative experiences of the young people in this study. Policy-makers and people working with children should use the evidence in this report to support better identification of abuse by adults, reduce the barriers to disclosure and to improve the experience of disclosure for young people. Practitioners should particularly consider how they can change their practice to ensure that the experiences of the young people in this report are not repeated
    • Working with older drinkers

      Wadd, Sarah; Lapworth, K.; Sullivan, Mary Pat; Forrester, Donald; Galvani, Sarah; University of Bedfordshire (University of Bedfordshire, 2011-08)
      Findings presented in this report demonstrate that older drinkers have different stressors, precipitating factors and risk factors for relapse than younger drinkers. They also face a number of unique barriers to treatment and are more likely to remain ‘hidden’ from services. Despite these challenges, age-specific practices required to meet the needs of older people and draw them into treatment are poorly understood. The purpose of this project was to develop guidelines on what strategies and treatment approaches are likely to work best with older drinkers based on synthesis of relevant literature, insight from alcohol practitioners who specialise in working with older people and the perspectives of older people receiving alcohol treatment. A set of concise guidance documents will be prepared for health and social care workers and alcohol service providers in due course.
    • Working with alcohol and drug use: exploring the knowledge and attitudes of social work students

      Galvani, Sarah; Hughes, Nathan; University of Bedfordshire (Oxford University Press, 2008-10-20)
      Many social workers in the UK work daily with the social harms linked to problematic substance use. Historically, however, their drug and alcohol training needs have been overlooked. This study set out to achieve two key objectives: (i) to assess social work students' knowledge of, and attitudes towards, working with people with substance problems; and (ii) to develop and test a questionnaire to meet this objective. A four-part self-completion questionnaire was developed and administered to a purposive sample of 156 social work students. The focus of this article will be on the results of Part 2 of the pilot survey, which focused on the students' attitudes towards, and knowledge of, substance use. One hundred and twenty-one completed questionnaires were used as the basis for analysis. Three factors emerged as the key explanatory factors demonstrating significant relationships between them: ‘knowledge’, ‘support from colleagues’ and ‘legitimacy of role’. Social work training needs to recognize the need for alcohol and drug education within social work qualifying programmes in order that future social workers will feel equipped with the knowledge and legitimacy to do their job and meet the needs of people who have problems with alcohol and drugs.
    • The development of problem-solving knowledge for social care practice

      Marsh, Peter; Fisher, Mike; University of Sheffield; University of Bedfordshire (Oxford University Press, 2006-12-13)
      The continuing modernization of social care in the UK has placed a high premium on evidence. However, there is a lack of investment in social care research in general, and in practice-based research in particular. The paper argues that there is a need to make better connections between research and practice if there are to be substantial improvements in services. The implications of these improved links include more efficient translation of research into action, and more embedding of research within the range of literature that supports service development. The necessary increase in research can be achieved by building on the substantial, albeit piecemeal, achievements of social work research, and by enhancing the practice literacy of the academic workforce as well as the research literacy of the practice workforce. In the context of a new strategy for social work research in UK universities, this paper examines the obstacles to achieving a voice for social work research and how these obstacles are being addressed.