Micro-meso-macro practice tensions in using patient-reported outcome and experience measures in hospital palliative care

This article applies a micro-meso-macro analytical framework to understand clinicians’ experiences and perspectives of using patient-reported outcome and experience measures (PROMs and PREMs) in routine hospital-based palliative care. We structure our discussion through qualitative analysis of a design and implementation project for using an electronic tablet-based tool among hospital-based palliative clinicians to assess patients’ and their family caregivers’ quality of life concerns and experiences of care. Our analysis identified three categories of practice tensions shaping clinicians’ use of PROMs and PREMs in routine care: tensions surrounding implementation, tensions in standardization and quantification, and tensions that arose from scope of practice concerns. Our findings highlight that clinicians necessarily work within the confluence of multiple system priorities, that navigating these priorities can result in irreducible practice tensions, and that awareness of these tensions is a critical consideration when integrating PROMs and PREMs into routine practice

Enhancing Student Commitment to the Micro-Mezzo-Macro Continuum: The Macro Practice Assignment

Despite the importance of macro practice to the social work profession, research related to social work students’ preparation and enthusiasm for macro practice suggests that there is significant room for improvement within macro social work education. The purpose of this report is to describe and explore a novel macro social work pedagogy that is designed to encourage student engagement within macro practice social work courses. The Macro Practice Assignment (MPA) offers students a real-world learning exercise with embedded micro, mezzo, and macro social work applications with one vulnerable population. The results of a multiple case study exploring the effectiveness of the MPA reveals that the MPA 1) reduces students’ negative perceptions of macro practice courses and careers, 2) fosters students’ interest in future macro practice, and 3) helps students see macro practice as a necessary component of the micro-mezzo-macro practice continuum. In order to address shortcomings in macro social work education, educators should consider adding real-world macro practice learning exercises such as the MPA, grounded in Bloom’s Taxonomy, with the goal of enhancing social workers’ lifelong commitment to macro practice

Debunking macro myths: findings from recent graduates about jobs, salaries and skills

Research suggests that interest in macro social work practice is declining, a trend that has been well documented in the United States. Studies find that social work educators and practitioners may foster beliefs among MSW students that discredit macro practice and associated skills while asserting macro graduates are likely to face poorer employment prospects and lower salaries than micro counterparts as they start their careers. This study builds on and extends this literature by examining 27 skills in their current job using a 5-point Likert-type scale among the early career trajectory of MSW alumni (N=182) who graduated between 2008--2012 from a public social work institution in the southeastern United States. The skills included in the survey, as well as decisions about how to group them into scales, were made based on theoretical links between the skills by macro faculty members. Findings highlight the use of macro practice skills regardless of concentration focus, no differences in salary, or the time it takes to find employment between micro and macro alumni. Implications for social work education are discussed

Sustaining and Strengthening a Macro Identity: The Association of Macro Practice Social Work

Macro practice focuses on community-level interventions, such as management, organizing, research, and policy advocacy. Despite social work’s deep roots in this type of work, macro practice and macro practitioners often practice without support or connections with other macro practitioners, and are underrepresented in the profession. In 2006, a group of social workers, including academics and practitioners, formed the Association of Macro Practice Social Work (AMPSW). AMPSW works to strengthen the professional identity of macro practitioners, elevate the status of macro social workers, and address common concerns within the social work profession

Increasing Social Work Students’ Participation in Macro Specializations: The Impossible Dream?

Much effort has been made to increase the number of social work students in macro practice specializations in graduate school. Despite the development of pedagogical techniques which have shown to increase interest in and appreciation for macro practice, the proportion of macro students has stayed low and stable over time. Using survey data collected from 474 Master of Social Work students and graduates, this exploratory study identified both structural and attitudinal barriers which impede specialization in macro practice. Data reveals that despite exposure to these methods, those whose original motivation to enter the profession was based on a desire to do clinical work are unlikely to concentrate on macro practice. Structural barriers such as the lack of availability of macro programs also prevented increased specialization in macro practice. Social workers who are Black/African American are more likely to concentrate in macro practice, perhaps due to a recognition of the need for systems change in the United States to promote equal opportunities and rights for those who have historically been marginalized. Findings indicate that current efforts to increase the number of graduates with macro specializations may not be effective. Treatment of macro methods as a specialization, rather than integral to social work education, should be revisited if the profession wants to ensure enough graduates are able to make system-level changes to rectify current societal inequities

Social Workers’ Knowledge Of Human Trafficking

The purpose of this study was to assess social workers’ knowledge of human trafficking. The hypothesis was that social workers needed to be further educated on this issue. A survey to assess social workers’ knowledge of human trafficking was placed in the quarterly newsletter of the Rhode Island National Association of Social Workers. Fourteen surveys were returned revealing the actual level of knowledge of these participants. The study revealed that social workers have differing competencies pertaining to knowledge of human trafficking. It is recommended that it is necessary to increase knowledge and identification of human trafficking. Implications for policy are indicated

Rural Social Work Practice: Maintaining Confidentiality in the Face of Dual Relationships

Includes bibliographical references.Management of dual relationships and confidentiality in social work practice is an essential ethical task for all professionals. Practitioners face special challenges presented by the choice of practice environment and the differential client and community expectations that may be inherent in rural practice. This article addresses the challenge through an analysis of dual relationships, boundary management, and confidentiality in rural practice environments across micro and macro practice activities and settings. The nature of the ethical challenge of dual relationships and the preservation of confidentiality and privacy are explored and an analysis of special practice issues in the rural environment is provided. Tools and suggestions for rural practitioners are presented to use in the ethical management of boundaries with clients, colleagues, and organizations

25 Years of the \u3cem\u3eCanadian Journal of Community Mental Health\u3c/em\u3e: Reflections and Future Directions

As a former senior editor, a long-term member of the editorial board, and a regular contributor to the Canadian Journal of Community Mental Health (CJCMH), I am delighted with the invitation to comment on the 25-year review of the contents of CJCMH by Fortin-Pellerin, Pouliot-Lapointe, Thibodeau, and Gagné. I want to begin by acknowledging that I cannot pretend to give an objective account of CJCMH, not only because of my deep investment in it, but also because of my personal and professional biases, values, and position of privilege. What I can offer are some reflections on CJCMH, as well as suggestions for future directions, from my perspective as a senior academic community psychologist

An Assessment of Social Worker Attitudes Regarding the Domestic Sex Trafficking of Children in America

Human sex trafficking, defined as a “modern-day form of slavery in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such an act is under the age of 18 years” (USDHHS, 2009) is a problem that many people do not think is issue in America, but in fact is. This study investigated the attitudes of social workers towards domestically sex trafficked children in the United States, as well as towards pimps and johns, and federal and state policies regarding the safety of sex trafficked children. It was hypothesized that social workers who work in child welfare would have a greater knowledge of domestic sex trafficking of children in America than those social workers who work with adults. It was also hypothesized that overall, social workers would have a greater knowledge of international sex trafficking than of domestic sex trafficking. To test these hypotheses, a survey was distributed to 42 social workers at different agencies who were gathered through snowball sampling. Results found that overall, males had a slightly higher opinion of children who were sex trafficked and a lesser opinion of pimps and johns than females. The results found that social workers’ attitudes towards trafficked children and those who traffic them varied among questions, based on the social worker’s field setting. Social workers need to be aware of the impact of sex trafficking so they can advocate for children who have been sex trafficked and so they can provide effective therapeutic services to those effected by sex trafficking