One size does not fit all, but we can offer a framework for alterations: tailoring mental health social interventions for diverse contexts

Meredith Fendt-Newlin and Martin Webber received a Rapid Response Fund grant to develop learning materials to teach students how to adapt evidence-based social interventions for use with service users from diverse cultural backgrounds and within resource-poor environments

Mental health nurses sharing case studies that describe cultural experiences of service users and families

Mental health nurses sharing case studies that describe cultural experiences of service users and families

Diversity in Social Work practice

Social workers in professional practice work with some of the most disadvantaged and marginalised individuals, families and communities, often at the most difficult points in their lives. Working with diversity and becoming a culturally competent practitioner is a key aspect of social work training and is in line with current legislation and evidence. The College of Social Work emphasises nine key domains within the Professional Capabilities Framework (PCF), demonstrating all aspects of learning and explaining how social workers should expect to evidence their skills in practice. One of the nine PCF domains is the capability to recognise diversity and apply cultural competence principles in practice.

Social work students need to be better prepared to enter the workforce and support the increasing number of migrants and individuals from diverse backgrounds in York, North Yorkshire and the UK.

Another key element of social work practice is the analysis, implementation and critical reflection of intervention models for use in different contexts and with service users with diverse needs. Paying particular attention to the evidence base, we ask students, ‘what worked and how do you know?’ But this question is increasingly difficult to answer, as the evidence base in social work is slim when compared to more easily measurable psychological and medical interventions. What sets social work apart from many other professions concerned with mental health is the seemingly unlimited ways its work can be demonstrated. The idea that social interventions should be based on evidence has been tempered by the fact that each individual or family is unique and it is difficult to specify approaches.

A framework to adapt social interventions

Dr Stania Kumara, King’s Sierra Leone Partnership, teaching problem solving techniques

Dr Stania Kumara, King’s Sierra Leone Partnership, teaching problem solving techniques

Offering a framework in how to adapt approaches that have been proven effective is one solution to address this need in social work education. However, to date there has not been guidance on how to translate effective social interventions and currently no such toolkit for social work training exists.

Researchers in the International Centre for Mental Health Social Research (ICMHSR) are bringing together colleagues at the University of York and internationally to generate evidence that informs social policy and mental health social work practice by developing and adapting social interventions across economic and cultural contexts.

With a grant from the Rapid Response Fund, we developed teaching and learning materials that provide a framework and guidance in adapting evidence-based social interventions for use with service users from diverse cultural backgrounds and within resource-poor environments. By teaching social work students not only that it’s possible to use social interventions in diverse settings and with a multitude of client groups, but also giving practical lessons in how to adapt interventions for their future practice, the materials produced by this project offer a massive step forward for the field of social work.

Using a real-life case exemplar

Using the Sababu Model to teach community mapping, a key social intervention strategy

Using the Sababu Model to teach community mapping, a key social intervention strategy

Students learn best by using real-life exemplars to understand how models can be adapted and used effectively in their own practice, offering a research-enriched teaching and learning opportunity. For this reason, we chose to develop teaching and learning materials that reflect adaptions of a social intervention from a high-resourced to low-resourced setting.

The Connecting People Intervention (CPI), developed by a team of researchers and led from the University of York, is a social intervention model that aims to support people with mental health problems to enhance their social networks. Members of the research team initially developed the Connecting People Intervention (CPI) and accompanying training materials for use with UK-based practitioners. However, there were challenges around which contexts and client groups the CPI was most applicable to, which is what led us to explore adaptations in Sierra Leone*, Malawi and India.

The CPI adaptation created co-productively in Sierra Leone with local stakeholders has been used as a real-life exemplar, set within the framework and guidelines for adapting social interventions generally. Meaning “connections that may bring benefit” in one of the local languages, the Sababu Model incorporates elements of social interventions such as building trusting relationships, communication skills with service users and families, assessing an individual’s assets in addition to their needs, and networking in the community.

Learning and teaching materials

Filming role play in Sierra Leone by Way Out Arts

Filming role play in Sierra Leone by Way Out Arts

The work in Sierra Leone improves and extends training materials previously developed in the UK. For example, we were able to develop step-by-step methods to be undertaken by practitioners, a more concrete template that is non-prescriptive and can be adapted for a variety of contexts. This approach is particularly useful in social work teaching.

“The training greatly helped me to know to connect myself and my clients to other people or organisations for support.” – Sierra Leone Mental Health Nurse

Filmed over two weeks during training and practice observation in Sierra Leone, members of the research team worked with local (to Freetown and York) film crews to develop a series of videos that will be used in this autumn’s social work teaching programme. Using interactive learning such as role-plays, small group work and discussions how to use the adapted social intervention in practice, these videos capture diverse practice experiences. Combined with training manuals and workbooks this offers a comprehensive toolkit for adapting social interventions in diverse contexts and with service users with a variety of needs.

Link to blog post about the visit to Sierra Leone and filming: http://www.icmhsr.org/2015/07/22/latest-news-on-our-work-in-sierra-leone/

Video production by Sierra Leone based youth arts organisation, Way Out Arts. Post-production editing by York-based company Digifish Limited.

*The feasibility study in Sierra Leone was part-funded by the Wellcome Trust [ref: 105624] through the Centre for Chronic Diseases and Disorders (C2D2) at the University of York. Model adaptions and training programme development was funded by the Maudsley Charity.

A8_Meredith-Fendt-Newlin-biopicMeredith Fendt-Newlin, is a researcher and PhD candidate in the International Centre for Mental Health Social Research (ICMHSR), University of York, where she is supervised by Dr Martin Webber to undertake research projects in a range of diverse contexts and countries. Having previously studied health psychology at King’s College London and University College London, and serving on the Board of Directors and Trustees for two community development organisations in Africa, Meredith is passionate about empowering people through social innovation to improve mental and physical health care in low & middle-income countries. meredith.newlin@york.ac.uk

A8_martin-webber-biopicDr Martin Webber, is a registered social worker with experience of working with adults with a learning disability and mental health problems. Director of the International Centre for Mental Health Social Research (ICMHSR), University of York, Martin is passionate about achieving social change through high quality social work and social care practice that is informed by rigorous research evidence. His teaching interests include research methodology and the practice implications of developing and evaluating of social interventions with vulnerable and marginalised people. martin.webber@york.ac.uk

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