You may think that social work in the United States and the United Kingdom is identical but actually that’s not true…To get a glimpse of what are some of the similarities and differences about social work, I had the pleasure of interviewing cb who is a social worker in the U.K.
cb is also an Approved Mental Health Professional (AMHP) and a Best Interests Assessor (BIA). Some of you may already know cb by her moniker @monstertalk or her very well-known blog Fighting Monsters.
So without further ado, cb, what type of work did you do before you became a social worker?
I’ll go back a little way to explain how I got into this ‘field’. After I graduated from my BA, I had difficulty finding a job so I did some long-term voluntary work with adults with learning disabilities in residential care. After that, I got a job in the field that what we would call a ‘support worker’. I worked in small residential care homes for adults with moderate learning disabilities and the focus on the work was about independent living.
It was just after there was a large government move away from large residential care homes and hospitals for this user group so we worked with people who had been discharged from these large ‘institutions’. The work involved everything from assisting with hands on personal care to supporting with social activities, preparing meals and cooking.
I worked in that setting for about 5 years. I loved it but I felt I needed to ‘move on’. I continued working in the same care home while I was doing my social work training to earn the money to keep me through the course. London isn’t a cheap place to live!
What made you decide to become a social worker? And how long a process is that in the U.K.? Is it a two-year Master’s program as it is in the United States?
After working in residential care, I really wanted to ‘move on’. A lot of people were quite dismissive of my choice of work as well and I felt under pressure to start my ‘career’ as I knew I didn’t want to move into management.
I came into contact with social workers through my work as they would make placements and review placements in the homes I worked in and I thought it would be a way to progress my career without moving into management which I was sure I didn’t want to do!
It also helped my decision making that the Masters was fully funded through the bursaries. The route to qualification as a postgraduate is through a two years Masters program.
The other route into social work in the UK is through an undergraduate degree. In effect, for the purposes of work, it doesn’t make much difference to employers whether someone qualifies through the Master’s route or the Bachelor’s route.
We also have an undergraduate degree path into social work but someone with an undergraduate degree would not be qualified to do all the work that a social worker with a master’s degree could… In the U.K., are you saying that an undergraduate social worker has equal opportunities for advancement as the graduate social worker?
Yes, that’s exactly what I’m saying.
How long have you been working as a social worker? And could you describe your current position?
I qualified in 2000 but I’ve spent a couple of years since then doing other things. Since I qualified, most of my social work experience has been with older adults but I’ve also worked with younger adults with physical disabilities.
Currently, I work in a specialist mental health team for adults with age-related mental health difficulties. This includes different types of dementias, but also late onset depression, psychosis and schizophrenia.
The team I work in is multidisciplinary so we have social workers, clinical psychologists, occupational therapists, mental health nurses and psychiatrists. We all work alongside each other to try and provide a service that meets the different needs of those who have specific needs around their mental health care.
I have a lot of tasks! Primarily my work is about ‘care co-ordination’ or case management so we are allocated to individuals to look at the ways we can move towards recovery.
It might be about linking in with other community resources for social engagement or providing and organizing care in the home.
We work with families and carers (caregivers) and use a social model as best we can to provide support to particular government standards and targets. We also would monitor any changes in someone’s mental state and serve as a link between the doctors and the individual and refer back to our medical team frequently.
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 @monstertalkand 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!
Thanks so much, cb, for providing us with this interesting glimpse of social work in the U.K., as well as for your efforts on starting to create an international online forum for social workers 🙂
As always, please feel free to share your thoughts and comments. Your feedback is most appreciated!
You May Also Enjoy:
The New Social Worker: An American Social Worker in London
The Social Work Podcast: So You Want To Work Abroad?
Photo Credits: Scenes of London by my husband
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.
April, 2014 addendum: cb is writing again 🙂
It is interesting to read/hear about social work in different countries and how it is similar to and different from social work in our own country. In the U.S., the BSW is typically a generalist degree, whereas the MSW allows for more specialization by offering concentrations. U.S. social workers may still choose to get additional training to further specialize, but it is not necessarily required in the same way as in the U.K. It sounds as if in the U.K., both the BSW and MSW are generalist degrees, thus making additional training more essential for someone who wants to specialize.
U.S. social workers who are licensed are generally required to receive a certain amount of continuing education in order to continue to be licensed. The number of hours and the type of training accepted varies from state to state, since licensing is on a state-by-state basis. Some states require a certain number of ethics hours or some other specific types of training. Some may require training in specific state laws.
Social work as a profession has a very broad scope of practice. I am often in contact with social workers from all over the world, and I think that one issue is that social work is perceived differently in different places. Also, as pointed out in your post, the training may be different and the “typical” roles may be different. But overall, it is a very diverse profession.
THE NEW SOCIAL WORKER published an article a while back called An American Social Worker in London (http://www.socialworker.com/home/Feature_Articles/General/An_American_Social_Worker_in_London/), which provides some insight into the writer’s experience practicing in the U.K. with a U.S. social work degree.
Thanks so much, Linda, for all the valuable additional information you provided here about the American social work track.
With your experience and expertise in social work (as well as being the publisher/editor of The New Social Worker and several books on the topic), you were an invaluable resource to add important clarifications on American social work.
By the way, I had inserted a link to that terrific article you mentioned in the “You May Also Enjoy” section 🙂
With much appreciation,
Dorlee
Thanks for publishing the interview and I love the pictures. I’m not sure about the generalist/specialist distinction and what it is so I can’t really comment on that – from what I know from US media etc (and i could be completely wrong on this so please feel free to correct me as all I’ve learnt, I’ve learnt through television and films!), in the US degrees seem less ‘specific’ than here from the start – for example, if we are generally studying social work, as a BA, you wouldn’t do modules or studies in any other subject – there’s little of the major/minor thing here (well, not in social work anyway) – but I’m not sure that’s what you meant!
Thanks for this interview! Very interesting. And helping to fuel my daily pipe dream of running away to London 🙂
Great post and really enjoyed learning about CB and how things are done in her Country. CB, interesting that you would mention that “liberal arts” degrees aren’t common in the UK and I wonder about the depth and breadth of knowledge for both students and if anyone has ever studied social work intervention effectiveness on an international scale.
4 years ago I went to the annual Social Work Conference at the United Nations HQ in NYC and it was absolutely amazing. It was not only cool to hear about fascinating international interventions, but humbling to listen to other countries talk about social issues that we have already addressed! The best part was when a country in Africa(the name escapes me)shared photos of their first graduating class!
Thanks dorlee+cb for the content!
cb,
I will try to get Linda back to refer to your comment about the undergraduate degree in social work. I don’t really know much about that degree.
Regarding the master’s degree, I can tell you how things were at my school… I chose my specific school because of its specialty and strength with clinical practice. Had I wished I could have also chosen to “specialize” or take my electives in Children, the care of older adults, school social work and a few other areas.
I happened to have chosen not to specialize because I was not sure on which population or issues I wanted to focus on. Therefore I used my electives to learn other modalities such as cognitive behavioral therapy, gestalt therapy, as well as some mini courses on dialectical behavior therapy, eating disorders and one on medications.
Later, once I know which population(s) and/or specific problems I want to delve more deeply in, I will be taking additional course work (whether or not a small number of credits are required for continuing education to maintain one’s licensing).
SocialJerk,
I’m so glad you enjoyed this interview and I hope you fulfill your dream of working one day as a social worker in the U.K. Do click on both the first two links under “You May Also Enjoy.” They cover this topic!
Mozart,
I’m so glad you enjoyed this post.
How exciting that you were able to attend a Social Work Conference at the United Nations and hear about various international interventions…
cb will be responding herself shortly.
Thanks so much for sharing and commenting,
Dorlee
Back from work – Thanks Dorlee. I get it. With the degrees here both masters and bachelors, you generally will only do modules which relate to social work the whole way through but some universities might push towards choosing one particular section (childrens/mental health) but they seem a lot less specific than yours. We wouldn’t do a specifics about counselling for example, that would be picked up if it were relevant in the place you end up working it..
SJ – always welcome. I was on a course just yesterday with a US social worker who had relocated here and come across them from time to time.. there was a lot of international recruitment at one point but it’s tailed off a bit now.. I’m a bit partial to London of course but then, I’m a Londoner!
Thanks Mozart – i’m not sure what you mean by liberal arts – is that a generic-type degree where you take modules in lots of different subjects? If so, then yes, they are more uncommon. Generally, if you go to University to study Maths, Maths is what you study from the start. If you go to study Philosophy, you study it from the start. You might get an opportunity to do one or two modules in a different subject but you have to choose what you are going to study at the start (that’s a bit general as there can be circumstances in which you might change but usually you’d repeat years).
The conference does sound great. There is a lot of potential for international development of ideas and practice.As I mentioned above we have quite a lot of international social workers in London – mostly Commonwealth – Australian/New Zealander/Canadian/South African but also quite a few from the US…
CB, it sounds as if when you talk about “social work” courses, you are talking about what in the U.S. are considered generalist “core” social work courses. The Council on Social Work Education accredits social work degrees (BSW and MSW) in the U.S. There are certain core courses that are required that cover general social work knowledge and skills that would be applicable in any setting. This is the “generalist” part. Then there are a certain number of credits that can be devoted to electives or more specialized courses. These might still be considered social work courses, but would focus on social work with a specific population or in a particular setting. An example might be social work with older adults, or social work in mental health, etc. Many MSW programs in the U.S. allow (or require) students to choose a specialization or concentration. So, in addition to the core required courses, they would take a specified number of courses/credits within that specialization.
I hope this helps clarify what I meant in my previous comment!
Linda
Hi Linda
Yes, that is a fantastic explanation. Yes, that is what I meant. Here you don’t do an initial social work qualification anything but generically (although some universities might offer different options)- there are post-qualifying degrees and qualifications that offer much more specialisation exactly as seems to be the case there so you could choose childrens/adults/mental health/practice education/research pathways.
Dorlee and @monstertalk,
Thank you so much for participating in and posting this interview. I think this kind of international perspective is invaluable. In my social work career as a clinician and educator I’ve drawn extensively on my experiences living in Mexico, England, and France. Living abroad (or reading a rich and fascinating interview like this one) helps those of us in the USA to critically reflect on what makes our country “American.”
One of the things that struck me about this interview was @monstertalk’s description of her job duties, the education, training, and licensing (certification) of social workers. What do you know? There ARE differences in what social workers do in the US and the UK. This, of course, makes sense for many reasons: 1) the health care system in the UK is completely different than the USA, and with it different laws and regulations; 2) Professional duties reflect societal values, and the US and the UK have different values. The differences in the length of time for psychiatric commitments (6 months vs. 48 – 72 hours) is a great example of how different values manifest differently; 3) In the USA, social workers became psychotherapists in part because insurance companies realized they were the cheapest option around, and psychiatrists realized they could make more money prescribing medications and psychologists could make more money doing psychological assessments. In the UK, I suspect (although don’t actually know) that the nationalized health insurance system mediated some of the factors that, in the US, drove psychotherapy into the domain of social work.
Thanks again for this interview. If social workers from the US are interested in information about how to do social work in the UK, check out an interview I did with a international social work recruiter: http://www.socialworkpodcast.com/2010/04/so-you-want-to-work-abroad-interview.html.
Best,
Jonathan
Jonathan,
Thank you so much for your thoughtful and detailed response.
How interesting to hear about the reasons behind the existing differences in social work in the U.K. vs. the U.S….and what you are explaining makes total sense when you put social work in the larger context of the whole healthcare system.
I also really enjoyed hearing how you have had the opportunity to work as a social worker abroad in three different countries (and would love to hear more about your experiences abroad when the time will be right).
Thanks also for sharing the info about your interesting U.K. interview – FYI, I have it listed above among the articles “You May Also Enjoy.”
With much appreciation for your expert guidance,
Dorlee
Hi Dorlee and cb,
I find it interesting that in the U.K. social workers can get specialized training as Approved Mental Health Professional (AMHP) and Best Interests Assessor (BIA) and then have statutory power to have people committed or declared incompetent.
In the U.S. social workers, counselors and psychologists all have to rely on psychiatrists and judges for this. In the U.K., psychiatrists rely on social workers for their knowledge in this area.
Thanks Dorlee and cb for a very interesting interview.
Warmly,
Andrea
Hi Andrea,
Thank you… It is most reassuring to hear an experienced mental health practitioner such as yourself validate what I said in the body of the interview vis a vis the American procedures for having a person committed or declared in competent.
This is because I had to rely on research…I haven’t had enough experience yet nor did I remember covering this in school.
Thanks again!
cb and I are so glad that you enjoyed this interview 🙂
Warmly,
Dorlee
Dorlee and cb, thank you so much for posting this. I have often gotten glimpses online that have alluded to the differences in social work around the world and have wondered about the training and responsibilities that differ. You’ve made this so much clearer now.
I do want to add (as one of the professional counselors who lurks on your site, Dorlee) that the laws that determine who has the authority and responsibility to have someone committed for 72 hour holds is actually determined state by state. Here in Colorado Licensed Professional Counselors as well as Psychologists also have that authority. And, I think, Social Workers do, too – not positive about that, though. I mention this because when you move to another state, you need to remember to check this out. It varies.
Thanks, again, Dorlee, for another great post!
Hi Tamara,
I appreciate you emphasizing the state to state variance within the United States with respect to the laws on committing someone to a mental health institution.
While I mention this within the body of my interview, it is an important distinction that may be overlooked by many readers.
It is also interesting to hear who has the authority for short commitments in Colorado.
I’m thinking that to get the most accurate and detailed reading on this complex issues in at least one state in the U.S., I would need to conduct at some point an in-depth interview with either an experienced mental health professional currently in the field…
Thanks for your kind feedback and thoughtful comment,
Dorlee
cb: We all miss you and your blog so much…
A copy of cb’s Sept 20th post:
Goodbye
For reasons that I can’t go into, I am having to close this site for a while. I want to allow people to take and copy information that they might want or need from it and will open it up over the next few days but please do bear in mind that I’ll probably have to shut down again pretty soon. I had to go both here and from Twitter very quickly without an opportunity to say ‘Goodbye’ properly and I’m sorry for that. I am taking a risk by writing this but it’s something I felt I had to do and I ask any readers to try to understand that I had strong reasons behind it. I wouldn’t just ‘throw away’ over three and a half years of work easily or quickly without a reason.
I’d rather not ‘go’ like this to be honest but sometimes things happen and we don’t always have ways to ‘control’ them.
I hope I’ll be able to be back in some form.
Thanks everyone for your support over the years.
I’ll still be writing and ranting but just finding other places and I’m not precluding a return here either in the future but I don’t want to make any promises either.
It’s been a fantastic journey and I’ve really learnt a lot about the value and pains of social media, social networking and building links across sites and systems. It’s helped me so much and mostly it’s helped me grow as a professional. On the other hand, this experience has taught me a very useful new lesson to add to my potential opus about the way that systems, social media, anonymity and jealousies work in the world of ‘social media’ and ‘faceless communication’.
I’m thinking about working on an off-line project with a number of strands just because not-writing is more difficult than writing. One is a series of essays and examples of putting different social work theories into a practical context and explain with a lot of anonymised case studies how important theory is in informing the work I do both explicitly and implicitly and the other is a series of guides for social media and technology specifically in social care and social work.
Other projects (including this blog) remain on hold.