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As executive director of Disability Rights Tennessee, social worker Lisa Primm manages lawyers and relies on information from researchers, analysts, community leaders and other social workers to do her job.

"There's no way that I could do this job in a vacuum," Primm said. "I rely constantly on others who are in other professions, who have other types of knowledge in order to inform the work that I do."

The ability to work on a team and collaborate effectively is a necessary skill to succeed in the field of social work. Whether they are working at a macro level to pass legislation to improve public health or providing direct client care, social workers at all levels often find themselves collaborating with different stakeholders.

Those stakeholders can include:

What Are the Benefits of Collaboration in Social Work?

For social workers, there are a number of advantages to working collaboratively:

Why Is Collaboration Important?

As Primm explained, social workers often can't solve problems alone.

Take, for example, the delivery of health care. While a more traditional model may have been physician-centered, practitioners in the field are increasingly recognizing the need for interprofessional collaborators to perform different functions to improve a client's health. A physician may be better equipped to provide treatment for a client, but a social worker plays an important role serving as an advocate for the client and bringing attention to social justice issues that may be overlooked by others on the team.

With the help of a team, social workers can take a more holistic approach to solving problems for clients. Indeed, many social workers believe teamwork results in the best outcomes for clients.

Who Do Social Workers Collaborate With?

Social workers have many specialties and collaborate with a host of professionals.

Many in the field also benefit from professional collaborations and affiliations that allow them to interact with their peers. They find support from organizations such as the American Council for School Social Work, Association of Oncology Social Work, Clinical Social Work Association, National Association of Social Workers, School Social Work Association of America, Rural Social Work Caucus, Society for Social Work Leadership in Health Care and the International Federation of Social Workers.

Why Are Collaborative Partners Important?

While social workers play important roles connecting clients to appropriate resources to address challenges in their lives, they are still limited in their perspective. There are likely many people in a client's life who have pertinent information about their circumstances that will help a social worker deliver the services needed.

For example, child welfare social workers are charged with keeping children safe (PDF, 144 KB). They often make life-changing decisions informed by family history, behavioral concerns and environmental conditions. To do so, they may need to engage other family members, teachers and local authorities who can help them determine what is going on in a home.

"There's so much going on behind the scenes before you even see a child being taken from a home," said Cornell Davis III, a child welfare social worker in Pennsylvania.

The collaboration does not end there. If it is determined that a home situation is dangerous, social workers need to provide the resources to ensure that a child moves to a safe situation. That can require working with local agencies to find temporary housing or reuniting the child with a parent who may need help finding a stable job or housing.

Cooperation and collaboration aren't just recommended for social workers; they are, in many cases, a routine part of the job.

What Is Interdisciplinary Collaboration?

Interdisciplinary collaboration is also an important aspect of social work. This occurs when a team of specialists from different helping disciplines, such as psychiatry, psychology, counseling, medicine and public health, join the social worker to provide services to a client. Specialists may have the authority to perform tasks outside the social worker's qualifications.

Why Is Interdisciplinary Collaboration Important?

Social workers perform a variety of functions; some serve as advocates, while others are licensed to provide mental health treatment. However, there are specialists in other helping disciplines who have the authority to perform tasks beyond the social worker's qualifications that are necessary to improve outcomes for clients.

A physician may be able to provide medical treatment for a client, but that client and their family may still struggle with the financial costs related to treatment. Social workers can advocate for families, inform them of their options and connect them to financial assistance.

Ultimately, the client needs both perspectives to receive the care to address their challenges.

"Interdisciplinary collaborations are important because systems and people are vast and complex, so it's almost arrogant to think that you can see everything that your client needs from just your perspective," Davis said.

What Are the Challenges of Interdisciplinary Collaboration?

Because their training and education varies, each partner in an interdisciplinary collaboration may have different approaches and expectations, which can lead to a number of challenges, including:

How Social Workers Can Facilitate Collaboration

When social work collaboration produces positive results for the client, everyone wins.

Here are some ways to improve social work collaboration, adapted from the experts interviewed and National Association of Social Work's guide to making interdisciplinary collaboration work (PDF, 517 KB):
Create guidelines for how to work together. Understand what the other disciplines can contribute. Be transparent. Be fair. Maintain collegial rapport.
"We have to be able to work together to do better work and do greater work," said Davis, "but we have to be humble enough to say, 'Hey, somebody else might have a better perspective than I do.'"
More resources:

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As executive director of Disability Rights Tennessee, social worker Lisa Primm manages lawyers and relies on information from researchers, analysts, community leaders and other social workers to do her job. "There's no way that I could do this job in a vacuum," Primm said.

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A group of two or more committed people working together to improve the life of the client.

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Teams differ from work groups in two ways:

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Teams differ from work groups in two ways:

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The real benefits..

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The Real Benefits of Team Collaboration in the Workplace

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We know collaboration is important, but why? Here are some of the top benefits of team collaboration at work.

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DOI link for Building Effective Social Work Teams

Building Effective Social Work Teams book

DOI link for Building Effective Social Work Teams

Building Effective Social Work Teams book

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Building Effective Social Work Teams | Taylor & Francis Group

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DOI link for Building Effective Social Work Teams Building Effective Social Work Teams book DOI link for Building Effective Social Work Teams Building Effective Social Work Teams book

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1. A team can consist of social workers from the same agency.

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1. A team can consist of social workers from the same agency.

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Teams may be internally within a agency and can also include representatives from the macro environment external to the agency.

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2. Team composed of social workers but from different agencies.

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2. Team composed of social workers but from different agencies.

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what it's all about: Do's & Dont's

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Networking for social workers involves building, maintaining, and leveraging professional contacts in the field. You can network at large conferences hosted by professional associations or by having coffee with a colleague who works in your department. Most networking begins with a face-to-face connection, though the internet has shifted the way we establish and continue professional relationships.

For recent graduates, networking can help you find your first job even when you lack experience. For young professionals, growing your network can help you learn about and pursue new career paths within your field. For seasoned social workers, networking offers the means to share best practices and develop new skills.

Knowledge-sharing plays a critical role in the field of social work: it can help you connect clients with the housing or educational resources they need to get back on their feet or allow you to adjust your approach when dealing with victims of domestic violence or individuals coping with substance abuse problems. More than just finding a new job, networking enables social workers to do their current jobs better.

Networking for Social Workers

Different Types of Professional Networks in Social Work

Professional networks can be divided into three categories: operational, personal, and strategic.

First, operational networks often exist within organizations. They consist of your coworkers, managers, employees, clients, and vendors. Developing positive and productive relationships with these individuals helps you succeed on a day-to-day basis. Second, personal networks exist across organizations and fields. Your personal network may comprise friends, former colleagues, teachers, and members of your community. While you can call upon this network for advice in your current role, most people tap personal networks when looking for a new job. Third, strategic networks span companies and industries. People often use these to pursue a broader goal than finding a new job. For example, a social worker may call upon political leaders within his strategic network to fix a policy that disadvantages clients.

Social workers benefit from all three types of networks, though early-career professionals should focus on developing operational and personal networks.

Networking Events in Social Work

Attending social work networking events can help you meet new people and expand your professional circle. These events often take place at large venues, such as convention centers and hotels. Organizations like the National Association of Social Workers (NASW) regularly host large national conferences and smaller regional events.

Social work networking events often feature lectures, seminars, and discussions of interest to those working in the profession. For example, a conference for social workers may feature a presentation on a community health project or a panel of experts debating how to reduce homelessness in urban areas.

In addition, these events provide an opportunity to connect with other social work professionals. Depending on the nature of the event, you may meet others through structured group discussions or in more informal ways, like during coffee breaks or cocktail hours. Remember to pack plenty of business cards, and follow up on the connections you make at these events.

Elevator Pitches in Social Work

Through an "elevator pitch," you briefly introduce yourself, discuss your professional background, and articulate a goal. For example, at a networking event, you may meet the person in charge of hiring for a large hospital. Using your elevator pitch, you would tell this person who you are, that you have extensive experience working with individuals with physical limitations, and that you want to use your skills to help people leaving a hospital after surgery.

Your elevator pitch should be no longer than thirty seconds. Make sure to practice it aloud and before others, if possible.

Social Networking Sites for Social Workers

Although the strongest professional networks involve in-person connections, social media platforms like LinkedIn play an increasingly important role in maintaining social work networks. For example, if you meet a connection at an event, but forget her name before you have the opportunity to follow up, you can search online using the name of her organization or other information. Social networking sites also allow you to determine who in your network can facilitate a connection to a particular person or recommend you for a given job.

Relying exclusively on online networking sites can cause trouble. You may find yourself with many professional "connections" but few individuals in your network willing to vouch for you or offer assistance. Try to think of these sites as tools to supplement in-person networking rather than replacements for it.

Tips for Networking in Social Work

Like any other skill, networking requires practice. Don't feel discouraged if you forget your elevator pitch or leave an event without making meaningful connections. Throughout your career, you will have many opportunities to develop and deepen your professional network.

Ask Questions: Ask questions to keep a conversation going and to develop a rapport with a potential connection. You may learn something new and acquire meaningful information for your follow-up.

Be Bold: Many of us shy away from meeting new people, but networking requires you to leave your comfort zone and introduce yourself. If you struggle with this, try to attend networking events with a friend or colleague so you can introduce yourselves together.

Stay Professional: Asking personal questions can help you create a bond with a fellow social work professional, but avoid discussing difficult topics. In addition, many networking events offer alcohol, so make sure to know your limit or abstain altogether.

Know What You Want: If you want a new job, prioritize events and activities that allow you to meet new people and talk about your accomplishments. If you want new knowledge or skills, try to attend events that offer you the chance to learn from experts in your field.

Give More Than You Take: Prepare for the next time you need a favor by helping others in your network. Think about what you can give to your colleagues and connections rather than simply thinking in terms of what they can do for you. When you need assistance later down the road, your network will likely respond enthusiastically.

Networking Event "Do's" for Social Workers

Set Goals: Whether you want to talk to 10 new people or have a follow-up conversation with a potential future employer, know what you want to accomplish before you attend a networking event. Having a goal can help you use your time wisely.

Dress Appropriately: Unless the event organizer specifically mentions an informal dress code, wear business-casual attire: dress pants or suit, skirt, button-up shirt, or its equivalent. It's best to avoid jeans, sneakers, and t-shirts.

Bring Business Cards: You meet many people at networking events, and business cards allow you to share contact information quickly so you can follow-up at a later date. Also, bring a pen so you can write additional information, such as a personal number or the name of a mutual acquaintance, on the back.

Be Concise: Stay focused, speak clearly, and give other people the chance to talk. Work on your elevator pitch to make sure you convey the most important information about yourself quickly. You can always follow up with more information after your conversation.

Follow up on Connections: To build a network, you must follow up. After an event, sort through business cards you have collected to prioritize those with whom you should follow up. Reference a detail from your conversation, or ask a question to encourage your connection to respond. Avoid following up on the phone unless the connection requested that you do so.

Networking Event "Don'ts" for Social Workers

Distribute Paper Copies of Your Resume: No one wants to carry around dozens of pieces of paper. Stick to business cards at an event and incorporate your biggest accomplishments and qualifications in your elevator pitch. When you follow up, you can share or link to your resume to provide additional detail.

Use a Shotgun Approach: A few meaningful conversations can yield better results than many superficial encounters. In advance of an event, identify individuals with whom you want to talk, and seek them out. This kind of approach also makes follow-up easier and more productive.

Interrupt/Talk over Others: Wait for the right opportunity to contribute to a conversation, especially when talking with a senior social work professional. Likewise, listen to what others say instead of simply chiming in with an unrelated piece of information during a moment of silence.

Be Intimidated: Everyone attends networking events to meet new people. Don't worry that you might bother someone stop you from beginning a conversation. In all likelihood, the person you approach will be happy she can respond to your introduction rather than having to introduce herself.

Neglect to Follow up on Connections: If someone gives you his or her business card, respond either via email or social media. For important connections or when networking in social work management circles, send a handwritten note thanking the individual for his time. A single conversation means nothing if you cannot use it to help develop an ongoing professional relationship.

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Networking for social workers involves building, maintaining, and leveraging professional contacts in the field. You can network at large conferences hosted by professional associations or by having coffee with a colleague who works in your department. Most networking begins with a face-to-face connection, though the internet has shifted the way we establish and continue professional relationships.

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3. Professionals from different backgrounds but same agency.

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3. Professionals from different backgrounds but same agency.

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Abstract

Interprofessional collaboration is increasingly being seen as an important factor in the work of social workers. A focus group was conducted with Canadian social work educators, practitioners, and students to identify barriers and facilitators to collaboration from the perspective of social work. Participants identified six themes that can act as barriers and facilitators to collaboration: culture, self-identity, role clarification, decision making, communication, and power dynamics. These findings carry important implications for interprofessional collaboration with social workers in health practice.

Keywords: collaboration, interprofessional care, mental health, power dynamics, role clarification

There is an increasing trend toward greater inclusion of interprofessional collaborative care models in the health care system ( Goldman, Meuser, Rogers, Lawrie, & Reeves, 2010). Collaborative models bring various health care providers together-such as physicians, nurses, social workers, psychologists, pharmacists, dietitians, and others-to provide team-based care. Key factors can help influence or deter successful collaboration. Social work has historical experience in team-based care and brings a unique perspective to health care environments. The purpose of this qualitative study was to explore social work's experiences of interprofessional collaboration.

Interprofessional Collaboration

Interprofessional collaboration can assume various forms and be defined in diverse ways ( D'Amour, Ferrada-Videla, San Martin-Rodriguez, & Beaulieu, 2005; Kvarnström, 2008). Collaborative care involves providers from different specialties working together to provide care for individuals and their families in the most appropriate and efficient manner ( Craven & Bland, 2013). The goal of interprofessional collaborative practice is to help improve health outcomes for those using the health care system ( Canadian Interprofessional Health Collaborative [CIHC], 2010). Interprofessional collaboration happens when practitioners, patients, clients, families, and communities develop and sustain interprofessional working relationships that facilitate optimal health outcomes ( CIHC, 2010). Primary health care provides one example in which we see increasing shifts from care provided by an independent physician to care provided by interprofessional teams ( Goldman et al., 2010; Hutchison, Levesque, Strumpf, & Coyle, 2011).

A number of factors facilitate and enhance collaborative care. In the United States, the Interprofessional Education Collaborative (IPEC) (2011) outlines four core competency domains for interprofessional collaborative practice: (1) adopting values/ethics for interprofessional practice; (2) understanding interprofessional roles/responsibilities; (3) enhancing interprofessional communication; and (4) facilitating teams and teamwork. Similarly, the Canadian Collaborative Mental Health Initiative (CCMHI) ( Gagne, 2005) also described four key elements of collaborative mental health care that are consistent with IPEC's four core competencies. According to CCMHI, the four key elements guiding collaborative mental health care are (1) increasing accessibility to mental health services; (2) consumer centeredness; (3) the need for systems and structures to support collaboration; and (4) enhancing the richness of collaboration ( Gagne, 2005). IPEC and CCMHI ( Gagne, 2005) have suggested that achieving quality collaborative mental health care requires inclusion of these competencies. Additional factors that support successful interprofessional team collaboration are organizational structure, professional identity, scope of practice, and understanding and addressing problematic power differentials ( Belanger & Rodriguez, 2008; CIHC, 2010; Goldman et al., 2010; Hansson, Friberg, Segesten, Gedda, & Mattson, 2008).

Organizational Structure

Organizational structure influences interprofessional collaboration and includes clinical and administrative systems that guide cooperative practice, as well as the characteristics of the health care facility structure ( Kvarnström, 2008). Structural factors that facilitate collaborative care include collaborative leadership, organizational culture that supports collaboration, effective methods of communication, and colocation ( Goldman et al., 2010; Howard, Brazil, Akhtar-Danesh, & Agarwal, 2011; Kates et al., 2011). Kates et al. (2011) emphasized the importance of colocation of team members in working collaboratively. Colocation refers to various professionals working within the same organizational facility, and likely under the same roof. Communication between team members can be affected when there is more than one site, or even when team members are housed on different floors in the same building ( Goldman et al., 2010; Kates et al., 2011).

Professional Identity and Scope of Practice

Interdisciplinary teams require clarity of roles and responsibilities to ensure optimum team function ( CIHC, 2010). Individual members come to the team with varying degrees of understanding concerning the capabilities of other professions ( Goldman et al., 2010, Lynch, 2011). Statements about scope of practice from professional associations ( College of Nurses of Ontario, 2014; International Federation of Social Workers, 2012) provide a cursory overview of one's professional role.

Social workers who work as the sole social worker on a health care team must often negotiate their role on an interdisciplinary team without consultation with other members of their profession ( Oliver, 2013). Hugman (2009) acknowledged that the role of social work is often directed by the goals of the agency. Social workers are in a position of having to carve out roles and demonstrate how this assists the team in a unique way. "If social work cannot show that it can do certain things, then its authority will be challenged" ( Hugman, 2009, p. 1143). Competence in a particular task may direct practice more than professional scope ( Oliver, 2013). Oliver (2013) stated that the professional identity of social workers is weakened by conflicting messages within the profession itself. Ongoing debates concerning micro or macro practice models, and philosophical debates between medical model and anti-oppressive paradigms, may cause new practitioners to struggle in their attempts to determine the nature of their role within an interdisciplinary team ( Hugman, 2009; Oliver, 2013).

Power Differentials

Interprofessional collaboration can be facilitated or hindered by overt and covert power differentials; power dynamics must be considered when developing and implementing collaborative models ( Baker, Egan-Lee, Martimianakis, & Reeves, 2011; Nugus, Greenfield, Travaglia, Westbrook, & Braithwaite, 2010; Whitehead, 2007). Overt power differentials are revealed in structural ways such as with existing governance models that place one profession in decision-making positions over other professions, and compensation practices that reward some professions more lucratively than others. Covert power differentials require a level of critical reflection as they are often more subverted. Whitehead (2007) provided the example of interdisciplinary teams in which communication regarding patients takes place around the doctor's schedule, reinforcing the doctor's "centrality." Issues of power determine to what degree collaboration occurs. Interdisciplinary care seeks to change the dynamic of interactions between health professionals to form a system of cooperating independents. The flattening of hierarchies inevitably affects the role of the physician, who traditionally held a privileged position of power ( Lynch, 2011; Nugus et al., 2010; Whitehead, 2007).

Social Work in Interprofessional Collaborative Health Care Teams

For many years social workers have provided mental health counseling to individuals, families, and groups within the social services context ( Canadian Association of Social Workers [CASW], n.d.). As models of health care delivery are expanded to include interprofessional health care teams, social workers have the opportunity to play an important role in providing collaborative health care. This study engaged social workers in an exploration of barriers and facilitators of interprofessional collaboration in health environments. It was conducted during a two-day joint national conference of the Canadian Association for Social Work Education (CASWE) and CASW.

Method

An exploratory qualitative design guided a semistructured focus group and analysis of data. The sample population for this study was social work faculty members of Canadian universities, other social work educators, practitioners, researchers, and students attending the CASWE and CASW joint annual conference held at Brock University in St. Catharines, Canada, on May 26-29, 2014. The focus group was advertised in the conference program using the conference program terminology of "think tank" and clearly described as a research study. For the purpose of this article, and because our approach to conducting the think tank is consistent with a focus group, we are using the term "focus group" to describe our study. Research ethics board approval was obtained for this study through the University of Waterloo located in Waterloo, Canada.

At the beginning of the session, an information letter describing the study-the purpose of the session being to collect research data, the focus group process, and how to receive a copy of the results of the study-was provided to each participant. The session began with the first author (Wayne Ambrose-Miller) stating that the purpose of the focus group was to gather data that would be used to prepare a journal article. A process of informed consent was used and was described in the information letter and the verbal statement given at the beginning of the session. Participants were informed verbally and in writing of their right to opt out of having their comments included in the written record. Participants were informed verbally of their right to attend the session without verbally participating and that they were welcome to leave the session at any time.

A semistructured interview format was used to conduct the focus group interview. Both authors co-facilitated the focus group interview. Although the focus group was not audio recorded, a research assistant acted as a notetaker throughout the entire focus group session and recorded comments directly into a word processing file. The research assistant was given the directions to take notes verbatim as much as possible and to exclude identifying information such as participant names, institute and organizational names, and other identifying information. Instead, each participant was assigned a code (P1 through P11). Immediately following the conclusion of the focus group, both authors and the research assistant met to do an initial review of the notes compiled during the focus group. The focus group session, including a brief introduction of the study and short introduction on interprofessional collaboration, was 90 minutes in length.

Thematic content analysis with some elements of grounded theory was used to analyze the data ( Braun & Clarke, 2006; Charmaz, 2006). We used a modified version of coding similar to the three phases of initial coding, focused coding, and axial coding ( Charmaz, 2006). Coding and analysis were interrelated processes that involved both authors equally throughout. The initial coding and focused coding processes occurred with both authors simultaneously. Both authors cross-checked their coding structures and, in cases where mismatches occurred, conducted detailed discussions to achieve consensus. A preliminary coding scheme was developed after identifying major themes.

Findings

Eleven individuals participated in the focus group and agreed to have their data included in the study. Specific demographic information was not collected from the participants at the outset of the focus group. However, from the data we ascertained that there was a range of representation of social workers, including baccalaureate- and master's-level social work students, clinical social workers (BSW and MSW educated), social workers in managerial positions, and academics with doctoral degrees in social work. Although we did not collect specific data on the length of experience of each participant, it ranged from early-career to later-career social workers.

Six main themes emerged in the data: (1) collaborative culture, (2) self-identity, (3) role clarification, (4) decision making, (5) power dynamics, and (6) communication (see Table ). The themes were similar to the interprofessional competencies identified by IPEC (2011) in the United States and two of the four key elements of collaborative mental health care described by the CCMHI ( Gagne, 2005).

Table 1:

Collaborative culture

Individual attitudes and beliefs Nurturance Leadership

Self-identity

Awareness of social work contributions, role Diversity of social work Organizational resistance

Role clarification

Formal educational opportunities Educating through demonstrating Professional bodies Colocation

Decision making

Professional differences

Communication

Communicating through action Client care chart Time

Power dynamics

Power differentials acting as barrier

Collaborative Culture

Participants spoke of the importance of a culture of collaboration in their organization. This theme is consistent with IPEC's (2011) core competencies of interprofessional communication and teams and teamwork and appears consistent with CCMHI's ( Gagne, 2005) elements of collaborative structures and richness of collaboration. Having an organizational culture that supports, values, and encourages collaboration was described as being important for successful collaboration. Participants stated that attitudes and beliefs of individuals within the working environment, leadership, and nurturance shaped the organizational culture. Participants indicated that it was important to attract individuals who encourage collaboration and stated that there are individuals who seek out collaborative environments in which to work. For example, one participant stated, "Different nurses voted to be under my unit in the cooperative instead of elsewhere because of the approach. Ours is very egalitarian overall" (P8).

Leadership was also identified as an important contributor to how well collaboration occurs, because formal and informal leadership reinforce collaborative ideas to the rest of the team. One participant described the importance of her informal influence: "I think I'm a good role model" (P3). Yet participants described the minimal presence of social work in formal health care leadership roles as problematic.

A collaborative organizational culture also requires nurturance: "It takes the dedicated people to keep it going or else it does backslide ... if you don't have someone embracing that, it does go back" (P5). A collaborative culture helps to address challenges, "especially at moments when there are slip-ups" (P5). Participants described the traditional medical model as a "default setting" in health care that interprofessional teams may revert back to if nurturing of the collaborative culture is neglected. The broader work environment contributes to or challenges the collaborative experience. For example, one participant stated, "Something that's missing is looking at the broader structure and the environment that we're working in. Collaboration takes time. There's a large push right now in my work where there's a lot of number counting that doesn't necessarily look at quality care" (P3). This participant suggested that collaboration takes time and the environment needs to support that to be successful.

Self-Identity

Participants discussed the role of self-identity in the following three ways: (1) awareness of social work contributions, (2) diversity within social work, and (3) resistance in response to the social work identity. This theme was related to the IPEC (2011) core competency roles/responsibilities and the CCMHI ( Gagne, 2005) elements of collaborative structures and richness of collaboration. Collaboration starts with an awareness of one's own individual contributions as a social worker. Participants stated that social work enriches interprofessional collaboration by adding a different conceptualization and approach to health within a team that is broader than the traditional medical model: "We look at the human aspect, both individual and in the society" (P6). Another participant stated, "Humanizing in practice is my role" (P4). What both participants suggested is that the social work role helps to give greater context and relational understanding of the individual.

Participants indicated that social workers have to proactively carve out their role within health settings in a way that is self-directed. Participants emphasized the need for social workers to be competent in their role and confident in their identity. Social work's role fluidity was identified as an asset because it helps fill in service gaps and address clinical complexity: "I think we pride ourselves in ambiguity so that there's still a place for complexity" (P5). However, having an unclear social work role can lead to challenges in collaboration: "[The] lack of clarity in social work roles is extremely challenging. ... It makes me think, what is the professional identity that we want to portray?" (P6).

Participants indicated that social worker's role as client advocate can create tension between the worker and the rest of the collaborative team. Social worker as advocate was seen as an inherent part of the social work identity, yet participants described having other colleagues tell them not to act in the advocacy role: "[What] do hospitals expect when they discharge a client that needs rehabilitation but isn't eligible to receive it, what is our job with advocating for this care when they don't have any funding? When you stand your ground, they often say that's not your job" (P6).

Role Clarification

Role clarification and having an awareness of one's interprofessional colleagues were described as important to collaboration. Awareness of others was described in three ways: (1) interprofessional educational opportunities, (2) educating colleagues, and (3) the influence of colocation. This theme was related to the IPEC (2011) core competency roles/responsibilities and the CCMHI ( Gagne, 2005) elements of collaborative structures and richness of collaboration. Participants emphasized the importance of various professions learning from each other and valued some of the opportunities for collaborative learning provided at the university level. For example, one participant stated, "In [university] right now, there's about five different courses that include doc's, nurses ...  that you're placed with an interdisciplinary team with various different professionals to gain information and experience" (P4). Another participant stated, "interdisciplinary training is mandatory at [university]" (P7). As well, "In my schooling there's a two-week medical rotation where medical residents spend time with social workers" (P8). However, participants indicated that opportunities that exist for formal interprofessional learning are sparse: "In my training in my MSW there was no training with the medical faculty" (P2).

Educating colleagues occurred in various formal and informal manners: "Once a month we'll have an education session on something. Changes on care, social work month, little workshops make other people engage in it ... we have been able to teach each other and share in what everyone does" (P2). Participants also described how learning about one another happened organically: "I learned a lot from the nurses, and I like to think that they learned something from me as well" (P5).

Participants emphasized the importance of educating through demonstrating: "When you do specifics and show specifics things become much better identified" (P5). "It's not just the standards, it's not just collaborations, it's what we can do and what we do, do in work" (P2). Participants also described how educating colleagues could also occur at the broader macro level. For example, one participant recommended that social work's professional bodies engage with medical professional bodies so as to help dynamics that occur within clinical collaborative settings:

I'd love to see our body talk more with the medical body. As social workers we need to have this conversation so often. Medical doctors don't need to do that so I think we need to show how we, as social workers, need to communicate this. If we did this in the education then things would change drastically. If we didn't have to keep tap[ping them] on their shoulders to keep telling them why we're so important, then services would be different. We need to push for more. (P6)

Colocation with other interprofessional colleagues was considered important for social work. Participants indicated that colocation was an important means for physicians and nurses to learn about social work in daily encounters. These types of encounters facilitated by colocation can help demonstrate the social work role, which in turn assists in better utilization of social work services. For example, one participant stated,

Colocation sure can help or hinder work. We provide services to our member clinic. ... The doctor and nurse were taking on that role. We now have automatic referrals for traumatic accidents, cancer ... because they now identify it is the social worker's role. (P2)

Here the participant suggested that challenges existed in social work referrals in the clinic where the social worker was located off-site. Interestingly, participants also spoke about how knowing oneself and knowing the roles of others helped to foster role fluidity that was described as an asset for enhancing collaboration: "If someone needed something, the professional in the room would complete that" (P5).

Decision Making

Decision-making processes were identified as important for collaboration. This theme was related to the IPEC (2011) core competency teams and teamwork and the CCMHI ( Gagne, 2005) elements of collaborative structures and richness of collaboration. Participants emphasized how existing decision-making processes had often been problematic for interprofessional collaboration. Ultimately, participants advocated for a collaborative method of decision making. For example, "Most informed decisions should include the team. If it's their liability then I should be looking at the whole team" (P3). Decision-making processes were identified as a barrier when differences emerged across professions as to the decision-making process and outcomes that participants experienced. For example, "Individual doctors are also ... risk adverse. ... I don't know how that is all framed but 'I'm making the decision' is how most doctors make these choices" (P2). Along with differences across professions, this participant also suggested that there could be concerns with the heterogeneity that exists within professions: "[A] suicidal patient was approached completely different by one than by another doctor on our team" (P2).

Communication

Participants spent a great deal of time talking about the importance of communication in collaboration. Effective communication was described as necessary for interprofessional collaboration, whereby poor communication was considered a barrier to collaboration. This theme was related to the IPEC (2011) core competency interprofessional communication and the CCMHI ( Gagne, 2005) elements of collaborative structures and richness of collaboration. Participations spoke about various forms of communication that were an asset to collaboration. For example, communicating through one's action was one way that the various team members could learn about one another's roles. One participant described how a social work colleague offered clinical consultation to the team as a way to support the team as well as demonstrate the role of social work: "One thing that a coworker has done to define his own role in the team is by recognizing his strengths to them. Every other Thursday, the nurses and doctors are offered time with him. Support and value have increased since then" (P4). What this participant suggests is that by having regular access to the social worker, physicians and nurses in that team have been able to grasp a better understanding and value of what social work offers.

Participants described documenting in client charts as a vehicle to demonstrate one's own contributions to the collaborative. For example, one participant stated, "I'm trying to make my charting for clinical impressions and personal insights, 'what was going on there?' Charting has [provided] critical reflection opportunities and this is where I'm starting to find my voice" (P4). Patient care notes were also described as a vehicle for acknowledging colleagues: "In my notes, I need to identify the good work of others" (P1). Another participant stated, "These are the important things to chart! We need to note these" (P2). Participants also stressed the importance of face-to-face dialogue to help colleagues understand a different approach than what they are familiar with. For example, one participant stated, "Harm reduction ... if we don't have a conversation with the doctor then no one will know we're talking about it" (P4).

Participants also spoke about the method of communication being problematic for collaboration. Several participants described the use of electronic medical records (EMR) for charting as problematic for collaborative communication. Participants described that other team members did not read social work-specific chart entries in the EMR and felt that the EMR itself eroded the potential for reciprocal communication. One participant explained that some providers' notes were being kept from other providers for reasons of confidentiality: "Some problems include locked files for social workers, which then spread to be all locked files. Balance between confidentiality and care is definitely a challenge" (P8). Another participant agreed and stated, "When we ha[d] the paper files it was different" (P2).

Power Dynamics

Power inequities and dynamics emerged in the data as a barrier to collaboration: "Power differentials are there" (P3). This theme was related to the IPEC (2011) core competency interprofessional communication and the CCMHI ( Gagne, 2005) element collaborative structures. Power inequities affected social work's voice and contributions: "Physicians come in with power. ... We as social workers in general are pretty awful at doing this. If doctors come in and take that power, we get talked over and lost" (P6). Participants indicated that salaries was one way that power inequities were demonstrated: "Power inequalities and with that, we're pushing for a change in salary, [which] could be influential too because of the inherent worth portrayed in the dollar amounts in salary" (P8). Power inequities were considered particularly problematic for collaborative care when acted out through the actions and behaviors of colleagues. For example, one participant described an incident in which a colleague did not interact in a way that was considered respectful and suggested that she was not an equal among her collaborative peers: "I was doing work as a multidisciplinary team ... he asked if I wanted anything to drink and said, 'Get this little girl some tea'... to his secretary" (P3). Because of existing power inequities, participants believed that social work had to be even more diligent with demonstrating worth to the collaborative team. One participant stated, "There's something so satisfying with having to prove yourself but then prove your worth when no one else believed it to be possible" (P3).

Discussion

Interprofessional collaboration is increasingly being viewed as a necessary component in the delivery of health care ( Gocan, Laplante, & Woodend, 2014). Social workers seem ideally situated to be important contributors to health care teams ( Beddoe, 2011; Oliver, 2013). Social workers in this study have found collaborative care to involve both challenges and rewards. Challenges arise when social workers take part in interprofessional teams without a clear understanding of their role and the roles of their interprofessional colleagues. Social workers have also identified how power differentials have been exposed when opportunities arise for team decision making.

There remains a need for clarity in the roles of social workers on interprofessional teams while still maintaining a sense of flexibility to look at team-specific needs. Social workers who have a strong sense of what social work can provide to the team have the ability to communicate that vision in the work that they do. Bell and Allain (2011) advocated for a dynamic core social work identity that is adaptive to changing contexts. Participants seemed to agree that there were benefits to having fluidity in one's role to meet the needs of the team. To maintain the profession's integrity and traditional values such as advocacy for one's client, however, it was necessary to have a firm grasp on the unique perspective that social workers often brought to the team. This was particularly important when the perspective of the social worker was in conflict with the perspectives of the rest of the team. Advocacy for patients and calling attention to social justice issues was one role that participants identified as having the potential to cause conflict among team members.

Participants highlighted a possible link between clear interprofessional roles and experience with interprofessional education. Both formal and informal methods of interprofessional education seem to be effective ways to strengthen teamwork ( Jones & Jones, 2011; Kenward & Stiles, 2009; Nisbet, Lincoln, & Dunn, 2013). Interprofessional education programs within formal professional training ( Kenward & Stiles, 2009), teamwork-training programs for pre-existing teams ( Jones & Jones, 2011), and informal interprofessional learning ( Nisbet et al., 2013) all have the capability to provide familiarity and comfort with the various professions that make up interprofessional teams in health care.

Collaborative care in interprofessional health teams requires leadership, mentoring, and the ability to guide decision making within the team ( Sims, 2011; Whitehead, 2007). Participants of this study expressed the view that decision making in collaborative teams sometimes exposed old power dynamics in which professions that had traditionally held the most power in decision-making situations expected to continue to be in that role. Participants remained hopeful that greater inclusion of interdisciplinary education and collaborative opportunities would produce an increase in decision making that demonstrated a sharing of power within the team. Jones and Jones (2011) reported that interdisciplinary education opportunity often results in the development of common goal setting and trust building. This in turn leads to other by-products such as conflict management: "Intra-team trust and unanimity of purpose can moderate conflict within a team" ( Jones & Jones, 2011, p. 180).

There has been ample attention on the reform of health care systems in Canada, the United States, and elsewhere ( Deber & Mah, 2014; Forest & Denis, 2012). Aims to improve interprofessional team-based collaborative care include, but increasingly extend beyond, physicians and encourage intersectoral collaborations across health and social sector domains ( Bickerstaffe, 2013; Danaher, 2011; Groszkruger, 2011; Hutchison et al., 2011). The shift away from the traditional physician-centered model of care presents challenges to assumptions embedded in the traditional health care system ( Hutchison et al., 2011; Romanow, 2002; World Health Organization, 2008). We believe that this is an opportunity for social work to shape collaborative mental health care, and assist the transition to greater collaboration, by enacting our leadership abilities in practice and policy.

Conclusion

Interprofessional collaboration in health care offers many rewards and challenges. Social workers have the ability to bring to the team a unique perspective concerning the patients to whom we provide care. This study highlights several areas of concern for social workers in interprofessional teams, including the tension between a clearly defined social work role and the necessity for fluidity of roles in interprofessional teams. A continued discussion about the role of social work in interprofessional health care is necessary to build a stronger sense of our potential role and to improve ways to better meet the needs of our clients.

References

Canadian Association of Social Workers. (n.d.). Social work practice in mental health. Retrieved from http://www.casw-acts.ca/en/social-work-practice-mental-health

Goldman J., Meuser J., Rogers J., Lawrie L., Reeves S. (2010). Interprofessional collaboration in family health teams: An Ontario-based study. Canadian Family Physician [[, 56, e368-e374.PubMed] PMC free article] [Google Scholar]

Howard M., Brazil K., Akhtar-Danesh N., Agarwal G. (2011). Self-reported teamwork in family health team practices in Ontario: Organizational and cultural predictors of team climate. Canadian Family Physician [[, 57, e185-e191.PubMed] PMC free article] [Google Scholar]

Hutchison B., Levesque J. F., Strumpf E., Coyle N. (2011). Primary health care in Canada: Systems in motion. Milbank Quarterly [[, 89, 256-288.PubMed] PMC free article] [Google Scholar]

Interprofessional Education Collaborative. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Retrieved from https://www.aamc.org/download/186750/data/core_competencies.pdf

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Challenges Faced by Social Workers as Members of Interprofessional Collaborative Health Care Teams

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Interprofessional collaboration is increasingly being seen as an important factor in the work of social workers. A focus group was conducted with Canadian social work educators, practitioners, and students to identify barriers and facilitators to collaboration from the perspective of social work.

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4. Professionals from various backgrounds and different agencies.

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4. Professionals from various backgrounds and different agencies.

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5. Social workers working together with indigenous and paraprofessionals from internal agency.

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5. Social workers working together with indigenous and paraprofessionals from internal agency.

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6. Social workers working together with indigenous and paraprofessionals from external agency.

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6. Social workers working together with indigenous and paraprofessionals from external agency.

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The many fields that work together

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Administration and Management

Social work administrators are proactive leaders in public and private agencies that provide services to clients. Many elements of this area of social work practice are common to administration in other organizations. However, administration and management also require knowledge about social policy and the delivery of social services, vision for future planning, an understanding of human behavior, and commitment to social work ethics and values.

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Advocacy & Community Organizing

Advocacy is one of the keystones of social work practice. Social work advocates champion the rights of individuals and communities with the goal of achieving social justice. Community organizing and advocacy work with the power of numbers-many people thinking, working, and acting together-to counterbalance wealthy and powerful groups and the means they have to protect and extend themselves.

Historically, community organizing and social work were responses to the many forces that created inequality in our society. They remain as necessary and effective as ever today.

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Aging

Social workers link older adults with services that help them live independently and with dignity, thereby maximizing their quality of life and participation in society. Social work with older adults focuses on the physical, psychological, social, and economic aspects of daily living.

Download Aging Social Work infographic (JPG format)

Child Welfare

Child welfare social workers serve some of the most vulnerable children, youths, and families. Social workers specialize in building on the strengths of families and helping them to provide a safe and nurturing environment for children and youths.

However, when families are unable to do this, social workers must intervene to protect the children from harm. Child welfare social workers ensure that children and youths who have experienced abuse or neglect are supported through a range of services.

Developmental Disabilities

Social workers also help parents of children with developmental disabilities understand their legal rights. They help parents learn to be advocates and find special services that enable their children to be as independent as possible.

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Health Care

Since the early 1900s, professionally trained social workers have helped people deal with personal and social factors that affect health and wellness. Some health care social workers are in direct services and concentrate on individuals, families, and small groups.

Others work in settings where the focus is on planning, administration, and policy. In the health care setting, social workers may conduct research, develop programs, and administer social work and other departments.

Download Health Care Social Work infographic (JPG format)

International Social Work

The functions of social work in international development are diverse. They include direct services in communities, refugee camps, orphanages, hospitals, and schools, as well as supporting the efforts of national governments, intergovernmental organizations, and non-governmental organizations to enhance social well-being.

Justice and Corrections

Social workers who work in justice and corrections can be found in courts, rape crisis centers, police departments, and correctional facilities.

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Mental Health and Clinical Social Work

Clinical social workers are one of the nation's largest groups of providers of mental health services. They provide mental health services in both urban and rural settings, where they may be the only licensed provider of mental health services available.

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Mental Health and Substance Use Social Work

Social workers help individuals, families, and communities find ways to recover from substance use. They provide a much-needed ecological perspective to treatment that focuses on the client in relation to family and neighborhood environments, community support systems, cultural attitudes, and policies.

Consequently, social workers trained in treating alcohol, tobacco, and other drug addictions can be found doing case management, group and individual therapy, family counseling, advocacy for jobs and housing needs, community resource development, education, and policy making.

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Occupational and Employee Assistance Program (EAP) Social Work

Occupational social workers help organizations re-engineer their structure and methods to improve efficiency, creativity, productivity, and morale. They may also work for a union and be involved in job counseling or organizing.

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Policy and Planning

Social workers analyze policies, programs, and regulations to see what is most effective. They identify social problems, study needs and related issues, conduct research, propose legislation, and suggest alternative approaches or new programs. They may foster coalitions of groups with similar interests and develop organizational networks.

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Politics

There is a natural progression in the careers of many social workers from activism to leadership. Increasingly social workers are holding elective offices from school boards to city and county governments, from state legislatures all the way to the U.S. House of Representatives and the Senate. Social workers also play leadership roles in local, state and federal agencies.

Download Politics Social Work infographic (JPG format)

Public Welfare

Social work in public welfare entails planning, administering, and financing programs, training and supervising staff, and setting and evaluating standards and criteria for service delivery. Public welfare offers many challenges that require creative thinking and leadership from professional social workers.

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Research

Social workers in research typically tend to be academics with postgraduate degrees in social work. Research provides the framework for effective practice. Although considered an art by some, social work is also a science based on evidence.

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School Social Work

School social workers act as the connection for school, home, and community services to help children with emotional, developmental, and educational needs. Most school social workers practice in public and private schools, although a small percentage may work in social services agencies or other service sites such as a preschool program or residential treatment center for children who are emotionally disturbed.

Download School Social Work infographic (JPG format)

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Social workers are employed in schools, hospitals, mental health clinics, senior centers, elected office, private practice, prisons, military, corporations, public and private agencies and more.

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Many companies have had to adjust to virtual workdays these past couple of months because of the coronavirus Covid-19 crisis, which means navigating a whole new form of leadership. With an uncertain future ahead, our virtual working conditions may continue for some time, perhaps forever - Twitter just announced its employees could continue working from home permanently if they choose.

SAN FRANCISCO, CA: A sign is posted outside of the Twitter headquarters in San Francisco, ... [+]
2014 Getty Images

Pat Flynn, an online business owner since 2008, has been leading a virtual team for more than a decade. He had to find unique ways to "show up" for his followers and employees since he doesn't get to see them every day physically. He suggests the first thing to do is ask yourself, what does my audience need most right now? With many at-home struggling with unemployment, finances, and mental health, there's a lot of need out there right now. Once you've determined what that need is, the second question you should ask yourself is, what can I give them for free?

Pat's entire world turned upside down when he lost his architecture job in 2008 at the start of the great recession. He knew that the future of architecture was grim, and he had to completely reinvent himself if he was going to provide for his family. We are now seeing the most significant financial crisis since 2008, and many are in that same boat Pat found himself in 12 years ago. Knowing he has valuable information to give people, he's done a few things:

● He's offering his book, , as a free download for people. The story outlines his journey of being let go from his job and redefining his career and life in the years ahead - a topic that many are dealing with right now. Additionally, his course Smart from Scratch is also available for free and has already given away more than $3 million worth of the course.

● He's releasing a few emergency podcast episodes that cover much-needed topics right now, including what steps to take if you've been laid off recently, how to podcast during a crisis, how to find opportunity in tough times, and more.

● He's gone live on YouTube for an hour every day since the pandemic started to answer people's questions and help those who want to start a business.

Whether it's on social media, your podcast, or an e-newsletter, being generous during these times is a great way to get people in the door and introduce them to the other solutions and products you have to help them. Being a leader means being there for those who rely on you. Just because we're at home, that doesn't mean your customer-base has stopped needing you. Right now, it is imperative to be proactive in how you're showing up for these people every day.

Matt Gartland, COO of Smart Passive Income, also shared a few ideas on how to "show up" as a leader to your employees. Pat is showing up and leading on the front of the audience; his business partner Matt is taking charge on the employee front. "Showing up" for your team is a critical leadership quality in the best of times. Now, amid COVID-19, it's downright essential. People need a safe place to share their feelings and know they won't be judged. They need answers they can trust to ease their doubts and direction they can follow that provides confidence. Here are a few things Matt has implemented since the beginning of the pandemic:

● Friday Retrospectives: Every Friday the team meets (you can do it on Zoom, Skype, or whatever platform you're using) to share their accomplishments and struggles from the week both at work and in life. The "retros" have long been an anchor point for Smart Passive Income's team culture. Since the pandemic hit, they've taken on a new, more considerable significance. Team members talk openly about how COVID-19 is affecting their families and express heightened levels of gratitude for each other.

● Internal News Digest: The operations team puts together an internal news digest and sends it out weekly to the team. It contains useful news about COVID-19 response measures for every team member's home state. It also includes lighthearted news about people or companies doing good things despite the chaos and constraints of the moment.

● Quarantine Care Subscriptions: A couple of weeks ago the operations team surprised everyone during the Friday Retrospective with personalized care subscriptions. They hunted for and chose subscriptions unique for each person on the team.

● Annual Headspace Subscription: They also gifted the entire group with an annual subscription to the Headspace app to helpease mental fatigue and stress. These days, the little surprises really matter. Your employees need to know you care about them now more than ever.

● Personalized 1:1's: Matt's regular one-on-one meetings with his direct reports have evolved. He still hits the crucial questions to clarify priorities, gauge engagement, resolve conflict, etc. But to begin, he always asks, "Are you okay today?" and then listens. This adjustment has helped make sure he prioritizes his team's emotional state first and foremost during these hyper-emotional times.

These proactive cultural dynamics are here to stay for the foreseeable future. The leadership techniques they use center around safety, security, togetherness, and resolve. Once considered a valuable leadership model, they're now priceless.

... Read More

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How To Lead A Virtual Team During The Coronavirus Crisis

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Many companies are adjusting to virtual workdays due to Coronavirus which means navigating a whole new form of leadership, for how do you lead a permanently virtual team? A global expert shares his advice and expertise on the matter, helping you to discover exactly how amid the Covid-19 crisis

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Treatment Groups in Social Work

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Understanding Treatment Groups in Social Work

Social workers can expect to be constantly navigating and working in group spaces and dynamics, no matter their specific level of practice or specialization. Additionally, social workers can be reasonably sure that at some point in their career they will be in the position of leading a group, so it is important to understand treatment groups in social work.

Whether leading group therapy, community organizing, a peer task-force, or advocacy campaign, group leadership requires a capacity for structure and fluidity, intention and openness, and exhibiting those traits in a well-organized group may help foster them among group members and establish cohesive group norms.

Leading treatment groups in social work might be a big part of your job description.

As a social worker and member of the International Association of Social Work with Groups, I have specialized in groupwork (an early sibling to social work).

One of the first readings that I feel resounded through my core disposition about groupwork (and social work in general) was Glassman's Humanistic Values 1 & 2, from the Encyclopedia of Social Work with Groups which describe group work's emphasis on the inherent worth and capacities of members and their responsibility for and to one another; "the norm for building cooperative rather than competitive relations in the group fosters member's collective abilities to create a caring and supportive social milieu poised to facilitate member change."

The following are the basic guidelines for general social groupwork:

Tasks of the Group Leader

Mediate & facilitate the working through of conflict

Prepare agenda for group (provide rationale for using either structure or laissez-faire approach)

Maintain posture of intentionality, openness, curiosity, and interest

Provide members & set time/place to meet

Model behavior for group members e.g., respect, punctuality, vulnerability, expressing here and now feelings tend to be most helpful.

Remain Aware of 3 levels of Focus:

1. Individual (what is happening with each group member)

2. Interpersonal (what is happening between group members)

3. The group as a whole (the collective dynamic)

As a Group Leader in Social Work

As a group leader, one of the earliest lessons I learned was the importance of being organized, and setting and maintaining the frame of group treatment, the physical space arrangement and the time boundaries.

Knowing how many members are in the group, maintaining a space or seating arrangement that accounts for everyone (including absentee members), how many meetings there will be, and announcing or following up on sessions led by others are parameters of professionalism and mindfulness that impact the confidence of the group in the leader, and thus the capacity of the group to meet their needs.

Understand the Power of Silence in Treatment Groups in Social Work

I have also learned more about the power of silence, and allowing the group to hold it. In many of my group sessions, I have had to face my impulse to "rescue" groups from their silence at times by commenting or questioning, and in so doing recognize that my own anxiety was a driving force of my choices to alleviate what I perceive as uncomfortable or unproductive treatment groups in social work.

Furthermore, I have come to acknowledge the immense potential value of silence as both a symptom of work being done by the group as well as a refuge or respite for group members who may not have opportunities to indulge silence in their social and family groups.

The Importance of Modeling Group Behaviors and Norms

Overall, group leadership has reinforced the notion and power of modeling group behaviors and norms, and guiding the development of the group culture through carefully challenging and stirring while also safeguarding members from harm. Toward this, I am convinced of the leader's obligation to respect each individual's place within the group journey while working to cultivate a safe and brave space that makes speakable the member's strengths and struggles, and stimulates shared awareness.

I also found great resonance with McRae and Short's Racial and Cultural Dynamics in Group and Organizational Life, in which they assert that "every transaction between two or more people depends on the unique personalities of the individuals and the messages that individuals receive and internalize from their own group." I found myself constantly reflecting back to the notions of group boundaries, power differences, unconscious parallel processes and the role of cultural identity that highlights the systems perspective with which we as social workers may be most importantly equipped as we position ourselves to serve helping processes.

Taking Group Coursework in My MSW Program

Taking coursework in social work with groups provided me with opportunities to more consciously and confidently organize the group process and dynamic into theoretical frameworks which galvanize my clinical intuition.

This, in turn, has led me to recognize my valence for leadership or co-leadership roles in groups, due in part to a confidence in speaking to groups of individuals toward a shared experience or goal, while endeavoring to maintain and model a mind of openness, curiosity, and humility. Moreover, social workers are unique in that we are often called to lead, attend, and form all manner of groups, as we intervene across many areas of impact on client's lives in a number of settings.

Clinical Groups

While this reflection has focused more on my experience with clinical groups, it is important to recognize that groups are steady features of whether we are attending hospital discharge meetings with nurses and doctors, leading training seminars with law enforcement or school staff, working on our agency teams, or facilitating clinical groups, we are engaged in forms of group work, and an understanding of group work theory and practice is essential to effective social work.

Related Articles:

Brandon Haydon, LCSW is an expert contributor to MSWcareers.com and currently works at the LifeWorks Psychotherapy Center in Chicago. Lifeworks is an explicitly inclusive practice welcoming clients of all ages, ethnicities, races, spiritual practices and religious traditions, genders and sexualities.

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Group Leadership: Reflections from the Field

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Understanding Treatment Groups in Social Work Social workers can expect to be constantly navigating and working in group spaces and dynamics, no matter their specific level of practice or specialization. Additionally, social workers can be reasonably sure that at some point in their career they will be in

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Professionals, paraprofessionals, and volunteers from disciplines other than social work are part of the environments our clients live in, and because social workers focus on the interaction between people and their environments, we must work effectively with people from other disciplines if we are to effectively serve our clients. Learning to work effectively with other disciplines can be a challenge. Each discipline has its own set of assumptions, values, and priorities, and these differences can easily lead to uncoordinated services, or, even worse, to resources being spent on interdisciplinary conflict.

There are many different models of interdisciplinary relationships. Competition and conflict are two examples that are easy to conceptualize. The model most consonant with social work values is collaboration. Collaboration may be defined as working together. It connotes that collaborators share power and that they each contribute special knowledge or skills. Smith (1985) highlights the distinction by using the terms multidisciplinary and interdisciplinary, the former to refer to many disciplines working in the same setting and the latter to refer to members of those disciplines working together as a team. Although this distinction is not standard in the literature, it is a useful distinction.

When individuals from various professions work together day to day in one setting, they often think of themselves as forming an interdisciplinary team, and yet interdisciplinary teams may function in other ways. For example, a group of individuals from various disciplines may meet periodically or episodically to review critical incidents. They are an interdisciplinary team even though they do not work together every day. Similarly, an ethics committee typically consists of individuals from various disciplines and may even include members external to the organization to assure representation of diverse views. This too is an interdisciplinary team.

And social workers frequently form both brief and ongoing interdisciplinary relationships that do not constitute team practice but that are nevertheless necessary for effective service. Relationships with police officers, probation officers, attorneys, and judges are interdisciplinary in nature. Similarly, relationships with teachers, school administrators, and playground supervisors may be necessary for effective practice. To practice effectively, social workers must be prepared to work with all of the individuals in the client's environment. The focus of this brief review is on relationships with allied health professionals, not because those relationships are most important, but because those have been examined most in the professional literature.

Social work knowledge is influenced by and in turn influences other disciplines. Cheung (1990) reviewed interdisciplinary contributions in professional journals from 1981 to 1985. The top five disciplines cited in social work journals were social work, family studies, psychiatry, sociology, and education. If clinical psychology, psychology, developmental psychology, educational psychology, social psychology, and applied psychology had been counted together, they would have placed second after social work as the source of citations. The same article showed that social work was cited most in social work, education, family studies, clinical psychology, and psychiatry. These finding demonstrate strong interdisciplinary relationships in professional knowledge, and suggest not only considerable overlap in knowledge but also the potential for significant ideas from one discipline to influence another.

Abramson and Mizrahi (1996) examined the characteristics physicians and social workers identified as important in collaborative relationships. Those rated most important by social workers were, respect for collaborator, similar perspectives, positive quality of communication, social worker role well understood by physician, and amount of communication was positive. Those items rated as most important by physicians were: the social worker was capable, positive quality of communication, respect for the physician, similar perspectives, and the social worker kept the physician informed.

Abramson and Mizrahi reported that the most common negative variables for social workers were: dissimilar perspectives, poor quality of communication, physician's negative style, lack of respect for the social worker, and negative personal traits of the physician. They reported the most frequent negative variables for physicians were: dissimilar perspectives, amount of communication was inadequate, social worker's feedback was not timely, social worker did not keep the physician informed, and poor quality of communication.

A synthesis of those finding suggests that relationship variables are more important to social workers and that amount, timeliness, and content of communication are more important to physicians.

According to Sullivan (1998), the medical literature on collaboration is extensive. It appears to be most extensive for relationships between physicians and nurses. She cites five attributes as contributing most to an effective partnership: respecting each other, communication, working together, partnership relationship, and trusting each other. She also reports on similar terms and related concepts that illuminate the idea of collaboration: joint practice, shared governance, coalition, cooperation, collegial, working together, teamwork, interdependence, and professionalism.

Sullivan goes on to cite work by Blake and Mouton (1970) and Kilmann and Thomas (1977) that examined assertiveness and cooperation as elements of collaboration:

High assertiveness + high cooperation = collaboration
Moderate assertiveness + high cooperation = compromise
Low assertiveness + low cooperation = avoidance
High assertiveness + low cooperation = competition
Low assertiveness + high cooperation = accommodation

Sullivan expands the concept of collaboration to the workplace as a whole. Citing Evans (1994), she lists characteristics of capacitating environments:

Empower workers
Stimulate creativity of workers
Promote teamwork and learning
Promote comfort with implementing change
Motivate staff to accept increased responsibility
Develop workers' potential
Facilitate staff understanding of organizational goals
Leaders delegate responsibility appropriately
Enable workers to communicate openly and directly
Foster collaboration with peers

These ideas suggest that important information about collaboration may be found in management literature that focuses on organizational environments and their contributions to organizational effectiveness, and it makes sense that collaboration can occur most effectively in an environment that supports it. Interdisciplinary teams can occur with a variety of relationships. Creating interdisciplinary collaboration is a goal for social workers to strive for.

Smith (1985) identifies benefits of interdisciplinary team practice: improved organizational effectiveness, improved service to clients, synergistic effects, learning from other disciplines, mutual support, and team maturation as it grows from interdisciplinary tension. Schofield and Amodeo (1999) list the benefits of increased awareness of one's own discipline, more respect and understanding of other disciplines, opportunity for cooperative research, and development of a cooperative mind-set. They cite additional benefits of improved access to care, improved patient efficacy in self care, improved role satisfaction for practitioners, reduction in length-of-stay and premature admissions, increased use of team members to meet varied needs, relieved burden for team members, facilitated work with difficult patients, and improved objectivity.

Smith goes on to discuss the importance of role boundaries, role maintenance, role clarity, and role overlap. Good social work practice suggests that these issues be openly discussed among team members. Similarly, obstacles to effective team functioning should be identified and openly discussed. Schofield and Amodeo identify problems in teams that may merit attention: differing status among team members, unequal benefits for participation, variability in the organization and administration of each discipline that contribute to tension, different levels of personal commitment, disparate jargon and technologies, physician dominance, role confusion and blurring, increased time demands, insecurity about the value of the team approach, shift in professional status among disciplines, and lack of administrative support. They cite additional difficulties: competition for clients, disagreements over leadership and authority, lack of a common value base, frequent rotation of some disciplines, unclear definition of team leader's role, inadequate patient care, ineffective and inefficient communication, and lack of consensus on the prognosis of some clients.

Schofield and Amodeo discuss their findings:

[T]he conceptualizations and descriptions of the teams were so poor that reliable conclusions could not be drawn. . . . We also discovered that practitioners and researchers have invested an enormous amount of time, energy, and resources exploring this issue. However, the costs incurred seem to have exceeded the benefits, because the cost effectiveness and clinical effectiveness of these teams have not been studied or documented adequately.

These findings demonstrate the need for social workers to be cautious in their conclusions and to continue the research about the effectiveness of interdisciplinary teams. Social workers cannot avoid interdisciplinary relationships. The nature of those relationships and the value of those relationships can be a matter of conscious choice. The University of Washington School of Medicine web site (2002) provides a good summary:

Ethically, every member of the . . . team has separate obligations . . . based on the provider's profession, scope of practice and individual skills. . . . Different knowledge and experience in specific issues both ethically and legally imparts unequal responsibility and authority to those care providers with the most knowledge and experience to handle them. But also because of differences in training and experience, each member of the team brings different strengths. Team members need to work together in order to best utilize the expertise and insights of each member.

Bibliography

Abramson, J. & Mizrahi, T. When social workers and physicians collaborate: Positive and negative interdisciplinary experiences. Social Work 41(3), 270 – 282.

Cheung, K. (1990). Interdisciplinary relationships between social work and other disciplines: A citation study. Social work research and abstracts 26(3) 23 – 30.

Schofield, R. & Amodeo, M. (1999). Interdisciplinary teams in healthcare and human service settings: Are they effective? Health and social work 24(3), 210 – 219.

Smith, N. (1985). Social work in team practice. In P.J. Lecca and J.S. McNeil (Eds.), Interdisciplinary team practice: Issues and trends (pp. 97 – 123). New York, NY: Praeger Publishers.

Sullivan, T. (1998). Collaboration: A health care imperative. New York, NY: McGraw-Hill.

University of Washington School of Medicine (n.d.) Interdisciplinary team issues. Retrieved April 16, 2002 from http://eduserv.hscer.washington.edu/bioethics/topics/team.html

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Professionals, paraprofessionals, and volunteers from disciplines other than social work are part of the environments our clients live in, and because social workers focus on the interaction between people and their environments, we must work effectively with people from other disciplines if we are to effectively serve our clients.

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The focus of task groups, in general, is on producing products, developing policies, and making decisions as opposed to enhancing the personal growth of members. According to Hempworth (2009),

"task groups are organized to meet client, organizational, and community needs. Among the various types of task groups are teams, treatment conferences, and staff development groups... Task groups instituted to meet community needs include social action groups, coalitions, and delegate councils" (p. 297).

Fatout (1995) states that task groups date back to ancient civilization and considers early systems of social organization, such as clans or tribes, to be a form of task groups. Task groups are at the heart of social action and change; they are the building blocks of society. Fatout further explains that "it is within groups that task accomplishment is determined, planned, and carried out" (Fatout, 1995). In social action task groups, members can take action(s) intended to bring about environmental change.

Ideally, these groups should consist of a large, diverse membership to represent the major constituencies affected by the problem being targeted, and the participants should possess "adequate skills and knowledge for addressing the group purpose" (Hapworth, 2009, p. 297).

Task groups differentiate from treatment groups in several ways, the biggest difference being that the focus of a task group is to accomplish a specific task or to bring about change outside of the group, rather than within. Social action task groups, for example, work to create change within the community or within society.

There is a long history of task groups within the field of social work. This history can be traced back to the 1890's when Jane Addams and Ellen Gates-Starr opened Hull-House , where the focus was on education and individual empowerment through community services. Today, the professional focus of social work has shifted between therapy and social change. "A conception of practice which sees groups as instruments for social change was close to the thinking of some early leaders in group work, though it seems to have been side-tracked along the way" (Shapiro, 2010, p. 8).

[Jane Addams Hull House]

More recently, themes of empowerment have become even more prominent. In social work, empowerment is a concept, an overall philosophical perspective (Cox, 1992, p. 77). The term itself is equated with, among other concepts, social action (1992). "Empowering practice differs from many other forms of social work practice in that it proposed that the goal of effective practice is not coping or adaptation but to increase the actual power of the community so that action can be taken to change and prevent the problems they are facing" (Cox, 1992, p. 78)

Use of task-centered groups can occur in governmental settings, administrative settings, board groups, advisory commissions, task forces and other task and goal centered groups (Staples, 2012).

More specifically, social action groups are interconnected with task-centered groups and when community involvement is necessary to move forward a social justice issue, for example, an understanding of task-centered group work will be invaluable.

When to use a task-oriented approach:

Social change campaigns

Agency or governmental d ecision-making and information gathering

Project development

Program development

Community grassroots c ampaigns

Media campaigns

Product development

Task forces or think tanks

Proposal development and grant writing

Small and large scale projects, program or product development

Further, task-oriented groups can also be quite useful in therapeutic group settings (Garvin, 1974). In this sense, work around specific therapeutic or treatment goals using the task-centered approach can be very meaningful to assist individuals in reaching their individual goals within a group setting when defined and viewed through this perspective (Garvin, 1974).

*For the purposes of this curriculum, we will focus more on the use of task-centered groups for the purposes of reaching and obtaining goals related to administrative, governmental, social action, and other advisory or task-force group-type settings. Further information and resources regarding task-centered therapeutic group approaches can be found at www.infed.org.

Cox, Enid (1992). The Critical Role of Social Action in Empowerment Oriented Groups. Social Work with Groups. 14 (3-4), pp. 77-90.
Garvin, C. (1974). Task-centered group work. Social Service Review, 48(4), pp. 494-507.

Fatout, M. and Rose, S. (1995). Task Groups in the Social Services. Thosand Oaks, CA: Sage.

Hepworth, D., Rooney, R., Dewberry Rooney, G., Strom-Gottfried, Larsen, J. (2009). Direct Social Work Practice: Theory and Skills. Retrieved fromhttp://books.google.com/books?id=e22Hiy4Ev2sC&pg=PA297&lpg=PA297&dq=what+is+a+social+work+task+group&source=bl&ots=DPnFzJq8xi&sig=DSNa0bxlVptC1RB8oHG4GvNzm7M&hl=en&sa=X&ei=AKXOU9m-LIrBigKG3YHIDQ&ved=0CFAQ6AEwBA#v=onepage&q=what%20is%20a%20social%20work%20task%20group&f=false

Shapiro, Ben (1992). Social Action, the Group and Society. Social Work with Groups. 14 (3-4), pp. 7-21.

Garvin, C. (1974). Task-centered group work. Social Service Review, 48(4), pp. 494-507.

# data[].attributes.attachment_link.description
The focus of task groups, in general, is on producing products, developing policies, and making decisions as opposed to enhancing the personal growth of members. According to Hempworth (2009), "task groups are organized to meet client, organizational, and community needs. Among the various types of task groups are teams, treatment conferences, and staff development groups...