A Paradigm Framework for Social Work Theory for Early 21st Century Practice

By Caroline McGregor 

British Journal of Social Work, 49(8), pp. 2112-2129. 

Review written by: Dr David Wilkins

What question does this study focus on? 

This discussion paper considers whether theoretical frameworks for social work in the 20th century are still useful for social work in the 21st century.  

How did they study it?

The author reviewed the work of several notable social work academics, including David Howe and Robert Mullaly. 

What did they find?

For the 21st century, social work theory needs to recognise and emphasise the importance of local context in global conditions, move away from the dominance of ‘Western’ ideas, identity the commonalities between social work as practiced globally in different circumstances, and recognise the importance of critical reflexivity. Specifically, the article outlines a paradigmatic framework for understanding different types of theories, suggesting they can be understood on a set of continuums from transformational to reformist and from individualist to collectivist (see figure). 

A figure which supports the article review. Constants
Care and control
Person-in-environment
Ethical and practice codes
Attachment and Loss
Human rights and social justice

What are the implications? 

Social work as a profession, and social workers, need theoretical frameworks to provide a scaffold around which questions can be asked, challenges identified and to facilitate dialogues between services users, practitioners, educators, and policymakers. A-theoretical social work is a contradiction in terms. 


Review written by

Photo of Dr David Wilkins

Dr David Wilkins

‘Maybe a maverick, maybe a parent, but definitely not an honorary nurse’: Social worker perspectives on the role and nature of social work in mental health care.

By Tucker, L. and Webber, M. 

British Journal of Social Work 51, 545–563.

Review written by Professor Jonathan Scourfield

What question does this study focus on? 

What is the distinctive role of social workers in a mental health system that is multi-disciplinary but medically led? Surprisingly, perhaps, the authors of this paper say there has been little research on social workers’ own perspectives on their role – more research has been done on what other professionals think of social workers and on the Approved Mental Health Professional role. They set out to help fill this gap.

How did they study it?

They interviewed seven White British female social workers from multiple settings within one English NHS trust. Four interviewees were employed by the NHS and three by local authorities. 

What did they find?

Views of the mental health social work role tended to refer to the ‘context and intentions of practice’, more than to ‘tasks and responsibilities’. Recovery and social inclusion were not seen by interviewees as core to their practice – rather these aims were the responsibility of others, such as support workers. Working with and risk and family complexity was seen as central to mental health work in general, rather than just social work. Community work was not seen as everyday social work, but occasionally engaged with. Even then, it was seen to involve working with (other) statutory and voluntary services, rather than anything wider. 

There was a clear difference between those employed by the local authority and those working in the NHS in their views of statutory responsibilities, with the NHS employees not seeing social care law as part of their job.

Interviewees saw themselves as helping to bridge the health-social care divide, having a more holistic view and sense of the bigger picture for service users, as opposed to a narrower medical focus, and helping in a flexible way, in response to wider needs that are not directly or immediately about mental health. 

What are the implications? 

This was a study with a small and demographically specific sample in a single NHS trust. However, it raises some interesting issues. It suggests that national policy in connection with the mental health social work role may have had very little impact. Interviewees had either not heard of or were barely aware of the Strategic Statement from the College of Social Work. More work is needed at a national level in each of the UK nations to define the distinctive role of mental health social workers within a multi-disciplinary mental health system.


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Professor Jonathan Scourfield

Perceived Impact on Client Outcomes: The Perspectives of Practicing Supervisors and Supervisees

By Katrina Rast, Daniel Herman, Tony Rousmaniere, Jason Whipple and Joshua Swift 

SAGE Open 

Review written by: Dr David Wilkins

What question does this study focus on? 

This study considers two questions – (i) what is the perceived impact of supervision on client outcomes and (ii) how important is it to supervisors and supervisees that supervision affects client outcomes? The study was undertaken in relation to psychotherapy training and clinical supervision.

How did they study it?

The study used a survey to investigate the views of supervisors (n=189) and supervisees (n=185). The survey asked questions about the impact of supervision on clients and the importance of supervision having an impact on clients. Most of the questions called for a Likert-style response, with a 5-point scale (from 1 = do not agree, to 5 = totally agree). 

What did they find?

Supervisors and supervisees alike were positive about the impact of supervision on client outcomes, with overall average scores of 3.65 and 3.54 respectively (out of 5). In relation to the importance of supervision having an impact on client outcomes, supervisees were more positive than supervisors, with overall average scores of 4.06 and 3.87 respectively (ditto). Supervisors and supervisees agreed that supervision made a difference in relation to the impact of counselling / psychotherapy for clients and that it could help reduce client deterioration (problems getting worse). 

Supervisors also said that supervision helped with the personal and professional growth of their supervisees, for example by helping identify areas for professional development. Supervisors also said they helped supervisees by supporting them to develop collaborative relationships with their clients. Supervisees said that supervision helped by making them feel validated and well supported, and by providing them with ideas, activities, techniques and strategies to try out with their clients. 

They found no significant differences in the views of respondents in relation to gender, age, type of degree qualification, type of therapy offered, length of experience, number of clients or the use of outcome measures. 

What are the implications? 

Supervisors and supervisees in counselling / psychotherapy settings agree that supervision can and should make a difference for clients and feel this is an important aim for supervision. However, this link between supervision and client outcomes has yet to be empirically established (in counselling / psychotherapy, or in social work). The best evidence we have currently does not support the contention that supervision makes a major difference for people in counselling, or those using social work services, despite the views reported here. In two of the best designed studies of counselling supervision, the amount of variance in client outcomes explained by supervision ranged between 16% and 0.01%. In summary, these results indicate that supervisors and supervisees believe that supervision impacts on client outcomes, but there is no evidence or consensus to explain how this happens, or to what extent. 


Review written by

Dr David Wilkins

Building knowledge for policy and practice based on service user and carer experiences: A case study of Scottish adult safeguarding research

By Fiona Sherwood-Johnson and Kathryn Mackay

Journal of Social Work 

Review written by Dr David Wilkins

What question does this study focus on?

This study considers how the knowledge base for adult safeguarding policy and practice can be developed through collaborative dialogues between policymakers, professionals, service users, carers, researchers, educators, and students. The article starts from the perspective that despite its obvious importance, the knowledge base for adult safeguarding is limited, and the views of service users and carers have been under-represented in research. 

How did they study it?

The study was based in Scotland where, much as in Wales, there has been a concerted effort in recent years to ensure that social services are more responsive to the wishes and views of citizens, with important policy changes made in order to promote choice and human rights perspective on practice. 

What did they find?

The authors draw on their experiences of undertaking a range of research projects in the field of adult safeguarding, and their efforts to promote the participation of service users and carers. Reflecting on these projects, they identify two themes based on evaluative approaches (in simple terms, questions about what works) and exploratory approaches (questions with a broader focus).

For evaluative approaches, the paper highlights the importance of causing no (further) harm. When researching adult safeguarding, many of the service users (and carers) involved will have experienced different forms of abuse or neglect. Understanding how services can respond to this effectively is important, but not at the cost of causing further harm, for example from trauma resulting from revisiting difficult experiences. There is also the question of informed consent. Some adults involved with safeguarding services will have dementia or learning difficulties. Learning from their experiences is vital, but gaining informed consent is not necessarily straightforward. Some gatekeeping processes, whereby professionals help to contact service users and carers on behalf of the researchers, may inadvertently end up excluding some people and certain groups. One key message is that service users and carers tend not to understand adult safeguarding processes as being wholly distinct from other professional activities. For exploratory approaches, the authors found that working with service users and carers at an early stage helped to inform their research questions and make them more relevant, as well as leading to the use of more creative methods. 

What are the implications?

The paper highlights the complexities and limitations of much of the research in fields such as adult safeguarding, which by its nature is often tentative and exploratory. Yet policymakers and sometimes practitioners are often looking for research that provides clear answers, perhaps even simple answers, to what are very complicated and complex problems. Research rarely provides ‘how to’ messages for practice, and there is a risk that indefinite and somewhat speculative findings are metamorphized into something more certain and concrete once they are disseminated into policy and practice. 


Review written by

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Dr David Wilkins

The social worker in community mental health teams: Findings from a national survey

BMichele Abendstem, Mark Wilberforce, Jane Hughes, Andelijia Arandelovic, Saqba Batool, Jennifer Boland, Rosa Pitts and David Challis.

Journal of Social Work

Review written by Dr David Wilkins

What question does this study focus on? 

Social workers have long been part of community mental health teams (CMHTs), yet in recent years and in some areas, the make-up of these teams has been changing. This study explored the current position and role of social workers within English CMHTs, and how this might be changing.  

How did they study it? 

In 2018, the authors undertook a national survey of CMHT managers in England. They did this by obtaining a list of NHS mental health trusts in England (n=54) and finding contact details for their CMHTs. In total, they located 421 teams from 50 of the Trusts (they were unable to contact two, and two withdrew). Surveys were distributed to the team managers. In total, 188 surveys were completed (a 44% response rate), spanning all 50 Trusts and nine English regions.  

What did they find? 

The average size of a CMHT was just over 25 people. All of them included a team manager, nurses and at least one consultant psychiatrist. Four-fifths also included a social worker, while nearly 90% had an occupational therapist. More than half of the team managers said that social workers made a ‘good’ or ‘very good’ contribution to the team. Most of those who were more negative also described losing social work staff from their teams in the previous 12 months. The more social workers there were in the team, the more likely their contribution was to be rated positively. Social workers acted as care coordinators, or enhanced CPA (Care Programme Approach) coordinators, and in most teams conducted initial assessments. In a very small number of teams, social workers prescribed or administer medication. Social workers were also the largest professional group involved with making funding decisions and acting as Approved Mental Health Professionals.  

More than half of the managers described major changes for their teams in the previous 12-months. These involved restructurings, more integrated working between health and social care professionals, the loss of staff, including social workers, and changing roles. Where social workers had been lost from the team, managers often described a loss of experience and knowledge, increased workloads for other staff, and a negative impact on people using services.  

What are the implications? 

These findings point to the important role that social workers have within many CMHTs, but also their changing roles and in some cases, their absence. Team managers expressed concerns about losing social workers from their teams, and in particular how this could limit or reverse attempts to integrate health and social care service provision.  


Review written by

A photo of Dr David Wilkins, the author of this article review

Dr David Wilkins

Choice, control and person-centredness in day centres for older people

By Katharine Orellana, Jill Manthorpe and Anthea Tinker

Journal of Social Work

Review written by Dr David Wilkins

What question does this study focus on?

This paper argues that day centres for older people are often assumed to be outdated or too expensive, particularly given the Care Act 2014’s focus on choice, control and person-centredness. The authors explore what professionals and older people think about these services, and the extent to which person-centred support can be enacted at day centres. 

How did they study it?

The study ran for three years in total, with a focus on four generalist day centres. The centres were chosen purposefully, so that they spanned the local authority, housing association and voluntary / not-for-profit sectors. Two of the centres were in highly urban areas, one in a small town and one in a rural area. 

The lead author for the paper undertook weekly visits to the centres between September 2015 and December 2016. During this time, interviews were conducted with 13 local authority staff, including social workers, commissioners and those making referrals, 23 older people, 10 family carers and 23 day centre staff, including managers, volunteers and carers. 

What did they find?

The paper presents its findings across three themes – professionals’ views of day centres, the enactment of person-centred care, and older people’s views of day centres. 

– Professionals’ views

Practitioners viewed day centres as relevant to their work, on the whole more so than local authority commissioners. Practitioners noted the importance of having a range of services available in the area, including day centres, so that older people can make meaningful choices about what they want. However, some commissioners thought that within day centres themselves, choices would be limited by the availability of activities, meal options and impersonal staff rotas. 

– Enactment of person-centred approaches

Practitioners talked about the importance of matching people to the right centre for them, which meant knowing about the centre, and its activities, as well as the individual. Day centre managers also noted the importance of taking a personalised approach. Older people attending day centres talked about being able to choose where to sit, what drinks and meals to have, and what activities they wanted to do. On the other hand, some older people had not been offered the choice of other centres or services, and individual needs and preferences were not always provided for. Sometimes the choice available was to do an activity or not, rather than choosing between different activities, and in one centre, there was no choice of meals. Some commissioners and practitioners felt that the use of day centres was largely needs-driven. 

– The views of older people

Older people said they valued the communal nature of the day centres, and the continuity of relationships with staff. However, some older people also said they found it difficult to live with other residents, particularly if they exhibited upsetting or disturbing behaviour. Sometimes staff were too busy helping people with physical or medical needs to organise and take part in social activities.  

What are the implications?

These findings suggest that day centres can help enact personalisation and choice for older people and can have some advantages compared with individualised support packages. However, they may not represent a genuine choice, either at the macro level (because there are no other services available) or the micro level (because choices within the centre are limited or superficial). 


Review written by

A photo of the article review's author, Dr David Wilkins

Dr David Wilkins

Influence of adoption on sibling relationships: Experiences & needs of new adoptive families

The influence of adoption on sibling relationships: Experiences and support needs of newly formed adoptive families

By Sarah Meakings, Amanda Coffey and Katherine Shelton 

British Journal of Social Work, 50(5), pp. 1324-1344
Review written by Dr David Wilkins

What question does this study focus on?

This paper looks at how sibling relationships, in their various different forms, are affected by adoption. 

How did they study it?

The case-file records of 374 children recently placed for adoption in Wales were reviewed. In addition, 96 adoptive parents completed a questionnaire, and 40 of these parents were also interviewed. The questionnaires were completed four months after the child was adopted, and the interviews took place another five months later. 

What did they find?

Analysis of the case-file records found that most of the children placed for adoption (n=325, 87%) had at least one brother or sister, and one-third (n=122, 33%) were adopted as part of a sibling group. From the questionnaire sample, nearly one-third (n=29, 30%) were placed for adoption as part of a sibling group, while the majority (n=81, 84%) had at least one sibling living elsewhere. New sibling relationships were created in nearly one-third of the families (n=28, 29%). Sibling relationships were reported to provide the child with companionship, reassurance and comfort. However, parents were also concerned about unexpected levels of sibling discord, and perceptions of harmful dynamics. Several described sibling relationships as being characterised by fierce jealousy. There were some reports of physical violence between siblings. For adopted children with birth siblings living elsewhere, parents spoke passionately about the importance of maintaining meaningful contact, although a smaller minority did not want this because of safeguarding concerns in relation to birth families more generally. All the parents who did want to promote sibling contact felt they needed help from the local authority to facilitate it. Some said they had to prompt social workers to help, while others noted a distinct lack of support. 

What are the implications?

The process of adoption does not just have the potential to sever and create child-carer relationships, it also severs and creates child-child relationships. Social workers need to recognise and value the importance of sibling relationships for adopted children, while local authorities need to think carefully about what support they offer to adoptive families to promote and facilitate sibling contact. 

Dr David Wilkins

What do service users want from mental health social workers? A best-worst scaling analysis

By Mark Wilberforce, Michele Abendstern, Saqba Batool, Jennifer Boland, David Challis, John Christian, Jane Hughes, Phil Kinder, Paul Lake-Jones, Manoj Mistry, Rosa Pitts and Doreen Roberts. (2020)

British Journal of Social Work, 50(5), pp. 1324-1344. 

Review written by Dr David Wilkins

What question does this study focus on?

This paper explores what service users most and least value about mental health social workers. 

How did they study it?

The study involved participants (n=144 from five different English regions) reading a series of case studies and selecting their most and least preferred outcomes for each one. The study was co-produced by a mixed team of academics, people with experience of mental health services and carers. Through a process of discussion, shortlisting and piloting, these case studies were designed to invoke ten social work attributes, as follows:

The social worker…

  1. Thinks about my whole life, not just my illness
  2. Protects my rights and entitlements
  3. Is non-judgemental
  4. Arranges access to other services
  5. Looks carefully for signs of abuse and neglect
  6. Understands why people become vulnerable
  7. Suggests different ways of helping me, and does not concentrate on medication alone
  8. Is a reliable and continuous point of contact
  9. Understands how people’s difficulties can vary from time-to-time
  10. Is compassionate

Each time one of these attributes was selected as ‘best’, it scored one point. Each time it was selected as ‘worst’, it scored one minus point. As each attribute appeared six times in the case studies, this means for each participant the attributes could score between -6 (chosen as the worst attribute every time) and +6 (chose as the best attribute every time). 

 What did they find?

The overall results indicated that participants ranked attribute 8 most positively, and attribute 4 least positively (see table for the full ranking). Some of the attributes, such as numbers 2 and 5, appeared to divide opinion, with some participants viewing them very positively, and others very negatively. 

Overall rankingAttribute
1Is a reliable and continuous point of contact
2Thinks about my whole life, not just my illness
3Suggests different ways of helping me, and does not concentrate on medication alone
4Understands how people’s difficulties can vary from time-to-time
5Looks carefully for signs of abuse and neglect
6Protects my rights and entitlements
= 7Is non-judgemental
Understands why people become vulnerable
8Is compassionate
9Arranges access to other services

What are the implications?

As noted in the article, the overring concern of participants was for social workers to be a reliable and continuous point of contact, and this was true irrespective of the individual characteristics and experiences of the service user. This suggests that services as a whole need to pay close attention to the importance of maintaining relationship-continuity, and not expect service users to form and re-form relationships with different workers unnecessarily. The second most important attribute was paying attention to the service user’s whole life, not just their illness. This highlights the continuing significance of the social model of mental health – seeing and understanding people in context, not as a set of symptoms. It also reflects the important contribution that social workers can make for people with mental health difficulties, not simply as care coordinators, but as reliable people with whom they can form an holistic relationship.  


Review written by

Dr David Wilkins

Rethinking how we view gang members

By Sarah Frisby-Osman and Jane L. Wood (2020) 

Youth Justice, 20(1-2) 93–112 

Summary of article by Nina Maxwell

What question does this study focus on? 

This article focuses on the question of whether young people involved with gangs have higher levels of affective, behavioural, and mental health needs than young people who are not involved with gangs. Both groups were compared in relation to their levels of (1) anxiety and depression, (2) emotional distress and proneness to guilt, (3) conduct problems, (4) exposure to violence as victims, and (5) socio-cognitive processes, including moral disengagement and rumination (where anger-provoking thoughts are constantly replayed).  

How did they study it? 

The authors used a cross-sectional, between-participants design. Young people were invited to take part from three coeducational schools in areas of England that have identified as having high levels of gang activity by the UK government. The schools included one mainstream secondary school, one further education college and one Pupil Referral Unit. Ninety-one young people took part in the study with a mean age of 14.93. Of these, 56 (62%) young people were identified as nongang-involved, 32 (35%) as gang-involved and 3 (3%) were unspecified based on findings from a robust screening tool.  Their affective, behavioural, and mental health needs were measured using a range of scales including the Beck Depression Inventory, the Moral Disengagement Scale and the Strengths and Difficulties Questionnaire.   

What did they find? 

Young people involved in gangs were more likely than those not involved with gangs to report anxiety and depression, conduct problems, exposure to violence as victims, moral disengagement and rumination. There was no difference between the two groups regarding emotional distress and proneness to guilt. To explore which level of need was more likely to be associated with gang involvement, discriminant function analysis were undertaken. This analysis found that conduct problems, moral disengagement and angry rumination were more likely to account for gang involvement followed by anxiety, depression and violence exposure. Emotional distress and guilt-proneness were not related to gang involvement.  

What are the implications? 

This study highlights the need to consider the psychological and socio-cognitive predictors of gang involvement within early intervention and prevention strategies. Specifically, findings highlighted the need to target antisocial and problem behaviours as these were the biggest predictor of gang membership. Early intervention and prevention strategies should also address youth anxiety and depression as feelings of low self-esteem or perceived lack of opportunity were associated with the perception that gang membership was a way of getting their basic needs met. Finally, early intervention and prevention strategies should address the emotional impact of exposure to violence and the socio-cognitive processes of moral disengagement and rumination.  


Review written by

Nina Maxwell

No two gangs are alike: The digital divide in street gangs’ differential adaptations to social media.

By Andrew Whittaker, James Densley and Karin S. Moser (2020)

Computers in Human Behaviour, 110.

Review written by Dr Nina Maxwell

What question does this study focus on?

This article focuses on the question of whether there were differences in gang member use of social media at the individual level (younger members versus older members), and the group level (less established gangs versus more established gangs) in Waltham Forest, London.

How did they study it?

This was a mixed methods study that included two stages of data collection. First 

qualitative, semi-structured interviews were conducted with ex-gang members, gang-affected young people, police officers, criminal justice workers, local authority workers, including community safety, education, early help and terrorism prevention, and voluntary sector grassroots workers. Second, preliminary findings were tested with two focus groups comprising stakeholders from local government agencies, criminal justice and grassroots workers. Due to ethical issues surrounding interviewee and researcher safety, the study did not include active gang members.

What did they find?

The article found that gangs differ in their use of social media. Broadly speaking, older members with established reputations tended to avoid social media to reduce the risk of detection by the police. Younger members, with less established reputations were more likely to embrace social media to build their reputation and status. Findings showed that gangs have moved away from open platforms that could be used for police surveillance such as Facebook and towards end-to-end encrypted platforms such as WhatsApp. Applications such as Snapchat are also being used to advertise and sell drugs as these tools automatically render photographs and messages inaccessible after a set time period. For those gangs that used social media, some were using apps with GPS tracking, such as Find MyiPhone or Find My Friends to increase their monitoring and control of younger members, for example by requesting photographic and video evidence of their activities. 

What are the implications?

While gangs may differ in the extent to which they use social media, even those gangs who shun its general use were aware that it could be weaponised against them or they could use it against their competitors. The authors conclude that where police and social workers monitor social media to identify the warning signs for conflict, this can be used to effectively de-escalate situations before serious violence occurs. This article highlights that service providers should be aware that younger gang members may be subject to constant monitoring and control by older gang members using social media. Such surveillance can limit young people’s opportunities to seek help.  


Review written by

Dr Nina Maxwell