On Being Shadowed

Beckenham Hospital. Located in Croydon Road an...

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Last week, I had the pleasure of having a second year social work student shadow me as I worked. She was a student in a voluntary agency that I had come across because she had been doing some work with one of the service users I work with. I asked her if she wanted to come and join me to see ‘the statutory side of things’. Bless her, but she almost bit my hand off.

We usually have students in our team but we don’t at the moment. I have had students shadowing me from time to time and  I try to give people the opportunity when I am asked and am happy to offer the opportunity to students I come across if they are interested in seeing how we work.

I miss having students. I really enjoy the teaching element of the practice teaching but, as I explained to the student herself, the reas0n I didn’t take a student in this ‘round’ of placements was because I was not convinced I would be able to protect them from the pressure of work in the office at the moment and I was concerned that they might be used as an ‘extra pair of hands’ in an extremely sparse office. It might not have been the best learning environment, although, come to think of it, it would have likely been a realistic one.

I am toying with the idea of being an off-site practice teacher next time round.  I enjoy talking students through linking theory with practice. I enjoy discussing recent policy and research and the implications for practice. I enjoy teaching all in all, actually. I enjoy the enthusiasm and the realisation what they learn at university can be used to practical effect.

There is something wonderfully invigorating about showing an enthusiastic student the work that makes up practice. We visited a couple of people and she watched as I completed some paperwork – ok, that bit might not have been so thrilling – but it allowed me to talk through the process of writing and the reasons that the forms are compiled in the way that they are.  It allowed me to reflect on some of the tasks I might ordinarily take for granted or complain about and step back with a realisation of what a well-completed and well undertaken assessment can mean.

We had lots of conversations about law. I think there was a law exam coming up. My particular joy was looking at the case study they had been given for their law test and being able to talk my way through it without barely catching  a breath. I clearly haven’t forgotten as much as I thought I had about Community Care Law (I’m fairly hot on Mental Health Law if I do say so myself – simply because I use the Acts (Mental Health and Mental Capacity) literally on a day by day basis in my job).

We also had a Mental Health Act Assessment come up while the student was around and I left her behind to read up on the codes of practice. I won’t take students to shadow Mental Health Act Assessments. I remember being pulled up on this while doing my Practice Assessor Course but I stand by my principle.

Firstly, Mental Health Act Assessments take place by their nature at a time when the person being assessed is in a high state of distress or illness and whether they would be able to give their consent to someone ‘observing’ is questionable. Personally, I believe strongly that the Assessment is about the person being assessed and not for me as a professional to control any more than I do through legal measures. So much control is taken from the individual that having students around reinforces the already massive power imbalance.

Finally, there’s no need for a student to attend. Of course AMHP trainees have to attend. They need to carry out observed assessments of Mental Health Act Assessments in order to complete the qualification but general social work students do not. Just as general medical students do not.

I explained to the student that I did not want her to come with me. She showed some disappointment but this is an area I feel very strongly about on an ethical basis and I promised when I returned that we would have a long discussion about the use of the Mental Health Act. Which we did.

I thought about how often the student/practice teacher relationship emphasises the student as the recipient of ‘knowledge’ but in practice, the teaching is a two-way process. I learn a lot from every student that comes. I learn about the impact of different lived experiences and different viewpoints. I learn about how my work is perceived by different cultures and communities. Things that I  might take for granted, I learn to challenge.

The teaching and learning relationship allows more considered reflection and while the nature of the role is that the experienced practitioner is placed in the position of ‘expert’, we can look at the same theoretical bases that we use in relation to students as the experts of their own learning and experiences.

As for the student, she seemed bright and enthusiastic. She wanted to do well and I have no doubt she will.  She had a background in a completely different area but she showed an empathy and understanding that will serve her well in the future. When she thanked me at the end of the day, I think I might have well forgotten to thank her.

I am sure I got as much, if not more, from the day as she did. She probably didn’t realise that.

15 thoughts on “On Being Shadowed

  1. As someone on the ‘receiving end’ of MH Act Assessments several times in the past, I would say the fewer people the better at the assessment, and so approve your stance.

    • Thanks. I feel very strongly about it. I’m surprised at how often I am challenged on this. For me it’s obvious that the fewer people the better.

  2. Pingback: On Being Shadowed - Fighting Monsters - Member blogs - Social Work Blog - Carespace from Community Care

  3. I was going to say exactly what Andrew said. He has beaten me to it! I had a MHA assessment once where the approved social worker, as it was then, brought along a student. I asked the student to leave because three people was very overwhelming let alone four and it didn’t help that the room it took place in was very small. I don’t think the social worker had really considered it from my perspective as you have. Your post made for a good read.

  4. Shame these things could not happen in a hospital that might have rooms with two-way mirrors. That way, you could get the permission of those involved and the student could watch the process, but without taking up valuable space, or being in the face of those being assessed. It would be valuable learning and maintain the dignity of the assessee. Do these typically take place in the home of the assessee?

    • Hi Carolyn,
      These assessments are not standard ‘mental health’ assessments where someone would have more time to consider their response but they are often emergency or at the very least urgent assessments related very specifically about the need for a compulsory period of detention in a psychiatric hospital. Sometimes they happen in hospital, sometimes in police stations (although more rarely), sometimes in peoples’ homes. There should always be at least 3 people present (AMHP and 2 doctors) and sometimes a lot more (police, ambulance staff, locksmith) depending on whether we have to exercise a warrant for entry or not.
      It is difficult to get permission in advance because sometimes it is not possible to discuss the process of the assessment before they take place due to the nature of the assessment. Or the person whom we are assessing would not have the capacity to give consent..
      I think and hope there are many other learning opportunities in our agency!

      • Well, then if the student does get to sit in on standard assessments, that will at least give him/her a flavour and you can always discuss (back at the ranch) how the emergency ones differ. I can appreciate that in those circumstances running off to a hospital so that you can avail yourself of a room with a two-way mirror is difficult at best. After being on my local crisis lines for a year as a volunteer, I have lost my interest in becoming a mental health worker. 🙂

        Keep up the great work on the blog, btw. It’s great!

      • May I make the observation that s135(1) warrants are not just about entry; that police officers don’t just attend MHA assessments where warrants are in existence and that in my experience (not London), more / better planning and far greater understanding on the part of police officers is required where MHA assessments are being supported by the police.

        • Of course. I didn’t explain very well partly because I didn’t want to go into too many details and just wanted to explain my thoughts. I have always had incredibly good support from the police but the point I was making was about the amount of people that can be present. I should have been more mindful of the details. Thanks for your clarification.

  5. You mention that your student had an an empathy and understanding that will serve her well. This is what will make her a good social worker. And that wasn’t supposed to sound sarcastic.

    I knew a lovely girl a few years back who wanted to join your profession. I said to her ‘I’m not nice enough to do that sort of thing.’ Those sorts of people are the salt of the earth, unlike all the self-serving greedy leeches who think only of money and materialistic wealth

    • I don’t know about ‘being nice’. Empathy helps and compassion helps but that isn’t the same as ‘being nice’. You have to be able to make hard decisions sometimes.

    • It isn’t always about ‘being nice’ though. Empathy and compassion are necessary but difficult decisions also have to be made.

  6. Speaking as a patient I have no objection to someone sitting in. Every time I see the consultant and at CPA meetings there is someone there. I like to think I’m contributing to the system/sharing my experiences.

  7. Thanks for your response. I’d have to say that a CPA is a VERY different context from a Mental Health Act Assessment. For general visits, assessments and reviews, I often ask to have students sit in and they are almost always positively received 🙂

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