Working with service user knowledge to assist social work students in competence development in the United States

ABSTRACT

This research evaluated the impact of service user involvement on the knowledge and competence development of social work students in their Field Forum class at Belmont University, Tennessee, USA. Over a two-week period in March, 2019, students heard from service users with diverse aspects of lived experience in the following areas: Childhood abuse, trafficking, domestic abuse, mental ill-health, homelessness, addictions and disability. The service users involved worked closely with local community groups in the university’s neighboring area and shared their lived experience with the students in key aspects of social work skills, knowledge and values. In their evaluations, the students indicate positive growth in their perceptions and understandings in important aspects of social work competence such as communication skills, attitudes, values and principles of social work practice. Importantly also, the students indicated that exposure to service users’ lived experience in the classroom helped sharpen their preparations for field practice. These findings have resonance and applicability internationally, particularly in the US, for social work educators preparing to involve social work service users/clients in social work education.

KEYWORDS:

• Service user involvement
• field practice
• social work competence
• experiential knowledge

Introduction

This pedagogic research systematically evaluated, for the first time, the impact of service user involvement on the knowledge and competence development of a group of social work students in their Field Forum preparation classes at Belmont University in Nashville, Tennessee, USA. Over a two-week period in March 2019, students heard from three service users with diverse aspects of lived experience in childhood abuse, trafficking, domestic abuse, mental ill-health, homelessness, addictions and disability. The service users involved were members of local community groups with close contacts to the university. In the third week of this specialist project, the students were firstly introduced to the topic of service user involvement so as they could understand the rationale for this approach to teaching. This project was coordinated by the lead author, a US-UK Fulbright Scholar based at the university’s Social Work Department, who worked closely with social work academic colleagues in its organisation. The students involved (n = 31) were on the 3rd year of their social work undergraduate programme and were taking a Field Forum 16 week teaching sequence designed to prepare them for their first period of field practice.

Literature context

Service user and carer involvement was formally introduced to social work education in the United Kingdom (UK) some twenty years ago (Department of Health [DOH], 2002). This was in response to a wider reform of social work education nationally, central to which was recognition that service users should no longer be left on the outside of such important professional education but should occupy a central position in this. An important principle to this advancement in the status of service users was recognition that the lived experience of being on the receiving end of social work services was important for social work students to learn about (Beresford, 2000, 2005). Other parts of the UK soon reflected this innovation (Department of Health Social Services and Public Safety [DHSSPS], 2003) and service user and carer involvement became the norm for all students studying social work education. Service users/carers have therefore been involved in assessment, teaching, course administration/management and in the recruitment/selection/interviewing of social work students in the UK context (Robinson & Webber, 2013; McLaughlin et al., 2018). Much has also been written reporting findings of a range of UK curricular initiatives (see Dill et al., 2016; Hitchin, 2016; Hughes, 2017; McLaughlin et al., 2018; Robinson & Webber, 2013; Stanley & Webber, 2022) and, increasingly, other European scholars have also advanced creative ways of involving service users in classroom teaching (Askheim et al., 2017; Casey et al., 2021; Driessens et al., 2016; Videmšek, 2017; Zavirsek & Videmsek, 2009).

Service user/carer/client involvement in the context of the United States has, however, not developed in the same way. Unlike in the UK, there have been no policy mandates to require involvement in program evaluation or in social work curriculum design and delivery. Goossen and Austin (2017) review the history of service user involvement in the UK and offer that the process of adopting this pedagogy from the UK requires focused research in key areas. This includes addressing the institutional resources needed to implement and sustain service user involvement in social work education, as well as how service user involvement would challenge the power and privilege dynamics (Goossen & Austin, 2017). Stanley and Webber (2022, p. 2) refer to service user involvement in the US social work education context as being ‘elusive’ citing the prior work of Austin and Isokuortti (2016). Importantly, also, in terms of alluding to the wider context, the absence of any policy directives mandating service user involvement are potential obstacles (Adamson et al., 2022)

In the interests of brevity, this paper will use the term ‘service user’ to refer to the wider range of terms used to infer a relationship to receiving social work services from public service providers. The language associated with service user involvement is, however, contested (Beresford, 2005; Beresford & Croft, 2004; McLaughlin, 2009) and arguably linked to more nuanced power relationships (Tew, 2006) between those responsible for planning and delivering services and those people in receipt of these. The knowledge contribution that service users can bring to social work education is also important to examine critically. Can such knowledge, coming from a lived and personal experiential standpoint be objective, reliable and valid? These questions of epistemology have been addressed in the literature (El Enany et al., 2013; McLaughlin, 2009; Popay & Williams, 1996; Prior, 2003). Prior (2003), for example, contends that knowledge that comes from an experiential ‘lay’ perspective is questionable in reliability and not capable as such of objectively delivering a valid perspective. Ramon (2003), however, responds by stressing that service users bring new knowledge that is very relevant to understanding questions of policy, practice and research. Rimmer’s observation about ‘ordinary people taking on powerful roles’ is reflective of the questioning of the status of service user experiential knowledge (1997, p. 33). McLaughlin (2009) takes the view, as do some others (Prior, 2003; Tritter & McCallum, 2006), that any claims for knowledge expertise from a lived, experiential standpoint, should attach more to the individualistic nature of this experience rather than focusing on wider application and generalizability. Nonetheless, Beresford (2013) argues against service users being ‘othered’ and cautions against perceptions of service users being kept on the outside and, as such, being treated as in some way ‘deviant (Banks, 2006; Beresford, 2013; Zavirsek & Videmsek, 2009). Turning to the critique of service users’ experiences being overly subjective, Beresford (2000) also argues: “ … Service users’ knowledges grow out of their personal and collective experience of policy, practice and services” (2000, p. 493). The recent special edition of the British Journal of Social Work alludes also to the positive contribution of lived experiential knowledge whilst also highlighting the challenges. Howells et al. (2023), for example, argue that knowledge from ‘service participants’ may pose a challenge to more established ways of thinking about knowledge. Fillingham et al. (2023) also flag concern about the skepticism that some individuals may have about the contributions they can make based on their prior negative experiences of services. Mackay (2023) observes that the experiences of being ‘in a system, or to receive care gives insight that cannot be learnt from a book’ (p. 1836) and Storm (2023), writing in the same collection, highlights the centrality of lived experience to social work and social work research. Indeed, Trevithick’s (2008) earlier and seminal work on social work’s knowledge base, also firmly locates service user knowledge within what is referred to as the Factual Domain of this knowledge base.

These tensions are fundamental to the very question of the epistemic value of service user involvement in the educational context; these are thus core pedagogic questions. There is a convincing body of evidence indicating that service user involvement can make a positive difference to social work students’ competence development in important areas of their social work education journey (Adamson et al., 2022; Anghel & Ramon, 2009; Duffy, 2021; McLaughlin et al., 2018; Stanley & Webber, 2022). McLaughlin (2009) applied the term ‘service user standpoint theory’, building on Swigonski’s (1994) and Harding’s (1991) work on ‘standpoint theory’, to contend that: ‘service users who are on the receiving end of social work practice, research or theory are better placed by their location and identity as service users to know what matters in practice, to identify what works and to generate critical research questions rather than practitioners, policy makers or academics’ (p. 13). The early work of Paolo Freire’s ‘Pedagogy of the Oppressed’ in 1972 recognizes the transformative potential that can come from recognizing one’s own knowledge (Freire, 1972). Rapp et al. (2005), writing on the strengths perspective in social work, also remind us of Jane Addams’ thinking in social work’s nascent beginnings about the pivotal contribution of the individual to society’s social order. So, whilst this focus on knowledge is, arguably, contested, Dalrymple and Burke (1995) and Clifford and Burke (2005) helpfully suggest a way forward in arguing that all [our emphasis] knowledge perspectives should be exposed to critical questioning as a way of opening up new avenues for developing insights to promote change.

Methods: approach to the study

The project involved evaluation of teaching and, as such, was approved by the university’s Institutional Review Board (IRB). A mixed methods approach involving a ‘Before’ (T1) (n = 15 students) and ‘After’ (T2) (n = 13 students) Qualtrics on-line survey was used with the students. Additionally, a focus group was conducted at the conclusion of the semester in which the students had been learning from service users. A thematic approach to analysis was applied to both the focus group findings and the qualitative findings from the on-line survey. A facilitated ‘Conversation’ method (McKeever, 2019) was applied which involved a series of questions pre-agreed with the service users as the basis for the dialogue with the lead researcher at the front of the class. A co-production/co-design approach was, therefore, applied with service users as fully in control as practically possible about the aspects of their lived experience to be shared with the students. Careful and sensitive preparations also involved the lead author meeting with each service user in their own home or community facility so as they could each feel fully prepared and in control in regard to their choice to be involved in the teaching sessions. Pre teaching visits to the university were also arranged, again ensuring the service users felt comfortable in advance of teaching. The service users prepared their responses to the agreed questions and also wrote short biographies which were sent to the students in advance. On the day of their involvement, the lead researcher interviewed the service users individually and in pair format (Day 1, Day 2) ‘live’ with the students observing. During the course of the interviews, the lead researcher would also turn to the students for intermittent summary points, where appropriate, and at the end of the interviews, the students were given time to also ask questions. It was important that an ‘ethic of care’ (Hugman, 2005) approach very much undergirded all aspects of this project in line with good practice on preparations for service user involvement (Duffy, 2006; Levin, 2004) which would avoid tokenistic practice (Campbell, 1996) and advance service user involvement that was meaningful for everybody involved (McLaughlin, 2009).

Pre-survey

The scaling questions included in the pre-survey were designed to gauge the students’ understanding of service user issues as well as their expectations for learning from this model of structured and facilitated conversations with them and how this would prepare them for practice. Students were also asked to reflect on the strengths and limitations of this type of model as well as being presented with an open response question to allow for additional qualitative input.

Post-survey

The scaling questions included in the post-survey mirrored the questions in the pre-survey with respect to the questions about students’ perception of their knowledge of service user issues, the usefulness of this model in preparing them for practice, and the strengths and limitations of this model. Students were also asked to reflect on particular aspects of what they learned from service users as well as the process of facilitated conversations. Students were also asked to reflect on how this process assisted in their understanding of trauma and its impacts. Finally, they had an open response question to share anything else they wanted to share about the process.

Focus group

A total of (n = 8) students took part in a focus group at the conclusion of the teaching sequence and was chaired by the lead researcher. The students were asked to consider the following questions:

1. Now that a few weeks have passed since the service users/clients visited field forum class, what are the lingering take-aways from this experience?

2. What thoughts and feelings have you had about the social work profession, and your role in it, since this experience?

3. How will this experience of hearing from service users help you as you enter the field next fall?

4. What would have made this experience even more beneficial?

5. At what other points in the curriculum do you think this would be a helpful addition?

These questions were thus designed for evaluative purposes in eliciting the students’ reflective thoughts on how this type of pedagogy had impacted them. The research team examined the students’ responses to these questions on a shared basis so as to maximize reliability and validity of data analysis. In doing so, the team undertook a thematic approach to analysis in their scrutiny of the student responses.

Analysis of findings: T1 survey

Q1.

How confident do you feel at this point in your knowledge of service users issues?

Table 1 indicates that the mean response of 4.13 positions the students as having a mid-range/moderate degree of confidence on their knowledge of service users’ issues. Students in Field Forum have completed or are completing all required social work classes prior to entering their senior year field placement. As such, they have had exposure to service learning in an agency during Introduction to Social Work, they have been exposed to common issues experienced across the lifespan in Human Behavior & Social Environment (HBSE) and practice courses, and they have explored practice issues related to structural discrimination. However, other than service learning as a freshman (first year student) or sophomore (second year student), and an interprofessional simulation experience in the Fall (Autumn) semester of junior year (third year), the students have had limited exposure to service user experiences in the traditional curriculum.

Table 1. Student Confidence of service users' issues.

Q2.

How would you describe your expectations in terms of what you hope to learn from service users?

Table 2 indicates that the students express very high expectations in regard to how they anticipate learning from service users (Mean = 6.07). This is a very positive expression of how the students envisage this type of pedagogical approach given that it will be very new to them.

Table 2. Expectations of Learning.

Question 3 on the pre-survey asked the students to identify what they hoped to learn from service users sharing their experiences in the classroom. There was a range of responses given, but the common theme that was expressed in this response was that they hoped to gain increased empathy and awareness of issues from the service users’ perspectives.

Having a critical understanding about the impact of social work practice in regard to service users’ experiences of both positive and practices to avoid were also found to be important by the students. As a student expressed, ‘I hope to learn the ways in which we help or hurt our clients by interacting with them’. Similarly, another student stated that, ‘I want to know what, if anything pushed them away from service and anything in particular that helped them to feel safe in the service environment’.

Q4.

To what extent do you think this type of learning will prepare you for practice?

As shown in Table 3, with a Mean of 6.20, the students indicate a clear sense of positive expectation about how service user involvement in their teaching will contribute to preparations for practice. This is particularly noteworthy because the students have only had limited information shared about the experience at this point.

Table 3. Preparing for Practice.

Q5.

What do you think will be the strengths and limitations of hearing directly from service users?

With respect to the strengths, the students clearly expressed their anticipation about learning from the lived experience of the service users. As one student said, ‘I think it will be helpful to hear from them because they are the ones who received the service and their experience more than anything else should be what guides our practice’. Along these lines, another student shared that, ‘hearing directly from service users offers a level of humanity that is often absent in text’.

Some students also endorsed the association between lived experience from service users and how this links in with the embodiment of bringing social work values and principles to life. The following student makes the point: ‘I think this thinking is especially in line with honoring the value of human dignity and worth and human relationships within the social work profession’.

Limitations

The students expressed some insightful thoughts about the possible limitations they anticipated concerning this type of teaching approach. The intricacies of the social work relationship were underscored by several students: The following student remarked: ‘it’s hard to know all of the sides of what happened between the service user and the social worker’.

The issue of subjectivity expressed as ‘bias’ was also expressed by several students. One student articulated this as follows: ‘They are limited to their own experiences. Not everyone that has received services will be represented, or their stories be shared’.

Q6.

Anything else you would like to tell us about your thoughts at this stage about this type of teaching approach?

This final question in the T1 survey asked the students for any additional comments/observations they had in anticipation of the teaching beginning. Excitement about the innovative nature of this pedagogical approach was a recurring theme in the students’ observations as can be seen from the following quote: ‘I think that this teaching approach is exciting and innovative. I am eager to participate in this process’.

Analysis of findings: T2 survey

The second survey (T2) was administered after the final day of teaching and had a response rate of (n = 13) students. The survey was designed to evidence the impact on the students’ knowledge, development and insights in key areas associated with this type of teaching approach. As with T1, the findings are presented thematically based on the trends evidenced through the students’ responses to each individual question.

Q1.

How confident do you feel at this point in your knowledge of service users issues?

There has been a shift in students’ increased confidence in knowledge of service users’ issues as is evident from Table 4 when this is compared to their responses to this same question at T1. With a Mean score of 5.85, we can see that the students evidence an improved confidence base with 77% of students (n = 10) indicating that their confidence levels were very high. This compares to a finding of 0.00% at T1 for these higher levels of confidence, giving a 100% improvement based on the service users’ teaching.

Table 4. Student Confidence of service users' issues.

Q2.

How would you describe your expectations in terms of what you hope to learn from service users?

This question recognized the importance of trauma as an underpinning topic in the practice preparation curriculum and was a common thread in the stories being shared by the three service users. As evident in Table 5, 92% of the students describe the teaching from service users as having a ‘very significant impact’ on their understanding of trauma, which is a significant finding.

Table 5. Expectations of Learning.

Student comments on the T2 survey, as well as in the focus group, indicated that they benefitted from seeing the lead researcher’s live application of the principles of a trauma-informed approach to care, from the way he used language, held space for the voice of the service user to be primary, and how he explored broader issues of culture and bias.

Observations of the co-investigators at the university are that, while students had learned about trauma and adverse childhood experiences in previous courses, and some had self-reflected on their own experience with trauma, the use of this pedagogical technique allowed students a unique window of observation. Students were able to hear about the experiences of trauma that the service users survived, and they were able to feel it viscerally and see the impact of both trauma and resilience on the service users. In addition, while the students were able to process this through their experience of having finished core courses and be in preparation for field placement, they were not responsible for asking the next question and for responding to what the client said. They were thus in a unique space of being able to bear witness to someone else’s story and process it through a professional or almost professional lens, while at the same time having a safe space of their own to be a student.

Q3.

What in particular did you learn from service users sharing their experiences in the classroom?

The application of social work skills in practice was valued highly by the students as the following quote indicates: ‘I loved this experience because we got to watch a social worker in action express empathy’. Students witnessed skills in action as evidenced by one student’s noting, ‘Undivided attention, eye contact, a soft caring voice, and taking it slow will make for more meaningful connections and further the work more efficiently’.

In addition to applying these skills to practice, the students also appreciated at a critical level the nuances involved in meaningfully implementing practice skills, expressed in quotes including: ‘I learned that even the most subtle of cues can shut off a client’. and ‘This was very impactful because they explained how and how not to act/treat them in certain situations. I learned how to be more empathetic, patient, kind and understanding. I also learned more about how to enhance positive body language’.

The practice application of social work values was also illuminated for students through their observations: ‘I learned how pervasive the Social Work values are. It is one experience to “rehearse” them in a classroom setting, but our clients see our values playing out (or not) in their experiences with us’. Treat clients as humans first, do not view them as their issues they are so much more than that.

Q4.

To what extent do you think this type of learning will prepare you for practice?

92% (n = 12 students) affirmed that the involvement of service users in their Field Forum class would effectively prepare them for field practice with an increase in the students’ perception of how this type of teaching would prepare for field practice from T1.

Q5.

What do you think will be the strengths and limitations of hearing directly from service users?

Strengths

The students in their responses to reflecting on ‘Strengths’ consistently placed high value on learning from lived experience as the following series of quotes express:‘It is a first-hand account of the experiences these individuals had which allows us as students to be able to hear real stories’.; ‘Real world experience from people who have experienced this is something our professors couldn’t give us’.

Observation of intervention and practice skills through the facilitated conversation approach was also valued by the students as indicated in the following quotes: ‘Being able to learn from the client and watch first-hand how to use the skills we learn in class’.; ‘It becomes real and tangible and is easier to learn. It is coming from a new and honestly the most important perspective, the perspective of the people we will be serving’.

The contribution of this type of service user involvement to developing practice skills was also valued by the students as indicated in the following statement: ‘The greatest advantage to this is hearing a first-hand account. These service users are experts through lived experience and are able to give great insight to the various environments they lived in and through’.

Limitations

From the outset, the students were also reminded about the importance of viewing service user knowledge through a critical lens, which is an important backdrop to their assessment of limitations associated with this type of pedagogy.

A number of students (n  = 5) could not identify any limitations with this initiative. Whilst there were no consistent themes connecting student responses to this question, there are a number of individual observations which are importantly highlighted by the following quotes:

Reflecting individualized approaches to learning, the following student remarked:

Some students might not learn through actively listening to conversation, though I personally feel that this teaching style integrated student interaction and the service users’ experiences well.

Needing more time to process the learning from service user lived experiential knowledge was also highlighted by students. The individualized nature of experiential knowledge was also importantly highlighted as evidenced by the following quote:

I believe the limitations of this approach lie in the fact that each person has a unique experience and what one client loved another might have hated. Something that helped one person might have not been helpful for another. The diversity of human beings I believe might be the only limitations I sensed from the experienced.

Q6.

Anything else you would like to tell us about your thoughts at this stage about this type of teaching approach?

This final question encouraged the students to engage in both reflection and reflexion concerning their perceptions and feelings about being involved in this type of pedagogy. There was a consistent and powerful expression of endorsing the value of this type of service user involvement-based teaching by the students as evidenced by a range of comments and observations. There were several comments expressing their ‘love’ of this model for the classroom and their thankfulness at having been able to experience it. Others discussed the value of this in their learning, as exemplified by statements like ‘I have learned more in these two sessions about vulnerability and feeling with the client than in any class I have taken’., and ‘“Priceless experience” is what I would say. You cannot learn this from a textbook or traditional lecture’.

Several students also remarked that this type of approach should be expanded in teaching social work, as articulated by a student who said, ‘This type of approach is innovative. I think that more social work programs should utilize this concept’.

The commitment to the profession of social work expressed by the following student is arguably apt to conclude with: “I have been so deeply touched by the service users that were so kind to teach us about their lives through experience. I am forever touched and changed by this and further called to the social work profession”.

Analysis of findings: Focus group

Q1.

Now that a few weeks have passed since the service users/clients visited field forum class, what are the lingering take-aways from this experience?

The interconnectedness of social work knowledge, skills and values/principles were themes that were prevalent in the students’ responses to this question. The involvement of service users in teaching helped the following student in realizing the importance of partnership working as a social work value/principle: ‘The realness of it all … we’re walking with people through their journey … we’re there to help’.

Service users who shared their lived experience of homelessness helped deepen the students’ knowledge about the challenges they face but also importantly how again social work values play an important role in informing social work intervention and practice. One of the service users likened being homelessness to ‘having a job’ insofar as day-to-day living had to be carefully thought about concerning the basics of just getting through and managing. This, alongside other areas shared, resonated with the students: ‘People that experience homelessness are people … .everyone is a person and people are people at the end of the day, the way that (name of facilitator) interacted with the clients, the way he spoke to them, the way he looked at them, he gave them the respect they deserve and that’s important to remember … we’re in different positions in life but you’re a person just like I am’.

The interplay between social work skills and values was also evident in the students’ reflections on this question: ‘It reminded me how easy it can be to get desensitized to what we do, overwhelmed by cases we can overlook body language, smiling, eye contact, to hear that re-iterated over and over again by every single client, the importance of first impressions, genuine, unique and personal being able to see them as they are, a humbling reminder’. and ‘I never came in contact with someone who is homeless, so getting the opportunity to experience that kind of diminished the sense of otherness, this was huge for me, to develop empathy to the subject of homelessness was really great’.

Observing the implementation of skills by the facilitator in ‘real time’ was also important for the students in regard to modeling for future practice. On a related point, the following student highlighted how self-disclosure in the helping relationship was valued by the service user: ‘It wasn’t until her therapist opened up about her personal life that she felt she could share and start doing some work and it finally got through to her’.

Q2.

What thoughts and feelings have you had about the social work profession, and your role in it, since this experience?

It clarified and simplified the students’ understanding of the profession of social work on the cusp of their entrance to field work. While they are well trained, they often feel inadequate to enter direct practice with clients and question their capabilities. They reflected that this experience clarified the essential role of a social worker and therefore was affirming to them. One student stated, ‘Our job is to walk alongside people in their pain and suffering- help them find answers’. Another simply stated: ‘Bottom line: listen’.

It also helped students to see the embodiment of the practice of social work values and ethics as they participated in the process and observed the interactions of the lead researcher and the service users. The following quotes are evidence of this:

Being taught by them brought values and ethics in a deeper way- why these values matter and how to do them”; followed by another student stating, “To watch [name of lead researcher] do this in real life (referencing the above-mentioned comment) helped, he asked permission, his body language, rephrasing.

Q3.

How will this experience of hearing from service users help you as you enter the field next Fall?

The students shared many ways in which they believed these teaching experiences would will help their entrance into field work. Several themes emerged:

Humility and Grace toward themselves: Students were impacted by what they termed the lead researcher’s grace toward the service users as well as to the students. This was a powerful experience for them and provided a model for them to follow including the realization, ‘I will make mistakes. I must give myself grace but really be intentional’.

Viewing the Client as Expert: was displayed through the process, the interactions with the students and service users. The lead researcher referred to the guests as ‘teachers’ and ‘content experts’. Having this modeled as well as demonstrated by the content that was shared and the lessons taught by the service users reinforced this impact. Students learned to: ‘Ask permission for little things (from the client). The client is the expert of their experience’. and ‘Let client be a pacing partner- based on what they can handle’.

Q4.

What would have made this experience even more beneficial?

The students made a number of suggestions about ways in which the involvement of service users might be improved going forward, detailed in the following sections.

Diversity of service users

Some students felt that having a diversity of service users with different experiences in areas such as adoption, fostering, children’s services would also bring added value as well as involving service users who are currently in receipt of services.

Preparation

Some students felt that more focused preparation in advance would have helped them consider the types of questions they could ask the service users in the classroom situation as they had been sensitive to ensuring they avoided any distress in what they would probe on: ‘A session beforehand what can I ask, what don’t I ask’ was how one student expressed this point.

Earlier on in the curriculum

Having service users involved in teaching earlier on in the curriculum was suggested as important by several students not only in terms of preparation but also for concrete preparation for the career choice that being on a social work course would lead to. The following quotes reflect these points: ‘Giving it to us earlier … we can read the books and talk about it all day but it still wasn’t as real as actually being there and observing somebody actually give a true sense, it was more beneficial than reading the case scenarios we read out of a book … doesn’t really pull out the emotion you really feel in the moment … having access to it earlier may help’.

At the same time, there were focus group participants who expressed that this technique should not be demonstrated too early in the curriculum, because students in earlier foundation classes wouldn’t have the contextual knowledge (of practice skills, of theories and frameworks, of policies that impact service delivery) to understand the service user experience as fully. After some group dialogue, participants agreed that Fall (Autumn) semester of junior year (which is the semester before Field Forum) would be an ideal place for introducing this technique.

Field practice preparation

Some students felt that service user involvement could have an important place in helping students simulate their practice skills with each other and also receive feedback from service users about their practice skills in the classroom situation. As one student described: ‘If we were able to have students simulate what (name of facilitator) did with his clients … to have that exposure to service users … we can simulate that with our classmates … so that we know we’re competent’.; and ‘Inviting service users to be actively feeding back to students on their intervention skills’.

Discussion

As we noted earlier in this paper, the USA country context, unlike the UK, does not have an educational policy requirement for service user involvement in the social work curriculum. As remarked by Goossen and Austin (2017), ‘without the existence of legislation or funding aimed at strengthening the involvement of service users in social work education, U.S. social work education programs appear unlikely to adopt any broad-scale initiative to include service users’ (p. 48). However, the recent work by Adamson et al. (2022), where these authors undertake a scoping review of service user involvement in social work education, is important in this debate. This review acknowledges the paucity of published pedagogic research in the US and Canada in this field but also importantly includes examples of where innovative initiatives have occurred, particularly with service user populations that are seldom heard and harder to reach (Hernandez et al., 2010). For example, Maschi et al. (2013) undertook innovative work involving students collaborating with older adults to develop a deeper understanding of their issues toward more nuanced levels of cultural competence. Mogro-Wilson et al. (2014) provide an example of creatively approaching joint teaching with disabled service users over a five-day period. Nordberg et al. (2017) address oppressive perspectives toward criminal justice experienced service users by directly exposing students to such personal testimony. Some academics in the US have thus taken progressive steps forward in creatively endeavoring to meaningfully include service users in an educational context to help deepen social work students’ understanding and competence. Adamson et al. (2022), also positively remark, that ‘the reasons why educators implement service user involvement in social work education without having a legislative mandate may be related to the inherent value base of social work and the promise of stronger collaborations with service users in practice relationships’ (p. 14). Schön, in their 2016 literature review of service user involvement in social work education across the globe, posited that there are a number of structural conditions that should be in place for expansion of this pedagogy (Schön, 2016). These structural conditions include government policy that sets the expectation for service user involvement as well as compensation to the service users for their involvement. Rather than governmental policy, US social work education is guided by educational policy and accreditation standards (EPAS) from the Council on Social Work Education (CSWE), the accrediting body for social work programs in the US. While CSWE historically specified types of courses that should be included in undergraduate and graduate programs of social work, more recent iterations of EPAS have identified competencies that should be achieved. Current competencies, published in 2022, outline educational standards in which social work programs could choose to implement service user pedagogy to promote the achievement of competencies. In particular, the authors believe that engaging service users in the curriculum would provide students with rich opportunity to gain knowledge in Competency 3: Engage Anti-Racism, Diversity, Equity, and Inclusion (ADEI) in Practice as well as in Competency 6: Engage with Individuals, Families, Groups, Organizations, and Communities (Council on Social Work Education, 2022). The authors believe that through exposure to service users, social work students will have deeper understanding of how privilege and power, as well as oppression and discrimination, shape service user experiences with systems and individual practitioners. Likewise, in the context of service user pedagogy, students will also have the ability to practice self-reflection and assess how their own experiences with privilege, power, oppression and discrimination will shape their ability to engage with clients. As such, programs are free to structure their curriculum in a variety of ways, as long as each program can demonstrate through assessment of student learning that competencies have been attained. At the time of writing, the lead author is proposing curriculum guidance for CSWE, which, if adopted, may add further impetus to strengthening and developing the innovative work which some US colleagues have already pioneered. This can, arguably, help in making service user involvement less ‘elusive’ in the US (Dill et al., 2016).

Service user involvement, occurring in the way in which this paper describes, would be quite the norm in the UK tradition by contrast. What is interesting to note, however, is that the findings from the student evaluations would support and align with the findings of similar pedagogic research about the positive impact that this type of experience based knowledge from service users can have on the competence development of social work students (; Anghel & Ramon, 2009; Coulter et al., 2013; Duffy, 2012; Levy et al., 2018; Robinson & Webber, 2013).

This pedagogic initiative, however, did include the additional component of ‘live interview’ between the classroom facilitator and the service user, which, of itself, brought an innovative twist to the medium of service user involvement in teaching. The literature already recognizes the importance of role play and role modeling as being useful techniques through which students learn from service user involvement in the classroom (Moss et al., 2007; Skilton, 2011). Applying these methods to ‘live’ teaching through facilitated interview with service users and students, arguably, introduces additional layers of possibilities and complexities. The students in their evaluations positively appraise the opportunities to ‘witness’ the emotionality in interview dialogue being played out in front of them without having to take responsibility for this. This, however, is not for the pedagogically feint hearted! Attention to detail is critical in this work and very well established as essential in the journey toward achieving meaningful service user involvement in the educational context (Duffy, 2006; Levin, 2004). The need for careful preparation cannot be overstated and is central to expressing the ‘ethic of care’ toward service user facilitators and social work students. These findings, thus, suggest that the implementation of service user involvement in the US can bring added value to the social work education experience. Existing ‘communities of practice’ (Wenger, 1998) in this initiative in the Tennessee region fully embraced the opportunity to be involved with their local university. Adopting this approach to relationships at a community level which have been both nurtured and well established can, thus, form a useful foundation from which to begin and ultimately grow such partnership based approaches to social work education in alliance with service users and community groups. Much has already been evidenced in terms of achievement in this way, where service user groups and academics can work collaboratively in the education of social work students (Casey et al., 2021; Zavirsek and Videmsek, 2009).

Though the integration of service user experience only happened in one course, it happened throughout several weeks of the course with continued opportunities for reflection, both verbal and written. As these students moved into field placements in their senior year, they continued to remark on the usefulness of this pedagogy and referred back to this learning in their field journals and in their field seminar course. Many reflected on it again in their exit interviews with the program at the time of graduation as being a critical component of their professional identity development. The fact that the professor in the course in which the service user pedagogy was implemented is the same professor who taught the students in field seminar was also likely a facilitating factor in the successful transfer of learning from classroom to field.

The authors recognize that this is a small scale study and, as such, the findings may not be widely generalizable. Nonetheless, the students’ reflection on their learning is indicative that the pedagogy is one that other programs would find worthy of exploration and implementation.

Conclusion

Our paper concludes with the overall observation that service user involvement, conducted in a careful and measured way, has positively impacted on the knowledge and competence development of these social work students in a university in the United States. This was very much a novel departure away from more traditional methods of teaching these core concepts of knowledge, skills and values, so foundational in the students’ learning. We can now argue, albeit recognizing that this was a small-scale study with attendant limitations on generalizations, that there is much scope for educators in the United States, to explore similar ways in which this type of service user based pedagogy can find expression in the social work curricula. The students in our study have clearly indicated the benefits they have accrued to exposure to this type of teaching and we would, therefore, encourage others to develop similar opportunities and initiatives.

Acknowledgments

Susan Lantrip was a member of the Education Team at Open Table, Nashville and, in this role, contributed to this teaching initiative helping students understand issues around homelessness. Sadly, Susan passed in June 2021. Susan had a gentle and compassionate spirit, was a gifted educator to students and community members and a strong advocate for others. She was seen and loved.

We would also like to express our appreciation and gratitude to the following organisations in Nashville, Tennessee, whose members participated in this teaching initiative: Open Table Nashville, an organisation supporting people affected by homelessness (https://opentablenashville.org) and Thistle Farms, an organisation supporting women survivors of abuse and exploitation (https://thistlefarms.org/)

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The lead author in this pedagogic research was supported by a scholarship from the US-UK Fulbright Commission 2018-19.

Notes on contributors

Joe Duffy

Dr Joe Duffy is a Professor of Social Work at Queen–s University, Belfast, Northern Ireland. A US-UK Fulbright Scholar in 2018–19, his research specialises in service user involvement in social work education, public policy and research. His pedagogic research in this field also focuses on the direct involvement of individuals with lived experience of trauma and political conflict in classroom teaching.

Sabrina Sullenberger

Sabrina Sullenberger is a Professor of Social Work at Belmont University in Nashville, TN. She is especially passionate about teaching courses on community practice, policy, human development, and poverty and child welfare. Her research interests include attitudes on poverty, system reform, and the scholarship of teaching and learning.

Julie Hunt

Julie Hunt is an Associate Professor at Belmont University in Nashville, Tennessee. She has developed and taught many courses including: Human Diversity, Practice with Individuals, Spirituality & Social Work Practice, and Professional Skills of Social Work. Julie is currently the Director of Field Education for the program. Her scholarly work is focused on best practices inteaching and learning including developing empathy and self awareness, as well as spiritual and professional formation.