Research Summary - April 2020

Social work in extremis: A COVID-19 edition - This edition of our monthly Research Summaries comes at a time of unprecedented national crisis. Research on social work practice during ‘extreme events’ offers valuable insights and transferable learning, applicable to social work during the current COVID-19 epidemic.

Introduction

This edition of our monthly Research Summary comes at a time of national and international emergency as practitioners across the country try to grapple with the new challenges brought about by the current COVID-19 pandemic. Services that support adults, children, and young people and families are adapting and continuing to deliver safeguarding work and support to people in communities across the country, and this is more important now than ever. We know that while people will be facing many of the same issues in their practice during the current pandemic, these are likely to be amplified and made more complex where they intersect with new challenges.

The unprecedented nature of the current crisis means there is only limited research relevant to social work practice during the COVID-19 pandemic. However, research on social work practice during other ‘extreme events’ offers valuable insights and transferable learning, applicable to social work during the current crisis. We have distilled key messages in the following summaries in order to support practitioners in their work at this time. We also list below recent UK guidance and policy in response to COVID-19 which will be relevant to you and your teams, in your work with children, young people and families.

  • The first summary by Howard et al. (2018) examines the impact of disasters on already disadvantaged groups and in particular the complex ways that existing social inequalities can be exacerbated when people are socially isolated, leaving them at greater risk in times of crises.
  • The second summary by Maglajlic (2019) identifies elements of good organisational practice from social work carried out in the context of natural disasters including approaches which are community focused and strengths-based.
  • In the third summary, we highlight key messages from Ersing (2020) which examines community-based disaster social work and theory with the aim of promoting community resilience in times of emergency.
  • Finally, research by Ager et al. (2011) looks at approaches to managing child protection work in the context of a humanitarian crisis.

How social isolation amplifies vulnerability during national disasters. 

Howard, A., Agllias, K., Bevis, M., & Blakemore, T. (2018). How social isolation affects disaster preparedness and response in Australia: Implications for social work. Australian Social Work71(4), 392-404. https://doi.org/10.1080/0312407X.2018.1487461

What is this article about?

This article examines the impact of natural disasters on vulnerable populations – including those already experiencing significant health, income, and social disadvantage. In particular, the researchers look at the complex ways that existing social inequalities can be exacerbated when individuals are socially isolated, leaving them at greater risk in times of crises.

What do we already know?

Previous research shows that disaster amplifies existing social inequalities leaving some individuals and communities disproportionately impacted because of their particular difficulties in adapting and responding (Bui et al., 2014; IPCC, 2014; McGuire et al., 2007). These groups include older people, children, disabled people, cultural or language barriers, and those on low-incomes.

  • During disasters older people are more vulnerable because of their increased likelihood of health-related conditions or death due to age-related physiology, and where they have limited mobility or disability, an increased reliance on medication, or chronic illness (Mallon et al., 2013; Wilson, 2011). People’s response to a disaster may be reduced if they cannot use or access computers or mobile phones (Howard et al., 2017). They may also be more vulnerable to abuse, theft, and fraud (Gutman & Yon, 2014).
  • Children are at increased risk mainly because of their reliance on others for care (Tang et al., 2014). 
  • Disabled people are at greater risk where they have limited mobility and reliance on others, increased health or mental health needs, or those who may experience additional barriers to ‘receiving, understanding, and acting upon disaster related information’ (Howard et al., 2018, p. 394; Kettaneh & Slevin, 2014). 
  • Those individuals and communities that have minority status in terms of culture and language may be disproportionately impacted by disaster because of language barriers to accessing information and guidance (Hansen et al., 2013). 
  • Finally, low-income groups are at a disadvantage when it comes to preparing for disaster in terms of purchasing items essential to disaster preparation (Wang et al., 2012). They are also more likely to experience poor living conditions including overcrowded or substandard housing which may increase their vulnerability (Mallon et al., 2013). 

However, the authors remind us that ‘vulnerability should not mean inevitably poor outcomes for particular groups, rather it should highlight the areas that need to be addressed to ensure human rights and safety for all community members’ (Parr, 1998, cited in Howard et al., 2018, 394).

For this study researchers carried out seventeen focus groups with 111 participants including older people, disabled people, families with children under five, low-income households, and people from culturally and linguistically diverse backgrounds in order to examine natural disaster preparedness in Australia.

Key findings

  • Whilst each group was associated with vulnerabilities in terms of ability to prepare and respond to disasters, the researchers found that it was the intersection of these factors with being socially isolated which ultimately and significantly increased the risks and vulnerabilities to people.

Social isolation is defined in this paper as ‘the inadequate quality and quantity of social relations with other people at the different levels where human interaction takes place (individual, group, community and the larger social environment)’ (Zavaleta et al., (2014) cited in Howard et al., 2018, p. 394).

  • Some participants described having no one they could call during a crisis. For others, access to support networks was limited or uncertain, such as when participants relied on family or friends who lived some distance away. 
  • People without good community ties and social connection were disadvantaged when it came to planning, preparation and accessing information in the event of a disaster. 
  • For people with cultural and language barriers, being socially isolated or a new immigrant, combined with these barriers to potentially create further vulnerabilities. 
  • Across all groups, but particularly for those in the low-income group, participants were at a clear disadvantage due to a lack of resources which impacted the extent to which they could plan and respond to a disaster – such as buying items needed during an emergency. 
  • People with lower incomes and without a stable support network were disproportionately disadvantaged as they didn’t have family, friends or neighbours that they could rely on during an emergency. 
  • People without informal support networks were more reliant on potentially already stretched services, and the compassion of unfamiliar neighbours and community members which may also be stretched. Those with large support networks – both formal and informal – were more likely to be able to receive adequate and timely support. 
  • People who were reliant on just one person or carer for support during an emergency situation, and who had limited mobility, were additionally vulnerable as it assumed that the carer would be nearby and able to access them or be unaffected themselves. 

Summary

This research highlights how the risks and impacts faced by already disadvantaged groups in the face of national emergencies is ‘amplified’ and ‘intensified’ by experiences of social isolation – which here is understood as the lack of an adequate support network – where people have no, uncertain or minimal support networks to draw on. The researchers emphasise that it was the ‘intersection of factors such as age, disability, and income with social isolation, rather than those characteristics on their own, which was found to increase vulnerability, and impede response, to natural disasters.’ (Howard et al., 2018, p. 401). 

Reflections and implications for Practice during the COVID-19 crisis

  • Practitioners may find it helpful to think about the pre-existing inequalities being amplified by the current pandemic and how they might support people to access food, medicines, and other essential resources – including technology to enable continued communication with services – this may be particularly important for people experiencing economic deprivation. 
  • People may benefit from practitioners carrying out risk-assessments to ensure informal and formal support networks can be developed to help people access everyday provisions. 
  • Reflecting on what local, online cooperative efforts in the community practitioners might link people with in order to widen their social networks of support at this time may also be beneficial. 

For references see the original paper by Howard et al. (2018)

The organisation and delivery of social services in extreme events

Maglajlic, R. (2019). Organisation and delivery of social services in extreme events: Lessons from social work research on natural disasters. International Social Work, 62(3), 1146–1158. https://doi.org/10.1177/0020872818768387

What is the article about?

This article describes the delivery and organisation of social work during an ‘extreme event’ such as a natural disaster. It identifies elements of good organisational practice from social work carried out in the context of natural disasters by analysing a range of international studies using social practice theory (Shove et al, 2012).

Good practice for disaster social service agencies

Social practice theory (Shove et al., 2012) holds that social work organisational practices are shaped both by the people who work in social work services, as well as by the social contexts in which the services are located.

Social services are called upon to be increasingly more flexible when responding to an extreme event (Smith, 2012). While statutory services may be more constrained in terms of how they work, non-statutory services often have a greater degree of flexibility (Kulkarni et al., 2008; Manning & Kushma, 2016) making collaborative working between organisations highly beneficial in this context.

When an extreme event occurs, we know that people continue to require the ‘traditional’ social work services they used before the event, as well as needing services to meet new needs prompted by the event itself (Smith, 2012). In addition, while extreme events effect everyone in the community, ‘traditional’ social service ‘users’ – including older adults, children, disabled people, people on low incomes – and ethnic minority populations (Manning & Kushma, 2016), tend be affected to a greater extent. This is particularly the case for these groups’ longer-term recovery after an extreme event, which is often shaped by experiences of oppression and or marginalisation (Sundet & Mermelstein, 1997; Zakour, 1997). 

A review of the literature indicates that extreme events can exacerbate existing community difficulties, while also producing new ones, with increased incidences of domestic abuse (Reese, 2004; SafeLives, 2020) and child abuse (Curtis et al, 2000; Smith, 2012). Gender inequality is also likely to increase during and after an extreme event (Dominelli, 2015). 

Key findings

While research reflects differing views on the precise role of social work organisations during an extreme event, it also builds a picture of what good practice ‘looks like’ in the delivery of immediate and longer-term interventions during and after an extreme event such as the global COVID-19 health pandemic. They include the following:

  • Good communication, information sharing, coordination and collaboration across social work services, and at all governance levels helps to ensure the provision of relevant and timely support to the people affected by an extreme event (Ager et al, 2011; Kulkarni et al, 2008; Vo, 2015; Webber & Jones, 2013). 
  • During an extreme event, it is difficult to predict what the priority issues for short and longer-term response and recovery might be; it is therefore useful for services to be as flexible as possible, as well as creative in the way they strive to deliver services (Dominelli, 2015; Huang et al., 2014; Larson et al., 2015; Smith, 2012; Wang et al., 2013; Webber & Jones, 2013). This coincides with the need to recognise what already worked before the extreme event, in terms of resource management and organisation in a given locality or community (Araki, 2013). 
  • A focus upon individuals’ and communities’ ‘existing assets’ (Ku & Ma, 2015), rather than their ‘needs’ is beneficial for the planning and delivery of more effective, strengths-based support during and after an extreme event. An extreme event can also sometimes open-up opportunities for social change and development; an asset-based community engagement approach (Ku & Ma, 2015) can help to build upon these for the future. 
  • There is consensus across the disaster literature that community work and mobilisation should be one of the key activities for social work in times of emergency (van Heugten, 2004; Webber & Jones, 2013). Community social work can support people to identify goals and encourage solidarity at the community level and in supporting each other during recovery (Sherrard, Sherraden & Fox, 1997; Lesnik & Urek, 2010). Community work post-disaster also reinforces resilience in the community through the sharing of information and the organisation of assets and resources (Araki, 2013). 
  • Social work practice which considers the cultural relevance of the intervention being delivered has been shown to be more effective at meeting peoples’ needs during an extreme event (Manning & Kushma, 2016; Webber & Jones, 2013). This is in keeping with a human rights based approach
  • Maglajilic (2019) notes that embedding anti-oppressive and anti-racist principles in social work practice helps to increase more marginalised communities’ resilience, as well as develop their capacity to cope and recover from an extreme event. 
  • Good communication channels to enable the sharing of accurate and timely information both for people using services, as well as those working in them, pay real dividends (Manning & Kushma, 2016; Smith, 2012; Wang et al., 2013). They are valuable for countering myths or ‘fake news’, as well as to ensure that people understand their rights and entitlements, and what services are available to them (Poulin & Soliman, 1999).
  • Knowledge is an important driver for longer-term recovery after an extreme event. Comprehensive and up-to-date records of what services and resources are available at a local level, including voluntary or non-statutory organisations which may be able to support social work operations (Wang et al., 2013), can improve this process.

Reflections and implications for Practice during the COVID-19 crisis

  • The need for social distancing means that practitioners face particular communication challenges during the COVID-19 pandemic. Research in Practice have released some top tips on video conferencing to support practitioners, and agencies, to stay connected with each other.
  • How can practitioners be supported to bring flexibility and creativity into their practice with children, young people, families and adults at this time in order to be responsive to the need to socially distance during the COVID-19 crisis? Research in Practice has published a blog on carrying out social work with children and families during the pandemic. Also useful may be the following guidance on supporting mental health across children, young people and adults at this time:

Public Health England: Guidance for the public on the mental health and wellbeing aspects of coronavirus (COVID-19)

NHS: Mental wellbeing while staying at home

Anna Freud National Centre for Children and Families: Supporting young people’s mental health during periods of disruption

Mentally Health Schools & Anna Freud National Centre for Children and Families: Coronavirus: resources for mental health and wellbeing toolkit #1

For references see the original article by Maglajlic (2019)

Community practice during disasters

Ersing, R.L. (2020). Disaster Response through Community Practice. Community Practice and Social Development in Social Work, 1-20. https://doi.org/10.1007/978-981-13-1542-8_11-1

What is this article about?

This article examines community-based disaster social work and theory with the aim of promoting community resilience in times of emergency.

What do we already know about community social work during disasters?

The author emphasises the long history of community social work during times of natural disaster – particularly in the relief and recovery stages by decreasing vulnerability, building capacity and empowering people – and outlines a framework capturing this type of community social work, building on the concept of community resilience. Here ‘community resilience’ is defined as ‘a process linking a set of adaptive capacities to a positive trajectory of functioning and adaptation after a disturbance’ (Norris et al., 2008, cited in Ersing, 2020, p. 2) and successful outcomes are characterised by collective action which works to identify and apply local assets, build effective partnerships, and empower community action at local levels. This approach raises some important strategic challenges for the social care practice environment in England, where work is more often focused on individuals than on developing and supporting community level responses.

Social workers have an important role as advocates - to influence policy, promote social justice and drive system improvement to make practice responsive to the needs of marginalised communities affected by the disaster. Indeed, the author argues that what makes ‘disaster social work’ distinctive is the ability to work both at a direct practice level with people but also at a macro systems level to challenge wider societal discrimination to effect change.

Three components which are tied to community resilience, and therefore community social work, are outlined below:

1. Community vulnerability and strengths

Vulnerability factors from the disaster literature, identified in this article and relevant to the current COVID-19 emergency, are presented below:

  • Social Vulnerability. Those most vulnerable in a disaster include: women, children and older people (Enarson, 1999); low-income households (Fothergill & Peek, 2004); those with English language barriers (Drolet et al., 2018); people with physical health or mental health difficulties (Bethel et al. 2011), and rural communities along with under-resourced inner city neighbourhoods (Cutter et al., 2016). For a discussion of inequalities exposed by the COVID-19 pandemic see: https://www.bruegel.org/2020/03/how-COVID-19-is-laying-bare-inequality/
  • Economic Vulnerability. Losses to communities may include affordable housing, employment, and transportation. Those with low wage and/or insecure employment, and those living below the poverty line are most vulnerable and least able to recover post-disaster (Pine 2009; Wisner et al. 2003).
  • Ecological Vulnerability. Indicators of ecological vulnerability include the condition of natural resources and the environment. Relevant to the current COVID-19 crisis is food security and the ability to access sustainable resources to meet nutritional needs as well as the ability to reconstruct livelihoods post-disaster (Kein, 2008).

It is also important to emphasise individual and community-based strengths and assets which can mitigate against the worst effects of a crisis.

2. Adaptive capacity

‘Adaptive capacity’ considers the requirement for knowledge and skills to encourage recovery (UNISDR, 2005) and draws on a strengths-based approach which empowers communities (Paton, 2006). Adaptation can result from new knowledge, skills, and community networks that increase access to resources. These new social networks promote a sense of community which can also alleviate social vulnerability and isolation, and help to rebuild lives and communities (Paton & Johnston, 2001; Hawkins & Maurer, 2010). According to Ersing (2010), strengthening the adaptive capacity of groups, organisations and communities, is vital is post-disaster social work requiring community-level practice strategies.

3. Collective efficacy

‘Collective efficacy’ describes the importance of increased community engagement, cooperation, and active participation for effective responses to, and recovery from, disasters (Paton & Johnston, 2001). Vital to collective efficacy are social networks – the trusted relationships between people and connections to other support systems, assets, organisations and resources. Key to collective efficacy is bringing about change to reduce inequality and promote fairer distribution of resources (Ersing, 2020).

Community-based approach to disaster social work

  • Identify assets to reduce vulnerability

The author suggests that identifying individual and community assets can lower vulnerability and assets can in turn become resources which can mitigate against threats. Social connections have been highlighted in particular, with research showing that individuals with greater and more varied support networks at their disposal are less vulnerable (Collins et al., 2018).

  • Organise community assets to promote adaptive capacity

Following the identification of assets, grassroots community organising is critical for deciding the best use of those assets and how they fit into a larger strategic plan. Ersing (2020) proposes that the power to transform existing resources is an outcome of adaptive capacity. Given that community is central to adaptive capacity, the degree of successful recovery post-disaster is associated with the level of community involvement and cooperation.

  • Utilise assets to empower collective action

Collective action must be grounded in trust in order to engage and communicate vital information with community members effectively (Sampson et al., 1997; Paton, 2007). The idea of empowering collective action is that people each have a part to play in reducing factors leading to vulnerability and building an overall capacity to mitigate against hazards.

Reflections and implications for Practice during the COVID-19 crisis

  • What vulnerabilities are individuals, children, young people and families facing that may be heightened during the COVID-19 emergency? What practices or support can practitioners employ to mitigate against this increased vulnerability? Guidance and advice is available from Social Work England, the British Association of Social Workers, ADCS and the Department for Education. Research in Practice has also published a number of resources to support social workers at this time including a blog on carrying out social work with children and families during the pandemic.
  • Are there assets at the individual, family or community level that practitioners can build on and connect people with to help them access the support and resources they need at this time? The current pandemic and the requirement for social distancing presents new challenges for children, young people and families who rely on family contact time to stay connected where children live out of home. Research in Practice, together with the Nuffield Family Justice Observatory, has published a webinar which outlines key considerations in supporting children to stay in touch with their birth family during UK wide lockdown in response to coronavirus (COVID-19).
  • Thinking of ways that people can be encouraged to broaden and diversify their social connections may support and strengthen their resilience. Research in Practice together with the British Association of Social Workers (BASW) have published a webinar exploring how social care can support social connections during the COVID-19 pandemic and into the future.
  • How might people might be encouraged to participate and or contribute at a community or group level to empower, build resilience and support recovery?

For references please see original article by Ersing (2020).

Learning from child protection in humanitarian emergencies

Ager, A., Blake, C., Stark, L., & Daniel, T. (2011). Child protection assessment in humanitarian emergencies: Case studies from Georgia, Gaza, Haiti and Yemen. Child Abuse & Neglect35(12), 1045-1052.

What is this article about?

The article looks at four different approaches to managing child protection work in the context of a humanitarian crisis, where children were directly or indirectly at risk of violence and insecurity. The article looks to find common themes and suggestions for responses in similar settings.

What do we already know?

The study examined the barriers to assessment and identify effective strategies in addressing these. A child’s wellbeing may be compromised by a natural or man-made disaster, both in terms of their physical safety and long term development (Toole & Walmand, 1997). Disasters may also increase their vulnerability to neglect, exploitation and abuse (Boothby, Wessells & Strang, 2006). Children’s vulnerability may be further increased as there is often a breakdown of formal and informal communal systems and institutions that support them (Wessells & Montiero 2004).  Many statutes support a child’s right to the protection and restoration of education even during a humanitarian emergency (CRC, 2008).

The authors of this article drew on the following contexts: Georgia, 2008; Gaza, 2008; Haiti, 2010; and Yemen, 2010. Each area was given a toolkit to complete child protection assessments. The evaluation of this work was completed through email correspondence, telephone based structured interviews, and review of documents from child protection agencies.

Key Findings

The cases varied in respect of the nature of the emergency, the socio-political context, and institutional capacity. Despite this however, common themes to effective assessment were identified as:

  • Inter-agency coordination – Whilst the coordination of agencies was identified as a challenge, stronger assessments were achieved where this happened. Aspects of a successful assessment included the sharing of resources and knowledge, using agency strengths, and avoiding duplication. This had the benefits of wider ownership of assessment, increased assessment quality, and utilisation of strengths and resources.
  • Preparation and capacity building – Each context showed the importance of preparation and ability to expand work capacity, as well as creating shorter and easy to use tools which could be adapted to new assessment contexts. Findings included suggestions for more staff training as part of a disaster preparedness strategy, and ability to bring in experienced child protection practitioners with relevant skills to support in a crisis setting.
  • Ensuring timeliness – Assessments completed in a timely manner helped to plan responses and decision making. Organisations that were better prepared were more consistently able to complete assessments within expected timelines. Factors that prevented assessments being completed included a shortage of workers and an agency focus on responding to immediate needs. Time constraints and logistical capacity made it difficult to obtain the toolkit and use in the context and most practitioners were not used to working in crisis emergency contexts. A shortage of child protection specialists impacted the response to child protection needs.

Reflections and implications for Practice during the COVID-19 crisis

For references see the original article by Ager et al. (2011)

Related resources by Research in Practice

Case Law and Legal Summaries (monthly publications)

Digital family contact time: sharing and building knowledge: Webinar (2020)

Loneliness and social connection: Good practice now and in the future – Webinar (2020)

Policy Updates (monthly publication)

Assets-based work with communities: Adults Leaders' Briefing (2018)

Embedding human rights across adult social care: Adults Webinar (2019)

Embedding human rights in adult social care: Adults Leaders' Briefing (2017)

Good assessment: Adults Practitioners’ Handbook (2014)

Good decision making: Adults Practitioners' Handbook (2013)

Legal literacy: Adults Practice Tool (2016)

Mental health law: Risks, rights and responsibilities – Adults Webinar (2019)

Risks, rights, values and ethics: Adults Frontline Briefing (2018)

Social Work Organisational Resilience Diagnostic – Resources (2020)

Social work with children and families in the pandemic – Blog (2020)

Communicating with younger children about COVID-19 – Blog (2020)

Trauma-informed responses in relationship-based practice – Webinar (2017)

Trauma-informed approaches with young people: Frontline Briefing (2018)

Analysis and critical thinking in assessment: Resource Pack (2014)

Neglect in the context of poverty and austerity: Frontline Briefing (2019)

Related resources by others

ADASS: Published COVID-19 guidance and resources for adult services

ADCS: Published COVID-19 guidance and resources for children’s services

Anna Freud National Centre for Children and Families & Mentally Healthy Schools: Coronavirus: Resources for mental health and wellbeing and Supporting adolescents mental health during periods of disruption

British Association of Social Workers: Coronavirus (COVID-19) BASW updates

Cafcass – Family Justice Young People’s Board: Advice on COVID-19 for children and young people

Care Quality Commission: COVID-19 registrations and COVID-19: interim guidance on DBS and other recruitment checks

Department for Education: Coronavirus (COVID-19): guidance for local authorities on children’s social care and Coronavirus (COVID-19): guidance on vulnerable children and young people

Department for Health and Social Care: COVID-19: ethical framework for adult social care

Gov.UK: Coronavirus support for ‘clinically extremely vulnerable people’

Home Office: Coronavirus (COVID-19): support for victims of domestic abuse

National Institute for Health and Care Excellence: Coronavirus (COVID-19) rapid guidelines and evidence summaries

Public Health England: COVID-19: guidance on social distancing and for vulnerable people (multi-lingual guidance),Guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19, Easy read information on COVID-19, COVID-19: guidance for residential care, supported living and home care, COVID-19: rapid tests for use in community pharmacies or at home and a collection of other Coronavirus (COVID-19): guidance

Skills for Care: COVID-19 updates for social work

Skills for Health: Coronavirus (COVID-19) Awareness​ course

Social Work England: Coronavirus (COVID-19): Information and advice

Youth Work Support: Advice, guidance, support and tools for youth workers, young people and organisations during the COVID 19 pandemic

 

Professional Standards

PQS:KSS - Lead and govern excellent practice | Designing a system to support effective practice | Support effective decision-making | Promote and govern excellent practice | Shaping and influencing the practice system | Effective use of power and authority | Confident analysis and decision-making | Purposeful and effective social work | Relationships and effective direct work | Communication | Analysis, decision-making, planning and review | Influencing and governing practice excellence within the organisation and community | Promoting and supporting critical analysis and decision making | The role of social workers | Person-centred practice | Safeguarding | Effective assessment and outcome based support planning | Direct work with individuals and families

CQC - Responsive

PCF - Rights, justice and economic wellbeing | Intervention and skills | Contexts and organisations