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This paper aims to explore how social work students can support lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+) young people in schools. Drawing on the reflective practice portfolio documents of four students who worked with LGBTQ+ young people in a school as part of a social workers in school (SWIS) student placement project, the article uses thematic analysis to identify how the students were able to support young people identifying as LGBTQ+. The article subscribes to a poststructuralist theoretical framework which sees gender and sexual identities as multiple, fragmented and constructed in relation to others and within the systems of knowledge and power that exist in schools. The article demonstrates the benefit to schools of having social work students on practice placement. The students' own reflections critically contemplate the way in which they were able to spend more prolonged periods of time with young people than the teachers could, both with individuals and LGBTQ+ groups. The students' reflective portfolios show the value of the school placements to their own development of knowledge and skills [ABSTRACT FROM AUTHOR]

Teachers in Lady Agatha's Boarding School (Lady Agatha's) find teaching Sex and Relationships Education (RSE) uncomfortable. This paper investigates one aspect of the discomfort that they feel, namely the impact RSE has on their professional status as teachers. I use focus group data to reflect on the professional and personal location of teachers at Lady Agatha's and to explore their understanding of RSE through the recurring themes of professionalism and professional reputation as symbolic capital; deprofessionalisation and risk as symbolic violence; and the connects and disconnects between the doxa and illusio of the school. Findings suggest that by interrogating the sites of symbolic violence which generate RSE discomfort, we can start to unpick the fabric which creates discomfort about RSE, allowing both for a deeper understanding of RSE discomfort in teachers and an opportunity to address this discomfort as a barrier to RSE delivery at Lady Agatha's. [ABSTRACT FROM AUTHOR]

A growing number of researchers are trying to provide explanations for continuity and change in drug policy in different contexts. Such research predominantly falls in the pluralist realm of public policy where various actors compete to have their policy proposals accepted. Using a critical framework called Policy Constellations (PC), developed by Stevens and Zampini, this paper attempts to explain reactions of the British Government to Novel Psychoactive Substances (NPS) between 2008 – 2016. Qualitative data comes from in-depth interviews with stakeholders (N = 15), including NGO workers, a former Home Secretary, drugs ministers, governmental advisors, a former senior police officer, former Deputy Drug Coordinator, and a former Advisory Council for the Misuse of Drugs (ACMD) member. Two 'constellations' competed in British NPS policy setting. The PC framework illustrates power imbalances between these competing stakeholders. Abstinence orientated actors (the conservative constellation) enjoyed strategic advantages and media power which allowed them to create a favourable policy setting. These advantages were not enjoyed by the liberal constellation who struggled to access the policy setting and influence policy developments. The prohibitive nature of the policy used to counter NPS can be explained with the domination of actors whose values align with the conservative constellation. [ABSTRACT FROM AUTHOR]

As a key driving force in adult social care policy in both the United Kingdom and internationally personalisation has wide-ranging implications for the social work profession. Yet its meaning can be elusive and is often contested. This article explores findings from a doctoral study which sought to explore the current meanings associated with the notion of personalisation, by asking those with lived experience how it is experienced by them. Unique features of the study's participatory and psychosocial research design, which placed lived experience at its centre, are outlined. Original findings from the study explored in this paper include a range of themes related to dependence, independence and interdependence, depersonalisation and reciprocity. Risks associated with contemporary practice models in adult social work, including strengths-based approaches are explored. Based on the findings a reorientation towards 'contribution-focused practice' within a relationship-based practice model is proposed. [ABSTRACT FROM AUTHOR]

This paper examines the association between workforce retention and related staffing measures and the quality of English care homes using a national database of social care providers' staffing. The analysis finds significant correlations between quality and the levels of staffing vacancies and retention of both residential and nursing homes, but no association was found between quality and the use of temporary contract workers nor the resident to staff ratio. Only for staff vacancy rates was there a significant difference in the size of these relationships between types of home. The findings suggest that quality could change for the average care home with a relatively small alteration in staffing circumstance. Long-term care is a labor-intensive industry and many countries face relatively high levels of staff turnover and job vacancy rates. These findings are therefore of interest for policy internationally and for England in particular, where the development of social care recruitment and retention strategies are ongoing. [ABSTRACT FROM AUTHOR]

Research suggests that intimate relationship violence and coercive control are prevalent in young people's relationships. Furthermore, young people often fail to recognise such behaviour as abuse. While such findings indicate the normalisation of controlling and coercive behaviours amongst young people, there is little focus on how these behaviours are normalised. This paper presents findings from a study exploring young people's experiences and expectations of intimate relationships. Focus groups were conducted with young people (aged 13 to 18 years) in schools in the West Midlands, England. Young people talked of navigating precarious and competitive heterosexual relationships. Their expectations and negotiations of these relationships often upheld and reinforced gender double standards around dating practices. Young people's discussion also highlighted how they came to accept and rationalise controlling and coercive behaviours as 'love', 'care' and 'protection', legitimising these practices as reasonable. Heteronormativity remains a dominant discourse shaping young people's experiences and expectations of relationships with coercion and control being defining features of this discourse. Supporting young people to critically examine constructs of heterosexuality and gender norms should be a key component of England's forthcoming statutory Relationship and Sex Education. [ABSTRACT FROM AUTHOR]

Foster care research and social work practice tend to focus on how women look after children living in foster care. This focus has limited our understanding of what it is that men do within foster caring families and they are automatically assigned secondary or breadwinning roles. Families who foster involve some form of renegotiation of roles to care for children they foster. While foster caring arrangements are internationally diverse, foster carers often work with social workers. It would therefore seem important for social workers to understand how foster carers negotiate their parenting roles. This paper reports findings from seven main caring foster-fathers who took part in a wider study involving twentythree foster-fathers. The evidence provided by these foster-fathers demonstrate they are highly motivated to care for children and, alongside delivering traditional parenting roles, they negotiate new, non-traditional parenting roles as foster-fathers. These new roles, taken on by foster-fathers, often challenge stereotyped masculinity while they also concurrently enact parenting norms. This study applied Judith Butler's work on performing gender to foster caring families to theorise on the process whereby foster-fathers negotiate diverse masculinities and continue to reproduce gendered relations in foster caring families. [ABSTRACT FROM AUTHOR]

This paper offers a theoretical analysis of the place of substance use within social work education and workforce development in England. Using ecological systems theory as its theoretical framework, it explores the relationship between social work education and practice, and wider systemic and situational constraints which have helped or hindered social work’s engagement with substance use issues. Furthermore, it suggests that the current direct government intervention in social work education and practice, in addition to the cuts in budgets and its privatisation agenda, has been unhelpful in supporting change and professional development in relation to substance use. It will draw on the limited international data that show similar challenges for social work in relation to substance use beyond England and the UK. It will conclude with an argument for strengthening the social work voice in relation to substance use education and practice in spite of the systemic pressures. [ABSTRACT FROM PUBLISHER]

It is now widely accepted that context matters in evaluations of the health inequalities impact of community-based social initiatives. Systems thinking offers a lens for uncovering the dynamic relationship between such initiatives and their social contexts. However, there are very few examples that show how a systems approach can be applied in practice and what kinds of evidence are produced when this happens. In this paper, we use data from ethnographic fieldwork embedded within a multi-site mixed method evaluation to demonstrate how a systems approach can be applied in practice to evaluate the early stages of an area-based empowerment initiative – Big Local (funded by the Big Lottery Fund and delivered by Local Trust). Taking place in 150 different local areas in England and underpinned by an ethos of resident-led collective action, Big Local offers an illustration of the applicability of a systems approach to better understand the change processes that emerge as social initiatives embed and co-evolve within a series of local contexts. Findings reveal which parts of the social system are likely to be changed, by what mechanisms, and with what implications. They also raise some salient considerations for knowledge generation and methods development in public health evaluation, particularly for the evaluation of social initiatives where change does not necessarily happen in linear or predictable ways. We suggest future evaluations of such initiatives require the use of more flexible designs, encompassing qualitative approaches capable of capturing the complexity of relational systems processes, alongside more traditional quantitative methods. [ABSTRACT FROM PUBLISHER]

This paper examines the ‘coming out’ decisions at work of four lesbian, gay and bisexual (LGB) teachers in England. It argues that such decisions are complicated by heteronormative discursive practices within schools that render LGB sexualities silent while simultaneously demanding that they are spoken. This double bind for LGB teachers as well as the professional and personal implications of choosing to come out or not to come out within the workplace is examined. The paper demonstrates that three choices dominate participants' experiences of coming out at work: to speak to no one at work about the private world, to come out to colleagues and to come out to colleagues and students. The paper posits, however, that the narrative devices deployed within coming out (at work) stories are limited by linguistic techniques that constrain the telling of sexual selves to the binary categories of straight or gay/lesbian. The possibilities for teachers whose lives and experiences interrupted the dominant heteronormative discourse are also examined. [ABSTRACT FROM PUBLISHER]

The objective of this article is to explore how education for innovation of our young people may help develop an innovative mindset. The article develops the theoretical justification of a skills set which, it is argued, is fundamental for the development of an innovative mindset of young people, and consequently their personal development. We focus here on the qualitative work - focus groups and interviews with teaching staff and students aged 14-19 years - that informed our understanding of the five characteristics of this mindset; leadership, creativity, self-efficacy, energy and risk-propensity. The research attempted to capture the differences in context, constraints and school types and ethos that potentially shaped behavioural expression. Case studies based on types of school revealed detailed differences in context - regional, local and personal - that shaped students' engagement and their innovative behaviour in particular. The paper also reflects on teaching style, extracurricular opportunities for skills' development and student motivation to acquire an innovation skills set. The paper reflects on practical and policy implications of this work and identifies areas for further research. [ABSTRACT FROM AUTHOR]

A sample of women ( n = 5) participated in a qualitative service evaluation concerning an open-ended, therapeutic group for women only. Data analysis followed suggestions by Halcomb and Davidson (2006). Main themes derived from the evaluation included: 'Groups are different from individual work', 'Belonging/ not being alone', 'Performance in the group', 'The group as a safety net', 'Life improvements and hope for the future' and 'The extent of emotional despair felt'. In this paper, several sub-themes within the main themes and relevant theories and implications for theory and service provision are discussed. [ABSTRACT FROM AUTHOR]

The Good Lives Model (GLM) is a strengths-based approach that conceptualises sexually harmful behaviour as an individual's inappropriate means to meet their core personal and social needs. It promotes managing potential risk through acknowledging the individual's needs, goals and aspirations and working towards meeting these in safe and positive ways. As a specialist organisation working with adolescents who sexually harm, G-map has adapted the GLM for its client group and employs it as a framework for problem formulation and intervention planning. Using a single case-study design, this paper illustrates how the GLM can be used as a framework for therapeutic practice. The case study involves an adolescent male who sexually assaulted an adult female. G-map's experience of the clinical utility and strengths of the Good Lives Model are discussed, alongside an acknowledgement that the dearth of outcome research relating to this model is a limitation. [ABSTRACT FROM AUTHOR]

There is a paucity of published statistical information regarding women who are in relationships with men who pose a sexual risk to children. Women non-offending partners (NOPS) fulfil various important roles such as mother, stepmother, carer and supervisor, and need individual psychological formulations and programmes of therapeutic intervention to help increase their abilities to protect their children from sexual harm. This paper provides a description of an innovative service for NOPs with an emphasis upon exploring the sociopolitical context and developing a psychological understanding of the needs of this marginalised client group. We conclude that as part of a public health approach to sexual violence, academic researchers, professionals and clinicians need to work collaboratively to address the unique needs of NOPs. If, as a society, we place paramount importance, and prioritise, safeguarding children, there needs to be acknowledgement and increased resources and appropriate services, including psychological intervention for non-offending partners. [ABSTRACT FROM AUTHOR]

Background The majority of deaths in the UK occur in acute hospitals, and older people have the highest hospital death rates. Improved palliative care for older people has been identified as an international priority, yet little is known about the profile of older patients with palliative care needs in hospitals. Objective To describe the profile of older hospital inpatients (≥85 years), and to explore the prevalence and nature of palliative care needs among this group. Methods A cross-sectional survey of palliative care need in older people was undertaken in two UK acute hospitals. Hospital case notes were examined for evidence of palliative care need according to Gold Standards Framework (GSF) prognostic indicator criteria. Patients (or consultees) completed assessments of palliative care need. Subjects Data were collected for 654 consenting patients/consultees. This paper describes data from 110 patients aged ≥85 years. Results Forty per cent of the older patients were identified as having palliative care needs according to GSF criteria. Frailty was the most common indicator of palliative care need (16.7%). The most common reason for admission to hospital was general frailty (25.5%). Conclusions While this study is limited by its small sample size, the results suggest that older people with frailty conditions constitute a substantial proportion of hospital inpatients with palliative care needs. However, it is unclear whether a specialist palliative care framework is the most appropriate model for this group. The care provided to older people at the end of life may best be provided by generalists such as geriatricians, as part of a comprehensive generalist-led palliative care framework. [ABSTRACT FROM AUTHOR]

This paper analyses data from a focus group conducted with a group of female pupils aged 13–14 to re-examine the assumption that pupils' negative assessments of sex and relationship education (SRE) should be understood only as a reflection of inadequate teaching. Focusing on the emotional aspects of their accounts, and the inconsistencies in their efforts to present a collective story of SRE, findings suggest that there are other ways in which such accounts can be read. Drawing on insights from psychoanalytic theory concerning the emotional aspects of learning and the teacher–pupil relationship, it is suggested that these accounts can also be understood as a result of transference. Using psychoanalytic understandings of the role of sexual learning in adolescence, findings reveal that pupils' relationships to SRE are complex and need to be understood as being tied up with internal struggles and anxieties about their own sexual development. This reading is presented as an additional perspective for teachers and is one that would benefit from further exploration. [ABSTRACT FROM PUBLISHER]

This paper develops a typology of people using social care services’ preferences for care workers and satisfaction with social care services from a large multimethod study that explored international recruitment to the English social care sector (home and health care, including residential homes). We developed this typology with two questions in mind: (a) what led to satisfaction of care and (b) what led to preference and satisfaction with workers? Data were collected from face-to-face interviews with 35 people who were using social care services and carers (2007–2009) and these data were used to develop the typology. Using the theoretical concept of homophily, we explored contentions that people might prefer to receive care and support from individuals resembling themselves. We observed that preferences for care workers and satisfaction with social care services may be linked, but highlighted that the concept of meeting a preference is personal to the individual. The implications of users’ preferences for certain care workers at a time where policy is promoting greater consumer-led care or self-directed support are discussed. [ABSTRACT FROM PUBLISHER]

The Munro review of child protection explains in depth the contemporary challenges in delivering statutory child protection services. It notes that complexity, uncertainty and emotional challenges inherent in social work are contemporary issues not resolved through new national guidance or more bureaucratic procedures. Rather, practice needs reforming at the local level. Tragedies in practice have tended to usher in more and more bureaucratic responses alongside an unabated blame culture for practitioners. There is no doubt that practice reforms are needed to address this; however these are neither straightforward nor easily achieved. Busy and overloaded offices of child welfare, managers and workers wedded to pre-existing frameworks, and an ever anxious political system and public can unwittingly act against the development and reforming of social work practice. While challenges exist that need overcoming, this paper describes one such initiative, the new practice framework for assessments, developed and implemented in the London Borough of Tower Hamlets, as part of the Munro review. [ABSTRACT FROM AUTHOR]

This paper addresses the question of benefits of education from a life course perspective. Using data from a study of 1600 students (response rate 48%) on an open access program at a London University college, it explores educational activity within the framework of a transitions model. In addition to the quantitative evidence, the article uses material from interviews to illustrate how different aspects of educational activity help individuals cope with transitions. This approach, while clearly not covering all possible education contexts, offers a way of adding to our understanding of the benefits of study in mid- and later-life. [ABSTRACT FROM PUBLISHER]

New medicines represent exciting possibilities to individual patients for improved futures through reduced morbidity, as well as the potential for disappointment where promised outcomes are not forthcoming. For healthcare systems these technologies can enable enhanced effectiveness as well as spiralling costs, depending on value-for-money offered. Amidst uncertainty over efficacy and pricing, institutions such as the National Institute for Health and Clinical Excellence have been set up to regulate the cost-effectiveness of new products. The increased transparency of this new regulation, combined with inescapable uncertainties, leads to the heightened politicisation of decision-making and an insidious subjectivity beneath a veneer of rational-bureaucracy. This paper develops a theoretical framework for understanding the influence of hope within such contexts. Conceptualised here as ideological, affective and prone to lapsing into trust, hope is considered to shape the lifeworld-background of regulatory decisions and mask uncertainty around effectiveness. These processes challenge regulator legitimacy and effectiveness within polycentric regimes, through the distortion of communication and the manipulation of blame. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of UK mental health practitioners' experiences of working with the contested condition, dangerous and severe personality disorder (DSPD). Our interviews focused on the issues of treatability, risk assessment and decision-making in multi-disciplinary teams. We discuss the approach of values-based medicine (VBM) as a useful framework for interpreting the data: respondents cited both explicit values (based on occupational training) and implicit values (based on personal beliefs and subjective perceptions). There was evidence of conflicting values -- within individuals, between occupational groups, and between individuals in occupational groups -- which led to widespread uncertainty and caution about whether and how those with 'dangerous' personality disorders could be treated. These disputes were resolved by a 'slide to pragmatism', whereby practitioners, reluctantly acknowledging their own empowerment in the process, sought to make whichever choice was least risky for their own professional reputation, and most pragmatic, given the resources available. [ABSTRACT FROM AUTHOR]

By often taking as its focus the experience of illness in itself, medical anthropology has sometimes neglected the meanings that patients may assign to the diagnostic procedures that they are expected to undergo. This paper puts into anthropological perspective the author's experiences working as an assistant psychologist in two British memory clinics for the detection and treatment of dementia, using comments by patients to illustrate the significance that one aspect of these procedures - cognitive testing - had for them. These comments suggest that the meanings that patients construct with regard to such testing are complex and cannot be understood if one persists in seeing it as a neutral diagnostic tool without broader implications. It is argued that a strong association made by many patients between the cognitive tests and their childhood school experiences informs their reactions for better or worse. It is important to acknowledge the implications of this active interpretation of medical procedures if the memory clinic experience is not to become an alienating and infantilising one. [ABSTRACT FROM AUTHOR]

Factors that contribute to sexual decision-making among young people are varied, and several determinants have been identified as contributing to the process. However, the influential role of music preference has been sidelined both in the literature and by sex and relationships educators. The research outlined in this paper explores the normative impact of music preference, and highlights the importance of influences drawn from teen culture. A preliminary study had indicated that representations of sex and relationships within lyrics were found to be genre specific. The main study comprised six single-sex focus group discussions on music and sex with young people aged between 14 and 19 years. Thematic analysis revealed that preferred genre and artists were found to be associated with all aspects of participants' lives and culture generally, with music functioning specifically as an educational tool for adult relationships. The findings from these studies indicate that the norms portrayed by young people's preferred genres reinforce (oftentimes inappropriate) beliefs about sex and adult relationships. [ABSTRACT FROM AUTHOR]