This paper critically reflects on a social work student placement experience at an Improving Access to Psychological Therapies (IAPT) service. It utilises ethical concepts to analyse the goals and working methods of the medical-dominated service alongside the professional and personal values taken to the role. Discussion focuses on the organisation's assessment process and use of Cognitive Behaviour Therapy (CBT), concluding that the utilitarian and managerialist principles embodied in their procedure conflict with anti-oppressive social work ethics. Particular attention is given to (...) the role and power of a student including personal reflection on the social work methods used and how practice would be changed in the future. (shrink)

Although a ?realist? stance is sometimes contrasted with a ?principled? one, this article argues that realism is, of itself, an important ethical principle. Acknowledging the problems that exist in defining ?reality?, and the fact that the nature of reality is contested, the article nevertheless insists on an ?out there? reality. It asserts that the existence of this external reality is, in practice, generally accepted, and indeed must be accepted if we are to make the important distinction between truth and falsehood. (...) The article proposes that discourse which is not grounded in the concrete reality of the specific situations in which social work is practised is potentially harmful because it results in a decoupling of language from what it is supposed to represent and creates a potential for language to be used to deceive. The article then discusses ?Realism about Outcomes? and ?Realism about Context? as two out of a number of different areas in which realism is important in practice and policy making. It concludes that genuinely ethical social work practice and policy making require that we attempt to engage with the world as it actually is. (shrink)

Increasingly, mental health social workers in the United Kingdom and elsewhere in the world are employing coercive interventions with clients. This paper explores this trend in the context of community-based settings, using national and international research literature on this subject. It begins with a discussion about the complex, contested nature of ideas on coercion. The authors then explore debates about how coercion is perceived and applied in practice. They choose two forms of coercion?informal types of leverage, and the legally mandated (...) use of Community Treatment Orders?to highlight the range of ethical problems and dilemmas that confront practitioners in this field. The authors conclude by developing a tentative, explanatory model to explain how and why mental health social workers should consider a more holistic, situated approach to help deal with ethical concerns about the use of coercion. (shrink)

This paper studies the construction of ethics in interactions between professionals in meetings, in relation to the rationing of resources. The research context is a supported housing unit targeted at clients with mental health and substance abuse problems. The service is provided for a municipality, which expects good progress of the clients. The research question is: how do the professionals produce implicit ethical justifications for setting limits to helping, even though the need for professional help is not called into question? (...) Five types of justification appear in the data covering 28 meetings. However, these types of justification do not solve the central ethical difficulty arising in the conversations. Limiting help would easily push people out of reach of all help. Thus, in spite of the talk about ethical justification, workers do not ultimately resort to limiting help in situations with no real alternatives for getting help. The ethical principle of following non-exclusionary practices is highly prioritized. (shrink)