Lessons learned from an in-house social work placement: practicum students’ views about a stress reduction peer support pilot project

The BSW program at Trent University

Trent University’s Bachelor of Social Work (BSW) program is a four-year, 40-course, undergraduate program in a primarily undergraduate university near Toronto, Canada. Consistent with the standards as laid out by our accreditors, the Canadian Association of Social Work Education (CASWE, Citation2014), ‘the curriculum at the Baccalaureate level (BSW curriculum) provides students with knowledge and skills for generalist practice’ (p. 9). In this context, generalist practice refers to working across a range of micro, mezzo, and macro levels of social work practice with a range of populations.

In the first two years of the program, students take 20 courses across a broad range of liberal arts and social science courses with only four introductory courses in social work, one in each of four semesters. Once admitted to the third year, all the remaining 20 courses in third and fourth year are typically social work specific. Six of these 20 courses include the CASWE (Citation2014) required 700 hours of field placement. The 700 hours are divided into 240 hours in the second term of the third year of the program and 460 hours in their fourth year. At the time of this project, students met bi-weekly with their seminar instructor and classmates to debrief about their placement and discuss the integration of their placement experience with the social work theories they had learned in their courses.

Prior to their first social work placement, all students at Trent University must have successfully completed a social work communications course, a social work theory and practice course with a focus on structural social work practice, an introductory social work research methods course, an Indigenous social work course, and a course on social work and diversity. Overall, the program has a focus on anti-oppressive practice (AOP) and structural social work. In addition to various workshops which prepare students for their first field placement, students are required to have completed a two-day Applied Suicide Intervention Skills Training (ASIST) within the past two years, and a one-day Non-Violent Crisis Intervention (NVCI) training within the past three years.

According to our accreditors, the field component of accredited programs in Canada is expected to ‘connect the theoretical/conceptual contributions of the academic setting with the practice setting, enabling the student to acquire practice skills that reflect the learning objectives for students identified in the Standards’ (CASWE, Citation2014, p. 13). How this is accomplished varies depending on ‘the nature and objectives of [the] program and the influences of its university and local context’ (p. 13). There is an expectation that ‘field placements provide multiple opportunities for developing and refining a range of practice skills’. (p. 15) and ‘while simulations and labs may form an acceptable part of direct practice teaching, they are not substitutes for direct responsibilities in real practice situations’ (p. 14). Further, it is expected that students are supervised by someone with a social work background and when this is not possible, the social work department offers additional support for those students. Since the 2018–2019 year was only the fifth year of Trent University running its BSW program and the first year that a full complement of over 100 students required a placement, there were no specific standards within the program beyond these accreditor’s requirements.

The SRPS placement

The Winter 2019 semester was the first time that this program experienced a shortage of social work placements. As a result, the first author (director of the program at the time) and second author (experienced faculty member at another university) created the SRPS in-house placement and evaluation protocol over the December 2018 holidays so that 12 students who had not been placed would have a placement to go to 16 January 2019. While we developed the protocol, we were aware that we were not meeting the expectation of placing students in the community, although it is not unheard of to assign students to in-house university student support services. We were also aware that we were not meeting the expectation of providing students with a social work supervisor, but this was unavoidable due to the new-ness of the program and the short planning period. Our experience with placements in the past has been that third-year undergraduate students are typically placed in settings where they can shadow others and have support-type roles (e.g. group homes, shelters, schools, support services). It is rare or even unheard of for third-year undergraduate students to be provided with the opportunity to offer counseling to clients and work as independently as was expected in this case. It is also unheard of, and even questionable under normal circumstances, to spend so many hours on training rather than direct practice. Because of the unconventional aspects of this placement, attempts were made by the Trent University Social Work Field Education Coordinator to match students for this particular placement based on their maturity level, ability to work independently, and learning needs.

Twelve practicum students attended the SRPS placement Monday through Wednesday, for seven hours a day, for a minimum of 240 hours across 12 weeks in the Winter 2019 semester. The practicum began with a one-hour presentation by the director (first author) covering the details of how the SRPS program would be administered and the rationale for having participating students be trained in the Applied Metapsychology (AMP) modality. This presentation included how the entire project was developed to align with social work values and accreditation requirements as AMP is known for being person-centered, empowering, and adhering to principles of self-determination and respect (Applied Metapsychology International [AMI], Citation2022). AMP facilitators are trained to be present, listen with intention, and acknowledge what the client says without paraphrasing, reflecting feelings, offering interpretations, diagnosing, or giving advice. AMP includes the option to use several structured techniques that guide the client in exploring their concern in depth with a goal of reaching a resolution. Because much of the AMP protocol is very structured, it is quick and easy to learn and has no academic pre-requisite, making it suitable for students in their first placement of a social work program. The structured framework for providing sessions also reduces the risk of boundary issues, transference/countertransference, and the social work student slipping into using other therapeutic methods for which there was no available supervision. An additional reason for choosing this modality was that an AMP certified trainer was available on short notice and agreed to take on the role as trainer for three weeks and as supervisor for the remaining nine weeks of the placement.

The director’s presentation was followed by two four-day standardized training workshops delivered in-person by the AMI Certified Traumatic Incident Reduction (TIR) and Life Stress Reduction (LSR) trainer who was also the placement supervisor (not a social worker and only supervising online from off-site). The TIR techniques are more exposure-oriented and lengthier than the LSR techniques, focus on resolving traumas, and typically require preparation sessions before engaging the client in the in-depth techniques. The LSR techniques are lighter, shorter, focus on reducing stress, and can be used at any point in the counseling process. Because the TIR workshop is typically taught before the LSR workshop, and we could offer students this opportunity to attend both trainings at no cost to them, and students could add both workshop completions to their resume, students in this placement participated in both sets of training. However, practicum students were asked not to use two exposure techniques they learned in the TIR training because typically those techniques cannot be completed within the short timeframe of one semester and because they are intended to resolve trauma that is more in-depth than the mild to moderate stress that the SRPS program was intended to address.

Both standardized AMI-approved workshops included: presentations about the theory and practice behind the modality and techniques; practicing sequential drills to learn communication micro-skills in the context of life stress reduction; facilitating real practice sessions with each other so that all students experience both facilitating and being a client; observation, feedback, and consultations with the trainer; a comprehensive quiz at the end of the workshop; and an information session about future training options with AMI.

The intent of the placement was for each practicum student to have the opportunity to meet with two to four Trent University students as clients for a maximum of six individual stress reduction sessions throughout the semester. Each practicum student shared an office with one other practicum student and was responsible for scheduling their weekly sessions with clients and coordinating private use of the office with their office mate. When not meeting with clients, practicum students could use the office or another shared space for supervision, reviewing video recordings of themselves in session with clients (with earphones and no video view of the clients), taking self-reflexive notes, documenting client progress notes, practicing life stress reduction techniques with each other (on light topics), and developing and implementing mezzo-level projects to be carried out across the university campus. Examples of mezzo-level projects included: a display table in a university common area for recruiting clients; a wellness event to reduce stress through raised awareness about mental health and self-care; the completion of a chart comparing the AMI Code of Ethics to the Canadian Association of Social Workers (Citation2005) Code of Ethics; an exploration of grants to support similar projects in the future; the creation of a student wellness package to be distributed around campus; and a review of ‘what is social work?’ including definitions of AOP and social justice. Although there were many challenges with this placement (as described in the findings section), all participating practicum students completed the required 240 hours of placement time and exhibited significant learning with regards to generalist social work practice.

Clients of the SRPS program

The eligibility criteria for Trent University students to receive SRPS services included: being an undergraduate student and experiencing a mild to moderate level of stress, including but not limited to concerns about meeting academic expectations, uncertainty about career path, and relationship concerns. Exclusion criteria included: 2^nd, 3^rd, and 4^th year social work students so as to avoid dual relationships; students with suicide ideation or thoughts of self-harm in the past two years; and current unmanaged mental illness, a psychotic disorder, or recent substance use concerns. Clients were screened by the Trent University Social Work Field Education Coordinator (FEC). Trent students were informed about the SRPS service through flyers posted in high-traffic areas, the Trent University Wellness Center, class presentations given by the director and some of the practicum students, various social media outlets, and a display table staffed by practicum students in campus common areas.

Only ten clients enrolled to receive services through the SRPS program over the nine weeks when practicum students were available to meet with clients: three practicum students saw two clients, four practicum students saw one client, and five practicum students did not have any clients. In total, 42 sessions were provided to clients: six sessions were provided to four clients, five sessions to two clients, four sessions to one client, two sessions to one client, and one session to two clients. Session length ranged from 30 to 100 minutes, with an average of 60 minutes.

Research design overview

Because we were interested in understanding students’ experiences from their perspective, we approached the methodology from an interpretive lens. At the end of the placement, all 12 social work practicum students were invited to participate in a 1.5-hour in-depth video-conferenced interview with the second author (independent of Trent University). A semi-structured interview guide was used to ask students about their learning experience in this placement, their perceptions of the SRPS program, and their recommendations for future life stress reduction programming for Trent University students. Questions included topics such as students’ expectations prior to and throughout the placement, the level of ease/difficulty in learning the AMP modality, the supervision received, the transferability of the skills learned, how the experience contributed to building their social work identity, how they believed clients experienced the modality, and how the modality was aligned or not aligned with social work values and principles. Prompts and requests for examples were used to obtain clarifications and depth in their responses. All interviews were recorded and transcribed verbatim. The research component of the study was approved by two Research Ethics Boards: Trent University (first author) and the University of Windsor (second author). Given that the first author was the director of the social work program at the time, ensuring the anonymity of the practicum students who participated in an interview was a top priority. As such, the second author de-identified all transcripts prior to them being shared with the director. We ensured that there was no way the director would know which students did or did not participate, and no way for the director to know who said what during the interview.

Interview participants

Eight of the 12 practicum students participated in an interview. Participants were all female between the ages of 20 and 29 years (M = 23.6). All identified as White, Caucasian, or European. Five of the eight reported having a previous degree or diploma related to social work and four reported receiving training in some other counseling methods or related supportive modalities. None of the participants had heard of AMP in any class or elsewhere prior to this placement.

Data analysis

Microsoft Word was used for open, axial, and selective coding (as described by Strauss & Corbin, Citation1988). For open coding, both authors reviewed each transcript line-by-line and identified each meaning unit related to the research questions while being open to any possible idea or meaning. For each meaning unit, a code was assigned with wording as close as possible to the participant’s words. Given the high degree of consensus between the two authors, only the first author completed the axial and selective coding with the second author reviewing and providing input and direction through a peer debriefing process. Axial coding included a process of combining all the headings and supporting quotes from each individual transcript into one document. Because of the voluminous amount of data (185 pages in total; 6,900 lines), the following five separate documents were created: experiences of the placement, reflections about supervision, views about the AMP modality, learning the modality, and experiences with clients. An iterative process was used to group and re-group, name and rename headings, turning the groupings into themes supported by quotations and capturing all the ideas expressed. Once this process was completed, a selective process was used to create a narrative that flowed in a way that conveyed the entirety of the data. Saturation was reached because by the end of the eighth interview, no new themes were emerging. To add to the trustworthiness of the analysis, both authors met repeatedly to discuss and deliberate the meaning of the findings and how to best present the results in a way that ensured the voices of all participants were accurately captured.

The overall idea of the SRPS project was supported but poorly executed

The idea of in-house student placements that focus on student mental health was supported, but the fact that this particular placement was planned on such short notice was viewed as problematic. In the in-depth interviews, practicum students expressed sentiments such as, ‘The idea behind the pilot project and behind reducing stress for students is fantastic. I think that the way this pilot project was put together very quickly and executed was poor’. Regarding the recruitment for clients only beginning in January when classes started for all Trent University students, a practicum student indicated, ‘You need way more time to have students sign up and really go in person and explain it. We had tables setup to explain [the SRPS service] to students after the fact, which isn’t beneficial at all’.

In support of the peer-to-peer concept, one practicum student indicated, ‘The idea of social work students providing support, peer support [that is] accountable, based on knowledge, based on an education level, all of those things—I think is a really solid idea’. Another practicum student elaborated,

Expectations were not met

Despite the project being a good idea, practicum students expressed that their expectations were not met: ‘My perception of placement was definitely off from what this placement was, and I have had other practicums through past schooling, so I had an expectation that it would look kind of similar’. Some indicated an expectation that this third-year placement would be the same as what they were hearing from Trent University fourth-year social work students placed at community agencies and they expected an on-site supervisor:

Practicum students expressed expecting to have more clients:

Practicum students expected to consolidate theory learned in the program with practice and for some participants that meant community, big picture issues, power, and oppression rather than micro-level practice:

Some others did not even consider micro-level practice to be part of social work:

For those who did consider social work to include micro-level practice, some of them expected to be able to talk back-and-forth with clients and give advice:

The title ‘peer support’ might have given students the false impression that the expectation was for them to converse with clients, rather than using a counseling format.

Students did not expect to practice their micro-level skills with each other even when the topics were expected to be light and this practice is common in AMP training workshops. As one student indicated:

This placement should be offered again, but only if certain changes are made

Practicum students who had a client found the experience rewarding: ‘I’ve never worked one-on-one with someone before. I learned so many different skills with it’. Also, some found the mezzo-macro projects to be useful. When asked about whether they would recommend we offer the placement again, some practicum students indicated ‘Absolutely not’, and others indicated that they would recommend it but only under certain conditions:

Several sub-themes emerged about necessary changes if the placement were to be offered again.

Ensure students in unconventional placements are supported and not ostracized in the integration seminars

One practicum student expressed feeling ostracized during the integration seminar because of where they were placed:

The negativity of some practicum students impacted other students

Participants shared that several students were negative about the placement for the reasons indicated above:

This negativity affected student behavior: ‘There were students who weren’t treating our supervisor respectfully’. And another student indicated, ‘I think we genuinely were acting like babies. Sure … . I can say that as a whole I don’t think we represented [sic] in the best way’. This negative behavior impacted students who were interested in learning the AMP modality:

The negativity prevented some students from taking initiative:

As a result of this negativity, when asked for their recommendations for improving the placement, some practicum students indicated,

One participant suggested that the university should continue to provide students with the opportunity to participate in a confidential research interview as a mechanism for receiving student feedback: