Social Work Education: Interdisciplinary teams a growing area of training

smiling man at an informal meeting

During a field placement at a hospital, a social work student became concerned after a mother with a young girl gave birth to a premature baby and had to remain in the hospital. The hospital would not let the girl on the floor, and the mother had no one to care for her.

Keri Neblett, clinical assistant professor and field education director at the University of Iowa School of Social Work in Iowa City, said the student became concerned when different ideas were discussed and someone said the girl should be put in foster care.

“She said the child should not be separated from her mother,” Neblett said. “In the end, the child was allowed on the floor after it was arranged for a volunteer to engage with her. (The student) felt comfortable enough to speak up, and it worked out well.”

After graduating from college and starting first jobs, students in many professions undergo a learning curve.

Social work students need knowledge of other professions, what those roles are and the language and terminology they use — as well as knowing how they fit in as social workers.

From lessons infused in coursework to special programs and field experiences, social work schools are using varied and creative ways to ensure students are ready to begin their careers.

For most in today’s practice world, that means being prepared to work on interdisciplinary teams — and different schools use different methods for this training.

The following schools are among the leaders in interdisciplinary education, most of which focuses on social work in health care settings.

Arizona State University

Robin P. Bonifas

Robin P. Bonifas

Robin P. Bonifas is associate professor, associate director for curriculum and instruction, honors faculty member and the John A. Hartford Faculty Scholar in Geriatric Social Work at the School of Social Work at Arizona State University’s College of Public Service and Community Solutions in Phoenix.

Interdisciplinary training was basic at first, involving the schools of medicine, pharmacy and social work, she said. “We would bring students together to work on a complex case study and introduce an ethical dilemma they had to work on together.”

Then the College of Nursing received funding — two grants over a six-year period — and they used it to strengthen their interprofessional curriculum so nursing and nutrition students were added to the interdisciplinary mix, Bonifas said.

The focus was on clinical training sites so students could learn together in the field with coaches from every field involved.

“We’ve developed online learning modules, and a lot of community events and workshops provide an additional opportunity for them to learn together,” Bonifas said.

On the social work school’s curriculum side, “We’ve been doing more and more each year and planning more events,” she said.

Starting in the fall of 2010, students began a new requirement of choosing one event to participate in throughout the semester and writing about their experience after completing it.

Grad students were put into a practice in a behavioral health setting in the fall, and in the spring, advanced practice in health was a specialized medical care practice, and the Objective Structured Clinical Exam was built into the course, Bonifas said.

“In the practice program, MSW and nursing students work with an actor trained to play the role of a person with complex medical needs and complex psychosocial needs,” she said. “Nursing students first do a needs assessment, then social workers do a needs assessment, then they compare notes and move forward to develop a collaborative intervention plan.”

Each session is filmed and students get feedback. “It approximates practice as closely as it can,” Bonifas said. “It’s a simulation that allows the psychosocial process in social work and interprofessional collaboration.”

The school tries new things every year, she said, and this year a new simulation will bring in a communications student who will play a Muslim client.

The idea is due to a new faculty member and Ph.D. coordinator, David R. Hodge, who specializes in spirituality, religion and culture.

“We don’t do enough work on spiritual assessment, so it will be nice to bring that into his course: Spirituality and the Helping Professions,” Bonifas said.

Interdisciplinary training is primarily in student internships in health or mental health settings, where students work with nurses, doctors, psychologists and occupational and physical therapists, she said. MSW students complete 960 hours of internship over two years, and BSW students must complete 480 hours.

Other disciplines they work with depend on their placements, mainly in health care, schools and criminology or legal settings where they interact with lawyers, police officers and parole officers, Bonifas said.

Field experience students say challenges include having someone on the team who tries to take over, or they get into a situation with a medical student or advance practice nursing student and they’re afraid to speak up, she said.

“That’s part of the learning,” Bonifas said. “They can have that in their practice, too.”

After ASU leased a space for an interprofessional social service health care clinic in a downtown apartment building named Westward Ho, some students have had the opportunity for interdisciplinary learning with its older residents.

“About 300 people live there, and there is a lot of chronic illness,” Bonifas said.

Tenants can receive health and social services from students in social work, nursing, nutrition and recreational therapy. Social work students provide individual counseling, group counseling, referrals and case management, she said.

Two doctoral students are field instructors, and the number of field placements has grown from five in 2015 to eight this year.

University of Texas

Catherine (Cossy) Hough

Catherine (Cossy) Hough

Catherine (Cossy) Hough, a clinical assistant professor at the Steve Hicks School of Social Work in Austin, teaches BSW and MSSW students.

She teaches practice I and II, field seminar to MSSW students and integrative seminar classes. She also is faculty liaison to BSW and second-year MSSW students in agency field placements.

She thinks the biggest challenge for students placed on interdisciplinary teams is their confidence level.   

“Students are not sure they’re ready to speak up,” Hough said. “They need to be encouraged to just jump in. We tell them ‘You’re more prepared than you think you are. It’s just about practice.’ Once they’ve been doing the work for a while, they say ‘Yeah, I’m more prepared than I thought I was.’”

She said the school has always taught students about interdisciplinary teams and practices as part of social work training, but has pushed farther in that direction over the last several years.

This is partly because of the advances in medical social work and a new medical school at U.T., Hough said. “Our students work with lots of different professions. We want them to have that experience in school.”

They offer some programs with the law school where many students, especially at the BSW level, work in legal clinics in an experience Hough calls “eye opening.”

The other disciplines are primarily nursing students — and pharmacy students, with whom they have the opportunity to work a twice-a-year simulation. And there is a class taught with medical and nursing students, who are “pretty much everywhere in the medical field and social work field together,” Hough said.

“If they haven’t done interdisciplinary work before, they’re nervous, but it’s an amazing experience for students, who can take the values and basics they’ve learned and apply them with the students around them,” Hough said. “There always is a professor-clinician there to provide feedback. Our BSW students say the simulations are one of the most powerful tools we have, and they always say ‘can we do more?’”

Interdisciplinary work is involved throughout coursework, Hough said.

“At the very beginning, we talk about what social work is about — its values and ethics — and they’re different in other professions,” she said. “We also talk about roles that first year, and you can define your role by talking to other people around you whether it’s a legal situation, a medical situation or therapy. We talk about what social work is, what it means for the client and social determination.”

Then they move into how practice works and how to advocate for the client within interdisciplinary teams.

“Professional use of self is a huge thing,” Hough said. “It’s the way you conduct yourself, the way you communicate your point of view, the way you come across with anybody, the way you encounter others as a social worker.”

The reason it’s so important in training is so they not only know their roles but how to work with others to advance the position and wishes of the client, she said.

“You understand where the client comes from and convey that,” Hough said. “You drive home the how and why.”

One simulation students do is with a client who has substance abuse problems and is homeless.
“It was interesting to see a nursing student turn to the social work student and say, ‘What do we do?’” Hough said. “If anything is complicated with the person, they’re going to turn it over to the social worker.”

Hough tells students to make sure they say they have worked on interdisciplinary teams and to transfer their knowledge about interdisciplinary teams and the roles of others.

“I think the biggest piece of learning is, you’re not going to be working with all social workers,” Hough said.

University of Iowa

Keri Neblett

Keri Neblett

Keri Neblett administers the BSW and MSW field experience programs, advises and mentors students, and provides direction and support to field administrators at the school’s distance learning centers.

A lot is covered in the school’s curriculum, including organizational and community practice and how the dynamics of power works in different organizations and disciplines, she said.

“As social workers, it’s our duty to shift through that power to help our clients — who don’t have power,” Neblett said.

They talk about different disciplines and where they’re coming from, she said. “For example, a police officer’s No. 1 concern is safety. You need to frame your requests so they’re stated in the way a police officer is going to see as a priority.”

One aspect of the program she thinks is unique is the university’s affiliation with the National Coalition Building Institute, and all students are required to go through a NCBI course.

It covers how to listen when someone else is saying their point, then how to convey your point and calmly state it.

The daylong class during orientation builds an atmosphere where students can work better together in the course, Neblett said. And information on working in interdisciplinary teams is touched on or integrated into most university classes.

“It’s something we talk about throughout entire courses,” Neblett said.

One class that had been mandated in the past is Interprofessional Education. In it, social work, medical and pharmacy students work on projects together in teams.

“It was made optional last year, but it’s highly encouraged, and they all see the benefits of it,” Neblett said.

Because students receive a wide range of placements and practicum settings, they don’t provide courses that pertain to each group, she said. Instead, they have an individual-skills lab with high-intensity role plays for many different situations or sites.

“They practice working together,” Neblett said. “For the final project, it’s recorded and they’re required to give reflection on how they did.”

A common challenge students say they face, especially in hospital social work, is finding themselves in situations where the doctor may not be listening to the social worker, she said.

“Some see that with supervisors,” Neblett said. “They really see how power dynamics work. In field seminars, they see how different people see things a different way that might not be the same. In training, they learn how to navigate that situation.”

As a master trainer of applied suicide intervention skills training, Neblett — in her field instructor role — took a practicum student with her to a community meeting about reducing the means of suicide.
“I purposely invited a variety of people,” Neblett said. “There were multiple voices.”

They included law enforcement, veterans, people who had lost loved ones to suicide, an NRA member, a firearms trainer, and people who owned gun shops. She asked people to go around the group and say who they were and why they were there.

“One retailer said, ‘I think that’s a no-brainer. Nobody wants anybody to use a gun for suicide, and I don’t want it to be a gun from my shop,’” Neblett said. “We found the common thread. Opinions differ, but all agreed no kids should die from guns. On what can we do to reduce death by suicide, we really came about in a way that shows how we work best together to prevent this from happening.”

Having social workers on interdisciplinary teams is instrumental to advancing the field, Neblett said.

“People may view social workers in one way if they do not know what we do,” she said. “People sometimes think social workers are the ones who take children away from their families. Once a person gets to know and interact with a social worker, they see the extreme value we add to a situation.”

St. Catherine-St. Thomas

Tanya (T.J.) Rand

Tanya (T.J.) Rand

Tanya (T.J.) Rand is a clinical faculty member and coordinator of aging services at the University of St. Thomas in St. Paul, Minn. She is weekend cohort field coordinator at the St. Catherine University-University of St. Thomas School of Social Work, a shared school, and MSW clinical field education liaison. She also does field supervision and seminar facilitation.

In her area — work with the aging — “we’ve been working with interdisciplinary teams as long as I can remember,” she said.

In the school’s academics, the concept of interprofessional education is “infused all over in an organic way” in multiple professions, Rand said. “It’s ingrained in about everything we do.”

In social work, “it’s infused across the curriculum,” she said. “We all come together with projects using teams of students, and there are educational opportunities social workers participate in. It’s been part of work with our students and with our Aging Scholars that we want to focus on.”

Between 120 and 150 students connect with the interdisciplinary model in an interactive workshop with students in their first year of MSW training and student scholars in the HEALS Program (see page 1 for more on HEALS) and the Area of Emphasis in Aging Scholars Program.

Students who join are from a variety of other disciplines, which can include diatetics/nutrition, respiratory care, physician assistants, public health, nursing, and physical and occupational therapy, she said.

“They’re given a case and all work through it,” Rand said. “One we have is an elder from the Hmong community, and they learn about culture and different ethical processes. There’s a growing demand for having more of those.”

One requirement for field practicum is a team-building workshop that focuses on healthy aging, where students work on a care plan together, she said.

“They learn to recognize the unique contribution of each profession on the team, especially in the field,” Rand said. “It’s central to what we’re teaching: You can’t operate without it. Best practice is that. If we’re not doing that, we’re not providing the best training we can.”

Varied students, usually Aging Scholars, HEALS Scholars, and social work students take the semester-long Elder Teacher course with students from other disciplines.

“It’s a unique model,” Rand said. “Students from four to five different disciplines come together in small teams, and each gets an ‘elder teacher’ — a person living in the community. They hold class where that person is. They look at healthy aging goals and do presentations at the end.”

The course is two hours a week for 15 weeks. There is no credit, but they don’t pay to take it, she said. “It’s a wonderful segue to what they’re going to do.”

Students write about their experience, and Rand shared part of what one of her students wrote:

“My IPE experience actually became one of my favorite parts of the week. I got to meet and collaborate with a group of students from different health programs at St. Kate’s, as well as residents and staff at Carondelet Village. The biggest takeaways I got from this experience were learning about the different skills that other health professions bring when working with older adults, the benefits of team debriefings, and our elder teachers taught me more about the older adult’s perspective of health care. A typical day was meeting with your group, then meeting/working with your elder teacher towards something they wanted to accomplish, something they needed.”

Rand said when she was a field instructor in a hospital, she “purposely would talk to and shadow other disciplines. Only when we understand what they do are the patient outcomes so much better.”

She has heard that in rural areas in some states — including Minnesota — there are not enough social workers to be on interdisciplinary teams.

“There are not enough advance-trained social workers in all areas of Minnesota,” Rand said. “In out-state Minnesota, I worked with a health system that actually said it was very hard to employ social workers there. Here in the metro area, there are jobs for social workers in health care settings, especially hospitals. That’s what social workers want. It’s better pay, more support and a greater work-life balance.”

She also believes there is a need for more social workers who focus on the aging population.

“We know interdisciplinary teams are put together to help all ages across the life span,” Rand said. “They’re even more critical with the aging population. They usually are going to need a full-team approach more than most age groups.”

Overall, Rand said, training social work students to work on interdisciplinary teams is important work for the profession.

“Based on my years of experience as a health care practitioner, I can’t see any place or any setting where a social worker would not be needed on a team.”