A training programme in the DSM system for social workers

Abstract

The lack of a scope of practice for social workers in South Africa, and with that their right to do mental health diagnoses or even work with mental health clients, has led to conflict. There is not yet a clear agreement between the role players within South Africa, such as the South African Council for Social Service Professions (SACSSP) and South African Association of Social Workers in Private Practice (SAASWIPP). From the initial investigation, it became clear however that social workers in South Africa are often using the DSM system without training. One of the main concepts, namely ‘clinical social work’, is well defined in international literature. However, very little literature could be found within the South African context pertaining to who is qualified to be a clinical social worker or a social worker with the right to diagnose. This has caused some conflict on a practical level among social workers and ‘clinical’ social workers when operating in the field of mental health since the perception exists that some social workers overstep their boundaries or scope of practice. The research problem was formulated, based on social workers admitting that they are using the DSM system, regardless of their training or lack of training in the DSM system. Social workers do not receive sufficient training in mental health diagnostic systems in undergraduate training. The purpose of this study was to develop, implement and pilot test a programme to train social workers in the utilization of an accredited diagnostic system, namely the DSM system, when dealing with individuals who present with a specific disorder. The hypothesis that directed this research indicated that social workers, who receive formal training in the utilization of the DSM system, would be equipped with knowledge and insight with regard to the mental health of their clients. This could enhance the profession, since social workers would be able to participate in the multi-professional team with insight with regard to mental health terminology and pathology. A combined quantitative/qualitative research approach was followed, more specifically applied intervention research since the aim of the study was to contribute towards addressing a practical issue. The research objectives were to complete a literature study regarding social workers’ assessment in the context of the DSM system; to explore social workers’ knowledge, attitude, and utilization of the DSM system; to develop a training programme and train social workers in the utilization of the DSM; to implement the developed training programme for social workers in the utilization of the DSM; to pilot test the effectiveness and content of the training programme; and to draw conclusions and make recommendations with regard to the benefit for the social work profession as well as to multi-professional teamwork, should social workers receive training programme in the DSM system. The researcher collected data while the respondents attended a two-day training programme in the DSM system. Respondents completed a pre-test questionnaire as well as a post-test questionnaire on completion of the training programme. This data analysis was based on a quasi-experimental design, namely the ‘one-group pre-test-post-test design’. Conclusions and recommendations were made relating to social work training, social work in mental health and the DSM utilization in social work practice. The limitations of this study were the lack of literature, the need for training over a longer period, and especially the uncertainties regarding a nationally accepted scope of practice for social workers. The need for in-depth evaluation and advanced development of the programme is identified as both a limitation and a recommendation for future research.