Interprofessional Collaboration in Social Work

Interprofessional collaboration involves professionals from different specialities working together to provide care for service user, their families and work with them to meet service user centred goals. (Craven & Bland, 2013; Ambrose-Miller & Ashcroft, 2016. P.101). The aim of interprofessional collaboration is to help improve service user positive outcomes. Leathard (2003) defined interprofessional working as “a team of individuals, with different training backgrounds, who share common objectives but make a different but complimentary contribution”. (Littlechild and Smith, 2012, p.53).

The role of a social worker is to help improve the lives of individual’s, through helping them with social crisis or difficulties they may have, promote their human rights and wellbeing. Social workers protect both adults and children with the support from other professionals.

When interprofessional collaborating with interpreters, whilst working with service users, the social workers must ensure that they are avoiding the use of jargon when delivering messages and must keep conversations in small chunks to ensure the interpreter can interpret the message accurately. The social worker must also have an understanding that some words in English may not have a direct translation into the other language and the interpreter may have to find other words to communicate effectively. Furthermore, social workers must ensure that all body language including eye contact (if culturally appropriate to the service user) should be directly with the service user rather than the interpreter. (Berthold and Fischman. 2014. P.3).

Whilst on placement, I was working with the Learning Disabilities team which requires social workers to work with adults over the age of 18, with a learning disability. My role whilst on placement included completing community care assessments and providing support plans. The case I will be discussing involves one occasion where I had to use an interpreter on whilst completing a community care assessment with a service user, who will be referred to as ‘S’.

S is a 68-year-old female whose originated from India. She is diagnosed with a mild learning disability. S can only speak in Gujarati and requires an interpreter who speaks Gujarati to translate when speaking to professionals whom can’t communicate with her. S lives with her mother ‘R’ who is S main carer. S daughter ‘H’ referred her mother to Adult Social Care with concerns regarding her mother becoming socially isolated and has developed depression due to lack of access to the community. H requested Adult Social Care to provide day services for her mother 3 days per week.

My role as a student social worker, whilst working with S and her family required me conducting a community care assessment to assess S needs and creating a support plan to allow her to access the community. In addition, my role was to support individuals with learning disabilities and their families through a crisis and ensure safeguarding from any harm. The main aim is to improve the individuals lives by maintaining professional relationships and act as their guides and advocate. (British Association of Social Workers, BASW).

The Department of Health published a guideline for Social Workers working in adult services “Knowledge and Skills Statement for Social Workers in Adult Services”. (2015). Social Workers have a duty to communicate effectively with those with communication needs, including learning disabilities and language barriers. They must enable person-centred practice when supporting their service users to make their own decisions. The guideline stated that Social Workers should work together with other professionals, local communities and agencies, for instances interpreters to help support the service user. (Department of Health, 2015).

The Care Act (2014), states that the local authority have a duty to prevent and reduce any form of risk of abuse or neglect to vulnerable adults who have care and support needs. In order to protect the individual, it is vital that all professionals have an understanding of their roles and responsibilities. In addition, partnership from the six key principles which underpins all work when safeguarding adults, highlights that communities and other professionals have a role in preventing or detecting neglect and abuse. Section 6 of the Care Act 2014 (Statutory guidance) highlights that local authorities must co-work with other relevant professionals using each of their roles to protect and support vulnerable adults for the best possible outcome. (Department of Health, 2018).

Section 15.30 of the care and support statutory guidance explains that for joint working of professionals to work effectively, it is important that all professionals involved are clear about each responsibility towards the service user and how they can work together.

To ensure that the service user views was clearly stated, I used the person-centred approach to underpin my work with S by providing an interpreter. The role of an interpreter is to interpret accurately in both languages, i.e. in this context, English and Gujarati translation. I tried my best to ensure the same interpreter was present during all visits I had with S, to allow her to communicate freely “hence it is important to recognise the challenges that face people when attempting to express their thoughts and feelings in a language other than their first language” (Sue, 2006; Lucas, 2014. p.30). In addition, I only used a professional interpreter to avoid any conflict of interest if I had used a family member to interpret. Larkin (2019) found that when using the same interpreter, it promotes consistency for future meetings, allowing the service user to feel free to open up on every visit.  (Larkin, 2019. p.258).

With the collaboration of the interpreter during my visit with the family, I was able to successfully receive information to complete the assessments I had undertaken to access S needs. The interpreter ensured that S felt comfortable and happy to freely express her views, including explaining how she wanted to attend a Guajarati speaking day service to meet her cultural needs, as well as her social needs. With the involvement of the interpreter, I managed to find and enrol her into an appropriate day service which she currently attends 3 days per week.

Roat et al (1997) recommended that interpreters should ensure that they integrate an interpretation style in first-person to encourage a relationship between the client and social worker to minimise the ‘presence’ of the interpreter themselves. (Lucas, 2014, p.29). The use of an interpreter is vital for communicating successfully and provide an open access for service users, who may not share a common language with professionals such as social workers. By providing service users such as S, the use of an interpreter, S will be able to express her views without feeling distressed. As having to explain herself in English would have been difficult for her. The support from an interpreter is vital, to allow an effective conversation flow.

Gill et al stated that “nearly 400,000 adults from the four main minority ethnic communities, who have a need for interpreting”. (Gill et al, 2011). It is important to use professional interpreters and not informal interpreters such as family members or friends, as this can often cause problems when the service user is faced with personal issues. In addition, having ensured that the interpreter met S cultural needs, I had ensured the use of an interpreter who had the same gender and who shared the same ethnic origin as S as it could be an important factor to allow good interpretation. It is vital to consider the clients cultural norms as certain religions and culture may prohibit female clients from using an interpreter who is male. (Sawrikar, 2015; Thom, 2008. p.2). Furthermore, the interpreter should have a professional attitude including showing respect for all parties involved, the service user and their family and the social worker. Respect can be shown through the following “being polite, introducing themselves, keeping the code of confidentiality and showing empathy” (diva link reference p.31) towards the service user and social worker.

NRPSI (National Register of Public Service Interpreters) Code of Professional Conduct which came into effect 22^nd January 2016. The code of contact sets out the following:

-          Those who are working as an interpreter must only accept work that they believe they have the capability to interpret effectively.

-          Interpreters should “disclose any potential conflict of interest or other factors” which can be deemed to be inappropriate for them to work with that particular service user or case.

-          Interpreters must not disclose any information to third parties, unless advised by management to do so. Such disclosure including private details of the client can be unlawful.

-          Interpreters must not give any advice or express their opinions in conversations. Although, can provide additional explanations when requested by either service user or social worker.

(NRPSI, 2016).

The code of professional conduct ensures that any information the service user discloses is kept confidential and the interpreter must not express or indicate any personal views to contradict the conversation.

In terms of communicating with the interpreter directly, I had discussed with the interpreter prior to the meeting outside the house and explained the case. Freed 1988, expressed that debriefing before the session can be useful for interpreters, as it allows “clarifications, deeper understanding, descriptions of cultural dictates and explanations of specific behaviour’. (Larkin, 2019; p.259). I used the person-centred approach whilst underpinning my work with S by using an interpreter to overcome the language barrier. It had allowed S to understand the interpreter role and my own, allowing her to express freely. The person-centred approach recognises the importance of partnership when working with other professionals for the service user needs to be met overall with the assistance of the service user themselves. (British Association of Social Workers, 2014-The Person-Centred Care made simple). Furthermore, I ensured that the interpreter had enough time during the session, as I was aware that a session that would involve interpretation, can take longer than compared to other sessions that don’t require any interpretation.

The empowerment theory recognises the importance in promoting the service users to make decisions regarding their own life. Working alongside with an interpreter allowed us to promote S independency by her expressing herself through the interpreter regarding which day service she wanted to attend. Once she had decided on what she wanted, I successfully enrolled her with the chosen service. This action was also underpinned via the Task-Centred Practice model, which I used to create short-term goals with S and her family to find an appropriate day service to meet her social and cultural needs. (Maclean and Harrison, 2015).

As a student social worker, I had to trust that the interpreter was not summarising all communication with any personal values to influence the conversation. To limit any confusion, I ensured I asked short simple questions for instance, asking if S felt she was confident in providing her own meals without support etc. Giving the interpreter short simple conversations to translate, allowed me to receive a thorough explanation and that the information would not be lost through translation. Although I did not understand the translation between the interpreter and the service user, I had monitored both individuals body language and length of conversation, asking the interpreter if she could translate what S was trying to portray across. Lucas (2014) suggested that in some cases, social worker’s may not understand the conversation between the service user and the interpreter, however, they would still attempt to monitor the interaction through the interpreter’s body language and the length of spoken dialogues, therefore the social worker may have an understanding of what makes an ‘ideal’ interpreter.  (Lucas, 2014, p.177)

One poor experience S may have experienced is when the interpreter turned up 20 minutes late, into the booked meeting. I had to contact the agency directly requesting for them to enquire about the interpreter where about and to find out how long my service user and I had to wait to proceed with the meeting. Although S daughter H was present at the meeting and did suggest she could interpret for us, I explained to H that a professional interpreter must be present to avoid any conflicts of interest and due to the local authorities’ policy. Fortunately, the meeting did not need to be rescheduled. Furthermore, due to the lack of timekeeping from the interpreter, I felt that S and her family were agitated and reluctant to answer questions at first as they had plans for the day. However, after settling down, S and her family began to feel comfortable and express their feelings.

It is vital that social workers ensure they clarify within the first meeting with the client, the role and boundaries of the interpreter. The interpreter and social worker should then agree on the type of style on how to communicate between the all parties including the client before the meeting. (Berthold and Fischman. 2014. p.5). This was done in my case with S and the interpreter during the start of the meeting introducing the interpreter role to S and her family. Furthermore, the interpreter and I agreed before the meeting that I would converse with simple sentences to allow me to receive in depth information from the translation. Ambrose-Miller and Ashcroft (2016) described professionals’ awareness of others as “(1) interprofessional educational opportunities, (2) educating colleagues”. It is vital that professionals understand the importance in learning from other professions whilst meeting the service user needs.

Moreover, the service user may build a relationship with the interpreter rather than the social worker by putting all their trust and concerns directly to the interpreter, excluding the social worker. This can create potential conflicts with the social worker, interpreter and service user relationship. (Miller et al., 2005; Berthold and Fischman. 2014. p.6)

Furthermore, interprofessional working does have it’s benefits for the service user and professionals involved as it can prevent any barriers the client and social worker may have, and the use of each profession can combine their skills. Interprofessional practice can be considered a type of partnership or joint working. Krayer et al. 2018 defined interprofessional working as a “shared commitment, where all partners have a right and an obligation to participate”. (Smith, 2018).

The power dynamics between professionals can have an impact on the service user. In the context of my case with S. The concept of an interpreter is to be a “neutral party or gatekeeper” to communicate and provide an understanding that links the interviewer and the interviewee. (Edwards, 2012, p.3; Edwards, 1998; Dean 2004). However, a Social Worker should always be the “lead professional and can and should manage the interaction”. (Larkin, 2019. p.257). As a student social worker, if I notice the conversation is becoming controlled by the interpreter, I would work within in my power as a student social worker, to be assertive and direct to ensure the conversation is not dominated. (Larkin 2019. p.257). The flow of the conversation and information gathered depends on the interpreter. Mason and Ren (2012) expresses that interpreters ensure that communication via all parties are understood. (Russell, 2016. p. 3)).Therefore, the interpreter will only have a power dynamic in terms of when initiating or assisting the social worker within the conversation.

In terms of decision making of S case including the day services she requests depends on the interpreted interaction between all parties. Furthermore, if all information gathered was accurate from the interpretation, I as a student social worker had the power to arrange day services for S with the confirmation from my on-site supervisor.

In conclusion, reflecting on undertaking this intervention with S and her family, I found that it had allowed me to reflect on my practice and the importance of inter-professional working and how it helps build a professional relationship with families who are in a crisis but do not share the same language as myself.

I feel that the importance of interprofessional collaborations ensures that the service user is not discriminated, due to any language barriers they may have and are given the opportunity to communicate freely without thinking how to put it in another context that may not be their first language.

Reflecting on my placement experience, it gave me the opportunity to gain knowledge on how to effectively work with other professionals in practice. I feel that I engaged effectively with S and her family whilst using the interpreter due to the resulting outcome of finding a day service that met her needs. However, according to Westlake and Jones (2017) studies have shown that nine out of ten social workers they had interviewed said they could not build a positive relationship with those who required an interpreter and found it challenging to express empathy through the interpreter. Through my personal family experiences, I’ve often had to use informal interpreters when communicating with extended family members, who don’t share the same language as myself. My personal experiences have allowed me to apply this experience to my placement and overcome the language barrier between S and I.

I have respect for interpreters and grateful for their collaboration in working alongside with social workers to support their language barrier needs. However, in my future placement I would like the opportunity to work alongside other professionals such as health nurses etc. who need to collaborate with social workers to aid their client’s social needs. I would like to observe an interprofessional team meeting to develop my knowledge on addressing concerns the professional may have regarding the client and how both professionals communicate. It is important that professionals recognise that the client does not ‘belong’ to any of them. Kennedy (2001) expressed that when working with other professionals as a team, there must be collaborative effort of all those involved with the care of the client, it is vital to understand that “parents do not belong to any one professional; they are the responsibility of all who take care of them”. (Meads and Ashcroft, 2005. p.74). 

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