[Editor’s Note: Estella C. Williamson is the Social Work Field Director at Seattle University. Dr. Williamson also teaches advanced practice and human behavior coursework in the MSW program. She currently serves as chair of the CSWE Council on Field Education. Dr. Williamson earned her DSW from the University of Pennsylvania and her MSW from the University at Albany, State University of New York. Her research interests are in field education, mental health, and HIV prevention among Black women. Dr. Williamson has professional social work practice experience in child welfare, outpatient mental health and addictions, prenatal services, and HIV clinical and preventive care. She has instructional and curriculum development experience. Dr. Williamson has also maintained a private clinical practice in New York State for many years.]
Introduction
An updated edition of the Council on Social Work Education’s (CSWE) Educational Policy and Accreditation Standards (EPAS) is currently underway. To ensure standards of excellence in social work education, the EPAS is updated every seven years. The EPAS is developed by CSWE’s Commission on Accreditation (COA), which writes the accreditation standards, and the Commission on Educational Policy (COEP), which writes the educational policy statements.
In 2017, the two commissions formed a Joint COA-COEP Committee to begin preparing for the 2022 EPAS. In order to inform the committee of the views of social work programs regarding the 2015 EPAS, the COEP began environmental scanning activities in 2018. From data collected through surveys, focus groups, and feedback sessions, five key areas of focus emerged that were identified as integral to the next EPAS revisions. The key areas of focus are:
• Diversity, Equity, & Inclusion
• Data Driven Standards
• Changes and Challenges in Higher Education
• Technology & Information Literacy
• Field Education and the Changing Practice Context
The first draft of the 2022 EPAS was written in June 2019 and was presented at the CSWE 2019 Annual Program Meeting (APM) later that year. There were several feedback sessions held, including one at the 2019 Field Education Institute and one at the Council on Field Education’s (COFE) Field Connect Session. As chair of the COFE, I served on the Joint COA-COEP Committee and sought to receive an abundance of feedback from field directors/coordinators. Following the APM, I initiated a listening tour to learn of the experiences of field directors within regional field consortia around the country. Several of these stakeholder groups submitted formal letters to CSWE providing feedback on the first draft of the 2022 EPAS. The COFE also submitted a formal response letter. As of this writing, review of all feedback responses is currently being considered in the second draft of the 2022 EPAS. The second draft will be shared with different constituents before CSWE presents a full draft at APM and to the National Association of Deans and Directors of Schools of Social Work (NADD) in November 2020. CSWE plans to provide multiple opportunities for receiving feedback on the full draft throughout 2020 and 2021. After this draft review process is completed, a final draft will be presented to CSWE’s Board, COA, and COEP in Spring 2022.
One strength of the EPAS has been a move towards competency-based education. Competency-based education establishes educational policies that focus on student learning outcomes. For field education, evaluating learning outcomes is achieved by identifying and assessing students’ competency of social work practice through their real-world practice with client systems. As the signature pedagogy of social work education, field education provides the critical nexus for integrating course content into the development of knowledge, values, skills, and cognitive and affective processes through this real-world practice. Through the field practicum experience, students must demonstrate these practice domains by developing proficiency of all nine social work competencies (CSWE, 2015).
Despite the establishment of field education as the signature pedagogy for social work education, it has been challenged to ensure quality learning experiences for students due to a variety of internal and external barriers. Almost 40 years ago, then CSWE president Michael Frumkin stated that the existing voluntary-based agency field practicum model was unsustainable (Bellinger, 2010). He recommended that schools of social work seek other mechanisms for evaluating practice skills and that schools construct mutually-beneficial agency-school partnerships that would maintain quality learning experiences for students in the field. Few took him up on his advisement. Since that time, several mezzo-level political and economic phenomena have provided a cautionary tale of the threats to quality field education.
Changes in the Practice Environment
While managed care was enacted under the Nixon administration through the Health Maintenance Organization Act of 1973, it was fully implemented and expanded under the Reagan administration during the early 1980s (Patel & Rushefsky, 2006). To control spiraling health care costs, fee for service payment models were replaced by set fee structures that were bundled together to reduce costs. The emergence of Health Maintenance Organizations undergirded political efforts to control health care expenses, while seeking to better coordinate health care delivery. This trend towards managed care has become ubiquitous in the United States, as observed through an expansion of coordinated health care under the Affordable Care Act of 2010.
The last 40 years has also seen a series of financial crises that threatened economic stability in the United States (Eisenbeis & Horvitz, 1994; Rowe, 1982). Economic recessions, fluctuating unemployment trends, and banking and industry downturns have all contributed to cycles of financial instability that have directly impacted human service delivery and its response to achieving desired health outcomes. Nonprofit agencies and health care organizations have observed significant budget cuts that burdened the delivery of social work services. Social workers have experienced increased workloads within fractured organizational systems. Crisis management within the human service delivery system has taken precedence over the educational development of health professionals (Bellinger, 2010).
Additionally, the health care industry observed patients presenting with more complex health, social, and emotional issues. Further, the industry has been caring for a growing aging population living with chronic illnesses (Roberts, Ogunwole, Blakeslee, & Rabe, 2018). The complexity of health concerns and the increased number of patients have shifted staffing resources from teaching/education of the next generation of health care professionals to a primary focus on an expedited outcomes-focused direct care model (Kuluski, Ho, Hans, & Nelson, 2017).
Health care has shifted its delivery system from an acute care model that established medical interaction with individuals during periods of identified health crisis, to a preventive practice that has sought to engage patients in care before the occurrence of a health crisis (Institute of Medicine, 1996). What has emerged from primary preventive care models is the implementation of an interdisciplinary approach to identifying and responding to health care more holistically. This proved to be an energizing time in health care, which sought to respond to escalating health care costs, while simultaneously improving health outcomes (Ashcroft, McMillan, Ambrose-Miller, McKee, & Brown, 2018). Social workers have proven to be invaluable practitioners within the interdisciplinary model of care, contributing expertise in preventive care through an ecological framework.
The impact of changes in health and human service delivery on social work practice learning has been profound. Within nonprofit organizations and health care institutions, field supervisors historically viewed their roles as both teacher and mentor to social work interns (Bellinger, 2010). However, the demand for emergent responses to an ever increasing and complex health care system has resulted in a desire for student interns to be skilled in advance social work practice upon entry to internship. Schools of social work have noticed a decline in quality internship requests, and when requested, a desire by agency sites to have students who can “hit the ground running.” The understanding that field education provides education and training for developing social work practitioners has subsequently been eroded by external pressures to have skilled interns to address complex health issues (CSWE, 2014).
Changes in Student Demographics
Social work education has also observed changes in student demographics and characteristics. Although the majority of students in BSW and MSW programs remain White and female, there is more racial and economic diversity among students over the age of 26 (CSWE, 2019). Black students are more likely to be employed, and they are subsequently among an increased population of working students choosing online social work programs as a pathway to advancing their professional careers. This is a consequence of social work programs having limited financial resources to support students’ pursuit of higher education in social work. As a result, there is an increase among students pursuing undergraduate and graduate education while also working full-time. This phenomenon highlights the increased financial, social, and emotional burdens placed upon students, which impacts their ability to successfully progress through and complete their social work programs.
Social work programs are also observing students presenting with underlying mental health challenges that impact their progression in their programs. For example, research reveals disproportionately higher scores of ACEs (adverse childhood experiences) among adult students in social work programs (Thomas, 2016). Because reports of mental health trends among students is largely anecdotal, more research is needed to better understand the degree of mental health and substance use disorder experiences of social work students. A key strength of the profession is its practitioners, many of whom come from diverse backgrounds and have survived their own traumatic experiences; this serves as a critical empathic tool and exemplar for helping clients heal from their own life challenges. However, social work programs have been challenged to respond to the needs of students, while dually trying to uphold educational and professional standards for the social work profession.
Challenges within the Administrative Structure of Field Education
Among social work programs in the United States, the average length of employment for a field director is 5 years (Fisher, Homes, & Lewis, 2018). Field directors are often placed in the untenable position of serving multiple constituents with competing demands. Further, field directors have reported feeling unsupported by the administrative leadership in their efforts to respond to this conundrum. While field education is espoused as the signature pedagogy, discourses around curriculum development, enrollment targets, and academic standards that are informed by field education data have not always been inclusive or equitably applied within the administrative structure of social work programs.
The Road Ahead
The challenges outlined above are not meant to convey a sense of hopelessness for the future of social work education nor for field education. The development and application of innovative and creative responses requires a clear understanding of the challenges to achieving the desired outcomes of any program. In response to agency challenges and student demographics, field education programs have developed innovative models for practice skill development. There are volumes of peer-reviewed publications on the state of field education and innovations within field education (Bogo, 2015; Bogo, Regehr, Baird, Paterson, & LeBlanc, 2017; Tompsett, Henderson, Byrne, Mew, & Tompsett, 2017). Each year, the CSWE APM holds field institutes, field presentations, and peer-learning communities for field educators and directors. The North American Network of Field Educators and Directors (NANFED) provides a host of services and resources for field educators. Regional field consortia collaborate and create rigorous educational tools and curriculum guides that add tremendous value to students’ learning experiences. These educational leaders create robust models of field education that strive to uphold quality learning experiences for students within an ever-changing practice landscape.
This brings us back to the 2022 EPAS. The next EPAS will guide the curriculum of social work programs for the next seven to ten years. Because field education and the changing practice context is a key area of focus, there exists a prime opportunity to engage in a critical review of the 2015 EPAS. We must participate in feedback sessions offered by CSWE and share the strengths and challenges of managing field education programs under the current accreditation standards and educational policies.
Field educators are encouraged to examine the five key areas of focus through an intersecting lens. For example, you cannot provide quality field education without applying diversity, equity, and inclusiveness in every element of curriculum development and programming. Field educators must apply data driven standards to articulate resource needs for quality field education programming. The practice environment is applying new technologies every day to respond to the complex needs of vulnerable populations and field education is well-positioned to understand and incorporate technological advances into the field practicum experience.
Resource allocation for quality field education programming is directly impacted by budget constraints experienced in higher education. The heavy reliance on graduate education tuition dollars will be pressed significantly by an anticipated decline in graduate enrollment over the next four years (Grawe, 2018). However, juxtapose this phenomenon with the anticipated increase in the demand for health professionals, such as social workers, over the next 10-15 years. Employment of health care occupations is expected to grow by 14% overall by 2028 (Bureau of Labor Statistics, U.S. Department of Labor, 2018) and 11% for social workers by 2028 (Bureau of Labor Statistics, U.S. Department of Labor, 2020). As leaders in social work education wrestle with the question of how to survive, perhaps the question is how do we position social work programs to respond to the anticipated health care demands over the next decade? Field education is central to this discourse as we work to prepare the next generation of social work students for professional practice.
A critical examination of the state of field education, as it pertains to its educational standards and curricular objectives, is necessary for preparing for future demands. This requires an assessment of how the 2015 EPAS supports or hinders field educators’ efforts to uphold quality field education for all students. Please join me in actively gathering and analyzing field data, advocating for greater inclusion in the administrative structure of social work programs, and evaluating the existing educational policies and accreditation standards. Participate in all opportunities to provide feedback on the different drafts of the 2022 EPAS. Finally, do not operate in a silo, but stay connected to field educators and colleagues around the country. When CSWE announces calls to apply to Councils and Commissions, field educators are encouraged to apply so that there is field representation on the various councils and commissions that inform the EPAS. Consider joining and actively participating in NANFED and your regional field consortium. There is much work to do, but this is the right time and we are in the right place to influence the future of social work education.
References
Ashcroft, R., McMillan, C., Ambrose-Miller, W., McKee, R., & Brown, J. B. (2018). The emerging role of social work in primary health care: A survey of social workers in Ontario family health teams. Health & Social Work, 43(2), 109–117. doi:10.1093/hsw/hly003
Bellinger, A. (2010). Studying the landscape: Practice learning for social work reconsidered. Social Work Education: The International Journal, 29(6), 599–615. doi:10.1080/02615470903508743
Bogo, M. (2015). Field education for clinical social work practice: Best practices and contemporary challenges. Clinical Social Work Journal, 43, 317–324. doi:10.1007/s10615-015-0526-5
Bogo, M., Regehr, C., Baird, S., Paterson, J., & LeBlanc, V. R. (2017). Cognitive and affective elements of practice confidence in social work students and practitioners. British Journal of Social Work, 47(3), 701–718. doi:10.1093/bjsw/bcw026
Bureau of Labor Statistics, U.S. Department of Labor. (2018). Occupational outlook handbook: Healthcare occupations. Retrieved from https://www.bls.gov/ooh/healthcare/home.htm
Bureau of Labor Statistics, U.S. Department of Labor. (2020). Occupational outlook handbook: Social workers. Retrieved from https://www.bls.gov/ooh/community-and-social-service/social-workers.htm
Council on Social Work Education. (2014). Internships, department of labor regulations, and social work field education: Setting the record straight. Retrieved from https://www.cswe.org/getattachment/Accreditation/2014-02-25AnnouncementreDOLandField-EF.pdf.aspx
Council on Social Work Education. (2015). Educational policy and accreditation standards. programs. Retrieved from https://www.cswe.org/getattachment/Accreditation/Accreditation-Process/2015-EPAS/2015EPAS_Web_FINAL.pdf.aspx
Council on Social Work Education. (2019). 2018 statistics on social work education in the United States. Retrieved from https://cswe.org/getattachment/Research-Statistics/Annual-Program-Study/2018-Statistics-on-Social-Work-Education-in-the-United-States.pdf.aspx
Eisenbeis, R. A., & Horvitz, P. M. (1994). The role of forbearance and its costs in handling troubled and failed depository institutions. In G. G. Kaufman (Ed.), Reforming financial institutions and markets in the United States (pp. 49–68). New York, NY: Springer-Verlag.
Fisher, W., Homes, J., & Lewis, L. (2018). The state of field education: A survey of directors of field education on administrative models, staffing, and resources. An initiative of the CSWE Council on Field Education. Retrieved from https://www.cswe.org/getattachment/05519d2d-7384-41fe-98b8-08a21682ed6e/State-of-Field-Education-Survey-Final-Report.aspx
Grawe, N. D. (2018). Demographics and the demand for higher education. Baltimore, MD: John Hopkins University Press.
Institute of Medicine. (1996). Primary care: America’s health in a new era. Washington, DC: The National Academies Press. doi:10.17226/5152
Kuluski, K., Ho, J. W., Hans, P. K., & Nelson, M. L. A. (2017). Community care for people with complex care needs: Bridging the gap between health and social care. International Journal of Integrated Care, 17(4). doi:10.5334/ijic.2944
Patel, K., & Rushefsky, M. E. (2006). Health care politics and policy in America (3rd ed.). New York, NY: M. E. Sharpe.
Roberts, A. W., Ogunwole, S. U., Blakeslee, L., & Rabe, M. A. (2018). The population 65 years and older in the United States: 2016. American Community Survey Reports – U.S. Census Bureau. Retrieved from https://www.census.gov/content/dam/Census/library/publications/2018/acs/ACS-38.pdf
Rowe, J. L., Jr. (1982, October 20). Regulators see bank failures rising steadily. Washington Post. Retrieved from https://www.washingtonpost.com/archive/business/1982/10/20/regulators-see-bank-failures-rising-steadily/37554a84-6809-4686-b40b-2a21d6cc17c2/
Thomas, J. T. (2016). Adverse childhood experiences among MSW students. Journal of Teaching in Social Work, 36(3), 235–255. doi:10.1080/08841233.2016.1182609
Tompsett, H., Henderson, K., Byrne, J. M., Mew, E. G., & Tompsett, C. (2017). On the learning journey: What helps and hinders the development of social work students’ core pre-placement skills? Social Work Education: The International Journal, 36(1), 6–25. doi:10.1080/02615479.2016.1249836