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Hello everyone, welcome to the Social Work Stories podcast. I'm Dr. Mim Fox, and finally I am back behind the microphone with my wonderful colleague Liz Murphy.
Hi Liz. Hello Mim. Hello everyone and Mim, I'm feeling a bit nervous.
It's been a while, my friend.
It's been a while. I know, I know.
I'm so sorry everyone that we have not been recording as regularly as we had been before.
We took a little bit of a breather, but are so committed to getting those practice stories back out there Liz and it turns out there are still people wanting to share their practice stories which is so amazing right?
This is actually a kind of an amazing story.
In how I got to this particular story was a colleague of a social worker contacted me and was curious about you know how does someone record a story and get it on the podcast. I've got this colleague friend who I think is a great social worker and is doing great work.
What do we do? So this was something that started last year.
So from a colleague to then the social worker, we've received this story and This social worker is a paediatric social worker, Mim, and she's working with children in an outpatient rehab capacity.
And what she's wanting to talk about in her stories is the concept of hope and how, as a practitioner, she weaves this concept into her connection with both patient and also patient's family.
And she gives a few examples.
But she also talks about a philosophy that's emerging in her practice, and I guess I've really enjoyed listening to her reflections, but of course, Maem, it wouldn't be an episode if you and I didn't put our 10 cents' worth in as well, would it?
Oh, absolutely. And I think also, Liz, often we've had stories that are sort of at the beginning stages of people's practice.
so depending on the different sector you're in, the first however many years often is an orientation of sorts, where you're really bedding down those core generalist practice skills, but this story really is about an advanced practitioner who has been working in that one -on -one therapeutic space with clients, and is, like you say, embracing a new philosophy, and I really love We've delved into thinking about some of the scholarship that came out of Dr. Carmel Flaskus from the University of New South Wales a number of years ago now, in the late 90s, early 2000s, and a lot of work there around hope
and hopelessness. And so I'm really looking forward, Liz, to get into this conversation with you.
Me too, Mim, so how about we listen and then, of course, we're going to come back and have a chat.
Sounds good. I work as a paediatric social worker in a large regional hospital.
I've become increasingly curious about the concept of hope in my practice and I'm interested in the concept of hope and hopefulness as an intervention in improving the lives of children and their experiences of health care.
In public paediatric care there are multiple barriers to accessing health, not least the waiting lists where hope is sometimes diminished in waiting to see a paediatrician.
There are diverse and profound social complexities of so many of the children and families that I work with.
They have often experienced unparalleled trauma, disconnection, marginalization, and experienced themes in their lives of trust, dishonesty, uncertainty, and futility.
Families frequently come to paediatric clinics with a sense of hope.
that they will get answers, a medical outcome or a diagnosis for their children.
And I see that in that diagnosis they hold on to this threat of hope, that perhaps NDIS might fund support, that the outcome isn't as grave as they expected or as lifelong or as complex. So many feelings of hope.
Or that they will simply be heard when living with a child with complex or chronic health condition is isolating and they just want their story to be heard. So I consciously started thinking about theories of hope.
My curiosity and hope is always fueled by the hardest of situations.
The children who through no fault of their own are given the toughest ticket in life and in health.
One day I was called up to the pediatric ward and I went to see one of my favorite pediatric patients, a young person who has a lifelong chronic health condition but was experiencing an acute episode.
I have of course lots of favorite pediatric patients.
The kids at my work and in my role are remarkable humans.
They are gutsy, vulnerable, tenacious, strong.
They are so strong.
On the pediatric ward I a coffee because as I watched her eat her breakfast she told me this toast is as cold as my soul so I was so taken by this statement and you know this is in the context of a young person living such a hard life so I asked her what do you think about this quote from adversity can grow opportunity to which She said, that seriously fully sucks.
So we both laughed and we moved on.
I love the insights young people have in a medical context where often their voice is not the loudest, their agency over their health is at times minimal, but their presence is large.
I love working with big personalities, creating change amongst the raw struggle of their lives and finding small windows of hope.
I think their stories that just so powerful and their insights are just so unique.
I have always believed that every moment of engagement is an opportunity.
And every opportunity might magnify as new change or a new way forward. I was brought up in my family to believe that community is everything and this is what fuels my fire each day.
Hope is not just a concept.
It is a feeling, it is an act, It is a gesture, it is a moment and it is a way of holding space and presence when it is needed most. Hope is connection and connection reminds us that we are never truly alone.
As a paediatric social worker my job is to support children accessing paediatric care but it is easy for families to feel powerless.
I have heard this from more than one medical professional.
What hope does that family have?
or in response to children growing up in intergenerational situations where kinship carers or grandparents are caring for them, or they've experienced intergenerational trauma, that family situation is absolutely hopeless.
It is easy as professionals to also feel hopeless and powerless, particularly in medical clinics that are packed with children with a diverse range of needs, all seeking answers.
Some families and children have impossible odds but I refuse to subscribe to the overwhelm we can experience as clinicians.
The interactions we have, the care we show, who we show up for in our professional lives, and how we use our voice, our training as social workers, our compassion and our energy, it all absolutely matters.
Social work is all about relational gains.
It is about finding and cultivating hope.
This is where I choose to invest my energies.
Hope and hopefulness can be neighbors, they can be held in one hand, they can be in conflict.
I recently listened to another podcast on this topic with Dr Emily from the Imperfects, who references the despair that comes with hopelessness.
Despair, as we know, causes people to fail to grow, to stall, to succumb to feelings of rage, anger and depression.
So to share and illustrate another point, I have had the absolute privilege of listening to one woman's narrative of hope following the birth and the growth of her child.
She didn't define her story as hope at its core, but she came to realise that hope is what she has carried through.
This is her truth the coexistence of hope and hopefulness.
She said this is not what I'd hoped for this is not what I wanted parenting to look like.
So I asked her what should it look like?
What did you expect?
What has kept you going?
And what did you hope for?
She says I did not want a child with a disability but I have him and I love him.
I know he can't walk or talk but maybe he just can't walk yet.
This mum said goodbye to her son three times.
And each time he was either resuscitated or he survived.
I've learned so much from this family.
I've learned about how we perceive children with disability.
She's taught me so much about the medical professionals and their reference to documentation over their sighting of her son or over their interaction with him.
She would say he's not a miracle, he's my boy.
They love him deeply but does this mean she always holds hope?
No she doesn't, she struggles.
She struggles with feelings of fear and all -consuming worry.
She worries for the future.
Hope for social work is not just a conversation.
Hope lies in action, in advocacy, in reducing the shame in re -framing the picture, in simply just being present.
I just look at him Kirsten and I love him.
She demonstrates to me the power of holding the balance of hope in her hand.
Exposing ourselves to human experiences as social workers and medical professionals can mean exposing ourselves to the brutality of life, to the unfairness of children who were born with disability, the unfairness of chronic conditions that reduce your life quality.
We have a responsibility, I believe, to contribute to hope and recovery, to provide space for mental wellbeing, to give voice to hope in the darkest of spaces.
Hope is a universal and overriding thread, but it is often least referred to in the hospital setting.
I would like everyone to consider that hope is such a possible and positive way of intervening and supporting people through the hardest of their times.
I hope you've enjoyed listening to my reflections on hope not just as a concept but as an intervention And my hope is that hope is shared throughout the work that I do.
Thank you for listening.
All right, Mim. Let's do our dance.
Our dance usually starts with what are your first impressions?
Okay, so I used this opportunity listening to this story to go back and read some of Karmalfaskars work at your suggestion.
And I was doing it at the same time listening to the story as well as having a read of the articles.
And we're going to link in the show notes for you guys some of those articles.
But I really encourage everyone, particularly if you're interested in family therapy practice, to go back and look up Carmel Flaskis's work.
So, what really excited me, Liz, is this notion of the pendulum between hope and hopelessness.
And that it's not so much a spectrum, but I'm imagining a pendulum in my head, like it has a swinging motion between the two states.
And that in the same way this can happen for the client, they can swing between hope and hopelessness quite regularly so too can the practitioner, and I really like that idea that this social worker is grappling with her own notions of hope and hopelessness at the same time as her clients are, and she's trying to think through what is the impact of working in a space of hope, and therefore hopelessness, with people in in this close therapeutic way.
Mem, what struck me was the fact that hope is such, it's an active word, right, in this context.
It's not passive at all.
I loved how she was able to talk about that it's about connecting with my clients and their families.
It's a great connector.
But it's also something that I use in my actions with them, in my advocacy.
I thought that's so good because, look, the last thing you'd want to do as a social worker is abuse the concept of hope, right?
Because the last thing our clients want is for someone to be shutting down the conversation with false hope, with inauthentic hope.
Or being flippant in that hope.
Or being flippant. And all it would do, I would imagine, is not only shut down the conversation but disconnect the alliance which she talks about as being so essential in her work with hope and connecting.
Yeah, so those moments of disconnection when the practitioner does that, that's what Carmel Flaxus calls an anti -therapeutic sequence, so it's the opposite of a therapeutic intervention.
It's an anti -therapeutic sequence or anti -therapeutic moment and you're right, it's a shutting down of sorts.
It would be, like if you could imagine and I think she uses an example of a mother who is talking about hope within the context of a child with a disability.
Now I could imagine that if you're too trite, if you're overusing the hope with a mother like this, I'd have mentioned times pretty essentially, she'd be packing her bags and leaving him.
Absolutely. What would you know?
And she's also heard that 20 times before.
That's right. She's heard those flippin' comments, that mother.
So this, that example, that story took me right back to my early days of practice, Liz, when I was working in the disability sector, right before I got into health, and I worked with some families with adult children with severe disabilities and it was really interesting with those, particularly the mothers.
They're not hoping that their child doesn't have a disability.
That's not the hope.
Now you could go in there and assume that that's the hope they're living with, it's not and so, what the trick is is to figure out where the hope sits for that person, to think about hope, not as a solution or an endgame, but thinking of hope as a ray of light, what is it that's bringing light to this person in this moment in time?
That's a different way of thinking about it, I think.
It is, Mimi, and you could imagine it in its various contexts, so you talk about the area of children with disabilities, so does our our social worker, But you could imagine this in the area of say oncology, end of life, rehabilitation after a person experiences a stroke.
That's right. And Carmel gives examples from the child protection space and child abuse space that, you know, children who are born with into families where there are so many elements of intersectionality, what is the hope for that child as they grow up, right, and where does that hope sit.
And I think that's really key, Liz, is that this is absolutely transferrable, the notion of hope versus hopelessness.
It crosses sectors in the work that we do.
Nim, one of the things I was kind of reflecting on is also the timing aspect of hope.
And it's linked a little bit with your comment about the pendulum swinging between hope and hopelessness, right?
And I was reflecting on times when as a social worker, I have sat with the client in the despair and the hopelessness.
And that was all that was required at that time.
You know, maybe it's a death of a child, for instance, or you can't be rushing to hope that there are times when our role and we talk about this a lot in this podcast where our role is to bear witness and to contain or support the person in that despair and hopelessness.
Yeah. And not rush to hope.
Well, hope then becomes, if you rush to hope, it becomes a band aid.
Yeah. Yeah, rather than actually a helpful therapeutic space.
Yeah, the other thing I wanted to mention to you, Min, that I also reflected on was the sense of agency that can come as a result of feeling more hopeful about your situation.
And a little thing happened this week.
I'm working at this as a volunteer and a food co -op out near where I live.
And this woman comes in and shares with me that she's buying up big in the organic foods, she's buying chickpeas, bags of chickpeas, all organic stuff.
And she tells me that her adult son has just been diagnosed with chronic fatigue.
And she talks about how despairing it's been to have this beautiful young man slowly fade in terms of his energy, his strength, his appearance, his mood, et cetera, and how they've been bounced from cardiologists to endocrinologists.
Because we like that in Western medicine, don't we?
We like, no, it's not my silo, I'll flick past you over to their, might be their silo.
And this sense of hopelessness as a result of people going, yeah, I don't know, I've run this test. I don't know what it is.
Maybe go over to my mate over there and maybe they can do something.
And she said she eventually came across an integrated GP.
And the GP said to her, we've got this, I've got this.
I've got this. And she kind of did this little hand motion of a tag, I'm with you here now, and we'll get through this.
And she said it completely changed her, not just her mood, but her sense of possibility.
And from there she was really throwing herself into this special diet that this doctor was wanting her son to be on.
And it raises again, that sense of agency that can come as a result of feeling hopeful about something and I think you know in positive psychology there's definitely a link between the sense of hope and the importance that that leads to then agency and empowerment and action absolutely absolutely yeah my mum had a similar experience with a geriatrician everyone was compartmentalizing her health but the geriatrician brought it all together and looked at her as a holistic being and she sort of came out of that feeling like a new lease on life like she was finally heard and understood as a whole
person. And I think that is the danger of the compartmentalization, isn't it?
That there, it can be quite a despairing space to sit in.
And the other point that's despairing, and I think she mentions it.
First thing she talks about, is a despair that our clients feel on a bloody waiting list and how that contact after sitting on a waiting list can actually be the first step in terms of hope for the client and or the family.
And, Mim, I just wanted to share with you something that I've heard quite a number of social workers talk about, in terms of the dilemma they have around being hopeful and strength -based in their approach, but having to acknowledge deficit and hopelessness.
And this is in the area of NDIS.
So this is our disability insurance scheme, right?
So imagine a person coming in post having a stroke, for instance, there's a period of time when there's a lot of intensive rehab that goes on for many of the patients and there's discussions about short term goals and getting mobility back and communication back.
So there's a very strength -based approach that you'll often find in rehab units.
Then you had the poor social worker that has to come in and say, listen, I've gotta write a report so that we can get you some funding because you're gonna need some funding when you go home for modification, various things.
But I'm gonna have to write this in a way that isn't supporting this strength -based approach It's like this warning, warning what you are about to read is going to be quite devastating to you but it's only because the system that I am applying to is only interested in the deficits.
So I thought this is a perfect example of having to be very clear about the hopefulness of the situation but having to also talk about deficits, disability, perhaps a more hopeless situation than what the social worker feels is required.
And I think that families and individuals living with disabilities definitely feel that about the system, that it's deficit -focused, and that they are constantly having to prove how bad they are.
And actually that really does not give them hope to move on in any sort of level of strength for the future, right?
Yeah. Yeah, yeah. I think that's really fair, Liz.
I'm wondering if this social worker came to you in a supervision session, right, and said to you that they're sitting with this change in their philosophy about how they work with their clients, and that they started to notice that a theme of hope is emerging in their discussions, and seems to be quite an interesting therapeutic practice, and they want to, they want to sit with that, and they brought it to you for discussion.
What do you, where do you you would take that conversation?
So I would bring curiosity to it, Nim.
Initially, I would want to find out more about the things that this particular social worker is noticing as a result of weaving hope into their practice.
What does that look like?
Maybe talk me through a case study, a couple of case studies, and I'd be inquiring about what was the intention behind that particular question?
What were they hoping as a result of weaving hope into that conversation, what did they see, and then, this is what's happened to me in the past, often my social work supervisor would say, actually there are some really good articles in this space.
So maybe they'd give me the Carmel Flaskus article, and then our next supervision session, we would discuss that, right?
Or maybe I would be saying to this person, what's your understanding about hopefulness in practice elsewhere?
Maybe what you could do is source an article and we can actually have a look at it in terms of, you know, what your practice is telling you and what the research is telling us about hope and social work practice.
Was that something that you would do?
Yes, so you'd take actually, take them out, sit in the clinical space of it and explore that as far as it could go but then you might take them into a scholarship space, into knowledge space.
So how do we, what are we informed by in our practice?
And so we might be informed by the experiences we've had in the past and when it's worked and when it hasn't worked, but we're also informed by the writing on this topic.
We're also informed by the research people have done in this area and that's when I think the articles are really helpful.
But also I might take it step further and say what do you think the impact on the person that you're working with is and how do we know that and what are our questions in this area that we are left with?
What is the gap that we can see either in the knowledge that we are trying to use to inform us or in your practice that you might want to explore?
Because when we sit in that space in that curious space, Liz, then it takes us into a research space, and we say, well, what are some of the potential research questions that we might ask?
And that's when the really beautiful practice -based research projects start to emerge, because you can say, well, I actually saw this phenomenon, but I'm really curious about what this means for the person on the other side of the couch to me, or when I'm in a home visit and it's all chaotic And there's so many different things happening in the space at once.
How do I retain hope and what happens when I do?
And so that leads us to some really interesting questions that are worth exploring.
I really like that, Mim.
I really like how the inquiry goes beyond I think this is going fantastically, you know, I feel so energised and it looks like the client got a lot out of it, to then being curious about has it in fact had the impact that you've assumed or that you're noticing in your work or that they're kind of anecdotally perhaps telling you the next time you see them.
It's finding out what am I doing and is it actually making a positive impact on the people I'm working with.
Yeah I think it's that genesis of evidence -based practice right so when we are practicing, some of it is the practice wisdom that we bring, the experience of, particularly as an advanced clinician, you're often coming back, drawing from the experiences you've had in the past. But that's not where it stops.
Then the other knowledge that you're drawing from often is theoretical knowledge or empirical knowledge, research that has occurred before.
And that's when you can actually turn around and say, but what would interest me to know?
What are the questions that I am asking that's lingering?
And that's where we have to take our curiosity as practitioners because if we don't ask those questions and then seek to answer them, we're limiting where we can create change for people, right.
We're limiting it to the interpersonal, when actually that person is one of many who are sitting in that space and you could be asking questions that get answered for a whole range of I'm imagining that there's going to be perhaps a email sent to you from this beautiful social worker saying, Mim, let's talk a little bit more about ...
A lizard happens all the time and that's fine.
These are my favourite conversations is when a practitioner turns around and says, I've noticed something and I want to figure out how to address that.
I reckon this is one.
Just the impression I got from communicating with her, the passion that she feels about both her work, but also this element that she's weaving into her practice.
It was so beautiful to listen to the passion that she has.
Yeah, yeah, yeah. It's really interesting to me Liz, like that I do think, and I don't know where it's from, I'm not gonna be arrogant enough to think that it's just the conversations that you and I have on this podcast. But there's definitely been an uptake practice -based PhD candidates coming forward where social workers who are in practice are wanting to do significant pieces of research that come from practice questions.
And that is beautiful.
The aim has always been for me in my work to increase the amount of social workers who are out there practicing, who are coming from a research base that is both informed and knowledgeable and and can therefore go out there and run research projects themselves.
So this is, this is, we're seeing this and I think that's beautiful.
That's a sweet spot.
And it's possibly a sweet spot for us to now draw to an ending.
And I might just say on this, firstly, thank you, thank you, thank you, thank you to this social worker who shared a story.
Yes. Thank you. It was great.
It was great. Such a good discussion, Liz.
Great discussion. We're back in the saddle.
And also a bit of a plug for – you can contact me and we can talk about a story that Mim and I can kind of share with the rest of our podcast community.
But also if you're like this person and you are passionate about the practice that you're growing into, So, MIM might also be someone who might wanna email if you were thinking that I'm gonna go from practicing to scholarship.
Yeah, well, there is me, and there is a whole range of other academics out there who that's their passion area.
Well, this is the thing MIM, you know every single person that I know about Social Work.
So if you can't do it, you just plug them into someone who, you know, whether they're in America or England or Zimbabwe or Australia, you tend to know.
Well, referral is a key social work skill.
All right, love it.
That's a beautiful place to draw to a close.
It's been lovely being back on the pod and so good sitting in space with you Liz, as always and everyone who's listening, we hope you've all been well, we hope it's not been too chaotic a time for you and that you're taking care of yourself and particularly to our American listeners, we hope that this year we know it's a troubling year for you it's been very difficult in your political context and we are standing in solidarity my friends from afar.
Absolutely. Holding hope.
Holding hope. Holding hope.
That's it. We're very interested watching and if you want to get in touch with us on our social media or send us an email through our website we would absolutely love to hear what's happening for our American colleagues at the moment.
Take care everyone.
We will speak with you soon.
Bye, bye. Thanks for listening to the Social Work Stories podcast. All of the stories we share are de -identified, to respect and protect the people involved.
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The Social Work Stories podcast is made by Liz Murphy, Dr. Mim Fox, Justin Stesh, Dr. Ben Joseph, and Mattie Stratton.
Thanks so much for listening.
same.
