Why I believe specialisms in social work are not dead

I have been a Deaf specialist social worker at Sight for Surrey for nine years, so I admit I may have a natural bias. However, I believe I am clear on one thing – the importance of specialisms in social work is something that cannot be ignored.

For clarity, this article is specifically about working with people with a hearing loss, not about specialism in social work generally. I am the only hearing worker in my team of 6; everyone else is Deaf with a first language of British Sign Language (BSL). To receive support from our team your primary presenting need has to be your hearing loss. This means you can be a native British Sign Language user; hard of hearing; an older person who has suddenly lost all hearing and everything else in-between.

I have learnt, and am still learning, that we live in a world designed for hearing people with uncountable barriers for those who cannot hear. I was recently supporting someone to contact their mortgage provider and was informed that as the person was Deaf (and unable to communicate using their voice), the bank’s policy was not to ask the security questions; instead we would have to drive 20 minutes to the nearest branch in order to access their personal information. Their Deafness meant they were refused access and therefore discriminated against.

As a nation, in the social work profession we have moved towards strengths-based approaches.

“Strengths-based (or asset-based) approaches focus on individuals’ strengths (including personal strengths and social and community networks) and not on their deficits” (Social Care Institute for Excellence (SCIE) 2019). How can a social worker truly support someone in this way without understanding a person’s culture, their social and community networks and services that would work well for them? How would a worker be able to identify strengths when they are not able to communicate directly? And how can they advocate or re-able when they are not able to understand the barriers a person faces?

I recently saw a video of a Deaf man placed into a care home – with only hearing people and no signing staff. He had no one to speak to, no one who could sign with him and no method of being able to explain his needs. He was completely isolated. A generic care home was not able to adjust sufficiently to meet his needs and therefore, his wellbeing and mental health were affected. Whilst changes can be made in generic social work, we need to ask if it can be adjusted sufficiently to meet a specialist need.

I fully agree that social workers have shared values and transferable skills; however, experience shows this is not enough to negate the needs for individual specialisms. Too often, I have been asked to add to assessments completed by generic social workers to find key evidence missed under Care Act outcomes.

To fully apply a strengths-based approach there is an innate need to understand the person you are working with and be able to work with them to promote their wellbeing. George Bernard Shaw writes “The single biggest problem in communication is the allusion it has taken place.

Recently, I was faced with the irony that an audiologist unit’s only method of contact was a phone number. I have faced the assumption that a Deaf person can read English uncountable times and this assumption is often made with no consultation with the Deaf person for their preferred method of communication. BSL is not like English. It has its own grammatical structure and is a language in its own right. There is an intrinsic lack of understanding that Deaf people are able to communicate fluently and clearly – it is simply in a way that cannot be heard.

Without knowing or understanding these key pieces of information or the barriers people face; without being able to communicate fully and in-depth; without considering and honouring a person’s preferred communication method, it is not possible for a social worker to maintain all of their professional standards. A generic social worker would not be able to do this.

It is for this reason that I maintain the view that when working with people with a hearing loss, knowledge and a specialism is vital.