As austerity targets care work, students are increasingly placed in skilled frontline roles

In an overwhelmed and under resourced sector, student care work placements are creating a vicious cycle that burdens the students, organizations and clients.

Anna Bianca Roach
4 October 2019, 5.33pm
Protestors gathered outside Doug Ford's company, Deco Labels and Tags, in Etobicoke, Ontario, 17 November 2018
NurPhoto/PA Images

Ontarians have spent 2019 watching Doug Ford, the province’s Trump-like premier, slash billions of dollars’ worth of welfare programs. While debilitating across the board, the cuts specifically paralyze caring sectors like healthcare, education, and childcare.

This is happening at a time when Toronto is facing multiple crises. The housing crisis has been getting worse for years – with the shelter system inadequate for the city’s ever-growing homeless population. Meanwhile, as the number of fatalities from the overdose crisis skyrockets, the government is failing to adequately implement even the cheapest and most effective harm reduction methods.

All of this is leaving frontline workers overburdened and underfunded. To mitigate the effects of these cuts, organizations that provide relief to low-income people are increasingly relying on students from accredited universities who need the experience to fulfill mandatory program requirements. While it’s a source of much-needed relief, the widespread availability of free labour is pushing down wages and shifting critical responsibilities that require skilled employees onto students who, by no fault of their own, are underprepared.

Care work education at odds with a shrinking job market

At the core of the issue is a contradiction that social work scholars have labeled the field education crisis. As the need for care work rises, so too does enrollment in social work faculties; yet there are fewer and fewer paid positions in the field. The tensions that arise from this dynamic are complex, and often critical. Social work scholars and educators have seen this issue coming since as early as 1964, and it’s been the centre of rich scholarly discourse since at least the mid-2000s, but the problem has also been considered more pedagogical than societal. Yet, it’s at the core of an austerity feedback loop that dismisses the needs of students, social workers, and vulnerable people alike.

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As frontline organizations function with ever-shrinking staff numbers, many vital and skilled responsibilities end up being shifted onto students. In shelters or other crisis centres, for instance, students are frequently put in situations that have the potential to be threatening. In some cases, students are even required to visit clients in their home. While these kinds of risks are inherent to social work, and it makes sense to include them in social work education, if they’re not accompanied by serious de-escalation training, they can be dangerous and traumatizing for students and clients alike.

For clients looking to frontline organizations for support, students are not just students but service providers. So when they are unequipped to deal with complex situations, that has an important impact on the people they work with.

“When you have vulnerable people having negative experiences with service providers … they're much more hesitant to accept services in the future … because they've seen it fail them time and time again,” says Evelyn Johnson, a community mental health worker in Toronto. The specific consequences of having students become frontline workers without adequate training is difficult to measure, but providing insufficient services to people in need often worsens the issues at hand rather than solving them.

The negative effect on students is much better understood. Anecdotally, every student interviewed by openDemocracy has had their own traumatic experiences in their placement, and has estimated that this is the case of most of their classmates as well.

One 2011 study found that nearly every student in one social work programme had experienced a disturbing event during their placement; 20% had been verbally or physically assaulted, including by coworkers or supervisors; one quarter reported seeking out therapy to help deal with the negative effects of their practicum; many more experienced vicarious or secondary trauma or compassion fatigue. The researchers also found that a disproportionate number of social work students had already experienced trauma prior to their education; for these students, many of whom choose to pursue social work to support people experiencing situations similar to those they themselves endured, the placements can also trigger and worsen their own trauma.

Another study considers that students who don’t have experience or support in dealing with compassion fatigue often finish their degree and gain accreditation having never truly found coping mechanisms. As a result, social workers “often begin their careers unprepared for dealing with the possible consequences to their mental and physical well-being of repeated contact with traumatized clients.”

Marie Moore, a social worker in Southern Ontario, described her bachelor’s-level placement at a centre for people who have experienced sexual violence as traumatic. Without the adequate training, Moore was not able to help her first client, who had been experiencing vivid hallucinations and violent urges.

“It’s a skilled job,” Moore said, “and I was not prepared for it.” Eventually, feeling that she was not receiving the necessary support to provide proper care for her clients, Moore dropped the placement and delayed her graduation by a semester. “I had really intrusive thoughts about the placement” for a long time after it ended, she told openDemocracy.

If students aren’t faced with work they are unequipped for, they are often tasked with duties that have little relevance to social work education, like grant-writing or secretarial tasks. These responsibilities are often essential for organizations to continue operating, but “they could never afford to pay people” for them, says Johnson. “They certainly benefit from having someone pick up that slack, because typically those kinds of things are the domain of already overworked managers and caseworkers.” This is another dynamic that, while it is challenging to quantify, has been described to openDemocracy as extremely common by multiple students.

Field education has long been considered the signature pedagogy of social work: the complex and delicate social situations that social workers deal with make the required skills virtually impossible to learn in a classroom setting alone. In fact, most educators and scholars of pedagogy see experiential learning as one of the most effective methodologies across disciplines and professions. But with the field of care work in the condition that it’s in under consistent budget cuts, the practice is leaving more and more social workers burnt out and overwhelmed before they even start working.

The signature pedagogy of social work

In many fields, experiential education can help mitigate the costs of education. That’s not the case for social work students who, like nursing students and students of other care work fields, can expect to pay tuition for their placement. It’s not uncommon for students to pay full tuition for semesters in which the overwhelming majority of credits are placements; yet, student’s roles in placements are increasingly focused on productivity and work instead of learning. Supervisors’ lack of time to adequately guide students is one of the core issues of the field education crisis, and is a big component of students’ poor experiences.

The lack of remuneration for placements, even by well-funded institutions like hospitals, reinforces structural inequalities. Beyond creating additional credits that students pay for, placements often incur additional costs.

“In some placements, you’re taking clients to doctors’ appointments, or you’re required to travel from one site to another,” says Kimberly Vas, the VP of Services and Finance for the continuing education students’ association at a university in Toronto. Transit costs, police background checks, medical exams, or screening fees required by workplaces are often expected to be paid out-of-pocket. For students who are financially independent and are already working a job and taking on debt to put themselves through school, these additional costs, not to mention the cost of childcare which is necessary for some, can be prohibitive.

“I’ve seen people end up dropping out of school,” says Johnson. “Every year, there’s a few people who end up leaving for various reasons … They just can’t afford to continue the program.”

Students’ experiences with placements are also heavily informed by race. Like many fields, Moore explains, social work has an informal hierarchy: the most prestigious and best-paid social workers are those who work in hospitals or child welfare, while the lowest-paying are usually the less institutionalized and more community-run initiatives like ethno-specific organizations. But with a shortage of placements, students are pressured to take whatever they can get, lest they have to pay for another semester’s tuition. At the same time, it’s often easiest for placement coordinators to place racialized students in a relevant ethno-specific organization, especially if the student speaks the language – even if their chosen focus is elsewhere.

What this means, in the context of an increasingly precarious job market in which more students are competing for fewer jobs, is that racialized students’ choice of placement might well pigeon-hole them into a branch of social work they didn’t choose. Even within that branch, they might not even be remunerated in accordance to their skills.

“I got paid $5 less than than a regular worker,” said Moore, who was chosen to work with an organization based on her cultural competencies. “It’s seen as something natural. It’s not seen as a skill.”

One South Asian student interviewed for a study was turned down from a prestigious clinical institution on the basis that she didn’t have the requisite experience – and this despite having had multiple relevant positions. She was later recommended for a placement at an immigrant women’s centre. Another student, who was from Nigeria, was inexplicably placed in a Carribean agency.

“Race was central and unavoidable as a marker of professional status and competence,” notes Sinthu Srikanthan, the author of the study. What’s more, even students who do find their way to their desired placements are not immune to casual racism in the workplace.

Social work is a discipline that aims to provide support for those who are most marginalized in society. It is firmly rooted in anti-oppressive practices – a focus which some social work programmes make very explicit in their curricula. But the field education crisis, which has been foreseen and then observed for decades, persists and worsens. Fewer placements, have led to greater competition – making social work education less accessible to students from disadvantaged backgrounds.

Whose problem?

Care work has consistently been undervalued in Western society. As ‘gendered’ work, typically coded feminine, most care work was previously considered the responsibility of mothers and wives – like childcare or care for the elderly. The undervaluation of care work skills and the mistreatment of workers doesn’t just affect students. Migrant care workers, whose immigration status is often tied to their employer and whose labour rights are rarely enforced, have been successfully organizing in Toronto for some time now.

What the student care work crisis points to, rather than a novel dilemma, is the cyclical nature of austerity governments. The crisis isn’t new to Ontarian workers, who remember a similarly debilitating wave of welfare cuts under Mike Harris’ conservative government in the ‘90s. It was called the Common Sense Revolution, and like Ford’s government, tied eligibility for welfare to having a job.

Like Trump and Ford, Harris swept in on the idea that he was opposing the establishment. “The government isn’t working,” Harris said while campaigning in 1994. “The system is broken.” He paved the road for the late Rob Ford, who as Toronto’s mayor extolled the virtues of restoring “respect for taxpayers” and stopping “the gravy train.”

The anti-government spending rhetoric is accompanied by two contradictory ideas. First, that people who are on welfare are simply milking the system rather than trying to use it to lift themselves out of poverty. Second, that it’s possible to cut spending and taxes without impacting the amount or quality of social assistance the government gives out. Together, this framework goes a long way to delegitimize the need for care work.

Students going into frontline work find themselves at the crux of these austerity policies. When education funds are slashed, students incur more student debt, and are sometimes forced to drop out of the degree they need to enter the care industry. Meantime, cuts to frontline organizations make it harder for employees to fulfill the needs of both their clients and the students they are training – and that undermines the services they’re providing now as well as the services their students will provide in the future.

Field education contributes to helping future social workers build the resilience they’ll need to perform well throughout their career. Yet, when it operates under forced precarity as it does in the field of social work, it creates a vicious cycle, culminating in the under-valuation of care work. As a result, students are burdened with the daunting task of facing and fixing the most acute problems of welfare retrenchment – all before even starting their career.

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