Introduction

Ensuring the mental health and well-being of students is an increasing concern in Australian higher education (Rickwood et al., 2016). This is particularly the case for academics supporting social work students who come from a wide range of backgrounds and embark on what can be a personally challenging journey of learning to work with diverse groups in a complex and changing social service sector. Given that many students have personal issues, including mental health concerns, social work studies can feel somewhat daunting and overwhelming.

This chapter introduces a curriculum-based response to student well-being for first-year students, providing them with a foundation for their studies and a pre-emptive response to these concerns. In their Reflective Communication subject, students are introduced to an Aboriginal Family Well-being Empowerment program. Pilot research on the impact of this subject highlights its relevance for enhancing student well-being, foundational social work skill development and student’s capacity to manage an increasingly complex and changing world (Whiteside et al, 2017).

Background

The Australian higher education sector is increasingly concerned about the mental health and well-being of students; however, formal evidence is limited. Orygen, the National Centre of Excellence in Youth Mental Health, aptly named their 2017 research project Under the Radar: The mental health of Australian university students as a way of highlighting the lack of evidence. However, a study conducted in 2016, by the National Union of Students in partnership with Headspace, a mental health agency focused on young people, reported that of the 3300 survey respondents, 65% of the 2636 respondents aged between 17 and 25 reported high or very high psychological distress, with 53% of students over 25 reporting the same levels (Rickwood et al., 2016). While the authors of this report point out that this may be due, in part, to self-selection, given the concept of well-being is defined by one’s own perception and is therefore highly subjective, students’ own judgement of psychological distress is important.

Browne et al. (2017) suggest a number of risk factors related to poor mental health among university students, including academic pressure and performance expectations, financial pressures and low SES, coming from rural and regional areas and/or being an Aboriginal or Torres Strait Islander. Both anecdotal information and more formal data from counselling services (Andrews, 2016) indicate that the number of higher education students with mental health issues continues to increase. However, a recent Australian study by Burns and Crisp (2019) did not find an increased level of mental illness among people in tertiary education, inferring the rise in support service engagement is due to students’ increased willingness to seek help. Whether there is a rise in the prevalence of mental illness or the number of students seeking support, our experience as social work educators is that more students need extra support related to mental health issues, particularly in relation to anxiety and depression.

As with other student cohorts, there remains a need for more research on the mental health of social work students, with international evidence indicating a significant level of depression (Ting, 2011). Some students fear their mental illness will mean they are seen as not fit for practice, so they are reluctant to divulge it. Furthermore, many social work students avoid seeking help due to stigma, distrust and concerns about confidentiality and cultural competence (Ting, 2011). There are unique stressors that can impact well-being for students enrolled in social work degrees. They are from a wide range of backgrounds but also need to work with many groups with experiences different from their own in an uncertain and constantly changing context. This is particularly confronting when these students experience personal challenges to their health and well-being.

There is an expectation that social work students develop self-awareness, with Trevithick (2012) suggesting the capacity to constructively reflect on our own experiences and understand their possible influence on our behaviour is an integral part of social work practice. Chenoweth and McAuliffe (2017) emphasise the importance of social workers and social work students knowing themselves, understanding their own motivations and the relevance of their own family and personal history. Related to this, these authors propose that each student needs to “(p)repare yourself to be challenged about your views of the world and your morals and values” (Chenoweth & McAuliffe, 2017, p. 3).

Given these expectations, their own anxieties and those of the people they will be working with, social work students need to manage their own mental health and learn greater resilience. Essentially, social workers need to be able to cope with the emotional demands of the job without these impacting their mental health and well-being (Cuartero & Campos-Vidal, 2019). Grant and Kinman (2012) observed that trainee social workers who were more resilient were also more psychologically healthy and that emotional intelligence, reflective ability, empathy and social confidence are predictors of resilience. However, while self-awareness can help build resilience, the focus on this in the social work course can be unsettling or challenging for students with past traumatic or distressing experiences.

Curriculum-Based Response to Foster Student Well-Being: Reflective Practice Subject

This chapter introduces a curriculum-based response to these issues of student well-being and to building self-awareness and related resilience, in an Australian social work higher education context. In a foundational first-year subject, students are introduced to an Aboriginal Family Well-being Empowerment program (Aboriginal Education Development Branch, 2002) in combination with an embedded process of critically reflecting on their feelings, thoughts, assumptions, values and reactions to the subject.

From a First Nations perspective “(m)ental health results from an adjustment to one’s life circumstances. This adjustment allows ease instead of dis-ease and can be developed further into the idea of self-actualisation” (Grieves, 2009, p. 44). This is firmly connected to Spirituality: “a state of being that includes knowledge, calmness, acceptance and tolerance, balance and focus, inner strength, cleansing and inner peace, feeling whole, an understanding of cultural roots and ‘deep well-being’”(Grieves, 2006, p.52). An understanding of the interconnections between a holistic approach to well-being is embedded in the Family Well-being Framework (Whiteside et al, 2014). As such, the subject fosters self-awareness, confidence, critical thinking, being ethical, relationship management and interpersonal skills.

Our pilot research of the impact of the subject highlights its relevance for enhancing student well-being, foundational social work skill development and student capacity to manage an increasingly complex and changing world (Whiteside et al., 2017). Developing the capacity to reflect on our own well-being, and how to influence it, is a significant aspect of the subject. It is hoped this will provide a foundation for effective social work practice by workers who are able to practice self-care for their own mental health and well-being as well as that of their clients and co-workers.

Reflective Practice Subject

Background to the FWB Empowerment Program

One of the authors (Mary Whiteside) is part of an Indigenous-led university and community research partnership seeking to strengthen the evidence for the Aboriginal Family Well-being Empowerment program (FWB). Developed in 1993, by The Aboriginal Employment Development Branch (AEDB) of the TAFE South Australia, the program adopts the premise that physical, emotional, mental and spiritual well-being enables people to take greater control for their lives at personal and community levels (Whiteside et al., 2014). The program involves a structured reflective process through which participants explore topics such as human qualities, basic human needs, managing emotions and relationships, life journey and conflict resolution. Participation in the program has been shown to bring about transformative life changes for participants. Participants report building resilience, improving problem-solving and relationship skills, engaging more fully in education and employment and participating in collective efforts for organisational and community change (Whiteside et al., 2014, 2017).

In some of the organisations where the program has been delivered, including Queensland child protection services, Aboriginal participants have called for non-Aboriginal workers to train in FWB as a means for enabling culturally sensitive practice (Whiteside et al., 2006). This aligns with the call within social work to integrate the understanding of Aboriginal and Torres Strait Islander knowledges in social work education and practice (Zubrzycki et al., 2014) and to practice in culturally responsive ways (Australian Association of Social Work, 2015). With permission from Aboriginal leaders and TAFE South Australia, social work academics at La Trobe university made the decision to trial FWB within the first year of their social work course as a strategy for student well-being, foundational skill development and, most importantly, to learn from Aboriginal Australians about a culturally respectful approach to practice, including the need to be critically reflective (Zubrzycki et al., 2014).

How the FWB Program Is Used in the Subject

In our adaption of the FWB program, students are taken through a variety of topics in weekly two-hour workshops. Given that students are asked to reflect on their experiences, assumptions and values, a key first step is to create a culturally safe space for learning through the negotiation of a class group agreement. This is a significant part of establishing an effective group process. Students are encouraged to develop group guidelines that would help them to feel comfortable in exploring their own experiences. Students are often surprised that this is an expectation of the subject, making such comments as: “I never expected to have to be talking about myself”.

In each  group, educators facilitate explorations of how differently students may feel about engaging in self-reflection and how to allow for and be respectful of such differences. The preferred group culture generally includes protective qualities such as valuing and respecting different opinions, being honest and trustworthy, respecting others and self, keeping what’s shared in class confidential, being non-judgemental, open and not making assumptions, recognising each other’s strengths and being brave about sharing but also respectful of people’s right not to share on some occasions.

Students are introduced to the subject’s reflective model, foundational skills in helping others and theory of group work to enable them to facilitate the subsequent FWB topics with their peers in small groups. In the following weeks students work through the FWB topics of Human Values and Qualities; Basic Human Needs; Understanding Relationships; Life Journey; Conflict Resolution; Understanding Emotions and Crisis; Beliefs and Attitudes; and Self Care. Students are provided with a modified version of the FWB facilitator guide and topic handouts, as well as online resources such as facilitation demonstration videos and academic literature addressing empowerment, well-being and other concepts related to the weekly topic. Subject tutors receive training in course facilitation prior to subject commencement.

The FWB topics have clear connections to the mental health and well-being of students. The topic Basic Human Needs, for example, encourages students to think about what their own needs are in terms of physical, mental, spiritual and social well-being. In small groups totalling 5 or 6 students, students identify how they recognise and aim to fulfil their needs in these particular areas. The topic Emotions and Crisis fosters sharing of how emotions can be helpful or unhelpful in engaging with a crisis, but also how students have previously managed crises and how this could be helpful for building resilience. The weekly concepts that are explored in the smaller groups are discussed further in the whole of class discussions to allow the class facilitator to model the ideas and to talk about how the students found the experience. Students use the reflective model and the key questions outlined in the next section to more deeply interrogate their reaction to each topic and the implications for social work practice.

Reflective Model

The model for reflection used in the subject is based on the critically reflective approach developed by Fook and Gardner (2007) with a specific set of questions outlined in Gardner (2014). Here, critical reflection is defined as a “way of understanding and engaging with interconnections between an experience; the emotions, thoughts and reactions and actions related to that experience; meaning: what matters about the experience, including related assumptions and values at a fundamental level; and the influence of social context and history both individually and collectively with the expectation of the critically reflective process leading to socially just change” (Gardner, 2014, p. 34).

The critically reflective process is underpinned by four theoretical aspects. First, reflective practice emphasises the exploration of reactions and related assumptions by articulating beliefs and values that are often unconscious (Schon, 1983). Secondly, reflexivity encourages the exploration of “how we present to others, how we are perceived and the context within which we engage as well as our role and specific mandate” (Walsh, 2012, p. 192). This partly means acknowledging that the way we perceive ourselves and how others perceive us are not necessarily the same—and by implication, how we see others and how they see themselves may also differ. Postmodern thinking affirms there are many ways of perceiving and understanding any given person and situation and encourages us to see the discourses that influence our assumptions, those “general expectations about how society should be ordered, who has power and influence and how people should act” (Gardner, 2016, p. 51). This is complemented by critical social theory which makes explicit the assumptions and expectations of the wider social culture and context and how these influence individual and community experiences. As Fook (2012, p. 65) points out, this means having an “understanding of how the ways we talk about our world, that is, our frameworks, for understanding our social worlds, actually also construct it”. The aim of the critically reflective process is to use these theoretical ideas to more deeply understand reactions to particular experiences given the context in which they occur. The theories are implicit in the questions asked in the process. These questions are highlighted in the next paragraph.

There are four stages to this reflective process. In Stage 1a, a student or worker identifies an experience that has caused some degree of discomfort or is puzzling to them in some way. They then use reflective questions to identify their reactions (i.e. How did I react?, What were my feelings and thoughts?), the meaning they attribute to the experience and reactions (i.e. What was important to me?, Why did this matter to me?, What underlying values, beliefs, assumptions were there for me?) and the context that surrounded the experience and reactions (i.e. What was the background and how was my experience influenced by my individual family history and social context and to society I live in?). This process generally leads to a deeper beginning understanding about why the experience has been significant and an identification of the meaning attached to it, including the unconscious assumptions made. Given this is a foundational first-year subject educators ask students to use this part of the reflective process, to help them develop their skills in self-awareness, knowing that we build on the next phases of the reflective process in subsequent subjects.

In Stage 1b of the reflective process, the student/worker would use similar reflective questions to explore the experience from the perspective of another person who has been part of the experience, such as asking what might have mattered for the other person. In Stage 1c, the student/worker then re-examines their perception of the experience to see whether they now perceive it differently. Finally, in Stage Two the student/worker explores the implications for change, either in their assumptions or in possible changed actions.

What generally emerges from this process is that the person reflecting reaches a deeper understanding of where they were coming from: the particular assumptions and values that they were reacting from, which they may choose to affirm or change. An example follows.

Terry, had an experience where she reacted angrily to another student, Will, who was not as quick to complete their part of an assignment group task as Terry would have liked. When Terry was asked what values and assumptions were there for you? Terry realised that she had assumed that everyone would have the same expectations as she did: that a group assignment needed to be the first priority in her life and that being organised and efficient and finishing the task early was important. Terry remembered that Will had mentioned in the first class that their young daughter had significant health issues. This encouraged Terry to see that Will would have had very different priorities which she could well understand. Terry also remembered the class discussion about differences in personality which meant that some people like her had a high need for closure for getting things done and became anxious and stressed if this didn’t happen. Terry could see that others were relaxed and less stressed about leaving things to the last minute. When Terry returned to thinking about her own reaction, Terry realised that another assumption she had was that not only should everyone be the same but be the same as her. When asked how might your reaction be influenced by your family and social context?, Terry thought about her family and to some extent the society in which she lived, and Terry could see that her organised, task-centred approach was often validated, but that it had limitations in raising her anxiety levels and in not recognising the importance of relationships. Having understood this, Terry was better able to raise the issue of how to work together effectively in the group without becoming unhelpfully angry with Will. Terry was able to recognise that sometimes she put a lot of unhelpful pressure on herself to finish tasks early and that she needed a new assumption related to her own self-care and well-being.

Because the weekly FWB topics draw on students’ personal experiences, they are found to be contextually relevant for critical reflection and the two elements of the subject are highly compatible. The subject’s assessment tasks provide an opportunity for students to test their learning and enhance their knowledge through real-life experience. Students are required to keep a weekly journal using the reflective model, facilitate a FWB program topic with a group beyond the classroom (e.g. with family, friends or other students) and then write an academic report based on this experience, and design an innovative group presentation of a FWB topic. All of these helps demonstrate the subject’s core learning outcomes, but also aim to improve student well-being and mental health.

Findings and Discussion

This subject has been taught for 5 years with over 800 students from metropolitan and rural campuses. Each year the subject receives well above average scores on university student feedback surveys. A mixed methods study undertaken in 2016 by Whiteside et al. (2017) found significant changes on empowerment and well-being measures that were delivered pre and post the subject, suggesting that the subject is highly relevant for student mental health and well-being.

Building Self-awareness and Confidence

Qualitatively, students referred to building self-awareness and confidence, being able to better manage the stresses associated with day-to-day life and strengthening relationships that were important to them. Students could see they were gaining knowledge that was relevant to their future professional life, and this helped them to engage more fully with their university studies (Whiteside et al., 2017). The following quotations are illustrative of these findings:

“The FWB program has helped me look at my life from a different perspective and has allowed me to reflect on life wants and choices in a way that has allowed me to grow as a person”

“It has helped me to understand myself and my emotions more clearly as well as dealing with different stages of my life”

“FWB made me realise how strong and resilient I am as an individual and how I have overcome hard times in my life. This made me feel empowered and satisfied with life”

“Most of all the FWB has strengthened and helped me overcome the fear of not being successful and dealing with normal stresses in everyday life”

“FWB enabled me to be aware of the way in which I conduct myself, the way I interact with others, the way it affects others and how I can inspire others to make positive changes in others’ lives”

“FWB has enabled me to see my inner strengths and values. I know I can achieve whatever I want to”

In addition to these findings, as facilitators of this subject the authors have systematically considered their experience of the student groups combined with material from student journals that provide powerful examples of positive change in students’ attitudes, assumptions and values over the course of a semester. Students enter the course at different levels of social, emotional, mental and spiritual well-being. They come with a range of values, beliefs and assumptions; and they hold varying levels of skill in communication, group work and critical reflection. For some, these ideas are familiar and the FWB content serves to strengthen their skills by providing new and interesting topics to reflect upon in a group setting. For others, the chasm between who they espouse to be as budding social workers and the way they interact with the group is more expansive. Inevitably, some students are more vocal and others more reserved. Regardless of where students begin, the shift in values, attitudes and ways of interacting with others is evident in the weekly journals. We have outlined themes from these journals below:

Using Journaling to Explore Thoughts, Feelings and Assumptions

The journal is a useful platform for students to reflect on and share their thoughts, feelings and assumptions. We have been pleasantly surprised about how honest some students are at revealing inner thoughts that they may otherwise not readily admit to others. Facilitators help foster a safe non-judgemental environment, and this is evident in journal entries in which students have shared intimate views and experiences. Many journals proved to be an excellent record of change, revelation and positive development. Some students shifted from a place of judgement and even a dismissive attitude towards others’ thoughts and feelings, to an empathetic acceptance of difference. Students turned what they first considered to be an annoyance into a valued source of learning.

Changing Beliefs and Attitudes

An example of new learnings came from a group where it became clear that some students placed greater value on shared storytelling as a form of learning/teaching compared with others, and this influenced their level of contribution. This appeared to be linked to stage of life, with noteworthy differences between younger and older students. There were young students who were quite critical of older students “over” sharing their life experiences, considering them indulgent and time-wasting. Similarly, some older students were quite judgemental of what they perceived to be younger students’ lack of engagement and reluctance to share their stories, assuming that they were lazy or too selfish to create a communal learning experience. It became evident that as the students’ levels of self-awareness and ability to empathise increased, their opinions changed, and they became more understanding and responsive to their peers’ experiences. Students could appreciate having their values and attitudes challenged as Chenoweth and McAuliffe (2017) advocate. Younger students came to appreciate what they could learn from the older students who had a more diverse range of life experiences, and the older students were more forgiving of the younger students’ stage of life development and held more realistic expectations of them. Students developed a deeper group bond based on trust, empathy, acceptance (of self and others) and authenticity. This demonstrates how the FWB program improved students’ well-being and how the reflective process worked to bring about positive change.

Need for Self-empowerment

The reflective journals also provided evidence of why a program that fosters self-empowerment is important, as demonstrated in the following example. The second week of student-facilitated groups focusses on four basic human needs – physical, emotional, spiritual and mental. Several students mentioned their reluctance to share stories that would reveal their Christian beliefs because they thought that they may be judged harshly by their peers. These women, in their early 20 s, said that they draw strength, comfort and wisdom from their religion, but they did not feel they could be open about the ways in which it adds to their well-being in case it meant they were treated differently. This is the antithesis of what the program aims to nurture—empowerment—and highlights the importance of overcoming notions of “othering”, both real and perceived. This is not to suggest that their peers would have judged them or treated them differently, but this is a poignant example about how assumptions can hold us back from revealing ourselves and being authentic to our beliefs, thereby degrading our authenticity, which is ultimately disempowering and may impact our mental health. In this example, the journals have had an unintended positive outcome, in that the class facilitator has learned about some students’ trepidation about sharing these values, which can be addressed in future classes by highlighting the benefits that some people gain from being a member of an organised religion.

Learning from the Experiences of Others

A final anecdotal example of the benefits of the subject on student’s mental health is the moments in which students said something along the lines of “I didn’t think they had had such a difficult background … they seem so happy and together” in response to hearing one of their peer’s difficult life experiences. There have been several instances in which students come to learn that they assumed people must have had an easier upbringing than they had because they did not appear to be damaged or “messed up”. From this, students learned two important lessons. Firstly, that holding assumptions about others is unhelpful because it restricts relationship building. Secondly, as Grant and Kinman (2012) suggest they came to connect self-awareness with well-being, to learn the meaning of resilience and that they too could develop wisdom, kindness, inner peace and accomplish their goals and desires despite the adversities that they had faced. The FWB program offers a space to learn about other people’s experiences and the ways they develop their sense of self and notions of well-being—sometimes in spite of great adversity. The reflective component of the subject helps students to uncover their assumptions and learn that empowerment is a choice, and they can choose to drive their approach to life regardless of their history.

Conclusions

Our experience demonstrates the value of this kind of experiential shared learning and the related benefits in terms of mental health, well-being and the development of greater resilience. The FWB program offers a space to learn about other people’s experiences and the ways they develop their sense of self, well-being and self-empowerment. The reflective component of the subject helps students to uncover their assumptions and what they take for granted, thereby learning that their reactions, actions and sense of empowerment are a choice that they can control. The combination of the FWB program and the reflective journal help students develop self-awareness and foster self-empowerment, which together aid in positive well-being and mental health.

However, there are challenges that need to be made explicit and managed effectively. We are asking students to be vulnerable by revealing their own experiences, some of which are painful. It is essential that we ensure that the process is sufficiently safe so that students who have experienced past trauma are not further traumatised and that students see this as an enabling and supportive process leading to greater resilience. It is also important that we don’t reinforce unhelpful power differences, asking students to be self-revealing while we as the educators remain unknown. What helps here is being prepared to demonstrate our own vulnerability by using an example from our own experience: as Savaya (2013, p.185) indicates “My self-disclosure increased the students’ confidence in me as someone who was intimately acquainted with the process I was asking them to undergo and also learned from her critical reflection”. It is essential to set the class up with a clear and mutually supportive group culture, exploring with each class their particular hopes and fears related to this kind of reflective experience (Fook & Gardner, 2007). If the group doesn’t themselves name these, we need to make explicit the importance of confidentiality, being non-judgemental and to self-monitor what they choose to reveal.

Due to the uncertainty of COVID-19, this year the subject’s authors are trialling this as on online subject. This has its own challenges with less easy access to seeing how each smaller group in the class is engaging at the same time. However, early indications are that students continue to engage well with the process, possibly finding some security in being in their home or chosen environment. In the light of these changes, are repeating the 2016 study (Whiteside et al., 2017) of the subject to gain greater understanding of both the impact of COVID-19 on our social work students’ mental health and well-being and the experience of undertaking this subject in an online format.

To conclude, embedding a curriculum-based approach to improving student well-being has not only brought benefits in students’ ability to manage life stresses but it has also taught foundational skills for professional social work practice. The integration of a model of critical reflection with the opportunity to experience an Aboriginal Family Well-being Empowerment program has been very effective and highlights the opportunities for learning from Aboriginal Australia.