Shared Decision-Making in Social Work Practice in Israel: Exclusive Inclusion

Shared decision-making (SDM) partnerships between social workers and clients are among the most popular themes in research and practical fields of social work around the world; and often considered mechanisms for promoting... [ view full abstract ]

Shared decision-making (SDM) partnerships between social workers and clients are among the most popular themes in research and practical fields of social work around the world; and often considered mechanisms for promoting values such as social justice and equality and better quality responses to social problems. As such, SDM and adjacent concepts have been incorporated into legislation and administrative reform in many European countries. Generally, social work discourse promotes SDM, and it is presented in most social work papers as a worthy practice, intended to symbolically and tangibly challenge existing power structures of exclusion. Despite widespread agreement regarding its importance, scholarship on SDM is beginning to reveal a compound, ethically challenging, and multi-faceted relationship between SDM, social workers and their clients. The suggested presentation wishes to show the results of two large studies in this area, conducted among Israeli social workers, using both qualitative and quantitative methodologies.
The qualitative investigation included 77 social workers and policy makers whose responses were analyzed according to guiding principles of descriptive phenomenological content analysis and dialogical commonality. Participants’ responses represented themes of hope, change, identity and choice alongside elements of stigma, prejudice and fear. The quantitative investigation included 229 social workers. Preliminary findings from this study reveal significant associations between SDM and social workers' perceptions of their ethical behavior, workers' perceptions of their work environment as promoting SDM, moral-professional identity, attitudes towards people who live in poverty, and structural sources of poverty. Robust analyses suggest the option for a theoretical model which ties SDM behaviors and attitudes with contextual and ideological elements and inclusive or exclusive opportunities created by workers for authentic SDM with clients.
Both studies will be presented using critical conceptualizations, and provide suggestions for enhancing authentic, context-aware, effective, and bold SDM practices, policies and research which actually unravel excluding professional structures.