EP 7 Three legged stool

The three-legged stool is a concept in social work that refers to the three sources of knowledge practitioners rely on: practice, research theory, and personal life. These sources need to be balanced for optimal functioning and expertise. Practitioners work with the complexity of human emotion and thought, and need to consider various factors. They acquire knowledge through education, practical experience, and personal reflection. The three sources of knowledge are equally important and should be integrated. Relying too much on one source may lead to biases and errors. The three sources interact and influence each other in complex ways. Balancing the three legs is crucial for effective practice. Kia ora, and welcome to another episode of Bella Bird's Social Work Squawk, a podcast for all things social work. I wanted to talk about something that has come up in quite a few of the supervision sessions that I've been running recently, and it's a concept called the three-legged stool, or at least that's what I've learned it as. And for practitioners, the three-legged stool is a metaphor that refers to the three sources of knowledge that practitioners can rely on. Their practice, empirical knowledge, research theory, and also their personal life, right? Who we are as a person influences how we see the world, how we work with one another. So the three-legged stool was proposed by Scott Holt and Starkey in 2010 in an article about learning in the helping professions, and they argued that practitioners need to balance these three sources of knowledge to achieve optimal functioning and expertise. And certainly when I did my study, my post-grad, the three-legged stool was introduced to me as a concept around our decision-making, how we as practitioners utilise the information that we have available to us and are able to make clear, good, informed decisions around the interventions that we think might be appropriate. So we know, right, that practitioners work with the complexity of human emotion, thought, and variability, which at times makes the work confusing. We have a lot of things that we need to consider at any one time, and there are lots of variable factors. No one person's life is exactly the same as the next person's. No one's experience, no one's interpretation. We've talked a lot about this when we've talked about trauma, but we're very complex beings, right? So as we experience things, as we learn things, as we see the world, that has an impact then on the thoughts, feelings, behaviours that are exhibited as a result of that. So we have to take in as much information as possible. We undertake our assessment, and then we have to provide some level of analysis to that that enables us to be able to think about the interventions of how we move forward. So we know that in most worlds, whether social work, nursing, teaching, whatever profession, in order to be able to make sense of the information that we have available to us, we tend to study, right? We might go and do years of some kind of qualification, we go through schooling, we do practical experiences in our work experience or our placements, and all of these things are to prepare us to be able to work with other people. And then we have different philosophies, methodologies, frameworks that all assist, that give guidance to what might be the best sources of intervention in terms of what we do, how we do it, why we do it. So where should we develop our understanding? From where should we get our ideas around what the right thing to do is? So academic culture suggests that it should be through science. Practitioner culture suggests reflection. And candid discussion with practitioners suggests that our own personal lives can often be the richest source of knowledge. We know that lived experience and practitioners who have that lived experience can add a great deal of value to the work that they do because they have lived through that experience. So this leads to this concept of defining practitioner expertise as being three legs of a stool on which we must stand in order to be able to know how to move forward. But the issue is the stool has to balance, right? So Gobholt and Starkey proposed that practitioners in the health professions, such as counsellors, therapists, social workers, et cetera, need to balance these three sources of knowledge to achieve optimal functioning and expertise. These three sources of knowledge, research and theory. So this is the knowledge that comes from academic research. It involves empirical evidence, scientific methods, logical reasoning, conceptual framework. We often talk about things being evidence-based, researched, peer-reviewed. We want that robustness in our learning and our understanding that there has been some study around it. We've looked at outcomes. We've looked at what is the evidence that proves the validity and the viability of what it is that we're doing. So this information is often explicit. It is formal. It is clearly stated. It has structure. It is also generalisable, right, transferable, meaning that it can be applied to different situations in different populations. Often we take information and we think, well, if it's worked for this group of people, it's likely to work for another group of people. Or if it's worked for people with this experience, then it's probably something we can replicate again and again for people with similar experiences. So another leg on this stool is our practice, right? This is the knowledge that comes from direct experience of working with FANO, working in situations, working with people. It involves reflection, tuition, trial and error, feedback, conversation, dialogue. It's often tacit and implicit, meaning that it's not only easily articulated or explained, it's also dynamic and involving. It changes over time. It does change in different contexts. So something that we might learn, for example, working with FANO in one community, we might recognise, actually, may not work in a different community because there's variability to that. But over time, as we become more experienced and we have more examples of the environments in which we've worked, we're able to see some themes, some topics and understand that variability, the nuances of the environments that we're working in. That for some people, something might be effective in another environment or another circumstance. That thing might not be effective. And then, of course, the third leg that we stand on, on our stool, is us, our personal life, our lived experience. This is the knowledge that comes from within. It involves our values. It is our beliefs, our emotions, our experiences, our relationships. It is often subjective. It is deeply personal. It is influenced by our own perspectives on our identity, which means it's also rich. It's diverse. It encompasses a wide range of aspects of human existence. It's one of the great things I love about working in a team is how we can learn and grow from each other, seeing how other people do things, the words that they use, the way in which they relate, the ideas that they have, the perspectives that they hold, make for a very rich way of working. So, Schofhold and Starkey argued that these three sources of knowledge are equally important and useful. They suggest that practitioners need to integrate these sources of knowledge in a way that suits their own style and context. And they also warned against relying too much on one source of knowledge at the expense of others. This may lead to biases, gaps, errors in practice. So, these three legs are not independent or isolated from each other. They interact and influence each other in very complex ways. For example, a practitioner's personal life can affect their practice by providing them with empathy, motivation, or stress. Similarly, our practice can affect our personal life by creating satisfaction, joy, but also through burnout or ethical conflicts. When our moral values perhaps get challenged by the code of ethics of our work environment or our professional body, there can be this juxtaposition as to where do we go, what do we do, how do we work through it. And again, research and theory can affect both our practice and our personal lives by informing decisions and challenging our assumptions, inspiring us, but also sometimes confusing us. So, I think it's really important and something, as I say, has been discussed quite a lot in a few recent supervisions that I've had is around how do we balance these three legs. How do we understand how they relate to each other so that we can integrate our learning and make sure that we are balanced, rounded, we have different sources of information, we are constantly improving our practice, but we're not relying on one leg more than the other. And I think one of the reasons why I really like this kind of concept of there being this stool with three legs is that we know that actually if I'm standing on a stool and one leg is longer than the other two, I don't feel very safe. I am not balanced. I'm definitely vulnerable. And so how do we manage to secure the other leg? Because we might say that as a new graduate, I come out with some really good research and theory, and I've got my lived experience, my personal life, but my practical experience, that leg is going to be shorter because I haven't done the work yet. So, we're going to explore some of what that means in terms of how do we balance these legs. So, I want to just think about how we integrate these sources of knowledge. So, for example, let's think about we're working with somebody who might have some mental health needs. This is how we might combine those three sources of knowledge. So, first of all, in terms of our practice, we are using our clinical skills and experience to make an assessment. We're looking at symptoms, history, their presentation. This is also sometimes where we think about our intuition, our judgment. Often people say we have a gut reaction to things as if somehow that's not as valid. But actually, what we hold in our gut is all of that storage of knowledge that we've learned, that we've seen, that we grow. Through years and years and years of experience, we get a feel for things, right? So, trusting our gut, believing in what we're sensing, what we're feeling. We're not just observing, but we're picking up on the wider world, on the energy. We are understanding the person that is in front of us. So, we're watching them. We're monitoring their progress. We're looking for adjustments. And as we apply our interventions, we assess whether or not they're effective. We're seeking feedback from our partner that we're working with or from our peers. And we're talking in supervision about our practice. So, in order to provide an intervention, we are drawing on all of the clinical practice-based elements that we have come to know throughout our years of experience. Alongside that, we're using existing research and theory. So, we're informing our diagnosis. We're informing a treatment plan through research-based or evidence-based interventions. We have an outcome evaluation and evidence-based processes and feedback-informed treatment that may be proven to be effective for meeting whatever condition it is that we're facing. We might be using tools that are recognised, such as cognitive behavioural therapy, interpersonal play therapy. We are researching and staying updated on the latest developments. We might be looking at medication and contraindications and all of the things that come together, comorbidities. And we're looking at that from a research evidence-based perspective. And then, of course, there comes the personal. So, how I use my own personal values and beliefs to guide my ethical and professional behaviour. I'm using my emotions, my experiences to empathise with the person who's sitting in front of me. We're talking about the challenges they might be having, the stress of working in that space. How I'm maintaining a healthy balance between work and personal life. The support that I receive and all of those factors that are coming in. And any previous lived experience I may have had that has an empathy or a similarity to the situation of the person in front of me. So, by integrating these three sources of knowledge, we're providing a comprehensive and holistic service to FANO that's based both on science, but also humanity, objectivity, subjectivity, expertise, and that humanness. This model is really relevant to social work. And I think that's why I've been talking about it quite a lot. Because as social workers, we are impacted by all of these areas of knowledge. And we have to try and put it together and make that assessment and work out the best way forward. We are using research and theory to inform our intervention, to understand our assessments, to make evaluations and contribute to an evidence base of social work. But we're also using our personal lives to understand who are we? What are we bringing to the scenario? What are our values? What are our biases? What are our emotions and relationships that are impacting on the way in which we're working with people? Are we over-familiar because we have some lived experience? Are we making assumptions because that's what it was like for me, and therefore it must have been like that for when actually we're missing the signals that maybe it's not correct. There are lots of things that we're trying to understand and incorporate in what we do to make really good, effective ways of working with people. And so I think this model is really helpful to us as social workers when we're thinking about what opportunities are there for learning and our growth? How do we integrate practice and research and theory and personal in that really meaningful way that actually continues to have positive outcomes for the partner we're working with? So when we think about this theory, it can help us identify what are our learning needs, maybe some of our own personal goals and strategies. It can help us seek feedback, utilize supervision, undertake education. Because when we look at the three legs of the stool, we can always be assessing which ones may be a little bit short? Which one maybe is the one that's a little bit less stable? Which one have I spent a lot of time relying on, and the others are feeling maybe a little bit neglected? But balancing these three legs can be really challenging, but is very rewarding. There's no one right way to do it, and the different practitioners may have different preferences. It's about finding our own journey in that space. But I just want to think about a few strategies that may be helpful. Supervision is a really important place to be able to talk about some of this stuff. Getting that feedback, not just from our supervisor, but from our peers, from our mentors, from our managers, from the people who are witnessing our practice, and being able to look at what is it that we're drawing on the most? Is it our lived experience? Is it our personal values? What are we being most influenced by in our thinking and decision making? Are we relying really heavily on frameworks and theories and models without actually having that understanding of the practical implications? Have we applied any of those models in a real-world setting that enables us to be able to understand how best they're utilised? Is it our personal life that's really having the biggest impact on us right now? So, enabling that feedback and supervision space to be able to robustly explore and enable perhaps some feedback that isn't always what we want to hear, but is designed to be constructive. Another strategy is to be engaging in continuing education. Ongoing learning, I think, is critical to any profession, but within social work, things do change quickly. And attending workshops, seminars, conferences, courses, so that we're always updating our knowledge, our skills. I think that's obviously a key part of why our continuing professional development log is so important as part of our social work registration, but it's just also how do we connect with other people in terms of hearing other ways of doing things? If we just get stuck in the same rote of knowledge that we think we know, firstly, it may be out of date, but it's also about having a different experience or a perspective even on the same information. So, within that, part of that connectivity is also participating in professional networks, going on to groups, communities of practitioners where you can share your interests, values, challenges, people who can offer you opportunities for collaboration, for learning and advocacy. We work best when we work together. Social work is not something that is done in isolation. Social work is working socially. It is working with others. How do we draw on other people's knowledge and experience? If we ourselves are feeling a little bit like one of our legs on the stool is a bit shorter, can I borrow some of that expertise from someone else? So, if I don't have a lot of empirical knowledge about a particular topic, if I don't have a lot of research in theory, can I walk alongside somebody who has much more information about that? I can still have a relationship with the farmer. I'm still providing really good practice. I still have my humanness. But by working with other people who perhaps have more strength in that third leg of the stool where I'm lacking, then that enables me to feel more balanced, because I've got a safety in the fact that somebody else is also supporting that journey. It's also really important, like with anything in social work, that we ourselves are healthy. So, taking care of our physical, mental, emotional well-being, finding that balance between work and leisure, exercising, eating well, sleeping enough, meditating, relaxing, your general wellness. We talk a lot about the fact that if our cup is not full, then we cannot provide for others. If we ourselves are not well, if we ourselves are tired, then we tend to retreat back into the safe and the comfortable and the familiar. And we can tolerate a whole lot of imbalance on a stool because we ourselves are not balanced. And when that stool is wobbling, then we're not really doing good practice. I love to keep a journal. Part of my process is being able to write down our thoughts, my feelings, experiences. I think about our practice, all of that stuff that enables me to unload and release and leave behind some of that stuff so I'm not storing it emotionally. That's just an example, going for walks, thinking about that self-care strategy. But within that, what are our collective care strategies? So, those are just some examples of thinking about how we can balance these three legs, right? Being really reflective, being really mindful, talking to other people, that connection, that being able to get feedback, being able to engage in further learning, engaging in relationships, community networks, all of those things, really, really critical. There are also some possible limitations to this approach. It can be difficult to balance all three sources of knowledge, especially if they conflict or contradict each other. We've talked a little bit before, what happens if our personal values are different from research or our practice experience contradicts what should be occurring according to the theory? And sometimes we need to have an opportunity to resolve these tensions in a way that is still respectful and ethical. It may be challenging to integrate the three sources of knowledge, especially when they are complex and diverse. For example, you might find that there are multiple or competing theories or research findings on the issue that you're working with, and your personal life itself is multi-faceted, right? And we are complex, dynamic creatures ourselves. So, how we synthesise these with the people that we're working with, being able to prioritise what is the relevant bit of information and the perspectives that are going to help us to actually be able to move forward in a way that's coherent and meaningful. It may be demanding to maintain the three sources of knowledge, especially in those spaces where we require constant learning and updating. So, how do we know how to be able to draw on the support of others? We talk about the new graduate who has a strength in that empirical knowledge, the research and theory, possibly has a strength also in the lived experience and the personal life, but does not have that strength in their clinical practice because they simply haven't had that opportunity. I mean, we do two placements in a four-year degree. One placement is observation. It's a pretty limited exposure to actual practice working. So, a big part of that is around when we get a new job, what is the support programme around that? What is the mentorship that we've provided? There's internships that we can do that enable us to be able to work in a job, but in a really safe, secure way that enable those kind of training wheels to stay on a little bit longer, because otherwise we're going to be pretty imbalanced. You know, we have buddy programmes, people go out and do joint visits, all of that stuff. So again, I'm going to repeat, there are some possible limitations to this approach. By acknowledging and addressing these limitations, that also does help us enhance our practice and become more effective. Some of the possible ethical issues that may arise from this approach, so you may have a conflict of interest, you may face a dual relationship if your personal life overlaps with your practice or your research. For example, you have a personal or professional relationship with a client, a colleague, a researcher, a participant. You may need to disclose and manage these relationships in a way that protects the rights and interests of all parties involved. There may be things that challenge your personal beliefs, you may encounter a dilemma if your personal values or beliefs differ from your practice or research standards. For example, if you have religious, cultural, political views that are incompatible with the evidence-based practice or the ethical principles of your profession, you will need to accommodate these differences in a way that doesn't compromise your integrity. Boundaries is something that we talk a lot about as well. You may experience a boundary violation or a self-disclosure issue in your personal life that interferes with your practice. For example, you may have an emotional, physical, or mental challenge that affects your ability to provide a quality service. You may need to seek help and support for yourself and even terminate your involvement in the practice or in a research, if necessary, if you cross those boundaries. These are some possible ethical issues that may arise, but they can be prevented or resolved by following our ethical codes of practice, our guidelines for our profession, undertaking supervision, being aware of the responsibility for these issues. And we can, at all times, uphold the trust and respect of the FANO that we work with through that honesty and that transparency. So what are the risks when we really rely heavily on just one leg of the stool without having the balance of our decision-making from the other legs? People can make sure that the stool is balanced by being aware of their strengths and weaknesses in each source of knowledge and seeking to improve it. We've talked about ways in which we can improve it, that ongoing education, supervision, all of those things. If we feel that our personal life knowledge is rich but our practice knowledge is lacking, we can seek more feedback, supervision, mentoring from our peers and supervisors. People who are working from lived experience may have a unique advantage in having a deep and diverse personal life knowledge that can inform and enrich their practice and research. However, they may also face some challenges in balancing the stool. So there can be difficulties separating personal and professional roles and boundaries, especially if they work with clients or FANO that share similar experiences and backgrounds as them. They need to be careful not to impose their own views or expectations on others or to over-identify or over-disclose with them. And I think about this real importance of having a lived experience voice in a lot of the service delivery that we do at the moment. We have a lot of lived experience voice, for example, in mental health service delivery, in drug and alcohol addiction service delivery, and it's really important to understand from the perspective of the people receiving the service what is a meaningful service. That's part of not only lived experience, but it's also part of our research. How do we actually determine that what we're doing is effective and is having the outcomes that we hope it does? There is, however, this kind of risk that when we rely on practitioners solely from the perspective of they've got lived experience and therefore they are good practitioners, then we're not really doing a very good job in terms of our supervision, in terms of our management, in terms of our employment, in being able to support that practitioner. Because when we have practitioners who operate only from lived experience, in the same way that if we have practitioners that have only ever done research and never actually had a face-to-face conversation with a farmer that they're working with, then we are putting people into situations, practitioners into situations, that's simply unfair. I'm certainly not meaning that to sound like a disservice to people with lived experience or for people who have strong research backgrounds or indeed people who've been working in this industry for a long time, just highlighting the challenges. When we lean very heavily just on one leg of the stool, we're not necessarily enabling or equipping our practitioners to have that rounded view. I certainly know that when I work with people who've had similar experiences to what I've had, I can be at risk of over-relating with them and thinking, well that was what it was like for me, or this is what helped me and so it's going to help you too, and all of those kind of simple things that come from good intentions but don't necessarily allow that moment of reflection to think that your circumstances, your personality, your environment is different or needs something else other than what worked for me. So we just think about how we have difficulty separating our personal and professional roles in this space, working with people for whom we feel very familiar experiences and how I maintain my role as a social worker and not to be there as a friend or to be there as somebody who's walking alongside them with the same experience as them, that I still have to maintain I have a professional role and there is a purpose to my engagement. So we can sometimes have difficulty coping with the emotional and psychological impact of working from lived experience, particularly if we're not fully healed or resolved from our own issues of trauma. At our recent book club we had a conversation around trauma and there's that phrase that says, hurts people hurts people, that actually if we ourselves are not really healed, if we ourselves are carrying still some hurt and something unresolved, then the likelihood is that the work we do with others could be potentially more harmful than helpful. But we also know that there's that space of hurt people can heal people in terms of if I've been through an element of trauma, if I've been through challenges in my life, if I have that lived experience then I'm able to use that learning, that growth to help heal people. So maybe the phrase is that healed hurt people, heal hurt people, that actually by resolving, finding a solution, being able to have full reflection and understanding of the experience that I've been through, but I'm sitting now in that healthy space, that I'm able to utilise that to be able to help other people. It's a very complex concept. I don't know if as humans we're ever fully healed, but I think we have to at least be on that journey. So people who are working from lived experience can balance the stool by being aware of these challenges and risks and taking steps to address them. We can understand and recognise the value of lived experience as a source of knowledge and we share it with others in that respectful and ethical way, but it is only one source of knowledge. And again, I've talked about the similar challenges for new graduates who come with no practice experience, that they may have a different challenge in balancing the stool. The applied nature of being able to work, utilising research methodology, frameworks, that new graduates may have difficulty developing their practice knowledge, especially if they lack opportunities or support to in the workplace. So sometimes they have to be really proactive and persistent and seek diverse and challenging experiences that can enhance their competence and their confidence. People who are newly graduated with no practice experience can balance the stools by being aware again of these challenges, by looking at what knowledge they do have, how to use it and being able to get some support in finding that critical and creative voice that enables them to be able to really assess the effectiveness of the model or the framework that they're using. But as organisations we have this responsibility to make sure that our practitioners are working in the most balanced way. So how do we do that? So social work organisations can proactively identify people who are not kind of sitting on a balanced stool, so to speak, and support their development. They can use competency standards, professional capability frameworks in order to be able to make that assessment. We do performance reviews, we have development plans, we have these things that enable us to be able to really explore how well someone's doing in their job. We provide ethical education and training to our staff. But it's also really important that we've got supervision, consultation, mentoring, fostering a culture that enables learning within the organisation, where we encourage staff to seek, share and use different sources of knowledge, where we facilitate learning opportunities, workshops, seminars, courses, webinars, mentoring, coaching, whatever it might be. I think often about how busy we become in the workplace and when we get busy because we're short-staffed and there's a high level of need in the community, the first things that often go from our calendars are supervision, networking, training. They're the ones on the edges of the plate that we just push off when we don't have time for anything else. And yet they can be the most critical things to enable us to actually be effective in our practice. So we need to work within organisations that promote diversity and inclusion, that we respect the values of different sources of knowledge that staff bring, that we enable that kind of cross-contamination of knowledge, that we have people with strong lived experience, strong research backgrounds, long-term practice-based experience, being able to come together and share, acknowledge, respect and value each other. These are just some possible strategies that social work organisations can use to proactively support people, enabling them to be more balanced in these three areas. Of course, they're not exhaustive or exclusive and social work organisations may find lots of other strategies to suit their own context and their goals. Belbird is passionate about these aspects of supporting practitioners in order to be able to deliver effective social services. Supporting that learning, that connection, those opportunities for coming together as a community to be able to work together effectively, whether it's within your workplace or within a community, whether it's simply listening to a podcast to maybe learn something different, coming along to a book group to connect with like-minded people, having some practice forums, going to a training, attending a conference, or doing some work as a team around what are our values and how do we grow. If there's any way in which Belbird can help you then obviously please talk to us, but think about it for yourselves and in your own workplaces. What can you take away and think about? Not only what do you need for your stool, how do you make sure that your three legs are balanced, secure, safe, but how do you also help your colleagues too? Really reflect on your three legs. How balanced are you really feeling at the moment? What strengthens you and what could you enable your colleagues to also share in as well? What areas do you think you could spend a little more time enhancing? This is a continuous journey of development across all of our areas. If you've got any thoughts or feedback on this three-legged stool, I'd really love to hear from you. I think it's a really interesting concept to think about how we pull together those areas of learning. And in the meantime, thank you so much for listening. Take care.