Navigating Uncertainty in Clinical Social Work Practice: A Pilot Simulation-Based Study

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While clinical social work has a strong conceptual understanding of uncertainty, there is a lack of empirical data on how practitioners navigate uncertainty in practice. This paper reports findings of the data generated from a simulation-based pilot study designed to explore clinical social workers’ encounters with uncertainty and the strategies they use to navigate it. Experienced clinicians (n = 4), recent graduates (n = 4) and graduate students (n = 3) participated in a 30-min video recorded case-based simulated session with a live standardized client (SC). Using standardized clients, simulation-based research methodology allowed us to capture moment-to-moment practice behaviours and decisions among social workers. Following each simulation, participants reviewed the video-recorded sessions and engaged in an audio-recorded reflective dialogue with a researcher. Two themes emerged from the data sets: (1) there is a variation between less experienced participants who navigated uncertainty in pragmatic, task focused ways and more experienced practitioners who focused on the wider relationship with the client; and (2) less experienced practitioners tended towards struggling against uncertainty while more experienced practitioners demonstrated an ability to sit and wade within it. These findings offer several implications for clinical social work research and practice, including the important role that simulation methodologies have in exploring clinical practice and the need to understand specific aspects of uncertainty in clinical practice.