Sexual Health Social Work: Needed Clinical Practice Competencies and Skills

Background: There is widespread agreement that sexuality is central to human identity, holistic health, and wellbeing. Social work, an anti-oppressive, practice-based profession focused on social justice supports people’s access to and ability to create healthy lives. Therefore, social workers should not only understand and value a service user’s sexuality, but also be able to competently navigate this area of practice. Yet, there is also acknowledgement of the uneasy fit between sexual health /wellbeing and social work education and practice.

Neither the Council on Social Work Education nor the Australian Association of Social Workers requires accredited social work programs to provide comprehensive sexuality education. Additionally, there are no dedicated conference tracks to sexual health at either conference. Not unsurprisingly, there are limited studies that identify core sexual wellness competencies needed for entry-level social workers in sexual health practice settings.

Social workers as part of this research identified intervention skills for social work students to address sexual wellbeing, an often-taboo topic that presents increased injustices for marginalized populations. Implications for an innovative direct practice approach, a sexuality-informed practice lens are discussed.

Methods: The mixed methods study was influenced by our commitment to sexual justice and informed by anti-oppressive social work research with its focus on active participation and knowledge creation to identify, disrupt and challenge oppression.

The mixed methods study involved a scoping review of sexual health services in the Sydney area followed by an email to agency workers inviting them to participate in a survey and focus group. Approximately 50 agencies in Sydney were identified as providing sexual health and well-being services. Participants came from a range of agencies in the sexual health sectors.

Results: Key findings included: a) normalize, b) sexual health = social work, c) sexual history inclusive assessments, d) permission giving, e) sexuality resources, f) distinguish queer-affirming and sex positive social work, g) operate from sexuality models. Three basic skills: a) be respectful, b) be prepared, c) be curious combined into an overarching basic skill: be askable.

Conclusions/ Implications: A cornerstone of social work education is to help prepare students to enter the workforce as practitioners with an explicit value base promoting social justice and anti-oppressive practice. An understanding of “sexual justice” has implication for antiracist social work education and practice. However, there is “little preparation of social workers to engage clients around sexuality”. This is to the detriment of service users and remains an underdeveloped aspect of anti-oppressive practice along with limiting understandings of intersectionality. This study identifies key sexual wellness competencies and skills to be integrated in social work curricula. Social workers skilled in utilizing a sexually-informed practice approach are better prepared to support individual service users and families, but also have a richer understanding of anti-racist practice within the communities in which we work.