"It's Always Intentional": A Simulation-Based Study on Racial and Social Justice Work in Direct Practice

Background and Purpose: Social work aims to promote racial and social justice (RSJ) by centering the needs and strengths of those affected by intersecting systems of oppression. Literature on RSJ, however, remains conceptual and focuses largely on community and policy work, leaving its application to direct practice unexamined. The purpose of this study was to translate this commitment into a practice model, asking: How do social workers operationalize their commitment to RSJ within client sessions?

Methods: Simulation was used as a research method. We observed and video-recorded a 30-minute online session, where experienced social workers (n=30), ages 25–65, engaged with a Simulated Patient (SP; trained actor) who portrayed a client experiencing an intersecting nature of injustice. More than half of the participants identified as BIPOC, queer, and cis women. Post-session research interviews were conducted for the participant to identify a pivotal segment in the session and explore how the work was navigated from RSJ perspectives. Interviews were audio-recorded and transcribed verbatim for analysis on Dedoose, using Grounded Theory (GT) coding methods. A community advisory board representing diverse communities provided guidance to ensure the results reflect practice realities.

Findings: Results consisted of six themes that form the practice model, comprising three primary processes: 1) Intentionality, which informs every aspect of practice, 2) foundational model elements of Practitioner-in-Relation and Holding Space and 3) Inviting, Disentangling, and Catalyzing—three separate but interconnected critical process of direct practice. Intentionality was a central theme linked to all other themes. This theme reflects the power of one’s values and ethical principles that directs client work, which are informed by various RSJ theories and knowledge. The theme of Practitioner-in-Relation, similar to the use of self, means the practitioner’s integration of their own positionality and knowledge of RSJ movements, as revealed through their committed learning and critical self-reflection. This is a dynamic, context-dependent approach to disrupting power imbalances, contingent upon who the client is. Holding Space is a critical version of therapeutic relationship and refers to how the practitioner structures therapeutic safety, which allows the client to freely express their thoughts, feelings, and embodiments. The last three themes refer to a critical approach to client engagement, assessment, and intervention. Through the theme of Inviting, the practitioner foregrounds transparency and client agency, while inviting the client to share their experiences at their own pace. In addition to conventional assessment, practitioners engage in Disentangling the complex relationship between presenting concerns and the social and political relations of power across time, place, and RSJ movements. Finally, Catalyzing refers to a critical form of intervention, in which the practitioner joins voices with the client in honoring their identities, naming oppressions, validating embodied experience, and co-creating practices of healing.

Conclusion and Implications: Grounded in rich simulation-based data and robust GT analytic methods, results of this community-based study offer concrete ways in which practitioners might operationalize RSJ principles in direct practice. This empirically-derived practice model supports future work in theory development and the advancement of an intersectional approach to RSJ in direct practice.