Transformative Mental Health Social Work Practice: What,When,and with Whom Do We Learn?

Abstract

Transformative mental health social work fosters participatory processes that drive emancipatory changes in services and systems, addressing societal barriers to inclusion, equity, and full citizenship. This study explored how transformative practices, aligned with United Nations' calls for reform toward person-centred, rights-based mental health recovery across Canada and Australia, are learned. Using co-operative inquiry, the research captures diverse experiences and knowledge from social work practitioners, managers, students, academics, and family members in a practice research partnership to examine how learning prepares and sustains mental health social workers for transformative practice. Findings revealed an iterative approach to learning in mental health, highlighting the diverse foci of learning (what) at various career stages (when) and the reciprocal nature of learning for and from others in the practice environment (from whom). In this unique context, the study underscored the importance of professional identity resilience.

United Nations’ calls for the transformation of mental health services to protect the human rights of people who experience mental health challenges align with our parallel interest in learning enabling transformative mental health social work practice (United Nations Human Rights Office of the High Commissioner (UNHROHC), 2017). This paper reports findings from a study within research investigating mental health social work pedagogy and practice with people living with severe mental health challenges. The distinction between mental health and mental illness is notoriously difficult to define (Richter, 2025). This research focused on those experiencing severe mental distress or mental health conditions that can result in diagnoses such as schizophrenia, personality disorders, and bipolar disorder (Whitaker et al., 2024). Thus, we refer to mental distress and mental health challenges throughout. The research also referred to the Model for Holistic Competence which acknowledges procedural competencies (knowledge and skills) and metacompetencies (self-regulation and judgment) required for social work practice (Bogo, 2018). This study examined lifelong professional learning; a complementary study investigated practice (Whitaker et al., 2024).

Transformative Mental Health Social Work Practice

Social work is inherently aligned with UNHROHC (2017) calls for change to end decades of neglect, abuse, and violence toward persons experiencing mental distress, enabling a long overdue shift to rights-based approaches. Our research confirmed mental health social work is complex in part due to navigating tensions associated with discordance between the profession's values and dominant biomedical and neoliberal paradigms in mental health (Bogo, 2018; Whitaker et al., 2024). As a profession it is further confined by regulatory and legislative oversight which may limit desired advocacy practices. In this study, Transformative practice includes all elements of holistic competence in social work that aim to equalize power imbalances and align with calls for change/reform toward person-centered, rights-based mental health recovery. Such practice is driven by a commitment to social justice, which can be defined as “questions over the socio-political organisation of society, including how and on what basis social resources are distributed, human rights, and people's access to decision-making processes that impact on their health and their wellbeing” (Watts & Hodgson, 2022, p. 14). The study investigated learning which fosters and supports transformative social work practice in this field.

Lifelong Learning for Social Work Practice

Social work students move from learning about practice in the classroom to learning how to practice during field placements (Bogo, 2018). Although pedagogies are diverse and varied, the threshold pedagogy of critical reflection is employed throughout careers to uncover and challenge power dynamics that frame professional decisions and action (Whitaker & Reimer 2021). It brings explicit awareness to the human rights and social justice commitments of social work and allows for alternative conceptualizations of antioppressive practice (IFSW, 2014; Morley & Stenhouse, 2021).

The mental health field is characterized by distinct paradigms holding potential to shape the experiences of people with lived experience (PWLE) of mental distress and social workers alike. Among these is neoliberalism, the primary ideology driving contemporary healthcare delivery, characterized by reduced public expenditure, privatization, and individual responsibility (Edwards & King, 2022). Neoliberalism's alignment with the individualist focus of the biomedical view (Edwards & King, 2022) stands in direct contrast to critical social work and human rights paradigms aimed at reducing harm from coercive practice, compulsory treatment, and macrolevel determinants of health (Whitaker et al., 2021). Critically, reflective education uses critical analysis to develop practice alternatives to dominant psychiatric models where deeply embedded social work values compel significant change (Morley & Stenhouse, 2021).

Marion Bogo's evidence-based model of holistic competence in social work captures the complex, integrated nature of social work practice and emphasizes that competence involves more than discrete skills (2018). It requires the integration of skills and knowledge (competencies) with judgment, critical thinking, intentional use of self and self-regulation (metacompetencies), all of which are grounded in social work values and ethics (2018). The framework also reflects the varied organizational and community contexts of practice and their influence on the work. Although developed in an academic context to delineate holistic competency within a primarily Western cultural context, reference to this framework allows for consideration of practice learning toward transformative practice by revealing the challenge of navigating tensions in the unique context of mental health social work practice and by inviting deeper consideration of related competencies and metacompetencies in this field.

As students and graduates enter the practice field in mental health, they are challenged to possess the skills and confidence needed to engage in social justice-oriented practice and retain their emerging professional identities as social workers (Kourgiantakis et al., 2020; Hitchcock et al., 2024). While they will have been educated in a biopsychosocial and indeed spiritual approach—in both Australia and Canada—in their contemporary undergraduate or entry-to-practice Masters course, the clinical setting will present a hierarchical experience whereby many key meetings are chaired by medical staff, and the workforce includes a greater proportion of nurses than all of allied health combined. “Imposter syndrome,” the experience of discrepancy between the ideal professional identity encountered in the classroom and that encountered in day-to-day practice, is a common challenge undermining confidence in practicum and early-career learning (Hochman et al., 2023; Smith et al., 2022). Students and early-career social workers struggle to grasp a “social work identity,” particularly in a paradigmatically unfamiliar environment such as that of biomedically driven mental health systems (Smith et al., 2022). Identity resilience emerges as an ancillary construct of importance as social workers strive to develop and sustain professional identity within neoliberal environments (Long et al., 2023).

In this study, learning toward transformative practice refers to learning that occurs when individuals are confronted with experiences that do not fit with their current framework of understanding, in ways that disrupt stereotypes and established beliefs, and act as catalysts for the critical examination of assumptions and stigma surrounding mental distress (Mezirow, 1978). Transformational learning “involves shifting problematic frames of reference as fixed assumptions and expectations … to make them more inclusive, discriminating, open, reflexive, and emotionally able to change” (Mezirow, 2003, p. 58). It cultivates critical consciousness, which Mezirow (1978) sees as a deep shift in how individuals perceive reality and their role within it. Through ongoing critical and self-reflection, people reassess past beliefs and form new, more expansive understandings that can prompt them to act in new and different ways (Mezirow, 2003). New, critical frames of reference are better suited to transformational social work learning because they guide action through more meaningful, accurate, and justified beliefs and understandings.

Study Rationale

To date, pedagogical research has revealed numerous educational strategies for fostering the resilience of future practitioners and preparing students for effective critical mental health social work practice (Lee et al., 2020) and the need for a scaffolded or iterative approach to the development of holistic competence including professional identity. Acknowledging this wealth of pedagogical techniques, this study aimed to understand lifelong learning that supports transformative mental health social work practice specifically. We addressed the research question: What, When, and with Whom do social workers learn for transformative practice in mental health?

Method

Using cooperative inquiry, this research drew together an Australian/Canadian practice research partnership of colleagues involved in mental health social work education and practice (Julkunen et al., 2024). In cooperative inquiry, the researchers are the subjects. It is research “with” people, not research “about” people (Russ et al., 2025). This study sought to capture diverse perspectives from parent/caregiver advocates, students, practitioners, directors, and social work academics. Grounded in a shared recognition that the context of mental health practice, despite its variability in terms of setting, is often marked by unequal relations of power that can further oppress those individuals, families, and caregivers living with severe mental distress, we sought to engage these diverse perspectives to identify learning practices fostering transformative mental health social work practice.

Study Design

Cooperative inquiry was the approach selected for its potential to develop new knowledge derived from varied life experiences and perspectives and because of its rich participatory and iterative method that draws on experiential, presentational, propositional, and practical knowledge (Heron and Sohmer, 2022). It is a four-step approach that cycles through distinct phases of: engagement, focus, reflection, and analysis (Heron and Sohmer, 2022; Russ et al., 2025). This inquiry spanned a period of 30 months, spawning two complementary projects of which this is the second (Whitaker et al., 2024). Purposive sampling and recruitment aimed to engage a broad range of positionalities in critical mental health social work education, from Ottawa, Canada and Queensland, New South Wales and Victoria, Australia. Group composition remained highly consistent over time with early attrition of two participants (one PWLE and one student) and a third (the executive director of a mental health organization) at midpoint. Canadian participants included a social work student, a social work academic, a parent and family advocate, a youth mental health social worker, and the director of social work and allied health in a tertiary level mental health care facility. The Australian contingent were mental health social work academics from four Australian universities, each with mental health experience of more than 25 years. Ranging in age from 20s to 60s, the team included men (two) and women (seven) of diverse sociocultural identities. All co-inquirers collaborated in deciding on the research question, contributing to data collection and analysis, documenting findings, and refining the final manuscript. Thus, having agreed to join a cooperative inquiry into mental health social work education, all members of the team influenced all aspects of the research process, including determining conclusions.

The project was undertaken online, across distance and time zones, with regular, usually tri-weekly meetings via Zoom videoconferencing throughout 2022 and into 2024 (Whitaker et al., 2024). The method of data collection involved dialogue, reflection, and discussion online. Minutes of meetings were documented and these written transcripts referred to as data. Data were analyzed using NVivo and collaboratively in online meetings. Findings were documented iteratively, through asynchronous contributions of participants between meetings.

Data Collection and Analysis

During the first stage of the inquiry (January to February 2022), the research group was established. Participants were provided with an online drive and document for sharing relevant experience and biographical information. Collaborative principles were confirmed and collective authorship discussed. Ethics approval was not sought as no third-party data was to be collected. Cowriting of manuscripts would ensure all participants were able to influence how data and findings were reported (Russ et al., 2025).

In stage two (February to May 2022), the research group collectively reflected on experiencing and learning transformative mental health social work practice. The data set was developed by documenting discussions of working and learning within mental health services, accessing them as family members and supporting students in the classroom or practicum to prepare for practice. Literature and resources were shared and reviewed.

In the third stage (May to October 2022), the group collectively critically reflected on a preliminary analysis of the data. Referring to the Model of Holistic Competence (Bogo, 2018) and using NVivo software, two participants undertook this analysis. Discussion of the preliminary analysis with the team identified two distinct themes: the nature of transformative mental health social work practice and learning for transformative mental health social work. This inquiry focused on the latter.

In stage four (November 2022 to July 2024), through rich, in-depth discussion, participants explored their experiences of learning enabling transformative social work practice. An unavoidable break in 2023 allowed participants to reflect on the inquiry independently, prior to resuming in April to July 2024 for data analysis. Participants reviewed and synthesized understandings, discussed additional themes, and identified areas of consensus and points of divergence to document in a shared manuscript. Quotes derived from the data were selected and agreed upon to represent the range of views expressed throughout the inquiry to answer the research question.

Results

Scaffolded Learning for Mental Health Practice

Working in a mental health system that serves people with serious mental illness is this whole new world of medical dominance, shortages, immovable structures, political whims that fuel change, stigma that overlays everything for both the users of services and the service providers, and so on (Cynthia).

Findings revealed that learning sustaining transformative mental health practice in the context described by Cynthia is iterative, scaffolding across career trajectories from classroom to practicum, early career and mid-late career. Learning is fostered through relationships with a range of individuals in both professional and nonprofessional roles, evolving and accumulating across the career trajectory. In this section, we discuss the scaffolding of “what” is learned and of “from whom” social workers learn at each of these career stages. The “what” is presented with reference to the model for holistic competence (Bogo, 2018).

Phase 1: Learning in the Classroom

Findings revealed transformational learning in the classroom laid the foundation for future transformative mental health social work practice. We agreed that social work students need to learn about critical and constructivist frameworks alongside metacompetencies (critical thinking, judgment, self-awareness) to prepare graduates for transformative practice. While students may seek to develop clinical skills at this early stage, we agreed that grounding in the social justice imperative of the profession was imperative. As Brenda said, “The system is in dire need of transformation, [and] we want social workers to [be able to] contribute to the needed transformation.”

Disrupting biomedical models and inherent power imbalances through responsible critique and engaging diverse conceptualizations of mental health were seen to hold potential to unsettle pejorative internalized assumptions, biases, and mental health stigma. When considering the context of student learning, Louise asserted, “I think that you need to provide spaces in which they realise what transformation is … alongside transformational learning ….”

The classroom was revealed as a venue to question biomedical conceptualizations of emotional well-being and mental distress, bringing due recognition to their contested nature and establishing new understandings of how oppressive social conditions such as colonialism, patriarchy, ableism, cis-heteronormativity, and global capitalism, combined with social determinants of health, have impact on mental well-being. As Cynthia reminded us, students need to learn to think critically, fostering “a healthy scepticism to the very material that's being taught.” As Louise said, students need to “understand these different ways of thinking” and learn how to analyze and critique conceptualizations of mental distress.

Classroom learning occurs within relationships with instructors, academics, practitioners, PWLE, family members, and peers. Learning with and from PWLE emerged as a key feature of classroom learning and was seen as closely associated with recovery orientations to practice. As Cynthia said,

There are people who tell their stories in an encouraging way, and talk about how important staff are in this journey. … [This can] open the person's eyes to new ideas so they can start digesting what might confront them and how they’re going to deal with it [in practice].

As Brenda acknowledged, “Transformational learning is about very explicitly engaging the voices of people with lived experience… to disrupt the hegemony and belief systems of biomedical models.” There was recognition that codesign with PWLE is optimal as it involves centering PWLE and family as coteachers.

In addition to critical thinking and codesign, the classroom is an important space for students to discover when and how to disclose their lived experience, manage their reactions to other students’ worldviews, and relate across differences. Julian was concerned that “we don't talk enough about the self disclosure piece.” And, as Louise said, “uni is supposed to be the safe space to experiment with that rather than when you get into the workforce.”

Phase 2: Learning in Field Education/Practicum

Field learning requires movement from theoretical knowledge and commitment to social justice and human rights, to hands-on-practice within settings where students have little power and varying levels of responsibility. “What I am really learning in school is the toolkit … [How do I take] these tools, skills, and the values [of the profession,] …and then apply them in the workplace?” (Julian). A blend of clinical skills and knowledge (i.e., the application of biomedical basics such as the Diagnostic and Statistical Manual of Mental Disorders, mental status examination, and pharmacology), critical reflection, self-regulation, and the use of supervision are called for when bridging into practice from the classroom.

As Julian stated,

What I would want to know … (is) how to work with clients with severe mental health concerns to engage them in their care … how are they treated within the system and out in the community? What would be most helpful to them … and how can we advocate for them within organisations?

Emily elaborated on needed skills, stating, “When [thinking] about what promotes transformation in mental health practice…advocacy and activism in partnership with those with lived experience comes to mind.”

Both advocacy and activism may be quite new for practicum students. Advocacy requires moral courage to challenge systems that can limit client care, as well as distress tolerance and the ability to stay regulated when activated around human rights issues. And “advocacy is hard without much power. It's about leveraging others’ power” (Cynthia). Learning with and from supervisors and colleagues becomes key. “Those new to practise sometimes bring the energy and eagerness to change the system, and those who have been working in the field for a while often know how to get results … many have tricks in their toolboxes” (Emily).

Orienting advocacy efforts toward recovery and person-centered goals may place students in tension with team members focused on clinical management of symptoms. This advocacy can be complicated by the mainstreaming of recovery as a stated objective within predominantly biomedical health institutions, where its meaning can be shaped by clinical paradigms and reduced to symptom management (Rose, 2014). Findings identify that developing social capital and positive relationships with colleagues become critical ancillary skills underpinning advocacy.

Practicum learning involves learning with and from field placement supervisors, clinical educators, interprofessional teams, and community partners, in addition to those encountered in the classroom. In practicum, students learn more collaboratively with PWLE, family members, and interprofessional teams. Findings emphasize the reciprocity of this learning, enriching student understanding of lived experience and fostering empathy. “I had some of the most meaningful learning, hearing from those you know, the clients themselves and the family members themselves” (Emily).

Students learn to build professional relationships with clients and families, often navigating heightened emotional interactions. How to develop rapport while managing emotional responses and maintaining professional boundaries can be managed in supervision and through continuous critical reflection on self and practice. In the words of Melissa, “Critical reflection needs to be ongoing [not only on practicum] … People need to make a commitment to that on their own time.”

Phase 3: Learning in Early Career

Newly graduated social workers navigate complex interprofessional team dynamics and roles, and learn how funding and decision-making structures operate within their organizations. Simultaneously, they build essential clinical competencies such as assessment, documentation, and reporting, all while managing large caseloads. These expectations far exceed those of their practicum education. As Julian noted, new social workers are rapidly learning about “policy, context, and organization, developing team relationships, consolidating professional identity, and practicing clinical skills in a mental health context.” While these challenges may appear to be a simple extension of practicum learning, they come with heightened responsibilities, including professional obligations, ethical decision-making, clinical judgment, and risk mitigation.

Emily raised an important and ongoing challenge:

How do we help to keep the fires in the bellies of our new social workers burning, and how do we help them not to lose the energy needed for true transformation of our fragmented mental health care system?

Julian echoed this challenge. “Especially after graduating, where we're taught, like social justice, social justice, social justice, client first. How do we then go into organizations where their policies hinder that?”

Amanda similarly reflected on the internal conflict faced by early-career social workers:

I’m often weighing what the outcomes will be when balancing client needs and agency policies… What are the consequences if meeting my client's needs goes against agency policies? How much can I push against the system without it impacting my career?

New social workers are acutely aware of the risks of ineffective practice, with some expressing concerns about their competence as Julian shared: “You’re praying that you’re going to develop these [clinical] skills along the way, but also, you’re worried about losing your license.”

New professionals are immediately expected to de-escalate crises and intervene in high-risk situations with limited support and experience. This phase of practice marks a shift in accountability, from field supervisors and academics to social work colleagues, employers, managers, and discipline leads who are responsible for ongoing supervision and evaluation. These hierarchical relationships nonetheless provide rich opportunities for learning. New practitioners not only refine their clinical and relational skills but also gain a deeper understanding of client needs and effective advocacy, all while striving to uphold social work's core social justice values. Julian reflected on how this learning becomes increasingly contextualized, which also impacts learning needs throughout early career when practitioners may be assigned to changing clinical units or departments. “I’m learning about the population I’m working with and starting to identify common struggles they face, which makes it hard to switch between different positions or clinics” (Julian). The reciprocity of learning again emerged as a central theme: “We learn from the people that we're aiming to support …, and that's very circular and ongoing and nurturing our professional practice development all the way along…” (Brenda).

Early-career social workers face challenges as they transition from education to practice, navigating organizational structures and ethical dilemmas while building essential clinical skills. They encounter imposter syndrome, struggle to balance client needs with agency policies, and grapple with the tension between social justice values and the day-to-day realities of their organizations. Early-career practitioners benefit from supportive communities of practice within which they refine their clinical and relational skills and gain a deeper understanding of both the populations they serve and the systems within which they work. Through this process, they grow in confidence, professional identity, and the ability to advocate effectively for clients within often resource-limited and hierarchical environments. Early-career social workers learn from an expanding network that includes employers, managers, colleagues, and discipline leads.

Phase 4: Learning in Mid-Late Career

In this phase, competencies and skills increase and social workers become both formal and informal leaders. Developing skills of mentorship and multilevel supervision, midcareer social workers play a critical role mentoring identity resilience for junior colleagues and peers. Learning at this stage includes engagement with senior leaders responsible for strategic planning and high-level institutional decision-making. Reciprocal learning with clients and families continues. In mental health, subspecialization occurs and social workers develop expertise in specific areas of practice, engaging extensively with collateral or community contacts within service systems and networks, internally and externally. As they gain knowledge and confidence, midcareer social workers are often looked to for guidance by junior social workers, in addition to their career-stage peers. This provides an opportunity for mutual enrichment, with new staff bringing new perspectives, and more established social workers holding knowledge about system navigation, how to complete specialized assessments and advanced clinical skills. “I think there's a lot of learning from other social workers in the field, peers even, of course, more and more sort of senior social workers and also colleagues” (Emily).

Findings revealed that mental health is a rich but ethically fraught environment in which to practice. As social workers gain specialized expertise and confidence in their ability to support and partner with PWLE, they remain vigilant and aware of systemic pressures within their workplaces. More experienced and senior social workers who move into formal or informal leadership roles at midcareer grapple with the desire to continue to push for much needed change while simultaneously finding themselves more and more deeply embedded within institutions anchored in the biomedical model. In addition, “mental health care is in a constant state of flux” (Cynthia), bringing new priorities and responsibilities that require social workers to lead change that can be constrained by policies/procedures and/or funding source demands. According to Emily and Louise, “It becomes harder… when you're out there for a while… that identity gets a little bit more challenged” (Emily). “The requirements of the organization can start to dominate” (Louise).

Although well-positioned to engage in system-level advocacy within mental health systems, the resource constraints of neoliberal institutions combined with biomedical hierarchies of power can limit the impact of social work advocacy toward change. As advocates for social justice and members of regulated professions, social workers may find their efforts toward transformative practice further constrained by nonnegotiable legislative and regulatory responsibilities—structures that themselves may be in need of transformative change at a macro level.

As Fredrik and Cynthia note, change efforts can have implications in the work environment, sometimes creating resistance. “Someone usually stands to lose something, and it tends to be power… with any kind of transformation we're trying to do" (Fredrik). “Progress is welcomed and necessary BUT living in this time of so many changes is tough—especially for those of us who champion change” (Cynthia). In this context, social workers may experience ethical uncertainty relative to their commitments to institutions and relationships versus PWLE both within and beyond service institutions.

As social workers become more established within organizations, they are given opportunities to participate in rich educational spaces such as committees, town halls, or focus groups, which provide ongoing learning and the opportunity to represent the profession and reinforce professional identity. As Fiona recognizes, “This ongoing education is part of sustaining professional identity resilience.” Subsequently, they become go-to people who support colleagues to navigate discomfort with service delivery systems while simultaneously engaging in social work practices toward system change. Through their work supporting new staff in handling risk assessment, crisis intervention, client death, uncertainty, and imposter syndrome, they continue to learn from and with new staff.

Discussion and Applications to Practice

The study revealed an iterative approach to learning across career trajectories in mental health and highlighted the diverse foci of learning (what) at various career stages (when) and the reciprocal nature of learning for and from others in the practice environment (from whom). While not intended as exhaustive, identification of distinct phases of learning in mental health social work enabled distinguishment of foundational content and competencies.

Learning is iterative and cumulative. The study reinforced that social work learning for transformative practice is highly contextualized and influenced by near-constant change in mental health service strategy and clinical approaches. This results in rich nuanced knowledge, skills, and metacompetency development across multiple phases. Through our cooperative inquiry approach—while certain learning occurs across a number of phases—the individuals in this inquiry, across multiple perspectives and disciplines, found that certain key learnings were more typical or central in one phase rather than another. Core findings reveal the significance of scaffolding learning toward transformative practice across programs and careers, and the related value of thinking through key knowledge, skills, metacompetencies, and colearners at each phase of education and career.

Figure 1 illustrates the cumulative nature of learning as a lifelong, phased, and nonlinear trajectory marked by shifting areas of focus on key competencies (skills, knowledge) and metacompetencies (self-regulation, judgment) (Bogo, 2018). Findings also suggest that circular links and pathways exist between and among phases and learners, and the dimensions of what, when, and with whom are deeply entwined. Learning is continuous and may circle back on itself when practitioners change roles or areas of practice, or when treatment approaches and/or policy change, blurring the lines between “mid/late career” and “early-career” learning.

Figure 1.

Phases and Foci of Learning for Transformative Practice.

Learning is equally reciprocal. Learning with and from the expertise of others’ experience is critical in mental health social work, as it sustains both professional identity resilience and holistic competence toward transformative practice. It begins in the classroom when educators explicitly enact the concept of colearning through the involvement of a range of peers, academics, PWLE, practitioners, and voices from the literature in courses/subjects (Laing & Maylea, 2018; Lambert et al., 2021). This circle expands across subsequent phases to include clinical educators, managers, senior systems’ leaders, and beyond. Beginning in the classroom, educators decenter biomedical narratives of mental health in favor of constructivist approaches capable of integrating diverse frameworks including Indigenous worldviews, mad studies, and varied cultural perspectives, thereby fostering an openness to ongoing reciprocal learning from a wide range of others. Notably, findings underscore that critical conversations with PWLE and their families hold powerful potential to unsettle previously held pejorative beliefs about severe mental distress that underlie the exclusion of PWLE and their families from desired care and support in practice.

Regardless of career stage, findings emphasize the importance of professional identity and professional identity resilience within a practice context heavily influenced by biomedical approaches and neoliberal pressures. It begins when social work values, ethics, and principles are encountered in the classroom and subsequently honed through practicum and professional experience, then shaped by reciprocal relationships of learning with an ever-changing range of colearners. Transformative practice is sustained within trusted collegial relationships where knowledge, strategies, solutions, and metacompetency development are cocreated toward ethical practice, social justice, and human rights. These results align with Mezirow's (1978) understanding of transformative learning in which critical and reflective discourse fosters ongoing growth and change across various phases of learning. However, institutional demands can and often do, interfere with this commitment. Legislative and regulatory responsibilities around scenarios such as capacity assessment or involuntary admission, situations which lend themselves to ethical strain, further underscore the need for ongoing professional consultation and support. Professional identity resilience is a lifelong challenge.

Applications to Practice

The study captured diverse knowledge gained through decades of combined educational and mental health social work experience of the participants. While neither prescriptive nor exhaustive, identifying the key knowledge, skills, and competencies associated with each of the four phases may assist social workers to better articulate their learning and resource needs throughout careers, and allow educators, field supervisors, managers, and directors to anticipate and address these proactively.

The study also revealed bridges and nonlinear pathways between and among phases of educational and career development. This suggests an opportunity to scaffold learning explicitly and effectively across phases, as through academic and interprofessional partnerships and communication or other strategies.

Limitations

The study brought together a wide range of people, all with a personal or professional stake in mental health social work education. Although two PWLE were recruited, both were unable to continue beyond the very early stages of the inquiry. We acknowledge this gap as a significant limitation and throughout the inquiry, regularly reflected on the absence of this critical perspective. Additionally, participant authors approached the inquiry with differing levels of prior knowledge and preparedness regarding the seminal works addressing transformative learning and practice (Mezirow, 1978, 2003), and the model for holistic competence (Bogo, 2018), so there was time and work necessary to share resources and inform some members of the group about some of these knowledges to create mutuality and inclusions. While valuable, this does take time and lengthens an inquiry process.

Conclusion

This study concludes that transformative mental health social work practice is sustained by learning with, from, and about the lived experience of peers, formal educators, colleagues, service users, families, and interdisciplinary colleagues in ways that challenge the impact of managerialism and the privileging of biomedical and Western knowledges. Across phases of education and career, practitioners repeatedly re-engage with concepts, models, or theories as they gain practice experience, knowledge, and skill. The pathway is iterative and nonlinear, yet some of the knowledge and skills developed at each phase can be anticipated. In the mental health context, discordance between critical social work values and dominant practice paradigms reinforce the importance of professional identity resilience across the career trajectory.

Taken together, the study lends support in anticipating, articulating, and addressing social work learning needs, providing meaningful mentorship or supervision and clearly scaffolding mental health social work education in the academy. This paper contributes to a broader conversation gathering momentum regarding the pedagogical approaches aligned with aspirations for reform and emerging conceptualizations of mental health social work more broadly.