Mental health practitioners need professional support and opportunities to ‘think together’ to expand their knowledge. Peer groups are useful ways to achieve this. Modern technology makes a wider range of peer-support options available, including online communities of practice.
What are communities of practice?
The term ‘community of practice’ refers to a group of practitioners who, through their shared interest in, and passion for a topic such as mental health, voluntarily engage and collaborate with each other in a sustained manner to develop their knowledge and expertise (Jiwa, Chan, Ross, Shaw & Magin, 2011). Communities of practice (CoP) were first used successfully in business, industry and education, with high-effectiveness in large organisations to enhance knowledge-sharing and overcoming professional and structural isolation (Probst & Borzillo, 2008). There has been a growing international trend in CoP (e.g., in Norway, Spain, USA), with interest in CoP benefits now extending to health practitioners (Barnett, Jones, Bennett, Iverson & Bonney, 2013). Communities of practice differ from other types of work-related groups such as ‘project teams’ as participants do not have formal roles or share a specific target or goal. The benchmark for success is accrued practices, knowledge and exchanges in that community (Probst & Borzillo, 2008).
Benefits for psychologists
There are several benefits of CoP for psychologists. For example, part of the process of maintaining Australian Health Practitioner Regulation Agency (AHPRA) and Australian Psychological Society (APS) registration is ongoing updates on best practice and processes, as well as continuing professional development through support from peers and supervisors. Sole, rural and remote practitioners often struggle to maintain regular dyadic or group interactions with peers and mentors because of the nature and location of their work. Even with phone-based or online meetings, the organisation and attendance of these meetings at pre-assigned times can be challenging given that participants (i.e. supervisors, peers) need to align their calendar.
Online CoP can therefore provide a much-needed platform to support health professionals like psychologists and general practitioners in their professional development by tapping into a wealth of knowledge from a group of practitioners. Online CoP are also accessible, cost-effective, and most importantly, can lead to time-saving benefits because participants can choose what to contribute (or ask) at a time that is suitable to them.
Supporting evidence
A number of factors determine the success of CoP. Much of current research derives from investigations of CoP in intra-organisational contexts. Probst and Borzillo (2008) found that successful engagement and achievement of best practice in CoP tended to occur in those that:
- adhere to strategic objectives and sub-forums for topics
- provide good governance
- have moderators/facilitators who drive participation, and
- are hierarchy-free for members.
Probst and Borzillo (2008) identified six important elements for successful CoP in business. These were (1) leadership, (2) clear objectives, (3) senior executive sponsorship, (4) boundary spanning (and benchmarking), (5) a risk-free environment, and (6) measurements of the value of the CoP.
Barnett, Jones, Bennett, Iverson and Bonney (2012) applied Probst and Borzillo’s (2008) elements to the development of online health CoP and added two additional themes to those of Probst and Borzillo: (1) a supportive community and (2) technology enablers. They adapted these eight themes into a 7-Step Framework for the successful establishment and maintenance of online CoP in the health sector. They found that those CoP that lacked a core group or strong connections between members, or had members who did not identify with the passion and interest of the group (i.e., sense of belonging and commitment) were less successful.
These initial findings were gleaned from intra-organisational CoP with the aim of increasing best practice for companies and their specialty areas (e.g., sales, car engine fuel-efficiency). However, Barnett and his colleagues, among others, have turned their attention to the utility and characteristics of successful CoP in health settings for general practitioners. Most findings have been consistent with Probst and Borzillo’s initial stipulation for effective CoP; members needed to perceive the CoP as useful for their practice and professional development (Dijkman-Hadley, Bonney, & Barnett, 2015). Moreover, successful CoP for general practitioners also had a good balance between autonomy and good moderation, with rules and structure to maintain healthy engagement (Borzillo et al., 2011).
Importantly, rural/remote practitioners who used the internet frequently tended to perceive online CoP as useful tools for professional support and development. The varying levels and types of professional expertise in CoP are also of particular benefit to less experienced health professionals who are keen to enhance their knowledge and skills through ‘thinking together’ about clinical and ethical issues on a shared forum.
Mental health communities of practice
Black Dog Institute established a secure, private and online Mental Health CoP in 2016. It is a self-selected community of approximately 3,000 health professionals across Australia who are interested in working and ‘thinking together’ to improve their knowledge and skills. The aim is to enhance mental health and wellbeing outcomes for their clients and patients. Its key elements align with Barnett et al. (2012) evidence-based 7-Step Framework for implementing successful online health practitioner CoP. The table illustrates the framework and how it aligns with mental health CoP, along with specific benefits to psychologists.
Learning grows through participation in CoP as members share and transmit knowledge and reflections on practice, ultimately creating new knowledge. Members are interested in best-practice mental health care knowledge and in sharpening their expertise in this field via ongoing interaction with each other.
I particularly enjoyed the fortnightly case discussions as it gives me a window into what happens in the consult rooms of my GP and allied health colleagues - what approaches they take to history taking, formulation and treatment. Even in correspondence from psychologists and psychiatrists I rarely appreciate how they go about communicating with their patients, and the fortnightly case discussions allow me to consider different ways of understanding problems and solutions. It's given me new strategies and insights into how to approach some of the more challenging or complex mental health presentations - general practitioner
New CoP members offer fresh perspectives, knowledge, and ideas to experienced members’ thinking and practice. New members’ innovative considerations regarding others’ views and the dialogue between members enriches and advances the shared knowledge, generating new knowledge.
Participant exchange continuously develops and changes the community’s knowledge. This continuous transformation of new shared knowledge sustains the CoP by fostering dynamic, productive discussion and maintaining group interest. In line with research, a shared interest in mental health combined with diverse professional health identities is key to the community’s productivity and longevity.
The Black Dog Institute's CoP provides a restricted health-practitioners-only forum, which is vital for ensuring that practitioners can ask and answer questions without worry of patients or the public seeing their concerns or current work challenges. This makes it unique from other CoPs that have sprung up informally such as Facebook groups because we can be sure that it is well moderated, secure, and championed/supported by well-established and reputable organisations like eMHPrac and Black Dog - psychologist
Joining CoP
Research shows a plethora of benefits to health practitioners that arise from ‘thinking together’ as part of online CoP. The Mental Health CoP seek to provide a safe climate for members through:
- terms and conditions to which members must agree
- ensuring all members are AHPRA members (or members of a relevant approved professional organisation)
- the use of moderators who strive to ensure content and discussion is respectful and appropriate
- ensuring confidentiality; making clear that all case discussion must be de-identified.
While more research investigating mental health CoP for psychologists is needed, the literature to date suggests strong benefits in the form of professional support, benchmarking/validation, and knowledge enhancement and growth.
Membership of the Black Dog Institute Mental Health Community of Practice is free. To join visit: www.blackdoginstitute.org.au/cop
The first author can be contacted at [email protected]