Relationship-based practice: emergent themes in social work literature | Iriss
days, the importance of the relationship in social work has had something of a . cedented opportunities and challenges in its development and in definition of. explores how current social work practice can be understood in the context professionally challenging this relationship-based approach can. can contribute, and on the basis of which a definition of social work can be . The process and the relationship are a core part of the service and can represent . “ The social work profession promotes social change, problem solving in human.
However, when the social environment is not optimal, the tendency towards growth is thwarted so that people's development is distorted in ways that can result in the person moving towards a negative, socially destructive direction and typical of the many of the problem areas social workers encounter in engagement with service users.
It is unusual for people to experience such optimal social environments that they might be said to have self-actualised as fully functioning and so most people experience to a greater or lesser extent some degree of psychological dysfunctionality see Joseph and Worsley, Person-centred psychotherapy is based on the above theoretical understanding that people are intrinsically motivated to grow and develop in the direction of becoming more fully functioning, when the right social environmental conditions are present Rogers, In describing the right social environmental conditions, Rogers proposed that there were six necessary and sufficient relational conditions that, when present, led to constructive personality development.
Most social workers will, as noted above, be familiar with the three conditions of unconditional positive regard, empathy and congruence, but it is important to note that there were six conditions that, taken together, described the facilitative social environment.
The other three essential conditions are that there must also be psychological contact between the therapist and the client, the client must be in a state of incongruence and distressed in some way, and finally the communication to the client of the therapist's empathic understanding and unconditional positive regard must at least minimally be achieved.
Rogers paper on relational factors was an integrative statement of common factors thought to be both necessary and sufficient to promote therapeutic outcome. Thus, the person-centred practitioner endeavours to create a relational environment defined by the six conditions because it is this that is necessary to activate constructive personal change.
The understanding is that the client is the expert on their own experience and needs and will develop in a socially constructive direction when these six relationship conditions are present.
Thus, the person-centred practitioner's sole task is to provide a growthful relationship on the understanding that the client will be facilitated in such a relationship to make new socially constructive choices about the direction of his or her life. As such, the person-centred practitioner adopts a non-directive attitude in which they have no pre-determined and specific outcomes or intentions for the service user to achieve.
Rogers used the term non-directivity, but this term, which is often misunderstood, was clarified by Grantwho distinguished between principled non-directivity and instrumental non-directivity. Whereas principled non-directivity refers to the therapist's ethical values of non-interference and respect for the self-determination of the other and is itself the goal of the therapist, instrumental non-directivity refers to a set of behaviours applied by the therapist to achieve a particular goal, such as building rapport or frustrating the client.
As a result, this has meant that social workers who are claiming to be operating in a person-centred way within a relationship-based approach are, in effect, using the relationship instrumentally.
Using the relationship to facilitate engagement with the client in order to find out what the client wants, to develop rapport or to gain compliance with suggestions are all examples of instrumental practice in which the relationship has a utilitarian function. Below, we propose that social work has evolved to become overwhelmingly utilitarian such that person-centred practice as principled non-directivity is untenable. Impact of the changing context of statutory social work practice As noted previously, Ruch et al.
Despite Ruch et al. If the service user has not given something to the social worker, then the social worker, arguably, has no right to intervene upon it.
Grant has referred to this in the person-centred field as working only with what is given with regard to empathically responding to the service user. Consider, for example, the following situation in which a social worker makes a home visit in response to reports that a seven-year-old child is potentially at risk. The social worker needs to speak to the mother who is alleged to be feeling suicidal. The social worker begins by developing and building rapport and then asks the mother about her current suicidal intent and the mother states her intent is low, although her ideation is high.
The mother feels ashamed at having to disclose these thoughts and feelings to the social worker and subsequently averts her gaze and fixes eye contact to another part of the room. The social worker presses on with asking more questions about the service user's thoughts over the last two weeks and whether she has the means by which to commit suicide. She asks the mother to complete a simple suicide risk assessment form.
The mother completes the measure and hands it back to the social worker. The social worker is sensitive but feels satisfied that, whilst the mother is probably depressed, she is not suicidal.
The social worker returns to the office. There is a task to be completed and the relationship provides the context in which to carry out the more important social work task of assessing the level of risk of the mother's mental state for both herself and to the child.
More importantly, the content, process and nature of the interactions are provoked by the questioning of the social worker. What is given by the client from the stance of being in a principled non-directive relationship is not considered. The social worker is, understandably, focused on completing the task.
In short, it is apparent that person-centred theoretical constructs have little or even no place within the contemporary models of relationship-based social work practice. In the example above, the social worker might need to make more of the situation and disregard what the service user had given in her communication due to the need to complete the assessment. The same argument applies to relationship-based practices that have their roots in the social casework model Mayer and Timms, For example, Trevethick proposes a relational approach based on a psycho-social model of social work practice and argues that the relationship acts as the basis upon which the tasks of intervention can be carried out.
Trevethick's approach stands in contrast to the person-centred principled model that considers the relationship as an end in itself. In considering such models of relationship-based practice, Trevethick critically states that: Others have argued for a relationship-based approach grounded in models of empowerment.
Braye and Preston-Shoot have argued that the cornerstone of relationships between users and providers of services are the principles of empowerment and partnership. In order to understand how these principles are able to bring to fruition their potential, practitioners must also consider their application from the perspective of power, inequality and oppression. They need to consider and attempt to apply both personal and organisational commitments to challenging and changing the oppressive practices that maintain inequalities for service users.
The concept of a relationship-based approach to social care work remains a contentious issue for policy makers. Henderson and Forbat noted that, whilst the emotional and relational aspects are significant features of current constructions of what it means to provide care, these have been virtually invisible within policy strategies. Despite this, some empirical research has focused on the association of the quality of the relationship between the user and provider of a service with the outcome of the service being provided.
For example, service users in mandated child abuse cases who perceived the relationships with a social worker as more positive were more likely to show constructive changes with regard to subsequent discipline and emotional care for their child.
An ability to openly communicate, frequency of visits and receipt of public assistance were significant predictors of better-quality relationships. To clarify the role of the instrumental relationship further, let us go back to the scenario above in which the social worker had received a message via a school that a child's mother had been reported to be suicidal and there was a concern for the risk to the child's well-being in being in the home alone with her mother.
The social worker called to the house is going with a specific task that needs to be accomplished. In such a situation, the social worker holds the power and sets the agenda. In this sense, the interaction is a directive encounter and cannot therefore be considered to be enabling the service user mother to actualise her potential. Rightly, the social worker considers all the legal, ethical and moral implications of the situation in making her decision.
The social worker knows this event occurred after the mother had minimised her feelings of self-harming to the GP earlier that day. The social worker faces another dilemma and uses her relational approach to understand the situation. She feels the service user is using the situation to gain attention and offers her interpretation to try and bring some further awareness for the service user to the situation.
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The service user reacts angrily. The child is taken to a relative for the night and a call is made to the local emergency psychiatric clinic for a further assessment to be made. The service user—social worker relationship was concluded by Bell to have had a positive influence in children involved in child protection investigations.
Many service users reported substantial benefits of the relationship with their social worker, including positive changes at home, school and overall health and behaviour.
Despite this, Bell cautions that children should not be seen as a homogenous group and that, whilst it is necessary to protect the rights of children through positive working relationships, a child's experience must be understood from a child's perspective and not that of an adult. Much like the example above, whether the outcomes might be viewed as positive is as much a factor of the perspective from which they are determined as it is about the information collected to record the outcome itself.
As we have indicated above, the person-centred approach is founded upon a conceptual framework that is at odds with contemporary social work practice. In contrast to Trevethick's critique, to work in a person-centred way, one must, by definition, focus on the relationship-as-an-end-in-itself. As we shall discuss below, to view the relationship-as-an-end-in-itself is practically untenable because of the current political and professional context of social work practices.
Is a truly person-centred relationship-based social work possible?
Care ethics entails a shift in focus away from rules and rights towards responsibilities and relationships. There is, therefore, no one way of doing RBP. Care ethics are proposed by Meagher and Parton as offering an alternative to dominant managerial modes of practice in social work. Relationship-based practice and policy Increasingly, RBP can be found to resonate with the direction of Scottish public policy set out in the report of the Christie Commission Scottish Government, For example, policies such as Getting it right for every child GIRFEC emphasise the need to hear the voice of children and families in a spirit of openness and trust.
However, it is not just in children and families policy that the Christie principles resonate. They are also apparent inter alia in the Carers Strategy, the National Clinical Strategy and Community Justice and Mental Health initiatives, to the extent that they are now spoken of as reflecting a particular Scottish approach to public services. RBP thus, potentially, becomes a cornerstone of social policy, percolating, not just individual relationships but the ways in which workers across different professional disciplines and wider communities interact and relate with one another.
Features of relationship-based practice RBP draws on psychodynamic ideas, most closely associated with Sigmund Freud and developed by others. These explain human personality and functioning in terms of conscious and unconscious desires and beliefs, feelings and emotions, based on life experiences, including early childhood. While RBP does not require a sophisticated understanding of the psychology behind this, effective social work requires that a worker tune into the emotional world of a client and be able to communicate this understanding within the relationship.
It also moves the concept of relationship beyond the individual to incorporate an awareness of contextual factors such as power, professional role, poverty, social exclusion and political ideology. A sense of purpose To stress the centrality of human relationships in social work is not to say that these are, in themselves, sufficient to ensure good practice. Relationships are not intrinsically good or bad — they can be either. They exist in a mandated context and are formed for a particular purpose Ingram, — towards a client achieving positive change.
But this is a challenge, partly because relationships are complicated and subject to a range of psychodynamic processes, which require that social workers understand and use themselves, centrally, within their work. Beckett and Horner tell us that change comes about through relationships.
Even in situations where programmed interventions are employed, their impact is secondary to the social worker—client relationship Nicholson and Artze, Qualities of hope and expectancy that change will occur are also implicated in successful outcomes.
What clients want The literature gives clear messages of what clients value. Their conception of friendship identifies qualities of reciprocity of sharing aspects of oneself; of flexibility going the extra mile, perhaps through offering small gifts or maintaining contact out of hoursbut also straight talking.
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Kleipoedszus suggests that relationships can be forged through conflict; genuine engagement and negotiation rather than artificial sensitivity make it possible for workers to encourage and nurture change rather than demanding it.
Smith and colleagues identify the centrality of effective relationships even in work with involuntary clients. In all of this, everyday acts of care and recognition are more important than formal standards and procedural requirements. Professionalism and relationships A renewed emphasis on relationships challenges many of the assumptions that have built up over what it is to be a professional.
Professionalism is often associated with certainty, expertise and theoretical knowledge Brodie and colleagues, Noddingshowever, distinguishes between professionalism and professionalisation. She suggests that the latter is the result of a codified and rule-bound conception of professionalism that derives from a quest for status. There is, however, little connection between such rule-bound professionalisation and positive outcomes.
Indeed, it can create a distance between social workers and clients, that a more relational form of professionalism might work to reduce.
Murphy and colleagueson the other hand, suggest that the professional role significantly compromises the ability to form genuine relationships. Part of the difficulty in reconciling different understandings of professionalism is the tendency in the UK to conceive of separate personal and professional selves.
Practice traditions such as social pedagogy introduce a third element, the private. This poses challenges for workers and for organisations that operate to a narrow understanding of what constitutes acceptable personal and professional boundaries Maidment, It is important to distinguish between boundaries, which are dynamic and can be deployed flexibly, and barriers, which are static and prioritise consistent application.
In practice, individual practitioners act in ways that might be thought to be subversive of practice norms Alexander and Charles, Coadyfor instance, offers examples of the kind of flexibility required in negotiating everyday care practices. One of the difficulties that can arise in increasingly managerial and regulated practice cultures, however, is a tendency to minimise the complexity of such boundary work and to operate fixed understandings of the lines between professional, personal and private domains.
This leaves workers vulnerable to disciplinary action should they cross externally determined boundaries McLaughlin, This is not fixed and, as we enter relationships, we draw upon what we feel is required to engage with others within a given context. In social work, this is made more complex by the addition of professional values, roles and expectations.
Hennessey argues that this balancing act should be explicit and not shied away from; rather, it should be harnessed and used to bring about change.Social workers: Assessed and supported year in employment (ASYE): Challenges and rewards
Barnes and colleagues go further and underline the interdependence between social workers and service users, where both parties bring their own experiences and contexts to the encounter, laying the foundations for a trusting and dynamic relationship.
This requires a social worker to be able to develop a relationship that has a level of trust and which facilitates the sharing of emotions. This may require a degree of emotional exposure in order to truly understand the feelings of another and be able to express this in a genuine and attuned manner.
Transference and counter-transference A psychodynamic perspective can help social workers consider the impact of unconscious previous experiences within relationship building. The concept of transference reminds us that individuals can unconsciously transfer past feelings into the present. Ruch illustrates this with an example of previous negative experiences of parenting being transferred by some service users into the relationship with their social worker.
This dynamic can often be difficult to understand and manage and social workers can, in turn, find themselves reacting unconsciously, in a process known as counter-transference. Equally, social workers need to be mindful of their own unconscious transference and how that may impact on dynamics within relationships they form.
Such dynamics can be powerful and frightening, but can also be hugely helpful for social workers in understanding the inner worlds of service users and themselves. In turn this can lead to more positive relationship building Agass, Emotional intelligence Ingram highlights the role of emotional intelligence as a trait and skill that can help social workers manage the emotional complexities of practice.
Emotional intelligence can be briefly defined as the ability of an individual to: