A Theory Toolkit for Social Work Students: From Entry to Readiness for Direct Practice by Mark Allenby

SWK1008 â&#x20AC;&#x201C; Social Work Theories and Models A Theory Toolkit for Social Work Students - From Entry to Readiness for Direct Practice By Mark Allenby Published by Excitement of Excellence, Northampton, UK With the exception of Figures 2, 13 and 14 the author asserts copyright over the content of this publication.

Contents Chapter 1 - What is theory?.......................................................................... 8 Preparation .............................................................................................. 8 Introduction ............................................................................................. 8 An Early Detour into Communication Theory ................................................ 8 Theories, Models, Approaches, Practices and Methods ................................... 9 The Role of Theory in Social Work Practice................................................. 10 Reflection .............................................................................................. 13 Recommended Reading ........................................................................... 13 Chapter 2 – Theories of Social Work ............................................................ 14 Preparation ............................................................................................ 14 Introduction ........................................................................................... 14 Models of Social Work and Models for Social Work ...................................... 14 The International Definition of Social Work ................................................ 15 Four Models of Social Work ...................................................................... 16 The Social Work Process .......................................................................... 23 Practice Implications ............................................................................... 26 Reflection .............................................................................................. 27 Recommended Reading ........................................................................... 27 Chapter 3 – The Practice Pyramid ................................................................ 28 Preparation ............................................................................................ 28 Introduction ........................................................................................... 28 An Overview of the Practice Pyramid. ........................................................ 28 Reflection .............................................................................................. 36 Recommended Reading ........................................................................... 36 Chapter 4 – Person Centred Theory ............................................................. 38 Preparation ............................................................................................ 38 The Idea in a Nutshell ............................................................................. 38 The idea in summary .............................................................................. 38 The idea in more depth ........................................................................... 38 1

Theory in Social Work Practice ................................................................. 43 What it’s not .......................................................................................... 44 Theory Checklist..................................................................................... 45 Critique of the theory .............................................................................. 45 Reflection .............................................................................................. 47 Recommended Reading ........................................................................... 47 Chapter 5 – Models of Communication ......................................................... 48 Preparation............................................................................................ 48 Introduction........................................................................................... 48 The Idea in a Nutshell ............................................................................. 48 The idea in summary .............................................................................. 48 The idea in more depth ........................................................................... 48 Theory in Social Work Practice ................................................................. 55 What it’s not .......................................................................................... 58 Theory Checklist..................................................................................... 58 Critique of the theory .............................................................................. 58 Reflection .............................................................................................. 59 Recommended Reading ........................................................................... 59 Chapter 6 - Anti-Oppressive Practice ........................................................... 62 Preparation............................................................................................ 62 Introduction........................................................................................... 62 Discounting the Problem.......................................................................... 62 Pause for thought ................................................................................... 64 Thompson’s PCS Model ........................................................................... 64 Level of Oppression ................................................................................ 65 The Middle Ground Intersectional Model .................................................... 75 Reflection .............................................................................................. 83 Recommended Reading ........................................................................... 84 Chapter 7 – Problem-Solving ...................................................................... 86 Preparation............................................................................................ 86 Introduction........................................................................................... 86 The PRECISE framework for Problem Solving ............................................. 86 2

Thompson’s 10-Step Problem Solving Process ............................................ 91 Reflection .............................................................................................. 97 Recommended Reading ........................................................................... 98 Chapter 8 – Task Centred Practice............................................................. 100 Preparation .......................................................................................... 100 Introduction ......................................................................................... 100 The Idea in a Nutshell ........................................................................... 100 The idea in summary ............................................................................ 100 The idea in more depth ......................................................................... 100 What it’s Not ........................................................................................ 112 Theory Checklist ................................................................................... 112 Critique of the Theory ........................................................................... 113 Reflection ............................................................................................ 114 Recommended Reading ......................................................................... 114 Chapter 9 – Crisis Intervention ................................................................. 116 Preparation .......................................................................................... 116 Introduction ......................................................................................... 116 The Idea in a Nutshell ........................................................................... 116 The idea in summary ............................................................................ 116 The idea in more depth ......................................................................... 116 Theory in Social Work Practice ............................................................... 117 What it’s not ........................................................................................ 122 Theory Checklist ................................................................................... 123 Critique of the theory ............................................................................ 123 Reflection ............................................................................................ 124 Recommended Reading ......................................................................... 124 Chapter 10 – Ecological-Systemic Theory ................................................... 126 Preparation .......................................................................................... 126 Introduction ......................................................................................... 126 The Idea in a Nutshell ........................................................................... 126 The idea in summary ............................................................................ 126 The idea in more depth ......................................................................... 127 3

Theory in Social Work Practice ............................................................... 129 What it’s not ........................................................................................ 130 Theory Checklist................................................................................... 130 Critique of the theory ............................................................................ 131 Reflection ............................................................................................ 132 Recommended Reading ......................................................................... 132 Chapter 11 – Theory and Evidence Informed Practice .................................. 134 Preparation.......................................................................................... 134 Introduction......................................................................................... 134 Using Theories Forwards and Backwards ................................................. 134 The Basic Theory Toolkit ....................................................................... 136 Practice Wisdom ................................................................................... 137 A warning about practice wisdom ........................................................... 140 Evidence Informed Practice.................................................................... 141 Reflection ............................................................................................ 142 Recommended Reading ......................................................................... 142 Chapter 12 – Theories in Practice .............................................................. 144 Preparation.......................................................................................... 144 Introduction......................................................................................... 144 Engagement and Assessment................................................................. 144 Planning .............................................................................................. 148 Implementation.................................................................................... 149 Review and Evaluation .......................................................................... 150 Reflection ............................................................................................ 151 Recommended Reading ......................................................................... 151 Appendix 1 – Reflective Practice................................................................ 152 Appendix 2 – The Bio-Psycho-Social Model and Beyond................................ 158 Appendix 3 – Solution Focused Practice ..................................................... 162 Appendix 4 – Eclectic and Integrative Practice ............................................ 166 Appendix 5 – Social Work – repressive or revolutionary? .............................. 168 4

Appendix 6 - Ten Useful Principles for Understanding Human Behaviour ......... 170 Closing Remarks ..................................................................................... 172 References .......................................................................................... 174

Introduction This book has been written with the specific intention of helping to prepare you to move from the beginning of your course to the start of your first placement. It has been designed to be integrated with the Skills for Practice module, as skills require an understanding of the theories that underpin them and theories that do not have any practice implications are a waste of time. The first part of this book, chapters 1 to 5 set the scene for you. They look at understanding in general terms at what social work is and how it works. The next section, chapters 6 to 10, focuses on 5 central social work theories and models. These represent what I believe to be the five most central practice models within contemporary social work practice. This is followed with two chapters that focus on integrating theory and research into practice. Finally there are six appendices that cover issues that I think are important, but which I have not found space to include in the main body of the book or in my teaching. This book is very much a work in progress. It has been written in stages over more than two years. It is still developing and I am sure that as you read this book you will find many typographical errors and bits that make no sense to you. Please feel free to point the errors out to me and to ask me questions about the bits that don’t make sense. How else can we improve unless we are willing to learn from and change as a result of feedback? I don’t take offence very easily and I am probably far more aware of my limitations than even the most critical reader.

A comment on the writing style of this book It is important to notice that this book is not written in an academic style. It breaks many of the conventions of academic writing. You will find that at many points I will specifically address you, the reader. This is something you must avoid in your essays and most of your assignments. You will notice that I don’t always write things out in full, sorry, I do not always write things out in full. Again, you will not be able to get away with this in your assignments. Finally, and most seriously, throughout this book I will make multiple unsubstantiated claims. I will provide few references, and many of these will not be using the Harvard system. For an assignment, or even an academic text book, this would be considered shockingly bad form, but this is not an assignment or an academic text book; it is a module handbook. I am not addressing you as a faceless, nameless reader, but as a person who I will meet and talk with. My relationship with you will not simply be as ‘author’ and ‘reader’ but as ‘tutor’ and ‘student’, or as person to person. As a result I do not want to use the more formal style. Equally, in writing this book I want to share knowledge and experiences with you, but I want you to go beyond what I offer you here. I want you to read and learn for yourself. You cannot rely on any single book, even one written by your module lead, to get you through this module, let alone to prepare you to become a social worker.

A Word of Warning I believe I know myself quite well, and therefore at the start of this book I want to offer you, the reader, a warning: do not trust this book. I am not objective and in writing this book I am deliberately attempting to influence and shape your values, views, beliefs and

attitudes. I have a political agenda. I have strong views about the kind of society and world in which I want to live, and this book is, directly or indirectly, an attempt to get you to agree with my agenda. Therefore question everything I have written here. Do not for a moment simply accept that what I am saying in this book is true. Check it out for yourself. Read widely. Talk to other people, listen and think. My ultimate goal is not to get you to agree with me. I have deep respect for thoughtful individuals whose views, beliefs and values are very different from mine. However I will spell out my agenda clearly at the start. I believe that we need a society that is just and fair, one where power, decision making and the resources of society are available to all, and not just an elite who can control them. I believe that the best societies are not the ones that are the most materially or economically productive, but the ones that place the greatest value on well-being and social justice. It is those beliefs that took me into social work, and it is those beliefs that keep me passionate about the job. But you must not accept this simply because I said it. You must work this out for yourself. And that is likely, in my experience, to be a slow and sometimes painful experience. However if we can succeed together than social work and society will be the better for it. So read, learn, study and practice, and together we can change the world. Mark Allenby August 2014

Chapter 1 - What is theory? Preparation What comes into your mind when you think of the word ‘theory’? Do you have a particular thought or feeling about the word ‘theory’? What questions do you have about theory in relation to social work? What do you hope to get from reading this chapter? When you have finished reading this chapter how will you know that you have got what you wanted from the chapter?

Introduction Theory is a word with a range of meanings. At one end of the scale there is the idea that theory is something complex and profound; something that is only accessible to those who have studied for years and really know their subject. Theories like quantum theory and chaos theory are complex ways of explaining the world which are beyond most of us to understand. In this way theory becomes big and scary; something that leaves us feeling confused and maybe even scared. At the other end of the scale ‘theory’ can be used to dismiss an idea. You will hear people say “Oh, that’s just a theory” or “That’s fine in theory, but it doesn’t work like that in practice.” Here theory is being used to suggest that something is separate from the ‘real world’, and is impractical or irrelevant. Yet the reality is that we all use theory all the time.

An Early Detour into Communication Theory Later on I will explore the idea of communication theory in more detail, but here I need to introduce you to one key idea, a theory if you like. If you want to understand a word or phrase you need to look beyond the word or phrase to look at how the it is used. The word theory is used in a number of different ways. Perhaps the most commonly understood use of the word theory is that theory is a way of understanding what you experience. To put that another way, theories explain things. The psychologist John Bowlby noticed that a number of what were termed ‘affectionless psychopaths’, individuals who broke rules and hurt others without regard to the feelings of others, shared a history of having been separated from their parents, specifically their mothers, at a young age. Bowlby developed this idea over a period of time into something called ‘Attachment Theory’. Attachment theory was able to provide an explanation of why these people acted the way they did by seeing this as a result of the ‘broken attachments’ as young children. Although this explaining role of theory is the most widely used it is not the only one. Often theory lets us put together different bits into a single coherent model which more fully describes how things are. Urie Bronfenbrenner’s ‘Ecological-Systemic Theory’ is an example of this. This model does not specifically explain why something is the way it is, but it does let us put together what happens at the personal level, with what happens at the community level, with what happens at the social level to give a richer description of how individuals, families, groups and communities work. So as well as being explanatory

theories can also be descriptive, in that once we understand the theory things that were separate and disconnected now become joined together. A good example of this descriptive use of theory is something called ‘plate tectonic theory.’ For a long time people noticed that the coast of Africa and South America seemed to fit together quite well, but no one knew is this meant something or was just an accident. When people started collecting dinosaurs bones they noticed that often the same types of dinosaur bones would be found on the opposite side of big oceans, with no idea of how they could have got from one side to another. Later still they discovered that the Atlantic Ocean had a ridge and a trench in its middle. Again, no one knew why. Then someone proposed the idea that instead of being fixed in place the surface of the earth moved; that the oceans were spreading. Suddenly that made sense of all the observations. Africa and South America had once been joined. Dinosaur bones were found on opposite sides of the ocean because once they had been together. The ridge and trench were where the ocean floor was spreading. This became the theory of plate tectonics, and allowed all the different observations to be fitted into a coherent whole. This is another key use of theory. In a looser sense still theories can often be thought of a more similar to ‘principles for guiding actions.’ Many of the ideas in this book will fall into that category. Task Centred Practice does not give an explanation of why someone is the way they are, but it does provide a coherent framework for helping people overcome problems. Many professional and management theories fall into this category of theory. Often they are called ‘models’ rather than theories, and sometimes this causes confusion for students as they try and unpick the difference between theories and models. At this point though it is worth reinforcing the point made earlier – words do not have fixed, absolute and precise meanings. They can be used by different people in different ways at different times. For now the important point is that theories can explain, describe or guide actions, or they can do some combination of those three things.

Theories, Models, Approaches, Practices and Methods In various social work books the above five words will be used frequently, and in some cases interchangeably. The following table records my results from carrying out a Google Search for the term “Social Work” along with six different search terms beginning with ‘Task Centred’. Table 1 - Theories, Approach and Methods - a Google Search Search Terms

Number of Hits

“Task Centred Approach” and “Social Work”

86,500

“Task Centred Methods” and “Social Work”

55,600

“Task Centred Model” and “Social Work”

13,200

“Task Centred Practice” and “Social Work”

12,200

“Task Centred Theory” and “Social Work”

2,010

“Task Centred Method” and “Social Work”

102

Search conducted on 4th July 2014

As you can see from this even when looking at a single social work theory there is a range of different words used, approach, methods, model, practice and theory, and even a contradictory result in that whilst ‘methods’ gets a lot of hits, ‘method’ gets very few. This means that words like ‘theory’ or ‘model’ do not have strict absolute definitions. It is possible to have theory-like models and model-like theories. This can be confusing and anxiety-provoking, but only if you think the difference really matters. What I will present below is not the ‘right’ way to think about these terms, but a way I hope will be useful. Consider two important roles of theory: 1) to explain things and 2) to guide actions. Some theories are very good at explaining why things are the way they are, but have limited use in telling you what to do about it. Others give clear guidance on what to do, but do not give a detailed explanation of why you should do it. The first of these is most likely to be called a ‘theory’; the second is more likely to be called a method.

Theory

Approach

Method

Practice

Model Explains

Guides

Figure 1 - The Theory Landscape The other words tend then to fall somewhere in the middle. So although the whole of the space in the diagram could be called ‘theory’, it is when it explain most that the word theory is likely to fit best, and when it guides practice most it is likely to be called a method. However in the vast majority of situations the words can be used interchangeably without causing significant problems.

The Role of Theory in Social Work Practice Having reached this point it will be worth stopping and considering the question – what is the role of theory in social work practice? Why do social workers need to have a solid understanding of theory? How does having a good understanding of theory help social workers do their job well? In the first case a solid understanding of social work theory lets social workers know what they are doing and why. This may sound obvious, but pause for a moment and carry out this thought experiment.

Thought Experiment You have been put in charge of a mission to colonise a distant planet. The mission will involve transporting hundreds of thousands of people to a new planet to create a new society on the new planet. Think about the people you would want to take with you. Farmers? Doctors and nurses? Engineers? Teachers? Imagine the roles you would have to allocate and what you would want people to do. Would you take social workers with you? Why or why not? What does this tell you about your understanding of social work?

This is a point I will return to in the next chapter. Social work is not an ‘obvious’ profession. It is ‘obvious’ to most people what a fire-fighter or a chef does for a living, it is not ‘obvious’ what a social worker does. I have put obvious in inverted commas as in any profession there are many jobs where people do not do what most people think they do. Even allowing for that, in social work the public perception is less clear than on most other jobs. As a result there is a need for social workers to have a clear understanding of what their profession is for and what it is trying to achieve. Secondly, theory allows social workers to make sense of the situations they have to deal with in their jobs. This is where we must face a crucial issue: even when a social worker says that they are not using theory, they are. They may not be aware of the theories that drive their practice, but those theories will be there. Without a conscious awareness of theories all a social worker has is their prejudices and assumptions, and these are no basis for effective and ethical social work practice. Social workers need theories of human behaviour in order to understand why people act the way they do. These theories may be drawn from a range of different traditions. Many will come from the social sciences, particularly psychology and sociology. Others will come from research and practice experience – from looking at what works and what does not work. When making a mental health assessment social workers need an understanding of the factors that affect mental health. One of the most significant of these is the bio-psychosocial model which is addressed in Appendix One. It is important to know a little about the biological factors that influence mental health, from a basic understanding of how the brain works to a more everyday sense of the importance of practical things like food, drink, sleep and pain on mental health. It is important for social workers to know a little about cognitive theories to be able to spot the thought patterns that are most likely to help or hinder good mental health. Then it is important to be able to address social factors, from bullying and discrimination to social isolation. Once all these factors, and more, are taken into account a social worker can have a much more complete understanding of the factors that are impacting on a service user’s well-being. The same is true when carrying out a child protection inquiry or a care management assessment. A broad based assessment drawing on a range of sound theoretical perspectives is more likely to be robust than one based solely on one theoretical perspective, or worse still, no theory at all, only the prejudices and assumptions of the worker. The more varied and flexible the worker is in their use of theory the more likely they are to find a specific theoretical approach that works. There are several caveats to this position though. The first warning is that social workers need to adapt their theories to the person and not try and get the person to fit their preferred theory. The old expression is that if all you have is a hammer then everything looks like a nail. This holds true for theory. If you only have one theory or a preferred set of theories you will squeeze everyone to fit your theories. As far as possible workers should incorporate service users’ knowledge and theories into their understanding of the problems and needs of service users. Social workers may bring various general theories and expertise, but it is the service user who is the expert on their own experience. The second warning is that knowledge tends to solidify from sound practice into habit as beliefs and ideas begin to stick to existing theories. A social worker may begin practicing in one way, a way that is creative, flexible, effective and respectful, but over time that

becomes just ‘what I do’. It is easy for the latest fad or a piece of information with dubious validity to become accepted practice, sometimes with tragic results. The paediatrician, Dr. Benjamin Spock, stated in his 1957 book “Baby and Child Care” that babies should not be allowed to sleep on their back as this could lead to choking. Millions of parents followed this advice. However when detailed work was carried out in the 1990’s it turned out that this advice increased the risk of Sudden Infant Death Syndrome. Untested, unsubstantiated theory can be harmful, even fatal. In the same way an assumption that children are better off with birth parents and that removal from parents in inevitably harmful can lead to social workers ignoring clear signs of abuse. Theories need to be tested and treated as guides, not infallible rules for what will work. This is a theme I will return to in Chapter Eleven. As well as helping social workers know what their job is for and as helping social workers understand the situations they have to deal with, theories also help social workers structure their work. This is more likely to be true for theories that are more at the ‘methods’ and ‘practice’ end of the theory landscape (See figure 1). Two of the most widely used social work theories are Task Centred Practice and Crisis Intervention. Both of these provide a clear rationale for what to do at each stage of the work with a service user, but do not necessarily explain either why a worker should do this, or why the service user has encountered a problem to begin with. In many ways one of the key benefits of these models is that they create confidence in the worker – all they need to do is to follow the model. This confidence is expressed to the service user who in turn will feel more confident that the social worker knows what they are doing. This creates a ‘virtuous circle’ of increasing mutual trust, which makes the work both more mutually satisfying and more likely to succeed. There are many theories that can be useful for social work. This book will only explain a small number of them, enough to provide a framework which you can develop once you go on placement. In many ways the more theories you understand the better. However there are several things you must be aware of. Firstly, trying to use a theory you do not understand, or do not understand well enough, can be dangerous. In some cases this will be worse that not using theory at all. Secondly, theories in social work are only ever possible ways to make sense of things. There is no theory that is sufficient in itself to explain every situation or guide every action. This is why you must not become too dependent on just one theory. At the same time having a small number of theories you know well is very helpful. In my experience the best social workers have been able to use a range of a dozen or more theories, but have just two, three or four that form the backbone of their work. This is the third thing to be aware of: getting good at using a theory takes time. It requires reading, studying and practice. There are no short cuts here. It may take thousands of hours of practice to become really confident and effective in the use of just one theory. As a result you need to find that small core of theories that you can commit to, and then study and practice them hard. There are no short-cuts to excellence in social work. So in conclusion theory lets social workers know what their job is about, it helps them understand what they are dealing with, and it guides their practice. Having a range of theories is better than having none or only a small number. Social workers should treat their theories with caution, as reality is always more complex than the theories suggest. Theories should be made to fit the person, and not the person being made to fit the theory. Finally, if you want to be a good social worker, perhaps even an excellent social worker, you will need to read widely, study consistently and practice over a long period of time.

Reflection 1) Having read this chapter, how has your understanding or feelings about theory changed? 2) Looking back at your answers to the questions at the start of the chapter, what of the things you wanted did you get? 3) What new questions did this chapter raise for you that you hope might be answered in the rest of this book?

Recommended Reading Thompson, N. (2010) Theorizing Social Work Practice. Basingstoke: Palgrave Macmillan. Chapter 1 – “The Role of Theory” pp 3-19 Beckett, C. (2006) Essential Theory for Social Work Practice. London: Sage. Chapter 3 – “What do we mean by ‘theory’?” pp 29-44 Teater, B. (2010) Applying Social Work Theories and Methods. Maidenhead: Open University Press. – Chapter 1 – “Introduction to theories and methods.” Pp1-15

Chapter 2 – Theories of Social Work Preparation What is the purpose of social work? What do social workers do? Imagine a social worker investigating whether a child is safe to live with its parents, a social worker working in Care Management organising support for older adults with complex needs, a social worker working with children and families in a Child and Adolescent Mental Health Service and a social worker working with people with problematic substance use (drug addiction). What do they have in common that means that they are all ‘social workers’? Why did you want to become a social worker? When you retire, what would you like your colleagues and the people you worked with (service users) to say about you and what you did for them?

Introduction As I stated in the previous chapter, social work is not an ‘obvious’ profession. When you tell someone you are a social worker it is normal to have to wait while they mentally decide how to respond. This is because it is not obvious what a social worker does, or what a social worker is. This lack of clarity is challenging for new social workers, and perhaps even for experienced social workers, as this cartoon shows. Figure 2 - Confessing to being a social worker – Copyright Guardian Newspapers

This chapter will aim to do two things. Firstly, it will aim to put the role of social work into a context that helps makes sense of the complexities of practice. Secondly, it aims to provide a generic, general model of social work practice that can be used to explore the common core activities of social work.

Models of Social Work and Models for Social Work It is important to begin with a clarification of the difference between models of social work and models for social work. Models of social work are models of what social work is for, what its purpose is, in simple terms attempts to answer the question – what is the point of having a profession called ‘social work’. They do not tell social workers what to do as they do not provide a detailed guide for action. What they do is set out the general principles that will then guide action.

Theories for social work are all the theories and models that social workers can use to decide exactly what to do in any given situation. Some of the theories are useful in making assessments, such as say ecological-systemic theory or attachment theory, others are useful in giving detailed steps to take when implementing a plan, such as Task Centred Practice or Crisis Intervention. This chapter aims to set the scene for theories for social work by providing an overview of the theories of social work.

The International Definition of Social Work In 2000 the International Federation of Social Work provided the following definition of social work, which I have copied in full. â&#x20AC;&#x153;Definition The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance wellbeing. Utilising theories of human behaviour and social systems, social work intervenes at the points where people interact with their environments. Principles of human rights and social justice are fundamental to social work. Commentary Social work in its various forms addresses the multiple, complex transactions between people and their environments. Its mission is to enable all people to develop their full potential, enrich their lives, and prevent dysfunction. Professional social work is focused on problem solving and change. As such, social workers are change agents in society and in the lives of the individuals, families and communities they serve. Social work is an interrelated system of values, theory and practice. Values Social work grew out of humanitarian and democratic ideals, and its values are based on respect for the equality, worth, and dignity of all people. Since its beginnings over a century ago, social work practice has focused on meeting human needs and developing human potential. Human rights and social justice serve as the motivation and justification for social work action. In solidarity with those who are disadvantaged, the profession strives to alleviate poverty and to liberate vulnerable and oppressed people in order to promote social inclusion. Social work values are embodied in the professionâ&#x20AC;&#x2122;s national and international codes of ethics. Theory Social work bases its methodology on a systematic body of evidence-based knowledge derived from research and practice evaluation, including local and indigenous knowledge specific to its context. It recognises the complexity of interactions between human beings and their environment, and the capacity of people both to be affected by and to alter the multiple influences upon them including bio-psychosocial factors. The social work profession draws on theories of human development and behaviour and social systems to analyse complex situations and to facilitate individual, organisational, social and cultural changes.

Practice Social work addresses the barriers, inequities and injustices that exist in society. It responds to crises and emergencies as well as to everyday personal and social problems. Social work utilises a variety of skills, techniques, and activities consistent with its holistic focus on persons and their environments. Social work interventions range from primarily person-focused psychosocial processes to involvement in social policy, planning and development. These include counselling, clinical social work, group work, social pedagogical work, and family treatment and therapy as well as efforts to help people obtain services and resources in the community. Interventions also include agency administration, community organisation and engaging in social and political action to impact social policy and economic development. The holistic focus of social work is universal, but the priorities of social work practice will vary from country to country and from time to time depending on cultural, historical, and socio-economic conditions.” It is worth pondering deeply over this statement and asking yourself two questions, one immediate and one repeatedly over the course, and especially when you go out on placement. 1) Does this definition fit with my reasons for choosing a career in social work? 2) Does this definition match what I see happening in practice? The challenge in social work practice is to transform these lofty ideals and sweeping statements into practical actions within the limits of the teams in which you will work. Many social workers will find that the ideals of this definition simply do not reflect their lived reality of social work – for example the definition states that practice includes “counselling, clinical social work, group work, social pedagogical work, and family treatment and therapy” and yet very few social workers spent much, if any, time on these activities, unless you use a very broad definition.

Four Models of Social Work I believe that there are four common views of what social work is, what it is for, and how it should work. These are: the therapeutic model; the maintenance model; the managerial model and the radical model. In different countries and at different times the relative strength of these models has varied. Each of these will be considered in turn.

The Therapeutic Model of Social Work The Oxford dictionary defines therapy as ‘treatment intended to relieve or heal a disorder’. This definition, when applied to social work, is the idea that social workers work with those who are in some way ‘disordered’ in order to relieve their suffering or heal the cause of the disorder. The nature of this disorder can vary from the idea of someone whose life is so disorganised that they cannot function to the idea of people having a diagnosable mental disorder. The nature of the treatment too might vary within social work, from psycho-social casework to group work. At the heart of this model of social work is the idea that those individuals who require social work intervention are in some way disordered or damaged and that they need someone to

help them repair or manage their damage. This model gained support as the ideas of Sigmund Freud began to spread from the narrow field of psycho-analysis into the wider helping professions. Social workers began to see the personal and inter-personal difficulties of those they worked with as a direct result of problems in their early child development. The idea was because clients’ needs had not been met as children they were now exhibiting problems as adults stemming from that failure in childhood. As this was the view of the problem the solution was to re-build a trusting, intense relationship in which the social worker could build up a solid understanding of the person’s background and use this to provide the client with insight into why they acted the way they did. This insight would then allow them to change and begin to act in more effective and mature ways. Although the first psycho-therapeutic model to gain prominence in social work was psychodynamic theories there have been many additional theories that have informed social work practice. Person-Centred theory, which began in the field of counselling or therapy, gradually grew in influence, indeed much of the values base that can be found in the International Definition of Social Work has strong roots in the Person Centred Tradition. Both Attachment Theory, which was heavily influenced by psycho-dynamic theory, and Cognitive Theory, which was at least in part a reaction against the vagueness and openendedness of Person-Centred theory, have had an impact on social work practice. But in each case the idea is that the worker has expert knowledge and skills and they use these to intervene in the lives of people who have problems in order to alleviate their suffering. For many novice social workers and social work students this model seems very attractive. It connects with the desire to ‘help people’. It raises the status of social worker to ‘expert’. It provides a direct framework to guide practice. It aims to tackle those issues that are at the heart of the International Definition – well-being, helping people to: reach full potential; live enriched lives; and preventing dysfunction. Given all of this it seems obvious that this model is a reasonable one for social work. However:Effective use of therapeutic techniques requires hundreds of hours of training, followed by months or years of supervised practice. Very few social workers have this level of training and few social work jobs offer this level of training. Trying to implement poorly understood or inadequately practiced techniques can cause more harm than good; as the saying goes, ‘a little knowledge is a bad thing’. Many social workers have enthusiastically embraced a particular therapeutic theory only to find that when they use it in practice it does not go like it goes in the books or on training courses, and they soon end up lost or alienating the service user. Even where a social worker has good training and good supervision, the reality is that in many social work jobs case loads are too high to allow for good therapeutic practice. Many therapeutic approaches are intense and time-consuming. It is impossible to offer this service to 30 or 40 different people or families at the same time. Managing the problems and dealing with emergencies will often mean that for social workers having to comply with time-scales and form-filling on large caseloads there is simply not enough time to carry out therapeutic work. Finally, most service users do not see their problems as primarily personal and psychological, instead they see them as external and practical. For a parent whose child has been excluded from school they are more likely to be interested in how to get their child back into school than into exploring why their relationship with their child is a re-enactment of their own relationship with their parents. For a person with a severe mental difficulties it

might be interesting to explore their negative thought patterns and cognitive distortions, but if they are about to be evicted either preventing that or finding alternative accommodation is more important. The last three paragraphs may sound as if I am deeply cynical about either the Therapeutic Model of Social Work or social work generally, and to be honest I am somewhat cynical about both, but I remain passionately committed to the ability of social work to make a difference, both at the individual and the social level, and I recognise a role for the Therapeutic Model of Social Work. In Appendix Four I explore further the idea of Integrative Practice – the idea that social work is improved by being able to put together a range of theories, including therapeutic theories, into an individually tailored model that suits the needs of each individual service user. This does not require the complete knowledge of a theory that is required for a more purist therapeutic intervention, but it does allow social workers to use various theories in an effective, efficient and ethical manner. If you take a broad definition of ‘therapy’ to mean something like ‘the process of helping someone change’, then social work can definitely be therapeutic. Perhaps the single most important thing a social worker ever does is to actively listen to those they work with. Listening might be dismissed as ‘just listening’, but when a social worker actively and unconditionally listens to a service user this has profound positive effects. Listening, when combined with a belief that people can generate their own solutions, can be an important part of the process of change, even when the social worker offers no recommendations or solutions. So even if a full therapeutic model of social work is impractical , it plays an important part of social work practice.

The Maintenance Model of Social Work The Maintenance Model sees the role of social work differently to the Therapeutic Model. Whilst the Therapeutic Model focuses on treating disorders of the individual the Maintenance model focuses on the needs of society. The idea in the Maintenance Model is that everyone in society has a range of roles to play: parent, worker, carer, citizen, householder, neighbour, consumer, producer etc. As long as everyone performs their roles in an integrated way society will continue to function successfully. However for various reasons some people at times find that they struggle to fulfil all their roles. A parent stops providing adequate care for their child. Someone with an injury that leads to permanent impairment loses their job and can no longer pay their bills. The behaviour of a person with a mental health problem begins to impact on their neighbours. In each case the person is struggling to perform the roles expected of them by society, as parent, worker/provider or good neighbour. In the maintenance model the role of social work is to assess why the person is not fulfilling their role and to find ways to either help them fulfil it or to adjust to new roles. The maintenance model is not primarily concerned with disorders or healing, but with a practical solution to immediate problems. The leading writer in the field was Martin Davis in his book ‘The Essential Social Worker’. He clearly identified the maintenance model as being rooted in the Functionalist Theory of sociology. In this model of society it is essential for the maintenance of society that individuals, groups and institutions work together to meet the needs of all, or at least the vast majority of the members of a society. When individuals fail to fulfil their roles or when institutions fail to address the needs of citizens then things start to break down. In this context social workers become the engineers of society; they tinker with the parts to get them to work together well; they oil the machinery of society.

This was in many ways a reaction against the perceived failings of the therapeutic model of social work. Social work was expensive and had little research evidence to prove that it made much therapeutic difference on an individual level, so in order to justify its existence as a profession social work needed a new paradigm. The goals of social work moved from deep and profound psychological change for individuals to the more modest goal of helping adults live independent lives in the community and to protect the most vulnerable in society from abuse and exploitation. It is important to bear in mind that this is a ‘model of social work’, not a ‘model for social work.’ The maintenance model does not provide any detailed instructions for what a social worker should do, only a general framework for how they practice and what they are aiming to achieve. This creates a curious paradox or tension for social workers. From one perspective the maintenance model provides laudable aims for social work: social workers are promoting independence, assisting people to be successful and protecting the vulnerable and abused from harm. These are worthy and high ideals. At the same time the maintenance model actively supports the status quo; it has an uncritical view of the way that society is structured. In the maintenance model the goal is to fit people to the system, not to change the system to fit people. This is a theme I will return to shortly.

The Managerial Model Whilst the Maintenance Model can be seen as a reaction against the perceived failings of the Therapeutic Model, the Maintenance Model (and the Radical Model which I will describe next) came increasingly under attack in 1980’s and 1990’s for their perceived failings. Key to this was the attack on non-Market forces in society. The idea that drove this attack was that the most effective way to run all services in society was through market forces and competition. The idea was that if different services had to compete with each other the most effective and efficient services would thrive and grow and the least effective and efficient would either have to improve in order to compete or else close. This is a model known as neo-liberalism. A key to understanding this is to understand the problem of scarcity and fair allocation of resources. There is a potentially limitless need in society. As long as there is poverty, illhealth and relationship difficulties people in society will have needs. It is possible to spend a practically infinite amount of money on such services, and still find ways to spend more. So there has to be some way of limiting what society provides to meet all these perceived needs, as money and other resources are not infinite. This can be broadly done in two ways – a free market, in which people choose for themselves what services they want; and a planned economy, in which ‘experts’ determine what is needed and who is to get what. These two form extreme ends of the scale, with a third option, a mixed economy, being one that combines elements of the other two, in the middle. After the Second World War until the late 1970’s most Western states, including Britain, favoured a mixed economy, but one that had strong elements of a planned economy. Services were nationalised with strong Government intervention. Then from the late 1970’s onward the balance shifted away from planned economies towards the free market. This was driven by many factors, one of which was the perceived inefficiencies of planned economies as well as a deep suspicion of non-Market power sources in society, initially focused on breaking the power of the Unions but then moving on to attacking the power of the professions.

In the face of many scandals, social workers began to be seen as an incompetent profession, unfit to regulate itself. Similar things happened in teaching with the introduction of the National Curriculum and standardised testing. This set the scene for the development of the Managerial Model of Social Work – one that I believe is still THE dominant model of social work in the UK. According to the Managerial Model the way to allocate resources efficiently and to improve outcomes is to set targets and reward success and punish failure to meet these targets. This means that there is a focus on setting targets, developing standardised strategies to meet those targets and to closely monitor the outcomes to ensure that those targets are being met. With the therapeutic model the key goal of social work is growth and healing; with the maintenance model it is social integration and the smooth running of society; with the managerial model it is the efficient allocation of social resources. As a result under the managerial model social workers become administrators of the system. Needs are assessed and resources are allocated on the basis of pre-set and open criteria. The professional discretion, the ability to use individual judgement to assess, plan and meet the needs of individual clients, is replaced with systems for assessing need and systems for allocating resources to meet those needs. This model contains within it a curious contradiction. In one way the Managerial Model sees the ‘client’ as a ‘customer’, a consumer of services, who is making choices between different services. The idea is that the ‘customer is always right’ and that there should be a market that those who receive social work and social care services should be able to use to choose the services that best suit their needs. This is the neo-liberal idea of the market as the most effective and efficient way of allocating, developing and delivering goods and services in society. The Managerial Model aims to empower the service users to be able to make choices. This is the liberal ideal, liberal from ‘liberty’ the freedom to choose. At the same time services are assessed using pre-set criteria, for example the time in which people are assessed, the numbers of children taken into care, the length of time people spend in hospital and so on. This means that there is a standardisation of both measures of services and the way in which assessments and interventions are delivered. This is required in order to compare the performance of different services in order to produce things like ‘league tables’ (an important part of the Managerial Model). So although the stated goal is freedom of choice the pressure is on services to focus on those things that will best make their performance look good on the league table. So although the Managerial Model has gone a long way to remove some of the inefficiencies of the older systems it is far from perfect. When I began as a social worker it was by no means unusual for a person or a family to be worked with for months on the basis that they were being ‘assessed’. It was often unclear what was being assessed or how. Allocation systems existed in some services that meant that it might take many months for people to be seen by a social worker. The imposition of management led targets has helped reduce this. There was also massive professional discretion in the work which meant that different service users even in the same team might get very different services, despite having virtually identical needs. Again, the use of a Managerial Model has helped to reduce this. This has however come at a price. Services are more likely now to focus on meeting the service delivery targets than focusing on the detailed and complex needs of individuals. Whilst the system is meant to increase choice for service users in some cases there is a standardisation of service delivery which may in reality limit choice. Finally, the focus on

following systems and processes rather than developing professional judgements has in many cases undermined social workers’ confidence leading to a further demoralisation of the profession. It has also de-radicalised the profession. Something which has an impact on the final model of social work.

The Radical Model of Social Work All three of the models of social work covered so far focus primarily on helping the individual fit into society, either emotionally, socially or economically. The radical model of social work takes a profoundly different view of the role of social work. Whereas the other models primarily, although not exclusively, see the ‘problem’ for social work as being rooted in individuals and families who for one reason or another are dysfunctional, the radical model sees the problem as being primarily, although not exclusively, in society. The problem is not that people are not fitting in to society but that society is actively harming some people. The goal of radical social work is therefore not to ‘treat’ people, nor to help people fulfil their social roles, nor to allocate social resources efficiently, but to actively challenge the forces in society that oppress individuals and groups. Radical social work has its roots in a variety of critical views of society. These have included feminist critiques of the ways in which many of the practices in social work tend to blame women and disempower women for failing to live up to the expectations of a sexist society. Other critiques have come from a Marxist perspective. This views all the institutions in society as being set up and maintained to support the interests and needs of the dominant class. An example of this is that whereas working class families who need to work may be seen as being neglectful parents no criticism is levelled at upper class families who pay someone else to take on their parental duties. Social work in this view is merely a form of ‘soft policing’, a way of keeping in line those who might otherwise disrupt society. Further impetus in radical social work came from Black perspectives on social work. These critiqued the white (and frequently middle class) norms and expectations that were imposed on all families. Other cultural parenting practices where seen as ‘sub-standard’ or ‘inadequate’, even though there is no evidence these do any harm. An example of this is the expectation that parents will engage in ‘baby-talk’ with pre-verbal children. This is often held up as the ideal, and even as essential to child development, yet there are cultures where baby-talk is considered stupid. As a Guyanan friend of mine used to say when she saw me using babytalk to my children when they were babies, “Hey, Mark. What are you going to do if he answers you?” The psycho-linguist, Steven Pinker, notes that children in cultures that use baby-talk develop language at the same ages as those who are raised in cultures that do not. Yet the danger is that all parents are judged by the norms and standards of the dominant, in the UK white, culture. Further critiques have come from both disability rights campaigners and lesbian, gay, bisexual and trans-sexual rights campaigners. In these cases to the critique has been that those who are perceived as ‘different’ are marginalised and oppressed by a society that judges them by the norms of the dominant groups, not by their own standards, needs, and views. Even further than this is a history of critique from an anarchist perspective. This holds that the problem is not sexism, or classism, racism, ablism or homophobia, but hierarchy, especially a hierarchy supported, reinforced and enforced by a powerful, centralised state. The anarchist tradition seeks to break down all hierarchical structures that divide and oppress the majority whilst allowing a small minority to hold power without consent or justification.

In many ways this radical tradition, which had its greatest influenced from the 1960’s through to the 1980’s, has been significantly weakened by the influence of neo-liberalism and the managerial model of social work. However the influence can still be seen in the International Definition of social work which talks about social justice, Human Rights, empowerment, liberation and so on. For radical social workers the aim is to help both individuals and society to see how the current system is not working, how it oppressed everyone, but has an especially harmful effect on those with least power. The goal of radical social work is not simply individual well-being, but a radical transformation of society. The methods use vary, from insisting that the most marginalised and the least powerful are put at the centre of social work practice, to helping the oppressed see and challenge the nature of the oppression they face, to taking direct action with service users. A powerful local example of this occurred in Northampton when a black youth group, The Matta Fancanta took possession of a building that was about to be demolished and formed their own youth club. This action was a direct result of a sense of being alienated and rejected from the existing youth services which focused on the needs of the white children and felt unsafe for black children. What is powerful in this example is that the local Community Relations Officer spoke actively in support of what was an illegal occupation. (http://www.eafa.org.uk/catalogue/160652) This willingness to set aside law, policy and practice to support what was seen as ‘a good thing’ is extremely rare in modern social work or public service practice. However examples do still exist where groups of social workers work together to promote radical action for social justice. The Social Work Action Network (SWAN) is an example of this. The table below gives an overview of these four models of social work. Table 2 - Overview of the Models of Social Work Therapeutic Model

Maintenance Models

Managerial Model

To help people fulfil their roles in society

To allocate resources to meet pre-determined social needs

To create a fairer more just society

Therapist/ Counsellor

Social engineer

Resource administrator

Social activist

Case work, counselling, groupwork

Problem solving, Task Centred Practice, Crisis Intervention

Signposting, advocacy, case management

Anti-oppressive practice, Consciousness raising, group work, direct action

Main To help people purpose of overcome social and social work emotional problems Role of the social worker

Preferred Models and Methods

Radical Model

I would argue that good social work usually involves a balance of all four of these models. The act of listening to service users and allowing them to tell their stories and have their stories heard in a non-judgmental way is a therapeutic process, even if that is all that happens. People do have to cope in society, they have to find housing, food, company,

activity and so on, so a maintenance view makes sense. Resources are limited and need to be allocated fairly, effectively and efficiently, and the management model helps in that process. When people are taken seriously and equipped to make changes they can help change society, so although it might be more evolution than revolution radical practice is still possible. The reality is that for different people and for different posts the balance of these four models of social work will vary. This is shown in the figure below. Figure 3 - The balance of the four models

A Care Manager

A Drug and Alcohol Worker

A worker is Child and Adolescent Mental Health

A child protection worker

Therapeutic Model

Maintenance Model

Managerial Model

Radical Model

Pause for Thought Which of these four models attracts you the most? Which will you find most challenging? How can you ensure that no matter which model you are working under you can express all your values and goals for social work? Is social work just a job, a way to pay the bills, is it a career, something you can make progress in and develop as a profession, or is it a calling, something that expressed your deepest values for life? Your answer to this question will help shape how you respond to the demands of all four of the models of social work.

The Social Work Process At this point it is worth reflecting on what it is that social workers do: what are the common features of social work? These features can collectively be called â&#x20AC;&#x2DC;The Social Work Processâ&#x20AC;&#x2122;.

Pause for Thought What do social workers do? What are the things that happen when people meet with a social worker that are the same, regardless of when, where and why they are meeting? Social work is a human profession – it is about one person meeting with other people. This creates the beginning of the social work process. Social workers need to engage with people. They need to talk with them, meet with them and build some kind of working relationship. Once they have engaged with someone a social worker needs to make some kind of assessment. They need to find out what the needs and risks are. They need to understand what are the hopes and goals of the people they are working with. They need to identify resources that might help meet needs, reduce risks and help people reach their hopes and goals. The assessment will then help the social worker and those they are working with to devise a plan. This plan will say what the goals are, what resources are available to reach that goal and how the resources will be used to reach that goal. In very simple terms a plan will say who, will do what, with what, when, where and how, in order to achieve the desired goal. Plans are important, but they are useless unless acted upon, so social workers must implement a plan, and this also involves motivating and supporting others to implement the plan. The implementation phase is about putting the plan into action. The 19th Century German General, Helmet Moltke, had the maxim that ‘no plan can be relied upon beyond first contact with the enemy’. What he meant was that no matter how carefully planned a strategy is it cannot take into account everything, and once things begin to change the end results are unforeseeable. As a result a good plan must be clear up to the point in first implementation, but then must be adapted in the light of feedback. This leads to the next important phase of the social work process – review and evaluation. As a plan is being implemented a social worker must be careful to monitor the effects and see whether the results are the intended one. If they are, then the plan can be continued with until things reach the desired goal. However if the results are unexpected then this can be used to refine the assessment and redesign the plan, with new strategies being implemented to ensure the plan fits the unique circumstances of each person. This leads to a maxim that I have often applied, both personally and with others – you must have a plan, because you need to know what you are deviating from. Without a plan the social worker will just be fumbling in the dark; if the social worker pursues a plan without regard for the results the effect will be damaging, but a plan which responds to feedback is most likely to succeed. Finally social workers are usually not permanent features in the lives of service users. At some point the work will finish; the goal will be achieved, or the resources will have been exhausted. This leads to the final phase of the social work process – closure. This step is often missed, but has lasting importance. The process of assessment, planning, implementation and review can deeply shake up people’s lives. If this is not recognised then when the social worker leaves the service user can be left in a worse state then they were before. When closing a case it is important to review what has been learned and how the service user can maintain the progress made after the social worker leaves. When done well this greatly enhances the effectiveness of the work.

Sometimes you will see this process presented as a line, usually with engagement and closure missed off.

Assess

Plan

Implement

Review

Figure 4 - Carol Sutton's ASPIRE model Personally I do not think this reflects what really happens in social work practice. Instead of a nice, clear, linear progression from Assessment, to Planning, to Implementation, to Review and Evaluation, I believe that there are a range of processes that are happening at most points, but rise and fall in prominence as the work progresses.

Figure 5 - Social Work Process as Overlapping Phases

Engagement Assessment

Planning Implementation

Review and Evaluation Closure



First Contact



TIME

Middle of the Work



Closure

As you can see from this assessment begins from point of referral, even before the social worker has begun to consider how to engage with a service user. In the same way closure begins from the first point of referral. When considering how to work with someone there is an important question of ‘what will we need to see in order to know it is OK for us to close the case?’ This helps keep a focus in the work from beginning to end. The phase that is essential for the work throughout is engagement. Social work is all about forming effective working relationships. This means that engaging with service users from beginning to end is an essential part of the process at all stages of the work.

The other phases then tend to fit in with those three key processes, engagement, assessment and closure. At the first contact with a service user engagement and assessment will be the most important. In the middle of the work the main focus will be on implementation and review, towards the end the planning will have largely moved to relapse prevention and evaluating the work rather than creating new interventions. At the end of the work the planning and assessment have largely stopped, and evaluation is the main priority.

Practice Implications Social work is a job with high stress levels and with relatively low levels of job satisfaction. One of the key reasons for this is the gap between the aspirations of social workers, the things social workers want to do, and the demands of the job, the things social workers are allowed to do. Whilst having theories of social work cannot eliminate this gap, it can help explain it and give a tool for minimising the gap. I suspect that most social workers come into social work with a strong desire to help people. That may be rooted a therapeutic, a maintenance or a radical model of social work, depending upon how the new worker understands â&#x20AC;&#x2DC;helping peopleâ&#x20AC;&#x2122;. Once they begin to practice most of them will find that the managerial model is dominant and often feel this model has little to do with helping people. Having an understanding of the different models then gives social workers options. The first, and least challenging option, is to recognise that these four models overlap and interact. The managerial model exists for a reason and the goals that are set are not random. This means that a social worker can look for the therapeutic, maintenance and radical goals that are behind and beneath the targets and performance indicators set by the managerial model. This can help you fight the tendency to practice in order to meet or exceed the targets just for the sake of meeting targets and instead look at the bigger, least measureable goals that underpin those targets. It is possible to humanise the more brutal elements of the Managerial Model and to practice with compassion, even whilst you are processing people through a system. This will be covered in more depth in the chapter on the Practice Pyramid. Secondly, and with more of a challenge, you can find out ways to introduce elements of more person centred or radical models into the Managerial Model. Where the Managerial Model has become oppressive social workers may need to become agitators, taking actions that will disrupt the system. This is a theme that will be returned to in the chapter on AntiOppressive Practice. Finally, and with the most challenges, social workers can choose to change job. Within social work there is an enormous range of jobs. If you find that the job you are in is dominated too much by a model that does not play to your strengths then change job. If necessary get more training or study specific areas of practice so you can begin to develop the knowledge and skills that will get you to a job that builds on your strengths, interests and passions. This may include doing more Managerial Model work. Social work needs good managers, and all four models have their place, so if you are interested in becoming a manager you might need to move out of a job that is stuck in the therapeutic or maintenance model. At a more general level the Social Work process is an effective model for avoiding drift and identifying gaps in services. If you are starting work with a person or family the model helps

you decide where you should focus at first. If you are stuck in the middle of your work the model may help you see that you have not engaged effectively with the service user, or that your assessment has not been adequate, or perhaps that you have not developed and explained your plan clearly.

Reflection 1) 2) 3) 4)

What has stood out for you in this chapter? What has puzzled, annoyed or confused you? Which model or models of social work are you most drawn to? Looking at the social work process, what skills and knowledge do you think you will need in each phase of the process?

Recommended Reading Parker, J. (2013) “Assessment, Intervention and Review” in Davis. M. The Blackwell Companion to Social Work: Chichester, Wiley-Blackwell. Pp311-320 Doel, M. (2012) Social Work: The basics. Abingdon: Routledge. Chapter 1 “Reformist or Radical? Social work’s roots and different identities” Coulshed, V. aned Orme, J. (2012) Social Work Practice. Basingstoke: Palgrave Macmillan. Chapter 1 – Theory for Practice. Pp 1-20 Adams, R. (2002) “Social work processes” in Adams, R., Dominelli, L. and Payne, M. Social Work: Themes, issues and critical debates. Basingstoke: Palgrave. Pp Davis, M. (2013) “Maintenance Theory” in Davis. M. The Blackwell Companion to Social Work: Chichester, Wiley-Blackwell. Oko, J. (2008) Understanding and Using Theory in Social Work. Exeter: Learning Matters

Chapter 1 – “Introduction to understanding social work theory” pp1-15 Higham, P. (2006) Social Work: Introducing professional practice. London: Sage. Chapter 4 – “Social Work Roles” pp82-111 Payne, M. “Understanding social work process.” In Adams, R., Dominelli, L. and Payne, M. Social Work: Themes, issues and critical debates.” Basingstoke: Palgrave Macmillan, pp159174

Chapter 3 â&#x20AC;&#x201C; The Practice Pyramid Preparation Think of a time when someone helped you. What was it that made a difference? Was it something they did, or was it more the way they did it? Was it about specific actions, or about the way they treated you? When social work is effective, what do you think it is that makes a difference? What are the most important things social workers can do for service users?

Introduction This chapter is unique within this book. In all other chapters I have largely presented the ideas of others, with little, if any, new and original material. This chapter is an exception. Although I will be drawing upon the range of a work from different writers and researchers in different fields, in particular Michael Lambert from the area of therapy and Hilton Davis from the area of child health, the way these are formulated in this chapter is, to the best of my knowledge, my own. The key argument in this book is that the areas of practice that are often seen as most important, mainly the skills and techniques and the theories that underpin those skills and techniques, are not, in reality as important as other things. The most important single feature of successful social work is a successful working relationship between service users and social workers, and this relies less on the theories or the techniques used and more on the personal qualities and attributes of the worker, and on the core beliefs and values held by the worker. The basic idea is that when we focus on the techniques at the cost of the relationship, our work suffers. Paradoxically when we focus on making sure we bring the best of ourselves and we express the right values and beliefs even relatively weak practice can still be very effective.

An Overview of the Practice Pyramid. The idea of the Practice Pyramid is that good social work rests on a certain set of core beliefs and values. These beliefs are things like: every person is unique; people should be free to live as they choose as long as they do not harm others; those with the least power should be put at the centre of our decision making; social workers do not do things to other people, they do things with other people. These beliefs form a solid base Some qualities will help good humility, inner strength and arrogance, coldness, insecurity

to allow the social worker to express their personal qualities. practice, such as warmth, compassion, a sense of justice, so on; other qualities will harm good practice, such as and so on.

Sound values and beliefs which allows the social worker to express the right personal qualities will lead to a good working relationship. This will be a relationship of near equality, of mutual respect, of openness and trust, of honesty, of safety. Within this relationship there will be the ability to engage in mutual challenge; social workers will be able to challenge service users without breaking the relationship, but equally service users will be able to challenge social workers. It is not that the relationship will be smooth or unbroken. At times the social worker and the service user may â&#x20AC;&#x2DC;fall outâ&#x20AC;&#x2122;; perceived breaches of trust or

acts of disrespect will happen, but these will be worked through so that the relationship is restored. In this kind of relationship a social worker is able to bring their knowledge of theory to bear on the service usersâ&#x20AC;&#x2122; situations. They can create theories which respect the service usersâ&#x20AC;&#x2122; beliefs and theories, but which also draw upon both research and practice knowledge. These theories allow the social worker and the service user to have a shared understanding of why things are the way they are and what needs to happen to make things better. Finally the social worker can begin to use specific skills and techniques. These will only be as truly effective as possible when the social worker understands the theories that underpin them, uses them within an effective working relationship, brings the right qualities and attributes to the work, and holds values and beliefs that are consistent with the work they are doing. This can be presented visually like this: Figure 6 - The Practice Pyramid

Skill

Theory

Relationship

Qualities and Attributes

Core Beliefs and Values What is important to understand about this diagram is that it is not the height that indicates importance, but the size of the box. Skills, by which I mean the specific techniques used by the social worker, are the least important part. They are not unimportant, it is just that without understanding the theories that underpin them they can be dangerous. Theories are not useless, it is only that a theory can only be useful in truly effective social work when it is shared with the service user. Without this sense of a shared theory all that can happen is the social worker can impose their theories onto their service users. This may get the job done, but the cost may be very high and so the overall effectiveness of the work is diminished. In the rest of this chapter I will consider each element of the pyramid in turn.

Skills and Techniques Social work is probably one of the most complex and challenging jobs in society. Social workers deal with competing demands, changing goal posts and massive degrees of uncertainty. This is also true for most people working in what you might call the ‘people professions’: teachers, nurses, lawyers, psychologists, police officers. Objects are relatively simple and predictable, people are not. For social work this is magnified by the problems of defining what social work is and what it is for (See Chapter Two). For this reason social workers need to be highly skilled; but which skills are needed? One helpful way to think about social work skills is to divide them into generic skills and phase specific skills. Generic skills are those that are used throughout the social work process, skills such as communication skills or time-management skills. Phase specific skills are those that have most importance at the specific phases of the social work process, so for example: engagement skills, assessment skills, planning skills, intervention skills, evaluation skills and closure skills. A second way of thinking about skills is about the breadth of the skill. In this way of thinking ‘communication skills’ is a very broad set of skills which are relatively poorly defined. ‘Interviewing skills’ are still quite broad, but are becoming easier to define. When this is narrowed down more you get something like ‘questioning skills’. These are more specific, but still cover a range of things. Then you arrive at the specific techniques, the micro-skills, such as using open and closed questions, circular questioning, embedded questions, clarifying questions and so on. It is beyond the scope of this book to do more that to raise awareness of skills and techniques. Whole books have been written on this topic. In general the more varied and creative a social worker’s skills tool-kit, the set of available skills and techniques they have, the better, but only insofar as the social worker has the competence and the knowledge to understand and apply them safely and effectively. This requires a knowledge of theory.

Theory Using a technique without understanding the theory that underpins it is at best risky, and at worst professionally dangerous. I have had personal experience of this which I will share. This is not an apocryphal story; this really happened. When my eldest son was about three my wife and I were visited by a keen trainee nursery nurse. After she’d settled in she explain to us that they been ‘doing children’s drawings at college’ and she had learned that when a child shows you a drawing you don’t say ‘what is it’ you say ‘tell me about your drawing.’ A few minutes later my son came over with his latest drawing and showed it to the trainee nursery nurse. On cue she said ‘Tell me about your drawing?’ As my son began to explain about his drawing she said ‘It’s not very good, is it?’ That is what happens if you use a technique without understanding the theory. The reason, the theory, of why you don’t say ‘what is it’ was lost on the nursery nurse. The theory is that when you don’t know what a drawing is you are showing you have not been able to see the drawing from the child’s eyes and so have undermined their self-efficacy. She was unaware of this. Using a technique you do not understand is always to take a risk. If you do this whilst learning a theory then this is acceptable, we all have to start somewhere. When this is a

consistent feature of your practice this is not acceptable. The general rule should be: only use techniques when you understand the theory that underpins them. A very common example where this can be seen in social work practice is in child behaviour management programmes. Most of these contain strong elements of behavioural theory, which has reinforcement as one of its key theoretical bases. Yet many social workers do not understand the difference between positive reinforcement (which can be seen as ‘rewards’), and negative reinforcement (which is NOT the same as punishment). I would go so far as to say that any worker who cannot provide a coherent explanation of the difference between ‘punishment’ and ‘negative reinforcement’ should not attempt to use behavioural techniques in their work. In the same way it is dangerous to try and use behavioural techniques without an understanding of ‘reinforcement schedules.’ This allows us to understand why unpredictable rewards tend to lead to longer lasting behaviour change than predictable rewards. Over my time in practice and as an educator I have repeatedly seen work claimed as having one theoretical base when it is clear to me it does not. Perhaps the most common example is where one-off sessions are claimed to be ‘Task Centred Practice’. One-off sessions can be helpful and effective, but they cannot be Task-Centred Practice. If you do not see why this is the case it should become clear in Chapter 8. This book gives an overview of what I consider to be some of the key theories in current social work practice in the UK. It is not a complete guide to these theories. As a result if you want to be a good social worker all this book can do is give you a platform on which you can build. Find the theories that work for you, and then practice them until they become second nature for you. But remember, this is only going to really work if you use the theories you know in order to build and maintain effective working relationships.

Relationships The 1987 enquiry led by Dame Butler-Sloss into the Cleveland child abuse scandal made a powerful observation about the relationship between social workers and those they work with. They reported that ‘the child is a person, not an object of concern.’ This is a telling observation about the importance of relationships in social work. When service users (or clients, or people we work with) are treated as objects, as things to be ‘processed’ or ‘managed’, rather than as people, the result is poor practice. The quality of the relationship is probably THE determining factor in the quality of social work practice. The core theory that underpins relationships in social work is Person Centred Theory (See Chapter 4 for more details on this). This means that when working with service users social work will be most effective when the social worker endeavours to use empathy to enter into the service user’s personal experience of reality. This means recognising that service users have hopes and fears, goals and aspirations. Service users have complex personalities with different parts of themselves wanting and needing different things, often things that contradict and compete with each other. The quality of the relationship is heavily dependent on the social worker’s ability to enter this world, to see, hear and feel what it is like to be the service user, and to communicate this understanding to the service user. When this is done well the relationship between the social worker and the service user is marked by compassion and empathy. This is very different from sympathy. With sympathy the worker has an intellectual understanding of the service user’s pain. With empathy the worker can experience the service user’s world, without either feeling sorry for them or losing sight of their own experience of the world.

This in turn leads to relationships that aim for equality. It is unrealistic to expect the relationship to be one of true equality for reasons that will be returned to in Chapter 6. What is realistic is for the social worker to aspire and actively work towards minimising power imbalances and ensuring that power differences are only increased when it is necessary to do so in order to ensure those with the least power are protected from having their power lessened, for example, in general social workers working with parents will aim to keep the power difference between themselves and the parents they are working with down to a minimum, unless a child is being abused. In this case social workers will use strategies such as applying for legal orders, but they are only doing this in order to ensure that the needs of those with the least power, in this case children, are put at the centre of the work. There are many other qualities of good social work relationshi ps. There is an active aim to build relationships as partnerships, with shared understanding and shared goals. Social workers aim to keep relationships honest, keeping service users fully informed about what is happening and why. The partnership aim also means that social workers need at times to be assertive. Service users may push the boundaries and act in ways that are rude and disrespectful. Within an honest partnership relationship respect has to work both ways. If the social worker is rude or disrespectful, even if this is unintentional, then the social worker should apologise. If the service user is rude or disrespectful then the social worker should explain the effect this has had and, if appropriate, seek an apology from the service user. Social workers are not door-mats or the servants of service users, they are equal partners. This places a duty of respect on both sides of the relationship.

Qualities and Attributes As you can see from the above discussion on the working relationship, it takes a certain kind of person to be a social worker. Social workers need to be empathic, compassionate and understanding. They need to have a sensitivity to the needs and experiences of others. Without this quality they can never build the kind of relationships needed for effective social work. At the same time social workers cannot be soft or weak. Social workers are required to deal with difficult issues and face complex and challenging situations. This takes personal resilience; the ability to be insulted and attacked without just cause, and to not take this personally. It takes the ability to focus on what is important when service users are being threatening, abusive or unreasonable. It takes the ability to get the job done in the face of personal pressures, tight time limits, and high degrees of uncertainty. Social workers also need to be flexible and creative. They need to be able to adapt their approach to different situations and different people. They need to find different ways to reach their goals, as it is often the case that the first plan will not achieve the desired effect. One of the most consistent findings is that social workers need to have â&#x20AC;&#x2DC;quiet optimismâ&#x20AC;&#x2122;. They need to have the ability to believe that people can change, that people can reach their goal, but to hold this view without becoming too excited by this. Many service users are feeling demoralised and ground down by repeated set-backs and crises. If the social worker becomes pessimistic about change they will communicate this to the service user. This can harm the possibility for change. On the other hand if the social worker is too loud or showy in their confidence that the service user can change this may be experienced by the service user has having no idea how tough things are for the service user. This will undermine, not strengthen the relationship.

Personally I believe that a sense of humour is one of the most important attributes that a social worker can bring to their work. Having a sense of humour is important in that it lets you keep things in proportion. It stops you taking things too seriously. On a more theoretical note humour often works by being able to see two or more contradictory ways of seeing things and then flipping from one to another. This is an important problem solving skill, and one that helps build a relationship. Being able to share a joke with service users can really cement a relationship, although it is important to do this only in a way that builds up the service user and does not bring them down. As the comedian, Milton Jones, said in 2010 – ‘humour should be directed upwards’. What he meant by this is that humour can be used to undermine the power of the powerful, but should not be used to further disempower the powerless. Having said all of this it is important to remember that social work is as much an art as a science. I have seen warm, compassionate, humorous social workers who are not very effective in their work. I have also seen quite cold and clinical social workers who have nonetheless managed to form solid and effective working relationships with service users. It is not a case that any single quality or attribute is essential or will be enough to ensure good practice. It is more the case that when social workers bring the right blend of attributes and qualities then the work will be more effective.

Core Beliefs and Values What underpins all that I have written about so far in this chapter are our core beliefs and values. Values are the broader concepts such as respect, equality, choice, empowerment, well-being, justice, and so on. Core beliefs are more narrow concepts – for example ‘all people have strengths and resources that can help them achieve their goals’, and ‘people don’t resist change, they resist being changed.’ In this section all I can do is to sketch out my personal beliefs and look at how these relate to the shared values of social work. In doing this I must emphasise that this view will be personal. My beliefs and values have worked for me, but I have seen other social workers with other values and beliefs do just as good, or even better work than me. What matters is not the details of the beliefs as the integrity and honesty with which you can stay true to your beliefs in your work.

Values The values of social work are laid out in the International definition of social work. It is worth spending time exploring these in detail to see how they relate to social work practice and to the wider theory base in social work. The bedrock of social work is its ‘humanitarian and democratic ideals.’ I n this context ‘humanitarian’ relates to the idea that all people are united as members of a common humanity. This unites us across all other dividing lines; it takes precedence over nationality, ethnicity, gender, class, sexuality, religion, culture, language, or beliefs. In the same way ‘democratic’ extends beyond its everyday understanding of elections and what is correctly defined as ‘representative democracy’, voting for people to represent us in a governing body, to a smaller scale ‘participative democracy’, the idea that individuals should be actively and directly involved in the decision making processes that affect their lives. This is perhaps most powerfully expressed in the slogan of the Disability Rights Movement – ‘nothing about us without us’, in other words no decision should be made about service users that has not actively involved service users in the decision making process.

From these two bedrock values spring many more key values. The threads of “respect for the equality, worth, and dignity of all people” are clear implications of the humanitarian and democratic ideals of social work. Along with these come a value based on human potential, the belief that people can, and will, make good decisions for themselves when provided with the right conditions, and through these decisions they can meet their “human needs” and develop their “human potential.” The value of human rights and social justice are further added to the bedrock of social work. As the International definition says these “serve as the motivation and justification for social work action.” From these four key principles, humanitarianism, democracy, human rights and social justice, come many of the important actions and positions of social work. Social workers acting on these principles will stand “in solidarity with those who are disadvantaged” and aim to do so in ways which strive to “alleviate poverty and to liberate vulnerable and oppressed people in order to promote social inclusion.”

Core Beliefs As I stated at the beginning of this section core beliefs are more diverse and personal than the values base. However the above discussion of values already helps us begin to identify what might be seen as the most common and powerful core beliefs of social work practice. What I present below is an entirely personal list. You do not have to agree with all these beliefs, and there are a great many important beliefs that are missing from the list that I believe are still important, or at least helpful to social work practice.

General Core Beliefs - These beliefs are core beliefs about life. They are not specific to

social work, but are principles I try and incorporate in all aspects of my life. 1. All people deserve equality of respect and are of equal value and worth 2. People should be free to choose how they live, and this freedom should only be restricted when it actively harms another person 3. I am no better than anyone else, but there is nobody better than me 4. Life is about choices, and consequences 5. I need never be defensive, as when I am right I don’t need a defence, and when I’m wrong I haven’t got one 6. If you don’t make mistakes you won’t make anythin

Core Beliefs about Social Work – These beliefs are about the fundamental nature of social work. 1. The core aims of social work are to enhance well-being, promote social justice and protect human rights 2. Social workers should ensure that those with the least power are always put at the heart of their practice 3. Social work is primarily about helping people to help themselves; about doing things with people, not for or to people 4. The most powerful things social workers do for people are to listen to their stories and take their stories seriously 5. Social workers should never make decisions about people without actively involving the person in the decision making process 6. Social workers should only go against point 5 when doing so is the only way to stay true to points 1 to 4

Core practice beliefs – these beliefs are about the best way to practice as a social worker 1. When you stop seeing service users as humans of equal value and worth it’s time to get out of social work 2. There is no such thing as failure, only feedback 3. The service user is the expert on their goals and experience 4. It is harmful for social workers to do things for service users that they are capable of doing for themselves 5. When given the whole facts people are generally best placed to make choices that affect themselves 6. Everyone has strengths and resources that can help them achieve their goals What is important to recognise is that whilst it is quite easy to state these beliefs, it is harder to live up to them. It is easy to state that all people are of equal value and worth, but when you are working with someone who has raped a child or beaten up an older adult then it is hard to hold on to this belief. It is easy to state that there is no such thing as failure, only feedback, but when you have done your best and someone has still died this will be of little comfort. It is easy to state that life is about choices and consequences, but for the individual who has been trafficked into the country and has been threatened with their family being killed, the choices are desperate and the consequences of all decisions are horrible. Social work is not a neat job, with neat beliefs leading to uncomplicated actions and predictable consequences. Beliefs and values overlap and they can contradict. Social workers regularly find themselves in situations where to protect one person it is necessary to limit the freedoms of another person. This is why understanding your values and beliefs is vital. When your values clash some are more important to you than others. You may value freedom and choice, but if an individual is using their freedom and choice to oppress someone who is less powerful then your value for justice will supersede your value of freedom and choice. This will not always sit comfortably, but it is part of the professional responsibility of a social worker – to ensure that the most important values form the basis for resolving any conflicts in your values and beliefs. Another important issue to raise about values is that there is a key difference between ‘espoused values’, the things we say we value, and ‘values in action’, the things that our behaviour show we value. This can work in both directions. People may say that something is not important to them, say money or power, and yet act in ways that show that money or power are important to them. People may also state that something is important to them, say equality or respect, and yet act in ways which reinforce inequality or show disrespect towards others. This is not a problem that effects only a few bad people (hypocrites and liars) but is something we are all prone to, we are all prone to hypocrisy and we all sometimes lie, even if only to ourselves. We need to be extremely careful that we are prepared to seek and listen to feedback in order to ensure that we are ‘practicing what we preach’, as without that people will be too busy listening to what we do (our values in action) to hear what we say (our espoused values).

Values and Codes of Ethics Since I began in social work there has been a move from focusing on ‘values’ to a focus on ‘codes of practice’. This is even embedded in the International definition of social work

which at the end of its statement on values adds, “Social work values are embodied in the profession’s national and international codes of ethics.” This is linked to the dominance of the Managerial Model in social work. Values are rooted in professional autonomy and personal responsibility. They are about a professional doing their best within their job. Codes of practice are about ensuring that professionals behave themselves, that they do what they are expected to do. Given all the scandals that have gone on, from the Harold Shipman case, to various social work scandals to the Jimmy Saville affair we can see that repeatedly professionals have acted in very unprofessional ways. This explains in part why we have sought to introduce codes of practice. The danger however, is that workers begin to focus on ‘doing things right’ rather than ‘doing the right thing’. Social workers no longer practice to express their values but instead practice to be able to prove that they have followed orders. This is why I believe strongly that social workers must seek to understand and prioritise their values, and where necessary to focus on values-led practice rather than simply complying with the procedures and codes of practice.

Reflection 1. Review your answers to the questions in the introduction section. How does the material in this chapter fit with your answers? 2. Do you agree with the idea that values, beliefs and qualities matter more than theory or techniques in determining what is effective in social work? 3. What are your core beliefs? When and where might this conflict with each other? 4. How would you deal with a situation where a service user was doing something that whilst not illegal was against your personal value base? 5. If you cannot think of an example of the conflict in 3 and 4, ask yourself why? People have very different life-styles and different cultures hold different practices and it is highly unlikely you find all of these equally acceptable.

Recommended Reading It is hard to give recommended reading for this section as much of what is presented here is based upon my own thinking. Central to this thinking are the works of Hubble et al “The Heart and Soul of Change: what works in therapy” and Davis et al “Working in Partnership with Parents: The Parent Adviser Model.” Similar ideas can be found in: Coulshed, V. and Orme, J. (2012) Social Work Practice. Basingstoke: Palgrave Macmillan. Chapter 3 Social Work Processes – advocacy and partnership. Pp 45-65 And Tracey, T., Lictenberg, J., Goodyear, R., Claiborn,C., and Wampold, B. (2003). Concept mapping of the therapeutic factors. Psychotherapy Research, 13, 401-413.

Chapter 4 – Person Centred Theory Preparation Imagine you are working in a community mental health team. You are working with a man in his late 50’s who has severe anxiety and depression. When you read the man’s file you discover that when he was in his early 20’s he sexually assaulted and murdered a 10-yearold child. How would you feel? What would your thoughts be towards this man? How would you ensure you practiced in an appropriate manner?

The Idea in a Nutshell Our worth and value comes from being human, and not from who we are, what we do or what we own.

The idea in summary By accepting people as they are, in all the complexity and messiness of human experience, and by consistently and actively demonstrating this acceptance through your behaviour, you create the conditions necessary for people to become the person they have always had the capacity to become.

The idea in more depth Person centred theory (sometimes known as Humanistic Theory) states that human nature is essentially good. It believes that when people are accepted for who they are and are valued as a unique individual in their own right they will naturally seek to be the best they can be and will respect, love and value others. Although many writers, theorists and practitioners have influenced the theory it is still most closely associated with the main originator of the theory – Carl Rogers. For those who believe and practice Person Centred Theory there is a view that this innate, goodness and value is the natural state of humanity. However as people grow from babies, to children to adults they are often offered only conditional love, not the unconditional love that the theory says is essential to reach our fullest potential. Parents, carers, friends, lovers, family, peers and neighbours give us the message that in order to be accepted and loved we must be something other than what we are. As a result of this we come to believe that we are not good enough. We then begin to put an act; to present an acceptable face to the world in order to be loved and accepted. This however creates feelings of anxiety, inferiority and a lack of authenticity and integrity. The self literally “dis-integrates” as we present false selves to the world, and even to ourselves. Instead of having a core sense of value and worth as an individual we judge ourselves in terms of how we perform on many different scales. The sense of integration, of being a person in our own right, is lost as we try and earn respect from others. But person centred theory also notes that not only do we lose a sense of our own uniqueness and worth, but we also see others as less than fully human. Instead of being able to fully relate to others as a genuine meeting of equals we seek to judge relationships in terms of what people can do for us, or in terms of who is superior and who is inferior. So

not only are we as individuals “dis-integrated” but we are also separated from integrated human encounters with others by the roles we play and the roles we ascribe to others. One of the key ways in which we can see this “dis-integration” is by our tendency to see others as defined by their behaviour. When someone bullies another person we call them “a bully”. When someone lets people take advantage of them we call them “a doormat.” In both cases we identify the person with their behaviour. Person Centred theory explicitly rejects this idea. A person who kills another person is not a murderer, they are a person who has committed murder. A person who has sexually abused a child is a person who has abused a child, and not an abuser. The same goes for any single aspect of our experience as a human. A person diagnosed with schizophrenia is not “a schizophrenic.” When we called someone a dyslexic or a quadriplegic we are defining the person based on one part of their total experience as a human being. Once a person is labelled by their disorder something of their unique value and worth as a human being is lost. Rogers’ theory is often presented in a very neat and simplistic way – if you listen to people they will get better. However this does not do justice to what is a complex and integrated theory of human experience. Rogers presented nineteen propositions that he believed underpinned all his work. I have tried to summarise them below. The numbers in brackets relate to the number of the proposition in Rogers’ original list. People are actively constructing their understanding of the world by seeing and hearing what happens around them, and then trying to make sense of it. (1-3) A core part of this sense making is aimed at addressing the question ‘who am I?’ (4) Not only does the person think about who they are, they also form an opinion about how good they are, based on the reactions they get from others. (5) This also builds on an in-built drive to be the best they can possibly be, and also to survive in a changing and challenging environment. (6) As a result of this you cannot really understand another person’s experience or their behaviour until you can see it from their own internal model of the world and of themselves. When it comes to understanding behaviour this is best seen as an attempt to need the person’s needs, as they perceive them (8) and emotions are a result of the i mportance attached to the needs and the extent to which the person sees their needs as being met or blocked. (9) Needs are both instinctive and essential and also socially constructed. This means that the value placed on different experiences, and on the self, will vary depending on the reactions of others. This sets the scene in which some needs are seen as ‘good’ (socially approved of) and others as ‘bad’ (socially disapproved of). As the individual continues to feel these needs, regardless of whether they are socially approved of or not, there is a tension set up between ‘the kind of person I am’ and the experience of needs. Where the two are aligned this creates little tension, and most behaviour will fall into this category (12). However where the two are experienced as in conflict tensions arise. These may be denied or experienced in a distorted form. It will perhaps be helpful to give an example of this. (10 and 11) Imagine a person who has grown up in an environment where sexual activity is seen as shameful or bad. As they go through puberty and begin to become aware of their emerging sexuality this may create tension. The self-concept is that ‘I am a good person’ but the socially approved of belief is that ‘only bad people want to have sex’. This can then create an environment where the individual either completely denies their own sexual identity or

one where the responsibility is projected onto someone else. In the latter case the problem is no longer that ‘I have sexual desires and feelings’ but that other people are ‘acting provocatively.’ (13-16) When the threat of judgement is lifted the person is able to openly explore their own experience and their sense of self. They are able to take responsibility for their own behaviour and build a new, more accurate and healthier sense of the self. (17) This not only improves the well-being of the individual, but also makes them more able to be empathic towards others, recognising that others have needs and desires that are just as valid, no more, no less, than their own. (18) The end result, according to Rogers, is that this will allow the individual to both grow and mature as an individual, but to also develop values which are not distorted by the conditions and limitations imposed on it by society and by others who did not accept the person as they were developing. (19) Core to Rogers’ model of life was that each of us is born with a sense of our ‘real self’, an individual capable of doing and being unique and impacting the world in a powerful and meaningful way. When that ‘real self’ is met by carers and significant others who can offer ‘unconditional positive regard’, accurate empathy and who are congruent in themselves, then this real self will develop unfettered. However when the developing child is met with either a lack of positive regard, or regard that is conditional on meeting some kind of external judgement, or where they are met with a lack or inaccurate empathy, or encounter people who lack congruence, then the self will become hidden and a false-self will emerge, and this will harm later development. It is helpful to consider each of these three things in turn. Unconditional Positive Regard is central to Person Centred Theory. This means that regardless of who the person is or what the person has done they are seen and treated as a person of infinite value and worth. When this is experienced by a person, when they are met with an attitude that says ‘no matter who you are or what you’ve done, I will treat you as being of the same value as everyone else’ then the person can begin to accept themselves and take responsibility for their life and behaviour. It is important to note that this is regard for the person, not their behaviour. Person Centred Theory suggests that we must accept and respect people, not their behaviour. So as a child is growing up there is a world of difference between saying ‘That was a silly thing you did’, which can be done with Unconditional Positive Regard, and ‘You are a silly person’, which cannot. This leads directly to the non-judgemental attitude which is also central to Person Centred Theory. This does not mean that the worker never passes judgement on behaviour. Behaviour can be judged on both its intentions and its consequences, but the person doing the behaviour is not judged. This leads to an important distinction between ‘punishment’ and ‘discipline’. Punishment is about making someone pay for the past, it is about judging them as a person. Punishment basically says ‘you are a bad person, you must suffer.’ Discipline is about helping someone do better in the future, it is about them learning from the consequences of their behaviour. In that respect Person Centred Theory is not soft. Rogers went so far as to say that a person centred life was not “for the faint-hearted. It involves the stretching and growing of becoming more and more of one's potentialities. It involves the courage to be. It means launching oneself fully into the stream of life.” (Rogers 1961)

The second feature seen as necessary for healthy development is accurate empathy. Babies and small children have powerful feelings and experiences. These are real and important to the child. When a parent or another significant person recognises and validates the importance of that experience to the child, the child grows in their sense of being able to experience and deal with a wide range of powerful feelings. This is however something that quite often adults simply ‘get wrong’. Consider seriously for a moment this dialogue from the movie ‘Love Actually’. Daniel is Sam’s step-father. Sam is somewhere around 10 years old. Joanna, Sam’s mother and Daniel’s wife, has recently died and Daniel is raising Sam on his own. It is obvious to Daniel that something is wrong for Sam, but it takes him time to work out how to deal with it. Finally they have a conversation, which goes like this. Daniel: So what's the problem, Sammy-o? Is it just Mum, or is it something else? Maybe... school - are you being bullied? Or is it something worse? Can you give me any clues at all? Sam: You really want to know? Daniel: I really want to know. Sam: Even though you won't be able to do anything to help? Daniel: Even if that's the case, yeah. Sam: Okay. Well, the truth is... actually... I'm in love. Daniel: Sorry? Sam: I know I should be thinking about Mum all the time, and I am. But the truth is, I'm in love and I was before she died, and there's nothing I can do about it. Daniel: [laughs] Aren't you a bit young to be in love? Sam: No. Daniel: Oh, well, okay... right. Well, I mean, I'm a little relieved. Sam: Why? Daniel: Well, because I thought it would be something worse. Sam: [incredulous] Worse than the total agony of being in love? Daniel: Oh. No, you're right. Yeah, total agony. In this brief conversation there a several ways in which, quite unintentionally, Daniel fails to provide accurate empathy. Firstly, he laughs when Sam says he is in love. If you watch the scene Sam’s non-verbal communication alone makes it clear that for Sam this is not a laughing matter. Secondly, by stating that he is ‘a bit young’ he further dismisses Sam’s reality of being in love. Finally, by dismissing this as something that could have been ‘worse’ he minimises how bad this feels to Sam. As the scene develops Daniel displays accurate empathy, but this exchange is very typical of the ways in which adults can, without any malice, fail to respond with accurate empathy to the experiential world of children. This builds up over time into a situation where children no longer feel able to trust or respect their own feelings and so hide their true selves, even from themselves. Finally there is the importance of congruence. This in many ways is the mirror of accurate empathy. With accurate empathy the adult enters into the world of the child; with congruence the adult allows the child honest entry into their own world, but in a contained

way. If a child encounters adults who are able to openly and safely express a wide range of emotions they learn that emotions are safe and even useful. They learn that: when a loss happens it is fine to feel sad; when something good is going to happen it is fine to feel excited; when an important rule is broken, it is fine to feel angry; when something harmful might happen it is fine to feel scared; but above all they learn that these feelings do not overwhelm the person and they can feel them and carry on. This creates a strong, authentic sense of the self in the developing child. However when a child is surrounded by adults who either do not express their emotions, or who express one emotion but either deny or mislabel it, then the child develops an anxious, insecure sense of self. When a child finds that no matter what they do, good or bad, the parent does not react, this undermines the self. When a child hears a parent scream ‘I’m not angry’, this undermines the self. These three things, Unconditional Positive Regard, Accurate Empathy and Congruence form the basis of Person Centred Practice. Rogers further developed these from a view of human development to a set of ‘necessary and sufficient conditions’ for therapeutic change. When it comes to using this theory in practice Rogers suggested that there were six conditions required for this model to bring about change. • Psychological contact between worker and service user • The service user to be in a state of incongruence (experienced as a sense of anxiety or distress) • The worker congruent or integrated in the relationship. • The worker has unconditional positive regard for the service user. • The worker has an empathic understanding of the service user's way of making sense of the world. • The worker achieves some degree of success in communicating their empathic understanding and unconditional positive regard to the service user. (Rogers, 1957) Rogers argued that if a worker was able to be congruent (true to themselves and their core values) and could make psychological contact with a service user in distress; if they were able to fully value the service user as a person in their own right; if they could connect with the service user well enough to see life from the service user’s point view; and if they were able to communicate both the fact that they value the service user and can see things from their point of view then that alone will be enough to bring about positive change. In practice, Person Centred theory is applied in its purest form in non-directive person centred counselling. Here the worker seeks to listen with acceptance to whatever the person brings. The worker seeks not to challenge or change anything about the person or how they see the world, but only to empathetically understand the person’s view of the world. Key to this is the belief that by doing this the innate, natural drive to fully express all that is best in us will be set free by being accepted and understood by another human being. The reality of social work practice is that social workers rarely have the time or the responsibility to offer person centred counselling. Social workers use the person centred approach in a more general way, as an underpinning principle rather than in its purest form.

Theory in Social Work Practice When a social worker encounters a service user they have a fundamental choice of approach. A social worker can either choose to be person-centred, or they can choose not to be person-centred. When a person approaches a social worker the social worker may choose to see the person as a problem to be solved, a customer to be served, a target to be met. A social worker may listen very carefully to the service user in order to learn what they need to know to solve the problem, to give them what they want, or to meet the targets of the service. Each of these might lead to efficient and effective social work practice, but not to person-centred practice. A social worker using person-centred theory will approach a service user first and foremost as a human being of infinite value, worth and potential. They will seek first not to fix them but to understand and accept them. In this context a social worker will listen actively to what the service user says in order to see and feel what life is like for the service user. One of the most powerful applications of person-centred theory to social work practice is the separation of the person from their behaviour. Person Centred theory does not mean that we have to accept what people do. We can still be clear that certain types of behaviour, behaviours that have a harmful effect upon others, are wrong or bad. The key point from the theory is that a person does not become bad because they have done bad things. When applying person centred theory in social work practice the start point is the equal value and worth of all human beings. The person who has abused a child is not of less value or worth than the child that they have abused. Both are equally in need of being met by a social worker who will treat them as a human being. This is far from easy to do in practice as it is normal to have strong feelings about behaviour that offends our sense of morality. Rogers’ ‘necessary and sufficient conditions’ can be extremely helpful. When Rogers says that the worker must be congruent and integrated in the relationship this implies a high degree of honesty. This means that a social worker can express their feelings about a particular piece of behaviour, for example to say, “I know what you have done, and I don’t agree with it and I do feel uncomfortable when I think about it.” However they can then add something like, “However I think none of us should be judged by our behaviour and that what you did is not the whole story of who you are as a person.” From a person centred perspective this is not simply a technique, but a genuinely held belief. It can only be done well when you are sure you do separate people from their behaviour. If it is just words without belief then most service users will see the words as fake and react with due contempt for the worker who says them. However if you believe all humans deserve equal worth and respect and communicate this with integrity and empathy most service users will be grateful for your honesty. Some may object to this honesty; concerned that it will hurt the service user’s feelings. This however shows a lack of understanding of the person centred theory. If you think you have to hide your feelings from the service user (and if you believe that most service users will not be aware of the fact that you are hiding them) you cannot have a genuine person centred encounter with a service user. In many ways the skill in using person centred theory is to know when and how to share your feelings, not whether to share them. A purposeful use of self to model respectful

acceptance is a powerful person-centred tool. However it is easy to share your feelings with a service user in ways that serve your needs, not the service user’s needs. As stated earlier, Person Centred Theory rejects the idea of identifying an individual with a single aspect of their experience. This means that words and phrases such as “the elderly”, “a bully” or “an anorexic” are not acceptable. This is not a case of being ‘politically correct’. It is simply that these words take a facet of the person, their age, their behaviour, their medical diagnosis and use this to label the person. According to the Person-Centred theory when working with someone diagnosed with schizophrenia or manic depression there is a huge difference between seeing them as a unique individual who experiences the world in their own way and seeing them as ‘a schizophrenic’ or ‘a manic-depressive.’ So a person centred approach to social work practice means seeing the individual as a person of value and worth in their own right. It means accepting that whatever the person experiences is true and valid for them. It means actively seeking to place yourself in their place without losing sight of your own individuality and sense of the world. It is quite possible to do all of this whilst still challenging a person’s behaviour. It is possible to use a person centred theory base even when you are saying that someone cannot adequately care for their children or needs to be detained in hospital against their will. To be person-centred is not to deny that a person’s behaviour has consequences, or to fail to follow through on the consequences of a person’s choices. It does mean that even when doing so you never lose sight of the potential, worth, dignity and value of the person. You never treat them in a lesser way because of their behaviour. In many ways Person Centred Theory is more about a statement of values then a specific scientific approach to our work. It is also an approach that is much more espoused in theory than delivered in practice.

What it’s not Person Centred theory is not the same as active listening. Whilst active listening can help you treat others with respect and can help you see the potential in them it is also possible to actively listen without using a person centred approach. In fact some of the best active listeners on the planet are expert sales staff. Being able to see the world from someone else’s point of view is incredibly helpful if you want to persuade them to do something that is in your interest. It is quite possible to actively listen in a Person-Centred way or in a self-centred way. It is possible to use the technique of active listening without having a genuine unconditional positive regard for the other person. It is therefore important when we claim to be using a Person Centred Approach that we are using the core elements of the theory and not simply applying a few of the more superficial techniques that come from the theory. Mearns and Thorne, leading writers in the field of Person Centred counselling have identified how dangerous this lack of a solid understanding of Person-Centred theory is in practice. They comment that “many practitioners with inadequate or even minimal understanding were prepared to label themselves ‘person-centred’, bringing the approach into disrepute by their superficial, muddled or misguidedly anarchic practice, which had no solid foundation in genuine person-centred theory.” (Mearns and Thorne 2007, p2-3) A second thing that can be confused with Person Centred theory is Person Centred Planning. This is defined as “a way of discovering what people want, the support they need and how

they can get it. . . . . that assists people in leading an independent and inclusive life.” (DoH, 2010, p3) While this is consistent with Person Centred theory, it is not the same as Person Centred theory. It is possible to carry out Person Centred Planning in a managerial way. It is possible to engage in the process of Person Centred Planning without having a deep regard for the person. This does not necessarily mean it will be bad practice. Sometimes an effective and efficient response achieves goals more quickly than a more person centred approach. Despite this it is important to understand that just because an approach has ‘person centred’ in the title does not mean that it will automatically use all, or even most, of the things from Person Centred theory. Finally, being person centred does not mean putting the person at the centre of the process. If you put the person at the centre of the process, but you fail to recognise the person as a unique person with a fully valid experience of life you will not be being person centred.

Theory Checklist Do you believe that all people have an innate potential to be the best they can possibly be? Do you believe that all people have the same inherent worth and value, without regard for their past behaviour or any other characteristic? When talking with a service user do you seek to understand fully how they experience their life circumstances? Do you actively seek to communicate the belief in people’s innate potential and worth, and your empathic understanding of their lived experience? When you engage with service users are you conscious of being emotionally honest and genuine? Unless you can say ‘yes’ to all these questions you are not using Person Centred theory, regardless of what other techniques and approaches you use.

Critique of the theory Many people do not accept the idea of an inherently good human nature. Those who are influenced by evolutionary psychologists (such Steven Pinker) see human nature as being driven by competing demands. Whilst altruism, love and integrity are part of human nature, so is selfishness, hate and lying. In general how humans behave owes more to what will meet their self interest (as they perceive it) than it does to any innate sense of goodness. If a social worker sticks overly rigidly to a Person Centred approach they may fail to challenge a person when challenge is required. Instead of seeing the person as inherently positive a worker may begin to see all aspects of the person’s behaviour as positive. This can lead to very serious poor practice. For example in a child protecti on role a social worker may strive so hard to understand and validate a parent’s experience that they fail to recognise that a parent’s behaviour or view of their child might pose serious risks to a child. Whilst it is true that most parents do love and care for and about their children a significant number do not. Of those there are many who fail to do so in a way that actively harms their child’s well-being. A social worker must never allow a commitment to Person-Centred theory to lead to practice where they ignore the real harm one person can do to another.

It is also possible to critique Person Centred theory from a more political activist stance. Whilst Person-Centred theory rejects the idea of identifying people according to an individual characteristic there are strong political reasons for doing this. Feminist theory is largely built upon a collective experience of being a woman. By individualising and personalising women’s experience, by seeing the problems faced by women as a problem of denial of self, the oppression of women as a group, by men, as a group, is down-played or denied completely. For groups who have been oppressed in society such as women, lesbian and gay men, members of ethnic minority populations, older adults, people with disabilities, working class people, it is worth asking if the problem is one of individual authenticity or collective oppression. Person-Centred may in effect deny this oppression. Radical action may be helped by identifying the self primarily in terms of a part of your experience as a member of a group, rather than solely in person-centred individual terms. Many consciousness raising approaches require a person to actively embrace a label instead of denying it. In a similar way Person-Centred theory may be critiqued for having a Euro-centric bias. The model is based upon the individual as a discrete and separate entity, complete and entire in itself. In many cultures in the world this is not how a person is perceived. The concept of Ubuntu can be widely found in African cultures. This is often defined as something like “I am because of who we are.” In many African and Asian cultures the self is seen as far more of a connected, interdependent entity. As a result a worker using a Person-Centred approach cannot assume that someone will share the idea of a self-actualising individual as a universal model of human nature. Although there is a danger of a Euro-centric bias it is important to remember that Ubuntu is itself described as a humanistic model. A person using a Person Centred approach may be able to validate and accept another individual’s worldview that includes an inter-connected, interdependent self rather than in isolated, independent self. Despite these serious problems with Person-Centred theory it remains probably the most significant theory underpinning social work practice. There is a solid body of evidence that workers who work in a Person-Centred way build stronger relationships with service users, and that the strength and quality of the relationship is a key factor determining the overall effectiveness of social work practice. Whilst it may be true that Person-Centred theory has an overly positive view of human nature it seems likely that it is better to treat people in a positive light. The idea of a selffulfilling prophecy is very powerful here. (Merton, 1968) If you consistently treat someone as a person of value and worth; as someone with many positive qualities, they will often respond to such treatment by becoming the person you believe them to be. The cynics may be right; human nature may be far from the positive thing posited by Person-Centred theory, but the paradox may be that by acting ‘as if’ that positive view of human nature is true individual humans may become much more positive in ways congruent with the goals and roles of social work. In the same way a Person-Centred approach may be the first step on a journey of overcoming oppression. For example a gay man from a religious background that strongly condemns homosexuality may find the acceptance and respect of a Person-Centred worker a useful first step that leads them to taking a more strongly political position of identity politics.

On balance it is likely that if a social worker fails to operate in a Person-Centred way; fails to respect the unique value and worth of each person, their practice is unlikely to be as effective as it could be. Equally a commitment to fight oppression that fails to be PersonCentred is likely, in the end, to dehumanise and therefore increase the level of discrimination and oppression. However to be so Person-Centred that we fail to see the level of oppression faced by some individuals as a result of their actual or perceived membership of a particular group or class is also likely to lead to us failing to confront oppression. This is why effective social work practice needs both a Person-Centred approach and an understanding of social systems. It is only by integrating both that social work can really live out its goals of “empowerment and liberation” based upon “principles of human rights and social justice”. (IAASW, 2001)

Reflection 1) How could you work with someone if you knew that they had raped or murdered a child? 2) Think of a time when you have been really psychologically connected to another person. How did it happen? What let you know you had that connection? 3) What barriers might you find that would stop you having a truly person-centred approach to your work? 4) Given the power imbalance, statutory duties and involuntary nature of much social work practice, what is the role of person centred theory in social work?

Recommended Reading Maclean, S. and Harrison, R. (2011) Theory and Practice: a straightforward guide for society work students. Lichfield: Kirwan Maclean Associates. Chapter 31 “Counselling Theories” pp177-180 Gardener, A. (2013) “Person Centred Practice” in in Davis. M. The Blackwell Companion to Social Work: Chichester, Wiley-Blackwell. Pp459-463 Trevithick, P. (2012) Social Work Skills and Knowledge: a practice handbook. Maidenhead: Open University Press. Appendix 7 – “Person-centred approaches” pp337-340 Teater, B. (2010) Applying Social Work Theories and Methods. Maidenhead: Open University Press. Chapter 7 – “Person-Centred Approach” pp102-116

Chapter 5 â&#x20AC;&#x201C; Models of Communication Preparation Think of a time when either you misunderstood what someone said, or someone misunderstood what you said. How did this happen? How did you deal with it? What did you learn from this experience? What does it take to communicate clearly? What helps communication and what hinders?

Introduction Communication is the key tool of social work. Whilst social workers might use a variety of tools to assess, plan, implement and review their work, what they do more than any other single activity is communicate: to talk and listen, to read and to write. A social worker who is not a skilled communicator is unlikely to be effective. On more than one occasion I have heard people say that communication is a skill, not a theory. I think this is flawed for reasons I will return to at the end of this chapter. At this point all that is necessary to say is that the development of skill in any area is greatly aided by an understanding of the theories that underpin those skills.

The Idea in a Nutshell Communication involves sending and receiving messages. The interpretation of these messages is a complex and multi-layered process.

The idea in summary Language is essential to communication. It is therefore important that social workers have ways of understanding how language works. This understanding alone is insufficient as there is also a more general process of communication that goes beyond the words we choose in order to give a message. When we intend to give a message we must code that message in some way, usually through a mixture of words, voice and body language. The meaning of these messages is not as clear cut as we might think. Whilst it is true that social workers must make sense of the words and actions of service users, they must also not forget that service users are doing exactly the same to the words and actions of the social worker.

The idea in more depth In this chapter I will focus on three models that can be used to analyse and improve our communication. The first is a propositional model of language. The second is an embedded model of communication. The third is a cyclical model of communication.

The Propositional Model of Language Language does many different things. One of the key features of language is that it is the main way in which we let other people know what we think and how we understand the world. Spoken language is often propositional in that we make statements about what we

believe is true. Language breaks up the world into manageable and meaningful chunks. Think about the following three statements, each making a statement. ‘I can see a manufactured object from my office window’ ‘I can see a building from my office window’ ‘I can see the restaurant from my window’ Each of these three statements is true (at least when I wrote them), but each gives a more detailed picture of what I can see from my office window. You might ask why this is important, but it is important because different words carry very different meanings, that convey very different propositions. Consider these two statements which sound very similar. ‘It’s up to you’ ‘It’s down to you’ On one level these two statements convey a similar proposition – that you have a choice but they are significantly different in their detailed proposition. ‘It’s up to you’ means that you have the freedom to choose, and the speaker is not concerned with the outcomes. ‘It’s down to you’ means that you are responsible for the consequences of your choice. When social workers interview service users their aim is to understand the service users’ experience as fully as possible. This means listening extremely carefully to the word choice and to the word order and being aware that words rarely convey all the details necessary to make sense of the service user’s experience. The following exercise can help illustrate that. Thought experiment Think of an important event in your life, one that has great personal significance for you. Put yourself back into that event, see what you saw at the time, hear what you heard at the time, feel what you felt at the time. Remember how your body felt; remember the images, thoughts and memories that were in your head at the time. Now briefly describe that event in a few sentences. Capture the key points in as few words as possible. How well did those sentences sum up the experience? The fact is that for much of our most important experiences words cannot even begin to capture the experience. Even when we do find ways to express our experiences we often use short-cuts and shortened forms of wording that cut out much of the detail. Part of the art or skill of communication is to put back that missing detail, however that is hard to do unless we understand that the detail is missing and actively seek to ask questions and communicate in ways that put that detail back. This can be represented in the following diagram.

Figure 7 - Limits of Language Quite often when people talk they use words and phrases that make their propositions very unclear, or else reveal a particular way of experiencing the world which might be logically inconsistent. Here are two examples. 1) People scare me. 2) I have to finish this assignment. In the first example there is only one word whose meaning is clear: ‘me’. With the other two words we don’t know who the ‘people’ are and we don’t know what they are doing that the person feels scared about. The more we listen for these unclear propositions the better we can ask for clarity. 1) a) Who is it that is scaring you? b) What are they doing that scares you? In the second example there is another detail missing, and most likely a distorted view of reality. This could lead to a conversation like this. 2) Service User (SU): I have to finish this assignment. Social Worker (SW): What will happen if you don’t? SU: I will fail my course. SW: So if you fail this one assignment you will fail the course? SU: Yes, well I will if I fail the re-sit. SW: So if you don’t finish this assignment you will have to pass the re-sit to stay on your course? Whilst this might sound like nit-picking it is very important. Words really matter. They reveal people’s views of reality, and these views have profound effects on behaviour. Again, consider these three uses of a single word ‘accident’. 1) I went to the pub and drank five pints of beer. I then crashed my car on the way home. It was an accident. 2) I was changing the radio station on my car radio when I crashed the car. It was an accident.

3) I was driving along the road when I hit a patch of spilt diesel, skidded and crashed the car. It was an accident. In each case would you accept the word accident? This is complicated because one of the key tasks in social work is to help people take responsibility for their actions, and yet so often we use language to avoid responsibility. Look at the following dialogue and see if you can notice the denial of responsibility. What happened to that course you were going to take? Oh, it didn’t happen. This can also happen with positive events, where sometimes it is easy to show in our language that we do not always take full responsibility for our actions even in a positive context. You gave me an A+! No, you gave me an A+ piece of work and I told you what it was. It might help to reflect on why we are much more likely to say ‘I have got an A’ rather than ‘I wrote an A,’ and yet no one just ‘gets’ an A, they work for it. This also plays a vital role in interviewing. Words have been shown to have powerful impacts on what people remember. In one experiment people were shown a video recording of a car accident. Afterwards the subjects were asked a question that they could answer yes, no or unsure. The question was asked in two forms. 1) Did you see a broken headlight on the car before the accident? 2) Did you see the broken headlight on the car before the accident? Just that one small word change changed people’s reactions. With the first question a substantial number of people said they were unsure. This was because they had two options: either a) the car had a broken headlight which they saw or missed; or b) the car did not have a broken headlight. In the second form of wording they had only one choice: either they saw the broken headlight or they missed it. This resulted in a reduction of the number of people who reported that they were unsure. Without a detailed understanding of how language works this kind of mistake is simply too easy to make. Excellent listening skills require an understanding of communication theory.

Embedded Model of Communication The second model to understand communication is simple, yet powerful. This model suggests that when we use language we filter it through a series of biases. Firstly we have the personal, ego-centric bias. When I hear a word being used I assume that the speaker has the same understanding of that word as me. But this is a dangerous assumption. Consider the following sentence. I feel upset. When I use this phrase I am most likely to mean something like ‘I feel sad’ or possibly even ‘I feel guilty’. They are the two words that I most closely associate with the concept ‘upset’. However for many people upset has a very different meaning, it means something like ‘I am angry.’ If this difference is not acknowledged miscommunication is very difficult to tackle.

This ego-centric level of language bias sits inside a wider bias: and ethno-centric bias. In this context I am using ‘ethno’ in a very specific way. Here the word ‘ethno’ means the people you identify with, the people who share your understandings, your culture, your background. Within social work some words have specific meanings: beds, accommodation, residence, parental responsibility and so on. When social workers talk to social workers this is usually fine, but when social workers talk to service users an insensitivity to the differences in language can lead to serious problems. Finally there is a socio-centric bias. Within a given society some things are taken for granted, treated as normal. I remember in my teens going out with a girl whose mother was Spanish. I would sometimes think the family were arguing, but then everyone would be laughing. It took me time to realise that raised voices and arm gestures had a very different meaning in their Spanish society and culture to what I was used to. The therapist Insoo Kim Berg tells a story of first working with families in the USA having moved from Korea. She was deeply puzzled when families talked about ‘grounding’ their children. At first this was an ego-centric difference between ‘grounding’ and grinding’, but it then revealed a deeper socio-centric bias. In American (and UK) culture grounding, preventing a child from leaving the family home, is a normal form of discipline. In Korean culture this practice seems bizarre, ‘but isn’t that where the child wants to be?’ In Korean culture the sanction for misbehaviour is to exclude the child from the family home, send them to a relative or neighbour until they have reflected on their behaviour. A similar situation can arise with parenting behaviours, where what is considered normal or healthy can vary greatly from culture to culture, but without social workers knowing which practices are genuinely harmful and which are simply different ways of achieving the same result. These embedded biases can be shown visually.

Socio-centric bias

The Cyclical Model of Communication

When people communicate they communicate for a reason, it is an intentional act. In order to understand any act of communication the Ego-Centric question must be asked, what are the bias participants trying to do? When someone stops and asks for directions they are trying to establish the route to a destination. When someone orders food at a restaurant they are trying to get a meal they will enjoy. When Figure 8 - Embedded Bias someone talks to a friend about a wonderful holiday they have they are trying to share their thoughts and feelings about that holiday. This understanding of the intentional nature of communication is a fundamental aspect of Communication Theory.

Ethno-Centric bias

Understanding any communication begins with focusing on what people are trying to achieve through their communication. Social workers are usually trying to understand a person’s situation or trying to help them generate possible solutions to their problems. These intentions will fundamentally affect the way we behave in our communication.

Intentions by themselves can do nothing, therefore social workers need to have ways to turn their good intentions into effective actions. When it comes to communication they need to somehow code their intentions into language. They need to find the right words to say what it is they need to say in order to achieve what they want to achieve. This coding lets them combine words, tone of voice and body language to effectively fulfil their intention. It is important to recognise that coding may be both conscious and unconscious. A large amount of our non-verbal coding occurs without any conscious awareness. However awareness of issues such as eye-contact and non-verbal mirroring can greatly improve the effectiveness of social workersâ&#x20AC;&#x2122; communication. Verbal coding, selecting the right words to convey the intended message, is perhaps best described as being sub-conscious rather than unconscious, in that people usually say what it occurs to them to say without careful analysis. However quite often there is a degree of choice in coding verbal language. Social workers must choose their words carefully to find the words that are most effective in any given situation. Whilst this coding is being planned it does no good at all. A wonderfully crafted sentence left unsaid makes no difference. Social workers need to produce the communication they have coded. Their words, voice, faces and bodies must be brought into play so that they turn the message they have coded into language and produce this so the other person can receive it.

Decoding Decoding Reception Intention

Coding

Reception

PERSON A

PERSON B

Production

Intention

Coding

Figure 9 - Overview of the Communication Cycle However, once a social worker has said what they planned to say the other person must receive it. They must hear the words, be aware of the tone of voice and see the facial expressions and other body language. If the message is not seen or heard then no effective communication takes place and the process stops. Once the other person has heard the social workers words and tone of voice and seen their body language they must decode them to decide what the social worker meant. This process of deciding what the speaker meant, what their intentions were, will then let the listener decide how they will respond. The listener will have their own intentions which they will need to code and produce. And so the cycle of communication continues. This can be represented in the diagram above. What this diagram shows is that communication is a cycle where intentions are repeatedly encoded, produced, received, and decoded so that new intentions can be formed and encoded. This process is non-linear in that not only do messages pass backward and forward between the participants in the communication, but this all happens at the same

time. While one person is speaking the person may still be trying to decode what they have said a moment or two earlier. While one person is speaking the listener may be simultaneously coding a non-verbal message with the intention to show that they are listening while the speaker is speaking. A further factor that must be taken into account when understanding the communication process is the concept of ‘Noise.’ Noise here is used to refer to all the factors in a communication that tend to disrupt the process of mutual understanding. Noise might be a noisy environment that makes it hard for one person to hear the words the other person is saying. In a more subtle way an inability to see someone’s mouth may make it harder to interpret what they are saying. This is because lip-reading is an important part of differentiating certain sounds, even for people without a hearing impairment. Distractions, such as a television on in the background, also create noise that stops us from fully attending to all that the other person is saying. In this model noi se is not simply sounds, it is anything that interferes with the smooth transmission, reception and decoding of messages.

Reception Intention

Coding

Decoding

NOISE

Decoding

Reception PERSON B

PERSON A

Production

Intention

Coding

Figure 10 - External Noise in Communication Not all noise is external. Anxiety, tiredness or pain can all act as internal noise. Sometimes people can be so busy thinking about their own thoughts and feelings that they fail to pay full attention to the other person. Thoughts like “I’m making a mess of this” or “They must think I’m an idiot” will stop people from being able to communicate as effectively as they might. This too is noise. Although self-awareness, a recognition of how we are feeling moment-by-moment, can be an important part of empathic communication, when people focus too strongly on these this creates noise that stops people truly hearing others. Sometimes intentions themselves may become noise. When someone is so busy trying to get their point across that they shut themselves off from listening to the other person’s point of view. They may focus so much on rehearsing what they are going to say next that they are no longer with the person in the moment-by-moment experience of communicating. Sometimes social workers need to pay attention to their fleeting thoughts and feelings. Sometimes they need to carefully plan how they are going to respond. But when these factors stop them from listening to the other person they have become noise.

NOISE Decoding

Decoding Reception Intention

Coding

Reception PERSON B

PERSON A

Production

Intention

Coding

Figure 11 - Internal Noise in Communication

Theory in Social Work Practice The models covered in this book rely upon social workersâ&#x20AC;&#x2122; ability to communicate well. Despite this few people can articulate a clear understanding of how communication works. That is why communication theory is so helpful for effective social work practice. It is essential that in any encounter with a service users a social worker knows what their intentions are. This applies at both the overall intention of the situation and the momentby-moment intentions. At the widest level social workers intend to communicate respect. Social workers intend that service-users are left feeling that they have been listened to and valued by the social worker. At a mid-range level social workers will have specific intentions at different stages of the social work process. At the beginning the primary intention is to build a relationship. In the assessment phase the intention is to develop a clear sense of how the service user sees their situation and to establish what resources and strengths the service user has. In the planning phase the intention is to develop a shared understanding about what needs to happen for the goals to be met. In the implementation stage the intention is likely to be to encourage the service user to take various actions in order to implement the plan. In the evaluation stage the intention is to discover what the service user thinks has changed and what factors have led to that change. At a moment-by-moment level the social worker may be seeking something as simple as keeping the service user talking or giving the message that the social worker is taking them seriously, to something as complex as helping a service user express chaotic and conflicting thoughts and feelings in a coherent way. One of the most common ways in which social workers fail is by being unclear in their intentions. If service users are confused about what a social worker wants or needs (what their intentions are) this is likely to undermine the relationship. Clarity of intentions is vital for good communication.

Intentions are also important in that at times social workers may have poor intentions. If a social worker is simply seeking to get a service user out of the door as quickly as possible they are likely to engage in poor communication. When teams are overworked the main intention may become to close cases as quickly as possible. This may become more important than goals such as ensuring the safety of service users. It is important to link Communication Theory back to both the Social Work Process and the Practice Pyramid to keep the intentions both clear and ethical. Coding and production are the next steps in the process of communication. This moves from the why and what (why am I communicating, what do I want to communicate?) to the how (how will I communicate?) Most people readily identify with a situation where a thought sounded perfectly good in their head but what came out of their mouth was quite different. Choosing the right words, and being able to deliver these words in an effective manner is not an easy task. Coding language is far more complex than most people realise. Consider the following two questions, both intended to uncover the service user’s thoughts about their behaviour. Why did you do that? Why do you think you did that? Superficially these appear to be asking for the same information. However experienced and effective communicators will understand intuitively that these two questions are likely to get very different responses. The first coding is likely to get a justification or an excuse. It might even get an aggressive response. This is because when coded this way a ‘why’ question is likely to be seen as an accusation. The second coding is far more likely to be successful in eliciting the service user’s understanding of the situation. This is because it invites the service user to reflect on their thought processes rather than to justify their behaviour. It is important to understand that if the intentions are clear and based on sound values, service users will usually be forgiving of mistakes in coding. Despite this it is important that social workers accept that it is their duty to be as understandable as possible; it is not the service user’s job to be able to read their mind. In a similar way production of communication is vital. If a social worker mumbles or puts their hand over their mouth they will make it harder for the service user to understand them. In social work settings it is important to speak clearly and ensure service users can see the lips movements. This is because the shape of the lips is important in determining certain speech sounds even for people without a hearing impairment. Once a social worker has said whatever they said, using the tone of voice and the body language they have used the service user must see and/or hear this communication for it to be effective. Once they have received the communication they will decode what the social worker meant and construe a meaning for this. Depending on how they decode it and what meaning they give to it they will then choose how to respond. Once a service user has responded the social worker must also receive, decode and construe the service user’s intentions and meanings. In receiving service users’ communication social workers must employ good observation skills. Social workers must hear the words service users use, the tone of voice they use, and the body language. This means that social workers must look at service users; they must pay attention to visual cues. They must listen carefully to the speed, volume and

intonation of the words used; they must pay attention to the auditory cues. Social workers must also take service users’ words seriously. When communicating effectively a social worker will seek to pay attention to the congruence of the words, tone and body language. If all three match it is generally easier for a social worker to decode the content and the emotional tone of the communication. Where there is a mismatch, for example a service user who says, “I’m fine”, but sighs and looks down, then a social worker must notice and respond to this incongruence. This is where the process of decoding and construing are so vital to effective social work practice. When words and the non-verbal elements of communication are incongruent a social worker must seek clarification. This can be done very simply. In the example given in the previous paragraph a social worker can simply say something like, “You don’t sound fine.” This allows the service user to become more open about their feelings. Decoding and construing are much more complex than most people realise. Most people simply assume that they know what other people’s words mean. There are two equal and opposite dangers in this point in the communication cycle. The first is to ignore the nonverbals and focus exclusively on the words. A worker may simply think “They said they were fine, so they must be fine,” even though the non-verbal communication made it quite apparent that the person was far from fine. The second danger is to read complex meanings into the service user’s words without checking. So a service user might say something like “I’m feeling really down today.” A social worker might take their understanding of ‘down’ and impose this on the service user’s words, for example thinking that the service user is depressed and suicidal when the service user simply meant that they were a little less happy than normal. The most effective ways to deal with both these dangers is to seek specific clarification of key words used and to address incongruity with openness and honesty. The Meta-Model, which comes from Neuro-Linguistic Programming (NLP) is a useful tool for doing the first of these. Regular use of the skills of reflecting, paraphrasing and summarising whilst in communication will help keep the understanding of service users as clear as possible. This model of communication also helps social workers understand why it is important to deal with noise, both external and internal. It is perfectly acceptable to ask a service user to turn down or turn off a TV or a music system, as long as the social worker explains that this is so they (the social worker) can listen more effectively to the service user. Although this may seem uncomfortable or oppressive, it is far better to do this than to fail to hear important things the service user had to say. Internal noise is harder to deal with. Stress, anxiety, fear of making a mistake and many other things can and will affect a social workers ability to fully attend to what a service user is saying. In general it is best to accept that these feelings are a normal part of the complex task of communicating with people in vulnerable situations, and move on. It is important not to ignore this noise completely, as often the fleeting thoughts and feelings give important clues as to how to respond and they are an important part of developing rapport with service users. Communication theory helps to both explain why communication works and also to explain why it often goes wrong. As long as the social worker takes responsibility to communicate as effectively and ethically as possible, this model can be a useful tool.

What it’s not There are many popular psychology books that focus on non-verbal communication. Many of these create the impression that using subliminal cues it is possible to work out what someone ‘really means’. This model certainly does not do that. The best way to determine what someone really means is to ask them questions and let the meanings emerge through the discussion. By itself communication theory is not sufficient to let social workers know exactly what someone means. The model must be used with the skills of active listening and effective questioning. It is only when the theory is used with appropriate technical skill and relevant beliefs and values that it will be helpful to social work practice.

Theory Checklist Is the worker clear about what they are trying to achieve? Does the worker think clearly and creatively about how to communicate? Does the worker take time to clarify what service users mean by what they say? Is the end result a shared meaning that emerges through negotiation? Unless you can say ‘yes’ to all these questions you are not using Communication theory, regardless of what other techniques and approaches you use.

Critique of the theory Communication theory is a model rather than a scientifically tested theory. This means that it is a useful way of thinking about communication rather than a definitive statement of the way communication works. As with any model it necessarily takes what is a complex and multi-faceted process and reduces it to something comprehensible. This simplification process inevitably distorts the reality of communication. This does not make the model invalid. It provides a starting point for developing greater awareness of how communication works and how to improve your communication. On a number of occasions I have heard people criticise the idea of ‘communication theory’ on the grounds that communication is a skill, not a theory. This argument suggests that what is important in social work is not a robust understanding of how communication works, but the ability to apply practical skills like listening and questioning in order to get the job done. There are two main reasons why I reject this idea and favour a view that says that having models for analysing communication, in other words theories, is important. Firstly, the above argument makes a false distinction between ‘theory’ and ‘skill’. All skills are underpinned by a body of theory. Developing from mere competence in something to excellence in that thing often involves moving from unconscious performance of the thing to a conscious awareness of how you perform the thing. Running is a skill, but excellent runners learn about the theory of things like breathing patterns and cadences in order to be better runners. In the same way social workers who wish to move from competent communicators to excellent ones need to understand the theories that underpin their communication.

Secondly, I have seen the results of theory-less communication. Misunderstanding and miscommunication are not occasional failures in the communication process, they are an inherent part of it. This means that when communication breaks down, as it does frequently, social workers who lack at least a minimal understanding of communication theory are left with three reactions. They either become confused and frustrated, with no idea of what went wrong; or they become angry at the service user for failing to listen or communicate clearly; or they become guilty, feeling that they have failed and are not a good social worker. All three of these reactions can be avoided if the social worker has a range of tools for analysing how communication works, why it goes wrong, and how to improve it, and that is what communication theory provides. Finally, the idea that communication is only a skill, and not a set of skills and a theories, is undermined by the various graduate programmes and academic journals in the subject. Communication studies and communication theory are clearly recognised in the academic world as legitimate topics for theoretical study. As a result of this there is a strong argument that communication theory is a valid and important area of theory to cover in social work. As presented here the model does not take into account the wider cultural and social context. This means that the model must be used alongside models of anti -discriminatory practice and person-centred theory in order to be fully compatible with social work values.

Reflection 1) How has this chapter changed the way you think about your communication? 2) What has struck you most in this chapter? 3) How can you improve your communication, based on what you’ve read in this chapter? 4) What are the most important things a social worker needs to be aware of in order to communicate clearly and effectively?

Recommended Reading Thompson, N. (2010) Theorizing Social Work Practice. Basingstoke: Palgrave Macmillan. Chapter 12 – “The linguistic turn” pp190-206 Teater, B. (2010) Applying Social Work Theories and Methods. Maidenhead: Open University Press. Chapter 4 – “Empowerment and Use of Language” pp54-69 Hargie, O. and Dickson, D. (2004) Skilled Communication: Research, theory and practice. London: Routledge. Chapter 1 “Introduction: the importance of interpersonal skills” pp1-10 and Chapter 2 – “Interpersonal communication: a skill-based model” pp 11-42 Hargie, O. (2011) Skilled interpersonal communication Research, theory and practice. Hove: Routledge. Chapter 1 – “Communicating effectively: the skills approach” pp1-12 and Chapter 2 - “A conceptual model of skilled interpersonal communication” pp13-42 Thompson, N. (2003) Communication and Language; A handbook of theory and practice. Basingstoke: Palgrave Macmillan. Chapter 1 – “Understanding Communication” pp 9-35 and Chapter 2 – “Understanding Language” pp 36-62 Simpson, P. and Mayr, A. (2010) Language and Power: A resource book for students. Abingdon: Routledge. Read Section A

McKay, M., Davis, M. and Fanning, P. (2009) Messages: The Communication Skills Book. Oakland: New Harbinger Publications. Chapter 1 – “Listening” Trevithick, P. (2012) Social Work Skills and Knowledge: a practice handbook. Maidenhead: Open University Press. Chapters 6 and 7 – “Communication, observation, listening and assessment skills” pp153-184 and “Interviewing skills” pp158-224 Wilson, K., Ruch, G., Lymbery, M. and Cooper C. (2008) Social Work: An introduction to contemporary practice. Harlow: Pearson. Chapter 10 – “Communication skills” pp295-333 A good introduction to NLP (neuro-linguistic programming) will also help. Personally, I think that there is a lot of ‘hard-sell’, hype and pseudo-science around NLP, but the bits on use of language can be very helpful

Chapter 6 - Anti-Oppressive Practice Preparation Think of a time when you were judged because of some aspect of yourself, of who you are. Who did the judging? What impact did their judgements make? Think of a time when you haven’t been listened to, or when something you said was dismissed. Why did the person/people not listen to you or dismiss you?

Introduction I first became interested in social injustice and oppression as a child. By my teenage years I was aware that I was living in a society that was riddled with both racism and sexism and as time went on I realised that these attitudes affected me, I thought and acted in ways that were both racist and sexist. Later on I became aware of how much I took for granted around sexuality, class and disability. I continue to learn about how the problems of oppression in society are not ‘out there’, being perpetrated by ‘racists’ or ‘sexists’, but in me, in my thoughts and practices, in my daily experiences of people whose lives and experiences are different from mine. In this chapter I will share something of my journey in relation to how social work can challenge oppression in society. I will present several models that I have found helpful, and also introduce a model of my own that I believe can make a valuable contribution to combatting oppression and creating a healthier, more just society for all.

Discounting the Problem The first model I would like to discuss is taken from an approach called Transactional Analysis and was first proposed by Mellor and Schiff in 1975. They suggested that when confronted with an uncomfortable problem rather than address it people may choose to ‘discount’ it. They can do this at four different levels. The most basic level is at the level of EXISTENCE – a person may simply say that a problem does not exist. In relation to social injustice someone might refuse to accept that oppression exists – ‘we live in a fair society. People get what they deserve. If some do better than others it’s simply because they are smarter or work harder. There isn’t a problem.’ You cannot solve a problem whose existence you deny. The first step to developing anti oppressive practice is to educate yourself about the experiences of those in society who are facing oppression. This can be painful or uncomfortable. If you are being oppressed then you might have turned the other way and refused to address it – just keeping my head down and ploughing on. If you are part of a dominant group in society you may never have stopped to think about the impact of your behaviour and your attitudes on others. Either way, if you have been denying the existence of oppression then recognising this is an important first step to dealing with it. However recognising the existence of a problem is not enough, you also have to recognise its SIGNIFICANCE. When people discount at the level of significance they are prepared to accept that there is a problem with oppression in society, but they don’t see it as a significant problems – ‘it’s not a problem. Sure, women earn less than men, but then they

do other things. Maybe this isn’t ideal, but it keeps everything ticking along, and anyway, there are more important problems than this.’ When oppression is acknowledged as a problem, but discounted as a non-serious problem, the result will be a lack of commitment to action. In many ways this is a very significant danger in social work. When the immediate problem is the protection of a child it is easy for a social worker to place mothers (or female carers generally) into the role of ‘primary protectors’, and in doing so down-play the need to place the responsibility for abuse on fathers or other men who are doing the actual abuse. It is not necessarily that the social worker denies the existence of patriarchal oppression, only that in comparison to the demands of their job it is not seen as a priority. A commitment to combatting oppression begins by recognising that oppression is a serious, significant problem in society. When two women a week are being killed by their partners, when black and minority ethnic people continued to be discriminated against in the jobs market, young gay men are choosing to kill themselves rather than face the bullying and harassment they received because of their sexuality, this shouldn’t need stating, but it does. Across many social groupings oppression is a real and serious problem. Even when someone is willing and able to recognise the existence and significance of a problem, that does not mean they will be committed to solving it. The next level of discounting is SOLVABILITY. People may accept a problem exists, and is serious, but feel that it is not solvable. They may say ‘Yes, racism exists, and it is harming both individuals and society as a whole, but what can you do about it? It’s just how people are, they favour their own and don’t trust those who are different.’ We do not have to look far to see that although the final eradication of oppression is still a long way off, we are in some ways making progress. As I write this the Church of England has just voted to allow women to become Bishops. There are moves towards providing more equality for same sex (lesbian and gay) couples. Going further back in history we see that signs like ‘No blacks, No Irish, No Dogs’ that used to be common in the UK in the 1940’s and 50’s are now illegal. And women and men share equal voting rights. These steps suggest that the fight against inequality and injustice is not hopeless. The problem of oppression is one where we have and can continue to make progress. The final level of discounting is at the level of our OWN PART. Someone may accept that a problem exists, that it is significant and that it is solvable, but refuse to take any action in relation to it as they do not believe it is their role to do something about it. This may range from a kind of “learned helplessness” (Seligman, 1975) where someone says ‘I’d love to do something, but there’s nothing I can do’ to more of denial of responsibility, ‘I didn’t cause the problem, why should I fix it?’ In relation to this second point I am powerfully drawn to a statement by the author Terry Pratchett – “Even if it’s not your fault, it’s your responsibility.”

Own Part Solvability

Significance Existence

Figure 12 - Levels of Discounting - Mellor and Schiff, 1975 The heart, the very heart and soul of anti-oppressive practice is the recognition that oppression exists in society, that it is a significant problem that can be solved, and that like it or not, if you aren’t part of the solution you are part of the problem. It is more than a clever intellectual exercise; it is a full commitment to a just and fair society for all.

Pause for thought When you look at society do you see a society that is just and fair for all, or one that continues to be full of divisions and inequality around skin colour, gender, class, sexuality, nationality, accent and (dis)ability? How committed are you to challenging this? Can you point to things you have said or done in the last few weeks that in some small way have contributed to a fairer, more just society? If so, how did you manage that? If not, can you see where you have discounting the problem?

Thompson’s PCS Model It feels to me that reference to Neil Thompson’s PCS model is practically essential on any social work related course in the UK. Thompson’s book ‘Anti-discriminatory Practice’, currently in its fourth edition, is required reading on many courses. As a result of this I will deal briefly with some key aspects of his model here. Thompson argues that it is discrimination that leads to oppression, and therefore the way to end oppression is to end discrimination. He argues that discrimination occurs at three levels, the Personal, in the ways individuals think about and relate to each other, at the Cultural, in the way that groups of people engage in behaviours and ways of thinking and living that favour some groups over others, and the Social, in the systems and laws that regulate and control how society works and the consequences for certain types of behaviour. Whilst I think that Thompson’s model provides a good start point I think it has a major weakness: in trying to make everything fit into those three levels he over-simplifies the complexity in society. Oppression and discrimination occurs at more levels and with greater subtlety than Thompson’s model has room for. Alternative models, such as those from Lena Dominelli and Gurnham Singh provide greater scope to analyse and address the processes of oppression in society. What I present next is my own interpretation of the work of Dominelli and Singh.

Level of Oppression Oppression occurs at multiple levels. It can be found at the intra-personal level – in other words oppression can begin and thrive inside people’s own minds. This applies to what might be called ‘the oppressors’ and ‘the oppressed’, but I need to explain these terms first. In chapter four I wrote about the Person Centred model. A key principle of this model, and one that underpins the values of social work, is that people are not labelled or judged according to their behaviour. In this respect it then seems odd that I am using these labels which seem oppressive in themselves, who wants to think of themselves as ‘an oppressor’ or as one of the ‘oppressed’? It is important to understand that these are NOT labels of THE PERSON – there are position markers in an oppressive society. When the footballer Lionel Messi is described as a ‘forward’, no one would assume that this is passing some judgement on him as a person, it is simply describing his role and position during a football match. When I label myself as one of ‘the oppressors’ I am not passing judgement on me as a person; I am simply describing my position as a white, middle-class, (currently) ablebodied, heterosexual male. When I feel guilt it is not because I am these things, it is because I have used the fact that I am these things to gain some advantage over someone else who is not these things. This is not a guilt that condemns me as a person, but a guilt that motivates me to take action to create a society where no one will be judged or receive a worse experience because they are not part of a certain group. Having explained that, I will return to my point about intra-personal oppression. For those who in a given society or situation might be defined as ‘the oppressors’ the intra-personal oppression is the beliefs and perceptions of superiority and the internalised sense of deserving more than others. It is important to bear in mind that this intra-personal sense of superiority may not be conscious and it can be displayed in a number of different ways. At the most obvious and blatant level is the person who consciously and clearly has a sense of their own inherent superiority. Throughout history there have been countless examples where one group has perceived themselves as being superior to another. This has happened with gender, with men seeing themselves as superior, and with physical characteristics, where one visible ethnic group believes in their innate superiority. But this can also happen at a less obvious way. One example of this is something that has been labelled ‘mansplaining’. This is a process by which in a mixed gender group men may often presume that they have superior knowledge about a given subject and then take on the role of explaining the subject to the women present, without first checking if they already have knowledge of the subject. For the man doing this the intention is rarely, although not always, a conscious desire to place himself in a superior position, but the assumption that his knowledge is superior is already there behind the action. For social workers the belief that they must rescue their service users or must educate the service users, or that service users could not cope without them, are all examples of this unconscious intra-personal oppression. For those who are part of an oppressed group in society there is a mirror process. A person may start to believe that they are less important or inferior in some way to others. They regularly lay aside their needs and goals to meet the needs of others, not on the basis of mutual aid, but because they believe their needs and goals are less important than those who are part of the dominant group. This can have a range of harmful effects. Someone who is carrying this sense of internalised oppression may choose not to apply for jobs that match their skills, abilities and experience because they think that they do not

deserve or are not good enough for these jobs. They may find that they repeatedly choose to stay silent because they fear that they are not good enough to have their story taken seriously. An extreme example of this comes when people have been kept in bonded labour (slavery). This may lead to a complete deadening of emotions as it has been so dangerous to express, or even experience, emotions for so long the person can no longer even connect to their own emotions. This first layer of oppression is then embedded in a second level – the inter-personal. In an oppressive society when people meet there are complex power-plays. One example given earlier was mansplaining. There are many other examples, many of which occur regularly but rarely cause comment. For example it is still not uncommon for a women to make a comment or a suggestion at a meeting which is ignored. Then shortly after the same point is made by a man, but this time the point is picked up on and taken seriously. The range of inter-personal oppressive acts is long and complex. This list includes silencing (using techniques to prevent people speaking or being heard), objectifying (treating a person as an object to be admired or a tool to be used, not as a person), ‘othering’ (reinforcing difference and then overlaying this difference with a value label such as good/bad or normal/abnormal), rescuing (helping someone do what they can do for themselves, and so undermine their autonomy), shaming (acting in ways that leave the other person feeling bad about who they are). What makes this complex is that most of these processes are not always wrong in all contexts. When someone is being offensive or harmful then there is nothing wrong with silencing them. There are some situations in which we need to recognise that we need people to get the job done and we need an instrumental (but not an objectified) view of the people involved. Sometimes we can rescue someone in an emergency without undermining them. There are occasions and degrees to which shame can be helpful in promoting positive behaviours. What makes these a problem in an oppressive society is when they are used consistently and persistently against the same groups of people. These are no longer effective strategies to get the job done, but deliberate strategies designed to ensure one group maintains and strengthens its power over another group. Over time this develops into cultures and practices. One example of this can be shown powerfully in the following exercise. Look at the Table 3 below. For the group named in each box think of all the insulting, demeaning and hurtful words and short phrases (2-3 words) that can be applied exclusively or predominantly to members of that group. Write them in the box provided. I realise that it might feel uncomfortable writing these words down, but remember you do not have to share them, and it is not your fault that you live in a society where these words are so common. Do not self-censor or think that something is ‘unsayable’. Although writing these words may feel shameful or painful, it is important that we address the fact that oppression is not simply about ‘bad people’, but is embedded in our language and culture.

Women

Older Adults

Black People

Disabled People

Table 3 - Cultural Oppression - Part 1 Have a look at the words and phrases you have put in the boxes. What do you notice about them? What similarities and differences do you notice in the words and phrases you have used? Having done that turn to Table 4 and do the same again, this time for the groups that are on that Table. When you have completed that compare your two lists. What differences do you notice between the two lists? Which was easier to fill out? Which contained the most words? Which contained the most offensive words? Table 4 - Cultural Oppression - Part 2

Men

Young Adults

White People

Able Bodied People

What is important to bear in mind is that no single individual created this difference in the language. It was not deliberately planned this way; it was simply the working out of the oppressive forces in society that creates a language where men have a more offensive and

more diverse range of words to insult women than the other way round; where young people or able bodied people have words to insult the old, the very young and the disabled, but not the other way round; where words to insult white people are largely seen as juvenile and stupid, whereas words to insult black and minority ethnic people are highly offensive and harmful. This list goes on. The same applies around such diverse areas such as sexuality, class and even something as irrelevant as height. This is one example of cultural oppression. A second example can be shown by going on to Google images and searching for the term “beautiful woman.” Figure 13 - Cultural Oppression - Beautiful Woman

What is striking about the image is that the pictures are all of white women, all in a very narrow age range, and many of them wearing very minimal clothing. At this point it is important to notice your reaction and compare this to the levels of resistance I mentioned at the start of this chapter. Are you failing to see how this could lead to the oppression of women? (Existence) Do you see this as being something unimportant, just a quirk of Google’s search algorithms? (Significance) Do you see this as in inevitable part of ‘human nature’, something that is sad, but unchangeable? (Solvability) Or do you see it as something you cannot change? (Own Part) Or do you perhaps see it as something you will reflect upon, learn about and challenge, in the hope that we can create a better society? Google gives us a second insight into cultural oppression with its ‘autocomplete’ option. Below is an image of the suggestions, based on millions of other people’s searches when I began my search with the phrase ‘gay people are’.

Figure 14 - Cultural Oppression - autocomplete

As you can see from this, the list is not a positive one. Again, it is important to understand that this is a cultural phenomenon, not a deliberate act by Google or anyone else. From the language to the search terms, to the media or the myths and stories we tell our children, there is a message that some people are better than others and some types of behaviour belong only or especially to some groups. The cultural level of oppression is complex and multi-layered. At a micro-cultural level an individual is surrounded by people who shape their views, values and attitudes. It is easy to imagine two families living on the same street but having two very different sets of cultural practices. In one it is the women who cook, clean and care for the house and the people in it. In the other such tasks are shared equally without regard for gender. This goes beyond the inter-personal interactions of the family members and speaks to the cultural values and practices of the families. Again, two families may live next door to each other, but one may relate almost exclusively to members of their own ethnic, religious or class group, whereas the other has rich and varied relationships with people from many different backgrounds. This too is not about the inter-personal relationships but about the culture of the people involved. Moving up a level, communities, neighbourhoods and organisations can develop a culture. This can lead to situations such as the killing of Trayvon Martin. At the time of his death Trayvon was living in a gated community. Such communities exist because of a perception that those outside the community are a threat and the only way to protect against that threat is with barriers and the threat of force. In this context the actions of George Zimmerman in shooting Trayvon were the logic of the communityâ&#x20AC;&#x2122;s cultural values and practices played out in their extreme form. Communities may foster interaction and equality, or they may foster division and inequality. This in turn creates environments of either mutual aid and respect or of fear and suspicion. This can also apply within organisations. Organisations can create a culture where every member of the organisation, from the lowest paid cleaners to the most highly paid executive, is considered as important and listened to, or they can create a culture where power is centralised and respect is closely tied to the position in the hierarchy.

This level of culture can perhaps best be described as meso-culture and it involves more than just individuals who relate directly to each other, they involve wider systems, policies, procedures and practices within areas, communities and organisations. There may be organised geographically, in terms of a street or a neighbourhood; they may be organised around beliefs, such as in local branches of a religious organisation or political party; or they may be organised around a particular activity or interest, from a commercial company to a sports club. The reality is that wherever these are placed in society they can either reinforce or reduce inequality, injustice and oppression. Moving up from the cultural level there is the societal level. This provides the overall framework in which meso-cultures, micro-cultures and individuals operate. Two of the most important features of the societal level are the political level and the economic level. At a political level societies vary widely. At one extreme end of the scale are totalitarian dictatorships. In these societies all the power is held by an individual who controls all political decisions. In reality this is rare in all but the smallest societies as even in extreme dictatorships the leader is usually surrounded by a group of sub-leaders who can exercise a degree of discretion and control. However it can still be that practically all political power resides in very few people, whilst the rest have very little power. At the other end of the scale are truly democratic societies, ones in which all members have equal influence over political decision making, where every voice is heard, all decisions are made jointly and there is consensus on how the society runs. Again, in reality this is extremely rare, and then only in the smallest of societies. Even in nominally democratic societies there is a tendency for the society to rely on ‘representative democracy’, where communities choose a member to represent them in a decision making body, rather than a ‘participative democracy’, where people participate more directly in the decision making process. When analysing society we can use this model to both understand where we are now, where we have come from, where we are going, and where we’d like to go. It helps us see whether political power is genuinely shared or not, and whether things are moving in the direction of empowerment for all or in the direction of the centralisation of power. Figure 15 - Political Power

Centralised Power Dictatorship

Shared Power Representative democracy

Participative democracy

Exploring political power gives an insight into inequality and oppression in society. When you compare the backgrounds and characteristics of those in power and compare this to the make-up of society certain features are clear. In the UK political leadership is disproportionately white, male and upper/upper-middle class. Whether you look at MP’s, cabinet ministers or Union leadership a similar pattern holds true, although with Unions the class bias is weaker. It is possible though even to broaden the analysis to compare the rhetoric of democracy – rule by ‘the people’ - with the reality of representative democracy as currently practiced. For most citizens there only serious involvement in political decision making is to vote for

their representatives on a semi-regular, but infrequent, basis. Beyond this very little serious power is delegated to the average citizen. At the same time no political group can achieve any degree of influence without substantial financial resources. This means that under the current UK political system only those with access to funds, whether through private wealth or by collective power from things like businesses and unions, can mount any realistic challenge to the status quo. This is one reason why the continued attack on Unions and organised labour since the early days of the Thatcher government (1979-91) is important. This attack continued under the Blair/Brown governments (1997-2010) and under the current coalition government following the 2010 General Election. If Unions can be completely disempowered then the only serious source of political funding will be wealthy individuals and commercial companies. This is not inevitable. Local democracy is a possibility. Decentralisation of power within an overall system of checks and balances is possible. Historically this has happened in different countries and even within the UK, where centralised power was challenged by the banding together of diverse interests to move the political system from a more dictatorial system to a more democratic power. This can happen again, but only through an alliance of different interest groups, those ensuring class, gender, ethnicity, age, sexuality, and so on are all treated fairly, and no single issue or group manages to monopolise power. Ultimately this is required for a truly anti-oppressive practice to develop in society. As the above decision on political power has shown, political power and money are closely interwoven. Without access to economic power giving people more political power is meaningless. Economic power itself covers a broad spectrum across different societies. At one end of the scale are what can be called Plutocratic Societies. These are societies where the rich rule everything, own everything, control everything. This is where to be rich enough is literally to be â&#x20AC;&#x2DC;above the law.â&#x20AC;&#x2122; In an extreme case this results in systems like slavery and serfdom â&#x20AC;&#x201C; where people belong to the rich, where if you do not have economic freedom you are the property of those who do. Across much of Europe serfdom was the norm from the Middle Ages and in some areas well into the 19th Century. Serfs did not have the freedom to do what they wanted, go where they wanted, work for who they wanted to. There could be bought and sold, or even put up as stakes in a game of cards. In the same way the trans-Atlantic slave trade turned people into property to be bought and sold; an entire social and economic system developed on the back of human misery and oppression. Figure 16 - Economic Power

Extractive Economic Institutions Slavery

Inclusive Economic Institutions Wage Slavery

Co-operative Organisations

Whilst it is tempting to believe that things are now better and that this is no longer a problem, this is flawed for two main reasons. Firstly, at a global level injustice and inequality is so profound that although formal national and internationally sanctioned slavery no longer exists, slavery and bonded labour are still a de facto reality for millions of

people. Secondly, even in seemingly free-market liberal democracy the choice of work and economic freedom is far from evenly spread. The book ‘The Spirit Level’ makes a powerful argument that the more evenly spread economic power is in a society the higher the level of well-being in that society. However in a society where people face a choice between minimum wages, subsistence employment and homelessness then there is no real choice. This creates the illusion of choice, but a reality of wage-slavery. People no longer work because they wish to contribute to society or to meet their needs, but to feed the profits of those who own and run the companies with enough economic power to control the market. Again, alternative systems exist. Co-operative and social enterprises provide a realistic alternative to wage-slavery. On a global scale current Western patterns of consumption and production are not sustainable. We need to develop systems which focus on quality of life, not on growth for the sake of growth. However whilst economic power continues to be focused in the hands of small elite this is unlikely to happen. Finally in this section it is possible to focus the analysis on a global level. The world is not fair. Some countries have massive amounts of power, and use that to push their agenda onto other, weaker countries. Global injustice feeds problems as diverse as terrorism, environmental destruction, mass starvation and mass migration. Solutions that attempt to address these issues without tackling the fundamental injustices that underpin them are bound to fail, and in many cases will simply worsen the problem they were trying to solve. The ‘problems’ of immigration will not be solved by stronger borders, better screening processes or a quota system: they will be solved when people across the world work together to tackle the oppression and injustices that means that someone in one country would be willing to face profound risks in the hope that they might end up in a country where they can meet their needs and the needs of their family without facing the daily threat of death. These levels of analysis can be brought together in the following table. Before you read this table I must apologise for the briefness of most of the practice implications. In most cases I have presented them as aphorisms, short sentences capturing a key idea, sometimes my own, mostly borrowed from others. In some cases the meaning will be clear, in others it will not be. Please do not panic about this lack of clarity. In many cases I am still trying to work out the full implications of each statement, and in practically every case each individual will have a different way of implementing the practice implication. Anti-oppressive practice cannot be based on unthinking obedience to someone else’s ideas for how you should act, instead it has to be based on you working out for yourself how to practice in ways that will promote social justice, protect human rights and enhance individual and social well-being. That being said I hope you will find some of the following chart helpful as you discover your own way to make your practice increasingly anti-oppressive. Although the above model is an original formulation, it is based very much on the work of Lena Dominelli and Gurnham Singh. It also is informed by the works of writers like Neil Thompson and bell hooks, as well as the experiences of service users, colleagues and students in the various posts I have held. What this shows, I hope, is that when it comes to anti-oppressive practice you need to read widely and deeply and reflect on both your own experiences and those whose experiences you shared in your life and in your work.

Level

Description of Oppression

Practice Implications

Intra-Personal – Oppressor

Beliefs and attitudes that support and justify a sense of superiority and entitlement.

Intra-Personal – Oppressed

Beliefs and attitudes that reinforce a sense of inferiority and a denial of needs and experience.

Inter-personal

Ways of relating to individuals that reinforce unjust hierarchies of power

Micro-cultural

Attitudes, practices and customs that reinforced hierarchical relationship patterns between individuals.

Listen non-defensively to those who have experienced oppression Notice who has least power in any situation and focus your attention there, not on your own needs Treat people are individuals, not as members of a group Recognise that individuals are members of groups that get treated differently Become comfortable with the fact that the last two points are contradictory, but of equal importance Recognise your own privilege Challenge your own assumptions and prejudices Speak out when you see others being oppressed Develop non-comparative self-respect Learn how to be ‘an ally’, not ‘a rescuer’ As a white, middle-class, able bodied, heterosexual man I am reluctant to speak too strongly in this area. The following are tentative suggestions, not definite recommendations. Seek ‘critical friends’ who will allow you to explore your experience of oppression – it helps to know it’s not just you Accept that you do not have to prove that your experience of oppression is valid – if other’s reject your experience they are the ones causing the problem, not you Challenging self-limiting and self-deprecating thoughts and attitudes Avoid being positioned by others are a voice for your group – it is fine when you choose to be that voice, but not when others force it upon you Develop non-comparative self-respect Learn to recognises an develop ‘allies’, and how to avoid ‘rescuers’ Be careful that you don’t use-- your oppression to justify developing oppressive attitudes towards other disempowered groups Listen Respect others’ experiences Develop empathy Develop your knowledge and understanding of the processes of oppression If you are a member of a powerful group, be aware of your privilege When challenged, don’t be defensive: if you are right you don’t need a defence, if you are wrong you haven’t got one If you are a member of a disempowered group, be aware of how others use their privilege Place those with least power in any situations at the heart of what you do Learn to recognise and challenge strategies or silencing and discounting Choose your battles carefully. Oppressive hierarchies are pervasive and powerful, and no individual can fight them all.

Meso-cultural

Attitude, practices and customs that reinforced hierarchical relationship patterns in communities, groups and organisations.

Societal

Systems and structures that ensure that political and economic power is distributed unevenly in society.

Global

International relationships that enable some countries to exercise power over others and ensure that the global resources are not shared justly across the globe.

Increase your awareness of how culture shapes the experiences of and negatively impacts on the wellbeing of certain groups Challenge negative assumptions about and images of certain groups Work to challenge oppressive policies, practices and customs where you find them Find allies and work with groups to overcome such oppressive cultural practices Become politically awareness Develop a ‘sociological imagination’ – understand how people’s “personal troubles” are connected to “public issues” (Wright-Mills) Join a Union, and be an active member Join and/or support a Co-operative Become a member of a Credit Union Take part in political campaigns and direct action Support Fair Trade Write to your MP If you choose to vote, think carefully about how to choose who you will vote for If you choose not to vote, do so for political reasons, not out of laziness Question the way the media presents social, political and economic issues All the strategies in the section above are likely to help in this section In addition: Think globally, act locally Support organisations that work for non-violent solutions to international problems Think carefully about which charities you support – use tools to evaluate their impact Work to recognise the importance of human rights at all levels

Trans-Personally Ultimately you are just one person, flawed and limited. As I write this chart I am acutely aware of my own hypocrisy – of the number of things on this chart I don’t do, and the number of things on it I do far less consistently than I would like. What is important to remember is that this world is bigger than you or me. For some people this ‘biggest’ will be experienced as something ‘superhuman’, God, Allah, or some other supreme, supernatural being – ‘super’ being the idea of ‘above’ – for others it will be ‘ultra-human’ – humanity, the future, the environment – ‘ultra’ being the idea of being ‘beyond’. I have often stated that if we are the biggest thing we have in our lives then we will only live small lives. This trans-personal dimension is perhaps the ultimate step in thinking about antioppressive practice. We do not strive to combat oppression so that we can simply live a better life now, but so that we can create a better, fairer, healthier more just world for all and for the future, for generations yet to be born, and for those who will never be born unless we can create a sustainable world. So if you have the sense of the trans-personal level then perhaps it is important to recognise the role and power of prayer for or meditating upon peace, justice, respect and equality is also a form of anti-oppressive practice. However I must also add that however strong your faith in the supernatural, you retain your responsibility to work at all the other levels too, and not just expect a super-natural being to come in and do your job for you.

Table 5 - Levels of Oppression and Practice Implications

So far this chapter has focused on Discounting and how this acts as a barrier to creating a just and healthy society and on levels of oppression and the practice implications when attempting to tackle those levels of oppression. The reality is that it is only when a person recognises oppression as a problem and then commits to tackling it that the problem of oppression can be solved. The final model in this chapter will deal with some of the barriers to overcoming oppression even when someone is committed to doing so. To the best of my knowledge this model is original to me, although I must recognise the debt I owe to service users, colleagues and students, as well as a range of teachers and writers who have heavily shaped my understanding in this area.

The Middle Ground Intersectional Model As stated earlier, power is not distributed equally in society and so some groups have more power than others. Social and cultural norms, values, standards and practices tend to give some groups more power and use those to place some groups in generally dominant positions. This does not mean that all members of a dominant group are in themselves domineering, only that some groups get to be defined as better, more normal and more important than others. This allows them to create an ‘in-group’ and to define others as ‘the other’. This process of othering is closely linked to the concept of privilege – the unearned advantages that come from belonging to a dominant group. This creates the first axis of a scale – from the dominant group to ‘the other’. In general in society when it comes to political, social and economic power men tend to be dominant and women are seen as ‘the other’, white people tend to be dominant, and black and minority ethnic populations are seen as ‘the other’. Young adults are seen as dominant, with children and older adults being seen as ‘the other’. Heterosexual people are dominant, with lesbian, gay men and bisexual people being treated as ‘the other’. Middle class people are dominant and working class individuals are seen as ‘the other’. Anti-oppressive practice will have different implications for where on this axis and individual lies, and this may be in a different place when considering different types of oppression. In relationship to women, a gay man and a straight man share a similar position in terms of being part of a dominant gender group in society. However a lesbian and a gay man may share a similar position in relation to how their sexuality is viewed when compared to a straight woman and a straight man. This means that each individual needs to consider and be considered in relation to their total experience in society and not in relation to a single dimension. The second dimension is more complex and relates to this question of seeing the total experience of oppression. In relation to oppression a person may adopt that position of denial mentioned earlier. This can occur for both those in the dominant group and for those who are treated as ‘the other’. Both groups may fail or choose not to see that their experience is shaped by the oppressive forces in society. At the other end of the scale is an exclusive sectionality. This is where a someone sees the whole of a person’s experience as being related to a single dimension of their social position.

Oppressive denial

Liberal guilt, fear and rescuing

Internalised oppression

Externalised Helplessness

Exclusive Sectionality

Defensive Denial

Dominant Group

‘The Other’ Table 6 - Axes and Quadrants of the Middle Ground Intersectional Model These two axes create four quadrants of oppressive practice that apply only to those who are committed to anti-oppressive practice. For people with conscious, deliberate and selfaware hierarchical beliefs and values anti-oppressive practice makes no sense. If you genuinely believe you are better than someone else then why should you pretend that you are not? This is one reason why you cannot have ‘personal values’ and ‘professional values’, because either you value something, or you don’t. That does not mean that you cannot have ‘personal values’ and ‘other people’ values. I hold myself to a very high set of standards, and I expect myself to live up to them. However I often accept that others will hold different values to me and I respect their right to live according to their own values. It is not my job to judge others, only to be responsible for myself and, in certain specific situations, to judge other people’s behaviour. It would be hard to mark an essay if I did not accept that. Having made that point I will return to the quadrants. For someone who is in the dominant group they may simply fail to see that others do not have the social advantages that are common to those in dominant group. For example when a man walks past a woman late at night he may have absolutely no awareness of his potential to be perceived as a threat. To the man he may not even consider that although he knows he will not rape or sexually assault the woman, she does not know that. His lack of awareness means that simply things he could do, such as crossing over to the other side of the street, do not occur to him. For him this has no negative effect, in fact he can continue without any additional effort. However for many women this will have the effect of increasing anxiety and making her journey unnecessarily unpleasant. This is an example of the top left quadrant – oppressive denial. I remember in my late teens and early twenties being shocked to hear the experiences of black friends and colleagues when it came to the myriad experiences of rejection and hostility that they faced daily. I did not want to believe that I lived in a society that operated in that way, a society in which your surname or accent, if they identified you as ‘not white’ would reduce your chances of being short-listed for interview. And yet this is the reality. The many ‘micro-aggressions’ faced by those who are in ‘The Other’ group are too numerous to name here. These are usually not done as deliberate attempts to hurt or oppress, but that is their effect. Consider the effect on a young lesbian or a young gay man of repeatedly being asked ‘Have you got a boyfriend yet,’ or ‘have you got a girlfriend yet?’ The intention of asking that question is not to reject the person, but that is its effect. The

automatic assumption that everyone in society is ‘straight’ is based on denial. In the same way even the term ‘straight’ is problematic, as if you are not ‘straight’ what is the opposite? It is no defence to state that the opposite of ‘gay’ is also not a positive (‘miserable’ or ‘boring’ perhaps?) because this too is a denial that for lesbians and gay men the problem is not just a single word but a whole history and culture of oppression. For those in ‘The Other’ group the situation is quite different. This is represented by the lower left quadrant – internalised oppression. Here the problem is that social oppression is experienced as individual failure. A striking example of this can be found in a phenomenon known as ‘stereotype threat.’ This is a situation where the knowledge that the group to which you belong has a negative stereotype can in itself lead to worsening of performance. For example if you give a mixed gender group a ‘maths’ test on average men tend to perform better than women. However if you re-label the test as a ‘problem solving test’ the performance gap virtually disappears. This is probably because as girls are growing up in a patriarchal society in many subtle ways they receive the message that ‘maths is not for girls’. This is then internalised as ‘I am not good at maths’ and then when placed in a ‘maths’ position this anxiety affects performance. Other experiments, especially in the field of social psychology, have provided more examples of this. When people internalise the oppressive values of society they see the problem as being ‘me’ and not the result of an oppressive social order, where hierarchical relationships further the needs and goals of the powerful at the expense of the powerless. The third quadrant, the upper right, focuses on the problem in the oppressor group of focusing exclusively on a single area of oppression. This can lead to a variety of problems depending on how this is done. The first problem is what might be called liberal guilt. This can occur when a member of a dominant group is so concerned of the oppression felt by a group that is considered part of ‘The Other’ that they feel bad about who they are. This is a bad thing for several reasons. Firstly, a person who feels guilty or ashamed of their own identity is unlikely to be able to help someone else feel good about who they are. On a more serious level the result is an unwillingness to challenge unacceptable behaviour of someone who is considered part of ‘The Other’ for fear of adding to the oppression of an oppressed group. This was powerfully demonstrated in the Victoria Climbié case. In this case it was noted that various workers were unwilling to criticise or even investigate Victoria’s carers for fear of being accused of being racist. The reality is that no group has a monopoly on goodness or badness. In order to create justice people must be held accountable for the consequences of their actions. An experience of oppression is not an excuse for acting in a harmful or abusive way, and social workers need to have the confidence to assess such harmful or abusive actions. This is an example where an attempt to not oppress one individual on one ground may in fact lead to greater oppression of someone with even less power. Another example of this might be a case where a parent has a mental health difficulty. A social worker may be aware of how much stigma and prejudice people with mental health difficulties face, and quite rightly does not want to add to that oppression. If this leads to the worker not challenging harmful parenting techniques then the child or children may suffer even greater preventable harm. The result is that by focusing on the exclusive sectional oppression on grounds of mental health the worker fails to address the oppression children face on the grounds of their age and developmental immaturity. A second problem related to liberal guilt is ‘rescuing’. In this situation a member of the dominant group focuses exclusively on the oppression of ‘The Other’ and believes that

rather than being ‘power-less’ (as in having less power that the someone in the dominant group they are ‘powerless’ (as in having no power whatsoever). This means that the person in the dominant group believes that they have to speak for people in ‘The Other’ group. The motivation for this at a conscious level may be to be anti-oppressive, but the unintended consequence of this is to further oppression as it comes from a position of unequal power. The person in the dominant group is seeing themselves as more knowledgeable and more skilled than those in ‘The Other’ group. For social workers and for social work tutors this is a difficult challenge. Often our positional power, the power that comes from having a role within a powerful organisation, will mean that we have power over others. The training and the professional development we do will give us knowledge and skills that can be used to help people overcome oppression. The problem arises when we use this positional and professional power in a way that focuses exclusively on our power and reinforces the powerlessness of those we are working with. What makes this so hard is that when we are in the dominant position we have an intuitive sense we are ‘doing the right thing’ and so we fail to see the harm of our own actions. The example of ‘mansplaining’ mentioned earlier can be an example of this. If I, as a man, decide I am going to ‘educate’ women about the evils of patriarchy then in my own mind I see myself as ‘the hero’. I am using my position as a man and as a tutor to ‘rescue’ women students from the evils of sexism, and in doing so I am probably writing myself out of the equation as part of the problem. I will explain to women what their experience is, and by explain I mean ‘tell them’, rather than listening to their experiences and supporting them to develop their own understanding, whilst at the same time I continue to acknowledge how my behaviour and attitudes continue to reinforce gender inequality, despite my efforts to be conscious of and prevent this. Practice which has anti-oppressive intentions but which is based on the superiority a dominant group to solve the problem will in most cases only result in greater oppression and a lengthening of the problem. Thinking back to the Practice Pyramid, genuine antioppressive practice is based upon values of respect, equality and diversity. It is based upon core beliefs that those experiencing oppression are the experts on the experience of oppression; that listening is more important than telling; that everyone has resources and strengths that can be mobilised to help people reach their goals, goals that they themselves form. Finally in the lower right quadrant there is a difficulty of Externalised Helplessness. This is a situation where oppression is experienced so strongly that the person believes that they have no choice and no control. In the most extreme cases, for example in the case of slavery, this can lead to a complete deadening of emotional experiences, a loss of a sense of aliveness and of ‘being human’. Even the smallest actions of autonomy become practically impossible. In other cases it can lead to a denial of personal responsibility for oppressive behaviour against some other group. One example of this can arise when a gay man acts in sexist ways towards women. It is possible in this situation for the man, when challenged, to see this challenge as going from the perspective of being challenged because he is gay and not because his behaviour has a sexist effect. A similar situation may have arisen in the Ali Desai case. Desai was a senior police officer who was arrested and imprisoned for perverting the course of justice. When he was arrested his defence was that the allegations made against him were motivated by racism. This is a complicated situation and it is important not to rush to simplistic conclusions, but

racism can exist alongside personally and professionally inappropriate behaviour. The challenge comes in recognising the oppression experienced by members of oppressed groups whilst also holding people to account for their behaviour. As mentioned earlier this has serious implications in social work, as was shown by the Victoria ClimbiĂŠ case.

Where to focus your attention? Having outlined the Middle Ground Intersectional Model it is important to raise a vital point â&#x20AC;&#x201C; notice where you focus your attention? My guess, based on using this and similar models in my teaching, is that if you are part of a dominant group you will focus on the bottom right quadrant. You will draw comfort from this model by thinking it proves that oppressed people are making a fuss about nothing. If you do that, beware. You have just revealed how deep and how dangerous your dominant position is. If you use a model of oppression to prove that oppression is not a problem, not a serious problem, not a solvable problem, or not your responsibility to solve, then you need to re-read this chapter. If having re-read it you continue to do this then perhaps you should question your current readiness for social work practice. As Neil Thompson states, social work which is not anti -discriminatory/antioppressive is not good social work, no matter how good it is in other ways. If you are part of a group who regularly faces oppression, again, be careful where you focus your attention. Focusing exclusively on the problems of the oppressors will only reinforce your sense of powerlessness. You do not need to defend yourself from the oppressive beliefs of others. This does not mean you should not tackle the oppressive behaviour of others, that should be a given, but only that once you have examined yourself and taken responsibility for your behaviour you do not need to prove yourself to others. Racism is a problem FOR black and ethnic minority people, but a problem OF white people; sexism is a problem FOR women, but a problem OF men; homophobia is a problem for bisexual people, lesbians and gay men, but a problem OF straight people; and so on through a myriad of social oppressions. Whilst it is important to look at a range of strategies that are a problem FOR you, see table 5, you do not need to take responsibility for the problems that are OF other people.

Finishing the Model In bringing this all together it is possible to finish the model by exploring the Middle Ground. This is the area where we no longer deny the existence of a problem of oppression, nor do we focus on a single dimension of oppression to the exclusion of all other oppressions. This Middle Ground is the common practices that can help to combat oppression across all groups in society. It is, I admit, utopian. It suggests that we can solve the problems of a deeply unequal and unjust world, and that a world without hierarchy, or at least with minimal hierarchies which can demonstrate their legitimacy, is possible. I suspect that we are probably 500 to 1,000 years away from fully realising this potential, but I also recognise that we have made progress in many areas of equality and justice in the last 200 to 300 years, and so I remain optimistic that progress is possible, and probably essential if we are to maintain this planet as a place fit for human habitation. The final stage of the model will look different, depending on whether you are considering a situation where you are in the group that holds the most social power or the group that is being disempowered. For those in the dominant group it will look like Figure 17. Your middle ground will depend upon your commitment to social justice. It is extremely hard to give up power unless you see that there is some greater goal at the end of it.

Individual power when exercised without justice leads to an oppressive society, one that may be relative advantage to one group, but does so at the expense of well-being for all. This case is powerfully argued by Wilson and Pickett in their book ‘The Spirit Level’. Secondly, when you have power which is backed by privilege, you need to recognise that. Without recognising the unearned benefits that come from being part of a dominant group you cannot challenge injustice and create a fairer, healthier society. A direct result of that will come both the desire and the ability to listen non-defensively to those who are experiencing oppression. This is a third strategy for developing anti-oppressive practice. Listening also means being aware of how our communication, both in listening and speaking, is shaped by the biases discussed in chapter 5, ego-centric biases, ethno-centric biases and socio-centric biases. These are extremely hard to overcome as they are seen as being ‘normal’ and as such tend to be invisible to the person.

Figure 17 - The Middle Ground Intersectional Model - For those in the dominant group Fourthly, it is important to develop a secure sense of your own identity, in all its messiness and complexity. I am who I am, and unless I am respectful of that I am unlikely to really help someone else be proud of who they are. I did not choose my gender, ethnicity, class, nationality or sexuality. On one level it makes no sense to be proud of these things. On a different level I am increasingly accepting and proud of just being me. This is not pride based on being better than someone else, but just a sense that ‘I am OK in being me.’ This forms the basis for relationships where I can support others in accepting and respecting their identities. Fifthly, it is important in anti-oppressive practice to put the edge at the centre. This means in any situation asking yourself: ‘who has the least power?’ That person should be the one whose needs are put most central and whose views are most listened to. You can then work up through other people in the situation ensuring that your focus reverses the injustice in society. Sixth, if you are part of a dominant group, educate yourself. It is not the role of women to educate men about sexism. They may choose in a given situation to do so, but sexism is a

problem OF men and FOR women, and therefore, if you are a man, the responsibility to educate yourself about sexism is yours, and not that of women. It is not the role of black people to educate white people about racism, or of older adults to educate younger adults about ageism, or for those with disabilities to educate able-bodied people about ableism. Where it is YOUR problem, you must take responsibility to educate yourself. Finally, if you are truly committed to anti-oppressive practice you must challenge all hierarchies and all oppressions. If you say, prejudice is wrong, but it is OK to discriminate against young people as they know nothing, then you have opened the door for all oppressions. If you believe that fighting racism means that you shouldn’t challenge sexist practices in a specific group because they are black and ‘that’s just their culture’, then you have opened to the door to all oppressions. If you say: ‘Yes, I’m against oppression, but same sex relationships should not be treated the same as opposite sex relationships’, then you have opened the door to all oppressions. The only hierarchies that have any place in a just society are those that can justify themselves on open and clear grounds. When a parent grabs a child who is about to run in the road and pulls them back, that is an exercise of power, but it is a legitimate one, not based on age but on the parents greater ability to assess risk. When someone who has studied a field for years makes an announcement on that subject then it is legitimate that we give that more credence than someone who has only read a few pages on the internet about it. Again, this is not because we should defer to authority figures but because the evidence on which subject experts can call upon is legitimately greater than for nonexperts. That does not mean that we should not challenge ‘experts’, especially when they speak outside their subject area or draw conclusions that go beyond the best available evidence, but it is to say that some hierarchies can defend their authority, and others can’t, as the anarchist writer Bakunin was happy to admit – “In the matter of boots I am happy to defer to the authority of the bootmaker.” In many ways the position for those in ‘The Other’ group, for those who are experiencing oppression, the picture is similar, after all this is the idea of their being ‘middle ground’, but it is slightly different.

Figure 18 - The Middle Ground Intersectional Model for those in 'The Other' group Firstly, I must repeat what I said earlier: as a white, middle class, able-bodied, heterosexual man, I must be very cautious about telling those who are being oppressed what they should do. What I have seen that has seemed to be successful is when those who are being oppressed can engage in ‘unapologetic speaking’. This means avoiding words like ‘just’ or ‘only’, as in ‘I’m just a student’ or ‘I’m only a secretary’. Your daily lived experience provides amble proof that oppression is a reality, and you do not need to defend that. What often makes this hard is the fact that blatant, extreme and unambiguous acts of oppression are relatively rare, whereas smaller ‘micro-aggressions’, ‘othering’, ‘silencing’ ‘labelling’ and ‘denial’ are common. In any one given situation it may be impossible to prove that this was caused by prejudice. This is similar to the problem of proving global warming. No single hot summer or drought proves global warming, and no cold snap or snow storm disproves it. All we can say is that if global warming is true then we will expect these events to happen more often than before, and these other events to happen less often. In the same way most acts of oppression cannot be conclusively proved to be motivated by prejudice, but we can say that for some people in society such events are infrequent, whereas for others they happen on a regular basis. It is this that should be spoken about unapologetically – you (the oppressor) may or may not have intended to be oppressive, but my lived experience is that what you have just done is oppressive. Other aspects are the same whether you are in the dominant group or ‘The Other’ group. A secure sense of identity and putting the edge at the centre are equally important, as is challenging all hierarchies. Educating yourself is slightly more complex though, as you need to be careful to note whether those who are trying to educate you are speaking and listening to you or speaking for you. If it is the first then you will probably make progress, if is the latter then you will probably me better finding sources that more closely resonate with your own experience. As a test of that consider this chapter: has it left you feeling heard and empowered, or weakened and undermined? If it is the first than I am pleased with a job well done, if it is the latter than I will encourage you to keep looking, find other sources, find people who can empower you and feel free to ignore anything in this chapter that undermines you. Just because I have a job title ‘lecturer’ or claim to have ‘experience’

these are just labels, and in no way should undermine the validity of your own experience or silence your voice, regardless of my intentions. At the end of the day anti-discriminatory practice, anti-racist practice and anti-sexist practice are all about practice. Whilst I personally believe that the answer to oppression in society will ultimately be societal and cultural, this is of limited use in the day-to-day practice of social workers. That is why my model focuses on individual actions that can be taken by social workers and service users. I will finish this chapter with a story. I think that stories often form a better way to understand a concept than merely to describe the theory in abstract terms. I need to begin by clarifying what I mean by ‘story’. For some people the concept of ‘story’ implies something ‘made up’, something that is not true. For me story simply means events organised in a way that makes narrative sense to the speaker and listener. This story is about the South African anti-apartheid activist, Steve Biko. Biko was a founder member of the Black Consciousness Movement in South Africa, and spoke and wrote about the need for black people in Africa to form their own solutions for achieving justice in Africa. He was as critical of white liberals as he was of white supremacists, arguing that both of them in their own way disempowered black Africans. He was eventually murdered in police custody in 1977. Given that background this story illustrates an important point about anti-oppressive practice. On the way through the arid, flat Orange Free State he (Steve Biko) grew bored and lonely and gave a lift to two young whites. They seemed reluctant to talk, and as company and conversation had been the aim in giving them a lift (they were hitchhiking to Johannesburg) he decided to draw them out. “Are you boys English-speaking or Afrikaans-speaking?” he asked. After some hesitation one of them said: “We’re both English-speaking.” But Steve could detect from their accent that they were Afrikaners. “What a pity,” he said, “I was hoping you were Afrikaans-speaking because I want to improve my Afrikaans and I hoped to get some practice.” No response. “Kom, praat met my [Come, speak with me],” he said in Afrikaans. “No, we don’t know Afrikaans much,” one of them replied. But the more English he spoke the more they struggled, until eventually he challenged them with a smile: “Come on, you’re Afrikaans-speaking, aren’t you?” With great reluctance they admitted it. “Why did you deny it?” he persisted. Well, they said, they knew that black people didn’t like Afrikaners. Typically, Steve then delivered a long lecture to the effect that people should never, under any circumstances be ashamed or reticent about their origins or race or culture. “There’s nothing to be ashamed of in language or culture. In fact you should be proud of these things!” (Woods, 1987, p76-77)

Reflection 1) What struck you most in this chapter? 2) Are you proud to be yourself without comparing yourself to others?

3) Do you get angry at the injustice in the world? 4) What are you going to do about it?

Recommended Reading Maclean, S. and Harrison, R. (2011) Theory and Practice: a straightforward guide for society work students. Lichfield: Kirwan Maclean Associates. Various chapters – 5, 7, 9-16 Thompson, N. (2006) Anti-Discriminatory Practice. Basingstoke: Palgrave. Chapters 1 and 2, pp 1-47 (Focus on understanding these two chapters before approaching the rest of the book) Burke, B. (2013) “Anti-Oppressive Practice” in Davis. M. The Blackwell Companion to Social Work: Chichester, Wiley-Blackwell. Pp414-416 Thompson, N. (2009) People Skills. Basingstoke: Macmillan. Chapter 22 – “Antidiscriminatory practice” pp195-204 Dominelli, L. (2002) “Anti-oppressive practice in context” in Adams, R., Dominelli, L. and Payne, M. Social Work: Themes, issues and critical debates. Basingstoke: Palgrave. Pp 3-19 Burke, B. and Harrison, P. “Anti-oppressive practice. in Adams, R., Dominelli, L. and Payne, M. Social Work: Themes, issues and critical debates. Basingstoke: Palgrave. Pp 227-236. Trevithick, P. (2012) Social Work Skills and Knowledge: a practice handbook. Maidenhead: Open University Press. Appendix 9 – “Radical and activist perspectives in social work” pp345-348 Teater, B. (2010) Applying Social Work Theories and Methods. Maidenhead: Open University Press. Chapter 6 – “Feminist theory and practice.” Pp87-101 Doel, M. and Shardlow, S. (2005) Modern Social Work Practice: Teaching and learning in practice settings. Aldershot: Ashgate. Chapter 14 – “Anti-Oppressive Practice” pp207-218 Dominelli, L, (2009) “Anti-oppressive practice: the challenge of the twenty-first century.” In Adams, R., Dominelli, L. and Payne, M. Social Work: Themes, issues and critical debates.” Basingstoke: Palgrave Macmillan, pp49-64

Chapter 7 – Problem-Solving Preparation When you have a problem, how do you tend to try and solve it? When someone comes to you with a problem they’d like you to help them solve, what do you do? Have you ever been in a situation where you tried to solve a problem, and you made it worse? If so, what did that teach you about problem solving?

Introduction Within this book this chapter is unique. All the other chapters represent a range of ideas based on the work of different authors. In this chapter I will focus on two models taken from a single source – the PRECISE model and the Problem Solving Process, both from Neil Thompson’s book ‘The People Solutions Sourcebook.’ I believe these two models taken together form the basis of good problem solving in social work practice.

A personal View I believe that many social workers have no consistent model for how to solve problems. They tend to rely on a mixture of following agency procedures, repeating what seemed to work in the past, habit and guesswork. Social workers also vary greatly in how they approach problem solving. Some charge in as rescuers and start telling people what they should do, issuing a mixture of advice and orders. Others go in as counsellors, patiently listening whilst the person offloads their problems but then not really coming up with any plan of action to solve the problems. Both of these tend to be ineffective and inefficient. In many ways problem-solving is like communication. We all tend to think we are reasonable at it because we do it all the time, but when we stop to think deeply about what we are doing it turns out things are more complicated than they first appear. Problem solving which reinforces a sense of powerlessness or which relies on an oppressive use of power is likely to cause more problems than it solves, for this reason it is important that social workers have sound theories of problem solving which are ethical and effective. Yet despite this many social work theory books fail to provide a sound theoretical underpinning for problem solving, meanwhile many social work skills books focus on individual problem solving skills, but again fail to provide a coherent underlying model to gel those skills into effective practice. For reasons explained in Chapter 3 this undermines good social work practice. What the two models that Thompson offers do is to provide a safe and solid underpinning set of principles for working in partnership with individuals in order to solve problems. They are based on the values and beliefs mentioned in Chapter 3 and they help create the kinds of relationship that lead to empowered behaviour change and resilience, rather than subtly undermining the self-confidence and self-efficacy of service users.

The PRECISE framework for Problem Solving Thompson argues that effective problem solving in social work practice rests on seven key principles. The work is:

Partnership-based Realistic Empowering Creative Integrated Systematic and Effective I will consider each of these in turn.

Partnership-based Whilst it is true that usually the relationship between the social worker and the service user is not truly equal, the aim is always to keep the power differences to a minimum. If people feel pressured, if they believe they are being forced to change, then they will resist change, even if the change is something they want. When people feel accepted and respected, when they feel they are being heard and taken seriously they will be more willing to take risks and to work towards behaviour change. This was the point that was made in Chapter 3 where I discussed the types of relationships that are most conducive for good social work practice. In reality this is done in very practical ways. It means that the social worker will: Listen to the service user with full attention, listening not just to the words but to the body language and to the meanings and intentions behind their words and actions. (Chapter 5) Allow the service user to define their problems and their goals in ways that are consistent with the service user’s values and beliefs. Honour the problem solving strategies and strengths of the service user. Select methods of intervention that are congruent with the person they are working with. See the service user as a person to be worked with, not a problem to be solved or managed. Evaluate the success of the work using criteria relevant to the service user. An important point about Partnership working is that often social workers are not very good at assessing the quality of the relationship. At times the social worker may believe that they have a respectful relationship with the service user, but this is not how the service user experiences it. At other times the social worker may believe that their relationship with the service user is awful, yet the service user may experience it was being very helpful. It is important for social workers to keep a close eye on the quality of their relationships and regularly seek feedback on how they are doing

Realistic Thompson uses the concept of being ‘realistic’ in two senses. The first is perhaps best understood as ‘achievable’. The service user and the social worker must create targets or goals for their work that both believe to be achievable. If either believes that what is being

attempted is impossible the result is likely to be wasted effort at best and actively harmful at worse. The second sense of perhaps closer to what might be called ‘balanced’. For example a social worker needs to have both a belief in the strengths of the service user, but also an appreciation of the difficulties faced by them. They need the balance that Lord Laming described as ‘respectful uncertainty’; a faith in the service user balanced with an acceptance that for various reasons service users may present you with less than the whole truth, or even out-and-out lies. Perhaps the best way to understand the quality that Thompson means by saying that the relationship needs to be realistic is to think of this in terms of honesty. Social workers need to be honest about the benefits of the work that they do, but also about the risks faced by the service user both with compliance and with refusal to comply. Social workers cannot offer unrestricted confidentiality. If a parent is honest about how they parent this may result in the social worker being able to help them parent, but it could also result in a child being removed. If a person with a mental health difficulty is honest about the experiences they are having this can help in the process of recovery, but it could also result in the person being sectioned under the Mental Health Act. Social workers need to have the confidence and the courage to be realistic about this with service users. Anything less than that, even when done with the intention of not hurting the service user, may result in far more harm than good. Effective social work problem solving requires a delicate balance of quiet optimism with protective pessimism, expecting the best but preparing for the worst. At the same time it requires a blend of unconditional positive regard and healthy scepticism. This needs to be bound up in a respectful partnership.

Empowering Empowering is a complex word, and one that I have ambivalent feelings towards. The idea that social workers can ‘empower’ service users carries strong risks of paternalism or being patronising. The idea that a social worker can somehow give or share their power with a service user seems to me to reinforce the hierarchy of power in the relationship rather than reduce it. However what is more important is that the social worker does not act in ways that further disempower the service user. This is one of the key reasons why social workers need a model of effective, efficient, empowering problem solving. Coercing or advising models of problem solving may provide short-term relief from a problem, but they usually create either resistance, where the person finds ways to undermine the proposed solutions, or dependency, where the person takes no credit for the solution and so does not feel that they can solve their problems without the presence of the social worker. When social workers listen to service users, when they build on service users existing strengths and previous problem solving strategies, when they collaboratively build new solutions rather than telling people what to do, then the problem solving can be empowering. In many ways the greatest compliment a social worker can be given at the end of a piece of problem solving work is for the service user to say ‘I did it. I didn’t really need your help, did I?’ When that is said you know that you have empowered the service user to take control of their own life.

Even in situations where things cannot be a partnership, such as when removing children using legal powers or sectioning someone under the Mental Health Act, the social worker can still find ways to keep the service user informed and able to contribute to the process and to the decision making. At times this may be very limited, and may even feel tokenistic, but if the social worker is genuinely trying to build on the power of the service user, it is likely that eventually the service user will know and appreciate this.

Creative A common-sense bottom line in problem solving is ‘if the solution was easy and obvious the person would already be using it.’ As a result of this when a social worker is engaged in problem solving with a service user there will be a need to be creative and flexible; to be willing to experiment with novel ways to reach the goals. This can be a major challenge in social work practice. The reality is that when people are under pressure, when time and resources are low and demands are high, the tendency is to become more rigid in our behaviour. We fall back on policies, procedures and practice, onto ready-made, pre-set solutions and on habits. This often leads to very unproductive work and high levels of stress and dissatisfaction. Much of ‘The People Solutions Sourcebook’ is dedicated to a variety of creative problem solving strategies, more than I can go into here. All of these require the social worker to bring to the work a sense of rigorous creativity and playful seriousness. These sound contradictory but as Thompson points out the idea that only artistic bohemian types can be creative is a myth, and that whilst dealing with serious ideas retaining a child-like sense of curiosity, fun and playfulness in the relationship greatly increases the chance of effective work.

Integrated In his book Thompson focuses on the idea of being integrated in an inter-professional sense. Service users are often involved with multiple services and the more that services can work together the more effective the work is likely to be. This will be dealt with in more detail in Chapter 10. It is important in problem solving that the roles and responsibilities of each person are spelt out clearly. The problems where this is not done are not new, as this old skipping rhyme shows. There is however a second sense in which problem solving needs to be integrated. Problems and their solutions do not exist in isolation. Problems often revolve around conflicting values, either conflicts between different parties involved in the problem or even conflicts of different needs and desires in the person who has the problem. Solutions need to look beyond solving the presenting problem in isolation or solving the problem in a way that meets the needs of just one person to identifying solutions that will meet most of the needs of the

The Lady with the Alligator Purse Miss Lucy had a baby, His name was Tiny Tim. She put him in the bathtub, To see if he could swim. He drank up all the water. He ate up all the soap. He tried to eat the bathtub, But it wouldn't go down his throat. Miss Lucy called the doctor, Miss Lucy called the nurse. Miss Lucy called the lady With the alligator purse. "Mumps," said the doctor. "Measles," said the nurse. "Hiccups," said the lady With the alligator purse. Out went the doctor. Out went the nurse. Out went the lady With the alligator purse.

person or that will be acceptable to all key players in the situation. This may seem messy and time consuming, but compared to dealing with the mess created by a solution that fails to account for all these factors an integrated approach is both more efficient and more effective.

Systematic For Thompson the idea of being systematic relates primarily to the importance of knowing what you are trying to achieve and how you are attempting to achieve it. The way it functioned was very interesting. When This is vital to good problem solving the Drink button was pressed it made an instant as it helps prevent two dangers. The but highly detailed examination of the subject's first is drift. This is where instead of taste buds, a spectroscopic analysis of the having clearly defined end points and subject's metabolism and then sent tiny a clearly established strategy to experimental signals down the neural pathways reach it the social worker and the to the taste centers of the subject's brain to see service user meet without any clear what was likely to go down well. However, no one understanding of what they are doing knew quite why it did this because it invariably or whether they are heading in the delivered a cupful of liquid that was almost, but right direction or not. The second is not quite, entirely unlike tea. what I might call the ‘unlike tea’ solutions. This name is from the experiences of Arthur Dent in the Douglas Adams’ book ‘The Hitchhiker’s Guide to the Galaxy. There is a danger that social workers will follow procedures in a way that looks systematic, but which fails to understand the theory that underpins the systems. This means that service users end up being ‘processed’ without regard for their personal needs and circumstances rather than being treated as an individual.

Effective The final quality Thompson talks about in his effective problem solving is the importance of focusing on what is effective. It is important to remember that service users have many demands on their time and resources, and social workers should seek to be as effective as possible to avoid placing additional demands upon the service users. At the same time social workers have limited time and resources, so these two need to be mobilised wisely. Effectiveness comes from a variety of sources. At its most basic level it is embedded in the social work process that was discussed in chapter 2. The review and evaluation phase of the social work process should be about assessing whether or not the planned interventions are having the desired effects or not. In terms of choosing the most effective interventions the social worker can begin with the service user’s own wisdom, drawing on what they have previously or are currently finding helpful. Building on successful strategies is usually more effective than building new strategies from scratch. In the same way social workers will develop a range of proven strategies as their experience develops. Use of theories themselves can help increase effectiveness, especially when these have been practiced and developed. At first new strategies may be awkward or ineffective, but with practice and reflection they can become more effective.

Finally, social workers can draw upon research based evidence to discover which interventions are most likely to be effective in a given situation. Evidence based practice is something that I will return to in chapter 11. The PRECISE model provides a useful framework for creating the fundamental relationship for problem-solving, but it does not in itself give a framework for solving problems. For this Thompson provides a 10-step problem solving process.

Thompson’s 10-Step Problem Solving Process Before setting out the ten steps it is important to reinforce Thompson’s point that problemsolving has to take place within a relationship with the qualities from the PRECISE framework. Before you can begin effective problem solving you need to have developed a partnership which is honest and realistic; which is empowering and creative; and which is integrated and systematic. If those conditions are not met then problem solving is unlikely to be effective. However once those conditions are met then it is possible to move on to solving problems.

Step One – Information Gathering The first step in the problem solving process is information gathering. This is deceptively easy to state, but far more difficult to do in practice. The kinds of problems encountered by service users are usually complex, chaotic and multi -faceted. On top of that when the service user and social worker first meet the service user will often present their problems in a partial or a distorted way. It takes both patience and skill to unpick the service user’s story in order to grasp all the details of the problems that you are trying to solve. This is one of the key reasons that the communication skills and the theories discussed in Chapter 5 are so important. It is vital that social workers can both listen effectively to what a service user is communicating and can ask questions and use other techniques that will gather important information. The information required is not just about the problem, as important as that is. The social worker must also gather information about the strengths and resources the service user has and about the goals and desires of the service user. In terms of the problem, it is important to go for ‘sensory specific details’, when the problem arises what do you see, hear, feel and do? Who does what, when and where? What things tend to trigger the problem? What is the sequence of events that make up the problem? What are the consequences of the problem? This information is vital for effective problem solving. In addition to that, it is important to gather information on what the service user has already tried. What has worked? Can we try that again? What has not worked? Can we do it differently, or can we do something else? Finally, what are the goals? This is important as the absence of a problem is rarely the best solution. The best solution is usually the presence of something better than the problem. One of the most powerful ways of achieving this is to ask questions using the word ‘instead’? ‘How would you like to feel instead?’ ‘What do you want instead of that?’ This shifts attention from seeing the problem as the whole story to seeing the problem as a temporary phase on a journey to somewhere better.

This is a stage where it is important to focus on the Systematic part of the PRECISE model. It is possible to gather so much information that both the worker and the service user are overwhelmed by the amount of information. Before starting the problem solving process it is helpful to think about what information is required in order to do your job. It is a bad idea to randomly throw out questions in order to gather as much information as possible. Instead questions should be aimed at achieving specific results. Looking back at Chapter Five you can see that communication is an intentional act, however the intentions will change as the work progresses. At first you will be aiming mostly at gaining trust and rapport. This will mean that early information questions will be general and safe. As the work progresses the information needed will be more focused on the details of the problem, and the nature of the questions will change as a result of this. Information gathering is an important step, but by itself it does nothing to solve a problem. It is possible to know lots of facts about what is happening for a service user, but still not know how to help them. For this the facts must be analysed.

Step Two – Analysis and Problem Definition Having gathered the relevant information it is important to make sense of it. This is one reason why it is important to avoid being overwhelmed by information and instead gather information that is most relevant to your role and to the problems you are trying to solve. Having gathered information it is important to organise it according to a narrative, so that it tells a story that makes sense. Often service users feel swamped by a problem or problems that make no sense. Things ‘just happen’ and they don’t know why. As a result they don’t know what to do about it. The analysis organises individual events which are unconnected or only loosely connected, and puts them together into a coherent story. In terms of problem definition it is possible to return to the Mellor and Schiff Model that was introduced in the previous chapter. In order for a problem to be well-defined it must be something that the service user recognises as a problem (existence); something that is serious enough to put the time and effort into solving (significance); something that can be solved (solvable); and as something that it is the person’s own responsibility to solve (own part). Often a service user will find a barrier at one or more of these stages. A parent who is being abusive towards their child may see nothing wrong with this (existence); someone with a drink problem may accept that they drink more than most but say that it is not a serious problem (significance); someone who is depressed may believe that things can never get better (solvability); someone who is in a violent relationship may believe that the only possible solution is for their partner to change (own part). Looking at each of these in turn; the abusive parent must be supported to see the harm that their behaviour is causing their child (existence); and that this harm is significant (significance); and that alternative and better parenting strategies exist (solvability); and that they must take responsibility for changing their parenting. The person whose drinking is seriously impacting on their well-being and on the well-being of others must be helped to recognise the seriousness of these impacts (significance); and that alternative behaviour patterns are possible (solvability); and that they have the capacity to change their drinking pattern (own part). For someone who is experiencing severe depression they need to be supported to believe that things can change (solvability); and that although they cannot change everything about their situation there are things they can do that will improve the situation (own part).

Finally, for the person in the abusive relationship they are likely to be helped if they can recognise that they do not have to wait for their partner to change. They have options, from learning assertiveness skills, to leaving the relationship, to pressing for prosecution (solvability/own part). The social worker may not know in advance which of these will be most acceptable or effective for the person, or even if any of a range of other strategies might work better, but unless all four levels are dealt with then no solution is possible. So it is important that after gathering information the problem is defined in a way that recognises the existence and significance of the problem, states i t in a way that makes it solvable, and focuses on the person’s own responsibility to take action to solve it. Perhaps the strongest example of this is bereavement. The death of a loved one is a tragedy, but not a problem. It cannot be solved. So when working with someone with a profound grief reaction it is important NOT to define the problem as ‘the death of a loved one’, but as something like ‘strong feelings of sadness and guilt following the death of a loved one that are interfering with daily living.’

Step Three – Identification of Strengths and Opportunities When I do training with social workers I often carry out an exercise where I ask them to think of a service user they have worked with and then write a brief case summary describing the person and their situation. I then ask them to look at the description and break it into three parts: neutral facts, problems/weaknesses and strengths/resources. What is striking when I do this is that in the vast majority of cases the description is significantly skewed in the direction of problems, deficits, weaknesses, disorders and so on, with few, if any, mentions of positive qualities, potential resources or strengths. The fact is that too often problem solving focuses too much on the problems and not enough on what the service users are already doing or are capable of doing to help them manage or solve those problems. For this reason Thompson suggests that identification of strengths and opportunities needs to be a discrete part of the problem solving process. One core belief that feeds into this is the idea that ‘there’s nothing wrong with us that can’t be put right by what’s right with us’, and if we don’t explore with service users ‘what is right with them’ we are unlikely to solve problems in the way we would like to, in a way that empowers service users and does not foster dependency. An important point to mention here is that the idea of preventing ‘dependency’ is highly culturally related. In individualistic, capitalist and competitive societies great emphasis is placed on independence, autonomy and choice. These are often values that are taken for granted as being ‘good’. Globally, and even locally, there are many cultures and subcultures that favour inter-dependence over independence; that recognise that human beings do not exist as isolated units but in communities of inter-dependent relationships. As a result of this the identification of strengths and resources needs to account for this diversity, and seek as far as possible to locate individual strengths and opportunities within the context of networks of individuals and communities that can also provide support in the problem solving process.

Step Four – Exploration of Possible Solutions There is an old saying that ‘if you always do what you’ve always done then you’ll always get what you’ve always got.’ This often applies when analysing why people struggle to solve problems, they continue to apply strategies which perhaps used to work in the past but

which have stopped being effective, or strategies which they believe ‘ought’ to work, but which in fact don’t. This means that when exploring possible solutions it is important to create new possibilities rather than simply continuing with what has already been shown not to work. One of the most powerful tools for generating solutions is brainstorming. This technique is very simple, but unfortunately because it is seen as simple it is often treated as if it was easy. Good brainstorming is not an easy process. It involves stating the problem to be solved and then generating as many possible solutions without evaluating them. This has two key advantages. Firstly, it prevents a common tendency to latch on to the first available solution rather than patiently waiting for the best solution. Secondly, creative problem solving is associative and exponential, meaning that one idea will trigger associations to other ideas, each new idea generating a number of other ideas. This means that even an idea which is unethical or unworkable may lead very quickly to novel, ethi cal and workable solutions. If the first idea is silenced the later ideas will not emerge. Having stressed the importance of new and novel solutions social workers should not ignore the benefit of exploring present and past solutions. Often a solution can be a case of doing something that is already working more often or in a slightly modified form, or else restarting something that the person has stopped doing. People often find it easier to generate more solutions for someone else than they do for themselves. This can be used in the solution generation process. You can ask someone what they would advise a friend to do if their friend was experiencing this problem. It is possible to ask someone to think of someone they admire, real or imaginary, and ask them what they would think that person would advise them to do in this situation. You can also engage people’s imagination by inviting them to leap forward in time to a point where they have solved the problem and then ask them what they are doing differently, and, if they manage that, to ask them to think about how they have managed to do those things. There are many books and courses on creative problem solving, and these are well worth investing in. I have only managed to give a flavour of the options here, but I hope it will trigger ideas in you for how you might be able to help someone generate possible solutions. The key point here is summarised by Gerard Puccio, a professor specialising in creativity, that “the best way to have good ideas is to have lots of ideas.”

Step Five – Evaluation of Possible Solutions Having said that idea generation is about the number of ideas, quantity, and not the effectiveness of those ideas, quality, at some point in the process you have to move from having “lots of ideas” to selecting the ones that are worth investing in. This requires balancing a number of different factors. These can include: Efficacy – which solutions seem to be effective in solving the problem? Abandon those solutions which whilst interesting are not likely to be effective in solving the problem. Achievable – can you carry out this solution? Abandon those solutions that you do not have the resources, whether personal, material or otherwise, to carry out. There is no point working on a solution that you do not have the knowledge, skills or resources to implement, although bear in mind that part of the solution may be gaining the knowledge, skills or resources to implement the solution later on.

Congruence – does the solution fit with your values and your image of yourself? Abandon those solutions which might be effective and achievable, but which do not fit with your sense of who you are, your values, or your beliefs. One person might find a particular solution absolutely fine, for someone else that same solution might be absolutely unacceptable. Challenge Level – does the solution seem challenging, but achievable? Whilst this seems to contradict the achievable criteria, it does make sense. It may be obvious that some solutions are too difficult, people may also struggle with solutions that seem too easy. If our goal is to develop self-efficacy, the ability to solve problems without our help in the future, then we need to offer solutions that stretch people beyond their current level of ability, whilst still being manageable. Personal preference – put simply, which one do you fancy having a go at? Solutions that are seen as ‘right’ for the person are more likely to be successful. Urgency – what needs sorting out first? This is especially helpful when a person faces multiple problems, some of which pose serious and immediate threats. If someone is experiencing mental health problems but is under threat of eviction it is likely to make sense to look for solutions to the threat of eviction before working on recovery from the mental health problems. Using these questions or a range of other techniques, it is possible to sift through the possible solutions and select one or two that can be developed and implemented.

Step Six – Formulation of a Plan The next important step is to move from planning to implementation. This begins with taking the proposed solution and turning it into a plan. A plan spells out exactly who, will do what, when and where, and why they will do it. Planning is a good way to ensure that the evaluation of your chosen solution/solutions is realistic and systematic. It also ensures that issues of partnership and empowerment are addressed. A general rule in the plan is for the service user to be responsible for more than 50% of the planned actions. This may be a graded process, starting with small steps, then building up to the service user continuing on their own, but in most cases it is better for the social worker not to do things that the service user is capable of doing. This may sound harsh or uncaring, but the reality is that every time a social worker does something that a service user could do there is danger of conveying the message ‘I am doing this for you because I don’t trust you to do this on your own.’ Writing the plan down can be extremely helpful. This is both because the written record acts as a memory aid and also because often things that are written down take on a power and a permanency that is not always there in the spoken word. However, it is important that plans remain flexible and open to change in the light of experience. I often say of plans: “you need to have a plan because you need to know what you are deviating from.” This highlights the paradoxical nature of good plans: they must be solid enough to make sure you don’t simply drift along, but also be flexible enough that when circumstances change or new information comes in the plan can be adapted to take these into account.

Step Seven – Revisiting the Information and Analysis Before moving on to implement a plan it is helpful to go back to the original information, including the reasons for the referral. It is important that social workers remember why they are there and what they are trying to achieve. The need of this has been shown more than once in fatal child-abuse enquiries where a plan has been developed that failed to address the primary reason for the referral. Imagine a case where a referrer suspects that a child may be at risk of serious physical abuse. During the initial assessment the social worker also discovers that the house is unhygienic. There is a serious danger that if the social worker focuses exclusively on improving the standards of hygiene in the house and does not address the risk of serious physical abuse the child could come to harm or even, in extreme cases, die. In a more routine way it is important to ensure that the plan is in line with the initial assessment. If it is not then there are two choices: you can either update the assessment in the light of the new information gathered whilst carrying out the initial assessment; or else review the plan to make sure it is congruent with the initial assessment. At the end of this step it may be helpful to mentally rehearse the plan with the service user, running through in detail who will do what, when and where. If appropriate it may help to use role-play in order to both build the service-users confidence and also to check for any possible unexpected problems that might emerge as the plan is being implemented. If these arise then the plan can be amended or various back-up plans can be created to deal with foreseeable problems that might emerge during the implementation phase.

Step Eight – Implementing the Plan Ironically from a social work perspective the carrying out of a problem-solving plan is often the easiest bit. This is because with problem-solving the social worker is not the one implementing most of the plan. From the service user’s perspective implementation will be much easier if there is either a clear start point, an agreed time and place when the plan will be implemented, or an agreed trigger for the plan, for example next time the service user notices something specific starting to happen then they will implement the plan. The clearer this is in advance the more likely the plan is to be implemented.

Step Nine – Monitoring and Review This phase is clearly stated in the Social Work Process that was discussed in Chapter Two. It is important to continuously monitor the work to ensure that the plans are appropriate, that they are being implemented and that they are getting the desired results. In many ways one of the best methods for monitoring and reviewing plans is to use the model of reflective practice described in Appendix 1. This means that after the service user has implemented the plans the social worker sits down with them and helps them review what happened, what they did, and what the results were. They then link this to the goals for the work and create an understanding of why it worked or why it didn’t work, and use this to modify the plans and determine how best to implement them in order to achieve the desired end goals.

Step Ten – Concluding Involvement when Appropriate Successful ending of problem solving begins in the earliest stages. As early as stage one the worker needs to be asking ‘what needs to be different in order for us to know it is time for

us to stop working together?’ This stresses that social workers are not a permanent features in the lives of most service users, but are a temporary service that will help people get to the point where the person is ready to continue without them. Concluding begins to rise in prominence as Step Nine develops. An important part of the monitoring and review is to ask ‘have we got to where we wanted to be?’ This is an important point as it avoids ‘mission creep’, this is where as one problem is solved a new, less important problem is raised. Without a good review process it is possible that social workers will avoid closure by finding new problems to solve, but it is important to remember that the aim of social work is to enable service users to carry on without them. As the work moves into its final stage the social worker will want to focus on discussing with the service user what they have learned. It can be helpful to learn about Attribution Theory – this is a theory about the way in which people explain the causes of their behaviour and situations. If a service user sees the success in problem solving being primarily caused by the action of the social worker then this is likely to leave them vulnerable to relapse. If on the other hand the service users sees their success in solving the problem then they are more likely to feel confident that if the problem re-emerges then they can deal with it. By focusing on what the service user has done to solve the problem and what they have learned about how to solve problems the service user becomes more empowered to solve problems in the future. The less credit they give to the social workers for their successes the better the chances of future success. The reality is that problems and challenges are a natural and on-going fact of life. As Buddhists remind us, to live is to suffer. It can therefore be very helpful towards the end of the work to develop a relapse prevention plan. This is a plan that does a number of things. Relapse Prevention Plans may include:     

Identifying early warning signs that alert the person early that problems might be returning Identifying a network of support that can help resolve or manage the problems Agreeing what actions they will take as soon as they notice the warning signs Specifying when a returning problem will need outside help, including a re-referral Stating the signs that the returning problem has been successfully overcome

Finally in concluding, it is important to celebrate success and find ways to mark, and perhaps in a few cases even mourn, the end of a phase in the service user’s life. In most cases this will be low key and minimal, but in some cases it may be more significant. I have too often seen social workers arrive in the lives of service users, turn those lives upside down with intrusive and threatening questions, conclude that actually there is nothing wrong, and then pull out with no support or back-up for the service user. I find this unethical and unprofessional. If you have to turn a service user’s world upside down, say with a mental health or a child protection investigation, plan your exit strategy so you put back the things you got out and clean up the mess you have created. Anything less than that is at best incomplete problem-solving, and at worst unethical practice.

Reflection 1) What struck you as new or different in this chapter? 2) What is the difference between engaging someone in a problem solving process and advising someone on how to solve their problems?

3) How do you ensure that when involved in a problem solving activity you do not make the person’s situation worse? 4) Why do so few social work theory books provide sections on basic problem solving?

Recommended Reading As stated at the beginning this chapter is based largely around Neil Thompson’s book ‘The People Solutions Sourcebook.’ In addition I would recommend Egan’s book ‘The Skilled Helper’

Chapter 8 â&#x20AC;&#x201C; Task Centred Practice Preparation Think of a problem, something in your life youâ&#x20AC;&#x2122;d like to change. If I asked you to develop a plan to solve that problem in ten years, how would you go about developing and implementing your plan? If I said that I would help you develop and implement that plan, but we only had six meetings and we would need to be finished in 3 months, how would you go about developing and implementing your plan? Assuming your plans are different, how are they different? What do you make of that?

Introduction There is a tendency in life to think that more is better, but when it comes to social work there is good reason to believe that this is not always the case. When social work is open ended, the social worker and the service user work together for as long as is necessary, there is a tendency for things to drift. There is good evidence that the knowledge that involvement is short-term, that it has a definite end date, can help focus attention and help get more done. That is fundamental to Task-Centred Practice.

The Idea in a Nutshell Understanding what is causing the problem, and who must do what and when they must do it, in order to solve it.

The idea in summary TCP is a highly structured and disciplined way of helping people overcome problems. It involves working with people to reach an agreed understanding of their problems and to generate and implement strategies to overcome them. This takes place over an agreed period of time and uses an agreed number of meetings.

The idea in more depth The task-centred model is probably the most widely claimed model within social work in the UK. It is specifically designed to be short-term and focuses on solving the problems that exist in the interactions between people and their environments. While these problems may be considered a normal part of life in social living they fall into the remit of social work when the problems seriously affect peopleâ&#x20AC;&#x2122;s well-being or pose a risk to the person or others around the person. What is most distinctive about TCP is that it is time-limited and focuses on developing workable definitions of problems that lead to specific actions taken to solve the problem. When it is done well TCP is a very respectful and anti -oppressive way of working. This is because well done TCP is very person centred; it empowers individuals to define their problems in ways that work for them and to generate solutions that are individually and

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culturally specific. TCP is not based on any specific notion of ‘normality’. Finally the TCP model easily incorporates the problems of racism, sexism, homophobia and social injustice into the model. TCP consists of three distinct phases.

Initial phase - The initial phase focuses on agreeing the basis for the work and on creating a useful definition of the problem. It generally takes one or two meetings, but in more complex situations this phase might last significantly longer. The most important feature of the initial phase is the creation of a collaborative working relationship based upon person-centred values. This phase ends with the completion of a contract that sets out the tasks in terms of who will do what, when and how. It will also give dates to meet to review progress and an end date.

Middle Phase - The middle phase begins with the signing of the contract. It then focuses on the reviewing of tasks and changes in the problem. The definition of the problem may change in the light of information obtained in this phase. Equally, the appropriateness of tasks will change as the results of reviewing the tasks already undertaken. It is important to remember that it is normal for obstacles to arise when undertaking tasks. Some of these obstacles can be built into the plan; some will need to be accepted as normal parts of life; others will be more serious. In the latter case other approaches will need to be used. At each meeting the question ‘are we closer to termination’ needs to be asked. The importance of the end date must not be lost. In general 2 to 8 sessions are given to the middle phase.

Termination Phase - In many ways the termination phase has been structuring the work through previous phases. However it is usual for a final session to be devoted to reviewing the lessons learned from work undertaken. This termination session focuses on issues around managing without support and relapse prevention. Having briefly explained these three phases it is possible to look at each one in more detail. This will give a clearer understanding of how the model works.

Initial Phase The initial phase itself has a number of stages. While these are not rigid, the stages will generally include the following.

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Stage One – Rapport and Mandate Stage Two – Problem Exploration Stage Three – Selection and Prioritising of Targets Stage Four – Problem Modelling Stage Five – Goal Setting Stage Six – Contract making

Stage One – Rapport and Mandate It is essential at the start of the work to explain what you are doing there. If the person has been referred to your service you need to explain why they have been referred and why you are meeting with them. If the person has referred themselves to your service you need to explain what your service does. In either case it is common for people to have mixed feelings about you being there. As a result you must show a high degree of empathy. You will need to listen to their views on what they think you are doing there and what they expect you to do. By using active listening it is usually possible to build rapport and develop a collaborative relationship. It is important to establish your mandate, what is the basis for you being there. If you are there under a statutory duty, such as child protection or mental health, then you need to be clear about this. People do not have to like you being there but they do have to agree that you have a mandate to work with them. In cases where people self-refer this mandate comes from the person themselves and the remit of your agency. In both cases you can only proceed in a Task Centred way when this mandate has been accepted. Once a person has accepted the mandate and feels confident that you will listen to them and take them seriously you can move on to the next stage.

Stage Two – Problem Exploration The second stage involves developing a comprehensive list of all the things that are troubling the person. It is extremely helpful at this point to build up a detailed list of all the problems a person has, not just the most obvious ones. This can be done using a brainstorming technique. The aim here is on breadth not depth. It is tempting to focus immediately on the most pressing problem and solve that. While this can sometimes save time, in practice moving too quickly to focus on one problem can mean that progress is hindered by other previously unacknowledged problems. The result is that either progress is slowed or solving one problem only causes other problems to emerge. Once problems have been noted it is possible to focus on the most pressing ones without ignoring other problems.

Stage Three – Selection and Prioritising of Targets It is not uncommon for people to have dozens of areas of life that cause them difficulties and unhappiness. It is impossible to work on all these areas at the same time. It is therefore vital to work out which problems need to be worked on.

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Many problems will simply lie outside the remit of your agency. Where other specialist agencies exist then part of the Task Centred Approach can involve signposting people to those agencies rather than exploring them in detail. Your focus will be on those problems that are most distressing or pressing and fall within the remit of your agency. Simple questions will help identify the priorities for the goals you need to work on. These questions might include: What is worrying you the most? Which things are most likely to have the worst effect on your life? What will get worse if we don’t work on changing things? When a person feels overwhelmed, or the problems are complex, then you might need to begin by asking something like “which problem do you think it will be easiest to solve first?” This should not be used to avoid addressing more complex problems, but to agree to build confidence by working on a smaller part of the problem before tackling more complex areas. In the problem exploration stage you might uncover a whole host of problems. In this stage you want to pick one to three key problems to focus on.

Stage Four – Problem Modelling Having established which problems are the main priorities it is important to build a model of the problem. This should include a detailed description of what the problem is and how it works. This is probably the most complex stage of the entire process. You need to help the person explore the details of the problem in a way that puts the problem into a logical and explicable format. This will need to cover how the problem starts and how the different parts of the problem contribute to the whole. One particular subtle skill in this stage is to help people define problems in a solvable way. For example if the person perceives the problem as being caused by having a genetic predisposition to depression then there is little chance of changing this. People cannot change their genes. However if the problem is phrased as being because the person has a genetic tendency to focus on the negative aspect of any situation and to ignore the positives, then it is much more solvable. This is typical of the kind of problem modelling used in TCP. The worker does not try and argue the person out of seeing depression as being genetic (because maybe it is, and maybe it isn’t) but incorporates this into a model that creates space for change. The person cannot change their genes, but they may be willing to work on changing the way they see things. The model of the problem needs to incorporate as much of the person’s way of seeing the problem as possible. It is built on how they already see the problem. It needs to makes sense to the person. When reviewing the model the person needs to have an emotional and cognitive sense that the model explains why they are having the problems they are having. As mentioned earlier, model making will often include a specific exploration of issues of social injustice. The worker can explore with the person how sexism, racism, poverty, homophobia and other oppressive forces have an influence on the problems they are experiencing. It is important to strike a careful balance. To ignore these factors, to leave them unexplored, is in itself an oppressive practice. If TCP creates the impression that people have problems because of their individual characteristics then you oppress them. On the other hand if you focus only on these, and frame the person as a helpless victim of social forces, then you disempower them. The model needs to include both the oppressive social forces and the individual and social forces that help the person resist these forces.

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Stage Five – Goal Setting The Task Centred Model is focused and time-limited. In order to achieve this it is necessary to use the model developed in the previous stage to agree which problems need to change and in what way they must change. Although this might sound like an obvious stage, it is surprisingly easy to miss this step. Too often it is assumed that everyone agrees what the goal is without it having been stated clearly. Alternatively goals may be stated in too vague a format. For example if the reason for involvement is due to concerns around child protection then we can assume that the goal is for the child to be safe. This is a mistake for two reasons. Firstly, this may not be the most important goal. Sometimes other things need to change before we can hope for a child to be safer. Secondly, as a goal it is far too vague. How will you know that the child is safer? What do you mean by safer? The goal setting stage involves being clear about what you are aiming to change in specific terms. As an example, a goal might be to discover ways to set limits to a child’s refusing to do as they have been asked without shouting or smacking. If this was the goal for a piece of work then it would be important for the model the worker and person had developed covered what was meant by ‘setting limits’ and ‘refusing to do as they were told.’ In general these should have flowed from the conversation and should be the words used by the person and not be the words used by the worker. This goal setting brings us on to the stage where the worker and the person can create the contract.

Stage Six – Contract making The contract should spell out clearly why the worker is involved with the person (the mandate), the areas to be worked on, including the goals, and the time-scales. It should also include how often the worker will meet with the person. The clearer this contract is the more likely the work is to be successful. One important factor in explaining the contract is to ensure that the person understands that there is unlikely to be a single, simple solution to the problems or strategy to reach the goal. There are likely to be multiple small steps and many tasks to be completed between the way things are now and the goals the worker and the person have negotiated. It is often helpful to share the following diagram with the person as a way of explaining this process.

Goal Task Task Task

Task Problem

Figure 19 - Simplified View of TCP Process

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The signing of the contract effective finishes the initial assessment phase of the work and marks the movement to more active intervention in the middle phase.

Middle Phase As with the Initial Phase the Middle Phase involves a number of key stages. Again, it is not intended to be a rigid list but as a general guide to the work. Stage One – Generating possibilities Stage Two – Evaluating options Stage Three – Selecting an intervention Stage Four – Preparation and ‘problem planning’ Stage Five – Implementation Stage Six – Debriefing Stage Seven – Intervention modification Stage Eight – Reviewing progress In general stages one to four will take place within a single session. Stage five occurs between two meetings. Stages six to eight will form the basis of the following session. Each of these stages needs to be explored in more detail.

Stage One – Generating possibilities In many ways this is probably the most challenging point in the entire Task Centred process. If the solution to the problem was simple and obvious, the person would already have done it. Given that the person has not solved the problem you will need to create a range of possible solutions. Again the key technique here is to brainstorm possible solutions. It is important that you give the person a clear introduction to this stage and a rationale for what you will be doing. Something like the following might be useful. “So we are clear on what we think is causing the problems, and what it is we want to change. What I’d like us to do now is to think about what might help. We need to come up with as many possible ways to improve things so we can choose the best one; so what I’d like us to do is to brainstorm as many possible solutions, even if they seem silly or unlikely to work. That way we are more likely to come up with an answer that will work. Does that make sense?” Once the person has agreed to that you can begin this process with some fairly obvious and simple questions, for example “Given what we have talked about so far, do you have any ideas for things we could try that might make a difference?” “As we have been talking what ideas have popped into your mind about how we might tackle this, even if they may seem silly?”

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You can also tap into things the person has done in the past that have helped by asking questions like these. “When things have been bad in the past what have you done that helped?” “Have there been times in the past when you think you’ve handled things well? What did you do then?” “Can you think of a time when you faced a similar problem and managed to deal with it? How did you manage it?” Sometimes you can draw on ideas from people around the person to generate alternative solutions. Sometimes people find it hard to be flexible about their own behaviour, but can imagine other people being more flexible. You can ask questions that tap into this. “If you were to ask your best mate what they think would help you, what would they suggest?” “If Super Nanny (or Tricia) were here, what ideas do you think they would come up with for you?” You can also bring your own ideas into the mix of possible solutions. You need to be careful to introduce them as possibilities and not things you are going to insist on. You can do this by saying things like these. “What some of the other families I have worked with have found helpful is to do X. Does that sound possible?” “Given would we have said about why things are the way they are it sounds like it is worth trying doing X. What do you think?” Finally, if you are working under a statutory mandate you need to be honest about where this constrains your options. For example you might need to say something like. “Given what was said at the Child Protection meeting one of the things we will need to do is to practice walking away when you are angry. Let’s put that on the list.” “From what your doctor was saying we will need to consider changing the medication you have been taking. We can put that on the list of possibilities.” While generating this list of ideas it is important not to rush to evaluation. No ideas or suggestion is rejected at this stage. So if a parent might say something like this. “I could just tie him to the bed.” In almost all cases this will be an abusive option and the temptation is to reject it completely. But in the brainstorming technique this is simply added to the list knowing that it will be evaluated in the next stage. The list of possibilities will usually contain a mixture of ideas that are impractical or inappropriate and some that are very realistic. The next stage involves finding which of these possibilities are worth putting into practice.

Stage Two – Evaluating options Having generated possibilities it is necessary to choose which option you and the service user will put into practice. In the first instances it is possible to reduce the dozen or more conceivable solutions to a handful of practical solutions. The service user may be invited to reject any strategies that they feel are completely impossible, incompatible with their core

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beliefs, are too risky or clearly harmful. This will eliminate from the list any possible solutions that the service use thinks will be impossible or inappropriate. Next the social worker and the person can look at the remaining list and discuss which of the remaining strategies are most likely to bring about the chances the person wants to make. There are a number of key factors to be considered here. Two key ones are whether the service user believes they have the resources, skills or ability to implement the strategy and second how successful they think the strategy is likely to be. In evaluating the options the social worker must note doubts the service user may have about either their own ability to carry out a strategy or the likely effectiveness of a strategy. Sometimes it is important for a service user to practice easier strategies before moving on to more complex ones. At other times it is important to try a few more likely strategies before trying something that seemed unlikely to succeed, but which turns out to solve the problem. The end result of this stage is to create a list of possible strategies and solutions that the person thinks has some possibility of achieving the goal that was agreed in Stage Five of the Initial Phase of the Work. The next stage is to select an intervention.

Stage Three – Selecting an intervention In selecting an intervention it is important to remember Figure 1. Early interventions are not designed to completely solve the problem or reach the goal in a single step, but to be steps on the way to reaching the goals agreed in the initial phase. If the evaluation of options stage has been completed successfully the worker and person will have a clear sense of which strategies are most likely to be successful and which the person feels most confident about completing. Early interventions are more likely to be based on those that the person feels most confident they can carry out. The self-confidence that comes from successfully completing a task is central to the overall effectiveness of TCP, therefore selecting tasks that have a high likelihood of being completed is essential to this phase of the work. The old phrase “You have to be able to walk before you can run” is helpful at this point. The worker can explain this using a metaphor based on something the person can already do; learning to drive, learning to read, or even learning to talk. In each case the person did not suddenly wake up one morning fully able to do that thing. They made lots of mistakes on the way. They learned small, imperfect steps, but they can now do that thing well. The interventions are likely to be similar. As well as self-confidence the person has also to believe that the strategy will have some positive effect. This will generally take one of two forms. In many cases the strategy will be directly related to making the problem less of a problem or bringing the goal a step nearer. However at other times the strategy may be about learning more about how a problem happens or how a problem may be influenced or managed. This is important because it creates an atmosphere where even an ‘unsuccessful’ intervention can give useful information on how to do things better next time. The aim of this stage is to agree one or more possible solutions to be tried. It is possible sometimes to work on two or three possible solutions at the same time. However it is important not to overload the person with too many different tasks to be completed together.

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This phase ends when the worker and the person agree on which possible solutions are to be tried first. It is important not to rush into implementing solutions until the person feels fully prepared. The next stage will address that preparation.

Stage Four – Preparation and ‘problem planning’ The evaluation and selection of a solution will set the general approach to be taken, but they often lack detail. This stage adds specific details to the solution. The worker can begin supporting the person to think about what they will do to solve the problem; when they will do it; how they will do it. This is likely to involve careful mental rehearsal. Although this may seem like a waste of time when the person has already decided what to do, it is worth spending time to carefully prepare. Cognitive Psychology suggests that we use the same parts of our brains thinking about doing something as we do when we actually do it. By imagining carrying out the solution in detail the brain lays down pathways that will be used when carrying them out for real. The more vivid and emotionally real the rehearsal the stronger these pathways will be laid down and the more likely the strategy is to be successful when carried out in practice. In this stage the worker performs the role of a critical friend. They raise potential difficulties and build them into the plan. The aim here is not to undermine the person’s confidence but to prepare them for the fact that the solution may well not go according to the plan. By planning for problems and setbacks the person is less likely to be overwhelmed by them and may well feel confident that they can stay on track even if things do not go according to the plan. An important sign to watch for in this phase is the switch from ‘I’ll try’ to ‘I’ll do it.’ In practice the majority of those who say ‘I’ll try’ don’t do anything. The word ‘try’ is loaded with negativity. As Yoda says in ‘The Empire Strikes Back’, “Do or do not. There is no try.” If a person’s words or non-verbal communication expresses doubt about either the potential helpfulness of the agreed solution or their ability to carry out it is vital not to push ahead but to continue preparing and planning how to overcome difficulties, or even returning to stage three or two to find a more appropriate solutions. Once the person has something that they will do then this is the strategy or strategies that are implemented.

Stage Five – Implementation Ironically this is often the easiest stage, at least easiest for the social worker. Once the worker and the person have decided who will do what, when and how it is simply a case of getting on with it. Three general principles for this phase is that it is fair and reasonable for the person to expect the worker to contribute something as well as the person; that in general the worker should not do things for the person that the person can do for themselves; and that the worker should do less than 50% of the work. In many ways the real work of TCP takes place between meetings rather than in the meetings. It is by doing things on their own that the person’s self-confidence will grow. The key message is that success leads to success. As the person tries different strategies and discovers which ones work for them then they see themselves as having the skills and resources to take control of the situation successfully.

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Although the implementation is vital it is important for the worker and the person to meet to debrief after the implementation.

Stage Six – Debriefing In the debriefing the worker takes the person through what happened. If the solution led to an improvement the worker will help the person explore how and why it worked. This will lead to suggestions for how to keep doing what works or even for how to improve on what has worked. A key goal of the work is to use ideas from attribution theory to enable the person to develop personal causal attributions; that is to see the cause for the success as coming from themselves and not from causes outside the person’s control. It is even more helpful when these causal attributions are permanent (or at least easily repeatable) and pervasive (that is usable in a range of situations). When a strategy has led to an improvement it is important to consider whether the original targets been met; in other words are things good enough for the person to continue without further support from the social worker. Where an intervention has been unsuccessful it is important that the worker does not panic or lose faith in the person or the process. If the Preparation and ‘Problem Planning’ phase was completed successfully the person can first of all be reminded that set-backs are a normal part of making progress and not a sign that things have failed. The worker’s key responsibility in this case is to support the person in turning failing into feedback. When debriefing a service user who has not done the things they said they would do, it may be helpful to offer a validatory comment, for example “I’m sure you had good reasons for not doing what we talked about last time. What did you do instead?” The first part of this sentence assumes that the person did not simply fail to do it, but had reasonable reasons for not doing it. The second part assumes that although the person has not done what was agreed they did do something else. Quite often this spontaneous ‘something else’ contains ideas and strategies which had been missed in the planning phase but which nevertheless are useful ones. It is dangerous to assume that not doing what was planned is the same as not doing anything. There are many occasions where what seemed like a good idea in the planning meeting turned out not to be a good idea in practice. In this case it is common for the person to have done something else and for this something else to have been a useful thing. By exploring what the person did, instead of what they didn’t do, the person might discover important strategies that can be built into the plan. If these came from the service user’s own ideas this means they are more likely to attribute more of the credit of this to themselves. If it turns out that the person simply decided that the idea was too difficult for them, or too unlikely to succeed, then it is important to go back to the earlier stages of this phase and generate, evaluate, select and plan a new intervention. In doing this the lessons learned from what ‘went wrong’ with the previous implementation are helpful. In all cases there are four possible outcomes of the debriefing stage. Firstly, if the strategy has enabled the person to meet their goal you can move to Stage Eight of this Phase, and prepare for termination. Secondly, if a strategy has been highly successful then simply continuing with it is a sensible plan. Thirdly, if the strategy has been unsuccessful then it may be necessary to return to an earlier stage of this phase of the work. Fourthly, if the work has been somewhat successful, but this has been limited or has had unforeseen negative consequences, then the intervention will need to be modified. Debriefing needs to

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be cautiously optimistic, but also it needs to lead to feedback which allows flexible and effective strategies to emerge and grow as plans evolve rather than being about rigidly sticking to a plan. One of the key points of the debriefing stage is that it tests feelings against reality. Someone may ‘feel’ that they have failed or that a strategy didn’t work (probably because they feel frustrated that it didn’t work as well as they’d hoped or guilty because they didn’t use the strategy as often as they’d wanted to) but in the debriefing they discover that the reality is that thinks worked better than they had thought. Human memory is biased and imperfect, so debriefing is a way of reality checking in order to ensure that effective problem solving lessons are learned.

Stage Seven – Intervention modification This stage involves fine-tuning the intervention based upon what has worked and what has not worked. At its simplest it may mean simply confirming that what has been tried has been successful and should be continued. On a more complex level it might mean exploring in detail how the things tried could be modified to make them even more effective or easier to do. A powerful way of doing this is having debriefed the person following a time when they have used a particular strategy then ask them the following question. “Knowing what you know now, if we could rewind the clock to the start of that incident, what would you do differently in that situation?” This encourages the person to think actively about what they have learned, and how this learning can be applied in the future. This is a simple application of the reflective learning cycle which is explored in more detail in Appendix 1. Often we focus on reflective practice as a learning tool to help social workers learn from experience, but we forget that reflection is just as important for helping service users learn from their experiences. As well as improving the strategies that have been tried so far it is also important to remember the overall process as shown in Figure Five – The Social Work Process. Tasks build upon each other and a person may have succeeded in using part of a strategy but still have a number of steps left to go before things have improved enough for the worker to withdraw. It is important to remember that in the debriefing stage people may focus far more on what has not worked and to ignore what has worked. It is often the case that a strategy may have been used successfully numerous times and then on one occasion it did not work. This can lead to someone wanting to abandon or change the strategy. This may be a mistake as it might be more helpful to focus on the times it worked and then repeating it in the light of reflecting on when and how it succeeded rather than modifying i t based on the one time it didn’t work. On other occasions a good idea will simply not work. Some things work for one person, but not for another, or they work in some situations, but not in others. Plans can be modified by fine-tuning the plan (doing it slightly differently) or be modified by changing what you do (doing new things).

Stage Eight – Reviewing progress This is an essential element of TCP. The worker must not lose sight of the time-limited nature of the process. In each meeting the worker must remind the person of how many

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sessions have taken place so far and how many sessions are left. The key question is “How close are we to achieving the things we set out to achieve?” This question will help enhance motivation and keep the work focused. In the TCP model termination is seen as a positive driver for change and not a limiting factor. It prevents a person becoming reliant on the worker and supports them in seeing themselves as a competent, capable person who can and will manage to overcome whatever challenges they are currently facing. To avoid losing focus in the work it is important to keep linking back to the original goals. It is not uncommon for new problems to emerge. If these constitute a genuine crisis it may be more effective for a worker to suspend the TCP and switch to Crisis Intervention to resolve the crisis before switching back to TCP. If it is not a crisis, then the worker may take a Person Centred Approach to listen to the person, but then maintain the focus on the TCP. If this is not done the work is likely to regularly lose focus and become much less effective. In this stage of the work it is also important to ask the question, ‘have things improved enough for the work to stop?’ If done well it is likely that the person will have experienced the work as a positive event in their life. For many different reasons the person may be reluctant to ‘let go’ of the worker, but these feelings should never cloud the fact that the worker has a role and agency goals to achieve. The aim is therefore to complete the work as effectively and as efficiently as possible. In many ways it is the focused attention on reviewing what has been learned so far and what is still to be achieved within the time-limits that most defines the TCP approach, rather than the simple allocation of tasks to different people.

Termination Phase In many ways termination in TCP begins in the first session, when the person and the worker set limits for the total length of work and the number of times that they will meet together. As noted earlier the worker regularly reminds the person of the time limits and the number of sessions left. One of the key mistakes that can be made in TCP is to see the time limits as ambitions rather than fixed points in the work. Occasionally it might be necessary to negotiate a small number of additional meetings, between two and four, but if a worker is regularly taking more sessions than planned this is a possible sign that the process is not being followed well. In the termination stage a number of things will take place. The first is that the worker will review with the person what has worked and why it has worked. The aim is to support the person in seeing that their success has been rooted in things the person has done, things that are under the person’s control, and not matters of chance or coincidence. This is essential as a key aim of TCP is to empower individuals to see themselves as people who have the skills and resources to tackle the challenges of life successfully. In doing this the person is more likely to see the things learned as being useful in the future. This means that when problems do re-emerge the person will be able to solve them without any need for further help. A second key activity in the Termination Phase is relapse prevention. Many problems have a cyclical pattern. It may be unrealistic to expect that after four or five meetings over eight to twelve weeks that all these problems will go away and never return. Relapse Prevention involves exploring with someone the signs they might notice that could indicate that the

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problem is about to re-occur. At the same time a list of things the person will do (including supporters they can call on) when they notice these signs is drawn up. In many ways the presence of such a list may in itself reduce the likelihood that things will break down in the future. Finally, the termination phase should be a time of celebration. At times it might be helpful to give certificates or to write a letter of congratulations to honour the hard work the person has undertaken. Trivial or patronising as these ideas might sound the power of such ‘transitional objects’ should not be underestimated. Certificates, small awards, letters and cards can become physical, tangible reminders to the person that they have had their strengths and resources recognised and validated.

What it’s Not The thing that most often gets mistaken for TCP is the model of problem solving. The reason for this is that all the key elements of problem solving are also parts of TCP. The difference is that not all elements of TCP are in the problem solving approach. As an analogy, consider that all mammals are animals but not all animals are mammals. All TCP is Problem Solving, but not all Problem Solving is TCP. In a problem solving approach a worker identifies what problem needs to be solved. They then work with the person to generate possible solutions. These solutions are evaluated and one or more is chosen to be tried. This is then tried and normally the person feeds back to the worker how they got on. This may sound like TCP. However there is no contract setting; there is no problem modelling; there is no set limits for time. Problem solving can take place in a single meeting: TCP cannot. Another common practice that is mistaken for TCP is when a worker does things for a service user. A key principle of TCP is that it should develop a person self-efficacy. This cannot be done if the worker does things for the person that the person is capable of doing for themselves. In reality this may result in undermining the person’s sense of self-efficacy as it creates the impression that the worker lacks faith in the person to do things for themselves.

Theory Checklist Have you drawn up a contract of work which specifies the goals to be achieved and the time-scales for the work? Have you worked with the person to create a model of what is causing the problem and what needs to change in order to solve it? Have you worked with the person to generate multiple possible solutions; have you evaluated these with the person and selected the solutions to be tried? Have you debriefed after implementing the solutions and modified the interventions in response to the debrief? Do you know when the work will finish and how many meeting you have left?

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Unless you can say ‘yes’ to all these questions you are not using Task Centred Practice, regardless of what other techniques and approaches you use.

Critique of the Theory When critiquing TCP it is important to separate critiques of the model from critiques of its application. As stated earlier, when many social workers say they are using TCP they are only using an abbreviated form of the approach. This does not mean that it is bad practice, or that the work will be ineffective, only that this cannot be counted as TCP. The main criticism of TCP is that it is an individualised model. Implicit in the theory is the assumption that the problems people encounter in their lives are caused by a lack of appropriate problem solving skills. In terms of practice, day-to-day social work practice, this might be helpful and necessary. However it may also be oppressive. Many service users face problems related to structural oppression in its many forms. Racism, sexism, ableism (an ideology that implies that able-bodied people and those without learning difficulties/disabilities are ‘normal’, and that those with disabilities should fit into this normal pattern), homophobia and class oppression are all powerful forces that affect the lives of many service users. If TCP ignores these features it cannot be counted as good practice. It is possible however to incorporate an understanding of oppression into the TCP model. When modelling the problem a social worker can (and I believe should) introduce the idea of power into their understanding. It will often be helpful to support a service user in realising that the difficulties they face are not simply a case of individual failing but are strongly influenced by unjust social arrangements. In the same way a social worker can introduce consciousness raising or political action in its various forms as possible ways to improve the person’s situation when exploring potential solutions. In its original form TCP had a strong patriarchal and oppressive dimension. The model focused on difficulties in role performance and helping people perform the roles expected of them in society. This lead to social workers ‘helping’ women become good wives and mothers. With changes in social work practice in the last thirty years this is less likely to be the case now. While this danger still remains (and will as long as we live in an unequal society) as long as a social worker is aware of and uses Person-Centred theory and AntiDiscriminatory practice this danger is minimised. Another critique that is sometimes levelled at TCP is that of Euro-centric bias. When faced with this challenge it is important to consider what this means. It is hard to identify which aspect of the model is distinctively European in nature. Whilst it is true that the model was developed in North America and Britain, there is nothing in the model that fits the cultural values of those societies more than an African, Asian or South American culture. The model invites service users to develop their own, culturally appropriate models of both the problem and the potential solutions. As long as the model is applied with cultural competence it is hard to identify in what way the model is meaningfully Euro-centric. At the same time badly applied Anti-Oppressive Practice may be effectively Euro-Centric, so we need to focus on making sure they models and theories are applied in culturally appropriate ways rather than see the models as inherently flawed. A further critique is that TCP is less effective with chronic and complex problems. Whilst this is a valid criticism it is also a circular argument. All interventions work better with recent and simpler problems. To say that something is chronic and complex by definition means that interventions will take longer and be less successful. As has been demonstrated, when

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applied in full TCP is a thorough and complex process capable of being applied to a very wide range of problem areas. In reality with complex problems the number of meetings dedicated to the Initial phase and to the first four stages of the Middl e phase is likely to be higher, whilst with chronic problems the number of meetings dedicated to whole of the Middle phase is likely to be higher. However when performed with skill and appropriate social work values TCP is as likely to be effective as any other approach in complex and chronic situations.

Reflection 1) 2) 3) 4)

What struck you in this chapter? How does TCP differ from Problem Solving? Why is TCP so popular with social workers? Many things are called Task Centred Practice when one or more key element is missing. Why do you think this is? 5) How would you have to adjust TCP if you were working with someone who posed a risk to themselves or others? And what could you keep the same?

Recommended Reading Maclean, S. and Harrison, R. (2011) Theory and Practice: a straightforward guide for society work students. Lichfield: Kirwan Maclean Associates. Chapter 45 – “Task Centred Practice” pp241-246 Marsh. P. “Task Centred Practice” in Davis. M. The Blackwell Companion to Social Work: Chichester, Wiley-Blackwell. Pp492-495 Coulshed, V. and Orme, J. (2012) Social Work Practice. Basingstoke: Palgrave Macmillan. Chapter 8 – “Problem Solving Practice” pp152-173 Payne, M. (2014) Modern Social Work Theory. Basingstoke: Palgrave Macmillan. Chapter 5 “Crisis and task-centred practice” pp 127-149 Trevithick, P. (2012) Social Work Skills and Knowledge: a practice handbook. Maidenhead: Open University Press. Appendix 11 – “Task-centred approaches” pp353-356 Teater, B. (2010) Applying Social Work Theories and Methods. Maidenhead: Open University Press. Chapter 11 – “Task-Centred Practice” pp178-195

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Chapter 9 – Crisis Intervention Preparation Think of a time when you have felt unable to cope. What was it about the situation that you found so challenging? How would you define the word ‘crisis’?

Introduction The reality is that if people are managing with life, if their normal coping mechanisms are functioning well, then they don’t see a social worker. It is only when things go wrong, when a person stops coping, that a social worker is likely to be called in. Because crisis is a normal experience for those using social work services Crisis Intervention, along with Task Centred Practice, are two key models that social work can say are ‘home grown’.

The Idea in a Nutshell Crisis is a normal part of life; it is both a challenge and an opportunity.

The idea in summary It is normal for all people to find themselves confronting circumstances in life that they cannot deal with by using their existing coping strategies. When these things are experienced as being intolerable then this may be described as a crisis. When someone is in crisis they experience strong emotional and cognitive distress and disorganisation. Although at the time this may be experienced as catastrophic, in reality crisis generally pass and a more comfortable level returns. Crisis intervention is a process that supports people in crisis and assists them to restore their functioning and potentially to develop more robust skills and coping strategies leaving them is a more secure after the crisis than before.

The idea in more depth Before the introduction of Crisis Intervention there was a tendency to see Crisis as an abnormal experience caused by an underlying psychological problem; for example if someone had an insecure attachment style or an unresolved conflict from childhood. Crisis intervention changed this view by taking a view of crisis as a normal part of human life. For example James and Gilliland define a crisis as “a perception or experiencing of an event or situation as an intolerable difficulty that exceeds the person’s current resources and coping mechanisms.” (2005, p3) The important feature of this definition is that the exact details of the event or situation are irrelevant, it is the experience or perception that determines whether or not it is a crisis. Two individuals may go through the same experience. One of them may experience this as a profound and overwhelming crisis whilst the other sees it as no more than a bump on the journey of life. It is a crisis if the person experiences it as a crisis, otherwise it is just part of life. Caplan, the main originator of Crisis Intervention, noted that there were three main phases that a person would go through when experiencing a crisis. (Caplan, 1965) The first phase

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is the impact phase. In the impact phase the person may be overwhelmed and unable to process what is happening. Feelings may range from powerful and out of control to completely numb. Thoughts may be racing or it may be that the individual is unable to think at all. The second phase is called the recoil phase. At this point the implications of the crisis are becoming obvious. The person is more able to think through what has happened. This will not normally be experienced as a good thing. The person may experience profound changes in how they think about themselves, their life, the world or the future. Old assumptions have been shaken, but a new way of making sense of the world may not yet have emerged. Victor Frankl famously defined despair as suffering without meaning. This is a useful definition of the recoil phase. The suffering of the crisis is fully experienced but meaning has not yet emerged. The third phase is the Adjustment and Adaptation phase. Old assumptions have been either adjusted to take on what was learned in the crisis or they may even have been replaced by completely new assumptions. Crisis intervention recognises two distinct types of crises. The first type of crises are usually called Developmental Crises. These may be seen as the normal stages in life where old ways of behaving have to change to make way for new ways. Typical examples might be puberty, finishing school, having children, and retirement. The second type of crises are called situational crises. This includes all unexpected life events (even predictable unpredictable life events such as the death of someone close). Example of this might include bereavements, illnesses, accidents, the breakdown of a relationship, redundancy or a sudden change in life circumstances Regardless of the exact nature of the crisis, Crisis Intervention endeavours to support people emotionally during the impact phase; to enable them to develop new ways of thinking and behaving during the recoil phase; and to move into the Adjustment and Adaptation phase as quickly and with as little harm as possible .

Theory in Social Work Practice It is important to remember when applying Crisis Intervention in social work practice that the model is a flexible framework and not a rigid checklist. How a social worker approaches the task will depend upon the nature of the crisis and their role. So a social worker in a mental health team might complete the whole Crisis Intervention process with a service user with a mental health crisis, but only parts of it if the crisis related to the protection of children. Equally a child protection social worker might use the whole Crisis Intervention process when the crisis involves the safety of a child, but use the early parts and refer on if the crisis related to mental health. It is extremely unprofessional to take on work that is beyond your competence to deal with. As a result when using Crisis Intervention consider first if you have the role, competence and support to do the work safely. It is helpful to think of Crisis Intervention as proceeding through a number of over-lapping processes. These are rapport building, safety assessment, mutual exploration, psychoeducation, goal setting, resource mobilisation and evaluation. As stated earlier these are not rigid. There is no single, fixed and absolute rule as to what must be included or how these processes must be carried out. Different writers and different practitioners will use slightly different names for these stages or do them in slightly different ways. However the

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key goals are always the same, to create realistic perceptions of the crisis, to mobilise effective coping strategies and to connect the person with an appropriate support network. (Aguilera and Messick, 1994) It is important to understand each of these processes and see how they fit together.

Rapport building Rapport building involves developing an empathic understanding of the person’s experience. This requires the worker to use the Person-Centred theory and active listening to support the person in telling their story. The key aim here is to allow the person to express their feelings and have them validated in an atmosphere of non-judgemental acceptance. A key feature of being in crisis is that one feels in chaos. Simply having someone listen to you can allow the feelings to be expressed and processed. The worker effectively ‘contains’ the persons emotions by hearing them, taking them on board, but not being over-whelmed by them. This effectively detoxifies powerful distressing emotions and makes them more manageable.

Safety assessment While many crises are unlikely to have immediate or long-term risks some do. If the crisis contains the possibility of serious negative consequences, such as suicide, self-harm, a danger to self or others, or a long-term negative effect on the person’s well-being the worker will need to carry out a safety assessment. This will mean that the worker must follow up any indications of risk. Although new workers find this uncomfortable and may even believe it to be inappropriate, it is a good idea to ask about specific risks such as self-harm or suicide. This can be done using words similar to this. “A lot of people find that when they are faced with the things you have been faced with they think of harming or killing themselves. This is more common than most people think. Have you had thoughts like that?” This allows the person to share thoughts and feelings that they have felt very scared to share. If they have not had these thoughts then asking about them will not trigger such thoughts. However many people who have had these feelings will not share them unless specifically asked. It is also helpful to ask the question, “what is it in this situation that most scares you? What is the worst that could happen?” Again this gets unnamed fears out in the open. At times this may be enough to reassure the person that their fears are unrealistic. If however their fears are realistic it is important to build safety into the system. Safety assessments mean balancing risks with strategies to manage those risks in the most effective way. Life is inherently risky. To completely eliminate risks is to cut ourselves off from many of the positive things in life. For example SCIE have noted that in work with lesbian, gay and bisexual adults with learning difficulties, workers often focus on the risks and dangers of the person being sexually exploited but fail to explore how those dangers may be managed whilst still allowing the person to express their sexuality in ways that most enhances their well-being. (SCIE, 2011)

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In general it will be possible to balance the risks a person in crisis faces with the strategies to manage those risks safely. Where it is not possible, the work might need to be suspended whilst the person is assessed or further enquiries are made into the situation. If the situation has enough safety it is important to explore with the person how they see the situation and what they think needs to happen in order to get their life back on track.

Mutual exploration The mutual exploration stage of the work is identical to that in the Problem Modelling phase of Task-Centred Practice (TCP). The worker may draw on a range of theories to do this stage well. For example Person-Centred theory will set the overall tone for the exploration. Understanding of communication theory, for example using the Meta-Model for NLP will help develop precise understandings of the person’s works. Cognitive theory might help see the links between what the person says and how their feeling and why they act the way they do.

Psycho-education One of the main differences between Crisis Intervention and TCP comes from the use of Psycho-education. Whilst mutual modelling of the problem will help establish and maintain rapport it does not necessarily give the person new ways of seeing things; psychoeducation does. Psycho-education is a process whereby a person is provided with information from psychological research to make sense of their situation, thoughts, feelings or behaviour. The main benefit of psycho-education is that it normalise things that otherwise might seem bizarre or frightening. In this book it is impossible to give a complete list of areas of knowledge that can be useful for psycho-education. For someone who has experienced bereavement Kübler-Ross’s ‘five stages of grieving can be very helpful. (Kübler-Ross, 2005) More generally the bio-psychosocial model can be a useful tool for linking people’s biological well-being (including diet, sleep hygiene, pain levels, and exercise), their social well-being (including stressful and supportive relationships, social oppression and complex social systems) and their psychological well-being (including thoughts, feelings and behaviour). Understanding of both Attribution theory and the cognitive theory of trauma can help normalise experiences that may be troubling someone in crisis despite in fact being quite normal. In general in psycho-education it is best to avoid describing things as ‘normal’. On a statistical level a specific reaction to a crisis may be normal, in that more than fifty percent of people who have had that experience will have that reaction. However the one thing it does not feel like to the person concerned is ‘normal’. In such cases it may be far safer to describe the reaction as ‘natural’ rather than normal. One of the key effective elements of Crisis Intervention is that what seems scary or abnormal to the person makes perfect sense to the worker.

Goal setting In general the shift from rapport building, safety assessment, mutual exploration and psycho-education to goal setting is likely to be significant in the work. These earlier stages are essential for building a solid base for the work to succeed. These processes may overlap and may be completed with someone still in the impact phase of a crisis. Goal setting is only likely to be appropriate once this has been successfully completed and when the

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person has moved from the impact phase to the recoil phase and is at least minimally able to see the possibility of getting to the adjustment and adaption phase. The goal setting process acknowledges that the crisis has happened and that it is likely that the person’s sense of themselves and their life will have, in some way, changed permanently. Having acknowledged that, the key question becomes, how will things need to be different in the future for the person to feel that things are now ‘good enough’. In terms of goal setting the start point are questions like, “what will need to be different in order for you to feel that your life is back on track?” or “how would you like to think, feel or behave differently from the way you are now?” Another key goal setting word is “instead”. If the person is locked into their current ways of seeing life; their current feelings; their current behaviour patterns; it is possible to simply ask, “What would you like instead?” These questions are designed to help the person think in concrete terms about the things that they would like to change. It is important to state them in terms of positive, or presences, and not in terms of negative or absences. Instead of having a goal of ‘not feeling sad’ the goal could be phrased something like, ‘I will feel happy more often than I feel sad.’ Instead of ‘I won’t be crying all the time’ it could be phrases ‘when I think about X I will remember the good times we had and know that X would want me to get on with life.’ Negatives and absences are hard to assess and tend not to lead to motivation. Progress towards goals is stated as what the person will do, think or feel rather than what they won’t are better. This is because progress towards these goals is easier to recognise and so tends to be more motivating. When it comes to goal setting in a crisis situation the CIA model of stress reduction is very helpful. (Thompson, 2006a) This has nothing to do with the American CIA. The initials stand for Control, Influence and Accept. The basic idea is that in any situation in life there are certain factors that we can control. These control factors should be the main focus on our goal setting. Other factors we cannot control, but we can influence. Finally some things we just have to accept. This model can be shared with someone in crisis as part of the goal setting work. For example a person may be encouraged to see that they can control whether or not they take some daily exercise (something known to promote psychological and physical well-being), they may be able to influence the way a colleague at work talks to them, and they will need to accept that events in the past cannot be changed. The key purpose of the goal setting stage of the work is to create a plan that will enable the person to mobilise their resources to achieve their goals.

Resource mobilisation When talking about resources Crisis Intervention does not just mean a person’s material resources, money, possessions etc. Resources are the total sum of the emotional, psychological, social, spiritual, physical and behavioural things that a person can draw upon to achieve their goals. In many ways this is very similar to the Middle Phase of TaskCentred Practice. Much the same questions will be asked in much the same order. However special attention will be paid to two specific areas of problem solving and resource mobilisation within the Crisis Intervention model. The first is that the worker is likely to give even more attention to previous coping strategies. The definition of a crisis given earlier was “a perception or experiencing of an event or situation as an intolerable difficulty that exceeds the person’s current resources

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and coping mechanisms.” (James and Gilliland, 2005, p3) One very common effect of experiencing a crisis is that the person also temporarily loses their connection to previous resources and coping mechanisms. Often a worker can quickly and easily reconnect the person to these by asking a question like, “When you have faced difficulties in the past what did you do then that helped you cope?” Simply reminding the person that they are a competent human being with a wide range of effective strategies to cope with the challenges of life can make a huge difference to how someone feels when they are in crisis. This needs to be done in a Person-Centred way otherwise it can come across as patronising and harm the relationship. When done with a deep respect for the person’s value and worth as a person it can be incredibly helpful. These past coping mechanisms can be explored in depth. What the person did, how they did it, what effect it had and how they can apply it now are all fruitful lines of enquiry with the person. The key point is that any utilising existing strategies is always easier and more effective than trying to generate completely new ones. The second area that is more likely to be given prominence in the Crisis Intervention than in the Task-Centred model is the role of the social network. Crisis Intervention draws heavily upon an Ecological-Systemic model of human experience. In understanding the way a person experiences a crisis the roles of family, friends, and neighbours are important. For many people a crisis may also raise issues of the meaning of life and values. Core beliefs about spirituality, politics and purpose are often heightened by a crisis. Drawing on people who have a key role in this area, such as members of a person’s faith community, can be extremely important. On a more practical level bringing family, friends and neighbours in to the work can reduce the sense of loneliness and isolation that often accompany a crisis. As mentioned earlier physical exercise is linked to well-being, so also is the act of conversations with people who care about us as a person. As with Task-Centred Practice a key to the success of this stage of the work is what the person does after they meet with the worker. It is not the conversation between the worker and the person that makes a difference, it is the actions that this leads to that counts. Gently and compassionately the worker aims to create a safe space where the person can feel emotionally supported and then to use this safe space to plan and prepare to take action. Once this action has been taken the final part of the Crisis Intervention process is to review and evaluate.

Review and evaluation When the worker and the person meet again it is important to ask about what has been tried and what the results have been. This needs to acknowledge thoughts, feelings and behaviour. As with Task-Centred Practice the key goals of this phase are to encourage the person to internalise the credit for what has gone well and to learn and apply the lessons from what has not gone well. It will often be necessary to remind someone that progress is a case of ‘three steps forward, two steps back.’ Progress is rarely a smooth path from the way things are now to the way the person would like them to be. By normalising these set-backs the worker prevents the person from falling into the trap of despair when things go wrong, as they inevitably will. Even in the most disastrous of set-backs there will also be things that did not

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go as badly as they could have done, and things that give important information on how to do better next time. It is important that the worker calmly and supportively explores these with the person. When things have improved key questions will be things like “How did you do that?” and “What does that say about you?” These questions are designed to help the person make internal, permanent and pervasive attributions of the causes of the improvement. The worker must not try and impose this meaning on the person, but allow the person to reach this conclusion for themselves. If the person sees the reason that things improved as stemming from the type of person they are (strong, resourceful, creative, competent, caring etc) rather than from the actions of others or mere chance, then the chance of sustained improvement is greatly enhanced. The aim of Crisis Intervention is to keep the intervention as brief as is possible. Unlike Task Centred Practice CI rarely has a time-limit imposed on it from the start. This is because people cannot resolve a crisis according to a timetable. However CI does have a strong sense of ‘enough is enough’. If someone comes in crisis, meets with the worker, explores the crisis and mobilises their resources and then feels ready to carry on without the worker then the work is complete. Enough has been done and the work stops. At each subsequent meeting the worker begins with the assumption that this meeting might be the last one. For effective and efficient CI the worker will ask in the review session a question like, “do you think you have resolved things well enough to carry on with your life?” This helps avoid the work drifting or the person starting to become dependent on the worker. In the same way if the work continues for three or four meetings with no discerni ble progress then it is important to acknowledge this. It may be necessary to return to the goal setting stage or to review the CIA Model, as the person may be trying to control things that are beyond their ability to control. If so then the worker may need to negotiate a goal of acceptance rather than change. In an ideal world it will be the person who determines when enough is enough, but in practice when the worker and the person have agreed that the person is now experiencing the situation as being manageable the work will generally stop.

What it’s not The most important thing CI is not is rescuing people. This is one of the biggest mistakes workers make in social work practice. When someone is in crisis, when someone is distressed, it is normal to want to help them, to reduce their distress. But as soon as a worker gets into the role of ‘rescuer’ they immediately communicate the message that they do not believe that the person has the ability to manage the situation themselves. Although this may immediately reduce the distress level of the person (and make the worker feel better about themselves) in reality it is likely to undermine the person’s self-belief and so lead to increased ‘learned helplessness’. (Peterson et. al., 1996) When using CI the worker does not do anything for the person that the person can do for themselves. This does not mean that the worker will not help and support the person, especially in the impact phase of a crisis, but only that direct help is limited to what the person cannot do for themselves. At times it is possible to slightly ‘bend’ this rule. If someone in crisis has set a plan that involves a number of different tasks then it is sometimes possible to say something like. “You are doing A, B, C and D. That is going to take quite a bit of time. So while you are doing those things I will do E and F, and when we meet next week we’ll see how we’ve got

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on.” Here, rather than rescuing the person the worker is dividing up the jobs to be done and ‘sharing the load’. When done in negotiation with the person this is likely to be experienced as empathically supportive and not from any lack of confidence in the person’s own ability. CI is also not a simplistic, quick-fix approach to problems. Whilst it can, and often does, help resolve complex crises in a relatively short period of time it takes time and skill to do well. To be maximally effective the worker must have a thorough and evidenced based knowledge of the area in which they are working. They must also know when to refer on to other services as the crisis is outside their area of expertise. At the same time the worker must not refer on too quickly. The general model of CI is applicable to any crisis. Most of the stages will be the same and any worker competent in the use of the model can use it to contain a crisis until they can refer on. This will avoid leaving the person with a feeling that they are being referred on as the worker ‘doesn’t want them’.

Theory Checklist Does the person perceive current events as being beyond their current coping mechanisms? Has the worker actively listened to the person and validated their perceptions and feelings about their life? Has the worker normalised the thoughts and feelings as being a natural response to a crisis? Has the worker collaborated with the person to mobilise resources to enable the person to be in control of their life again? Unless you can say ‘yes’ to all these questions you are not using Crisis Intervention, regardless of what other techniques and approaches you use.

Critique of the theory The most important critique of Crisis Intervention is that it is built upon an entirely individual definition of crisis. By seeing ‘crisis’ as rooted in the experience of individuals and their perceptions it is easy to ignore the role of social inequality and oppression in shaping people’s lives. Many crises are not the result of individual’s coping mechanisms or perceptions, but of the structural power imbalance in society. As with Task-Centred practice it is essential that a worker incorporates elements of human rights and social justice into their practice. (IASSW, 2001) When using CI a worker must also be aware of the need to incorporate Anti-Discriminatory Practice into the model. (Thompson, 2006b) As with Task-Centred Practice, CI might also be critiqued for being Euro-Centric. A model cannot be accused of being Euro-centric purely on the basis of where the model originated. The question must be asked ‘is there anything inherent in the model that would be culturally inappropriate for someone from a non-European culture. For CI there is some validity in this critique as the model rests upon an individual definition of crisis. For many African, Asian or South American cultures crisis may need to be understood in a more collective and social embedded sense than those who come from more individualistic cultures. However the assumption that the concept of crisis or Crisis Intervention as an

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approach would automatically be inappropriate for someone from a more collectivist culture seems hard to sustain. To sustain this view it requires that those from different cultures possess such a different experience of life that they lack a sense of life presenting challenges beyond their current coping strategies. This creates the danger of seeing others as so ‘alien’ that workers from a different culture cannot understand their way of experiencing life. An acceptance of the idea of common humanity, human rights and social justice are embedded in notions of the universal humanity, that all people have the same rights with no preference given on grounds of perceived race, class, gender, culture or nationality. CI needs to be implemented with a clear regard for the unique cultural background of each person. The worker must show great respect for the way that both the concept of crisis and of resources are embedded in a specific cultural and social setting as well as having individual meaning.

Reflection 1) 2) 3) 4) 5)

What struck you in this chapter? How do you respond to the idea that a time of crisis is also a time for growth? When working with someone in crisis, how will you keep yourself calm? What crises to you think will be hardest to help someone deal with? What is the most important thing you can do with someone in crisis?

Recommended Reading Maclean, S. and Harrison, R. (2011) Theory and Practice: a straightforward guide for society work students. Lichfield: Kirwan Maclean Associates. Chapter 44 – “Crisis Intervention” pp237-240 Skinner, J. (2013) “Crisis Theory” in in Davis. M. The Blackwell Companion to Social Work: Chichester, Wiley-Blackwell. Pp428-431 Coulshed, V. and Orme, J. (2012) Social Work Practice. Basingstoke: Palgrave Macmillan. Chapter 7 – “Crisis Intervention” pp128-151 Payne, M. (2014) Modern Social Work Theory. Basingstoke: Palgrave Macmillan. Chapter 5 “Crisis and task-centred practice” pp 127-149 Trevithick, P. (2012) Social Work Skills and Knowledge: a practice handbook. Maidenhead: Open University Press. Appendix 3 – “Crisis Intervention” pp319-322 Teater, B. (2010) Applying Social Work Theories and Methods. Maidenhead: Open University Press. Chapter 12 – “Crisis Intervention” pp196-211

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Chapter 10 – Ecological-Systemic Theory Preparation Imagine you had been born 100 years ago or 4000 miles from where you were born, how might your life have been different? In what sense would ‘you’ still be the ‘you’ you are now? Think about the last time you got involved in an argument, a proper, inter-personal argument. Who caused it? What other factors led up to the argument? If you had been somewhere else, or with other people, how would the argument have been different?

Introduction For the last 400 years much Western scientific thought has been based on the model of ‘linear causality’, A causes B, which causes C. This type of thinking was effective when getting the Industrial Revolution going, but it does not reflect the thinking in much of the world, nor does it reflect more recent Western thinking. Many Eastern philosophies have been much more comfortable with the idea of circular causality, that A causes B which cause A which causes B and so on. This type of thinking forms the basis of Ecological-Systemic theory.

The Idea in a Nutshell The whole system cannot be explained by understanding the individual parts that make it up.

The idea in summary The world is made up of a practically infinite number of different things, from the smallest sub-atomic particle to entire universes. The different parts of the world fit together in a series of systems. Sub-atomic particles fit together in systems called atoms. Atoms fit together in the system called molecules. Molecules make up the system called matter. Matter arranges itself in many different forms. Some of these are inanimate systems, such as mountains, rivers, the atmosphere. Others form living systems. Living systems themselves can be broken down in sub-systems of organs; which in turn are made up of systems called tissues. These themselves are composed of cells. Cells are systems of organelles which allow the cells to function. Organelles are composed of molecules and atoms. The key point here is that it is impossible to describe the behaviour of organelles based simply on what we know about atoms. Understanding cells cannot be explained purely in terms of how organelles function. So we cannot explain the behaviour of the whole system by explaining the behaviour of the sub-systems. According to Ecological-Systemic theory societies, cultures, families and people are all sets of inter-related sub-systems. The types of explanation used at each level are different, and changes in any sub-system have the capacity to ripple through all the levels of the whole system.

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The idea in more depth From an Ecological-Systemic perspective what we think of as ‘a person’ is a complex set of systems that maintain a sense of being a whole system. There are biological systems. These include a person’s organs, their hormones, their brain, their body. A change in any of these will tend to affect the whole person. The person also has a complex psychological system. This includes their memories, their thoughts and beliefs. These two sub-systems may compose a large part of what we mean by being a person, but they are not the whole story. No person lives in isolation. People relate to those close to them. People have family systems, friendship systems, neighbourhood systems, school or work systems. You cannot understand a person without understanding how their personal biological and psychological sub-systems connect to all their social sub-systems. The behaviour of these groups cannot be explained purely in terms of the people who make them up. Shared meanings, shared signs and group norms tend to exert a more powerful influence on the social system than the beliefs of any one individual, or even the average of all the individuals in a group. A person’s individual sub-cultures are themselves embedded in a wider set of cultural and social systems. For example the way that individuals construct their sense of gender identity is linked to, but different from, the ways that families, sub-cultures or society construct gender. It is possible to apply an Ecological System frame to consider any issue of human behaviour and social systems. The issue of depression will be considered as an example. At an individual biological system level there is evidence that depression is correlated with low serotonin levels. Depression is also commonly found where people have had serious brain injuries. Depression affects sleep patterns. Depression rates increase if people have close relatives who are depressed, and the closer the person is related genetically the higher this increase. So the evidence for biological factors is high. At an individual psychological system level there is evidence that certain patterns of thought increase the risk of depression. Those who engage in persistent negative thought patterns are more prone to depression, experience deeper depressions that last longer and are more likely to relapse.

Biological System

Psychological System

However none of this explains why depression rates can shift with changes in social environments around a person. Figure 20 - The Individual System Certain life events, such as bereavements, losing a job, major life transitions etc are all associated with an increased risk of depression. While individual factors may influence and be influenced by these factors, a different level of explanation is required. It is unethical to explain depression in a woman who is being abused by her partner in terms of the woman’s individual biology and psychology. An understanding of depression must also take into account the ways that oppressive social systems can and do impact on the lives of individuals. Even this level of explanation only makes sense of an individual’s experience of depression in the light of their wider life experience. This by itself cannot make sense of wider changes

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in depression rates. For example between 1988 and 1992 the central-western United States had a male suicide rate that was roughly double that for the eastern United States. In the same way the evidence for a significant rise in depression rates over the past hundred years is strong. Changes in society at a wider level therefore also influence the likelihood that a person will experience depression.

Family System

Community System Individual System

Cultural Figure 21 - Neighbourhood/Cultural System

The systems way of thinking sees different levels of systems being embedded within ever wider systems. This can be presented in diagram form, beginning with the individual system moving to the wider Neighbourhood/ Cultural System. And then moving on to look at the wider National and even International context.

The important thing to note is that while each level of systems affects the levels above and below, explanations only work at one level. International Systems cannot be explained purely in terms of the behaviour of individual nations. Nations cannot be understood solely in terms of the cultures that make them up. People cannot be understood purely in terms of either their individual make-up or their social context. It is only when the complex web of relationships within and between levels is accounted for that any system can begin to be fully understood.

National System

International System

Figure 22 - National and International System

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Theory in Social Work Practice Ecological Systemic theory can be used at every stage of the social work process. Beginning with engagement, it is important for social workers to recognise that rather than engaging with individual service users purely as individuals a social worker engages with a person who is embedded in a series of social relationships. When a social worker is working with a person who is a parent they must not only engage with them as a person, but also as a parent-child system. Equally when working with children, social workers must realise that to engage with the child without engaging with the child-parent/carer system is likely to cause problems. There is a careful balance to be struck here. Person-Centred theory will mean that we focus on individuals as individuals, Systems theory means we will engage with people as parts of many systems. It is however quite possible to incorporate Systems thinking within Person Centred work and Person Centred thinking within Systems work. Simply being aware that an individualâ&#x20AC;&#x2122;s behaviour can and will be influenced by the systems around them and empathically showing this awareness to the service user will help with engagement. Many frameworks for assessment explicitly use a Systems way of thinking. One of the most widely used is the Department for Health/Department for Education and Employment/Home Office (2000) Assessment Triangle.

Figure 23 - Assessment Triangle This model sees the child and their developmental needs as one system, the parents and their capacity as another, and the wider family and community as another. By encouraging social workers to account for all of these systems in their assessment, and to look at the

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interaction between them, the Triangle produces a much more rounded assessment than one that focuses on one element or on the elements separately. It is common for social workers to use genograms or sociograms as part of their work. This can form an excellent tool for incorporating system thinking into the assessment. However, doing a genogram alone is not enough to make a piece of work ‘systemic’. It is only when this is used to map the complex relationships between different systems and parts of systems that the work becomes systemic. In terms of planning, an Ecological-Systemic perspective can help social workers focus their thoughts on areas that are most likely to lead to successful change. A key theme of systems thinking is that change in any one area is likely to lead to change in other areas. If a person has an acute mental health difficulty they may temporarily not be able to muster the resources to change. In such an event mobilising the family, the social support networks and the professional systems might lead to more productive change for the person than insisting that they must be the ones to change. In a similar way, systems thinking makes it clear that neither a child nor a parent is ‘to blame’ for a child’s behaviour problem, but it is likely that the parents will have the greatest capacity to change in ways that might alleviate those problems. This is also true for interventions. Systems theory allows social workers to choose different potential solutions to work at different levels. Where a person has serious financial problems then a worker may choose to focus on individual budgeting. However if a key part of those problems is caused by excessive heating bills due to poor insulation in the flats they live in then it might be more effective to tackle this at a community level by supporting tenants in carrying out a rent strike or lobbying a local council for better insulation. Finally, systems thinking can be used in social work practice in evaluating work. Instead of focusing purely on whether or not an individual person has changed a social worker can track changes in the individual person and in the relationships around the person. This is likely to show a much more accurate picture of what effect the social work intervention has had.

What it’s not Ecological-Systems theory is not the same as completing the assessment triangle or a genogram. Whilst both of these are compatible with systems thinking, it is possible to complete both of these in a very ‘non-systems’ way. It is only when the thinking uses different modes of thinking at different levels AND explores the relationship between levels that it is likely to be systemic. Systems thinking is not simple, easy or superficial. To understand and apply the theory well requires a high degree of skill and knowledge. While in many ways it can be applied in a relatively simple and understandable way in reality this is only likely to be helpful when this is integrated with other theories and models.

Theory Checklist Is the person seen in the context of a complex web of systems? Are different explanatory frameworks used for different levels of systems? Is influence seen as bi-directional (the large systems affect the smaller ones, but the smaller ones also affect the larger ones)?

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Unless you can say ‘yes’ to all these questions you are not using Ecological-Systems theory, regardless of what other techniques and approaches you use.

Critique of the theory One of the biggest critiques of the model is that it was originally developed in the physical sciences to look at the way mechanical and biological systems work. There are serious dangers in uncritically applying models from this field into the field of human behaviour and social systems. People are more complex than machines. People also bring their own thoughts and theories to the mix. When using an Ecological-Systemic framework it is important for social workers to remember that the meaning of systems and the relationship between systems is not a fixed and absolute quality of the external world, but is something that service users and social workers construct together through their communication. There is also a Feminist critique of Ecological-System theory. Whilst the model focuses on the inter-relationships between different parts of a system this often ignores the way that power may be used and abused. At one point a systemic understanding of child sexual abuse focused on the role of the adult sub-system of the family. The argument was put forward that one of the functions of the adult sub-system was to meet each other’s sexual ‘needs’. If one partner (usually a woman) did not meet the sexual ‘needs’ of the other (usually a man) then the second partner would seek an alternative source for their sexual ‘needs’ by abusing the children. In effect this shifted the blame from men as the main perpetrators of sexual abuse within a patriarchal power system, to women for ‘failing’ to meet men’s needs. This reading of sexual abuse served to perpetuate male power. This can be seen as less of a criticism of the theory as a whole and more a criticism of how the theory is used in practice. There are many of ways of using systems thinking to open up debates about the way that different models of oppression operate at different levels of systems. The International and National structures that reinforce male privilege are supported by and support cultural practices that promote male privilege. These are supported by and support individual ways of thinking and relating that work to oppress women in a patriarchal society. Thompson’s PCS model shows how this systems level thinking can be applied to all forms of discrimination and oppression in societies where power is unequally distributed between different parts of the social system. Another criticism sometimes made against the Ecological-Systems theory is that of a Eurocentric bias. This may relate to its more deterministic forms and that it originally developed in an American/Western European context. In many ways this criticism does not do justice to the model. Systems thinking actively rejects the linear causal thinking that has characterised much of post-Enlightenment thinking in Europe. It is much closer to a Buddhist way of thinking were cause and effect are seen as more illusions than a reality. It is also closer to the African concept of Ubuntu rather than something like Maslow’s concept of ‘self-actualisation’. Although Systems thinking is widely claimed in social work practice the reality is that the complete model has such a high degree of complexity that it is normally implemented in a relatively superficial way. As stated earlier this is why the model is most likely to be incorporated into a range of theories and models that help workers tailor an intervention to the unique circumstances of the service user.

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Reflection 1) What struck you most in this chapter? 2) Do you recognise how easy it is to focus only on the personal level and so miss the wider systems level? 3) How could you incorporate systems thinking into thinking about your own situation and that of those around you? 4) How might this theory apply in social work practice?

Recommended Reading Maclean, S. and Harrison, R. (2011) Theory and Practice: a straightforward guide for society work students. Lichfield: Kirwan Maclean Associates. Chapter 42 – “Systems theory” pp223230 Smeeton, J. “Systems Approaches” in Davis. M. The Blackwell Companion to Social Work: Chichester, Wiley-Blackwell. Pp499-491 Trevithick, P. (2012) Social Work Skills and Knowledge: a practice handbook. Maidenhead: Open University Press. Appendix 4 – “Ecological approach in social work” pp323-328 Teater, B. (2010) Applying Social Work Theories and Methods. Maidenhead: Open University Press. Chapter 2 – “Social Systems theory and the ecological perspective.” Pp16-37

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Chapter 11 – Theory and Evidence Informed Practice Preparation Imagine a situation where a social worker and a service user are about to meet for the first time. Be specific, imagine the reasons they will meet, imagine the service the social worker is part of, and imagine where they will meet. What will happen when they meet? Why will it happen? Why will the social worker be meeting the person? Why will the person need to see a social worker? Why will the social worker do what they will do?

Introduction It is impossible for a social worker to operate without using theories. The question is not ‘do I use theory?’ but ‘what theories are guiding my thinking and actions?’ In the first chapter I talked about theories as being the ways in which we make sense of experience, the ways we explain things, and the principles that guide our actions. Those things will exist whether we are aware of them or not. One of the most dangerous claims a social worker can make is that they do not use theory. If you ever hear this you can be sure that the person uses theories, but is unaware of which ones they use or how well or badly they are using them. Many theories take the form of maxims – ‘the leopard cannot change its spots’ or ‘blood is thicker than water’ both contain deeply theoretical views that can be applied in social work, sometimes helpfully but quite often dangerously inappropriately. In order to practice ethically and effectively we need to be aware of the theories that underpin our practice.

Using Theories Forwards and Backwards There are two very different ways in which a social worker may use theory. I have called these using theory forward and using theory backwards. At times a social worker will devise a plan that is based around a given theory. An example of using theory forward A social worker is meeting with a parent who is experiencing a deep episode of depression and is feeling they are a failure as a parent. The social worker is familiar with the cognitive theory of depression and so patiently helps the parent notice all the negative thoughts they have about their parenting and the effects these thoughts have on their mood and behaviour. The social worker then helps the person gather evidence for and against the critical thoughts about their parenting and helps them develop new, more balanced thoughts and uses these whenever the critical thoughts arise. In this example the social worker is consciously and competently using a theory to plan their work. They are fully aware what they are doing and are using it in a very deliberate way from assessment, to planning, to implementation, to review and evaluation. This is what I call ‘using theory forwards’.

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But quite often a social worker is thrown into a situation and has to react to what they see and hear going on in front of them. They need to adapt their approach and be flexible in how to respond to a person in need. As they are doing this they may be completely unaware of why they are doing what they are doing, they are either simply ‘doing their stuff’ or else improvising in response to the unexpected. Once they are out of the situation however they are likely to be able to reflect upon why they did what they did and recognise that although they were not aware of it at the time, their practice was guided by theory. This is what I call ‘using theory backwards’. An Example of Using Theory Backwards A social worker is doing a home visit to carry out a routine review of services. When they arrive at the house the service user is distraught. They have just had confirmation that their medical condition has worsened and the prognosis is that they will die within the next 12 to 18 weeks. The social worker listens, then asks for permission to ring back to the office. They ask the office to cancel all their afternoon appointments. They go back to the service user and listen more to the service user. They then ask if there is anyone else who knows or who they can contact to come round. Together the social worker and the service user contact a friend who comes round. They make a meal together and sit down and work out a plan to manage over the next 72 hours. The social worker agrees to call round the next day to make more plans. In supervision the social worker was able to identify how helpless and inadequate they felt at the time, but how they had used Person Centred Theory, Ecological Systems Theory and Crisis Intervention to meet the service user’s needs. The reality at the time for the social worker is that their main thought was probably something like “Oh s**t, this wasn’t what I was prepared for”, and as they reacted to the service user they were not consciously and deliberately using any given theory, but the aim of theoretical competence is to be able to use it with “unconscious competence” so it should not be a surprise that quite often we are only fully aware of our theory base after the event. This is what is meant by ‘using theory backwards’. It is important to take care with this approach though. There is a fine line between ‘using theory backwards’ and ‘self-justification’. When we use theory backwards our aim is to understand two things: why we did what we did and how well we did it. The ultimate goal is understanding and improvement. So in the example given above the social worker may be able to recognise that whilst they were using Person Centred Theory most of the time there were times when the professional role interfered with this and they started dealing with the person as a problem to be solved rather than as a person in their own right. Once they are aware of this they can use this to ensure that next time they are in a situation like this they are able to maintain a more effective person centred position. With self-justification the goal is not to understand or to learn, but to explain why what we did was acceptable. We are often motivated more by a desire to protect our ego than we are by recognising our limits and failings. There is evidence that people are capable of building very elaborate explanations for why what they did was right, even when it is clear to almost everyone else that it was not right. When you use theory backwards you must guard strongly against this danger.

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Never be frightened to admit your mistakes and failings. There is a proverb that goes ‘if you don’t make mistakes you don’t make anything.’ This is extremely important in social work. Social workers want service users to learn from the mistakes the service users have made, and one of the best ways to do this is for the social worker to show that they are willing to learn from their mistakes too. On a very practical level I have discovered that it is the mistake of covering up a mistake that really causes problems, not making them in the first place. If you recognise your failings early, own up to them and show in your behaviour that you are willing to put them right, you will rarely get in serious trouble. If you try to deny or cover up a mistake it is very likely to cause you big problems, and even if you don’t get caught the fear of being ‘found out’ will add to what is already a very stressful job.

The Basic Theory Toolkit One of the problems in social work is that the profession does not have an agreed and universally accepted set of theories. All I can therefore offer you is a message that is basic to this book: in order to be a competent social worker you need a basic theory toolkit, in order to be an excellent social worker you need a few theories you can use very well. The five most basic theories that are likely to help in most situations are: Person Centred Theory, Anti-Oppressive Practice, Task-Centred Practice, Crisis Intervention and Ecological Systemic Theory. A sound grounding in these five theories is likely to enable you to practice ethically and competently in most situations. For a more ethical basis to your practice it is important to explore anti-oppressive practice in more depth. It is important to understand that AOP promotes a basic framework, especially when linked to ideas of intersectionality, but this is greatly enhanced by studying anti-racist and anti-sexist social work, as well as focusing on areas such as class, sexuality and disability. Each of these will add a richness and depth to your understanding and your practice that focusing on AOP alone cannot achieve. There is a wide range of theories that can be used to supplement the basic theory toolkit. Several have been mentioned already: solution focused practice, cognitive theory, attachment theory and behavioural theory for example. Other theories exist and can be useful; narrative theory, transactional analysis, family therapy, trans-theoretical model of change and gestalt theory for example. In my experience the best social workers I have worked with have a solid grounding in the basic five theories, but then also have detailed knowledge and competence in using one or two in more depth. This may take time to achieve, but I would strongly advise continuing to experiment until you find models that are effective for you. I stated earlier that the dominant model of social work presently in the UK is the Managerial Model. One of the key dangers of this model is that it focuses on the ‘doing’ of social work rather than the ‘thinking’ of social work. The Managerial Model focuses on ‘doing things right’, in other words following policies and procedures, rather than on ‘doing the right thing’, understanding what you are doing and why, and having the wisdom and courage to do what is right in any given situation. This requires more than an abstract knowledge of theory, it requires ‘practice wisdom.’

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Practice Wisdom Practice wisdom is another of the ‘fuzzy concepts’ we have encountered many times in this book. It is used in different ways by different writers. Here I take practice wisdom as being the lessons learned from past experience that can be applied to a current situation. Central to this definition is the ability to draw together ideas from general theories such as those covered in this book, and information about the specifics of the present circumstances. In this respect practice wisdom is an ‘integrating vehicle’ allowing social workers to combine formal theory with personal experience. It is important to remember that social workers are not the only ones with practice wisdom, service users have practice wisdom too. Practice Wisdom – the service users’ perspective One of the great dangers of social work is what is known as ‘rescuing’. This is where a social worker believes that they have all the answers, and the service user can only be helped by trusting the social worker and doing what they are told. I have seen this happen more times than I care to remember, often with good intentions, but usually with a very damaging cost. The reality is that service users have developed their own coping strategies and problem solving skills. They have nearly always faced and overcome a wide variety of obstacles and have learned what works and what doesn’t on the way. Social workers need to take this seriously. The Strengths Based Approach, The Family Partnership Model, and Solution Focused Practice all rely heavily on the need to work with people’s existing beliefs, values, strengths and resources rather than ignoring these. Within social work assessments this means taking seriously people’s own accounts of what their problems, needs, goals, strengths and resources are. Even where the service user and the social worker have different views this can be incorporated into a collaborative assessment. An example of this was given in the chapter on Task Centred Practice. Case Example Service User There’s nothing I can do. Both my parents experienced depression, and my sister does too. We just have ‘depressed genes’. Social Worker That must be very tough for you. How do you cope? SU

You just have to, things go on.

I guess so, but I’ve seen other people with depression and they just seem to have given up. I’ve noticed you still keep going, even though things are really bad for you right now. How do you do that?

I don’t know. I guess I just know I can’t quit.

How come?

I’m not a quitter.

Hmmm, it sounds like you’ve got a depressed part of your genetic make-up, and then this other part, the part that means you aren’t a quitter?

I guess so. I’ve been told I’m a fighter; that I don’t give up.

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So you’ve got some depressed genes and some fighter genes?

(Laughs) Yes, I suppose so. We’re all a bit messed up, aren’t we?

I reckon so, I know I am. (Laughs) So what helps the fighter genes come out on top?

In this example the social worker does not really accept the idea that depression is largely genetic and sees it as being more social in its origins, but instead of arguing about what causes depression they use the service user’s idea that it has some genetic element and builds a more flexible theory around the idea of competing and multiple genetic factors. This forms the basis for helping the service user draw on their beliefs and past experiences to create an effective action plan. This fits back into the idea of the Practice Pyramid. Respecting, valuing and using the service users’ practice wisdom is not simply a technique, it is rooted in deeper theories of Person Centred and Anti-Oppressive Theories and also in a more deeply seated values base that social workers should aim to operate in as non-hierarchical way as possible, within the confines of their legal and professional duties. This requires personal qualities of empathy, warmth, compassion and understanding far more than a strict adherence to a rigid theoretical framework. Practice Wisdom – the social workers’ perspective It is a fact that a social worker may have a deep knowledge of a theory and yet be clueless as to how to implement that theory in practice. This is why personal practice wisdom is important. I can illustrate this with a personal example. I began learning and using Solution Focused Practice in about 1995. Although I found it quite effective, there was one specific technique that simply didn’t work well for me: the miracle question. I would ask the question occasionally, hoping that as I read more and became more proficient in Solution Focused Practice I would be able to get it to work, but it never got consistently positive results. It was only when I went on further training that I really understood the depth and subtlety of the question that I was able to change the way I asked the question. Once I did that I was able to get the question to work on a fairly consistent basis. This is the importance of practice wisdom from a social worker’s perspective. Imagine for a moment picking up a violin (assuming you have never played a violin before) and trying to get a tune from it. It is a safe bet that your first attempt is likely to be pretty dreadful. You may conclude from this that either a) the violin is a terrible instrument, it doesn’t work, or b) you have not yet developed the skill to get the best from a violin. This holds true for most social work theories. When you first try using them you are likely at best to get mixed results. You may conclude from this that the theory is rubbish or you may conclude that you have not yet developed the skills to implement the theory well. I have occasionally seen students ‘critique’ a theory by saying that it is ‘hard’ or ‘difficult to understand’. These are disappointing critiques as they reveal an attitude that says that theories should be simple and easy to put into practice and if they are not the fault lies with the limits of the theory and not the limitations of the person learning the theory. It is a sobering thought that a typical three year Social Work Degree course at best has about 1,300 hours of skills practice, and yet Matthew Syed has estimated that excellence in a skill requires about 10,000 hours of practice. This means that if your aim is to be an

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excellent social worker, and I certainly think it should be, you must either put in a lot of additional hours of skills practice whilst you are on the course or else accept that you will need to take years after you graduate to polish your skills in order to be excellent. This is also where practice wisdom comes in – it is what keeps you developing your skills in using the theories that work for you. Returning for a moment to the metaphor of the violin, it is important to remember that other instruments exist. Not everyone will excel at the violin. Some will be keyboard players, or wind instrument players, or percussionists, or singers. It is the same with social work theory. Not everyone will develop excellence in all the theories that are available to them, the importance is to find theories that suit you. I believe that whilst most theories can be useful in social work not all theories suit all workers. I use two elements from psycho-dynamic theory, transference/counter-transference and defence mechanisms, in my work, but in general I find the theory unconvincing and make very little use of it. I have however had colleagues who use many ideas from psycho-dynamic theory as an integral part of their practice, and this has worked for them. I also use elements of systems theory (or ecological-systemic theory) in my practice, but find the theory too complex for me personally. Again, I have had colleagues who have used the theory really effectively in their work. On the opposite side I have found Solution Focused Practice works well for me, but I have had many colleagues for whom its minimalism and simplicity just doesn’t fit, so they use other theories. Part of practice wisdom is to know that in general theories are not better or worse than each other, but some theories have a better fit for some workers than for others. There is a key danger in Practice Wisdom though. I wrote earlier about Dr. Spock who advocated that babies be placed to sleep on their fronts. This was based on practice wisdom and had fatal consequences for thousands of babies. The same can happen in social work. Social workers may end up ‘doing what they do because that’s what we’ve always done’. This can lead to highly damaging practice which can be passed off as ‘practice wisdom.’ One of the key dangers in using theory is trying to make the person fit the theory. Too heavy reliance on practice wisdom based around your have favourite theories, especially explanatory theories, there is a tendency only to look for evidence that fits the theory. The goal of good social work is to make your theories fit the person, and not try and get the person to fit the theory. The key way to do this is to develop a collaborative approach to practice wisdom. Practice Wisdom – a collaborative approach The goal of practice wisdom is for the worker to bring their knowledge of theories, policies, practices and the law and their expertise and skills based on past experience, and bring this together with the knowledge, expertise and values of the service user. This will create a ‘goodness of fit’, a situation where together the social worker and the service user are able to create together a unique, personalised theory of the person’s needs, goals, and strategies for meeting those needs and achieving those goals. This can be represented in a diagram as shown below.

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Service User

Social

Shared

Worker

Theory

Figure 24 - Goodness of Fit Practice wisdom involves a three way relationship. Firstly, the social worker must have confidence in the theories they are using and their ability to use them well. Secondly, the social worker must build a reasonable working relationship with the service user. At best this should be one of trust and mutual respect with a minimal power difference, at the very least their needs to be respect on the part of the worker and a willingness to work with the worker on the part of the service user. Finally, the social worker needs to be able to use the first two to create a shared theory that will guide the work from initial engagement to closure. There is an additional point about collaborative practice wisdom. Social workers overwhelmingly work in a multi-disciplinary environment. Social workers work with midwives, health visitors, nursery nurses, teachers, nurses, doctors, police officers, psychologists and psychiatrists, occupational therapists, physiotherapists, speech therapists, counsellors, and many other professional groups. Each of these has a values base and will develop a practice wisdom of their own. The more a social worker learns to respect and work with the professional wisdom of these different groups the better for their work. I have heard students state that social work is different from other groups because social workers have a values base to their work. This is highly disrespectful to other groups. All those working with people will have a values base, and all too often social workers practice in ways that are not related to their supposed values base. This is another area where practice wisdom comes into play.

A warning about practice wisdom Although this is a point I have just made, I will repeat it: practice wisdom must be treated with scepticism. Social work is complex and chaotic. What works in one context or with one person may be disastrous in another. There is a deep contradiction in practice wisdom, at least in my experience. The best social workers are usually the ones who are most modest in their assessment of their ability. There are some important reasons why this is the case. The first is that we have a tendency to suffer from something called â&#x20AC;&#x2DC;confirmation bias.â&#x20AC;&#x2122; This has many effects. For example if we like a particular theory we are likely to base our assessment around the theory, only asking for the kinds of information that is likely to prove our theories. We are also likely to notice and remember when a particular theory

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worked for us but ignore other times when a theory hasn’t worked. This can affect anyone. During the Second World War bomber crews would sometimes experience engine fires. Crews learned that a way to deal with this was to put the aircraft into a steep dive and the power of the wind over the wing would extinguish the flames. After the war it was discovered that this usually increased the intensity of the fire and the loss of the wing, but only the crews that didn’t experience this came back to talk about what they had done. Therefore practice wisdom literally killed bomber crews. Similar things happen in social work, for example there is a piece of ‘practice wisdom’ that if a child is angry getting them to hit a punch-bag will ‘release’ their aggression, however this strategy may in fact increase aggression, not reduce it. This is why it is so important to use evidence in social work and not simply rely on theory or practice wisdom.

Evidence Informed Practice In many ways social work is often indirectly informed by evidence. The number of children who are killed by their carers or other people associated with their carers has dropped in the past 40 years. In large part this drop is on the back of evidence gained from past failings. From Denis O’Neil in the 1940’s to Marie Colwell in the 1970’s, Jasmine Beckford in the 1980’s and Peter Connolly and Daniel Polka in the last 10 years there have been a string of enquiries into what can be learned from fatal failings in the child protection system. In less dramatic ways the increasing voice of the service user in social work has provided evidence to improve services. Mayer and Timms book “The Client Speaks”, published in 1970, had a profound effect on social work, giving clear evidence of how those who received social work services felt about the services they were receiving. Similarly the Disability Rights movement has led to changes in the way people who are disabled are treated by social work services, powerfully captured in the statement ‘nothing about us without us.’ These factors, scandals and service user feedback, feed directly into law and policy. As a result the legal and policy framework in which social workers operate is informed by evidence from these and other sources. There does however need to be care here. Policy and law can also be influenced by popular sentiment or political expediency, what the public likes and what will get politicians re-elected. Social workers cannot always assume that law and policy will automatically be evidence based or lead to best practice. There has also been growing evidence drawn from research on outcomes. When I was first involved in Child Protection work I was influenced by two papers, “The Untreatable Family” by Jones and “Prognosis for rehabilitation after abuse” by Bentovim et al, both published in 1987. These two papers provided clear, research based guidelines on what factors to consider when assessing families in which serious child abuse had occurred. In some ways the wealth of evidence from research for social workers ranges from daunting to overwhelming. Within a few key presses any social worker with internet access can find hundreds or thousands of research papers on practically any topic they wish to consider. This is why it can be helpful to use a more filtered approach to building the evidence base for your practice. One of the best of these for UK social workers is the Social Care Institute for Excellence, SCIE. (www.scie.org.uk) This provides a wide range of summaries of the research evidence

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on many different topics, from mental health to developing skills and services, from end of life care to safeguarding. Continuing to read up-to-date books is a second way to build the evidence base to inform your practice. Books often summarise a wide range of the currently available evidence and present this in an accessible form. Earlier in this book I suggested that whilst it is good to be familiar with a wide range of theories it is helpful to become excellent in a smaller number, the ones that make most sense and seem most helpful to you. This is another area where I would strongly advise you to keep reading. Theories and the practices related to those theories change and develop. If you do not keep on top of current practice you may find you continue to do something because that is how you learned to do it, when in fact the research has demonstrated a better way of doing it. Finally, you should not treat the social work course as the last word in your formal training. After you graduate continue to go on training events, attend conferences and join special interest groups, either those that meet face-to-face or online groups. This will also help keep your evidence base for your practice current and allow you to learn tips and tricks from others who are using the same theories.

Reflection 1) What struck you most in this chapter? 2) When it comes to helping other people, what have you found works for you? 3) How will you keep your knowledge and skills up-to-date?

Recommended Reading Orme, J. and Shemming, D. (2010) Developing research based social work practice. Basingstoke: Palgrave Macmillan. Chapter 1 – “What is research for?” pp9-27 Wilson, K., Ruch, G., Lymbery, M. and Cooper C. (2008) Social Work: An introduction to contemporary practice. Harlow: Pearson. Chapter 8 – “Understanding and using research in social work practice” pp235-263 Doel, M. and Shardlow, S. (2005) Modern Social Work Practice: Teaching and learning in practice settings. Aldershot: Ashgate. Part IV Themes and Practice pp179-188 Sheldon, B. and Macdonald, G. (2009) A Textbook of Social Work. Abingdon: Routledge. Chapter 4 – “Evidence Based Practice” pp66-91

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Chapter 12 – Theories in Practice Preparation Having read this far, how has your understanding of the role of theory in social work practice changed? Given that concepts like theory, model and approach are ‘fuzzy concepts’, how would you define the similarities and differences between these concepts? Which theories are you drawn to the most? What other theories, not covered in this book, do you think might be helpful in social work?

Introduction Early in this book I made the point that there is no such thing as ‘theoryless practice’. Anyone who says that they ‘don’t use theory’ is confessing that they are unaware of the theories that are guiding their practice. This is one of the most dangerous things in social work. And yet there is an opposite danger – to become so theoretically focused that we lose sight of the fact that we work with people and not objects that can neatly be fitted into our theories. I have met social workers with a deep understanding of a theory, but with no idea of how to use this theory to help enhance well-being or promote social justice. Theories are only good when they help us do those things. This chapter will aim to bring together theory and look at how it can be applied in practice, using the Social Work Process as a guiding framework.

Engagement and Assessment Even before a social worker and service user meet there is a role for theory. When taking a referral it is important to gather sufficient information to know if you will need to take action. This means reflecting upon your role as a social worker, which means that you will have to have theories of social work. It will make a difference if you see your role as mainly one of maintenance or of managing a system. This will be different if your role is more therapeutic or radical. Theory will help you balance these and deal with some of the tensions between what you personally value and how your agency operates. It will also allow you to manage the tensions between what you’d like to do in an ideal world and what is possible within the various constraints upon you. Moving on further, as you take details you will find that having a clear ecological-systemic and an anti-oppressive stance will help you take a more detailed and helpful referral. If someone else has taken the referral and you are reading it then these theories will help you plan how best to engage with the service user. Ecological-systems theory will help you see the person in their wider environment. This is important as there is a strong tendency to focus on individuals and to ignore the wider social influences on people’s behaviour, needs and goals. Anti-oppressive practice will also help you identify who is likely to be the least powerful in any given situation. It is important to remember that power is not a simple, neat hierarchy, with each person being more powerful than some and less powerful than others. It is a complex web so that any individual may have more power in one way or one area and less

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power in another. It is important to keep this in mind. It is easy to assume that a parent will be more powerful than a child, and yet you will find some families where children bully and harass parents. The goal of using anti-oppressive theory at this point is to identify who you are going to focus most of your attention, and that should be the person with the least power in the given situation. When it comes to engagement again, theories of social work and the social work process are likely to be helpful. Early on you will need to explain why you are there and what is likely to happen. Theories of social work and the social work process give you simple ways to explain this to the service user. They also encourage you to be honest about what you can and can’t do, what is your role and what isn’t. This helps create a culture of honesty. When it comes to meeting and early engagement, Person-Centred Theory is very helpful, even essential. If a service user feels that they are being treated as an object and not a person they will be unlikely to cooperate as fully as possible. Having accurate empathy and being able to communicate that to the service user is important. This means recognising that the service user is likely to have mixed feelings about you being there. Instead of reassuring them that everything is going to be alright, it can often be more helpful to acknowledge their anxiety and even their hostility and demonstrate that you see this as a perfectly reasonable response to you being there, and that you’d like to see if you can work together to show them that you can be trusted. Person Centred Theory is far easier to claim than to practice. I have repeatedly seen social workers act in ways that are dismissive or dehumanising towards service users. I vividly remember a few years ago a student on placement reflect upon his distress when a team celebrated the removal of a child from the child’s parents. The student was absolutely clear that it was the right thing and that it was a job well done, but he could not help noticing how the distress or even the humanity of the parents was dismissed by the team. The attitude was ‘we’ve got them’, not ‘we’ve managed to protect a vulnerable child.’ Every ‘successful’ removal of a child is also a recognition that even the best prevention sometimes fails. Person Centred Theory helps us keep this balance, neither overly negative nor overly positive about what we can do. Once we meet with a service user we have to do more than engage with them, we have to carry out an assessment. This will require the use of theory, but perhaps even more importantly it requires a theory or a model for how we understand assessment. One useful model was introduced by Smale et al (1993), who outlined three different approaches to assessment, approaches that tend to correspond neatly with the main models of social work. Although this model of assessment was introduced over 20 years ago it is still widely used in the social work literature and provides a helpful model for understanding the relationships between service users and social workers in the assessment process. The Expert Model of Assessment I suspect that when most people think of assessment they tend to think of it as being an expert who will ask questions and carry out tests in order to find out ‘what is really going on’. Many students appear to expect this. They believe that if they apply the right theoretical knowledge using the right skills they will be able to identify what is wrong with the service user and know how to fix it. This is most strongly associated with the therapeutic model of social work. In the Expert Model of Assessment the worker is the one who controls the assessment and who determines what things mean. The service user’s role is simply to provide the

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information the social worker asks for and to agree with the diagnosis and prescription of the social worker. Some service users will also expect social workers to use this model. They may assume that social workers can ‘read their minds’ or that the social worker is reading all sorts of things into their body language. At a human level it is true that we can sometimes have a shrewd guess about what someone is thinking based on their body language, but in general people’s body language is so personal and influenced by so many different factors that relying on such judgements would be highly unprofessional, however I have met social workers who believe that they have such expert knowledge and use it regularly. Sometimes this leads to interesting insights, but more often than not it leaves the service user feeling disempowered. Asks the Questions

Social Worker

Service User Answers the Questions

Figure 25 - The Expert Model of Assessment In settings where social workers have a therapeutic or an expert role there may be a time and a place for this model of assessment, at least at times. For most social workers the dominant model of social work is the managerial model. In Smale et al’s model this leads to a procedural model of assessment. The Procedural Model of Assessment When I began in social work assessment was frequently an open ended and individual process. Social workers would work with a family for months saying they were ‘assessing’ them, without any clear end point or decisive action being taken. This lead to the introduction in 1988 of the ‘Protecting Children’ guide, known as ‘the Orange Book’ (DoH, 1988), which attempted to provide a clear set of questions to ask when assessing in child protection. In 2000 this was replaced with the “Framework for the Assessment of Children in Need and their Families” (DoH, 2000) which was a more usable tool for assessment. Similar assessment tools were created in Care Management, mental health and other areas of social work. Although these tools have great potential, they also contain a great danger for assessment, and that is sometimes the tool can replace the relationship, leading to a procedural model of assessment. In the procedural model the agency determines what is to be assessed, how it is to be assessed, and what the outcomes will be, based on pre-set criteria. When the social worker goes to carry out the assessment they will ask the prepared questions, gather the answers, analyse the answers and then give an assessment based upon the criteria set out by the agency.

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Sets the Questions

The Agency

Asks the Questions

Social Worker Reports Back

Service User Answers the Questions

Figure 26 - The Procedural Model This model may be appropriate in high risk situations or where a decision has to be made on very factual grounds, such as an income related assessment, but in most social work settings this model tends to weaken the relationship between the service user and the social worker and to lower the professional esteem and self-confidence of the social worker. Smale et al introduce a third model of assessment, one that can fit very comfortably with both the Maintenance Model of Social Work and with the Radical Model. Exchange Model of Assessment With the Expert Model there is an assumption that the social worker knows best. With the Procedural Model there is an assumption that the agency knows best. With the Exchange Model there is an assumption that no single person knows best, but that when people cooperate and share information and ideas, then you get the best. In the Exchange Model the social worker seeks to collaborate with the service user to make sense of the situation and to develop ways to understand and manage the person’s situation in ways that meet both the needs of the service user and the legal duties of the social work agency. There is a pooling of information and a joint effort to try and understand and use that information. The social worker may well begin by asking the questions, but they will also encourage the service user to question them. The social worker will bring their knowledge and expertise to the assessment, but will do so with genuine humility and an openness to consider the views and ideas of the service user as an equal partner. Doing this well requires a level of theoretical knowledge that is beyond this book. If a social worker is wedded to an objectivist view of reality, a view that says ‘the truth is out there’ and that “when you have eliminated the impossible, whatever remains, however improbable, must be the truth”, then it will be very hard to carry out an effective Exchange Model Assessment. However if you take a phenomenological or subjectivist view of reality this model will feel natural. In this view reality does not exist independently of the person experiencing it, but is constructed by the person. This may be constructivist, that is created by the individual, or constructionist, that is created by society, but in either case the Exchange Model encourages social workers to treat assessment as an attempt not to uncover ‘The Truth’ about the person’s situations, but to co-create ‘a truth’ that will enable those primary goals of social work, well-being and social justice, to be promoted and enhanced. If you have read this book carefully you will be able to see that I have a clear preference for the Exchange Model of Assessment, and think that theory is only as good as the ability to use it with the theories and views of the service user. However I accept that all three models have a time and place where they can be used ethically and effectively.

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Asks the Questions

Social Worker

Answers the Questions Asks the Questions

Service User

Answers the Questions

Figure 27 - The Exchange Model

Planning Although it is a statement of the obvious it is still worth stating – all plans involve theory. If you plan to do something there will be a reason why you are doing it. In the procedural model the theory might be as simple as ‘my agency knows what it is doing, and that it is what it’s asked me to do.’ This may not sound like much of a theory, but most people who have worked in a variety of agencies will say that the belief that agencies know what they are doing is far more of a theory than a fact. Even where you are following agency policies and procedures, your practice will be greatly enhanced if you understand the theory that underpins those policies and procedures. If you think back to the Practice Pyramid you will see that implementing a strategy without having a sound grasp of the theory that underpins that strategy is at best risky and at worse out-and-out dangerous. Agency procedures and policies, despite what I wrote at the start of this paragraph, are usually based upon bitter experience; they usually have a sound rationale. This doesn’t mean that things haven’t moved on so the rationale might be out-dated, or that the way it is implemented runs contrary to the theories that underpins it, but it will nearly always be there. As a general rule you need to ensure you know why you are planning to do what you are planning to do. As far as possible ensure that the plans are shared with the service user and other key stakeholders and that they have an understanding of why you are planning to do what you are planning to do. In doing this you will need to be explicit about your theory base, and to ensure that you have a sound evidence base for this. It is not always possible to check out the primary research base for yourself but your practice should be based around current reading and on-going professional training and be in line with current policies and law. One key problem in using theory in the planning phase of the social work process, especially for students and newly qualified workers, is that it is impossible to stick to the rule that you should not try using a theory unless you understand it well. At first you will not understand theories well but you will still have to try them in practice in order to develop your competence. My advice here is to get as informed as you can and be honest. Before using a technique, read up on it. Look for training material. Go onto YouTube or the SCIE website to see what materials are available. Discuss it with colleagues and supervisors/practice educators. If possible role play it, or at least carry out a mental

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rehearsal by imagining the scenario in your mind before you put it into practice. Also watch other workers using the technique and if there is a colleague with experience in the technique, co-work with them and get feedback. Despite all that preparatory work at some point you are just going to have to get on and do it. Here it can be really helpful to be honest; to say something like “I’ve been researching a particular approach that seems to really help in situations like this, and I’d like to see if it would help. Are you OK about us trying it out?” You need to be ready for the service user to say “No”, but in my experience this is very rare if you have already built up a trusting relationship. If you haven’t got that, then you are probably better off working on that before you make plans.

Implementation One of the biggest shocks for many new social workers is that the text books tend to lie. In the text books you will read case studies where a social worker assessed and carried out a plan and it all went smoothly and got the desired results (or more commonly where the plan is described but the description gives little if any detail of the implementation). When you read or go on training the subtle message given is ‘do this and everything will be alright’, but the reality is rarely that simple. I certainly have had a few experiences where I have done what the theory suggested and got what the theory said I should get, but this has been a rarity. In general the theory simplifies a complex situation to make it understandable, whereas reality has no reason to be understandable. This is nicely encapsulated in the Harvard Law of Animal Behavior which states that "under carefully controlled experimental circumstances, an animal will behave as it damned well pleases." If this is true for animals this is even more the case with humans. One of the key reasons you must know a theory well before you implement it is that as soon as a plan is implemented things are likely to ‘go wrong’. I have put ‘go wrong’ in quotes because this is not a sign that anyone is being wilfully disruptive or that you have not implemented the plan well, but because life is infinitely more complex than the theories suggest. A theory is only ever a simplified version of reality so things will always be more complex in practice than the theory seems to imply. When implementing a theory in practice you will need to keep a careful balance between adhering to the theory through the twists and turns of people’s lived experience and adapting the theory to fit that lived experience. This means knowing which parts of a theory are essential and which are less important. This means that social workers can be most flexible in the less important parts of the theory and most focused on the parts that are most important. There is a very important point here, one that I think I cannot stress strongly enough. Even the best theories can be implemented badly and, due to things like placebo and the common factors effect (which states that what makes theories work are things like the relationship and the optimism of the client and worker and not the unique features of a given theory), even a relatively weak theory, when implemented within a sound relationship and with enough confidence, can achieve excellent results. The temptation is that when you try a theory and it doesn’t work, to blame the theory rather than seriously reflecting on why it didn’t work. You can also be tempted to think that when you used a theory and got the results you wanted that the success was due to the techniques (or your own brilliance) rather than being the results of many different factors,

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of which the theory was one of the less important ones. This is why I think that the Practice Pyramid is one of the most important models in this book as it focuses attention on the relationship, the use of self and your values and beliefs more than on the specifics of any given theory.

Review and Evaluation In the same way as service users are the only ones who can say what their situation mean to them, so too are they the only ones who can really say if a technique is working or has worked. For this to be effective social workers need to be clear from the beginning what they are trying to achieve and how this will be measured. Different theories have different aims and goals. For example, in Task Centred Practice the goal is usually to have the person resolve the specific difficulties that led to them receiving a social work service. With Crisis Intervention it is when the person feels that they are coping at least as well as they were before the crisis. There are a range of rating scales that can be used to assess work. Many of these are given in DoH (2000) guidance on assessing families of children in need. Similar scales can be found in other areas such as HoNOS (Health of the Nation Outcome Scales) produced for Mental Health in 1993 or the Wellbeing Self-Assessment (http://bit.ly/SWK1008Wellbeing01). These will provide a range of ways in which progress can be monitored in order to know what is working and what isn’t. This allows the social worker to either do more of what is working or else to change the plans or change the way they implement their plans order to be more effective in their practice. In many ways a much more flexible and effective way of evaluating work is to use simple self-rating scales. These can be things like 1 to 10 rating scales. Alternative visual methods can be used such as line scales. Given the importance of the relationship to social work practice it is also helpful to repeatedly ask service users to review and evaluate the relationship. Again formal relationship rating scales exist but number or line scales will work just as well. One important note of caution, for lots of reasons service users will not always be accurate or honest in their evaluations. There is a social desirability bias. This means that in general people tend to answer questions in ways that tend to protect their dignity or else to gain a positive response from someone else. This may mean that service users report more change than has actually occurred. Service users can also develop a strong sense of dependency and may fear the loss of the social worker if things get better too quickly. This may mean that they under-report progress. In certain situations, especially child protection, mental health, criminal justice and drugs and alcohol work, people may be strongly inclined to under report problems and over report progress in order to get social workers ‘off their backs.’ For this reason it is important to maintain the stance that Lord Laming described as ‘respectful uncertainty’ (Laming, 2003). It is important to respect a client’s self-rating but to also ask for concrete details. In general it is best to triangulate review and evaluating evidence. This means taking your personal observations and assessments of the person and the progress they are making and blending this with their self-reports and, as far as possible, from reports of other significant people in their lives. By drawing on this wide range of sources you can be confident that the evaluation is reliable and robust.

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Finally in terms of review and evaluation, do not lose sight of the ultimate goals of social work. Social work aims to enhance well-being and to promote social justice. In order to stay true to the heart of social work your reviews and evaluation should include a dimension on whether or not the person is in a better place than they were before the intervention, and whether this is likely to ripple out to wider social impacts. It is not always possible to do this but where possible this should be a goal of your work. It is this that will keep you alive and thriving as a social worker, regardless of which other theories you use.

Reflection 1) 2) 3) 4) 5) 6) 7) 8)

What have you made of this book? Which theories really appeal to you? Which other theories do you find interesting? If you could have had an extra chapter or two in this book, which theories would you have added? How will you develop this interest? When, where, how and with whom will you put into practice what you have learned in this book? List the three most important things you want to remember from this book Do you have what it takes to become an excellent social worker?

Recommended Reading Oko, J. (2008) Understanding and Using Theory in Social Work. Exeter: Learning Matters Chapter 5 – “Putting theory into practice” pp93-117 Thompson, N. (2009) Understanding Social Work. Basingstoke: Palgrave Macmillan. Chapter 6 – “Achieving Good Practice.” Pp152-179 Also have a look at Viviene Cree’s book “Social Work: A Reader”. It contains a wide variety of papers by different writers and will give you a rich set of source material to draw upon.

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Appendix 1 – Reflective Practice Introduction There is a saying that goes ‘some people have twenty years’ experience, and others have one year’s experience twenty times.’ What this suggests is that it is possible to do something for a long period of time without really getting any better at it. There is another saying that ‘practice makes perfect’. Although you will often hear this the saying is in fact wrong, or at best, partly right. Practice does not make perfect, practice makes permanent. Imperfect practice makes permanent imperfection, gradually improving practice makes permanent a process of gradual improvement, and I’ve yet to work out how to practice perfection. For these reasons we need a system of reflective practice to allow us to improve our practice.

What is Reflective Practice? I define Reflective Practice as the process by which events get turned into experience. Events are the things you do and the things you see and hear. They are the raw source material for reflective practice. Experience is the ability to use the events of the past to do better in the future. It is the final product of reflective practice.

How do you engage in Reflective Practice? A Model for Reflective Practice What I will present here is a model to help you reflect on your practice. It is also worth noting that this model is also helpful for supporting service users in reflecting upon their experiences, to help them turn the events in their lives into experience that will help enhance their well-being and be able to promote social justice. This model is adapted from David Kolb’s model of reflective practice.

Stage One – Event recognition Simply noticing that something has happened that is worth reflecting upon. Every day each of us is involved in countless events. We see, hear and feel things all the time so it is impossible for us to reflect upon all of these in detail. As a result, the first step in the reflective process is to select which events to reflect upon. This can be difficult as there are thousands of events happening but we only have a limited amount of time to reflect so it is impossible to decide to reflect upon them all. Choosing which events to reflect on can be difficult, however there are a number of simple guides to help us choose. A) Emotions When an event is important it is usually accompanied by strong feelings - anger, pleasure, fear, excitement, confusion. These feelings can provide a good starting point for deciding which events to reflect upon; reflect upon events which generated strong feelings.

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B) Cognitive evaluations Our feelings in any situation will be closely linked to our evaluation of that event; whether we thought the event was good or bad. Instead of focusing on the feelings we can focus on these evaluations. If you think that you did something successfully (a cognitive evaluation of the event) then reflecting on this can be useful in terms of getting it to happen again. Equally if you think something went wrong then reflecting on it can help you work out why it went wrong and how to avoid it in the future. C) Personal learning goals In many ways this is the most sophisticated guide for reflection. Rather than simply waiting for something to happen that creates strong feelings or went well or badly, we can set out to create an event in order to give us experience that will help us reach our personal learning goals. A very common mistake in reflection is to simply scan the things that have happened and choose to reflect upon something you happen to remember or that seems easy to reflect upon rather than focusing on something significant. There really is no excuse for this. When reflection is part of a course and you are busy or have a deadline, this may be understandable, but it destroys your chances of learning effectively from the things that happen to you. If you have no experiences that arouse strong emotions or important thoughts in your head, then go and create learning experiences for yourself and you will find you get these thoughts and feelings. It is possible that a significant event or connected series of events may take place over weeks, or they may last less than a minute. Using the indicators above, strong emotional reactions, strong cognitive evaluations and personal learning goals will help you avoid wasting time reflecting on trivial events rather than significant ones. This is vital if reflection is going to be more than an academic exercise and really help you build a higher level of competence in your work.

Stage Two â&#x20AC;&#x201C; Disciplined Recall Getting an accurate picture of what actually happened. Human memory is notoriously fallible. We often forget or distort past events - usually in order to fit the beliefs we have about those events. For this reason when engaging in reflective practice it is vital that events are recalled as fully and accurately as possible. The first time we recall a significant event we are likely to remember only a small percentage of what happened. This is especially true where we have had strong feelings or formed a strong initial evaluation of the event. If someone remembers an event where they felt scared they are likely to focus on all the things that could have gone wrong and the things that could have caused harm. They are likely to down-play or completely ignore various safety measures that helped keep them safe or reduced the harm. If someone finishes an interview and thinks that they have done very badly they are likely to remember all the things that were less than perfect and might completely miss the fact that the person they interviewed was quite happy at the end of the interview. Accurate, structured and disciplined recall is very important in reflective practice, however this can be hard to achieve. There are plenty of ways of increasing the accuracy, detail and relevance of your recall for significant events, but what is important is that you donâ&#x20AC;&#x2122;t

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simply rely on a superficial, unreflective recall of what happened. If you do you will fail to properly take account of all the details that are available to you and this will seriously limit the quality of your analysis and will stop you from learning as much as possible about the event. At best your learning will be limited, at worst you will keep repeating serious mistakes and harming other people. With a full, accurate and empathic description of an event you will find that your ability to reflect upon the things that happen to you is greatly enhanced; you will form better relationships with colleagues and service users; your practice will be more effective; you will experience lower stress levels and higher levels of personal satisfaction. For these reasons it is important not to rush this stage.

Stage Three – Making Sense of the Experience (Analysis) Being able to explain why things happened in the way they did, in a way that lets you do better next time. Stage Two will allow you to describe an event, but if you stop there you will not be able to make sense of it. It is only when we have practical ways to understand why things happened the way they did that we can really build on doing more of what works and avoiding the things that don’t work. To do this effectively we need a range of strategies to help us make sense of the event. Without this step, all you have is description, you won’t have analysis. We do not have time to reflect upon everything that happens to us, there are just too many things we could reflect upon. It is important to notice that we also do not have time to explain every aspect of the things we choose to reflect upon. Effective use of reflection means that we have to focus on what we want to reflect on (Step One); we have to focus on which aspects we want to describe in detail (Step Two) and also we have to focus on what we most need to explain (Step Three). In order to do this we will need to decide upon the desired outcome for our reflection. Although there is no exhaustive list of these outcomes the following list is a useful guide. Outcomes of reflection 1) Self-awareness – learning about yourself 2) Empathic awareness – learning about others 3) Professional awareness – learning more about professional practice 4) Theoretical awareness – learning more about specific theories 5) Practical awareness – learning more about how to practice effectively 6) Values awareness – learning more about the values and beliefs that underpin professional practice 7) Personal resilience – learning more about how to cope with the pressures of the job As stated earlier, the analysis of the event should not be random or unfocused. For that reason, before embarking on the analysis we need to begin with a view to which of these

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outcomes we are looking for in our analysis. Sometimes our analysis will focus on just one of the above outcomes. At others we will be able to achieve two or more of these outcomes. Knowing our desired outcomes will help keep our analysis focused. Once we have decided upon our desired outcome we can use a variety of techniques to help us develop our analysis. There are many different tools you can use for analysing the events you experience. Neil Thompson’s book ‘The People Solutions Sourcebook’ gives brief but useful guides to many of them, and there are several books devoted to reflective practice in social work. You are strongly advised to read a range of sources and experiment to find out which tools work best for you. Stage Four – Integrating and Applying the Analysis Reflective practice begins by noticing that an event or situation is worth reflecting upon, that it has useful things to teach us about good practice; it then moves into a reflective observation of the event in which key features are described as accurately and fully as possible; and that this material then forms the basis for analysing why things happened the way that they did. However this work will only be effective if it leads to changes in our practice. There are many different potential outcomes for reflection including, self-awareness, empathic awareness, professional awareness, theoretical awareness, practical awareness, values awareness and personal resilience. Although in many ways each of these has value in its own right the aim of reflective practice is not knowledge or awareness for its own sake. The true value of reflective practice is to enhance professional practice so that we avoid mistakes and achieve better results in the future. This is why the final stage of the reflective process is so important. Reflections on events will only become experience if they are remembered and used in the future. One of the things to emerge from studies of memory is that when something is familiar to a person it is easier to remember than when it is not. So a string of words (Sun, hat, spade, towel, beach, sea) is considerably easier to remember than a string of nonsense syllables (Tup, lef, shile, wotaf, heash, vog). In this example the fact that the first set of words is also linked to a trip to the sea side might also aid recall. The fact that new knowledge is retained better when it is linked to existing knowledge is extremely important in adult learning. As adult learners we enter a situation with a depth and breadth of background knowledge and understanding. Even if some aspects of the situation we are reflecting upon are new to us, we will bring our previous experience and knowledge to bear when analysing the situation. It is important therefore when drawing our reflections together to consider how what we have learned from this event fits with the knowledge we already have and our past experience. When we do this our analysis will move from being a temporary set of thoughts about an event to becoming an important resource we can draw upon in the future when similar events occur. It is important that this process of integrating knowledge gained in reflection works in both directions. Our previous knowledge and understanding can help us reflect upon and make sense of our new experience. At the same time our new experience will help us go back and correct errors and gaps in our previous knowledge, beliefs, values and practices.

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On a personal level I have moved from calling myself a feminist, to saying I was a profeminist male, to identifying myself as an anarchist, and in doing so reclaimed a sense of being a feminist. Whilst this may appear inconsistent, it reflects the belief that as we have new experiences we reconsider our old beliefs and refine them. In doing so we re-define our sense of self. Within this process my core values of justice, respect, choice, compassion, love, creativity and freedom remain unchanged, but the ways these are understood and lived out changes as I have gained more experience. The integration, which has the same root as integrity, comes from always striving to find a sense of wholeness and continuity within the change. As a result, reflection both changes you and keeps you grounded in a solid values base. The sense of consistency and change, being grounded but also growing, that comes from reflective practice also develops as we do more than integrate new understandings, but apply them in practice. If reflective practice is going to transform our practice then our analysis also needs to be consciously and deliberately applied. Reflection should not be considered an end in itself. Instead it should be seen as a means to the end of better practice. Some situations or events will re-occur frequently or naturally. If we are reflecting upon an interview with a service user we can reflect upon why the interview worked or why it didn’t work. We can then easily apply the lessons learned from this reflection in the next conversation we have and see if we get as good or better results than we did the previous time. At other times a situation might be less frequent. If we are working with someone with a stammer we might reflect upon how we dealt with this situation, but we might not be in this situation again very soon. Here we might need to think more creatively about how we improve our practice, or we might actively seek out more sources such as websites that support those who stammer or look for research on stammering. One of the key differences between workers who are excellent and those who are less than competent is that excellent workers consistently and persistently apply what they have learned to improve their practice. Excellent workers do not view reflection as a ‘chore’ or an academic exercise, but they integrate it into their routine practice. They do not wait to be trained or educated on a subject; they actively seek this out for themselves. Good workers are active learners; they actively set out to experiment with their knowledge and skills; they put themselves in new situations to help them develop their essential skills. So at the end of the reflective cycle it is important to ask: how will I take this forward? What will I do now to ensure that I can use in the future what I learned in the past? How will I find out more? How will I improve my skills? If this essential step is missing then the vast majority of the work that has been put in up to this point will be wasted. However if this step is done well then our practice will move quickly and smoothly from incompetent, to competent, to excellent. That is not only better for the people we work with, it will also mean we have a greater sense of satisfaction and pride in our work; we will feel less stressed; and we will achieve more of the goals that took us into the job to begin with. Ultimately reflective practice never ends. Each new cycle of reflection will result in some questions being answered, some practice being improved, but in turn this will open up new questions and show where practice is still short of being as good as it possibly can be. Whilst this may sound like a recipe for misery, when applied well it can be a source of contentment. Perhaps the real aim of reflective practice is to make a reality of the phrase “Better than yesterday, not as good as tomorrow, but thoroughly enjoying today.”

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Appendix 2 – The Bio-Psycho-Social Model and Beyond Introduction The bio-psycho-social model is one that is very simple, yet one that has subtle and profound impacts on practice. In its simplest form, it suggests that human behaviour and human needs are influenced by three major areas: the biological, the psychological and the social. In this appendix I will suggest a further level of influence, the trans-personal, or what is sometimes call the spiritual. Biological Factors In some areas the exact extent of biological influences on human behaviour is very controversial. One example of this is the role of biology in parenting. If you believe in evolution, and you believe that behaviour is at least in part genetically influenced, and you believe that some types of parenting are more likely to lead to children surviving to adulthood, then you must believe that genetics plays some role in parenting behaviour. However when this is applied uncritically it leads to many conclusions that have been applied with either oppressive or fatal results, for example that women are genetically programmed to be mothers (and therefore shouldn’t pursue careers) or that children are always better off being parented by their biological parents (even when those parents are dangerously neglectful or abusive). And yet there are ways in which understanding genetic factors can be helpful. When autism was first recognised a key theory for its development was that autism was the result of neglectful parenting, specifically by mothers. Bruno Bettelheim developed a very powerful model of the causes of autism called ‘refrigerator mothers’, suggesting that insensitive and unemotional mothering led to children developing autism. This must have had a devastating effect on countless families who felt completely responsible for their children’s developmental difficulties. The understanding that autism is a genetic/developmental condition helps explain both the children’s behaviour and the parents’ parenting. Children develop autism because they have a genetic predisposition for developing autism, and parents of autistic children will have a similar genetic make-up so may display some autistic traits themselves. There is nothing inherently deterministic about this model. Genes influence, but only in exceptionally rare cases do they determine. But on a more practical level biological or physical factors play an important part in human behaviour. This needs to be taken into account when assessing and planning social work interventions. Diet and exercise are important to well-being. Eating a healthy balanced diet and taking regular exercise are important, and yet quite often these factors are missing or superficially addressed in social work assessments. Sleep and pain are two other important factors in both well-being and understanding people’s behaviour. When people are sleep deprived this affects both their emotional wellbeing and their judgements. It is important to take this into account when assessing a person’s behaviour and situation. One of the key reasons for very young children being physically abused is that parents of very young children are often chronically sleepdeprived. It is a sobering thought that whilst sleep-deprivation is banned as a form of torture it is the daily lived experience of many new parents. Sometimes addressing the problems of getting enough sleep is the single most powerful intervention. In the same way when people are ill or in pain their behaviour is affected. Specifically asking about pain is

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important in a comprehensive assessment, but again it is something that is often missed. It is not difficult to address these practical biological influences, tiredness, hunger and pain, but this will only happen when a social worker consciously and deliberately puts them into the assessment and then plans and intervenes accordingly. The bio-psycho-social model can help with this.

Psychological Factors When assessing a person’s behaviour or situation, psychological factors are important in two main ways, firstly as a tool for understanding the behaviour directly; secondly for understanding how the person makes sense of their own behaviour or situation. It is important to keep these two separate. Psychological theories may provide useful insights, but they are only theories. There is little that we know for definite about why people do what they do or are in the situations they are in. However when we are working with a service user we can explore their way of making sense of things by asking them directly – why do you think that happens? In this book I do not have the space to provide details of the range of psychological theories that can be helpful in social work. Attachment theory can be very helpful, especially in fostering and adoption work and in understanding why some service users have difficulty accessing help or why they can become very dependent when working with a social worker. It can also help give us insight into our own professional working relationships. Behavioural theory is a very useful tool when working on parenting skills or working with habitual behaviours. The idea that behaviour that is rewarded is repeated helps us look for the rewards that reinforce negative behaviours and at how to create rewards for new behaviours. For anxiety problems in particular behavioural theory is an excellent choice of model. Cognitive theory, especially attribution theory, is helpful when working with emotional and behavioural problems, from depression to anger management. It can also help in interpersonal problems by helping us identify the thought patterns that reinforce negative interactional patterns. Psychodynamic theory also contributes a number of ideas which are useful for an ‘emotionally intelligent’ social worker. Two particularly helpful ideas are transference/ counter-transference, which helps us understand why service users may react strongly to a social worker and vice versa, and the idea of defence mechanisms, which helps us understand how people may react when faced with things that are threatening to their sense of self. These two parts of psychodynamic theory can be integrated into social work practice even if the rest of the theory is rejected. There are many other psychological theories that can be helpful in social work: transactional analysis, Gestalt theory, Group Theory, Neuro-linguistic Programming and Trauma Theory to name but a few. However psychological theory, like any other theory, must be used with caution. It is dangerous and inappropriate to rely heavily on theories you do not really understand. In many ways a weak theory applied well is more likely to be effective than a strong theory applied badly. For this reason it is important to continue to study hard and develop skills in using the theories that underpin your practice. It is also important to repeat that whilst many formal psychological theories exist, all of us, service users and social workers alike, hold informal theories about why we and others do what we do. When working with people it is important to weave together the formal theories

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we know and can use with the informal theories of those we work with. This ensures a ‘goodness of fit’ between our theories, those of the service user, and the evidence based that should underpin good practice.

Social Factors Finally, in the basic model, it is important to address social factors when assessing intervening in social work. Social workers can range from the immediate social world of the service users: their family, friends and neighbours, loneliness, bullying and social support, to the impact of social policy and law on the lives of service users. Key to this is an understanding of social oppression, as discussed in Chapter Six, and an understanding the systems that influence people, as discussed in Chapter Ten. It is important when addressing social factors to look at both strengths and difficulties. A strong, supportive social network is extremely helpful in enhancing well-being. Equally, the presence of peers, those sharing the same experiences, and allies, those supportive of your struggle, is important in terms of promoting social justice, combatting oppression and creating a healthier, more just society. Identifying and building upon such networks is very helpful in meeting the goals of social work. At the same time bullying, harassment and exclusion will all undermine well-being and social justice. Social workers need to be able to identify, name and challenge such social factors that are harmful to both individuals and society. There needs to be a careful balance between quiet optimism about people’s existing and potential social networks and a realistic scepticism about the actions of others in the lives of service users. It is important to get this balance right.

Creating Balance and Seeing the Bigger Picture A good social work assessment and intervention plan will keep these three elements in balance. It will ensure that the physical and biological needs are met, whilst also recognising both the psychological make-up of the individual and the impact of the social environment upon their well-being. Where these three are kept in balance there is likely to be a robust and helpful assessment and plan. However it is increasingly being noticed that this picture is incomplete. Biological, psychological and social health are not the whole story for most people, and where they are the whole story there is often a sense of something being missing. I argue that for the bio-psycho-social model to be complete there is a need to add a fourth dimension – the trans-personal. Trans-personal means “beyond the personal”, in other words, that which goes beyond the needs and experiences of individuals. Humans strive to create meaning in their lives, to see themselves as connected to or being part of something bigger than themselves. For some people this is expressed through religion or another clearly ‘super-natural’ or spiritual dimension to life. For other people this is expressed through a political or ideological dimension, a belief in a cause. For others still it is more tangible, the environment, or ‘my family’, or vaguer but still an immediate physical reality, such as ‘the future’. However this is expressed, what is clear is that if ‘I’ is the biggest thing I have in my life then I will tend to live a small life. The difference between existing, filling in the time between birth and death, and living, having a life that means something, is found in the ability of people to find and nurture this trans-personal dimension of their lives.

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Figure 28 - A Trans-Personal Bio-Psycho-Social Model

Psychological

Trans Personal

This transpersonal dimension to the model is enshrined in law, in the Children Act 1989 and the Mental Health Act, and yet is often absent from social work training or practice. Good social work practice needs to find simple yet effective ways to connect people back to the trans-personal. This is also perhaps why I am personally drawn to the radical model of social work. If all I am doing is fixing peopleâ&#x20AC;&#x2122;s psychological well-being (the therapeutic model of social work), or helping them fit into society (the maintenance model of social work), or merely administering a system (the managerial model of social work), then I sense that I am only having limited effect. If on the other hand I see my practice as part of a process aimed at radical social transformation then I am connecting to something bigger than myself, and also inviting service users to do the same for themselves.

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Appendix 3 – Solution Focused Practice Introduction Solution focused practice is one of the simplest approaches to social work currently available, however simple should not be confused with easy or simplistic. Two of the biggest challenges in solution focused practice are to stay close to the simple when you are being invited to become overly complex, and in applying the simple idea in ways that are anything but simplistic, in ways that recognise the complexity of people’s lives.

A basic start Solution focused practice is based around just two questions: 1) How would you like the future to be different from the present or the past? 2) What are you already doing that is moving you in that direction? Although each of those questions can be asked and answered in a virtually limitless number of ways, they will be the guiding principles for all that happens in a solution focused meeting.

Preferred Futures versus Goals Solution Focused Practice focuses on Preferred Futures and not on goals. Goals tend to be things that are SMART, Specific, Measureable, Achievable, Relevant and Time-scaled. Only one of those features is shared by Preferred Futures - Relevant. The only thing from this list that a Preferred Future must have is relevance; it must be something in the future that is different from the present or the past. Goals are specific, they are clearly defined and very narrow. Preferred futures are big, expansive, multi-layered and multi-sensory. Goals are measurable, you can count them, measure them, record them in an objective way. Preferred futures are beyond that, they are not countable, they are why things count. Goals are achievable, you’ve got to believe that you can get there. Preferred futures are impossible, they are too big and too grand, it’s just that you know that what you pass on the way will be worth it, even if you never arrive. Goals are time-scaled, you need to know when you are going to get there. Preferred futures are life-long, each step is another first step, each progress point is just a sign-post to the next one. There is an anonymous quotation that goes “We value what we measure, rather than measuring what we value.” This is the danger of goals. Goals set a measure and all too often we forget why we are doing it. So for example a person is over-weight and this is stopping them enjoying life. They decide to tackle this by strictly controlling their calorie intake and their exercise level. They obsess about this, feeling elated if there have kept within their limits and miserable if they have exceeded them, because their goal is now to stay within their calorie limits, which is measurable. But their Preferred Future was to enjoy life, something that cannot be measured by counting calories consumed versus calories burned.

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Asking About Preferred Futures At its simplest level you can simply ask someone about their Preferred Futures. What would have to be different for you to think it had been worth meeting with me today? What are your best hopes for our time together? How will you know in a week or a month’s time that what we have done together has been successful? It is possible to ask more complex and imaginative questions that help get a picture of the person’s Preferred Futures. Imagine you leave here today and we don’t meet for a year, but between now and then things change and your life has become exactly how you want it to be. When we meet in a year’s time what will you tell me, or what will I notice that will let me know that things are how you want them to be? Imagine we finish here today and you go home. Later tonight you fall asleep. While you are asleep tonight a miracle happens and all the things that have led up to you meeting with me today are no longer a problem. When you wake up tomorrow morning what is the first thing you’ll notice that will let you know this miracle has happened? Asking about what works As stated earlier, there are a practically infinite number of ways of asking the basic solution focused work questions. The simplest are to ask about exceptions to the problems. On the days when you feel slightly better, what is different? So when he’s not being cheeky, what’s he like the rest of the time? When was the last time you handled it in a way that seemed to work? Once you have found something that works the important thing to do is to move from these being seen as flukes to these being seen as something that the person themselves has created. People will often treat successes as accidents or as things that were caused by external factors, not to do with something they did. Carefully questioning usually reveals something the person did that made the difference. How did you get yourself to do that? What do you do that helped him be less cheeky? What did you do then? One really useful way of moving from Preferred Futures to specific details and to look at what is working is to ask Scaling Questions. Scaling Questions The simplest scales are number scales. On a scale of 1 to 10, where 1 is the worst it’s been, and 10 is how you’d like it to be, where would you put things now?

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Once you have asked this it is possible to look at what has got them from 1 to where they are now. This again needs to focus not just on what is different but on what the person did that made the difference. This is one of the key features of solution focused practice, the continuous search for the “difference that makes a difference”. Accidents, flukes and other people’s actions don’t lead to empowering change, but strengths and successes do. So as far as possible the worker wants to focus the conversation on these. Scaling questions can also help move from the big, unrealistic picture of the Preferred Futures to a manageable step on that impossible journey. This can be done by adding a series of follow-up questions. If 10 is where you’d really like it to be, where would it need to be for you to think things are good enough? What will let you know you are at that point? What will be the first thing you’ll notice that will let you know that you are one point closer to that point? I discussed earlier in the book that whilst some bits of this approach came easily to me others took five or so years of practice to be able to use them well. Solution focused practice is so simple that people can be fooled into thinking that it is easy: it isn’t. Solution focused practice demands that you pay exquisite attention both to your own language and the language used by service users. There is a need to develop a form of ‘deep superficiality’ – this means that people’s words are taken seriously instead of being interpreted. The worker adopts a ‘not knowing’ stance, working only with the words the person uses, but asks them to explain what they mean by the words that they use. SW – What would let you know things are working? SU – I’d be getting some respect? SW – Getting respect from who? SU – From my kids. SW – How would they show this respect? SU – They’d do what I’d told ‘em. They’d listen to me. You know? They’d respect me. SW – So you’d be getting respect if they did you you told them and if they listen to you? What else? At each point the social worker does not presume that they know what the service user means but incorporates the service user’s words in order to broaden and deepen their understanding of what they mean. This is an example of what I mean by superficial depth. Developing competence in solution focused practice is easy at the start but developing true proficiency is far from simple and takes years of dedicated practice. However this is more or less true for all the theories in this book.

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Appendix 4 – Eclectic and Integrative Practice Introduction A common theme throughout this book has been the need for social workers to work with service users to create a theory which fits the person instead of trying to get the person to fit the theory. There are two ways in which this can be done, through eclectic practice or through integrative practice. Eclectic Practice Eclectic is defined in the Oxford Dictionary of English as “deriving ideas, styles or taste from a broad and diverse range of sources”. What this means in effect is that a social worker will take ideas from a range of different theoretical approaches and use them together. You will sometimes see this written about positively in the social work literature, but I think it is a dangerous approach. In my experience when social workers have told me that they are being ‘eclectic’ this has been coded language for clutching at straws and not really knowing what they are doing and so desperately trying something and hoping it works. It is fine to derive ideas from a broad and diverse range of sources, but if you cannot weave them into a coherent whole then it is not going to be effective. Integrative Practice Integrative practice is based on the concept of integration, something the dictionary defines as “combine one thing with another so that they become as a whole.” It should be clear from this how integrative practice differs from eclectic practice. With eclectic practice there is simply the borrowing of ideas and techniques from a range of approaches in the hope that something will work. With integrative practice there is a conscious attempt to bring together the formal theories of the social worker with the informal theories (and in some cases the formal theories) of the service user into a coherent, combined, integrated whole. An ‘eclectic social worker’, might try using reward charts, a mood diary and an exercise plan in order to help a parent experiencing depression. An ‘integrative social worker’ might work with a parent to help them see how the parent might be unintentionally reinforcing their child’s misbehaviour whilst ignoring their good behaviour (behavioural theory), and then link this to how this is affecting the parent’s perception of themselves as an ‘incompetent parent’ (cognitive theory), which results in them feeling depressed and not taking any exercise which is worsening the depression (biological theory). Using this integrated understanding of what is happening the social worker suggests using a reward chart to tackle the behaviour, a mood diary to help challenge the negative thoughts, and an exercise plan to enhance physical well-being. As you can see from the above, although both social workers are doing the same thing, the difference is in how they do them. In the eclectic example they are doing what it seems like a good idea to do, in the second they have created a theory that fits the person and which is drawn from a range of sources. In summary – never be eclectic when you can be integrative.

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Appendix 5 – Social Work – repressive or revolutionary? Introduction Although the rhetoric of social work is about empowerment, liberation, justice and freedom, the reality is frequently very different from that. Social workers often go into the job with high hopes of being able to help people and change the world, and end up finding themselves as cogs in a machine that seems more interested in reducing costs and processing people through a system than in really changing the world. Beckett (2006) talks about this gap between rhetoric and reality. He gives examples of words like ‘partnership’ being used to ‘sweeten’ the painful reality. If the ‘partnership’ is based upon the idea that the person can ‘freely choose’ to comply with the plan or else the social worker will use their legal powers to make them comply, then what is the meaning of words like ‘partnership’ or ‘freely choose’? Beckett further warns of the danger of ‘decoupling’, this is where a theory is taught in a way that is utterly disconnected from what happens in practice. This was my personal experience of much of what happens with anti-oppressive practice. There was often talk of being anti-oppressive, or recognising the multiple levels of oppression faced by service users, yet when it came to ‘getting the job done’ these are conveniently ignored, or else rationalised away. So a service user is denied a service because it is too expensive or takes too much effort to provide, and the social worker explains this as being ‘anti-oppressive’ as they believed that not providing the service would enhance the person’s sense of coping. Social work may often talk a revolutionary talk, but it is tightly bound to the current social order. From recruitment processes, to education, to support for newly qualified staff, to service delivery to career progression we see the same inequalities and same injustices in social work as we see in the rest of society. Social workers are involved in policing ‘edge’ communities, from immigration control, to parenting, from mental health to drugs and alcohol services, social workers can be seen as building careers on the back of working for a system that seems to care little for those at the bottom of the heap. This is not inevitable. Social workers can fight back. At an individual level they can commit to being the best that they can be; to learning theories that liberate and don’t oppress, and in developing the skills to use those theories well. Collectively social workers can work with oppressed groups, not as ‘rescuers’ but as co-workers, to challenge stereotypes and create more just systems. As a profession social workers can work together to influence policy and practice to ensure that the profession is more than a softer tool to oppress, but is genuinely liberatory. All of this starts with you. Do not assume that just because you are training to be a social worker you will be a good one. Maybe you will, maybe you won’t, but you have a duty to take everything you’ve learned and everything you are and decide where you will stand – for repression or for . . . . a better future.

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Appendix 6 - Ten Useful Principles for Understanding Human Behaviour Introduction What I will present here are ten principles, developed over more than 25 years of practice, that I believe are helpful in understanding human behaviour, both your own and that of other people. I believe that in each case each principle is based on a sound evidence base, but here I only intend to outline them in brief. If you are interested you will have to research them for yourself and see if they can stand up to critical scrutiny. 1)

Human behaviour is multi-factorial. It is influenced by biological, psychological and social factors, and no single theory or model can account for the full complexity of what people do and why they do it.

Human behaviour is contextual. In general people behave the way they do more for reasons of the circumstances and situations they are in than for the type of person they are. This does not mean that personality and personal preferences play no part in human behaviour (see 1), but that in accounting for behaviour we tend to over-estimate the impact of personal factors and under-estimate the impact of environmental ones.

Humans attribute meaning to behaviour. Due to the factors mentioned in 1) and 2) it is often extremely hard to be sure why anybody does anything. Luckily understanding the causes of behaviour is less important than understanding the meaning people attribute to the behaviour. Understand this and the exact causes are largely irrelevant.

Meanings are co-created and contested. Different individuals will attribute different meanings to the same piece of behaviour. The person doing the behaviour may give it one meaning; the person on the receiving end of the behaviour might give it a different meaning; and a neutral observer might give it a third meaning. These meanings are also co-created in a wider social and cultural context so that different groups and different individuals will struggle to have their meaning taken the most seriously.

Meanings reveal power. In general the meaning the gets attributed to a behaviour is most strongly influenced by the person or people with the most power, for example, if a child thinks that they are not being heard and so shouts, the parent is likely to see this as the child being defiant. For the child the meaning is one of not being heard, but it is usually the parent’s meanings that carry most weight.

Meanings can help or hinder change. If a person believes that a behaviour is caused by things that are permanent they leave little room for change, for example thinking ‘I can’t help being depressed, I just have depression genes’. If on the other hand they believe that things can change then there is more chance of change.

Changing meanings leads to wider changes. Although sometimes a solution to a problem rests on doing something different, quite often it is possible to solve a problem by viewing it differently. If a behaviour is seen as being ‘naughty’ this will lead to a punitive approach being taken. If the parent changes their meaning and

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sees it as an ‘ineffective attempt by the child to have their needs met’, then a totally different, and probably more effective approach can be adopted. 8)

People do not resist change, they resist being changed. Seeing individuals as ‘resistant’ is likely to lead to them carrying out acts of resistance. Try to force others to change or imposing methods of change upon them without listening to them are all likely to be unsuccessful. So even where statutory powers are being used it is important to work with people, with their values and goals, and not against them.

Change is easiest from inside people’s own meanings. Changing someone’s mind about deeply held beliefs is not impossible, only incredibly difficult. In general the more you can understand and incorporate someone’s beliefs into your work the more likely you are to be able to help them change. For example, in the example given early of ‘depressed genes’ it is likely to be fruitless to try and persuade someone that genes play no part in depression, plus, we don’t know what role they play. Instead it is worth exploring that other genes the person has inherited that give other traits, and how maybe some of their other genetic traits could be used to mitigate the effects of their ‘depressed genes’.

10)

Assessment is about mutual meaning making. Many people believe that social work assessments are about uncovering the truth or finding out what is ‘really going on’. In my experience this is rarely the case. The truth is chaotic, complex and incomplete, and so much is ‘really going on’ that we never get the whole picture. Instead, when we make assessment we need to create meanings that come from a partnership power base, that respects the values, views and needs of all concerned, especially the least powerful, and which open up possibilities for wellbeing and social justice, rather than reinforcing oppressive views and practices.

As stated at the beginning, these are not absolute statements of facts about human behaviour, merely ways that I have found useful in thinking about human behaviour. If you are interested, test them out and see if they work for you. If you aren’t then develop your own principles, and make sure you are fully aware of the principles you do have, as they will definitely shape the way you interact with service users.

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Closing Remarks This book has been slowly evolving over nearly 20 years, since I first became a practice teacher and began thinking deeply about the role of theory in social work practice. In writing this book I have had to think carefully about what to include and what to leave out. As a result two of my favourite theories, narrative theory and cognitive theory, get no more than passing mentions. This is an inevitable result of trying to write a book that is manageable for both you as the reader and me as the writer. At the end of this book I would like to finish with a final theory, one that fascinates me and one that is deeply misunderstood. Over the past three or four hundred years we have seen the growth and development of the Nation State, with a corresponding growth in government interference in the lives of citizens. The ‘naturalness’ of the nation state and the ‘right’ of governments to tax and enforce laws are so taken for granted that it is rare to hear them seriously challenged, but perhaps that is ripe for change. There is nothing inevitable or natural about nations or governments or capitalism, any more than there was anything inevitable or natural about slavery two hundred years ago. The hierarchies that take root and grow in nationalism and capitalism, of class, gender, ethnicity, sexuality, religion, ability, status and so on can be challenged. I realise that a completely non-hierarchical world is impossible, after all those who are five feet tall will, on average, not be as good basketball players as those who are six feet six inches tall, and those who have studied a trade for years will, on average, be better at it than those who have just started. But these differences are minor and irrelevant. What I am talking about is a world of equality, respect and mutual aid, and this done through voluntary cooperation, not state coercion. The name for this is anarchy. Anarchy is not the same as anomie. Anomie is ‘normlessness’, a breakdown of the social order and a descent into chaos. That is not anarchy. Anarchy is ‘no rulers’, not ‘no rules.’ It is a self-organising, self-sustaining, self-managing social order of equals. This may sound like a dream, and I recognise that as things stand right now, it is. But go back three or four hundred years and the idea of women, or poor people, having the vote was a dream. We cannot achieve this overnight, and not in a single generation even, but if you will take the ideas of anarchy seriously, do some reading, and think about how you can create this type of society despite the state, with the state and against the state, you may be one of the pioneers who in a couple of hundred years is seen as one of the people who made this dream come true. Human rights, well-being, social justice, empowerment, liberation; social work is about making these a reality. So dream big, and change the world, one small act of resistance at a time. Mark Allenby – September 2014

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