Just what do social workers do? - Stephen Mordue

“Just what do Social Workers do!?” It’s a question you get used to hearing as a social worker. It can be born out of a misunderstanding and, sometimes, people are surprised to find that we don’t simply remove children from their family or place old people in care homes. Or it could be that people can’t quite put their finger on what it is that social workers do when they aren’t doing the two aforementioned things. I often ask first year social work undergraduate students, “What is the unique contribution that social workers make when they go about their jobs?”. They can come up with answers, usually after a period of musing on the question. “They listen to people”. So do doctors, nurses, and solicitors. “They provide people with solutions”. So do mechanics and architects. “They spend time with people”. So do counsellors and salespeople. 

My answer is that it’s not actually what social workers do that is unique but how they do it. They approach things, consistently, from a particular standpoint, or should, at least. People ‘consult’ those mentioned above because they are experts with knowledge that the person doesn’t have. The mechanic knows about a car engine, the architect knows how to design a building that won’t fall down, and the doctor knows how to analyse your symptoms and prescribe a medicine to ‘fix’ you. Social workers listen. Social workers guide. Social workers coax people to find their own solutions,  or they should. Social workers know that the person is the expert in their life, and that any solution prescribed by the social worker to overcome whatever adversity the person is currently confronting is likely to be less successful than a solution that the person arrives at and creates for themselves. The social workers ‘skill’ is helping the person realise that potential. The role is to empower them.

I practiced most of my social work with adults under a care management model. The care management model placed the practitioner in the position of expert, with a bag full of solutions like home support, meals at home, and day care that we levered people’s problems into. A one size fits all approach. I worked with older people. “You’re lonely? We have day care”. “You can’t get dressed yourself? We have home support”. “You can’t cook a meal? We have meals at home”. Gollins et al (2016) observe that such formal services are vital for some but that that wellbeing, as defined in the Care Act 2014, needs to move beyond such support and draw on the resources of individuals to build and maintain their family and social connections and have them engage in active citizenship. This approach is usually referred to as a strengths or asset-based approach. What does such an approach look like?

As a starting point, we should note the view of Ferguson (2012) when he states that whilst “good practice requires that workers seek to maximise their clients’ self-determination and support them to take risks, dependence is also part of the human condition. All of us will experience periods when we will be dependent on others” (p.59). This reflects the need for both formal services as Gollins et al (2016) pointed out and the need to place service users at the heart of the social work task. Ferguson (2008) also comments that we need an eye to social change and justice rather than simply involving people in services and their development. There’s a need to explore things from a social rather than an individual or biomedical model of health or disability. The social model locates the barriers to self-determination as being in the way society is constructed and, therefore, places responsibility on society to adapt and help, whereas the other models mentioned place the problem with the individual and with a deficit they may have.

The problem here, as I see it, is that if we are not careful this plays straight into the hands of an agenda that says (among other things) that we are personally responsible for our problems. The concept of a strength-based approach is sound. The risk is it is misappropriated to a different cause; that of saving money and fuelling a ‘you are your own responsibility’ way of thinking. That is the risk.   The solution, as Ferguson puts it, is to take a social model of disability perspective and reshape the structures of society by moving away from the ideologies that underpin it. Caution is required as the solution that social work is offered could place the problem back with the person by drawing, first and foremost, on their strengths and assets. Those who can’t solve their own problems, in that situation, are left with services underfunded and decimated by austerity. 

The strengths model moves away from assessment of need and deficits and the proposing of pre-arranged solutions and encourages a positive view of people’s skills abilities, aptitudes and preferences. It is about finding ways to maximise these things (Davies 2012). Saleeby (2009) explains that “All humans, somewhere within, have the urge to be heroic; to transcend circumstances, to develop one’s powers, to overcome adversity, to stand up and be counted.” This isn’t a new idea. Philosophers have been explaining this to us for some time. Aristotle (384-322 BCE) called it eudaimonia or human flourishing. He noted that people strive to reach their innate potential, and this occurs through making their own choices and taking their own actions. Cicero (104-44 BCE) said the same. Being autonomous and being part of a community are crucial to identity and a sense of self.

Echoing my opening paragraph, a strengths-based approach is just that; an approach. It is how social workers do what they do not simply what they do that’s important. It draws on the notion of being holistic and engaging with the whole person, not just any deficit they may have, because that’s where strengths will be found. It is about being collaborative. Inevitably social workers will have knowledge that can assist the person in their quest for their solution. This is about co-production not ‘professional production’ of solutions. It needs to be proportionate. There will be times a formal service is required but the provision of such services shouldn’t restrict people or disable people. Rather, such services should be provided to enhance and ‘set free’ people to live their lives and not be restricted by a disability or an issue they are facing. This may well need society to change. It needs to be aspirational with a focus on what matters to the individual, enabling them to flourish. This may involve people taking risks and practitioners living with feeling uncomfortable about that if, indeed, they do.

There are commentators who see this a ruse to move responsibility to individuals and save public money. The Department of Health (2019) respond to the detractors in relation to this approach by stating, in their strengths-based approach practice handbook, that it is not about reducing packages but, rather, about finding solutions that provide better outcomes. It’s not about signposting people elsewhere and offering less support. It’s not about shifting responsibly to carers and family to save money. I recollect, several years ago, listening to a Radio 4 feature where an older woman was being provided with meals at home and her service was being cancelled. She was talking about how the provision of the meal not only provided her with sustenance but with human contact. I was struck that in the reality of her situation her priority was to have someone to talk to and the provision she had received had been a meal at home. She wanted, she said, someone to sit with her and eat with her. She was a great communicator. A better solution may well have been connecting her to her community, to someone who was physically able to prepare a meal for them both and who was maybe looking for contact because they were lonely. Win, win. But she had been provided with a meal being delivered by someone who only had the time to stay for a few minutes. And now that meal was to be no longer provided. More effective solutions rely on drawing out her strengths and someone available to help find solutions, who has good knowledge of the community in which she lives. 

 

The 3 Conversations Model (Partners for Change 2018) sets out a different way to work in adult social work which may fit with such an approach. Partners for Change, who developed the model with a number of councils, claim it “has demonstrated how you can give a better deal to people and families who need support”. (Partners for Change 2018). The first conversation the person has with a social worker is focussed on finding out what really matters to the person and looking, with them, to see how they can use their own resources and the community around them to meet their outcomes. The impact of this is an increase in face to face work with people and a much more person-centred focus starting with the strengths of the person and their networks. This leads to people creating their own solutions that they may more readily engage with. 

The second conversation, often when there is a crisis, and time is of the essence, seeks to create stability from which people can find their own solutions with support. This could involve their own resources and those of the community but could also include some short-term commissioned services. Crucially though, the social worker ‘sticks like glue’ (to use the words of Partners for Change) to the person to make sure the plan works and, if it doesn’t, to seek to change it.

Third conversations seek to build a ‘good life’ for a person where there has been a significant change or development. It would still start with the persons own resources and the community but may well include a more extensive package of care. 

Not only is it claimed by Partners for Change that this model works better for service users but also that it’s much better for social workers. I can see that may well be so. In examples that Social Workers have described to me conversations one and two rely mostly on case recording of information, decisions and services with only the ‘full force’ of bureaucracy occurring during conversation three where extensive packages of care with significant financial consequences are required. This means less time in front of the computer and more time with people. A return to the roots of social work, you could argue, which creates liberating and exciting jobs for staff. (Partners for Change 2018).

The strengths-based approach is what good social work has always been about. Good practice has always been about placing the service user at the heart of what social workers do. An ‘exchange model’ of assessment, that places the service user in the role of expert in their lives has long been regarded as best practice. So, this ‘new’ approach is rooted in social work’s history. It may well shape its future, and I hope it will, as it draws on the uniqueness of the individual. It may encourage new shoots of ‘community’ and it may go on to shape a shift in society’s view of those in need of care and support. Time will tell.

 

 

 

Stephen Mordue is a Senior Lecturer in Social Work at the University of Sunderland. As well as teaching about Adult Care on the undergraduate and postgraduate programmes he is Practice Learning Coordinator and Programme Leader for the Best Interests Assessment in Practice Programme. He was a social work practitioner and manager for 12 years working mainly with older people and their families. His areas of special interest are effective communication, working with people with dementia, the Mental Capacity Act, and self care and productivity for professionals. You can read more about wellbeing in his book, available here; https://www.criticalpublishing.com/how-to-thrive-in-professional-practice or by visiting Stephen’s blog for self care www.selfcareshorts.com and social care socialworkshorts.co.uk

References

Davies, M., (ed) (2012) Social Work with Adults Palgrave Macmillan

Department of Health (2019) Strengths-based approach: Practice Framework and Practice HandbookDepartment of Health and Social Care

Ferguson, I. (2008) Reclaiming Social Work: Challenging Neo-liberalism and Promoting Social Justice Sage, London.

Ferguson, I. (2012) ‘Personalisation, social justice and social work: a reply to Simon Duffy’, Journal of Social Work Practice, 26(1), pp. 55–73. doi: 10.1080/02650533.2011.623771

Partners for Change (2020) Partners for Change http://partners4change.co.uk/ (accessed 3rd April 2020)

Saleebey, D. (2009) Strengths Perspective in Social Work Practice 5th Edition University of Kansas