LA ÉTICA EN LA ACCIÓN SOCIAL DE LOS TRABAJADORES SOCIALES
2. La racionalidad práctica en las profesiones
The most significant of the large-scale studies of social work activity, (and the most comparable to the social work field in this study) examined social services in 39 area and hospital (general and psychiatric) teams in the UK (DHSS, 1978). Several useful findings about the content and shape of social work practice were made:
(a) the diversity of problems and client needs made it difficult for social workers to generalise about their methods of work. While most workers referred to their work as ‘casework’, ‘the number of meanings ascribed to this rendered it less than useful in clarifying what social workers actually did with clients’ (p. 103), and for most it embodied a number of activities used singly or in varying combinations.
The generic casework approach was one which not only recognised multiple causation of problems but, in turn, drew from a number of specific techniques of intervention and cast the social worker in a number of different roles. (p. 103)
(b) the extent to which social workers planned their interventions varied: at times activities constituted part of a carefully worked out plan, but at other times, interventions were chosen on an ad hoc basis in response to unfolding events (akin to Eraut’s ‘cold’ and ‘hot’ situations).
(c) while most workers seemed eclectic in their methods and focused on the psychological, social and material causes of problems, there were some important differences in emphasis. For example, a few workers in one local authority office focused mainly on ‘in-depth’ work, concentrating on the emotional functioning of clients and seeking to offer help by use of the social worker-client relationship, or by adopting an interpretative role. Others concentrated on practical ‘service provision’. And there were indications of tensions between the two. ‘In- depth’ work was often the subject of derogatory remarks in the local authority setting: ‘too much concerned with changing the personal behaviour of clients, too little concerned with changing the environment’, but those who adopted an ‘in-depth’ focus were adamant that it did not diminish their interest in environmental problems or their sensitivity to material needs. In other social work locations, such an approach was accorded high status and equated with ‘real’ casework.
(d) Particular approaches to practice were equated to specific settings and agencies. The most common remarks about ‘in-depth’ work centred on its inappropriateness in a local authority
setting. Some found that they could use this skill only in a limited way on a small number of cases because of other demands on their time. Other workers, in psychiatric hospitals, engaged more extensively in psychotherapy or ‘psychotherapeutic discussion’. In the settings surveyed, with the exception of designated community work posts, most practitioners were engaged in work which reflected a therapeutic-reflexive or individualist-reformist orientation (Payne, 1997). While virtually all workers saw practical assistance of clients as part of the social work task, in some cases, social workers’ own orientations shaped their work towards practical provision. The finding that social workers do not necessarily engage in change-work is also supported by studies of social work in various settings which found that in many cases studied, no particular change was sought (Goldberg et al., 1976, 1977, 1978). Work often consisted of supporting or monitoring rather than actual attempts to achieve change.
A second study of relevance carried out by Sinclair and Walker (1985) was an evaluation of task- centred casework in two London intake teams.55 In only 35% of cases was the task-centred model completed and in only 17% of all cases did clients feel that ‘substantial inroads’ had been made into their problems. Client characteristics which appeared to influence outcome included motivation, capacity and opportunity. A key element was agreement between client and worker regarding the problem and what was to be done about it: ‘A simple agreement scale was constructed and, with one exception, all the high scorers on this scale also reported that their problems were completely or substantially reduced’ (p. 77)56
.
However the most significant finding for this study was the influence of individual workers on outcome:
Some workers got a relatively high percentage of their clients into task-centred work, and these clients were likely to report considerable problem reduction. Other workers had a relatively high proportion of drop-outs, and those clients who did not drop out were less likely to be satisfied with the results. As a result of these two processes, the ‘successes’ were almost completely concentrated in the caseloads of four of the thirteen workers. By contrast, the ‘worst’ five workers had only one success case out of forty. (p. 79)
The authors conclude that
In developing task-centred work it is necessary to take account of possible differences between individual workers … Curiously, investigation of individual differences in the effectiveness of social workers appears to have been neglected despite the crucial relevance of this subject to social work training. The present study suggests that there probably are such differences and that they are important. (p. 82)
Other studies have identified worker competencies rated highly by clients and/or social workers (Drake, 1994) or examined components of the ‘helping alliance’ between workers and clients (Dore
55
Social workers received training in task-centred casework and were then required to carry two cases each using the approach. Forms were devised to describe the work, using a simple ‘before and after’ design, and clients were interviewed by an independent assessor following closure of the case.
56 This supports the work of Maluccio cited earlier, which found that agreement between worker and client
& Alexander, 1996) but the issue of whether workers are intrinsically more suited to certain approaches over others has remained unexamined and will be considered in this study.
The use of theory by practitioners
‘Theory’ as a concept has many different meanings and a distinction needs to be drawn between ‘theory’ and ‘knowledge’. Theory is only one form of knowledge that professionals draw on. Drury-Hudson (1999) distinguishes between theoretical knowledge57, empirical knowledge58, procedural knowledge59, practice knowledge60 and personal knowledge61. Fook (2000) considers that ‘theory’
… can vary from a single descriptive idea, concept or label, to more complex sets of related ideas. Often just ‘naming’ or labelling a piece of behaviour can function to provide some explanation, or connect the behaviour with related ideas. (p. 4)
Payne (1997) makes a distinction between theory as ‘a general statement about the real world whose essential truth can be supported by evidence obtained through scientific method’ (p. 35), and a social constructionist/postmodern view of theory which has three different possibilities:
a) Models ‘which describe what happens during practice in a general way, applying to a wide range of situations, in a structured form, so that they extract certain principles and patterns of activity which give the practice consistency …
b) Perspectives on a complex human activity [which] express values or views of the world which allow participants to order their minds sufficiently to be able to manage themselves while participating … [and]
c) Explanatory ‘theory’ [which] accounts for why an action results in particular consequences and the circumstances in which it does so’ (p. 35).
Payne argues that social work theory should be considered in the second looser postmodern sense, because ‘most social workers use ‘theory’ to mean ideas that influence them as opposed to things they do in practice’ (p. 37).
57
Defined as ‘a set of concepts, schemes or frames of reference that present an organised view of a phenomenon and enable the profession to explain, describe, predict, or control the world around him/her’ (p. 150)
58 ‘Knowledge derived from research, involving the systematic gathering and interpretation of data in order
to document and describe experiences, explain events, predict future states, or evaluate outcomes’ (p. 150)
59 ‘Knowledge about the organisational, legislative, and policy context within which social work operates’
(p. 150)
60 ‘Knowledge gained from the conduct of social work practice which is formed through the process of
working with a number of cases involving the same problem, or gained through work with different problems which possess dimensions of understanding that are transferable to the problem at hand’ (p. 150).
61
‘An inherent or spontaneous process where the social worker is necessarily committing him or herself to action outside of immediate consciousness, or involves action based on a personalised notion of common sense. Such knowledge includes intuition, cultural knowledge and common sense’ (p. 150).
Empirical studies confirm the perception that practitioners in general do not rely on the use of theory or particular practice models in a linear, methodical manner to guide their practice (DHSS, 1978; Carew, 1979; Corby, 1982). For the purpose of this study, theory will be considered as a broad-ranging concept, encompassing single ideas and concepts which may be neither generalisable nor explanatory, as well as more complex interrelated structures.
Fook et al. (2000) make an important distinction between knowledge and skills, maintaining that for skilled social work practice both substantive information (or theory) and procedural knowledge (or skilled knowledge of how to use that information, especially in unpredictable situations) are necessary:
When professionals learn to practise, they must develop knowledge about a phenomenon, and knowledge about how to use that knowledge … the former may be termed ‘knowledge’ and the latter ‘skills’. (Fook et al., 2000: 9, my emphasis)
‘Formal’ theory is defined (Fook et al., 2000) as that which has been taught on academic courses, including practice methods. In this study, I will use the term ‘formal theory’ in the same way but will distinguish between an ethos or philosophy of practice (equivalent to Payne’s perspective) and a practice method (equivalent to Payne’s model).
Several features of practitioners’ use of theory were identified in the DHSS (1978) study.
Deviations from textbook models
Detailed questioning of the workers indicated that the specific approaches to practice (equatable to the ‘model’ level) most commonly mentioned were rarely understood and practised in the ways specified in textbook models. For example, crisis intervention theory was rarely used as a step-by- step approach to promote the client’s problem-solving capabilities, but was:
… frequently used to describe a crisis for the worker or agency … (with social workers’) offers of practical support and intervention … geared towards allaying their own anxiety, especially in ‘at risk’ cases, rather than the planned first step of a crisis intervention model. (pp. 115-6)
The study also found that the core principles of ‘contract work’, involving the client in discussions about role and time limits, were not adhered to; what was described as contract work was workers drawing up plans by themselves. Similarly in task-centred casework, descriptions of practice did not accord with the prescribed method, but instead ‘was interpreted rather widely to mean purposeful or focused work’ (p. 121).
The DHSS study found that workers did not modify definitions of task-centred work because they had experienced difficulty in implementing the textbook model, but because ‘they never fully
explored the relevance of the text book model’ (p. 121). The reason for this is not explored, but two possibilities can be suggested:
(i)practitioners had not spent enough time on training courses or placements exploring the nature and relevance of different approaches; or
(ii)agencies did not support an theory-based approach.
Both possibilities have received some support from subsequent studies. Marsh and Triesolitis’s (1996) survey of recent social work graduates found a high level of dissatisfaction with the teaching of social work methods on their training courses. They also found that, while most respondents saw value in a good theoretical grounding, they were not encouraged to apply theory in their daily practice62.
This accords with Stevenson’s and Parsloe’s (DHSS, 1978) point about the role of the team leader/supervisor in shaping practice, and also relates to Pithouse’s (1987) observation that, in area social work team culture, workers saw themselves as the definers of good practice. A point of some interest but not expanded in these studies, is why in some settings, peers become the definers, whereas in others, the team leader becomes the definer.
Matching client/problem and approach
Workers repeatedly referred to the problem of matching client and problem to approach at the assessment stage. A study of social assessments in a specialist (probation) setting, however, found that both practice models and theories were used formulating assessments and most workers used a psychosocial framework (Curnock & Hardiker, 1979). Secker found that social work students who used a ‘recipe’ approach and tried to apply particular methods methodically from the outset frequently ran into problems, because clients resisted this approach to practice especially from social work students who focused more on the right steps to take than on the establishment of a helpful relationship (Secker, 1993).
Personal models for practice