Social work is subject to a state of conflict caused by the incompatibility of two overall rationalities: individual client treatment and compassion on the one hand, and mass processing and rule-application on the other (Lipsky 1980: 44-45). These conflicts are mirrored in daily dilemmas when ideals and goals collide with the complex and ambiguous reality of staff-client en- counters. Using a Danish hostel for the homeless as an example, this article explores the nature of such dilemmas and the processes involved in trying to solve them.
Roughly speaking, hostels in Denmark can be divided into two catego- ries in terms of drug and alcohol rules: either the use of drugs and alcohol is tacitly accepted in certain areas (e.g. residents’ own rooms and outdoors), or it is not accepted on the premises at all1. In both cases, hostels are con- stantly confronted with the issue because the use of alcohol and illicit drugs like cannabis, heroin, cocaine and various kinds of pills is an integral part of homelessness.
In a larger perspective, the difference between rules corresponds to a dif- ference between two competing approaches to drugs: zero tolerance versus harm reduction. Policies of zero tolerance, if interpreted rigidly, maintain that drugs should be prohibited and eradicated through tough-on-crime police actions, and also (something which is important in this context) focus on abstinence when offering drug treatment. In contrast, harm reduction is a pragmatic approach based on the argument that the war on drugs has failed, consequently taking as a starting point that drugs are here to stay. Instead of only one goal of abstinence in treatment, goals should be differentiated and based on individual wishes and realistic assessments. Harm reduction
may or may not lead to abstinence in the long run, but the first priority is to treat the harmful consequences of use. Substitution treatment and free delivery of needles are examples of harm-reduction initiatives (Jepsen 1993; Ege 1997; Narkotikarådet 1999; Asmussen & Dahl 2002; Houborg 2007). To some degree, this difference in policies is reflected in the rules of hos- tels: zero tolerance translates into a non-acceptance rule, and harm reduc- tion into an acceptance rule. As a basis for analysis, this article focuses on a hostel that pursues a non-acceptance rule because doing so makes dilemmas engendered by the conflicting rationalities of harm reduction and zero toler- ance stand out with specific clarity – there is an obvious paradox in being a provider of services for homeless people who are known to be heavy users, while forbidding them from using drugs at the same time. The paradoxical nature of this rule is also displayed by the fact that forbidding residents to take drugs and drink alcohol, implying a degree of control, collides with a basic idea in social work: that social workers should try to establish a relationship based on confidence with clients. The establishment of such a relationship is considered to be basic if clients are to change or develop in directions that are believed to be better for them.
An equally important aspect of social work is that clients should be treated in a universalistic way – i.e. without discriminating. Despite sincere attempts to live up to this ideal, work is nevertheless, as Michael Lipsky (1980) rightly points out, influenced by worker bias: some clients are preferred to others. Lipsky draws attention to three circumstances in which street-level bureau- crats display biased behaviour: first, some clients simply evoke more sympathy than others; second, some clients are believed to be more worthy of services than others; and, third, some clients are preferred because they respond well to treatment (Lipsky 1980: 108-111).
These biases can also be viewed as elements of a model of social exchange which was developed by Marshall Sahlins (1972). According to this model, social exchange can be categorised in three analytically distinct forms: gen- eralised reciprocity, balanced reciprocity, and negative reciprocity. The dif- ference between the three is in the ‘spirit’ of exchange, and can be placed on an imagined continuum between two poles with the positive at one end (‘people we like’), the negative at the other (‘people we do not like’), with balanced reciprocity in the middle (‘people we have agreements with, almost
independently of likes and dislikes’) (Sahlins 1972: 194-195). Applying Sah- lins’ model to the categorisation processes of social work, it appears that generalised reciprocity includes clients who evoke sympathy, who are viewed as worthy, and/or who are responding well to treatment. In contrast, clients who are disliked or who do not respond well to treatment are subjected to negative reciprocity. Third, balanced reciprocity includes clients who are considered to be worthy and who respond well to treatment, while issues of likes and dislikes are scaled down.
This article argues that it is not the rule of non-acceptance in itself that causes dilemmas, but the conflicts between several overall rationalities that cannot be united into one unambiguous way of acting. It is at the point of trying to translate these conflicting policies into practice that dilemmas arise. Specific attention is paid to the conflict between rule application and individual client treatment because it seems to permeate all other dilemmas. Furthermore, this article argues that dilemma management in social work has a lot to do with classification processes. Placing relationships and people in categories reduces complexity, thereby engendering more straightforward solutions to problematic situations. Despite its dilemma-ridden nature, every- day life at the hostel nevertheless runs pretty smoothly. This may be partly explained by a pragmatic approach sometimes employed by staff in which they prevent a dilemma arising by not gaining knowledge about offences commit- ted by clients – or by ignoring knowledge they have already obtained. These arguments are based on an analysis of views and opinions shared by staff when they discuss the consequences of violating the rule of non- acceptance of drug and alcohol. Since meetings among staff constitute the structural frame for the exchange of views and decision-making, these are central objects of analysis. Here certain themes stand out: first, the resident’s possible benefits from the services provided by the hostel; second, the worthi- ness of the resident; and, third, the nature of the relationship between the resident and staff. This analysis has wider relevance for other hostels inde- pendently of the nature of their rules, as well as for social work in general.