Social work and the renewal of generosity towards service users and social workers

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World Social Work Day
19th March 2024

Shared future for transformative change

Image: Illustration of hands and the globe

By Professor Harry Ferguson
Professor of Social Work, Department of Social Work and Social Care, University of Birmingham

Every day in this country social workers perform countless acts that make a real difference to the lives of thousands of people. What they do involves kindness, compassion, courage, resilience, cleverness, wisdom and high levels of knowledge and skill. Social workers routinely meet the very difficult challenge of having to balance empathy and compassion with exercising power and authority to protect the hurt and the vulnerable. While in some situations the harm is so great that they have to remove children from their families, in many more they work effectively together with the family to prevent this from happening. They sit steadfastly with people in their pain, such as those troubled by mental health problems, the sick and the dying and help those who are consumed by the grief of losing loved ones.  They understand and are enraged by the ravages of inequalities and support people who are on the margins and dispossessed, most of whom no one else wants to know. They heal. Without social workers it would be hard to claim that this is what we can call a civilized society.

But despite all this, you would be hard pushed to know that social workers are doing anything worthwhile at all. This is because it is heavily criticised in the media and from all sides for various ‘failures’ to protect children and vulnerable adults from serious harm and death. Public responses to social work completely lack generosity. The costs for the profession and those directly involved in such tragic cases are huge. Meanwhile, what social workers actually do day in day out is ignored or misunderstood.

Research is now seeking to rectify this by conducting studies that get as close to social workers in practice as possible and observing what they do. In carrying out this kind of ethnographic research for over a decade I have been privileged to witness the sheer richness and complexity of what goes on.

For example, Maria (28) had been involved with social work on and off since a child. She had previously had her children taken into care due to drug addiction and a very abusive partner. She had become pregnant again with a new partner, Patrick, and the social work assessment concluded they had the capacity to provide good enough care for their baby girl, Isabelle. Maria initially mistrusted the social worker and in her own words they got off to a “rocky start”. I observed the social worker’s skilful use of empathy and how it enabled the parents to express their fears and needs and trust developed. They were helped to stay off drugs, to resolve arguments in safe ways and supported to learn about how best to care for their baby. Still, some tense, difficult moments were observed – such as when there was concern that Maria was breaking the terms of her authorised use of methadone to come off drugs by stockpiling it.

On all of the encounters I observed, Shelley the social worker gave quality attention to the baby, Isabelle. On a typical home visit Shelley held the baby for 12 minutes, placing Isabelle in front of her and making eye contact, smiling and talking to her and allowing the baby to nestle in her arms. The worker established a relationship not only with the parents but directly with the baby, who responded pleasurably, holding the worker’s gaze and wriggling. Isabelle was very well cared for and after a year she came off the child protection plan and involvement ended. Maria and Patrick were very clear that the social worker had helped them to transform their lives, for the better.

Finding a language through which the quality of care social work provides can be better understood, valued and developed is vital. In his book The Renewal of Generosity: Illness, Medicine and How to Live, the sociologist Arthur Frank argues that best practice in health and social care requires that the most basic of human practices are infused with generosity, an important part of which is the kind and considered use of touch and always looking the service user in the face. Connecting with their gaze helps to keep open a dialogue about their vulnerability and needs and enables workers to do their most generous best for this person in this moment. It was precisely the intimate quality of generosity, along with a critical understanding of power and the family’s social and economic situation that was at the heart of the skilled relationship-based practice Shelley used to help Maria and her family. The worker and parents crafted what I call a ‘holding relationship’ within which the baby was a ‘held child’.

It is high caseloads, time shortages, austerity and cuts to services and the excessive demands of bureaucracy that push stressed workers to look away from the gaze of their service users. The resulting anxiety can become unbearable and the needs of service users like abused children become invisible. Vitriolic public criticism has the perverse effect of making social workers struggle to ever feel good enough. Thus in the many conversations I had with Shelley the social worker she was quite self-critical and struggled to recognise how generous and effective she herself had been. She could not be generous to herself. Achieving this is not solely the moral responsibility of individual practitioners. If practitioners are to be generous to themselves and achieve the best for service users, they need to be treated generously, by their managers, peers, the government, media and by wider society.

The more generosity is renewed and shown towards social work the better it will be for the profession and most importantly those it seeks to help.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of the University of Birmingham.

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