Promoting therapeutic and relationship-based approaches in social work

Bristol Balloons

How do we understand relationships now?

A discussion which began during the Covid-19 Pandemic, two of our trustees begin by sharing their reflections

Nigel's reflections:

The social work relationship has always depended upon closeness and boundaries: the closeness of attentive listening, empathy and respect; the boundaries of professional role, context, task and statutory responsibility and requirements. First encounters are often by remote means – the letter, email or telephone – but the traditional heart of the social work relationship lies in the physical presence: being present, accessible and responsive. For me, as a probation officer, it was axiomatic that any relationship with a prisoner after release, when in all probability s/he would be required to come to me,  should ideally be built not only upon writing during the prison sentence – by which I mean an element of real correspondence – but also making the effort to visit the prison, however distant, and sit and ‘be with’ the person ‘in that environment’. Changes in policy on restricting prison visiting caused me distress and the occasional flouting of official instructions: I argued special cause in the written record and went anyway.  

During the Covid-19 crisis with lockdown – and restrictions quite possibly for months to come – this close physical proximity is denied us in most situations on grounds of public health and personal safety but, as with all positive relationships, this is based upon mutuality: it is your and my public health, your and my personal safety, your and my vulnerability. And this mutuality opens the door to the trust in the relationship upon which social work depends.  The unvisited prisoner carries the grievance that ‘I wasn’t worth the effort’ and/or ‘my probation officer couldn’t be bothered to make the effort’; finding creative ways to connect virtually – whether in writing, by telephone or visually through new technology – at a time of enforced isolation coupled with anxiety, stress and disorientation is a statement of determination to continue to ‘make the effort’ to reach out and care. And, as was pointed out at the last Trustees Meeting, the stress and anxiety applies as much to the social worker, with the unknowns of what is happening behind closed front doors and is harm and suffering occurring unnoticed and unsupported, as much as the service user, who may be experiencing near-intolerable levels of isolation or difficulty. Such virtual contacts from a distance have their own techniques and demand their own sets of skills – the responsive flux and flow of communication has a different quality and dynamic – but the underlying imperatives of building a relationship will still apply. Others in practice or near to practice – not a position I’m in nowadays – I’m sure are aware of this and find their confidence and skill in this respect growing through experience, guidance and reflection. 

From infancy and throughout life, close physical presence is rich is cues and communicative exchanges – verbal, non-verbal, affective – that even the best Zoom-style contact cannot replicate in full but underpinning the social work relationship will always lie that genuineness in the relationship which is manifested through a commitment to ‘be with you in this environment’, whether it is on the prison wing or virtually in a lockdown world.” 

I’m reading the new edition of Juliet’s book: I’ve not read it before, so it’s new to me and I’m enjoying it very much. The book has helped tune me back in and, I think, has encouraged me to see if I could get this discussion about relationship off the ground. And I’ll also be tuning in on Saturday: see you then although Zoom will never fully replace us all meeting together in one place when this is all over. 

Nigel, May 2020

Katharine's response:

I initially struggled with my response to this question but in rereading Nigel’s response, remembered how my own career as a social worker began as an unqualified carer in a small group children’s home. In the mid 1970’s residential care had moved on from the use of family oriented descriptions for carers such as aunty and uncle to assistant housemother. The role description represents an interesting blend of the personal and professional and in retrospect accurately describes my sense of the role during the two years I spent there.

At the time I knew little of the work of John Bowlby and the Winnicotts and nothing of Melanie Klein and although I was aware of Freud, this was primarily from my art foundation year and personal interest in art and literature. I was seventeen years old (almost eighteen) and moved away from home to take up the post. Looking back the idea that I might have had the skills, knowledge and experience to be an effective Assistant Housemother seems ludicrous. I had barely learned how to look after myself! It was of course a steep learning curve and I have since come to realise how significant these years of residential work (I later worked in an adolescent unit as a Residential Social Worker) were in shaping my understanding of the significance of relationships both personally and professionally.

I like to think my lack of experience was compensated by a strong belief in the value of each individual and the importance of a positive and nurturing environment. Fundamental principles instilled in me by my mother whose work as a primary school teacher in tough inner city schools, gave me a strong sense of the impact of inequality and deprivation on a child’s development.  Other influences included a Methodist/Baptist upbringing and an unformed and naive idea of “doing good” in the world. More of a somewhat impractical older sister, I quickly acquired a range of household skills including ironing and perhaps more importantly, not making lumpy custard! At the same time I built relationships with each of the children in my care aiming to create a sense of safety, security, and understanding within the home.

The quality of the care I gave during this time was informed more by instinct than theory and I have since developed a much deeper and appropriately informed understanding of the needs of looked after children and young people including what is most essential if they are to thrive and achieve. Understanding the central place of relationships in social work practice in whatever setting we might find ourselves and across the lifespan has been central to my practice as a qualified social worker in a range of settings including palliative care. I have continued to be interested in the boundaries between the personal and professional and considered these from a psychoanalytic perspective when completing recent research, designed to gain a deeper understanding of the experience of those providing end of life care in care homes. Learning more about the ways in which emotional experiences determine an individual’s capacity to be attuned to the particular needs of another, or compelled to defend against them, makes it possible to understand the importance of emotionally containing and reflective individuals, teams and organisations.

Relationships are essential for our survival as human beings. We suffer when they are lost to us or compromised for whatever reason, including the impact of a pandemic. What they offer us ranges from the obvious (love and security) to the more difficult to quantify or even explain (the emotional support offered by a colleague over a chat in the office kitchen whilst making coffee or at the water dispenser) to the devastating (not being able to say goodbye to a dying relative) and deeply distressing (having to break bad news remotely and without the possibility of the sense of support created by being physically present).

Covid 19 has challenged relationships in so many ways and yet there are as many examples of the capacity of human beings to adapt and continue to care for and about one another. Placing the importance of human relationships at the heart of responses to the pandemic makes it more likely that positive outcomes can be achieved in all settings and in the most difficult of circumstances. Relationships are no more or less important now than at any other time in history but they remain our most precious resource.

Katharine Scanlan August 2020


Posted by:

Hannah Pepper

GAPS Coordinator