BADD 2014: Are Social Workers Part of the Problem?

This post is part of Blogging Against Disablism Day (BADD). Please click the link to read the other posts being published for BADD 2014. The scope of social work varies around the world; please note that I am writing from a UK perspective.

When I was a first year social work student, I studied a module entitled 'Values, Ethics and Empowering Practice'. For me, this was one of the most fascinating and engaging topics of the whole course. It opened my eyes to things I had never considered, gave words to concepts I recognised but had previously not found the words to express, and heavily influenced my personal attitudes.

The module also made me uncomfortable at times. During the course I realised my white, middle class privilege for the first time, and felt immediately guilty for it. I realised that racism isn't dead (yes, I was quite naïve aged 19). Lastly, I was confronted with the idea that sometimes, social workers are part of the problem. Sometimes, they contribute to the oppression of minority groups, instead of working against it.

Looking back at my old lecture notes, the first slide of the lecture on disablism (given by Professor Lena Dominelli) clearly states that social workers have contributed to the oppression of disabled people. I also noted how disillusioned with social workers Michael Oliver (a leading disabled academic) seemed in his book The Politics of Disablement (1990). This has stuck in my mind ever since. I felt intense discomfort at the idea that I would be seen as a problem by disabled people. I was being taught that I was supposed to be part of the solution.

This discomfort only continued when I became disabled myself and started reading disability blogs, some of which have contained stories of negative experiences of social workers and social services.  What was I supposed to think now? I felt like a fraud identifying as disabled, when really I was on what appeared to be an opposing 'side' (despite the fact that I was no longer working at this point). I knew that those experiences of other disabled people weren't right, and I longed for them to have experience of good social work practice. In an ideal world, social workers and disabled people should be on the same 'side'.

I had hoped to write a post exploring in detail how and why social workers contribute to disablism, however it became clear that if I were to fully explore each idea it would end up being a series of posts (which I don't have the spoons to write) rather than one. So I have done my best to summarise everything instead.

Let's start with how things should be. Here are some things I was taught in university that I feel are relevant to social work with disabled people. These are from my memory of what was said at university, unless otherwise indicated.

Self-determination This is the idea that the person, not the social worker, should be making decisions and choices about the person's life (Biesteck 1961)

Empowerment The idea that the social worker's interaction with the person should result in the person having more power over their life.

The social model of disability The idea, developed by disabled people, that people with impairments are disabled by a society that is not structured to be fully inclusive of them.

Seeing the person in context During training, we were always told that we must view people we worked with within their social context. When working with disabled people, this means acknowledging the oppression they face in wider society.

Addressing structural inequalities Lena Dominelli's view was that the role of the social worker was not just to assist people on an individual level, but also to challenge the structural inequalities that impact on the people social workers work with. She felt that social work could not be truly effective without this latter element.

Holistic assessment A social workers' assessment should consider all aspects of a person's life, not just tasks of daily living such as eating, washing and dressing. An assessment should also include discussion of working life, leisure activities and hobbies, religious or spiritual practice, family life, social life and relationships. To a certain extent, this is represented in current social care guidance.

The person is the expert in their situation.

Needs-led assessment Current social care guidance states that assessments should be based on what the person needs rather than the resources available.

Partnership approach The social work relationship should resemble a partnership in which the social worker and person work together to overcome the problems and barriers the person faces (French and Swain, 2002).

Anti-oppressive/anti-discriminatory practice Being aware of the oppression and discrimination that people face, and ensuring that social workers' own actions do not condone or contribute to this experience (Thompson, 2002).

It is important to note here that the values of social work haven't evolved in a vacuum. They are a response to the campaigning of the marginalised groups with which social workers are working.

Whilst in the 1950s, social work was heavily influenced by psychoanalysis, the social movements of the 1960s and beyond have gradually pushed social work towards the ideals of social justice and the idea that social workers should be enabling and empowering people, rather than being an expert who is prescribing solutions to people's problems. Moreover, social workers should be actively addressing their own contribution to the oppression of marginalised groups.

So where does it all go wrong? I'm going to suggest that there are several ways in which good social work practice is compromised:

Lack of resources This has always been a problem, and in the recent economic and political climate has only got worse. Social workers are not always able to put in place what the person needs (and/or wants) because the funding just isn't there. Additionally, social workers themselves are viewed as a resource. Social work time costs money, so there is pressure to manage a higher caseload (in order to employ fewer social workers), which means less time spent with each person. The net result of this is that social workers are not able to really get to know people, nor do they have sufficient time to reflect on their practice, meaning they will be more likely to inadvertently contribute to oppression, and less likely to assist the person to achieve their aspirations.

The eternal tension between what social work wants to be and the role that the government have prescribed I have set out above the ideals that social work as a profession aspires to. However, this is often at odds with the ideology of central government, whose policies social workers have to implement and who make the laws that define the social work role.

The influence of wider society on the social worker Society at large still subscribes to the medical model and the personal tragedy model. If social workers are not careful, they can internalise these ideas and this can influence their practice.

The watering down of social work values Lena Dominelli in particular has picked up on the issue of empowerment basically not really being empowerment at all. She uses the example of complaints procedures (against individual social workers) as appearing to empower individuals but actually making little difference because decisions about the way services are designed and delivered are made by management (Dominelli, 2000).

Lack of professional voice If social workers are to address structural inequalities, they need to speak out against these with a collective voice. Unfortunately, social workers have little respect in wider society and their professional opinions are rarely valued by those in power.

Allowing knowledge of the available resources to influence their assessment.

Imbalance of power Oliver (1990) states that social workers, as professionals, hold knowledge and information about what is available. This means they hold power over a person who does not know these things. They also have a certain degree of power in terms of gatekeeping, as they are the ones who determine what the person needs.  Oliver (1990) also points out that professionals rely on disabled people in order to have a job role, so have a vested interest in keeping people dependent on services.

Conflicting roles The role of gatekeeper is in direct conflict with the idea of social workers empowering individuals.

Production line-type processes and tick boxes When assessment structures are reduced to ticking boxes and following a process, social workers may fail to engage fully with the person's aspirations, instead concentrating on meeting basic needs.

As you can probably see, a lot of the causes of disablism in social work are wider issues that are often beyond the control of individual social workers. However, social workers have a responsibility to make the changes that are within their control.

So, how can we work towards better social work with and for disabled people?

My suggestions to social workers are :

• Defend your professional values and be vigilant as to where and how they can be compromised. Do your best to stay true to what you were taught at university, where social workers themselves define what social work should be.
• Be aware of and challenge disablism wherever possible, including within the organisation for whom you work.

• Remember that the interaction with the person is the one thing you truly do have control over. Respect and acknowledge the person's aspirations and oppression, even if you can't see a way to do anything about them. If you are unable to provide something, explain this politely, respectfully and giving the reasons. This might seem obvious, but when I mentioned bad experiences that disabled people had, insensitive comments about lack of resources and disabled people's aspirations for their lives, was one of the things I was referring to.

• Be willing to learn from disabled people.
• Campaign alongside disabled people.

My suggestions to disabled people:

• Don't be afraid to challenge your social worker. Please do it respectfully, but don't remain silent if something isn't right.
• Recognise that there are some things which are outside of your social worker's control.
• Part of internalising society's attitudes towards you is accepting the idea that other people know what is best for you; remember that you are the expert in your own situation.

• Keep coming up with your own solutions and suggest them to your social worker.

• See your social worker as a resource. Ask questions, obtain information. Being an active participant in the interaction makes it implicit that you expect a partnership approach.
• Keep campaigning for your right to better social care.

I hope this will give social workers an opportunity to reflect on their own practice. I also hope that it gives disabled people some insight into what a good social worker looks like. I believe that social workers and disabled people can work together to address the structural inequalities that affect both disabled people and the ability of social workers to effectively empower them.

References

Biestek, F (1961) The Casework Relationship London: Allen and Unwin

Dominelli, L (2000) Empowerment: Help or Hindrance in Professional Relationships in Stepney, P and Ford, D (eds)  Social Work Models, Methods and Theories. Lyme Regis: Russell House Publishing

French, S and Swain, J (2002) The Perspective of the Disabled People's Movement in Davies, M (2002) The Blackwell Companion to Social Work Oxford: Blackwell Publishing

Thompson, N (2002) Anti-Discriminatory Practice in Davies, M (2002) The Blackwell Companion to Social Work Oxford: Blackwell Publishing