Changing Lives: Report of the 21st Century Social Work Review

Chapter 4: The role of the social worker

Introduction

A central part of the work of the review has been to define and clarify the distinctive contribution of the social worker in an environment increasingly focused on integrated teamwork. This work has been taken forward by a specialist sub group informed by a number of significant pieces of research and evidence gathered throughout the review. Although some functions of the social worker are derived explicitly from the duties of local authorities, social work is not defined by its organisational setting. Social workers can and do work across a wide range of settings within public, voluntary and private sector organisations, with a small but growing number working independently. This chapter describes the role of the social worker in all these settings.

What is social work?

The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Utilising theories of human behaviour and social systems, social work intervenes at the points where people interact with their environments. Principles of human rights and social justice are fundamental to social work. (International Association of Schools of Social Work (2001)).

Taking this definition as a starting point, the social worker's task is to work alongside people to help them build resilience, maintain hope and optimism and develop their strengths and abilities. Social workers must meet people on their own terms, in their own environment whilst retaining the professional detachment needed to help people who use services to understand, come to terms with or change their behaviour.

Social workers also have a role as agents of social control. They must confront and challenge behaviour and manage situations of danger and uncertainty. In this role they have statutory powers to act to protect individuals or communities. They are closely associated with the management of risk and with the distressing consequences of things going wrong in people's lives. This balance between care and control is perhaps the defining feature of social work and provides a dynamic tension which influences workload, priorities and public perceptions of the role.

A single profession

A key question that the review was asked to address is whether social work is in fact a single profession, or has it become so specialised that it forms a number of similar but distinctive professions. We concluded that it is and should remain a single generic profession, underpinned by a common body of knowledge, skills and values, set out in the Framework for Social Work Education in Scotland (2003). Despite this, social workers increasingly work in specialist settings. The challenge is to ensure that they are able to build up the knowledge, skills and competence relevant to their own field, work within the boundaries of their competence and strive to extend their knowledge and skills. In some areas, particularly remote and rural communities, generic social work roles will be the best, or indeed the only, solution. The particular challenge here is to make sure that they maintain a broad range of expertise, backed up by access to specialist expertise or consultancy, either locally or nationally.

Developing therapeutic relationships

Work done for the review, specifically McNeill et al (2005) and Kerr et al (2005) on the skills required in criminal justice social work and with older people respectively, both concluded that the quality of the therapeutic relationship between social worker and individual or family is critical to achieving successful outcomes. The findings of these pieces of research apply equally well to all areas of social work. The therapeutic approach and the working alliance that goes with it are key elements in developing a personalised approach to helping those with the most complex needs gain control of their lives and find acceptable solutions to their problems. Crucially, this is as important in compulsory aspects of services as it is in those actively sought by service users.

McNeill et al (2005) found three consistently identified common elements in successful interventions which lead to behaviour change or reduction in problem behaviours:

• accurate empathy, respect or warmth and therapeutic genuineness;
• establishing a therapeutic relationship or working alliance (mutual understanding and agreement about the nature and purpose of intervention); and
• an approach that is person centred, or collaborative and client driven (taking the client's perspective and using the client's concepts).

Figure 1 Effective relationships (McNeill et al 2005)

Working to achieve change is at the heart of what social workers do. Identifying needs and risks through assessment and developing and implementing action plans to address these will achieve nothing without an effective therapeutic relationship between worker and client. Although the diagram opposite relates to the supervision of offenders (McNeill et al 2005), it clearly illustrates the centrality of the therapeutic relationship. The principles it describes are equally applicable to all areas of social work practice.

Yet social workers consistently told us that it is this very aspect of their work which has been eroded and devalued in recent years under the pressures of workloads, increased bureaucracy and a more mechanistic and technical approach to delivering services. We must now legitimise and restore the centrality of working for change through therapeutic relationships as the basis of strengthening the profession for the 21st Century.

What do social workers do?

Statham et al (2005) identified three main functions that define what social workers do. They:

• intervene between the state and the citizen - assessing and determining eligibility for publicly funded services and assessing risks which determine the need for statutory intervention;
• maximise the capacity of people using services - enabling individuals as far as possible to become 'expert clients' or informed clients'; and
• contribute to policies and practice that support social and personal well-being - building the platforms from which personalised services can be developed and through which individuals can promote their own well-being or manage long term conditions.

In addition they consider that there are public benefits for local communities and wider society from social work intervention which they identify as:

• building on the capacity of individuals and networks to increase their independence and use mainstream rather than specialist services;
• maximising parents' and their children's life opportunities;
• reducing community tensions through promoting mutual understanding; and
• using innovative approaches to reducing socially disruptive behaviour.

They deliver these functions through fulfiling six core roles, identified by Clark et al (2005):

• case worker working with individuals to help them address personal issues;
• advocate on behalf of the poor and socially excluded;
• partner working together with disadvantaged or disempowered individuals and groups;
• assessor of risk or need for a number of client groups; also associated with surveillance;
• care manager who arranges services for users in a mixed economy of care, but may have little direct client contact; and
• agent of social control who helps to maintain the social system against the demands of individuals whose behaviour is problematic.

The combination and priority of these roles will vary, depending on the setting and the needs of the particular individual, family or community worked with. Social workers will also need to adapt in response to the evolution of more personalised services, requiring different roles and skills.

What are they specially well equipped to do?

What social workers do inevitably overlaps with what other workers do. This blurring of operational boundaries is a real strength as people's lives cannot be defined within organisational boundaries. Social workers are skilled navigators and co-ordinators of services across these boundaries. They are used to taking a whole system approach on behalf of people who use services, taking decisions in complex cases and collaborating with others in joint work around the needs of an individual or family.

Effective collaborative work requires a good understanding of the roles of different contributors. We concluded that social workers are particularly well equipped to be the lead professional in collaborative work when:

• the individual or family's social situation is unusually complex with a number of interacting factors affecting assessment and decision-making;
• the child or adult is at risk of serious harm from others or themselves and requires skilled risk assessment and protection;
• the child or adult is likely to put others at risk of harm, distress or loss and a response needs to take account of the individual's interests and well-being of others;
• the child's or adult's circumstances, including their health, finances, living conditions or social situation, are likely to cause them or others serious harm, social exclusion or reduction of life-chances;
• the situation requires assessment of, and intervention in unpredictable emotional, psychological, intra-family or social factors and responses;
• relationships, rapport and trust need to be established and maintained with a child, adult or family who find trusting relationships difficult;
• there is a high level of uncertainty about the best form of intervention and/or its likely outcome;
• the circumstances are such that there are significant risks in both intervening and not intervening, when a fine judgement is required;
• the person is facing obstacles, challenges, choices and/or life-changes which they do not have the resources to manage without skilled support;
• prescribed or standard service responses are inadequate, and sensitive, creative and skilled work is needed to find and monitor personalised solutions; and
• the child's or adult's situation is getting worse, either chronically or unpredictably, and is likely to need additions or changes to interventions.

What can only social workers do?

Local authorities have a statutory responsibility for the protection and promotion of the welfare and well being of children, vulnerable adults and communities. This responsibility is usually discharged through social workers and others in the social service workforce, however these services are configured or managed. Other legislation places particular duties on social workers in relation to people with mental illness and people in the criminal justice system as well as children in need. In these instances, the legislation reinforces the social worker's authority to act on behalf of society when people pose a risk to themselves or others or are placed at risk by the actions of others. We have concluded that there are a range of functions that only a social worker should carry out and that these should be set out in regulation (see recommendation 7). The protected functions paper on the CD gives further detail and examples of how these functions apply in different settings.

Reserved Functions of the Social Worker

Social workers should assess, plan, manage the delivery of care and safeguard the well-being of the most vulnerable adults and children, in particular, those who: are in need of protection; and/or are in danger of exploitation or significant harm; and/or are at risk of causing significant harm to themselves or others; and/or are unable to provide informed consent. To do this social workers must: carry out enquiries and make recommendations when necessary as to whether or not a person requires to be the subject of protection procedures; and be responsible for the development, monitoring and implementation of a plan to protect the person, in particular, identify and respond appropriately to any risks to the achievement of the plan and/or any need for the plan to be revised because of changing circumstances. (Reserved Functions of the Social Worker )

Making best use of social workers' skills

Social workers are a relatively scarce specialist resource, making up only around 5% of the total social service workforce. It is therefore essential that best use is made of their knowledge and skills. Yet we know that this is not always happening. We observed and heard from social workers who were being expected to routinely undertake tasks which did not require their level of training and expertise and which would be far more appropriately undertaken by others in the workforce including administrative and support staff. We therefore propose a tiered approach to defining how social workers should be deployed. This is further expanded in the report of the role of the social worker sub group (on the CD).

In line with the reserved functions of the social worker, the tiers of the pyramid represent the distribution of social workers time. Intervention increases between the tiers as need and risk increases. Social workers never work in isolation and are always part of multidisciplinary approaches.

At tier 4 the social worker is lead professional, fulfiling roles that only a social worker can do, negotiating a balance between care and control. This may be where the local authority is under statutory obligation, or the nature of the situation is complex. The focus of social worker's efforts and time should be spent at tiers 3 and 4 which maximise the use of their professional expertise. Other services will focus their efforts primarily at tiers 1 and 2. So a school, for example, is providing education to all children, but will be providing additional targeted support to some, as well as working alongside social work and other services to support those with the most complex needs. All social workers have a significant contribution to make at tiers 1 and 2, supporting and informing the delivery of services both within social work and across partner agencies.

The interconnections between social workers, other social service workers and other agencies across the tiers need to be properly developed and understood. This will need careful management, avoiding the sorts of boundary disputes we have seen in the past and ensuring that effective use is made of the skills of social workers and other workers across the public sector.

Figure 2: The Social workers role - a tiered approach