The three pillars of social work

THE THREE PILLARS OF SOCIAL WORK Malcolm Payne Professor of Applied Community Studies, The Manchester Metropolitan University, 799 Wilmslow Road, Didsbury, MANCHESTER M20 2RR. Telephone: UK+(0)161-247 2097, FAX: UK+(0)1204 853499, E-Mail: [email protected]

Introduction Recently, the British Association of Social Workers was asked by the new British government to provide in one page a description of social work which would help to inform the many new members of Parliament who have been elected for the first time this May. It is significant that even in a country which has had social work services for more than 100 years it is still necessary to explain what it is all about to members of the legislature. The government was concerned that people in Britain were not accepting the value of social work services. No country that is considering how it should implement social work within its own services should be anxious if it is a hard task to explain the value of social work to its people and its administrators and politicians, when such a longestablished social work profession faces this degree of uncertainty about its purpose and mission. Even more significant, many people in social work regarded describing it in one page as an impossible task, and various people struggled for quite a while to achieve such a brief explanation in a form and in language which ordinary people could understand. I made a contribution to this work, based on my recent book, What is Professional Social Work? (Payne, 1996) and that is where I want to start in discussing the nature of social work on this occasion. But it is only my starting point, because I then want to go on to argue that the nature of social work is adapted according to the political system and social and cultural context of any country in which it is practised. However, I argue that it is possible to define the nature of social work as it is relevant to any particular country by examining how much each of three specific analyses of social work influences practice in that country. I call these analyses, and this lecture, ‘The three pillars of social work’. By looking at these three analyses of social work we can understand more clearly the different aspects and balance of ideas in social work. Also, by presenting these different views, I can describe some of the continuing academic and professional debates which go on within social work. Every social work activity contains three elements, the three pillars of social work. Every social agency, every social service and every system of social services also contains those three elements. In every case, the balance of those three elements in a social work activity, in a social agency and in a system of social service varies. By understanding these three elements, we can analyse our activity as a social worker, we can analyse our agency and we can analyse the social service system in a particular country or administrative area. We don’t have to say that social work is one thing, or that it is always the same. We say

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instead that it has these basic characteristics which are implemented in a particular way in our activity, in our agency or in our country or administrative area. The three pillars of social work are views or analyses of four aspects of it: its purpose, the problems focused in the work, the type of activity which is undertaken and the area of social provision which the work concentrates on. The next three sections look at each analysis in turn.

The reflexive-therapeutic analysis The starting point of many accounts of social work focuses on the reflexive-therapeutic pillar,

and this is the kind of work you find in many introductory textbooks, particularly American textbooks.

The purpose of social work, according to this analysis, is therapeutic, that is the social worker tries to ‘cure’ the problems that individual people or families have in their lives, rather as a doctor diagnoses and cures an illness. If the approach is extended to working with communities or groups, it follows the same purpose, that of curing problems in the group or community. The problems that this analysis focuses on are mainly emotional or relationship problems, and many other problems are reduced down to such problems. For example, if people have financial problems, therapeutic social work often finds that relationships in the family or personal stress has led to disorganisation and bad management which has led to financial difficulties or inability to work properly. The argument is that if you resolve the emotional or relationships problems, the financial difficulties will sort themselves out. The type of activity that social workers undertake, according to this analysis, is to build up relationships with people with problems, who are called clients, so that the social worker’s personality in discussions about the problems will help the client gain the skills, emotional strength and support from round about, in their family and community for example, to resolve their difficulties. The focus is on clients’ personal growth fulfilling their ability and capacity to manage their own affairs more successfully. I call this approach reflexive because the work is done by interpersonal interaction. Thus, the worker sees the client’s behaviour and hears what the client says, which influences the worker’s assessment or judgement about what is going on in the client’s mind and in the client’s social experiences. This judgement then influences how the worker reacts to the client and this in turn influences how the client behaves, thus influencing the social work. This process continues, each influences the other, a reflexive process in which the client’s world is changed by the constant process of interaction. Practice theory and study of this approach concentrates on understanding and influencing people’s behaviour, particularly their emotions and perceptions. The areas of social provision where this kind of approach concentrates on are social work in hospitals and health-related settings, with people with marriage or family difficulties, in work with young people with emotional and behavioural disorders, who are delinquent or

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who need care because they have no parents or other family or because their family neglects their care or ill-treats them, and with people with mental illnesses. An example of reflexive-therapeutic social work is the following case, dealt with by a hospital social worker. A mother in her late 20s with two children was diagnosed with a cerebral tumour, which would shortly lead to her death. Her husband needed to take time off work to care for her, and both she, her husband and the children had to deal with the emotional consequences of her impending loss of life: this required much discussion with the worker. Arrangements were made for financial support of the family while the husband was unable to work. Both sets of grandparents, the husband’s and the wife’s parents offered to care for the children and there was a family dispute about who should have the children. The social worker negotiated an arrangement whereby the husband continued as the main carer of the children, but both sets of grandparents were involved, to enable him to return to work when his wife died. She was able to die supported by her husband, knowing that suitable arrangements had been made for the children after her death. In this case, much of the work was concerned with grieving for loss and in disentangling family conflicts and relationships. Although it has had a long history and a great deal of influence in elite social work agencies, this reflexive-therapeutic analysis of social work has been subjected to two types of criticism. The first critical view says that many of the problems that people face are broadly practical in nature, and it is the job of social services to deliver supportive services to its clients, rather than to be too concerned with their emotional and personal lives. Therefore, the worker should not be deviated from the main task of the social services into more complex interpersonal material which never leads anywhere. The second critical view argues that many of the personal and practical problems that people face arise from inadequacies in the social and economic system - this criticism is derived from Marxist radical theory. Therefore, the worker should seek change in the social system which creates them, rather than just dealing with personal and individual problems. The reflexive-therapeutic response will be inadequate in dealing with the individual’s problems. Problems may well recur, because the basic social causes have not been dealt with. Also, more general social change would prevent problems from occurring for other people in similar positions. These two positions which criticise reflexive-therapeutic social work do so from their own analysis of social work: they constitute the two other pillars of social work.

The individualist-reformist analysis The second analysis of social work comes from the first critique: the individualistreformist analysis. The purpose of individualist-reformist work is to deliver effective social services to the individual as part of broad welfare services in society. If the services are ineffective, improvements in their organisation and policy should be made.

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The problems focused on in individualist-reformist work are the practical problems which surround major disabilities, maintaining families successfully when they have problems, dealing with the practical and financial problems that offenders have which leads them to offend and helping elderly people who are finding it difficult to manage their lives as they get older. The type of activity which is undertaken concentrates on the maintenance of the present situation in people’s lives, or returning them to their previous position. There is a focus on providing services which will support and assist people, advice-giving, especially about what services people can obtain and education so that people improve their skills. Work often proceeds by specific, formal means. In task-centred work, for example, agreements or contracts are made between the worker and client (Reid, 1992; or Doel and Marsh, 1992) for the client to try to achieve particular objectives, with the worker helping in specified ways. These are organised to a time-limit, so that after each session there is a task to be completed by the client, and very often also by the worker, helping the client in some way towards achieving the client’s aim. The worker and client practise how to approach a task within their session together. So, if the client has the target of getting a job, the first task might be to obtain information from the job centre and the local newspaper. The worker and client would practise going through the information to find jobs which would be most suitable for the client. Then, it the client has little confidence, they would practise ringing for an interview, with the worker playing the prospective employer. If the client gets job interviews, the worker and client would rehearse how to answer the questions. The areas of social provision which individualist-reformist work concentrates on are social security, employment problems, delinquency, short-term crises or planning for long-term care services. An example of individualist-reformist work is the following case, in which a social worker works with an elderly man who has had his leg amputated in hospital, and is now ready for discharge, with an new artificial leg to be provided when he is at home. In the meantime, he is unable to manage alone at home. One alternative is to set up a package of services. This might include help in the home, delivery of meals, on some days taking him to a day centre providing occupation and social facilities for older people, making arrangements for someone from the local community to visit regularly in the evening to check that he is all right before he goes to bed, a nurse to visit regularly to bath him, making sure his social security allowances were correct and arranging adaptations to his home so that he is able to move around without danger. The worker acts as a case manager (Payne, 1995), organising and coordinating the services, checking regularly that they are working appropriately, and adapting them as his circumstances change. Social work help would also be provided to help him to come to terms with becoming losing a limb. This is complicated and expensive, but not as expensive as the alternatives of remaining in a long-stay hospital bed, or moving to a residential care home for elderly people. This kind of support at home is also usually preferred by older people, because it allows them to remain in contact with friends and continue to live in a community and surroundings that are familiar to them. It also maintains the community’s responsibility

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and awareness of the need to retain an interest in and support older people, maintaining them as part of the broader community rather than hiding them away in institutions. Research in Britain suggests that older people live longer and are happier in such community arrangements than in institutions (Davies and Challis, 1986). There are, again, criticisms of this analysis of social work. One such criticism we have already met in relation to the reflexive-therapeutic analysis, that is the Marxist radical criticism that focusing on the individual does not deal with the social causes of problems. However, an additional point from this position is that this form of work tends to be concerned with the regulation and control of people in society, to exert conformity and social order. According to this view social work is a ‘soft policeman’. This is particularly true where social work is used to deal with offenders, or to get families or mentally ill people to fit in with existing customs or norms of behaviour. Such customs are only social conventions, and people should be free to behave as they wish, provided they are not injuring themselves or other people. The individualist-reformist analysis counters this argument by accepting that it is an appropriate role of social institutions such as social work to contribute to social order. Societies need a range of institutions to manage large populations in complex social relations, and an organised form of social management through professions such as social work reduces the need for more authoritarian policing of social norms. The other criticism comes from the reflexive-therapeutic analysis. We have seen that both of these analyses of social work concentrate on working with individuals. However, the reflexive-therapeutic analysis argues that individualist-reformist work is not ambitious enough. It is possible to help people change their behaviour and their way of life, and fulfil their personal development. To limit social work to practicalities, maintaining situations and promoting conformity does not help society to move forward.

The socialist-collectivist analysis We have seen many of the ideas behind the socialist-collectivist analysis of social work in the criticisms it offers of the other analyses that we have been examining. The purpose of socialist-collectivist is transformational. That is, it seeks a change in society that will alter the fundamental balance of power in society in favour of equality, social justice and people’s empowerment so that they can accept freedom to, collectively with others in their family and community, organise to meet their own needs. The problems which socialist-collectivist work focuses on are where individuals and groups perceive injustices or where they are evidently disadvantaged in the present arrangements of a society. So family and social difficulties which arise from poverty, from discrimination against particular groups, such as offenders, mentally ill people, disabled people, alcoholics or drug addicts. Such discrimination may be hidden. So, for example, in Britain, we like to say that we respect and value the contribution that older people make to society, but in fact recent economic changes have led to older people losing their jobs before retirement age because they are seen by employers as not so flexible and willing to use new machinery or techniques. There is no real evidence of this,

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it is a prejudice against older people. The prejudice is hidden by statements valuing old people. One of the important things to do is to look behind what people say about others and see what the consequences for other people are of what they do, as opposed to what they say. The typical type of activity of socialist-collectivist work is to promote cooperation and mutual support among members of society, so that people gain power over their own lives and can change the social context in which they live. Workers see themselves as engaging in a dialogue of equals with clients, rather than being an expert ‘therapist’. Members of families, communities and social groups are encouraged to support each other to find their own solutions to their problems, and learn the value of working together. They may then apply this experience to other social situations and learn not to be put in conflict with other people in the same position. This is why I call this analysis collectivist. An example might be where there is only a limited budget for providing adaptations to homes for disabled people to be able to manage their disability in their own homes. The traditional view might be to decide who is the most disabled and divide the budget to help those most in need. A more participative view might be to encourage representatives of the disabled people to decide on the criteria for dividing the budget. The socialist-collectivist view is that this sets one disabled person against another. Instead they should all take part in seeking improvements in the budget or work out how to spread the money so that all their needs are met. Thus, an important skill for workers in this analysis is to act as advocates, like lawyers in the social system, for their clients, and encourage them to join groups with similar problems and learn advocacy for themselves. Building on this is welfare rights work, helping people to learn what they are entitled to and how they might apply for it. A common approach is groupwork or community work with people living in a particular area or suffering from a shared problem work together to identify, understand and resolve their difficulties jointly, finding the resources to do so (Mullender and Ward, 1991). The area of social provision which the socialist-collectivist work concentrates on are families in areas of social deprivation, groups with shared interests, such as people with disabilities and people affected by social and economic change, such as people living in areas where housing is being cleared, where populations are being moved for developments or areas where there is unemployment because factories are closing. Although you might think that workers taking this analysis of social work would not work for public authorities and government agencies, many do so, because the range and significance of public services for people in need is such that if you work there and manage to achieve change which benefits people you can achieve improvements for many. Also, many public authorities use work of this kind to deal with areas within cities, or increasingly rural areas, or particular widespread shared problems where they want a particular effort involving people to sort difficulties out. They also use advocacy services to help people make complaints about services which are inadequate. Many people whom social work services provide for do not have the skills or understanding to complain; young children, or people with learning disabilities or mental illnesses are examples. However, complaints help an organisation to find out where services are not up to a good standard, and to deal with particular problems that individuals face. People have a right to

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good service, and if the service is poor, their problems may be made worse, and cost more to put right. Hence, an advocacy service to help people complain effectively is a great benefit to any organisation, particularly public authorities which tend to be quite large and hard to manage. There are, inevitably, criticisms of this analysis of social work from the point of view of the other two analyses. Because of their concern for individual work, they criticise the socialist-collectivist focus on group needs or general social transformation. This might lead a socialist-collectivist worker to ignore the immediate needs of an individual in favour of broader collective needs in the future. Also, individuals are entitled to personal fulfilment and development outside of their contribution to some wider social improvement. Individualist-reformist analysis also argues that achieving general social changes is not easy, and often does conflict with the role of a social worker as the professional and employee of a public authority or the government. This puts the social worker in a conflict situation which makes it difficult to get things done for the individual, and sets the social worker against the properly elected authorities of a country.

Balancing different analyses in practice and in social service systems I suggested at the beginning that, although these different analyses exist, and you can occasionally see them argued in the literature, in practice they tend to balance and influence each other. It is obvious from the justifiable criticisms of each that none of them has a complete answer to appropriate practice in every situation. Social work, indeed any activity in social situations, is like to be far too complex for such simple analyses to be valid globally. In most social work practice, therefore, various activities influence each other and create a form of practice most relevant to the situation. You can see this in some of the examples of practice I have given. In the example I gave of typical reflexive-therapeutic work, I suggested the social worker, in addition to working on emotions and family relationships, would need to give advice about financial help to enable the family to manage at home, which is more typical of individualist-reformist work. Many social workers find that starting with immediate practical problems gets the best response from many clients, because that is what they come for immediate help with, they can understand it and they can test the worker out. Once they have seen that the worker is efficient and helps them with practical problems, they are more prepared to reveal more personal information and difficulties. Social workers have a proverb for such an approach: they say we should always start where the client is. However, individualist-reformist work recognises that sometimes the practical help is all that is required, and we should not always go delving into complex personal problems where it is not necessary. Neither should we take a socialistcollectivist line that everyone with practical problems wants to link up with others facing similar difficulties and campaign for changes to the social system. Looking at the example I gave of individualist-reformist work, that of an elderly person coming out of hospital after an amputation, I suggested that fixing up a

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package of services was insufficient. Someone in this position is facing a serious change in the way they can live their life. This is a severe challenge to their capacity to manage their life. One theory of social work, crisis intervention (Parad, 1965; Parad and Parad, 1990), proposes that any major change of this kind may lead to emotional disturbance, particularly if past experience of such crises has not led to good adjustment. So, the worker cannot just go ahead and fix a range of services. Still less is it possible just to tell someone in this position what is going to happen to them. If we want the disabled man to work hard to overcome his difficulties, we have to understand and help him manage his grief at his loss and his anxiety and fear at what may happen to him. If the worker takes a socialist-collectivist view, the disabled man cannot be just sent to a group to seek improvements in services for people in his position. He must be helped to see how this can help him gain skills for managing his life better and continue, in spite of being disabled, to make a good contribution to the community. This, then, is why I argue that each of the three pillars of social work contributes to every action that a worker takes. It is not necessary to take in each analysis in every piece of work, but we must be constantly aware that we must think through the possibilities to see if each analysis will be relevant to a piece of work. Very often, we can see three different ways of dealing with the problem, depending on the view we take, and we must make a judgement about the balance of issues we must take into account. I want to go further in this argument. I started out by suggesting that each social service system is adapted to the culture and social context of the people whom it serves. So their history, political system and culture will condition which balance of the three pillars of social work will characterise their work. The USA, for example, is a fairly individualistic culture, with a strong emphasis on personal achievement and growth, and which politically has been opposed to socialist, collectivist political systems during its period of influence as a world power. So its social work is characterised by a heavy emphasis on reflexive-therapeutic work. This trend has been criticised, for example recently by Specht and Courtney (1994) and historically in the 1930s and ‘50s by socialists such as Lurie (1935; Schriver, 1987) and Reynolds (1935). European social work, on the other hand, is much more strongly influenced by the welfare states set up during the 1940s, and so social work is frequently takes place in government services. It thus has an emphasis on individualist-reformist work, because it is much more concerned with delivering government services. The patterns of provision in particular countries varies. For example, in many European countries, social workers are involved in the provision of social security, and this makes the emphasis of their provision much more individualistreformist, because of the administrative burden of providing social security. In Britain, social security is provided by a separate administration, and social workers give advice on benefits from the outside, to help people who are applying. This relieves them of the burden of providing social security, and tends to make their services rather more therapeutic than is sometimes the case in other European countries. Britain is also influenced by American practice,

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because they share a language, and so it is more strongly influenced by the therapeutic American literature than other Europeans. Thus cultural and linguistic factors are an important influence on the balance of the three pillars of social work which has influence in any particular culture. We can see this particularly at work when we examine the analysis of social work outside the Western world. The typical forms of social work in Europe and the USA have not transferred to many developing countries, and the emphasis of social welfare in many countries has been on social development (see Payne, 1997, ch. 9). This concentrates much more clearly on the socialist-collectivist analysis, and it does suggest that individual work is much less important than developing appropriate social service structures and policies. It is also necessary to develop responses to wide-scale problems, rather than treat problems individualistically as Western countries tend to do. This is not solely a matter of development and the stage of social policy which particular countries have arrived at. It is also a matter of cultural and political preference. For example, substantial criticisms of Western social work have been made in Africa, India and in Chinese communities throughout Asia. Broadly, these say that Western social work is far too individualistic and seeks to achieve independence of individuals and groups within society. This is based on European cultural patterns and the Christian religion which tends to emphasise individual salvation. However, other cultures place a greater reliance on interdependence among members of families and communities - this is particularly so of Eastern cultures in many countries in Asia (examples of such commentaries referring respectively to China and India are Chow, 1987, 1996; Ejaz, 1990). Equally, the individualistic, confidential therapist or worker and client is criticised from Africa, where interventions are needed which involve the family and community as part of dealing more collectively with individual problems (Silavwe, 1995). In community work, theories in Thailand emphasise community work as an approach to respond to undesirable impositions of capitalist market economic systems on traditional collective cultures (Nartsuppha, 1991). Some of these critiques of the whole cultural and political bias of social work are beginning to have influence in the USA, because of substantial migration of non-European peoples there, which changes the balance of cultural expectation. We can see different views of social work changing as different countries and cultures come to adopt it, and as workers find appropriate responses to the problems which face them. Looking closely at how the analysis offered by the three pillars of social work gives us a way of looking at our work, and at our social service system and seeing exactly what balance of the various approaches to social work are adopting in practice. We can also examine the political and cultural traditions of our countries and identify the kinds of social work and models of developing it which may be appropriate. Most of all, we do not need to adopt wholesale models of social work which have been adopted in other countries for use in other cultures. The three pillars

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analysis enables us to produce a form of balance between these modes of social work appropriate to our peoples and our social and political system.

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Exercises Exercise on your own practice. Privately, consider for a few moments a situation you dealt with in the course of your work, or if this is not possible, consider a family situation which caused problems for someone in your family. Make a few notes about what you did or what a social worker would have done in your family situation. Make your notes under the four headings: purpose of social work in this case the problems focused in the work the type of activity which is undertaken the area of social provision which the work concentrates on. Decide what the main pillar of social work is for social work in this case. Then consider what factors require an approach from one of the other pillars. Discuss this case and your decisions with another member of the group. Agree what are the difficulties of thinking about each of these four headings of analysis, and making the decision about the main pillar, and contributing pillars of social work. Please report these difficulties back. Exercise on your agency’s role. Privately on your own, make a list of the main work your agency undertakes, or if this is not possible, do it for an agency that you know. For each item on this list decide which pillar of social work is the main pillar for this work. Discuss your decisions with another member of the group. Does the analysis of the main pillar fit with your overall thoughts about the agency’s role before you did this analysis. As before, consider the difficulties of making this kind of analysis, to report back.

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References Chow, N. (1996) ‘Social work education - East and West’, Asia Pacific Journal of Social Work 6(2), pp. 5-15. Chow, N. W. S. (1987) ‘Western and Chinese ideas of social welfare’, International Social Work 30(1), pp. 34-41. Davies, B. and Challis, D. (1986) Matching Resources to Needs in Community Care: An Evaluated Demonstration of a Long-Term Care Model, (Aldershot, Gower). Doel, M. and Marsh, P. (1992) Task-Centred Social Work, IAldershot, Ashgate). Ejaz, F. K. (1990) ‘The concept of familial duty in India: implications for social work practice’, Indian Journal of Social Work 52(3), pp. 437-45. Lurie, H. L. (1935) ‘Re-examination of child welfare functions in family and foster care agencies’, in Lowry, F. (ed.) Readings in Social Case Work 1920-1938: Selected Reprints for the Case Work Practitioner, (New York, Columbia University Press), pp 611-9. Mullender, A. and Ward, D. (1991) Self-Directed Groupwork: Users Take Action for Empowerment, (London, Whiting and Birch). Nartsuppha, C. (1991) ‘The community culture school of thought’, in Chitakasem, M. and Turton, A. (eds) Thai Constructions of Knowledge, (London, School of Oriental and African Studies, University of London), pp 118-41. Parad, H. J. (ed.) (1965) Crisis Intervention: Selected Readings ((New York, Family Service Association of America). Parad, H. J. and Parad, L. G. (eds) (1990) Crisis Intervention Book 2: A Practitioner’s Sourcebook for Brief Therapy (Milwaukee WI, Family Service America). Payne, M. (1995) Social Work and Community Care, (London, Macmillan). Payne, M. (1996) What is Professional Social Work? (Birmingham, Venture). Payne, M. (1997) Modern Social Work Theory (2nd ed.)(London, Macmillan). Reid, W. J. (1992) Task Strategies: An Empirical Approach to Clinical Social Work, (New York, Columbia University Press).

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Reynolds, B. C. (1935) ‘Social case work: What is it? What is its place in the world today?’, in Lowry, F. (ed.) Readings in Social Case Work 1920-1938: Selected Reprints for the Case Work Practitioner, (New York, Columbia University Press), pp. 136-47. Schriver, J. M. (1987) ‘Harry Lurie’s critique: person and environment in early casework practice’, Social Service Review, 61(3), pp. 514-32. Silavwe, G. W. (1995) ‘The need for a new social work perspective in an African setting: the case of social casework in Zambia’, British Journal of Social Work 25(1), pp. 71-84. Specht, H. and Courtney, M. E. (1994) Unfaithful Angels: How Social Work has Abandoned its Mission, (New York, Free Press).