Michael Preston-Shoot

Social work and society: downward spirals and double-binds?

We have argued that the value of psychodynamic and systems theories lies in the framework they provide for understanding themes, patterns, events and defences, and in the practice techniques through which this understanding may be applied. In this and subsequent chapters we intend to demonstrate the validity of this viewpoint, beginning here with social work’s interaction with, and relationship to, the larger systems within which it is located: social services organisations, public and societal expectations, and the political context. Social work is located within a social, psychological, economic and political frame or context which frequently appears to render social work an unloved and challenging (if not impossible) profession. This chapter is an attempt at a meta view, an examination of how social work’s complex psychological, political, organisational and social inheritance affects practitioners, and how they might intervene and practise strategically in it, using the contribution which psychodynamic and systemic thinking can make.

Making sense of social work tasks

This chapter will apply psychodynamic and systemic concepts to clarify dynamic processes in direct work between social workers and service-users. Dynamics, if not identified and understood, can be destructive since they are likely to be acted out rather than used as information on how to proceed. In a meeting to allocate places in an elderly persons’ home, a team leader had four urgent referrals for the one available place. Each social worker, on presenting their assessment, was heavily criticised for ineffective work: for failing to explore fully options other than residential care; for emphasising a user’s wishes above needs, or both above available resources; for overinvolvement rather than dispassionate evaluation. The workers felt angry, confused, distressed and de-skilled. What were the dynamics being dramatised here? Confronted with an impossible task and feeling unable to leave the field by communicating the difficulties to senior managers, the team leader used denial and projection as defences: denial of the anxieties evoked by the situation, and projection of ‘bad’ feelings about the task on to social workers where the ‘badness’, in the form of inadequate assessments, could be more safely challenged. The team leader thereby accomplished the task of allocating the one available place by accommodating to the situation and identifying with senior managers such that he was more aggressor than victim.

Supervision, consultation and individual and organisational tangles

There is a ‘surprising paucity’ of research and theorising about the ingredients necessary for effective supervision, coupled with widespread criticism from practitioners about the quality and reliability of supervision sessions, and confusion expressed by supervisors and line-managers as to what supervision should comprise (Clare, 1988). If social workers are to survive and be effective they require adequate preparatory training and good ongoing supervision. Without it their exposure to anxiety, anger and the dependency feelings of clients, to emotional and physical overload, is likely to erode their intellectual and emotional resources, their morale and their confidence (Clare, 1988). They are less likely to be able to retain hold of their skills and strengths, or to develop their practice competence. They are more likely to experience difficulties in keeping to their tasks and roles and retaining direction, and may succumb to collusive participation with service users: that is, to form a closed system as a result of the emotional pressures and dynamics contained within the work (Temperley and Himmel, 1986). Without supervision practitioners will experience difficulty retaining a meta position to monitor their interventions and their effectiveness, to check whether they are seeing what they want to see and not seeing what they want to miss, to analyse the process, to appraise their decisions critically, and to challenge their own blind spots.

Psychodynamics and systems: towards a working synthesis for the person-in-situation

The key factors for effective practice outlined in the introduction are not easy to implement or maintain. What might appear relatively straightforward has an uncanny tendency to become derailed. Workers, service-users and organisations can all, either independently or in their interaction, foul good intentions. Psychodynamic understanding within a broad ‘systems’ framework helps to clarify these forces. It illuminates individual and group behaviour and the interactions between people. Its contribution lies in the understanding it provides and the intervention techniques which follow. Since the first of these two contributions has been regarded as the more relevant for social workers, we start by examining the value of psychodynamic theory in understanding social work encounters.

Defining the theory: a systems approach

The impact of systems thinking on British social work has been patchy. Most recently trained practitioners are probably familiar with the ‘integrated’ or ‘unitary’ approach (Goldstein, 1973; Pincus and Minahan, 1973; Specht and Vickery, 1977). This broadly-based ‘systems’ perspective on social work practice has undoubtedly been influential, though it has not heralded the new dawn so eagerly awaited by some enthusiasts (Evans, 1976). The most dramatic infusion of systemic ideas into social work has in fact come from the family therapy field (Skynner, 1976; Walrond-Skinner, 1976; Selvini Palazzoli et al., 1978; Treacher and Carpenter, 1984; Burnham, 1986).

Postscript: openings into closed systems

Several themes have run through this book. Social work is a stressful and difficult, if not impossible, profession. Practitioners are required to work within disturbing, sometimes violent situations, with people who are severely disadvantaged and deprived materially and emotionally. Social workers regularly confront practice dilemmas; the necessity of having to take difficult decisions, in which there are no right answers, based on a delicate assessment of risks, needs and competing (if not conflicting) rights; and a myriad of pressures, including from within. The result is a complex maze and interaction of personal, professional, interagency and societal dynamics and pressures, and potential tangles between service-users, social workers, agencies and society. Figure P.1 attempts to represent diagrammatically how this complexity can lock all the participants into a closed system, individually and interpersonally, within and between. Workers bring to the task their personal and professional experience which may, via transference and projection, disrupt the helping encounter. What clients bring may trigger and provoke reactions in the workers (countertransference). Finally, societal attitudes — for example, ageism, intolerance of difference, conflicts in explanations for child abuse or heterosexism — are avoided or deflected through social work.

Defining the theory: psychodynamics

Our purpose in the next three chapters is to explore as clearly as possible the main features of a combined psychodynamic and systemic approach to social work practice. For the sake of clarity we have decided in the first place to treat ‘psychodynamics’ and ‘systems’ as separate bodies of theory, and then to attempt to bring them together by showing how they provide different perspectives on the same basic phenomena. In subsequent chapters this bringing together of the two approaches, this working synthesis, will be applied directly to practice.

Criticisms, myths and parodies

Even if psychodynamic and systemic approaches can be linked coherently and applied fruitfully in combination, what is the relevance of this for social work? Many social workers question the usefulness of anything to do with psychotherapy in their work and, whilst there is a growing acceptance of family therapy techniques among social workers in a variety of agencies (Treacher and Carpenter, 1984; Burnham, 1986), many are deterred by the jargon in which it couches itself and the clinical settings in which it habitually operates. Both approaches, therefore, have appeared to be precious activities with little relevance to social work.

Introduction: concerns, curiosity and visions

Although a much abused word, crisis currently typifies much of social work. It is no exaggeration; social work is approaching turmoil. Increasing workloads, multiplying responsibilities contrasting with static or contracting resources, the emotional and physical impact of the work, the deletion of posts in some fields to meet financial targets or the demands of child protection work, apparently contradictory public expectations and vitriol from the media which often sees little other than tragedies: these are all reflected in low morale, vacancy levels and burn-out. Practitioners face a plethora of pressing problems and yet do not feel highly regarded. Some conceal their occupation or derive little pride from their work. Few believe it commands public respect (Davies and Brandon, 1988). Given the work’s complexity and difficulty, this absence of public commitment to social work — and the concomitant low morale, confusion and frustration among practitioners — must be of major concern. Moreover, major changes are imminent: the privatisation of parts of the National Health Service and the possible reorganisation of social services whereby departments coordinate packages of care rather than provide directly many of the services currently within their remit. Other, arguably more beneficial, changes have been dismissed.