Chapter 23 – Lynn Leggett (D1SOP23)

Teresa Brown; Denise Lyons

Chapter 23 – Lynn Leggett (D1SOP23)

Domain 1 Standard of Proficiency 23

Be able to see the world as others see it; be able to practice in a non-judgemental manner and be able to understand another’s feelings and be able to communicate that understanding

KEY TERMS

Perception and empathy

Non-judgement

Active listening

Advocacy

Social care is … supporting people to live their best lives and reach their full potential through meaningful, person-centred interaction; supporting people to empower themselves through non-judgement and advocacy; encouraging and respecting the choices people make; and ensuring respect and dignity for the people we support at all times.

TASK 1

“Where would you sit?”

You board a bus and look for a seat. There are three empty seats, each next to a person. One seat is next to a male teenager. He’s listening to loud music and is wearing a hood over his head. One seat is next to a well-dressed middle-aged woman carrying several shopping bags and looking at her mobile phone. The final seat is next to an older man who looks dishevelled and appears to be talking to himself. Where do you sit, and why?

This short task may help you to gain an insight into how you see the world, find out if you harbour any unconscious prejudices and prompt you to be aware of others’ feelings

Perception and Empathy

Social care workers rely on perception and empathy every day in all sectors of social care practice. How we respond to service users is key to forming therapeutic relationships and having the ability to understand an individual’s needs. Two factors are important here: emotional intelligence (EI) and social competence.

The study of emotional intelligence is complex, with many theorists applying different meanings to and ways of measuring intelligence. However, it appears that there are ‘both genetic and social determinants of EI’ (Carthy & Jameson 2016: 20). Salovey and Mayer (1990) define EI as ‘the ability to recognise and monitor one’s emotions and to use this information ‘to guide one’s thinking and actions’ (in Carthy & Jameson 2016: 13). Bar-On et al. (2000) define EI as ‘an array of emotional, personal and social abilities and skills that influence an individual’s ability to cope effectively with environmental demands and pressures’ (cited in Zijlmans et al. 2015). Both definitions suggest that our emotions are strongly linked to our behaviours. Therefore, our own emotions and subsequent behaviours alongside the emotions and subsequent behaviours of service users are undoubtedly going to affect any interactions we have with those people we engage with and support in our social care roles. Interestingly, Rose et al. (1998) found that within residential settings ‘where staff reported low levels of stress, higher levels of support and more positive staff-client interactions were found’ (cited in Zijlmans et al. 2015). This suggests that people, i.e., staff, when managing their own stress levels well, are better able to focus on and empathise with others. Here, wellbeing matters. The National Economic and Social Council (NESC) says that wellbeing relates in part to ‘having a sense of purpose in life’ and is enhanced by ‘meaningful and rewarding work’ (2009:4). It also says that ‘the importance of care, both unpaid and paid, and its impact on the well-being of individuals and society is now coming into sharper focus’ (2009:17). Self-care is also a crucial component of wellbeing and self-awareness and is therefore a key component of effective social care. For more on self-care see Chapter 18. In her excellent TEDx Genova event, Louise Evans details how to become more conscious of our own behaviours, how they can directly shape our world and how they impact on those around us. Here, self-awareness is key. Louise details how she brought her partner’s daughter to a jazz club in Milan to help build a relationship with her.

Louise was enjoying the music, but when she glanced over to see her partner’s daughter looking at her phone, she was faced with a choice in how she could interpret and react to the situation. She attributes animals’ personalities to five human traits in order to cleverly demonstrate the possible reactions and outcomes she could have to the situation. Louise says that ‘our choices make a direct impact on the relationships we form’, and that ‘work can be a place where we make some of our most questionable and sometimes toxic behaviours’ (2017).

Social competence is an important concept in social care as it is a skill which, if underdeveloped, can make it difficult for service users to make sense of their emotional world. Seemingly small things we may take for granted, such as social cues, can have quite a negative impact on their lives. For example, if service users lack the capacity to understand and regulate their own emotions, it may be fair to assume that they may have difficulties interpreting the emotions of others. In their study, Owen and Maratos (2016) investigate the importance of social competence, stating that ‘understanding the facial expressions of others is critical, as emotion recognition is a prerequisite to empathetic responding and an essential factor in social functioning’ (2016: 344). Adults with intellectual disability (ID) have difficulty discerning the facial expressions of others, which is a crucial point to consider when trying to convey empathy or concern (Owen & Maratos 2016:352-3). People with ID also have difficulty communicating their emotions, and as social care workers we use our observation skills to note changes in the emotions of the service users we support. In other words, we need to use as many means as are necessary and relevant to the individual to show service users we empathise with them. This again highlights the importance of person-centredness. For example, staff might use a tool such as the disability distress assessment tool (DisDAT) (East Sussex NHS Trust 2017) to guide them in supporting the individual in relation to pain management. Here the person’s appearance, vocal signs, habits and mannerisms, posture and observations would be monitored over a period of time in order to draw up a summary of signs of when the person is content versus distressed so that the most likely cause of distress can be managed for the person. In order to develop meaningful relationships, it is vital to be able to see the world as others see it, to practice in a non-judgemental manner, to understand another’s feelings and to be able to communicate that understanding. Relationship-based care is an important concept here as it is based on the power of relationships. In her book Relationship-Based Care, Koloroutis acknowledges that ‘[w]ithin health care organizations, profound human experiences happen every single day’ (2004:1), and the book gives more information on the benefits, healing and transformative power of building relationships with the service users we support. It is also worthwhile acknowledging that at times, ‘health care staff often feel demoralised when they find themselves in the middle of a health care delivery system that seems to have lost touch with the very reasons they’ve chosen health care as their profession (Koloroutis 2004:2). However, showing that we care doesn’t have to be complicated and can be achieved by the simplest of means.

The Hanging Out Program (HOP), developed by Sheridan Forster (2008), is an excellent example of this. It highlights the importance of interaction and focuses on looking at the environment from the service users’ point of view. ‘The approach is to spend 10 minutes with a person giving them 100% of your attention’ (Forster 2008:1). In my experience, spending time with people over a cup of tea while having a meaningful and conscious conversation has proved invaluable in developing relationships and helping to identify necessary supports.

Many problems have been shared and solved over a cup of tea!

A black-and-white hand-drawn illustration features two characters with large eyes, small bodies, and simple facial expressions. They have long hair, with one character's hair tied in a high ponytail. Between them is a steaming mug with a heart design. Below the drawing, the name "Aoibhinn Leggett" is handwritten, likely indicating the artist's name. The style is childlike, with a focus on expressive features and minimal details. — Drawing by Aoibhinn Leggett and reproduced with permission.

Non-Judgement

A non-judgemental attitude is arguably one of the first principles of social care practice as judgement has the potential to violate equality.

In his article ‘Valuing equality in Irish social care’, Hanlon presents ‘an equality perspective on practice’, stating that ‘emancipatory practices, that is, ways of helping that provide egalitarian solutions and outcomes … begins with an appreciation of the nature and relevance of inequalities on the lives of diverse social care users’ (2009:6). Hanlon asserts that social care workers ‘who do not have at least an implicit appreciation of the nature of inequalities, and of how they impact on the lives on social care users, are lacking a basic knowledge required to do this work’ (p. 9). Therefore, working toward equality is two-fold – it is vital that social care workers work on building respectful relationships while also challenging prejudice and judgement (pp. 10-11).

Case Study 1

An example of non-judgement and respect in practice:

In terms of equality within the area of disability, the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) has provided ‘legislative structures’ that protect the rights and dignity of people with disabilities. Article 23 of the UNCRPD states that people with disabilities have the same rights as anyone else in the areas of marriage, family, parenthood and relationships (UN 2006). An example of where staff should work on shedding their own misconceptions and maintaining a non-judgemental and respectful approach would be when supporting two service users who have decided to have an intimate relationship. Here, both service users should be respected and offered supports in relation to initiating and/or maintaining a relationship. Remember, in practice we should always work towards questioning our preconceived notions about the lives of people we support. What kind of supports might you offer two service users in this situation? Some examples might include contacting a psychologist to meet with the service users in order to determine what each person is seeking within the relationship or perhaps asking an advocate to meet with the service users to clarify issues in relation to consent.

TASK 2

Reflect on your own values and how they impact on your practice.

Case Study 2

While working in a residential service for people with disabilities, social care worker Tom encountered the following situation. The service users living in the house Tom worked in had decided that they would like to go to the circus. Circus tickets were booked and paid for on an evening that suited the residents who wished to go. The staff on duty on the evening of the circus outing refused to accompany the residents to the circus as she felt the circus conflicted with her values. The residents didn’t have the ability to go to the circus on their own and were reliant on the support of staff. The person in charge (PIC) contacted Tom at short notice to ask him if he would work for the evening and take the residents to the circus. Tom agreed to do so. The PIC met with the staff member who refused to go to the circus to resolve the issue and ensure that a similar situation didn’t occur in the future.

Often times we may be faced with situations which challenge our values; however, the service users’ needs and choices should always be at the forefront of decision-making.

Case Study 3

The following case study outlines the difference between our expectations and those of the people we support and the importance of non-judgement and respect in relation to those expectations.

Joanne* was a service user attending a day service. She had a mild learning disability. She was a very sociable lady and loved to spend time with her partner and friends in the day service she attended. She volunteered three days a week in a charity shop and spent two days a week attending the day service and participating in her preferred activities, which included a craft group and cookery class. Joanne was always quite an active lady; however, as she aged, and her mobility naturally began to decline, she began to put on an increasing amount of weight. At her annual medical check-up with her GP she was advised to lose weight. Having received this news, Joanne confided in her key worker, Rose,* that she felt embarrassed and upset in relation to her appearance. She said that she had realised that she had put on weight but didn’t feel that anybody had noticed until the GP mentioned it to her. Rose reassured Joanne and together they began to implement measures in order to assist with weight loss, such as having Joanne assessed by the physiotherapist so that she could use the exercise equipment in her day service. A volunteer began going for walks with Joanne once a week and Joanne also decided that on the days she did cookery she would have some of the meal prepared in class instead of bringing in her lunch as well. Joanne’s wellbeing meeting was scheduled and her mother and sister attended. During the course of the meeting Joanne’s weight was discussed. Her mother began by saying ‘You’re getting awful fat altogether … look, those clothes don’t even fit you any more … what am I going to do with you?’ Rose could see the colour rise in Joanne’s cheeks and the tears begin to prick her eyes. Joanne’s sister said, ‘Yes, we’ll have to sort you out before you have a heart attack.’

Question: How do you think Joanne might feel? How would you support Joanne at this stage of the meeting?

Rose passed Joanne a tissue and reminded her of all of the great work that she has been doing and asked her if she would like to tell her family about her healthy eating choices and use of the exercise equipment. Joanne and Rose had prepared some visual support plans, which Joanne showed to her family. Rose made the decision to steer the conversation in a more positive direction so that Joanne might enjoy the remainder of her wellbeing meeting as she had worked so hard to prepare the agenda and content of the meeting. Rose decided that she would chat to Joanne later about how she felt the meeting went. It may have felt like the right thing to do to jump to Joanne’s defence directly after the comments in relation to her weight were made; however, Joanne’s family didn’t visit the day service often, and family relations were already strained. It’s important that we don’t make judgements or assumptions about how families interact, or care for their loved ones, as they too may have things going on in their lives that we are unaware of.

* Names have been changed to protect identities.

The image shows a yellow sticky note pinned with a red pushpin. The note contains a quote in black text: "If you judge people, you have no time to love them – Mother Teresa." The text is centered, with "Mother Teresa" in bold, emphasising the message of compassion and acceptance.

Thus, judgement has no place in social care and only serves to hinder relationships with those who are already marginalised. Social care workers have many opportunities, especially when accessing the community, liaising with families and multi-disciplinary teams, to help to change people’s attitudes towards marginalised groups within society. As social care workers it is crucial that we don’t judge a service user based first on their disability and second on the decisions they choose to make.

Active Listening

Being present with people is a core concept which stems from our ability to be self-aware and practice in a mindful manner. It means continually looking for subtle cues in relation to how an individual presents themselves on any given day. One of the most valuable lessons I have learnt throughout my social care career is the importance of active listening.Rogers and Farson first coined the term ‘active listening’, claiming it to be a ‘growth experience which can [build] deep, positive relationships and tends to alter constructively the attitudes of the listener’ (1987:1). Two components are important here: ‘the content of the message and the feeling or attitude underlying this content’ (p.3). As social care practitioners we aim to understand both components in order to understand the total meaning the person is trying to convey. Rogers and Farson also argue that ‘[in] some instances, the content is far less important than the feeling which underlies it’ (p.3). This is perhaps even more important in social care as often times the service user won’t have the skills to clearly articulate how they might be feeling. It is therefore crucial that we develop relationships with the service users we support and begin to recognise the non-verbal cues that may indicate how the person is feeling. This can help to offset any emotional upset or episodes of behaviours that challenge. It’s important to know how the people you support communicate and helping a person to develop a communication passport or support plan can be very useful here.

Rogers and Farson (1987:3-4) outline the following important cues to be mindful of when listening to a person:

Rogers and Farson also note that ‘Active listening carries a strong element of personal risk [as] we risk being changed ourselves’, for example, we run the risk of seeing the world from another person’s point of view (p. 5). They claim that ‘It is threatening to give up, even momentarily, what we believe and start thinking in someone else’s terms. It takes a great deal of inner security and courage to be able to risk one’s self in understanding another’ (p. 5).

It is vital to have a genuine interest in the speaker. Any pretence of interest will be picked up by the person and as a result they may ‘no longer express [themselves] freely’ (p. 5). This is so important in the area of social care, in particular; being willing to invest yourself emotionally will undoubtedly come as a result of actively listening to a person. If you chat with somebody you support for longer than a minute or two you are no longer engaging in idle conversation. Instead you should see this time as a valuable opportunity, one in which you can actively seek ways of gaining information which might translate into future goal-setting, problem-solving or advocating on behalf of the person.

TASK 3

Research positive behaviour support to better understand the link between non-verbal cues and behaviour and supporting the person in an individualised way.

Case Study 4

All About Me

The organisation I work for has an excellent person-centred planning system, part of which facilitates a service user and member of staff to embark on a process of discovering the person. Together, the service user and staff member compile meaningful information which the service user would like to share with those he/she chooses and in a format which is accessible to the person. For example, the All About Me could take the form of a photo album, memory book, video recordings or a combination of visual and audio. The finished product is a document entitled ‘All About Me’. It’s the journey and not just the finished product which makes this process so special. An All About Me offers an invaluable insight into the person’s world – everything meaningful to them. The All About Me process is an example of active listening in action and the resulting actions and positive outcomes that can result from the process in order to better the lives of those whom we support.

TASK 4

In social care we talk about ‘what is important to and for the person’. In your place of work, how is ‘what is important to the person’ recorded and

communicated to others?

Advocacy

According to Mind (2018), advocacy can be described simply as “‘getting support from another person to help you express your views and wishes, and help you to stand up for your rights. Someone who helps you in this way is called your advocate.”’.One of the key roles of social care workers is advocating on behalf of those whom they are supporting.

Judith Snow is an example of an advocate. In particular, she was an advocate for inclusion and has also been described as a ‘remarkable leader, philosopher, teacher, artist, creator’ (Inclusion). She believed not in disability, but in ‘giftedness and capacity’ (Inclusion). Inclusion provides many resources to gain a deeper insight into Snow’s work and life.
The Wellness Recovery Action Plan (WRAP) is an example of a mental health recovery tool which allows a person to advocate for themselves. The self-designed plan is created when a person feels well and documents exactly how the person would like to be supported should they become unwell (AHP online).
The HSE provides details of nationwide advocacy services for many groups in society (HSE online)
The Citizens Information Board (www.citizensinformationboard.ie) is also a great resource for information, advice and advocacy.

TASK 5

Think about how you would like to be supported if you needed somebody to advocate on your behalf.

To conclude, social care is based on the development of inter-personal relationships with vulnerable people. It requires empathy, strong communication skills, self- awareness and an ability to use self- reflection.

Finally, never be afraid to invest yourself in another person in the pursuit of truly understanding the world of another. Snow’s writing is testament to the notion that if we can try to understand an individual who has been marginalised or needs to be supported in some way, we may be gifted with a deep connection to the individual, whereby our lives are enriched with a better understanding of the meaning of life. She said, ‘Walk into the daily activities and environments of life with this person as dream and reality interact in a creative dance that expresses the meaning of life. Try this and may you rejoice in all that you create together’ (Snow 2015:63).

Tips for Practice Educators

It is important for the student to really try to place themselves into the shoes of the service user. A few key aspects are important here.

Respect an individual’s life choices and lived experiences. Enter into a relationship with the individual, not solely in a caring capacity, but one based on acceptance that the service user is the expert. For too long in the caring professions the service user and their families were disempowered and handed control of their loved one over to professionals who, it was assumed, knew best. The person-centred planning process, including the All About Me, is invaluable in this respect. The time spent on this process is always well worth the investment.

All too often service users are labelled and treated in a certain manner in line with whatever attributes they are deemed to possess. For students entering placement it is vital that they invest the time in getting to really know an individual instead of treating the service user as perhaps others do. In this way the service user will be at a greater advantage in relation to having their needs accurately communicated.

Advise the student to complete relevant recognised online courses that may enhance their skills and learning; for example, the online learning and development site HSELanD (www.hseland.ie) provides online learning courses including Communication with Consideration and Putting New Directions into Practice.

Finally, don’t make the fundamental attribution error and presume a student isn’t capable of engaging in tasks, projects or interventions. The new perspectives that students bring are often invaluable. The learning gained through placement and the opportunities given to students during this time will help to shape their future practice. Guiding students through placement allows social care workers a considerable opportunity to impart their knowledge and skills so that the students learn to become competent social care workers.

References

AHP (Advocates for Human Potential (online) WRAP: Wellness Recovery Action Plan. Available at <https://mentalhealthrecovery.com/wrap-is>.

Carthy, A. and Jameson, A. (2016) An Introduction To Emotional Intelligence. Chapter 1 of book entitled The Emotionally Intelligent College: Transforming Third level Education to help Students and Educators Reach their Maximum Potential, Cambridge Scholar, 2016.

East Sussex NHS Trust (2017) Disability Distress Assessment Tool (DisDAT). Available at <https://www.esht.nhs.uk/wp-content/uploads/2017/10/Disability-Distress-Assessment-Too l.pdf>.

Evans, L. (2016) ‘Own Your Behaviours, Master Your Communication, Determine Your Success’, TEDx Talk Available at <http://youtu.be/4BZuWrdC-9Q> [accessed 13 January 2020].

Forster, S. (2008) HOP: Hanging Out Program: Interaction for people at risk of isolation. [online]. Available at <https://sheridaforster.files.wordpress.com/2014/08/hop-a5.pdf> [accessed 29 January 2020].

Hanlon, N. (2009) ‘Valuing equality in Irish social care’, Irish Journal of Applied Social Studies 9(1): 6-14. Available at <https://arrow.tudublin.ie/ijass/vol9/iss1/3/> [accessed 10 December 2019].

HSE (Health Service Executive (online) Advocacy Services. Available at <http://www.hse.ie/eng/services/ yourhealthservice/feedback/services/>.

Inclusion (online) Judith Snow Writing and Videos. Available at <https://inclusion.com/inclusion- resources/change-makers/judith-snow-writing-videos/> [accessed 9 December 2019].

Koloroutis, M. (ed.) (2004) Relationship-Based Care: A Model for Transforming Practice. Minneapolis: Creative Health Care Management.

Mind (2018) What is Advocacy? [online]. Available at <https://www.mind.org.uk/information-support/ guides-to-support-and-services/what-is-advocacy> [accessed 12 January 2020].

NESC (National Economic and Social Council) (2009) Well-being Matters: A Social Report for Ireland. Available at <http://files.nesc.ie/nesc_reports/en/NESC%20119%20Highlights_Well%20Being.pdf> [accessed 19 March 2021].

Owen, S. and Maratos, F.A. (2016) ‘Recognition of subtle and universal facial expressions in a community-based sample of adults classified with intellectual disability,’ Journal of Intellectual Disability Research 60(4): 344-54. Available at <http://onlinelibrary.wiley.com/doi/epdf/10.1111/jir.12253> [accessed 15 December 2019].

Rogers, C. and Farson, R. (1987) ‘Active Listening’ in R. Newman, M. Danzinger and M. Cohen (eds), Communicating in Business Today. Lexington, MA: DC Heath. Available at <http://wholebeinginstitute. com/wp-content/uploads/Rogers_Farson_Active-Listening.pdf> [accessed 10 December 2019].

Snow, J. (2015) Great Questions: Writings of Judith Snow. Toronto: Inclusion. Available at https://resources.depaul.edu/abcd-institute/publications/Documents/Judith_book_1.1%20c opy.pdf> [accessed 30 December 2019].

UN (United Nations) (2006). Convention on the Rights of Persons with Disabilities: Article 23 Respect for home and the family. Available at <https://www.un.org/development/desa/disabilities/convetion-on- the-rights-of-persons-with-disabilities/article-23-respect-for-home-and-the-family.html> [accessed 19 March 2021].

Zijlmans, L., Embregts, P., Gerits, L., Bosman, A. and Derksen, J. (2015) ‘The effectiveness of staff training focused on increasing emotional intelligence and improving interaction between support staff and clients,’ Journal of Intellectual Disability Research 59(7): 599-612. Available at <http://onlinelibrary. wiley.com/doi/epdf/10.1111/jir.12164> [accessed 31 December 2019].

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Guide to the Standards of Proficiency for Social Care Workers Copyright © 2025 by Technological University of the Shannon: Midlands Midwest, Dr Denise Lyons and Dr Teresa Brown is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, except where otherwise noted.