Chapter 45 – John Balfe (D3SOP5)
Domain 3 Standard of Proficiency 5
Be able to demonstrate sound logical reasoning and problem-solving skills to determine appropriate problem lists, action plans and goals.
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KEY TERMS Safe holding spaces Restorative practice Trauma-informed practice Pace in practice Connection before correction |
Social care is … a skilled and evidence-informed profession that has at its very core the principles of human rights and social justice to work with individuals and groups who are the most marginalised in our society today. The main toolkit for social care workers is their ability to work in partnership with people through relations-based interventions on complex social problems. They use not just the evidence-informed skills of care, but also, more critically, self-reflection to effectively help the lives of others through sound logical reasoning, problem- solving and action planning. |
Introduction
The lives of our most vulnerable in society require interventions from social care workers who hold the requisite qualifications and knowledge of the standards of proficiency. In addition, the ability to problem-solve and develop goals in partnership with people using a relational and emotional dimension is critical for best practice. In this chapter, I argue that the nature of social care work encompasses both short interventions with lasting effects and also long-term relationships that require structure and an ability to build effective relationships. The domain of Safety and Quality is under-explored in this regard and can be interpreted to mean many things in different social care scenarios. In this section, I apply the concept of Safety and Quality of practice to that professional ‘holding space’ which social care workers can provide through a protective relationship using a structure of intervention, such as developing problem lists, action plans and goals. I use this particular proficiency as an example of how to maintain both short- and long-term relationships with the people we work with in social care settings by using a trauma-informed lens, concepts of PACE (playfulness, acceptance, curiosity and empathy) and a connection before correction philosophy of practice (Hughes 2011).
There has been a lot of focus on the technical application of the proficiencies to social care work following the publication of the 2017 Standards of Proficiency by the Social Care Workers Registration Board (Flynn 2020). I argue that in examining this proficiency we move away from the ‘technical rational approach’ of rigid application of the threshold standards (Mulkeen 2020) to a more critical commentary on the complexities of the relational dimensions of social care work. I propose to do this by exploring this standard with a case study example from my practice as a social care worker in a criminal justice setting. Using a restorative justice lens (Zehr 2005; Sherman & Strang 2007) I will apply the essence of this standard of sound logical reasoning through exploring the assessment process, then developing problem-solving skills by responding to the needs of clients and, finally, structuring an intervention using appropriate brainstorming of problems, action plans and goals in partnership with a young woman who had come through the care system.
Professional Holding Space
In many ways, this proficiency allows for demonstrating how we use sound logical reasoning and problem-solving skills to complement the concept of a safe holding relationship in social care practice. What do we mean by a safe holding relationship? Safe holding spaces are based on the concept of relationship-based practice, which is the cornerstone of much social care work (Ferguson et al. 2020). However, there is little attention given to the types of relationship that social care workers have with their clients. When we consider the domain of Safety and Quality, safety can mean giving the people that therapeutic space where we meet them on a regular basis and have meaningful encounters with them with the effect of helping them to change (Trevithick 2003). This proficiency adds value to the understanding of a ‘meaningful encounter’ as it provides a clear structure for long-term engagement with clients. It is the partnership element of our work that is critical to understand when we develop problem lists, action plans and goals with service users.
The concept of a ‘holding relationship’ has its foundation in psycho-dynamic theory (Kanter 2004; Winnicott 1989) and sociological theory related to concepts of power (Featherston et al. 2018). This is an important consideration. As social care workers, we often have more power than we realise and by developing problem lists, action plans and goals it is crucial that we critically self- reflect on how we work in partnership with our clients and that the problem lists are not how we see it, but are authentic to the individual’s needs, goals and wants. In this way, we should consider the ethical engagement of clients by taking into account the nature of our relationships, power differentials, the wider social inequalities in the lives of others and using ‘good authority’ with our problem-solving skills (Ferguson 2011).
For some of the most vulnerable in society to make a list of problems, develop goals and action plans with a social care professional, they must first feel safe. Van der Kolk writes, ‘being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives’ (2014: 79). This is the professional holding space that social care workers provide and is the fundamental starting block for demonstrating sound logical reasoning and problem-solving skills to our clients. For our clients to take stock of their problems, develop action plans and key goals to meaningfully change their lives they first must feel truly heard and ‘seen’ by the social care professional. This is the skill of relational and emotionally intensive labour. A critical element of this proficiency of developing authentic problem lists can only exist if clients truly feel a reciprocity in the caring relationship: a ‘visceral feeling of safety’ (van der Kolk 2014: 79). I will explore how to develop this holding space and how I used it as a platform to work through problem lists, action plans and goals with a case study example from a social care practice scenario.
Social Care Case Study: Michelle (Aged 17)
Donald Winnicott claimed that ‘one case proves nothing, but it may illustrate much’ (1989: 369). This case study is an illustration of how this standard of proficiency was used in one social care context and the importance of relationship-based practice, using a trauma-informed lens and concepts from restorative justice.
Case Study 1
Michelle was referred to me by a District Court judge to complete a pre-sanction report on offences of assault, larceny, theft and attempted arson. These were serious charges that carried a maximum sentence of up to two years’ incarceration in a young persons’ detention centre. Michelle had just turned 18 years of age and was living in a residential care facility run by Tusla. She had been in the care system since the age of three and had been sexually abused by her father at a young age. She has little contact with her mother, who was an active heroin user throughout Michelle’s life. Michelle had moved placement 13 times while in the care of the state. Her experience of residential care was irregular and she had a clear mistrust of professionals and her state care. As she was due to leave care at the age of 18 years, there was no onus on the state at that time to continue with aftercare supports as the legislation at that time indicated that the state ‘may’ have provided aftercare support in the event that she was continuing with education. At that time, Section 45 of the Child Care Act 1991 detailed the responsibility of the state in terms of aftercare provision. One of the main obstacles in the Act stipulated that the health board ‘may’ assist the young person for as long as the board is satisfied of his/ her need for assistance. As a result, the provision of aftercare was inconsistent and ad hoc. This legislation under the Child Care Act 1991 was amended in 2017, and now Tusla conducts an ‘assessment of need’ for each young person leaving the care system and then creates an aftercare plan based on that assessment. However, at that time no such legislation existed, and Michelle’s future was precarious on a number of fronts – questions remained about who would provide accommodation and the necessary supports for her leaving the care system.
When considering how to apply this standard of proficiency to this case it was clear that there were a number of issues that could be listed as problem areas in Michelle’s life. From a criminal justice perspective, she needed to address her offending behaviour. Her future accommodation and vocational training was uncertain and there were also issues around her trust in professionals and hostility towards any type of intervention. However, no one had asked Michelle what she saw as the problem and what goals she had wanted to pursue in her life. She had constantly been told that she needed to make a plan for her future, to take responsibility for her behaviour and to address her anti-social behaviour. However, with so many professionals involved in her case I was concerned about over-crowding her with these requests and bombarding her with further demands, conditions or requirements. Needless to say, Michelle greeted me with hostility, anger and aggression, considering my role with the court and the power differential that existed between us. I knew that there would be no room to problem solve her issues and develop a list of problems, develop an action plan or achieve any goals until we established a relationship.
Consider this …
- How would you feel if you were told that that you had to leave home and find your own accommodation with little support or knowledge of how to access accommodation?
- What if you were never asked what you wanted for your future and it was left for someone else to decide on your goals and plans? What if you didn’t even know how to make these life decisions but were afraid to ask for help?
- What would it be like to have ten different people in your life all at the same time telling you different things to do? How would that make you feel?
These may happen to all of us at different points in our lives but when you come from a place of being moved around from place to place, not having any sense of identity or belonging and all the uncertainty of the future unknown then it can lead to a moment of paralysis and can appear that you lack any insight or awareness. In reality it can be a frightening experience.
We will now consider the process involved in how to apply this standard of proficiency to the case study in the context of relationship-based practice using a trauma-informed lens. This case study illuminates the need for developing appropriate problem lists, goals and action plans with the young person, but sound logical reasoning and the skill of problem solving indicate that this cannot be achieved unless there is meaningful engagement from the young person. It is in this context that we can explore the benefit of that safe holding space in more depth and how it can be achieved using the principles of restorative justice. When working with involuntary clients (Trotter 2015) it is not the skills, plans or goals that our clients remember or respond to, but in how you make them feel is often reported as the most significant antecedent to change. As Maya Angelou said, ‘People will forget what you said, people will forget what you did, but people will never forget how you made them feel’ (Angelou 2015). This is true for establishing that holding space in which social care practitioners create a feeling of safety for clients to explore their plans and goals.
Restorative Practice as a Means to Problem-solving and Goal-setting
Smith (2018) discusses the dynamics of sustaining relationships where there is anger, mistrust and hostility present. One of the concluding observations is that to sustain a holding relationship, practitioners should respond empathetically to feelings of anger, rejection and hostility, and, critically, keep going back. My first encounter with Michelle was characterised by all these emotions but we didn’t talk about courts or family or anything that would be threatening to her. Our meeting ended abruptly when she aggressively left the room saying she would never talk to me again! However, I came back the following week and every week for the next three years. The formal order of the court mandating that she meet with me was invoking further suspicion and resentment and we needed to try something different.
One simple way of doing this was to show Michelle everything that was being written about her and presented to the judge. Sometimes holding relationships have to be forged and made and this was one way to develop transparency and trust with Michelle. In addition, I would meet with Michelle before and after every court appearance to explain to her what was being said and what was happening in her case. The formal court retribution system can be daunting, the language of the court can be alienating and sometimes defendants don’t even speak in the court hearings.
Restorative practice is the study of how to improve and repair relationships between people and communities. Its focus is on building healthy individuals in communities to decrease crime and anti-social behaviour, repair harm and restore relationships (Wachtel 2012). One part of restorative practice is the concept of using restorative justice, which is an alternative to processing criminal cases through the court. When I met with Michelle, she was outspoken about how alienating the court system was for because she found it frustrating not knowing what was happening in her case. I proposed a restorative justice approach in this case to the court, with the consent of Michelle, and this meant she could speak openly and directly to the judge when her case was called. In this approach, the judge even cleared the court to allow her to discuss the more sensitive aspects of her case and her past. It also allowed for Michelle to make amends for her offences by returning the goods she had stolen, doing some work for the hair salon in which she had caused criminal damage, without feeling shamed, and coming away with a sense of wellbeing having corrected the wrongs she had committed. All these plans came about after much time building relationships with Michelle, presenting consistently, being transparent with information and reports and involving her in the process all the time. For example, when addressing the problem of what to do to make up for her offences it was Michelle’s idea to return to the salon to do some work and to return the stolen items in person. All of this was done in the context of the relationship we had forged over time. As restorative practices focus on the relationship, Michelle was inadvertently identifying the problems in her life, making plans and achieving her life goals.
TASK 1
When working with young people who are before the courts, enquire about an alternative way of processing their case through the courts. Meet with the local garda/probation officer/defence solicitor and explore the option of a restorative justice approach. Check out Restorative Practices Ireland, http://www.restorativepracticesireland.ie/
When met with resistance from young people, consider a trauma-informed approach. Consider the concept that challenging behaviour is a form of communication and consider the work of Chris Trotter on working with involuntary clients. Check out Dr Karen Treisman’s information on trauma- informed practice, http://www.safehandsthinkingminds.co.uk/
Become a restorative practitioner. Look out for CPD courses in your area in training and becoming a restorative practitioner in your organisation or educational setting. You could use the principles in a wide range of settingsincluding social care organisations, schools, statutory organisations and NGOs. Here is a link to all training courses: https://www.restorativepracticesireland.ie/training/
Trauma-informed Practice
A strength in the restorative practice approach is the use of the principles of inquiry and assessment that are based in trauma-informed and human rights concepts. This means that practitioners do not ignore or dwell on past childhood trauma but use this information to understand the client’s current difficulties in the context of this past trauma. Trauma-informed practice aids practitioners in emphasising to survivors how their past influences their present and therefore empowers individuals to manage and problem-solve their lives better (Knight 2015). Therefore, the use of a trauma-informed lens can enhance the logical reasoning and problem-solving skills of social care workers by helping them to understand current behaviours in the context of past events. Such insight gives social care practitioners the ability to see the social world from the perspective of the client, in which feelings of powerlessness, insecurity, shame and a deep mistrust of others can prevail (McCann & Pearlman 1990). This insight and knowledge can enhance sound logical reasoning and assist in problem-solving skills when awareness of the trauma is utilised to understand current behavioural and emotional difficulties. One of the approaches that Dan Hughes uses is PACE in practice (2009). PACE is a concept used in dyadic developmental psychotherapy (Hughes 2011) and is based on a way of thinking, feeling, communicating and behaving that aims to make a young person feel safe. It stands for playfulness, acceptance, curiosity and empathy. By applying these concepts to our practice we are invoking a sound logical way of reasoning and working with individuals who are traumatised. Holding a stance of being ‘curious instead of furious’ (Hughes 2009) takes blame and shame out of the interaction and encourages understanding of the individual’s past. This is similar to applying the unique exception concept often used in family therapy (White et al. 1990). In this concept we look for the exception of good moments in the client’s life when they achieved something, and build on the skills that were required to make this happen. This can be an interesting tool to model problem-solving skills and help people identify how they have overcome previous problems to master new ones.
Concluding remarks:
To work effectively with people who are traumatised, we need to be able to create a safe, holding space between the person and the social care worker. This standard of proficiency provides a structure and a platform for social care workers to use when developing and sustaining relationships with service users by introducing the concept of a safe holding space. This is renewed focus on the type and quality of relationship, experienced through reliability and critical thinking in our meaningful engagement with vulnerable populations. An understanding of the different dimensions of safety and quality is demonstrated through sound logical reasoning and problem-solving skills. By considering the types of interventions we use, for example, trauma informed practice, person-centred care, and restorative practice, we are being creative and innovative in how we approach problems, goals and plans. Sometimes our caring relationships focus on external elements such as housing, care arrangements, court proceedings, poverty, and social injustice. These are valuable ways of connecting with people on what is important in their lives. Caring relationships also help people connect with their lives – their sense of self in the world, of self-efficacy and self-worth.
Tips for Practice Educators
When supervising students on placement, consider the organisational culture and the impact on the student and their work – consider the ‘sanctuary model’ by Dr Sandra Bloom on how to provide a trauma-informed organisational culture for the people and systems who provide care: https://www.thesanctuaryinstitute.org/about-us/the-sanctuary-model/
Use this resource list about adversity, culturally, trauma-Informed, infused, & responsive organisations & systems here – http://www.safehandsthinkingminds.co.uk/trauma-informed- trauma-responsive-organisations-systems/ and checklist from Dr Karen Treisman as a guide or check out her book A Treasure Box for Creating Trauma-informed Organisations; Chapter 14 in particular, on supervision and team meetings, is an excellent resource for practice educators.
Use a simulated educational game-based learning activity with your students – check out the Social Care CORU Standards of Proficiency Board game developed by Balfe (2021) in conjunction with FOCUS Games: www.focusgames.com. This will help both you and your students to understand the standards of proficiency in your supervision.
References
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