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The importance of the therapeutic relationship in social work - part 1

March 10, 2015

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Dr Andrew Thorne

 

 

Whither the therapeutic relationship?

 

To recap in brief, the managerialist agenda focussed around setting targets, measuring performance against targets, along with removing theoretical models not aligned with managerialism from practice. The impetus for this agenda came from a Tory Government trying to instil business values onto recalcitrant and inefficient public sector workers - their thoughts not mine!

The problems with this approach were and still are numerous. The deskilling of practitioners, tick box case management, fetishist bureaucracy, process being elevated over outcomes, the measurement of factors only because they can be measured rather than their importance to welfare etc etc

There are numerous negative impacts, however perhaps the most debilitating effect, in my view, was the diminishment of the therapeutic relationship between practitioner and service user. This came about largely because the therapeutic relationship itself was not open to easy measurement in terms of impact on process or outcomes. Because it could not be measured it was deemed unimportant, with disastrous consequences. Lest we forget this was not just a social services phenomenon. The approach became rampant in the NHS and the Mid Staffordshire Trust scandal is testament to what happens when a managerialist policy is encouraged and patient centred outcomes are relegated to optional rather than "must do". 

So how are we to encourage the relationship back to the heart of the practice? I have my own ideas - written in my thesis - and will address some solutions in part 2, however would welcome others…

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