In part 1 of this analysis we looked at how management targets had minimised the importance of the therapeutic relationship between practitioner and service user in favour of easily measured outcomes that could be highly deleterious to professional practice (Munro 2011). In this blog the we will briefly look at a few of the academic perspective from the discipline of social work which back up the relationship approach.
In this article she explores the nature of the relationship
"In the past, the relationship between clients (service users) and social workers was seen to be at ‘the heart of social work’ (Collins & Collins, 1981, p. 6) and essential to good practice, but in recent years, its importance and value has become ‘confused and ambivalent’ (Howe, 1998a, p. 45)"
She then goes to explore the benefits of such an approach summarising
"These changes indicate a recognition that service users and carers have much to contribute to social work in terms of their ‘expert’ knowledge as people with strengths and limitations in particular areas (learning difficulties, physical impairments, etc.) and also their experience of social work services and the way these services have been delivered in the past. For social workers to be able to demonstrate the skills and qualities needed to create an active partnership with service users in this way involves a sound theoretical understanding of the importance of building and maintaining good relationships and, more importantly, the ability to use this knowledge in practice."
This line has also been taken up most recently by Ruch et al in their book Relationship based social work (2010) who argued that a person focussed approach to working with service users should be adopted. They argued that the relationship should be at the centre of practice.
"We would argue that this principle (the service user’s right to self-determination) , and therefore a person-centred approach to social work, cannot be fully embraced within modern social work, as both the policy and professional context require practitioners to act instrumentally on behalf of the state in relation to the most vulnerable, notwithstanding the relational disciplinary rhetoric."
What they were getting at here is that the notion of a truly relationship based approach to working with service users in the context of statutory provisions is impossible. The social worker is contractually obliged to carry through the states wishes. Sure this may involve forming relationships with service users to improve outcomes but the forming of these relationships under this context means that they are not truly person focussed. They are state focussed.
Where does this leave us. Is the therapeutic relationship approach dead, due to internal incoherence or can it be rescued? In my view it can be rescued but for this to happen the concept requires great clarity from the practitioner and the service that they are employed by. The practitioner needs to be completely clear that the therapeutic relationship they are utilising has a statutory beginning and end. The therapeutic relationship therefore is merely one tool that will be used to gain a “good” end.
So how might this work in reality?
Rather than re-inventing the wheel, in my next blog I will look at what the statutory sector can learn from the most successful businesses in the world such as Nike and Apple in building and developing relationships with consumers. I will argue that the theoretical underpinnings of their approach are ones borrowed from the same roots as relationship based social work and can thus be adapted to the social work arena. The key concept in this approach will be the relationship between business and consumer with the theoretical approach going under the banner of value co-creation. (Vargo and Lusch 2008)