TY - JOUR
AU - Sinai-Glazer,, Hagit
AB - Abstract The helping relationship between a client and a practitioner is often described as the heart and soul in social work. This research explored the helping relationship between social workers and clients (the clients were mothers) in the context of public social services in Israel. The results presented here are part of a larger ethnographic study that included interviews with 14 social workers, 20 mothers who are clients, and extensive participant observations and textual analysis. Presented in this article are the results pertaining to the essential elements of the helping relationship as perceived by the research participants. Social workers and clients pointed to similar elements that comprise a good helping relationship: love and support; trust and feeling safe; listening and feeling understood; making an effort to help; humanness, compassion, and sensitivity; availability, continuity, and being there when needed; and chemistry. Participants’ accounts exemplify the importance and centrality of the helping relationship in social work. The article concludes with a discussion of the study’s implications for practice, policy, and research. The discipline of social work pays special tribute to the relationships between social workers and clients. These relationships have been described as the heart, core, soul, and steering wheel of the profession since the 19th century (Richmond, 1899). Although the importance of the helping relationship remained undisputed in social work scholarship up until this day and age, several scholars pointed to the erosion of the helping relationship in social work and beyond. Marketization and managerialism, the twin forces of neoliberal agendas that merged in the West during the 1980s, veered the profession away from being client-centered and relationship-based (Coady, 1993; Ruch, 2010). Scholars claimed that the move away from the relationship has been detrimental to the profession and its clientele (see, for example, Coady, 1993; Dybicz, 2012), calling “for a renewed emphasis on the worker–client relationship” in practice, education, and research (Coady, 1993, p. 295). My study focused on the helping relationship between social workers in public social services departments in Israel and clients of those departments (the clients were mothers). Not only are women heavily represented as social services users in Israel (Ben-Simhon & Goran, 2017) and other parts of the world (House of Commons Library, 2014; Status of Women Canada, 2012; U.S. Bureau of Labor Statistics, 2014), extensive scholarship also suggests a particularly complex and multilayered relationship between social workers and clients who are mothers in the context of child welfare and child protection. Narratives of mothers who are clients of welfare services suggest that they feel blamed for being “bad” or “unfit” by their social workers (see, for example, Hughes, Chau, & Poff, 2011; S. P. Johnson & Sullivan, 2008; Klease, 2008). Stephens (2019) recognized that child welfare–affected mothers often experience their involvement with child welfare services as traumatic. Thus, the prevalence of clients who are mothers in social services, along with the documented complexity of the relationships between mothers and social workers, lead me to focus this inquiry on the helping relationship between social workers and their clients who are mothers. The results presented herein are part of a larger ethnographic study I conducted in Israel during 2016. The project, an extensive institutional ethnography, traced the social organization of the helping relationship between social workers and clients who are mothers. The research question that guided the overall study was: “How does the social organization of a social services department in Israel coordinate the everyday experiences of the helping relationship between social workers and clients?” Presented in this article are the results pertaining to the essential elements of the helping relationship from the perspectives of social workers and clients who are mothers. HELPING RELATIONSHIP IN THE CONTEXT OF CHILD WELFARE AND CHILD PROTECTION The importance of the helping relationship and its complexity are well documented in social work scholarship. In the specific context of child welfare and child protection, the helping relationships are those forged between helping professionals and parents whose children’s well-being is questionable. The helping relationship between parents and professionals is often perplexing and intense for both clients (see, for example, Buckley, Carr, & Whelan, 2011; Ghaffar, Manby, & Race, 2012) and practitioners (see, for example, Altman, 2007; Bundy-Fazioli, Briar-Lawson, & Hardiman, 2009; Krumer-Nevo, Slonim-Nevo, & Hirshenzon-Segev, 2006). Different aspects related to the helping relationship between parents and professionals have been explored, including workers’ communication skills and attitudes toward clients (Forrester, Kershaw, Moss, & Hughes, 2008; Rhodes, 1978; van Houte, Bradt, Vandenbroeck, & Bouverne-De Bie, 2015) and power differences embedded in the helping relationship (see, for example, Bundy-Fazioli et al., 2009; Dumbrill, 2006). Scholars have also attended to organizational, institutional, and structural challenges to the helping relationship in social work and social services (see, for example, Alexander & Charles, 2009; Broadhurst & Holt, 2010; Healy, Harrison, Venables, & Bosly, 2016). This article contributes to the timely discussion about the significance of the helping relationship in social work by articulating what social workers and clients perceive as the essential elements of their helping relationship. Method Sampling and Data Collection Following the approach of institutional ethnography that guided the entire research project, any site that hosts the helping relationship between social workers and mothers in the context of child welfare could have been a suitable site for data collection. Thus, my choice of where to collect data was mostly guided by tacit and implicit considerations. In debating which social services department to approach I contacted a former colleague who holds a high-level position in the Central District in the Israeli Ministry of Labor, Social Affairs, and Social Services and who is familiar with the 73 social services departments within the district. I am also familiar with the majority of the departments from working in the district a few years ago, and we brainstormed which departments could serve as a site for data collection and sketched inclusion and exclusion criteria. First, the department should be of medium size (10 to 15 social workers) so that the institution can be studied in depth and at the same time have enough diversity and richness. Second, the department should be somewhat available and willing to participate. A department that is going through an acute crisis or change might not be the best choice for practical reasons. Finally, the department manager should show support and allow me access to the social workers and clients and also to various documents that are used in the department. We comprised a list of six potential departments. My first choice, and where I ended up collecting my data, was a department in southcentral Israel. Ethnographic fieldwork was carried out during fall of 2016 and included interviews, participant observations, and textual analysis. In this article I present data from interviews with all the social workers in the department, including the manager (n = 13); the administrative assistant (n = 1); and 20 clients who are mothers. I met clients for interviews at their homes (n = 7), in the social services department (n = 10), in their workplace (n = 1), or at a café (n = 2). Interviews lasted between 45 minutes and 1.5 hours. All but one interview were recorded and transcribed (in Hebrew). Clients ranged in age between 23 and 56 years (M = 40). They all had children; the average number was four. Eight clients were married, five divorced, four single, one a widow, one divorced twice, and one separated. Ten clients were unemployed, seven worked full- or part-time, and three did random housekeeping. One client completed 15 years of schooling, three clients completed 13 years, eight completed 12 years, four completed 10 years, and three had not completed any formal schooling (they immigrated from Ethiopia). Interviews with the department’ staff were conducted in the department during working hours and lasted between an hour and 2.5 hours. All the interviews were recorded and transcribed (in Hebrew). Of the 14 staff members I interviewed, 13 were social workers, one was the administrative assistant, two identified as male and the rest as female. Six of the social workers had completed an MSW. On average, this group of practitioners had been practicing social work for 14.5 years. The average number of years working at the social services department was 10 years. The age range of 14 staff members was 26 to 67 (M = 42). One staff member was single and one divorced; the rest were married. All but one had children (M = 3). Since the social services department where I collected data is situated in a predominantly Jewish city, all participants in this study were Jewish. Data Analysis All interviews were transcribed and uploaded to Dedoose (qualitative analysis software). I listened carefully to each interview while rereading the transcript and taking notes. Interviews were then coded in English, and each interview yielded 25 to 50 codes. Next, I sorted the codes into larger units of meanings striving to connect those units of meaning in ways that make sense. This was an ongoing process, infused by theoretical and methodological reading and long discussions with colleagues and mentors. Several versions of codes and themes were reviewed by and discussed with three qualitative scholars who mentored me throughout the research process. Twice during the analysis and writing process I shared the initial results with the social workers who participated in the research. Their feedback shaped the final results and informed the writing of this manuscript. Ethical Issues and Challenges The social worker–client relationship is hierarchical and power laden; thus I took into consideration that clients might feel uncomfortable about refusing to participate when being approached by their social workers. After the initial contact with the social worker, who asked the client’s permission to give me her name and number, I contacted the client, described the research, and reassured her that agreeing or not agreeing to participate would not affect the services she receives at the agency. Moreover, I stated that the social worker would not necessarily know whether the client participated or not. To keep confidentiality I use pseudonyms throughout the Results section with minimal identifying details. This is especially pertinent given that all the social workers in the social services department where I did the fieldwork participated in the study. To deidentify the two male social workers, female pronouns are used in referring to all of them. This study was approved by McGill University Research Ethics Board. Results The results presented here allude to what makes a helping relationship work based on the participants’ accounts. What are the required ingredients that need to be present for there to be a good helping relationship between social workers and clients who are mothers? Love and Support Clients and social workers talked vigorously about the importance of love in the helping relationship. Among clients, love was mentioned in various ways. Some clients referenced the relationship with their social worker as a familial relationship. Although during our interviews many of the clients described complex familial relationships that were often hurtful and traumatic, all mentions of social workers as family or family members included positive images and interpretations of what a family can or should be. Dalit’s description of her long-term relationship with her social worker is one example: She [the social worker] is not just a social worker, she is like my family. She is a very important figure in my life. She has been with me almost half of my life. She is very dear and special. Similarly, Bracha talked about the love she felt toward her social worker, the department manager, and the department administrative assistant: “The welfare department is like my family, really.” Some clients spoke of their relationships with social workers using the mother–daughter metaphor, referring to their social workers as their mothers. Meytal described her social worker as wise, always there for her, advising and providing discipline when needed: My social worker, I see her as a mother. She is an incredible woman. I am not afraid to tell her things. I know she’ll give me the best possible advice, like a mother advising her daughter… . When needed she empowers me, or tells me, “No, no, no, Meytal, I will not let you do that.” Meytal ascribed maternal identity and roles to her social worker, and took on the role of a daughter who is given advice, encouragement, and direction. Dalia turned the mother–daughter metaphor upside-down and referred to the social workers at the social services department as her daughters: “I feel them like my daughters, really like my daughters … I don’t know them as social workers.” Social workers also invoked the concept of love as they spoke about relationships with clients: I think that … there’s love, you know, it is not a romantic love, but it is indeed love, caring, involvement, wanting the best for them, and … understanding the difficulties … I don’t accept everything they do. It’s not like I have no criticism towards them; but you know, I also have lots of criticism towards my kids. One does not exclude the other. (Vered) When asked what makes a good helping relationship, one of the first concepts that Vered used was love. Loving the clients does not mean accepting everything they do, just as a mother’s love for her children. It is interesting that some social workers spoke of themselves taking on motherly roles in their relationships with clients. In addition to the loving relationships between social workers and clients, social workers also talked about love in the department, among themselves: She [the department manager] loves her workers. True love. And we love her back… . She protects you. Say you have a case you are not really handling; she will take responsibility. She will never leave a worker in the turret alone; she will take the fire on herself. This is why workers don’t leave here. (Natasha) To conclude this section, love and support were depicted in various ways by clients and social workers. The meanings of love varied among research participants, but feelings of love and support were described as a meaningful feature of the helping relationship. Trust and Feeling Safe The issue of trust in the helping relationship between social workers and clients who are mothers was a recurrent theme in participants’ narratives. From the number of times that participants referenced the notion of trust, it seems that trust is one of the main essentials of the helping relationship. Once established, usually following much labor, trust—in its various meanings—allows for certain dynamics to happen in the relationship. Trust manifested itself as the ability to fully share with the social worker the day-to-day happenings and the deeply emotional and convoluted events and feelings. Shani and Tadela talked about the day-to-day sharing with their social workers. Shani said, “I always update her, often on the phone. She knows every detail about me … I share with her everything.” Tadela similarly stated, “I tell her [the social worker] everything. I trust her with my eyes closed. All my heart I pour out in front of her, because when I pour out my heart I am clean from the inside.” Trust, according to both clients and social workers, does not happen in a day. Meytal described the process of opening up to a social worker a few years ago in a different social services department: At the beginning, of course I didn’t believe him [the social worker] for a minute. But slowly I opened up and it always was like, “If I tell you, you won’t say anything? Promise me you won’t say anything.” And I was afraid. But somehow he succeeded in giving me that confidence that whatever we talk about stays between the two of us. Social workers talked extensively about the labor that is involved in building trust with clients. Michal spoke of the long and tedious process of gaining the trust of adolescent girls: Once they realize that I am here for them and I don’t give updates to their parents about everything they do … I think that this is when the relationship really becomes good and beneficial, and they learn to trust me … it changes the dynamic in the room when it happens… . But this only happens when they really, really trust. And many times … it takes a very long time to gain their trust. Reaching out can take many months. Einav, another social worker, also talked time and again about trust as the main building block in the helping relationship: “Trust is the basis for everything … there’s no relationship without trust.” It is important to note that trust in the helping relationship, even when a social worker tries her best, is not always secured. Noa and others gave examples of times when they did not gain the client’s trust: “I can think of someone I really was not able to build a relationship with. . . . She had a very strong feeling we are hunting her, and I couldn’t … succeed in establishing trust.” To conclude, the participants in this study spoke of trust as an essential element in the helping relationship. For some clients who are mothers, trust is associated with the ability to share a lot or everything with the social worker. It can also refer to sharing deep emotions and traumatic experiences. Clients and social workers alike shed light on the process of giving and gaining trust. It seems that trust is not the outcome of a single meeting or an anecdotal action; it is often the result of a long process that requires much perseverance and reaching out on the side of  the social worker. Listening and Feeling Understood Clients and social workers emphasized the importance of listening as an essential component of the helping relationship. Both clients and social workers depicted certain qualities that characterize listening in the context of  the helping relationship. A client, Dalit, tied together active listening, understanding, and containment by giving her social worker as an example of how listening unfolds in their helping relationship: “[My social worker] always has this containing place that from the first moment she tells you ‘I understand you.’ She is not trying to test you, she first and foremost listens and understands you.” Dalit spoke of her social worker’s listening as a space she is given where she is heard, uninterrupted. In that space, Dalit is not confronted or disqualified—she is listened to and understood. Listening is depicted and described by social workers and clients as a thoughtful activity. Active listening requires social workers to be invested in their clients, as described by Rina, a social worker: “The investment and the diligence in the relationship are very important in my experience. I mean, where you are really present … and you really take the time to … invest, actively listening. True listening.” Rina brought together being present in the relationships with clients and active listening. She noted that true listening requires the social worker’s “investment and diligence.” Making an Effort to Help Making an effort to help was widely described as a key element in the helping relationship by both social workers and clients. One client, Raquel, called on social workers not to take no for an answer: I would suggest all social workers to just really, turn the world upside-down in order to help … [make] a true effort. And not to accept NO at face value. That’s it, that’s the thing really, not to accept NO. From Raquel’s point of view, and those of other clients, making an effort to help is to try hard, to fight, to do whatever it takes to meet the client’s needs. Making an effort to help, as depicted by clients, involves a social worker going beyond what is available to her here and now. Toward the end of our conversation, I asked Dana to give advice to an imaginary class of social work students who are about to graduate: “You [the social worker] really need to listen to a person, go into his world a little, see how you can really truly help him … and make a big true effort as much as you can.” Some clients pointed to receiving material goods and monetary benefits as proof of a true effort made by the social worker to help them. Shani, a client, said this about her social worker: She approached a few organizations that give donations and they got me a check … so you see that you come to her and there is a response. . . . I know it is not obligatory that I will get what I ask for, because I know not everything is up to her; but she is doing stuff. Aside from the much-needed monetary assistance she received, it meant a great deal for Shani to see that her social worker was “doing stuff” for her. From a social worker’s perspective, Eden shared a story, one of many, of going out of her comfort zone to help a client do something meaningful for herself: I have a client who didn’t have air-conditioning in her home. Now, air-conditioning is not a luxury in this summer. So now she just received checks from this organization. . . . I told her, “You take the money from the checks and you go and buy an air conditioner!” A month or two passed and nothing happened. Last week I picked her up and we went to a few stores, and eventually she bought an air conditioner! I was so proud of her. Making an effort to help, as demonstrated by Eden and other social workers, is stepping out of one’s own comfort zone and taking action. Action can mean writing letters, making phone calls, taking a client hand-in-hand to do something meaningful, and more. Whatever action is taken, it seemed always to be rooted in doing something that one does not have to do, but rather chooses to do for the well-being of the client. This is precisely the “above and beyond” and “turning the world upside-down” that clients referred to. It is apparent that social workers deploy much energy in going above and beyond when making an effort to help. Humanness, Compassion, and Sensitivity Humanness, compassion, and sensitivity were tied together as another essential element of the helping relationship. Clients iterated the importance of feeling welcomed, and social workers talked about remembering to be and act human, and to look clients in the eye. Unlike the previous category, which was dedicated to unpacking the notion of making an effort to help, here social workers and clients were not talking about any professional-related actions and practices. Rather, they were referring to acts of kindness that did not have much to do with being a social worker or a welfare client—it was about being human, compassionate, and sensitive: She [the social worker] is human … and sometimes she does things beyond what she is supposed to, even things that are not part of her job. If she can help, she will help … she has humanness. Yes, this is the word, humanness … [for example] when I was in my second pregnancy, she would sometimes offer to take me to pick up my son from daycare. Or, when I came to see her with my daughter when she was a baby, she [the social worker] would have toys for her that she always kept aside for my baby girl. (Dalit) Dalit described a social worker who makes her feel she is there for her. This feeling is embedded in the depiction of the social worker as a compassionate human being who has “humanness” that comes about in simple acts of kindness. It seems that these acts of kindness and humanness that are not tied to the professional role of the social worker held a deep meaning for Dalit and for other clients who spoke in a similar vein. The importance of a warm, positive, and caring attitude on the part of the social worker was mentioned by several clients. Toda described a negative experience in a different social services department to the point that she decided to come back to live in Ganim. She also illustrated the feeling of being cared for and noticed: Here they [the social workers] always ask, “How are you? … How were the [chemotherapy] treatments? How are you feeling?” … These are small things, but for me it’s a big deal. . . . [It means that] there is someone who cares about you, remembers that you exist. It’s important. Michal, a social worker, demonstrated humanness, compassion, and sensitivity through a story she told me about a time she went to visit a teenage girl who was placed in a locked residential facility for troubled young girls. On her way to visit the girl, she stopped to buy pastry and chocolate milk for the girl she was visiting. Intertwined in her story is the prominence of this act of humanness and the role it played in the helping relationship: This is something that she [the girl] will remember for the rest of her life. This [the chocolate milk and pastry] is what she likes, this is what she used to eat at home, and she will remember me bringing it to her not because I brought her something to eat, but because she realized that I remembered something that has great significance for her. Michal suggested ways in which these acts of humanness and compassion have long-lasting impacts on the clients and how they forge the helping relationship. The notion of feeding the clients came up in several of my conversations with social workers. Gili made repeated references to feeding clients practically and emotionally: He [the client] comes, I make him coffee… . I have a coffee kit here [in the office] and I don’t start a conversation without coffee. If I see that he is hungry, I will offer my lunch … and I will always start with something of general interest: “Did you find the place easily [the department is difficult to locate]? How did you get here? Did you find parking? … Come, sit, I will make you coffee.” Gili was very explicit in her approach to the helping relationship with clients as something that begins with humanness, compassion, and sensitivity before anything else. For the clients, humanness entailed sensitivity, a warm and welcoming attitude, and a genuine general interest in the client. Social workers described what it means to be human, compassionate, and sensitive mostly by giving examples: looking in the eyes and assessing the client’s situation; offering coffee, treats, or other food; and doing for the client simple things that have meaning to them. Availability, Continuity, and Being There When Needed Continuity, availability, and being there when needed were depicted by social workers and clients as essential elements in the helping relationship. It seems that for clients there are two forms of desired availability, continuity, and being there when needed when it comes to the helping relationship with their social worker: One form is a wish to have a routine established as part of the relationship, in which the social worker is the initiator of contact (mostly phone calls) meant to check in on how the client is doing and reinforce the notion that the social worker is there for her, caring and thinking of her. Clients also noted a second form of desired availability and being there when needed, which related to times of crisis, sharing many stories about social workers saving the day, being at the right place at the right time with the right attitude. Tal and Raquel exemplified the importance clients attribute to a continuous routine of the helping relationship. Tal described her relationships with her social worker as “OK”; her social worker calls her when there are food vouchers or donations of coats for the kids, for example. But in between, Tal said, there are “latent periods”: She [the social worker] could not call me at all for like two [or] three months. But you know, sometimes I want this call, just like “How are you?” … you know, once every two weeks, “How are you? What’s going on?” … That’s missing. She [the social worker] calls when things come up, like a meeting we need to have [about the children] or a food voucher I can collect. When asked why the social worker did not regularly call to check in, Tal responded, “Maybe she is very busy, I don’t know why. I believe she has a lot of work.” Tal had no major complaints about her social worker, and she described their relationship as “fine.” Yet, what was missing for her was a demonstration of general interest that would be consistent with the theme of humanness, compassion, and sensitivity; this dearth of interest was revealed as a lack of continuity in the helping relationship. Tal speculated that it had to do with the overload the social worker was facing and not because she believed her social worker did not care. Yet, realizing the heavy workload the social worker was facing did not translate into needing less of her social worker’s attention. This was made especially clear toward the end of our interview when I asked Tal what would be her message to a class of graduating social work students. She responded, Not to communicate with the families only when you need something. I mean, always, always, always, even once a week, pick up the phone … [because] the connection is important for me; it is important that the connection won’t be just formal and to the point. During our interview, Raquel emphasized the material help she had needed over the years from the social services department, and the time and effort she devoted to be eligible for a plethora of services. Thus, I was somewhat surprised that toward the end of our interview, when we discussed what was important in a helping relationship, she talked about the importance of continuity in the helping relationship: [Social workers] should really see the person, feel him, call. Maybe to have a law of some sort, of calling once a month and asking, “How is it going? What do you need?” … Do you know what a difference this would make? Raquel, who spent most of our conversation explaining that she was a welfare client because of the immense financial difficulties she was facing as a single parent, talked about the importance of social workers’ general and continuous interest in their clients as key in the helping relationship. Not only that, she even suggested that this continuous practice become statutory. The feeling that the social worker is there for you in a time of great need was also noted by some clients. These were powerful stories that seemed to have great meaning for the clients. Hila discovered one day that her ex-husband used drugs, and she described her world falling down around her. The first place she came to seek help was the social services department: I came here [to the social services department] and knocked on the door. … It wasn’t during reception hours, but … a holy person opened the door for me, this is what I call her, she opened the door and she saw my eyes and, hm … I said, “Listen, I need help, I don’t see how I can handle this alone,” and she let me in and saw me every week for a whole year. … This was my darkest hour and she helped me so very much … she was just there, believing in me. It was a breath of air in an acute moment. Dalit also described a critical moment when her social worker was physically there for her: I came here [to the social services department] after a night he [her husband] disappeared with our son and I didn’t sleep and I was looking for the child and I was completely mentally shattered, I came here. … [The social worker] took me to the police station to file a complaint and she even made a sandwich for me before … it was with cheese and little cucumbers. In the midst of the loss Dalit described, she remembered in great detail that her social worker was there for her when she needed her care and support. Social workers also talked about the importance of being available for their clients on a routine basis as well as in crisis. They emphasized the cost to the helping relationship when such availability becomes impossible because of organizational and professional constrains. Making calls to clients and being available when the latter call was a recurrent issue among social workers. Giving clients a number where the social worker could be reached outside office hours was a major issue on which social workers acted in different ways: Vered and Eden represent some of the variations. The departmental unofficial norm was that social workers are not to give their private cell phone numbers to clients, yet all the social workers who participated in this study gave their private number to some clients. Vered described giving her cell phone number to most of her clients as a means to be accessible for them: “I give my cell phone, it feels right … I am much more accessible, and I can be contacted more easily. You know, in the moment of truth when I am needed, I answer.” Eden was in a different position. She did not give her cell phone number to all of her clients (over 100 cases), and she expressed frustration at often being unavailable for them: I sometimes speak with clients and I feel like a hypocrite. It’s a terrible feeling when someone tells me, “I was looking for you and you didn’t answer”; they are looking for you and you are not there. And not just once, sometimes they can call many times and I don’t answer because I am not here. It really stresses me out because I don’t want to be in a situation where I don’t get back to people for too long. You know at some point that it won’t be relevant anymore … it creates a feeling that they can’t really trust me to be there. The troubled tone in which Eden described her pain of not being there when her clients needed her and the stress this caused her resonated with me long after our interview was over. Eden drew clear lines between her unavailability and time constraints: “If I had a few more hours just for phone calls I would give my cell phone number to everyone, really I have no problem. [I want] to really help and be there when I am needed.” Unable to deal with potentially dozens of clients calling her private number, Eden gave her cell phone number to a handful of clients: “I have a few [clients] whose lives are so rough that I want them to be able to call me so I will know they are OK.” Eden, among other social workers, gave examples of physically going outside their office hours to see clients in situations of great distress. Eden described in great detail the shaken mental health of one of her clients who was going through a difficult separation after years of an abusive marriage. Being there for her client in a time of need was of great importance for Eden, but at the same time, she felt torn about spending so much time with one client when other clients’ needs were not met because of time constraints: I wanted to be with her until she got a bit stronger, I didn’t want her to end up in a psych ward. … Her family offers no support, but I know I can’t be there all day long. …  One day she asked me to come [and] I went there around 11 p.m. … She had very difficult days. Apologetically, Eden explained to me how and why she found herself at a client’s house at 11 p.m. Although in clear breach of professional norms, Eden held a strong conviction that driving to be with the client late at night in response to the client’ request was the right thing to do. It is interesting that the many ways in which this essential element of the helping relationship—continuity, availability, and being there when needed—came about in the everyday experiences and perspectives of social workers and clients in this research. Continuity is seeing the same social worker for a long period of time, so that shared experiences can lead to meaningful relationships. For some clients, continuity was a desired routine communication whereby the social worker calls every two weeks or once a month just to see how the client is doing. Other clients described the ways in which their social worker was there for them just when they needed them, something that social workers also talked about widely. Among social workers, the phone issue was closely connected to their often-limited ability to offer availability and continuity to their clients and to be there for them in time of need and outside office hours. Chemistry When I asked social workers and clients who are mothers to try and pinpoint what is this “thing” that makes the relationship work with some and not work with others, most had a hard time naming it. Some called it a “click,” others talked about chemistry, compatibility, a bond, or positive vibes. That feeling of connectedness seemed to be more embodied than verbalized, located in the physical body more than in the left hemisphere. During our interview Dalit described over and again the very special connection she had with her social worker. In my efforts to understand what was in this relationship that made it special, she referred to compatibility: There needs to be suitability between people to make it work … it’s a very special bond we have. I believe it was created thanks to the—how do you say—that first click. Because there were other social workers they tried to connect me with over the years. … Once I came to one meeting and just walked out. I mean, it wasn’t it, it just wasn’t it, no. Simcha is a veteran welfare client who had various relationships with different social workers since she was a young girl. In an effort to articulate the differences between the good helping relationship she had and the not-so-good helping relationships with other social workers, she spoke of feeling the social worker, hearing her words, and developing an intuition, “Basically, by her reactions, what she is saying, what does she mean. I mean, I just see it according to how she speaks.” It seems that for the social workers it was harder to talk about that thing that makes a good helping relationship. They were usually quicker to attach well-articulated concepts to what is essential in the helping relationship—all the other elements I presented thus far. Still, some social workers were looking for the right words: “It [the helping relationship] is a connection, chemistry. When there’s some sort of agreement, when there’s a clear and respected setting … once a bond is made things can flow.” (Einav) Eden gave an example of a client relationship in which there was no chemistry and she was having a hard time establishing a good helping relationship: I have one client who I know I will never have a good relationship with her, ever… . I think that those I can’t work with are those who … maybe there is no chemistry. They don’t get me, I don’t get them, there is a lack of basic trust that it is really hard to establish. And then they evaluate me according to what I give, bottom line: Did I get them the whatever it is (i.e., material benefits) or not? They don’t really try to see me as a person who wants to help. To conclude, chemistry is an essential yet elusive component of the helping relationship as perceived by the research participants. Given the embodied nature of chemistry, the feeling of it being either present or absent, it proved to be a challenge for the participants and myself to define it. Discussion This article presents the essentials of the helping relationship as perceived by social workers and clients who participated in this study. Through their narratives I illustrated how love and support; trust and feeling safe; listening and feeling understood; making an effort to help; humanness, compassion, and sensitivity; availability, continuity, and being there when needed; and chemistry are perceived as key elements in the everyday experiences of the helping relationship between social workers and their clients. In the following discussion I briefly explore two issues emerging from the results: the emphasis clients place on seemingly mundane things their social workers are doing for them, and the discourse of love in the helping relationship. In line with previous research, the results of this study demonstrate the centrality of the helping relationship and its power to positively influence and shape practitioners’ and clients’ lives (see, for example, L. N. Johnson & Ketring, 2006; Knei-Paz, 2009). Theoretically, the results are also aligned with Bordin’s (1979, 1994) formative work about the working alliance, which he conceptualized as key to the change process. Bordin’s model emphasized the bond between the change-seeker and the change-agent as one of three core elements of the working alliance. It is interesting to note that clients repeatedly paid particular attention to the seemingly mundane actions their social workers do for them: the phone call to ask how things are going, the toys set especially aside for when they come with their young children, and the coffee they are offered when coming to a meeting. More grandiose acts were also mentioned recurrently, such as a special donation that the social worker was able to secure, or an extra food voucher that came just on time. The results presented in this article emphasize the importance of these monetary tools as a way for social workers to demonstrate their commitment toward addressing their clients’ needs. As these monetary goods become scarce under a neoliberal regime and welfare retrenchment, the results presented here might suggest that while monetary goods are highly appreciated by clients and can serve as catalysts for establishing good helping relationship, so are the daily acts of humanness and compassion. Although it may seem that these acts are grounded in the personal capacity of the individual social worker, professionals require a conducive working environment to help them remain compassionate and thoughtful practitioners. Such a working environment is becoming harder to achieve under a neoliberal regime in which practitioners are occupied with risk assessments and administrative duties that reduce the time and attention they devote to their clients (see, for example, Fargion, 2014; Parada, 2004; Swift & Parada, 2004). The notion of love and care in the helping relationship between social workers and their clients is often tabooed and considered unprofessional, crossing ethical boundaries. Although social work scholars have paid attention to elements of mutuality and reciprocity in the helping relationship (see, for example, Alexander & Charles, 2009; Alexander, 2013), and a growing body of scholarship highlights the importance and relevancy of ethics of care in social work (see, for example, Dybicz, 2012; Gray, 2009), love in the helping relationship remains underexplored. This might be tied to professional boundaries and codes of ethics that structure what is considered appropriate or inappropriate and ethical or unethical in the helping relationship (Dietz & Thompson, 2004). It is reasonable to assume that love in the helping relationship is considered dangerous as it can potentially lead to abuse of power. Yet, the love that participants in this study talked about is not a romantic love, but rather a deep feeling of care for one another. Following an alternative conceptualization of boundaries in a social work relationship that calls for connection rather than separation (Dietz & Thompson, 2004; O’Leary, Tsui, & Ruch, 2013), I suggest that feelings of love and care among social workers and clients should be nurtured, encouraged, and receive more empirical and theoretical attention. Implications for Practice, Policy, and Research The nuanced understanding of what this particular group of participants think of as the essential elements of the helping relationship can offer insights to better understand the helping relationship. Such findings can be of interest and importance for clients, practitioners, policymakers, and scholars within and beyond social work. Practitioners might benefit from listening closely to clients’ accounts regarding the importance they pay to their social workers’ seemingly simple acts and expressions of kindness, humanness, and compassion. These, as the results of this study suggest, can go a long way in establishing a good helping relationship. As noted previously, incorporating small acts of caring depends not only on the individual social worker, but also on the organizational culture within which social workers practice. Thus, I wish to refrain from giving advice on how social workers can improve their everyday practices in cultivating helping relationships with their clients; rather, organizational, institutional, professional, and social contexts shape practice and we need to be taking them into serious account when suggesting implications for social work practice (Sinai-Glazer, 2019). Policymakers play a pivotal role in enabling or disabling the helping relationship. The essential elements of the helping relationship as perceived by the research participants can guide decision making with respect to policies and regulations that have direct effects on the helping relationship. Policymakers can benefit from asking themselves whether a given policy or regulation nurtures or deters the establishment of a helping relationship built on love and support; trust and feeling safe; listening and feeling understood; making an effort to help; humanness, compassion, and sensitivity; and availability, continuity, and being there when needed. Policies and regulations that undermine the possibility of establishing a helping relationship might be reshaped so as to recognize the importance and complexity of the helping relationship. Some examples for policies that might promote the helping relationship include rewriting the often rigid and legalized forms that social workers use for documenting clients, most notably intake forms that orchestrate the first meetings and the establishment of a helping relationship between a client and a social worker. 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TI - The Essentials of the Helping Relationship between Social Workers and Clients
JF - Social Work
DO - 10.1093/sw/swaa028
DA - 2020-07-01
UR - https://www.deepdyve.com/lp/oxford-university-press/the-essentials-of-the-helping-relationship-between-social-workers-and-vAqpndSC2f
SP - 245
EP - 256
VL - 65
IS - 3
DP - DeepDyve
ER -