Worker-client Relationship Research Articles

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 MI, motivational interviewing, is a counselling method for increasing a person’s motivation for behaviour change that is prevalent in social work. MI emphasizes building trusting social worker-client relationships and is presented as concrete and simple to follow. The benefit of MI is limited by actual opportunities for change through poverty, the labour market and health. The article aims to critically examine the usefulness of MI in connection with the handling of social assistance. It is based on a study of the use of an assessment instrument and of individual action plans (contracts) in a municipality where MI is a central tool. The study is based on analyses of documents, individual interviews and group interviews with staff as well as observations of meetings and training.The results show that MI has been integrated into a comprehensive implementation of other elements to standardize initiatives within income support. The client’s obligations are emphasized through a strong individual focus, although extensive efforts may be needed from surrounding actors. The action plans have inherent problems in terms of clarity and legal certainty. The authors argue that it is paradoxical to use a method based on alliances and collaboration in connection with conditional decisions. The use of MI becomes a commitment that lacks reciprocity and whose activation of self-technologies can be questioned.

Challenges of Social Work Student Conducts A Practice on Family in Context of “Relationship of Social Worker – Client”

Field work in the field of social work is vital to support the application of learning in the class to the form of skills through experience with clients. The core of this study is to examine the challenges faced by the two cohorts of final year students of the social work undergraduate program in building relationships with clients while conducting fieldwork with child and family client. This research applied a qualitative method with a grounded theory approach as the study design. The data collection techniques are through document analysis and Focus Group Discussion (FGD). A total of 37 field work reflection documents written by the first cohort students are analysed to obtain the initial themes related to challenges of social worker-client relationships while 62 second cohort social work students were involved as focus group informants to get more in-depth information. The findings show that there are 5 main issues of challenges of social worker-client relationship namely (i) difficulty building trust because clients lack knowledge about social work (ii) projection towards the agency of social welfare (iii) limited relationship with certain family members (iv) denial of parenting style problem (v) authority of discussion distorted to advice. All identified challenges associated with the society’s understanding of the social work profession itself and few ethics issues are also discussed.

Examining a Child Welfare Parenting Intervention for Parents With Intellectual Disabilities

Purpose: There is scant child welfare research on parenting interventions for parents with intellectual and developmental disabilities (I/DD). This mixed-methods research examined client participation in an in-home parenting intervention, including client characteristics, which clients benefit most from participation, and key aspects of program participation. Method: The sample included participant program records, client satisfaction surveys, stakeholder interviews, and a staff focus group. The quantitative data were analyzed using growth curves and binary logistic regression. The qualitative data were analyzed using thematic analysis. Results: Time spent in Project Improving Parenting Achievements Together was predictive of improvement in parenting skills and the home environment and reduction in the odds of out-of-home placement for children of parents with I/DD. The intensity of services, tailored education, community engagement, and client–worker relationship were the key aspects of program participation. Discussion: With proper supports, parents with I/DD can learn parenting skills, improve the home environment, and keep their family intact.

The Discursive Struggles of the Client–Worker Relationship in the Social Services

This study examines how disability service workers identify the discourses of the client-worker relationships. We studied the clientworker relationship from the perspective of the relational dialectics theory with a focus on relational contradictions and the meanings created within discursive struggles. We analyzed the interview data from 22 social workers using contrapuntal analysis. According to the social workers’ perceptions, two discursive struggles exist in client-worker relationships: i) the struggle of integration, consisting of the contradiction of the ideal and the real and the contradiction of closeness and reservedness and ii) the struggle of certainty, consisting of the contradiction of predictability and novelty and the contradiction of openness and closedness. These struggles and contradictions arranges on the societal and relational frames to fully depict the nature of social work. Overall, our analysis shows that the client-worker relationship is both bound to the norms of a professional and a close interpersonal relationship, making its study particularly interesting.

Implementing 'universal' access to antiretroviral treatment in South Africa: a scoping review on research priorities.

‘Universal’ access to antiretroviral treatment (ART) has become the global standard for treating people living with HIV and achieving epidemic control; yet, findings from numerous ‘test and treat’ trials and implementation studies in sub-Saharan Africa suggest that bringing ‘universal' access to ART to scale is more complex than anticipated. Using South Africa as a case example, we describe the research priorities and foci in the literature on expanded ART access. To do so, we adapted Arksey and O’Malley’s six-stage scoping review framework to describe the peer-reviewed literature and opinion pieces on expanding access to ART in South Africa between 2000 and 2017. Data collection included systematic searches of two databases and hand-searching of a sub-sample of reference lists. We used an adapted socio-ecological thematic framework to categorize data according to where it located the challenges and opportunities of expanded ART eligibility: individual/client, health worker–client relationship, clinic/community context, health systems infrastructure and/or policy context. We included 194 research articles and 23 opinion pieces, of 1512 identified, addressing expanded ART access in South Africa. The peer-reviewed literature focused on the individual and health systems infrastructure; opinion pieces focused on changing roles of individuals, communities and health services implementers. We contextualized our findings through a consultative process with a group of researchers, HIV clinicians and programme managers to consider critical knowledge gaps. Unlike the published literature, the consultative process offered particular insights into the importance of researching and intervening in the relational aspects of HIV service delivery as South Africa’s HIV programme expands. An overwhelming focus on individual and health systems infrastructure factors in the published literature on expanded ART access in South Africa may skew understanding of HIV programme shortfalls away from the relational aspects of HIV services delivery and delay progress with finding ways to leverage non-medical modalities for achieving HIV epidemic control.

THE SOCIAL WORKER-CLIENT RELATIONSHIP: DIFFICULTIES AND SOLUTIONS

THE SOCIAL WORKER-CLIENT RELATIONSHIP: DIFFICULTIES AND SOLUTIONS

Social Worker–Client Relationships: Social Worker Perspectives

ABSTRACT Social worker–client relationship practice has always been and remains central to contemporary social work purpose and identity. The professional “helping relationship” can and does enable change and alleviate distress. Nevertheless, what happens in social worker–client relationships remains unclear warranting research attention. This article reports on a qualitative study that explored the lived experience of social worker–client relationships with 16 social workers employed in child and family welfare services in New South Wales and the Australian Capital Territory. Findings confirmed the centrality of social worker–client relationships for achieving client outcomes and revealed a distinctive practice approach where the social worker–client relationship is seen as the workspace for the intervention, and the social worker acts as relationship-building agent. Overall this constitutes a distinctive practice approach perhaps usefully described as social work relationship praxis (SWRP). The findings are discussed with reference to the literature and implications for research, practice, and education are outlined. IMPLICATIONS This study valorises the centrality of the social worker–client relationship for achieving client outcomes. A relational paradigm needs to be elevated in social work education to prepare students for practicing relationally. Development of social work practice theory needs to embrace relational views of “the self”.

Exploring emotional aspects of care and control in social work with children and families - a single case analysis of conversation

ABSTRACTIn this article, I explore how emotions are displayed and dealt with on a communicative level in face-to-face encounters between social workers and parents in a child welfare setting. The analysis draws upon detailed analysis of a whole encounter between a social worker and a parental couple who have recently had their new-born daughter placed in foster care. By examining the way emotional stances are expressed and responded to I discuss how orientations toward institutional tasks and goals create constraints for the display, recognition and validation of clients’ emotion displays. I consider the communicative challenges this poses for the parents and the social worker and the implications these may have for the client–worker relationship.

Platform Labour and Structured Antagonism: Understanding the Origins of Protest in the Gig Economy

This article investigates why gig economy workers who see themselves as self-employed freelancers also engage in collective action traditionally associated with regular employment. Using ethnographic evidence from remote gig economy workers in North America, the United Kingdom and the Philippines, we argue that labour platforms reduce the risk of false self-employment in terms of the worker-client relationship. However, in doing so, they create new forms of worker dependency on the platforms themselves. We term this relationship ‘platform labour’, and demonstrate that it entails a ‘structured antagonism’ which manifests as perceived conflicts over platform fees, pay rates, and lack of worker voice. This creates desires for representation, greater voice and even unionisation towards the platform, while retaining entrepreneurial attitudes towards clients. By refocusing industrial relations on structured antagonism instead of the employment relationship we can understand conflict, protest and organising in new and diverse forms of work.

Growth Through Participation: A Longitudinal Study of a Participation-Based Intervention for (Formerly) Homeless People

The current longitudinal study examined a participation-based intervention for homeless and formerly homeless clients, growth through participation (GTP), developed by a Dutch organization providing shelter services and ambulatory care. GTP is based on a combination of group and individual approaches, whereby clients are enabled to learn to identify their strengths and talents, to develop social skills through interaction with each other, and to learn to once more lead a structured life. The study was conducted among 172 (formerly) homeless clients and comprised three measurement time points. It examined whether (1) quality of life increased during the GTP intervention; (2) social participation (e.g., labor/recreation), self-esteem, clients’ experiences with care (i.e., satisfaction with the services received and with the client–worker relationship), and psychological distress improved during GTP; (3) clients exhibiting psychological distress benefit more from GTP than others. Results from latent growth modeling showed that quality of life and the amount of time clients spent on labor activities increased significantly, but the amount of time clients spent on recreational activities decreased over time. Clients with psychological distress experienced increased quality of life and self-esteem, and reduced psychological distress. Other variables did not significantly change during GTP. Although not all hypotheses were (fully) confirmed, it can be concluded that GTP seems to be a potentially promising intervention. It is recommendable to conduct a multisite RCT to determine the efficacy of GTP.

Romanian social workers facing the challenges of neo-liberalism

ABSTRACTWith a history of almost 90 years, professional social work in Romania once flourished up until World War II. The Communist Party disbanded the profession in 1968 and it was reinstated after the fall of the Iron Curtain in 1989. Within the context of the socio-economic transition from a centralised to a free-market economy, Romanian social policy and social work have evolved from a Marxist/socialist-type ideology, one that advocates for state intervention, to a libertarian/neo-liberal-type ideology, which promotes both state withdrawal from welfare provision and individuals taking responsibility for their own welfare. These two trends continue to co-exist subject to sometimes divergent forces such as international institutions and internal Romanian social pressures. Using a qualitative approach, we explore how Romanian social workers are adapting to the neo-liberal realities and identify three types of perceived challenges: 1. those related to regulation, 2. linked with collaboration in social work activity and 3. those related to the social worker-client relationship. Under neo-liberal pressures, the social worker's role of agent of social change becomes marginalised in daily practice, leaving little power to influence agency policies that negatively impact clients.

Assessing Child Welfare Agency Practices and Attitudes that Affect Father Engagement

ABSTRACTThe importance of fathers' involvement in their children's lives is irrefutable. Supportive, warm, and positive involvement of fathers leads to children being well-adjusted. Indeed, involved fathers positively influence their children's cognitive ability, social behavior, psychological well-being, and educational achievement. For children in foster care, when fathers are involved they have significantly shorter stays in foster care than those whose fathers are not involved. For parents to demonstrate fitness to parent they must show the successful completion of goals specified in a case plan that promotes safety and permanence of their child. This cross-sectional study investigated how fathers' perception of social workers' attitude and practice skills was associated with fathers' understanding and confidence with regard to completing the case plan goals. A purposive sample of 56 child welfare-involved fathers completed the Child Welfare Father Involvement Questionnaire. The findings indicated that the more positive fathers perceived social workers' attitude and skills, the greater their understanding about the case plan goals and greater confidence to complete case plan goals. The results were statistically significant. These results have implications for child welfare training to build the social worker-client relationship in a compassionate manner while maintaining a rigorous assessment and monitoring of fathers' parenting capabilities.

Shining the Light on Intersectionality: The Complexities of Similarity and Difference in the Therapeutic Process from the Perspectives of Black and Hispanic Social Workers

ABSTRACTFew studies have examined the experiences of non-White social workers in racially concordant and discordant therapeutic relationships. The relationship is often complex, with many factors intersecting. Three focus groups with 18 Black and Hispanic social workers and social work students were conducted to explore their perspectives on how racial similarities and differences affect the worker–client relationship. Qualitative data analysis revealed five themes: intersections of diverse characteristics, language discordance and concordance, similarity and difference affecting client engagement, assumptions and expectations based on racial/ethnic background, and use of social work skills and self when encountering difference. Implications for ethnocultural countertransference are highlighted.

Home Health Aides' Perceptions of Quality Care: Goals, Challenges, and Implications for a Rapidly Changing Industry.

Home care payment models, quality measures, and care plans are based on physical tasks workers perform, ignoring relational care that supports clients' cognitive, emotional, and social well-being. As states seek to rein in costs and improve the efficiency and quality of care, they will need to consider how to measure and support relational care. In four focus groups ( n = 27) of unionized, agency-based New York City home health aides, workers reported aide-client relationships were a cornerstone of high-quality care, and building them required communication, respect, and going the extra mile. Since much of this care was invisible outside the worker-client relationship, aides received little supervisory support and felt excluded from the formal care team. Aligning payment models with quality requires understanding the full scope of services aides provide and a quality work environment that offers support and supervision, engages aides in patient care, and gives them a voice in policy decisions.

Avoidable Ignorance and the Ethics of Risk in Child Welfare

Sources of risk to children include far more than risk of harm to children from biological parents. Key opportunities to reveal and decrease avoidable ignorance that contribute to avoidable risk to children and families have been neglected such as clearly describing the evidentiary status of services provided and outcomes attained. A systemic view of risk requires attention to faulty assessment, referral to agencies that offer ineffective programs, failure to monitor outcomes and the quality of the social worker–client relationship on an ongoing basis, dysfunctional organizational arrangements and failure to involve clients as informed participants. An examination of the websites of child welfare agencies in the San Francisco Bay Area revealed that not one offered information that would enable informed decision making. Education programs may fail to help students to acquire skills in the process of evidence-informed practice. Based on a systemic view of risk, an agenda to decrease avoidable ignorance that contributes to avoidable risks to children and families is suggested emphasizing informed consent obligations. This includes increasing transparency regarding what is done to what effect including professional education and welcoming criticism of practices and policies and related claims. Reasons for failure to reveal and decrease such ignorance are explored including economic interests in the adoption and child welfare services industry.

Exploring Use of Self: Moving Beyond Definitional Challenges

ABSTRACTUse of self is a central concept throughout social work history and theory, yet no unified definition and little empirical research exist. Thus, a qualitative exploration was required. Three focus groups (n = 10) were conducted with experienced BSW educators. Participants defined use of self in the context of their students’ beginning social work practice. The findings suggest that use of self incorporates personal self qualities such as openness, self-reflectiveness, attunement to others, commitment, and emotional maturity, and results in professional capacities such as nurturing the social worker–client relationship, reflective practice, and practice wisdom. Use of self is the integration of theory and practice embodied in the social worker and enacted in the worker-client relationship.

Neither “Bad” nor “Dirty”: High-end Sex Work and Intimate Relationships in Urban China

AbstractThe relationship between sex workers and their clients is generally characterized as being based entirely on the direct exchange of sexual favours for money. However, this received wisdom cannot account for a nation such as China which attaches significant value to “face,” social status and interpersonal dignity. This paper draws parallels with high-end sex workers elsewhere in Asia as well as globally. With a focus on the high-end sector, I examine how workers and their clients engage not only in pecuniary transactions but also in genuinely intimate and non-remunerative relationships. High-end sex workers make use of their earned economic capital to acquire cultural capital, and use online apps as marketing tools to target local elites and expats to forge longer-term intimate relationships. Male clients in more commercialized, post-industrial cities in China continue to seek diverse types of sexual experiences, with some clients seeking genuine intimacy. Furthermore, I explore how Chinese and foreign clients overcome social barriers to develop such relationships with sex workers. Building on this sociocultural perspective, this paper analyses ethnographically both sides of the female sex worker–client relationship in high-end karaoke lounges and bars in Dongguan, southern China.

Human Rights: Its Meaning and Practice in Social Work Field Settings

The goal of the study reported in this article was to explore the conceptualizations of human rights and human rights practice among students and supervisors in social work field settings. Data were collected from 35 students and 48 supervisors through an online survey system that featured two open-ended questions regarding human rights issues in their agency and human rights practice tasks. Responses suggest that participants encountered human rights issues related to poverty, discrimination, participation/self-determination/autonomy, violence, dignity/respect, privacy, and freedom/liberty. They saw human rights practice as encompassing advocacy, service provision, assessment, awareness of threats to clients' rights, and the nature of the worker-client relationship. These results have implications for the social work profession, which has an opportunity to focus more intently on change efforts that support clients' rights. The study points to the possibilities of expanding the scope of the human rights competency within social work education and addressing the key human rights issues in field education.

Rules or No Rules? Three Strategies for Engagement with Young People in Mandated Services

A qualitative study of 61 youth receiving mandated services (child welfare, mental health, probation) or services where there were no alternatives (residential care for homeless youth) explored worker-client relationships from the perspective of young people themselves. Findings suggest three different but related roles played by workers that successfully engage adolescent clients: (1) “Informal supporters” de-professionalize their role and flatten hierarchies, emphasizing empathy and enforcing few rules; (2) “Administrators” enforce rules that are in the child’s best interest but do so with little emotional engagement; and (3) “Caregivers” who hold reasonable expectations and impose structures but are flexible in their negotiations with youth when rules were broken. While youth spoke most positively about their workers when they acted as informal supporters, a deeper analysis of the data showed that youth also engaged well with workers who enforced rules when those rules were necessary for the child’s safety, applied flexibly, age-appropriate, and fit with cultural norms. Use of all three approaches to youth engagement may help workers create better therapeutic relationships with youth receiving mandated services.

Client Experiences With Shelter and Community Care Services in the Netherlands

Purpose: To gain insight into client experiences with shelter or community care services for homeless people, homeless youth, and abused women and identify priority improvement areas. Methods: Seven hundred and forty-four clients rated their experiences and 116 clients rated the services’ importance. Results: Clients had most positive experiences with the client–worker relationship and least positive experiences with the results of services. Abused women’s service providers scored higher than homeless adults and youth service providers. Day and night shelters scored lowest, followed by crisis shelters, supported housing, and outreaching teams. The results of care have the highest need for quality improvement for homeless adults and youth. Discussion: Clients’ experiences with shelter and community care services in the Netherlands are generally positive, with a strong client–worker relationship forming the basis of good quality care. Monitoring outcomes and increasing the focus on results are integrated in recent approaches aimed at improving the quality of shelter care.