How To Work With An Invountary Cients



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Engaging with invountary service users in socia work Good practice guide

This guide is based on a research project at The University of Edinburgh which invoved: Reviews of research on user engagement in socia work. Seminars with around 70 professionas from six Scottish oca authority socia work departments. Practitioner-ed research projects in each of these oca authorities.

The project found that: Worker-cient reationships are centra to engagement with invountary service users. 1, 2 Face to face work, coaborating with service users to sove their probems, is essentia. 3 Trust and respect, deveoped over the ong term, can hep to improve engagement. 4, 5 Cear and honest communication is aso vita. 6 Invountary service users may need active support to engage in socia work decision making, e.g. independent advocacy in case conferences. 7, 8

Invountary service users of socia work are diverse They range from those who won t respond to any contact, to those who co-operate because they fee they have no other choice. We use the term invountary cients for peope whose invovement with socia workers is mandated by aw, incuding famiies in the chid protection system, users of menta heath services, peope with disabiities, oder peope such as those with dementia, and peope in the crimina justice system. Engaging with invountary cients can be chaenging. Successes may be sma and hard-won.

drug users adut protection young peope offenders menta heath service users chidren chid protection oder peope disabed peope acoho users parents

The socia work reationship is vita for working with invountary cients. Some things which can hep to buid positive working reationships incude...

9, 10 Maintaining continuity by avoiding frequent changes of worker. Striking a baance between exercising socia work authority, and empowering the cient to contro the process where possibe. 11 Giving practica assistance, e.g. advocacy, heping cients to fight for their rights. 12 Paying attention to what is positive in the cient s behaviour and ceebrating a achievements. 3 Showing the cient your humanity, e.g. by finding a common interest, reveaing something about yoursef, showing empathy or going the extra mie in working with them. Where the reationship has broken down competey, independent mediation services may be worth exporing. 13

Buiding trust is essentia in engaging with invountary cients. 4,5 Invountary service users are often mistrustfu of socia services. Buiding trust, even on the smaest scae, can start to overcome their fears. Trust can be buit by simpe things: consistency; sticking to your word; being honest and upfront about the situation and why socia work is invoved; apoogising if you or your organisation makes a mistake. 14 This does not mean that cients shoud fee that they can trust you with their secrets, or to aways be on their side. It means that they can trust you to be honest with them, maintain appropriate boundaries and make these expicit.

Working with invountary cients takes time and persistence. 15 Progress is often sow. Cients often begin with negative attitudes towards socia workers. However, they may revise these opinions over the ong term. It is important to understand what the initia resistance is about and get beyond that. Many famiies have had bad experiences which eave them strugging to trust professionas. Cients timescaes might not fit with statutory or performance management requirements. It may hep if you can be fexibe 8, 14 and move at the cient s pace.

Cear communication is crucia for engagement with invountary cients. 16,17,18 Many invountary cients strugge to understand what is happening to them. This makes engagement difficut. Engagement can be improved by making cear at every contact what the purpose of the intervention is, what the cient has contro over and what they do not, what is going to happen next and what the ikey consequences wi be. 19

It may hep to stick to a simpe, cear message, and repeat this consistenty, e.g. I m here because we are worried about your safety. We need to make sure you are safe. Check with the cient that this is understood and agreed upon. Empathy is crucia for maintaining engagement even where difficut issues are being discussed. 20 Avoid professiona and management jargon and acronyms. Too much information (e.g. ong, compex reports) can be as unhepfu as too itte. 21

Invountary cients may be experiencing intense emotions A parent facing the remova of their chid, for exampe, may be feeing intense anger, regret, sadness and guit. They may be ooking for someone ese to bame for what is happening. Cients may aso be paying out scripts earned in earier ife. It can hep to ask why peope are behaving as they are, rather than taking behaviour at face vaue. It may hep to consider what aspects of hostiity are persona (responses to your own actions as a worker), and what aspects are not (e.g. anger at socia services in genera, or at previous workers).

It may aso hep to think about yoursef and how you are feeing If you fee a strong sense of dread prior to contact with a cient, or of reief if a cient does not answer the door, this may suggest that you need more support. It s OK to ask for support. Supervision ought to be there for you to use if you are finding things difficut. It ought to aow you the opportunity to discuss how working with particuar cients makes you fee. You might want to ask a coeague to accompany you to visit a cient you are having troube engaging. A third party may be abe to hep diffuse the situation.

What ese might hep cients? Acknowedging their circumstances and understanding their histories. Listening to cients experiences; trying to understand how they fee about intervention. Giving cients access to a compaints procedure which they coud reaisticay use. 9

What ese might hep socia workers? Empowering them to have more confidence in themseves; re-asserting socia work professionaism. Getting peer support e.g. through practitioners forums, from coeagues. Refecting criticay and honesty on socia work practice. Avoiding faing into the routine, box-ticking mode.

References: 1 Barry, M. (2007) Listening and earning: The reciproca reationship between worker and cient, Journa of Community and Crimina Justice, 54(4), 407-422 2 Tregeage, S. and Mason, J. (2008) Service user experience of participation in chid wefare case management, Chid and Famiy Socia Work, 13, 391-401 3 Trotter, C. (1999) Working with invountary cients: a guide to practice, Sage : London, Thousand Oaks and New Dehi 4 Schofied, G. and Thoburn, J. (1996) Chid Protection: the Voice of the Chid in Decision Making, Institute for Pubic Poicy Research : London 5 Tee, S., Latheen, J., Herbert, L., Codham, T., East, B. and Johnson, T-J. (2007) User participation in menta heath nurse decision-making: a co-operative enquiry, Journa of Advanced Nursing, 60(2), 135-145 6 Heay, K. and Darington, Y. (2009) Service user participation in diverse chid protection contexts: principes for practice, Chid and Famiy Socia Work, 14, 420-430 7 Esey, S. (2010) Advocacy makes you fee brave : Advocacy support for chidren and young peope in Scotand, The Scottish Government : Edinburgh 8 Hernandez, L., Robson, P. and Sampson, A. (2010) Towards Integrated Participation: Invoving Sedom Heard Users of Socia Care Services, British Journa of Socia Work, 40, 714-736 9 Munro, E. (2001) Empowering ooked-after chidren, Chid and Famiy Socia Work, 6, 129-137 10 Frankin, A. and Soper P. (2009) Supporting the Participation of Disabed Chidren and Young Peope in Decision-making, Chidren and Society, 23, 3-15 11 Doe, M. and Best, L. (2008) Experiencing Socia Work: Learning from Service Users, Sage : Los Angees, London, New Dehi and Singapore

12 Poste, K. and Beresford, P. (2007) Capacity Buiding and the Reconception of Poitica Participation: A Roe for Socia Care Workers? British Journa of Socia Work, 37, 143-158 13 Cooper, A., Hetherington, R. and Katz, I. (2003) The Risk Factor: Making the chid protection system work for chidren, DEMOS : London 14 Wosu, H. and Stewart, J. (2010) Engaging with Invountary Service Users: A Literature Review and Case Study, report avaiabe at www.sociawork.ed.ac.uk/esa 15 MacLeod, A. (2007) Whose agenda? Issues of power and reationship when istening to ookedafter young peope, Chid and Famiy Socia Work, 12, 278-286 16 Cashmore, J. (2002) Promoting the participation of chidren and young peope in care, Chid Abuse and Negect, 26, 837-847 17 McGhee, J. (2004) Young peope s views of the Scottish chidren s hearings system in McGhee, J., Meon, M. and Whyte, B. (2004) (eds.) Meeting needs, addressing deeds working with young peope who offend, NCH Scotand : Gasgow 18 Creegan, C., Henderson, G. and King, C. (2006) Big Words and Big Tabes: Chidren and young peope s experiences of advocacy support and participation in the Chidren s Hearings System, Scottish Executive : Edinburgh 19 MacLaughin, H., Brown, D. and Young, A.M. (2004) Consutation, Community and Empowerment: Lessons from the Deaf Community, Journa of Socia Work, 4(2), 153-165 20 Forrester, D., Kershaw, S. Moss, H. and Hughes, L. (2008) Communication skis in chid protection: how do socia workers tak to parents? Chid and Famiy Socia Work, 13, 41-51 21 Whitehead, I., Henderson, G., Hanson, L., McNiven, G., Lamb, D. and Duru, E. (2009) The views and experiences of chidren and famiies invoved in the Chidren s Hearings System in Scotand, Scottish Chidren s Reporter Administration : Stiring

This guide was produced by Dr Heather Wikinson, Mark Smith Dr Michae Gaagher and the Knowedge Exchange Team at CRFR, The University of Edinburgh. The research was funded by the Economic and Socia Research Counci (ESRC), Scottish Funding Counci and the Loca Authorities & Research Councis Initiative (LARCI). Thanks to the attendees at our seminars who contributed suggestions for this guide. Further information: www.sociawork.ed.ac.uk/esa We woud wecome comments and feedback to Mark.Smith@ed.ac.uk Pictures courtesy of IRISS (Institute for Research and Innovation in Socia Services). The University of Edinburgh is a charitabe body, registered in Scotand, with registration number SC005336. crfr centre for research on CRFR famiies ten and reationships years