Risk and Professional Artistry in Social Work Practice

8/14/2019 Risk and Professional Artistry in Social Work Practice

1/30

Risk and professional artistryRisk and professional artistry

in social work practice:in social work practice:between the contingencies of streetbetween the contingencies of street--

level operations and regimes of formallevel operations and regimes of formal

accountabilityaccountability

Tom HorlickTom Horlick--JonesJones andand Colin YoungColin Young

Cardiff University School of SocialCardiff University School of SocialSciencesSciences


2/30

IntroductionIntroduction

Risk as an allRisk as an all--purpose language ofpurpose language ofadministration, regulation and standardadministration, regulation and standard--setting.setting.

How has the adoption of a framework ofHow has the adoption of a framework ofriskrisk--based practice shaped professionalbased practice shaped professionalpractice in social work?practice in social work?

To what extent are contemporary theoriesTo what extent are contemporary theoriesof risk useful in capturing features of theof risk useful in capturing features of thereal world of social work?real world of social work?


3/30

1. The nature of social work1. The nature of social work


4/30

What is Social Work?What is Social Work?

Different definitions:Different definitions:

llBarclay Report (1982)Barclay Report (1982)

llGriffiths Report (1988)Griffiths Report (1988)

ll International Association of Social WorkersInternational Association of Social Workers

llGeneral Social Care Council (GSCC)General Social Care Council (GSCC)

statement of social work roles and tasksstatement of social work roles and tasks

(2008)(2008)


5/30

An informal definitionAn informal definition

The tasks of social work makes the tasksThe tasks of social work makes the tasks

the Israelites had to make bricks withoutthe Israelites had to make bricks without

straw look easy!straw look easy! Griffiths Report [1988]Griffiths Report [1988] Community Care: An Agenda for ActionCommunity Care: An Agenda for Action

(report which lead to the National Health Service and(report which lead to the National Health Service and

Community Care Act 1990)Community Care Act 1990)


6/30

The international definition,The international definition,

adopted in 2001adopted in 2001

a profession which promotes social change,a profession which promotes social change,problem solving in human relationships andproblem solving in human relationships andthe empowerment and liberation of people tothe empowerment and liberation of people toenhance wellenhance well--being. Utilising theories ofbeing. Utilising theories ofhuman behaviour and social systems, socialhuman behaviour and social systems, socialwork intervenes at the points where peoplework intervenes at the points where peopleinteract with their environments.interact with their environments. PrinciplesPrinciplesof human rights and social justice areof human rights and social justice arefundamental to social workfundamental to social work (emphasis(emphasisadded)added)

Care Council for Wales [2003] p.4Care Council for Wales [2003] p.4


7/30

Payne (2006)Payne (2006)

All social work contains elements of:All social work contains elements of:

llMaintaining social order.Maintaining social order.

llTherapeuticTherapeuticreflexivenessreflexivenessinteractioninteraction

between service users and social workers,between service users and social workers,

aimed at greater selfaimed at greater self--fulfillment.fulfillment.

llTransformationistTransformationistchanging society.changing society.


8/30

Social Work in the 21Social Work in the 21stst CenturyCentury

Admin and ICT skills (ECDL)Admin and ICT skills (ECDL)

InterInter--personal skillspersonal skills

Ability to think and act creatively acrossAbility to think and act creatively acrosstheoretical boundariestheoretical boundaries

MultiMulti--disciplinarydisciplinary

Listening and responding to the serviceListening and responding to the serviceusers / carer voiceusers / carer voice


9/30

General Social Care Council, 2008General Social Care Council, 2008

Social work makes a particularSocial work makes a particular

contribution in situations where there arecontribution in situations where there are

high levels of:high levels of:

ll Complexity, uncertainty, stress, conflicts ofComplexity, uncertainty, stress, conflicts of

interest, and riskinterest, and risk (GSCC [2008]:4)(GSCC [2008]:4)


10/30

Social work and riskSocial work and risk

Exposed to greater challenges (e.g. fromExposed to greater challenges (e.g. fromthe media) than other professions:the media) than other professions:llVictoriaVictoria ClimbieClimbie

llBaby PBaby PllShipmanShipman

llAdult deaths as well, but less press coverage.Adult deaths as well, but less press coverage.

Failures:Failures:ll Inadequate risk assessmentsInadequate risk assessments

llPoor collaboration with other professionalsPoor collaboration with other professionals


11/30

ClimbieClimbieLord LamingLord Laming

the legislative framework is fundamentallythe legislative framework is fundamentallysound. Not to the often hapless frontsound. Not to the often hapless front--lineline

staff that direct most criticism,staff that direct most criticism, ..

Greatest failure rests with seniorGreatest failure rests with seniormanagers and members of organisationsmanagers and members of organisations

whose responsibility is to ensurewhose responsibility is to ensure

servicesservices properly financed and staffedproperly financed and staffed(Laming[2003]:5)(Laming[2003]:5)


12/30

ClimbieClimbieLord LamingLord Laming108108

recommendations, inc:recommendations, inc: Training of social workers must equip them withTraining of social workers must equip them with

confidence to challenge other professionalsconfidence to challenge other professionals

Assessing child without carerAssessing child without carers consents consent

Document concerns, record visitsDocument concerns, record visits

Recorded discussions of differences in medical opinionsRecorded discussions of differences in medical opinions(esp. physical vs. non(esp. physical vs. non--accidental)accidental)

No child with protection concerns discharged fromNo child with protection concerns discharged fromhospital without permission of consultant (responsibilityhospital without permission of consultant (responsibilityrests with consultant)rests with consultant)

Those with child protection concernsThose with child protection concernsnot dischargednot dischargedwithout a plan, or a GP!without a plan, or a GP!

Check on previous concerns following admissionCheck on previous concerns following admission

P f Ri h d B k d i


13/30

Professor Richard Baker quoted inProfessor Richard Baker quoted in

Shipman report (p.69)Shipman report (p.69)

Since beginning to investigate Shipman inSince beginning to investigate Shipman in2000 I have been trying to understand how2000 I have been trying to understand howit was that he could kill so many withoutit was that he could kill so many without

detection. There were of course systemdetection. There were of course systemfailures, but it has been impossible tofailures, but it has been impossible toavoid the question as to why these wereavoid the question as to why these were

tolerated to the extent that Shipman couldtolerated to the extent that Shipman couldmurder over 200 patients. The conclusion Imurder over 200 patients. The conclusion Ihave come to is that all doctorshave come to is that all doctors shareshareresponsibilityresponsibility


14/30

Risk and professional practiceRisk and professional practice

Criminal justice and theCriminal justice and the new penologynew penology..Whither the welfare state?Whither the welfare state?

Assessing risk in child protection.Assessing risk in child protection.

Probation practice.Probation practice.

Mental health andMental health and dangerousdangerous people.people.

Health governance.Health governance.lland nowand now..

Risk management in social care.Risk management in social care.

2 H i i k2 H i i k b d tib d ti


15/30

2. How is risk2. How is risk--based practicebased practice

shaping the character of socialshaping the character of social

work?work?

G ti di l b tG ti di l b t


16/30

Generating a dialogue betweenGenerating a dialogue between

theory and practicetheory and practice

Experience, gained over a number ofExperience, gained over a number ofyears, of teaching risk theory to inyears, of teaching risk theory to in--serviceservice

social workers, studying on the postsocial workers, studying on the post--

qualification course.qualification course.

PracticePractice--orientation, interactive.orientation, interactive.

Opportunity for informal discussions ofOpportunity for informal discussions of

specific examples of practical experience.specific examples of practical experience.

Around 100 PQ students in total.Around 100 PQ students in total.


17/30

Five notable topicsFive notable topics

a.a. The use of risk ideas in documentation.The use of risk ideas in documentation.

b.b. Risk and professional expertise.Risk and professional expertise.

c.c. Use of formal techniques for riskUse of formal techniques for riskassessment.assessment.

d.d. TheThe jigsawjigsaw effect.effect.

e.e. Risk and accountability.Risk and accountability.


18/30

a. Risk ideas in documentationa. Risk ideas in documentation Example:Example:In safe hands: Implementing adultIn safe hands: Implementing adult

protection procedures in Walesprotection procedures in Wales(2000).(2000).

The presence of ambiguities and confusionsThe presence of ambiguities and confusions

Risk:Risk:ll

to the vulnerableto the vulnerablell to othersto others

ll to informantsto informants

ll (to social care agencies, staff)(to social care agencies, staff)

Risk:Risk:

ll PerceivedPerceivedll andand dangerdanger

ll assessment (but how?)assessment (but how?)

ll unacceptable (but criteria?)unacceptable (but criteria?)

ll management strategy,management strategy, where deemed appropriatewhere deemed appropriate (but(but

criteria?)criteria?)

. e r s. e r s -- ase ram ng o soc a worase ram ng o soc a wor


19/30

. e r s. e r s ase ram ng o soc a worase ram ng o soc a worpracticepractice

Service user,Service user,

carers,carers,

professionals,professionals,

otherother

stakeholdersstakeholders

Service userService userWho is at risk?Who is at risk?

RiskRisk

AssessmentAssessmentProfessionalProfessional

ExpertiseExpertiseBasis for actionBasis for action

PrescribedPrescribed

ActionsActionsProfessionalProfessional

autonomyautonomyPracticePractice

RiskRisk--basedbasedPrePre--riskriskProfessionalProfessional

RegimeRegime


20/30

c. Approaches to assessing riskc. Approaches to assessing risk

A range of practices, coA range of practices, co--existing acrossexisting acrossgeographicallygeographically--close administrativeclose administrativeareas.areas.

Formal techniques:Formal techniques:llCheck listsCheck lists

llRisk matrixRisk matrix

llRisk scoresRisk scoresHazard or risk management, or a hybridHazard or risk management, or a hybrid

of these?of these?


21/30

d. Thed. The jigsawjigsaw effecteffect

Notion coined by Firkins and Smith (2002), promptedNotion coined by Firkins and Smith (2002), prompteda strong resonance with the students.a strong resonance with the students.

DecisionDecision--making in conditions of incompletemaking in conditions of incompleteknowledge.knowledge.

Information is spread between differentInformation is spread between differentprofessionals, agencies and other members of theprofessionals, agencies and other members of thecommunity.community.

A practitioner may only possess a few pieces of theA practitioner may only possess a few pieces of the

jigsaw.jigsaw. How to gain the other pieces?How to gain the other pieces?

Working with an incomplete picture.Working with an incomplete picture.

The tradeThe trade--off between collecting further informationoff between collecting further informationand the immediate welfare of the service user.and the immediate welfare of the service user.


22/30

Unknown unknownsUnknown unknowns

as we know, there areas we know, there areknownknown knownsknowns; there are; there arethings we know we know.things we know we know.We also know there areWe also know there areknown unknowns; that isknown unknowns; that isto say we know there areto say we know there aresome things we do notsome things we do notknow. But there are alsoknow. But there are alsounknown unknownsunknown unknownsthethe

ones we donones we dont know wet know wedondont know.t know.

Donald H. Rumsfeld,Donald H. Rumsfeld,February 2002February 2002


23/30

e. Risk and accountabilitye. Risk and accountability

RiskRisk--based practice and formalbased practice and formalaccountability.accountability.

Slippage between everyday professionalSlippage between everyday professional

practice and what gets recorded in thepractice and what gets recorded in thepaperwork.paperwork.

Liability issues.Liability issues.

Back covering.Back covering.Getting things done by ensuring theGetting things done by ensuring the

assessments turn out appropriately.assessments turn out appropriately.


24/30

3. A little theory3. A little theory


25/30

PreamblePreamble

To what extent can sociological theories of riskTo what extent can sociological theories of riskhelp understanding of the praxis through whichhelp understanding of the praxis through which

social work is daily accomplished?social work is daily accomplished?

The distinction between contingency and risk.The distinction between contingency and risk. Risk Society, tooRisk Society, too broadbrushbroadbrush??

GovernmentalityGovernmentality, the technical discourse of risk,, the technical discourse of risk,

andand totalisationtotalisation?? Relevance of other grand theories?Relevance of other grand theories?


26/30

Some different perspectivesSome different perspectives StreetStreet--level bureaucracy (level bureaucracy (LipskyLipsky):): a corrupteda corrupted

world of serviceworld of service, under, under--resourced overload,resourced overload,informal techniques of practice.informal techniques of practice.

Keeping the peace (Bittner).Keeping the peace (Bittner).

Professional artistry (Professional artistry (SchSchn).n).

Good organisational reasons for bad clinicalGood organisational reasons for bad clinicalrecords (records (GarfinkelGarfinkel with Bittner)with Bittner)

ConflictingConflicting knowledgesknowledges ((KemshallKemshall))

Risk isRisk is decentreddecentred (Horlick(Horlick--Jones): a chronic,Jones): a chronic,situationallysituationally--specific, ambiguity over the naturespecific, ambiguity over the natureof the risk object; slippage between formal andof the risk object; slippage between formal andinformal practices.informal practices.


27/30

ConclusionsConclusions

Social workers operate in skilled and pragmaticSocial workers operate in skilled and pragmaticways to address the practical challengers ofways to address the practical challengers ofheavy workloads, whilst maintaining anheavy workloads, whilst maintaining anorientation towards the formal demands of riskorientation towards the formal demands of risk

management.management. Limited explanatory capacity of some grandLimited explanatory capacity of some grand

theories of risk to capture the diversity andtheories of risk to capture the diversity andsituational specificity of patterns of risk praxis.situational specificity of patterns of risk praxis.

Implications for the development of social workImplications for the development of social workpractice and risk scholarship?practice and risk scholarship?


28/30

Contact detailsContact details

Prof. TomProf. Tom HorlickHorlick--JonesJones

[email protected]@cardiff.ac.uk

Dr. Colin YoungDr. Colin Young

[email protected]@cardiff.ac.uk

Cardiff School of Social Sciences, CardiffCardiff School of Social Sciences, CardiffUniversity, Glamorgan Building, King Edward VIIUniversity, Glamorgan Building, King Edward VII

Avenue, Cardiff CF10 3WT, Wales UK.Avenue, Cardiff CF10 3WT, Wales UK.

References 1References 1


29/30

References 1References 1 Bittner, E. (1967)Bittner, E. (1967) The police on skidThe police on skid--row: a study in peace keepingrow: a study in peace keeping,,

American Sociological ReviewAmerican Sociological Review, 32, pp.699, 32, pp.699--715. The National Occupational715. The National OccupationalStandards for Social Work. Cardiff: Welsh Assembly Government.Standards for Social Work. Cardiff: Welsh Assembly Government.

Care Council for Wales (2003)Care Council for Wales (2003) The National Occupational Standards forThe National Occupational Standards forSocial Work. Cardiff: Welsh Assembly Government.Social Work. Cardiff: Welsh Assembly Government.

Firkins, A. and Smith, S. (2002)Firkins, A. and Smith, S. (2002) Judgement as a resource in childJudgement as a resource in childprotection practiceprotection practice inin CandlinCandlin, C. (ed.), C. (ed.) Research and practice inResearch and practice inProfessional Discourse,Professional Discourse, City University of Hong Kong, Hong Kong pp.309City University of Hong Kong, Hong Kong pp.309--332.332.

GarfinkelGarfinkel, H. with Bittner, E., H. with Bittner, E. Good organizational reasons for bad clinicalGood organizational reasons for bad clinicalrecordsrecords inin GarfinkelGarfinkel , H. (1967), H. (1967) Studies inStudies inEthnomethodologyEthnomethodology,, PrenticePrentice--Hall,Hall,Englewood Cliffs NJ. Pp.186Englewood Cliffs NJ. Pp.186--207.207.

GSCC (2008) Social Work at its Best . A Statement of Roles and TGSCC (2008) Social Work at its Best . A Statement of Roles and Tasks forasks forthe 21the 21stst Century. LCentury. London: GSCC.ondon: GSCC.

HorlickHorlick--Jones, T. (2005)Jones, T. (2005) OnOn risk workrisk work: professional discourse,: professional discourse,accountability and everyday actionaccountability and everyday action,, Health, Risk & Society,Health, Risk & Society, 7(3) pp.2937(3) pp.293--307.307.

HorlickHorlick--Jones, T. (2008)Jones, T. (2008) Risk, praxis and everyday lifeRisk, praxis and everyday life, keynote paper, keynote paperdelivered to a session ondelivered to a session on The Everyday Management of RiskThe Everyday Management of Risk, International, InternationalSociological Association congress, Barcelona, September, availabSociological Association congress, Barcelona, September, available fromle fromthe author or via:the author or via: http://www.kent.ac.uk/soru/Tom_Horlickhttp://www.kent.ac.uk/soru/Tom_Horlick--Jones.pdfJones.pdf..

f


30/30

References 2References 2 KKemshallemshall, H. (2000), H. (2000) ConflictingConflicting knowledgesknowledges on risk: the case of riskon risk: the case of risk

knowledge in the probation serviceknowledge in the probation service,, Health, Risk & SocietyHealth, Risk & Society, 2, pp., 2, pp.

143143--158.158. Laming, Lord W.H. (2003)Laming, Lord W.H. (2003) The VictoriaThe VictoriaClimbieClimbieEnquiry CM 5992.Enquiry CM 5992.

London: HMSO.London: HMSO. LipskyLipsky, M. (1980), M. (1980) StreetStreet--Level Bureaucracy: Dilemmas of theLevel Bureaucracy: Dilemmas of the

Individual in Public ServicesIndividual in Public Services, Russell Sage Foundation, New York., Russell Sage Foundation, New York.

National Assembly for Wales (2000National Assembly for Wales (2000) In Safe Hands Protection of) In Safe Hands Protection ofVulnerable AdultsVulnerable Adults Cardiff: National Assembly for Wales.Cardiff: National Assembly for Wales. http://new.wales.gov.uk/social_services/Publications/ArchivedPubhttp://new.wales.gov.uk/social_services/Publications/ArchivedPubliclic

ations/1348909/safe_hands?lang=enations/1348909/safe_hands?lang=en National Institute for Social Work (1982)National Institute for Social Work (1982) Social Workers Their RoleSocial Workers Their Role

and Tasksand TasksLondon: National Institute for Social Work.London: National Institute for Social Work.

Payne, M. (2006) What is Professional Social Work? Bristol: PoliPayne, M. (2006) What is Professional Social Work? Bristol: PolicycyPressPress

SchSchnn, D. (1983), D. (1983) The Reflective Practitioner: How ProfessionalsThe Reflective Practitioner: How ProfessionalsThink in Action,Think in Action, Basic Books, New York.Basic Books, New York.

Shipman Inquiry (2005)Shipman Inquiry (2005)

(Web(Web--site:site:http://www.thehttp://www.the--shipmanshipman--inquiry.org.uk/home.aspinquiry.org.uk/home.asp

Documents

Risk and Professional Artistry in Social Work Practice