Abstract

In recent years, there has been a resurgence of interest in social work towards relationship-based practice. In this article, we discuss the conceptualisation of relationship-based practice from a person-centred point of view and its applicability to contemporary social work. It will be shown that the person-centred point of view has a meta-theoretical basis that makes it incompatible with modern statutory social work practice. First, we outline the theoretical and philosophical underpinnings of the person-centred approach and argue that a potential conflict lies at the heart of the contemporary social workers' capacity to truly accommodate person-centred theory. Next, the resurgence of interest in relationship-based practice, paying particular attention to the person-centred approach, is considered within the context and influence of risk management, managerialism and consumerism on social work. We then challenge the assumption that relationship-based social work founded on the person-centred approach legitimately supports service users' ability and capacity towards self-determination. Our challenge is based on the premise that the person-centred approach is defined by principled non-directive practice. On this basis, we conclude that a person-centred relationship-based approach to contemporary social work is untenable.

Introduction

Recently, there has been a resurgence of interest in the professional and academic discourse in the concept of social work as a relationship-based approach to helping (Ruch et al., 2010). This is reflected most recently and arguably most influentially with the publication of the Interim Report of the Monro Committee into Child Protection (Monro, 2011). At first glance, it seems reasonable to emphasise the social worker and service user relationship as intrinsic to successful practice. However, the term ‘relationship-based practice’ refers to a range of ways of working. As such, the turn towards a relational approach has highlighted the need to provide a clarification as to what can and cannot be considered a valid and genuine relational approach to social work.

Social workers often align themselves philosophically with the person-centred approach originally developed by Carl Rogers in the 1940s and 1950s. For instance, Wilson, Ruch, Lymbery and Cooper (2009) refer to the therapeutic relationship conditions of empathy, unconditional positive regard and genuineness described by Rogers as essential communication skills for carrying out good-quality social work practice. As such, it might be assumed that social work is a person-centred practice. However, the aim of this paper is to show that the epistemological position of person-centred theory is largely incompatible with social work practice. First, we provide a detailed introduction to the key concepts in person-centred theory. This will present a challenge to the understanding that person-centred psychology can be integrated into social work practices and expose a major ideological split between person-centred psychology and contemporary statutory social work practice. Second, the impact of the changing context of statutory social work practice will be explored through a discussion of the effects of risk management, managerialism, bureaucratisation, consumerism and individualisation upon the social work profession. The implications for social work practice are considered. Third, in light of the above, the central issue of whether it is possible to have a truly person-centred approach to social work practice is discussed, concluding that principled person-centred relationships can have no place in an instrumental relationship-based approach to practice as is common in contemporary social work.

Within the fields of counselling, psychology and psychotherapy, relationship-based approaches to personal change are widely used. However, there are a variety of relationship-based approaches. Two of the main approaches to relationship-based practice are those derived from psycho-dynamic and person-centred understandings, respectively, of human nature and personal change (Joseph, 2010). On the surface, each of these approaches may look similar in practice insofar as they involve two or more people talking, with one person labelled as the helper and the other as the person being helped. However, as we will go on to show, each of these forms of relationship-based practice is based on different and mutually exclusive fundamental theoretical assumptions (Joseph and Linley, 2006).

Consequently, there are a number of theoretical questions to be answered regarding the compatibility of some relationship-based approaches with social work principles and with the reality of social work roles and tasks. For example, social work practice broadly relates to the help provided by professionals to enable people to live with greater success in realising their potential within the communities they live by being focussed on finding solutions to their problems. The International Federation of Social Workers defines social work as a profession which aims to promote ‘social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being’ (IFSW, 2010).

In the light of these definitions, it would seem reasonable to conclude that the implication of a relational approach to social work is that the social worker–service user relationship is viewed as a central and key component of bringing about change. The role of, and the extent to which, the relationship between the social worker and service user is considered to be directly responsible for change is dependent upon the theoretical underpinnings that inform the nature and scope of the helping relationship. Simply to suggest, however, that the whole repertoire of approaches to social work and the multiple practice contexts in which social work is carried out can together be reducible to a coherent generic description as a ‘relationship-based approach’ is too broad a generalisation.

As already noted, two relationship-based approaches are the psycho-dynamic and person-centred. What makes these two so fundamentally different is that the former consider the therapist–patient relationship to be the vehicle that enables the effective aspects of the intervention to be applied (notably exploring the unconscious processes of the patient) whereas, in the latter, the therapist–client relationship is viewed as the principle change process (hence the use of the word ‘client’ as opposed to ‘patient’). Within the former category, the therapist is implicitly positioned as the expert, in possession of the power and control over the outcome of the encounter. In the latter, the relationship is based on principles and values such as unconditional positive regard, mutuality and dialogue. Here, the therapist and the client have the potential for experiencing each other as full human beings where the client is considered the expert and is free to determine their chosen path and the outcomes of the encounter.

Thus, whether relationship-based practice in social work is defined from the stance of the psycho-dynamic or the person-centred approach is not a trivial issue. This presents a difficulty for social workers as they try to reconcile the tensions between holding true to the British Association of Social Work (BASW) values and fulfilling their responsibilities as experts in the assessment of the safety and capability of people to remain in control of their own lives. For example, on the one hand, many social workers might feel most comfortable and consider themselves and their practice to fall into the latter category of person-centred relationship-based practice—that is to say, in holding true to the social work value of respect for service user autonomy, placing the meeting of needs as they are expressed by service users at the fore and where the relationship is the process whereby they facilitate the identification and understanding of these needs.

But, on the other, Ruch, Turney and Ward (2010) have presented a model of relationship-based social work practice on an exclusive integration of psycho-analytic and psycho-social/systemic thinking. Whilst this model appreciates the complexity of working in a relationship-based approach, the epistemological position is one consistent with the psycho-analytic and systemic theory. However, it is important to recognise what this means from a meta-theoretical stance and how it differs from the person-centred approach. We argue that this is a rather narrow view of what relationship-based practice could be, but it is necessarily narrow due to the basic argument that social work practice is not able to hold true to the value and principle of respecting service users' autonomy and right to self-determination. In the following sections, we will develop the above argument to show why it is not possible for contemporary social work to be grounded in the person-centred approach.

Key concepts in person-centred theory

As already noted, many social workers have aligned themselves philosophically with the person-centred approach. The reason for the alignment is because the person-centred approach is based on the premise that social forces are at the root of peoples’ difficulties and it is through the empowerment of people as self-determining actors in their own lives that social and personal change can be brought about (Proctor et al., 2006; Sanders, 2005). While relationship-based practice has meant various things in social work over the years, it is this notion that lies at the heart of contemporary discussions within social work about relationship-based practice and of the social causes of mental distress (Tew, 2011) that we will argue creates an ideological split.

Person-centred theory and social work have a shared history that is not always apparent, particularly in the current positioning of person-centred social work. Carl Rogers, the founder of person-centred therapy, was for a time based in Rochester, New York, and influenced by a number of practitioners under the guidance of Otto Rank. Two social workers, Jesse Taft and Frederick Allen, had been working using relationship therapy that was based on non-directive principles. Kirschenbaum (2007), Rogers's biographer, suggested that Jesse Taft was the person who probably had the greatest influence on the development of Rogers's theories. Such was the significance of this influence, Ellingham (2010) suggested that the therapeutic casework carried out by Taft in the 1940s and Rogers (1942) original form of the non-directive therapeutic approach were essentially one and the same. However, despite these origins of the person-centred approach and the seemingly close link with social work, we would argue there is now a serious misunderstanding of the relationship between the two.

Currently, it seems that, within the social work field (e.g. Wilson et al., 2009), a person-centred approach refers to the relationship conditions that the social worker holds towards the service user, their empathy, unconditional positive regard and genuineness. However, to work in a truly person-centred way means that these relationship qualities are embraced for a specific theoretical reason. As such, and to avoid continuing the apparent confusion regarding the potential for a person-centred relational approach to social work, there is a need for a clear articulation of the theory underlying the person-centred approach. The most important aspect of theory is the idea of the actualising tendency.

Actualising tendency, the theoretical foundation stone of the person-centred approach, is the idea of human potentiality. The central theoretical construct is the actualising tendency. The actualising tendency is a universal human motivation, which, given the right social–environmental conditions, results in growth, development and autonomy of the individual (Rogers, 1961, 1963).

In short, people are intrinsically motivated towards growth, development and autonomous and socially integrated functioning. But this motivation is moderated by extrinsic social–environmental factors. Thus, the term actualising tendency implies the tendency for people to proactively grow, develop and move towards autonomous and socially integrated functioning, when the social–environmental conditions are optimal. However, when the social environment is not optimal, the tendency towards growth is thwarted so that people's development is distorted in ways that can result in the person moving towards a negative, socially destructive direction and typical of the many of the problem areas social workers encounter in engagement with service users.

It is unusual for people to experience such optimal social environments that they might be said to have self-actualised as fully functioning and so most people experience to a greater or lesser extent some degree of psychological dysfunctionality (see Joseph and Worsley, 2005). Person-centred psychotherapy is based on the above theoretical understanding that people are intrinsically motivated to grow and develop in the direction of becoming more fully functioning, when the right social environmental conditions are present (Rogers, 1951, 1959).

In describing the right social environmental conditions, Rogers (1957) proposed that there were six necessary and sufficient relational conditions that, when present, led to constructive personality development. Most social workers will, as noted above, be familiar with the three conditions of unconditional positive regard, empathy and congruence, but it is important to note that there were six conditions that, taken together, described the facilitative social environment. The other three essential conditions are that there must also be psychological contact between the therapist and the client, the client must be in a state of incongruence and distressed in some way, and finally the communication to the client of the therapist's empathic understanding and unconditional positive regard must at least minimally be achieved.

Rogers (1957) paper on relational factors was an integrative statement of common factors thought to be both necessary and sufficient to promote therapeutic outcome. Thus, the person-centred practitioner endeavours to create a relational environment defined by the six conditions because it is this that is necessary to activate constructive personal change. The understanding is that the client is the expert on their own experience and needs and will develop in a socially constructive direction when these six relationship conditions are present. Thus, the person-centred practitioner's sole task is to provide a growthful relationship on the understanding that the client will be facilitated in such a relationship to make new socially constructive choices about the direction of his or her life.

In short, person-centred practice implies a relationship that is an ‘end in itself’. As such, the person-centred practitioner adopts a non-directive attitude in which they have no pre-determined and specific outcomes or intentions for the service user to achieve. Rogers used the term non-directivity, but this term, which is often misunderstood, was clarified by Grant (1990), who distinguished between principled non-directivity and instrumental non-directivity. Whereas principled non-directivity refers to the therapist's ethical values of non-interference and respect for the self-determination of the other and is itself the goal of the therapist, instrumental non-directivity refers to a set of behaviours applied by the therapist to achieve a particular goal, such as building rapport or frustrating the client. As already noted, social workers are likely to be familiar with the term ‘person-centred’, but are not likely to be specifically trained as therapists in the person-centred approach or to have an in-depth knowledge of the theory and appreciation of the subtle nuances in these two definitions of non-directivity. As a result, this has meant that social workers who are claiming to be operating in a person-centred way within a relationship-based approach are, in effect, using the relationship instrumentally. Using the relationship to facilitate engagement with the client in order to find out what the client wants, to develop rapport or to gain compliance with suggestions are all examples of instrumental practice in which the relationship has a utilitarian function. Below, we propose that social work has evolved to become overwhelmingly utilitarian such that person-centred practice as principled non-directivity is untenable.

Impact of the changing context of statutory social work practice

As noted previously, Ruch et al. (2010) present a relationship-based social work practice based on psycho-analytic and psycho-social/systemic approaches. Despite Ruch et al.'s (2010) claim that there is a tendency for ‘[C]ontemporary relationship-based models of practice to play down the hierarchical “professional expert” approach’ (Ruch et al., 2010, p. 35), they go on to suggest that part of the task of social workers adopting a relationship-based approach is to make the invisible visible. Such an approach is clearly grounded in psycho-dynamic thinking and, by definition, is mutually incompatible with the person-centred approach, as it implies the social worker must take a position of expert and of ‘power over’ the service user. For example, to ‘make the invisible visible’ without the service user's permission or working with what is ‘not yet given’ by the service user is to inhibit service users’ rights to self-determination. If the service user has not given something to the social worker, then the social worker, arguably, has no right to intervene upon it. Grant (2010) has referred to this in the person-centred field as working only with what is given with regard to empathically responding to the service user.

Obviously, it is not easy to discern what has ‘been given’ by the service user and what is not given. Consider, for example, the following situation in which a social worker makes a home visit in response to reports that a seven-year-old child is potentially at risk. The social worker needs to speak to the mother who is alleged to be feeling suicidal. The social worker begins by developing and building rapport and then asks the mother about her current suicidal intent and the mother states her intent is low, although her ideation is high. The mother feels ashamed at having to disclose these thoughts and feelings to the social worker and subsequently averts her gaze and fixes eye contact to another part of the room. The social worker presses on with asking more questions about the service user's thoughts over the last two weeks and whether she has the means by which to commit suicide. She asks the mother to complete a simple suicide risk assessment form. The mother completes the measure and hands it back to the social worker. The social worker is sensitive but feels satisfied that, whilst the mother is probably depressed, she is not suicidal. ‘I'll call you tomorrow,’ says the social worker. ‘Thanks,’ says the mother. The social worker returns to the office.

There is a task to be completed and the relationship provides the context in which to carry out the more important social work task of assessing the level of risk of the mother's mental state for both herself and to the child. More importantly, the content, process and nature of the interactions are provoked by the questioning of the social worker. What is given by the client from the stance of being in a principled non-directive relationship is not considered. The social worker is, understandably, focused on completing the task.

In short, it is apparent that person-centred theoretical constructs have little or even no place within the contemporary models of relationship-based social work practice. In the example above, the social worker might need to make more of the situation and disregard what the service user had given in her communication due to the need to complete the assessment. The same argument applies to relationship-based practices that have their roots in the social casework model (Mayer and Timms, 1970). For example, Trevethick (2003) proposes a relational approach based on a psycho-social model of social work practice and argues that the relationship acts as the basis upon which the tasks of intervention can be carried out. Trevethick's approach stands in contrast to the person-centred principled model that considers the relationship as an end in itself. In considering such models of relationship-based practice, Trevethick (2003) critically states that:

… some practitioners fell into the deceptive and perilous trap of thinking that forming and maintaining good relationships, sometimes called relationship-building, was an end in itself, rather than a practice approach that provides the foundation on which to build future work’ (Trevethick, 2003, p. 166).

Trevethick (2003) goes on to suggest that the ‘relationship-as-an-end-in-itself’ approach to social casework is impoverished due to paying scant attention to an individual's wider social context and other political and structural barriers that might lie in the way to attaining more optimal and satisfying functioning in life. However, whilst it is not clear that Trevethick is speaking specifically about a person-centred model, the ‘relationship-as-an-end-in-itself’ reference is precisely what Rogers (1957) referred to when presenting the six conditions as both necessary and sufficient.

Others have argued for a relationship-based approach grounded in models of empowerment. Braye and Preston-Shoot (1993) have argued that the cornerstone of relationships between users and providers of services are the principles of empowerment and partnership. In order to understand how these principles are able to bring to fruition their potential, practitioners must also consider their application from the perspective of power, inequality and oppression. They need to consider and attempt to apply both personal and organisational commitments to challenging and changing the oppressive practices that maintain inequalities for service users.

The concept of a relationship-based approach to social (care) work remains a contentious issue for policy makers. The last two decades have seen an increase in the drive towards ‘outcome or solution-focused’ interventions in modern professional practice. Henderson and Forbat (2002) noted that, whilst the emotional and relational aspects are significant features of current constructions of what it means to provide care, these have been virtually invisible within policy strategies. Despite this, some empirical research has focused on the association of the quality of the relationship between the user and provider of a service with the outcome of the service being provided. For example, service users in mandated child abuse cases who perceived the relationships with a social worker as more positive were more likely to show constructive changes with regard to subsequent discipline and emotional care for their child. An ability to openly communicate, frequency of visits and receipt of public assistance were significant predictors of better-quality relationships.

To clarify the role of the instrumental relationship further, let us go back to the scenario above in which the social worker had received a message via a school that a child's mother had been reported to be suicidal and there was a concern for the risk to the child's well-being in being in the home alone with her mother. The social worker called to the house is going with a specific task that needs to be accomplished. The social worker needs to build a positive relationship with the service user and will require the use of some ‘soft skills’ in rapport building to complete her assessment of the immediate risk to the child of being left in the mother's care and of the need for further services for the mother. In such a situation, the social worker holds the power and sets the agenda. In this sense, the interaction is a directive encounter and cannot therefore be considered to be enabling the service user (mother) to actualise her potential.

Rightly, the social worker considers all the legal, ethical and moral implications of the situation in making her decision. She might consider the last time she was with the service user after the child had called an ambulance because the mother had ‘cut up’ pretty badly. The social worker knows this event occurred after the mother had minimised her feelings of self-harming to the GP earlier that day. The service user threatens to the social worker that, if her daughter is taken away for the night, ‘I might as well kill myself’. The social worker faces another dilemma and uses her relational approach to understand the situation. She feels the service user is using the situation to gain attention and offers her interpretation to try and bring some further awareness for the service user to the situation. The service user reacts angrily. The child is taken to a relative for the night and a call is made to the local emergency psychiatric clinic for a further assessment to be made. The encounter is considered a success, as the child is safe with a relative and the social worker reflects on her use of the interpretation to support her hypothesis that the mother was a danger to herself and/or her child.

The service user–social worker relationship was concluded by Bell (2002) to have had a positive influence in children involved in child protection investigations. Many service users reported substantial benefits of the relationship with their social worker, including positive changes at home, school and overall health and behaviour. Despite this, Bell (2002) cautions that children should not be seen as a homogenous group and that, whilst it is necessary to protect the rights of children through positive working relationships, a child's experience must be understood from a child's perspective and not that of an adult. Much like the example above, whether the outcomes might be viewed as positive is as much a factor of the perspective from which they are determined as it is about the information collected to record the outcome itself.

Bell (2002) also suggests that child protection structures such as review meetings, records and care plans should be ‘genuinely child centred’ (Bell, 2002, p. 9) meaning, from a person-centred relational perspective, it would be the child who leads, directs and sets the objectives. The person-centred approach to relationship-based practice in such a situation would hold that, if the ‘relationships’ the child has with those involved in the care services being provided were characterised by the six relationship conditions set out by Rogers (1957) and described above, then the child will be able to make the choices and decisions that will enable their own development. It is almost inconceivable to imagine, in the current climate of risk management, and in the light of cases such as ‘Baby P’ that services users, adult or children, are supported to enable the development of such autonomous being.

However, the use of the term ‘child-centred’ strikes right to the heart of the confusion within social work of the role of relationship-based approaches and that this paper seeks to address. ‘Child-centred’, ‘person-centred’ and ‘client-centred’ are technical terms that were originally developed to describe theoretically informed interventions that draw from the ‘person-centred’ approach set out by Rogers (1957). As we have indicated above, the person-centred approach is founded upon a conceptual framework that is at odds with contemporary social work practice.

In contrast to Trevethick's (2003) critique, to work in a person-centred way, one must, by definition, focus on the relationship-as-an-end-in-itself. As we shall discuss below, to view the relationship-as-an-end-in-itself is practically untenable because of the current political and professional context of social work practices. To this extent, the use of terms like ‘child-centred’, ‘person-centred’ and ‘client-centred’ is misleading insofar as they imply that the values of the person-centred approach—and respect for self-determination—are being adhered to, when in fact they are being used as a form of double speak to mean the opposite of their original intended meaning.

Is a truly person-centred relationship-based social work possible?

The (re)turn towards the pre-eminence of relationship-based practice amongst social work academics and practitioners is an understandable response in a context in which social work has been vilified in a powerfully adversarial debate between the media in the UK, the professional system itself and the wider public (Ayre, 2001). Gough (1996) has observed that:

… the news media tend to report rare hazards rather than common place events but in dramatising such extreme adversities such as child murder, sex rings and social workers abducting children into care, encourages the development of moral panic and over-sensitises people to the risks involved’ (Gough, 1996, p. 363).

The lengthy history of media outrage in the context of over thirty years of highly visible fatal child abuse inquiries or serious case reviews has led to a well-documented increase in regulatory and managerial control of the social care workforce (McLaughlin, 2007) and a loss of professional autonomy and confidence (Smith, 2001). A consequence of this has been the corralling of the profession into a policy and practice system that, it is suggested, seeks to deny the inherent uncertainties that accompany the safeguarding role through processes of excessive ‘rationality’ (Parton, 1998). Growing professional discontent with the increasing formalisation of practice through systems of risk and performance management and audit, particularly in statutory children's services but apparent also in adult services, in which the role is arguably even more constrained, have given rise to an introspective quest to find and articulate the relational ‘heart’ of social work practice. Ruch et al. (2010) acknowledge the uncertainties and ‘messy realities of practice’ (Ruch et al., 2010, p. 27), however, and suggest that reorienting social work practice towards a more relational perspective is likely to provoke defensive reactions that might limit the development of a relational-based approach to practice really gaining significant status among the routine practice for social workers.

However, the very context that stimulates the debate about relationship within social work also undermines it. Whilst social workers undoubtedly use both inter and intrapersonal dynamics in practice and, irrespective of the instrumentalism of risk management techniques, are obliged to use ‘informal processes’ (Broadhurst et al., 2010) in shaping decisions and actions, the systemic bias towards measurement and risk reduction means that relational processes remain necessarily subordinate to administrative ones.

This is apparent in the example above in which it is clear that the only ‘point’ in the social worker developing a relationship with the mother was to fulfil the task. Interestingly, in the scenario, the social worker, also there to protect the child, has virtually no interpersonal relationship with the child in the encounter. The child appears almost to be a ‘unit’ within the environment—someone/thing to be protected, the mother a destructive force to be contained and the social worker as some sort of agent provocateur whose interpretation incites the mother to react angrily, confirming the hypothesis that the child was indeed at too great a risk if left with her mother.

Adults’ and children's statutory social work are both ‘saturated by the language and techniques of risk’ (Horlick-Jones, 2005). Thus, this has had the effect of repositioning social work in relation to perceptions of risk in contemporary society and clearly challenges the potential for a relational approach based on the values of respecting the client's right to self-determination and autonomy. These can only be held to a certain point and that point is determined by the social worker, with the end of the line being decided upon within the social worker–service user relationship within a broader context of the social worker–service/agency relationship. Where services are defining the parameters of tasks that social workers are to carry out, the relationship in this sense is always instrumental in determining the outcome that is acceptable to the social worker.

It is suggested that the underlying climate of fear and the distrust that drives these perceptions has the dual effect of defining the subjects of social work only as vulnerable or dangerous or both and of viewing social workers themselves as simultaneously ‘assessors of risk, at risk and as a risk’ (McLaughlin, 2007). The statutory context of child protection social work in the UK in particular is of key importance in this debate. Whilst the legal framework provides some important protections against the unwarranted abuse of power by the state, the adversarial nature of the UK system has the unfortunate consequence of placing ‘families and the authorities working with them in opposing camps rather than in mutual endeavour’ (Cleaver and Freeman, 1995). The territory for the development of relationship in such potentially conflictual circumstances is clearly both challenging and constrained. At the same time, the capacity of social work to be a force for progressive policy has been eroded, in as much as it has been suggested that social work in the UK ‘has been re-branded and re-shaped’ (Stepney, 2006) under successive governments within an overall transformation of the post-war welfare settlement in the last thirty years or so.

In these circumstances, the resurgence in social work discourse of ideas about relationship may hold both threats and promises. The Interim Report of the Monro Committee (2010) illuminates this. On the one hand, the intention of the Committee to de-clutter the managerial and administrative landscape to enable practitioners to maintain a better focus on the ‘child's journey’ provides welcome support for the voices of committed and beleaguered professionals who have been struggling to do that as the administrative burden has increased exponentially. The report cites the considerable evidence base that highlights the importance of relationship in producing good outcomes and identifies a lack of relationship-based practice in the way that social workers have been practising. It recommends that social workers develop the ‘soft skills’ involved in practising in this way, particularly if the service user wants and requests to be worked alongside in a relational way.

This is not to suggest that the report has come to the wrong conclusions. As shown above, it is clear that good relationships are associated with better outcomes. However, we would argue that, even when this is the case, this does not reduce the instrumental nature of these relationships. In person-centred practice, there is no instrumental element to the relationship. By definition, when an instrumental aspect is introduced into the relationship, it is no longer person-centred in the technical sense of this term. As such, it is difficult to see how social workers can, in the true sense of the meaning, consider themselves to be person-centred.

The emphasis on relationship in the discourse is also potentially in tension with the growing and powerful evidence base about the need for upstream preventative policies aimed at addressing the social determinants of disadvantage and inequality and its multiple negative impacts (Marmot, 2010; Wilkinson and Pickett, 2009). Whilst individualism is a characteristic of the current neo-liberal policy and cultural zeitgeist, the proponents of relationship-based practice may find it hard to convince some practitioners that this will be adequate to address the needs of the poor and the marginalised (Jordan, 2001). As such, there may be a need to make common cause with public health and other disciplines working with sociological and epidemiological perspectives in addressing structural inequalities and promoting empowerment, rather than borrowing, somewhat tendentiously and partially, concepts of relationship-based practice from the disciplines of psychology, counselling and psychotherapy that, we would argue, can more accurately lay claim to it.

In light of the contextual background set out above and as the profession of social work increasingly develops a relational focus, the question is whether social work can adopt theory from person-centred psychology. One way of answering this is to extend Grant's (1990) notions of principled and instrumental non-directivity to the whole relationship within social work practice.

Cooper and Bower (2005) have stated that relationship-based practice within social work is considered a means to an end and certainly not an end in itself. Relationship-based practice, they suggest, is intrinsic to good, safe practice and, moreover, can modify the managerial ethos of practice we have outlined above. Yet, the extent to which this claim can be substantiated is arguable in a context dominated by ‘risk assessment instruments and structured formats [which] aim to improve “unassisted” professional judgments’ (Broadhurst et al., 2010, p. 1048). These processes configure the field in which social workers build their relationships with service users and the territory is not, of necessity, free of judgement and characterised by ‘unconditional positive regard’. A recent study of the perceived consequences of seeking help and health care among households living in poverty suggested that seeking support or care is seen as a ‘gamble’ in which needs may or may not be met with the perceived threat of losing resources, being harshly judged by practitioners and subjected to increased levels of surveillance, sometimes leading to avoidance of child health and social services, anxiety and self-imposed isolation (Canvin et al., 2007). Clearly, if social work is to develop itself as a relationship-based profession, it has a long way to go and perhaps will never be able to claim to be truly person-centred.

These findings lend support to our contention that the simple answer to the question as to whether social work can be a truly person-centred profession is ‘no’; unless the underlying principle of trusting in the actualising tendency is fully embraced by the social work practitioner, the service user's right to self-determination can never be unconditionally respected. We would argue that this principle, and therefore a person-centred approach to social work, cannot be fully embraced within modern social work, as both the policy and professional context require practitioners to act instrumentally on behalf of the state in relation to the most vulnerable, notwithstanding the relational disciplinary rhetoric.

It is incumbent on modern social work that, while it can take an instrumental stance, it cannot take a principled stance to non-directivity in practice. Modern social work invariably demands that the relationship is a utilitarian one in which it serves another purpose such as to create rapport in order to act as a context for the application of pre-determined specific intervention or, indeed, as Canvin et al. (2007) suggest, the abandonment of the search for rapport to fulfil a coercive purpose on behalf of the state. In part, this derives from the paradoxes that accompany our systems for protecting the vulnerable. Cooper (2009) suggests that these paradoxes derive from the two primary tasks attendant on protective systems. The tasks, he suggests, are, first, to protect the most vulnerable from severe injury and/or death and, second, ‘protecting people from the emotional impact of knowing about the torture of babies that may be happening just down the street from where each of us is living’ (Cooper, 2009, p. 3). Cooper further suggests that it is failure in this second task that triggers the visceral emotional attack from the media and general public that has shaped the public image of social work and eroded professional self-esteem in recent years. Such failures count for far more than all the undoubted protection successes because they disturb the psycho-social equilibrium in which terrible events, particularly those involving children, are denied as unthinkable. Consequently, it is hardly surprising that social workers have sought to protect themselves from such an unfair assault by talking up the value of relationship even as the instrumentality of the role has intensified.

As such, while social work might value the relational qualities of empathy, unconditional positive regard and genuiness, or indeed the notion of an actualising tendency, it is theoretically misleading to refer to these relationship qualities as person-centred unless they are coupled with the stance of principled non-directivity, which we have shown is incompatible with what is required of modern social work practices.

Conclusion

In conclusion, relationship-based models of practice grounded in psycho-dynamic or systematic approaches are suitable for contemporary social work practice. But social work cannot be relationally based in the sense that it is an expression of person-centred practice. We have argued that there is a mutual incompatibility of the person-centred approach brought about by the context and tasks of modern social work. While it might seem to some that we are splitting hairs, the political importance of this discussion is that the use of the term ‘person-centred’ belies the function of modern social work in which the relationship is for the utilitarian purposes of compliance and externally imposed direction on the service user. Social work is not person-centred; it is state-centred. We urge all those involved in social work—educators, students, experienced practitioners, service users, employers and policy makers—not to attempt to transfer person-centred psychology into their models, as the true meaning and validity are lost in the process of translation. The danger is that, if we continue to use the term ‘person-centred’ as if social work was based on the psychotherapeutic principle of self-determination, we serve to diminish the potency of the theoretical principle of the actualising tendency and obscure the true nature of the modern social work profession.

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