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This paper was first published in Care: The Journal of Practice and Development 6(4), 1998. Reproduced with the kind permission of Pepar Publications

Avoiding Dangerous Practice

Neil Thompson and John Bates

Summary

Social work practice has the potential to cause a great deal of harm as well as do a great deal of good. This paper therefore describes five categories of dangerous practice that can be seen to contribute to harmful outcomes (routinised, defensive, defeatist, chaotic and oppressive practices) and considers strategies for avoiding them.

It would be naive in the extreme to fail to recognise that social work intervention is capable of not only making a positive difference to people’s lives but also doing considerable harm. The social worker has a great deal of power, and such power can result in successful or unsuccessful outcomes. However, the absence of success can be much more than failure - intervention can also have an extremely detrimental effect on individuals, families and groups. This can include:

Consequently, it is important to ensure, as far as possible, that intervention avoids inflicting such harm. The need to avoid dangerous forms of practice is therefore of crucial concern for practitioners, managers and educators. In view of this, this paper explores five different categories of dangerous practice and considers the steps that need to be taken to avoid such potentially harmful forms of intervention.

Routinised practice

Some degree of routinisation is inevitable; that is, we cannot concentrate on every fine detail of our work, analyse it and consciously plan our every move. Attempting to do so would be not only unrealistic but also a recipe for a mental breakdown. What needs to be avoided, then, is not routines per se, but an over-reliance on such routinised practices - an unthinking, uncritical approach to practice.

Routine practice can be seen to be dangerous for both client and worker. For the client, an unthinking approach to practice can lead to important aspects of the situation being overlooked or inappropriate services or solutions being proposed. For example, routinised practice may lead a worker to fail to appreciate the significance of loss (Thompson, 1995a). For the worker, routinised practice can be problematic in terms of reducing job satisfaction and opportunities for professional development. Over an extended period of time it can be a significant factor in succumbing to burnout (Thompson et al., 1994). Consequently, it is very important that routine forms of practice are not allowed to predominate.

Practice Focus 1

Pat was an experienced social worker in a multidisciplinary mental health team. She was confident in her own abilities and felt very comfortable with the type of work she was doing. However, when a new, inexperienced colleague joined the team, this caused some problems for Pat. The new worker was very enthusiastic and very keen to learn. Consequently, she was constantly asking questions like: “Why do you do it that way?” “What led you to decide that?” Pat found it very difficult to answer these questions and began to realise just how much she had come to rely on working in a routine way. She realised that she had become too comfortable with her work and was in danger of being complacent. She therefore decided to use her new colleague’s arrival as a means of reviewing her practice and considering her own professional development.

An important factor in fending off the dangers of routinised practice is the development of ‘reflective practice’. This is a concept that has long been used in nurse education but is now increasingly being used in a social work context (Thompson and Bates, 1996). It refers to a form of practice in which active reflection becomes part and parcel of the process of intervention - practitioners are encouraged to reflect critically on their actions and reactions both before and after the event.

Reflective practice can be defined as:

the starting point for informed practice. In order to maintain and enhance standards of professional practice, it is essential that practitioners reflect on their practice, that is engage in a critical and reflective dialogue with the situation in which they operate. Reflective practice avoids the pitfalls of a routine, uncritical practice which can do more harm than good. (Thompson, 1995b, pp 123-124)

What is needed, then, is an emphasis on continuous professional development (CPD) in order to prevent routinised practice, complacency, burnout and the related problems that can arise when practice ceases to be a professionally-based reflective practice.

Defensive practice

Social workers often face the possibility of ‘trial by media’ if or when a particular piece of work goes wrong (Aldridge, 1994). In addition, there is always the possibility of an official inquiry, a formal complaint or some other type of investigation. In principle, then, social worker can have their practice questioned at any point in their working life. Unfortunately, however, the knowledge that this can happen motivates some workers not to ensure that their practice is beyond reproach but, rather, to practise in defensive ways, to avoid risk-taking and to ‘cover their tracks’ where possible.

This phenomenon is a recognised danger in child protection work where the tendency to lose sight of the safety and wellbeing of the child is acknowledged as a form of ‘professional dangerousness’ (Dale et al., 1986). However, it would be naive to assume that it does not apply in work with other client groups, as Practice Focus 2 illustrates.

Practice Focus 2

Sara was a newly qualified social worker in a specialist team working with older people. She had been warned that Mrs Turner, the daughter of one of her clients, was very difficult to please and tended to be quite unreasonable at times - she had twice made formal complaints about community nurses involved in the care of her mother. Consequently, Sara made every effort to make sure Mrs Turner was satisfied with the work she was doing as she was very anxious indeed about having a complaint made against her, especially in her first year as a qualified worker. However, the irony of the situation was that, in her eagerness to please Mrs Turner, she failed to notice significant tensions and differences of perspective between Mrs Turner and her mother. Consequently, Sara’s defensiveness meant that the client’s voice was not being heard.

One important way of avoiding such defensiveness is through the use of ‘systematic practice’. This can be defined as follows:

A systematic approach to practice is one that is clear and focused, with little or no tendency to vagueness or drift. That is, systematic practice involves having clear objectives and a firm focus on the actions being taken and their effects. . . ‘Drift’ is an important term that refers to the tendency to lose sight of what we are doing and why we are doing it. When this occurs it can be highly problematic. . . Systematic practice is therefore an important ‘antidote’ to the destructive effects of drift and vagueness. (Thompson, 1996, p 164)

It can also be seen as an ‘antidote’ to defensive practice where the misguided focus on saving one’s own skin can so easily lead workers to lose sight of what they are doing and why they are doing it.

Defeatist practice

It is not uncommon for some experienced practitioners to develop a very cynical approach to their work that engenders a mood of pessimism and defeatism. Despite the long-established social work value of not being judgemental, some workers may have a tendency to ‘write off’ their clients, to see them as beyond hope, unable or unwilling to change. While this may at times be a legitimate conclusion to draw after appropriate attempts at intervention have been made, it is a very damaging premise with which to begin one’s assessment (or to use as a substitute for an assessment).

Most forms of social work are not the type of work in which entirely successful outcomes are commonplace. The situation is very different from a factory production line where only a very low failure rate can be tolerated. Given the ingrained nature of many problems due to poverty, deprivation and related social ills, the best that social work intervention can achieve is often only an amelioration of the situation, rather than a completely satisfactory resolution. It is therefore necessary to find a balance between a naive idealism on the one hand and a destructive defeatism on the other.


Practice Focus 3

Lynn was a student on placement at a residential centre for people with alcohol-related problems. She began the placement with considerable enthusiasm but soon met a barrier. Whatever ideas she suggested, her practice teacher undermined and devalued them with her pessimistic and defeatist outlook. Lynn soon began to feel that nothing was going to be possible apart from containment and moral support. She was beginning to feel downhearted about the whole experience when another worker at the centre reassured her by commenting that he hoped that her practice teacher’s defeatist attitude was not going to rub off on her.


At the root of much defeatist practice two key factors are often to be found:

Defeatist practice seriously undermines the potential for empowerment and therefore represents a very destructive attitude towards social work. To give up on people without first trying to achieve success is a self-defeating approach that undermines the very basis of social work as a form of humanitarian assistance.

Chaotic practice

Schon (1983) recognises that professional practice is ‘messy’. He points out the stark contrast between the ‘high ground’ of theory and research and the ‘swampy lowlands’ of practice where little is clear cut or straightforward. It is not surprising, then, that success in social work can be seen to depend, to a large extent, on the ability to juggle a number of things at the same time, and also to cope with conflict, uncertainty, competing demands and dilemmas.

This paints a picture of a job where the potential for descending into chaos is a very real one. Consequently, good practice necessarily entails the ability to maintain a reasonable degree of control over one’s activities and overall workload. This does not mean that we have to have a rigid, unbending or over-controlled approach, but it does mean that a haphazard, unco-ordinated approach is one to be avoided, as Practice Focus 4 illustrates.


Practice Focus 4

Colin was a social worker in a child protection unit. He prided himself on the quantity of work he managed to get through. However, the quality of his work was a different matter. He was very disorganised, often forgetting appointments or being double-booked, neglecting to do important tasks, failing to keep people informed of what was going on, failing to set priorities and so on. He created a lot of bad feeling by not returning phone calls, not keeping paperwork up to date and generally being unreliable. His colleagues were very concerned and realised that his chaotic approach to practice could one day have very serious consequences. They knew they would have difficulty supporting him in the event of a formal inquiry if something were to go seriously wrong.


Finding the balance between an inflexible, regimented approach to practice and one based on chaos and a lack of control is a chall-enge that all social workers face. However, as Parnell (1995) acknowledges, this aspect of practice has not traditionally received a great deal of attention on training courses or in the theoretical literature:

Social work literature offers little practical guidance to students on strategies for organising their time, and student placements with their limited workloads rarely prepare new workers adequately for this aspect of the job. Theories about time management generally fail to take account of the unique factors in social work which complicate the process. Social work managers, often overworked and stressed, sel-dom offer more than sympathy; workers who run into diffic-ulties are readily blamed for poor time management. (p 154)

It is perhaps not surprising, then, that chaotic practice is a very real danger in busy social work teams. Consequently, time and energy devoted to achieving the balance between regimentation and chaotic practice can be seen to be a worthwhile investment. Indeed, this can be recognised as a basic principle of time management - the need to invest time in workload management and priority-setting in order to save time in the long-run (Thompson, 1996).

Oppressive practice

In the day-to-day demands of social work, with numerous pressures, tensions and frustrations, it is not surprising that practitioners often feel powerless. However, we must not allow these feelings of powerlessness to distract us from the recognition of the very real power social workers hold. And, of course, the type of power that people do not realise they have is potentially a very destructive power.


Practice Focus 5

Mrs Jessop had been experiencing difficulties living on her own and had had a number of falls recently. Paul, the social worker who visited her felt she would benefit from respite care at the local resource centre for older people. He ‘persuaded’ her that this would be in her best interests and so she agreed to spend a week in respite care. However, when her son called to see her the day after Paul’s visit, Mrs Jessop broke down and told him how frightened she was about the care arrangements. Consequently, her son made a formal complaint to the Social Services Department about Paul’s oppressive behaviour. Paul had failed to appreciate his own power as an authority figure working with older people in an ageist society.


The unthinking, uncritical use of power can therefore produce very oppressive outcomes in general. However, it is also important to recognise instances of oppressive practice in relation to more specific examples of discrimination and inequality such as sexism, racism, ageism and disablism. Despite the development in recent years of more emancipatory forms of practice (Dalrymple and Burke, 1995; Thompson, 1995c; 1997), the awareness of oppression as a feature of the situations social workers encounter (and of their responses to such situations) remains at a far from ideal level. The potential for social workers to reinforce, for example, racist or sexist stereotypes continues to be an area of concem for social work education, management and practice.

The need for theory, policy and practice to challenge discrimination and oppression must remain high on the social work agenda if the dangers of oppressive practice are to be avoided. The tendency to trivialise issues of equality and social justice by dismissing them as ‘political correctness’ is one that has to be challenged and resisted if the progress made to date is not to be lost.

Conclusion

We do not have to go very far to find examples of excellent practice in social work. High quality work is by no means a rarety. However, balanced against this must be the recognition that poor practice is by no means a thing of the past. Such poor practice, as we have seen, can not only fail to achieve success but can actually make the situation worse. Social work practice can be dangerous.

The list of forms of dangerous practice outlined here is by no means exhaustive, nor are they mutually exclusive. Defensive practice, for example, can lead to chaotic practice when the lack of focus leads to a loss of control and a failure to manage one’s workload effectively. Similarly, all the forms of practice discussed here can be seen as potentially oppressive:

Clearly, then, there is a very strong and pressing need for social workers to be very aware of the dangers of certain forms of practice, and the ways in which these can combine to reinforce, exacerbate and add to the various forms of oppression to which users of services are so often subject. Consequently, there is much to be gained from developing forms of practice that are reflective, systematic, empowering and anti-oppressive.

References

Aldridge, M. (1994) Making Social Work News, Routledge, London
Carter, P., Jeffs, T. and Smith, M. K. (eds) (1995) Social Working, Macmillan, London
Dale, P., Davies, M., Morrison, T. and Waters, J. (1986) Dangerous Families: Assessment and Treatment of Child Abuse, Routledge, London
Dalrymple, J. and Burke, B. (1995) Anti-Oppressive Practice, Social Care and the Law, Open University Press, Buckingham
Parnell, C. (1995) ‘The Daily Round’, in Carter et al. (1995)
Schon, D. A. (1983) The Reflective Practitioner, Basic Books, New York
Thompson, N. (1995a) Age and Dignity: Working with Older People, Arena, Aldershot
Thompson, N. (1995b) Theory and Practice in Health and Social Welfare, Open University Press, Buckingham
Thompson, N. (1995c) ‘Promoting Anti-Discriminatory Practice’, Perspectives in Social Work, 1
Thompson, N. (1996) People Skills: A Guide to Effective Practice in the Human Services, Macmillan, London
Thompson, N. (1997) Anti-Discriminatory Practice, 2nd edn, Macmillan, London
Thompson, N. and Bates, J. (1996) Learning from Other Disciplines: Lessons from Nurse Education and Management Theory, University of East Anglia Monographs, Norwich
Thompson, N., Murphy, M. and Stradling, S (1994) Dealing with Stress, Macmillan, London

© Neil Thompson and John Bates 2004
www.neilthompson.info

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