Lea Šugman Bohinc

SOCIAL WORK IN INVOLUNTARY TRANSACTIONS:

qualitative meta-analysis of existing research in the last decade in Slovenia

ECSWR 2015, Ljubljana

Lea.SugmanBohinc@fsd.uni-lj.si

THE CONTENT OF PRESENTATION

• SW in involuntary transactions: basic concepts and state of the art on education, research and practice in Slovenia

• Qualitative meta-analysis (secondary analysis of primary data) of 2 qualitative , 2 qualitative / quantitative and 1 quantitative research studies (2005, 2006, 2007, 2009, 2012): samples, methods, results with tentative theory, suggestions for future research

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EPISTEMOLOGY & DEF. OF SW IN INVOLUNTARY TRANSACTIONS

• who is the expert? • who is a SW service user/client? (Doel & Marsh 1992,

Cooper Altman 2003) • who are “involuntary” service users (su) in SW?

ENTERING involuntary CONDITION voluntary* leg. mandated non mandated

* most „voluntary“ decisions refer to coercive and limited choices

• DEF.: dynamic exchange of resources; not entered by su on his/her own iniciative but coerced on basis of legitimate regulation or formal /informal pressure from social environ.

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• differences between sw and su (oppressed groups) • power imbalance • multiple desired outcome definitions &

interpretations of help by su & sw • outcomes at least partially determined in advance • motivational (outcome) congruence • counselling & therapeutic models -

in education & practice • frustrations & ethical dilemmas • compliance-oriented methods of sw • high importance of initial communication (first contacts) • deviance, resistance, reactance, selective self-presentation,

imbalanced power relations as potencial perspectives instead of high-risk contextual factors

(Rooney, 1992, 2009, Rooney & Bibus 2001)

CHARACTERISTICS OF INV. TRANS. IN SW

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• SOCIAL CONFLICT PERSPECTIVE (Cingolani 1984)

• TASK-CENTRED SW – A PARTICIPATIVE MODEL, A DOING MODEL (Doel & Marsh 1992)

• LEGAL & ETHICAL SW PRACTICE IN INV. TR.

(Rooney 1992, 2009, Rooney & Bibus 2001)

• CO-CONSTRUCTIVE, SOLUTION-FOCUSED MODEL OF COOPERATION (De Jong, Berg 2001)

• SPECIFIC INTEGRATIVE INTERVENTION MODEL (Trotter 2006)

• RELATIONSHIP-BASED APPROACHES TO PRACTICE (long & rich history of ideas and practices; Ruch, Turney & Ward 2010; Čačinovič Vogrinčič 2002, 2005; etc.)

SOME MODELS OF SW IN INV. TRANSACT.

QUALITATIVE META-ANALYSIS of 5 research studies of SW in INV. TRANSACT. (6 students, FSW UL, superv. Šugman Bohinc, Rode, 2005-2012)

Golubič, Turk, 2005:

SW with involuntary service users (Ql/Qn)

A

Golubič, Turk, 2006:

Involuntary SW service users (Qn)

B

Beznik, Doltar, 2007:

Methods of SW with involuntary service users (Ql/Qn) C

Pegam, 2009:

Resistance and reactance perspective in SW involuntary

transactions (Ql) D

Pungeršič, 2012:

Involuntary transactions in child protection (Ql) E

Interpretive integration (synthesis) of qualitative/quantitative research (see Weed 2005, etc.) 7

DATA-GATHERING METHODS

- interview (18 q.)

- standardized questionnaire (5 q.)

standardized questionnaire (11 q.)

standardized questionnaire

(16 q.)

standardized questionnaire

(7 q.)

half standardized questionnaire (18 q.)

SAMPLES

A: convenient; A1. 8 sw / 8 CSWs; A2. 34 managers / 62 CSW B: 64 su / 6 CSWs; 26 , 38 C: convenient; 37 sw: 26 (CSW), 3 (elderly h.), 5 (ᴪ hospitals), 3 (corrections), 0 (care & work centres); 34 , 3 D: convenient; 26 sw: 12 (CSW), 3 (h. elderly), 3 (care&work centres), 3 (youth educ. pr.), 2 (school), 2 (health), 1 (correct.) E: convenient; 5 su (family & child protection)

A B

D

C

E

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DATA-ANALYSIS METHODS

- qualit. analysis

- freq. distribution, arith. mean

freq. distribution, %,

median, SD; T-test, Chi square

- freq. distribution, %, arith. mean

- qualit. analysis

- qualit. analysis

- freq. distribution, arith. mean

Qualitative analysis:

open coding, selective coding

ordering (reflection, themes, patterns,

relations etc.)

presentation

qualitative analysis

A

B

D

C

E

making conclusions, verifying,

tentative theory building

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INTERPRETIVE INTEGRATION of RESULTS 1 • estimated % INVsu / Vsu? sw-s‘ vs. CSW managers‘ perspective!!! • estimated % INVsu Vsu?

Very good quality of collaboration: 60% su: (very much) improved sw-su relationship; 55% su: sw (very) helping; 74% su: (complet.) satisfied

sw: 75% INVsu (60-90%), 25% Vsu

(interview)

A managers: 30% INVsu

(bipolar!), 70% Vsu

(questionn.)

M

sw (CSW): 65% INVsu Vsu

35% INVsu INVsu

!!! extreme differences in

estimation INVsu Vsu

(10%-97%) in relation to

specific area of SW

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sw (CSW, eld., ᴪ, corr.) 54% INVsu Vsu 46% INVsu Vsu B

A

-

su personally responsive,

attend meetings, express desire to

collaborate (to gain benefits,

regain lost freedoms)

C

B

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INTERPRETIVE INTEGRATION of RESULTS 2 • different/same SW approach to

INVsu / Vsu? (sw perspective)

• same: professional, ethically sensitive SW

practice & respecting legal regulations with all service users!

• different:

more detailed explanations „why“, roles, mandates;

harder work to establish personal contact, safety, conf. & trust: more time and endeavour needed!

higher importance of SW skills (empathy & personal engagement, respect. su‘s rights, setting clear outcomes & plans, negotiation, creating motivating context for collab., etc.)

sw (CSW, eld. homes.):

54% same 46% diff.

C

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INTERPRETIVE INTEGRATION of RESULTS 3 • sw methods & skills in INV transactions (sw‘s persp.)?

quality personal relationship, import. of initial contacts: sw‘s self-intro., respectful attitude, confidential., explanat. of services & reasons for contact, work approach, mandates etc.

exploration of su‘s motivation to collaborate: su‘s perspective of problems & desired/possible outcomes etc.;

10% su not given opportunity to express their problems & agree on collaboration! 15% not informed about avail. services

quality working relationship: strengths persp., choices, anti-discriminatory & anti-oppressive SW, co-creating problem & solution def., ethics of participation, understandable language, no controlling /checking, sw‘s confidence in su 50% su think sw acknowledged their opinion (problem/solution def. and co-creation, active listening, resuming etc.)

A

B

B

C

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D

E

INTERPRETIVE INTEGRATION of RESULTS 4 initial sw-su contacts in child protection & family SW -

described from su‘s perspective: + & - expectations , ideas (help, trust, help acceptance? or additional

problem-creation, distrust, rejection?)

legal mandate-based invitations or home visits

prevalence of negative emotions, feelings: su feel stigmatized, inferior, humiliated, injustice-done, unequal in power relations, coerced into collab., excluded, ignorant, stg is wrong with us

distress at 1st contact due to sw‘s disrespectful, superior, blaming, judging attitude, sw knows everything better, is the clever one, not understanding su, is interfering into family without permission, is controling

dual-roles, dual relationship of sw: blending care with control! keep DR separated, if not possible: explain it to su (always: 7/8 sw)! professionally difficult & ethically problematic! DR 32%.

some positive 1st-contact experiences: sw‘s conversation style, liste-ning, exploring su‘s lifeworld, giving opportunity to settle life circum.

E

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A

INTERPRETIVE INTEGRATION of RESULTS 5 • sw methods & skills in INV transactions? quality working relationship (sw‘s perspective): empathy & understanding (96%),

strengths persp. (96%), give compliments (92%),

remain objective/impersonal – calm?(58%),

explore su‘s situat., problem-def., suggest solutions (often 35%, rarely/never 39%),

use humor (always added 31%, rarely/never 66%),

use prof. language (rarely/never 85%, often 12%)

get more info. of su‘s perception (never/rarely 58%, often 38%)

explain double role (never/rarely 53%, often 42%)

• need for additional SW competences (knowledge, methods, skills)? YES 69%, NO 31%. Generic & specialized (ranging from administrative to psychiatric knowledge).

D

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INTERPRETIVE INTEGRATION of RESULTS 6

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signs of resistance in su? (sw) - not responding to invitations - avoiding sw & meetings, tardiness - rejecting further collaboration - expressing mistrust, doubt - finding no meaning, use in relation. - expr. anger, verbal agression - expr. anxiety, fear, apathy - silence, delays, sabotaging agree-ments, evasion, denial, not listening, withdrawal, leaving decisions to oth. - criticism, rebelling, defenses, disappointment, blaming / mocking / threatening sw - behaving involuntary in community (late for or missing at work, ignoring org.‘s rules, isolated, socially unaccept. beh.) source of R? 73% su, 15% sw-su!

sw responses to resistance in su? - attempt to establish working relationship - define problem/solution together - encourage su‘s insight by confronta-tion, by using different perspectives of problem (other particiants) - explain purpose of invitation, of help - define roles, rights & duties, legal mandates of institution - explain work procedures/approach - keep calm, give time to su to get oriented - use personal appr. – less formal, kind, unintrusive, ignore offensive remarks, no moralizing - explain benefits, focus on su‘s positive attitudes, give posit. affirmat.

D

INTERPRETIVE INTEGRATION of RESULTS 6

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resistance & coping with frustration – su‘s perspective - feelings: negative: threatened, anger, fear, horror, resentment, feeling bad, why my family?, not finding offered help useful, meaningful; sometimes positive: new experiences, gratitude for help - behaviours: excitement, agressive-ness, witholding violence - resistance: not their decision, feeling terrible, they are not ok, no need to collaborate, not motivated (not respo-nding to invitations, missing meetings, coming late, meaningfulness); reinforced resistance: when not infor-med why sw comes, what intentions, what will happen, sw critical, moraliz.

overcoming resistance – su‘s perspective a. based on „inner coercion“: collaborate due to wish and hope to regain lost freedoms, due to fear of consequences for not collaborating, helplessness of situation, strong feelings & emotions b. based on sw-su relationship: warmth, respect, personal contact, emoathy, support, being heard, sw not acting smart (bullshitting), co-creating solutions, motivating , making agreements, have enough time

D

INTERPRETIVE INTEGRATION of RESULTS 7

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signs of reactance in su? - seeming/fake collaboration (agreeing but not respecting agreement) - refusing to respond to invitation, to collaboration - denying having problems (all is well, no need for help) - direct or indirect reactance (agressive beh., rebelling, defensive, non-cooperative beh., stressing irelevant info., disagreeing with allegations, accusing, interrupting sw, demolishing inst.‘s property, specific opposing beh.& body language, expres. sadness, anger, rage, resistance, psychosomat. problems) SW BLAMING SU! LACKING STRENGTHS PERSPECTIVE, SU‘S VOICE, PARTICIPAT.!

sw responses to reactance in su? - attempt to establish working relationship - define problem together (PROBLEM-FOCUSED DESCRIP.!!!) - offer help, solution - define roles, rights & duties, legal mandates of institution, assess situation - explain work procedures/approach - try to understand su‘s behaviour, warn su of their inappropriate beh., negotiate - use personal appr. – show respect to su, talk of sw‘s own feelings, respond calmly, less formal, kind, unintrusive - use (peer) supervision - sometimes don‘t know how to respond

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INTERPRETIVE INTEGRATION of RESULTS 5 • What do su need from sw to collaborate better?

more empathy & understanding that it is not easy for su to enter working relationship of help

more time, safer context! more meetings (not only 1/month) - important for motivation!

sw should keep trying despite su‘s resistance and continue with invitations to co-create the process of help

other forms of help: more material & financial help, housing, intervention in community (more coordination between institutions, collaboration with extended family)

• su assess there are more positive than negative effects of SW process! meaningfull: „grounding“, positive approach, problem coping, pressure to change, better life, open possibilities, small steps toward desired change, becoming „better people“, etc.

D

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su‘s entering condition sensitivity

RELATIONSHIP

- BASED SW

PRACTICE

su‘s voice, perspective

normalization

instead of

patologization!

not yet explored potencial perspective in su‘s responses to INV. SW tr.: resistance, reactance; in SW power relations!

SW in INV. trans. in SW formal educati-on & lifelong learning!

TENTATIVE THEORY

initial contacts, communication

personal relationship

3/4 of INVOL. enterings!

working relationship of

co-creating

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prevent DR

future research

more of sw‘s critical self- reflection needed