Social care practice, strengths-based practice and meaningful relationships in hybrid working

Published: March 2023

There is ample evidence to support the importance of building rapport and establishing meaningful relationships in social work practice.

The COVID-19 pandemic and the restrictions on face-to-face interactions imposed as a consequence have brought full awareness for many professions, including Adult Social Care, of the potential benefits that on some occasions a non-face-to-face intervention can have, and how some elements of many interventions can, and potentially should, be done using means other than face-to-face interactions.

Let’s explore below the key points for meaningful relationships that are at the cornerstone of good social work and strengths-based practice:

Social care practice and meaningful relationships

The social work profession has its foundations in the intention of promoting positive change in clients’ situations as set out in the International Federation of Social Workers’ (2014) definition. Beckett and Horner (2006) tell us that change comes about through relationships. Even in situations where programmed interventions are employed, their impact is secondary to the social worker–client relationship (Nicholson and Artze, 2003).

Figure 1: Social work and relationships

Source: CareKnowledge: The importanct of relationships in social work

  • Effective relationships are central to successful outcomes
  • Relationships are at the heart of social work
  • There is a need for effective personal/professional relationships
  • Relationships are complex and require awareness of ‘self’ and the negotiation of inter-personal boundaries

In a profession such as social care, the creation of relationships must always be a balance between involvement and detachment. The midpoint of that balance may vary depending on the situation and setting. Getting it right can influence the wellbeing of both the client and social worker.

Relational capability – the ability to have positive social interactions and relationships where all parties benefit.

Social care practitioners must think about their own beliefs and behaviours and how they combine them with their professional policies and procedures to influence relationships with those they support.

We all have experienced the difference it makes for us and those we work with, when we are able to connect with the adults and carers we are working with, when we actively listen and discover what else is going on for them, when we build trust and manage to explore solutions together.

So, what gets in the way?

  • Traditional care management
  • Long box ticking forms
  • Large caseloads
  • Deficit based approach.

It is undeniable that creating the right culture and incentives across the system are crucial to social care practitioners to put in practice the establishment of rapport and meaningful relationships, but at times this is impacted by the above factors.

In order to establish meaningful interactions, it is important to demonstrate the importance of good relationships at all levels, from strategic leaders to front line practitioners. It must be shown at all levels that the quality of the relationship is a priority. For example, Performance Management and Indicators should be based on outcomes, not on timescales.

Relationships in social work and social care standards

The importance of establishing meaningful relationships with the community, peers, stakeholders, partners, etc. is central to many social work and social care standards. Find below an extract of some key points in relation to professional-individual relationships.

Includes the following key expectations for qualified social workers. Social workers must:
  • Acknowledge the centrality of relationships for people and the key concepts of attachment, separation, loss, change and resilience.
  • Demonstrate the ability to engage with people, and build, manage, sustain and conclude compassionate and effective relationships.
  • Identify and understand the impact of the power invested in the social worker role on relationships and interventions, and have the ability to adapt practice accordingly.

The Statement, published by the Department of Health and Social Care (DHSC), and, again, applicable in England, says that social workers:
  • Need to apply a wide range of knowledge and skills to understand and build relationships, and work directly with individuals, their families and carers to enable and empower them to achieve best outcomes.
  • Need to be able to work directly with individuals and their families through the professional use of self, using interpersonal skills and emotional intelligence to create relationships based on openness, transparency and empathy. They should know how to build purposeful, effective relationships underpinned by reciprocity.

The Statement, published by the Department of Health and Social Care (DHSC), and, again, applicable in England, says that practice supervisors should:
  • Build positive relationships with adults and their carers, and other professionals, through their professionalism and optimistic attitude, as appropriate and model this approach to others.
  • Recognise the impact that relationships with the [people with whom they are working] may have on social workers, including [those who draw on services] and their carers, as well as other professionals, and [consider how these can influence practice effectiveness].
While the above relates specifically to qualified social workers, they are equally as applicable to unqualified social work practitioners although registration for practice is not reliant upon them being demonstrated in practice. It is not easy to find a definition of relationships-based practice, but there is ample agreement that it is related to and builds on psychosocial approaches to practice and the psychodynamically informed case-work tradition (Hollis, 1964). There are four agreed key characteristics of relationship-based practice:
  • Recognition that each social care interaction is unique.
  • Understanding that human behaviour is complex and multifaceted.
  • Focussing on integrating internal and external worlds of individuals.
  • Accepting that the human relationship is an integral component of any professional intervention.
In relationship-based practice the emphasis is on the professional relationship as the medium through which the practitioner can engage with and intervene in the complexity of an individual’s internal and external worlds. The relationship between the social care practitioner and the service user is recognised to be an important source of information for the worker to understand how best to help, and simultaneously this relationship is the means by which any help or intervention is offered. The Care Act 2014 defines the assessment of needs and the carers assessment as a crucial intervention, precisely because it is underpinned by relationship-based practice. Relationship based practice draws on psychodynamic ideas that explain human personality and functioning in terms of conscious and unconscious desires and beliefs, feelings and emotions, based on life experiences. Effective social work requires that the social care practitioner tunes into the emotional world of an individual accessing support and is able to communicate this understanding within the relationship. It requires moving the understanding of the relationship beyond the individual to incorporate awareness of contextual factors such as power, professional role, poverty, social exclusion and political ideology. One of the key challenges a social care practitioner will face, is being able to focus simultaneously on what is happening to the individual and what is happening to them. Developing the ability to understand holistically both the individual’s and their own response to a specific situation will ensure that they are acting in the individual’s best interest.

Emotional intelligence

Emotional intelligence is a skill that can help social workers manage the emotional complexities of practice (Ingram, 2013) and is described as the ability to:

be aware of their own emotions; be able to understand and manage these effectively within relationships; be motivated to similarly understand the emotions of others; and to communicate this within relationships.

Salovey and Mayer, 1990; Morrison, 2007

Emotional intelligence is crucial for relationships-based practice:

…as they underline the existence and importance of emotions as a stream of information within social work relationships and practice

Munro, 2011

What individuals want

Hear from adults and carers

  • ‘Treat us like people, think about us like people.’
  • ‘I feel like a case rather than a person.’
  • ‘Some people don’t want social work intervention, there are many reasons for this.’
  • ‘Some people read the notes and go beyond – and have the necessary empathy.’
  • ‘They need to put interest in the person!! And flexibility, transparency and openness are key!!’
  • ‘They come with forms and processes and the individual gets scared.’
  • ‘Forms and processes get in the way.’

Professionalism and relationships

It is important to ensure that a ‘professionalised’ approach to human relationships does not bring inequalities that ‘may be unethical for both social workers and their clients, belying a message of inequality (that) is ultimately patronizing and disrespectful’ (Alexander and Charles, 2009).

Professionalism is often associated with certainty, expertise and theoretical knowledge (Brodie and colleagues, 2008).

It is undeniable that the ‘professional’ holds a series of skills and knowledge that are important for the relationship, but the ‘professional’ must understand and behave in a way that recognises the ‘skills and knowledge’ that the individual brings to the relationship as different in nature but equally important for the success of the relationship and its outcomes.

A key element for a meaningful relationship is trust – the person has to perceive that they can trust us and that we do have empathy towards them and their situation.

Working collaboratively is key in co-production as described in the co-production principles.

Also see: Relationship-based practice: emergent themes in social work literature (Iriss Insight 41)

Evidence suggests many young people can feel more at ease in digitally mediated communication (PSW research, 2020). Indeed, data from the Principal Social Workers national research and the more recent information, observations and feedback from frontline practitioners, IROs, CP chairs and others indicate that practitioners have noticed better and more open communication with children and young people and some parents online.

The PCFSW & Social Work England best practice guide for video call/contact and virtual/online home visit

In the last few months during the COVID-19 pandemic, we have had to depend much more on technology like mobile phones and video calling to communicate with others, including in the social care sector. Many of us have found that some people actually are more open and feel more comfortable talking to us on the phone or through a screen.

Strengths-based practice and meaningful relationships

Excellent social work is about emphasising the use of professional engagement and judgement, as opposed to procedural approaches, with a focus on the individual, taking a holistic and co-productive approach to keeping the person at the centre of all decisions, identifying what matters to them and how best outcomes can be achieved. It is about enabling people to find the best solutions for themselves, to support them in making independent decisions about how they live. I whole heartedly believe in taking a strengths and asset based approach to supporting individuals and empower people to live the lives they want.

Romeo, 2019

Strengths-based practice is a collaborative process between the person supported by services and those supporting them, allowing them to work together to determine an outcome that draws on the person’s strengths and assets. As such, it concerns itself principally with the quality of the relationship that develops between those providing and being supported, as well as the elements that the person seeking support brings to the process.

Duncan and Hubble, 2000

If we look at what strengths-based practice is and is not, there are some key elements that underpin the development of meaningful relationships:

Strengths-based approach and meaningful relationships in social work are…Strengths-based approach and meaningful relationships in social work are not…
An approach ‘how to carry out interventions’An outcome
Holistic and multidisciplinaryAbout reducing packages
CollaborativeAbout signposting and providing less support
Aligned with risk enablement and positive risk takingOne size fits all
A ‘focus on what matters to you’A focus on ‘what is the matter with you’
Applicable to any intervention, setting, type or level of need and profession

The importance of communication during a strengths-based process

Building a rapport and trusting relationships with people who may have care and support needs is a fundamental foundation for working in a strengths-based way. Different people will need different communication approaches such as:

  • interpreters,
  • sign language,
  • easy read documents,
  • pictorial information.

It is vital to find the most appropriate method of communication for the individual so that they can be fully involved in the strengths-based conversations. If the person has difficulty in engaging in the process, then independent advocacy must be arranged.

Social care practice and meaningful relationships in hybrid working

Over the last three years, the practice in social care has changed enormously mainly due to being forced to perform practice exclusively through technological means at times during the COVID-19 pandemic.

There is no longer a need to limit social care practice to phone and online, but there is also evidence that online and phone interactions can be, and are, either suitable or more suitable in some circumstances. The experience of the pandemic has taught us to not assume that all adults prefer face-to-face interactions, many have found that some people are more open and feel more comfortable talking to us on the phone or through a screen.

The Care Act 2014, introduced appropriate and proportionate interventions, explicitly mentioning how either the entirety or part of the intervention can be done in methods other than face-to-face. It also highlights the duty of adapting interventions to the individual circumstances, which entails a level of flexibility in the means used for the interventions.

Even when using technology, it is still possible to gather information by observing the context or through non-verbal communication. This will help you build rapport and establish a meaningful relationship despite not being face-to-face.

We have explored here the pros and cons of each method of interaction, and one important area is, ‘how do we ensure we build rapport and establish meaningful relationships in any means of interaction?’

Good professional skills, competences and the right professional attitude are more crucial to building rapport and establishing meaningful relationships than seeing the person face-to-face.

Evidence suggests many young people can feel more at ease in digitally mediated communication (PSW research, 2020). Indeed, data from the Principal Social Workers national research and the more recent information, observations and feedback from frontline practitioners, IROs, CP chairs and others indicate that practitioners have noticed better and more open communication with children and young people and some parents online.

Key elements for a meaningful relationship

A key element for a meaningful relationship is trust: the person has to perceive that they can trust us and that we do have empathy towards them and their situation.

Adults and carers agree that the main ways for a social worker or social care practitioner to build rapport or establish a meaningful relationship with them are:

1. Be human and person-centred

It is not so much about the means of communication, but the approach, behaviour and attitude of the professional.

Letters

A letter could be good, but a good welcoming letter!! I received an impersonal letter starting ‘Dear sir/madam’. It said nothing about what to do if I didn’t understand the letter or where to call for further information or whether it will be a follow up.

Phone calls

A phone call could be helpful, if the social worker introduces themselves, gives time to the person to respond, shows respect and consideration to the person’s circumstances, etc. “Is this a good time to talk?”

Having a perfect stranger ringing you up and asking personal questions about your health, etc. is a barrier on its own. They – social workers – need to start with the assumption that they are a problem, there is a barrier.

I was contacted by mobile phone by a care manager, saying that she would like to come by the following day and do my review. I didn’t know the woman!

Video calls

A video call could be more convenient or less intrusive in many circumstances (see Decision-making tool for interventions) the onus is however not in the what but on the how:

A person I didn’t know called out of the blue and asked ‘are you ok?’

Paula got a call from somebody who was nice, human, close asking how she was, giving her time… she feels lucky and thinks it was good.

Social workers and social care practitioners should reflect on what could be the impact of a video call or the phone on the dynamics of the relationship. This will vary depending on the person, the circumstances, the reason for the interaction, etc.

Whereas some people feel that a video or phone interaction is more formal, others will feel that the professional boundaries are blurred, as they feel less formal, more like other informal or social communications. Social workers and social care practitioners should identify how to put the adult and/or carer at ease.

There may be a need to be more explicit about what the rules of interaction are, and to ask the adult and/or carer how do they find the video call or phone interaction and what, if anything is preventing them from being at ease. (See technology checklist)

Social workers and social care practitioners must be able to gather information with less non-verbal communication clues and should make explicit through questions or feedback any perceptions they have to give the adult and/or carer the opportunity to confirm them or clarify them.

2. Be fair to the adult and/or carer and their circumstances, ensure you are open minded enough to adapt to them when and if needed

Look into the individual’s records to see if there is information about the preferred method of contact/communication and ensure that it is respected.

Ask the individual which is their prefer method of contact/communication, for what and in which circumstances. “Would you like to receive this information verbally, website, link, email, etc.?”

  • Some people have iPads or tablets but not for communication.
  • Some people don’t have a landline and some people only have a landline.

Hear from adults and carers

  • “It sounds like it is the one size fits all here and that is not right.”
  • “Social workers are gatekeepers, they have access to support and the person needs them.”
  • “First default way to contact is landline and ask are there alternatives you prefer? And build from there.”
  • “Ask about access needs, be open minded … is a fairly basic thing from my point of view.”
  • “Don’t be judgemental.”
  • “I had a practical problem, and the social worker did not need to do and did not do an assessment of needs or risk assessment, she connected me to people – it was a problem with cameras – she did not panic and safeguarded me, she just enabled me, she provided a practical solution to a practical problem, and was very helpful and exactly what I needed.”

3. Be aware of equality and diversity – don’t make assumptions based on age, race, disability or anything else

Remember:

  • Sometimes people face communication problems, this could be temporary, fluctuate or be permanent.
  • Not everybody has access to all means of intervention.

Hear from adults and carers

  • “If I go into relapse I can’t speak and I have great difficulty in typing and reading, the way my brain works.”
  • “Discrimination has to be incorporated into guidance. Racism is nasty and can call out.”
  • “How people communicate is subtler. There are assumptions about people that social workers make based on race or disabilities. It is beyond being aware.”
  • “Majority of older people still have their landlines and it is their means of communications and they are not familiar with technology and they don’t use mobiles.”
  • “Sometimes getting to the door on time is difficult as a wheelchair user.”

4. Enable or enhance engagement with advocacy, consider how it could help the adult and/or carer in being engaged in the process

Hear from adults and carers

  • “Would be good to get the questions in advance. So, I am prepared and they can be answered in my own words.”
  • “At the end of the day it is whether the social worker or social care practitioner can adapt and be flexible and go that extra mile.”

There are different types of advocacy, and each of them can support the individual in different ways. It is important that the social care practitioner is familiar with all these types to ensure they provide the most appropriate support to the individual to maximise their involvement and therefore succeed in building a meaningful relationship.

Resources