Chapter 1
The social work context, pressure, stress, and some alternatives
Introduction
These are really difficult times for social workers, who clearly operate within challenging socio-political, cultural, and organisational contexts. New managerialism, market-oriented practices, ideas from the business and commercial world, and the private sector have been transferred to, and incorporated into, social work (Harris, 2003, 2007). Since about 2008 with the establishment of austerity in the UK, there have been cuts to public services, local authority budgets, and resources – with the prospect of more to come. Local authority budgets will have fallen in real terms by one third by 2019–2020 (Greer, 2016). There has been an increase in rationing, gate-keeping mechanisms, standardised assessment measures, rules, procedures, performance monitoring, and targets in statutory social work agencies. Individual responsibilities of social workers have been emphasised, with decreasing power for social work collectives and unions. The media continues to focus on the failings, problems, and negative aspects of social work.
Hence social workers are said to be “despondent and disillusioned” (Stanford, 2011, p. 1515). There are concerns about the recruitment of workers and difficulties in retaining staff, especially in the child care and mental health fields (e.g. Evans et al., 2005). Practitioners are said to “feel powerless to enact their professional vision and values in a climate [that emphasises] proceduralisation, legislation and regulation”, with little space for preventative work (Stanford, 2011, p. 1515). Critics have talked about a climate of passivity, powerlessness, despair, despondency, and hopelessness in social work, with practitioners trapped and struggling to survive. This is a bleak picture.
However, are social workers trapped? Practitioners can turn to alternative concepts, to alternative models. There are positive ideas which continue to motivate social workers to help them to survive, to sustain themselves, to take up challenges, to thrive and flourish. There are positive discourses, options and choices beyond narratives focused upon role ambiguity, role conflict, demands, pressure, stress, exhaustion, and burnout. Yes, pressure, stress, and burnout are clearly evident, but social workers also experience considerable rewards and job satisfaction alongside the difficulties. In conjunction with their teams, colleagues, managers, and organisations social workers can tolerate, can resist negativity, working both individually and together to recognise, to work with, and towards alternatives. Members of the social work profession sometimes may feel unappreciated, vulnerable, anxious, lacking in knowledge and skills. But they also have strengths. They can, and do, cope; they can, and do, feel confident, experience resilience, hope, optimism, support, a sense of control, and enthusiastic commitment to their work (Collins, 2008; 2015; 2017).
In this wide-ranging introductory chapter we will consider the dangers of an excessive focus on pathology. We will explore disease model thinking and some alternative approaches, such as the role of positive expectations, affirmative post-modernism, appreciative inquiry and the inevitable co-existence of both positive and negative experiences. We will move on to consider, in some depth, pressure, stress, and burnout, alongside job satisfaction and the rewards of social work. Then we will discuss other alternative approaches such as salutogenesis, sense of coherence, positive use of resources, and hardiness.
Disease model thinking
Several factors have contributed to an emphasis on negatives and deficits which should be recognised and partly accepted, but also can be understood and countered. There has been a tendency to develop a physical, emotional, and behavioural preoccupation with pathology, with what is difficult, flawed, and problematic. This has been influenced, for example, by some aspects of medicine, psychiatry, and psychology. Hence the emphasis that follows can be on disease, disorder, illness, problems, and pessimism. Perhaps we should more often ask ourselves asset-based questions such as “what makes us healthy?” and “what is working well?”, rather than deficit-based questions such as “what makes us ill?” and “what is wrong?” (Garven, McLean, and Pattoni, 2016).
However, this is not to disregard the real suffering, pain and struggles of individuals, families, and communities nor, for example, the realities of abuse and addictive behaviours. Also, we should be wary of not undervaluing the successes of so-called pathology-based approaches. For instance, the biological, chemical, and genetic components of illness clearly can, and do, play important roles. As Saleebey (2009) points out, the organic and the neurological contributions to major physical and mental health problems have had many impressive aspects – without traditional medical help our physical and mental health would be infinitely more problematic.
Placebos and expectations
Nonetheless several social work writers in the past, for instance Smale (1977) and Saleebey (2009), have drawn attention to the limitations of some aspects of medical models, prescribed medication, placebos, and the power of expectations. The placebo effect has been the subject of extensive studies over many years, whereby one group of people is given a particular drug, while another group is given an inert substance. In many clinical trials it is not unusual for 25 to 40 per cent of the placebo group to experience the therapeutic outcomes provided by the relevant drug (Saleebey, 2009). One meta-analysis of clinical trials for anti-depressants even found no difference in the effects of placebos and drugs (Kirsh et al., 2003). Therefore a person’s expectations, their belief that they will get better plays a part in the mobilisation of healing systems. Expectations and beliefs that healthy, positive outcomes will follow also mobilise hope along with the belief in the possibility of things improving in the future (Saleebey, 2009). Verbal, non-verbal, and emotional messages can galvanise hope. Therefore placebo effects, positive expectations, and hope are powerful predictors of successful counselling, psychotherapeutic, and social work help. Both ourselves and service users need realistic, positive, and hopeful expectations to sustain our endeavours. These topics will be explored extensively in the second chapter of this book.
Negatives and positives
It is also necessary to challenge the emphasis on pathology, problems, and deficits as a medical and moral imperative. This helps us move towards a more balanced approach that places more focus on resources, competences, capabilities, assets, and strengths (Seligman et al., 2005; Saleebey, 2009; Garven et al., 2016). Cameron (2008) has highlighted some mechanisms that can help explain bias towards negativity. These include:
- Intensity – negative stimuli are experienced more intensely than positive stimuli; they are often perceived as threats that require immediate attention.
- Novelty – the rate of “ordinary” and positive events is usually commonplace; such events tend to be accepted, quietly internalised, and go unnoticed. Negative events tend to be more unusual or unexpected compared to “everyday” happenings and occurrences. Negative events tend to stand out; they capture our attention. Positive events, experienced more frequently, subside, fall, and fade into the background; they become diminished in relation to what may be relatively rare negative events.
- Singularity – in any system a single “ negative” component, or person, can cause a whole system to malfunction, while a single positive component or person does not guarantee optimal system functioning. An example of a single person causing a system to malfunction can be seen when a “damaged”, or even dangerous, team member can disrupt the otherwise healthy functioning of a team.
Myers (2000) and Robertson and Cooper (2011) have also pointed out psychology research and literature contains at least 15 times as many articles about negative topics – such as negative emotions – compared to positive ones. Negative organisational outcomes have also received a similar disproportionate amount of attention (Robertson and Cooper, 2011). Thus negativity tends to have a stronger effect on our attention, on our information processing systems, memory, self-concept, and relationships, while outcomes of positive events can be experienced as under-noticed, under-emphasised, and under-valued. In turn, perhaps psychology has paid comparatively little attention to psychological health, positive growth, development, and well-being. There are some exceptions, such as the work of Carl Rogers (1980; 2004). Rogers emphasised constructive growth, forward movement, “becoming”, and self-actualisation, within a supportive social environment.
Also, some postmodernists have presented negative and nihilistic perspectives. Rosenau (1992), cited in Parton and O’Byrne (2000), talks about sceptical postmodernists who present gloomy, pessimistic, despairing, hopeless, meaningless scenarios, portraying the end of the subject, the end of the active agent, and the impossibility of truth, with few opportunities to make social, political, or practical commitments. Alternatively, Rosenau (1992) talks about affirmative postmodernists who, although agreeing with the critiques of modernity around science and rationality, have a more optimistic, hopeful view. There is a concern not just with deconstruction, but with reconstruction. The affirmative approach involves trying to build political, practical interdependence and collaboration with different cultures which, while appreciating the diverse nature of subjectivities, clearly recognises and opens up wide-ranging possibilities, including choice, control, and agency which are discussed later in this book (Parton and O’Byrne, 2000). Affirmative post-modernism therefore links more closely with constructive, positive approaches.
In considering an emphasis on positives, appreciative inquiry (AI) has an important contribution to make. AI was established in the late 1980s in the field of organisational analysis, development and change (Cooperrider, Witney, and Stavros, 2003; Whitney, 2004). It has also been developed as a research approach (Ludema, Cooperrider, and Barrett, 2001). AI focuses on the transformational power of positivity, based on strengths, hopes, possibilities, and opportunities (Whitney and Trosten- Bloom, 2010). It involves a mind shift towards recognising good practice, seeing what works, what is right and what people really care about in creating a future with new, expanded opportunities (Cooper, Flint Taylor, and Pearn, 2013). AI often follows distinct phases:
- Discovery – involving an extensive, joint search to ascertain what already works well, the best of what is, and has been, building on success, good practice, achievements, and positive attributes.
- Dream – looking beyond what is, envisioning the best of what might be, a better future, what might work well in the future, exploring hopes and dreams for organisation and organisational relationships.
- Design – involving “provocative propositions”, describing the ideal, planning, and prioritising goals, what would work well and further developing good practice.
- Destiny – comprising a series of inspired actions to support learning innovations and what will be, delivering, maintaining, and sustaining the ideal in a “real” world.
Work is undertaken in all of these stages by sharing experiences with participatory, collectiv...