- Learning outcomes
- 1. Introducing diversity and difference
- 2. ‘Difference’ and communication
- 2.1 A communication ‘problem’?
- 2.2 Analysing communication problems
- 2.3 Ways of understanding ‘difference’
- 2.4 The social construction of ‘difference’
- 2.5 ‘Difference’ and identity
- 2.6 Reflecting on identity
- 2.7 Aspects of identity
- 2.8 ‘Difference’, power and discrimination
- 2.9 Experiencing prejudice and discrimination
- 3. Ethnicity
- 3.1 ‘Race’, ethnicity and communication
- 3.2 ‘Race’
- 3.3 Ethnicity
- 3.4 Describing your ethnicity
- 3.5 Ethnic categories
- 3.6 ‘Racialisation’ and racism
- 3.7 The process of 'racialisation'
- 3.8 The impact of 'racialisation'
- 3.9 Being on the receiving end
- 3.10 Working with difference
- 3.11 Ethnic matching
- 3.12 Services for inter-ethnic communications
- 3.13 Employing interpreters and link workers in health and social care
- 3.14 Challenging racism
- Current section: 3.15 Exploring anti-oppressive practice
- 4. Gender
- 4.1 Thinking about gender
- 4.2 Talking about gender
- 4.3 Reflecting on gender and identity
- 4.4 Where does gender come from?
- 4.5 Gender and power
- 4.6 Gender and power in the workplace
- 4.7 Gender and power in helping relationships
- 4.8 Gender and difference
- 4.9 The revival of gender essentialism
- 4.10 Men and women communicating differently?
- 4.11 Critiquing gender essentialism
- 4.12 The implications of gender differences in communication
- 4.13 Gender and parenting
- 4.14 Changing fatherhood identities
- 5. Disability
- 6. Conclusion
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Diversity and difference in communication
Interpersonal communication in health and social care services is by its nature diverse...
Interpersonal communication in health and social care services is by its nature diverse. As a consequence, achieving good or effective communication – whether between service providers and service users, or among those working in a service – means taking account of diversity, rather than assuming that every interaction will be the same. This unit explores the ways in which difference and diversity impact on the nature of communication in health and social care services.
After studying this unit you should be able to:
- Demonstrate an understanding of competing perspectives on issues of communication, difference and diversity;
- Demonstrate an understanding of the ways in which issues of ethnicity, gender and disability impact on interpersonal communication in care services;
- Apply ideas about communication and difference to everyday interactions in health and social care contexts;
- Analyse the ways in which ideas about difference can both reflect and reproduce inequalities between groups in the context of care services;
- Identify strategies for working with difference and diversity in the context of challenging discrimination in health and social care contexts.
3.15 Exploring anti-oppressive practice
Click view document to read: Anti-Oppressive Practice
Read the extract ‘Anti-oppressive practice’, by Beverley Burke and Philomena Harrison and make notes on the key elements of anti-oppressive practice. How might you apply these ideas to your own experience or practice?
Although the concept of anti-oppressive practice is highly contested, Burke and Harrison argue that (social work) practitioners have ‘a moral, ethical and legal responsibility to challenge inequality and disadvantage.’ They remark that anti-oppressive practice is a ‘dynamic process based on the changing complex patterns of social relations.’ They use the definition of anti-oppressive practice espoused by Clifford, who uses the term ‘anti-oppressive’:
to indicate an explicit evaluative position that constructs social divisions (especially ‘race’, class, gender, disability, sexual orientation and age) as matters of broad social structure, at the same time as being personal and organisational issues. It looks at the use and abuse of power not only in relation to individual or organisational behaviour, which may be overtly, covertly or indirectly racist, classist, sexist and so on, but also in relation to broader social structures for example, the health, educational, political and economic, media and cultural systems and their routine provision of services and rewards for powerful groups at local as well as national and international levels. These factors impinge on people's life histories in a unique way that have to be understood in their socio-historical complexity.
Clifford, 1995, p. 65
In considering how you could apply anti-oppressive principles to your own work, you would need to think about the following.
Social differences and understanding how they interconnect and overlap.
Linking the personal and the political, particularly when examining and trying to assess individual life experiences.
Addressing power and powerlessness.
Locating events within a historical and geographical perspective.
Practising reflexivity and mutual involvement.
One of the driving forces of anti-oppressive practice is being able to challenge inequality and recognise that challenges are not always successful and may be very painful both for the person or group being challenged and for those who are challenging. One important aspect of challenging inequality is being self-aware and understanding how your own social location affects the communication between yourself and the individual or group you may be challenging. The process of thinking and reflecting is a core part of working in an anti-oppressive way.
Burke and Harrison offer the following set of challenges for people wanting to work in an anti-oppressive way which:
is flexible without losing focus
includes the views of oppressed individuals and groups
is theoretically informed
challenges and changes existing ideas and practices
analyses the oppressive nature of organisational culture and its impact on practice
includes continuous reflection and evaluation of practice
has multidimensional change strategies, which incorporate the concepts of networking, user involvement, partnership and participation
has a critical analysis of the issues of power both personal and structural.
Describing the fragmented and highly contentious notion of anti-oppressive practice, Lena Dominelli argues that:
Challenging inequality and transforming social relations is an integral part of anti-oppressive practice. Knowing oneself better equips an individual for undertaking this task. Self-knowledge is a central component of the repertoire of skills held by a reflective practitioner … Moreover, reflexivity and social change form the bedrock upon which anti-oppressive practitioners build their interventions.
Dominelli, 2002, p. 9
If Lena Robinson's approach draws on a psychological perspective, anti-oppressive practice clearly derives from a more critical, social model of ‘difference’. Anti-oppressive practice builds on a social constructionist model of ‘racial’ and ethnic differences, as well as differences of other kinds, as produced within a context of unequal power relationships in society. Rather than having a sensitivity to apparent ethnic or cultural ‘differences’, anti-oppressive practice argues that what is needed urgently is practice that challenges and changes structures of inequality at every level.
In terms of ethnicity, this means starting from an acknowledgement that racism is endemic in organisational structures in health and social care services, as in society more generally. The MacPherson Report, produced in the aftermath of the murder of Stephen Lawrence, offers the following definition of institutional racism:
The collective failure of an organisation to provide an appropriate and professional service to people because of their colour, culture, or ethnic origin. It can be seen or detected in processes, attitudes and behaviour which amount to discrimination through unwitting prejudice, ignorance, thoughtlessness and racist stereotyping which disadvantage minority ethnic people.
MacPherson Report, 1999, para. 6.34
Institutional racism has been a factor in the experience of black staff in health and social care services. Building on what Burke and Harrison say about the intersection of different kinds of oppression, it is worth noting that black women in particular have experienced discrimination, particularly within the National Health Service. The NHS, like many other organisations, reflects a history of discrimination in its employment practice. Research into the experiences of black women health workers has identified many areas of discrimination (Baxter, 1997; Doyal et al., 1980). Early studies showed clearly that black women from the Caribbean who migrated to England in the 1950s and 1960s were channelled into ancillary and auxiliary jobs within the NHS. Even when they attempted nurse training many were offered training opportunities within the less senior State-Enrolled Nurse (SEN) programmes. This reduced career opportunities severely and limited the career development of many black nurses up until the present time. Indeed, changes in nurse training and promotion policies in the 1990s have weakened the position of SENs still further (Beishon et al., 1995).
Black nurses were also channelled into the least prestigious areas of work – in particular, psychiatric and geriatric nursing. Baxter (1977) argued black nurses were an endangered species, with discrimination operating in schools and colleges. This coupled with the knowledge of discrimination and lack of promotion prospects has meant fewer and fewer black women are choosing to do nurse training. A report in the mid-1990s from the Policy Studies Institute (Beishon et al., 1995) highlighted the fact that ethnic minority nursing staff often suspected racial discrimination by their managers, that they identified racism within working relationships and often experienced blatant racial harassment from patients.
At the time of writing, there are very few black women senior managers in the NHS. A survey of non-executives of health authority and trust boards reported that only 45 out of 1531 non-executive members of regional health authorities, NHS trusts and special health authorities in March 1993 were from black and ethnic minority communities (3%) (National Association of Health Authorities and Trusts and the King's Fund Centre, 1993). Similarly, only 4 out of 534 chairs of health authorities and trusts were from black and minority ethnic communities and only one of those was female. This demonstrates the difficulty black and ethnic minority women have with both race and gender discrimination.
The staff shortages within the NHS at the time of writing have led to a recruitment drive somewhat reminiscent of the 1950s and 1960s, when people were recruited directly from the Caribbean to staff a newly developed NHS. At that point processes and policies were not developed to ensure Caribbean nurses and auxiliary staff were not discriminated against. Many agencies have employed Filipino and South African nursing staff on limited contracts.
An anti-oppressive approach to ethnic diversity and difference would begin by acknowledging the impact of racism on the experience of both staff and service users. The next step would be to challenge existing structures and practices, for example in relation to employment, training and promotion within services, to ensure they did not discriminate against people from particular backgrounds. In terms of work with service users, an anti-oppressive approach would challenge the ways in which current practices disadvantage, either directly or indirectly, patients or clients from different ethnic groups. This approach would not ignore ‘differences’ in terms of needs but, rather, would see such differences as the result, at least in part, of existing racist and discriminatory practices.
Anti-oppressive and anti-discriminatory practice emphasise the impact of racism and the need to challenge racist structures and practices in health and social care organisations.
This is an extract from an Open University course which is no longer available to new students. If you found this interesting you could explore more free Social Work course units or view the range of currently available OU Social Work courses.
Copyright & revisions
Originally published: Tuesday, 21st June 2011
- Creative-Commons: The Open University is proud to release this free course under a Creative Commons licence. However, any third-party materials featured within it are used with permission and are not ours to give away. These materials are not subject to the Creative Commons licence. See terms and conditions. Full details can be found in the Acknowledgements section.
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