Service users’ perceptions
This section describes service users’ perceptions when they seek help from social workers or are directed to them.
Few people find it straightforward to ask for help in their personal lives. They may feel that they should be able to stand on their own two feet and that their need for help shows a failure to do so. There may also be a worry about how professionals will respond to their request for help. Will they be sympathetic and understanding? Or will they be rude, dismissive, belittling? Will there be a benefit or will it make things worse? If the involvement of the social worker is being imposed, then these questions will be sharper, and the service user may well view the social worker with ambivalence or even hostility.
These sorts of questions may be familiar to you from occasions when you have been a service user – for instance, when you have used the National Health Service (NHS) or perhaps been involved with teachers over your child’s progress at school. As a service user, perhaps you have felt unsure of what to expect from other professionals. If the service you have received has in some way been unsatisfactory, perhaps you have not known to how and to whom you might complain.
Activity 8 Your experience of being a service user
Think of two occasions when you have been a service user and have had to ask for help. Think of one occasion when your request was dealt with in a helpful way, and another when you found the response to be unhelpful. These experiences could have been with the NHS, an educational institution, the police, public transport, and so on.
Write down what was helpful in the first instance and what was unhelpful on the second occasion.
- How much did it matter that you did or didn’t get what you wanted?
- How important was the way in which you were treated?
- What lessons can you draw for your practice from your own experience of being a service user?
You may have felt that the way in which people in official positions responded to a request was significant, and it may have been as important as the outcome, whether or not you got what you wanted.
You may be more likely to recall the experience as a positive one if:
- you were able to deal directly with one person representing the organisation
- you were treated courteously and promptly
- you felt that your point of view was being taken seriously
- you were given explanations, so that you understood why the help you were requesting was or was not available.
Conversely, you are likely to recall the experience as negative if:
- you were not able to find anyone to talk to or found yourself getting an automated answerphone
- you were dealt with in an impersonal and unnecessarily officious way
- you had to wait for a long time to be seen and/or to know the outcome of your request
- you felt that you had not been listened to properly
- you were not given any reasons for the decision.
Previous experiences will doubtless affect your expectations when you need help in the future.
All the points above are as true for users of social work services as they are for you.
What service users want
Users in all client groups value, it seems, similar characteristics in their social workers. They want workers who keep appointments, understand the user’s perception of the problem, are straight and not two-faced, and are warm and are efficient in getting services and benefits.
In his review of client perspective studies, Martin Davies draws out eight lessons for social workers and their agencies:
- Lesson 1: Improve the pathways to social work service.
- Lesson 2: Handle the intake process with imagination, sensitivity and tact – put clients at their ease.
- Lesson 3: Be concerned with the client as a person. Handle the personal in a professional manner. That is the heart of social work.
- Lesson 4: Identify the client’s expectations and relate these to the agency’s obligations and resources. Be active. Be alert. Be helpful. And don’t string the client along.
- Lesson 5: Be a good counsellor.
- Lesson 6: Remember that the social work role puts you in a position of power and privilege. You cannot escape or deny it. And you must be honest and open about your agency’s responsibilities.
- Lesson 7: Use your knowledge and experience to benefit the client. Keep it up to date.
- Lesson 8: Always be trustworthy. Always be reliable.
Service users above all else value relationships they have with social workers which are based on warmth, empathy, reliability and respect (Beresford, 2012). This is the opposite of formulaic and bureaucratic contact.
Beresford (2012) identifies the following four qualities:
Good social work is social and based on seeing people’s lives as a whole, not just their problems.
It offers practical as well as emotional support. Social workers do not treat psychological and emotional difficulties in isolation from people’s real worlds.
Listening and not judging. Service users saw the quality and skill of being able to listen as the basis for much else that service users value.
Delivering what service users want.
Beresford suggests that sometimes this means rediscovering the community orientated side of social work, which fosters empowerment, discourages discrimination and can mean social workers taking the side of service users even when that conflicts with their employers and other state agencies.
Traditionally social work has emphasised that it should treat service users with respect, valuing them as unique persons and accepting them with all their failings. It has often failed to live up to these high ideals, but there is no contradiction between what service users want and the values that social work professes.
Changing roles for service users
Many service user groups have wanted to become far more involved in having some say in the services they receive. People with disabilities, users of mental health services, older people, carers and children in the care of local authorities are just a few of the examples of such groups.
A good example can be seen in the work of Voice of Young People in Care (VOYPIC) in Northern Ireland, which was created in 1993 by a group of young people in care as well as professionals. Their stated aim is to promote the rights and voice of children in care and care leavers.
In their service user case study on palliative care in 2008, Beresford and colleagues found that service users valued being actively involved as equal partners in co-producing and having a say about services, rather than adhering to a traditional model where service users were expected to be passive, dependent, grateful and well behaved (Beresford et al., 2008).
This is a major challenge to social workers and to social work agencies and it leads on to what has been called ‘a user-led model of social work’ (Croft and Beresford, 2002). Croft and Beresford argue that in order for this to happen, service users’ demands for autonomy, participation and inclusion must be met. Service users are looking for social workers and social services which:
- are concerned with enabling people to be independent rather than maintaining their dependency on social workers and their services, by focusing on people’s abilities rather than their incapacities, and supporting their independence
- do not serve as a palliative for the failure of mainstream policies but instead are systematically related to broader rights and need-led social and economic policies which include rather than marginalize groups like disabled people, lone parents and psychiatric system survivors, ensuring their access to education, training, child care and employment
- provide support rather than direction and are fully participative.
This requires a major shift, not just from social workers, but from their agencies and from many other services too, not least because social workers have pressing statutory (legal) responsibilities and limited time and resources to support people.
The need for education, training, child care and employment highlights the fact that many service users are disadvantaged in several ways. Croft and Beresford (2002) point to the connections between social disadvantage and personal distress and to the need for policies, agencies and workers to tackle both. These issues are relevant to the next section, where social work values are considered.