1. Introduction

This Special Report has been pulled together to mark this year’s World Social Work Day on the 19th of March, which focuses on promoting the importance of human relationships. The Report draws attention to some of the key content to which we provide access, that has something important to say on the subject of relationships.

Although some of the publications in the report are applicable specifically to England, the bulk of the issues discussed, and the material available, have relevance across the UK – and, in some cases – internationally.

Social work is arguably, to a much greater extent than many other professions, founded on a belief in the value of human relationships. It is also a profession which is highly dependent, for its impact, on the establishment and maintenance of effective relationships – with the children and adults whom it supports, with their families and communities, and with fellow professionals and the agencies for whom they work. If those relationships are not well-established, or sustained, or if they fail, the consequences can be serious, and, at the extreme, fatal, for some of the most vulnerable people in society.

Of course, individual social workers are not solely responsible for the maintenance of that full web of relationships, and managers, employers and the agencies with whom social workers are engaged must play a full part in creating the conditions in which positive relationships can flourish. But there remains a core responsibility, on individual practitioners, to maximise the opportunities that are available to support effective relationships; and to seek wider solutions if those are less available than they should be, or, are absent.

With that introduction in mind, it is perhaps slightly disappointing that the centrality of relationships to the practice of social work has not been given quite the prominence in recent years as may have been the case in the past. Although a wide range of publications – some of which are highlighted later in this report – are available, through CareKnowledge, that, in part, address the subject, there are fewer that can be said to centre wholeheartedly or, in full detail, on relationships.

We were also a little surprised to note that the definition of social work – promulgated by the International Federation of Social Workers (IFSW), the main sponsors of World Social Work Day – has been changed fairly recently. The previous definition is still referred to by a number of organisations and features in several of the reports highlighted below.

The original definition ran as follows:

“The social work profession promotes social change, problem solving in human relationships and the empowerment and liberation of people to enhance well-being. Utilising theories of human behaviour and social systems, social work intervenes at the points where people interact with their environments. Principles of human rights and social justice are fundamental to social work.”

The new definition – approved by the IFSW General Meeting and the International Association of Schools of Social Work (IASSW) General Assembly in July 2014 drops the specific reference to relationships:

“Social work is a practice-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people. Principles of social justice, human rights, collective responsibility and respect for diversities are central to social work. Underpinned by theories of social work, social sciences, humanities and indigenous knowledge, social work engages people and structures to address life challenges and enhance wellbeing. The above definition may be amplified at national and/or regional levels.”

There are good reasons for the change in definition, discussed on the IFSW website, but the omission of reference to relationships jars a little with the chosen focus for World Social Work Day.

The current BASW definition set out in set out in this House of Commons Briefing also makes no specific reference to the importance of relationships:

“Social work is a profession that is centred around people – from babies through to older people… Social workers work with individuals and families to help improve outcomes in their lives. This may be helping to protect vulnerable people from harm or abuse or supporting people to live independently. Social workers support people, act as advocates and direct people to the services they may require. Social workers often work in multi-disciplinary teams alongside health and education professionals.”

Whilst all of the above may confirm something of an absence of an ‘on-the-label’ focus on the importance of relationships in social work, there are a significant number of publications, available, through CareKnowledge that do address the issue in their more detailed material. In what follows, we’ve selected a number of those publications and, in some cases, highlighted content that speaks to the importance of relationships with people who use services and their families and communities; with colleagues including supervisors and managers; and with and between agencies.

2. Standards

2.1 BASW’s refreshed Professional Capabilities Framework for Social Work in England includes these key expectations for qualified social workers. They 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 SW role on relationships and interventions, and have the ability to adapt practice accordingly
  • Build and use effective relationships with a wide range of people, networks, communities and professionals to improve outcomes, showing an ability to use appropriate assessment frameworks, applying information gathering skills to make and contribute to assessments, whilst continuing to build relationships and offer support
  • Work effectively as a member of a team, demonstrating the ability to develop and maintain appropriate professional and inter-professional relationships, managing challenge and conflict, with support
  • Promote a culture which supports empathetic compassionate relationships with other professionals, people who use services, and those who care for them
  • Promote positive working relationships in and across teams, using strategies for collaboration and contribute to a supportive organisational culture
  • Develop strategic engagement, influence and relationships with a range of stakeholder groups

2.2 The Knowledge and Skills Statements for Child and Family Social Workers

The Statements, now with titles establishing them as post-qualifying standards under Section 42 of the Children and Social Work Act 2017, cover child and family practitioners, their supervisors and practice leaders. Published by the Department for Education (DfE) and applicable in England they say that social workers must:

  • Build effective relationships with children, young people and families, which form the bedrock of all support and child protection responses. Be both authoritative and empathic and work in partnership with children, families and professionals, enabling full participation in assessment, planning, review and decision making
  • Help children to separate from, and sustain, multiple relationships recognising the impact of loss and change
  • Observe and talk to children in their environment including at home, at school, with parents, carers, friends and peers to help understand the physical and emotional world in which the child lives, including the quality of child and parent/carer interaction and other key relationships
  • Reflect on the emotional experience of working relationships with parents, carers and children, and consciously identify where personal triggers are affecting the quality of 7 analysis or help. Identify strategies to build professional resilience and management of self
  • Maintain personal and professional credibility through effective working relationships with peers, managers and leaders both within the profession, throughout multi-agency partnerships and public bodies, including the family courts.

Practice supervisors must:

  • Demonstrate optimistic behaviour, and build positive relationships with children and families and other professionals
  • Apply a proportionate and ethical approach to the exercise of authority, which develops and maintains relationships with families and professionals and ensures the protection of children
  • Recognise the patterns of relationships between professionals, identifying where these are likely to compromise the welfare of families and the safety of children, taking immediate and corrective action
  • Build relevant relationships with children and families and professionals to test current hypotheses and dominant perspectives
  • Recognise how different relationships evoke different emotional responses, which impact upon the effectiveness of social work practice and provide responsive, high quality individual supervision

2.3 The Knowledge and Skills Statement for Social Workers in Adult Services

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
  • Should focus on the links between the individual, their health and wellbeing and their need for relationships and connection with their families, community and wider society
  • 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
  • Will, for example, be able to complete assessments of need independently, which start from a perspective of the service users' desired outcomes and have become more effective in their interventions; deal with more complex situations; develop respectful and situation-appropriate professional relationships, thus building their own confidence; and earning the confidence and respect of others

2.4 Post-Qualifying Standards for Social Work Practice Supervisors in Adult Social Care

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
  • Support social workers to develop influential and respectful working relationships with partner agencies
  • Develop a collaborative, supervisory partnership in which the relationships with adults in need of care and support have a central position
  • Recognise the impact that relationships with the [people with whom they are working] may have on social workers, including [those who use services] and their carers, as well as other professionals, and [consider how these can influence practice effectiveness]

Practice supervisors should recognise the dynamics of relationships between professionals, identifying where these are likely to compromise the well-being of adults and take immediate and corrective action.

[Understand} that reflective supervision involves helping, through supervision processes, to create an environment which enables such learning and reviewing to take place. This means first and foremost that a reflective supervisor needs to model a critically reflective ability in their own approach to relationships in the organisation.

3. The relevant literature

Relationship-Based Practice: Emergent Themes in Social Work Literature

This report is part of the Institute for Research and Innovation in Social Services’ (IRISS) ‘Insight series’. It sets out to review the literature on relationship-based practice in social work and includes discussion on:

  • The historical context
  • The philosophical underpinnings for such practice
  • Care ethics
  • Relevant policy
  • Professionalism
  • Boundaries and barriers
  • The use of self
  • Transference and counter-transference
  • And reflective practice

The report argues that:

  • There are compelling philosophical, policy and practice reasons to put relationships at the heart of social work
  • The importance of relationships is increasingly recognised in ‘people work’ but especially in social work and social care, across all domains of practice
  • Effective relationships are central to successful outcomes
  • Current policy directions in Scotland are rooted in the need for effective personal/ professional relationships
  • Relationships are complex, requiring an awareness of ‘self’ and the negotiation of inter-personal boundaries
  • Current practice cultures can make it difficult to practice in properly relational ways and would require a radical shift for issues of power, agency and status to be addressed

4. Practice and supervision

Signs of Safety

In this Special Report for CareKnowledge, Wendy Hill described the key elements of the Signs of Safety approach and set out this core underlying principle which might stand as suitably brief summary for much else that is said across the publications in this current report:

"Constructive working relationships between professionals and family members, and between professionals themselves, is at the heart and soul of effective practice. Compassionate relationships, working ‘with’ not ‘doing to’ are the bedrock of human change and growth."

4.2 Empathy, Tenacity and Compassion

In October 2015 Brighton & Hove implemented relationship-based practice as a whole system change across Children’s Social Work Services. The new model of practice, the Team Around the Relationship, involved a move to small social work teams, or pods, which support children from the assessment stage through the whole of their journey across social work services.

The Team Around the Relationship is premised on the idea that, if social workers feel safe and contained, they can build relationships with families and use these relationships to affect change. The model of practice, therefore, incorporates group supervision, reflective practice groups and a new model of relationship-based assessment and recording, One Story, as key processes to support whole system change. The practice system is supported by a cultural transformation towards becoming a relationship-based organisation, which inspires trust and confidence in its practitioners.

To measure the impact of the Team Around the Relationship the Council is undertaking an ongoing evaluation based on a targeted consultation to test its theory of change. The evaluation focuses on the context, mechanisms and outcomes of the model of practice. This paper outlines the findings of the evaluation so far and sets out the key messages from the first 20 months.

The evaluation has found that, in general:

  • Families have a better experience of social work
  • Social workers feel more supported and more able to make a difference for families
  • Relationship-based practice seems to be supporting safe and stable family lives for children
  • The model of practice appears to have decreased demand for social work (a 5.4% decrease in the number of open families) and high-level interventions (a 10% decrease in both children with child protection plans and in care) during a time of increasing national demand

4.3 Culturally Competent Practice

This CareKnowledge briefing pulls together a number of the references that are available on culturally sensitive practice or on closely associated subjects. Establishing and sustaining relationships with people with a wide range of cultural – and sometimes very different – cultural backgrounds is an increasingly important part of effective social work.

As well as an introduction to the topic and a short review of relevant available web-based material, the briefing sets out discussions and links in relation to:

  • Values and cultural issues in social work
  • A cultural competency toolkit for health and social care
  • Standards and indicators for cultural competence in social work practice
  • Ethnic sensitive social work practice
  • Safeguarding children in black and minority ethnic communities
  • Black and minority ethnic parents with mental health problems and their children

4.4 Relationships and Sexuality in Adult Social Care Services

This guidance is for CQC inspection staff and registered providers. It is about people’s relationships and sexuality in social care services for adults receiving personal care and support. It focuses on caring for people who need support to express their sexuality and to have their needs met. The guidance includes information on:

  • When providers should assess a person’s sexuality needs
  • How providers can help people develop their understanding of sexuality and relationships
  • Whether a best interests assessment can be made in relation to a person’s consent to sex
  • How providers can support people living with a physical disability
  • How providers can support people with accessing dating services
  • Sexual disinhibition and how providers should support people who exhibit such behaviour
  • Situations where someone lacks capacity to consent to sexual relations
  • How someone’s capacity to consent to sexual relations can be assessed

4.5 Helping Vulnerable Children and Adolescents to Stay Safe: Creative Ideas and Activities for Building Protective Behaviours

The whole thrust of this Special Report written for CareKnowledge by Katie Wrench is to describe how effective practice can lead to the establishment of trusting relationships between professionals and vulnerable children and can help those children develop the protective behaviours that will enhance their chances of remaining safe in the full range of other relationships of which they will be part, or which they will develop.

Katie herself has a wide experience of maintaining relationships through her work as a HCPC registered social worker and art psychotherapist, and SW Team Manager. Katie has worked for over twenty years with children in care and children who have been adopted from care and continues to provide consultation and training to frontline social care practitioners, adoptive parents and foster carers.

4.6 Strengths-based Approaches to Working With Adults: Ensuring a Person-centred and Outcomes-focused Approach

The entire concept of strengths-based work relies on the establishment of the right kind relationships with those who use services and with a whole network of professionals and agencies to ensure that people can build on a potential multitude of strengths in themselves, and in their families and communities, to secure better outcomes for their futures. Those are the themes that Jon Skone discusses in this Special Report for CareKnowledge.

4.7 Stability for Children in Care

The establishment of fully supportive relationships is absolutely central to the wellbeing of children in care. Those relationships cannot be sustained if there is otherwise a lack of stability for the children concerned. The Children’s Commissioner published the second in her new series of reports on stability for children in care. This CareKnowledge briefing provides an update on what had changed since the Commissioner’s 2017 report, and includes a link to the original briefing we prepared at that time.

4.8 Building Trusted Relationships for Vulnerable Children and Young People with Public Services

Unusually, this evidence review was commissioned by the Home Office. It says that previous reviews of the child protection system have suggested that children who experience abuse lack a designated adult outside of the family system who is able to provide consistent support – or a ‘trusted relationship’. The focus of the review is on early intervention with children and young people who are vulnerable to either child sexual exploitation (CSE) or child sexual abuse (CSA). The work included a rapid review of the published evidence-base and new, small-scale qualitative research with practitioners in this field.

The core findings of the review are that:

  • There is a strong logic for thinking that trusted relationships between a practitioner and a child can protect vulnerable young people from CSE or CSA, but as yet there is no evidence to support this
  • There is some evidence that supportive practitioner–child relationships in other circumstances can improve child outcomes in and of themselves
  • There is a lack of high-quality research evidence on the risk and protective factors for becoming a victim of CSE or CSA
  • The ability of public services to build trusted relationships with vulnerable children and young people appears to be influenced by the characteristics of the child or young person, the practitioner and the organisational context
  • There is good evidence for the effectiveness of high-quality mentoring approaches
  • There is broad consensus between research and practice on the features which allow trusted practitioner–child relationships to develop

On that last point, the review concludes that the identified factors for successful relationships are already embedded in professional advice and guidance and goes on to quote Ofsted’s Time to Listen report:

  • Practitioners need to be sensitive and understanding to develop a trusting relationship with a child
  • In the context of CSE, inappropriate language (such as ‘promiscuous’, ‘consensual’, or ‘small age gap’) is a key barrier to developing trusted relationships
  • Children want to feel they are in control of their situation. Effective practitioners carefully plan their work together with the child and are persistent and skilled in engaging children in the process
  • While children value having a trusting relationship with one adult, having too many professionals involved in direct contact with the child can be unhelpful and overwhelming

4.9 Supervision - Practice Essentials

In this Special Report for CareKnowledge, Jane Wonnacott takes a detailed look at those elements of supervision practice that are essential, whatever the environment or practice methodology being employed in a social work/social care team. Jane’s report contains the following section on developing and reviewing the supervisory relationship, Here, she says:

“Although causal links cannot be proven, it is not unreasonable to assume that where supervisors are able to build good relationships with supervisees, practitioners will in turn be more likely to develop positive relationships with service users. Time and time again, we hear that what is important to service users is the capacity of the practitioner to be “real” and “genuine” showing that they “really care” yet practitioners may be expected to show this behaviour without a similar experience themselves within their organisations.

There are perhaps more challenges in relationship-development between supervisor and supervisee in group settings and there is the additional issue of creating safe relationships across the group. However, as with supervision delivered one to one, practitioners need to feel contained and safe if they are to share uncertainties and anxieties, as well as successes and the group leader has a responsibility to develop group relationships where this can happen.

Key features in any setting will be:

  • An authentic supervisor who is genuine and acts in a way consistent with their stated beliefs and values
  • A supervisor who is interested in their supervisees for who they are, where they have come from and their practice aspirations
  • The capacity to create of a safe, contained space where boundaries are clear and maintained
  • Re- evaluation of the supervisory relationship built into the process”

4.10 The Current Context for Supervision in Social Work and Social Care

In her earlier report for CareKnowedge, Jane looked at some of the challenges and potential barriers to the provision of effective supervision, and included the following section on the importance of relationships in finding a way forward:

“Alongside this rather gloomy picture there are committed, enthusiastic, skilled practitioners and managers and organisations where effective supervision flourishes. Although the overall context for supervision is challenging, in some areas (both in terms of geography and type of service) supervision thrives. A legitimate question is what enables this to happen?

One obvious answer may lie in the skills of individual supervisors and the amount and quality of training that they have received. A study of what happened in child and family social work supervision (Wilkins et al, 2017) found that 10 out of eleven managers had received no training in supervision and said they were modelling their approach on the supervision that they had received.

In the current climate, there may be a drive to minimise the amount of time and money spent on traditional training activities along with an assumption that an experienced practitioner can move smoothly into a supervisory role. The problem with this assumption is that it underestimates the complexity of the task and any new supervisor who has not experienced good supervision themselves will have little to draw on, when starting out as a supervisor. Bad practice can be modelled as well as good.

Developing into a skilled supervisor takes time, including the opportunity through training to understand what good supervision looks like, as well as practice, feedback from supervisees and ongoing support from practice leaders. One short training event is unlikely to create sustained change, and organisations where supervision flourishes are likely to be those where there is recognition that supporting and sustaining supervisors over time, and in a variety of ways, is crucial.

Perhaps one area for exploration is the degree to which the organisation promotes the importance of relationships as a vehicle for change. One notable difference between the children’s practice supervisors’ framework and that proposed for adults is the emphasis on the supervisory relationship. There is no explicit reference to the relationship as an important aspect of supervision for children’s social workers, yet a relationship based approach to supervision appears to be central within the framework proposed in adult services.

Given that there is good evidence that the quality of the worker/service user relationship is critical in promoting good outcomes (Molloy, et al 2017) it is not unreasonable to argue for an approach to supervision that has, at its heart, a positive supervisory relationship. It is within this context that constructive challenge, and support for excellent practice is likely to flourish. Positive supervisory relationships will enable staff to reflect openly and safely on their practice, identify strengths, admit mistakes and grow and develop as workers.

It is possible that the relationship is not always given explicit focus as it is assumed that experienced supervisors will automatically understand that successful supervision must take place within a safe, contained relationship. This is a mistake. Relationships need time, work and attention and this has to be legitimised and mirrored throughout the organisation.”

5. Organisational relationships

5.1 How to Survive in an Integrated Health & Social Care Organisation: a Guide for Social Workers and Health and Social Care Integration – A Director’s Story

A key focus over the last few decades has been the need to develop more integrated working, particularly between health and social care. At root, all successful integration is built on the development and maintenance of relationships between professionals and between the agencies for which they work. John Skone’s Special Reports look at how those relationships can be best secured at both the practitioner and senior manager levels.

5.2 Cooperative Working in Safeguarding and Promoting the Welfare of Children

This Special Report, written for CareKnowledge by Colin Green, considers the elements of good practice in working cooperatively to safeguard and promote the welfare of children who are looked after. If there is any situation in which there is a need for effective relationships between organisations and the people working in them, it is the field of ensuring best outcomes for children in care. Colin’s report takes a wide-ranging look at many of the relationships that need to be built and sustained if cooperative working is to be successful. It includes discussion on:

  • The challenges to building effective relationships
  • The role of leadership
  • The influence of structures
  • The role of guidance
  • The role of training and development
  • Organisational issues that can affect relationships and cooperation

6. Communities

6.1 What Works in Community Led Support?

This summary draws together the headline findings and lessons from an evaluation of the Community Led Support (CLS) Programme hosted by the National Development Team for Inclusion (NDTi).

Between June 2016 and November 2017, NDTi supported seven local authorities and their partners to plan, design, implement and evaluate a new model of delivering community based care and support (community led support) – using approaches intended to ensure each local model is continually evolving, learning and developing.

The CLS programme is based on the following principles, most of which have direct implications for relationship-building:

  • Co-production brings people and organisations together around a shared vision
  • There is a focus on communities and a recognition that each will be different
  • People can get support and advice when they need it so that crises are prevented
  • The culture becomes based on trust and empowerment
  • People are treated as equals and their strengths and gifts are built upon
  • Bureaucracy is kept to the minimum necessary
  • The system is responsive, proportionate and delivers good outcomes

6.2 The Place of Kindness

This report from Carnegie UK looks at ways of combating loneliness and building stronger communities, and the barriers to those objectives.

The report argues that kindness is at the very heart of people's wellbeing. With the support of the Joseph Rowntree Foundation, Carnegie UK has been working with seven organisations to test what, if anything, could be done to encourage kinder communities, exploring ideas around the importance of places and opportunities to connect, and the intrinsic values underpinning people's interactions and relationships.

This report sets out what has been learned, highlighting examples of where kindness and everyday relationships can affect change and support the wellbeing of individuals and communities.

The report also highlights some of the major factors that get in the way of engaging and encouraging kindness both in individuals and organisations, including real and imagined rules relating to risk; funders and policy makers valuing the formal and organisational over the informal and individual; and modern definitions of professionalism and good leadership crowding out everyday kindness and intuitive human interactions.

7. Final comment

This report presents just a selection of the publications we hold, or to which we provide links, that have something important to say about the central role of relationships in social work. One issue not much covered in the selection we have made is the need to recognise that the development of relationships can have a downside if professionals do not recognise the appropriate boundaries and power imbalances inherent in the roles that social workers can carry. Here the words of Scotland’s Codes of Practice for health and social care staff are worth repeating:

“[As a member of staff] I will not form inappropriate relationships with people who use services or carers.”

And, on another, more positive note, you may want to read this short blog from last year which neatly encapsulates what we know about the importance of human relationships and their implications for social work.