ESTABLISHING PROFESSIONAL RELATIONSHIPS

The Smiths’ case, like most, would have required that the social worker relate to many different individuals— both clients and other professionals—in the process of carrying out the social work role. Relationships with Clients Several decades ago, Perlman (1979) identified the main features of professionals’ relationships with clients as stemming from their purpose, their time-limited and client-centered nature, and the implicit expectation that the professional will exercise responsibility and self-control in carrying out his or her role. This means that the worker–client relationship is quite different from social relationships because it is essentially unbalanced, with the primary focus on the client and on the purpose of the contact. The power of the professional relationship flows from the client’s experience of personal validation through being the full center of another person’s attention. Carl Rogers’s client-centered approach to therapy (see Rogers, 1951) emphasizes the special qualities of warmth, acceptance, empathy, caring/concern, and genuineness as essential attributes of relationships. In a helping relationship, when the worker listens carefully to the client’s concerns and communicates both verbally and nonverbally an attitude of acceptance, the client feels validated and “safe,” thereby setting the foundation of the worker–client alliance. Fox (2001) sums this up by stating that “the relationship is the keystone of the helping process” (p. 53). Landreth’s model of “child-centered play therapy” (2002a, 2012) subscribes to many of these same values in child therapy, using play as the method of interacting and communicating with the child. Whether the client is a child or an adult, the engagement process must rest on a relationship of respect and trust as the foundation for work on setting appropriate goals. Initiating Relationships by Telephone Face-to-face contact offers the best opportunity for two people to meet and begin the process of getting to know one another, because people communicate nonverbally through body language such as eye contact, posture, gestures, and dress, in addition to words. In telephone conversations, these visual cues are absent, and the speakers must rely primarily on words and tone of voice. When I decided to contact Mrs. Smith to obtain her permission to write about her family, I obtained her phone number from the filmmaker, Kathryn Hunt, with whom the family had a very positive relationship. Because my call occurred on the evening before the family was being evicted from the apartment they had lived in for almost a year, they were in the midst of packing and preparing to move (the same situation Ms. Hunt depicted in the video). I had to make several calls before I reached Mrs. Smith, and in the process I spoke briefly with David and with Barbie. Ms. Hunt had told Mrs. Smith that I would be calling and about the purpose of my call. Mrs. Smith had told Ms. Hunt that she would agree to my request, but I wanted to speak with her personally and ask her to sign release forms. Because I had already seen all members of the Smith family in the videotape (Hunt, 1992), I had their physical appearances in my mind as I was speaking to them. My initial comments to Barbie, to David, and to Mrs. Smith when I spoke to each of them referred to the video and to my (telephone) relationship with Kathryn Hunt. My mention of Ms. Hunt’s name was critical in the family’s acceptance of me. I also identified myself as a professor of social work in New York, despite the risk that they might have negative feelings about social workers. This did not register as important in any way I could determine, because they (especially Barbie) were excited that I was calling from New York, and my association with Kathryn Hunt ensured their willingness to speak with me. My contact with Mrs. Smith surprised me in its intensity. When I said something to her about how impressed I was by her struggle to keep her family together, she began crying and spoke almost nonstop for at least 10 minutes. It was hard to understand everything she said because of her sobbing and her clipped, rapid speech; nonetheless, I sensed her strong need to reveal some of her own sad history and to vindicate herself. I shared with her my feelings of regret that I was so far away and therefore unable to offer any firsthand assistance to the family. This did not seem to trouble Mrs. Smith, as her opening up to me seemed to serve the purpose of ventilation rather than to indicate any expectation that I would help. I experienced Mrs. Smith as being very accessible to forming a helping relationship and would not consider her as “reluctant” or “uninvolved” when she engaged with someone who listened to her with empathy. Initiating Relationships with Child Clients In beginning work with a child client, the practitioner needs to set the tone for a type of adult–child relationship that is different from others the child has experienced. The child usually expects the worker to relate to him or her as a teacher or parent usually does, with corresponding expectations about how the child should “behave.” Because the nature of the helping relationship is so very different and unfamiliar to most children, it is the worker’s responsibility to say something to the child, in language that the child can understand, about the nature of the helping process. A statement about who the worker is (“I’m a [lady, man, doctor] who helps children and parents with their troubles and worries”) and about how the worker will help (“Sometimes we talk, and sometimes we play”) gives the child the framework for this unique relationship, even though he or she probably does not comprehend it fully. It is also important to have some preliminary discussion with the child regarding the reason for the child’s contact with the worker, as this has usually been a source of conflict and anxiety for the child and the family. Children, like adults, deserve to be treated with honesty and respect as the basis for an effective helping relationship. Using Toys to Engage and Work with Children As will be apparent in many examples of intervention with children in this book, the preferred method for engaging and working with children involves the use of toys and play. Most children have limited verbal abilities, but they communicate their worries and anxieties very graphically through their play. Therefore, it is essential for social workers to have familiarity with and a degree of comfort in using toys with children so that they can interact effectively with their young clients (Webb, 2007, 2011, 2015). I have conducted workshops across the United States and abroad focused on helping social workers and other practitioners learn the rudiments of communicating with children through the symbolic language of play. Although mastery of the complexities of play therapy requires specialized knowledge and training, I believe that every social worker can and should have some minimal knowledge about working with children using play techniques. Given the likelihood of having to work with young children in family sessions or in schools, foster care, residential settings, hospitals, mental health agencies, and family service agencies, social workers must be prepared to use both verbal and nonverbal communication in their interactions with child clients. Figure 3.3 lists the basic play materials that should be available in every office to facilitate appropriate interactions with children, and the Appendices list some suppliers of these materials. Students who are beginning their careers and expect to work with children should acquire play materials that they can carry with them in a tote bag, so that they will not be dependent on the presence of supplies in the various offices in which they are doing their internships. In previous publications (Webb, 1999, 2007, 2015), I have reviewed various play materials and their use in work with young clients. In this book, examples of the use of drawings Trying to engage young children in a helping relationship without the use of toys and play materials would be as unthinkable as trying to communicate with a deaf person without the use of sign language! A young child may have a rudimentary understanding of verbal communication, and a hearing-impaired person may be able to communicate in writing or may have some knowledge of lip reading, but neither situation respects the basic principle of “starting where the client is.” Children (and the physically challenged) have too often been overlooked and treated like inferior beings. The concept of “adultcentrism” (Petyr, 1992; Tyson, 1995) calls attention to the fact that many practitioners expect children to respond as if they were adults. It argues that children should be accorded the rights that are due them, beginning with the use of communication methods (i.e., play) that are “user-friendly” to child clients. Relationships with Other Professionals Any social worker who provides services to children will, of necessity, have reason to interact with other professionals. Depending on the circumstances of the case, it may be necessary and appropriate to collaborate with the following range of persons who may have contact with the child: • The child’s teacher • The school psychologist • The child’s special education teacher • The child’s physician • The child’s caseworker/guardian ad litem (i.e., a lawyer or other individual assigned to protect the child’s legal interests) Necessary procedures must be followed prior to any discussion with other professionals. A social worker must have signed releases from a child’s parent(s) prior to engaging in any contact with others involved in the case. In addition to obtaining these releases, it is a good idea to discuss with the parent(s) just how much information about the family they are comfortable having the worker disclose (Wachtel, 1994). For example, parents may understand the importance of the worker’s learning about test results (either medical or educational) to clarify the agreed-upon purpose of helping their child with self-esteem issues. However, they may not see the utility of the worker’s sharing information about his or her psychosocial assessment and intervention with school personnel. Wachtel (1994) points out how helpful it can be for the teacher to be able to reinforce certain goals with the child in the classroom, so that the teacher, parents, and worker are all emphasizing the same objectives. When this approach is presented to parents as in their child’s best interests, the parents usually will permit the worker to use his or her professional judgment regarding what to share with others. When working with families of diverse cultural backgrounds, the worker should be aware that the family may feel shamed because of the child’s problematic behavior, and/or they may be very uncomfortable about revealing details about the family members, especially when different children may have different fathers and/or when the family resides with grandparents or other relatives. As mentioned in Chapter 1, social workers should be sensitive about cultural differences and try to learn about the values and expectations regarding parent–child behavior in the specific family with which they are working. As a rule, a worker should exercise restraint about sharing family information that is not directly related to helping the child. Other professionals do not necessarily subscribe to the same code of confidentiality as that of the social work profession, and once personal matters move into the “public” domain, the clients’ right to privacy can no longer be guaranteed. A continuing focus on the purpose of sharing information will help determine what and how much to share; the best interests of the clients should be the guiding ethical principle in each instance.