Daniel Lombard considers the ethical dilemma faced by social workers when transferring a case to another professional
Social workers are in the business of building relationships with service users based on empathy and respect, but what happens when it’s time to close a case or pass it on? Saying goodbye to a service user you have developed a strong relationship with can be difficult.
Handle this insensitively, and you can cause untold emotional damage to the client; on the other hand, maintaining contact with service users you are no longer working with could lead to a blurring of professional boundaries.
So how should social workers go about ending working relationships with service users in a sensitive, professional way?
Judy Hicks, social work lecturer at Anglia Ruskin University, believes skills-development in this area is often missed in social work training, and hopes the review of social work practice by Professor Eileen Munro will address it.
Sometimes, abrupt endings of working relationships may be driven by resource constraints, causing social workers to question the decision. It can be hard for some practitioners to let go, especially when they believe the individual or family is still in need of support.
For example, a social work student on Community Care’s online forum, CareSpace, told how she bumped into a service user she worked with during her second placement a few months after her case had been transferred to another worker.
The student agreed to continue helping her after the woman explained that the new worker hadn’t visited her, and made some calls and arranged for more support on her behalf. “I did that because I’m human and cared about her, and she knows I do. She knows she can contact me when she needs help,” the student wrote.
Other forum users suggested her actions were naïve at best and at worst, unprofessional. “Having to move on is the nature of the beast,” one wrote.
Maintaining contact with service users outside one’s official remit could be damaging for both parties. It could foster a culture of dependency and lead to breaches of the code of practice for social care workers, according to Hicks.
At the other end of the spectrum, when a working relationship is ended insensitively, the experience can prove traumatic for the service user, leading to feelings of loss and abandonment, Hicks says.
“We cannot expect this ethical dilemma to be understood by a service user who may be isolated, lonely or dependant on the social worker for some degree of social communication,” says Hicks.
The relevant parts of the code of practice that should be upheld are respecting service users’ needs and dignity, supporting their rights to control their lives, and establishing and maintaining the trust and confidence of service users.
The academic points out that the “very nature of the social work relationship is complex, multilayered and necessarily involves an emotional element”, and the needs of some service user groups, such as looked-after children, demand “sound, consistent and reliable relationships” with professionals.
“These don’t spring up overnight and take time and skill to be bring about successful outcomes,” she says.
The important thing social workers need to understand, says Hicks, is the “difference between a healthy, boundaried longer-term professional relationship and a loose, unstructured, unclear ‘friendship’ which threatens the safety of all involved, the value of the codes of practice and ultimately undermines the status of the profession”.
How to end a working relationship with a service user
Establish a contract
The social worker should establish a contract with the service user as part of an effective working alliance at the beginning of any relationship. You are not a friend to the service user; it is not an open-ended relationship and it will be focused on clear objectives within a limited time frame, with the ultimate aim of helping the service user take control of their own life.
Don’t make promises you can’t keep
It is important for practitioners not to make promises or false reassurances to service users about what you can deliver. This can lead to a blurring of professional boundaries and unrealistic expectations of the social worker from the user.
Ensure communication with the service user is transparent throughout the relationship. Don’t assume the user understands how long the social worker will have contact with them. Review the progress of your relationship regularly and recognise the service user’s progress.
Plan the ending
Plan with the service user how they will access support after your relationship ends and ensure a smooth and sensitive transfer of the case to another worker or agency if required. Aim for a face-to-face meeting with the new worker; if not, then effective communication by email and telephone must be used.
Be prepared for a host of different responses as your work nears termination phase; do not underestimate the part you’ve played in someone’s life and accept that some resistance, challenge, fear, distress or confusion may go alongside the process of saying goodbye.
Be aware of your own feelings
Understand how personal experiences of endings may affect how you work. For example, a difficult ending in your life may lead you to rescue service users rather than assisting them to help themselves. Be willing to explore in supervision how my character traits may affect my boundaries. For example, “do I need to be needed and will I consequently find it difficult to let go?”.
Take part in our quick-fire quiz to test your skills and awareness around ending a working relationship with a service user.Source: Sally Riggall, lecturer in social work, University of Lincoln, and Judy Hicks, senior lecturer, Anglia Ruskin University
Case Study: ‘She shouted at me and swore a lot’
Daisy Bogg, an approved mental health practitioner and social work consultant, reflects on the lessons she learned as a newly qualified social worker on ending relationships and transferring cases.
“I qualified as an approved social worker in 2000 and Sam*, 19, who had been in mental health services for four years, was one of my first cases. Sam had a history of suicide attempts and sexual abuse, coupled with a troubled family background, and was viewed as high risk. But, over time, Sam and I built up a relationship. It was often difficult and distressing, for us both, but had become something she relied on. After a couple of years I was due to leave the team. I went to see her and told her I was leaving my job and moving away and her case was being transferred to another worker. I wasn’t prepared for her extreme reaction.
“She was angry, felt betrayed and blamed me for being yet another person to abandon her. She shouted at me and swore a lot. Her self-harming behaviour escalated and she was detained under the Mental Health Act.
“Although this reaction was a symptom of her condition, it said more about how much value service users put on the relationships they form with their workers – a value which in this case I neither appreciated nor understood until it was too late.
“I felt incredibly guilty and it played on my mind for a long time afterwards. I felt it was my fault that she had deteriorated, but I realised later that that was what she wanted me to feel.
“A couple of years later I was allocated to Tracy*, 21, who again had a history of self-harm; she would starve and cut herself. As with Sam, Tracy had experienced abuse and used alcohol to mask her feelings. Tracy also had a troubled family past – her father had died suddenly which left her feeling abandoned. I had learned from my experiences with Sam: from the outset I was clear that our working relationship was time-limited. When the time came to transfer her case to another worker, I went to see Tracy and told her I was going. I met her after that to review our progress and discuss the next steps. The ending was based on a mutual sense of closure.
“So what did I learn from these two cases? First, the winding down of a working arrangement can be just as powerful as a beginning, and this needs to be acknowledged from the outset. If closure is dealt with throughout it becomes a more natural process – loss may be inevitable, but it can be a positive one. Second, the value an individual places on the relationship with their worker needs to be acknowledged. In some cases it may be the only stable influence in their lives and it is easy for busy social workers to miss that fact.
“Tracy looked me up on Facebook six months ago and told me she was working as a support worker in a sheltered housing project. I felt proud that my intervention might have helped her along the way, but it was her work, not mine.”
* Not their real names
This article is published in the 28 October issue of Community Care magazine under the heading How to say goodbye
Take part in our quick-fire quiz to test your skills and awareness around ending a working relationship with a service user.