Social work in rural communities and small towns

Social workers based in close-knit communities often live alongside the people they support. How should you react when your personal and professional worlds meet, asks Rosie Walker 

When Anne Mathison, adult social work team manager for Orkney Islands Council, was being treated in her local hospital for septicaemia, her main concern was her health.

But the Orkney Islands have a total population of just 20,000 people, so she was not surprised when the surgeon came to her bed to ask her advice – on another patient. “The client had a mental health issue that I knew about,” says Mathison.

“It’s impossible to avoid these situations here. Once I felt a bit better, I had to get up to help another patient with dementia back to her bed. I’ve been chased along the street by service users, and I’ve had people come to my door. In a small community like this, it’s expected that people do things for each other whether you’re in work or not.”

According to Colin Turbett, author of Rural Social Work Practice in Scotland, urban social workers rarely live in the areas where they work, and most make a conscious choice not to.

But for social workers in small communities, “dual relationships” – when a social worker might also be a neighbour, a friend of a friend or even a family member of a service user – are unavoidable. But, short of leaving the house in disguise, what can a social worker do to handle it?

We asked practitioners and regulators how they would handle typical “small-town social work” scenarios.

What if my children go to school with a service user’s children?

Working with children and families can be the most difficult area of social work in which to manage the overlap between personal and professional lives, says Mathison, because there’s often an adversarial nature to the work. She advocates a multi-agency approach. “Rely on your colleagues in education to be alert to problems, and use the other parts of your close knit community.”

No social worker would divulge details about a service user’s case to their own children, but nevertheless, word gets around. In his book Turbett describes a scenario in which a social worker overheard two schoolchildren discussing, incorrectly, the fate of another child.

Setting the children straight may have been in breach of the client’s confidentiality, he says, but using a phrase like “don’t believe everything you hear” would be wise.

What if a homeless person known to me is sleeping on the street near my house?

“If you see a service user in public, the general rule is not to initiate any conversation; take your cue from them,” says Angela Gregg, an MSc social work student at Brighton University who works in a rural part of West Sussex.

“If you go and say hello to them, you’re revealing that they’re a service user to whoever they’re with. So you’re breaking their confidentiality, no matter what service it is.”

Gregg was working at a residential rehabilitation centre for homeless people with drug addictions in Worthing, West Sussex, when she saw a former resident begging on the street where she lives. He had left the centre after he relapsed, but as his key worker, Gregg had worked with him closely. “I would cross the road to avoid him,” she says.

“Once, he was sitting next to a cash machine that I needed to use, and I had to run down the street to use a different one. It was partly in his interests, because I didn’t think he would want to talk to me, but I also didn’t want him to know where I lived – I could have become a target.”

Gregg says where a social worker lives is always taken into account when cases in small villages are allocated, but unexpected meetings still happen. “You don’t have to be completely cold; if a service user approached you in a pub you could say hello, but then you should excuse yourself and leave.”

What if a service user turns up at my door?

This can happen if service users have misunderstood where the boundaries lay, says Mathison. As the Orkney team works a 24-hour emergency rota, it is easy for service users to assume that all workers are available all the time.

“If people are really in difficulty, we might have to deal with it on the doorstep,” says Mathison. “But usually we tell them that we’ll call them the next day, in working hours. One social worker, who works on one of the smaller islands, uses her husband to screen phone calls.”

Turbett points out that in failing to draw proper boundaries, a social worker can make life harder for their colleagues. The extra attention they are offering might be similarly expected of other workers and by other service users.

He suggests raising the issue when meeting a service user for the first time, agreeing on boundaries together and planning what to do in the event of an unintended meeting.

What if I know the service user in a personal context?

A social worker and anonymous contributor to CareSpace, Community Care‘s online discussion forum, describes a home visit she made to assess a service user’s health needs. When the woman went to make a cup of tea, the worker looked at a wedding photo hanging on the wall, and was shocked to discover that the user’s husband was in fact her ex-partner.

“It made me very anxious, but in the end I told her and we laughed,” she says. Although the service user said she did not mind, the practitioner thought it would be wrong to continue, and asked to be taken off the case.

Mathison has had a similar experience. “I took a duty phone call, and within minutes realised who I was speaking to. I aborted the call and asked one of my team to take it on. But if there hadn’t been another colleague to take the call, I would just have had to do the best I could. I probably wouldn’t allude to the relationship or the complication; I would just deal with the matter in hand.”

What if I went to school with a service user, or know something that could help their case?

Sometimes, it can be in a service user’s interests to pass on information picked up outside of work, whether from the past or the present. “I once had a service user whose father went to school with a local police officer I was working with,” says Mathison. “What he told me about the service user’s childhood was enormously useful. Some might see that as intrusive, but it helps to have a picture of how they became the person they are.”

Gregg agrees. “It’s OK to report things you saw in public – for example, if you saw someone with alcohol problems buying litres of vodka. If you’ve seen it, you can’t undo that – and it’s not as if you’re stalking them.”

Turbett points out that gossip in small communities can be both a positive and negative force. “It keeps information and news in circulation and shapes community approval or disapproval of the actions of others; it thus performs a social regulatory role,” he says.

In some circumstances, like a child protection case, the worker may have a duty to report something they’ve seen. But, he warns, in other circumstances discretion is important. “While we should not act on gossip we might want to take information back to a service user to check things out with them,” he says.

Gerry Evans, director of regulation and standards at the Care Council for Wales, warns against seeking to access information for personal use, by using the title of social worker.

“There is a constant need for social workers to maintain the boundary between their personal and professional lives,” he said.

Published in 7 April 2011 Community Care under the heading Keeping a Low Profile

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