By Richard Devine, Social Worker for Bath and North East Somerset
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These are five books that have profoundly influenced my social work practice. These books have been selected for their practical usefulness in our endeavor to be better, more effective social workers. I have not listed them in rank order. So far I have Working with Denied Child Abuse by Turnell and Essex, Effective Child Protection by Munro, The Boy Who Was Raised as a Dog by Perry and Szalavtitz and Raising Parents by Patricia Crittenden. Now, last but certainly not least, the final book.
One line review: An enjoyable, impressively engaging and highly accessible book outlining philosophical and practical ideas of motivational interviewing applied to child protection.
What I learned reading this book: This is the most recent book I have read out of the five, (and wrote a review when I originally read it last year). I was immediately impressed by the practical ideas and tools offered and the fit between the ideas of MI with challenges of child protection.
In social work, a great deal of relationship-based practice has derived its ideas and principles from counselling and psychoanalysis. However, an overlooked and fundamental challenge in applying these concepts to statutory social work is that most parents we work with don’t want us involved. In addition to resisting our involvement, many parents are resistant to changing the issues that result in our involvement.
Forrester, Wilkins, and Whittaker point out that as a result, much of social work practice is unintentionally antagonistic and fraught with conflict. In our well-intentioned attempts to help parents, research examining social work practice reveals that we often tell parents what the problem is and how we think they need to fix it. The authors refer to this as ‘the telling people what to do trap’ (p.101). It is understandable given the pressure social workers face in addressing risk and their distress at seeing how children are harmed. Unfortunately, however, this response is mostly ineffective, not least because it makes parents more defensive, not less and makes them more resistant to change.
I found this book especially helpful because resistance is a central concept within motivational interviewing, and this is also a defining feature of child protection social work. Resistance is to be expected, and thus the ideas and methods advocated for by the authors are organized around this basic fact. There are two key points in this book that really clarified an aspect of my work I found challenging, and helped to gain a more productive perspective.
Firstly, resistance is not just a product of the person but is also influenced largely by the relationship between the person and the worker. When practitioners adopt a direct, forthright view or challenge, parents will respond defensively, almost instinctively. Whereas, when practitioners adopt a non-judgmental approach and carefully attempt to understand a parent’s point of view, this decreases resistance.
Secondly, motivation to change is almost always characterized by ambivalence. Again, like resistance, this is normal and to be expected. In considering whether to change a behaviour, parents can often identify reasons not to change and reasons for change. Even when the behaviour is self-destructive or harmful to others, it usually has a self-protective function, even if not noticeable or evident. The authors provide a range of tools to help guide the conversation such that the aspect of the person that wants to change is supported, bolstered, and encouraged. This approach facilitates the parents’ ability to articulate the reasons for change, thus increasing the probability of change occurring as well as encouraging their autonomy in the change process.
Since I read this book, I have been much more sensitive to parents’ resistance and sought to understand and empathise with their position. I have also become more sympathetic to parents’ ambivalence (even towards harmful behavior for them or their children), understanding that it is part of the change process. I can better guide the conversation, encouraging them to explain the reasons for changing a behaviour. It is a subtle difference that significantly impacts the quality of the conversation I have.
‘When there are concerns about a child, it is easy to find ourselves telling parents what their problems are and what they need to do about them. In fact, we have heard this many times in meetings between social workers and parents…. One problem with this approach, quite aside from a lack of effectiveness, is that it often leads to (even) more difficult conversations, which sound more like arguments than ways of helping’. (2020, p. 21)
‘…a fundamental principle in MI is autonomy: the idea that people are far more likely to make changes when they feel in control of their choices. By prescribing the solution, we run the risk of making people feel that they are being told what to do. Second, even if we have some ideas about change, the person we are working with probably has better ones. At times, people’s ideas might be at odds with the go-to ‘service prescription’ in your agency. This might suit our needs as professionals by providing a quick fix and tangible solution, but it is important that any people we are working with first and foremost’ (2020, p.91)
‘A key axiom in MI is that people are more likely to be convinced by their own arguments than by those that you make for them and much of MI is about how to facilitate people to convince themselves to change behaviour’ (2020, p. 195)
A question: What has been the most influential book, in terms of practical usefulness you have read? Please get in touch or leave a comment below.
An invitation: If you read any book I recommend and you are interested in sharing your learning, I would love for you write a blog post. Just get in touch.
By Richard Devine (21.01.22)