Reflections from twenty years ago about relationships in care settings.

Involvement and detachment

Fears that a member of staff is "over involved" with a resident may lead to gossip among colleagues, the alienation of the staff member and the resident within the community (a sure way of strengthening the bond), or even a warning from the head of the home.

On the other hand, references and student reports sometimes note a reluctance on the part of the worker to "become involved", the inference being that he has thereby been less effective as a member of staff.

Hoping to indicate the ideal level of concern we have coined a number of phrases, for example, "controlled emotional involvement" and "meaningful relationships", both of which, I feel, should be used sparingly. In talking about real people, their likes and dislikes, their loves and hates, these expressions seem out of place, assuming as they do that, by means of simulated experiences, residents will thrive on what the rest of the world would reject.

"Semi-detached"

I wonder whether a recent advertisement for staff in children’s homes in a London borough is more helpful. Under the heading "semi-detached’ we read the following:

"When you’re a residential worker you have to maintain some degree of detachment. However close a relationship you might form with a client – and close relationships are often very important – the ultimate goal will always be a reduction in clients’ dependence on you. If they are eventually to realise their own independence, you have to keep a discreet distance. In [our local authority] we understand the problem ... within our children’s homes we have nurtured a warm but nevertheless semi-detached approach. It’s often referred to as a professional approach, and it’s a professional approach that works."

The heading "semi-detached" is certainly eye catching (and the passage contains many elements in line with good child care practice), but I am left wondering whether the advertisement drawn up by that particular local authority was born of a series of unfortunate incidents between staff and residents which now require new limits to be set. In living and working with young people, in helping children to move towards adolescence, and from adolescence to adulthood, is it possible to remain "semi-detached"?

Furthermore, this boldly stated goal of independence is stark in its isolation. We must bear in mind that independence grows out of dependence; that too hastily and too highly developed independence is not a trait to be encouraged; and that a healthy state of interdependence is one of man’s most desirable characteristics.

I am sure that many residents – young or old, handicapped or non-handicapped – are living in homes, schools and hostels because nobody has ever become involved with them, or because the personally satisfying involvement they once knew has, for whatever reason, been lost.

We can all identify those who seem to be withdrawn, belligerent or depressed, and altogether out of touch with the normal cut and thrust, and joy and pain of everyday exchanges with other human beings for whom a special part of life is reversed.

I have little confidence that the needs of residents experiencing these depths of feeling (and, after all, some of them would not be living away from home had they been able to sustain "normal" relationships) are best met by the formally stated "semi-detached" approach. This is especially when, at the same time, we may be cocooning an individual from the extremes of intimacy with other residents and perhaps have to accept that his family network is no longer accessible to him.

Involvement

If a person is to survive, and later to thrive, he cannot live in emotional limbo. Life, in fact, is all about involvement. Involvement is about making links with a person or people who will go just that little bit further along the road with you, regardless of prescribed duties or institutional boundaries.

Even within my belief for the need to guard against exploitation, I realise that I am moving into dangerous ground. Examples can be given where such involvement has been disastrous for the resident and the staff member. Equally though, other instances show that, with safeguards, staff licence for a special relationship between a colleague and a resident will be acknowledged and approved by other residents, provided that their own needs are being met.

Sooner or later, and most appropriately, a person’s need for involvement will hopefully best be met outside the home, although too often staff seek to place unnatural restrictions on residents as they explore and expand their circle of contacts.

There will always remain occasions when what a resident lacks in order to move forward, to come alive in the best sense, is the "enduring irrational involvement of another person", a phrase attributed to Urie Bronfenbrenner. Sometimes the staff member will find himself caught up in the chemistry of responding to this need, undoubtedly having some of his own needs satisfied at the same time.

In a cloud of strong emotion, of mutual concern, man’s ingenuity knows no bounds, and I can recall two agonising instances of "involvement". In one case the staff member and the resident were eventually married and, in the other, a man in charge of a children’s home "adopted" a 13-year-old boy in his care before leaving to take up employment elsewhere.

Rumour was rife in the departments and there were those who saw only evil about them, but for the people concerned the relationships were real and, as far as I know, as successful and rewarding as any others.

Faced with an incident of "involvement" it may be that our own fears and actions (and not the involvement itself) will precipitate the very outcomes we have worried about. Time and the changing pattern of human relationships may bring about a natural resolution without rancour and harsh intervention. For me, one important question must be: Is the hurt we impose greater than the hurt that seemingly exists? If so, perhaps we should leave well alone.

Leonard Davis was a lecturer in Social Work, a regular contributor to social work and educational journals, a Consultative Editor to Social Work Today, and author of Residential Care: A Community Resource (Heinemann/Community Care), 1982.

Social Work Today 11 (45) "Involvement – is it always a bad thing?"