How Theories Obstruct Or Assist Practice Social Work Essay

Published Date: 23 Mar 2015

A requirement for Social Work Training is to "ensure that the teaching of theoretical knowledge, skills and values is based on [students'] application to practice" (NHS, 2002 p.3). In response to the death of baby Peter, the Social Work Taskforce published fifteen recommendations including social work degrees requiring a "greater focus on linking theory to practice" (DCSF, 2009 p.18). This increased emphasis between theory and practice, will be considered in this essay, by discussing if theories of human growth and development obstruct or assist social workers practice.

It is important to recognise that there are a vast amount of human growth and development theories, which cover the life span, although one assumption is that they only relate to childhood. This essay, in considering how theories obstruct or assist practice, will draw on those relating to working with older people. To clarify, this essay will use the word 'theory' to mean both 'grand theories' (those borrowed from other disciplines such as psychology, sociology etc) and 'middle range theories' (those which combine the grand theories with practice experience) (Wilson et al, 2008 pp.106-107).

The history of social work is helpful in understanding how theory became relevant for practice. The nineteenth century industrial revolution impacted on the community structures, which led to concerns over social unrest and disorder. These concerns influenced the growth of the social sciences with the idea being to understand and change society. Howe states, "as new theories and explanations of human behaviour were generated by psychologists, so new social work theories and practices arose" (Howe, 2009 p.17).

The Charity Organisation Society (COS), founded in 1869, embraced the psychological theories in their charitable work. COS initially resisted any formal education for charity workers preferring supervision in the job. However, worries over the standard of staff and the impact of the job on them, together with the desire to be recognised as professionals in the social field initiated them to set up "formal social work education" (Howe, 2009; Payne, 2005b; Jones, 1996 p.191). The value of teaching human growth and development theories to social work students is still recognised today in university courses. Teaching on theory is included in the education as it is seen to legitimise social work, giving the social worker assurance, significance and understanding in their work "without any taint of meddling" (Jones, 1996 p.193). The use of theory helps the practitioner to feel that their views are knowledgeable and grounded (Milner and O'Byrne, 2002). Secker's research on social workers students found that those who had a comprehensible understanding of theory were more likely to be approachable and responsive with their service users, sharing their theoretical suggestions with the person (Howe, 2009; Payne, 2005a).

Alongside this, is the professionalism a theoretical knowledge gives to social work (Howe, 2009). Thompson (2010) argues that other professionals and service users will be more confident in a social worker who is able to demonstrate that their work is based on a theoretical framework, thus showing skills to comprehend and make sense of the service users situation, rather than one who conjectures. Walker states, "it is important that social workers have an understanding of human development to work effectively with other disciplines and to demonstrate a professional literacy commensurate with their status" (2010, pp.xiv-xv). An example of this is a social worker working within a Community Mental Health Team alongside Psychiatrists and Community Psychiatric Nurses who advocate the medical model and "its emphasis on diagnostics and cures' (Parrish, 2010 p.10). Working in this setting does not mean that the social worker needs to ignore a psychosocial perspective. To advocate for service users effectively, the social worker needs to understand both the medical and psychosocial perspectives, as Parrish states it "necessitate[s] the professional equivalent of being 'bilingual' in being able to understand both perspectives simultaneously" (Parrish, 2010 p.10).

In 1992, Hindmarsh's research on social work graduates, showed that an understanding of theory did provide the graduates with confidence. However, Hindmarsh argued that this confidence did not continue in practice as graduates viewed the use of theory as just a tool to justify their actions or provide accountability to their management (Payne, 2005a). Thompson argues that the professionalism of the social worker is being impacted on by what he describes as 'managerialism' (2010, p.51). Thompson explains that government's budgeting tactics through 'performance indicators' is pushing local government to meet targets. This is filtered down the management structure, so that middle managers are dictating what is required and should be implemented by social workers, in order to achieve the targets. Although social workers are dedicated to the use of theory in their practice, managerialism has led to them lacking 'professional confidence' (2010 p.51).

It is argued that theory is too complicated and restricts spontaneity, therefore it is pointless for practice. Instead a more realistic model of using facts about the person, an understanding of the law and practical skills ('common sense') is more effective for social work practice (Parrish, 2010; Walker and Crawford, 2010). This view has been strongly argued against, as Coulshed states, "theoryless practice does not exist; we cannot avoid looking for explanations to guide our actions, while research has shown that those agencies which profess not to use theory offer a non problem solving, woolly and directionless service" (1991, p.8). Some theories become so familiar and accepted that they become incorporated into everyday life and language, for example, Anna Freud's defence mechanisms and Daniel Levinson's mid-life crisis. By the fact that these theories become so socially accepted and embedded into everyday language (described as 'informal theory'), it is difficult for a social worker to avoid using it in their practice. Thompson argues, "some sort of conceptual framework (and therefore theory) is therefore inevitable" (2010, p.7).

Our own life experience does not provide us with sufficient knowledge to be able to help others. It can cause us to filter assessments through our own experience, which may be prejudicial but we could be unaware of this. An advantage of having a theoretical understanding of human growth and development is that it gives us a broader view than our individual life experience and balances decision-making (Walker and Crawford, 2010).

Research has shown that social workers have found it difficult or are unaware of how they apply theory to practice (Tanner and Harris, 2008; Smid and Van Krieken, 1984). Therefore, work is a routine 'procedure' for social workers if they do not have an understanding of theory (Parton, 1996, p.92). Social worker education is blamed for this difficulty with universities either being too theoretical, or too practical, whichever emphasis taken, it results in making theory and practice appear as separate entities (Smid and Van Krieken, 1984).

The different theoretical approaches to human growth and development can appear confusing to the social worker, as each stress different areas as a reason for the person's situation. An illustration of this is the process of 'ageing': a biological perspective is to focus on the physical impact of a person growing older; a psychological view however, will focus on the deterioration of cognitive functioning; and finally a sociological perception will look at the social structures and the older person's place in that structure. As Hughes states, "The images created by the various theoretical perspectives - biological, psychological, sociological, political-economic - are intrinsically different and create quite distinct pictures of the experience and social condition of older people" (Hughes, 1995 p.18). Although each approach emphasises different areas, they all potentially provide something helpful and 'equally true' (Milner and O'Byrne, 2002 p.81). With each approach providing something useful in understanding the person's situation the social worker needs to support the service user in finding which one with be most helpful to use (Milner and O'Byrne, 2002). However, rather than seeing this confusion as a hindrance to social work practice, this is what is central to social work. It is what gives it its value and importance "because it specialises in situations where there are no known solutions" (Statham and Kearney cited in Howe, 2009 p.190). It is the ability of the social worker to draw together the various theoretical perspectives in order to prepare a realistic and balanced care plan.

There are development theories that are in direct conflict and/or dismiss each other such as 'Disengagement' and 'Activity' theories (Hughes, 1995; Howe, 2009). Disengagement Theory proposes that as someone ages they naturally disengage from certain social roles and functions, which "ensures continuity of the system and equilibrium between different social groups" (Hughes, 1995 pp.25-26). Disengagement was viewed as fulfilling for the older person and providing well-being, as it freed them from certain roles and functions that they no longer were able to fulfill, such as retiring from work, thereby, helping people to age well (Hughes, 1995; Bond et al, 2007). Activity theory completely opposes this idea and proposes that remaining actively involved in the community, both physically and mentally, provided well-being and satisfaction for the person (Walker and Crawford, 2010). Both theories provide definite explanation for the difficulties in getting old.

The activity / disengagement debate has led to a number of further theories either trying to resolve the conflict, such as Gubrium's socio-environmental approach, or challenge one theory to support the other, such as Cowgill's modernisation approach (Lynott and Lynott, 1996). The practitioner's dilemma is similar, should they align themselves with one or disregard both theories.

A danger for the social worker is that s/he uses theory as a way to discover 'the truth' or ultimate solution for the person (Thompson, 2010, pp.11-12). Lee argues against this, "theoretical statements are the general principles that give rise to hypotheses, or speculative facts" (1985, p.22). No person or situation is exactly the same which means neither can there be a universal solution or theory to fit all (Lees and Lees, 1975). A postmodern view is that truth cannot be found in one solitary theory, instead a plethora of truths for a particular situation can be found in using multiple theories (Milner and O'Byrne, 2002). As Pease and Fook cited in Howe state, "There are many perspectives and voices and it is now recognised that they all need to be heard if the complex nature of 'truth' is to be established" (2009, p.191).

Walker (2010) argues that a person's growth and development cannot be clarified by one theory. Parrish takes this further by stating that if a social worker's practice were based on one theory it would "prove woefully inadequate" (2010, p.6). An alignment to one specific theoretical viewpoint can be dangerous, as the social worker is unable to recognise important issues that do not correspond with that particular viewpoint. For example Erikson's 'eight stages of development' although helpful in understanding age related activities, has been criticised for its male, patriarchal stance in lacking awareness of other factors that can impact on development, such as gender, race, social class etc. (Thompson, 2010; Parrish, 2010). This highlights the value of recognising and critically analysing a number of theories in a situation, rather than believing one is more superior to another. As Thompson illustrates, "the reflective practitioner being a tailor cutting the cloth of the knowledge base to produce a closely tailored solution to the practice challenges being faced, rather than looking for a ready-made, off-the-peg solution (2010, p.16).

A social worker may consider amalgamating a number of theories so to provide one combined theory, which Payne describes as 'eclecticism' (Thompson, 2010 and Payne, 2005a p.31). Eclecticism has been criticised as an inexperienced way to use theory (Payne, 2005a). Instead the current view is to take a critical, reflective approach, using the person's history, behaviour and circumstances. Theories should be considered and weighed up as to their usefulness for each person (Adams et al, 2009; Thompson, 2010). "Using a range of theories allows a multi-dimensional understanding of situations ... to develop and enables the limitations of one perspective to be offset by the advantages of another" (Tanner and Harris, 2008 p.37).

By taking a critical and reflective approach to theory and practice this can help the social worker make sense of the differences and disagreements between the various human growth and development theories (Payne, 2005a). A critical and reflective approach, allows the social worker to value and accept the variety of theories applicable for a particular situation (Adams, 2009). As Fook argues, "critical and postmodern practice therefore involves a recognition of different ways of knowing, in particular a reflexive ability to engage with changing situations" (2002, p.44).

According to Thompson (2010), the main significant purpose for applying theory to practice is that it defines our practice. Misca states, "knowledge of human growth and development plays an essential part in assessing, planning and intervening in a successful, positive way in people's lives" (2009 p.116). Fook describes using theories, "as our intellectual tools, rather than as rule books" as they assist and direct practice (2002, p.69; Walker and Crawford, 2010). This means that a theoretical knowledge can provide a practitioner with the understanding and explanation of a person's behaviour and situation. Consideration of Bowlby's Attachment theory with aging and dementia will be used to illustrate this. Bowlby stated that typically within the first 9 months of a person's life, they develop an attachment to their 'primary caregiver'. Ainsworth, working alongside Bowlby, extended attachment theory. Through the 'Strange Situation' trials, she proposed three types of attachment behaviours: Anxious/Avoidant, Anxious/Resistant and Securely Attached (Parrish, 2010). Although Bowlby did not carry out any studies on older people, he did argue that, "attachment behaviour continues to play a necessary role into adulthood" (Browne and Shlosberg, 2006 p.135).

It has only been since the late 20th century, that Bowlby's attachment theory has been applied throughout the human lifespan and in particular to dementia (Bond et al, 2007). Bowlby suggested that when adults are unwell or under stress then attachment behaviour is likely (Browne and Shlosberg, 2006). Miesen, an advocator for attachment theory, researched the general behaviours of people with dementia. He likened a demented state of 'crying, clinging and calling' as being in Ainsworth's strange situation (Bond et al, 2007). Miesen researched 'parent fixation' which is when a person with dementia believes that his/her deceased parent is still alive. His study concluded that dementia triggers attachment behaviours (Browne and Shlosberg, 2006). De Vries and McChrystal state, "Bowlby's attachment theory has provided a conceptual and empirical framework for examining some behaviours of people with dementia and provided a means of interpreting them in terms of responses to loss" (2010, p288).

A theoretical knowledge also provides solutions for approaches of intervention, to assist the service user and enables the practitioner to anticipate future issues (Parrish, 2010). Continuing to use the above example, two new ways of working within an attachment theory framework have recently been developed to assist working with people with dementia: simulated presence therapy (SPT) and 'doll therapy' (Browne and Shlosberg, 2006).

The difficulty for the social worker is that separate theories can lead to different approaches to practice, so that the social worker has to choose which is the right one (Walker and Crawford, 2010). Milner and O'Bryne (2002) argue that the theory, which provides the greatest insight and leads to an approach that meets the service user's objectives, is the one to use. The problem with this is who decides which is the theory that gives the greatest insight, is it the social worker or managerial/government decision. If it is the latter then it disempowers the social worker. However, if it is the former it is dependent on the knowledge base of the social worker.

Beckett and Taylor explain, "Fortunately or unfortunately, no theory about human life can ever be completely objective or value free" (2010 p.4). Human growth and development theories have been criticised for reflecting the dominant beliefs of the theorist's society. As Thompson states, "Theorising is by no means a 'pure' activity, detached from the reality of the social and political world" (1995, p.32). For example, Erikson, Levinson and Havighurst's theories on adult stages of development have all been criticised

This essay has noted some theories of human growth and development in aging. However, it is also important for a Social Worker in his/her practice to acknowledge that service users will have their own ideas to explain their circumstances and behaviour. As Gubrium and Wallace explain, "We find that theory is not something exclusively engaged in by scientists. Rather, there seem to be two existing worlds of theory in human experience, one engaged by those who live the experiences under consideration, and one organised by those who make it their professional business systematically to examine experience" (cited in Tanner and Harris, 2008 p.36). Erickson emphasised the need to look at a person as an 'individual' and therefore, a social worker in his/her practice needs to take this into consideration, rather than trying to get a theory to fit the person's situation (Milner and O'Byrne, 2002). It is important for the social worker to be aware of anti-oppressive practice in considering a theoretical framework by not taking into account the service user's views. S/he needs to be aware of his/her professional power and also the need to empower the service user in making decisions and changes (McDonald, 2010; Thompson, 2010).

As shown, having a theoretical understanding of human growth and development can assist social work practice by legitimising the work done, giving the social worker confidence and providing a framework for the work. However, it is not the theoretical understanding itself that hinders practice but instead the application of the theory. Theory in practice is hindered by managerialism, the danger of anti-oppressive practice and limitations of social workers knowledge and experience .