Supporting people. Towards a person-centred approach by Peter Beresford, Jennie Fleming, Michael Glynn, Catherine Bewley, Suzy Croft, Fran Branfield and Karen Postle (foreword by Shami Chakrabarti), Bristol, UK, The Policy Press, Joseph Rowntree Foundation, 2011, 433 pp., £19.99 (paperback), ISBN 978-1-8474-2762-5
The function of this book is to elaborate on social work as a practice that is based on service user's or client's own views on what they need or want. The book deals with the concept of person-centred support as a basic tool for ideal social work. It is a question of an approach where clients are treated in a way that their own comprehension of their life situation and need for support is valued and respected. At the same time the client is offered more possibilities to influence the arranging his services, since the need for personal support will be assessed with the service-user himself involved in all stages of the process. The idea of personal-centred support is introduced as a new way of thinking, which has a considerable impact in quality of services, working practices and cultures and most importantly, on client's position as a service user. Within such an approach it should be possible to avoid uniformity in treating clients and planning their services.
The book has been written in collaboration with developers and researchers, who have carried out a long-term development project ‘Standards we expect’ during the years 2005–2009 in UK. The aim for the project has been to reinforce practices of person-centred support in social work for example with people with disabilities, mental health service users and elderly people. The authors define person-centred support as an approach where the traditional idea of caring for people should be displaced with the idea of supporting them. This conceptual change contributes to the principle of self-determination and people's rights to have more influence on their services.
The book consists of four parts, where the approach of person-centred support is widely discussed in the light of large amount of qualitative data. According to the authors, the aim of the book is to clarify what ‘person-centred support’ really means, what the main barriers are to such an approach in social work and how these barriers can be overcome. The aim and motives of the book are interestingly and properly justified, as the authors insist that social work should meet the challenges of contemporary society, where living conditions and environments are under constant social and cultural changes.
Qualitative data has been collected from managers, workers and their clients from different service sectors in UK. The interview data used in the book is valuable in itself for this kind of research work, but unfortunately such methodological apparatus that would validate the interpretations derived from data are not provided in the book. Every now and then the reader gets confused with the amount of interview extracts, which as yet are not properly analyzed. Sometimes the reader gets an impression of hastily made interpretations, where previous studies and theory are mixed with such observations of interview data that rather serve as first impressions than research results. For example, in Chapter 7, where organizational issues are considered, the connection between increasing bureaucratization and consumerism seem not to be based on thorough inspection on what this link means in the context of person-centred support and social work. The idea of consumerism is straightly derived from George Ritzer's idea of ‘McDonaldization,’ where consumerism is understood as an ideology, which is served by efficiency of production of goods with using detailed division of labour in the production process. The authors claim that consumerism is an outcome of increasing bureaucratization in the same sense as efficient production of goods, which can be a false interpretation in the context of social work. For example, according to research work done on the issue of personal budgeting, consumerism is understood as an ongoing tendency in contemporary societies, where market forces are widely made use of in the public sector of social and health services. In micro-level, these tendencies of service production provide the service-users social positions as consumers, which are seen as an important outcome of these new processes (e.g. Kremer 2006.) Therefore, when examining the impact of person-centred support in social work, the issue of consumerism should be discussed in the context of the changing positions of service providers, workers and service users and therefore changing power relations.
Arguments that deal with increasing bureaucratization where social work practices are challenged with the systems of person-centred support are yet important in this research. The idea that person-centred support takes the service user's views and desires into account in the assessment processes of their support and services has led to variety of paperwork through increasing requirements of regulatory bodies and funders, which paradoxically restricts the time the workers can actually spend with the client. These unwanted outcomes are important to discuss here, as well in further research work dealing with new client-based practices, since they tell about the actual resources that can be directed to these new arrangements in public sector.
The authors argue that the approach of person-centred support entails changes in social work practices, working cultures and interaction with clients. They argue that the clients would prefer such interaction with social workers, where they would feel to be listened to and their actual needs would be understood in the context of their life histories. However, since these kinds of interaction traits or patterns or qualifications are claimed to be necessary in person-centred supporting work, such argument can be stated that this book mostly deals with changing professional demands in the social work sector. In itself, the book offers a lot for a researcher whose interests are in the field of professionalization processes or changes in professional work.
Nevertheless, these perspectives of a new kind of commitment in the client's views are not new in the sense that client-based or individual-based social work has, in the past decade, been discussed in studies concerning social work practices. For example, the practices that are based on personalization are considered to entail certain ethical approach to client's life situation and assessment for his needs. Again they argue in those discussions, that these practices should provide new kind of expertise in social work. Such ‘anti-oppressive’ approaches in social work, which are based on ethical understanding are considered as morally demanding principles in contemporary society. These principles also change professional ethos and expertise (Clifford and Burke 2009; see Banks 2004). The authors seem to think that the professional theoretical expertise of social workers is not straightly accumulating from the life experiences of clients or from the solutions made together with the clients. The notion of ‘new expertise,’ where the client is considered to be a self-evident party in developing solutions for his life problems, is already introduced in social work, at least argued by many theoretical discussions.
Throughout this book that authors claim that such professional traits, where the client's own views are respected and valued, still need to be implanted in social work practices. Being based on rich qualitative data, the book shows in many interesting ways that such an approach cannot easily be taken into use in practical sense. Traditional working cultures, persistent ways of doing one's job, lack of time or other resources and finally, lack of professional quality and low level of commitment in the clients’ cases pose many obstacles. Based on thorough fieldwork in the social service sector, the authors discuss sharply the outcomes that these requirements of doing individual-based social work have revealed in different working practices. These observations are expressed in such a manner that the book seems rather to serve as a report of a development project than a research work, even though the authors appeal to its value as a research. Despite of the analytical shortcomings dealing with demands of qualitative research, the book offers an interesting scenario of professional changes in doing social work.
Centre for Research and Development, Finnish Association on Intellectual and Developmental Disabilities, Helsinki, Finland
© 2012, Susan Eriksson