petek, 10. april 2020

Operation D Intensities of intervention (operations 13, relationship 3)


The goals, projects and plans are invitation of user to enter into his or her life. And should be taken as invitations are – politely and respectfully. However, this invitation may be issued for varying degrees of entering the Life-World, or to put it clearly – various degrees of social work intervention in one’s Life-World. The relationship can start and stop at level of just representing the Life-Worlds in a talking encounter, which is usually termed counselling. In this case, a social worker does not enter the realities of the user.

Next degree is to enter into world actually lived by user by providing support to user in specific activities (by informing, encouraging, assisting the activity materially and morally but in the real contexts of one’s Life-World, like it happens in what is called personal assistance or could be termed “support-work”. When this is a case, the “supporter” enters the Life-World of the user and for the moment of support becomes a part of it.

In the operation of “help” the “helper” acts from the position outside the Life-World and brings into the field force not only originating but being also anchored in the domain outside the user’s Life-World. This duplicity of the positions creates a power relationship, in which the “helper” does not only contribute to the activities of the “helped” but is “by doing things for or instead” of the “helped”, adding actions of his own and from his own position. In this action, a middle ground between the ordinary Life-World and the institutional world is being generated, in which the user is still embedded in his or her Life-World but is drawn into relationships where he or she loses a degree of the sovereignty characteristic of Life-World. This intensity of help is usually referred to as “casework”.

“Help” and “support” are essentially synonyms. Here we use the two terms to denote a difference that in everyday parlance is negligible. “Support” denotes an activity that upholds the activity of an actor by adding a force to it without altering the direction or intention of the activity. In this context, we define “help” as a force in the field that operates as a vector, thus contributing to the activity of the actor but introducing an extra dimension to it and thus, however slightly, changing its direction and adding to its intention. In the terms of mechanics, support is a “scalar” and help is a “vector”.

When things get more complex, and especially if more input of the institutional resources is needed, there is more organisation and coordination involved – there are more “helpers” and “supporters” needed, the intensity of intervention increases and reaches a new quality. This comprehensive taking care is often referred to as “care management” and brings the social work action onto a level of organising. It happens still mostly in the intermediate space between the Life-World and the institutional world, but it is tangential to the latter by virtue of spanning the whole arch of activities from the actors’ finalities of Life-World across the various degrees of intensity of the help.

The most intense social work intervention[1] into the Life-World is taking somebody from his or her environment and relocating it to some, usually readymade institutional space. This is usually called “institutional care” or in a post-institutional setting “residential care”. Here, the person is up-rooted from his or her Life-World and transferred to a simulacrum of it.

This progression of intensities of interventions can be seen as a series of non-corporeal transformations of space as well as relationships situated in it, and of respective professional and user roles. The space transforms from an ideatory space of Life-World representations, “theoretical context” in Freirean terms, created in an interpersonal encounter, into blending of the social worker with the user’s Life-World, bridging the institutional space with the personal, to making “a dome” of care to the artificial institutional space. The work relationships thus formed range from a free exchange of ideas that bear no immediate consequence in the Life-World with a usual goal of reflecting the Life-World, getting an insight and creating a new orientation to a relationship where the provider of care takes a person in charge and is basically, even if not legally a guardian relationship. In between, there are relationships of companionship in action in one’s Life-World, power relationship resulting in and out of help and a relationship of care brokerage between the Life-World and institutional realm.

Action
Level
Term
space
relationship
remedial action
Talking
Representation
Counselling
ideatory
reflective
reflexive thought + mutuality, symmetry of exchange
Supporting
Deeds (action)
Personal assistance
(Support-work)
Life-World
companionship in action
user perspective
Helping
Power
Casework
Life-World – institutional space bridge

empowerment
Caring
Organisation
Care management
institutional “dome” over the Life-World
broker
self-management, re-appropriation of institutional resources
Placing
Shift in space
Residential care
institutional
guardian
temporary and personalisation of the space

In the progression of the intensity of intervention, we can observe two very strong tendencies. One is related to the power drop caused by power differential introduced by the professional and the very idea and process of help. The other, concurrent with losing power is one of losing ground, being uprooted from the Life-World. This de-territorialisation can have a productive result in increasing the capacity of improving one’s life – by expanding the view of reflection, by expanding manoeuvre space, gaining autonomy of everyday Life-World and by providing access to the goods of the institutional space. However, it may lead to progressive exclusion from meaningful relations, estrangement from one’s home and community. This upscaling of help stages a series of metamorphoses – non-corporeal mutations, that cease to be not merely situational (as they are usually in everyday life) and lead to progressive objectification into an institutional object. The path to hell is paved by good intentions.

The intentions, in social work, are good indeed. Even the results need not to be catastrophic, but quite benign. However, this is not enough to undo the underlying processes of losing power and ground. Good news is that social work has an arsenal of antidotes to these “iatrogenic” harms. Just as in everyday interaction there has to be a remedial action to each hazard of losing ground and power capacity.

One is the conscience of Life-World being the point of departure and return. Not only because it is a criteria of social work intervention, as described above, but also because of the basic finalism of support, in which the intervention takes place. We need to keep in mind that we are dealing with activity, which is by definition purposeful that has its goal (by default specific, in general, to improve one’s life conditions) and this is the point of common action. Therefore, acquiring and consistently applying the “user’s perspective” is the main way of fending of the negative corollaries of social work intervention.

There are diverse types of remedial action regarding the hazard of each degree of intensity. Even at the least intruding action of representation, since it takes off from the Life-World, is an act of de-territorialisation, there is a danger of skewing the vision by importing the ideas via representation into person’s living world (Freire – invasion). Dialogic precautions have to be made in order to eschew them by critical and reflexive stance, as well as with mutuality and symmetry of the exchange.

Empowerment is a general antidote to losing power immanent to different degrees in social work intervention. If helping diminishes the power of the help, the power must be “measured” at the completion of intervention to assure that “the patient is not dead after successful operation” and to design the remedial action to restore power beyond the side effects of helping.

In coordinated care, it is important to observe all the hazards being uprooted and not in control of one’s life that come up on the levels of lesser intensity and integrate them in specific of this intensity. Special concern must be made about symmetry, critical thought, user’s perspective and empowerment at all stages of planning and coordinating care. However, specific to this intensity is the imperative of “self-management”, being in charge of one’s care and the influx of the means from institutional resources should not be treated as a state charity but as an of re-appropriation of the public good.

Displacement should be omitted at all cost (and erased as a panergic and paramount response to distress). When necessary, as in family violence, or need for safe haven etc. it must be as short as possible temporary solution, preserving the connections to one’s usual Life-World, with intense work on lower intensities of intervention to enable the return to it. In the case when the return is not possible a maximum of personalisation of the new place (i.e. creating a new home) should be enabled, as it is the case when people move their home from one environment to the other in the ordinary life.

This five-gear shift of intensities in social work, inter alia, demonstrates the ability and necessity of social work to traverse and connect the Life-World (concrete) and institutional (abstract) planes. In doing so, it creates crevices into what would otherwise be solid construction with no interim space between the two. The “Life-World” of social work is in these cracks of the social construction. The critical moments of transitions induce the necessity of social work.



[1] Of all the other social work interventions removal of legal capacity matches this intensity. As it happens these two interventions – displacement and disqualification – often take place simultaneously, as a part of the same combined operation. However, in principle they are two distinctive doings. In one, the subject of the operation can remain in his place, but is “deterritorialised” by inability to inscribe into meaningful dealings, in the other deterritorialisation is by necessity a physical one.

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