6. Organisations that foster relationships
Just talking? How relationships disrupt social disadvantage
Those with relational capability are extraordinary individuals. But placed in another context, their skills might be neutralised. By definition, those we interviewed were practicing within a culture that named, taught, and supported relational work. While the organisations we studied differed from one another, in many ways, we saw important similarities that may inform others working to improve human health and development.
In most organisations, including those with proven impact on human health and development, the worker’s first responsibility is to conduct an assessment and to develop a service plan. In organisations partnering in this study, the first job is to build a relationship.
1. Relationships are at the heart of practice. Leaders in our partner organisations understand relationships to be essential to the task of responding to disadvantage. They routinely talk about relationships and create contexts in which relationships can flourish, so standing against the grain of professional thinking over the last 30 years in which a more transactional exchange between worker and the other has been encouraged. For these leaders, developing a relationship with each “service user” becomes an explicit goal — sometimes as an end in itself, because it is seen as the essential precondition to any substantial change in a young person’s life.
Research told us… that healing happens in relationship. (Organisation leader, US)
Everything we do is about relationships. (Organisation leader, UK)
(Language to describe the person being helped is recognised in these organisations as a potential fillip or hindrance to the promotion of healthy relationships. Many retreat from terms like “service users” since it would be seen as an impediment. There is no agreement about correct terminology, and often organisations tie themselves in knots in trying but failing to do the right thing. Ironically, those kinds of things matter less to the helped so long as their worker sees them as they are, in the round).
In most organisations, including those with proven impact on human health and development, the worker’s first responsibility is to conduct an assessment and to develop a service plan. In organisations partnering in this study, the first job is to build a relationship. Because the relationship comes first, important issues can get noticed but left unaddressed and unrecorded for a time. That is viewed as good practice. Writing them down and speaking about them weakens the bond between helper and helped.
Many caring organisations are set up for linear improvements in the situation of those they support. The partner organisations in this study are set up to expect vicissitudes in the lives of the helped and unevenness in the relationship between helper and helped. Setbacks in the health, development or connectedness of the helped are seen as opportunities. Difficulties in the relationship are seen as part of strengthening the bond, not as a reason to think about re-allocating the ‘case’ to a different practitioner.
Because even through all these relapses and all these ‘Go to hell. I don’t want anything to do with you’, we’re going to keep showing up, we’ re going to keep trying to do what we’re trying to do, to help you understand that you have other options and choices, and you could have a different view and it could be different, and life could be different. You don’t have to go to jail or die. And that’s a really powerful thing. (Organisation leader, US)
In putting relationships at the heart of practice, these organisations are clear that a strong relationship between helper and helped is an important step towards a wider range of healthy relationships with family, friends, and neighbours.
… we can help them repair those relationships that might have been disrupted over time –or build new relationships with new caregivers or the permanent caregivers that they’re going to be with. It really requires the workers understanding all of those factors and then the ability for themselves to not become the primary attachment source but to facilitate that between the primary care giver and the youth or the other caregivers in the child’s life. (Organisation leader, US)
2. Meeting critical needs. Relationships may be at the heart of the practice model but they are not the only component. Our partner organisations also meet basic needs such as a safe place to live, a chance to get back into school, or a job. They deal with practical issues such as piles of unpaid bills, legal advice associated with un upcoming court case or access to a mobile phone. These supports reduce the sometimes extraordinary quotidian stresses on the people they support. They contribute to the building blocks of a healthy relationship, trust for example.
… I dropped out my freshman year, I ain’t about to go back to school. I need a job, she came out of nowhere … We got a job program in here. Do you want to come? I could say that’s when I really hit it off with her. (Young person, US)
…the accommodation changed. So, it went from sort of chaotic environment to calming… (Worker, UK)
3. A practice model. Especially in the larger organisations we visited in the U.S., the focus on relationships was typically one part of a broader practice model. For example, one organisation embeds relationship as one of seven essential elements of practice, alongside an understanding of trauma; building self-regulation skills; and helping young people identify their hopes and dreams. Another sees relationships as a part of a model of “unconditional care”; a third has developed a modification of Cognitive-Behavioural Therapy that can be used in everyday interactions between workers and young people. Several of the organisations in the U.K., most of them smaller that our U.S. partners, spoke about having increased their clinical knowledge in order to be able to serve many of their clients. We might say that all of these organisations view relationships as necessary for change, but not sufficient. In one of our interviews with executive staff, this point was made very strongly:
…our original theory was … we’ll surround kids with people that love them, and that would be healing in and of itself and you know what? It wasn’t. Because when they left here they met circumstances that were so unbelievably stacked against them that they couldn’t possibly hold that relationship into the future inside as an internalized part of them. (Organisation leader, US)
As a result, a great deal of attention is paid to the knowledge and skills helpers need and the services and supports the helped need, in addition to relationships, with the potential to help transform their lives.
Get Ratio’s stories in your inbox
Join Medium for free to get updates from this writer.
4. Hiring and supervision. Our partner organisations hire workers whom they believe have the capacity to excel at relating, focusing first on personal qualities and only second, if at all, on applicants’ past work experience and related qualifications.
We hire based on values, not based on experience. I can train skills … I can’t do as much with values. (Organisation leader, US)
Personality attributes trump experience in what we’re looking for. (Organisation leader, US)
We have described the desired attributes of workers in the last section. Some of the techniques organisations used in the hiring process to try to find these attributes include:
- having candidates meet with several staff members, sometimes in informal settings;
- having the helped be part of the panel of interviewers;
- getting feedback from everyone a candidate meets (including the receptionist);
- group interviews with multiple candidates, to see how they relate to one another; and
- developing internship programmes with local colleges as a pipeline to employment, giving the organisation and prospective worker a chance to get to know one another out over an extended period before making a long-term commitment.
These organisations also act quickly when a new hire proves problematic. Despite all of the thought that goes into the hiring process, not every recruit turns out to be successful. Problems are identified quickly, and staff are moved out if necessary.
5. Culture. Our partner organisations make substantial efforts to create patterns of relationships between workers that model how helpers should relate to helped. One executive described a set of “spoken and unspoken rules” that include “speaking kindly and directly to one another”; ensuring that anyone who is being spoken about is in the room (or, when this is impossible, talking about them only as you would if they were present); and expecting everyone to hold each other accountable for these behaviours without regard to the organisational hierarchy…It is important to avoid shaming and blaming when dealing with problems.”
…you can’t connect with youth and do good work if you don’t feel safe as an employee. (Organisation leader, US)
People have to show reflective practice, people have to show their workings out, they have to be prepared to share what they’re struggling with, they have to be prepared to talk about what they’re finding difficult. We always own everything, so if … a worker’s talking about something or someone they’ve got a problem with, it’s always our problem. (Organisation leader, UK)
These organisations give considerable emphasis to the development of a supportive culture and a spirit of camaraderie among staff. In one organisation, induction for new workers focused largely on establishing connectedness with other staff. Another created positions for the few staff who excelled relationships to mentor other workers and help them build the same skills.
6. Data. Some of the large organisations in the U.S. have built the infrastructure needed to routinely use data to track the progress of relationships between helper and helped and to promote improvement in practice. These processes go beyond measuring contact time by tracking the status of each relationship, providing the data for supervisors to respond when things aren’t going well.
One of the partner organisations tracks whether there has been conflict between the helper and the helped early on in a relationship. When things are going smoothly, and the relationship is getting stronger, they may use this information to encourage the worker to challenge and “stress test” the relationship.
