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Ethics in Professional Interaction: Justifying the Limits of Helping in a Supported Housing Unit



This paper studies the construction of ethics in interactions between professionals in meetings, in relation to the rationing of resources. The research context is a supported housing unit targeted at clients with mental health and substance abuse problems. The service is provided for a municipality, which expects good progress of the clients. The research question is: how do the professionals produce implicit ethical justifications for setting limits to helping, even though the need for professional help is not called into question? Five types of justification appear in the data covering 28 meetings. However, these types of justification do not solve the central ethical difficulty arising in the conversations. Limiting help would easily push people out of reach of all help. Thus, in spite of the talk about ethical justification, workers do not ultimately resort to limiting help in situations with no real alternatives for getting help. The ethical principle of following non-exclusionary practices is highly prioritized.
Justifying the limits of helping in a supported housing unit
Kirsi Juhila and Suvi Raitakari
The paper studies the construction of ethics in interactions between professionals in meetings,
in relation to the rationing of resources. The research context is a supported housing unit
targeted to clients with mental health and substance abuse problems. The service is provided
for a municipality, which expects good progress of the clients. The research question is: how
do the professionals produce implicit ethical justifications for setting limits to helping, even
though the need for professional help is not called into question? Five types of justification
appear in the data covering 28 meetings. However, these types of justification do not solve the
central ethical difficulty arising in the conversations. Limiting help would easily push people
out of reach of all help. Thus, in spite of the talk about ethical justification, the workers do not
ultimately resort to limiting help in situations with no real alternatives for getting help. The
ethical principle of following non-exclusionary practices is highly prioritised.
Keywords: professional ethics, ethnomethodology, interaction, ethical difficulty, rationing,
justification, help, need
“This is an Accepted Manuscript of an article published by Taylor &
Francis in Ethics and Social Welfare on 6/04/2010, available online:”
Justifying the limits of helping in a supported housing unit
Ethical issues are an inseparable part of professional social work. Ethics is studied during
education, textbooks are written about it and codes are established by professional
associations. The professionals in the field are expected to know the ethical principles shared
by the profession and to apply them in their daily work. In addition it is emphasised that good
professional practice relates to the personal values and moral character of professionals (e.g.,
McBeath and Webb, 2002; Clark, 2006). Parallel to these two interpretations of ethics ethics
as external codes and as characteristics of persons doing the work there is also the
suggestion that ethics should be approached by studying how it is produced in social work
practices (e.g., Rossiter et al., 2000; Rossiter, 2005; Banks and Williams, 2005). Applying the
norms of professional ethics is not a straightforward or individual process. As Amy Rossiter
et al. (2000, p. 95) put it: ’the application of those norms is interpretive, and depends on the
local and particular features of each situation’. Because of this it is important to study
professional ethics in action, as it occurs in the mundane interactional practices of work (see
Banks, 2001, pp. 160185). Our study follows this line of research.
The research context is a supported housing unit situated in a large Finnish city. The unit is
targeted to clients who suffer from mental health and substance abuse problems. The data
consists of interactions in meetings among the unit’s professionals. The focus lies on
interactional episodes where the professionals discuss putting limits to their helping work in
situations where they nevertheless consider that some kind of professional help is needed.
This links the study to analyses of professional practices dealing with the rationing of
resources, client selection, criteria of clienthood, the assessment of client eligibility and the
categorisation of clients as ‘good’ and ‘bad’ (e.g., Lipsky, 1980; Dingwall and Murray, 1983;
Light and Hughes, 2001; Loseke, 1992; Griffiths, 2001; White, 2002; Juhila, 2003; Hall et al.,
2006). Putting limits to helping is an ethically difficult topic. The analysis aims to show how
this difficulty is dealt with in the meeting interactions.
Although the research is based on the mundane practices of one Finnish organisation, the
ethical difficulty studied here is widely recognized by social and health work actors.
Professionals cannot escape the duty of rationing resources. In their organisations they are
inevitably involved in discussions where the type and quantity of the help demanded is
deemed to be more than the organisation can possibly supply (e.g., Lipsky, 1980, pp. 81156;
Beckett and Maynard, 2005; pp. 89105).
The supported housing unit offers community-based services for people who have been
assessed as having mental health and substance abuse problems. The unit is part of a larger
mental health organisation (NGO), which provides services to a municipality. As the
purchaser, the municipality expects good quality and above all, effective service. The
principal aim of the supported housing unit is to strengthen the clients’ ability to lead
independent lives, in other words, to rehabilitate them. Thus, no one is expected to stay in the
unit permanently, but the clients are expected to move on after a maximum rehabilitation
period of three years. The unit can be defined as a sort of half-way house: the need for help
must not be too slight, but not too great either. The client eligibility criteria are based on these
The unit was set up in 2004 to respond to the needs of citizens who appear not to receive
professional help elsewhere. To take an example, the services specialising in either substance
abuse problems or mental health problems often define people who are deemed to suffer from
both of these as too difficult to help. On the other hand, institutions offering intensive or long-
term care, such as psychiatric hospitals and nursing homes, usually assess such people as not
needing the all-inclusive help provided by these institutions. As a small-scale service provider
the unit obviously cannot meet the needs of all those who have been excluded by these other
helping organisations. Consequently, it also has to consider the limiting of help.
The unit is located in a conventional high-rise housing estate, where 10 council flats have
been reserved for the unit’s clients at any one time. A facility in the same area called the
‘support centre’ functions as a meeting point for both the clients and professionals. The
clients may visit the support centre, and the professionals organise group and work activity
there. The five professionals employed have previous experience of both social and mental
health work.
The research data consists of 28 meetings among the professionals in the period of April 2004
to June 2006. The permission to record and use the data was given by the Board of the mental
health organisation which maintains the unit. The average length of the meetings is 80
minutes, and all the workers are present. The meetings follow a uniform agenda. They start
with a discussion of general issues related to the unit’s activity and the eligibility of potential
new clients, followed by the main part of the meeting, during which the workers talk about
the situations of the current clients. Case talk about the current clients does not have a pre-set
agenda. It is initiated by the client’s key worker, but after the opening (s)he assumes no
special authority in the course of the discussion. The purpose of this talk is to assess the
clients’ progress or lack of it, and to reflect on how the workers have succeeded in helping the
clients or failed to do so. During the two-year period of research, the clientele was fairly
stable in spite of the rehabilitation expectations, as the same nine clients were talked about at
each meeting. The clientele of the unit was male-dominated: only about 20% of the clients
were women.
The study is anchored to an ethnomethodological frame of reference (Garfinkel, 1967;
Heritage, 1984; de Montigny, 2007) and to research on social and human service work, in
which naturally occurring conversations between professionals and clients or among
professionals is analysed (e.g., Jokinen et al., 1999; Hall et al., 2003 and 2006; Taylor and
White, 2000). Ethnomethodology approaches people’s activities as fundamentally
interactional. Interaction occurs mainly through language, which we use in describing and
explaining things that happen to ourselves and others, in order to make sense of them (Francis
and Hester, 2004, pp. 119). In this study the application of the ethnomethodological
orientation means a detailed analysis of the kinds of limits to helping that the professionals
produce in the meeting conversations and the way in which this is done.
Limiting the help provided by the supported housing unit is an ambiguous theme, which the
workers themselves construct as a topic in the course of meeting conversations. When
discussing the topic they simultaneously talk about the rationing of resources (Lipsky, 1980).
The talk is linked with the discourse of professional ethics, though the workers do not
explicitly mention ethics during their conversations. We argue that the professionals who take
part in the meeting conversations share the principles of professional ethics discourse, set
forth in the ethical codes of professional associations, for instance (Banks, 2001, pp. 84111).
The code of ethics adopted by the Finnish social work union (Talentia Union of Professional
Social Workers, 2007) follows the code set by the International Federation of Social Workers
(International Federation of Social Workers and International Association of Schools of
Social Work, 2004). At a general level these codes share the view that the social work
profession aims at enhancing people’s wellbeing and fights against discriminatory and
exclusionary practices.
The aim to ensure people’s well-being and the simultaneous struggle to ration the unit’s
resources produce ethical problems, which are discussed in talk that deals with the clients’
situations. Rationing resources for the purpose of limiting help is ethically difficult, for it can
be defined as a discriminatory and exclusionary practice. This applies especially in this unit
that was set up to eliminate gaps in the helping system and to counteract such practices. A
more specific research question arises out of this ethically difficult set-up: how do the
professionals produce implicit ethical justifications for setting limits to helping when the need
for professional help is not questioned?
In the meeting data, all conversation episodes where the workers discuss the limits of their
helping activity were identified. The total number of these episodes is 36. The episodes are
evenly distributed in that the matter is discussed at least once in every meeting. In these
episodes, we located five types of implicit ethical justification:
1) The unit deals with certain kinds of problems only
2) Clients need more intensive care and control
3) Excessive care produces dependency
4) Clients make their own choices in life
5) The interests of other clients ought to be considered.
In the following section we will explore each of the five types by an analysis of one episode.
The episodes are selected to represent the range of justifications displayed in the data. The
meeting talk was transcribed verbatim. The original language of the meetings is Finnish, but
the excerpts have been translated into English for the purposes of this paper. All references to
names, localities and services that might threaten the anonymity of the persons involved have
been changed or removed.
1. The unit deals with certain kinds of problems only
This type of justification, which occurs a total of 10 times in the data, is often produced by the
workers in the meetings when talking about potential new clients to be selected for the unit. If
the candidate is selected, the situation is ethically simple in the sense that the unit decides to
respond to the need for help. In contrast, discussions on a potential refusal to help are always
associated with a justification of this act, which shows that the matter is ethically difficult.
Gale Miller and James A. Holstein (1991) write about social problems dealt with by street-
level bureaucracies, where an essential element is constructing the mutual division of labour
between various helping organisations. The different organisations are defined as dealing with
different problems. Non-selection and therefore non-response to the need for help can thus be
justified by interpreting the candidate as not belonging to the category of those helped by a
given unit, and thus not eligible for support, (see Loseke, 1992). Because the supported
housing unit studied here is a fairly new actor in the field of helping work, its position and
task are not yet established or generally known. Thus, in their meetings the workers
repeatedly discuss how the professionals in other helping organisations often refer clients who
in the workers’ interpretation should not properly be dealt with by the unit.
The background of the following discussion is that the local psychiatric hospital actively
searches for places for patients assessed as not needing hospital treatment. The unit is one
potential option and thus under pressure to provide such places.
Extract 1
P1: There was a strong message from the psychiatric hospital wards, that if at this stage
the unit [refers to the supported housing unit] is full, there must be another option
for them then. There’s just this big question mark and they must have some other
option for sending people for further treatment.
P2: Well we’ll just have to think about it in good time next year about whether this
[refers to the unit] is going to be it. Or are we going to develop this work so that it
might be done someplace else in addition to this housing estate. And are we happy
with the municipal housing foundation telling us that ten flats is the maximum?
Would it be possible to have any more flats? I mean this is a pilot really, so it’s one
of those trial projects.
P1: Exactly.
P2: And another thing I’ve really thought quite a lot about just as you said, is getting 14
inquiries from possible clients. We have to think very carefully about it. I mean, is
it going to be possible at all? What service helps those who can’t be accepted by a
service like ours?
P1: Yes, that is so.
P3: Would it mean a higher degree of support, for we often have the problem that
people can’t really cope here?
In this episode the talk is particularly about the ‘division of problems’ between the psychiatric
hospital and the unit. Professional 1 opens the topic by producing the challenge to helping:
there are people on the hospital wards who need somewhere to go, but the unit has no space.
The situation is defined as ethically difficult, for it appears that a suitable place cannot be
found for some people who need help. If nothing exists, this would lead to the exclusion of,
and even discrimination against, a certain group of people. As the talk continues the workers
begin to discuss who is responsible in this ethically problematic situation. Is it the hospital,
which cannot sort out further treatment, or is the unit also responsible? At first, in the turn by
Professional 1, it seems like the buck is passed to the hospital: they must have some other
option’. After that, however, Professional 2 allocates some of the responsibility to the unit as
well. Perhaps the unit should not be content with the number of flats currently offered by the
local authority, since more help is clearly needed. This opinion is also supported by another
At the end of the conversation, Professional 2 further continues the discussion of this ethical
problem by creating a third option for helping. The third option would be situated between the
hospital and the unit, i.e., it would be targeted to people who on the one hand no longer need
to be in the hospital, but on the other hand need a place with more support than can be offered
by the unit. However, the workers do not give a specific name for such a helping unit, for it
may not even exist at that point. In this conversation the workers give implicit ethical
justifications for the setting of limits to their helping by invoking the unit’s task. Within the
scope of its resources (number of flats), the unit cannot respond to all requests for help, but in
addition, the candidates’ need for help must be appropriate, not too great. However, the
ethical problem cannot be solved completely, as apparently no suitable options exist for those
who need more help. This unsolved problem is strongly present in the conversation, as the
workers discuss questions of responsibility, the stretching of the limits of their own unit and
the possibility of creating new options of helping.
2. Clients need more intensive care and control
This type of justification, which was found a total of seven times in the course of meeting
conversations, also invokes the organisation’s tasks in the field of helping work, as was the
case with potential client relationships. The workers construct certain clients as clearly
needing more intensive care and control than is possible in the unit. So, if they start out from
the clients’ needs, they must direct these clients to some other helping organisation. The
following example shows the elements of this type of justification in a very concise form. The
professionals discuss the situation of a client who appears not to progress as the workers
Extract 2
P2: I’m wondering what really is the right place in this world for someone like Jali?
P1: We’ve been thinking about that.
P3: Yes that’s what we do think about.
P4: Every time we visit him at home we notice it.
P1: More support. This just isn’t enough for him because you can see he’s afraid and
anxious all the time.
P3: He was really anxious yesterday when he left here.
P1: Yes.
P3: So that’s like what he’s telling you all the time.
P2: So in this case it’s cooperation with other services that provide treatment.
P5: Yes.
P3: And there’s going to be a meeting about that.
P5: And hey something you’ll have to remember is that the team is strong, and is able to
direct someone to somewhere else outside the unit.
P1: A better place could be found for him so he wouldn’t panic as badly.
P5: He can’t just be thrown out.
In this episode Professional 2 begins to talk about Jali in a way that clearly defines his
situation as a cause for concern. Opening the conversation with a question about the right
place for someone like Jali suggests that the unit is not the right place for people of his kind.
Three other workers confirm the relevance of this doubt by responding to the opening
question in a succession of complementary turns. They have also been wondering about the
same thing. Professional 4 further confirms the actuality and repeated nature of the matter:
‘every time we visit him at home we notice it’. In this way, the workers jointly produce the
problematic nature of the matter from the viewpoint of helping. Jali clearly needs something
(‘the right place’), but what is it he needs?
The conversation continues with a discussion of Jali’s needs, as Professional 1 begins to
define the content of help that would be appropriate for Jali: he needs ’more support’. The
comparative form and the formulation ‘this just isn’t enough for him’ confirm the emerging
interpretation that the unit is not capable of helping this client. The client’s continuous fear
and anxiety are constructed as the cause of this incapability. The situation is defined as acute,
having last been noted the day before. The workers not only read the need for more intensive
help from the client’s behaviour, but also interpret that he himself is sending out a message to
this end. During the conversation an interpretation based on the client’s needs and thus
ethically justified emerges: the client could be better helped somewhere else. This
interpretation justifies setting limits to the help offered by the unit. At the end, the workers
define the limiting of help in situations of this kind as high-quality professional activity: the
unit and its workers recognise their own knowledge, skills and therefore also the limits of
their helping (see Clark, 2000, p. 53; Beckett and Maynard, 2005, p. 81). Ultimately,
however, this activity is ethically justified only if a more appropriate place is found for the
client, and so far at least they do not know of anything of this kind. The final turn in the
conversation on Jali is important from an ethical point of view. Even if the unit might not be
the proper place for this client, it would not be right to discharge him unless another place was
found. Clients cannot be just turned out with nowhere to go.
3. Excessive care produces dependency
While the previous type of justification was concerned with the definition of the clients’ needs
as too great, the third type continues on the same theme, but with arguments coming from a
different direction. The workers self-critically consider that they may have cared excessively
for some clients. They justify this assessment by saying that excessive care may turn against
the clients and produce dependency. The clients might not really need so much support, but
through its own activity the unit has created the need for care and keeps it up through its
practices. For this reason, in the clients’ own interest, limits must be set to the helping. There
were four instances of this type of ethical justification in the data.
In the next extract the workers talk about a client whose ability to take care of even his basic
needs has caused concern for some time already.
Extract 3
P1: My personal opinion is that, if we notice these situations that Tarmo’s run out of
money and he has no food, then we shouldn’t start bringing food to him but instead
he’d have to go to an institution. Because in my view that’s where the limit goes,
that we can’t start feeding anyone.
P2: Or alternatively if he begins to drink.
P1: Yes, begins to drink and then has no money and there’s nothing in the fridge, I think
he should then see the doctor and then maybe the mental hospital.
P2: We should make a clear decision about this.
P1: There has to be a limit. We shouldn’t really prop him up like.
P2: Yes.
P1: If he can’t look after himself.
P2: Because then we’d make it possible.
P1: Yes we’d make all of it possible if it came to that.
P2: We have done that a couple of times.
P1: Yes indeed, we’ve fetched food for him twice now.
P2: Yes
P1: I think it’s not rehabilitation, if we go and look after his basic needs, like that. He
takes a shower and we feed him.
The episode is similar in many ways to Extract 2, which discusses the ’right place’ for a
person like Jali. Professional 1 mentions ’an institution’, which he later specifies as ‘maybe
the mental hospital’, as the right place for Tarmo. However, the types of justifying the
limiting of help are different. While Jali’s case is discussed from the viewpoint of the
insufficient helping potential of the unit, in Tarmo’s case the focus falls on assessing the
client work at the unit in the sense of what the workers are enabling through their own
actions. The workers are defined as active agents whose actions have consequences for the
clients’ lives. In the first turn Professional 1 proposes the setting of clear limits to helping
Tarmo: ’carrying food’ to Tarmo or ’feeding’ him should not be part of the helping role of the
unit’s workers. The proposal includes an interpretation of what has caused the lack of food, in
other words, running out of money. Professional 2 takes up the proposal and constructs
another cause of the situation, that is, starting drinking, and Professional 1 immediately agrees
with this and repeats her proposal of limiting the help and concretises the following move,
contacting the doctor and considering the mental hospital as an alternative.
Although the worker who opens the conversation stresses that this is his personal view, the
setting of limits for helping is eventually produced as a joint interpretation of the two workers.
The interpretation includes a self-critical assessment of what the workers enable through their
actions and how this relates to the unit’s objectives. This is crystallised in the final turn by
Professional 1: the unit’s objective is to rehabilitate the clients, which will be endangered if
the workers begin to look after the clients’ basic needs. Instead of rehabilitation, the unit’s
practices would then enable dependence. The clients will not have to assume responsibility
for their lives, such as their own finances and their drinking, if the workers help them too
much and do not set a clear limit to their helping actions. The workers blame themselves for
having helped Tarmo too far, and thus having enabled a life that conflicts with the
rehabilitation objectives. They have assumed a paternalistic, dependency-producing
orientation towards the client which is commonly seen as ethically objectionable in
professional work (see Clark 2000, p. 176). In spite of these justifying arguments to limit
help, the ethical problem remains unsolved, and is similar to the one in the previous extract.
What will happen to people who are defined as not capable of looking after themselves even
after clear limits have been set? What is the proper place for them?
4. Clients make their own choices in life
This type of justification, which comes up 12 times in the meeting data, is based on the
argument that clients can only be helped to the extent that they are prepared to accept help.
The argument is employed in conversations especially when the professionals produce an
interpretation that clients have been given many opportunities to change their problematic
behaviour, and means of change have been suggested. As an example, the workers discuss
how a client who has been drinking heavily has been given the opportunity to go to
detoxification, and the workers have tried to motivate him to accept this treatment.
Nevertheless, if the client himself finally decides to refuse this help, he and his will cannot be
steamrollered by the workers. So, even if the workers define the client as needing help, they
set a limit to their help on the basis that no one can be forced to accept help. Ultimately, the
clients make their choices in life themselves.
The starting point of the following conversational episode is the professionals’ increasing
concern for a client’s drinking habits:
Extract 4
P1: Eeli is drinking. There was a call yesterday from a client, saying that Eeli is
drinking now. That was the only reason he called.
P2: Eeli is one that you really have to wonder about.
P3: Like what is Eeli’s proper place, that’s right.
P2: He’s just not about to change his way of life.
P3: Not even if he had daytime activities.
P2: He’s really keen to start all sorts of things now and then.
P3: Yes, like yesterday he had a long working day [in a rehabilitative work place].
P2: And then it goes overboard.
P3: Well he thinks that after all those working hours a man is entitled to have a drink.
P2: So that’s what he thinks then.
Again the workers bring up the topic of the most appropriate place for a client. The question
is put by Professional 3 as if in direct continuation to the sentence begun by Professional 2:
‘Eeli is one that you really have to wonder about’. The joint production of this concern
constructs the matter under discussion as a problem acknowledged by all the workers. The
problem involves not only Eeli, but also more generally all the clients: Eeli is just one of the
persons causing concern because of this. The question about the proper place is produced as a
response to the opening by Professional 1, in which he informs the meeting of a phone call he
has received from another client, reporting on Eeli’s drinking. The opening and the responses
to it create not only this generally acknowledged problem, but also the interpretation that
Eeli’s drinking comes as no news to anyone present. As Professional 2 puts it, it is a way of
life with Eeli. The client’s own agency in his drink-focused way of life is defined as an
essential aspect. It is as if the client has chosen his current way of life instead of seeking to
change it.
The conversation continues with a discussion of the limits of the unit’s helping potential. A
client’s way of life will not change even if there was a lot of organised daytime activity. In
fact, the workers argue that the daytime activity is dysfunctional, for it would seem that ’a
long working day’ justifies drinking in the client’s eyes. The client’s agency and his own
choice are constructed by the workers in the conversation by a reference to Eeli’s own
’thinking’. Appealing to the client’s own choice is ethically consistent in the sense that
clients’ self-determination is a highly emphasised value in professional ethics (see Banks,
2001, pp. 9596; Beckett and Maynard, 2005, pp. 129146). During this conversational
episode the workers construct the shared opinion that the unit no longer has a great deal of
tools to cut down Eeli’s problem drinking, for he is committed to a way of life where drinking
is a matter of course. While the workers accept this ‘difference’ or give in to it, they still
cannot solve the ethically significant issue of the proper place for Eeli in the event that he
must be excluded from the unit.
5. The interests of other clients ought to be considered
A type of justification for setting limits to helping which is less frequent (3 conversation
episodes) than referring to clients’ personal choices, though closely associated with it, is
making reference to the interests of the unit’s other clients. This involves the construction of a
situation with a choice, in which the unit’s clients are set against each other. If one of the
clients causes direct or indirect trouble to the others, the workers must side with the ones who
suffer in the situation. The sufferers are then placed in the position of victims, and those
causing the suffering are placed in the position of guilty ones. The guilty position arises
particularly when a client’s disturbing activity is interpreted as being his or her personal
choice. In such a set-up, safeguarding the position and rights of those wronged is defined as
an ethically justified action, even if it might lead to limiting the help given to the clients who
cause trouble.
The discussion in the following extract deals with a client who has repeatedly failed to follow
the unit’s shared rules and agreements:
Extract 5
P1: If you allow him to go on living as he wants, what will happen if he doesn’t really
try to keep to agreed hours and such? Of course there are certain pressures in a
community such as this, what you could call as collective pressure.
P2: The pressure, (why doesn’t he comply?), will come from the community
P1: Yes.
P3: Yes, there is a conflict there.
P2: A conflict.
P1: Indeed.
P3: If we require certain things of the other clients as well.
P2: Yes.
The episode starts with the final turn of the preceding conversational episode by Professional
1: the talk concerned a client’s way of life which is defined as problematic for the unit. At the
same time, the turn opens a discussion on the limits of help. The opening turn is presented as
a hypothetical question. In this way the worker invites the others to discuss the possibility that
the client continues his current way of life in defiance to the rules agreed in the unit. She also
provides a direction for the discussion: the matter could best be approached from the
viewpoint of ‘certain pressures’ in the community. By the community she refers to the group
formed by the unit’s clients. Professional 1 further clarifies her message: such as this, what
you could call as collective pressure’. The other workers take this up immediately in a way
that shows that the workers recognise the situation and are in agreement as to what should be
done. It is likely that similar situations have been discussed before. Professional 2 first repeats
the words of Professional 1, but then continues to process the theme by placing the clients in
two conflicting camps: ‘the pressure, (why doesn’t he comply?), will come from the
community’. The worker more or less takes the position of advocate for the other clients. The
other clients expect that in the name of fairness, compliance with the agreed ways of
behaviour applies to all clients.
At the end of the episode, the professionals jointly define the situation as conflicting. The
expectations should be the same for all clients. Implicitly, the conversation produces the
interpretation that if a client is allowed not to comply with the unit rules, the commitment of
the others may also be eroded. Thus, one single client may cause considerable trouble in the
unit. Therefore general and common interest would ethically justify the removal of the
disturbing client from the unit if his behaviour does not change. Just as in the previous
examples, the episode ends with nothing definite being said about where a client of this type
could be directed. The ethical problem remains unsolved.
Ethical issues and difficulties are constantly discussed and negotiated in mundane
professional work practices, even though the word ethics is not necessarily mentioned at all.
In this study we have analysed how professionals jointly produce implicit ethical justifications
for potentially setting limits to helping in the supported housing unit. We located five
different types of justification.
In meeting conversations, different principles familiar from the ethical codes of social work
(International Federation of Social Workers and International Association of Schools of
Social Work, 2004; Talentia Union of Professional Social Workers, 2007) struggle against
each other. The ethical responsibility to offer professional help when needed and thus avoid
exclusionary and discriminatory practices is mitigated by using other ethical principles in
order to defend the potential limiting of help. In the first type of justification (the unit deals
with certain kinds of problems only), the principle activated can be formulated as follows: the
services provided should be based on the skills and competences of the professionals. The
professionals’ expertise would be wasted and it would be frustrating or even detrimental to
the clients if the clients selected needed something that the unit could not supply. The second
type of justification (clients need more intensive care and control) also attaches attention to
the unit’s and the professionals’ expertise and to the principle of responding to the clients’
real needs. The third type of justification (excessive care produces dependency) arises from
the principle that the professionals should promote clients’ participation and empowerment.
The fourth type (clients make their own choices in life) is linked with the principle of
respecting client self-determination. The last type of justification (the interests of other clients
ought to be considered) can be associated with the principle that professionals should ensure
that the clients’ choices do not threaten the rights and interests of others.
Thus, the professionals justify the limiting of help with ethical arguments. However, this does
not solve the central ethical difficulty arising in these conversations (Banks and Williams,
2005): the termination of the client relationship easily pushes people out of reach of all help.
The professionals discuss this problem in the meetings. This is visible in questions as to what
the proper places for these people would be, where the clients would be helped if not in the
unit, or where the prospective clients will end up if they are not accepted by the unit. By
recognising the problem the professionals show responsibility and concern for people who
need help. Someone must look after these people and their rights. The supported housing unit
was created a few years ago to respond to the needs of a group of people for whom the
existing provision of professional help was not sufficient. Consequently, the very reason of
the unit’s existence obliges the professionals to make sure that they do not uphold an
exclusionary and discriminatory policy.
In all the conversation episodes the ethical problem remains unresolved, while both the act of
limiting help and the duty to respond to the need for help are justified. The meeting
interaction constructs a social reality which has the effect of causing consequences. The
consequences can be of two kinds: either help is limited, or the needs are responded to
regardless of problems. As was mentioned in the beginning of the article, the same nine
clients were discussed in each meeting during the two-year period covered by the data. This
means that none of the clients were excluded from the unit during that period even when
helping a particular client was repeatedly defined as ethically questionable, using the types of
justification of the limits of helping analysed in this paper. As researchers we have had the
opportunity of following up life in the unit even after the period covered in the data. On the
basis of what we have observed, the option of limiting help has mainly been resorted to in the
case of prospective clients, and the professionals continue with their rehabilitation work
among the existing clients despite its difficulties. This being so, our concluding argument is
that although the workers reflect continuously on the ethical justifications of the limits of
helping, this does not mean that they end up limiting help in situations where no real
alternatives for getting help for their present clients exist. This shows that the ethical principle
of following anti-discriminatory and non-exclusionary practices is highly prioritised.
However, the workers have to struggle with the fact that the municipality as service purchaser
expects good rehabilitation results and an adequate progress of clients so that new clients can
be taken in (Banks, 2004, pp. 151155). This creates pressure towards excluding clients who
are constructed in the ways seen in the episodes: needing more intensive care, being too
dependent on help, preferring self-destroying choices in life, and disregarding shared rules. It
may be claimed that excluding these clients is a reasonable rationing of resources. The entire
existence of the unit may be threatened if the purchaser is not convinced of the results of the
activity; no one is meant to stay at the unit permanently. The impact of the expectation of
good results is also strongly present in the meeting talk. Saario and Raitakari (2009), who
have studied the same data corpus, call this talk effectiveness argumentation: they refer to the
workers’ discussions of better ways of demonstrating the economical and progressive aspects
of their work (see also Juhila et al forth).
Our hypothesis is that the more strictly the unit is steered on the basis of measurable results,
the narrower the workers’ opportunities for non-exclusionary practices will become. The
greatest concern should be felt over what happens to people who, despite their need for help,
will be rejected even by this unit and other similar helping organisations set up to catch those
not caught by other services. Using ethical justification, these people can be interpreted as
needing a different kind of help, but the kind of helping places needed, which provide long-
term care, for example, are not necessarily available at all.
The article is part of the research projects ‘Dilemma between Control and Support in Social
Work Practices’ and ‘The Categorization of the Most Difficult Cases in Social Work
Practices’ funded by the Academy of Finland and conducted in the Department of Social
Policy and Social Work at the University of Tampere. We would like to acknowledge the
important contribution of the other members of the projects to this text, as well as comments
from colleagues in the international research group DANASWAC.
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... This suggests both comparative similarities and differences with our research. For the former, two of the justifications found by Juhila and Raitakari's (2010) were also supported in our data. The notion that 'excessive care produces dependencies' resonates with the industrial logic described below, while the notion that 'clients make their own choices in life' reflects the market logic's assumption of a free and fair J.A. Wasserman and J.M. Clair 4 field of exchange (Juhila and Raitakari 2010, 60). ...
... However, while Juhila and Raitakari (2010) concluded that service workers in Finland resisted exclusionary practices, we found something of the opposite among our participants. The influence of cultural values, more prominent in the USA, will be discussed later as framing these practices among our participants. ...
... It is important to note that many service providers themselves also would not be willing to let someone starve because he or she will not submit to treatment, but that is because there are other logics of justification operating within their individual character. Such internal conflicts illustrate that even when a person is a member of the service institution, a complex personality that utilizes diverse logics of justification as he or she negotiates a complex social world still can be sensitive to the problematics engendered by the rigid and exclusive logics of the institution itself (see also Juhila and Raitakari 2010). We also note this to make clear that ours is not an indictment of service providers themselves, who, from our experience, nearly all are very good, well-intentioned people. ...
This paper reports on discursive justifications of homeless service institutions in the USA, illustrating a conceptualization of service founded on economic logics of industry and the marketplace. Emerging from ethnographic data, we found that homeless service administrators utilized economic logics of justification to legitimize the exclusion of the street homeless by framing delivery within western notions of fair exchange and efficient production. When these logics are used exclusively to frame justifiable criteria for receiving services, certain people are empowered to participate in social welfare institutions, while others are disfranchised. We conclude that addressing gaps in service requires legitimizing varied administrative models, which, although underpinned by different, perhaps even oppositional, justifications, will engender a service sector responsive to the diversity of the homeless population.
... Within social welfare work, a key focus of professional ethics is on the attitudes and actions of practitioners towards service users, particularly how practitioners support and advance service users' independence and autonomy Williams 2005, 1005). Occasionally, however, professionals may judge it ethically right to limit service users' wider independence and autonomy in order to safeguard their well-being or enhance autonomy in specific areas of their lives (Juhila and Raitakari 2010). The 'right amount' of independence cannot be prescribed by codes or ethical principles, but is negotiated in everyday practice (Banks 2013, 597). ...
... However, our approach is based in empirical research on professional interactions, examining how people jointly negotiate and make sense of ethical issues in professional life (e.g. Juhila and Raitakari 2010;Räsänen and Saario 2017). The article draws on recordings of naturally occurring interactions in 16 review meetings in community mental health settings in England and Finland. ...
This article develops the concept of ‘ethics work’ (Banks [2016]. “Everyday Ethics in Professional Life: Social Work as Ethics Work.” Ethics and Social Welfare 10 (1): 35–52) from a focus on efforts made by professionals, to a domain co-constructed with service users and others. It takes an ethnomethodological approach to examining verbatim interactions in review (multi-party) meetings concerned with reviewing progress and making decisions about and with service users in community mental health settings in England and Finland. Drawing on the everyday, micro-level ethics of social welfare practice, this article demonstrates the ‘doing of ethics’ in real-life situations, thus widening the applicability of ‘ethics work’ as an analytical concept. Extracts from two meetings are discussed, focussing on the ethical challenges of supporting service users to live independent lives, while also protecting them from harm and respecting their own choices. While this is a classic ethical tension in social welfare work, it is also exacerbated in the current austerity regimes in many Western countries as service users and carers are ‘responsibilised’ and required to become more self-sufficient. Our analysis shows the significant ethical content in review meetings as professionals, service users and family members negotiate plans together.
... This use of 'work' is influenced by social interactionist and social constructionist accounts of social life, including the thinking of Goffman (1969Goffman ( , 1974, who studied people's everyday interactions and performances; Foucault (2000bFoucault ( , 2000a, whose later work explored the making of the ethical self; and discourse and conversational analysts, who study complex conversational moves (Sacks 1992;Wooffitt 2005), including discourse analytic accounts of social work interactions (e.g. Hall, Sarangi, and Slembrouck 1997;Hall, Sarangi, and Slembrouck 2006;Kirsi and Suvi 2010;Hall et al. 2014) . This meaning of the term 'work' is analogous to its use by sociologists and social psychologists in relation to the concepts of 'emotion work' or 'identity work', where it relates to how people construct and perform identities or engender, manage and perform emotions. ...
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This article outlines and develops the concept of ‘ethics work’ in social work practice. It takes as its starting point a situated account of ethics as embedded in everyday practice: ‘everyday ethics’. This is contrasted with ‘textbook ethics’, which focuses on outlining general ethical principles, presenting ethical dilemmas and offering normative ethical frameworks (including decision-making models). ‘Ethics work’ is a more descriptive account of ethics that refers to the effort people put into seeing ethically salient aspects of situations, developing themselves as good practitioners, working out the right course of action and justifying who they are and what they have done. After identifying seven features of ethics work, including work on framing, roles, emotion, identity, reason, relationships and performance, each element is illustrated with reference to two case examples from social work practice. It is argued that the concept of ethics work, with its focus on the practitioners as moral agents in context, is an important antidote to the rules-based managerialism of much contemporary practice.
Responsibility and professionalism are increasingly issues of concern for professional associations, employers and educators alike. When bad things happen, professionals are often held personally accountable for complex situations. Professional Responsibility and Professionalism advances our approaches to professional responsibility from individual-centred, virtue-based prescriptions towards understanding and responding effectively to the multifaceted challenges encountered today by professionals working in dynamic complexity. The author applies a sociomaterial examination to specific examples drawn from different professional contexts of practice. She examines important implications for what professional responsibility and accountability might mean individually and collectively, and what it might be becoming when demands increasingly conflict, and when we accept that capacities for action are performed into existence in emergent and precarious webs of both human and non-human forces. The chapters explore some of the most prominent questions in professional responsibility, including: • What does professional responsibility, and accountability, mean in the escalating complexities and conflicts confronting today's professionals? • How does professional responsibility become developed and enacted, and through what social and material entanglements? • How should responsibility be determined in multi-agency and interprofessional practice? • What happens when professional decisions are delegated to software algorithms and diagnostic instruments? • How are new governing regimes of professional work, such as innovation imperatives, excessive audit and logics of blame and scapegoating, reconfiguring responsibility? • How can professionals respond simultaneously to individuals in need, the obligations of their profession, the demands of their employer and an anxious society? A major concern addressed by each chapter, and the book as a whole, is educating professionals in and for responsibility. Specific dilemmas and strategies are offered for educators in universities, workplaces and professional development contexts who seek new approaches to helping professionals learn to critically understand and practise responsibility today. This book will appeal to a wide audience of education researchers and post-graduate students studying professional practice, professionalism and education across a wide range of disciplines. Health professionals, professionals working in private practices, such as law, architecture and engineering, newer professions such as social work and policing, and educational professionals at all levels will find stories and strategies reflecting key issues of their practice in this detailed exploration of professional responsibility and accountability.
With communication and relationships at the core of social work, this book reveals the way it is foremost a practice that becomes reality in dialogue, illuminating some of the profession's key dilemmas. Applied discourse studies illustrate the importance of talk and interaction in the construction of everyday and institutional life. This book provides a detailed review and illustration of the contribution of discourse approaches and studies on professional interaction to social work. Concentrating on how social workers carry out their work in everyday organisational encounters with service users and colleagues, each chapter uses case studies analysing real-life social work interactions to explore a concept that has relevance both in discursive studies and in social work. The book thus demonstrates what detailed discursive studies on interaction can add to professional social work theories and discussions. Chapters on categorization, accountability, boundary work, narrative, advice-giving, resistance, delicacy and reported speech, review the literature and discuss how the concept has been developed and how it can be applied to social work. The book encourages professional reflection and the development of rigorous research methods, making it particularly appropriate for postgraduate and post-qualifying study in social work where participants are encouraged to examine their own professional practice. It is also essential reading for social work academics and researchers interested in language, communication and relationship-based work and in the study of professional practices more generally. © 2014 selection and editorial material, Christopher Hall, Kirsi juhila, Maureen Matarese and Carolus van Nijnatten. All rights reserved.
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This article explores how discourses of time are produced and negotiated in professional client interaction when making mental health rehabilitation plans. The discourse of linear time is dominant in interaction and shared by both participants to create joint future talk. However, the clients might challenge the dominant time talk by using the discourse of the time of mindful body (Fahlgren, 2009), resulting in clashing time talk. The discourses of time are linked with identity categorisation and with the criteria of ‘good’ and ‘bad’ professional work and clienthood. The analysis demonstrates the relevancy and consequentiality of time talk in professional client interaction.
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Professionals in human service work are at the centre of complicated client cases. The ways client cases are constructed and the problems explained form the basis for professionals' assessments, decisions, actions and interventions. In this article the ways professionals make sense of dual-diagnosis client cases are examined. Applying the concept of causal accounting, it is argued that 'theories of cause' are embedded in professional discourse and profoundly shape professionals' understandings of social and health problems, as well as of their own roles and responsibilities and of what interventions and outcomes are possible. The data consist of 48 tape-recorded weekly team meetings among professionals in a supported housing unit targeted for clients with both mental health and substance abuse problems. It was found that professionals reason about the relationship between these two problems in four different ways: (1) substance abuse causes or makes mental health problems worse; (2) substance abuse eases mental health problems; (3) mental health problems cause or make substance abuse worse; or (4) good mental health reduces substance abuse. Causal account research makes visible the ways professionals do institutional work by categorizing clients, accounting for responsibilities as well as assessing their work and clients' achievements according to moral expectations of a 'good'professional and a worthy client.
Methadone maintenance treatment has been subjected to much debate and controversy in Sweden during the last decades. Thresholds for getting access are high and control policies strict within the programmes. This article analyses how professionals working in a Swedish methadone clinic discuss and decide on appropriate responses to clients' rule-breaking behaviour. The research data consist of field notes from observations of three interprofessional team meetings where different clients' illicit drug use is discussed. A micro-sociological approach and accounts analysis was applied to the data. During their decision-oriented talk at the meetings, the professionals account for: (1) sanctions, (2) nonsanction, (3) mildness. In accounting for (2) and (3), they also account for clients' rule-breaking behaviour. Analysis shows how these ways of accounting are concerned with locating blame and responsibility for the act in question, as well as with constructing excuses and justifications for the clients and for the professionals themselves. In general, these results demonstrate that maintenance treatment in everyday professional decision-making, far from being a neutral evidence-based practice, involves a substantial amount of professional discretion and moral judgements. Sanctions are chosen according to the way in which a deviance from the rules is explained and, in doing so, a certain behaviour is deemed to be serious, dangerous and unacceptable - or excusable.
Saario S, Raitakari S. Contractual audit and mental health rehabilitation: a study of formulating effectiveness in a Finnish supported housing unit Int J Soc Welfare 2010: 19: 321–329 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. Mental health NGOs in Western Europe are increasingly managed by contractual audit procedures. This article concerns how contractual audit and its emphasis on effectiveness of care impact on the practices of long-term mental health rehabilitation. To demonstrate this, a case study of a Finnish NGO that provides supported housing is presented. The study looks at how service purchasing practices, as stated in the contract between the municipality and the NGO, are reflected in the meetings among practitioners. Documentary and meeting data were utilised together with Mitchell Dean's notion of technologies of agency. It was found that practitioners actively sought to show the effectiveness of their everyday work in terms of contractual audit by demonstrating both the economic and progressive aspects of care. Thus, professional competency in mental health rehabilitation appears to entail both the skills of care interventions and the ability to perform these interventions as efficient and financially accountable activities.
This paper concerns the relation between critical reflective practice and social workers’ lived experience of the complicated and contradictory world of practice. I will outline how critical reflection based on discourse analysis may generate useful perspectives for practitioners who struggle to make sense of the gap between critical aspirations and practice realities, and who often mediate that gap as a sense of personal failure. I will describe two examples of discourse-based case studies, and show how the conceptual space that is opened by such reflection can help social workers gain a necessary distance from the complexity of their ambivalently constructed place. Discourse analysis can provide new vantage points from which to reconstruct practice theory in ways that are more consciously oriented to our social justice commitments. I understand these vantage points in the case studies I will describe as: 1) an historical consciousness, 2) access to understanding what is left out of discourses in use, 3) understanding of how actors are positioned in discourse, all leading to: 4) a new set of questions which expose the gap between the construction of practice possibilities and social justice values, thus allowing for a new understanding of the limitations, constraints and possibilities within the context of the practice problem.
Analysis of language and discourse in social sciences has become increasingly popular over the past thirty years. Only very recently has it been applied to the study of social work, despite the fact that communication and language are central to social work practice. This book looks at how social workers, their clients and other professionals categorise and manage the problems of social work in ways which are rendered understandable, accountable and which justify professional intervention. Features include: •studies of key practice areas in social work, such as interviews, case conferences, home visits •analysis of the language and construction used in typical case studies of everyday social work practice •exploration of the ways in which professionals can examine their own practice and uncover the discursive, narrative and rhetorical methods that they use. The purpose of this engaging study is to increase awareness of language and discourse in order to help develop better practice in social work. It is essential reading for professionals in social work, child welfare and the human services and will be a valuable contribution to the study of professional language and communication.
This book explores the far-reaching ethical implications of recent changes in the organization and practice of the social professions (social work, community and youth work), drawing on moral philosophy, professional ethics and new empirical research by the author. What does the development of external regulation and audit mean for the autonomy, discretion and creativity of practitioners? How does inter-professional working in community mental health, youth offending or neighbourhood regeneration challenge conceptions of professional identities and roles? What relevance does an ethics of proximity, care or virtue have for professional ethics, alongside more abstract, principle-based approaches?
This article argues that in a complex socio-political world social work ethics needs to re-cast the moral identity of the social worker in terms of virtue ethics. We review virtue theory's Aristotelian foundations and criticisms of Kantian and utilitarian theory and show how they apply to social work. Subsequently we offer an account of a virtue-based social work that questions the validity of several models of practice currently fashionable. Virtue theory emphasises the priority of the individual moral agent who has acquired virtues commensurate with the pursuit of a revisable conception of the good life - the well-being of all in a defined community. The virtues are the acquired inner qualities of humans - character - the possession of which, if applied in due measure, will typically contribute to the realisation of the good life or 'eudaimonia'. The role of the virtuous social worker is shown to be one that necessitates appropriate application of intellectual and practical virtues such as justice, reflection, perception, judgement, bravery, prudence, liberality and temperance. This ‘self-flourishing’ worker, in bringing together the capacity for theoretical and practical action makes possible a hermeneutic or interpretive praxis best appraised in dialogue with fellow-practitioners and clients. With a social work remit increasingly routinised by accountability, quality control, and risk management there is an emphasis on regulation and duties. This has produced a culture of following approved or typical processes resulting in defensive forms of social work wholly uncongenial to the development of human qualities likely to promote social workers’ engagement in critique and revision of what counts as best practice. In sum, our core proposition is that social work practice and education to fit an unpredictable, non-linear world should develop means by which professionals nurture the virtues would reflexively enhancing of social work itself.