Effect of Communication on Practitioners and Service Users

Effect of Communication on Practitioners and Service Users Standing still enough to absorb the emotional impact of (service users) experiences is something that allows the movement hidden beneath the frozen state of psychological hypothermia to emerge in a tolerable way at the right time.† (Kohli, 2007, p. 180). This paper will address the relevance of Kohli’s statement above to the discussion on the effective communication with accompanied minors. The paper will first define the term â€Å"unaccompanied minors†. It will then provide a definition of communication, then identify and examine its main theoretical perspectives. The paper will unpack the meaning of Kholi’s quotation by advancing a discussion of the importance of timing when working with unaccompanied minors and the intricacies involved in navigating the sometimes harrowing and emotional experiences of unaccompanied minors. The paper will also examine the issue of silence and how this reflects a state of being frozen in time with unaccompanied minors and will interrogate methodologies for delving below these issues, in a timely manner while ensuring that the service feels safe revealing their often locked away emotions. All these factors will be examined in the context of how communication can impact both the practitioner and the service user and how managing each factor effectively is essential to unlocking hidden feelings, emotions and trauma from which unaccompanied minors may suffer. The paper will draw on contemporary literature to empirically ground its arguments. Both the United Nations High Commission for Refugees (UNHCR) and the United Nations Children Fund (UNICEF) defines unaccompanied as: â€Å"under 18 years of age or under a countrys legal age of majority, are separated from both parents, and are not with and being cared for by a guardian or other adult who by law or custom is responsible for them. This includes minors who are without any adult care, minors who are entirely on their own, minors who are with minor siblings but who, as a group, are unsupported by any adult responsible for them, and minors who are with informal foster families.† (United Nations: 2007) More recently, there have been a plethora of studies examining the psychosocial and day to day needs after they arrive in Western countries. Communication is said to be a difficult concept to pin down by way of definition because of its many complexities, forms and application to everything. For the purposes of this paper, the definition provided by Fiske (1990:2) that communication is â€Å"social interaction through messages†, provides a good starting point to examine the concept in relation to unaccompanied minors. Thompson (2003) contends that the social aspect of communication is vital to consider because individuals interact within a social space and the nature of this communication dictates the nature of a relationship or how that relationship develops or breaks down. Thompson (2003) navigates various theoretical model of communication by drawing on the work of other scholars. He identifies Shannon and Weaver’s 1949 definition of communication which locates 3 elements: The transmitter (person who starts communication), noise (the actual message communicated, and the receiver (the person who the message is communicated to). This definition has received ample criticism for oversimplifying a difficult concept wherein communication is not always transmitted by noise but also through silence and body language. In addressing these omissions, the semiotics model was advanced as an alternative. In this model, communication is described by Cobley (2001) as a form of semiosis which is concerned with the exchange of any messages whatsoever: from the molecular code and the immunological properties of cells all the way through to vocal sentences.† This definition introduces other aspects rather than the spoken word into the communication discourse and Miller (1973) articulates that â€Å"communication includes not only the study of spoken communication between people, but also the many kinds of unspoken communication that go on constantly when people interact.† In this respect, communication also encompasses culture, because culture determines shared norms and values, language and ultimately these norms affect how information is communicated or transmitted. Thompson (2003) draws on Pierre Bordieau’s concept of cultural capital based on the strength of power bases, to explain ho w culture and power can interact to determine how information is understood and communicated, because it informs the semantics of language and the formation of identity. The identification of language as a prominent variable in any communication discourse is inescapable because as Thompson (2003) states, language does not only reflect reality, but it also constructs reality. This fact is elucidated when certain words or actions communicate a task, or certain actions communicate joy, distress or uncertainty, as is postulated by the speech act theory. Similarly, identity is informed by cultural norms and values, and determines how individuals view themselves and how they relate to others. It is this connection between culture, identity, language and power which informs the foundations of the discussion on how practitioners can cut through the difficulties of intercultural communication barriers to assist usually traumatized unaccompanied minors. Intercultural communication skills in the social work discipline, is fraught with difficulties. Husbands (2000) maintains that the various biographical routes and stories of practitioners does interact in the social space of service users and can affect how information is communication based on how trust is fostered when communicating to service users that difference will be accepted and not judged. Kohli (2006) deftly describes the vulnerable unaccompanied child who arrives in a new country and who is reticent about divulging details to practitioners. He, alongside other scholars (Kohli and Mather: 2003; Beek and Schofield: 2004) observes that unaccompanied children often remain silent, or emotionally closed about their past. He writes that such children have usually been told over and over by others to remain quiet about themselves in order to keep safe. Kohli (2001, 2006, 2007) insists that it is imperative that social work practitioners gain skills that enable them to probe the past of unaccompanied asylum children, in order to truly understand their needs. Kohli recognizes that demands to meet targets faced by modern day practitioners, may interfere with the time they need to build trust and safely pry open the thoughts of unaccompanied minors. In light of this, the nature of their silence and the impact their experiences may have had on them must be explored, before addressing how social workers should â€Å"time† their intervention to open communication and prompt life histories from unaccompanied minors. The silence displayed by unaccompanied minors should not be immediately adjudged to be because they are hiding harmful secrets. In fact, scholars such as Finkenauer et al (2001), argues that the keeping of secrets are normal adolescence developmental characteristics. However, the literature on silences among refugee children often points to explanations of fear and the silencing effects of war on children. Psychological studies (Melzak: 1992) contend that children often bury extreme hurt, pain or loss in order to survive, some to the extent that they can forget some events or the sequence of events as a defense mechanism. The risk of acting out buried emotions in a harmful way, compels many practitioners and scholars to argue for methodologies to unlock these stories which according to Kohler’s quotation, presented at the beginning of this paper, may be in a â€Å"frozen state of psychological hypothermia†, wherein they are unable to communicate their hidden pain. Papad oupolos (2002) posits that this frozen state could be purposely imposed to assist in healing and may be necessary to allow affected children the space to reflect, make sense of and accept before being able to move on successfully. Kohli (2006) therefore views this silence as both â€Å"burdensome and protective†, and it requires a skillful practitioner to know when to encourage unaccompanied minors to open up. Krause (1997) and Rashid (1996) both warn against social workers rushing to conclusions about unaccompanied minors based on their cultural backgrounds and what is known about their country of origin. Focusing on organizational targets and not the clients needs first, may result in the practitioner missing the cultural contexts of the minors’ experiences, within specific times and risks simplifying complex information that may be transmitted without adequate reflection on the communication experience overtime. In order to determine when it is appropriate to prompt for hidden information or stories from unaccompanied minors, social workers must recognize that such children may be trying to be accepted within a new culture while suffering a loss from their own (Kohli and Mather: 2003). Therefore, social workers must be observant and reflective (Schà ¶n: 1987, 1983) to determine when a child is assimilated enough and trusting of the practitioner service user relationship to revea l any hidden stories of their past lives. Richman (1989) also reminds that many unaccompanied children are very resilient because of their experiences and they may be busy trying to figure out their next move, or how to survive within a new environment and culture, or thinking about their asylum status, than they are interested in reliving past experiences which do not in their estimation contribute to their present survival. Consequently, practitioners are encouraged to engage in â€Å"therapeutic witnessing† (Kohli and Mather: 2003) rather than feeling the need to wring past experiences from unaccompanied minors. In drawing on Blackwell and Melzak (2000), Kohli and Mather (2003: 206) states: â€Å"In essence, workers are asked not to become action orientated helpers in the face of ‘muck and bullets’, but stay still enough to bear the pain of listening to stories of great loss as they emerge at a pace manageable for the refugee.† While Kohli acknowledges that it is difficult for a practitioner to remain still and allow a â€Å"discovery by drip† process to unfold with the refugee, he maintains that it allows refugees to â€Å"exorcise their demons and ghosts in the process of self-recovery† (Kholi and Mathers: 2003). This does not diminish the level of practical support that workers should offer to refugees, in fact it is through assisting to order their lives, that they will also make sense of their past and be more willing or open to sharing information about themselves. However, if and when refugees begin to share their experiences, practitioners must be versed on skills to encourage such interaction and should also be cognizant of their own reactions and judgement which can also be communicated to the client nonverbally and affect the â€Å"drip† method of divulging information. It is to these issues which this paper now turns. Relationship based interaction between service users and practitioners remain central to the core value of social work and reflect its best practice. Holloway (2003) concurs with this view by asserting that conversations between practitioner and client dictate how the trust relationship is formed and how the worker is emboldened to assist the client. In this context, a discussion on emotional intelligence (EI) and its importance to the communication process is relevant. Morrison (2007) quotes Goleman’s 1996 definition of EI as â€Å"Being able to motivate oneself and persist in the face of frustrations; to control impulse and delay gratification; to regulate one’s moods and keep distress from swamping the ability to think; to empathize and to hope.† This delayed gratification is applicable to the need for social workers to allow unaccompanied minors the space to understand themselves and their new realities while making sense of their past. It requires great empa thy and being able to perceive and identifying feelings in the self and others. Morrison (2007) links emotional intelligence and successful social work as being able to be conscious of the self while establishing good communication channels with the refugee. Morrison advises that social workers must be in tuned with their own prejudices and assumptions because many vulnerable clients such as unaccompanied minors are used to reading body language and silent communication signs to determine whether they should trust individuals. Therefore practitioners must ensure that their methods of practice reinforce good communication values rather than downplay them. One of the first methodologies used by the social work practitioner is that of assessment. Assessment frameworks in the UK give little space for the exploration of histories (Morrison: 2007). Consequently, the emotions which compel youth behaviour is often not deeply understood from unaccompanied minors, especially since they may be silent and initially provide minimal normative sketches of their past. Accurate observation during assessment will take note of feelings which may hide deeper emotions and record the moments when these windows into the past were glimpsed or sensed. Much can also be gain by the observation that expression is void of emotion, as this may also be an indicator that the unaccompanied minor realize that communication certain emotions in their language may give the practitioner space to questions their past and they may be skilled at hiding such feelings in their language and tone. If information from the refugee is sparse and void of emotion, the practitioner s hould make extra effort to be reflective in practice to ensure that their own perceptions or impressions are not being transmitted to the client. Goleman et al (2002) articulates that there is a situation of dissonance when one party feels like the other is out of touch with their feelings. The Audit Commission’s 2006 report (p.66) into the treatment of unaccompanied children, demonstrates how practitioner bias can affect the level of treatment given to refugee children: â€Å"Many unaccompanied children have multiple needs because of their experiences of separation, loss and social dislocation . . . Yet in many cases they do not receive the same standard of care routinely afforded to indigenous children in need, even though their legal rights are identical.† Practitioners must therefore guard against treating unaccompanied minors as â€Å"another client†, because the literature identifies them as being particularly in tune to all forms of communication within the interaction process, and they use this as a guide on who, when and how to trust. A vital part of the assessment is the interviewing of the unaccompanied minor. Wilson and Powell (2001: 1) maintain that â€Å"a childs thinking is dependent on a number of factors including memory, conceptual development, emotional development and language formation.† They further assert that there are three aspects to remembering information: knowledge, sequencing and prioritizing. They contend that practitioners must seek to gain all three trough safe methods when interviewing and practice patience. It is important to note their guidance that a memory may not always be told in the right sequence, and be prioritized according to the present needs of the child or in the case of this paper – the unaccompanied minor. Furthermore, they remind us that a child’s memory may not be accurate, this could be deliberately so (as already explored by Kohli: 2006), and they argue that it is up to the interviewer to use a method of questioning when appropriate to maximize the accuracy of responses. The Achieving Best Evidence in Criminal Proceedings (2007) document which provided information on interviewing children stated that interviewers must approach the interview with an open mind and that enquiries should not increase the distress of a child by allowing them to reluctantly relive bad experiences. Similarly, the 1998 Cleveland Inquiry Report suggests that: All interviews should be conducted by a professional with child interview training; Interview questions should be open-ended; There should be one and no more than two interviews for the purpose of assessment and it should not be too long; the interview should be paced by the child not the adult among others and it is recommended that the both the police and the social worker (if necessary) interview the child at the same time. These guidelines ensure that the interview adopts a child-centered approach. Another method that is advised with unaccompanied children is the phased interview approach. The phased interview approach is structured in three parts: the introduction and initial rapport establishment, the free narrative section and questioning section where the child is given space to communicate, alongside being questioned, and the closure of the interview. It is important to prepare children for the interview, through pre-interview contact to lessen any stress which may arise from being fearful of the process. Children should get ample time to consider whether they wish to share their stories or keep them locked away. Furthermore, the skill to actively listen is paramount to a social work practitioner as it not only assists with accurately observing, but it assures the child that what they are saying is being heard (Wilson and Powell: 2001). To assist in accuracy, the interviewer should reflect back the child’s responses to them for affirmation of clarification paying particular attention to maintaining neutral body language and tone while doing so (Thompson: 20 02). However, Wilson and Powell (2001) maintain that if a term is not familiar to the interviewer or seems like slang, the interviewer should make every effort to clarify its meaning with the child in order to maximize accuracy and assist in avoiding possibilities of intercultural communication. Bradford (1994) further posits that the interviewer has the responsibility to ensure the validity of the communication process by pursuing the statement validity analysis (SVA). The SVA checks that the testimony contains no contradictions or logical inconsistencies, the abundance of details, the accuracy of contextual evidence which may be verifiable, the ability to reproduce conversations and interactions and the presence of complicated obstacles. However, Davies (2006) warns that while this tool may be useful, it is not a accurate fix, particularly in the case of silent children who may choose to withhold traumatic information (Kohli: 2006). Wilhelmy and Bull (1999) argues that the use of drawings within interviews with child by practitioners should be encouraged where appropriate because it also provides assurance to the child that the interviewer is child centered. If this method is used, the interviewer must be very observant that this method does not make the child uneasy. While drawing may presents many opportunities to further question the child, the practitioner must as Kholi’s quotation suggests be extremely patient to unlock information and allow the interview to be paced by the child, thereby giving them space to trust the interviewing process. A child’s comfort with drawing, ay actually provide an opening to more difficult or painful areas and care should be taken to note and protect the child’s wellbeing and level of distress when painful information is disclosed. The use of role play and storytelling also offers unique methodologies to social workers to assist children in disclosing pain ful information. Outside of the interview process, Chamberlain (2007) recounts the use of storytelling by the Medical Foundation for the Care of Victims of Torture to assist refugee children from war torn countries to unlock their deeply buried painful memories when they are ready. He quotes Sheila Melzack the centers consultant child and adolescent psychotherapist as saying: â€Å"Many are in a state of suspended animation because they do not know whether they will be forced to return home. We are trying to give them coping strategies to deal with all these issues. But instead of saying directly what they saw or did we deal with it through displacement. They can be extracted through stories which create safe arenas to talk about these issues.† Therefore, Chamberlain (2007) and Davis (1990) asserts that stories can be utilized as a therapeutic intervention method to assist unaccompanied children to recall incidents, not necessarily airing them, but developing coping strategies that assist in building resilience in a new environment. There are however, instances where unaccompanied children come from countries whose language differ from that of the receiving country. Gregory and Holloway (2005) maintain that language is used both to grant and restrict access to a society or organization. Chand (2005) identifies the lack of adequate interpreting and translation services within the UK social work sector. Chand’s research located many instance where the services of interpreters and translators were needed but they did not show, usually because of lack of resources, so they prioritise which cases they believe are more important such as more formal case conferences. Humphreys et al (1999) found that many interpreters left case conferences and assessment early, or that interviews or conferences may be rushed because of lack of resources. In light of the previous discussion on the need for social workers to be patient and allow unaccompanied minors to work through past recollections until they are in a space to s hare, this practice of rushing sessions to facilitate interpreters, is detrimental to the communication process between practitioner and the unaccompanied child and could discourage disclosure and engender trust issues. As was discussed earlier in the theoretical section of this paper, language is closely related to power and can be used to control and regulate discourses and effect social control, based on its ability to include or exclude. The client-practitioner relationship is one in which the practitioner asserts their professionalism and therefore must take great care that such imbalance of power is not misunderstood by the client or imposed on them to hinder effective communication (Gregory and Holloway: 2005). Unaccompanied children, who have suffered trauma are usually used to being victimized by relationships of power imbalances, and therefore the social worker must always recognize that the relationship with such individuals is aimed at building their resilience and capacity :to adjust to all or any part of their new environment. While keeping practice client focused, recent years have seen the introduction of numerous guidelines, new legislation and policy changes which require the adherence and commitment of the social work practitioner. Some critics (Young: 1999; Malin: 2000), debate that social work has become mediatory and managerial under modern day guidelines and stipulations which risk the developing of solid client-practitioner relationships and the development of trust. While Gregory and Holloway (2005) argue that the language of such guidelines can be interpreted as the social control of the social work profession which ultimately seeks to â€Å"fix† the meanings of grounded work with vulnerable clients to suit political agendas. Social workers must remain committed to the ethic of the profession and promote good social work values by ensuring that such language of control is not transferred from the managerial spheres to what Schà ¶n (1983) terms as the trenches of social work, that is, th e interpersonal communication with clients. It is this regard that social workers must be aware of the power of language in working with unaccompanied minors, and ensure that the practice language is not dominated by a controlling or power induced thrust, but recognizes the vulnerability of clients and their need to slowly build trust and thaw their emotions (Kohli: 2006, 2007). As with language, the relations between social work practitioners and other services, can directly affect relationship with unaccompanied minors and how they trust the professionalism of those who communicate to them that they care. The death of eight year-old Victoria Climbie presents an example of how the lack of effective communication between professional practitioners can result in harm, especially to children from foreign cultures. The Laming Report of 2003, an inquiry into Victoria’s death concluded that the young girl’s death could have been avoided if individual social workers, police officers, doctors and nurses who came into contact with the girl, had effectively responded to Victorias needs. The National Service Framework for Children and Young People (NSF) and the Common Assessment Framework (CAF), both strive to ensure the effective communication between service providers across sectors. Glenny (2005) states that: â€Å"a lot of inter-agency collaboration is not about collaborative activity as such, but about communicating effectively with regard to individual pieces of work , ensuring patchwork of individual effort in relation to a particular [case], made sense†¦Ã¢â‚¬  Ensuring proper communication between agencies when dealing with unaccompanied minors, is therefore essential to build trust in the client-practitioner relationship (Cross:2004) and to remove any doubts the minor may have that the capillaries of power that agencies appear to be, will work for their benefit and well being and not contribute to any further victimization they may have suffered. It is therefore conclusive to say that the issue of managing effective communication is absolutely essential to successful social work practice with unaccompanied minors. The paper navigated the theoretical intricacies of the concept of communication to highlight its broad nature and how culture, language, body language and even silence are powerful communication tools tapped into by both practitioner and the unaccompanied minor in establishing boundaries of trust. One of the most evident revelations of this paper, is the need for practitioners to practice patience to allow unaccompanied minors the space to unlock their hidden stories, while providing them with support for their daily needs. Furthermore, the issue of intercultural communication difficulties that lack of interpreting and translation resources can cause in fostering best practice with accompanied minors was explored and it was identified that despite the lack of resources, unaccompanied minors are better served when th ey are not rushed for their hidden experiences. 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