Southern Cross University
ePublications@SCU
School of Arts and Social Sciences
2013
Relationship-based practice with families where
child neglect is an issue: putting relationship
development under the microscope
Elizabeth C. Reimer
Southern Cross University
Publication details
Postprint of: Reimer, EC 2013, 'Relationship-based practice with families where child neglect is an issue: putting relationship
development under the microscope', Australian Social Work, vol. 66, no. 3, pp.455-470.
Published version available from: http://dx.doi.org/10.1080/0312407X.2013.814694
ePublications@SCU is an electronic repository administered by Southern Cross University Library. Its goal is to capture and preserve the intellectual
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world. For further information please contact [email protected].
Relationship building in child neglect
1
Running head: RELATIONSHIP BUILDING IN CHILD NEGLECT
Relationship-based Practice with Families Where Child Neglect is an Issue: Putting
Relationship Development under the Microscope.
Elizabeth Claire Reimer *
Centre for Children and Young People
School of Arts and Social Sciences
Southern Cross University
*
Correspondence to: Dr Elizabeth Reimer, School of Arts and Social Sciences, Southern
Cross University, Tweed Heads, NSW, 2485. Email: [email protected]
Relationship building in child neglect
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Abstract
Child neglect is a persistent social issue in Australia, with factors that hinder efforts to
intervene. Of particular concern are difficulties that have been raised regarding building
working relationships with parents where child neglect is a concern. This article draws on
findings of an Australian qualitative study that explored in depth multiple perspectives on the
development of relationships between family workers and parents where neglect is a concern.
It was found that the process of building trust, which was central to the establishment of the
working relationship and increased parent willingness to engage in child-welfare related
interventions, was something the parents in the study engaged in actively. They did this
through testing workers’ trustworthiness and by attempting to reduce perceived power
inequities between workers and themselves. It is argued that resistance to workers’ attempts
to build relationships are a healthy protective response by parents to challenge the
professional expectation they submissively build relationships with strangers who wield great
influence over their lives, and the lives of others in their family. Implications for
professionals include developing greater understanding of why parents might resist attempts
to build working relationships, and using this knowledge to accommodate parents’ resistance
where it arises.
Relationship building in child neglect
3
Child neglect (neglect) is a concerning social issue in Australia and elsewhere, with factors
that hinder efforts to intervene. It is a persistent problem and is usually recurrent (Berry,
Charlson, & Dawson, 2003; Daro, 1988; Polansky, Chalmers, Buttenwieser, & Williams,
1981; Tanner & Turney, 2003). Theorists and researchers have distinguished neglect as a
distinct type of child maltreatment, which justifies responding to it in ways that vary from
other forms of child maltreatment (Gershater-Molko, Lutzker, & Sherman, 2002).
While neglect is not a new phenomenon, the way in which it is understood is still
relatively undeveloped (McSherry, 2007; Wilson & Horner, 2005). There is considerably
more research that focuses on child physical and sexual abuse (or child abuse and neglect in
combination), than on neglect exclusively (Berry, et al., 2003; Tanner & Turney, 2003).
Furthermore, despite many years of research, no clear, uniform, comparable, reliable, and
unambiguous conceptualisation of neglect exists (Dubowitz, Newton, et al., 2005; Zuravin,
2001). While multiple definitions of neglect have been suggested (Zuravin, 2001), it is
generally understood that neglect is the result of omissions (rather than commissions) in care
by the child’s primary caregivers, usually their parents (Dubowitz, Pitts, et al., 2005). This
situation restricts efforts to understand the distinct nature and consequences of neglect. It also
inhibits making fiscally sensible decisions with respect to research and policy, and the
development of interventions that successfully reduce both its prevalence and impact
(Dubowitz, Newton, et al., 2005; Zuravin, 2001).
Of particular concern are difficulties that have been raised regarding the working
relationship (the relationship) with neglecting parents. Neglecting families have been found
to be more difficult to engage and retain in child welfare services than families experiencing
other types of child maltreatment (Berry, et al., 2003; Stone, 1998). Furthermore, Daro
(1988) showed that 40% of neglecting families prematurely disengage from services at a rate
Relationship building in child neglect
4
that is substantially higher than for other types of child maltreatment. In addition,
practitioners who work with neglecting families report higher feelings of apathy,
hopelessness, helplessness, and experience higher rates of burnout compared with
practitioners who do not work with such families (North Eastern Health Board & Horwath,
2005).
There is some evidence of the important role of working relationships to support
engagement of neglecting families in services (Berry, et al., 2007; DePanfilis, 1999).
However, the issues and processes relating to building working relationships with these
families remain largely unexplored (Girvin, DePanfilis, & Daining , 2007).This is partly due
to simplified ways of thinking about engagement in services (Littell & Tajima, 2000), which
could be ameliorated by more explicit and thoughtful focus on theories regarding
relationship-based practice when working with neglecting families (Turney & Tanner, 2001).
Literature Review
The development of a relationship has been regarded as one of the core features of work
in the human and social services (Clemence, Hilsenroth, Ackerman, Strassle, & Handler,
2005). This relationship has intrigued social workers, clinicians, researchers, and theorists for
over 100 years, dating back to the early social casework literature of Mary Richmond (1899),
and the relationship is the most empirically researched concept in psychotherapy
(Castonguay, Constantino, & Grosse Holtforth, 2006) and in social work (Priebe & McCabe,
2006).
Despite this, there are very few publications that utilise rigorous empirical evidence to
explore and make inferences about issues relating to working relationships with neglecting
families. Furthermore, there is very little literature that provides detailed examination of the
interplay between these client and worker characteristics, and their influence on the evolution
of relationships in neglect-related interventions.
Relationship building in child neglect
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The Relationship in Neglect-related Interventions
A number of researchers have found the development of a relationship that is
collaborative and authentic to be important when working with families where neglect is an
issue (DePanfilis, 1999; Zeira, 2007). Also, some have argued that it is important for the
client to see the worker as a “confidant”, because this helps reduce client resistance and
hopelessness (Gaudin, 1993a), along with linking clients to a range of community and social
supports (Berry, et al., 2003; DePanfilis, 1996).
Such relationships are considered important in order to improve retention and treatment
success, reduce family stress, and to improve the worker’s perception of the client (Berry, et
al., 2003; Girvin, et al., 2007). The relationship is a useful tool to model relationship and
conflict resolution skills (DePanfilis, 1999; DePanfilis, Lane, Girvin, & Strieder, 2004).
In relation specifically to the beginning phase of the relationship, it has been noted that an
important dimension includes building trust (Fernandez & Healy, 2007; Zeira, 2007), as this
supports parents to be open and cooperative with workers (Zeira, 2007). It has also been
noted that during this time, it is important to be empathic, although not excessively so.
According to Kenemore (1993), it is important to balance empathy with objective distance,
an idea Reimer (in press) has developed by exploring how family workers use friendship-like
characteristics to build highly personalized professional relationships.
Building a relationship is assisted when workers calm clients’ anxiety by being clear
about worker and client roles, boundaries, and expectations. This includes ethical boundaries,
agency policy, and legal requirements that might affect them (Kenemore, 1993), and to what
extent workers may intrude into clients’ lives (Fernandez & Healy, 2007).
Furthermore it is important to be perceived to accept the family, which involves an
attentive and nonjudgmental way of working (Zeira, 2007) ), approaching families more
tentatively than usual (Fernandez & Healy, 2007). This includes approaching family
Relationship building in child neglect
6
members from a position of respect, equality, mutuality, and reciprocity. This assists clients
to develop a sense of agency over the situation (Beeman, 1997; Fernandez & Healy, 2007;
Zeira, 2007).
A number of researchers have noted that providing for immediate emotional and concrete
needs, such as using brokerage money to pay outstanding utilities bills or to purchase white
goods, is important when building the relationship (Berry, et al., 2003; Fernandez & Healy,
2007; Gaudin, 1993a; Zeira, 2007). However, this must be done in a way that is relevant to
clients (Kenemore, 1993). Furthermore, relationship building is supported as workers and
clients develop mutual understanding of clients’ needs and intervention approaches
(Kenemore, 1993), and as workers become prepared to alter preliminary treatment plans in
light of changed understandings of the families’ needs (Zeira, 2007).
Clients may come to the relationship with barriers to developing effective relationships.
Such barriers include difficulties regarding, and resistance to, developing and sustaining
professional relationships generally (Kenemore, 1993). Common family relationships that
have been found to affect relationship building are marked by negative issues such as a sense
of hopelessness (Polansky, et al., 1981), maternal depression (Gaudin, Polansky, Kilpatrick,
& Shilton, 1993; Wilson, Kuebli, & Hughes, 2005), and a history of negative relationships
and communications, such as conflict, and lack of warmth and empathy (Beeman, 1997;
Gaudin, Polansky, Kilpatrick, & Shilton, 1996). These issues, which some identify as
involving a reduction in, or absence of, a care relationship generally (Turney & Tanner,
2001), lead to lack of responsiveness within relationships (Beeman, 1997; Wilson, et al.,
2005). In line with this, some note that it is common for neglectful families to offend
potential sources of informal support, such as neighbours (Crittenden, 1985).
Others have explored the way in which power inequities between participants can hinder
relationship building in such families (Turney & Tanner, 2001). This includes viewing
Relationship building in child neglect
7
professionals who are offering help with suspicion (DiLeonardi, 1993), especially when
families fear statutory intervention in their lives (Fernandez & Healy, 2007; Petras, Massat, &
Essex, 2002).
Finally, some have noted that clients need space and time to put the effort into developing
the relationship because of their often chaotic, overwhelming, and complex circumstances
and needs, and because of the many other services with which they are frequently involved
(DePanfilis, et al., 2004). In the case of chronic neglect, workers need to be persistent and
should expect and be prepared to work consistently with families over the long term (Daro,
1988; Gaudin, 1993a; Stone, 1998; Thoburn, Wilding, & Watson, 2000).
Rationale
This paper draws on research findings of a qualitative empirical study which took place in
a regional area of New South Wales, Australia. The study was designed to explore how
parents, family workers, and supervisors in family services, who are working with families
experiencing neglect issues, understand the nature of the working relationship: its purpose,
value, and meaning (Reimer, 2010). The research involved exploring reported perceptions of
their experience of the relationship, the meanings they ascribed to these experiences, and
factors perceived to affect the development of the relationship.
Greater awareness and understanding of the nature of professional relationships with
families where neglect is an issue, and in particular of the types of issues that arise, which
facilitate effective engagement and limit premature intervention closure, will assist in a
number of ways. Such research can identify elements of best practice for the development
and maintenance of relationships during neglect-related interventions. This may ameliorate
responses that label neglecting families as “untreatable”, and so reduce “the need to move
quickly to terminate parental rights on behalf of their young children in out-of-home-care”
(Wilson & Horner, 2005, p. 476). It is also expected that greater knowledge will decrease
Relationship building in child neglect
8
levels of worker apathy and sense of helplessness and hopelessness, and so help reduce rates
of worker burnout and staff turnover.
Method
Methodology
The study utilised qualitative methods to explore, in depth, and in a holistic fashion, the
complex multiple and layered dimensions of eight relationship dyads (Ruckdeschel,
Earnshaw, & Firrek, 1994; Stark & Torrance, 2004). Case study methods (Yin & Campbell,
2003) provided a way to organise the data, while thematic analysis (Braun & Clarke, 2006)
enabled rigorous analysis and confidential presentation of the findings. Confidentiality was
required as the participants live and work in small rural communities, and could be easily
identified. It is also for this reason the specific location where the study took place remains
undisclosed. Such organisation and analysis enabled the author to analyse and describe
patterns between different peoples’ lived experiences of like relationships (Braun & Clarke,
2006).
Ethics
The author secured ethics approval from the University of South Australia. Ethical issues
related to potential perceived power differences between the participants and author, and the
participants and services (Macdonald & Macdonald, 1995), as well as to the matter of
providing payment to parent participants for their involvement in the study (UnitingCare
Burnside, 2002). To ameliorate issues of power, the research was conducted retrospectively,
and participants were repeatedly informed that their involvement was voluntary. Participants
were also informed that the study was independent of the service, and so would not affect
their involvement with the service. Regarding the A$40.00 payment, which only parents
received, participants were informed that it was to go towards costs incurred related to their
participation.
Relationship building in child neglect
9
Context
The participants involved in this study are part of the 30-year long tradition of family
work in NSW, Australia. The services were originally developed to fill a support gap for
families who cannot access normal informal support (Wolcott, 1989; Zigler & Black, 1989),
or who find that previously established formal social welfare services cannot adequately meet
their needs (Wolcott, 1989; Zigler & Black, 1989). The workers deliver multiple programs
such as home visiting, information and referral, playgroups, parenting groups, centre based
support, and counselling services (NSW Family Services Inc., 2009). The workers operate
within a framework of voluntary, strengths based, community embedded, and empowerment
practice that includes building connections to the broader community through universal
support mechanisms such as playgroups (NSW Family Services Inc., 2009). Despite this,
many parents who attend family services have been referred due to their involvement with the
statutory child protection system. While the family workers are clear that parents are not
mandated to attend, that the service is not explicitly an agent of the statutory child protection
system, and that the workers do not have statutory child removal powers, parents usually feel,
at least initially, that the threat of child removal is real.
Sample Selection and Recruitment
Eligibility depended on the relationship having been established around a neglect-related
focus and having ceased within the last three months. Parents who recruited to the study had
to have been a client of the workers who were also recruited. At the time of the study, neglect
was defined in NSW legislation as “the continued failure by a parent or caregiver to provide a
child with the basic things needed for his or her proper growth and development, such as
food, clothing, shelter, medical and dental care, and adequate supervision” (NSW Department
of Community Services, 2006, p. 6).
Relationship building in child neglect
10
Recruitment involved informing workers of the study and inviting them to participate.
Workers who subscribed were asked to provide eligible parents with minimal information
about the study, subsequent to ceasing a family work intervention. This included an invitation
to parents to inform the worker’s supervisor, or researcher directly, if they were interested in
being involved, and inviting them to subscribe after a conversation where further information
was provided.
Participants
The number of participants in the study totalled 21, made up of 9 parents (where a couple
had been engaged with 1 worker in a relationship), 8 workers, and 4 supervisors. The
relationships varied in duration, but all could be considered medium to long term, lasting
from over 1 year in all cases to over 5 years in two cases.
With the exception of 1 parent and 2 workers, all of the participants were female. Six of
the parents and all of the workers and supervisors identified as being from Anglo Celtic
background. One parent had emigrated from Ireland within the past 10 years. One parent
identified as being from an Aboriginal background and another parent was from a New
Zealand Maori background. The ninth parent did not specify her cultural background.
Consequently, there may be cultural and gender limitations, where most participants were
female, and of Anglo Celtic origin.
The eight workers had from 2- to over 30-years family work experience and all were
tertiary educated. Five held bachelor degrees in areas such as social science, social work, and
community work. The other three held vocational diplomas in community welfare. The
supervisors were all tertiary trained. One had completed a Masters degree, two others held
Bachelor degrees, and one had received vocational education in community work. They had
from 3- to 12-years family work experience.
Relationship building in child neglect
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Procedure
Using in depth interviews (Minichiello, Aroni, Timewell, & Alexander, 1995), and
drawing on literature about the notion of phases in relationships, participants were asked to
provide a chronological account of the relationship. While the parents were involved in the
relationship due to neglect concerns, the focus of the interviews was the relationship, rather
than on the child or child protection issues that may have existed.
With the exception of three of the supervisors, each participant was interviewed once
only. Of those three supervisors, one supervised 3 workers, and completed 3 interviews,
where the interviews were focused on a different relationship each time. Two supervised 2
workers each, and each spoke to the author on 2 separate occasions, each time about a
different relationship they were involved in.
Analytic induction (Denzin, 1978) was used to examine the de identified transcribed data
for key words in three relationship cases. This involved highlighting, and then grouping, the
key words that concretely described parent, worker, and supervisor “actions” and “attributes”.
These key words concretely described the experiences of the participants, which is what the
research questions related to, and became subthemes under the themes “action” and
“attribute”. A list of other key words was also developed. These recorded who was speaking,
who was being spoken about, the phase of relationship, where the relationship took place,
other contextual issues, and the purpose, value, and meaning of the working relationship.
These became the starting point for generating a more standardised thematic analysis
across the eight relationships. Following this process, the manually analysed data were
entered into NVivo qualitative analysis software (Bazeley, 2007), and the remaining
transcripts were analysed using the inductively derived subthemes.
Once completed, the author developed a Microsoft Excel spreadsheet to organise the
action and attribute subthemes by the participant voice and phase of the relationship themes.
Relationship building in child neglect
12
This spreadsheet helped build a picture of how common subthemes were to the participants’
experiences of the relationship, and it was used for closer examination of patterns between
the relationships. Disconfirming evidence in particular stood out clearly. The interviews,
transcriptions, and analysis were conducted by the author.
Results
The following will summarise the findings of the parents’ and workers’ reported
perceptions of the factors affecting the building phase of the relationship in which they were
involved. While the aim of the paper is to explore all facets of these developing relationships,
the theme of developing trust emerged as the key factor involved. In light of this, the
remainder of the paper has been arranged to explore how trust developed, and discuss this
theme in light of the literature and its implications.
Given that the supervisors sit outside the relationship dyads, but are part of the context,
they were more limited than the parents and family workers in their ability to comment on
key attributes of the building relationship. Consequently the paper explores the building
relationship from the parent’s and worker’s perspectives. Direct quotes will be used
throughout.
Parents’ Desperation and Ambivalence
The building phase was characterised by the parents feeling a high level of vulnerability,
desperation, and ambivalence. In particular, parents and workers described how the
associated anger or fear of poor experiences impacted negatively on the early part of the
relationship.
The parents were often unwilling, commonly making it difficult for the workers to engage
them. Parents used words like “desperate” and “defeated” to describe how they felt before
commencing the relationship. They described how fear of child removal, distrust,
guardedness, and concern about confidentiality became a barrier to trusting the family
Relationship building in child neglect
13
worker. Workers reported that parents described feeling angry, hurt, and distrustful as well as
tired, burdened, and unmotivated when faced with the prospect of having to develop another
relationship with a professional.
Parent apprehension came from unfamiliarity with the family service and worker, fear of
being judged, and not knowing what to expect. It also came from feeling under some kind of
pressure to engage. Most common were feelings of extreme desperation or fears related to
statutory child protection intervention, both currently, and in the future.
All of the parents described previous positive and negative experiences with human
services workers from government and non government agencies alike, for example,
The whole counselling side of it was very daunting for me. I’ve had really bad
experiences with counsellors….[They] were not understanding. Were very
cold...Turned me off a lot of counsellors. So coming in I was very, “Is this one gonna
work?” I was really reserved that they weren’t gonna be able to help me. Weren’t
going to understand where I was coming from. I wasn’t really up for it. But, in order
to keep my children….I had to do something. (Parent 7)
Common reflections on previous negative experiences were that they increased parent
distrust and ambivalence to build a new relationship. In contrast, some parents also
commented that previous positive experiences of relationships with workers assisted the
attitude with which they approached building the relationship. One parent, who had
experienced both positive and negative relationships previously, reported that her feeling of
vulnerability reduced when she focused on the degree to which the worker made her feel
comfortable, rather than the previous very negative experiences with child and family service
workers.
While a combination of these concerns resulted in ambivalence for the parents, this was
resolved by parents putting aside their fear and becoming sufficiently motivated, or willing,
Relationship building in child neglect
14
to give their worker a chance to prove why the parent would want to engage. A common
factor was recognition that they needed assistance from an outside source, as their own
personal and existing professional support systems were inadequate. This was usually
because they felt people were not listening or were unable to respond adequately to their
needs. The parents recognised that they deserved better for their lives, and were motivated to
achieve this. However, they felt overwhelmed, uncertain, and nervous about achieving the
change.
Interestingly, it was also common for workers to feel apprehensive and struggle with
motivation during this phase. Apprehension mostly occurred prior to meeting the parent.
While none of the workers said that they felt apprehensive about their ability to build a
relationship with the parent, some were anxious because of what others had said about the
parent, some doubted their ability to help the parent meet their needs, while some were
concerned that the parent would not be willing to engage or work on the identified issues.
While apprehension reduced once workers realised the parents were willing to engage and
were receptive to what the worker was saying, a powerful source of motivation was their
identification and strong emotional connection, which they developed with the parent.
Parents Assessing Worker Qualities
Although parents felt unable to meet their own needs and be the kind of parent they
wanted to be, and this motivated them to either seek or accept support, they were not yet
willing enough to lose some sense of agency over the interaction. Most participants reported
that parents tested workers during this phase, as explained by one worker,
I think there was some testing from her. She was testing the waters to see if I would
judge her. From one session to the next, she would often repeat the same
conversation. But then there’d be just a little bit extra detail. And I felt that was a test.
(Family Worker 3)
Relationship building in child neglect
15
This included testing the character of the worker to decide whether or not they were
trustworthy, judgemental, and if the parent felt comfortable with the worker. It required
getting to know the worker, but at the same time not revealing too much about themselves
until they decided the worker was “right”. It also involved being guarded when discussing
their issues, telling varied accounts of situations, remaining silent and avoiding contact, or
making contact randomly and intermittently.
Knowing a worker was “right” was also promoted through discovering some similarity
with the worker, for example a common experience of parenting, both being smokers, or
having had similar interests or hobbies. Parent identification with the worker seemed to mark
a turning point in the building relationship. It reportedly influenced the degree to which
parents trusted, opened up, and were attentive and responsive to the worker regarding their
needs and making life changes. Furthermore, while most workers and two parents also
reported that doing something practical to meet a need early on was important, focusing on
building an emotional connection seems to be considered more important in this study than
focusing on meeting an immediate need during the first few encounters.
Worker Actions and Attributes
Important worker actions and attributes during this trust building phase included workers
providing a first impression that they were genuine/authentic, active in their attention to the
parent, willing to help, focused on capacities, empathic, non judgemental, patient, flexible,
collaborative, and confident in their dealings with the parent. Underpinning all of this was a
perception of worker respect for the parents. As one worker expressed it,
You’ve got be very natural. You’ve got to be not pushy. You’ve got to be very
respectful of them....Everyone is different so you’ve got to get a sense of what’s going
to work with that person. How am I going to work with this person? Build that
Relationship building in child neglect
16
trusting relationship. Because, it’s that first meeting with the family. It’s that
important to build that trust. (Family Worker 5)
Being attentive and responsive occurred from the first meeting and remained important
throughout the entire relationship. It involved providing solutions to parents’ concrete and
emotional needs, but not in such a way that they felt disempowered. This required gaining
parents’ perspective on needs, tailoring responses to those expressed needs, and
acknowledging parents’ ideas and their roles in meeting the needs. It also involved taking
time to build trust and clarify what needed to be done, instead of moving to setting goals
early in the life of the relationship.
Parents and workers also reported that worker empathy was important. This was
described as the idea that workers understood what the parent was experiencing to some
degree. Empathy was also described in terms of workers showing care and giving the
impression that they cared about the parent. These ideas were summed up by one parent who
described her family worker as, “the type of family support worker who understands. She
actually feels at the same time. It’s like she understands how you're feeling” (Parent 2).
Furthermore, it was considered important that workers were interested in more than
just the professional issues. This meant having a wide range of topics for conversations and
being prepared to follow the parent’s interests even though it might not seem related to the
family work focus. Some parents described how they felt workers from other organisations
were not similarly helpful as they could not be flexible and go outside the exclusive focus in
those agencies.
Worker patience and flexibility, along with workers being available to the parent as needs
arose, were reported to help form a strong foundation to the relationship. The relationships
took different lengths of time to build, where two virtually instantly developed trust, but the
others took up to six months to achieve this. The workers involved in relationships that did
Relationship building in child neglect
17
not form quickly commented on the need to be patient and flexible, and to take the time to
enable the parent develop trust and overcome unwillingness. They said that this needed to
occur before they could begin to focus on meeting the parent’s needs and begin challenging
them to focus on their needs themselves.
Collaboration as reported by the parents was characterised by open and honest
communication and negotiation, particularly about the parents’ needs, what the workers could
offer, and the relationship parameters. It also involved the parents feeling some sense of
choice and power regarding the process. It is apparent that this was made possible by the
workers’ flexible and accommodating approach regarding what they were prepared to do and
how involved they were prepared to be, depending to some extent on what the parent said
they wanted.
Finally, some parents noted that it was important to perceive the workers as confident or
competent. They described the workers as resourceful, knowledgeable about a range of areas
of professional expertise and life in general, able to respond to the parents’ changing needs,
and able to connect with people from a variety of backgrounds.
Trust
Parents and workers described that parents progressed from unwillingness to willingness
as they got to the point of connection and feeling comfortable, the lynchpin of which was
trust. As one parent noted, “I think the relationship’s really important in regards to it all
because if you don’t trust someone, if you don’t have the respect there, between both client
and counsellor, then there’s really no point in having counselling” (Parent 7).
Trust for the workers had strong practical implications. Parents described becoming more
attentive and responsive to what the worker was saying once trust was built. Willingness to
engage openly and honestly about deeper issues was specifically described by all but one of
the parents as linked to trusting the worker. Interestingly, the parent who did not report a link
Relationship building in child neglect
18
between the relationship and trust took a long time to engage with the worker, approximately
six months, and, according to both the worker and supervisor, did not make herself available
to the worker until trust was built.
Prior to this point, the parents discussed more obvious or publicly known issues, such as
those related to the immediate and concrete needs they wanted met, or issues they thought
might shock the worker. They used disclosing these types of issues to test the worker’s
trustworthiness. Most workers and a couple of supervisors reported that parents used this
strategy.
For some, this process was instant and occurred during the first meeting as they got to
know the worker whereas, for others it developed over a period of months. In addition, one
parent who had been involved with the family service previously, described feeling willing to
work with the worker from the outset because she had already established trust in the service.
Discussion
This study supported previous findings of studies focused on child neglect that
found trust to be central to the establishment of working relationships (Campbell, 1997;
Fernandez & Healy, 2007; Zeira, 2007). It supported others focused on families where
neglect is an issue who recognise the historical context of negative relationships (Beeman,
1997; Gaudin, et al., 1996) and power laden aspects of working relationships (DePanfilis,
2002; Petras, et al., 2002; Turney & Tanner, 2001). It also supported previous findings that
parents may test the level of worker trustworthiness and attempt to reduce power inequities
(Beeman, 1997; Turney & Tanner, 2001; Zeira, 2007). However, this study expanded on
previous studies by exploring in depth the nature of trust development with families where
child neglect is an issue, which had been raised but not explored extensively (Zeira, 2007).
Importantly, this study found that the parents’ active attempts to test for workers’
trustworthiness was fundamental to reversing the parents’ unwillingness to discuss the issues
Relationship building in child neglect
19
that went to the heart of the neglect concerns regarding their children. This began with the
finding that a very important feature of establishing trust involved the parents discovering a
personal connection, or similarity, with the worker in the context of a professional
relationship. This finding further supports the notion that it is important to find a balance
between objective, or professional, restraint, and empathic attention when working with
clients in social welfare settings (Campbell, 1997; Kenemore, 1993), including statutory child
protection (Petras, et al., 2002). However, this balance is difficult to achieve because while it
is obvious that setting expectations and boundaries around the relationship is very important
(Fernandez & Healy, 2007; Kenemore, 1993), the parents in this study were clear that an
integral aspect of trust development involved workers themselves providing some level of
personal disclosure.
In light of such findings, it could be argued that active parent resistance to developing
working relationships is a reasonable and healthy protective response, rather than a
perception that such families are ‘untreatable’ or deficient (e.g. Wilson & Horner, 2005;
Kenemore, 1993; Stone, 1998). The basis for this idea comes from the finding that eight of
the nine parents involved in the study discussed testing their worker’s trustworthiness
actively. None of these eight parents had previously experienced the worker or service, and
all eight of them had prior negative experiences with professionals from other services. This
contrasted with the parent who reported coming to the relationship with her family worker
from a position of trust from the outset because she had previously experienced positive
relationships with workers from that service, so felt she had no need to test the worker. With
this in mind, it is worth considering that the way these parents approached these relationships
is similar to the way most people approach building relationships where there is an obvious
power imbalance; that is, with ambivalence, suspicion, caution and, depending on the
circumstances, desperation, but measured by motivation to try.
Relationship building in child neglect
20
The implication is that the onus is on the profession to ensure that clients’ experiences
of client/worker relationships are positive ones, and that they meet clients’ need for testing
trustworthiness, rather than considering negative client deficiencies to be the problem. More
could be done to build relationships with members of the target community prior to them
being formally referred for interventions, as this would ameliorate the need for clients to test
for trustworthiness later. Furthermore, it would help if workers considered client resistance to
developing relationships through the client’s perspective. This would include reflecting on
how they would feel if they were similarly being asked to build a relationship with someone
they do not know, had no reason to trust, and where there are obvious power imbalances;
particularly when previous experiences of such situations have been negative.
Conclusion
The findings offer useful insights and may contribute to the developing body of
knowledge about the nature of relationships with families where neglect is an issue.
However, this study needs to be seen as exploratory, and the findings as tentative, and
requiring further research. Such research should be conducted to test the current findings,
utilising research participants with varying characteristics and in a number of different
practice settings.
Interestingly, since the study began, a number of studies have been published that are
very salient to the relationship focus of this research (e.g., Ruch, Turney, & Ward, 2010).
This places the current study within a context of growing interest in, and exploration of, the
nature of relationship-based practice in child welfare work (Thoburn, et al., 2000). It sits
alongside a growing body of qualitative work that explores the relationship in greater detail
than has been done previously, supplementing the qualitative literature and complementing
the quantitative literature.
Relationship building in child neglect
21
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