Diversity (and what it really means in society in practice), and especially in terms of social work (anti-discriminatory) practice is an ongoing issue.  Social workers in an increasingly diverse society are being presented with issues which are underpinned by a range of difference in domains which extend beyond race or ethnicity. People are adopting a variety of lifestyles based upon personal beliefs that are just as much about their culture as their ethnicity might be. In the context of this ever-growing notion of diversity, our commitment to cultural competence also needs to continue to develop. Do we need to step back from our defensive, reactive practice and revisit cultural competence as a core tenant of social work practice?

The UK is becoming increasingly diverse and society more questioning. More and more people are rejecting traditional approaches to education systems;  and complimentary and alternative healthcare is on the rise.  People are increasingly choosing to live in a variety of ways that challenge concepts of health and social wellbeing; and beliefs around medical care and education are key areas which present a challenge to health and social care professionals when working with people. When presented with people deemed a risk to themselves or others owing to preconceived notions of standards or societal norms, organizational anxiety is often generated. It is in the context of this anxiety that social workers receive referrals. Whilst social work training acknowledges issues such as Jehovah’s Witnesses and blood transfusions and other cultural and religious beliefs that influence people’s choices around healthcare, there is a need to evaluate all facets of an individual’s belief system, values and culture in this ever-changing climate.

Power and authority being challenged

Oftentimes it is not the social worker but allied professionals driving prejudicially-influenced practice. There have been a number of high profile cases of children where parents have refused or advocated for certain treatment which is considered ‘outside of the norm’ and have had their parenting called into question as a result; vaccinations are a prime example where medics threaten parents who refuse to vaccinate with referral to social services as a coercive tool.  High profile cases where home education was a factor in a wider picture of neglect has led to medics and education services also regarding it in itself as a ‘red flag’ and using it as a prime referral reason. However, we might ask, is this in fact about power and authority being challenged and the anxiety generated by being confronted with diversity or really about the welfare of the child?  Evidence shows that children who are home educated are disproportionately scrutinized:  whilst they are almost twice as likely to be referred to social services, they are five times less likely to be placed on a Child Protection Plan than schooled children (Charles-Warner, 2015). Other examples where prejudice may be driving practice include examples such as a child put into care owing to concerns over the impact of the mother’s religion (e.g. Bingham, 2015) and cases of fabricated illness syndrome (e.g. Adams, 2019).  Bilson (2019) asserts that, “we have got a huge increase in this and more and more families are being harmed by our misled attempts to rescue children.” Commitment to cultural competent practice is key: understanding and being sensitive towards others’ cultures affords us the unique opportunity to educate but importantly “dispel any generalizations or myths” (Vasquez, 2019). 

At what point does a lack of reflexivity lead to prejudicial practice?

The dichotomy for those in the caring professions is balancing the responsibilities of care and control. However there is a danger that social workers fail to question those institutions which it sees as being part of the same community-serving body – i.e., education and health services – even when they may ultimately be sources of oppression. Guidance that social workers are directed to rely on is based upon empirical evidence arising from research which is often not as impartial or bias-free as we would like to think. Many medical and education professionals have little time or space to really evaluate that which they were spoon-fed in training and therefore it could be that we are being guided by the blind or at least seriously blinkered.   It is easy to forget that it was not that long ago that the medical profession advocated for the health benefits of smoking; whereas now it is regarded as the root of many serious health complaints. I would argue that we mustn’t lose sight of our unique opportunity to be impartial and that begins with listening to the individual. Perhaps the question is at what point does a lack of reflexivity lead to prejudicial practice?

We live in a culture where scientism is the dominant discourse

Social work occupies a unique space where its knowledge base is drawn from many different disciplines; but increasingly a profession which has formerly prided itself on being open and questioning of the dominant discourses may be at risk of being part of the same machinery that discriminates and wields power if we fall prey to the same prejudice that other, less reflexive professions, may hold.  At one time, social workers in mental health teams saw their roles as advocating for the service user and (with the role of approved social worker) ensuring that admission was indeed necessary; often they would see themselves as the only voice aside from the service user powerful enough to question the medical model. Over time this role has changed and is now no longer the preserve of the social worker (although the extent to which this has changed practice is unclear). Increasingly we live in a culture where scientism is the dominant discourse but, as Hughes (2012 ) argues, “..is it true that science is more capable, even singularly capable, of answering the questions that once were addressed by philosophy?”  Social workers have always tended towards a more philosophical or questioning approach to understanding the unique challenges that individuals face as understanding values (underpinning the majority of human action) requires philosophy; we need to be careful that we don’t lose this unique perspective in the context of ever defensive practice.

Reflecting upon our own beliefs

Anti-discriminatory practice (through reflective practice) has at its core the practice of reflecting upon our own beliefs, how they might be different to those we work with, and how they might influence how we intervene. Ryan Wise argues that we cannot be expected to put our beliefs to one side but that we need to engage with ourselves reflexively when encountering difference. He suggest we engage with the Social Graces (areas of diversity in beliefs, power and lifestyle) in order to be truly aware of what we think and believe. Recognising that cultural competence needs to encompass more than more obvious forms of oppression is essential in this process. Only once do we do this and employ a more philosophical approach to working with individuals, can we be sure our commitment to diversity and anti-discriminatory practice is fulfilled.

By Lucy Padina