BUILDING A RELATIONSHIP WITH A SERVICE USER

The 1960’s social revolution saw a change from the traditional medical approach to health to the Humanist approach of America’s third way and the theories of Maslow (1908-1970) and Rogers (1902-1987).
Gordon Allport also disagreed with earlier ideas of self concept, claiming all individuals were unique with unique experiences which shaped there understanding of the world.
According to Prentice-Dunn and Rogers (1982, 1983) there are two types of self awareness, public and private.
Public self awareness is how we reflect ourselves to others, how we are perceived, involving facts like name, age, gender, culture/creed, description, looks, the behaviour and personality we show in public. It is an indication how society may label us.
Private self awareness is how we see ourselves, our thoughts and feeling and the attention we pay to these and our emotions.
Labelling is how society groups us. This may be by gender, racial, cultural and social background, physical and or mental impairment and is often a result of stereotyping, when people are labelled by others according to perceptions of how groups in a specific label are assumed to behave or be.
Labelling and stereotyping people in this way is often a result of prejudice judging and treating people differently because of preconceived ideas of what we think they are like or because they are different, instead of respecting the uniqueness of every individual.
Labelling, stereotyping can make us feel we belong but can lead to prejudice and reduce public and private self awareness as it will affect how we see ourselves, our thoughts and feelings and therefore affect or cause loss of self identity. McIlveen, R and Gross, R.(1998).



There are two types of communication, verbal and non-verbal and is affected by tone, volume, language, body-language and facial expression.
Listening and writing are also methods of non-verbal communication.
Communication is affected by tone, volume and language as well as non verbal communication such as listening, body language and facial expression.
Writing is also a form of non- verbal communication.
Barriers which affect communication include linguistic and cultural, physical mental impairment and the words we use and how we use them.
Linguistic barriers could be our accent, language of origin, jargon, or a physical/mental impairment which affects speech.
Environmental, could be the surroundings, noise, temperature. Social barriers result from cultural difference, prejudice resulting
from stereotyping and labelling, and physiological barriers are often due to past experience or emotional trauma.
as illustrated by Lago (1997) who notes that language is a ever changing minefield, and alerts us to the power it has to buoy us up or pull us down, inflict pain or to encourage, to influence positively or negatively, to enhance self esteem or sabotage self-confidence or to manipulate or to understand.

Communication is paramount in care delivery where the biggest cause of inadequacy is often a result in political correctness gone made causing major inadequacies and discrimination in our ability to communicate. As suggested by Hutton, W. (2001) and explained by Thompson (1998).
Non verbal language may often be our first form of contact with service users so listening and looking is paramount as the ability to read body language, posture, stance, facial expression and how the service user behaves may often reflect mood or emotion.
Equally important is what our body language tells the client about us, friendly, approachability and open body language needs to be our reflection of our own emotional state. For example if a service user is displaying heightened emotional or aggressive behaviour facilitators must maintain a relaxed and controlled demeanour and not express emotions of fear or loss of control.
Equally important is as service providers we realise not all cultures share the same interpretation of body language and what is acceptable to one, may not be to another.
Verbal communication falls into two categories, formal and informal.
Informal is what we use when talking to friends, family and those who we are familiar with. Formal is how we speak to strangers or on a professional level. In communication with service users it is essential to find a balance of these forms of communication that the user understands, relates to and is not offended by.

Often paraphrasing is used to indicate we are listening, interested. We repeat back to the user what they’ve said in order to keep the communication loop flowing. Reflective language is also used in this way when we repeat something back and broaden it indicating empathy or sympathy enabling the service user to continue. Head movement like nodding or facial expression and eye contact often accompany paraphrasing and reflection.
The following example reflects how communication can be initiated, maintained and ended with a service user.
A colleague informs me that A, a 14year old client is “kicking off” having been told she can’t go to the park due to inappropriate dress. As key worker I address the situation.
When approaching A’s room I call fashion frump approaching is the cat walk clear?” and look round the door smiling demonstrating a non confrontational or oppressive approach. A is sitting on her bed and says “ your not fucking funny that bitch said I looked like

a slapper and can’t go out, she can’t tell me what to wear I can wear what I like. I’m making a complaint.
I ask A if I may enter, she nods, I sit next to her. A’s expression is angry and she is fidgety indicating heightened emotional behaviour. I explain in a calm tone that if she wants to make a complaint she has that right, that I can understand her upset if this is what she was called, reflecting sympathy in my facial expression. I assure her my colleague meant no offence and that she had A’s best interest at heart and was probably trying to reflect the unsuitability of her attire for the park trying to defuse the situation with humour. Saying that stiletto heels ain't best for climbing trees and miniskirts might leave her with a grazed bum that will make sitting down a joy. A smiles through a frown, I suggest she changes into suitable attire and thinks about what she wants to do regarding compliant telling her I will address the situation with my colleague. I tell her she can clear up when she gets back. She apologises saying “she wound me up.” I nod
sympathetically; say I know, downstairs for park 10 minutes. And leave.




REFERANCES

1 Davenport. G, C. (1995). Introducing GCSE Psychology. Collins Educational.
2. Hutton, W. (2001)
3 Lago (1997).
4. Lago, C and Smith, B.(2003) Anti-discriminatory counseling practice. London; Sage publications
5. Maslow (1908-1970) and Rogers (1902-1987). Anti -discriminatory practice in counselling (2001)
6.. McIlveen, R and Gross, R.(1998).
7. Prentice-Dunn and Rogers (1982, 1983)
8. Thompson (1998).