Introduction
This article provides insights into the client−practitioner interaction, as understood through the eyes of those working at the front-line in a Drop-in Centre for homeless people. It will show that workers oscillate between conditional and more flexible approaches, as part of efforts to challenge or shape clients’ behaviour. Analysing techniques, ideas about service users and the practitioners themselves enables us to understand modern ideas about social problems, beliefs about causes of individual clients’ needs and experiences and the perceived benefits of specific policy and practice responses. Practitioners adopt a range of techniques for the responsibilisation and ‘recovery’ of clients. In part these approaches reflect or are permeated by ’top−down’ policies. However, the article argues that practitioners’ ideas about clients operate alongside government recommendations for practice, and occasionally lead those working at the front-line to subvert or deviate from such strategies. The ‘realities’ of clients’ ‘support needs’ (specifically a combination of substance mis-use (alcohol and drug addiction), mental-ill health problems and traumatic histories) mean that it is not always possible to achieve change in clients’ behaviour in a linear or process driven way. Empirical research presented here suggests that workers’ perspectives were influenced by assertions that service users required tolerant responses that acknowledged their human fallibility and frailty, as well as recognising the outcomes of certain approaches in a more ‘pragmatic’ way.
The research presented in this article is part of a study that aimed to explore disciplining and therapeutic elements of support work with clients recognised as both vulnerable and transgressive. In recent years, the emergence of discipline and therapies in social welfare policy and practice has been subject to some scrutiny (cf. Burney, Reference Burney1999; Rose, Reference Rose1999; Burney, Reference Burney2005; Rose, Reference Rose2000; Harrison and Sanders, Reference Harrison, Sanders, Dearling, Newburn and Somerville2006). For the purposes of this discussion, ‘discipline’ refers to the notion that workers can deploy tactics that contain authoritarian, paternalistic and enforcement measures (including legal sanctions) as part of their efforts to help clients. The use of the term ‘therapeutic’ indicates more holistic, careful and less conditional approaches. Findings show considerable overlap between the concepts, with the disciplinary believed to possess therapeutic possibilities, and vice versa.
The article concludes that it is vital to move beyond an analysis of the conditionality in front-line support work as just an indicator of individualising tactics. Instead there are a range of drivers underpinning practitioner motivations for challenging client behaviour. This article focuses on how perceptions of clients, and ideas about ‘support needs’ in particular, shape practice choices at the front-line, conceptualised here as bounded agency (Phillips, Reference Phillips2006).Footnote 1
The role of ‘behaviourism’ for policy and practice
The term ‘behaviourism’ is used to conceptualise conditional policies and practices that make efforts to influence client behaviour that institutions and practitioners judge as problematic, deviant or troublesome. In the present discussion, the notion of ‘influencing’ refers to efforts to normalise, responsibilise and socialise clients towards behavioural norms associated with autonomous living. The notion indicates an individualising approach when conceptualising ‘social problems’ and responding to clients, which contrasts to a more structural analysis. It might be argued that what all social policies have in common (as a basic conjecture) is a desire to generate behaviour change (cf. Pawson, Reference Pawson2003). However, in recent years, scholars have suggested a distinctive emphasis on controlling, managing and remedying behaviour identified as problematic for government, local areas and communities, as well as for individual clients themselves.
Researchers have pointed out New Labour's emphasis on regulating citizens’ conduct by way of conditions and sanctions (Rose, Reference Rose1999, Reference Rose2000; Deacon, Reference Deacon2002, Reference Deacon2004; Crawford, Reference Crawford2003, Reference Crawford2009; Flint, Reference Flint2004c, Reference Flint2005, Reference Flint2006a, Reference Flint and Flint2006b, Reference Flint, Barnes and Prior2009; Rodger, Reference Rodger2006). For example, under Labour, the use of Anti-Social Behaviour Orders and a host of other sanctions designed to regulate individuals (including tenants and rough sleepers), was part of a project apparently informed by popular appeal (‘neighbours from hell’), and demands for change from the workers and tenants’ groups at the front-line (Flint, Reference Flint2002, Reference Flint2004a, Reference Flint2004b, Reference Flint, Barnes and Prior2009; Flint and Nixon, Reference Flint and Nixon2006; Rodger, Reference Rodger2006; Squires, Reference Squires2006; Squires and Stephen, Reference Squires and Stephen2005). It has been documented that those who are homeless or in housing ‘need’ have become increasingly subject to the disciplining gaze of state and voluntary sector organisations (Fitzpatrick and Jones, Reference Fitzpatrick and Jones2005).
Historically speaking, it is possible to identify that housing services, and housing itself, have been offered as a ‘gift’ as opposed to a social right. This perhaps sits in contrast with different arms of the UK welfare system that offer more collective benefits, available at point of delivery, such as health. Making receipt of provision conditional upon adhering to standards of behaviour and the idea of a ‘social contact’ between citizen and state in welfare provision are not necessarily new, and context is important for analysis of the ‘gift’ at any one time (Harrison, Reference Harrison1995). For instance, increased rationing of public resources during times of perceived economic crisis may encourage focus on how far recipients are ‘deserving’ of provision. This in turn can result in selectivism on the basis of assessed ‘need’, and attendant growth in policies and practices to support such processes. For example, Harrison and Sanders (Reference Harrison, Sanders, Dearling, Newburn and Somerville2006) have explained that assessment of clients’ (including rough sleepers) ‘deservingness’ involves identification of ‘victims’ who would receive greater resources than those who had behaved in ways that ‘caused’ their problems, and were therefore undeserving, and that reduced access to resources might represent ‘punishment’ for deviant behaviour.
Scholars have noted that at the grassroots, practitioners may resist ‘tough’ or disciplining policy messages, by way of efforts to be ‘supportive’ and offer therapeutic responses towards transgressive clients. Prior (Reference Prior, Barnes and Prior2009) has discussed potential for counter-agency in policy implementation, describing processes of revision, resistance and refusal by practitioners, whereby objectives or intended outcomes of policies are modified in the course of implementation by workers adopting techniques other than, or in addition to, those prescribed in official strategies. Practitioners’ perceptions about appropriate courses of action can result from specific local or individual needs and circumstances, or from local political or professional values that may be at variance with the values embedded in official strategy (Prior et al., Reference Prior, Farrow and Paris2006).
Regarding responses to homeless clients, there have already been some important investigations into sites of discipline and care. Johnsen et al. (Reference Johnsen, Cloke and May2005) highlighted the regulation of behaviours, and illustrated agency as exercised by workers and clients in a Drop-in Centre. The researchers questioned traditional assumptions about day centres as being characterised by caring relations between service users and practitioners. Instead, findings showed processes of surveillance (CCTV, fluorescent lights in bathrooms to prevent intravenous drug use, creating open rather than closed off spaces) intended to ensure the safety of service users and practitioners. The researchers concluded that, although the creation of a ‘caring’ environment may be the ultimate aim of service providers, the ‘realities of the service spaces themselves, and the complexities of the homeless lives engaged with’ mean that centres are ‘under-girded by complex and fragile forms of social control and inter-personal relations’ (Johnsen et al., Reference Johnsen, Cloke and May2005: 801). Commentary from Johnsen and Fitzpatrick (Reference Johnsen and Fitzpatrick2010) also touches on the complexities of coercive responses to rough sleepers, through identifying that such tactics are not devoid of compassion.
Methods and analysis
The findings presented here are drawn from a small-scale study of five housing and homelessness organisations, and there is a focus on one of the participating organisations, a Drop-in Centre. This organisation was part of a local Housing Related Support Sector (hereby referred to as HRSS). The concept ‘HRSS’ captures the way that homelessness organisations identify a set of needs and experiences amongst clients that are associated with issues beyond (but not excluding) physical housing need. Rather than comparing ‘like for like’ policies and practices, research aims involved locating a range of ‘official’ and ‘informal’ techniques used to influence clients’ behaviour, and reflecting on their ‘meanings’ across different HRSS organisations. Organisations were selected on the basis that they used conditional approaches, albeit in different forms.
In order to explore perspectives towards techniques, it was important to find out about practitioners’ ‘social worlds’. The focus was on observing, talking and interacting with practitioners to identify their concerns and ‘meanings’ (Yanow, Reference Yanow2000). Research methods aimed to build sets of stories about individual practitioners and participating organisations by capturing narratives that illustrated workers’ realities. The study's focus on practitioners and analysis of front-line techniques required emphasis on how informants constructed their role, what they felt about it and how they perceived that their approaches worked in practice. Crucially, the study also investigated the various influences which inevitably coloured practitioners’ activities and perspectives towards conditional tactics.
Methods included shadowing front-line workers alongside in-depth semi-structured interviews with volunteers, front-line workers, managers and ‘strategists’ (six interviews per organisation). Interview data were complemented by a series of ‘official’ meetings with key informants from the HRSS and allied fields, and informal exchanges and phone calls with contacts in the sector. Data were subject to thematic analysis (Braun and Clarke, Reference Braun and Clarke2006). The study also benefitted from the present author's tacit knowledge of practitioners’ social worlds, drawn from experiences as a front-line worker and senior manager in one of the participating organisations (a local authority homelessness unit; for an analysis of this involvement in the research site see Dobson, Reference Dobson2009). For information purposes, Drop-in Centre services and techniques are categorised in Table 1.
Table 1 Drop-in Centre services and techniques
A focus on clients is important for this discussion because ideas about ‘support needs’ were influential for how far conditional techniques were considered effective. Responses suggested that mental ill-health, addictions and other related problems (homelessness, employment, etc.) were a significant feature of client needs (Kemp and Neale, Reference Kemp and Neale2005; Tyler and Johnson, Reference Tyler and Johnson2006; Johnson and Chamberlain, Reference Johnson and Chamberlain2008). The temporal sequence for mental ill-health and homelessness was unclear, with ‘vulnerabilities’ arising from the problem acting as both ‘cause’ and ‘consequence’ of housing need. The theme of mental ill-health featured in descriptions of clients with ‘high needs’ and as ‘high risk’.
The majority of informants tended to associate addictions with a homelessness ‘lifestyle’ or ‘scene’, and considered that drug use (in a ‘cocktail’ of various substances and alcohol) had worsened in recent years amongst younger people. Informants made distinctions between older or former service users as alcoholics and ‘vagrants’, and contemporary service users with other drug addictions. Contemporary HRSS work was now associated with increased risk and more intense practice experiences, because the sort of behaviour associated with drug use included being demanding, angry, unpredictable, aggressive, using abusive language and a general lack of humility when requesting and/or receiving resources. Such behaviour was considered problematic for client's ability to engage with support services in the homelessness sector and allied fields, which hindered their capacity to ‘achieve’ autonomous living.
Conditional techniques; possibilities, problems and practice realities
This section highlights complexities of front-line practice, as seen through the eyes of practitioners working in the Drop-in Centre. As already discussed, these approaches reflected ‘disciplining’ and ‘therapeutic’ methods, which aimed to influence client behaviour. Significantly, practitioners conveyed fragmented and contradictory views. At one moment, workers favoured conditional techniques and disciplining measures (e.g., ‘tough love’ and strict approaches); at the next moment, therapeutic methods took over.
Disciplining strategies
Disciplining tactics included informal processes of persuasion, nudging service users towards certain choices and ‘tough love’. Official measures involved targeting support to especially marginalised groups by altering the structure of provision. Practitioners justified these different methods on the basis that it was an appropriate response to contemporary social problems, that organisations risked generating or exacerbating clients’ support needs and problematic behaviour and that methods worked to responsibilise clients, with improved ‘readiness’ for autonomous living. The Drop-in Centre was a Christian organisation and discussions with some informants highlighted the impact of this faith orientation (cf. Cloke et al., Reference Cloke, Johnsen and May2005). For instance, the majority of participants believed that service users were ‘damaged’ as a result of painful experiences and that more tolerant approaches offered the ‘welcoming’ and ‘love’ that would help individuals to ‘heal’. However, Sue's response demonstrated concerns to ‘do more’ for clients:
It's moved beyond . . . providing tea and coffee . . . encouraging people to have a shower, giving advice, maybe listening . . . [to doing] more advocacy . . . Doing just a little bit more . . . to try and see people move on in a positive recovery process. (Sue, Team Leader, Drop-in Centre)
This quotation reflected how expectations of service users and demands for practice had changed. Practitioners were now required to take a ‘proactive’ role through aspirations for ‘recovery’. This push for a different type of support was driven by concerns to respond to contemporary social problems and support needs. For instance, manager Matthew's comments made claims about a new generation of practitioners who wanted to create change in light of shifts in client demand:
In the past . . . we really have been a sticking plaster charity . . . I would like to think [we're] more visionary than that. When you've got an older generation of clients, the tea and sympathy approach was just what you needed. But now we find . . . the larger majority of [our client group] is between eighteen and twenty-five, which means something's going wrong very early. (Matthew, Service Manager, Drop-in Centre)
This quotation indicated that fresh ‘practice realities’ informed perceptions that less conditional approaches were unable to respond to increasingly complex needs. One official method of support felt to better respond to especially marginalised clients included structured provision, which aimed to target those who ‘really’ needed support. The organisation now constrained clients’ access to resources, such as free food and shelter:
We had 120−150 people eating . . . but out of that there might have been six homeless people . . . Now the main meal is served at lunch time where we can engage with those homeless people . . . We can concentrate on the people who really need the charity rather than an open house . . . (Matthew, Service Manager, Drop-in Centre)
Matthew's comments suggested that disciplining client movements and access to provision was necessary to ‘engage’ individuals. There was also an introduction of charges for formerly free food, which aimed to responsibilise clients (Whiteford, Reference Whiteford2010). The two managers interviewed believed that this shift challenged ‘cultures’ of behaviour deemed problematic for autonomous living. The next quotation justified the charges:
If they can afford cigarettes, drink, drugs and the bus fare into town, they can afford 50p for a meal . . . We're saying, ‘own the fact that you've got to pay for things and there's no freeloading in life’ . . . You get the guys . . . saying, ‘I haven't got 50p’. Well you had £80 on Monday . . . didn't you put £3.50 away? Or next time you get your [benefits] would you like to . . . [pay] to guarantee seven days’ meals? . . . That's the kind of mindset we're trying to encourage . . . You can plan ahead and it's not all hand to mouth . . . (Matthew, Service Manager, Drop-in Centre)
This quotation showed perceived benefits of conditional techniques, which were felt to generate practical skills conducive for settled living. Responsibilising strategies considered beneficial for autonomous living were also evident in informal processes. This next quotation showed the dilemmas experienced by all participating staff members, especially for those interacting regularly with clients:
We'd arranged for [a service user] to have a meeting today to look at [detox services] . . . She said, ‘I am coming’ . . . I knew it was going to take her forty-fvie minutes . . . If I had . . . my car, I would have been very tempted to say . . . ‘I'm going to come up to meet you and . . . drive you back’ . . . However I didn't want to because . . . there has to be a point where . . . people take responsibility for themselves. If that means that they lose their hostel place or if she had to move that meeting and re-schedule yet another . . . then so be it. (Sue, Team Leader, Drop-in Centre)
Here Sue grappled with the potential consequences of different helping interventions for both short- and long-term outcomes and opted for a conditional approach to support, as part of efforts to shape the client's behaviour. Sue believed that it was vital for clients to experience the consequences of their problematic behaviour, in order to generate meaningful change, and this was a view shared by the majority of informants.
Therapeutic strategies
So far, discussion has focused on the use of disciplining and conditional approaches. Yet practitioner perspectives were fragmented, with a combination of disciplining and therapeutic techniques. This apparent contradiction in responses highlighted the complexity of front-line work. Less conditional tactics were considered beneficial because they enabled endogenous change in clients. Tolerant and flexible practices were thought to facilitate inner strength and self-realisation in clients, whereby they would recognise their problematic behaviour, seek to change it and sustain such shifts over the long term. There were also ‘pragmatic’ drivers for therapeutic responses, in that practitioners identified that troublesome behaviour was a result of addictions and/or mental ill-health problems, and reflected traumatic histories. Workers perceived that tolerance, less time-limited provision and flexible responses would facilitate rapport in the client−practitioner interaction, which was believed conducive for engagement and compliance with support practices. In the next quotation, Matthew voiced these concerns:
let's befriend that person and build up some trust before we start telling them what they're going to do . . . [The benefits are that] you've got the relationship, and that person feels they can trust you, and you're not going to sell them straight down the swanee because it's a sausage machine. [That] whatever the support plan will – in fruition – come to is for their own good and not because you're processing them and they're number 53 this week, and you've got to get them a tenancy. (Matthew, Service Manager, Drop-in Centre)
These views were driven by perceptions of client needs and their attendant behaviour(s). All Drop-in Centre informants tended to describe how the ‘realities’ of clients’ needs meant that it was not possible to achieve change in a linear or process driven way. These perspectives were also influenced by assertions that clients required tolerant and flexible responses that acknowledged their human fallibility and frailty. The next quotation helped illustrate this viewpoint:
[A service user] gets an appointment at 10 o’ clock, [they] don't show, it's a black mark. That person could have been picked up off the streets by the Police for an old court case or whatever. A lot of places [would say] ‘well it's not my fault you didn't turn up at 10 o’ clock, it's a black mark’. We'd say, ‘that's not very good is it, we'll make another appointment for tomorrow’. You've got to go with the flow. You're dealing with people! [laughs]. (Matthew, Service Manager, Drop-in Centre)
The message conveyed here indicated a more tolerant approach, which accepted that clients were not ‘committed’ to trying to change their lives in ways commonly understood by practitioners in allied agencies. The practitioner didn't seek to excuse or hide service user culpability for their behaviour. Instead, he seemed to just accept that this was part of ‘practice realities’ informed by the texture of clients’ lives. In another example, restriction from the night shelter was considered inappropriate on the basis of the client's mental ill-health problems:
we have one guy at the minute who we have this incredibly flexible attitude with. His name is on the [night shelter] board now, every night, and he regularly leaves in the middle of the night. And with most clients, that would be [breaking the rules] . . . But with him . . . he doesn't take any medication, and he's rough sleeping. (Laura, Housing Support Worker, Drop-in Centre)
Laura's comments provided a good example of how conditional approaches (sanctions for non-compliance with structured provision) were felt to be incompatible with the ‘realities’ of support needs, such as mental ill-health. These ‘realities’ often led the Drop-in Centre informants to assert claims to expertise about their ‘safety net’ provision. A couple of practitioners described, in explicit terms, how other organisations ‘failed’ to achieve change because of their faith in conditional tactics:
[The city] is probably fortunate to have a place like this . . . This is the last stop for [clients] to get a hot meal, to look for a bed or help with accommodation . . . There is nowhere else for them to go. They've been to [the council] . . . and [they've] sent them here . . . If they haven't got here, then they've literally no chance, they are on the streets. (Wes, Support Worker, Drop-in Centre)
In summary, workers described how clients had to reach a point of ‘self-realisation’. Less conditional approaches, in the form of less time limited, more tolerant and flexible responses, were felt beneficial in order to achieve endogenous change. Attempting to enforce change through process-driven and linear methods was considered problematic because it would not achieve meaningful shifts over short- and long-term stages. Therefore, although staff emphasised the advantages of conditional measures, the same practitioners also stressed the benefits of less conditional strategies.
Conclusion
This article has highlighted the use of approaches in a homelessness Drop-in Centre, which aimed to influence client behaviour. It has been shown that practitioners inhabit complex roles, and that they are able to identify potential benefits and limitations associated with conditional techniques. In practice terms, this means that workers are drawn to both disciplining and therapeutic methods when supporting clients. This article has focused on how perspectives towards clients (e.g., ‘support needs’ and ‘practice realities’) coloured workers’ perceptions of conditional tactics. Phillips’ (Reference Phillips2006) term ‘bounded choices’ offers a useful explanatory insight for understanding practitioner views and practice choices. The author's concept has been appropriated to convey how client actions were constrained and shaped by the texture of their lives, based on past or contemporary experiences, issues or ‘support needs’. Similarly, practitioners’ choices about helping techniques were influenced by these ideas about clients, which meant that workers experienced bounded agency.
In focusing on workers’ views about clients, this discussion has concentrated on ‘individual’ issues. In fact, practitioners were influenced by multiple inter-related factors, of which clients represented just one component. The present author located a range of other components that influenced workers’ perspectives and approaches, and developed an approach to research that captured the complexity of practitioners’ lives, described here as a social worlds analysis. The approach identified factors in practitioners’ social worlds that impacted their perspectives and practice choices. Factors included: further ‘individual’ factors, such as workers’ personal and professional biographies; ‘mechanistic’ points, such as institutional cultures and organisational processes; and ‘environmental’ issues, such as beliefs about material and social inequalities; and political agenda. The conclusion is that a careful and empirically grounded review of practice environments and client contexts is vital in order to move towards a critical set of ideas about the nature and efficacy of conditional techniques and the relationship and balance between ‘discipline’ and ‘therapy’ at the front-line.
Acknowledgements
Sincere thanks go to Malcolm Harrison, Alan Deacon, Peter Dwyer and two anonymous reviewers for their input and feedback.
