What does it mean to ‘start where the person is at’?: Reflections on personhood in social work

Abstract

Summary: The quality of the helping relationship is experienced when theories and principles are enacted in practice. Here, the people social workers seek to serve are able to decide whether the practice they experience is useful. One way that social workers can enhance the quality of the relationships they develop is to ‘start where the person is at’. In order to explore what this phrase means in and for effective social work practice, this paper revisits Martin Buber’s articulation of the I/thou relationship seeking to shed light on the notion of personhood in this value-based profession. Two participants, within a larger research project exploring the experiences of social workers in the Australian child welfare field, independently used the language of personhood to refer to the way they conceptualised the process of engaging with people. Both were referring to enacting the transcendent value of each person in terms of a practice philosophy. These personal narratives inspired the authors to move away from the usual professional discourse about the skills involved in relationship building and instead reflect on their own practice in order to capture something philosophical about caring relational processes. Revisiting humanistic conceptualisations of the helping relationship such as the I/thou has the potential to discourage practitioners from seeing relationships as transactional. This has particular significance in practice contexts characterised as risk-averse, austere or involuntary, and/or where people may be feeling anxious, stressed and/or simply unheard. Contemporary implications for social work practice are discussed.

Keywords

Relationships personhood practice wisdom ethics Buber

Introduction

The phrase ‘starting where the person is at’, common in social work and counselling professions, can be used in differing ways. It can be used clinically in relation to assessing problems and needs that bring a person to see a counsellor or social worker, and it can be used in terms of assessing the readiness of a person to engage in change, as is the case in motivational interviewing (Hohman, 2012). It can also be used to refer to the process of engaging with people, in which social workers draw on a ‘use of self’ (Ward, 2018) in order to read the intricate emotional, cultural and environmental nuance of the interaction in starting where the person is at. This paper is concerned with the latter meaning. By revisiting and building on existing practice knowledge, the authors articulate a practice philosophy that values such an end. This is a reflective and conceptual piece generated from within a previous research project (Morley, 2015), where participants, Emma and Penny (pseudonyms), were two of 12 participants in a qualitative study exploring relational dynamics within the child welfare field in Australia. Independently, Emma and Penny used the term personhood when describing their practice process of engaging with people. Melding their reflective insights with our own practice philosophies borne of knowledge and experience, we explore the notion of personhood and suggest it acts as a reminder of the relational knowing that is needed to ‘start where the person is at’.

The philosophical grounding of our exploration is influenced by Martin Buber’s (1958) notion of the I/thou relationship. Distinguished from an I/it relationship, which is characterised by the maintenance of abstraction and the objectification of others, the I/thou relationship involves complete presence with another person. Presence refers to the way a person openly presents their unique self in an encounter with another person without the constraints created by one’s sense of duty or necessity, or the norms related to one’s role or identity; I/thou is about the absolute revelation of one’s self to the other as well as the absolute commitment to openly receive the other without first cognitively analysing the situation.

Our interest in exploring this idea came from our personal and professional experiences over time. Fran, from her practice experience with individuals, families and communities in the Kimberley in Western Australia during the turbulent rise of Aboriginal agency in the 1970s and 80s across human rights issues of land, mining, voting and drinking (Crawford, 2011), and Louise from her practice experience in Australia and on the West Coast of Ireland in foregrounding the importance of listening to children and their families (Morley, 2015). Our experiences are very different, but reflectively combined generate the identification of two salient points for this paper. The first is the way in which the relational knowledge bestowed to human beings can become marked by trauma and injustice; when such ills are sustained over long periods of time, it can erode the human spirt and destroy a person’s sense of hope. When people are perceived as less than human, as only an object or commodity, the outcomes can be harmful for all concerned. Such a perspective is supported by historical facts such as the Australian systematic policies of control and dehumanisation of Indigenous people (resulting in the phenomenon known as the Stolen Generations). In Ireland unwed mothers and their children were also systematically marginalised within society. The literature on working with those personally impacted is extensive and telling (Bateman et al., 2013; Bessarab and Crawford, 2013; Menzies, 2019; O’Mahoney, 2018). One of the underlying themes in this body of work is that those who endeavour to reach out in order to help, need to dig deep to find their responsive selves in order to experience genuine connection. Such a process takes time. It cannot be contrived, and must be experienced and interpreted by each individual if it is to have any meaning. The policies and practices of colonisation and globalisation have been inscribed on each of us and to reach through this requires the common personhood of each of us be validated.

The second point takes us again to the humanity of the social worker and their fallibility as human beings. In a practice world of increased scrutiny and depleted professional autonomy (Healy, 2009; Hingley-Jones and Ruch, 2016), finding the time needed for facilitating meaningful relational encounters can seem like an impossibility (Brown et al., 2018; Leeson, 2010). Additionally, prolonged exposure to issues related to poverty, including trauma, can overwhelm workers to the point of impacting their capacity to suspend judgement and thus uphold the fundamental principles of ethical practice (Lavee and Strier, 2018). Such experiences can quell practitioner hope and impact negatively on the relational wellbeing of social workers doing their best in difficult circumstances (Leeson, 2010).

Combined, our perspectives broaden our starting point for this paper. Rather than focussing only on the experiences of people seeking social work support, or those of social workers, we see both as equally important. We are concerned with the relational encounters that unfold between them (Martin and Cowan, 2019). This is where relationships are experienced in practice. Here, knowing is glimpsed in fleeting moments through time and space and, as individuals within these moments, social workers are vulnerable to becoming entrapped by social prejudices. Despite volumes of quantifiable knowledge informing social workers as to what they should be doing, and why and how they should be doing it, they are essentially on their own in these moments with little guidance. Quantifiable knowledge, we suggest, may be able to specify the outcomes to be desired from relational moments and inform practitioners of the dangers of prejudice, but it can never tell them how to be in relational moments. The notion of personhood, as we present it, may help to fill this gap.

In occupying this ‘space between’, we have stepped away from traditional research norms by embracing an interpretive narrative perspective where differing pathways to knowledge are valued (Crawford, 1997). This positioning has made it difficult to describe the genre of the paper for an academic audience. By integrating ‘insider’ practice knowledge with reflection and conceptualisation, this paper amalgamates differing pathways to knowledge.

The following discussion begins by defining key terms before exploring contextual factors that contribute to shaping relational processes in the contemporary context. Following this, Penny and Emma, the research participants who talked about personhood, will be introduced and their insights explored. With their narratives in mind, we then further explore the idea of personhood conceptually using Buber’s notion of the I/thou relationship. The implications for social work practice will then be discussed.

People and personhood

A challenge in writing this paper was grappling with the implicit assumptions inherent in the language used when referring to practice interactions. Throughout the paper, we refer to those whom social workers serve simply as ‘people’ rather than ‘clients’, ‘service users’ or ‘consumers’ (McLaughlin, 2009). Our intention in doing this is to prioritise their humanity and to avoid objectifying them in terms of a role within the economic structure. We suggest that if social workers are going to ‘start where a person is at’, any conceptualisation must begin with a person’s humanness or personhood. We recognise that social workers and other professionals are also people and that their personhood is fundamental in the process of meaningful interaction. For ease of discussion, however, we have maintained their professional label ‘social worker’ in exploring what it means to ‘start where a person is at’.

There are many meanings associated with the notion of personhood (Short, et al., 2018). Is it that we become a person when we are conceived, when we are born, or when we develop our personality in childhood? And do we stop being a person when we die, or do we continue to be a person in the memories of those who love us? These are deep philosophical questions that plague ethics (Tabensky, 2003), especially bioethics (Shah, 2012; Spagnolo, 2012), and the law as well as theological debates (Jones, 2013). We understand personhood in relational terms, and in alliance with Buber (1958) suggest that it can be experienced in I/thou moments. Such an exploration begins from the premise that our essential nature as human beings is relational (Appleby and Kenny, 2010; Foster and Herring, 2017; Tolhurst et al., 2017) and that the quality of our relationships with those who care for and about us determines our physical, emotional, psychological and spiritual development and wellbeing (Howe, 1997). In the context of relationships in social work practice, this idea of personhood takes us inside the presence of relational moments with those whom practitioners serve.

Contextualising relational values

The value and meaning of human relationships is fundamental to human experience, so much so that it forms the basis for many of the great narratives within the western canon and beyond. The human need to be loved and accepted, for example is central to any good love story and the act of betraying sacred relational values forms the basis of many great tragedies. These narratives fascinate us, maybe not so much because we are intellectually stimulated by them, but perhaps because we somehow relate to this humanness in a very personal way (Neitzsche, 1993). We identify, for example with characters who demonstrate dignity and respect in their actions and we empathise with characters who, owing to their fallibility or circumstances beyond their control, deny or betray these values. Dreamtime storytellers, Ancient Greeks, Shakespeare and others throughout history have traded in such narratives as does much current entertainment because arguably this offers a social mechanism for displacing emotions to a less threatening environment (Wang, 2021).

In the contemporary socio-political context, which can be broadly characterised in terms of economic rationalism, individualism, competition and rising inequality (Davidson et al., 2020) there has, over time been an ideological shift away from the relational towards the transactional. This has had far reaching implications across many institutions within society. In Australia’s higher education sector, for example Arts and Humanities courses have been vulnerable to funding cuts since the 1980s when the Humanities came to be perceived as threatening to the status quo (Barnes, 2020). In recent policy changes, the Australian Government funds courses deemed to be ‘job ready’ more favourably than those that are not. Arts and Humanities courses become expensive for students seeking to study this area. Social work was pragmatically deemed as ‘job ready’ (Duffy, 2020), but social work courses within Arts or Humanities faculties, are at risk of losing this traditional base with migration to Health faculties. Such moves, already evident in the Australian setting, could threaten the humanitarian foundations embedded within social work education (Barns et al., 2021). This could in turn threaten the value base of the profession.

Human beings are sensitive to their environment, and what Weber termed ‘the disenchantment of the world’ (1958: 155) has the capacity to erode social bonds (Gould and Hijzen, 2016) thus, contributing to anxiety and depression as well as the burden of disease more generally (Australian Institute for Health and Welfare, 2020). This phenomenon is mirrored in other developed economies where inequality continues to rise (Wilkinson and Pickett, 2009). The intent of a social safety-net has been undermined by a world of mechanised managerialism where financial bottom lines outweigh a focus on care for humans (Ferguson and Woodward, 2009). This undermining is exemplified with the ideological assumption that face-to-face interaction is no longer an essential component in the provision of welfare (Shorten, 2021: 72; van Extel, 2021). Such pressures are exacerbated in the current context of the pandemic, resulting in increased anxiety and separation (Australian Institute of Health and Welfare, 2021).

Despite the pandemic, or even because of it, we contend that there is a general discontent with mechanisation and this has resulted in a re-invigorated focus on the centrality of relationships in our lives and increased public debate about the importance of the relational, within the human services (e.g. Munford & O’Donoghue, 2019). Aged care services are a case in point. The recent Royal Commission into Aged Care, Quality and Safety (Pagone and Briggs, 2021) in Australia found many instances of substandard care. In response, the Commissioners are explicit that aged care services need to be grounded by human qualities such as dignity and respect for each person (Pagone and Briggs, 2021). Such an assertion of relational values is not about how standards of care need to be calibrated or even how well systems function. Rather, it is about the quality of the relationships through which such services are provided. Being heard and valued by another person has always provided the foundation for the therapeutic turn (Martin and Cowan, 2019) and one of the keys that opens the door to positive change (Rogers, 1989). Such a core principle extends out to service provision and standards of care in any practice setting.

Valuing and maintaining dignity and respect has long been considered a core element in the development of the helping relationship in counselling (Martin and Cowan, 2019) and social work (Biestek, 1957; Hay, 2019). Social workers know axiomatically that those they serve should never be treated as instruments or objects, but that all people should be valued by virtue of the fact they are human, regardless of who they are, where they may have been, or what they may have done (Australian Association of Social Workers, 2020; International Federation of Social Workers, 2018). These fundamental principles continue to provide core elements for evidence-based practice (Ferguson et al., 2020; Ferguson and Gates, 2015; Reimer, 2013; Ruch, 2005; Ruch et al., 2018) along with best practice processes to ensure the development of successful working relationships, including reflection (Fook, 2015) mindfulness (Hick, 2016) and cultural sensitivity (Bessarab and Crawford, 2013; Zubrzycki and Crawford, 2013).

For those who receive social work services, there is little doubt as to what makes any such service successful. Repeatedly, research brings us back to the embodied experience of feeling valued as opposed to just being told this is the case (Beresford et al., 2008; Butler et al., 2012; Ferguson and Gates, 2015; Kam, 2020). People value being heard and accepted by helping professionals, not because this is their role (though this is their role) but because they are human and being heard is an essential human need. To achieve this, social workers need to demonstrate dignity and respect not through empty words, but through actions, as is so aptly exemplified through the idea of the ‘holding relationship’ (Ferguson et al., 2020). This not only refers to the longevity of the relationship, but the caring qualities within it, such as encouragement and patience (Ferguson et al., 2020; Ferguson and Gates, 2015) where such qualities can be enhanced through reflective learning (Ward, 2018). Fundamentally, however, they constitute ‘relational knowledge’ that is inbuilt within all human beings, the purpose being to enrich our relationships with others and thus our experience of the world (Buber, 1958).

This relational turn can create something of a dilemma for social workers, especially in many contemporary organisational contexts, where arguably there is more need for relational processes, yet less time and space is afforded to them. Such a dilemma highlights that social workers are human too and that their personhood is central for critically reflecting on their own cultural positioning within in the work they do as well as their own emotional wellbeing (Beddoe, 2021).

Child welfare has long had to be addressed within the social, political and intellectual context of its times (Staller, 2020). Whilst the particular challenges change across time and place, a constant has been the need to engage with and listen to the voices of the children involved. Pioneers of social work such as Charles Brace of the Children’s Aid Society in the New York of the mid-19th century started from where the children they sought to serve ‘were at’. Brace from local direct engagement then worked with others to better the lives of poor children in the multiplicity of areas required (Staller, 2020). Now over one hundred and 50 years later in another country we find practitioners identifying the same starting point of meeting people where they are in effectively working to support them.

Emma and Penny on personhood

Emma and Penny participated as part of a study aiming to explore social workers’ experience of the relational dynamics involved in child welfare practice in Australia (Morley, 2015, 2021). Both experienced practitioners, Emma was a counsellor in a local area health service and Penny was a private practitioner contracted to conduct assessments for her state’s child protection authority. Both referred to the notion of personhood in in-depth interviews.

In her interview, Emma explained that many who come into contact with child protection systems may not have experienced positive and nurturing relationships in their lives, so that when they come to see a social worker in an organisation ‘we can be part of providing that to them…to give them a sense of personhood’. For Emma, personhood is something that is given to another person. When I asked her what she meant by that, she paused and then said

Valuable perhaps. You know that there is that sense of themselves as being as valuable as anyone else, that everybody is valuable […]. They just are what they are and so is everyone else…. so yeah, I think that’s where that links probably with that practice stuff, it’s that idea that they see themselves as not being a thing or an object or not belonging to someone else, or the target of something. They just are what they are and so is everyone else.

For Emma, the idea of personhood is about the intrinsic worth embedded in what it means to be human, as opposed to people being seen as objects that are instrumental to some other purpose. She suggested that when she works with people she aims to ensure that they do not feel as if they are the target of her interventions; she needs to work with them in such a way that they know they are ‘as valuable as anybody else’. In saying this, Emma seems to strip away the problems that people may be experiencing, as well as her intervention and the goals she is hoping to achieve by interacting with them. This approach brings interaction down to a simple but profound moment of simply valuing the people that she meets in the course of her professional work.

Penny’s idea of personhood is similar. In her interview she suggested that a good working relationship is formed through ‘one human being relating to another’. She then went on to qualify this by explaining that connecting with people required her to use her knowledge and skills, but that respecting personhood was fundamental to this. When asked what she meant by using the term personhood in follow-up contact via e-mail, she responded by saying

It’s about relationships, about who I am. People can take on board what I am saying if they feel accepted and valued by me. A positive relationship with their worker is good for people’s self-esteem and wellbeing. They need to be able to trust me and enjoy their relationship with me, then change can happen as we work together on the issue. I have to be real and genuine and affirming with them.

As with Emma, Penny’s interpretation of personhood is concerned with how people feel. She also wants them to feel valued and accepted because not only is this an essential human need, but it is important if they are to engage in any change process. Penny is perhaps more focused on the purpose of her interaction, yet she seems to also suspend ideas of change until people feel at ease in her company. Only then can they begin to work together to resolve problems.

For both, personhood is something that is attributed to another person and this offering (Game and Metcalfe, 2010) is essentially about the interactional space created for positive regard (Rogers, 1989) or care of others that is shown in relational moments in time and space (Noddings, 2012). As well as being about the way social workers value people in interactional moments, personhood is, perhaps more importantly, about how they experience the social worker’s presence and how this makes them feel. So how can social workers give personhood and how can they ensure that this is a meaningful reciprocal experience for them?

Conceptualising personhood in practice

The idea of personhood in practice extends the commonly used expression in social work ‘the conscious use of self’ (Ward, 2018) to another level. A ‘conscious use of self’ refers to the continual judgement and summing up of a given situation so that one is able to be responsive by drawing on ‘the self’ in order to show empathy and genuine concern. Giving personhood to another person, however, involves giving oneself over to those I/thou (Buber, 1958) moments, which constitutes an embodied experience of valuing and accepting the other person within a moment in time. Linehan (1997) uses the term validation to describe this process of conveying empathic understanding in a moment in time.

Buber’s conceptualisation has been enhanced by feminist scholarship. In her work on the ethics of care, Noddings (2012) argues that caring about another person involves an intuitive process which moves beyond rational abstraction. Caring for another person involves action that is motivated by an inner call to connect and to share one’s energy in the act of caring. This takes us beyond the idea of showing respect in caring roles to an experience in which one feels compelled to offer and receive the other unconditionally as well as the situation that surrounds them. This inner calling does not constitute a constant state of being, but rather an experience between people that occurs momentarily. Experienced intermittently the I/thou relationship is constituted by a spiritual energy that binds everything in the world to the eternal thou (Buber, 1958). As mortal beings, we are only able to capture small glimpses of this at a time. For most of our lives, we exist in the I/it (Buber, 1958) state of being, which relates to the relationships that people engage with in the everyday. For Buber (1958) and for Noddings (2012), relationships are always in a state of flux as we move between the two forms of relationships. There will be times when we are able to experience the magical qualities within the I/thou connection, yet we also need to function in the reality of everyday, which requires us to enter the I/It connection in order to gain distance from those with whom we have connected (Itzhaky and Hertzanu-Laty, 1999).

Giving personhood to someone else is different to simply drawing on skills to cultivate I/thou moments. Skills such as the mindful use of silence are needed, but the I/thou relationship involves moving beyond skills, by suspending time, knowledge, professional identity and all social constructions, thus creating a break from the societal norms in order to be truly present with a person. So instead of just needing to deploy knowledge and skills in this process, it also entails letting them go in moments of time in order to allow for meaningful connection.

Buber (1958) applied this idea to the context of teaching children. Whilst a teacher’s formal role is to educate students, teachers are also in the position of offering relationship to students (Game and Metcalfe, 2010). Even if the students are unaware that this offer is being made, its value is that, as the relationship grows and changes with the child, the teacher is then in a position to be able to find out about the child’s world in order to understand their individual needs. This enables a meaningful points of connection that can sustain them through their learning journey. Blenkinsop (2005) explains,

Buber saw the teacher in a position not of ‘making’ things happen, but of bringing the world to the student, of allowing for the possibility of encounters with that world, of providing support, of offering relationship and of meeting students where they are at (p. 302).

Noddings (2012) puts a similar proposition forward. For her, teaching should be about offering the attitude of care and trust to the student and this is necessary in order that children can learn and grow in the world. This, she argues, not only facilitates learning, but also moves towards developing a more caring world. In a social work context, this means the social worker offers a meaningful encounter, which in turn, provides the basis for support.

The concept of I/thou offers a way of understanding what it means to be genuinely present with a person in order to give them a sense of their personhood. This kind of ‘giving’ is not paternalistic as is the case when one gives charity to another person. On the contrary, it is concerned with complete acceptance and valuing of the moment with another person, which is experienced at the deepest level of human understanding. People may not be aware of what is being offered to them, or they may be unable to articulate or reciprocate it, yet at the same time they can and do experience the authenticity through which it is offered. This is supported by Emma when she states,

They [people] know if you are just here to fill out your paper work and go back to your office and write your risk assessment, or if you genuinely care about them.

Emma relates to the eternal and intuitive knowledge inherent in all human beings, which is not able to be quantified or even adequately articulated, but only known through sensual experience. We know if someone genuinely cares about us, or if their care is offered because of their sense of duty (McBeath and Webb, 2002). The latter is often rationalised as genuine, but it cannot be genuine if it is not grounded in care.

Implications for social work

The idea of personhood, as it appears in Buber’s I/thou relationship, offers a powerful reminder of what is important to human beings and what has always been core in social work practice. What is indispensable is that social workers are in-tune with the practice of ‘starting where a person is at’ and being present so that people can experience the feeling of being heard and valued. For practitioners, this means being comfortable in letting go in order to share those relational moments as they emanate from the experience of the I/thou. This most certainly requires knowledge and skills, yet it also requires the courage and a kind of leap of faith towards the relational at a profound level. Within the context of the restrictive norms that have come to characterise everyday practice, engaging with the relational is made ever more challenging. Yet paradoxically, this challenge is exactly why the relational is more important than ever. In the shrinking social spaces of community services, created by economic rationalism, technology and managerialism (Ferguson and Woodward, 2009), more attention is afforded to processing people efficiently than to the space needed to comprehend the full dimensions of what human beings need in order to lead fulfilling lives. The effectiveness of a pre-set response in addressing human problematics is questionable and this issue is particularly pertinent where people who see social workers are vulnerable in some way. This may be through their experience of trauma, discrimination, marginalisation or through their sense of alienation or social isolation. When human beings have experienced hardship, they may need more time and space in order to trust the hand offered in help. In the human services generally, doctors, teachers, nurses and allied health professionals are subject to similar pressures, which have the capacity to compromise the care that is offered.

The notion of personhood, in the context of Buber’s I/thou, provides a conceptual tool that has the capacity to reach beyond modernist principles and procedures as well as professional roles and boundaries, even transcend them. This means the I/thou is not just about the work social workers do for others, but also about how social workers themselves make meaning of this and how they too can feel validated by meaningful connection created through being present with others. Such moments where the presence of humanity can be fully embraced provide an important site for resistance in contexts where human interaction is often all but reduced to a procedure to be followed.

The notion of I/thou is also a powerful concept for thinking about the supervisory relationship. In this relationship, moments of pure presence between supervisor and supervisee are necessary for building the trust that is needed for deep critical reflection and to ponder questions about what it actually means to ‘start where the person is at’ (Itzhaky and Hertzanu-Laty, 1999). What are the implications of a style of practice with the capacity to transcend the usual professional norms of a divide between the knowing professional and the known client (Zubrzycki and Crawford, 2013)? This dialogical space is not just about social worker’s productivity in the context of the people they serve. It is also essential for their sense of wellbeing. Many students and practitioners have their own trauma backgrounds, or may have experienced discrimination or marginalisation because of where they are from, how they look, or how they chose to shape their identity as a human being (Butler et al., 2017). The notion of I/thou could also be seen as a way of easing the pressure created by always needing to achieve outcomes, yet at the same time still achieving an outcome.

Not only does the notion of I/thou remind us of what is important in social work practice, it also has the potential to re-invigorate dialogue about the relational elements of practice and what it might mean to create the space needed for these moments to unfold. This is important in a profession, which relies on an efficacious ‘use of self’ to reach its overall goal of influencing positive, meaningful and lasting change. Relationships are key to achieving this end as is dialogue that prompts us to reflect what it means to be in relational moments with others.

Conclusion

In this paper we have explored what it means to ‘start where the person is at’ using Buber’s (1958) humanistic conceptualisation of the I/thou relationship. This takes us beyond some of the standard and commonly accepted conceptualisations within social work discourses that are premised on the separation between social workers and those they serve. What the I/thou relationship does is free workers to embrace their own humanity within the relational process so they are better positioned to offer full presence in the moment. This is radically different from ideas where social workers are compelled to show elements of humanity within the constraints of a firm separation between the knowing social worker and the known recipient of service. A freedom to move between connection and separation, as necessary, makes ‘starting where the person is at’ easier for workers, whilst allowing meaningful connection with and for people.

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Louise Morley

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