Difficult conversations on the frontline. Managing the tensions between care and control: are communication skills enough?

This professional doctorate in psychoanalytic psychotherapy considers the role of psychoanalytic thinking in contemporary child protection social work particularly in relation to communication with adult clients . The dual mandate of social workers to care and control creates conflict in the role which is well recognised. Less well understood is how such conflict affects communication between social workers and clients in subtle and often unconscious ways. This study uses psychoanalytically informed observations and interviews to investigate an area of defensiveness which may be evident in the ‘micro-process’ of conversations where difficult matters are being discussed. The study asks whether identifiable ‘moments of avoidance’ occur during these conversations at points of heightened tension between care and control. Results suggest that despite good communication skills, there is evidence of practitioner anxiety within the psychodynamic process of interviews; this can lead to transitory avoidance which can affect engagement and throw practitioners off course. These diversions are discussed with reference to Kleinian theories of enactment and projective identification with an emphasis on the internal pressures that initiate defensive manoeuvres of this kind. This is a timely and detailed study which illuminates the nuances of real practice and hopes to contribute to training initiatives for frontline, family social workers.