Attachment Theory for multiculturalism?

BOOK REVIEW : The Myth of Attachment Theory: a critical understanding for multicultural societies by Heidi Keller, pub: 2022, Routledge, Oxon

Discovering attachment theory as a student social worker in the year 2000 was like a flashing blinding light coming into my life. Suddenly so many of my experiences and those of my family and friends around me made sense. I was completely and utterly hooked. A devotee.

That was before I worked with people who grew up in different cultures, and, especially, before I travelled (as opposed to holidayed). Whilst I still wholeheartedly believed in attachment theory I was finding I was having to ‘apply’ attachment theory as I knew it to the ways in which other cultures functioned in their childrearing and parenting styles. I came to understand that the Eurocentric models of parenting were not the only successful ways for communities to support the raising of their next generations. And it was OK.

Until one particular fostering & adoption assessment broke my heart, and is probably what really drove me to accept that front line assessment work was no longer where I belonged. It showed me the impossibility, for me as an individual social worker, to break out of the barriers of what is in effect unintended institutionalised ignorance and racism embedded in some of our key theories that underpin so much of modern social work. So I was immediately interested when I came across Heidi Keller’s book.

The particular assessment I refer to involved an African woman who had moved to the UK as a young adult. Let’s call her Zena (obviously not her real name). She had been ambitious and determined to fit in with her new culture and in almost every way the way she lived her life was a model example of what anyone would expect of a future adoptive or foster parent. Although myself a white social worker, I had worked with many carers and families from both African and Caribbean backgrounds, and I had learned so much from them, starting with the language of cultural identity. Hardly surprising Zena identified as either from her native country or African (as well, I should add, as British), and throughout the assessment I used one of her own identified terms to describe her nationality and culture. The second thing about the assessment was I began with an attempt at a deeper understanding of her own childhood experiences and upbringing, so different to a child born in the UK, in order to provide a layer of context that doesn’t always seem so necessary for someone who was born and brought up in the culture in which they are being assessed and about which we make implicit assumptions.

In the second decade of the 21st century, not only did management remove much of the culturally relevant information that rounded out this applicant’s personality and life experiences, but, more devastatingly, changed all references to her identity from African to Afro-Caribbean, a culturally offensive term best described as white laziness for ‘blacks we can’t so easily tell apart’. I saw how that wounded her, as the full weight of institutionalised racism came down upon her head.

I have seen over the years how assessments on cultural and social assumptions rooted in the middle class experiences of the theories we depend on, and less on the lived experiences and their impact on the individual(s) involved, even within the same supposed culture. The richness of assessments, and the consequential understanding of the dynamics of families, that were written half a century ago, have been lost, ironically as “anti-discriminatory” practice became better understood, and, particularly with the development of greater openness in sharing what we think and write with those we think and write about. A negative consequence of what should only have been a positive change.

But, as always, I have strayed from my purpose!

In the forward to the English edition of Keller’s book Nandita Chaudhary introduces the reader to WEIRD people – Western, Educated, Industrialised, Rich, Democratic, and elsewhere the book reminds us that academia is the preserve of the educated middle classes, based on their experiences and perceived needs. Chaudhary also comments on the rise and normalisation of the nuclear family, adding “The shift from bigger to smaller and detached families led to a system that liberates the rich and marginalises the poor. Larger families had greater resilience, with a large group of people to fall back on in times of need.”

Keller begins with an overview of the origins of attachment theory and the vulnerabilities even in the very beginning of its development: Bowlby was warned, but did not heed, by Margaret Mead ‘not to over generalise from a monocultural perspective’. Concerns are raised on the over-dependence of Ainsworth’s Strange Situation Procedure as lacking comparisons to outcomes that might have been observed in a child’s natural environment. Where later research came up with different conclusions (such as the incidence of secure versus avoidant or ambivalent models of attachment), it seems that the research was deemed at fault rather than using it as an opportunity to challenge the theory itself, the very underpinning of the ethos of good research in the first place.

Regardless of these early flaws, the question now is, is the attachment theory of the academic middle classes of over half a century ago, still fit for purpose in a modern multicultural society. Or as Keller writes in her personal preface to the book, “The challenges of multicultural societies just cannot be met with one single doctrine.”

Criticism of attachment theory has not been welcomed and Keller observes that despite some apparent ‘mini attachment theories’, the ‘attachment theory of the 21st Century is largely identical to the attachment theory of the 1950s/60s’.

The world has changed in over 60 years. Our own WEIRD society has changed dramatically in the last 20 years, as my previous blogs discussing mental health and community have covered. Why then can’t the theory that underpins everything we believe in as a social work profession provide the evidence that it has kept up with changing society?

Keller’s quote of Ross Thompson that “While culturally oriented researchers ask for greater culturally informed attachment research, attachment researchers wonder where they can find greater attachment informed cultural studies” particularly struck me as reflecting my own dilemmas in undertaking assessments with Caribbean and African adults whose childhood experiences were so far outside the norms of attachment theory, and yet had still ended up as emotionally secure and stable adults, partners and parents, I was left with the sense of trying to fit the culture to the theory, or, in other words, writing attachment informed cultural assessments whereas what I really needed was a culturally informed attachment theory.

Keller provides a well-evidenced presentation that not only was Bowlby’s original attachment theory based on narrow set of assumptions of what constituted family and parenting, even for the 1950’s, but that criticisms since have not been taken on board and Bowlby’s attachment theory remains relevant to a culture that even the society to which it originally applied has largely moved away from. Leaving social worker assessors to continue to try to fit the evidence to the theory rather than having a theory that encompasses the evidence.

As a taster of some of the observations from the book – Cameroonian Nso mothers watching clips of German middle class mothers caring for their babies being surprised at what they considered to be the insensitivity of the German mothers; when the baby cries the Cameroonian Nso mothers first instinct is to feed the infant, while they saw the German mothers talking to the babies and checking if the baby had other needs to be met before finally offering feeding. And the one that surprised me: the phenomenon of the “terrible twos” occurs predominantly in Western middle class societies. First time parents in their 20’s or 30’s in Western cultures are more likely to have their first experience of caring for an infant when they have their own baby to care for, while in many other countries, particularly poorer rural countries, the new mother will have experience of parenting younger children since she herself was a very young child. Some cultural expectations of play being with others means that children will have no experience of manipulating and playing with any object while alone; this will affect the effectiveness and interpretation of a child from that culture in the Strange Situation test.

Further Reading

https://www.pnas.org/doi/10.1073/pnas.1720325115?fbclid=IwAR0OoZUscOCvClXmonYrC_nASDIixMWcmnrOxV079SYYFW98-fr-VDAz4UQ

Heidi Keller is also the author of this 2018 paper, using different cultural examples than the book. It points out that as our Western countries become more culturally diverse this has potentially significant consequences for other cultures migrating to Western countries, and the Westernisation we also see going on. The conclusion is that the lack of cultural contextualisation means there is no validity in the claims for universality in attachment theory, and as it is the underpinning basis for the UN Convention of the Rights of the Child, the UN Convention is also culturally flawed.

Overall, despite being from the same author, this paper is an easier read than the book, above.

The Assessor Relationship

Social worker Miss Jones was suspended by the GSCC in September 2011, the decision was upheld in August 2012 and again by the HCPC in August 2013.  Although Miss Jones is on record as having said her actions were silly and cited some changes in her personal life the HCPC panel found that she had shown insufficient insight into the seriousness of her behaviours.

There can be no doubt that her practice was inappropriate and that boundaries were breached, but there are some aspects that merit discussion.

As social workers we are always developing some form of relationship with the people we are working with.  The concept of the Casework Relationship is still relevant.  We walk a fine line between befriending someone in order to work with them and help them and maintaining professional boundaries and distance.  I hope nobody really believes it is OK to have a sexual relationship, share drugs, socialise or seek advice, counsel, services or loans from service users, although sadly there are some who cross these boundaries.

Of course, it is easy to get into a conversation in which a professional states the name of a band or type of music they like, or they may have a sticker on their car that indicates they are in to a particular sports activity.  For some workers it comes under the concept of ‘use of self’ in the relationship.  And with many social workers using social media such as Facebook these days our private lives have become less private.  Some service users might offer much wanted tickets to a concert or sports event, or tell you about a friend who does building work ‘on the cheap’.  Why shouldn’t they?  You’ve developed the relationship until you are viewed as a friend.  It takes tact and careful handling to refuse without damaging the relationship.

But Miss Jones was not working with a vulnerable service user (although in some of the reporting the term service user is used).  She was carrying out a Form F assessment with a prospective foster carer.  The Form F is a particularly complex assessment with a specific purpose.  It’s unlike any other assessment.  It is, in effect, a job application and a part of the assessor’s role is to ensure that the application meets the needs of both the employing agency’s Fostering Panel in the first instance and then provides the information required by placing social workers looking for a foster placement for a specific child, while ensuring that the applicant is suitable and prepared for the job ahead of them.

There are some subtle differences that apply to the relationship between an assessor and a fostering applicant:

• The applicant is not generally deemed vulnerable, otherwise their application would not have progressed as far as the Form F Assessment, although there is a power differential that creates a degree of vulnerability that the assessor should work to overcome.
• The Form F assessment is very intensive.  The assessor is asking the applicant to share very personal information, often of greater psychological depth than in assessments with service users.
• The assessor role will include informal provision of information and training, additional to the training provided by the agency that may be employing the applicant.
• The assessor should be ‘modelling’ professional behaviour.
• If successful in their application the applicant will become a fellow professional, a member of the ‘team around the child’.

It is this last point that can cause some conflict.  Not unlike a relationship between a student and a practice placement tutor, the assessor will want to develop a professional identity in the applicant.  They know that once the applicant has been accepted their relationship will need to move on from assessor-applicant to professional colleagues, and they will want to prepare the applicant for that, while retaining the option that the assessment might reveal information that would cause the termination of the assessment.

So, what went wrong for Miss Jones?

• Miss Jones met the applicant and carried out parts of the assessment in a pub on more than one occasion (presumably, but not specified, not in the private accommodation part of the pub)
• Whilst in the pub and on duty Miss Jones consumed alcohol
• Miss Jones accepted (borrowed) money (around £70) from the applicant, which was later repaid
• Miss Jones interviewed one of the applicant’s referees in a pub (comment as above)
• Miss Jones asked the same referee to help her obtain theatre tickets
• Miss Jones asked the same referee for help in preparing papers for a court case (ie, sharing personal information)

Clearly professional boundaries were not maintained on several occasions.  But, as well as raising considerations of the particular nuances of the Form F assessment, Miss Jones’ experience did resurrect a memory and raise a question for me.

I have ‘observed’ an applicant and their family in a public place (not a pub) as part of an assessment.  I have also, once, been in a position where I met a referee in a public place, not intentionally.  The referee in question had asked me to meet them during their lunch break at their place of work, a busy London hospital.  With this being the only option on offer for the interview I agreed on the basis that they would find a room or somewhere private we could meet.  When we met I was asked to carry out the interview in the staff area of the hospital’s restaurant as there were no private rooms available.  With some reluctance I agreed only once we had located a table sufficiently far from any other occupied tables and as I mentally adjusted how I would conduct the interview (taking care to use language that avoided using the applicant’s name or personal details).  Would I do it again?  No.  Chalk it up to experience.

Could borrowing money from the applicant ever be considered acceptable?  If this were a vulnerable service user I would say never.  But what if you realise you’ve lost your purse or wallet, or even left it at home, it’s evening and you need to buy fuel to get home?  There’s no-one at home who is able to come and meet you with some money.  Many a times I’ve been carrying out an assessment a two hour drive away, at a time when my husband has been working in another part of the country.  It didn’t but it could easily have happened.  Is there any freedom to make a professional judgement in this situation?

As I said above, there are some subtle differences that apply to the Form F assessment.  There are shifting patterns as the assessment progresses, as the applicant shares more of their personal life to someone who would otherwise be a complete stranger, moving towards helping the applicant prepare for a professional role, often knowing that your own relationship will be terminated at the end of the assessment (especially common in independent fostering agencies who often use independent social workers for their assessments rather than their own staff who may go on to become the applicants supervising social worker).  For me, remembering that we are modelling professional behaviour is probably the best way of maintaining those professional boundaries.

The Community Care report of the committee findings in Miss Jones’ case can be found here, while the full report from the HSPC can be found here.

A safe working environment?

Community Care regularly provides links to further information on the outcomes of hcpc fitness to practice decisions, which can make for interesting reading.  As well as making one wonder at the absence of professional common sense in some people.

Of course, a news reporting, or even a report from the hcpc only gives the information that is publicly available.  Perhaps its the social worker in me, but unable to speak to the individuals themselves I always hold back a small portion of reserve in any judgements I make.

One social worker who garnered a little of my sympathy was struck off for faking a conversation with a vulnerable child in an assessment report.  Of course, there is no excuse for doing this and it absolutely should not happen.  The social worker pleaded on the grounds of stress and sickness, but as the panel stated, these are no excuse for poor practice, and that “A social worker has an obligation to report any personal difficulties that might affect their ability to do their job competently and safely.”

The trouble is it’s too easy to say that a social worker has an obligation to report personal difficulties.  In this case the social worker was working as a locum in Harrow.  She presumably didn’t have a permanent contract with the local authority and sick pay and provisions can vary for casual/locum work.  Who should she have reported her ‘personal difficulties’ to, what effect would that have had on her ability to work, would she have lost her agency placement in Harrow and would her agency have continued to place her in other roles in future?

Front line social work, particularly in children’s services, can be one of the most stressful jobs going.  With high caseloads, government targets, deadlines and rigid timescales, it’s inevitable that some people with resort to taking unacceptable shortcuts.  Front line social work is a job in which there’s no emotional space for coping with non-work difficulties: a partner who leaves or an acrimonious divorce, a child or parent who is sick, the death of a friend, moving house, financial worries.  But perhaps most damaging is a tendency among social work departments towards a culture of ‘coping’.  It’s not done to admit that you, a carer, in a caring profession, with a professional and responsible image, are struggling, especially with stress.  It’s just not done.  Having worked in front line child protection I know that there is a distinct lack of sympathy: everyone is too busy trying to manage their own coping skills most of the time.  Where the pressure is greatest management can often be unapproachable, similarly under stress and not able to admit to the extent of it, and certainly not wanting to hear that someone needs a relaxing of their caseload or might be going off sick.

We all need to be prepared to speak up when we are in difficulty and we need to be prepared to work alongside our colleagues to support them when they face difficulties in and out of work.  Government and the profession’s leaders need to recognise the pressures that are exacerbated by shortage of staff, the administration of deadlines and targets and the managerialist culture prevalent in social work for much of the last 20 years.

The social work environment is not always a safe environment to work in.  While the hcpc is there purely to control registration and take disciplinary actions it would be better if they could consider and campaign for a safer working environment and atmosphere, taking on a more supportive role with the profession, such as that offered by BASW.

In this case there appear to be two primary factors that clinched the decision to strike this social worker off the register: the deliberateness of her deceit and her lack of recognition of the potential serious consequences of her actions for the child and his family, something that is particularly concerning considering she had been qualified for 17 years.