Social workers given guidance on inappropriate relationships with clients

Rise in misconduct cases prompts regulator to publish advice on professional boundaries for staff

Aisha was flattered when her children’s social worker began paying her attention. She had been going through a spell of mental health problems and felt a mess.

The attention turned into a friendship and eventually an affair. But the social worker was a domineering Christian fundamentalist who sought to convert Aisha and stop her taking her medication. When she objected, he said he had the power to take away her children.

Aisha’s ordeal is one of a growing number of cases of social workers found to have formed inappropriate relationships with their clients, which has led to disciplinary action, including dismissal and removal from the professional register.

The General Social Care Council (GSCC), social work’s regulators for England, will on Monday respond to the trend by publishing guidance on observing what it calls “professional boundaries”. Social workers, it will say, need to take particular care to ensure their support for vulnerable clients does not develop into something more.

Penny Thompson, the GSCC chief executive, said the guidance was “not a list of do’s and don’ts” but was designed to stimulate reflection and discussion around a series of cases that had been heard by the body’s conduct committee.

There were grey areas in a social worker’s dealings with a client that did not apply to other caring professions, Thompson said. “Making a relationship with the service user is part of the professional duty. That’s the basis for making an assessment of how they are and what needs to happen or change.”

The GSCC, which regulates almost 103,000 social workers and social work students, says the number being disciplined for inappropriate relationships is relatively small: 53 cases since 2006. However, these cases represent almost one in five of all 278 misconduct findings in that period. By contrast, one in 27 of all fitness-to-practise cases heard last year by the General Medical Council involved an alleged improper relationship between a doctor and a patient.

Cases outlined in the GSCC guidance include:

• A male social worker who took a married female client from his office to a nearby pub, where he complimented her on her appearance, suggested he could pay for her to go to university, touched her hands repeatedly and hugged and kissed her.

• A manager in a fostering service who treated children whose cases were allocated to his team, taking them swimming, to football matches and out for meals.

• A female social work student who by chance met and began a relationship with the father of two children whose case she had been allocated while on placement. She had the children to stay with her while their mother was in hospital.

Thompson said social workers should always note and report situations that could be misconstrued, such as having a cup of coffee with a client in a cafe or finding themselves discussing spiritual or faith matters with them.

A good test of whether a situation was improper was for a social worker to ask themselves if they would feel comfortable discussing it. “If you feel you couldn’t talk to your supervisor, or even a friend or colleague, about what you are doing, that might give you a pointer that maybe all is not well and there could be issues about boundaries,” Thompson said.

Aisha’s case, which led to the striking off the professional register of her children’s social worker, Rodney Smith, reveals some of the complexities of the issues involved. Even now, Aisha, 46, admits she felt supported by some aspects of the relationship, which began during the three years that Smith was assigned by the local council to her family and continued for more than five years. “There were parts of me that didn’t like it and parts that did,” she said. “It was a bit confusing.”

Aisha, a mother of six who lives in east London, was brought up in a strict Muslim family, had little education and had an arranged marriage as a teenager. She has been in several abusive relationships.

When Smith arrived, she was feeling particularly low because her weight had increased as a consequence of the medication she was taking for her psychosis. “He started to say that I intrigued him, that he was interested in me as a person and he felt sorry for me.” Soon, he was urging her to stop taking the drugs.

Conversations turned to religion, with Smith telling Aisha that Islam was “corrupt”, that her children had been taken by the devil and that she would find peace only through Christianity. He gave her a Bible and tapes of sermons and took her to church.

The relationship ultimately became sexual, although Smith was married with children. Feeling increasingly desperate, Aisha managed to break free only by going to her MP to report Smith’s behaviour and his threats to take away her children.

Aisha said: “I was quite flattered that somebody in a high position like that would want to get involved with riff-raff like me.”

Aisha’s name has been changed

Case study

Andy Atkins now coaches social workers on observing professional boundaries. But he himself paid a high price for crossing them.

Employed as a mental health social worker by Leeds council, Atkins became involved with a woman who had been his client and with whom he was still in contact through his work with a support group. Two months after he began the relationship, he told his line manager and was immediately sent home.

There followed two years of recrimination and anxiety: a 17-month suspension, followed by dismissal, three months’ unemployment, reinstatement on appeal with a final written warning and, finally, an admonishment placed on his record for nine months by the GSCC.

“It cost a lot of money and a lot of heartache for everybody concerned,” said Atkins, 59. “They are not interested in ‘Andy Atkins has fallen in love’; they are interested in proving your guilt.”

Atkins was a practising social worker for 24 years, for 18 of them as an “approved” mental health specialist. He was not allowed to return to such work on reinstatement and eventually took early retirement this year, enabling him to focus on coaching through his business, Professional Boundaries Training.

He welcomes the GSCC guidance, saying social workers have never been taught enough about the “slippery slope” of boundary violation that can start with something as innocent as sending a Christmas card to a client or calling them on a personal phone.

“That’s a particular one I remember: someone had noted the number and stored it for the future. They then rang me to say they were thinking of committing suicide. The message you give to clients if you give out your number is that you are available 24 hours a day.”

Atkins’s own story has had a happy ending: Anita, the woman he fell in love with, is now his wife.