Managing tensions in statutory professional practice: living and working in rural and remote communities.
Living and working in small communities poses challenges for many professional in the execution of their daily work-tasks. The juggling of multiple roles which straddle both their professional and personal worlds becomes an ongoing negotiated space of conflicting responsibilities and allegiances with increased potential for ethical dilemmas (Hargrove, 1986; Fertman, Dotson, Mazzocco & Reitz, 2005; McAuliffe, 2005a). When the nature of the work includes a statutory requirement, which carries some legal responsibilities such as mandatory reporting, policing or the regulation of mental health patients, the frequency and intensity of these dilemmas are likely to be increased. Highly publicised events such as the intervention in the Northern Territory, the prosecution of a police officer working in an Indigenous community and the standing down of child protection workers in a remote Queensland community or the shooting of a person with mental illness as an act of police containment all highlight the more severe consequences of these tensions and statutory work more broadly. Little is known about how communities perceive and relate to these professionals or about how the professionals work through these dilemmas while maintaining their position as community members. Such dilemmas are likely to arise, we argue, in the work of social workers, health professionals, teachers, police officers, doctors, community corrections workers and other human service practitioners.
Several key questions arise, then, when considering these events and the context of rural and remote communities: What is the nature of the relationships between professionals and their communities? How are these issues negotiated in smaller communities? And more broadly, how can health and human services workers be better equipped to address multiple relationships and thus improve health, law and order, welfare and educational outcomes for rural citizens?
SOME RECENT STUDIES ON LIVING AND WORKING IN RURAL COMMUNITIES
Our analysis of literature shows that there is an identifiable gap in our knowledge of the managed tensions experienced in the day to day routines of professionals with statutory responsibilities in rural communities. Indeed much of the research writing deals with issues relating directly to particular professions, rather than exploring the possible factors for comparison across professions.
In the field of Education there are a number of identifiable themes in the literature with respect to rural and remote education. Many studies have investigated issues of transitions (MacDonald, 2008; Collie, Willis, Paine & Windsor, 2007), teacher preparation (Lock, Reid, Green, Hastings, Cooper & White, 2009), technologies to overcome distance (Crump, Twyford, Littler, 2008; Devlin, Feraud, & Anderson, 2008) and place pedagogies (McConaghy, 2006; McConaghy, Graham, Patterson, 2006).
Similarly there are a number of 'threads' that are common across discipline areas. In social work recruiting and retaining professionals in rural and remote communities is a major problem well documented in social work (Cheers, 1992; Chenoweth, 2004; Lonne & Cheers, 1999; McAuliffe, Chenoweth & Stehlik, 2007), allied health (Gibbs & Keating, 1999; Ricketts, 2005), medicine (Veitch, Harte, Hays, Pashen & Clark, 1999; Jones, Humphreys & Adena, 2004) and education (Appleton, 1998; Yarrow, Herschell & Millwater, 1999; Herrington & Herrington, 2001). In professions such as policing or teaching, which typically mandate posting to rural and remote communities within the terms of employment, recruitment is less problematic for professionals who often serve shorter employment terms (Montgomery, 2003).
However, difficulties often arise through lack of 'outsider' acceptance in rural cultures (Weisheit, Wells & Falcone, 1995). This can make the performance of work roles more difficult (Payne, Berg & Sun, 2005). At the same time, communities are disadvantaged by such short-term postings because insufficient time is committed to building mutual trust (O'Connor, 2007).
It is widely accepted that statutory work and work with mandated clients poses significant practice and ethical challenges in all geographic locations (Burman, 2004; Trotter, 2006). Professionals in statutory contexts are confronted with the dual dilemmas of maintaining "social control" or promoting the general welfare of society and "helping" or fostering improved functions and self determination (Burman, 2004). It is argued that practice will be much more effective if these difficulties are able to be acknowledged and understood both by workers and their clients (Trotter, 2006). The degree to which these dualities are explicit varies across different professional groups. For example, in policing or correctional work, the social control agenda is clearly the major priority for intervention. We suggest that community members too have clearer expectations and awareness of these roles. In other fields such as child protection, teaching or mental health, the mandated role is less well known in the general community and thus the potential dilemmas are more covert. When such roles are performed in smaller communities these issues become intensified. In fields such as education, boundaries are often blurred in parent-teacher relationships. A significant factor in the relationships in school communities is the increased overlap and nature of dense complex social networks. Often relationships between schools and communities go beyond any sense of the client and service-provider "divide" in rural contexts (Johns, Kilpatrick, Falk & Mulford, 2000; Wilkie & Newell, 2000). Further, as Sutcliffe (2001) notes "the school, particularly in rural communities, is often the strongest community institution. It is a gathering point, a centre symbolising community and a resource that can unite the community". This prominence of the school--and its staff--in the community can create tensions as teachers negotiate a delicate balance between their professional and personal life.
However, what the work cited above does not do, and where the literature in general is short on explanation, is in the production of research that looks through an interprofessional lens as it examines multiple professions with statutory responsibilities. In particular very few studies have examined the nature of statutory work in rural communities. Studies of child protection work in rural settings tend to focus on the attitudes of rural residents to child abuse (Calvert & Munsie-Benson, 1999) or the patterns of notification of child abuse in rural towns (Craft & Staudt, 1991; Manning & Cheers, 1995). A recent Qld state wide study (O'Connor & Cannon, 2007) of carers' perceptions of support for family members with mental illness identified conflicts between some professionals' discharging their statutory responsibilities and the compromised care of service consumers. However, these studies do not provide findings about the relationship between statutory workers and communities or how it plays out for professionals in the discharge of their duties or for communities in understanding and supporting a presence expected to support its integrity.
The ethical dilemmas of dual relationships in rural practice have been documented in psychology (Campbell & Gordon, 2003; Hargrove, 1986) and social work (Chenoweth & Stehlik, 2001; Chenoweth, 2004; Martinez-Brawley, 2000; McAuliffe, 2005b). Evidence from an early Queensland study on disability services (O'Connor, Bramley & Gunn, 1983) revealed a willingness of diverse professionals serving communities distant from their employing authority, to make local adjustments rather than slavishly follow central bureaucratic requests. These accounts not only outline the inevitability of dual relationships in rural and remote settings, but also acknowledge the strain on professionals trying to work within organisational parameters, legislative frameworks and ethical codes of conduct. There is little published beyond problem identification with few supported strategies for addressing concerns.
In other contexts where multiple relationships generate conflicts of allegiances, for example in the work of military psychologists stationed on aircraft carriers, Johnson, Ralph and Johnson (2005) argued that the primary allegiance is to the mandate authority. Using the concept of embedded psychology, they suggested that the psychologist has profound power over the client's life and encounters multiple-role strain through boundary crossing. Cheers (1998) also used this notion of embeddedness to describe the context of rural social work practice. This refers to the way in which rural professionals are entwined in community life and thereby identify with and have allegiance to their community while executing organisational and legal responsibilities as agents of the state.
Our brief review of some of the relevant recent research has led us to argue that there is little evidence that research focussing on professionals with statutory responsibilities living and working in a rural community is a concept that has been adequately described. We suggest that this kind of knowledge is a critical precursor to reconceptualising approaches to improving health, welfare and educational outcomes for rural communities.
MANAGING TENSIONS IN PROFESSIONAL STATUTORY PRACTICE: THE PROJECT DESIGN
The ARC Discovery project described in this section builds upon previous work of recruitment and retention issues for child protection practitioners in rural Queensland the findings from which highlighted the difficulties for many child protection practitioners in carrying out statutory responsibilities such as removing a child from a family in small communities where they also lived. These activities and the reaction from community members were reported as highly stressful and fear-provoking by many practitioners. Juggling the demands of statutory work, the needs of clients and becoming accepted members of the local community emerged as a crucial issue influencing their decisions to remain in or leave their position.
The "Managing Tensions in Professional Statutory Practice" project aims to develop knowledge about how communities and those professionals providing key health, welfare and educational services can work more effectively for more positive outcomes for individuals, families and whole communities and how such services change when impacted by local issues and place imperatives. The research involves interdisciplinary issues across different professions and explores and examines the ethical issues confronting them and to identify possible factors for comparison across these professions. Specifically the research aims to address the following research questions:
1. What statutory responsibilities and requirements exist for professionals in rural and remote communities in Qld?
2. What are the experiences of professionals with statutory responsibilities who live and work in rural communities?
3. What are the experiences and views of community members about their relationships with these professionals?
4. How do professionals balance the competing demands between the central authority (agency) and local relationships?
5. How do these tensions impact on ethical practice and professional agency? and
6. How can theories of power and governmentality explain these phenomena?
This 3-year project uses both qualitative and quantitative methods to map the terrain of rural and remote statutory work, to explore the nature of the relationships between professionals and communities and examine how professionals manage ethical and allegiance conflicts which arise. The key elements of analysis in the study are statutory programs and roles, the professionals performing these roles and the communities in which they live and work. Figure 1 illustrates the site for the study and the corresponding methods used.
[FIGURE 1 OMITTED]
As a way of defining the elements of this study the following explanations of the concepts have been adopted.
Statutory work: Human service agencies and workers increasingly operate under legislative regimes that require them to do certain things in their work or avoid other activities. A number of professionals have statutory duties and powers, which may be specific (e.g. mandatory reporting) or more general. Much of this work happens within a complex arrangement of interlocking and legislative provisions, regulations and employer procedures--e.g. privacy legislation (Kennedy, 2004). It also highlights the importance of the inter-relationships between central control and working in dynamic rural/remote environments. In this study we are including activities such as policing, mandatory reporting, child protection work, regulation of mental health patients and enforcing community correction orders.
Professionals involved in statutory work: For the purposes of this study across the health, justice, education and human service systems, the following professionals will be included in the study: police officers, corrective services officers, social workers and welfare workers, teachers, mental health professionals, medical practitioners, and allied health professionals. Some of these professionals may encounter statutory responsibilities infrequently (e.g. teachers having to report suspected child abuse) while others deal with statutory work in most of their daily tasks (e.g. police officers).
Rural and remote communities: The study draws on several approaches to determining rural/remoteness. First, communities will be assessed using Accessibility/Remoteness Index of Australia (ARIA) scores. It is anticipated that communities will include Moderately Accessible, Remote and Very Remote communities. Second, degrees of disadvantage will be taken into account using Socio-economic Index for Areas SEIFA, 2001. Qualitative definitions, while recognising that population size and distance are a contributing elements to what constitutes 'rural' focus on the cultural and relational dimensions of places and people (Halsey, 2007). As well we will take into account the different organisational definitions of rural and remote, for example across health, education and policing.
The aim of the online survey was to explore the nature of the relationships between human services professionals with statutory responsibilities and communities, and to examine how professionals manage ethical and allegiance conflicts which arise.
Purposive sampling was used in order to target human services professionals with statutory responsibilities, such as medical practitioners, nurses, allied health professionals, social workers, teachers, and human service workers, currently working or who have previously worked, in rural and remote communities in Queensland. Participants were recruited through advertising the survey through Government agencies, unions, professional associations, and non-government organisations.
The survey was developed using the application Lime Survey. The survey consisted of both close- and open-ended questions, and took participants approximately 30-45 minutes to complete. The survey was developed from the researchers' existing knowledge of those factors likely to influence rural practice and statutory work.
Section one of the survey asked questions around basic demographic data such as age, gender, professional background and position, and family situation. Section two included questions about prior experience of both living and working in rural and/or remote communities, and the nature of statutory responsibilities, other work and roles, perceptions of acceptance or exclusion by rural and remote communities. Section three of the survey was about how professionals manage any tensions experienced, from living and working in rural and/ or remote communities. The survey was pilot tested and evaluated by human services professionals with statutory responsibilities currently living and working in rural and remote communities in Queensland. Their feedback was incorporated into the final version of the survey.
PRELIMINARY FINDINGS FROM THE SURVEY OF PROFESSIONALS
With a response rate of n=900 the data generated is rich and varied. Many of the respondents took the opportunity to 'tell their story'. Participants were very motivated to provide highly informative comments in the open-ended items responses. Consistent with the emerging literature in this area, the survey provided a valuable means to capture the thoughts and perspectives of the respondents dispersed over a wide geographical area (Klieve, Beamish, Bryer, Rebollo, Perrett & van den Duyzenberg, 2010).
As noted the respondents came from a range of professional areas such as police, teachers, social workers, medical practitioners, nurses, paramedics and other areas. Of those surveyed 612 currently live within a rural or remote area, with 22% graduated within the last 5 years. The majority of the respondents worked in some capacity within the State Government (69%), around 5% in private practice and 12% in Non-Government Organisations (NGOs).
Major tensions and strategies to deal with them
Are multiple role relationships problematic in the day to day practice experience of professionals working in rural and remote communities? Preliminary data would suggest that the answer is yes. Indeed the data suggests that the blurred boundaries and dual roles within the community constitute a considerable contribution to the tensions experienced.
The survey revealed 82% of respondents indicated that they experienced some sort of tension related to living and working in a rural and/or remote community. As indicated earlier professionals in rural and remote areas must juggle multiple roles which straddle both their professional and personal worlds. The statutory nature of their work complicates matters as boundaries become blurred and the execution of their daily work tasks becomes difficult.
Common themes emerged from the preliminary analysis such as tensions juggling relationships (personal and professional); professional boundaries; difficulties associated with the centrality of the organisation in which participants worked and their lack of 'rural' understanding; maintaining confidentiality; and, role specific tensions. Throughout the common themes the notion of managing a professional identity weaved through all of the tensions identified by the respondents.
The following response from a School Principal currently living in a rural or remote community highlights the many difficulties associated with managing personal and professional relationships:
Parent community relations: Living and working in a small remote community with small number of families can at times create tensions. Need to be mindful of local politics, local kinship relationship connections, traditions, customs and cultures of community and respect these.
Staff relationships: living and working with small number of staff creates tensions particularly when performance of staff is being questioned and monitored. Having those difficult conversations re: performance places emotional stress on Principals.
Personal relationships: As there are limited number of opportunities to "release work tensions", partners often have to deal with work stresses at home which can create tensions within a relationship.
Social interactions: Limited social opportunities. Parents also at majority of social events so behaviour and conduct must be exemplary at all times. Hard to '; unwind' and relax at social events due to nature of the position and people socialising with (parents, families, students) (School Principal)
Relatedly, another major source of tension identified was the blurring of professional and personal boundaries. The following quote illustrates how being 'embedded' within a community as a professional and a community member can cause considerable tension and potential conflict:
One of the biggest tensions is the size of the community--you sometimes end up doing investigations on people that you went to school with, or people that you work with (from other organisations), or the solicitor that you are 'battling with' through court is the same person that turns up at the local netball club. We have to be really mindful of conflicts of interest and our ability to still make good decisions for children and their families and if that is compromised, then that needs to be declared and managed appropriately (Social Worker)
From another perspective, however, a lack of knowledge and familiarity of rural communities associated with working for an organisation where the central office was metro-centric also contributed to a sense of tension. The following quote from a High School Principal highlights the result of a lack of real understanding of rural issues on the ground:
Rarely is it a situation of outright conflict with people however, it can be a common tension to have to tell people that a service or support that they have been receiving is no longer able to be provided as a policy has changed. Being the public mouthpiece for the corporate line often creates significant internal tension as what one is required to say and implement can often be at significant odds with personal values and beliefs and at times is just plain wrong. Being required to implement constantly changing policies and practices with an ever diminishing range of resources is a central element of the role and not being able to achieve to a standard that one believes is needed is a source of tension. A bureaucratic approach to staff selection and management by the organisation creates significant tension as any performance issues require a disproportionate amount of time, energy and never actually achieve a lasting solution unless there is a criminal matter involved (School Principal)
A common feature of all the professions surveyed was the need for confidentiality with respect to sensitive information and circumstances with members of the community. Maintaining this confidentiality proved difficult for many respondents as the following quotes highlight:
People sometimes have an expectation that you will discuss confidential issues with them regarding family or friends--they do not like to be told that information is confidential. There is also a proportion of the community who expect that you will be available to them 24 hours a day even though this is not a job requirement. You are never really "off duty" (School Teacher)
Being the holder of quite a lot of sensitive and confidential information, tends to embarrass the giver of the information. Social situations can be difficult for the other person and maintenance of professional discretion is paramount to the job (Regional Manager, Human Services)
Within particular professions some very significant role-associated pressures were raised. Preliminary analysis suggests that the more significant the areas of statutory responsibility, the more significant the tensions experienced. The following is an experience of a Police Officer currently serving in a remote community:
To the community I am a police officer and nothing else. Taking action against any person for an offence creates negative reactions in the community against Police. Remote locals feel they should be immune to the law because of remoteness, this increases possible violent behaviour when action is required. General dislike of Police prevents my involvement in activities outside my work. Unable to enjoy a hotel environment dinner or a few drinks due to risk of violence from other patrons (Police Officer)
Further, the following responses from a Mental Health Worker, Childcare Worker and Social Worker consecutively describe similar role-associated tensions and how it is exacerbated due to size of the community:
Given my role is to make decisions about fundamental human rights or the revocation of those rights people often feel aggrieved and then I run into them on the streets (Mental Health Worker)
Parent to staff relations can be strained when parents do not get what they want. Being a small community, people assume that laws and legislations don't count for us. They feel that certain things should be overlooked to suit them. Parents then become hostile towards staff when staff enforce rules and policies within the centre (Childcare Worker)
I experience a high degree of interaction with consumers outside my workplace, e.g. at shops, at church, at sporting events, at community events associated with my friends/family. I think adherence to codes of ethics/statutory roles complicates my private life. E.g. I completed a Child Safety Notification that resulted in a family being assessed. The family were able to identify me as the reporter. I knew that I played in the same touch football competition and would probably see them there. However, I care greatly about my role and would rather do what is right despite the impact that it has on my life--I guess it just means there is a higher cost of doing this in a rural/remote area (Social Worker)
The tensions highlighted here raise particular issues for people working as professionals in rural and remote communities. Issues surrounding the management of professional identity and dual roles, the size of the community and the number of professionals working in a particular area, over familiarity with community members and the metro-centric nature of many organisations contribute to the type and severity of the tensions experienced. How respondents managed the tensions was also explored through the survey. These issues are consistent with the characteristics of rural communities identified by Johnson, Ralf, and Johnson (2005, p. 74). They suggest that it is these tensions that make multiple relationships more common and difficult to avoid. They include:
Community members want to know details about others in the community;
* Non-community members can be distrusted and may be viewed with suspicion;
* Multiple levels of relationships are expected and viewed as normal;
* Geographical isolation in these communities results in a limited number of social relationship options;
* There is an increased incidence of personal contact and interaction outside of the professional boundaries;
* The existence of some multiple roles between 'professionals' and 'clients' is nearly certain.
Participants identified a number of strategies they drew on to manage those tensions. The strategies can be categorised into three broad areas: Avoidance strategies, involvement in Activities, and Work Related strategies. Table 1 highlights the strategies identified.
The strategies listed in Table 1 range from effective to ineffective coping strategies. Strategies such as "drinking" and "online gaming" for example may mask more serious conditions such as depression. Other strategies, such as "don't leave the house on days off" also sit at odds with potential benefits of "embedded practices". As Johnson, et al, (2005) suggest, "as a visible member of the community, the professional enjoys a boost in credibility; he or she is a genuine insider and gains considerable currency from abiding by community standards" (p. 76). However, as can be seen in Table 1, many effective strategies were also identified placing the professional in the community as both member and professional.
DISCUSSION AND CONCLUSION
As demonstrated professionals assume multiple and sometimes competing responsibilities as judicial and statutory systems intersect with others such as health, education and human services. There is a proliferation of blurred boundaries. The data presented in the paper suggests that the fusion of professional and personal interactions with member of the community is commonplace and often creates difficulties in balancing relationships, understanding relevant ethical obligations and avoiding potentially harmful relationships. The preliminary analysis shared points to a commonality of issues across professions for professionals living in rural and remote communities in Queensland. One message that emerges from the brief portrayals of professionals' experience is that the context of small rural communities influences what professionals do in the course of their professional practice and the ways in which the deal with the related tensions of that practice. Cultural contexts are very pervasive in determining the types of relationships and networks that are available. As McDowell (1999) puts it "places are made through power relations which construct the rules which define boundaries. These boundaries are both social and spatial--they define who belongs to a place and who may be excluded, as well as the locations or site of experience". These factors can severely impact on a professional's capacity to meet work commitments and function successfully as a community member.
The stories here demonstrate that despite a range of workplaces and practices, a commonality exists. It highlights the value of incorporating knowledge of how "professions" fit in a community, how communities work and how people with a variety of professional backgrounds can work effectively together with community partners.
Our suggestions here help to underscore the importance of the kind of knowledge we are saying is necessary. We have presented an argument in this paper that began with an assumption that there is a discernable interest and focus on issues regarding rural and remote issues. This research predominately focuses on particular professions or disciplines with a definite thematic thread connecting common issues. The result of our thinking is the claim that to better equip professional working in rural and remote communities will only be improved when there is a much more substantial knowledge base and indeed theoretical explanation about the tensions professionals with statutory responsibilities face whilst living and working in rural communities, and the interrelationship between professional practice and common tensions, that presently exists.
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Paula Jervis-Tracey, Lesley Chenoweth, Donna McAuliffe and
Charles Darwin University
Table 1: Strategies for dealing with tensions Avoidance Activities Work Related * Don't leave the * Drinking * Use of discretion house on days off * Joined a * Speak to others who * Avoid work social shooting club have the same role as functions out of myself hours * Informal entertaining * Speak with Human * Work at home on our Services Officer farm * Exercise * Avoid certain clients * Holiday outside the * Fishing community * Cope and put in extra * Martial Arts hours * Maintain very few personal friendships * Bought a dog * Debriefs within the community * Make new friends * Discuss in Clinical Supervision * Shop * Online gaming * Be involved in the community
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|Author:||Jervis-Tracey, Paula; Chenoweth, Lesley; McAuliffe, Donna; O'Connor, Barry; Stehlik, Daniela|
|Publication:||Australian and International Journal of Rural Education|
|Date:||May 1, 2012|
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