Layout 1 [Qualitative Research in Medicine & Healthcare 2020; 4:8688] [page 13] Introduction Social work is strongly client-based, and one of the main reasons that social workers choose this career lies in its focus on relationships with clients.1 Previous re- search on client-worker relationships in the social services sector indicated that clients view communication and in- teraction as important. They expect a friendship style of interaction and emphasize their wish for informality and the most appreciated social worker qualities are associated with respect, empathy, listening, and warmth.2 However, social workers have a wide variety of communication styles and skills.3 For example, child and family social workers appear to use a confrontational style of commu- nication in which a lack of empathy is typical.4 In addition to challenges with communication skills, client-worker relationships include various tensions due to the nature of social work. Client-worker relationships in the social services sector are affected by different kinds of power and dependency relations and pressures related to welfare and justice.5 Furthermore, social workers ex- perience a high degree of role ambiguity and role conflict, which manifest in discrepancies between ideal and actual work outcomes.1 In addition, social workers have a diffi- cult time avoiding being viewed as the other, as well as effectively making themselves understood.6 Negative im- ages and uncertain identities7 harm their cooperation with clients and are associated with burnout and dissatisfaction with their work,8 threatening social workers’ well-being. Additionally, tension between the philosophy of social work and growing work demands,1 such as the value con- flict between anthropocentrism and managerialism,7 may hinder the client-centered approach of the service. Previous research1-7 has clearly shown the challenges and tensions of social work, but how this paradoxicality is manifested in the client-worker relationship has not yet been studied. The tensions may lead to challenges in the collaborative client-worker relationship, which aims not only to support clients’ welfare but also to offer workers opportunities to achieve personal accomplishments. The current study takes a Relational Dialectics Theory (RDT)9 approach to describe how relational contradic- tions of client-worker relationships are manifested in the talk of disability service workers. We pursue this aim by identifying discourses and analyzing the types of mean- ings that are created in the interplay of these discourses.9 Specifically, we observed client-worker relationships from an RDT perspective and concentrated on contradic- The Discursive Struggles of the Client–Worker Relationship in the Social Services Hanna Nykänen and Leena Mikkola Department of Language and Communication Studies University of Jyvaskyla, Finland ABSTRACT This study examines how disability service workers identify the discourses of the client-worker relationships. We studied the client- worker relationship from the perspective of the relational dialectics theory with a focus on relational contradictions and the meanings created within discursive struggles. We analyzed the interview data from 22 social workers using contrapuntal analysis. According to the social workers’ perceptions, two discursive struggles exist in client-worker relationships: i) the struggle of integration, consisting of the contradiction of the ideal and the real and the contradiction of closeness and reservedness and ii) the struggle of certainty, consisting of the contradiction of predictability and novelty and the contradiction of openness and closedness. These struggles and contradictions arranges on the societal and relational frames to fully depict the nature of social work. Overall, our analysis shows that the client-worker relationship is both bound to the norms of a professional and a close interpersonal relationship, making its study particularly interesting. Correspondence: Hanna Nykänen, Department of Language and Communication Studies, University of Jyvaskyla, P.O. Box 35 (A- building) FI-40014 University of Jyvaskyla E-mail: hanna.k.nykanen@jyu.fi Tel.: +358400630327 Key words: client-social worker relationships; contrapuntal analy- sis; relational dialectics theory; social services; interviews. Conference presentations: This research has been presented in ICA 69th international conference, Washington DC, USA, 26.5.2019. Conflict of Interest: The Authors declare no potential conflict of interests. Received for publication: 18 November 2019. Accepted for publication: 6 June 2020. This work is licensed under a Creative Commons Attribution Non- Commercial 4.0 License (CC BY-NC 4.0). ©Copyright: the Author(s), 2020 Licensee PAGEPress, Italy Qualitative Research in Medicine & Healthcare 2020; 4:13-21 doi:10.4081/qrmh.2020.8688 Qualitative Research in Medicine & Healthcare 2020; volume 4:13-21 No n- co mm er cia l u se on ly tions in these relationships to identify relationship-based tensions and the meanings of the relationships that are constructed in the interplay of these tensions. Theory RDT is Baxter and Montgomery’s10 theory of rela- tional meaning making, which explains how the identity of an individual and his/her interactive relationships are built through language. Baxter’s9 elaborated and remod- eled the theory, RDT 2.0, guides the rationale for this study. The theory is based on Bakhtin’s11 ideas about di- alogism and the creation of meanings through the inter- action of competing and often opposing discourses. In this study, we refer to discourse as a meaning system—that is, a set of claims and suggestions that combine to form a particular meaning. Contrary discourses, in turn, form contradictions.9 Baxter and Montgomery10 identified three main con- tradictions that appear in relationships: i) the contradiction of autonomy-connection refers to the tension between aims for independence and demands for integration, ii) the contradiction of novelty-predictability consists of seeking novelty while simultaneously trusting the safety of stability, and iii) the contradiction of openness-closed- ness refers to simultaneously sharing information and try- ing to require privacy from others. Baxter and Montgomery10 defined the contradictions as discourse pairs that are inherent in all social life. Thus, they are not interpersonal conflicts, they are not charged positively or negatively, and they do not require resolution. Contradictions are always present, and, when we bal- ance them, we create meanings. RDT is an interpretative theory that offers alternative perspectives for communica- tive phenomena compared to positivist theories, which aim for predictability. In this theory, the key focus shifts away from the individuals and focuses on the interaction and language of the relationship parties.9 According to Baxter,9 the contradictions formed by discourses are discovered in language utterance chains, which consist of individual utterances. Each utterance is built on an interface between the past and the present. The distal already-spoken dimension links the utterance to the existing discourses of a larger culture. The proxi- mal already-spoken dimension links the utterance to what has been said in this specific relationship, affecting how statements are expressed and interpreted. The con- struction of utterances is also influenced by anticipation of the party’s acceptance both in this specific relation- ship (proximal not-yet-spoken) and outside the relation- ship in the form of societal responses (distal not-yet-spoken). All of these dimensions thus influence how utterances are formed, as well as how meanings are generated through interaction. Power is a significant actor in RDT.9 However, power is a feature of the discourse rather than a feature of the ac- tors in the relationship. Power is perceived by analyzing how strong discourses are conveyed in the text. It is per- fectly normal that the discourses in the text are not equally strong but are partly centripetal and partly centrifugal. Baxter9 explained that a discourse takes a centripetal po- sition when it is given greater power or importance; in other words, the discourse is accepted as normative or nat- ural. When a discourse is given a less powerful and mar- ginalized position, it is considered to have a centripetal role and is categorized as unnatural. RDT was developed and has mostly been used to study close relationships,12,13 although it has been applied to health services research in a few studies,14-19 which pri- marily focused on roles and relationships involving doc- tors, patients, and nurses. Health care relationships include many challenging interactions, and understanding their relational contradictions is important in order to de- velop communication. Closeness is an essential part of the health care relationship; this is especially true in challeng- ing situations, where balancing becomes harder and em- phasis easily shifts towards distance.14 In addition, contextual factors may create contradictions, which then interpenetrate10 the relational contradictions experienced in interpersonal relationships.15 The topics of interaction in the health care context are sometimes tough. Studies demonstrate the applicability of relational contradictions in the context of end-of-life communication in order to provide physicians with im- proved communication skills to address the challenges that dealing with death produces in their client-worker re- lationships. Amati and Hannawa16 noted that relational contradictions are always present in client-worker inter- actions; they also identified new contradictions, such as desire versus ability and standardization versus personal- ization, and authenticated the three original contradictions of autonomy-connection, predictability-novelty, and openness-closedness. In addition to challenging topics of interaction, work- load and pressure also create tensions in client-worker re- lationships in health care settings. For example, physicians in Emergency Departments (EDs) favor effi- cient communication at the expense of comprehension or rapport; this is understandable due to the fast-spaced na- ture of EDs, but it does not support the idea that patient- centered perspectives are usually the main objective of health care relationships.17 Challenges occur also in client-worker discussions of diabetes management. O’Hara and Shue18 studied the client-worker relationship by analyzing diabetes manage- ment discussions between patients and physicians. They realized that understanding these discourses and their in- terplay helps physicians focus on the cultural discourse that shapes their own and their clients’ views of diabetes management, as well as notice the transformational pos- sibilities that can occur in treatment plan discussions. In addition, Peltola and Isotalus19 explored competing dis- courses in type 2 diabetes management by analyzing pa- [page 14] [Qualitative Research in Medicine & Healthcare 2020; 4:8688] Article No n- co mm er cia l u se on ly tients’ descriptions of interactions with their health care professionals. They found a new struggling discourse pair—having the right to care versus deserving care— which had not previously been emphasized as a central contradiction. Although applications in the health care context indi- cate that RDT is suitable for describing and explaining client-health care provider interactions and relationships, and although there is evidence of a different kind of con- tradiction in client-worker relationships in the social serv- ices sector,5 RDT has not been applied in the context of social services. The only themes covered by RDT from the social services point of view have been adoption and foster families.20-22 Those studies researched the discursive construction of family but did not emphasize the relation- ship between the client and the worker. In the present study, we explore the relational contra- dictions of the client-worker relationship in the context of disability services. The relationship is interesting to ex- plore using RDT because it is a long-term dependency- based relationship, which includes many pressures, such as controlling versus helping, in its basic nature. More- over, to achieve successful collaborative relationships, so- cial workers need to identify interpersonal contradictions and learn to manage them. Aim of the Study This study aimed to understand the social construction of the client-worker relationship in disability services by identifying what kinds of related discourses disability service workers manifest in their talk. We study the client- worker relationship from the RDT perspective, which concentrates on relational contradictions and the mean- ings created in those discursive struggles. The Research Questions (RQs) are as follows: i) RQ1: What competing discourses, if any, social work- ers’ present in their talk about client-worker relation- ships? ii) RQ2: What kinds of meanings regarding the identity of these relationships the competing discourses create? Answering the first question involved analyzing inter- view data and identifying various discourses that mani- fested in the social workers’ talk. Answering the second question entailed a continuation of the analysis process by elaborating how the discourses interacted with each other, as well as what kinds of meanings the interplay cre- ates. RDT provided insights into how the meaning of the social workers create the identity of the client-worker re- lationship in their talk. Communication practices constitute relationships, and the communication parties author selves in the interaction.23 The client-worker relationship, in this study, is a professional relationship between a disability service worker and a disabled client or his/her next of kin, which functions as a service and counselling relationship. Materials and Methods The Context In Finland, the Ministry of Social Affairs and Health is responsible for promoting the health and well-being of people with disabilities, developing the tightly interde- pendent totality of social and health care services, and se- curing each client’s livelihood. Various laws, such as the Social Welfare Act, stipulate disability services. Rights to equality, participation, and necessary services and support are the three principles of the Finnish policy concerning individuals with disabilities. The aim of the Finnish dis- ability policy is to support the autonomy and agency of individuals living with disabilities. Municipalities organ- ize and finance services and support for everyday life. So- cial workers develop a personal service plan for clients and make decisions regarding the services and support that the clients need, such as transportation services and personal assistance.24 A social worker is assigned to a client based on the region in which the client lives. The client cannot choose the person with whom he/she works. Data We interviewed social services workers from two dif- ferent organizations for a total of 22 interviews. This was a two-researcher study, the first author carried a main re- sponsibility of the interviews. The first data set consisted of 12 in-depth interviews25 of social service workers from the same disability services unit. The length of their ca- reers ranged from a couple of months to 20 years. One participant was male, and 11 were female. We asked open-ended questions, such as how would you describe your work/client relationships? In addition, participants provided examples about various situations at work and with clients. Themes about successful/unsuc- cessful interactions, general reasons for meeting clients, receiving feedback, instructions for working with clients, power relations, client expectations, conflicts, and ethical concerns were discussed. In addition, we also provided questions about peer and supervisor relationships. After conducted the first dataset, we transcribed and coded it, and afterwards gathered the second one. The sec- ond data set consisted of 10 in-depth interviews of social workers from a different disability service organization. Their careers varied from a couple of years to dozens, but all of the participants had only worked in their current unit for a couple of years. Most of them had a long history of working with disabled clients. All of the participants were female. First author conducted also the second set of inter- views and she asked the same open-ended questions as in the previous set, along with questions derived from the earlier analysis to determine whether the social workers recognized the contradictions that emerged from the first data set. We did not directly name the contradictions in [Qualitative Research in Medicine & Healthcare 2020; 4:8688] [page 15] Article No n- co mm er cia l u se on ly the questions; but instead described the themes and asked the social workers to give examples of interactional situ- ations with clients in which they identified the specific theme and how they felt it affected the client-worker re- lationship. Interviewees decided whether they want to give the in- terview in the meeting room of social services office or on campus at the university. The interviews took anywhere from 40 to 85 minutes, varying with each participant. The average duration was 55 minutes. We transcribed all the in- terviews verbatim, yielding 283 pages of transcribed text with Lato font and line spacing set at 1.07. Method of Analysis We chose to analyze the data using contrapuntal analy- sis,9 which is a form of discourse analysis related to RDT 2.0. According to Baxter,9 the key focus of contrapuntal analysis is the interaction of competing discourses, while basic units of interaction, utterances, and utterance chains lie at the core of the analysis. This analysis makes inter- action-based discourses visible so that the researcher is able to understand how discourses are maintained, how they construct meaning, and how the balance among dis- courses affects the client-worker relationship. Discourses can interact through diachronic separation or synchronic interplay.9 In diachronic separation, the dominance of the discourse changes through different pe- riods of time or the power of the discourse varies within different contexts or themes. In synchronic interplay, there is a co-occurrence of multiple discourses in a given period of time; an example of this kind of interplay is a non-an- tagonist struggle in which multiple discourses are identi- fied in actors’ utterances. According to Baxter,9 a non-antagonist struggle is common for interview data in which one party of a relationship constructs the meaning of the relationship. Three different discourse markers may help identify competing discourses in a text: negating (denying one discourse entirely), countering (replacing the obvious discourse), and entertaining (indicating that the given discourse is only one of many possibilities).9 Conducting the Analysis The first author coded the data and conducted the analysis of the interplay of the discourses, however to- gether we critically discussed all interpretations to strengthen the credibility of the analysis. The analysis was initiated by importing the transcribed interview data into the Atlas.ti application. The interviews of the first data set formed an entirety, which was rationalized because the key focus of this study is understanding how contradic- tions in the client-social worker relationships were mani- fested in the utterances of social service workers. Therefore, all of the contradictions interpenetrate utter- ances appearing in the data as a whole instead of focusing in one interviewee’s utterances. First, the first author coded the text multiple times to determine possible initial coding categories related to the client-worker relationship.26 We then captured what was said in the text and what was indicated by the relation- ship’s identity by initial coding categories that consisted of meanings that we combined into semantic themes, as in discourses. For example, the sentence: It was so clear to me that I am here for the clients was coded as integra- tion (initial coding) and categorized into the semantic theme of closeness. Second, after identifying the semantic themes, we ini- tiated an in-depth analysis of interplaying discourses. This part of analysis the first author conducted by exploring whether multiple discourses were present in the text and, if so, whether they had any interplay with each other. The analysis of the interplay meant identifying the discursive markers9 as negating, countering, or entertaining. In the example below, the word but reveals the interplay. This example we labelled as synchronic interplay that led to a non-antagonist struggle. And the other one [client] is over the moon like this is awesome. Although their child got diagnosed and will not get better, they will have this kind of worker who they can use and turn to, and this worker will support them and helps them when necessary. But, then we have these [clients] who just make calls [saying] that do not come here. For the second dataset, we focused the analysis on the interplay presented around the already identified dis- courses. The next example is an excerpt in which a social worker described how distance and closeness resonated in his/her client relationship. The social worker presents the working role itself as being generally distant and something that the worker did not want to be seen. It is really important to me that the client relation- ship works and I am seen [as something] other than [an] authority [figure]. Of course, [I want to be seen] as [a] professional, but [also] as [a] human, not that you are going to see just some auntie social worker. In the service plans, I am using suitable language, but many of them cannot read so I’m trying to use [language in] ways [so] that it does not feel like a cold review message but that there is some kind foreword and flower or something. The coding did not proceed as linearly as described because analysis is a recursive process.26 We coded the data multiple times in order to obtain an effective hold on the totality of the data and understand the meanings con- structed in the interplay of the contradictions, as well as the discourses forming the contradictions. All of the in- terview examples presented here and in the results section, we have carefully translated from Finnish to English while striving to maintain the original tone and meaning. Ethical council of University of Jyväskylä has ap- proved the research plan. The researchers have followed the ethical principles27 throughout the study, including re- [page 16] [Qualitative Research in Medicine & Healthcare 2020; 4:8688] Article No n- co mm er cia l u se on ly specting the integrity of the subjects and providing exten- sive information about the study prior to the data collec- tion process. Participation was voluntary, and the participants provided written consent to the researchers so that their interview data could be used for research pur- poses. To support the credibility of the results, we have presented examples of the interviews. In the discussion section, we will indicate how previous research compares with our results. Findings According to the social workers’ talk, their client- worker relationships consisted of four contradictions: i) ideal-real, ii) closeness-reservedness, iii) predictability- novelty, and iv) openness-closedness. These four contra- dictions, in turn, formed two discursive struggles, as described in Table 1: i) the struggle of integration, con- sisting of the contradiction of ideal and real and the con- tradiction of closeness and reservedness and ii) the struggle of certainty, consisting of the contradiction of predictability and novelty and the contradiction of open- ness and closedness. Table 1 also illustrates how these contradictions were arranged in regard to the societal frame and the relational frame to describe the balancing of close interpersonal and professional relationships. The frames link to the idea of the proximal and distal sites of the utterances. However, they are not referring to the strategy of refram- ing.9 In the societal frame, the main influence on contra- dictions originates from outside the client-worker relationship, meaning that the utterances appear to be in the distal already-spoken dimension. The struggles are largely societally constructed based on the context in which the relationship occurs. Society sets the rules and limits for the relationship and guides its aims and func- tions. In the relational frame, contradictions rely more heavily on the interaction between the two parties in the relationship. These struggles are present when social workers describe communication in client-worker rela- tionships. We label the struggles here as contradictions of the proximal already-spoken dimension, although they are only retrospectively described by one party of the relationship. The discursive struggle of integration The struggle of integration emphasizes manifestations of the creation of a rewarding cooperative relationship. Table 2 presents the meanings of expected identity/other- ness and supportiveness/facelessness created in struggle of integration. Societal frame The discursive struggle of integration emerges in the competition between discourse of the ideal and discourse of the real. This contradiction supports the meanings of expected identity or detracts from expectations creating otherness when actors’ goals are authenticated or dimin- ished, respectively. The contradiction is linked to the ex- plicated mission of the social services sector, which is the provision of care. However, when social workers attempt to support the welfare of their clients, the workers may also constrict their clients’ freedoms and rights since the system, the budget, and the law set the boundaries on what and how much help can be provided. Client and worker expectations concerning the nature of the relationship are not always aligned with the real. This contradiction causes tension concerning reciprocal appreciation in which clients conclude that social workers are violating or ig- noring their civil rights, and social workers are uncertain about their career identities when they are unable to help. This contradiction of ideal-real possesses features of Baxter and Montgomery’s10 contradiction of autonomy- dependency. The system provided by society is expected to help clients achieve as autonomous a life as possible even though the clients are truly dependent upon social services. In some cases, the system makes the clients even more dependent upon the services than is necessary. A constant battle is thus waged between helping but not re- stricting and seeking help while remaining independent. The examples below demonstrate how social workers de- scribe the non-antagonist struggle9 between the ideal and the real by showing various semantic positions in their ut- [Qualitative Research in Medicine & Healthcare 2020; 4:8688] [page 17] Article Table 1. Struggles, contradictions, and frames. Societal Frame Relational Frame Integration Struggle Ideal-real contradiction Closeness-reservedness contradiction Certainty Struggle Predictability-novelty contradiction Openness-closedness contradiction Table 2. The constructed meanings in the discursive struggle of integration. Contradiction Frame Constructed meaning Ideal-real Societal Expected identity/otherness Closeness-reservedness Relational Supportiveness/facelessness No n- co mm er cia l u se on ly terances. For example, use of the phrase I should see, in- dicates that there is also a possibility that the social worker’s decision is not the best one for the client: I go to the client’s home, and there we think and see what is the client’s need for the day. What is the thing we should be doing? And because, they are people who need special support, I, as a worker, should see what is beneficial for the client and what is good, although he wouldn’t himself see it the same way as I do. Antagonist struggles were also shared by social work- ers when they described challenging situations in which clients’ expectations truly differed from reality: Yes, the situation still is that the mother feels that the society cannot support them enough, although they have a really strong [set of] services already. Nevertheless, no services can be tailored so that they could be totally individualized. There are al- ways specific borderlines. When discussing the burdensome characteristics of so- cial service workers’ duties, there were also hints at a se- rious-playful struggle. A serious-playful struggle emphasizes the tone of the utterances. In this struggle, the social workers created a meaning of their own manage- ment skills to protect their reputations. In the example below, the interviewee acknowledged that sometimes the feedback he/she receives is rough while simultaneously diminishing that roughness with laughter, exemplifying the serious-playful struggle: Hmm, sometimes it gets under my skin so that I, as a person, feel bad, but most of the time I can take it. It just goes with the career, this kind of [sit- uation] (laughing) that you can face anything. [It] go[es] in one ear and out the other, [as] if it is groundless. Otherwise, you cannot cope with this. Relational frame In the relational frame, the struggle of integration con- sists of the contradiction of closeness-reservedness. The social workers demonstrated this contradiction by describ- ing their interactions with their clients, including longing for more personal conversations in which they might chat, lighten the atmosphere, and boost the collaboration. Closeness helps the social service workers endure rough working days and makes the interactions more pleasant, which may encourage cooperation. In other words, rela- tional closeness creates meanings of supportiveness. Meanwhile, reservedness was an essential element of the relationship. A client and a social worker do not have an intimate relationship; although their aim is to work to- gether to help the client, a state of formality is retained. Face-to-face meetings and laws used in decision making create a huge gap between the discourse of closeness and reservedness, which, in turn, creates meanings of face- lessness. The segmenting9 of closeness and reservedness is illustrated in the following example, in which a worker describes how the closeness of the previous interaction made the official part of the work—the decision mak- ing—harder. Reservedness helps social workers to stay objective in order to produce equal decisions, and not to admit any more to that client than you do to another client: Like I have said, the equality, when it feels that sometimes you find the connection with the client straight away. Then, you have to be really careful because you cannot admit any more to that client than the S-client [inappropriate phrase]. The social workers noted that closeness and reserved- ness are both needed, but the discourse of reservedness becomes more powerful—and centripetal—when they are declining clients’ applications. The discursive struggle of certainty The struggle of certainty emphasizes manifestations of certainty in the relationship. The dynamism of society cre- ates uncertainty about the context in which the relationship operates, and challenges related to openness bring a cau- tious factor to the interaction and communication between the client and the social services worker. These struggles create the meanings of dynamism/stability and understand- ing/insensitivity like presented in Table 3. Societal frame The discursive struggle of certainty illustrates the dy- namic societal context of the relationship that the contra- diction describes as predictability–novelty. The contradiction of predictability and novelty creates the meanings of the stability or dynamism nature of the rela- tionship. Society is changing, and all kinds of reforms are re- modeling the social and health services. Laws change the requirements for the provided services, and the addition of new clients with different disabilities begin to challenge the functionality of the system. Social service workers must constantly learn new approaches and methods to stay up-to-date and work hard to find suitable services to help new clients. Dynamism also brings challenges in terms of offering equal service to everyone, which is one of the [page 18] [Qualitative Research in Medicine & Healthcare 2020; 4:8688] Article Table 3. The constructed meanings in the discursive struggle of certainty. Contradiction Frame Constructed meaning Predictability-novelty Societal Dynamism/stability Openness-closedness Relational Understanding/insensitivity No n- co mm er cia l u se on ly main aims of social work. In the following example, the social worker states that all the changes of society, law and work makes it harder to follow consistent line while making decisions and working with the clients. Yes, indeed [changes affect our work]. I have thought about it and leaned on other[s] when trying to find the consistent alignment with the decisions made. We are not an old organization, but we should have consistent lines, at least within this area. But, even that is impossible, because the im- plementation methods differ in [the] municipali- ties. And we have discussed that disability services are like no other. Many things have to be inter- preted from the law, and we have to use a lot [of] individual consideration. A lot more than in some other areas. Their lines are clearer. Relational frame Social workers talk about the openness-closedness contradiction when describing complex situations, leading to misunderstandings. Misunderstandings can be caused, for example, by the lack of a mutual language and shared meanings or difficulties in interpreting the law because, although the law is strong and understandable, the deci- sions are still based on interpretations, and some client cases are not so distinct. A mutual language refers to both an actual language, such as if clients have problems with speech production, and the language of bureaucracy. These struggles create meanings of understanding, but they also create insensitivity. Openness deals with recip- rocal information sharing, which is required for successful cooperation. Social workers must balance how much in- formation is sufficient for everyone, which details clients need or would like to hear, and how to reach all clients: Often, in the beginning of the new client [relation]ship, they ask a very wide question: To which [services and support] I am entitled? There, you really have to watch your words, [especially] when you go through what the client needs to man- age independently or as independently as possible. In addition to a non-antagonist struggle, these dis- courses also possess a direct-indirect struggle in which certain aspects are concealed due to using caution when saying something, which, ultimately, could be used against the social workers. A direct-indirect struggle deals with the ambiguity of meaning. Here, ambiguity is as- sisted by disqualification,9 which functions as a way to elude or avoid the interplay of the discourses. Disqualifi- cation leaves multiple interpretations existing among par- ties. For example, when describing their work as supporting clients, social workers used vague phrases, such as services necessary for the disability and reason- able compensation. In addition, instead of answering clients’ demands, they tell them that the decision needs to be taken to the team for further discussion. In these cases, the exact answer remains unidentified. The following ex- ample illustrates this kind of obscurity: It is unfortunate to go and say that only services necessary for the disabil- ity are admitted. Sometimes the openness-closedness can vary in dif- ferent themes and can escalate to total closedness, as in leaving the interactional situation. We present the extreme example of segmenting in openness-closedness is excerpt below, in which social worker ceases the interaction by hanging up the phone when the discussion was not pro- gressing: The client may have experienced that I just hung up the phone – well actually, that is what I did, be- cause the discussion was not leading anywhere. That is what I did. That kind of hostile talk and shouting, no one deserves to hear that. Not [a] so- cial worker or anyone else. These examples show that the social workers must take caution when interacting with clients. The social workers must be very conscious of the words they use in order to avoid misunderstandings or make promises that may not be followed through. Although Baxter and Mont- gomery,10 positioned the contradiction of openness and closedness under the struggle of expression, in the present study, it was strongly linked to uncertainty in interactional situations and, therefore, positioned under the struggle of certainty. Discussion This study illustrates the relational contradictions of the client-worker relationship in the social services sector, and the results show how discourses compete and are manifested in social workers’ talk. The relationship vac- illates between the nature of close interpersonal and pro- fessional relationships; this is visible in the division between the societal and relational frames, which link to the proximal and distal sites of the utterances.9 These in- tertwined contradictions and their interplay create the meanings of the client-worker relationship in the social workers’ talk. The balance between the discourses reflects the degree to which the social workers experience the client-worker relationship as burdensome or satisfactory and how the goal of helping clients is reached. In our analysis, we arranged the contradictions into societal and relational frames, originating from the nature of social work. The client-worker relationship is a work- related professional relationship that is not only societally constructed but also reflects features of close interpersonal relationships. The frames describe how our surrounding culture is manifested in interpersonal relationships, as well as how interpersonal relationships maintain and cre- ate social order.28 Our society creates a frame within which this relationship works by arranging the parties in specific roles; they are positioned in an involuntary asym- metrical relationship but are reciprocally dependent upon each other. The autonomy and dependency in this rela- [Qualitative Research in Medicine & Healthcare 2020; 4:8688] [page 19] Article No n- co mm er cia l u se on ly tionship are defined by the structures of the society, which lead to struggles between care and control in the client- worker relationship, as Nijnatten et al.5 pointed out. Therefore, our findings authenticate Nijnatten et al.’s5 ideas of tension between care and coercion by showing the kinds of contradictions this tension creates in the client-worker relationship. The tension between care and control especially re- flects in our findings on the contradiction of the ideal and the real. If the expected meanings of this supportive and helping relationship are destroyed in the interaction, the objective of care is easily reframed as control, especially in the clients’ point of view. In addition, according to Lloyd et al.,1 social workers effectively stress the role of conflict between client advocacy and the ability to meet agency needs. Social workers may also feel personally re- sponsible when they fail to help their clients. In addition, our results show that social workers appreciate the fluent process of helping and try to minimize all uncertainty fac- tors and challenges in order to reduce conflict concerning their professionalism. Matthies6 questioned whether social work is understandable to those who are outside it; we built on this question and argue that working with these contradictions can make social work difficult even for the social workers themselves. Social workers have a hard time presenting themselves as helpers in controlling and combining the roles of care and control.5 With transfor- mative dialogue, in which the competition between the discourses vanishes and discourses are presented as equal,9 it may be possible to shift the emphasis from de- fending actors’ positions to a more cooperative standpoint. In that way, the client and the social worker are seen not as opposite poles but as entities that twine together, which subsequently enables the creation of new meanings. Consequently, it is crucial to highlight the special na- ture of the client-worker relationship in disability services, including features from close interpersonal and profes- sional relationships, in order to open up new ways to plan and apply communication in social services context. Al- though client-worker relationships are long-lasting and cover sensitive and personal subjects, they are still work- place relationships that are accompanied by some degree of reservedness. Successful cooperation additionally de- mands some aspects of closeness. These observations are extremely important, as client work is at the core of social work; a social worker is a key player in supporting dis- abled clients’ welfare in everyday life and in the wider context of improving their inclusion in society. The theoretical contribution of this study is that it demonstrates the applicability of RDT when studying client-worker relationships in the social services sector. Although RDT has been primarily used to study close pri- vate-life relationships,12,13 we find that the theory is also applicable for studying contradictions among professional relationships in the social services, since these are work- related relationships that also possess elements of close interpersonal relationships. In addition, please note that, while this research relies heavily on RDT 2.0, most re- search applies the earlier version of this theory,10 and only a few studies have observed client-worker interactions in the terms of RDT 2.0.18,19 Baxter and Braithwaite29 have critiqued existing research for simply identifying dialec- tical tensions and encouraged adding complexity by look- ing at how competing discourses interpenetrate to construct meaning in a relationship, which is done in this study. Baxter9 also suggested identifying the sites of dis- cursive struggles, which is done here by presenting these discourses in societal and relational frames. Conclusions In the present findings, we have identified multiple contradictions in the client-worker relationship in the so- cial services and emphasized how societal and relational frames of this relationship interpenetrate each other. The present study’s results can be used to advance social workers’ well-being at work by paying attention to how social workers could manage contradictions in client- worker relationships in terms of the actors’ well-being and job satisfaction. The results may also be applied to com- munication training aimed at helping social workers iden- tify future contradictions in their work. Furthermore, the results increase our understanding of how the client- worker relationship affects job satisfaction, as the results also describe the challenges of making social workers themselves understood.6 Overall, if we learn how to man- age these tensions to improve well-being, we can also af- fect the quality of client interactions. Future studies in this research area should gather data from both parties in the client-worker relationship, such as by conducting observations or paired interviews. It would be interesting to compare the results of this study to studies in which the client is also present in order to determine how contradictions appear in that kind of data. In addition, researchers could use RDT to analyze longi- tudinal data, which offers a possibility to emphasize also diachronic separation. Cross-sectional studies do not re- veal the differences between these diachronic practices and single-voiced monologues.9 Researchers could also study, social work tailored toward other than disabled clients to see if we might identify the same kinds of con- tradictions when observing client-worker relationships. The societal frame is an important aspect of all client- worker relationships in the social services, and it is im- portant to untangle how that frame affects relational contradictions and the construction of meanings. To im- prove cooperation, social workers should strengthen the relational frame since the societal frame is beyond each actor’s power. However, every interpersonal interaction can also gradually remodel the societal frame, and that is why every meeting and interaction counts. Transparent and open communication about the frames and the con- [page 20] [Qualitative Research in Medicine & Healthcare 2020; 4:8688] Article No n- co mm er cia l u se on ly tradictions would increase the mutual understanding of the relationships’ context, rights, and duties. Transparent communication can be achieved by being honest and dis- cussing societal problems with clients while simultane- ously emphasize the aims of mutual trust and relational integration. References 1. 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