‘Professional’ is yet another of the ‘us and them’ words that dominate our narrative. It’s a blanket term used to distinguish the people who work in organisations (regardless of any professional qualifications held) from the people seeking and drawing on support (regardless of any professional qualifications held).

“Professionals and people who need their services.”

“Professionals and people who use services.”

“Professionals and service users.”

“Professionals and those in need of support from Adult Social Care.”

“Professionals and those who need care.”

“Professionals and those being cared for.”

Professionals and those.

People employed in our organisations automatically acquire a label that implies status, authority and expertise, while people requiring assistance from our organisations become ‘cases’ and ‘users’. Those they them are the anonymous, homogenous, passive recipients of ‘care’. Of services ‘delivered’ as a ‘professional gift’ [1] – revealing and perpetuating not just an ‘us and them’ categorisation and division but also an approach to care and support that is the antithesis of co-production – despite the explicit statement in the Care Act guidance that “local authorities should ensure that individuals are not seen as passive recipients of support services, but are able to design care and support based around achievement of their goals.” [2]

An approach where professional ‘experts’ are needed by ‘the needy’, to rescue, solve and fix. Where “the culture is one of a business [and] we have normalised the idea that for every problem there must be a service.” [3] Where “people buy a diagnosis of both problem and solution that is sanctified by professional expertise [and by] some strange coincidence, that diagnosis always seems to require a response that only the professional can supply”. [4]

And of course you can’t be both. You’re either/or. This perpetuates the perception that ‘professionals’ have no ‘lived experience’ of disability, neurodivergence, mental health challenges, ageing, caring, or of drawing on support, and that ‘service users’ are not professionals.

“Trained professionals or people with real-life experience.”

“Professionals or people with experience of mental health and disability.”

“They are “experts-by-experience”, not professionals.”

It locks us into a way of working, and being, where people are described and defined by labels and lanyards – and all the stereotypes and assumptions and judgements that they bring.

What I really want to tackle here however is the adjective rather than the noun. How attitudes and behaviours that are seen and described as being ‘professional’ so often dehumanise ‘professionals’, who then become an anonymous, homogenous ‘them’ to those of us who are seeking some support. 

Being ‘professional’

When I’ve spent time with different groups of people who work in adult social care and we’ve talked about ‘rehumanising’ practice, I’ve noticed how often people mention the dichotomy between ‘being professional’ and ‘being human’. This contrast is implied in Alex Fox’s reference to people being in “relational, not purely professional, mode” [5] and in Gord Tulloch and Sarah Schulman’s suggestion that “sometimes the answer is not a rule or a professional demeanour, but is instead love and vulnerability.” [6]

How have we ended up in a place where to work in the human services – to ‘be professional’ – means crushing instinctive human emotions, and repressing both the humanity of the people we serve and our own humanity?

Gord Tulloch and Sarah Schulman write how the shift of ‘care work’ from the home to a “professional function tied to deep skill and expertise” began “in the 1960s with the postwar rise of caring occupations such as social work, and social workers’ growing push for professional status and higher pay. To be professional was to not be an amateur: it meant to do a job well, to use sound judgement, to demonstrate ethical behaviour.” [7] However, the rise of managerialism in the 1970s and 1980s saw the focus shift to consistency and efficiency, and in turn to resource allocation, rationalisation and ‘care management’. And now social workers are recruited to “undertake screening and duty work”, “deal with complex and varied cases” and “manage a caseload of service users.” To “ensure that all cases are progressed efficiently through the system within this fast-paced environment” and “be able to complete their interventions within the team timescales.”

So, despite what our strategies suggest about ‘strengths-based approaches’ and ‘person-centred practice’, our job adverts and job descriptions still equate ‘professional’ with process and efficiency. Dealing with. Closing cases. Moving on.

This industrialised approach encourages and perpetuates distancing and dehumanising. Alex Fox claims that “detachment is the only manageable relationship one worker can have with numerous service users”. He suggests that our current approach brings together “two people in crisis: the personal crisis of the support seeker and the ongoing professional crisis of the hard-pressed public service worker”, and that “impersonality protects each from the other’s crisis”. [8]

There’s no place for connection continuity compassion curiosity care on the conveyor-belts of our system. There’s no space for relationships in our “fast-paced team[s] [where] you don’t hold cases for long”.

Professional boundaries

Connection and relationships should be at the core of our purpose and the heart of our practice. The connections we make with and for people. The relationships we tend and mend.

But we know relationships can get messy and navigating them is often tricky, so we establish ‘professional boundaries’ and avoid getting too involved. Fear caring too much. Showing we care. 

Being ‘unprofessional’. 

“Codes [of ethics] draw fortified circles around us so that we cannot spill out and others cannot spill in. They create distance when what’s needed is authentic connection, and they convert moral interactions into transactional ones.”
– Gord Tulloch and Sarah Schulman [9]

So our ‘boundaries’ become impenetrable walls, built ever higher to ‘maintain an acceptable distance’, and natural, human emotions are stifled to remain ‘professional’.

We’re alert to the dangers of getting too close, but what about the consequences of our distance?

Professional knowledge

Despite the Care Act guidance cautioning against decisions “being made on the assumption that the views of the professional are more valid than those of the person”, [10] ‘professional knowledge’ acquired through education and employment is still generally viewed as superior to the wisdom, insight and ideas gained through personal experience. Through life and love and loss.

“I took a friend to a meeting which included nine professionals. The main agenda point of the meeting was the LA’s plan to move Steven to Wales. As usual, I put up my normal argument that if they let Steven come home, all the challenging behaviour would disappear. The chair of the meeting said: “Mr Neary. Why do you believe your opinion is more valid than any of the professionals sat around this table?”. I responded, “Because I know him. Because I love him”. At this point, my friend nudged me in the ribs. I looked across and the social worker was laughing. Love had become laughable. It was invalid. So consequently, if knowledge arises from love, then that knowledge becomes laughable too.” 
– Mark Neary [11]

Knowledge can also easily be withheld or assumed instead of shared. Sara Ryan writes how she’s “lost count of the times I and other parents said that ‘we don’t know what we don’t know’ as we discovered something completely new but important enough that we can only think health or social care professionals assumed we know about it.” She references a serious case review that “recorded how a mother was asked if she had a carer’s assessment before her daughter died. ‘I don’t know,’ she replied, ‘though a social worker did ask me how I felt once’”. [12]

Professional language

“People were ‘patients’ or sometimes ‘service users.’ This language protected me from the reality of what I was doing to people caught in the system… I learnt that dehumanising people through my use of the language of the professional made it easier for me to cope.”
– Elaine James, Rob Mitchell and Hannah Morgan [13]

Knowledge is power and language is powerful. I’ve written before about ‘professional language’ and why we use it. How it offers us an identity, indicates we’re ‘a professional’. How the ubiquity of our jargon and acronyms offers some legitimacy to their use. How we teach, and learn, this language. How it’s efficient and effective for processing cases within our dehumanised, dehumanising, fast-paced environments. How it helps us cope within our dehumanised, dehumanising, fast-paced environments. How we’re not challenged, and we don’t challenge, and how ultimately it reveals the perceptions and prejudice that too often underpin our practice.

How so much ‘professional language’ is oppressive and does far more to exclude than include. 

And how vital it is that we flip the idea of ‘professional language’, so it becomes ‘professional’ to use kind, respectful and plain language, and unprofessional to use, or not to challenge, words that dehumanise and other and blame.

Professional standards, registration and regulation

As citizens we have a shared responsibility towards each other as fellow human beings. Shared standards of humanity. Jon Alexander writes that, “It is human nature to want to contribute positively and meaningfully to shape the communities and societies we are part of” and that “if you analyse the language of Citizen organisations… you can see that they don’t so much seek to be trusted or admired by people; rather, they start by trusting and believing in people.” [14] But once we citizens step into serviceland – suddenly we need ‘professional’ standards and registrations and regulations. And suddenly we’re doing things right instead of doing the right thing.

The adult social care ‘sector’ is awash with ‘professional standards’, ‘professional registrations’, ‘professional regulation’. And still we seek more.

There is currently much discussion about the creation of National Care Standards as part of an anticipated National Care Service, and calls for “a proper fully accredited professional registration scheme for care workers” – the motivation for which was described this week as being to “help prevent scandals emerging which would damage the image of the profession” [15] – wow.

There’s an enduring and misguided perception “that, particularly for people who are (and I quote) ‘complex’ and ‘vulnerable’, you need registered, regulated, formally trained professional people to, and again I quote, ‘look after and take care of people’.” That “regulated workers [have] superior knowledge, skills, and expertise, and that the regulatory processes are what keep people safe.” [16]

But of course, we know really that it’s our relationships that keep us safe. That it’s the people who know and understand our passions and preferences and peculiarities and potential who ensure we thrive. And as Tricia Nicoll explains, the most human networks of support are regulated by the most human networks of support – “the people in places where we are known and have a presence” [17], in the “ordinary houses in ordinary streets” [18] where people get to live the gloriously ordinary lives they choose to lead.

We can have all the ‘professional’ criteria and checklists we like, but if we continue to bolt them on to services that prize process (and profit) over people, correction over connection, and efficiency over efficacy – well, what’s that maxim about doing the same thing over and over again and expecting different results!?

Human

It seems to me that we have a choice. We can continue to perceive that our ‘profession’ is responsible for fixing problems and managing need and containing risk, and to believe that being ‘professional’ means being distant, detached, clinical and efficient.

Inhumane.

Or we can commit to our purpose being to grow good lives and develop capability and create possibility [19] and recognise that to genuinely achieve this ambition we must flip the narrative, so that being ‘professional’ means we’re trusting and honest and curious and kind. That we’re present and we’re vulnerable and we really, genuinely care.

So that being ‘professional’ always means being human first.

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References

[1] Professional Gift Model, Simon Duffy, Citizen Network, 2009

[2] Care and support statutory guidance, Department of Health and Social Care, GOV.UK, Updated 22 July 2025

[3] Radical help: How we can remake the relationships between us and revolutionise the welfare state, Hilary Cottam, Virago Press Ltd, 2018

[4] No more throw-away people: the co-production imperative, Edgar Cahn, Essential Books, 2000.

[5] A new health and care system: Escaping the invisible asylum, Alex Fox, Policy Press, 2018

[6] The trampoline effect: redesigning our social safety nets, Gord Tulloch and Sarah Schulman, Reach Press, 2020

[7] The trampoline effect: redesigning our social safety nets, Gord Tulloch and Sarah Schulman, Reach Press, 2020

[8] A new health and care system: Escaping the invisible asylum, Alex Fox, Policy Press, 2018

[9] The trampoline effect: redesigning our social safety nets, Gord Tulloch and Sarah Schulman, Reach Press, 2020

[10] Care and support statutory guidance, Department of Health and Social Care, GOV.UK, Updated 22 July 2025

[11] Love Baffles, Mark Neary, Love, Belief and Balls, 22 October 2015 

[12] Love, learning disabilities and pockets of brilliance, Sara Ryan, Jessica Kingsley Publishers, 2021

[13] Social Work, Cats and Rocket Science: Stories of Making a Difference in Social Work with Adults, Elaine James, Rob Mitchell and Hannah Morgan, Jessica Kingsley Publishers, 2019

[14] Citizens, Jon Alexander, Canbury Press, 2022

[15] Who cares? Solutions for the Social Care Review, Rt Hon Damian Green, Social Care Foundation, 13 September 2025

[16] What good support really looks like – Gloriously Ordinary Sundays – 7th September 2025, Tricia Nicoll, Gloriously Ordinary Lives, 7 September 2025 

[17] What good support really looks like – Gloriously Ordinary Sundays – 7th September 2025, Tricia Nicoll, Gloriously Ordinary Lives, 7 September 2025

[18] An ordinary life : comprehensive locally-based residential services for mentally handicapped people, The King’s Fund, February 1980 

[19] Radical help: How we can remake the relationships between us and revolutionise the welfare state, Hilary Cottam, Virago Press Ltd, 2018