Lived Responsibility in Encounters With Service Users—A Phenomenological Study of Municipal Caseworkers in Allocation Offices

Abstract

This phenomenological study explores how responsibility is lived in everyday encounters by municipal caseworkers in a Norwegian allocation office. These professionals assess applications for health and care services from people living with illness, disability, or psychosocial challenges, often in situations marked by uncertainty, vulnerability, and limited possibilities for resolution. Drawing on van Manen’s phenomenology of practice, in-depth interviews were conducted and worked into phenomenological anecdotes that attend closely to concrete moments of lived experience. Rather than approaching responsibility as accountability or role-based duty, the analysis explores how responsibility is encountered and carried in practice, prior to reflection and beyond procedural resolution. The phenomenological accounts bring forward situations in which responsibility appears as bodily weight, quiet presence, fragile openness, and lingering silence. Across these moments, responsibility shows itself not primarily as something done or decided, but as something lived in posture, atmosphere, and relational attunement. By attending to these subtle and often overlooked textures of professional life, the study illuminates how responsibility is carried in frontline municipal casework and invites reflection on how such lived responsibilities might be better recognized and supported in health and care services.

Prelude

One winter afternoon, I noticed a man curled on the frozen sidewalk. A social worker knelt beside him, while police stood nearby. After a quiet exchange, the social worker simply said: “I’ll take care of him.” The words were ordinary, yet they lingered. What I witnessed stayed with me, not as an example, but as a call. It made me pause as a researcher and ask: How is responsibility not only assigned, but lived, when the Other comes into view? The image of the man on the frozen street and the quiet presence of the social worker beside him, accompanied me back to my writing about caseworkers in Norway. It does not change my approach. Instead, it draws me closer to something quietly essential: the way responsibility comes into view not through policy or principle, but in the nearness of another person.

(Field notes, Canada, 2025)

Introduction

This article explores the lived experience of responsibility among caseworkers in Norwegian municipal allocation offices. These professionals make decisions that shape people’s access to vital welfare services, including home nursing, institutional care, housing, and practical assistance. Their work is governed by the Norwegian Health and Care Services Act (Norwegian Ministry of Health and Care Services, 2011) and situated within a welfare state grounded in principles of universality and trust. Caseworkers are often referred to as frontline workers (Lipsky, 2010), who operate at the point where policy meets people, where public frameworks are translated into individual lives. Rather than examining structures or systems, this study turns toward the affective, relational, and interpretive dimensions of professional life. It seeks to understand how responsibility is experienced by those who daily encounter people living with complex physical or psychological challenges and how meaning is made in situations that resist resolution.

Professionalism is not only about applying knowledge, it is also about carrying the trust others place in you, especially when consequences are real and clarity is rare (Grimen, 2008). Caseworkers do not merely follow regulations, they interpret, adjust, and respond often in ethically charged situations where the stakes are high and answers are few.

By focusing on everyday encounters in the Norwegian welfare state, this study seeks to illuminate how responsibility is not only defined by law and policy, but emerges in practice as an existential phenomenon. The guiding research question is: How do municipal caseworkers in Norwegian health and care services experience responsibility in encounters with service users?

Responsibility in Existing Research on Professional Practice

Although responsibility is widely recognized as a central dimension of welfare and care work, its lived qualities remain less examined, particularly within municipal allocation offices. Caseworkers working at the intersection of legal mandates, organizational expectations, and individual needs must continually interpret what responsibility comes to mean in concrete, situated encounters. Much contemporary scholarship approaches professional responsibility through an accountability-oriented lens, framing responsibility as adherence to formal rules, documentation practices, procedures, and managerial control structures (Gross, 2025; Raudava, 2025; Svensson, 2025). In this literature, responsible practice is articulated through compliance, risk management, and institutional answerability, positioning professionals as accountable actors embedded within bureaucratic frameworks. Other studies show how responsibility is negotiated under conditions of conflicting care obligations and organizational pressures, illustrating how everyday judgment becomes shaped by procedural and accountability-driven demands (Ylvisaker & Rugkåsa, 2022). Taken together, these contributions foreground responsibility as something primarily defined and evaluated through institutional and procedural logics, yet such perspectives do not fully capture how responsibility is experienced in professional practice.

In contrast, qualitative and phenomenological research has begun to illuminate responsibility as embodied, affective, and morally charged. Studies of students in caring professions describe experiences of “moral disquiet,” a felt disturbance that arises prior to explicit rules and decisions and emerges in the tension between structure, relation, and vulnerability (Torsteinson & Sævi, 2023). Comparable insights appear in therapeutic and emergency care, where responsibility is portrayed not as a principle applied after reflection, but as a movement of attunement, risk, and relational responsiveness to another (Glover & Philbin, 2017; Hammarbäck et al., 2023; Holmberg & Fagerberg, 2010). Other work shows how responsibility is carried bodily and emotionally, as an existential summons that endures quietly, often in solitude and uncertainty (Clancy et al., 2023; Fabella, 2023). Across these studies, responsibility becomes visible not primarily as a cognitive task, but as something lived through presence, posture, and endurance over time.

More recently, research situated in municipal health and care services has highlighted responsibility as an ethical tension that unfolds when regulatory frameworks must be translated into the singularity of lived lives. Here, responsibility presses upon caseworkers’ judgment and embodied engagement as they navigate competing expectations and the immediacy of human need (Ekenes et al., 2024; Pedersen et al., 2024). These contributions begin to shed light on responsibility within allocation practices, yet empirical explorations of caseworkers’ lived experiences of responsibility remain limited.

At the same time, studies show that responsibility shifts under changing systemic and political conditions, particularly when professionals must reconcile conflicting mandates, ethical principles, and organizational demands (Teixeira et al., 2022; Tier et al., 2022).

Across these diverse contexts, a recurring insight emerges: professional responsibility cannot be reduced to competence or procedural compliance; it is lived in time, relation, and moral complexity. Little attention, however, has been directed toward caseworkers in municipal allocation offices, professionals whose everyday judgments shape access to essential welfare services while mediating between legal frameworks and intimate human encounters. The intention of this study is not to fill a conceptual gap, but to dwell closely with how responsibility is lived in this setting, allowing dimensions of professional experience that are often muted or taken for granted to come into view. In attending to these quiet, affective moments of practice, the study seeks to bring into view a largely unarticulated corner of welfare work in which responsibility takes shape in the immediacy of human encounter.

Methodology

In order to approach this inquiry in a manner consistent with the philosophical underpinnings of phenomenology, I turn to the conceptual orientation that informs my understanding of responsibility as an existential phenomenon. Responsibility is approached here not as accountability or role-based duty, but as an existential phenomenon that arises in lived encounters with others. In phenomenological research, concepts such as responsibility are not treated as fixed or predefined, but as lived phenomena arising in experience, often prior to reflection or abstraction.

Within van Manen’s (2014, 2023) phenomenology of practice, meaning unfolds through embodiment, temporality, and relational encounter. Responsibility, from this orientation, is not something one possesses, but something one meets or undergoes. Levinas (1969) describes responsibility as an ethical call from the Other, something that reaches us before any deliberate choice is made. Buber (1971) takes this further, pointing to how responsibility arises in the space between I and Thou, where the other is not approached as a case, but encountered as a presence. Together, these perspectives invite us to think of responsibility not as a task to complete, but as something that unfolds in the way we meet one another.

Marion (2002), on similar grounds, emphasizes the givenness of this appeal: responsibility is not initiated by us, but comes to us, addressing and demanding response without clarity, warning, or control. From this view, responsibility as an existential phenomenon is not reducible to role, rule, or duty. It arises in the gravity of a moment, in a gesture, a silence, a hesitation, and quiet perhaps, but felt in the body, in uncertainty, in presence.

Merleau-Ponty (2012, pp. 67–68, 207–208) further illuminates how responsibility is not a detached moral ideal but emerges through our embodied being-in-the-world. We do not first encounter it as a rule or obligation, but as a felt responsiveness arising in our bodily orientation toward others, in the intracorporal space where suffering and need make themselves present. This philosophical orientation shapes the present inquiry. Rather than defining responsibility theoretically, the study seeks to attune itself to how responsibility comes to expression in lived experience, in practice, and in moments that might otherwise go unnoticed.

Phenomenology of Practice

This study draws on a hermeneutic-phenomenological approach in order to come as close as possible to the existential phenomenon of responsibility, seeking to bring forward the lived experience of caseworkers. For this purpose, I turn to van Manen’s phenomenology of practice (van Manen, 2014, 2023). Van Manen’s work stands in continuity with Husserl’s call to return to the things themselves through descriptions of lived experience (Husserl, 1982) and with Heidegger’s hermeneutic concern for being-in-the-world as it shows itself in everyday existence (Heidegger, 1962). Merleau-Ponty further grounds this tradition in embodiment and intersubjectivity (Merleau-Ponty, 2012). Although several phenomenological approaches within qualitative research could have been employed, each offering distinct ways of approaching lived, embodied, and relational meanings of human phenomena (e.g., Dahlberg et al., 2008; Finlay, 2011; Giorgi, 2009; Smith et al., 2022; Zahavi, 2025), the phenomenology of practice was chosen due to its specific orientation toward understanding the lived experience of professional practice and its demonstrated adaptability across diverse practice settings and human activities. This orientation aligns with the study’s focus on everyday professional encounters in municipal casework. As van Manen explains, the phrase “phenomenology of practice” refers to inquiries that address and serve professional practice as well as the quotidian practices of everyday life (van Manen, 2014). In this sense, phenomenology of practice is less a fixed method than a way of attending to lived meaning in ordinary professional life, where what matters often remains unnoticed.

Phenomenology of practice seeks to hold together a philosophical concern with life as it is lived and a practical concern with how life is enacted in work and relationships. It invites us to turn toward what is easily overlooked, moments that may appear ordinary yet still matter. To understand experience in this sense is not to explain, summarize, or classify it, but to dwell with it as it presents itself. Coming to know another’s experience calls for attentiveness and openness, a willingness to let something of how it was lived and what it might mean come through. As Husserl (1982) emphasized, reflection is directed at pre-reflective experience, those moments before categories or theories intervene, when experience still speaks in its immediacy. Merleau-Ponty (2012) would later describe this as the body’s primordial openness to others and to the world.

In this study, the focus is directed toward moments where responsibility is experienced at the crossing point of professional function and human need. Van Manen (2014) reminds us that such inquiry requires thoughtful attentiveness, a reflective openness that allows experience to reveal itself. The process is dialogical and interpretive, moving back and forth between part and whole, between description and reflection, and between what is lived and how it comes to matter.

Researcher Position and Reflexivity

This inquiry is shaped by both personal and professional experience. As a clinical family therapist with many years in social services, I share the institutional landscape of the participants. I know the regulations, ethical tensions, and relational demands that mark municipal casework.

My interest in responsibility also arises from personal life. As the parent of an adult child with a disability, I have met hospitals, educators, and welfare services over many years. These encounters have carried moments of care and recognition, but also silence and struggle. This dual perspective, professional and relative, has sharpened my attention to how responsibility is lived in encounters marked by vulnerability and asymmetry. I did not enter the study as a neutral observer. My position is shaped by closeness and commitment. Before beginning analysis, I reflected on possible biases and emotional investments. This was not about bracketing experience, but about cultivating openness. Supervision and discussions during a research residency in Canada supported me in holding space for the participants’ voices, whether they resonated with or challenged my own. In phenomenological inquiry, such reflexivity is not a detour but a condition for analysis.

I was also aware of my professional assumptions. Having worked in the welfare system, I often equated responsibility with finding solutions, believing that to take responsibility was to resolve a problem. Recognizing this preconception became a turning point. It reminded me that my own expectations could shape interpretation and it challenged me to let responsibility appear in ways that did not necessarily align with problem-solving. I asked myself: can professionals remain in touch with themselves in ethically charged moments, or does the weight of the system pull them away from presence? Can such moments later be spoken of within the language of the workplace? Staying with these questions, and confronting my own tendency to see responsibility as solutions, helped me to remain open and to allow the phenomenon to speak more clearly on its own terms.

Participants and Recruitment

The study included 17 caseworkers from a Norwegian municipal allocation office responsible for processing applications for public care services such as practical assistance, home nursing, institutional stays, and support for people with disabilities, mental health conditions, or substance use challenges. The office was organized into three departments: services for older adults; services for mental health and substance use; and services for children and people with disabilities. Participants were selected to capture variation across departments. The aim was not statistical representativeness but to gather experiential insights into responsibility as lived in different areas of casework. All participants held permanent positions and had at least three years of employment, with backgrounds in nursing, social work, child welfare, or special education. All had a three-year university degree in health or social care and all were women aged 30–55.

Recruitment began with staff meetings where I introduced the study and distributed written information by email. Participation was voluntary, with assurance that they could withdraw any time. Interested staff contacted me or the research assistant directly to arrange an interview. Individual interviews were conducted between May 2023 and February 2024.

They were open-ended, guided by prompts inviting concrete descriptions of lived responsibility such as: “Can you describe a situation in your work where you felt a strong sense of responsibility?” or “Can you recall a specific encounter with a service user where this feeling of responsibility became especially present?”. Such questions encouraged participants to move beyond general reflections and into the immediacy of lived moments. Interviews lasted 60–90 minutes, and all were audio-recorded, transcribed verbatim, and anonymized. Most interviews were conducted in office rooms within the municipal service, located outside the main shared workspace. Participants were also offered the option of meeting in my office at the town hall. Four participants chose this, largely for logistical reasons given their tightly scheduled workdays.

To attend to the influence of prior professional relationships, a trained research assistant interviewed participants with whom I had prior professional contact; at the same time, his familiarity with the field offered a depth of experiential attunement that can be advantageous in phenomenological interviewing.

The research assistant’s role was limited to conducting the interviews. He did not participate in the analytic process, which was undertaken by the author. In phenomenological research, such relational familiarity may not only reduce social desirability effects but can also deepen the interviewer’s sensitivity to experiential nuance, allowing descriptions to unfold with greater immediacy (Finlay, 2002). Field notes and a reflective log were maintained.

Analysis

The analysis was guided by van Manen’s phenomenology of practice (2014), an approach oriented toward understanding lived experience as it unfolds in everyday professional life. Rather than applying predetermined analytic procedures, the work developed through sustained phenomenological reading and writing, grounded in attentiveness to how responsibility showed itself in embodied, relational, and affective ways (van Manen & van Manen, 2021).

The analytic process began with holistic readings of each interview to gain a sense of participants’ experiential worlds as a whole. These readings were followed by more selective engagement with the transcripts, in which attention was directed toward passages that carried particular experiential force, moments marked by bodily tone, emotional intensity, hesitation, silence, or subtle shifts in relational atmosphere. To remain close to these moments, I repeatedly returned to the audio recordings, attending to inflections and pauses that can be flattened in transcription. In this process, I moved back and forth between listening, reading, and writing as understandings gradually took shape. Throughout the analysis, the guiding concern was how responsibility was lived in concrete situations rather than how it was spoken about in abstract or generalized terms.

Working phenomenologically with the material involved an orientation toward meaning rather than categorization. The analysis did not aim to summarize accounts or generate explanatory themes, but to dwell with particular moments of lived experience in order to discern their possible meanings (van Manen, 2014). Across the material, approximately 40 to 60 experientially forceful passages were identified. These passages were selected not for their frequency or representativeness, but for their capacity to open directly onto the phenomenon of responsibility, what van Manen (2014) describes as “knots in the webs of our experiences, around which certain lived experiences are spunand thus lived through as meaningful wholes” (van Manen, 1990, p. 90). Accounts framed primarily in institutional or abstract language contributed to the contextual horizon of the study, but did not carry the experiential density required for phenomenological analysis.

Passages carrying what van Manen (2014) refers to as incipient meaning were gathered into meaning units, small experiential motifs that disclosed how responsibility was lived through bodily stance, relational attunement, spatial atmosphere, or temporal pressure. The lifeworld existentials, lived body, lived time, lived space, lived relation, and lived things, were not used as analytic categories, but as orienting sensibilities that attuned the analysis to subtle experiential nuances (van Manen, 2014, 2023). As meaning units from all seventeen interviews were compared, returned to, rewritten, and reconsidered, certain experiential motifs began to resonate across participants.

From these constellations, phenomenological anecdotes were composed. The anecdotes are not verbatim reproductions of interview transcripts, nor are they fictional accounts, but interpretive condensations crafted from participants’ descriptions. In some cases, meaning units from several interviews were woven together when they resonated existentially with a core situation. Each anecdote thus became a condensed configuration of lived meanings rather than an individual participant’s story. As van Manen (2023) notes, the strength of the anecdote lies in its capacity to disclose meaning by tilling “the soil of daily existence” (p. 153).

Participants were invited to read the phenomenological anecdotes in order to dwell with them and sense whether the experiential tone felt recognizable and intact. These encounters were approached not as a procedure, but as moments of ethical and phenomenological responsibility, where the analysis remained answerable to the lived experience it sought to bring into view. The reading of the texts held open the possibility that something essential might not yet have been seen, or might have been rendered otherwise than lived. No participants expressed a lack of recognition or asked for changes to the experiential core of the anecdotes. Resonance, in this sense, was not taken as confirmation, but as a condition for remaining faithful to the phenomenon under study (van Manen, 2014).

These moments of attentiveness and ethical responsibility were carried forward in the writing, which formed an integral part of the analytic process. Through iterative writing and rewriting, informed by philosophical, humanistic, and professional sources, meanings were gradually clarified and deepened. Writing thus functioned not merely as representation, but as a phenomenological practice through which the phenomenon of responsibility was allowed to show itself, sometimes in what could be articulated and sometimes in what resisted being fully said. Throughout the analysis, I maintained a questioning and reflective stance, attentive to my own assumptions while remaining open to being surprised or unsettled by what the material disclosed. The research question remained present as an orienting horizon throughout the analytic work, without determining in advance how responsibility should appear.

Ethical Issues

The study was reviewed and approved by SIKT, the Norwegian Agency for Shared Services in Education and Research (Project No. 478323) in May 2023 and conducted in accordance with the ethical guidelines outlined in the Declaration of Helsinki (World Medical Association, 2013). To protect participant privacy and adhere to ethical, legal, and scholarly standards, all identifying information was removed or masked in both transcripts and written materials. Names of individuals, institutions, and locations were not included.

The municipality’s Data Protection Officer was informed about the study in advance.

Written informed consent was obtained from all caseworkers prior to their participation in the study.

Findings

The phenomenological accounts are presented as phenomenological anecdotes. These are not raw data or illustrative examples, but interpretive texts crafted to bring the lived experience of responsibility into view as it unfolds in everyday casework. Each anecdote opens onto a singular moment, inviting the reader to dwell with how responsibility is felt, endured, and responded to in practice. Rather than explaining responsibility in advance, the following accounts allow the phenomenon to show itself through concrete situations, gestures, silences, and relational tensions. The anecdotes are offered as openings into lived experience, through which meaning may gradually emerge.

Blamed Beyond Control

Chloe, a caseworker working with older adults, tells me of one particularly memorable experience:

I was walking down the corridor. It was early afternoon, quiet on the ward. That familiar hospital smell lingered in the air, disinfectant mixed with something warm and faintly dusty. I was on my way to meet with the family. The patient, a man, had been seriously ill, but was now recovering. We had offered everything available, services, equipment and follow-up. I had done my part to ensure it. That was why I was there. The atmosphere in the room was calm when I entered. We began the conversation. Then, almost without warning, the words came. One of the family members looked straight at me and said: “If he had died, it would have been your fault.” The sentence hit hard. I didn’t know what to say. Something in me stopped. I felt a tightness in my chest, heat rising in my face. I have never wanted to hurt anyone. Never intended to cause suffering. And yet, in that moment, I was made responsible for something unimaginable. I continued the conversation, tried to remain composed. But the words stayed. Even as I left the room, I still felt them, like an invisible weight in my stomach, in my thoughts, a shadow that hasn’t lifted. I’ve learned to carry words like that differently. To endure. But some things I do not forget. (Chloe)

Chloe’s story draws us into a moment where responsibility is not carried out, but placed suddenly, uninvited and bodily. Caseworkers like her often enter emotionally charged situations shaped by illness, uncertainty, and fear. Their task is to coordinate services and uphold rights, but also to stand inside relationships where frustration, sorrow, or blame may land on them sometimes without warning. Here, responsibility takes on a different shape. It’s not tied to what was done or omitted, but to what the professional comes to represent, the face of a system that may not be enough. The words Chloe hears are not about facts. They assign meaning: If he had died, it would have been your fault. It is a moment of attribution, not necessarily truth. And yet, it strikes with force. Responsibility in such cases is not requested, it is given and projected. In Chloe’s case, there is no decision to be made, only the residue of having stood close to someone else’s vulnerability and loss. It is in hindsight that the ethical meaning begins to unfold, how a moment stays, how it alters us, and how we begin to carry it differently.

Chloe becomes more than a helper; she becomes the one who could have prevented harm. Not because she failed, but because she was there. At once too much and not enough.

The responsibility assigned to her may be unreasonable, even painful, but she does not reject it. Instead, she absorbs it and finds a way to live with it. Chloe’s quiet endurance shows us this. Some words do not go away. They settle in the body, change how we carry ourselves, how we understand our role. Perhaps this is where the professional and the human begin to blur, not in grand decisions, but in the silent weight of what we learn to carry.

Weight of Being Present

Leah, a caseworker supporting young people with disabilities, shares another lived moment of responsibility:

I remember that girl clearly. She was seriously mentally ill and had almost no contact with her support system anymore. She had turned her back on it. She didn’t want anything to do with us. But I was still allowed to come to their home this day in June. I remember sitting on the edge of a chair in the living room. Her mother kept talking, filling the space with words. The girl sat quietly on the sofa; legs pulled up underneath her. She didn’t say a word. She didn’t look at me. But I could feel that she knew I was there. I also knew I wasn’t there to achieve anything right away. This wasn’t a “task” I could solve. I was there because I thought: if I don’t try to be here, who will? After the visit, I felt it in my body. A kind of unease. I didn’t know what would work. But I knew I had to tolerate being in it, even without a response. So, I started sending her messages. Simple ones. Like “Would you like to go for a walk?” There was no reply, not at first. But then one day she answered: “Ok.” We went for a walk. She hardly said a word. I didn’t say much either. But still, it became something. I realized she was testing me, watching to see if I’d give up, too, like others probably had before. Later, she got worse and was admitted. I was told she didn’t want to talk to anyone, only me. And I felt then that maybe I should draw a line. That it was someone else’s job now. But my body had already stood up, and I went. Not because I had to, but because I knew it mattered to her that I still came. Eventually, we managed to arrange a place for her to live. I simply said, “Come with me and take a look.” She said yes. I remember us sitting on the bed together. The room was empty, but it was hers. And then she said: “This wouldn’t have happened without you.” Later, at Christmas, I received a handwritten card. It simply said: “You made me believe someone would stay.” (Leah)

This story is not about doing something. It is about repeatedly staying with someone when nothing is happening, when nothing is asked. The girl does not speak. She does not look. But by her very lack of engagement, she tests the caseworker’s presence. This test is not about action or tasks, but about commitment to others. And the caseworker, sensing this, returns again and again. Responsibility, in this moment, is not triggered by a request. It emerges from proximity. It takes shape in the quiet demand of the Other’s vulnerability of merely existing. Levinas (1969) speaks of this as the ethical appeal of the face, an appeal that does not come in language, but in presence itself. The girl’s silence, her stillness, becomes the space where responsibility is formed. Staying, then, is not about waiting idly. It implies resolve, weight-bearing, and quiet commitment. To stay is to say, without words: I will remain. Levinas (1969) insists that responsibility is not a matter of choice. It is given to us before intention and before reflection. “I am responsible for the Other,” he writes, “without waiting for reciprocity” (p. 245). This is what the caseworker lives: she becomes responsible because she is there. Not because of a job description, but because the presence of the Other has called her into relation, even if the call is only a gaze withheld. In this story, staying becomes an act of ethical resistance: to resist the impulse to retreat when nothing is clear, nothing can be done. To remain when the traditional means of providing care has no obvious effect. When providing care becomes providing an unwavering presence. What this reveals is that responsibility in the helping professions is not always about active helping or problem-solving. It is about not withdrawing. To stay is to hold space not with answers, but with attention. When the girl finally writes, “You made me believe someone could stay,” we understand what was at stake all along, not progress or recovery, but presence and faith in human existence. Not solution, but solidarity. What is at stake here is not merely professional responsibility, but a relational presence. To be a caseworker, then, is not simply to carry out assigned tasks, but to live close to the question: What is asked of me here? And to answer that question not through instruction, but through attunement and attention. As Levinas reminds us, “Responsibility is not a matter of freedom; it is the experience of being bound before any choice” (Levinas, 1985, p. 95). In such moments, the role stretches beyond the professional, and it becomes deeply human, even ethical—not because a demand was made, but because the situation itself called for a response and something in us answered.

Fragility of Openness

Unlike the stillness and silence in the previous accounts, Deana’s story carries a different tone, where something more forceful takes shape in the space between those present:

I will never forget one incident with a client. It was a home visit with a colleague. The patient was furious, hostile and rude. The tension filled the room, pressing against me. I felt it rise within myself, an irritation, a voice in my head saying: “We are here to help you, and this is how you treat us?”, but I had to hold it back. I had to remain professional. I forced myself to stay composed, to not let my own frustration take over. Until, at a certain point, I had to set a boundary. I said: “We are here to inform you about your rights and the services available to you. But if this conversation is to continue, your behavior must change. We do not tolerate being spoken to like this.” (Deana)

In this story, responsibility is not encountered in withdrawal, but in heat. Emotion surges in the space between those present. Her experience reminds us that responsibility is not only carried in thought or decision-making, but in the immediacy of bodily presence. The tension in the room is not abstract; it presses in, lands in the chest, and stirs irritation.

What Deana describes is not a detached observation of a difficult encounter but an embodied response, one that she must hold back, shape, and control in real time.

Merleau-Ponty (1962, p. 150) reminds us that the body is not an object we use, but the very site of our being-in-the-world. Her inner protest “We are here to help you, and this is how you treat us?” signals the clash between personal hurt and professional restraint. But she stays composed. Not because she doesn’t feel, but because she must hold those feelings with care. She modulates her tone, regulates her expression, and eventually sets a boundary.

Not as a retreat, but as a stance. To draw such a boundary is not only an act of self-protection, but of ethical positioning. It protects the relationship’s frame, preserving respect for both client and self. Merleau-Ponty (1962, p. 169) notes that we are always already in relation, our postures, gestures, and voices part of how meaning is created in the moment. Deana’s body participates in this; her professionalism is not cold or detached, but physically sustained in the face of aggression.

The body reacts before reflection can catch up. In these encounters, professionalism is not about suppressing emotion, but about holding the tension between feeling and response. Van Manen (2002) suggests that this form of holding oneself open is itself part of the ethical task, to remain present, to absorb what unfolds, and to respond in proportion. Levinas (1969, p. 215) also reminds us that even hostility can be a call to responsibility. The client’s anger, however misdirected, still demands a response. And here, responsibility may not mean action; it may mean not reacting and not retaliating—to protect the dignity of the client and one’s own. Deana’s story shows us how responsibility is lived not as abstract principle, but as something worked out moment by moment, in breath, in silence, and in self-control. It is in these moments, when affect and ethics collide, that the deeper dimensions of care work come into view.

Silence That Lingers

Fanny, a caseworker in the Department for Mental Health and Substance Use Services, shares her experience following a meeting she had been called into:

It was supposed to be a simple meeting, an exchange of information, perhaps a discussion about housing. Instead, it became an emergency. She sat across from me, looking directly at me, saying she would take her life, because of what I had said, because there were no other housing options. It was a Friday afternoon. I carried the weight of it into the weekend, the shock, the helplessness. Some meetings I prepare for, bracing myself when I know mental health struggles are present. But not this time. I walked in unprepared, expecting something ordinary, and suddenly, I was at the center of something much larger. There were threats, anger, despair, all directed at me. I had fought for her, secured a place I believed was right, but in that moment, I became the enemy. I left shaken. The feeling sat heavy in my body. I do not usually take work home, but this time, I did. All weekend, the questions circled: Was it something I said? Something I missed? The helplessness of knowing that no words could guarantee her safety stayed with me. Back at the office, emotions surged. Tears pressed. I turned to a colleague, simply saying, “Come.” She followed without question. When I spoke, it all came out, the shock, the burden, the fear. Later, my manager arrived, offering support. It helped, not to erase the feeling, but to share it. (Fanny)

Fanny entered the meeting expecting a routine task, a brief exchange of information about housing options. Her body, her mindset, her anticipation was aligned with the familiar rhythm of casework: predict, prepare, and proceed. But the situation unfolded otherwise. The client’s sudden declaration, that she would take her own life, landed not only as a shock, but as a disruption of Fanny’s professional stance. What started as a routine task quickly turned into something else, confusing, urgent, and deeply personal. The encounter laid bare the fragility of professional certainty and exposed Fanny to the unfiltered weight of the other’s despair. In this moment, what emerges is not only a confrontation with the client’s suffering, but with the limits of professional judgment itself. Fanny had fought for a housing placement she believed to be right. She had acted within the scope of her competence, her responsibility as she knew it. Yet now, that very decision appeared to her, through the eyes of the client, as failure, even as harm. Her sense of what was right was unsettled.

Responsibility here does not present itself as a stable ground, but as a shifting terrain, where the past decision must be carried in light of its unforeseen consequence. The force of the moment lingered in her body, during the weekend, in her sleep, in the recurring internal questioning: Was it something I said? Something I missed? This was not only emotional residue, but a bodily echo of responsibility, one that outlived the meeting itself. The work followed her home, not as an unfinished task, but as an unresolved relation. Yet, it is not only in the encounter with the client that responsibility unfolds.

On returning to work, Fanny reaches for a colleague, not with explanation, but with a single word: “Come.” The colleague follows without needing further context. In this gesture, we glimpse the shared nature of responsibility, how it moves between professionals not just through division of labor, but through mutual attunement and bearing witness. The relational weight is not carried alone. Later, her manager also joins, and together they hold what could not be managed alone. What this moment reveals is not only the vulnerability of the client, but also the vulnerability of the professional’s self-understanding. The familiar boundaries between role and person blur. As Levinas (1969) suggests, ethical responsibility arises not from intention, but from exposure, being claimed by the other in a way that precedes preparedness. Buber (1971) asserts that responsibility emerges in the dialogical space of the I-Thou relation, where the other is encountered not as an object of care but as a presence that summons a response. It is a form of recognition, where the other is not a problem to be solved, but a presence to be met. Fanny’s account is singular, but not isolated. It arrives suddenly, reconfigures meaning, and often demands to be held together with others.

Discussion

Responsibility appears here not as a task to be completed, but as something that stays, felt in the body, carried in silence, and lived on in relation to others. The accounts illuminate four experiential constellations through which responsibility becomes visible in practice. Blamed beyond control (Chloe) showed responsibility as a sudden burden placed from the outside, carried in the body long after the meeting. Weight of being present (Leah) revealed the quiet demand to stay, where simply remaining with the other became a form of responsibility. Fragility of openness (Deana) depicted the struggle to hold on to presence even when hostility and resistance made it hard. Finally, Silence that lingers (Fanny) brought forward what was left unsaid, showing how responsibility stayed on in the body and was shared with colleagues afterward. Taken together, these four accounts portray responsibility not as a fixed duty but as something carried, negotiated, and endured in silence, presence, and affective intensity. In contrast to research that primarily frames professional responsibility as accountability to rules, procedures, and organizational mandates, the responsibility that emerges in this study appears as a personal and relational call. It persists beyond formal task boundaries and is lived in tension with institutional expectations.

This way of seeing responsibility complicates how it is often described in research on health and social care. Much of the existing literature emphasizes dilemmas, role conflicts, or system-induced stress (Clancy et al., 2023; Hammarbäck et al., 2023). Such perspectives are important, yet they may suggest that responsibility is something to be reasoned through or resolved within procedural, organizational, or accountability-oriented frameworks. The present study highlights instead textures that resist resolution, silences that must be endured, affect that lingers in the body, and moments where presence itself carries weight.

Torsteinson and Sævi (2023) have described a moral disquiet that arises when professionals cannot help as they wish. What emerges here is that such disquiet can also arise simply from being there, from staying with another whose need may exceed what the system can offer. In this sense, responsibility does not always rest in action, but in presence. Chloe’s account brings this to light. She found herself held responsible for something larger than her role, not because she had failed, but because she embodied, for the client, the face of the welfare system. The affective weight that followed was not part of her job description, yet it remained in her body and memory. Moments like these suggest that responsibility may take shape not only in what professionals do, but also in how they are perceived and received by others.

What also becomes clear is the particular position of municipal caseworkers within health and care services. They are often the first professionals people encounter when leaving hospital, or when illness, disability, or other life changes make support necessary. In these moments, the caseworker is more than an administrator of services; they are the face of the welfare state, the one who receives a person’s story at a point of vulnerability. This is especially significant given that welfare organizations are frequently subject to reforms and restructuring (Lipsky, 2010). Even as systems shift, it is the caseworkers who continue to meet people in need and carry responsibility in practice, responsibility that is not dissolved in organizational change, but persists as a lived and embodied demand.

These findings invite reflection on how responsibility is understood. Levinas (1969) describes it as an ethical demand that arises in the other’s presence, prior to intention or decision. Van Manen’s (2014) notion of tact resonates here, the sense that listening, pausing, holding back, or simply staying present may themselves be forms of care. Merleau-Ponty (2012) grounds this further in the body, not as a container of experience, but as the very site where meaning lingers and takes hold over time. Fanny’s account brings this into view, as responsibility does not end with the encounter, but stays in the body, carried into the weekend and held together with colleagues through shared silence and presence. Such embodied traces are not peripheral; they are how responsibility comes to be lived. Rather than treating responsibility as an abstract principle, the findings suggest that it may be more fruitful to attend to these embodied details and to what they disclose.

At the same time, the study points toward the importance of attending to responsibility as it is lived in fragile, bodily ways. Rather than being seen as signs of weakness or professional failure, moments of silence, hesitation, and difficulty in staying might be understood as integral aspects of practice. To recognize and hold space for such experiences is not to undermine professionalism, but to acknowledge the depth and complexity through which responsibility is carried in everyday encounters.

From a theoretical perspective, these findings suggest that responsibility may be understood less as a fixed stance than as a relational-bodily practice. It takes shape in the interplay of bodies, spaces, and silences, often beyond what can be captured in guidelines or procedures. Responsibility here appears inseparable from care, not an additional duty, but one of the ways care is lived. This resonates with Løgstrup’s (1997) idea of the ethical demand that arises simply because we live in relation to others. The work of responsibility often begins where procedures end, suggesting that professional responsibility cannot be fully understood as accountability alone, but must also be approached as a lived, ethical, and relational demand. Prior research has largely approached professional responsibility through rules, accountability, and decision-making within welfare bureaucracies. The present anecdotes extend this knowledge by attending to how responsibility is lived as it emerges in encounter, sometimes at moments where procedural responses are exhausted.

The study design does not aim for generalization, and the meanings that come into view are shaped by this particular practice-world. The findings may resonate with practitioners in other welfare and health services who meet vulnerability at the threshold of the state, yet what is shown here carries the texture of this setting. Responsibility is approached as something lived by professionals in encounters with service users, taking form in the tensions between presence, vulnerability, and expectation. What is brought into view in this study is how responsibility comes to appearance from within professional practice in such moments.

In these accounts, responsibility does not end with a decision or a procedure, but continues to echo in the body and in the atmosphere of encounters. To notice these reverberations is to recognize that responsibility belongs not only to what professionals do, but to how they remain with others. Rather than closing the phenomenon, the discussion lingers with these moments, allowing responsibility to appear as something quietly carried in the ordinary practices of care. It is from here that the text turns back to lived experience, returning to the scene from which the study began.

Concluding Reflections

The moment described in the prelude stays present. A brief scene on the street: one person in distress, another leaning toward them, lowering their body, staying close. Nothing is explained, nothing is fixed, yet something happens. A gesture of nearness that does not resolve, but responds. In the caseworkers’ accounts, this same quality of responsibility becomes palpable. It does not arrive as a decision or a clearly defined task. It emerges in the moment, before words and before reflection. It is carried in posture, in the way a chair is drawn closer, and in the pause that allows another to speak or not speak. Responsibility shows itself in the willingness to remain with another’s need when there is nothing more to do.

From this perspective, the prelude does not stand apart. It belongs to the same landscape of lived responsibility that unfolds throughout the study. Across the accounts, responsibility settles quietly. It is felt in the body, as tension, heaviness, and alertness. It shapes the atmosphere of a room. It moves in the small adjustments of presence, turning toward, holding back, and staying a moment longer.

These reflections do not bring the phenomenon to a close; they return us to it. They invite attentiveness to the fragile, embodied, and relational ways responsibility unfolds in everyday encounters. To notice these moments is to recognize how deeply responsibility is lived and how easily it can be overlooked. The study circles back to where it begins, responsibility not as something enacted or resolved, but as something encountered and carried in ordinary gestures of care. What has been brought into view here belongs to this particular setting. Elsewhere, responsibility may show itself otherwise, not as a direction for further study, but as a reminder that lived experience is always singular, situated and open to renewed attentiveness in practice. It does not conclude here. It remains, quietly present, in the spaces between people, in the moments where someone chooses to stay.