Self-determination and Paternalism in Community Care: Practice and Prospects

Correspondence to Dr Chris Clark, Senior Lecturer in Social Work, Adam Ferguson Building, George Square, Edinburgh EH8 9LL, Email: Chris.Clark{at}ed.ac.uk Summary Self-determination is long established as a key principle ofsocial work ethics, but has seldom been the subject of empiricalresearch. This article reports on a qualitative study of theprinciples and beliefs of community care social workers in alocal authority. It is shown that, while workers retain strongattachment to traditional ideas about self-determination, theyalso appreciate that paternalistic intervention is sometimesjustified. The more recently fashionable concept of empowermentappears to have had little useful impact. The paper argues that,while the persistence of self-determination is a strength ofsocial work and should be defended, traditional practice ethicsare weak on the political issues embedded in community care.Five key issues are identified: the threat to individualizedservice under care management; the problematic determinationof mental competence; social ambivalence about the extent offamily responsibility for dependent adults; the threat to equityarising from variable interpretations of self-determination;and the excessively elastic interpretation of empowerment.     

Self-determination: Lessons to be Learned from Social Work Practice in India

Correspondence to Dr F. K. Ejaz Research Associate Applied Research Institute Menorah Park Center for the Aging 27100 Cedar Road, Beachwood, OH 44122 USA. Summary Self-determination is a controversial principle in social workpractice. On the one hand it is accepted as being central tosocial work and stems from the broader philosophical issuesof autonomy and respect for the individual. On the other hand,there are many doubts about its implications for practice. Thisarticle examines how the Western social work principle of self-determinationis influenced by cultural beliefs and expectations in India. Twenty-six social workers participated in a qualitative studyon the influence of culture on casework practice in Bombay,India. Open-ended questions and case studies were used to examinehow culture specific problems were handled and how workers interpretedand used some of the principles of social work practice. Social workers believed that Indian clients expected to be guidedin a therapeutic relationship. Further, clients were generallyapathetic and fatalistic about circumstances in their lives.Indian social workers came across as being maestros at bridgingeast-west differences. They subtly fulfilled social and culturalexpectations and at the same time enabled clients to assumeenough autonomy to handle their own problems.     

Social Workers Talking to Clients: A Comment

Summary I read Baldock and Prior's article with interest in view ofthe shortage of studies examining day-to-day practice in socialwork, but the authors' analysis leaves me reflecting uneasilyupon the state of uncertainty into which social work has fallen.The authors conclude by describing as ‘skilled’,practices which they say resulted in confusion for clients andwhich only apparently reflected social work principles. We arenot told whether the authors checked their analysis with workersor clients and it is possible that the clients were not as confusedas we are led to believe, given their long term contact withthe workers. If, however, the picture is an accurate one, shouldit really be described as representing skilled social work?Baldock and Prior do so but neglect to examine the ends towardswhich interviewing skill should be directed in social work.The result is a strangely ambiguous statement about practice,particularly in the light of research findings on effectivenessand client satisfaction, and one which offers little scope forcomplacency.     

Reflections on Gender, Knowledge and Values in Social Work

Summary This paper is a discussion of the application of social workknowledge and values in practice. It draws on ethnographic researchin a child-care team in the UK which set out to explore theconstruction of clients as gendered. It is argued that socialworkers' accounts of practice reveal tensions between an emphasison clients as individuals and an emphasis on social collectivity.These tensions could be seen as inherent in social work knowledgeand values. There are various implications of these tensionsbetween the individual and the social, but there is a particularfocus in the paper on the implications for questions of gender.It concludes with some ideas for a theory for practice thatwould better equip social workers for the complex task of negotiatingthe gender tensions raised in the paper.     

Social Networks and Social Service Workers

Correspondence to Peter Sharkey, School of Law, Social Work and Social Policy, Liverpool Polytechnic, 98 Mount Pleasant, Liverpool, L3 5UZ. Summary ‘Networks’ is a word often used in the discussionof social work practice and within social services departments.It was a word which was central to the Barclay Report (1982)and important within the more recently published Griffiths Report(1988) on community care. It is a word also known to sociologistsand anthropologists through the development of ‘networkanalysis’. There is, however, a fairly wide gap betweenits use within social work and its use within social science.This article tries to explore this gap and the ways in whichsocial science ideas might have some use and relevance to socialservice workers. It does this by using some illustrative datafrom a study done of the personal networks of thirty elderlypeople who were all clients of a social service district office.     

A Political Critique of Kantian Ethics in Social Work

Correspondence to Stephen A. Webb, Department of Social Work, University of Dundee, DD1 4HN. Summary This paper addresses the Kantian theory of the subject whichis found in contemporary social work discourse on ethics andvalues. It is argued here that the Kantian idea of persons as(i) rational, (ii) autonomous, and (iii) ends-in-themselvesis wholly inadequate to the social work doctrine of ‘respectfor persons’. To show this, we counterpose a Foucauldianview of history, moral codes and theory of the person, and themeaning this can have in the social worker-client relation.This alternative reading claims that social work is essentiallya political practice which is constructed by various discursiveand institutional strategies of power. Therefore, it is suggestedthat social work needs a political reading of its own discourse.To this end we outline a Foucauldian micro-political analysisof the social work ‘subject’ or person as a pointwithin a field of discursive-knowledge based strategies.     

The Introduction of Contracts in a Family Service Unit

Summary An article written by John Corden, in an earlier issue of thejournal, examined the application of the concept of contractin social work practice, drawing on the legal paradigm. Thispaper develops some of these ideas in a more specific way; itdescribes the way in which contracts were introduced betweenthe workers and clients of a Family Service Unit After settingout the context in which the idea was introduced, the differentfeatures of some contracts between workers and families arereported, along with the views of the different parties. Thismaterial is used to illustrate and develop some of the ideasdiscussed in the earlier paper.     

Open Records: The Client's Right to Partnership

Summary Many Social Services Departments have opened their files totheir clients or intend to do so. This reflects the incomingtide of concern about citizens' rights and client participation,but what effect might the opening of records have on the practiceof social work? The paper summarizes the findings of a small scale study inwhich a team of social workers opened their case recording toa selected number of clients. The workers’ and clients‘views of this process are described, along with the implicationsfor practice. The study suggests that a focus on shared recordingcan begin to alter the kind of work done by the social worker,helping to promote a partnership between the worker and theclient. Finally, the paper argues that a policy of client access enforcedonly as a right is prone to sabotage or a fall into disuse.A seven point training programme is outlined in order to helpsocial workers use Open Records as an opportunity to promotea partnership in their work with clients.     

Models of Assessment in Social Work

Summary The provision of a social work service depends significantlyupon assessment of the social situation of clients as determinedby social workers. It is argued that the social worker's ‘understanding’of the social situation is framed within a particular way ofthinking about cause and effect. Three different models of suchthinking are used in practice. They are identified as the linearmodel, systems analysis and the management model. The originsand attributes of each model are described and related to thesocial, economic and political environments which have influencedtheir separate developments. The value base underlying eachmodel is explored. Issues relating to the present position ofsocial work are clarified.     

Defensive Social Work

Correspondence to Nigel Harris, Department of Philosophy, The University, Dundee DD1 4HN. Summary Social workers with child clients face the possibility thatsome mistake or oversight of theirs could lead to a child abusetragedy, for which they may suffer opprobrium and blighted careers.How can they guard against such risks? This paper shows howsocial workers might use different types of ‘defensive’measure to protect themselves. These parallel the types of measureused by some doctors, particularly in the United States, facedwith risks of litigation on grounds of malpractice. Becausedefensive practices have undesirable consequences, it is importantto find ways to eliminate their use by protecting social workersby other means.     

Social Work Tomorrow: Towards a Critical Understanding of Technology in Social Work

Correspondence to Bob Sapey, Department of Social Work, University of Central Lancashire, Preston PR1 2HE Summary This paper makes use of theoretical ideas that have been developedto understand the impact of new technology on organizationsand applies them to its use within social work agencies. Thesedeveloping theories employ ideas that are familiar to socialworkers—organization theory, decision making theory, andcommunication theory. The paper therefore argues that socialworkers are in a good position to understand and influence theuse of computers within welfare agencies and do not need tobe inhibited by a lack of technological knowledge. It is furtherargued that, unless social workers do become involved in theways in which new technologies are used within organizations,they will fail to influence its impact upon their clients andmay further fail to control the way in which computers affectthe nature of social work itself in the future.     

Theory and Practice in Long Term Social Work: a Case-Study of Practice with Social Services Department Clients

Summary This study is based on empirical research into the practiceof 14 social services department social workers with 42 of theirlong term clients. The findings suggest that, contrary to expectation,this type of social work practice is not characterised by aproblem solving approach, but rather by a concern for the containmentof problems and the maintenance of stability. This leads toa restricted form of social work practice which is not linkedto any particular method of intervention. Reasons for this theory-practicehiatus are suggested along with a discussion of the issues surroundingtraining for long term social work of this kind in the future.     

A New Structure for Intake and Allocation in a Field Probation Unit

Summary From a background of practice and a post-qualifying fellowship,the author draws on the experiences of other Senior ProbationOfficers, as well as his own and his team members. In this article‘intake’ within the probation setting is taken asinitial agency impact as well as that part of team strategywhich has a bearing on allocating new work. Allocation and theconsequential deployment of resources are then seen as centralto the professional lives of team members. A structure is presentedwhich in practice pervades the totality of the team's life;most radical is the author's notion of allocating ‘workepisodes’. The model provides a structure for team membersto specialise in different forms of social work, and at thesame time allowing clients choice to be supervised without being‘sentenced to social work’. It also depends uponthe active use of a team as a group of interacting, interdependentprofessionals who share their work.     

From Paradigm to Practice in a Special Probation Project

Summary Between January 1980 and December 1982, a team of probationofficers in South Yorkshire attempted a new approach to probationpractice. The project arose initially out of the ideas put forwardin Bottoms and McWilliams (1979) ‘A Non-Treatment Paradigmfor Probation Practice’, but the team members developeda version of the paradigm which in many respects differed markedlyfrom the original. In this paper, their statutory work is describedwith particular reference to their social enquiry practice andto their attempted separation of the care and control aspectsof probation orders.     

The State of Welfare

Summary The word ‘welfare’ is difficult to define becauseit combines within it a range of ideologies and actions. Twoconclusions are drawn from this: first, that social servicesshould be regarded as contributors to, but not providers ofwelfare; second, that the study of social work and social administrationshould be concerned not only with the relationship of ‘service’to ‘need’ but also with societal movements and pressureswhich determine the emergence of both. The article reviews theprofessed values of the welfare state, particularly ‘socialequality’ and the problems associated with its achievement,namely public attitudes, and the discontinuity between intentionand practice in the welfare services. The implications for socialwork education and practice are considered.     

No more than Contact: An Outcome of Social Work

Summary This study of the experiences of eight sets of clients withtheir respective social workers illustrates how the outcomeof each case is a reflection of each party's interpretationsof crucial aspects of their meetings. In many respects it isa one-sided picture of social work but part of its purpose isto emphasize the process whereby past events and present circumstancesaffecting both parties' perspectives make it probable that manyclients will fail to obtain help and will regard their meetingswith social workers as being little different from passing contactswith other 'officials' who feature in their lives.     

Constructivism in Social Work: Towards a Participative Practice Viability

Summary Social work has traditionally drawn upon an expansive rangeof social science research and theorizing as its claim upona ‘knowledge base’. Recent debates have exploredthe need for the profession to develop its own theory of socialwork knowledge arising from practice. This paper seeks to extendthe boundaries of these ideas through an operational and epistemologicalelaboration and critique of Sheppard's (1995a; 1998) notionof a practice paradigm. In an examination of the contributionof constructivism and the seminal work of George Kelly's (1955)Psychology of Personal Constructs, arguments are put forwardfor social work practice to focus upon the co-construction ofviable working relationships with service users as the basisfor an anti-oppressive and participative professionalism. Itargues that the sterile philosophical dichotomies between objectivism/realism-subjectivism/interpretivismand the equally unhelpful social work division between practice-theoryshould be integrated within a situated, participatory, constructivistapproach to knowledge creation in social work practice and continuingprofessional development.     

Is Social Work a 'Non-Traditional' Occupation for Men?

Correspondence to Alastair Christie, Department of Applied Social Studies, University College Cork, Cork. Email: A.Christie{at}ucc.ie Summary The European Commission and the Equal Opportunities Commissionhave called for the increased employment of men in occupations,such as social work, where men are numerically under-represented.In Britain, men's employment in social work is contentious but,as yet, little discussed. This article draws on Williams' (1993,1995) concept of ‘non-traditional occupations for men’to explore the positions of men in social work. It focuses inparticular on continuities and dissonances between dominantconstructions of men's gender and professional social work identities.These are discussed in relation to particular areas of practiceand an agenda for further investigation is considered.     

Notes on Theory and Practice in Social Work: a Comparative View

Please address reprint requests to Robert van Krieken, Department of Social Work, University of Sydney, Sydney, New South Wales 2006, Australia. Summary There are still a number of problems surrounding the relationshipbetween theories of social work practice and that practice itself.This paper examines the factors underlying those problems andemphasises their roots in the failure to examine the diversityof social work theories and practices. We refer to one attemptto resolve the problems—the distinction between ‘practicetheory’ and ‘theory of practice’—pointout some difficulties with it and suggest an alternative, three-folddistinction within theorising: between (a) materialist socialtheory, (b) strategic practice theory and (c) working concepts. As an example of how those distinctions can be used, we thenbriefly discuss the work of Oskar Negt and its introductioninto the Dutch welfare context, as it was the issues raisedby that which stimulated the ideas in this paper. We concludeby arguing that only this kind of perspective on theorisingcan produce ideas which are of real use to progressive socialwork practitioners.     

Primary Health Care Workers' Views about Social Work

Summary SUMMARY A comparison of the views about social work held by 188 primaryhealth care workers—118 GPs, 31 health visitors and 39district nurses—working in the same teams is presentedhere.^* The study focussed particularly on their perceptionsof social workers, their role and performance. The data indicatea general acceptance of the social work role, but a lack ofknowledge of or extensive criticism about, social work performance.Significant differences of view emerged about social work training,role and clients, indicating occupation is a significant factorin perceptions held. In particular, the client group predominantlydealt with appears to have had an impact on perceptions. However,views about social work performance did not differ greatly,suggesting the influence of occupation on perceptions shouldnot be overstated.