Survival Analysis in Social Work Research

Correspondence to Dr Richard Pugh, School of Social Relations, Keele University, Staffordshire ST5 5BG, UK. E-mail: spa08{at}keele.ac.uk Summary Survival analysis is a method of analysing any data set thatconsists of time to event where the data set is not temporallycompleted. That is, where not all of the initial events havebeen succeeded by the end events. Its major advantage is thatit allows the researcher to model the data using the whole set.Although widely used in other disciplines, with a few exceptions,it has received relatively little attention in social work.This paper provides a review of the method and illustrates itsapplication in a study of child protection practice.     

Non-Statutory Mental Health Social Work in Primary Care: A Chance for Renewal?

Correspondence to Malcolm T. Firth, Honorary Research Fellow & Senior Psychiatric Social Worker, 'DEAL', Department of Psychiatric Social Work, 12th Floor, Mathematics Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK. E-mail: malcolm.firth{at}mhsc.manchester.nhs.uk Summary The current status of evidence-based practice in the field ofmental health has led some to question the potential for innovationif social work practice is organizationally proscribed or reducedto a dogged adherence to methodological orthodoxy. Conversely,social work's value base is esteemed disproportionately to itsevidence base. Changing service contexts in the UK, particularlythe emergence of Primary Care Trusts as gatekeepers and commissionersof health and social care services, are providing opportunitiesfor social work to develop a new presence and purpose. The authorsdescribe their work in a small-scale service based in primarycare that anticipated these opportunities, by a retrospectivestudy of 120 cases. A new evidence base that derives directlyfrom practice is suggested as a way forward for social workeducation and training, as well as for service and professionaldevelopment.     

Considering the Countryside: Is There a Case for Rural Social Work?

Correspondence to Dr Richard Pugh, School of Social Relations, University of Keele, Keele, Staffordshire, ST5 5BG, UK. Email: spa08{at}keele.ac.uk Summary Most British social work literature is written with the implicitassumption of an urban context, but large numbers of peoplestill live in comparatively rural settings. Rural social workremains a largely unrecognized dimension of practice, receivinglittle attention beyond the reportage of individual projectsor initiatives. This paper considers whether it is a sufficientlydistinctive area of practice to warrant specific consideration.It concludes that it is an under-researched aspect of practicewithin the UK which merits particular attention and identifiessome areas for future development.     

Service Users and Practitioners Reunited: The Key Component for Social Work Reform

Correspondence to Professor Peter Beresford, Centre for Citizen Participation, Brunel University, Osterley Campus, Borough Road, Osterley, Middlesex, TW7 5DU, UK. E-mail: peter.beresford{at}brunel.ac.uk or Suzy Croft, Senior Social Worker, St John's Hospice, 60 Grove End Road, London, NW8 9NH, UK. E-mail: suzy.croft{at}hje.org.uk Summary This article explores the pressures towards both regulatoryand liberatory social work. It identifies a range of factorsoperating to push social work in each direction. It discussesthe key significance for more liberatory social work of theroles and engagement of social work practitioners and serviceusers. Highlighting four key characteristics in the currentpolitical and policy context of social work: ambiguity, uncertainty,complexity and contradiction, it argues that social work isunlikely to develop a more emancipatory role, unless socialwork practitioners gain more support to play a central rolein its construction and develop much closer links and allianceswith service users and their organizations and movements.     

The Impact of Criminal Conviction Disclosure on the Self-reported Offending Profile of Social Work Students

Correspondence to University of Edinburgh, School of Social and Political Studies, 31 Buccleuch Place, Edinburgh, EH8 9JT, UK. E-mail: richard.perry{at}ed.ac.uk. Summary Data gathered at a Scottish institute of higher education between1986 and 2000 indicate a significant reduction in the scaleof self-reported offending behaviour by social work students.The change coincided with the introduction by the Central Councilfor Education and Training in Social Work (CCETSW) in 1989 ofa requirement that applicants for training disclose prior toadmission any criminal convictions recorded against them. Thearticle suggests that more prolific offenders have been deterredfrom applying to DipSW programmes and the social work professionneeds to take steps to create a more positive climate for therecruitment of those offenders who represent no more of a threatto users than non-offenders.     

Yes Minister: Reviewing the 'Looking After Children' Experience and Identifying the Messages for Social Work Research

Correspondence to Paul Michael Garrett, Centre for Social Work, School of Sociology and Social Policy, University Park, Nottingham NG7 2RD, UK. E-mail: paul.garrett{at}nottingham.ac.uk Summary The heavily promoted Looking After Children: Good Parenting,Good Outcomes (LAC) project continues to exert a powerful influenceon social work in the UK and elsewhere. Despite the repeatedassertions that the documentation associated with LAC is embeddedin ‘objective’ research, this not sustainable onaccount of the failure of the researchers to interrogate theirown normative assumptions and judgements. Specific criticismscan also be levelled at the ‘community study’ connectedto the evolution of the Action and Assessment Records (AARs)which are the key part of the scheme. The system should alsobe viewed in the context of wider pre-occupations about ‘outcomes’.In addition, the project needs to be politically situated andthe researchers' relationship with the Department of Healthshould be more fully explored. In conclusion, it is suggestedthat the LAC experience contains important ‘messages’for the future of social work research.     

Sleepwalking through an Epidemic--Why Social Work should Wake up to the Threat of Hepatitis C

Correspondence to Dr Ian Paylor, Department of Applied Social Science, Cartmel College, Lancaster University LA1 3HY, UK. E-mail: i.paylor1{at}lancaster.ac.uk Summary One of the many consequences of injecting drug use is the potentialrisk to infectious blood-borne viruses. There is evidence thatthe risk of contracting Hepatitis C (HCV) is greater than thatof HIV. Despite repeated warnings from a variety of sourcesand thousands of new infections among drug users each year andrising incidents of ‘'crack’ injecting, successivegovernments have failed to address a public health emergencyof immense proportions - the HCV epidemic. This article exploresthis issue and the implications it has for social work.     

Case Management and Care Management in Community Care

Correspondence to Prof. Peter Huxley, Mental Health Social Work Research Unit, Department of Psychiatry, Mathematics Building, Oxford Road, Manchester University M13 9PL. Summary This paper reviews the purpose of case management, its introductioninto the UK, and its central components. While case managementhas empirical referents which have been developed over manyyears (largely in the USA) care management has, until recently,had none. The paper examines different models of case managementin terms of organizational structure, content, and outcome assessment.The importance of the distinction between clinical and administrativecase management is emphasized, especially in work with mentallyill persons. The review of existing evidence suggests that inorder to produce effective intervention services must have clearlyidentified objectives, closely specified target groups, interventionswhich match the objectives, and employ related outcome measurements.Some of the current issues in the implementation of care managementare considered.     

Participants or Recipients--Disabled People's Involvement in a European Programme

Correspondence to Jackie Powell, Department of Social Work Studies, University of Southampton, Highfield, Southampton S017 1BJ Summary Drawing on an evaluative study of UK participation in a Europeandisability programme (HELlOS I), this paper explores the extentto which and the ways in which disabled people were-or werenot-involved in the programme as active participants ratherthan passive recipients, at local, national and European levels.The findings presented here draw attention to the differentperspectives of the programme's various stakeholders and arediscussed in relation to two broader themes. The first of thesethemes is the involvement of disabled people themselves in anyprogramme aiming to promote the full participation of disabledpeople in society. The second is the role and value of formalizednetworks as a means of promoting information exchange and learning,as a prerequisite for promoting change in individuals (thatis in day-to-day practice) and change in organizations (thatis service developments). These two themes are pertinent tocurrent developments in social work, with its explicit attentionto anti-discriminatoiy practice and its strong tradition ofvaluing the learning gained from experience.     

Beyond Retroduction? -- Hermeneutics, Reflexivity and Social Work Practice

Correspondence to Susan White, University of Manchester, Department of Social Policy and Social Work, Williamson Building, Oxford Road, Manchester Summary Over the last three decades qualitative research methodologieshave been in the ascent within social science. Yet social workevaluation studies have tended to be quantitative in nature,conventially relying upon the generation of criteria againstwhich interventions are retrospectively judged. The generationof such criteria inevitably depends upon pre-suppositions, whichin themselves go unresearched. As a consequence the .sense makingactivities on which social work interventions depend are renderedimmune from critical analysis. This reflects a broader tendencyfor social work to cling to naive realist epistemologies, whichare arguably obsolete within the interpretive paradigm in whichits activity is properly located. By examining the debates withininterpretive social science, this paper argues for an approachto social work assessment which avoids the pitfalls of naiveobjectivism and the nihilism of anarchic relativism, whilstretaining creativity, imagination and hope.     

Evaluating Social Work and Medical Practice with Black and Ethnic Minority Groups Using the Clinical Audit Model

Correspondence to Kish Bhatti-Sinclair, Department of Social Work Studies, University of Southampton, Highfield, Southampton SO17 1BJ, UK. Summary This paper is based on the External Audit-Ethnically SensitivePractice (EA-ESP) project which was undertaken within six primaryand secondary health care settings. This project is used asan example of how the clinical audit model can be used to monitorand review health and social work practice in the UK. The paperexamines quality, compares approaches to evaluation, and suggeststhat audit can be a useful tool for agencies in obtaining userand staff views on many areas of practice but in particularon equal opportunities, anti-racism and anti-oppression. Attentionis drawn to audit within broader evaluative and review approachesalready employed by social work academics and practitioners.The issue of quality and how it can be measured is consideredthrough an analytical comparison with approaches which employaction research and other evaluative means in the process ofreview. Audit is explored in the context of a growing need for the developmentof monitoring and review systems which provide evidence to supportand develop professionalism within social work. External auditis explored and compared to internal audit. Finally, the needfor the development of quality services in anti-racist and anti-oppressivework is highlighted and it is suggested that audit can be acost-effective and efficient way of achieving this.     

A code of ethics for social work and social care research

Summary This Critical Commentary is the final product of the Economicand Social Research Council sponsored seminar series, TheorisingSocial Work Research to appear in the BJSW. The special editionof the British Journal of Social Work published in August 2000carried several key papers arising from the seminar series aswell as reports of some of the events themselves. The responsibilityfor drafting the Code of Ethics for Social Work and Social CareResearch fell to me and although discussed at the Luton Seminarand at the final conference in Manchester, the text presentedhere is much as it first appeared. This is simply to reaffirmthat it has no particular status and is reproduced in the Journalas a prompt to further discussion, precisely the purpose itwas to serve for the seminar series. Before reproducing the Code, it might be helpful to revisitsome of the main points which were raised in the paper presentedat the Luton Seminar which set the context for the Code (Butler,2000).     

Social Work: Gender, Care and Justice

Correspondence to: Joan Orme, Department of Social Policy and Social Work, Lilybank House, Bute Gardens, University of Glasgow, Glasgow G12 8RT, UK. Summary This article, in examining gender and justice, seeks to examinethe relationship between feminist theory and social work. Specificallyit reviews writings on social work ethics and suggests thatlittle attention has been paid to feminist scholarship thatresonates with social work practice. Focusing primarily on communitycare, it demonstrates how debates within feminism have becomemore complex and have problematized understandings of both careand justice. It argues that for social work it is unhelpfulto dichotomize justice and care; we should aspire to just socialwork practice.     

Liberty and Respect in Child Protection

Correspondence to Sally Holland, Cardiff University, School of Social Sciences, Glamorgan Building, King Edward VII Avenue, Cardiff CF10 3WT, Wales, UK. E-mail: HollandS1{at} cf.ac.uk Summary The paper begins by introducing Isaiah Berlin's concepts ofpositive and negative liberty and the application of these conceptsto child protection. There is discussion of some recent debateson the social and political context of state social work andchild protection in particular. The authors then consider, inturn, the experience of children, parents and social workersin the child protection system. There is also a considerationof partnership and rights. The conclusion is that opportunitiesfor statutory child protection to be liberating are limited,but that there is more potential than the most pessimistic accountsmight allow. Rather than libertarian child protection, socialworkers can aim for child protection practice that is respectful.The paper concludes with some principles for respectful practice,based on the ideas of Richard Sennett. Most importantly, Sennett'sideas recognize the importance of relationships in social welfareand acknowledge the context of inequality within which socialwork takes place.     

Gender and Illicit Drug Use

Correspondence to Dr Joanne Neale, Department of Social Policy and Social Work, University of York, Heslington, York Y010 5DD, UK. E-mail: jsn3{at}york.ac.uk Summary There has been no recent large-scale systematic UK investigationof differences between male and female drug users seeking treatment.Equally, there has been no debate within the social work fieldregarding how best to address any gender-specific needs of drug-usingclients. This is despite the fact that social workers frequentlywork with both drug-dependent individuals and members of theirfamilies. This paper examines differences between men and womenbeginning a new episode of drug treatment in Scotland and considerssome of the implications of the findings for social work practice.Data were collected from structured interviews conducted with1,033 individuals (715 males and 318 females) in a range oftreatment settings. Chi-square statistics were computed to investigatesex differences on key categorical variables relating to: (i)patterns of drug use; (ii) education, employment and income;(iii) offending behaviour; (iv) housing circumstances; (v) healthstatus; and (vi) personal relationships. Analyses identifiedmany differences between the men and women interviewed, butalso many common difficulties faced by respondents of both sexes.Additionally, the extensive range of problems and stressfullife circumstances encountered suggested that the lives of individualsseeking drug treatment were extremely heterogeneous. It is concludedthat social workers can employ a range of practical interventionsand theoretical approaches when working with both male and femaledrug-using clients.     

Early Recognition of and Responses to Dementia: Health Professionals' Views of Social Services' Role and Performance

Correspondence to Jill Manthorpe, Social Care Workforce Research Unit, King’s College London, 150 Stamford Street, London SE1 9NN, UK. E-mail: jill.manthorpe{at}kcl.ac.uk. Summary Increasing calls for early diagnosis of dementia look set toimpact on social services. This article explores some of theissues, drawing on a series of multi-professional dementia workshopsheld in the UK. The workshops identified a series of questionsthat need to be addressed by social services in the areas ofthe drivers for early assessment, ensuing expectations, problemsand advantages in involving social services, and the benefitsof early diagnosis for individuals and their families. The articlediscusses the implications for social services in light of thedata and notes a possible move to specialist services, withinor without the social services sector. Tensions between currentresource shortages and anticipated demands for services areidentified. The difficulty of meeting low level needs whileservices are targeted on those with high levels of need presentsa further challenge to service delivery.     

Is Gender Inequality in Social Work Management Relevant to Social Work Students?

Correspondence to Ms C. Taylor, Research Fellow, Social Work Research Centre, University of Stirling, Stirling FK9 4LA. Summary This paper reports on a study carried out in 1991 based on questionnaireswhich asked 169 female and male social work students about theiraspirations and expectations in respect of promotion in theirfuture career. Underlying the study is a concern about the unequalrepresentation of male and female workers at management levelsin social services in the UK, there being at present a predominanceof male managers. The phenomenon is not regarded as unique tosocial services, but as part of the pattern of gender inequalityin the workforce as a whole. The view that women contribute to the phenomenon by a fundamentallack of interest in, or unwillingness to apply for, promotionwill be challenged. It will be argued that the differences inthe aspirations and expectations of male and female employees,which previous research studies have reported, may be an effectof the experience of the organization rather than a cause ofthe scarcity of female employees in promoted posts. The paper will focus on some of the findings, including students'aspirations and expectations, their opinions about the unequalrepresentation of men and women in social work management, theimplications of this for their own career and whether they considerthis issue is, or should be, a significant component of socialwork training.     

Keeping Social Work Honest: Evaluating as Profession and Practice

Correspondence to Ian Shaw, School of Social and Administrative Studies, University of Wales Cardiff, 50 Park Place, Cardiff CF1 3AT Summary The central argument of this paper is that social work needsa radical alternative to existing options for evaluating practice.Social workers at present are offered three choices. They areinvited to choose between applying research, conducting researchor adopting specific forms of empirical research-based practice(for example Everitt et al., 1992; Thyer. 1993; Fuller and Petch,1995). We touch briefly on reasons why we believe none of these optionsprovides an adequate grounding for social work, referring especiallyto the growing call for social work to find new purpose throughan empirical, research-based practice. If alternative approachesare to be persuasive, they must be fashioned from the materialsof a new approach to research on social work practice—‘one that is exploratory rather than confirmatory, buildinga model of evaluation from the practitioners' own accounts ratherthan superimposing an ideal model’ (Elks and Kirkhart,1993, p. 555). The major part of this paper is taken up withevidence from research of this kind. The model of evaluatingin practice with which we conclude the paper is simultaneouslytrue to social workers' accounts of their practice, while offeringa critical starting point for evaluating and refashioning thatpractice.     

Social Work, Social Science and Practice Wisdom

Correspondence to Michael Sheppard, Department of Applied Social Science, University of Plymouth, Drake Circus, Plymouth PL4 8AA. Summary Social work has for some time had an ambiguous and ambivalentrelationship with its social science knowledge base. However,this has arisen, at least in part, because of the emphasis onthe outcome or product of social science rather than the processby which research is conducted. This paper, focusing on assessment,argues that an emphasis on process goes some way to closingthe gap between social science and social work, that the methodsused by social researchers are, in many respects, simply refinementsof the methodology of everyday life, and that social workers,when conducting assessments operate rather like practical qualitativeresearchers. Using Analytical Induction as an heuristic device,it proceeds to explore critical characteristics of good practicein social work assessments. It concludes that practice shouldbe characterized by critical awareness, involving imaginativedevelopment of alternative hypotheses, a sceptical attitudetowards case assessments and a principle of adopting hypothesesleast likely to be in error.