Towards the Use and Development of Games for Social Work Practice

Summary This paper reviews games that may be of use to social workersin their work with individuals, couples, families and groups.A typology of games is presented, which categorizes games accordingto their structure and their function. Games are seen as eitherunstructured or structured, and as stressing either cognitiveor behavioural goals. Selected games are presented in more detailas examples and others are presented in brief in an annotatedbibliography. Issues relating to designing games are discussedas well as issues in applying games to social work practice.     

Coping with a Life-threatening Illness: an Experiment in Parents' Groups

Summary Four separate series of parents' groups were held between 1977and 1981 in order to help certain parents of children who sufferfrom cystic fibrosis which is a serious life-threatening disease.These group experiences were found helpful by those parentswho did not have overt problems and who were therefore unlikelyto be referred for individual counselling. Families who hadobvious problems, for example marital, financial or psychiatricwere apparently not helped by the experience, nor were the parentsof newly diagnosed patients. As a result of this groupwork experiment it may be possibleto predict those families who are unsuitable for groupwork help.     

User-Practitioner Transactions in the New Culture of Community Care

Correspondence to Nicky Stanley, Lecturer in Social Work, University of Hull, Hull HU6 7RX, UK. Summary This article describes the findings of a research project whichexamined the views and practice of social workers undertakingassessments in one local authority following the implementationof the NHS and Community Care Act 1990. While the assessorsexpressed dissatisfaction with some aspects of the new systemof care management, overall they appeared to be taking the newculture on board. Managers were consistently more enthusiasticthan practitioners. Both groups saw needs-led assessment, userchoice and keeping users in their own homes as central objectivesof care management. The shadowing of ten community care assessmentsallowed the degree to which these objectives were realized inpractice to be explored. Users' experience of the new culturewas also studied. The user-practitioner transactions observedsuggest that those users who were able to articulate their ownneeds forcefully were most likely to be able to exercise choice.It is argued that the new culture of community care embodies‘consumer choice’ rather than ‘user choice’.     

Research Note: An Attempt to Classify Adolescent Parasuicide Attempters

Correspondence to David Gilliland, Principal Social Worker, The Royal Belfast Hospital for Sick Children, 180 Falls Road, Belfast BT12 6BE. Summary This paper examines some of the literature available on thesubject of adolescent suicide attempts. It discusses the extentto which it is possible to identify sub-groupings within groupingsof young people who took overdoses. It suggests on the basisof the study undertaken (and in reference to other studies)that it may be possible to identify sub-groupings. The paperalso discusses in detail a study carried out examining characteristicsof two groups of young people—one who had been admittedto hospital following a single overdose attempt, and a secondgroup who had several admissions to hospital following repeatedoverdose attempts. The implications of these findings are discussedin terms of the possibilities of identifying young people whoare at an increased risk of repeating an overdose attempt, andthe issues for practitioners and service managers are identified.     

'Secret Justice': The Use Made of School Reports in the Juvenile Court

Summary The data collected for this review confirmed the suspected widevariation in practice relating to school reports, with a biastowards their not being shown to parents and defendants. Nogeographic or demographic explanation for the variety of practiceemerged, however the comments of justices' clerks suggest thatin many courts it is their influence together with that of headteachersand juvenile panel members which effectively determines practice.The data also reveals a disturbing incidence of disregard forthe rules as laid down in the Magistrates Courts (Children andYoung Persons) Rules 1970.     

Working in the Social Services: Job Satisfaction, Stress and Violence

Correspondence to Professor Jan Pahl, Department of Social and Public Policy and Social Work, Darwin College, University of Kent at Canterbury, Canterbury CT2 7NY. Summary A major survey of the social services workforce (Balloch etal., forthcoming), carried out in the Research Unit at the NationalInstitute for Social Work, has produced new data about sourcesof job satisfaction and about the incidence of stress and violence.The survey took place in five different local authorities inEngland, and interviews were carried out with 1276 individuals,selected from four groups of staff: managers, social work staff,home care workers and residential staff. The results suggestedthat those who work in the statutory, social services do experiencemore stress and violence than workers in other parts of thehealth and welfare services. However, different jobs presenteddifferent hazards. In general, home care workers were the mostsatisfied with their jobs, and were also the group least likelyto be stressed or to experience violence in the course of theirwork. By contrast, residential workers, especially those withmanagement responsibilities, were most at risk of both violenceand stress. Men were more likely than women to experience violence,while other groups with a higher than average risk of stressincluded younger members of staff, and managers and social workstaff responsible for elderly people.     

A Study of Families' Expectations and Experiences of a Child Guidance Clinic

Summary Recently there has been considerable debate concerning the useof child guidance/psychiatric services. There is a lack of consumerstudies in this area, despite opinion that such studies areessential in the evaluaton of these services. This paper considersthe expectations and experiences of ten families who attendedtheir local child guidance clinic. These families had attendedthe clinic for no more than six appointments before termination.Most parents had expectations which conflicted with those ofclinic staff. The only three families whose expectations concurredwith clinic practice had had previous experience of the ‘helpingprofessions’. Overall less than half the families feltthey had been helped and this seems related to the differencesbetween their expectations and experiences. The clinic's andthe families' opinions concerning the helpfulness of clinicintervention do not always coincide, nor do their reasons fortermination. Ideas for preparation of families prior to attendingthe clinic and for modification of treatment by clinic staffare considered.     

Letters and Visits to Long-stay Broadmoor Patients

Summary Long-stay psychiatric patients are at risk of being institutionalisedand abandoned by their relatives. Special Hospital patientsare particularly vulnerable due to the compounded features ofmental disorder and criminality, together with the long termnature of their detention. A survey of 132 long-stay Broadmoor patients showed that a largenumber were neglected by their families but that many were sociallyisolated before admission. There was a significant differencebetween the amount of contact enjoyed by male and female patients.It is suggested that isolated patients should be identifiedand encouraged to take a more active interest in the outsideworld, and relatives given more encouragement to maintain theirinterest.     

Case Finding and Screening for Social Work in Acute General Hospitals

Paul Bywaters, Senior Lecturer, Department of Social Science and Policy Studies, Coventry Polytechnic, Priory St., Coventry, CVI 5FB. Summary Since the first appointment of a ‘Lady Almoner’social workers in hospitals have complained about the problemof obtaining referrals appropriate to their skills and knowledge,and sufficiently early in the patient's stay to allow for effectiveintervention. Often, due to shortage of staff, workers haveto rely on referrals from other staff, patients and carers.But where social workers find their own cases, a wider rangeof problems and patients are selected. In the United Statesduring the past twenty years there has been a rapid spread ofscreening at the point of admission or pre-admission, to identifyhigh risk patients for social work assessment. The evidencefor the effectiveness of this approach to case finding is examined.     

Social Workers' Experience of Distress--Moving Towards Change?

Correspondence to Martin Smith (Emergency Duty Team), The Katharine Knapp House, Stretton Close, Tylers Green, High Wycombe Bucks, HP10 8EW, UK. Summary Recognizing the current concern relating to social workers facingdistressing experiences, a qualitative research investigationwas undertaken which asked workers of grade 3 or above withina social services department to recall one distressing experienceencountered in their working life. Each was asked to describethe experience and recount the immediate and longer term impactsof the experience. They were then asked to evaluate what hadbeen helpful and unhelpful in their attempts to deal with, andprocess, the experience. Finally, they were asked what organizationalstructures they thought should be in place to help workers affectedby distressing experiences. Both qualitative and quantitative evidence is presented. Anunexpected repercussion of the study was that the interviewerwas asked to share the findings with his employer's DivisionalManagement Team who expressed interest in making appropriateprovision for staff care.     

Going missing from residential and foster care: linking biographies and contexts

Summary The findings discussed here derive from a Department of Healthfunded study into young people who go missing from foster andresidential placements. We found going missing to be a widespreadphenomenon especially, though not exclusively, in residentialcare. The risks encountered by young people included involvementin offending, substance misuse, rough sleeping and sexual exploitation,including prostitution. However, patterns of going missing werecomplex. Different patterns were identified for those who wentmissing to be with friends or family as compared to those whoran away, the latter group tending to place themselves at greaterrisk. Those who went missing repeatedly were at risk of increasingdetachment from substitute carers and school and were more likelyto have offended in the past. However, these longer-term risksdiffered significantly from those who had first gone missingfrom home when compared to those first missing from substitutecare. The complex motivations that prompt young people to gomissing are also discussed and the balance between individualand environmental factors in explaining this phenomenon is explored.     

Financial Hardship and Shame: A Tentative Model to Understand the Social and Health Effects of Unemployment

Correspondence to Ulla Rantakeisu, Centre for Public Health Research, University of Karlstad, S-651 88 Karlstad, Sweden. E-mail: ulla_rantakeisu{at}kau.se Summary Young unemployed people in six local communities in Sweden wereinterviewed to test the assumption that variations in the socialand health effects of unemployment could be seen as a functionof financial hardship and of experiences of shame. The resultsindicate that there seems to be a link between the health andsocial effects of unemployment, on the one hand, and the degreeof financial hardship and the number of shaming experienceson the other. The group of unemployed people who suffered agreater degree of financial hardship and also experienced agreater number of shaming experiences seemed to exhibit thepoorest health, reported deteriorated health to a greater degreethan other groups, experienced negative changes in their lifestyle,did less in their free time, and had lower self-confidence thanother unemployed persons. The opposite applied for those whoexperienced less financial hardship and less pressure in termsof experiences of shaming. Against this background, we haveformulated a theoretical model based on financial circumstancesand social bonds; a model that could have a wider value in explainingsocial and health problems.     

The Social Work Task in an Acute Psychiatric In-Patient Unit

Summary This paper reports the results of monitoring all admissionsfrom a prescribed geographical area to an acute psychiatricin-patient unit for a six month period. Members of the hospitalsocial work department assessed all admissions and selectedapproximately one-half of these for high social work input Demographicdata for the whole subject group is examined and compared tothe high input group. The case review system outlined by Goldbergand Fruin (1976) is used to describe the clients' social problemson admission, as well as the social work task, in terms of practicalservices and other social worker activities. These findingsare compared to those of Goldberg et al. (1977) who examinedthe social work task in an area office social services departmentintake team. Despite differences in demographic profiles ofthe two groups and consequently differing social problems, thesocial work task in both settings was found to be similar. Inboth studies 53% of clients were offered some practical (althoughdifferent service) and the most common social work activitieswere found to be assessment, information and advice, and mobilizingresources.     

Helping Children Directly

Summary The mothers most able to respond to the child's communicationsare those whose personal needs do not obtrude and who have onlya minimum of preconceived ideas. Thus they are able to considerthe child as an individual and are interested in his expressionof individuality. They want to listen and to understand andenjoy the flow of communication between him and them. (Heinickeand Westheimer¹)     

Prior Criminality and Employment of Social Workers with Substantial Access to Children: A Decision Board Analysis

Correspondence to Joanne M Smith, Department of Social Policy and Social Work, 20 Portland Villas, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA Summary The central purpose of this research was to find the extentand circumstances of the influence which a criminal record hasupon appointment as a social worker with substantial, unsupervisedaccess to children. One would suppose that applicants with aconviction for indecently assaulting a child would never beappointed, but that those with other kinds of record would beappointed to the extent to which prior offences were relativelytrivial, distant in time and involved property rather than people.The reality was much less clear-cut. The study may be seen asa way of depicting the pattern and process of current practice.It has clear implications for the refinement of guidance toachieve nationally desired ends of child protection. This article will draw upon data gathered for a Ph.D., incorporatinginterviews with every social services department (SSD) in Englandand Wales. The study has yielded interesting findings relatingto (inconsistency in decision making across SSDs. The findingsfrom the first 64 interviews have been used for the article.Preliminary analysis suggests that the remaining interviewsshow similar patterns. The focus will be on possibly the mostsignificant finding of the research: that six SSDs in a decision-makingprocess relating to a number of fictitious candidates, revealedthat they would have agreed to employ one of the candidatesas a children and family social worker, despite knowledge ofthat candidate's conviction for indecently assaulting a child.     

Anti-Discriminatory Practice: Pedagogical Struggles and Challenges

Correspondence to Narda Razack, Assistant Professor/Field Education Coordinator, School of Social Work, Atkinson College, York University, 4700 Keele St., North York, Ontario M3J 1P3, Canada. E.mail: nrazack{at}yorku.ca Summary Transnational alliances and changing global realities have resultedin a proliferation of material relating to diversity and socialwork practice. More recently the focus has rested on anti-oppressionand multicultural social work. Although there is growing acceptanceof the need to be sensitive to diverse populations, the struggleoften lies in pedagogical and practice considerations. Coursesdealing with oppression have emerged and the emphasis has beento encourage student and teacher to examine their own biasesand understand their ethnicity and culture while seeking todevelop a framework for sensitive practice. Issues relatingto power and subjugation are highlighted along with an understandingof history and present realities. Pedagogical and practice strugglesneed to be addressed on a consistent basis to ensure that theslippage towards a more didactic approach is not adopted inorder to avoid dealing with sensitive material and issues. This article represents a synthesis of my experiences of developinga half credit course on anti-discriminatory practice and teachingit over a period of five terms. The guidelines and approachesused for teaching this course include journals, reflective papers,coalition groups and small group discussions. These approachesare discussed, together with an examination of the locationand struggles of staff and students, and ongoing challengesto effect social knowledge production that is premised on ananti-discriminatory and anti-oppressive framework for practice.Excerpts from student journals, my observations, and feedbackfrom student evaluations are utilised to promote a criticalreflection of pedagogical and practice concerns necessary forsustaining an anti-oppression framework for social work practice. The ways in which groups, individuals, and ideas come to bemarginalized in a given culture, society, and/or place has muchto do with what is considered to be knowledge and who is consideredto possess it, who is perceived as knower and who is known (Edgerton,1993, p. 222). Curricula are revised but rarely transformed from the insideout (McGee, 1993, p. 281).     

Prior Agency Contact and Physical Abuse in Cases of Child Homicide

Correspondence to Ania Wilczynski: Faculty of Law, University of Sydney, 173–175 Phillip St, Sydney, NSW 2000, Australia Summary This article describes the features of child homicide offenders'previous contact with professional agencies and the incidenceof prior physical violence towards their victims. This is basedon an examination of 48 cases notified to the Director of PublicProsecutions in 1984 in which children had been killed by parentsor parent-substitutes in England and Wales. Professional agencieshad been involved with two-thirds of the offenders. Women'scontacts were usually with medical agencies, and men's withsocial agencies. Of those cases with prior agency contact, whilstalmost two-thirds involved a history of violence towards thechild, in only a third of the cases had the reason for agencycontact explicitly included concern about physical abuse. Infact, the most frequent reason for agency contact was concernabout the offender's mental health. Agencies had taken actionin two-thirds of the cases seen by them; this tended to be psychiatrictreatment for women and child protection measures for men. Aquarter of the offenders seen by professionals had been hostileto this intervention. The above findings run counter to thepopular stereotype (fostered by the child death inquiries) thatchild-killers will have had extensive contact with social agenciesand explicitly concerning physical abuse. Professionals needto be aware of more ‘subtle’ warning signals inidentifying potentially filicidal parents.     

Factors Predicting Admission of Elderly People to Local Authority Residential Care

Correspondence to Dr Ian Sinclair, Director of Research, National Institute for Social Work. Mary Ward House, 5–7 Tavistock Place, London WCIH 955 Summary Successful community care may partly depend on identifying thoseat risk of entering residential homes and targeting servicesto them. This article is concerned with how this identificationcan be achieved. It considers a sample of old people livingalone. in touch with home helps or social workers and followedup for between two and four years. The research examined thefactors likely to produce admission, and used discriminant analysisto predict it.     

Towards Accountability in Social Work: A Case Review System for Social Workers

Summary After discussing the huge undifferentiated tasks facing socialworkers in the social services departments, it is suggestedthat one of the most urgent research needs is the developmentof systematic record and review systems to provide basic informationabout social worker activities and their effects on differentclient groups. The development of a social worker oriented computerizedCase Review System in close collaboraation with a group of fieldworkersin an area office is described. The system enables social workersto evaluate and plan their work for individual clients; it canassist the process of supervision; as a management tool it cancontribute towards the planning of fieldwork services; as aninformation system it gives an on-going account of the size,nature and scope of social work activities with different clientgroups. So far the impact of the system has been to raise questionsabout practices and to encourage a climate favourable to change.     

The Role of Residential and Nursing Homes in the Last Year of People's Lives

Dr Ann Cartwright, Institute for Social Studies in Medical Care, 14 South Hill Park, London NW3 2SB. Summary Almost a quarter of a random sample of adults dying in 1987had spent at least part of the last year of their lives in aresidential or nursing home; one in eight spent all of thatyear in one. The old, the unmarried, those with difficulty lookingafter themselves, the confused, the incontinent, the blind,the deaf, and the bad tempered were more likely to be in suchhomes than others. With their greater dependency, people living in residentialhomes received rather more consultations and home visits—althoughnot night calls—from their general practitioners. Butthey did not get more help from community nurses and they wereless likely to be admitted to, or to die in, a hospital or hospice. According to the assesments of relatives, friends, and neighbourswho answered the questions, the quality of life of people whohad been in a residential home for a year or more before theirdeath was similar to that of others who died but had never beenin such a home. It was those who were admitted in the year beforethey died who were perceived as having a relatively poor qualityof life in that year. Increasingly, the quality of life duringthe year before death is going to depend on the attributes ofresidential homes and their staff.