Reconciling Cash and Care: Home Care Charges and Benefit Checks in Social Services

Correspondence to Pete Alcock, Health and Community Studies, Sheffield Hallam University, Collegiate Cresent, Sheffield S10 2BP Summary This article contains the report of a small research projecton the development of welfare rights checks for home care clientsin social services departments. Welfare rights take-up activityhas become an important feature of provision by local authoritysocial services departments, frequently targeted on particulargroups of clients known to experience problems in claiming fullbenefit entitlement. Users of home care services are such aclient group. Take-up work with home care clients is also, however,a product of the impact of community care policy changes andof financial pressures on local authority social services. Thesehave resulted in the introduction of charges for home care servicesby many authorities, and the use of rebates from such chargesto protect low income service users. Welfare rights work hasthus become an important feature of the reconciliation of thesenew charging policies with the continued service needs of poorhome care clients. The research examined a successful take-upinitiative, linked to home care charges, in Sheffield and contrastedthis with similar activities in other authorities throughoutthe UK. The conclusion is reached that levels of non-take-upof social security benefits are particularly low amongst homecare clients and that benefit checks can secure significantadditional income for them, which may also have the indirecteffect of increasing the income to social services departmentsfrom the charges for home care services.     

Client-oriented Quality Assessment within Municipal Social Services

The hypothesis of this article is that quality assessment, despite the fact that it has now become a part of social services, has largely occurred without taking clients into consideration. There are supposed to be at least three possible explanations for this: organizational structures and professionalism, the difficulty in defining client needs, and the opinion that a client is not an equal companion in social service organizations. The research method entailed a questionnaire which was sent to 60 managers working within municipal social administration during the periods of construction (1950–1965), supplementation (1966–1983) and reform and redistribution (1984 onwards) of the Finnish welfare state and a questionnaire for 146 public social welfare organizations in Finland. Fewer than 30% of the social managers of the construction (1950–1965) and supplementation (1966–1983) periods and fewer than 50% of the managers of the last period (1984 onwards) said that clients really had assessed quality. The needs of clients and client feedback were said to be important during all three periods but the managers did not include them in the most important tasks. The managers of the period of supplementation did this the least. The managers from the period of reform and redistribution (1984 onwards) were more likely to trust the ability of clients to assess quality of social services and they also gave more opportunities to do so. The most important reasons for neglecting client needs and feedback in quality assessment were organizational structures and difficulties in defining client needs. There also seem to have been some methodological difficulties in assessing social services. Statistics are still largely in use and concrete criteria related to quality are missing. More specific questionnaires, cross-experimental designs and interviews, more possibilities for clients to describe needs in their own words, and the specification of general concepts in more concrete terms of quality are needed in order to avoid abstract and general assessments.     

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.     

Ethical Assessment of the Use of Influence in Adult Protective Services

The role of influence in social work practice has been generally understated despite its importance to the course and outcome of the clinical process. This paper examines the influence strategies used by adult protective service workers with clients who refuse the services that the workers think the clients need for their own protection. It then discusses the moral justifications provided by the workers for using influence to overcome their clients' reluctance to comply with their recommendations. Finally it suggests questions to guide an ethical assessment of the use of influence in practice.     

Advocacy and Social Action: Key Elements in the Structural Approach to Direct Practice in Social Work

The structural approach to direct practice in social work assumes that opportunities and resources are unequally distributed and that members of deprived and vulnerable populations are social victims. Thus, the basic thrust of the social worker is to change oppressive situations instead of the people trapped in them. Disenfranchised, powerless, and oppressed people need a fairer share of basic economic and social goods. This makes advocacy a key practice role involving both work with groups of clients and with others who can make things happen for clients. The paper describes and illustrates instances of advocacy as the structurally oriented social worker applies six basic principles to help meet the needs of clients.     

Social Work and Self-determination

Correspondence to Department of Political Science and Social Policy, University of Dundee, Dundee DD1 4HN. Summary Self-determination is a curious concept, related to, but notquite the same as, freedom and autonomy. As an ethical principle,the principle of self-determination bears little relationshipto the way social workers behave. It is used as if clients werebeing allowed a free, independent choice; but clients are subjectto pressure, and the social work relationship is often conceivedwithin a structure of authority. As a guide to practice, theconcept of self-determination ignores the cases where directionis legitimate or desirable. Self-determination can be seen as a professional ideology—aninter-related set of values and ideas. The concept is derivedfrom a number of ideas and values outside social work, but itappears to have little direct relevance to social work in practice.The paper suggests that the concept of freedom may be more usefuland less remote from the realities than ‘self-detemination’is.     

Bilingual Social Workers in Mental Health Service Provision: Cultural Competence,Language, and Work Experience

Many agencies actively recruit bilingual social workers. This study presents the reactions of 10 Chinese bilingual social workers to the expectations and demands of their agencies. The study employed a qualitative design with a phenomenological approach. The participants’ responses provide insight into how they manage ethnic and cultural mental health issues in Chinese populations. This study aims to improve social service delivery for clients with limited English proficiency by identifying effective, culturally competent services. The findings suggest that when hiring bilingual social workers, it is just as important for them to be culturally competent as it is for them to be an ethnic or language match with the client base. Having all of these qualities will result in staff members who can provide more effective services by making accurate diagnoses and identifying appropriate treatment plans. In addition to employing bilingual social workers, it is important to maintain good supervision as this will allow supervisees to have a unique perspective on what is involved in providing effective delivery of services to clients with limited English proficiency. Implications for research, practice, and policy are discussed.     

Social workers' perceptions of their power and service outcomes

While social workers are becoming increasingly interested in methods of client empowerment, little attention has yet focused on the links between workers' own power and the services they provide to clients. The authors examine the link between workers' perceptions of their power on the job and perceived service outcomes. Bivariate and multivariate analyses were conducted on survey responses from 591 direct practice social workers in Israel. Results indicate that power perceptions are significantly associated with an array of perceived service outcomes. These findings highlight the relevance of self-efficacy and control theory in understanding social workers' efforts toward effective service delivery. Further, they underscore a need to consider more carefully direct practitioners' own power concerns as they increasingly consider empowerment of their clients.     

Does Anything Work?

This paper reviews the results of effectiveness research in five areas of professional practice: social work, psychotherapy and counseling, corrections, psychiatric hospitalization, and education. In all these areas the research indicates that, at best, professionals are operating with little or no empirical evidence validating their efforts, since lack of effectiveness was the rule rather than the exception. In addition, a pattern of deterioration was found in which clients of professionals frequently were found to do less well than people with similar problems who received no professional services whatsoever. Some hypotheses are presented that may account for this situation, and a number of suggestions are offered for enhancing the effectiveness of professionals in all five areas. To the extent that professionals are unable or unwilling to make substantial changes in their practice, the paper concludes that such changes may be imposed from outside the professions in the form of governmentally mandated standards and regulations.     

Cooperation between social security and employment services: Evaluation of a reform strategy in the Netherlands

Since the early 1990s in the Netherlands a process of restructuring social security has been going on. A central element is the introduction of regional Centres of Work and Income, stimulating people living on benefits to return to paid work and making services more client–oriented. In these centres, social security organizations and employment services are supposed to cooperate. In practice this cooperation is hard to accomplish. The intended activation of clients is hardly realized. The problems encountered by this policy are characteristic of a top–down reform strategy in a corporatist welfare state like the Netherlands.     

The Influence of Professional Identity and the Private Practice Environment: Attitudes of Clinical Social Workers Toward Addressing the Social Support Needs of Clients

This study uses focus groups and follow-up interviews to explore how clinical social workers in private practice settings address the social support needs of their clients. Findings indicate that the social workers understand the importance of addressing these needs; however, because of concerns about status, identity and reimbursement, they tend to avoid case-management-like tasks despite their intrinsic understanding of the social support value of these services. Recommendations for practice follow the discussion of these findings.     

The continuing relevance of casework ideas to long-term child protection work

This paper is a personal reflection on how casework ideas have informed my own practice. Traditional social work is under threat. Casework, which was once a core method of working in social work, is particularly vulnerable because it has become a private, personal activity that is often misunderstood. It still has its followers but it is hard to find any modern accounts of casework practice. This paper attempts to remedy this by describing the application of casework ideas to work with families following registration of a child on the child protection register. The casework approach is described and illustrated using two case examples. This shows that casework with involuntary clients remains an important method of working but there are inherent constraints within the statutory role which limit what social workers can achieve in terms of therapy or in tackling poverty and inequality. This is followed by a discussion of contemporary social work practice and ideas for ways forward.     

Concepts of Risk in Relation to Organizational Structure and Functioning within the Personal Social Services and Probation

The main argument of this paper is that personal social services, including probation, at both a policy and practice level are increasingly focused on issues of risk. We postulate that risk assessment, risk management, the monitoring of risk and risk-taking itself are rapidly becoming the dominant raison d'être of such agencies, thus supplanting ideologies of meeting need or welfare provision. In turn they have become key to priority setting and rationing, the basis for organizational rationales and structures, the central focus for professional activity and accountability, and measuring quality. Thus an analysis of risk as an organizing principle offers fundamental insights into the rapidly changing nature and organization of statutory social work and probation. There is very little literature that focuses on risk across the spectrum of services. Risk analysis, as such, is most developed in the criminal justice and child protection fields. However, the mental health literature, being centrally preoccupied with notions of dangerousness, is quickly adopting risk terminology. Apart from work on elder abuse, literature on child welfare and community care has been framed in terms of need, issues of risk only coming to the fore around potential admission to residential care. We contend that as issues of rationing and accountability become more dominant, so do concerns with risk. Thus we predict the extension of notions of risk as central organizing principles throughout the social services and probation.     

社会工作实务效果优化的路径探讨与分析

在社会工作实务过程中,实务效果的最大优化是一个基本而关键的主题。为了更有效的帮助服务对象,使服务对象从问题中走出来,让自己的日常生活达到一种和谐的状态,运用具体的案例和实务经验,分别从服务理念转变、服务介入、服务进展以及服务维持等四个维度来分析了如何优化辅导服务,达到良好的辅导效果。     

Risk, Mental Disorder and Social Work Practice: A Gendered Landscape

Whilst the importance of gender for social work practice, riskand mental health has been recognized theoretically for sometime, few attempts have been made to explore this area empirically.This paper presents findings from a mixed-methods study of socialwork practice in relation to mental health service users perceivedto be ‘high-risk’. Findings suggest, first, thatthe concept ‘high-risk’ was gendered because theprimary focus in social work practice was on the risks posedby male service users to others. Second, female social workersin the present study were found to have more female serviceusers from their caseloads who had been defined as ‘high-risk’compared with their male counterparts. The paper goes on toexplore this apparent congruence between female social workersand female service users and highlights how the management ofrisk could be considered gendered because it reflects a worker’s(perceived) capacity in cultural terms to ‘decode’the nature of the risks that their clients face as genderedsubjects. The paper demonstrates how the intersections betweenrisk, mental disorder and social work practice can thereforebe understood as a gendered landscape. It concludes by highlightingthe implications of these findings for social work practiceand research.     

Voices From the Front Line: State Social Workers and New Labour

Summary The article explores the condition of state social work in Englandtoday. It is based on interviews with experienced social workersemployed by local authority social services departments acrossthe north of England. These front line state social workersprovide a penetrating insight into the diverse ways in whichtheir work has been transformed and degraded and the mannerin which the needs of clients have been largely ignored. Fromtheir perspective, the election of a Labour government in 1997proved to be a massive disappointment and many social workersreported that it has further undermined state social work practice,workers and clients. The paper seeks to offer an explanationby noting the neo-liberalism of Labour's social policy and thedire consequences which flow from New Labour's fixation withwaged work as the principal solution to social exclusion andpoverty. Above all, it seeks to provide an opportunity for theviews of front-line state social workers to be heard.     

Social Work and Child-centred Family Court Mediation

Correspondence to Dr Greg Mantle, APU, Ashby House, Floor 2, Brook Street, Chelmsford CM1 1UH, UK. E-mail G.J.Mantle{at}apu.ac.uk Summary In April 2001, the Children and Family Court Advisory SupportService (CAFCASS) became responsible for family court work,including the provision of mediation services. Family courtmediation offers a gateway for social work with children andfamilies whose needs are largely left untouched by current services,and could thereby play an important part within the broaderextension of prevention, early intervention, parenting and supportservices recommended by government. Over the past two decades,mediation has become a popular approach to reducing conflictand resolving disputes in a wide range of inter-personal, communityand organizational settings. Given the professional interestthat social workers have in helping their clients achieve moreharmonious lives, the space for mediation would appear considerableand yet the connections between mediation and social work are,as yet, insufficiently mapped and analysed, in terms of boththeory and practice. This paper draws on literature and recentresearch to review the relationship between family court mediationand social work.     

Double jeopardy: the link between child abuse and maternal depression in child and family social work

The link between child care and mental health problems in social work clients has begun to attract some attention. Despite some review articles, research is, as yet, at a very early stage of development. Maternal depression and child care problems in particular appear likely to be closely associated. This paper focuses on the link between maternal depression and the most severe of child care problems: child abuse. The paper shows a significant relationship between maternal depression and child abuse. It explores this relationship by distinguishing three groups: families where no abuse had occurred (non abuse families), families where abuse had occurred but where the mother was not depressed (non depressed-abuse group) and families where both child abuse and maternal depression were present (depressed-abuse group). The depressed-abuse group are shown to be considerably worse off than both the other groups for a range of measures, including indices of deprivation and range and severity of social problems. The depressed-abuse group were also more chronic users of services and consumed far more resources than the other two groups. Remarkably, there were few differences between the non abuse group and the non depressed abuse group in nature and severity of problems and intervention. Depression in mothers, then, provides the major distinction between families where abuse was an issue compared with families where abuse was not present. Such families are characterized not simply by maternal depression and child abuse, but frequently by abuse of the mother herself, who is often socially isolated. These findings are of major importance for child care practice, indicating that working with the mother's depression and the social conditions that provide its backdrop, are a major aspect of social work practice.