Child Abuse, Social Anxiety and Welfare

Summary This article attempts to locate the ‘moral panic’concerning child abuse within the context of broader changesin the material conditions and ideological forces in Britainin the early 1970s. It argues that the development of a senseof social anxiety amongst certain sections of the populationand the appeal of the New Right were crucial in the processof establishing the problem as the major issue for social workers.As a consequence social workers have been constrained into amore punitive and interventive relationship with children andfamilies, particularly the poor. The analysis illustrates thatthe way social workers experience role conflict and tensionin this area of their work reflects much wider historical andcultural confusions and contradictions.     

Theory and Practice in Social Work: A Re-examination of a Tenuous Relationship

Summary This article discusses the need for an agreed framework withinwhich a genuinely reciprocal relationship between social worktheory and practice could be developed. After pointing out theinconsistencies of the present relationship, the author goeson to conclude that three main obstacles stand in the way ofthe achievement of this goal. He cites firstly, the presentdesign of the social work curriculum, with particular referenceto the underlying principle of eclecticism; secondly, the negativeattitudes held by many in the profession towards science asa means of evaluating competing concepts; and thirdly, the lackof an acceptably rigorous field work evaluation procedure whichsocial workers could use to register their impact on the morenebulous aspects of their work. Suggestions are made as to howthese obstacles might be overcome.     

Attitudes of Medical School Workers Towards Reorganization

Summary This paper arises from a four-year project funded by the Departmentof Health and Social Security, concerning the social needs ofthe physically sick—a study of some aspects of the socialneeds of the physically sick and of the services designed tomeet needs. The present focus is on social work services andin this part of the project a development study has been undertakenand postal questionnaires have been sent (a) to all medicalsocial workers employed in the Hospital Service and in localauthority Health and Welfare Departments, and (b) to all otherhospital social workers engaged in helping the phsically sickand handicapped persons. In addition, a Survey is being carriedout through records of 9,000 admissions to a number of hospitalsto see how many of these patients are referred to the hospitalSocial Work Departments in a nine-month period, at what stagein their hospital careers they are referred, etc. A Survey is being carried out in four hospitals using a randomsample of patients and another sample referred for social workhelp. These patients are being interviewed in hospital and afterdischarge to see what kind of problems are encountered in hospitaland after discharge and what services are provided. Interviewswith medical, nursing, administrative and social work stabstractand included in this survey. The overall objectives of the Survey are to study needs andservices and to indicate how closely services respond to needs.     

Cognitive-Behavioural Social Work with Children

Correspondence to: Dr Tammie Ronen, The Bob Shapell School of Social Work, Tel-Aviv University, Ramat-Aviv, Tel-Aviv 69978, Israel Summary The paper aims to explore the complex and important links betweeninterventions with children, cognitive therapy, and social work.Although children comprise about half of the referrals to socialwork services, they do not generally receive direct treatmentin these settings. Social workers are involved with childrenin the roles of mediator or counsellor and as the supervisorwho is concerned with the placement of the child in appropriatesettings. When the need for direct therapeutic interventionarises, children are usually referred to educational or clinicalpsychologists. Social work as a profession has been foundedupon a psychodynamic approach; however, social workers havealways been concerned with effective treatments, the definitionof clear goals, and the clarification of client needs. Thesefeatures link social work to cognitive-behavioural therapy.Cognitive therapy, although not frequently used with children,is presented in this paper as a means for conducting directinterventions with children which fulfil social work's basictargets and needs.     

Implementing Care Management: Issues in Relation to the New Community Care

Correspondence to Professor Jane Lewis, All Souls College, Oxford OX1 4AL Summary The official guidance on the new policy of community care emphasizedcare management as the means of securing needs-led services,together with user empowerment and choice. This paper uses datafrom eighteen months intensive fieldwork in five local authorities,first, to examine the very different interpretations of caremanagement in these authorities; secondly, to examine two majorsources of difficulty in the implementation of care managementsystems—the simultaneous development of purchaser/providersplits, and the tension between needs and resources—and,finally, to draw some conclusions about the implications ofcare management for social workers.     

Risk and Supervision: Social Work Responses to Referred User Problems

Correspondence to Peter Burke, Department of Social Work, University of Hull, Hull HU6 7RX Summary This study examines social work responses to users followingcase allocation of the initial referral. The aim of the studyis to demonstrate the need for supervision of social workersdealing with cases which have in common an inherent quality,described as ‘risk’. The study also links referralsto other practice responses identified as ‘service delivery’and ‘advisory’ work. The relationship between theseparticular responses is tested against the outcome decisionreached on case closure. All referrals were allocated betweentwo fieldwork teams over a one-year period and a total of 312referred cases was allocated within the categories mentioned.Findings are indicative that more ‘risk’ type referrals,however defined, are resolved with additional supervisory inputthan without, and that lower status workers favoured ‘middleground’ decisions of outcome when compared to their seniorcolleagues. A consideration resulting from this research isthat agency definitions of risk are different to the type ofrisk which requires crisis intervention. The question of riskto the user or to the agency requires the workers concernedto be able to discriminate between such cases. The implicationfor team training is that supervisory input should clarify thenature of risk, if any, and the task required of the workerfollowing case referral. The matching of skills which wouldultimately be the objective of this type of research cannotbe finally determined until a more comprehensive set of parametersfor practice is identified. This study shows that the responsecategories used demonstrate some basic supervisory needs ofthe worker.     

Ambiguities in Decision Making: Social Work's Response to 'Glue-Sniffing' in Scotland

Correspondence to Dr Elizabeth Jagger, Social Science Department, Park Campus, 1, Park Drive, Caledonian University, Glasgow G3 6LP Summary This paper examines how social workers make decisions aboutwhich cases of ‘glue-sniffing’ require intervention,in the context of a government policy which construes the problemprimarily within the arena of parental responsibility. Usingdata from interviews with social workers and research on ‘glue-sniffing’,it shows that social workers were frequently reluctant to dealwith cases. It explains that this has to do with factors suchas organizational priorities, lack of resources and, in particular,the ambiguous status of ‘glue-sniffing’ within theirown professional discourse. It concludes that the complex interplayof these factors means that government policy is not translatedinto practice in any simplistic manner.     

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.     

Problems in the Perinatal Prediction of Child Abuse

Summary The aim of this paper is to consider and comment criticallyupon the recommendation by some eminent authorities that effortsbe made to design and implement procedures to predict the abuseof children. My view is that this move toward prediction—‘sponsored’largely by American paediatricians—is less of a new departurethan an extension of the dominant conceptual tradition wherebychild abuse is seen as analogous to a disease. However, in spiteof its basis in a medical model, it is clear that the idea thatthe abuse of children can be accurately predicted has greatappeal for many social workers. I shall argue, however, thatserious obstacles stand in the way of prediction; that theseobstacles are insufficiently appreciated by the advocates ofprediction; and that—consequently—social workers(and others) should temper with scepticism their enthusiasmfor these developments.     

Feminism and Social work: Resistance or Dialogue?

Summary This paper seeks to explore some of the factors underpinningsocial work's apparent resistance to feminism and to dilineateways in which a more active relationship might benefit socialwork's women consumers. It argues that, by marginalizing feminism,social work has perpetuated individualistic explanations andresponses to women's specific needs and problems. Finally, insuggesting some practical strategies for making use of feministideas and experiences, particular consideration is given tosome of the contradictions which may be engendered for thosesocial workers who are actively endeavouring to integrate feministperspectives into their practice.     

From Hollis to the Orange Book: Developing a Holistic Model of Social Work Assessment in the 1990s

Correspondence to Margaret Lloyd, School of Social Work, University of Manchester, Dover Street, Manchester M13 9PL. Summary Amidst questioning of its essential identity, social work iscurrently developing new procedures and training programmesin assessment, traditionally one of its core activities. Thedemand for this redevelopment has been created by the changingprofessional climate in both probation and social work practice,in particular the response to legislative changes such as theNational Health Service and Community Care Act 1990. This paperexamines the established model of social work assessment inhistorical context and identifies its shortcomings for practicein the 1990s. It argues that despite the apparently diverserange of assessment tasks now undertaken by social workers andprobation officers, there remains an identifiable, common setof skills. Moreover, unless social work anchors these assessmentskills in a conceptual framework, retaining a sense of its ownhistory, the essential character of social work assessment willbe lost amidst mechanistic procedures and competing philosophies.This paper suggests a typology for making sense of the rangeof assessment tasks in current practice, arguing that this mustbe rooted in a holistic theoretical and philosophical model.The term ‘social work’ is used in its generic senseto include probation practice.     

Welfare, Society and the Social Worker

Summary This article attempts to locate some common stereotyped transactionsbetween social workers and their clients as elements in theproduction of distinctive welfare identities. By comparing thisprocess to that of a rite of passage, the client is found tobe like a ritual subject frozen in the moment of transitionbetween social categories and thereby denied a place in society.An opposition is accordingly presumed to exist between Welfareand Society. The matrix of stereotyped expectations which derivesfrom this opposition is shown often to intrude on the relationshipbetween social worker and client, constituting a pressure toresolve the tensions produced by anomaly through the impositionof a welfare identity on the client. In this respect, the specialvulnerability of marginal groups is noted and a brief discussionthen follows of the characteristic qualities of ascribed welfareidentity. Through Welfare, Society is found to displace imaginativelyits sense of entropy beyond the moral community. But the essentiallink between Welfare and Society remains and increasing socialdisorder brings the paradoxical feature of this strategy tothe fore. The preservation of the social order requires increasingconcentrations of entropy to be symbolically located in Welfareand as a result Welfare comes to take on the aspect of a threateningand subversive entity. In conclusion, it is suggested that behindthe apparent ‘crisis’ in social work lies a crisisin the management of social entropy.     

The assessment relationship: interactions between social workers and parents in child protection assessments

Summary This paper is concerned with a relatively unresearched areaof child protection practice: the comprehensive assessment.The study comprises qualitative research of social workers conductingthese assessments. Sixteen assessments are analysed in detail.It is noted that these assessments, like many other in-depthsocial work assessments, are mainly based on verbal interactions.Some of the core evidence cited by social workers as formingthe basis of their assessment decisions is based on verbal interactionbetween social workers and parents. Such verbal interactionsare viewed as being inextricably intertwined with the socialworker-client relationship. A particular aspect of the relationship,the ability to agree a plausible explanation for the familysituation, is highlighted as particularly important in determiningthe outcome of the assessment. The possible implications ofthese findings for assessment practices are outlined.     

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.     

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.     

'Low Key Practices' in Social Work. Towards a Socio-historical Method

Summary In this article a ‘socio-historical’ method of analysisand intervention in social work will be developed, illustratedby an example drawn from social work with families, the programknown in France as Action Educative en Milieu Ouvert. Our purposeis to support and encourage what we call ‘low key practices’,which refers to practices in which social workers within theexisting structures of so-called ‘individual social work’attempt to explain the social struggle taking place in the situationsthey are dealing with.     

Constructing social work identity based on the reflexive self

Summary In this article, the social work identity is conceptualizedbased on concepts of the self (Benjamin, 1995; Foucault, 1988),rather than concepts associated with ego psychology. Socialwork students, teachers and practitioners have historicallyattempted to gain a sense of ego mastery and control by theacquisition of theory to enhance skill-based practice expertise(Austin, 1952; Zetzel, 1953; Bandler, 1960; Memmot and Brennan,1998). In so doing, they have attempted to manage anxiety asa means to enhance learning. Traditional social work functionssuch as acceptance, non-judgemental attitudes, and empathy (Biestek,1957; Woods and Hollis, 1990) have been utilized to encouragepractitioners to manage their feelings related to difference.We argue, however, that the social work identity is enrichedwhen social workers allow their selves to be in a state of disassemblyin the presence of the other (Smith, 1997). When social workersexperience their selves as complex and dialogical, they aremore open to the influence of the other (Bakhtin, 1993). Wemake the case for practitioners to work on a reflexive selfrather than attempting to achieve ego control through the managementof anxiety.     

The Supervision of Child Protection Work

Correspondence to Alan Rushton, Course Director, M.Sc. in Mental Health Social Work, Social Work Department, The Maudsley Hospital, 101 Denmark Hill, London, SE5 8AZ, UK Summary It has frequently been recommended that statutory child protectionservices in Great Britain need greater provision of specialistsupervision to support front line social workers. This qualitativestudy, based in social services departments in London, usedthe focus group method to explore the provision of supervisionby team managers in a very pressurized work environment. Thestudy highlights the difficulty of protecting adequate supervisiontime but shows how supervisors can use their skills to conductcase related discussion concerned with developing professionalskills. ‘Inquisitorial’ and ‘empathic-containing’functions are identified and an approach is proposed for combiningthem in training courses for child protection supervisors. Thepaper recommends that supervision training needs to be expanded,to be more precisely targeted, and that outcomes need to berigorously and appropriately assessed.     

The Social Environment--A Model for Exploring Service Interventions with Mentally Handicapped Adults

Summary Using a model derived from systems theory, the needs of mentallyhandicapped adults are examined. Interventions are generatedwhich have implications for social workers in implementing normalizationprinciples.