Parton, Howe and Postmodernity: A Critical Comment on Mistaken Identity

Correspondence to Carole Smith, School of Social Work,, Department of Social Policy and Social Work, Dover Street Building, The University of Manchester, Oxford Road, Manchester M13 9PL Summary In their contributions to the debate about social work, modernityand postmodernity Parton(1994) and Howe (1994) argue that therecent changes in social work practice can best be understoodas features of, or responses to, the postmodern social orderin which it is located. This has led, they argue, to an increasingfragmentation of the profession and an undermining of its formalknowledge base. We will argue here that, not only does suchan argument oversimplify the nuances of the ‘postmodernity’question, but it represents a misreading of the pressures affectingpractice at this time, which are more properly attributableto the operation of the discourses and ideologies of a particularphase of late capitalism and high modernity.     

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.     

Accommodation and Employment: A Survey into the Circumstances and Expressed Needs of Users of Mental Health Services in a Northern Town

Correspondence to Barbara Hatfield, Mental Health Social Work Research and Staff Development Unit, University of Manchester, Department of Psychiatry, Mathematics, Tower, Oxford Road, Manchester M13 9PL. Summary A sample of 120 mental health service users in a Northern Townwas interviewed about satisfactions and expressed needs in arange of life domains. Most of the 120 users were male, in theolder age ranges, and not in current partnerships. Most hadservere and long-term conditions. Living situations includedhospital wards, hostels, a group home, living with family orfriends, and living alone. The domains of accommodation andemployment are discussed in this paper. The majority of peopleexpressed themselves as ‘satisfied’ with their accommodation,although a sizeable monority were not satisfied. Lack of choiceof alternatives emerged as an underlying feature of ‘expressedsatisfaction’. A sizeable group expressed the need forhelp in obtaining employment, particularly those living in thecommunity. It is argued that for consumer choice to have a realisticmeaning, people with severe mental illnesses need the experienceof choice from more than one alternative.     

The Probable Extent of Minor Mental Illness in the Adult Clients of Social Workers: A Research Note

Summary A small scale pilot study was conducted in two area teams andfour part-time GP attachment schemes to test the use of a psychiatricscreening instrument (GHQ28) and social assessments. The instrumentswere administered at case allocation and again at three months.Few clinical and social changes were observed in the short term.It was found that 27 out of 40 cases (68%) were identified bythe psychiatric screening instruments as probable cases of minordisorder, on both occasions, and that a further seven clientscould have had a transient disturbance. On the basis of theseresults it was felt that a larger two-stage enquiry was warranted,and necessary, before definite conclusions could be drawn.     

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 Care Programme Approach: Dimensions of Evaluation

Correspondence to Barbara Hatfield, Mental Health Social Work Research Unit, School of Psychiatry and Behavioural Sciences, University of Manchester, 12th Floor, Mathematics Building, Oxford Road, Manchester M13 9PL, UK. Summary The study examined the first six months of implementation ofthe Care Programme Approach (the CPA) at a psychiatric unitof a district general hospital. From an analysis of the researchliterature on case management, and from current policy, a frameworkwas developed which was used to analyse the implementation understudy. The framework included such features as: a keyworkeroffering a continuous relationship and co-ordinated care; assessmentand intervention over a range of ‘needs’; multidisciplinaryworking in the community; and involvement of user and carer.The objectives were to ensure continuity of care and reducehospital admission. The targeted service users were to be thosewith severe and enduring mental health problems. The study showsthat most of these features were achieved in the implementation,although there is no evidence that hospital admission was avoided.A number of factors were found to be associated with re-admission,and these are discussed in the light of the findings of otherstudies.     

Mental Health and the Asian Communities: A Local Survey

Correspondence to Barbara Hatfield, Lecturer in Psychiatric Social work, Department of Psychiatry, 12th Floor, Mathematics Building, Manchester University, Oxford Road, Manchester M13 9PL Summary The survey of people from the Asian communities in ‘Milltown’included people who used mental health services, family membersof service users, and members of the Asian general public. Personaland social stresses of the group were explored, as were theirperceptions of the ‘causes’ of mental ill-healthand appropriate responses. Although most people saw family andsocial stress as central, a religious dimension was also prominent,in terms both of causes and treatment of mental ill-health.There was no evidence of rejection of mainstream services becauseof a choice on the part of Asian families or communities tobe self-servicing. A range of issues identified by respondentssurrounded the cultural acceptability of services in ‘Milltown’to Asian people. A lack of knowledge of service availabilitywas also apparent, with a heavy reliance upon GP services formental health care in the community. The findings of the surveyare compared with similar studies, where available, which focuson indigenous white British service users. Some findings arecommon; other issues are specific to this Asian group.     

The Limits of Competence in Social Work: The Assessment of Marginal Students in Social Work Education

Summary Out of a population of 208 final year social work students,a sample is gathered of those whose fieldwork gave rise to commentby tutors. A further sample of 35 deemed to be ‘at risk’is identified, and the process by which all but four obtainedtheir Certificate of Qualification in Social Work is carefullymonitored. Among topics discussed are the need to define theprocess of assessment more clearly, the weakness of so-calledtheoretical foundations in social work practice, the risk ofmisunderstanding between fieldwork teachers (supervisors) andcourse tutors regarding their respective responsibility forjudging competence in practice, and the desirability of requiringstudents to demonstrate competence rather than expecting coursesto prove incompetence.     

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.     

The Treatment of Enuresis amongst Child Clients of a Social Services Department

Summary The adoption of an ‘outpatient’ model of supervisingthe treatment of bedwetting amongst child clients of a socialservices department is described. The treatment technique usedwas the generally effective ‘enuresis alarm’, or‘bell-and-pad’. Fifteen out of a total of 25 concludedcourses of treatment were successful, with an average treatmentduration of 14.9 weeks. Both this outcome, and the rate of drop-outbefore completion of treatment (ten cases) are comparable withthose obtained with non social services clients, and the useof the enuresis alarm with children in care (including thosein residential establishments) was found to be quite practicable.A high relapse rate (43%) was, however, found for social servicesclients, relapse usually following a placement change or othermajor stress.     

Anti-oppressive Social Work Practice with Women in Prison: Discursive Reconstructions and Alternative Practices

Correspondence to Shoshana Pollack, Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada N2L 3C5. E-mail: spollack{at}wlu.ca Summary An anti-oppressive practice (AOP) framework emphasizes issuesof power and oppression within the provision of social workservices themselves as well as within the lives of clients whohave been marginalized and oppressed (Preston-Shoot, 1995; Garciaand Melendez, 1997). AOP seeks to deindividualize clients’problems in order to see them within the wider social contextof their lives. In addition, this framework attempts to moveaway from an ‘expert’ model of service deliverytowards one that is more inclusive of clients’ experiencesand that incorporates a recognition of coping and resistenceto oppression. In this paper I discuss how an AOP frameworkcan contribute to our understanding of and interventions withwomen in prison. In particular, I will focus upon how we canbetter understand and respond to women’s mental healthissues and the experience of imprisonment. Peer support servicesare examined as an example of AOP programming for women in prison.     

The Significance of Past Abuse to Current Intervention Strategies with Depressed Mothers in Child and Family Care

Correspondence to Professor Michael Sheppard, Department of Social Policy and Social Work, University of Plymouth, Drake Circus, Plymouth, Devon, PL6 7EW, UK. Summary There is now considerable evidence that a high proportion offamilies subject to child and family care social work interventioncontain depressed mothers. There is also evidence that the presenceof clinical depression is associated, amongst these clients,with child abuse. Vulnerability to both depression and childabuse have been traced back to the early child-care experiencesof those who are currently parents, expressed in child abusein terms of intergenerational transmission, although it is alsoclear for both that further factors also contribute to thisvulnerability. Despite the link between maternal depressionand child abuse, we have little evidence about the processesand mechanisms, based on social workers judgements about thesituation, by which families with depressed mothers are morelikely than other clients to be involved with intervention forchild abuse. This paper seeks to ‘map’ the pathwaysand the intermediate mechanisms which provide the link betweenthe experience of past abuse and social workers interventionstrategies. Drawing on theoretically significant factors, itfocuses on the following variables: the experience of past abuse,the mother's attributed character, attachment and bonding, childbehavioural problems and intervention strategy. The paper demonstratesa number of significant ‘paths’ through which familiesbecome subject to one or other intervention strategy. It showsthat, while an emphasis on needs assessment is to be welcomed(Department of Health, 1999), they need to be considered (i)within a theoretical framework which helps social workers makesense of, and respond to situations and (ii) through an understandingof longitudinal dimensions (key factors in mothers' earlierlife) which are aspects of this theoretical understanding.     

Euthanasia: Israeli Social Workers' Experiences, Attitudes and Meanings

Correspondence to Dr Ronit D. Leichtentritt, Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel. E-mail: ronitl{at}post.tau.ac.il Summary Sixteen social workers in Israel were interviewed about theirexperiences with and attitudes towards various forms of euthanasia,as well as the meanings they ascribe to them. Using phenomenologicalanalysis, seven themes were identified, emphasizing individual,interpersonal, organizational, social and therapeutic considerations,and suggesting a holistic and integrative structure of the phenomenon.The themes were arrived at by identifying distinctions and similaritiesbetween different forms of euthanasia. Two themes suggestingsimilarities were revealed: ‘diminishing the value oflife’ and ‘a call for help’. Three themeswere found to distinguish between passive euthanasia (withholdingand withdrawing life-sustaining treatment) and active forms(active euthanasia and assisted suicide): ‘legality’,‘social acceptance’ and ‘concern for the sickand dying’. The last two themes distinguished betweenwithholding treatment and assisted suicide, on the one hand,and withdrawing treatment and active euthanasia, on the other:‘the involvement of others as executor’ and ‘thepublicity of the act’. Further research and training isrequired to better inform social workers in this ethical area.Given their unique position, social workers should activelyparticipate in legal, social and therapeutic discussions concerningend-of-life decisions, for the benefit of clients, their familiesand health-care providers.     

Reforming Professional Training and Protecting Vulnerable Adults from Abuse: A Thematic Analysis of the New Social Work Degree's Prescribed Curriculum

Correspondence to Phil Slater, School of Health and Social Sciences, Middlesex University, Queensway, Enfield EN3 4SF, UK. E-mail: p.slater{at}mdx.ac.uk Summary This paper analyses the Prescribed Curriculum of the new Degreein Social Work in relation to the Department of Health themeof ‘protecting vulnerable adults from abuse’. Areview of post-war social policy first establishes the significanceof these terms, both individually and in varying combinations.Subsequently, the phrase as a whole provides the focus for acontent analysis of the three constituents of the PrescribedCurriculum, namely, the Secretary of State’s Requirementsfor Social Work Training, the employment-focussed National OccupationalStandards for Social Work, and the academically oriented BenchmarkStatement for Social Work. With the exception of ‘abuse’,the key terms are all registered, albeit unevenly. This presenceis subsequently enhanced via strategic considerations of ‘logicalimportance’ and ‘organising rubrics’. Finally,terminological variants of ‘abuse’ are traced, withparticular regard to the emerging language of ‘rights’.     

Social Work as Uncommon Sense

Summary Social work needs to resist pressures to identify itself solelyat a superficial level of common sense responses to social problems.It has to go beyond this to recognize its use of ‘uncommonsense’ as the means by which social workers cross therelationship gap and respond to their client's needs. The importanceof doing this in the early stages of relationship, as in crisisintervention, are considered, and stress is placed on holdingtogether both the explicit task-related aspect of the relationship,and the less obvious emotional interchange. By means of theiruncommon sense, social workers are enabled to reflect for, andshare with clients their areas of pain, in such a way as torender them more tolerable.     

A Profile of Adult Placement Carers

Correspondence to Andrew Gage, Manchester City Council Social Services Department, Adult Homefinding Team, Fenham, 5 Moorfield Road, West Didsbury, Manchester M20 8UZ. Summary This study examines the social and personal characteristicsof the people providing support in their own homes (adult fostering)to people with severe learning disabilities. Comparisons aremade with the general population on social and personal areas.A typical carer is identified and the results lead into issuescurrently affecting carers. Links are drawn between carer characteristicsand service user quality of life which require further study.     

Understanding 'Going Missing': issues for social work and social services

Correspondence to Malcolm Payne, Professor of Applied Community Studies, The Manchester Metropolitan University, 799 Wilmslow Road, Didsbury, Manchester M20 8RR. Summary Recent research about young people and adults who ‘gomissing’ raises important issues for social work and thesocial services. Large numbers of young people go missing eachyear, becoming vulnerable to exploitation and at risk of committingcrime and suffering from other social difficulties. Adults leavebehind families with practical and emotional difficulties. Adefinition of ‘going missing’ should focus on absencefrom social expectations and responsibilities. Five groups ofmissing person are identified: runaways, pushaways, throwaways,fallaways and takeaways, reflecting different social situationsin which going missing occurs. It is argued that going missingis one of a range of choices which people in difficulties maymake, depending on their approach to problems in their livesand the availability of opportunities. Effective local co-ordinationto focus on reasons for going missing, on reunions and returnsto residential care or home, and to provide emotional and practicalhelp to people ‘left behind’, are required, providedthat care is taken to protect people who go missing becausethey are subject to abuse and violence.     

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.     

The Psychiatrization of Post-Traumatic Distress: Issues for Social Workers

¹Howard Davis, Centre for Studies in Crime and Social Justice, Edge Hill, St Helens Road, Ormskirk, Lancashire L39 4QP, UK. Summary The psychiatric category of post-traumatic stress disorder (PTSD)is described and critiqued. Problems of definition and applicationmay lead to the non-inclusion or minimization of some formsof post-traumatic distress. Questions of what constitute ‘healthy’and ‘unhealthy’ reactions to trauma are raised andthe depoliticization of trauma explored. The absence from theliterature of sufficient acknowledgement of traumagenic actionson the part of official agencies is noted. The potential forcritically informed social work interventions in prevention,mitigation and longer-term response is outlined.     

Psychological Distress in Staff of a Social Services District Office: A Pilot Study

Correspondence to High Winnard, Church Road, Bishopsteignton, Devon TQ14 9QH, UK Summary This comparison study of fieldworkers and administrative workersin a social services district office addressed three researchquestions. Would fieldworkers show more internality and wouldthey perceive higher job demands than administrative workers,and would there be a positive relationship between perceivedstress and perceived job demands for all workers? The GeneralHealth Questionnaire 28 was administered, in addition to a jobdemand inventory. Self-reported absenteeism due to illness wasconsidered, and locus of control was considered as a moderatorof stress, as were years of service, age, and whether the employeeworked part- or full-time. Because fieldworkers might generallybe thought to be under more stress due to their work contentthan their support staff, data from fieldworkers were comparedwith those from administrators. Gender differences were alsosought. Statistical tests showed no significant differencesfor gender or between the administrative staff and fieldworkstaff for internality or job demand. A positive relationshipwas evident between perceived stress and perceived job demandwith a correlation of 0–40 (p <0·05). In addition,over 72 per cent of the sample scored above the cut-off pointon the GHQ 28 indicating psychiatric morbidity. The implicationsof the results are discussed.