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.     

Poetry Can Help: The Work of Kenneth Koch

Summary Living in an institution at the end of one's life can be a verysad and drab affair—even soul-destroying. This articlelooks at an experiment by a poet in teaching poetry writingto a group of people in a nursing home who were old and ill.The poet shows how poetry made them happier and gave them alively interest and sense of achievement in doing somethingthey had never done before, enabling them to look at the thingsaround them with fresh eyes. He believes that poetry is an artform that many kinds of people can learn to enjoy and practiseindividually and in a group, opening up as it does a world ofdelight previously unimagined.     

Social Work with Failure-to-Thrive Children and their Families: Part I: Psychosocial Factors

Summary The problem failure-to-thrive is described and a brief reviewof the main causal theories is provided. Part I of this studydetails an investigation of psychosocial factors associatedwith non-organic failure-to-thrive in 17 children (comparingthem with two contrast groups). There were significant differences between the groups (interalia) in the adverse temperamental attributes of the index children,problems in the mother's feeding of their children and otheraspects of their interactions and relationships. The mothersshowed no specific psychopathology but were socially disadvantagedin various ways. The implications of these findings—preventiveand therapeutic—are discussed.     

The Characteristics of Children with a Disability Looked After away from Home and their Future Service Needs

Correspondence to Professor Roy McConkey, School of Nursing, University of Ulster, Newtownabbey, N. Ireland BT37 0QB. E-mail: r.mcconkey{at}ulster.ac.uk Summary Little is known about the characteristics of children with disabilitieswho meet the British legal definition of ‘looked after’children. Data were obtained on 108 such children living withinone geographical area in Northern Ireland and who spent 90 daysor more in a 12-month period living away from the family home.However, this figure may under-estimate the numbers, given thedifficulties in tracking children aged over 14 years who wereadmitted to hospitals on a short- or long-term basis. The medianage of the children was 14 years; most had learning disabilitiesallied with challenging behaviours, communication difficulties,autism and some were technologically dependent. Many of theirfamilies experienced a range of problems. One-third of the childrenwere accommodated in various residential settings but half ofthese placements were in hospital or adult residential accommodation.However, there were marked differences in the services providedto this client group by the four provider agencies. Future serviceneeds included increased respite breaks for families and theprovision of both more residential placements and more appropriateaccommodation, especially for teenagers. The dilemmas in reconcilingthe need for local, but specialized, service provision are discussed.     

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.     

From Values of Rights in Social Work: Some Issues in Practice Development and Research

Prof. E. Sainsbury. Dept. of Sociological Studies. University of Sheffield. Sheffield S10 2TN. Summary The following is a discussion paper prepared for a researchteam engaged in a project funded by the Joseph Rowntree MemorialTrust. The problems it sought to address concerned how the teamcould derive a clear statement of clients rights from broadformulations of professional values, and the extent to whichresearch can measure the realization of these rights in socialwork practice. It was found in the research that the practical wisdom (commonsense) of social workers is frequently assumed to be based onprofessionally agreed values, and that—in the pressuresof daily work —values are seldom articulated in ways whichchallenge the procedures and solutions dictated by common sense.Thus, an initial purpose in preparing the paper was to commenton ways in which matters concerned with values become obscuredin practice, and to find ways of linking together values. rightsand practice more strongly. In offering this paper for widerpublication. the research team hopes that it will stimulatecomments which will assist their thinking.     

Notes on Theory and Practice in Social Work: a Comparative View

Please address reprint requests to Robert van Krieken, Department of Social Work, University of Sydney, Sydney, New South Wales 2006, Australia. Summary There are still a number of problems surrounding the relationshipbetween theories of social work practice and that practice itself.This paper examines the factors underlying those problems andemphasises their roots in the failure to examine the diversityof social work theories and practices. We refer to one attemptto resolve the problems—the distinction between ‘practicetheory’ and ‘theory of practice’—pointout some difficulties with it and suggest an alternative, three-folddistinction within theorising: between (a) materialist socialtheory, (b) strategic practice theory and (c) working concepts. As an example of how those distinctions can be used, we thenbriefly discuss the work of Oskar Negt and its introductioninto the Dutch welfare context, as it was the issues raisedby that which stimulated the ideas in this paper. We concludeby arguing that only this kind of perspective on theorisingcan produce ideas which are of real use to progressive socialwork practitioners.     

The Quality of Life of the Chronically Mentally Ill: A Comparison of Public, Private, and Voluntary Residential Provisions

Correspondence to J. P. J. Oliver, Lecturer in Psychiatric Social Work, Department of Psychiatry, University of Manchester, Rm 11.11, Mathematics Tower, Oxford Road, Manchester, M13. Summary A pilot survey was undertaken as part of a long-term investigationof the needs which people with chronic mental illness have forcommunity support. The main purpose of this preliminary exercisewas to develop relevant measures of need. particularly measureswhich give due weight to the assessments which chronic patientsmake of their own quality of life. Results have particular relevancein the light of the ‘White Paper’ on community care,Caring for People and the National Health Service and CommunityCare Act, 1990 because the survey considered patients' experienceof life in three distinct types of resettlement facility: thepublic, the private and the voluntary. While differences inregimes, the personal characteristics of residents and objectivequality of life were noted, no differences in subjective qualityof life (either in general or in specific domains of life) werenoted from one type of facility to another. These results andtheir implications are discussed.     

Virtue Ethics and Social Work: Being Lucky, Realistic, and not Doing ones Duty

Correspondence to Graham McBeath, Department of Sociology and Politics, University College, Northampton, Northants. NN2 7AL, UK. E-mail: graham{at}spooner.demon.co.uk; Stephen Webb, Centre for Social Policy and Social Work, University of Sussex, Falmer, Nr Brighton, Sussex, UK. E-mail: s.a.webb{at}sussex.ac.uk Summary This article argues that in a complex socio-political world,social work ethics needs to re-cast the moral identity of thesocial worker in terms of virtue ethics. We review virtue theory'sAristotelian foundations and criticisms of Kantian and utilitariantheory and show how they apply to social work. Subsequentlywe offer an account of a virtue-based social work that questionsthe validity of several models of practice currently fashionable.Virtue theory emphasizes the priority of the individual moralagent who has acquired virtues commensurate with the pursuitof a revisable conception of the good life—the well-beingof all in a defined community. The virtues are the acquiredinner qualities of humans—character—the possessionof which, if applied in due measure, will typically contributeto the realization of the good life or ‘eudaimonia’.The role of the virtuous social worker is shown to be one thatnecessitates appropriate application of intellectual and practicalvirtues such as justice, reflection, perception, judgement,bravery, prudence, liberality and temperance. This ‘self-flourishing’worker, in bringing together the capacity for theoretical andpractical action makes possible a hermeneutic or interpretivepraxis best appraised in dialogue with fellow-practitionersand clients. With a social work remit increasingly routinizedby accountability, quality control and risk management thereis an emphasis on regulation and duties. This has produced aculture of following approved or typical processes resultingin defensive forms of social work wholly uncongenial to thedevelopment of human qualities likely to promote social workers'engagement in critique and revision of what counts as best practice.In sum, our core proposition is that social work practice andeducation, to fit an unpredictable, non-linear world, shoulddevelop means by which professionals nurture the virtues. Thiswould reflexively enhance social work itself.     

Older People and Access to Care

Correspondence to Denise Tanner, School of Health and Social Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK. E-mail: d.tanner{at}coventry.ac.uk Summary At the heart of a number of New Labour health and social policyinitiatives are stated concerns with supporting independence,preventing deterioration and extending access to services. Thisarticle examines the potential impact of these initiatives,including Prevention Grants (Department of Health, 2000b), theNational Service Framework for Older People (Department of Health,2001a), the Fair Access to Care Services Guidance (Departmentof Health, 2002a), and the Single Assessment Process (Departmentof Health, 2002b), on older people with ‘low level’needs who have increasingly been excluded from services targetedat those in high risk categories. Key standpoints for this analysisare research findings indicating what older people themselveswant from preventive services. Central messages, consistentwith those from other service user ‘groups’, arethe need for support services that enable older people to continueto exercise choice and control over their lives. New preventivemeasures are evaluated in the light of these findings and foundwanting. It is argued that recent policy initiatives are likelyto do little to widen access to support services for those withlow intensity needs, and, moreover, that the processes involvedin identifying those at future high risk will detract from ratherthan enhance citizenship. A more diffuse approach to preventionis advocated, based on mutuality, community development, andcapacity-building.     

Social Work with Single Parent Families: Consumer Views

Summary The article describes a research project undertaken to determinethe satisfaction of a particular client group—single parents—withthe service they were given. The research examines five kindsof problems—legal, accommodation, financial, child care,and emotional-and concludes that problems were likely to arisein all these areas, and that, whatever the problem, the socialworker's ability to help solve it depended to a large extenton the quality of the relationship with the client.     

Mapping Child-Care Social Work in the Final Years of the Twentieth Century: A Critical Response to the 'Looking After Children' System

Correspondence to Paul Michael Garrett, c/o, British Journal of Social Work, University of Warwick, Coventry, CV4 7AL Summary This paper explores aspects of the Looking After Children: GoodParenting: Good Outcomes system (LAC) (Parker et at., 1991).It is suggested that the scheme, to be used with children andyoung people who are ‘looked after’ by local authorities,needs to be subjected to greater critical scrutiny. The paperseeks, therefore, to situate the LAC system in a social andpolitical context and highlights how it also relates to thedominant operational modalities of social work interventionin the late 1990s. In addition, the paper explores how ‘troublesome’children and ideas centred on ‘parenting’ featurein the LAC discourse. The discussion concludes with an examinationof Action and Assessment Records (Ward, 1995b), the centrepieceof the LAC system.     

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.     

Understanding Adolescent Female Prostitution: A Literature Review

Correspondence to Dr Jill Jesson. Aston Business School, Aston Triangle, Birmingham B47 7ET. Summary Sexual behaviour and sexuality are currently topical issuesof concern for child care social workers. Social workers arespending more and of more of their time with children who comeinto care because of sexual abuse, or who have an involvementin the ‘rent’ scene or Prostitution. In additionmany teenage young women come into care because of social orparental concern over their lsquo;promiscuous’ behaviour.The review of research on adolescent prostitution offers severalexplanations for involvement in prostitution. which vary accordingto the discipline of the author. Explanations vary from pathologicaland personal psychology factors to the wider social aspectsof the family and local environment. This literature reviewwas used as a basis for research which examined the incidenceof female prostitution for a social services department. Thisis a relatively new field of interest and consequently thereis very little British research published on the issue of adolescentprostitution, or on under age (16) prostitution. There is nopublished research on girls in care and prostitution. We needto know much more about the reality of young people's livesbefore social workers can offer a meaningful response.     

Questions Raised for Local Authorities when Old People are Evicted from their Care Homes

Correspondence to Peter Scourfield, School of Community, Health and Social Studies, Anglia Polytechnic University, Cambridge CB1 1PT, UK. E-mail: p.scourfield{at}apu.ac.uk Summary Successive government policies have created a situation wheremost residential and nursing care is provided by the independentsector. It is in the nature of a marketized and privatized caresystem that homes will periodically close or change ownership.The physical and mental well-being of elderly residents experiencingeviction and relocation can be seriously damaged by the experience.No policy and practice guidelines have been issued from centralgovernment to cover how care home closures should be managed.Local authorities are therefore dealing with such events onan ad hoc basis. Understandably, the main emphasis is oftenput on actually finding appropriate alternative placements.Practices vary across different local authorities. This articleasks whether the necessary work required to minimize the harmfuleffects caused by the stress of relocation is actually beingcarried out properly. It also raises the questions of what exactlyshould be offered to older people when they are given noticeto quit, who is best qualified to do the work and whether caremanagement as it has developed within the ‘purchaser/providerframework’, is adequate to the task. In short, where cansocial work for older people be found when it is needed?     

A Winter's Tale

Summary ‘My father named me Autolycus; who being as I am litteredunder Mercury was likewise a snapper-up of unconsidered trifles...’ (Shakespeare, The Winter's Tale).     

Play Therapy with Rosy

Summary Rosy is typical of many problematic children in residentialsettings as well as natural homes. What is perhaps not so typicalin social work practice is play therapy, an intervention thathas been acknowledged as having contributed to a significantimprovement in Rosy's behaviour and emotional stability. Certainconditions are necessary—a suitable playroom; assuranceof regular sessions; a play therapist who is, at least to someextent, freed from her own unconscious preoccupations so thatshe can work effectively on the child's needs without interjectingher own. The aim of this paper is to present a synopsis of thetheoretical background, to outline some practical considerations,and to quote from my work with Rosy as a living example of playtherapy in the hope that others will be stimulated to considerplay work as a viable method of intervention with some children.Rosy's play sessions lasted a little over a year, many othercases require less time.     

Children in Secure Accommodation

Correspondence to Professor Robert Harris, Pro-Vice-Chancellor, Department of Social Policy and Professional Studies, The University of Hull, Hull HU6 7RX. Summary This paper describes the characteristics of a sample of children(N = 399) being held in secure accommodation in eleven localauthorities prior to the implementation of the Children Act1989. It is argued that secure accommodation cannot be divorcedfrom other aspects of child care policy and practice; that anyconfidence that problems of excessive or variable usage canbe removed by more restrictive legislation is largely misplaced;that when social workers resort to secure accommodation it isoften through a combination of ‘worry’ about anunpredictable child and uncertainty as to what else to do; andthat since not all children in secure accommodation wish toleave it (and the more secure accommodation constitutes goodquality child care the more children are likely to want to stay)a ‘rights’ framework, though necessary, is not asufficient moral or conceptual basis for developing secure accommodationpolicy and practice.     

Adolescents in Care and their Social Workers: A Research Note

Summary There has recently been an increasing concern that young people,and especially those in residential care, should be encouragedto express their views, and that the views expressed shouldbe used in improving the care which they receive. The publicationof the Who Cares? booklet (Page and Clarke¹), and the emergenceof ‘Who Cares’ groups and the ‘Voice of theChild in Care’ organisation, is evidence of this concern.In sympathy with these developments has been a study of adolescents'perceptions of social workers, and a part of this research hasincluded a pilot study of the views of adolescents living intwo family group homes.     

Adolescent and Young Adult Male-to-Female Transsexuals: Pathways to Prostitution

Correspondence to Dr Ronit D. Leichtentritt or Dr Bilha Davidson Arad, Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel. E-mail: ronitl{at}post.tau.ac.il Summary The current study aims to reveal the experiences of young male-to-femaletranssexuals who work as prostitutes in Israel, providing astage where the voice of this marginal group may be heard, aswe believe social workers need to know more about the realityof these young people’s lives before they can offer meaningfulresponses. The study was guided by two main questions: (1) Whataccounts do young male-to-female transsexuals who work as prostitutesprovide for their involvement in the sex industry? and (2) Whatare their experiences as young transsexuals engaged in prostitution?Using the life story interview and thematic analysis, two mainthemes were revealed: (a) what I ran away from or was thrownout of; and (b) why I became a prostitute, how I became professionalizedand why I continue to work as one. The first theme focuses ontranssexualism; the second on prostitution. Yet, these two themesare intertwined: from the respondents’ perspective, prostitutionis a price you must be willing to pay if you want to achievegender transformation at the beginning of the twenty-first centuryin Israel. Practical implications and further research are recommendedto better inform social workers assisting this high-risk population.