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 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.     

Models of Assessment in Social Work

Summary The provision of a social work service depends significantlyupon assessment of the social situation of clients as determinedby social workers. It is argued that the social worker's ‘understanding’of the social situation is framed within a particular way ofthinking about cause and effect. Three different models of suchthinking are used in practice. They are identified as the linearmodel, systems analysis and the management model. The originsand attributes of each model are described and related to thesocial, economic and political environments which have influencedtheir separate developments. The value base underlying eachmodel is explored. Issues relating to the present position ofsocial work are clarified.     

Social Work Tomorrow: Towards a Critical Understanding of Technology in Social Work

Correspondence to Bob Sapey, Department of Social Work, University of Central Lancashire, Preston PR1 2HE Summary This paper makes use of theoretical ideas that have been developedto understand the impact of new technology on organizationsand applies them to its use within social work agencies. Thesedeveloping theories employ ideas that are familiar to socialworkers—organization theory, decision making theory, andcommunication theory. The paper therefore argues that socialworkers are in a good position to understand and influence theuse of computers within welfare agencies and do not need tobe inhibited by a lack of technological knowledge. It is furtherargued that, unless social workers do become involved in theways in which new technologies are used within organizations,they will fail to influence its impact upon their clients andmay further fail to control the way in which computers affectthe nature of social work itself in the future.     

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.     

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.     

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.     

Social Work Values: The Moral Core of the Profession

Correspondence to Cynthia Bisman, Graduate School of Social Work and Social Research, Bryn Mawr, PA 19010, USA. E-mail: cbisman{at}ada.brynmawr.edu Summary This paper argues that an emphasis on the profession’sknowledge base has come at the expense of attention to socialwork's values and mission. The discussion examines the relativeimportance of knowledge, values and skills in an effort to understandthe shifting emphases of the profession within a social andhistorical context. The consequences of these shifts for theprofession and for its relationship to society are also considered.Concepts from the intellectual struggles of social work andfrom an interdisciplinary perspective suggest ways to groundthe profession’s skills and knowledge in its values ofhuman dignity, service to humanity and social justice. At itscore, social work must respond to the moral imperative of caringfor the neediest among us. This entails re-claiming and buildingon the commitment of early social workers ‘to work withforces that make for progress . . . to forward the advance ofthe . . . common people’ (Richmond, 1899, p. 151). Thepaper concludes that for social work to have a future, the professionmust take pride in its moral core, define its contemporary meaningand work for the social welfare in ways that are relevant toboth social workers and non-social workers.     

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.     

An Evaluation of Social Support Intervention 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 PL4 8AA, UK. Summary The significance of maternal depression to social work practicein child and family care has become increasingly apparent inrecent years. Social support, furthermore, is a concept (aswell as a reality) which provides a major focus for social workpractice. Indeed, social support, it is also clear, is of considerableimportance in helping prevent depression. This paper seeks toexamine social support work carried out by social workers inrelation to depressed mothers in child and family care. In particularit seeks to evaluate the quality of that intervention in thelight of key problem areas associated with high levels of supportneeds, the extent to which social workers target support needsthrough direct, indirect and informal supports, and the extentto which particular interventions are associated with a higheradequacy of support experienced by these depressed women. Thepaper finds a certain degree of haphazardness in social workers’targeting of support needs, although in some areas of indirectsupport, in particular, their targeting is reasonably accurate.There is little evidence of any one form of intervention beingassociated with more adequate support with one significant exception,relief care of children. The paper concludes that social workersneed to develop a keener awareness of support deficits so thatthey are targeted better; they need to monitor more carefullyinterventions carried out by other agencies and professionals;and they should look to relief care of children as a major formof intervention to support these women.     

Abortion: With Particular Reference to the Developing Role of Counselling

Summary This paper suggests that counselling is a rapidly expandingfield in which professional and para-professional workers mightcombine to produce an effective service, given appropriate selectionand training procedures. Initially these are seen as being providedby professionally qualified social workers with relevant experience.The author has used her own social work experience in abortioncounselling to exemplify the article and to discuss some ofthe existing problems for workers and clients alike.     

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.     

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.     

Social Work, the State and the University

Summary Some aspects of the triangular relationship between the state,the university and social work are explored. Is it appropriatefor social work to be taught in a university? What are the implicationsof the fact that well over 90% of social workers are employedby the state? And what above all, is the nature of the relationshipbetween critical analysis as the corner-stone of scholarshipand the need to prepare the social work student to functioneffectively in the real world? It is argued that the respectiveattitudes of higher education and government towards socialwork are influenced by the nature of social work's relationshipwith sociology, but that this in turn has not been fruitfulfor practice development.     

Tackling Inequalities in Physical Health: A New Objective for Social Work

Correspondence to Eileen McLeod, Department of Social Policy and Social Work, University of Warwick, Coventry, CV4 7AL, UK. Summary We argue that tackling the impact of social inequality on physicalhealth should become a central objective of social work andintrinsic to the development of anti-oppressive practice. Thisis on three grounds. First, the suffering embodied in inequalityin physical health should be a cause of concern to social workers,as a pervasive social problem. Secondly, awareness of socialwork's complicity in contributing to such a problem, throughits historical role in implementing state policies, needs toinform assessment of social work outcomes. Nevertheless, thirdly,social work—not confined to health care settings—whichredresses social disadvantage and tackles its consequences forphysical well-being can contribute to greater equity in health.Indicative examples of such practice are provided in relationto health maintenance, living with ill health and terminal illness.Finally, consideration is given to the current wider politicalcontext in which social work addressing health inequalitiesis embedded and to the need for complementary organizational,professional and political initiatives to buttress its development.     

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.     

Care Management and Professional Autonomy: The Impact of Community Care Legislation on Social Work with Older People

Correspondene to Mark Lymbery, Centre for Social Work, School of Sociology and Social Policy, University of Nottingham, University Park, Nottingham NG7 2RD, UK. e-mail: Mark_Lymbery{at}nottingham.ac.uk Summary The 1990 National Health Service and Community Care Act appearedto herald a new dawn for social work with older people, whichhad previously been a relatively neglected and undervalued areaof social work practice. The legislation proposed a new rolefor social workers as ‘case managers’, with considerableautonomy and flexibility about the way in which the ‘casemanager’ responded to need. By the time community carepolicy was implemented, the role of ‘case manager’had been transformed into that of ‘care manager’,with a focus which emphasized procedural and managerial requirementsrather than a more flexible professional practice. This paper explores the extent to which this shift has substantivelyaltered the nature of social work practice with older people.It outlines key theories of professions and their applicabilityto social work, and critically analyses the impact of the ‘newmanagerialism’ within social services departments. Thepaper also examines the nature of social workers' practice witholder people following the impact of community care legislation,and concludes that the impact on the social work professionhas been to locate an increasing control of practice with socialwork managers, with potentially serious consequences for thecontinuation of a distinctive social work role in relation toservices for older people.