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.     

The Families of Agoraphobics Treated by Behaviour Therapy

Summary The article describes a study of the families of agoraphobics.On the basis of interviews with patients undergoing treatmentby extensive exposure the P.S.W. assigned them to 3 groups:‘well-adjusted families’, ‘anxious-patientsfamilies’ and ‘sick families’. 6 of the 7patients in the ‘well-adjusted’ group showed significantimprovement, maintained over a follow-up period of 1 year. At3 month's follow-up none of the other patients had shown improvement,at 1 year's follow-up one ‘anxious’ patient enteredthe significantly improved category with additional help, and3 showed a trend towards improvement; of the ‘sick families’patients one eventually showed a trend towards improvement.Possible associations between family adjustment and the patient'schances of recovery are then discussed     

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.     

A Consumer Study of Young People's Views on their Educational Social Worker: Engagement as a Measure of an Effective Relationship

Correspondence to Colin Pritchard, Mental Health Group, University of Southampton, Royal South Hants Hospital, Brintons Terrace, Southampton, SO14 0YG, UK. Summary This, the first ever consumer study of education social workers(ESWs), uses qualitative material and quantitative analysisby examining the views of 110 users of a county ESW service.Most pupils belonged to families with long-standing disadvantage;e.g. 53 per cent had unemployed fathers; over 70 per cent hadparents with disturbed personal and social relationships, 39per cent had a single parent; 30 per cent plus had mental healthproblems; and 10 per cent of parents had been in care as children,i.e. more than ten times the national average. The young people also had considerable disruption in their lives:for example 78 per cent frequently missed school; over 50 percent had school and peer difficulties; 30 per cent offended;over 30 per cent experienced bullying; 5 per cent were the subjectof child protection enquiries, 10 per cent had previously beenin care and 2 per cent had had an incident of ‘attemptedsuicide’ (50 times the national rate). They averaged sixmajor difficulties each. Despite these antecedents, 91 per cent of the young people demonstratedan ‘engaged’ relationship with their social worktrained ESW, with many examples of practical psychosocial helpbeing received. The concept of ‘engaged’ was statisticallyvalidated in the comparison of views between the ‘engaged’and ‘non-engaged’ research participants. The resultsindicate the value and effectiveness of a supportive rapport/relationshipas a vehicle to reach and to be of practical assistance to disturbedand disturbing young people.     

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.     

'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.     

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.     

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.     

User-Practitioner Transactions in the New Culture of Community Care

Correspondence to Nicky Stanley, Lecturer in Social Work, University of Hull, Hull HU6 7RX, UK. Summary This article describes the findings of a research project whichexamined the views and practice of social workers undertakingassessments in one local authority following the implementationof the NHS and Community Care Act 1990. While the assessorsexpressed dissatisfaction with some aspects of the new systemof care management, overall they appeared to be taking the newculture on board. Managers were consistently more enthusiasticthan practitioners. Both groups saw needs-led assessment, userchoice and keeping users in their own homes as central objectivesof care management. The shadowing of ten community care assessmentsallowed the degree to which these objectives were realized inpractice to be explored. Users' experience of the new culturewas also studied. The user-practitioner transactions observedsuggest that those users who were able to articulate their ownneeds forcefully were most likely to be able to exercise choice.It is argued that the new culture of community care embodies‘consumer choice’ rather than ‘user choice’.     

Responding to Youth Crime in Scotland

Correspondence to Bill Whyte, Director, Criminal Justice Social Work Development Centre for Scotland, School of Social and Political Studies, University of Edinburgh, Flat 1FR, 31 Buccleuch Place, Edinburgh EH8 9LJ. E-mail: B.Whyte{at}ed.ac.uk Summary Scotland’s Children’s Hearings deal with young peoplewho offend within an integrated system dealing also with youngpeople in need of care and protection, on the assumption thatthe difficulties of both groups have similar roots in multiplesocial disadvantage and social adversity (Whyte, 1998a). A government-fundedstudy, one of the first since the system’s inception in1971, was commissioned to examine the social characteristicsof over 1,000 children and young people referred for offenceand nonoffence reasons. This paper describes the characteristicsof 465 of the young people who were referred specifically foroffending. It provides the first ‘official’ datain twenty-five years on young people in the system. The studyfound that most of those referred for offending had characteristicsstrikingly similar to those referred for nonoffence reasons,as predicted when the system was first established, and similarto those present in the general literature on young offendersfrom other jurisdictions. The study poses fundamental questionstaken up by the Scottish Executive’s review of youth crimeon how best to design systems and develop social interventionsthat can address offending and social disadvantage in an integratedway.     

A Revisionist History of Intermediate Treatment

Correspondence to John Pratt, Department of Social Policy and Social Work, Massey University, Palmerston North, New Zeland. Summary This paper examines and challenges the view that intermediatetreatment for young offenders in England and Wales has alwaysbeen intended as an alternative to custody provision. It arguesthat its origin and subsequent development have to be understoodwithin what was the prevailing welfare discourse at the timeof the 1969 Children and Young Persons Act. It traces some ofthe processes involved in the change that has since taken place,characterized by a move from ‘welfare’ to ‘justice’talk, and suggests that it was only then that the conceptualspace for intermediate treatment to operate as an alternativeto custody was established. Finally, it examines some of thecritical issues raised by these changes in policy and discourse.     

Keyworkers Re-examined: Good practice, quality of care and empowerment in residential care of older people

Correspondence to Rosemary Bland, Department of Applied Social Science, University of Stirling, Stirling FK9 4LA, Scotland Summary Social work definitions of ‘good practice’ in residentialcare which were originally developed in work with children andyoung people have also been applied to residential settingsfor other user groups, including older people. However, anylink between such elements of practice and positive outcomesfor users has not always been demonstrated. The introductionof market principles and orientations into social welfare inthe 1980s re-defined the social work ‘client’ asa ‘consumer’ with the associated power to make choicesin the area of social care. The success with which such an approachcan be applied to services for people who are very often, notin a position to exercise much choice, is debatable. Alongsidethe notion of the ‘consumer’ or ‘user’of services has grown the ideology of ‘empowerment’of people who use social work services. Drawing on findingsfrom a recent study, this article explores the contributionof the keyworker role to good practice and the empowerment ofolder people living in residential homes. It concludes that,because their understanding of the concept and practice is largelyundeveloped, the role as currently interpreted is not consonantwith good practice and tends rather to reinforce the power ofstaff.     

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.     

'No Irish Need Apply': Social Work in Britain and the History and Politics of Exclusionary Paradigms and Practices

Correspondence to Paul Michael Garrett, Centre for Social Work, School of Sociology and Social Policy, University of Nottingham, University Park, Nottingham NG7 2RD, UK. E-mail: paul.garrett{at}nottingham.ac.uk Summary In Britain, Irish people have continually been excluded fromthe discourse of anti-discriminatory social work theory. Themain reason for this centres on the dominant tendency to exclusivelycentre on ‘race’ and visible difference. Recentpolicy documents in relation to social work with children andfamilies illustrate the fact that Irish people are omitted indiscussions seeking to promote culturally appropriate services.Conceptually this approach is founded on implicit ideas aboutBritish identity and erroneously suggests that white ethnicitiesare homogeneous, unified and clearly demarcated from a (new)black presence. Historically, ideas associated with ‘theproblem family’ can be related to the racialization ofIrish people. Archival research examining responses to unmarriedmothers travelling to Britain to have ‘illegitimate’babies adopted also highlights how Irish women have been subjectto exclusionary social care practices. Whilst rejecting an essentialistconceptualization of ‘Irishness’, the article goeson to suggest that the mainstream and hegemonic discourse on‘race’ needs to take specific account of Irish peopleand other minority ethnicities not identifying as ‘black’,particularly during a period of globalization and new migrationinto Britain by refugees and asylum seekers.     

'The Integration of Theory and Practice': a Re-examination of a Paradoxical Expectation

Summary Social workers seem to agree that the nature of the relationshipbetween theory and practice is problematic. However, few ofus have asked what we really mean when we talk of these problems.This paper re-examines the meanings commonly attributed to eachnotion and to the relationship between them. As a result ofthis process the paradoxical nature of the current expectationof ‘integrating theory and practice’ is exposed.This leads to a proposal that we modify our way of framing themeaning of ‘integration’ and thus introduce a newdimension to questions we pose when trying to improve socialworkers' ‘integration of theory and practice’. ‘Wecan no longer explain a paradix by running away fromit; we muststand and look it in the eye’.     

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.     

A Role for Anyone? A Description of Social Work with the Elderly in Two Area Offices

Summary This article analyses information from Case Review Forms completedby social workers on 199 allocated elderly clients. These peoplewere very frail, most were considered to be ‘at risk’and to require regular, reliable and frequent care. The questionof the client moving to a tafer setting arose in two-thirdsof the cases, concerning which there was often some dispute.It is argued that social workers require a high level of professionalskill in dealing with clients, and others involved, faced withsuch questions and that this requirement will remain with thedevelopment of ‘community social work’.     

Social Adjustment: The Design and Use of an Instrument for Social Work and Social Work Research

Please address correspondence and reprint requests to: Dr. R. Corney, General Practice Research Unit, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5. Summary This article discusses some of the problems encountered whentrying to assess social adjustment and describes a standardizedsemi-structured interview designed to measure social adjustmentand dysfunction. The interview can be used by social workersas a research tool, a screening device or in making an assessmentThe interview is composed of items grouped under the three headingsof ‘Material conditions’, ‘Social management’and ‘Satisfaction’. Ratings are made on a four-pointscale by interviewers standardized in its use. The interviewwhich takes 40 minutes to one hour to administer, covers housing,finance, occupation, social and leisure activities, and relationshipswith significant individuals in the subject's life.