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 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’.     

The Field Social Work Implications of Residential Child Care

Summary The workloads of field social work staff vary markedly, andlittle is known about the ‘burdens’ imposed by differentgroups of clients or cases. The research study reported hereset out to examine the extent to which field social work involvementin residential child care varied between individual childrenand to attempt to explain that variation in terms of the characteristicsof children, the characteristics and workloads of staff andtheir teams, the packages of services received by children andtheir families, and some general features of the residentialplacements. Field social worker involvement was measured interms of the number of contacts between ‘caseholders’and ‘case’ and the total amount of time spent onthe case over a three month period. The observed variationsin these two indicators were found to be significantly associatedwith the characteristics of cases and other factors. Indeed,these characteristics explained almost two-thirds of the variance.The empirical results have a number of policy implications whichare discussed under six heads: supply constraints, caseloadweighting, fieldwork organization, coordination and monitoring,out-county placements and travelling time, and comparative costings.     

Success or Failure? Outcomes of Bailees at Hope House Hostel

Correspondence to F. A. Waton, 16 regent Terrace, Lower Haedingley, Leeds LS6 1NP. Summary This article reports research on the short-term outcomes ofa sample of male bailees at Hope House bail hostel (not itsreal name) from 1987 to 1990. The research aims were to: (a)discover if hostel records could be used to evaluate work anddetermine whether clients had ‘successfully’ completedresidency, (b) determine if hostels are more or less likelyto succeed with some clients rather than others, and (c) seeif this method might prove useful in developing a ‘clientprofile’ for success or failure. The sample was divided into ‘successes’ and ‘failures’,based on simple criteria developed with hostel staff. Each groupwas then correlated with a number of other factors staff identifiedas significant determinants of success, as well as standardvaiables. While no clear profile emerges of either ‘success’or ‘failure’, some trends are reported. Most significantly,none of the sample charged with sexual offences, arson or drugoffences were among the failure group, while violent offenderswere disproportionately represented among the failures. Thearticle concludes that research on a nationally representativesample could identify a profile of characteristics useful forscreening potential bailees. Using this, the percentage of successescould be improved.     

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.     

The Psychiatric 'Caseness' of Clients Referred to an Urban Social Services Department

Correspondence should be sent to Dr. Peter Huxley, Mental Health Social Work Research Unit, Department of Psychiatry, Manchester University, Stopford Building, Oxford Road, Manchester M13 9PT. Summary Of 158 clients referred to two area offices and six generalpractice attached social workers, 141 weré interviewedusing standardized social and psychiatric research interviews.The General Health Questionnaire (GHQ) was completed by 138clients. Their social worker completed the Case Review Form.Scores of 5 or more on the PSE Index of Definition (for theclient) were used to indicate psychiatric caseness. Using IDscores of 5 or more, 53% of the sample were identified as ‘cases’.The GHQ (cut-off 4/5) identified 73% of the clients as cases;and the GHQ (cut-off 10/11) identified 51% cases. Morbidity was significantly greater in the general practicesetting. Social workers' judgement (about the presence or absenceof mental illness/emotional disorder) was not significantlybetter than chance in the identification of specific disorders,but was significant in relation to the whole sample. The results are discussed and further studies are being conductedusing more sophisticated judgements of ’caseness’,and extending the enquiry beyond an inner city population.     

Conceptualizing Community Social Work--a Response to Alan York

Summary This note takes further the task of conceptualizing communitysocial work begun by Alan York in his paper for the June 1984edition of this Journal. York's approach is criticised firstlyfor unhelpfully conflating ‘community work’ and‘community social work’ and, secondly, for developinga schema unable to satisfactorily theorise the range of communitywork approaches currently to be found within social work. Buildingupon York's suggestion that ‘dichotomous formulations’provide an appropriate way forward for analysing community practice,three, distinct, dichotomies are elaborated, and recommendedas a basis for locating and comparing current approaches tocommunity social work.     

'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.     

The State of Welfare

Summary The word ‘welfare’ is difficult to define becauseit combines within it a range of ideologies and actions. Twoconclusions are drawn from this: first, that social servicesshould be regarded as contributors to, but not providers ofwelfare; second, that the study of social work and social administrationshould be concerned not only with the relationship of ‘service’to ‘need’ but also with societal movements and pressureswhich determine the emergence of both. The article reviews theprofessed values of the welfare state, particularly ‘socialequality’ and the problems associated with its achievement,namely public attitudes, and the discontinuity between intentionand practice in the welfare services. The implications for socialwork education and practice are considered.     

A New Structure for Intake and Allocation in a Field Probation Unit

Summary From a background of practice and a post-qualifying fellowship,the author draws on the experiences of other Senior ProbationOfficers, as well as his own and his team members. In this article‘intake’ within the probation setting is taken asinitial agency impact as well as that part of team strategywhich has a bearing on allocating new work. Allocation and theconsequential deployment of resources are then seen as centralto the professional lives of team members. A structure is presentedwhich in practice pervades the totality of the team's life;most radical is the author's notion of allocating ‘workepisodes’. The model provides a structure for team membersto specialise in different forms of social work, and at thesame time allowing clients choice to be supervised without being‘sentenced to social work’. It also depends uponthe active use of a team as a group of interacting, interdependentprofessionals who share their work.     

The Social Worker as 'Bad Object'

Correspondence to Dr Marguerite Valentine, 56 Osbaldeston Road, London N16 7DR Summary A ‘bad object’ has been defined as an ‘objectwhom the subject hates or fears, who is experienced as malevolent.A bad object may be either an internal or an external object’(Rycroft, 1988, p. 100). This paper explores the circumstancesin which public fears and anxieties over child abuse becomeprojected into the social worker. It discusses how social workersintroject these feelings, become a ‘bad object’,and how social services departments have developed a numberof strategies which defend against feelings of blame and responsibility.The exploration is derived from my own experiences and observations,and applies Kleinian psychoanalytic theory to studies of institutionaldefences.     

Group Work in Intermediate Treatment

Summary This article is concerned with the development of group workin a specialist intermediate treatment project. Using the techniqueof participant observation the author describes the use madeof groups over a six-month period with young people, all ofwhom presented problems of disturbance and/or delinquency. Thepractice portrayed is not ‘model’ but illustrativeof the dilemmas of practitioners beginning to work with groupsof young people for the first time. The evidence of the studypoints to the difficulties that an over-simplified view of participationand democracy can create, and indicates the need for group workersto define their purpose and objectives and to establish a contractor working agreement with group members. In relation to thedebate about ‘talking’ and ‘doing’ inintermediate treatment, it is suggested that a model of groupwork practice that distinguishes between ‘activity asan end in itself’, ‘activity as a means to an end’,and ‘focussed discussion’ may be helpful to groupworkers in conceptualizing the totality of their task. Socialwork with groups is still more talked about than practised.This article describes the attempts of a newly established teamof intermediate treatment workers to practise group work withyoung adolescents whose behaviour and social circumstances wereregarded as problematic. As a part-time researcher attachedto the project team, the author had access through participantobservation to groups over a six-month period and he also hadthe opportunity of listening to group workers discussing theirwork at review meetings.     

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.     

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.     

'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.     

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.