A Brave New World of Personalized Care? Historical Perspectives on Social Care and Older People in England

Social care policy for older people in England continues to generate extensive discussion around the need to break with the past and to deliver a personalized response to need. This article explores the extent to which this represents a complete break with the past by looking at four key reports from the past, namely the Rucker Report (1946 ) on the break up of the Poor Law, the Seebohm Report (1968 ) on the personal social services, the Griffiths Report (1988 ) on community care and The Royal Commission on Long Term Care ( Sutherland Report, 1999 ). Each is interrogated in terms of how social care is defined, how services are to be delivered, how quality is understood and the assumptions made about who will be able to access services. This analysis is used to draw out key continuities in policy assumptions such as the primacy of family and the ongoing debate about ‘What is social care?’ and how it can be distinguished from health care. The article also argues that the voluntary sector has always been seen as a ‘key player’ in social care. Finally, the analysis of the four reports is used to trace the ever changing role of local authorities in the planning, purchase and provision of social care services for older people.     

Results of a nationwide hospice and palliative care social work job analysis

The role of the hospice and palliative social worker is often ambiguous and misunderstood by colleagues and fellow team members. One reason for this is the lack of identified, clearly delineated roles, skills, and tasks employed by these specialty social workers in their daily work. This article summarizes the first nationwide job analysis of hospice and palliative social workers. A contextual, cross-sectional survey design was used to identify current and relevant job tasks from practicing hospice and palliative social workers. A sample of 482 social workers representing 46 states responded to a survey that included demographic questions and ranking of 152 tasks and importance to the position. Tasks were categorized into four broad categories: assessment and reevaluation; planning and intervention; death, grief, and bereavement; and professionalism; which includes subcategories consisting of multiple tasks and skills. Respondents identified performing a psychosocial assessment from a patient/family centered care perspective, assessment of the patient’s current and desired quality of life and of coping skills as the tasks most important to their role. This outline of the role of the hospice and palliative social worker was then used in the development of an evidence-based certification exam that may be required of those who want to receive specialty certification in the field.     

Participation and opportunity: Redefining social security in Australia and New Zealand

Against a political background of shifting societal expectations about the role of social security in terms of mutual obligation and social responsibility, both Australia and New Zealand have conducted major social policy reviews within the past two years. Two of the central themes of the McLure Report (Australia) and the Pathways to Opportunity Report (New Zealand) are social participation and opportunity creation. This paper focuses on these issues from several perspectives. An outline of the motivations for reform and the concepts guiding it is followed by a summary of the reform strategies identified in each report. After a discussion of the similarities and differences in the changes implemented since the two reviews, the conclusion points to some of the potential problems raised by the critics of the reform proposals.     

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.     

Needs Assessment, Street-level Bureaucracy and the New Community Care

In the wake of the Seebohm reforms of the personal social services, a number of studies were carried out in the 1970s to explore the role of frontline professionals in identifying and meeting social need. A common finding was that social workers behaved like "street-level bureaucrats", using their discretionary authority defensively to manage an otherwise overwhelming workload. In the 1990s, top-down assessment and care management systems were put in place as part of community care reforms. Their aim was to reduce the scope of professional discretion so as to standardize responses to need and control demand according to resources available. In this paper, the authors consider the success of new systems in controlling "bottom-up" decision-making by drawing on a recent empirical study of needs assessment practice in three types of social work team. They point out that the assessment practice of those teams facing the highest bombardment rates was most obviously criteria-driven, reinforced by the use of new technology. Rather than creating informal stereotypes to manage demand, social workers could mobilize legitimate forms of rationing to protect their time and other resources. Yet the sense of professional identity, the level of frontline autonomy, and the ways in which this was exercised, varied across the different types of team. The authors conclude, therefore, that the scope of discretionary space available to frontline staff in social services departments, and the practices to which it gives rise, are empirical questions only adequately addressed by methodologies able to connect with "bottom-up" decision-making.     

Social Work in a Managed Care Environment

Managed care has created a new service environment, eliminating distinctions that have sustained social work ideology and the profession throughout its history. This paper reviews important features of managed care, considers changes it has brought to practice ideology, the practitioner/client relationship, and the practice environment, including social work employment. The paper discusses the new opportunities, challenges and problems that have emerged with this approach.
While social workers should not embrace managed care, they should not run from it or blindly oppose it. They need to aggressively pursue it, fighting its major drawbacks, while adapting to a competitive market place. Given the current managed care market, the social work profession is now in the right place, at the right time, with the right skills, and available at the right price. It must now take on a leadership role to maintain its competitive position, protect its clients and insure quality practice.     

新时期学校社会工作开展的必要性研究——与学校心理咨询相比较

经济社会的剧烈变化使学校教育面临前所未有的冲击，原有的学生工作和学校心理咨询工作虽然在一定程度上发挥了功用，但也暴露了诸多弊端。对我国而言，学校社会工作是一个全新的领域，且由于其在工作性质、工作原则及某些工作方法上与学校心理咨询存在相似性，因而使其在学校领域的介入和发展受到一定的质疑。全文以新时期学生发展的需求为基础，以与学校心理咨询相比较为重点，总结出学校社会工作的特质，从而论证了新时期开展学校社会工作的必要性和紧迫性。     

Historical development and characteristics of social work in today's China

Social work education has experienced three stages since its introduction to China in the 1920s: introduction, abolishment and reinstatement. Theoretically, there are four types of social work in China: official–educational, official–practical, voluntary–educational and voluntary–practical. In practice, all four types of social work have not necessarily been embodied in each developmental stage, and the order of their historical development is not the same as the order of their logical development; i.e. some types are lacking in some of the stages. Each type of social work has its own characteristics, which are integrated into each development stage. Today, Chinese social work faces two major interrelated tasks: the professionalisation and the institutionalisation of social work. The former refers to the development of standardisation in Chinese social work; the latter has to do with the development of the social welfare institution in general and the development of institutional welfare in particular. In general, the dramatic development in Chinese social work largely depends on the accomplishment of the two tasks.     

Towards Establishing School Social Work in Malaysia

This paper calls for the introduction of school social work in Malaysia. Many industrialized countries have introduced school social work, partly because teachers are not able to tackle students' personal and social problems. Teachers are burdened with teaching tasks and are not trained to handle social problems. The introduction of school social work in these developed countries was an admission that there was only so much teachers could do in addressing the problems of school children. Even with school counselors, the problems have not decreased. Many parents in Malaysia perceive schools to be incapable of providing sufficient education to excel in the major exams. The existence of many private tuition institutions and private teachers is a testimony to that perception. If society has already deemed these teachers to be incapable of providing quality education, to expect them to look after students' social problems is presumptuous on society's part. The need for school personnel who understand the social ills of the community is urgently needed, and it is the contention of this paper that school social workers are best equipped for that responsibility.     

Emotional Knowledge for Child Welfare Practice: Rediscovering Our Roots

Child protection is arguably in a state of crises, with indications that current approaches to practice are failing to protect children and support families. A variety of competing approaches have been put forward to address the current inadequacies, such as evidence‐based social work and antioppressive approaches to social work. These approaches to practice promote rational and technical analyses of social work with little attention to what lies beneath the surface in the encounter between social worker and client. In this paper we consider the value of psychoanalytic concepts for child protection practice. Notions of ambivalence, transference, and counter‐transference might offer a much needed source of insight for child protection practice that might help to address some of what has been lost in the field over the last few decades.     

The Probation Officer as Social Worker

Summary In this article the author argues for a detachment of the probationservice from the function of carrying out court orders to superviseoffenders. He suggests that changes in social work traininghave not been matched by any fundamental changes in the probationservice's relationship with the court or by any fundamentalchanges in the probation service's own organization or philosophy.The consequence is that probation officers spend a disproportionateamount of time doing tasks for which their training has notequipped them. He postulates a new relationship between theprobation service and the courts which gives the former greaterautonomy in social work decision making, and gives the lattergreater scope to administer punishments within the community.The need to move away from the utilitarian justification forwork with offenders that it reduces crime is also urged, andit is suggested that there is a need to establish, as a value,the importance of social work provisions and counselling foroffenders as a deprived group in society, irrespective of theeffect of these measures on the crime rate.     

The state of the German social insurance state: Reform and resilience

At the core of the German system of welfare provision stand social insurance schemes whose central role contributes to Germany being labelled a social insurance state. In recent decades, Germany has been experiencing major social policy reforms that are often evaluated as paradigm changes. These changes have been reflected in analyses that sometimes even questioned common classifications of the German welfare state. The article sheds light on recent developments that have affected the German system of social insurance. It focuses on four aspects of social insurance: benefits, financing, governance, and coverage. Although confirming many earlier analyses of reforms in detail and sharing assessments of changes such as retrenchment and marketization, the article nevertheless stresses that social insurance remains structurally intact and that the work–welfare nexus underlying welfare provision has been reinterpreted but not surrendered.     

Social Work and the Shift from 'Welfare' to 'Justice'

It has become increasingly clear that the emancipatory capacityof social work has been eroded. Several scholars link this tothe influence of neo-liberal and ‘Third Way’ thinking.However, it has recently been argued that social work was notonly a victim of these new influences, but that it is also veryadaptable to the influence of such new ideas (Jordan, 2004)and not very critical about its own role in these changes (Lorenz, 2005).In this article, we will further develop this criticism, byfocusing on the debate surrounding youth delinquency. Accordingto Sharland (2006), youth delinquency has become someone else’sproblem. By analysing the role of social work within the youthjustice system, the article shows that (i) social work has notonly been the victim of recent changes, but that it has alsowithdrawn from the debate on youth justice, and (ii) that thisprocess is related to how social work is defined as a methodicalanswer to the problem of youth delinquency.     

Local Authority Intake Teams

Summary Amongst the many developments in social services organisationin the decade since Seebohm, specialist Intake Teams responsiblefor all initial referrals and short term work received by anArea Team, remain a popular form of local organization. Thispaper describes a small national survey of English local authoritiesto collect information on both intake teams and their long termcounterparts, and briefly outlines some of the major findings.The survey produced a broad picture of both the present structureof local authority fieldwork departments, and the personal characteristicsof social workers and their team leaders. The paper goes onto examine the relationship between intake and long term teams,particularly in terms of referral rates, relative caseloadsand the case transfer process; and concludes with an outlineof teams satisfaction with the intake system, and some indicationsof desired future developments.     

The Bruce Report and social welfare leadership in the politics of Toronto’s “Slums”, 1934–1939

Slum clearance and rebuilding first became a serious political project in Toronto during the 1930s. Following the release of a systematic housing survey known as the Bruce Report (1934), a set of actors distinguished by their planning authority with respect to social agencies, influence over social work education, coordination of social research, and role as spokespersons of religious bodies inaugurated a political struggle over state power. While the campaign failed, it called forth a reaction from established authorities and reconfigured the local political field as it related to low-income housing. This article gives an account of these processes by drawing upon correspondence and minutes of meetings of city officials and the campaign’s organizers, newspaper clippings, and published materials.     

Culture, cultural identity, and cultural sensitivity in child and family social work

Child care legislation, policy, and procedures increasingly emphasize the obligations of social workers to give due consideration to the culture and cultural background of children and their families. This paper explores the implications of those obligations. It seeks the meaning of these terms, and critically examines meanings attributed to them. There are many obstacles in the way of fulfilling these specific statutory obligations in child and family social work: there is a history of neglect, confusion, and negativity towards culture in social work literature, and a current attempt to subsume culture within the concept of ethnicity; racism has often been regarded as a more significant issue than culture; the cultural heritage of clients and their families has been perceived as oppressive, and culture has been misinterpreted to explain and to tolerate unacceptable behaviour. Other disciplines, for example anthropology, sociology, and cultural studies, perceive culture and cultural identity differently. They have much to offer social work. The paper provides a definition of culture and cultural identity which reflects much of what has been learnt in the literature generally. It should contribute towards an enhancement of cultural sensitivity, and a fulfilment of statutory obligations relating to culture in child and family social work.     

The definition of social work in the United Kingdom, 2000–2010

Dickens J. The definition of social work in the United Kingdom, 2000–2010. This article reviews the approaches that the four countries of the United Kingdom – England, Scotland, Wales and Northern Ireland – have taken in recent years for organising, regulating and defining social work. Social work is one of the policy areas that have been devolved to the constituent countries. This has brought extensive organisational changes, multiple policy initiatives and a proliferation of regulatory and advisory agencies. The article focuses on the attempts by these official bodies to define social work, treating the United Kingdom as a case study of the tensions of specifying what social work is and what it should be. The various attempts expose the strains and overlaps between the different agencies, and a bigger struggle to contain and control social work. The article highlights four key dimensions in the enduring debates: values–roles, social–individual, care–control and public–professional.     

The End of the Welfare State?

This paper critically examines claims of a new consensus on welfare and the end of the welfare state. We first review the concept of welfare consensus, concentrating on the idea of welfare pluralism, in particular the relatively neglected distinction between national minimum (base) and extension ladder (superstructure). We then examine these concepts in the 1990s under Conservative and New Labour governments. Important changes to welfare pluralism are noted. There have been changes in the character of means-tests, with the national minimum replaced by a series of residual minima, which represent fundamental changes to structural incentives governing the social division of welfare and work. The line between state and non-state provision has been blurred and there have been moves to achieve universalism in the private sector. It is possible to tentatively classify Labour's principles and fledgling policies into three categories: essential continuity with the Conservatives, reversing Conservative policies and extending Conservative policies. However, it is difficult to detect the degree of consensus because a new flexible language is beginning to pervade social policy, with the result that the welfare state is being redefined, notably in areas of full employment, citizenship and conditionality. It is possible to detect, in our terms, moves towards turning Beveridge inside out and from the "Marshall" towards the "Beveridge" welfare state. It is clear that the welfare state is being redefined, but reports of its death have been much exaggerated.     

Biological Realism and Social Constructivism

In this paper we attempt to reconcile two important, current intellectual traditions: Darwinism and social constructionism. We believe that these two schools have important points of contact that have been obscured because each school has feared that the other wanted to put it out of business. We try to show that both traditions have much to of offer psychology, a discipline that has often been too individualistic, too concerned with the private and the subjective. The spirit of American pragmatism can be found in both camps; like the social constructivists, pragmatists focused on social transaction rather than internal happening, and like the Darwinian they were rooted in functionalism and the biological.     

The future of social work education: beyond the state of the art

David Cox (1995) argues that social work educators need to engage with social issues if they are to move social work away from the doldrums in which it has become trapped. Although this is true, changes of a greater magnitude are required if social work practice is to remain relevant in the twenty-first century. In a globalizing world, social work educators have to play a key role in internationalizing the social work curricula (academic and practicum) and socializing practitioners to embrace emancipatory approaches to social work if they are to counteract the brutalizing forces of industrialism and militarism. Engaging with social change to empower excluded groups requires social workers to work with "clients", policy-makers and international welfare organizations in ways that link the personal and structural dimensions of social life. In short, practitioners need to go beyond the state of the art if their interventions are to respond to the "person-in-their-situation" in a modern context.