Maternal Depression, Child Care and the Social Work Role

Correspondence to Michael Sheppard, Principal Lecturer, Department of Applied Social Science, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA. Summary This article reviews findings on the relationship of maternaldepression and child care problems, a relationship which haslargely been ignored in social work. These findings are of particularimportance in view of the philosophy in the Children Act 1989that the best place to bring up a child is usually with theirfamily and the duty of local authorities to promote this. Thefindings consistently identify a clear relationship betweenemotional and behavioural child care problems and maternal depressionshowing that depression is likely to affect the mother's childcare abilities and also her perceptions of the child's behaviour.These have important implications for education, training andpractice, and these are discussed.     

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.     

Theory for Approved Social Work: the Use of the Compulsory Admissions Assessment Schedule

Correspondence to Michael Sheppard, Department of Applied Social Science, University of Plymouth, Drake Circus, Plymouth. Summary In his work on compulsory admissions under the Mental HealthAct, 1983, Sheppard (1990) developed the Compulsory AdmissionsAssessment Schedule (CASH) in response to identified knowledgedeficiencies and as a means for operationalizing a knowledgebase distinctive to social work. While subject to detailed theoreticaldevelopment it was not tested in practice. This article examinesthe use of CASH in practice, and the results have implicationsfor compulsory admission assessments. This paper indicates thatCASH is practical to use, that, although there are some greyareas, CASH on the whole distinguishes clearly between possiblesections and those not possible to section, that dangers, hazardsand risks are clearly identified, that rating is consistentwith the seriousness of dangers identified, that cumulativeuse of CASH may help develop accountability, and that socialwork evaluation of CASH is positive. This article concludesthat there are considerable benefits from the use of CASH, thatASWs should be trained properly in its use, and, more widely,that these results, together with Sheppard's (1990) originalresearch and theoretical development, indicates that, when conductedappropriately, social science can directly, and beneficially,be applied to practice.     

Contact and Collaboration with General Practitioners: A Comparison of Social Workers and Community Psychiatric Nurses

Correspondence to Mr M. Sheppard, Department of Applied Social Science, Polytechnic South West, Drake Circus, Plymouth, Devon PL4 8AA. Summary For some years good communication and collaboration betweenhealth and welfare professionals has been emphasized as a desirablegoal by both official reports and relevant professions. Thisis as much the case in mental health as other areas. This papercompares communication and collaboration between social workersand general practitioners (GPs) with that between communitypsychiatric nurses (CPNs) and GPs. Both social workers and CPNswere based at a community mental health centre, and the contactwas interagency (with primary health care). Major differenceswere found between social workers and CPNs. CPNs were far morelikely to contact GPs than social workers, although GPs veryrarely initiated contact themselves. Differences reflected different‘philosophies of contact’. Social workers contactedGPs when this could be purposively related to their case management.In addition to this contact, CPNs also made contact to provideGPs with information, reflecting awareness of GPs' long-termcontinuing care responsibility. The excess of CPN contacts wasnot limited, but involved a wide range of problems. GPs, however,when contacted, exerted greater influence on social work casemanagement. The article concludes by explaining differencesbetween CPNs and social workers in terms of occupational culture.It suggests, furthermore, that the results arise at least inpart from assumptions of team leadership by GPs, and that socialworkers' and CPNs' behaviour represents different responsesto this.     

Social Work, Social Science and Practice Wisdom

Correspondence to Michael Sheppard, Department of Applied Social Science, University of Plymouth, Drake Circus, Plymouth PL4 8AA. Summary Social work has for some time had an ambiguous and ambivalentrelationship with its social science knowledge base. However,this has arisen, at least in part, because of the emphasis onthe outcome or product of social science rather than the processby which research is conducted. This paper, focusing on assessment,argues that an emphasis on process goes some way to closingthe gap between social science and social work, that the methodsused by social researchers are, in many respects, simply refinementsof the methodology of everyday life, and that social workers,when conducting assessments operate rather like practical qualitativeresearchers. Using Analytical Induction as an heuristic device,it proceeds to explore critical characteristics of good practicein social work assessments. It concludes that practice shouldbe characterized by critical awareness, involving imaginativedevelopment of alternative hypotheses, a sceptical attitudetowards case assessments and a principle of adopting hypothesesleast likely to be in error.     

Practice Validity, Reflexivity and Knowledge for Social Work

Correspondence to Professor Michael Sheppard, Department of Social Policy and Social Work, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA, UK Summary In the last few years there have been significant developmentsin conceptualizing the role and nature of knowledge in socialwork. This has been based on a fundamental review of epistemological,ethical and theoretical facets of social work and its knowledgebase. Amongst some of the most significant developments havebeen the emergence of new concepts (for social work) such asprocess knowledge, reflexivity and a range of ideas relatingto hypotheses. In a recent article, Susan White (1997) soughtto critique some of my ideas on this matter. This article representsa response to her paper; one which uses the opportunity to drawout wider issues for a general theory of social work knowledge.In particular, it focuses on three key dimensions: the centralityof the concept of practice validity, the importance of a conceptof reflexivity which is not simply transferred from the disciplineof sociology but which has a social work-specific meaning, andthe dangers of an unrestrained relativism.     

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.     

Social Work and the Justice Model

Summary Three sets of ideas, which I am calling justice, welfare, andcommunity approaches interact in the criminal justice systemsof England and Scotland. Social workers are usually most influencedby a welfare approach but this approach is always in dangerof becoming arbitrary. The essential values of a welfare approachmight in fact be strengthened by introducing from the justiceapproach ways of structuring discretion. This idea will be examinedin relation to juvenile justice and parole where compulsorypowers back the application of welfare ideas. Ways of ensuringthat social work discretion is confined, structured and checkedwill be considered.     

Managing Human Services in a Market Environment: What Role for Social Workers?

Correspondence to Karen Healy, Department of Social Work, Social Policy and Sociology, Building A26, University of Sydney 2006, New South Wales, Australia. Summary International research suggests that the market reform of humanservices is leading to reduced opportunities for social workersto achieve organizational management positions. This paper exploresthe future of social workers as managers of human service organizations.It examines the tensions between the social justice principlesthat guide social work and the emerging contexts of social welfaremanagement. The exploration draws on in-depth interviews withthirty-four social welfare managers working in the non-profitsector in Australia. These managers were identified by theirpeers as progressive, that is, as championing social justicevalues such as access, equity and social inclusion. This paperwill report on their approaches to social welfare managementand their perceptions of the threats and opportunities for progressivemanagement practices in a climate of public sector reform. Thepaper will consider how social work educators can better prepareservice professionals for social welfare management positions.     

Prior Criminality and Employment of Social Workers with Substantial Access to Children: A Decision Board Analysis

Correspondence to Joanne M Smith, Department of Social Policy and Social Work, 20 Portland Villas, University of Plymouth, Drake Circus, Plymouth, Devon PL4 8AA Summary The central purpose of this research was to find the extentand circumstances of the influence which a criminal record hasupon appointment as a social worker with substantial, unsupervisedaccess to children. One would suppose that applicants with aconviction for indecently assaulting a child would never beappointed, but that those with other kinds of record would beappointed to the extent to which prior offences were relativelytrivial, distant in time and involved property rather than people.The reality was much less clear-cut. The study may be seen asa way of depicting the pattern and process of current practice.It has clear implications for the refinement of guidance toachieve nationally desired ends of child protection. This article will draw upon data gathered for a Ph.D., incorporatinginterviews with every social services department (SSD) in Englandand Wales. The study has yielded interesting findings relatingto (inconsistency in decision making across SSDs. The findingsfrom the first 64 interviews have been used for the article.Preliminary analysis suggests that the remaining interviewsshow similar patterns. The focus will be on possibly the mostsignificant finding of the research: that six SSDs in a decision-makingprocess relating to a number of fictitious candidates, revealedthat they would have agreed to employ one of the candidatesas a children and family social worker, despite knowledge ofthat candidate's conviction for indecently assaulting a child.     

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.     

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.     

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.     

Compulsory Persuasion: A Problem for Correctional Social Work

Summary Social work risks being misused as a technique for controllingundesirable behaviour, regardless of clients' expectations orchoices. This approach to social work involves certain underlyingassumptions about human nature which raise considerable ethicaland practical difficulties. Recent trends in the probation andafter care service are considered, together with some researchstudies of the effectiveness of social work in reducing offendingbehaviour. From these it is argued that social work servicesfor offenders are more likely to be effective when the emphasisis on helping with perceived problems and difficulties ratherthan on crime prevention.     

Mental Health and Social Justice: Gender, Race and Psychological Consequences of Unfairness

Correspondence to: Professor Michael Sheppard, Department of Social Policy and Social Work, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK. Summary It is not immediately obvious how social justice might relateto mental health. Mental health or ill health is, by some, thoughtto be inherent within the individual, whereas social justice,as its name indicates, resides within the realm of the social.However, where we understand social justice as, on the one hand,an issue involving equality and fairness, and on the other ashaving both material and symbolic dimensions it becomes clearthat there is an important link. In particular groups whichsuffer disadvantage and discrimination may be expected to sufferhigher rates of mental ill health. However, the key to understandingthis is by identifying the mechanisms by which this can happen.In order to do this it is necessary that we do not look at mentalhealth (or illness) in an undifferentiated way, since thereare different processes involved for different forms of mentalill health. We shall, therefore, look at this by focusing onthe issue of social justice through two significant relationships:gender and depression, and race and schizophrenia. We shallexamine the mechanisms which link these together, and show howthey are significant psychological consequences of social injusticearising in both material and symbolic form.     

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.     

Evaluating Social Work and Medical Practice with Black and Ethnic Minority Groups Using the Clinical Audit Model

Correspondence to Kish Bhatti-Sinclair, Department of Social Work Studies, University of Southampton, Highfield, Southampton SO17 1BJ, UK. Summary This paper is based on the External Audit-Ethnically SensitivePractice (EA-ESP) project which was undertaken within six primaryand secondary health care settings. This project is used asan example of how the clinical audit model can be used to monitorand review health and social work practice in the UK. The paperexamines quality, compares approaches to evaluation, and suggeststhat audit can be a useful tool for agencies in obtaining userand staff views on many areas of practice but in particularon equal opportunities, anti-racism and anti-oppression. Attentionis drawn to audit within broader evaluative and review approachesalready employed by social work academics and practitioners.The issue of quality and how it can be measured is consideredthrough an analytical comparison with approaches which employaction research and other evaluative means in the process ofreview. Audit is explored in the context of a growing need for the developmentof monitoring and review systems which provide evidence to supportand develop professionalism within social work. External auditis explored and compared to internal audit. Finally, the needfor the development of quality services in anti-racist and anti-oppressivework is highlighted and it is suggested that audit can be acost-effective and efficient way of achieving this.     

General Practice, Social Work, and Mental Health Sections: The Social Control of Women

Michael Sheppard, Senior Lecturer in Social Work, Polytechnic South West, Drake Circus, Plymouth, Devon PL4 8AA. Summary A survey was undertaken of all referrals for compulsory admissionreceived by a city mental health centre over a one year period.The centre receives the overwhelming majority of all these referralsin the city. Referrals from GPs were compared with other referralsfocusing particularly on women. The results indicate GPs discriminatedagainst women, referring considerably more women than men withless emphasis on major (psychotic) mental illness. The involvementof approved social workers (ASWs) in the assessment processwas associated with diversion of many of the women away fromcompulsory admission, although even they appeared affected bypatriarchal assumptions. GPs' behaviour with regard to sectionsis consistent with reports about sexist practice in other areasof work. This, however, is particularly grave with sectionsbecause of civil liberties implications. The article concludesthat ASWs need be aware of potential sexist GP practice, thattheir psychosocial perspective is critical to assessment andthat ASW training should include gender issues.     

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.     

Social Work in Accident and Emergency Departments: A Better Deal for Older Patients' Health?

Correspondence to Eileen McLeod, School of Health and Social Studies, University of Warwick, Coventry CV4 7AL, UK. Summary Well-established internationally, the current development ofsocial work in UK accident and emergency (A&E) departmentsis part of a conjoint health/social care policy drive to divertolder people from ‘unnecessary’ admission to acutehospital care on social grounds. However, from older serviceusers' standpoint, the prime criterion for assessing A&Esocial work is not its powers of diversion, but its contributionto optimum health and social care. Our account indicates thatA&E based social work can provide important benefits, includinghelp with negotiating the A&E environment and readier accessto social services. Nevertheless, continuing professional–serviceuser power imbalances, together with shortages in health andsocial care services, undermine its positive contribution bothwithin A&E and following discharge. Notably, under-resourcedcommunity based health and social care can lead to servicesimplemented through A&E, swiftly unravelling. This has seriousconsequences for older service users facing interlinked healthand social problems, and may be implicated in re-attendanceat A&E.