Attachment Theory’s Universality Hypothesis: Clinical Implications for Culturally Responsive Assessment

Attachment theory has achieved a major influence in social work practice as a basis for research and as a foundation for clinical approaches. The contention that attachment as it is contemporarily understood is a ubiquitous phenomenon has been labeled the universality hypothesis. This hypothesis is built on three assertions—that healthy attachment is facilitated through parental sensitivity, that secure attachment is normative, and that healthy attachment leads to longitudinal competence. Critics argue that contemporary attachment theory privileges a conception of child-rearing that is fundamentally based on family structures and societal conditions that ignore the cultural practices of most of the non-Western world. Although the universality hypothesis is intended as a tool for research, this author contends that it can be used as a construct to guide culturally responsive clinical work. The article will first provide an extensive review of the debate around cross-cultural attachment and then explore its clinical implications. A brief case study of clinical work with an ultraorthodox family will be used to elucidate the author’s contention.     

Attachment and Coping Strategies in Middle Childhood Children whose Mothers Have a Mental Health Problem: Implications for Social Work Practice

Mental health has implications for the quality of relationshipswithin a family, particularly between parents and children,but also between other family and non-family members. Previousresearch has investigated parental reports of attachment infamilies with mental health problems, but relationship representationsas experienced by these children, especially in middle childhood,have not been so frequently investigated. An understanding ofchildren’s representations of attachment relationshipsand the different coping strategies that may result is importantfor social work practice when offering support, not only tothe children, but also other family members. Methods of investigatingattachment, such as the Separation Anxiety Test, have been usedto understand the relationship issues, fears and coping strategiesof other vulnerable children, and this study was designed specificallyto investigate relationship issues in middle childhood childrenwhose mothers had previously been hospitalized with mental healthproblems. We found that these children tended to be less emotionallyopen and secure, and generated fewer adaptive coping strategiesthan children whose mothers had never had mental health problems.Other themes also emerged from the interviews, such as a senseof trust in the parent–child relationship and the ‘containment’of fears. Implications for social work practice are discussed.     

The story of the PPO queen: the development and acceptance of a spoiled identity in child protection social work

The efficacy of child protection social work is regularly being questioned in the media as vociferous critics deride the profession for the apparent failings of its practitioners. This paper aims to examine the impact this hostility can have on practice and the relationship practitioners develop with their organization and subsequently the families they work with. By using autoethnography, a personal experience I encountered whilst working as a statutory social worker for an Emergency Duty Team will be explored in detail in order to analyse how discursive regimes can endorse and encourage particular ways of thinking and doing for social workers. I also intend to demonstrate that when workers operate in a risk averse environment, oppressive practices can develop subconsciously. These not only affect professionals’ values and assumptions but also fortify distance between the social worker and the client. If social work is to facilitate positive change in the current climate of uncertainty, then it is hoped that this story may enable both practitioners, and their critics, to recognize that being open to different forms of knowledge could lead to better outcomes for all involved.     

A secure base? The adolescent–staff relationship in secure residential youth care

The client–therapist relationship is recognized as an important factor contributing to outcomes of child and youth care. Particularly in secure residential youth care, in which adolescents with mainly externalizing behaviour problems are often placed coercively, the client–staff relationship seems to be important for the achievement of positive outcomes. The present study aims to assess the client–staff relationship for a group of 135 adolescents in secure residential care and factors associated with a positive relationship. The results show that adolescents, group care workers and teachers experience a limited affective bond in their relationship 2 months after the adolescents were admitted to the secure care centre. Adolescents do tend to use care workers and teachers as a secure attachment figure, which suggests that an affective bond is no precondition for the adolescents to experience staff as a secure base. Main predictors of a good relationship are the positive treatment skills of both group care workers and teachers. These findings point to the need for training of care workers and teachers so that they are better prepared for working with these adolescents.     

哈氏理论对社会工作的启示——把哈贝马斯带到社工实践中来

本文主要探讨的是哈贝马斯的理论对社会工作四个面向的启示。在社会工作反思方面,批判理论有助于社工警惕服务的异化。在社会工作分析方面,生活世界殖民化理论有助于社工洞察案主困扰的根源。在社会工作伦理方面,商谈伦理学有助于社工走出伦理的迷失。在社会工作实务方面,理想的沟通情境有助于社工开启温馨的对话。总之,本文致力于把哈贝马斯的论述带到社会工作实践中来。在文章最后,也对在社会工作实践中运用哈贝马斯理论的局限性作了说明。     

社会工作实务课程“体验教学”活动设计

体验教学法关注学生的心理体验,通过合理设计课堂体验活动,把社会工作实务技术与学生的生活实际结合起来,并鼓励学生重视自己的体验,在体验中领会社工实务的理念。实践证明,体验教学能够激发学生的学习兴趣,让学生更深刻地认识自己、了解自己,理解社工实务技巧。     

社会工作实务课程“体验教学”活动设计

体验教学法关注学生的心理体验,通过合理设计课堂体验活动,把社会工作实务技术与学生的生活实际结合起来,并鼓励学生重视自己的体验,在体验中领会社工实务的理念。实践证明,体验教学能够激发学生的学习兴趣,让学生更深刻地认识自己、了解自己,理解社工实务技巧。     

The impact of peer death on adolescent girls: a task-oriented group intervention

Adolescents' exposure to death is high, with approximately 40% of adolescents reporting past year death of a peer. Each of the estimated annual 14,000 deaths of adolescents has an impact on friends, classmates, and peers, with adolescent girls experiencing more peer deaths within a one year time frame than boys. Much of the literature focuses on parent or sibling death but little on the death of a peer. The sudden and unexpected nature of adolescent deaths appears to be a common experience that deeply affects adolescent girls and puts them at risk for a wide range of negative physical, emotional, social, and cognitive outcomes. The author outlines a task-oriented group intervention that meets the developmental, emotional, cognitive, and gender-specific needs of adolescent girls grieving the death of a peer.     

Family treatment of childhood anxiety

Anxiety in childhood and adolescence can cause serious impairment across many settings in a child's life. Childhood anxiety may be impacted by parent‐child attachment and by three specific parenting characteristics: acceptance, control and modelling of anxious behaviours. We review two evidence‐based family interventions for childhood and adolescent anxiety problems. Cognitive behavioural treatment is currently the most commonly used form of psychotherapy to treat specific anxieties. Global or diffuse anxiety, however, may be better suited to experiential interventions such as communications approaches to family treatment. Experiential therapists examine how dysfunctional family roles exacerbate childhood anxiety. These intervention techniques and their implications for social work practice were discussed.     

“Build a friendship with them”: The discourse of “at‐risk” as a barrier to relationship building between young people who trade sex and social workers

Young people in statutory care and protection interact with social workers, who hold potential to provide a supportive adult role in their lives. Many however, run away at an early age and end up on the street trading sex for money or other favours. There is potential to improve outcomes for young people in care if the relationship between young people and their social workers is better addressed. This paper uses data from a qualitative study of 14 young people who traded sex and who had experienced interactions with social workers. A thematic analysis identified three themes: the rigidity of social work practice; contesting the family situation; and resisting the at‐risk label. We argue that to have any impact on outcomes for young people in care, social workers need to prioritise relationship‐building above the need to conform to organizational protocols and guidelines. Such guidelines assist the social worker in assessing whether family situations pose high risk for a young person, but the “at‐risk” label is contested by young people, which results in a lack of trust and a barrier to relationship building.     

Assessment and decision-making in a case of child neglect and abuse using an attachment perspective

Assessment and decision-making in complex cases of child abuse and neglect is a difficult and taxing process. Although social workers have become increasingly good at collecting information, often under the direction of agency checklists and manuals, there is less confidence in knowing how to make sense of that information for purposes of assessment and decision-making. Theories help organize knowledge and attachment theory is proving to be a powerful player in helping practitioners make sense of what they know. The paper outlines the basic tenets of attachment theory. When adapted to the context of social work, a key principle of an attachment-based practice is the recognition that young children develop a range of adaptive strategies that are designed to help them cope with, survive, and function in whatever caregiving environment they happen to find themselves, including ones in which there is abuse and neglect. Although these strategies are functional within the context of adverse caregiving environments, they carry the risk of children suffering a variety of developmental impairments and failure to develop social competence. A case is described in which there are elements of abuse and neglect both within and across the generations. An attachment perspective is used to analyse and assess the quality and character of parenting and the different adaptive strategies developed by each child in the caregiving context in which they have found themselves. The assessment is then used to inform the decision whether or not to leave the children in the care of their mother or to place them with a long-term substitute family, with or without contact.     

The significance of a secure base: a psychosocial model of long-term foster care

ABSTRACT Long‐term foster care has been a much neglected area of social work practice and research. Yet there are obvious challenges that need to be understood when building a family for life in foster care. Is it possible for foster families, where there are no biological or legal ties between carers and children, to provide care, concern and family membership not only through childhood but also into adult life? The study on which this paper is based set out to explore that question by investigating the experiences of 40 adults, aged 18–30, who grew up in foster families. Qualitative interviews were conducted, transcribed and analysed. Theoretical frameworks from attachment and resilience were brought together with concepts such as ‘belonging’ and ‘family membership’ to make sense of the narratives provided. An integrated and dynamic psychosocial model of long‐term foster care was developed, which emphasizes the significance of a secure base and has some important implications for practice.     

Adolescent sexuality and premature parenthood: role of the Black church in prevention

The issues of sexuality and premature parenthood with the background of the Black experience in the United States are discussed. According to a 1986 study, 40% of US girls get pregnant at least once before the age of 20. In 1981, 45% of teenage pregnancies were terminated, and in 1982, 46% of girls 14-19 years old had had sexual intercourse. The gap between Black and White adolescent women regarding sexual intercourse has essentially disappeared, indicating that the underlying causes of teenage pregnancy are social not racial. The costs of adolescent childbearing are huge: in 1985 the public cost was at least 16.65 million dollars. In response to this crisis, many states have been searching for effective solutions enlisting clinics, schools, and social service agencies. The Black church has been a central institution within the Black community, in the forefront of many social changes with the ability to mobilize congregations and the community. Therefore, the cooperation of social service agencies, community groups, and the religious community could be fruitful in preventing adolescent pregnancies and childbearing. Such a venture would first require understanding the processes of adolescent development, self-esteem, socialization, relationship building, gender differences in physical and psychological changes, and moral development. A 1986 Gallup poll showed that 74% of 13-15 year old youth said that religion was one of the most important influences in their lives, indicating that they would be perceptive to moral reasoning. However, the fear of genocide was significant among the Black population (39%) when birth control and family planning programs were mentioned. This had to do with their brutal treatment in the past and coercive sterilization proposals to reduce welfare rolls. To overcome such fears and still prevent adolescent pregnancy, the Black church should organize workshops for parents and adolescents about sexual development, birth control, and the consequences of sexual activity with a view to postponing sexual activity and parenthood.     

Rhetoric vs. reality in social work supervision: the experiences of a group of child care social workers in England

Whilst the contribution of good supervision to high‐quality social work practice is widely recognized, research exploring practitioners' experiences of supervision is surprisingly limited. Set within the context of the supervision framework for employers of social workers in England, this small‐scale survey, using an extended questionnaire, examined the experiences of supervision of a group of child care social workers. The aim was to find out what aspects of supervision worked well and where there was room for improvement. The findings suggest that whilst the majority of employers had appropriate supervision policies in place, day‐to‐day practice varied enormously, frequently falling well short of national standards, with the quality of supervision often depending more on the characteristics of the supervisor and the agency context than the needs of the worker. Supervision sessions typically focused predominantly on case management, with much less attention paid to the worker and opportunities for them to reflect on their practice. Only a quarter of the social workers in this survey could be considered to be satisfied with their current supervision, with a much higher proportion clearly dissatisfied.     

Patterns of practice: An exploratory factor analysis of child and family social worker skills

There is relatively little research on the communication skills that social workers use in direct practice with families. This study explores patterns of practice skill found in child and family social work home visits. The study analysed 127 practice interactions in family homes, coding for seven dimensions of worker skill using a coding framework drawn from motivational interviewing. Exploratory factor analysis was employed to establish patterns of skill within the data and to group key dimensions of skill. The findings make two contributions. First, three fundamental dimensions of good practice emerged, which we characterize as care and engagement, good authority, and support for behaviour change. Second, in exploring the relationship between “care” and “control” elements of social work, skilled social workers were able to combine good authority and empathic engagement, whereas those who were less skilled in use of authority were also less good at engagement. This contributes to debates about care and control in social work. The usefulness of these dimensions for conceptualizing practice in child and family social work is discussed and directions for further research are suggested.     

医务社会工作者：他们的工作与专业训练

英美医务社会工作起源于医院社会工作,北京协和医院社会工作开创亚太地区和中国医院社会工作的先河。蒲爱德是中国医院社会工作服务模式的奠基人。她首次系统阐述开展医院社会工作的必要性、重要性和紧迫性,科学总结协和医院社会土作服务模式,明确提出医院社会工作者的配置原则、职责范围、服务方法和专业训练途径,为当代中国医院社会工作人才队伍建设提供宝贵历史经验,具有重要的现实意义、理论意义和政策意义。     

The effect of characteristics of human service workers on subsequent morale and turnover

The authors examine the relationship of sociopsychological characteristics of human services workers to their subsequent morale and continuance on the job. Eighty-two intensive case managers (half of them social workers) who had caseloads of clients with severe mental disorders were invited to participate in a four-wave panel study. Explored are the relationships between 16 predictors (general background, prior work experience and training, and social psychological variables) and worker outcomes (beliefs, attitudes, perceptions, and turnover). The major finding was that better personal well-being at the time of hiring was the most consistent and significant predictor of lower burnout, higher job satisfaction, and generally higher worker morale at later points in time. Those from higher social class backgrounds and those with lower starting salaries were more likely to leave the job. Those workers with more experience had a tendency to perceive greater client improvement.     

Poverty‐aware social work practice: service users' perspectives

In recent years, there has been an increase in scholarly writing on the theory and practice of critical social work with people living in poverty. Yet there is a lack of research on the experiences and perspectives of service users regarding this kind of practice. This paper presents a qualitative study that explored the practice of a special poverty‐aware social work programme in Israel, through the experiences of women who took part in it. Using an interpretative interactionist approach, in‐depth interviews with nine women were held three times over a 2‐year period. Findings reveal a high degree of satisfaction with the programme on the part of the women. The satisfaction was derived from four main experiences: the experience of visibility, the experience of the active partnership in the fight against poverty, the experience of close, hierarchy‐challenging relationships, and the experience of responsiveness to material and emotional needs. The findings are discussed in terms of three principles of practice: intervention in a real‐life context, relationship‐based intervention and the focus on both the material and emotional needs and their fulfilment.