Distress among Children whose Separated or Divorced Parents cannot Agree Arrangements for Them

Correspondence to Ann Buchanan, Department of Social Policy and Social Work, University of Oxford, Barnett House, Wellington Square, Oxford OX1 2ER, UK. E-mail: ann.buchanan{at}socres.ox.ac.uk Summary This paper, based on a larger study of children and their parentswho were subjects of a welfare report for the court followingparental separation and divorce, highlights the very high levelsof distress amongst the children involved. As measured by theStrength and Difficulties Questionnaire (SDQ), 52 per cent ofboys and 48 per cent of girls had significant adjustment problemsimmediately after the proceedings and a year later, 62 per centof boys and 32 per cent of girls were still maladjusted. Childrenwere more likely to have problems where parents were also distressedand where there was domestic violence. These findings suggestthat these children should be considered ‘children inneed’ under the 1989 Children Act. and that preventiveservices need to be developed to help parents resolve the arrangementsfor the children without going to court.     

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.     

Accommodation and Employment: A Survey into the Circumstances and Expressed Needs of Users of Mental Health Services in a Northern Town

Correspondence to Barbara Hatfield, Mental Health Social Work Research and Staff Development Unit, University of Manchester, Department of Psychiatry, Mathematics, Tower, Oxford Road, Manchester M13 9PL. Summary A sample of 120 mental health service users in a Northern Townwas interviewed about satisfactions and expressed needs in arange of life domains. Most of the 120 users were male, in theolder age ranges, and not in current partnerships. Most hadservere and long-term conditions. Living situations includedhospital wards, hostels, a group home, living with family orfriends, and living alone. The domains of accommodation andemployment are discussed in this paper. The majority of peopleexpressed themselves as ‘satisfied’ with their accommodation,although a sizeable monority were not satisfied. Lack of choiceof alternatives emerged as an underlying feature of ‘expressedsatisfaction’. A sizeable group expressed the need forhelp in obtaining employment, particularly those living in thecommunity. It is argued that for consumer choice to have a realisticmeaning, people with severe mental illnesses need the experienceof choice from more than one alternative.     

No-one else could understand': Women's Experiences of a Support Group run by and for Mothers of Sexually Abused Children

Summary Previous studies have shown that when a woman finds out aboutthe sexual abuse of her children the consequences for her areserious and can represent a major life crisis. Women in thisposition frequently report a lack of professional understandingand support. The current study explores the experiences of women attendinga busy peer support group at the NSPCC in York. It demonstratesthe vital role that peer support can play. It traces a varietyof factors which mean that family, friends and social workersare not well placed to help. At the heart of these difficultiesare the powerful feelings of guilt and failure in their roleas mothers which the women experienced as a result of the sexualabuse of their children. For these women it was impossible toshare with social workers their doubts about their own abilitiesas mothers, particularly in a context in which those workerswere making judgements about their ‘ability to protect’.On the other hand the support group provided a safe and non-judgementalforum in which these powerful emotions could be expressed anddealt with. The study explores the role that social workerscan play in relation to such groups.     

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     

Towards an Alternative Model of Social Groupwork

Summary This paper arose from our disagreement with some of the suggestionsin an earlier article in this journal (Brown et al., 1982).Before and since, we have both worked in and studied numerousexamples of groups of a type which, according to Brown and hiscoauthors, scarcely exists in British social work practice.This paper explains what we believe to be the actual significanceof the type of group work we refer to as ‘self-directed’,together with our view of its place within wider social work,community work, and groupwork practice. We also give examplesof such groups and conclude that their proliferation would enableworkers to go beyond the alleviation of individual distressinto the achievement of external change.     

Coping with a Life-threatening Illness: an Experiment in Parents' Groups

Summary Four separate series of parents' groups were held between 1977and 1981 in order to help certain parents of children who sufferfrom cystic fibrosis which is a serious life-threatening disease.These group experiences were found helpful by those parentswho did not have overt problems and who were therefore unlikelyto be referred for individual counselling. Families who hadobvious problems, for example marital, financial or psychiatricwere apparently not helped by the experience, nor were the parentsof newly diagnosed patients. As a result of this groupwork experiment it may be possibleto predict those families who are unsuitable for groupwork help.     

Birth Mothers and their Mental Health: Uncharted Territory

Correspondence to Janette Logan, Department of Social Policy and Social Work, University of Manchester, Oxford Road, Manchester Summary This article reports the findings of a study commissioned bythe Mental Health Foundation which examined the experiencesand needs of birth mothers who relinquished a child for adoption.Historically, birth mothers have been neglected in the Britishliterature; their experience is considered to have ended atthe time of placement. This research however, indicates thelong-term implications of relinquishment are severe—particularlyin relation to mental health. They demand that the complexityand uniqueness of relinquishment as a form of loss be more fullyunderstood, birth mothers' reactions to those experiences arenot pathologized and professionals learn to respond more positively.GP's in particular need to develop a more sensitive understandingof their needs and in so doing could prevent the medicalizationof some birth mothers.     

The Quality of Life of the Chronically Mentally Ill: A Comparison of Public, Private, and Voluntary Residential Provisions

Correspondence to J. P. J. Oliver, Lecturer in Psychiatric Social Work, Department of Psychiatry, University of Manchester, Rm 11.11, Mathematics Tower, Oxford Road, Manchester, M13. Summary A pilot survey was undertaken as part of a long-term investigationof the needs which people with chronic mental illness have forcommunity support. The main purpose of this preliminary exercisewas to develop relevant measures of need. particularly measureswhich give due weight to the assessments which chronic patientsmake of their own quality of life. Results have particular relevancein the light of the ‘White Paper’ on community care,Caring for People and the National Health Service and CommunityCare Act, 1990 because the survey considered patients' experienceof life in three distinct types of resettlement facility: thepublic, the private and the voluntary. While differences inregimes, the personal characteristics of residents and objectivequality of life were noted, no differences in subjective qualityof life (either in general or in specific domains of life) werenoted from one type of facility to another. These results andtheir implications are discussed.     

Government, Social Services Departments and the Health of Children and Young People: Which Way Forward?

Summary Despite the dearth of research into the health of children andyoung people in contact with or ‘looked after’ bylocal authorities, a series of official and quasi-official reportshave begun to raise awareness of this issue. There are goodreasons to believe that this group of children will be disadvantagedin terms of health as they are in other aspects of their lives.The evidence suggests that local authorities do not live upto the standards of ‘good parents’. Current notionsof good practice are critically appraised and the article concludesthat social work is unable to do more than mitigate the effectsof Government policies which affect health and social servicesand which have lead to widening social inequalities.     

Parton, Howe and Postmodernity: A Critical Comment on Mistaken Identity

Correspondence to Carole Smith, School of Social Work,, Department of Social Policy and Social Work, Dover Street Building, The University of Manchester, Oxford Road, Manchester M13 9PL Summary In their contributions to the debate about social work, modernityand postmodernity Parton(1994) and Howe (1994) argue that therecent changes in social work practice can best be understoodas features of, or responses to, the postmodern social orderin which it is located. This has led, they argue, to an increasingfragmentation of the profession and an undermining of its formalknowledge base. We will argue here that, not only does suchan argument oversimplify the nuances of the ‘postmodernity’question, but it represents a misreading of the pressures affectingpractice at this time, which are more properly attributableto the operation of the discourses and ideologies of a particularphase of late capitalism and high modernity.     

The Role of Father Involvement and Mother Involvement in Adolescents' Psychological Well-being

to Eirini Flouri, Department of Social Policy and Social Work, University of Oxford, Barnett House, 32 Wellington Square, Oxford OX1 2ER, UK. E-mail: eirini.flouri{at}socres.ox.ac.uk Summary This study of 2,722 British adolescents aged 14–18 yearsexplored whether paternal involvement can protect against lowlevels of well-being even when maternal involvement and riskand protective factors are controlled for. Results showed thatalthough both father and mother involvement contributed significantlyand independently to offspring happiness, father involvementhad a stronger effect. Furthermore, the association betweenfather involvement and happiness was not stronger for sons thanfor daughters. There was no evidence suggesting that familydisruption weakens the association between father involvementand happiness, or that father involvement is more strongly relatedto offspring happiness when mother involvement is low ratherthan high.     

Implementing Care Management: Issues in Relation to the New Community Care

Correspondence to Professor Jane Lewis, All Souls College, Oxford OX1 4AL Summary The official guidance on the new policy of community care emphasizedcare management as the means of securing needs-led services,together with user empowerment and choice. This paper uses datafrom eighteen months intensive fieldwork in five local authorities,first, to examine the very different interpretations of caremanagement in these authorities; secondly, to examine two majorsources of difficulty in the implementation of care managementsystems—the simultaneous development of purchaser/providersplits, and the tension between needs and resources—and,finally, to draw some conclusions about the implications ofcare management for social workers.     

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.     

Citizenship, Social Inclusion and Confidentiality

Correspondence to Tony Evans, Oxford Brookes University, Social Work Department, Heritage Gate, Sandy Lane, West Oxford OX4 6LB. E-mail: tevans{at}brookes.ac.uk Summary Confidentiality has tended to be disconnected from wider debatesabout citizenship and social inclusion. It has been hived offinto self-referential legal and professional discourses concerningthe principles that should inform social workers' conduct. Thelacuna concerning the significance of confidentiality in widerdebates is made more remarkable by the shift towards consumercitizenship, a shift that has ostensibly emphasized serviceusers' rights, including their capacity for active participationin service provision. The rights discourse, as a component ofactive consumer citizenship, is considered in relation to theperspectives of ‘interests’ and ‘will’.The arguments that support moving in the direction of a critical‘will’ perspective, through deliberative processesthat involve service users in developing and framing informationrights, are highlighted and linked to data from a small-scaleempirical study. This perspective is regarded as consistentwith a politically dynamic formulation of social citizenship.Such a formulation involves seeing citizenship as a practicethat requires on-going debates about claims to rights, movesin the direction of seeking to rectify imbalances in power andrecognizes the capacity of service users to act in their owninterests as citizens.     

Foster and Residential Children's Perceptions of Their Social Environments

University of Oxford, Department of Social and Administrative Studies, Barnett House, Wellington Square, Oxford OXI 2ER. Summary This paper compares foster and residential children's perceptionsof their social environments (placements). The exercise formedpart of a larger examination of care practice in special fosterhomes and Children's Homes. The application of a combinationof quantitative and qualitative techniques showed that the fosterchildren's perceptions of their placements generally comparedfavourably with those of the residential children.     

Case Management and Care Management in Community Care

Correspondence to Prof. Peter Huxley, Mental Health Social Work Research Unit, Department of Psychiatry, Mathematics Building, Oxford Road, Manchester University M13 9PL. Summary This paper reviews the purpose of case management, its introductioninto the UK, and its central components. While case managementhas empirical referents which have been developed over manyyears (largely in the USA) care management has, until recently,had none. The paper examines different models of case managementin terms of organizational structure, content, and outcome assessment.The importance of the distinction between clinical and administrativecase management is emphasized, especially in work with mentallyill persons. The review of existing evidence suggests that inorder to produce effective intervention services must have clearlyidentified objectives, closely specified target groups, interventionswhich match the objectives, and employ related outcome measurements.Some of the current issues in the implementation of care managementare considered.     

What Makes for Successful Groupwork? A Survey of Agencies in the UK

Summary This paper reports the findings of a survey of Social ServicesDepartments, Probation Services and the major voluntary agenciesin the UK. The survey aimed to shed light on the factors whichpromote successful groups in social work and probation agencies.The survey did not attempt to map the extent of current groupwork.A questionnaire was piloted in a Social Services Departmentin northern England with social work and social care practitionersparticipating in ‘The Groupwork Project’, a trainingand development programme which continues to have as its aimthe establishment of a groupwork service in a mainstream socialservices agency. The survey was designed to be illuminativeand exploratory rather than conclusive. In this paper, the authorsreflect on the research process and on the findings of the survey.These findings point to the complexity of factors consideredsignificant to the success of a group, and to the importanceof contextual factors in establishing and sustaining a groupworkservice.     

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.