Client Responses to Family Conciliation: Achieving Clarity in the Midst of Confusion

Correspondence to Dr. R. Simpson, Family and Community Dispute Research Centre, Claremont Bridge, University of Newcastle upon Tyne, NE1 7RU. Summary The present paper deals with one particular issue raised inthe course of a major piece of evaluation research into theeffectiveness of family conciliation in England and Wales. Fromaccounts of clients it became apparent that many of them wereexperiencing some confusion and misunderstanding regarding theprocesses they were undergoing. These confusions are describedand their implications for conciliation and the divorce processin general are discussed. The paper concludes with some suggestionsas to how this confusion may be minimized through the developmentof a broad-based and independent agency offering a comprehensiverange of services for those experiencing difficulties arisingfrom the break-down of an established relationship.     

Theory and Practice in Long Term Social Work: a Case-Study of Practice with Social Services Department Clients

Summary This study is based on empirical research into the practiceof 14 social services department social workers with 42 of theirlong term clients. The findings suggest that, contrary to expectation,this type of social work practice is not characterised by aproblem solving approach, but rather by a concern for the containmentof problems and the maintenance of stability. This leads toa restricted form of social work practice which is not linkedto any particular method of intervention. Reasons for this theory-practicehiatus are suggested along with a discussion of the issues surroundingtraining for long term social work of this kind in the future.     

Abortion: With Particular Reference to the Developing Role of Counselling

Summary This paper suggests that counselling is a rapidly expandingfield in which professional and para-professional workers mightcombine to produce an effective service, given appropriate selectionand training procedures. Initially these are seen as being providedby professionally qualified social workers with relevant experience.The author has used her own social work experience in abortioncounselling to exemplify the article and to discuss some ofthe existing problems for workers and clients alike.     

Aspects of Social Work on a Cancer Research and Treatment Unit in a London Teaching Hospital

Summary With the rapid growth of technology and science in society today,an increasingly large number of people are becoming patientsin specialized research and treatment units. The reorganizationof social work support to the health service is upon us, andgreat care must be taken to ensure that this important groupof clients will receive the social work help it needs. The paper is based on work in a cancer unit in a London teachinghospital and seeks to illustrate ways in which the work is specialized     

Applying Single-Case Evaluation in Social Work

Summary This article reports on a research project involving the useof single-case designs on an agency-wide basis within KirkleesMetropolitan Education Social Work Service. Following a programmeof training, 21 social workers (69 per cent of the service)applied the methodology in 83 cases. The extent of practitionerinvolvement in this project prompted Bruce Thyer (Professorat the University of Georgia, USA and editor of Research onSocial Work Practice and author of Thyer, 1993) to state ina letter to the authors, ‘Please allow me to offer mycongratulations on a most valuable project. To my knowledge,this is the largest agency-based study of this type which hasever been conducted. Your agency social workers are especiallyto be commended for their implementation of single-case designswith real life clients and families’ (6 May 1994). Theproject's strategy was to concentrate on the prerequisites ofsingle-case methodology which include specifying target problemsand selecting an appropriate measure to monitor progress. Thetype of single-case design used was determined by the courseof natural practice, hence indicating the flexible nature andviability of this methodology in the evaluation of social workpractice. The use of single-case designs encouraged a systematicapproach in the definition of target problems, identificationof goals, selection of intervention procedures and in monitoringoutcomes. The practitioners found that single-case designs enabledcontinuous assessment of outcome data by both the clients andthe practitioners, providing a model of accountability and collaborativeworking. A paper based on this article was presented by MansoorKazi at the ADSS Research Group Conference, Stafford, 17–18November 1994.     

Monitoring Interventions with Young Israeli Families

Correspondence to Dr Rami Benbenishty, School of Social Work, Hebrew University, Jerusalem, Israel 91905. Summary This paper describes a study monitoring interventions with familiestreated by a welfare agency in Jerusalem, Israel. The treatmentapproach is eclectic and is based mainly on a view of the familyas a system and on task-centred and problem solving orientationsto family treatment. Sixty families were studied. The clients'median age was about 30 years old and the median number of childrenwas two per family. The clients approached the welfare agencyfor four main reasons: financial difficulties (especially heavydebts), severe health problems and disabilities, marital difficulties,and problems in raising children. The practitioners identifiedin two thirds of the families dangerous situations that neededimmediate attention. A repeated measures design utilizing several outcome measureswas used. According to the workers' assessments, based on theCRS (Epstein et al., 1982), functioning improved and progresstoward goal attainment was observed in most families. The magnitudeof changes in functioning, however, was small. The workers'and clients' assessments of change and of goal attainment weremore positive. There were indications of deterioration at followup. The treatment outcomes are discussed in light of the clientand treatment characteristics. Changes in client selection,length of treatment, and an active follow up strategy are suggested.     

The Enduring Relevance of Case Management

Correspondence to Peter Ryan, School of Health, Biological and Environmental Sciences, Middlesex University, Archway, 7, Highgate Hill, London N19 5NF Summary This article summarizes the main results and policy implicationsof a Department of Health funded mental health case managementresearch and development project. The project implemented casemanagement services in four different sites, and worked withclients who were severely disabled with long-term mental illness.Higher levels of engagement (95 per cent) were achieved by case-managedas compared to control clients. They were also linked to a widerrange of community services. However, costs of the experimentalservices were higher, and client outcome variable. In two sites,case-managed clients achieved significant improvements in psycho-socialadjustment, whereas on the third site, there were no differencesin outcome between the control andexperimental clients. The article concludes that case management continues to be amode of service delivery which can achieve real benefits forclients in terms of preventing them from falling through thenet, and in linking them in responsive ways to community services.However, the increased costs can make it an unattractive optionfor purchasers, and ways need to be found to retain the establishedbenefits, whilst reducing the costs to service purchasers.     

A Danger to Themselves and to Others

Summary Some account is given of a small group of offender/patientsdefined as dangerous or potentially dangerous. Reasons are putforward in an attempt to explain an apparent reluctance to workwith such clients and the unease that often occurs when so doing.It is suggested that an approach may be required to such offender/patientswhich differs in some respects from more traditional modes oftreatment. Emphasis is placed upon the need for careful observationof material facts and events in the lives of such clients inaddition to the careful observation of the manifestations offeelings and attitudes which may give premonition of dangerousor potentially dangerous behaviour     

Agency Function and Social Work Principles

Summary The concept of agency function is examined in relation to thenature of the social work task. It is often the case that agencyfunction is seen more as a problem for social work and not asone of its characteristics. It is argued in this paper thatthe agency itself is not responsible for the apparently delicatestate of present day social work, but that on the contrary,the failure to appreciate social work's relationship to societyand social processes in part accounts for its uncertain condition.     

Social Work as Uncommon Sense

Summary Social work needs to resist pressures to identify itself solelyat a superficial level of common sense responses to social problems.It has to go beyond this to recognize its use of ‘uncommonsense’ as the means by which social workers cross therelationship gap and respond to their client's needs. The importanceof doing this in the early stages of relationship, as in crisisintervention, are considered, and stress is placed on holdingtogether both the explicit task-related aspect of the relationship,and the less obvious emotional interchange. By means of theiruncommon sense, social workers are enabled to reflect for, andshare with clients their areas of pain, in such a way as torender them more tolerable.     

Client Perspectives in a General Practice Attachment

Summary In this study, 50 clients of social workers in an attachmentscheme were interviewed and their views compared with the assessmentsmade by the social workers. The results were very favourablefor the attachment; the clients were well satisfied with theservice given and the majority of clients felt that they hadbeen helped, especially with their emotional problems. However,there was much disagreement between the social worker's assessmentand that made by the client, especially regarding the type andnumber of problems helped.     

The Independent Social Work Agency: A Report on the First Year of an Experiment in Social Casework

Summary The authors present an account of their experiences in organizinga research project to explore aspects of the need and demandfor social work through the use of an independent fee-payingagency. Some of the problems encountered in setting up the projectand the agency are discussed, along with some observations onthe first year's work in the agency.     

Agency Decentralization: Planning and Assessment

Summary Criteria are examined for the location of area offices in SocialServices Departments, drawing on the monitored experience ofdealing with voluntary callers to an area office in the ProbationService. Changes were observed in numbers of voluntary callersand the kinds of problems presented, together with developmentsin inter-agency relationships. The caller's subjective feelingsregarding the accessibility of the agency were found to be importantdeterminants of agency use. Implications are drawn out for planningdecisions in local authorities     

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.     

Work Satisfaction in Probation and Social Work

Correspondence to Professor Martin Davies, University of East Anglia, Norwich, NR4 7TJ. Summary The design and preliminary development of a research instrumentintended to provide comparable measures of work satisfactionwithin different social work settings is described. The resultsof administering it to two separate samples of social workersand probation officers are presented. It appears that probation officers feel themselves more highlyregarded by members of the general public and are less likelyto say they are badly paid; they enjoy more job autonomy; rathermore social workers tend to feel alienated at work, but mostbelieve that they have better chances of career advancementthan is the case in the probation service. There are broad similarities between the two work settings sofar as work with clients and attitudes towards colleagues areconcerned; it is argued that the emergence of these similaritiesis methodologically reassuring because it suggests the stabilityof the data overall, and therefore increases the likelihoodthat the findings regarding agency differences are a valid reflectionof social reality in each setting.     

Social Workers Talking to Clients: A Comment

Summary I read Baldock and Prior's article with interest in view ofthe shortage of studies examining day-to-day practice in socialwork, but the authors' analysis leaves me reflecting uneasilyupon the state of uncertainty into which social work has fallen.The authors conclude by describing as ‘skilled’,practices which they say resulted in confusion for clients andwhich only apparently reflected social work principles. We arenot told whether the authors checked their analysis with workersor clients and it is possible that the clients were not as confusedas we are led to believe, given their long term contact withthe workers. If, however, the picture is an accurate one, shouldit really be described as representing skilled social work?Baldock and Prior do so but neglect to examine the ends towardswhich interviewing skill should be directed in social work.The result is a strangely ambiguous statement about practice,particularly in the light of research findings on effectivenessand client satisfaction, and one which offers little scope forcomplacency.     

A Clash in Perspective? A Study of Worker and Client Perceptions of Social Work

Summary This study explores in a small sample of a worker's own clientswhether clashes in perspective occur between clients and socialworker, and how this is linked with satisfaction and dissatisfaction.Dissatisfied clients did not share a framework with the worker,but felt blamed and criticized by her, and the worker's ownbehaviour at the contract setting stage contributed to this.In contrast, satisfied clients and the worker appeared to havea positive shared perspective of the treatment process.     

Social Work as an Aspect of Primary Health Care: The Social Workers' View

Summary This study is based on an analysis of social workers' viewsof their work with 168 clients referred over a six month periodin 1977 in a health centre setting. A wide range of referralswas made and there was close collaboration with other primaryhealth care professionals as well as outside agencies. Far morepsycho-social problems were encountered by the social workersin the course of their intervention than were apparent on referral,although most of the work was short term. Social work with theindividual predominated and a variety of traditional socialwork skills were employed, although the elderly received relativelylittle help with emotional problems and were offered mainlypractical help. Social workers' perceptions of their clientsare discussed in relation to their choice of methods of interventionand feelings of efficacy. The attachment scheme emerges as generallyfruitful both in terms of social workers' job satisfaction andclients benefitting from a multi-disciplinary approach; howeverthe need for closer inter-professional collaboration in meetingthe needs of the elderly is highlighted.     

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.     

Reflections on Gender, Knowledge and Values in Social Work

Summary This paper is a discussion of the application of social workknowledge and values in practice. It draws on ethnographic researchin a child-care team in the UK which set out to explore theconstruction of clients as gendered. It is argued that socialworkers' accounts of practice reveal tensions between an emphasison clients as individuals and an emphasis on social collectivity.These tensions could be seen as inherent in social work knowledgeand values. There are various implications of these tensionsbetween the individual and the social, but there is a particularfocus in the paper on the implications for questions of gender.It concludes with some ideas for a theory for practice thatwould better equip social workers for the complex task of negotiatingthe gender tensions raised in the paper.