Would Palliative Care Patients Benefit from Social Workers' Retaining the Traditional 'Casework' Role rather than Working as Care Managers? A Prospective Serial Qualitative Interview Study

Social workers have made a significant contribution to the developmentand delivery of palliative care. Both palliative care and socialwork are rapidly evolving but, given their changing contextsand increasing workloads, can they sustain compatibility? Advancesin treatment of life-threatening illness mean that people livelonger in a period of palliative care. Social work has undergoneradical change in the wake of the 1990 NHS and Community CareAct and subsequent local-authority modernizations, with socialworkers now given the role of care managers, rather than themore traditional ‘casework’ or therapeutic role.This paper aims to explore the current and potential role ofthe social worker in palliative care for people with cancerand other prolonged life-threatening illness. It draws uponevidence from a prospective qualitative, patient-centred researchstudy, which detailed the experiences of forty people with lungcancer and advanced cardiac failure, and their personal andprofessional carers (Murray et al., 2002). A total of two hundredand nineteen qualitative interviews were carried out. We found that social workers were conspicuous by their absencefrom the lives of these forty vulnerable adults, who were livingand dying in the community with many unmet needs which, potentially,could be met by social-work input. The study highlights sixareas of concern in which social-work assessment and interventioncould have impacted on dying patients’ quality of lifeand that of their carers: loss and dependency, family-centredissues, carers’ needs, practical tasks, emotional andspiritual struggles, and finally, support needs of staff. Theseareas are outlined to explore the territory which a social workermight inhabit if resources and policies permitted.     

Making 'Anti-Social Behaviour': A Fragment on the Evolution of 'ASBO Politics' in Britain

The British Association of Social Workers has actively opposedAnti-Social Behaviour Orders (ASBOs). It is the contention ofthis article that there is a pressing need to interrogate factorswhich are influencing and driving the ASBO agenda during theperiod of New Labour in Britain. The discussion begins by referringto the significance of keywords and phrases in social work andsocial policy. This is followed by an examination of the recent(re)appearance of concern about ‘anti-social behaviour’.A critical overview of the White Paper Respect and Responsibility:Taking a Stand against Anti-Social Behaviour (Home Office, 2003a)is then provided. It is then argued that Tony Blair and formerhome secretary, David Blunkett, played distinctive roles increating Britain’s ASBO politics. This, moreover, is apolitics which potentially narrows social work’s roleand purpose.     

'Lifeworld', 'System' and Family Group Conferences: Habermas's Contribution to Discourse in Child Protection

Habermas’s critical social theory has been challengedon a range of fronts. However, the authors see merit in hismediation thesis as set out in the seminal text, Between Factsand Norms (1996). Adopting a pragmatist defence of the thesis,we review and demonstrate the effectiveness of what we believeis a coincidental expression of some of its main tenets—TheFamily Group Conference in Child Protection. Drawing furtheron Habermas’s work, we then proceed to re-work aspectsof the conference’s core processes, thereby accentuatingthe possibility of empowering dialogue between its key participants:the families (who embody the ‘lifeworld’) and thesocial work professionals (who represent the ‘system’).In the final section, we argue that moral practice in childprotection must be safeguarded by communicational proceduresthat explicitly address issues relating to the use of powerand the need for ‘recognition’ between subjects.     

Looking Back: The View from Here

This article considers key developments in social work in thelast decade. From the vantage point of Australia, British socialwork (and the British Journal of Social Work) is seen in a particularperspective. However, some international comparisons are possible.Thus, the article focuses on two apparently contradictory developments:the ‘search for uncertainty’ in post-structuraltheory and the ‘search for certainty’ in evidence-basedpractice. It concludes that both, in different ways, describesocial work in the early twenty-first century.     

'Low Key Practices' in Social Work. Towards a Socio-historical Method

Summary In this article a ‘socio-historical’ method of analysisand intervention in social work will be developed, illustratedby an example drawn from social work with families, the programknown in France as Action Educative en Milieu Ouvert. Our purposeis to support and encourage what we call ‘low key practices’,which refers to practices in which social workers within theexisting structures of so-called ‘individual social work’attempt to explain the social struggle taking place in the situationsthey are dealing with.     

Mapping Child-Care Social Work in the Final Years of the Twentieth Century: A Critical Response to the 'Looking After Children' System

Correspondence to Paul Michael Garrett, c/o, British Journal of Social Work, University of Warwick, Coventry, CV4 7AL Summary This paper explores aspects of the Looking After Children: GoodParenting: Good Outcomes system (LAC) (Parker et at., 1991).It is suggested that the scheme, to be used with children andyoung people who are ‘looked after’ by local authorities,needs to be subjected to greater critical scrutiny. The paperseeks, therefore, to situate the LAC system in a social andpolitical context and highlights how it also relates to thedominant operational modalities of social work interventionin the late 1990s. In addition, the paper explores how ‘troublesome’children and ideas centred on ‘parenting’ featurein the LAC discourse. The discussion concludes with an examinationof Action and Assessment Records (Ward, 1995b), the centrepieceof the LAC system.     

'Anti-Oppressiveness': Critical Comments on a Discourse and its Context

This paper identifies and aims to explain an apparent dissonancebetween the dominance in Britain of ‘anti-oppressive’social work discourse and the socio-political context surroundingits use; a context often claimed to feature excessive regulationand control. Pursuing this, some politically radical aims associatedwith ‘anti-oppressiveness’ are spelt out, and thedifficulty of achieving these in an unconducive climate is discussed.Then, a distinction made by Robert Merton between ‘latent’and ‘manifest’ functions is used to suggest thatthe manifest radicalism of ‘anti-oppressive’ discoursecan helpfully be distinguished from some latent largely unrecognisedconsequences of its use – not consequences with politicallyradical impact, but with a social meaning congruent with a climateof control. It is concluded that the ‘success’ ofanti-oppressive discourse might well be viewed as requiringmore of the kind of critical analysis that the discourse itselfwas supposed to espouse.     

Modernity, Postmodernity and Social Work

Correspondence to Prof. David Howe, School of Social Work, University of East Anglia, Norwich NR4 7TJ. Summary For so long in search of a common base, there are early signsthat social work's intellectual outlook is fragmenting. Theunity that was once sought in both theory and practice as wellas policy and organziation is being abandoned. A child of modernity,social work now finds itself in a postmodern world, uncertainwhether or not there are any deep and unwavering principleswhich define the essence of its character and hold it togertheras a cohernt enterprise. The article outlines some of the characteristics of modernityand postmodernity, relating them to the rise of social work,its formation within modern society, and its current conditionin what many observers believe is a postmodern world. Thereare three ‘visions’ within which people look toleam the ’truth‘ of things, including matters offact and matters of value: those centred in God's word (revelation);those centred in the minds of men and women (reason); and thosede-centred and dispersed withing language, meaning and culture(relativism).     

Responding to Youth Crime in Scotland

Correspondence to Bill Whyte, Director, Criminal Justice Social Work Development Centre for Scotland, School of Social and Political Studies, University of Edinburgh, Flat 1FR, 31 Buccleuch Place, Edinburgh EH8 9LJ. E-mail: B.Whyte{at}ed.ac.uk Summary Scotland’s Children’s Hearings deal with young peoplewho offend within an integrated system dealing also with youngpeople in need of care and protection, on the assumption thatthe difficulties of both groups have similar roots in multiplesocial disadvantage and social adversity (Whyte, 1998a). A government-fundedstudy, one of the first since the system’s inception in1971, was commissioned to examine the social characteristicsof over 1,000 children and young people referred for offenceand nonoffence reasons. This paper describes the characteristicsof 465 of the young people who were referred specifically foroffending. It provides the first ‘official’ datain twenty-five years on young people in the system. The studyfound that most of those referred for offending had characteristicsstrikingly similar to those referred for nonoffence reasons,as predicted when the system was first established, and similarto those present in the general literature on young offendersfrom other jurisdictions. The study poses fundamental questionstaken up by the Scottish Executive’s review of youth crimeon how best to design systems and develop social interventionsthat can address offending and social disadvantage in an integratedway.     

Keeping Social Work Honest: Evaluating as Profession and Practice

Correspondence to Ian Shaw, School of Social and Administrative Studies, University of Wales Cardiff, 50 Park Place, Cardiff CF1 3AT Summary The central argument of this paper is that social work needsa radical alternative to existing options for evaluating practice.Social workers at present are offered three choices. They areinvited to choose between applying research, conducting researchor adopting specific forms of empirical research-based practice(for example Everitt et al., 1992; Thyer. 1993; Fuller and Petch,1995). We touch briefly on reasons why we believe none of these optionsprovides an adequate grounding for social work, referring especiallyto the growing call for social work to find new purpose throughan empirical, research-based practice. If alternative approachesare to be persuasive, they must be fashioned from the materialsof a new approach to research on social work practice—‘one that is exploratory rather than confirmatory, buildinga model of evaluation from the practitioners' own accounts ratherthan superimposing an ideal model’ (Elks and Kirkhart,1993, p. 555). The major part of this paper is taken up withevidence from research of this kind. The model of evaluatingin practice with which we conclude the paper is simultaneouslytrue to social workers' accounts of their practice, while offeringa critical starting point for evaluating and refashioning thatpractice.     

Beyond Social Constructionism: Critical Realism and Social Work

Summary Theories within the social and psychological sciences continueto shape social work practice. However, recent debates withinthese sciences on the shortcomings of ‘social constructionism’,and the attempt to overcome them through a critical realistposition, have so far failed to capture social work's attention.This paper provides a critical overview of these theoreticaldebates, highlighting the shortcomings of social constructionismfor social work. The critical realist challenge to social constructionism,as articulated by the British philosopher Roy Bhaskar, is consideredand its relevance to social work formulated in terms of a returnto ‘depth’ in practice.     

How to be Modern: New Labour's Neoliberal Modernity and the Change for Children programme

In England the New Labour administration is seeking to embeda ‘transformational reform agenda’ within children’sservice. Social workers, among others appear, however, to bewary of the agenda which is now rhetorically rooted in the EveryChild Matters: Change for Children programme (CfC). The mainsocial work practice elements of this programme are associatedwith the introduction of a Children’s Index, a multidisciplinaryCommon Assessment Framework and the role of Lead Professional.In terms of the promotion of this programme, the governmenthas maintained that the focal aim is to create a ‘modern’children’s workforce. However, the entire ‘transformationalagenda’ can be interpreted as reflecting New Labour’sneoliberal modernity. This is particularly apparent in the termsof the ideas associated with ‘flexibility’ whichare so central to the CfC programme.     

Use of Critical Consciousness in Anti-Oppressive Social Work Practice: Disentangling Power Dynamics at Personal and Structural Levels

One of the limitations of anti-oppressive perspectives (AOPs)in social work is its lack of focus at a micro and individuallevel. AOPs should entail the social worker’s addressingthe needs and assets of service users, challenging the oppressivesocial structure and, most importantly, critically challengingthe power dynamics in the service-provider/service-user relationship.Critical consciousness challenges social workers to be cognizantof power differentials and how these differentials may inadvertentlymake social-work practice an oppressive experience. The authorscontend that critical consciousness fills in some of the gapsof AOPs, and argue for a fuller integration of critical consciousnessinto teaching and practice of AOPs. The methods to work towardcritical consciousness, such as inter-group dialogues, agent–targetdistinctions and empowerment, are detailed.     

Yes Minister: Reviewing the 'Looking After Children' Experience and Identifying the Messages for Social Work Research

Correspondence to Paul Michael Garrett, Centre for Social Work, School of Sociology and Social Policy, University Park, Nottingham NG7 2RD, UK. E-mail: paul.garrett{at}nottingham.ac.uk Summary The heavily promoted Looking After Children: Good Parenting,Good Outcomes (LAC) project continues to exert a powerful influenceon social work in the UK and elsewhere. Despite the repeatedassertions that the documentation associated with LAC is embeddedin ‘objective’ research, this not sustainable onaccount of the failure of the researchers to interrogate theirown normative assumptions and judgements. Specific criticismscan also be levelled at the ‘community study’ connectedto the evolution of the Action and Assessment Records (AARs)which are the key part of the scheme. The system should alsobe viewed in the context of wider pre-occupations about ‘outcomes’.In addition, the project needs to be politically situated andthe researchers' relationship with the Department of Healthshould be more fully explored. In conclusion, it is suggestedthat the LAC experience contains important ‘messages’for the future of social work research.     

Irish Social Workers in Britain and the Politics of (Mis) Recognition

The article focuses on the perceptions of Irish social workersworking in ‘children and families’ settings in Britain.These respondents cannot be seen as representative of all Irishsocial workers in Britain, yet they do provide insights intofive significant themes: the approach to ‘race’and ethnicity in social work education; Irish identities inBritain; racism and stereotyping; children and families whoare Irish Travellers; and an agenda for the future. The discussionconsiders some of the issues raised in the context of what hasbeen referred to as the ‘politics of recognition’.     

Problems in the Perinatal Prediction of Child Abuse

Summary The aim of this paper is to consider and comment criticallyupon the recommendation by some eminent authorities that effortsbe made to design and implement procedures to predict the abuseof children. My view is that this move toward prediction—‘sponsored’largely by American paediatricians—is less of a new departurethan an extension of the dominant conceptual tradition wherebychild abuse is seen as analogous to a disease. However, in spiteof its basis in a medical model, it is clear that the idea thatthe abuse of children can be accurately predicted has greatappeal for many social workers. I shall argue, however, thatserious obstacles stand in the way of prediction; that theseobstacles are insufficiently appreciated by the advocates ofprediction; and that—consequently—social workers(and others) should temper with scepticism their enthusiasmfor these developments.     

Moral Positioning: Service User Experiences of Challenging Behaviour in Learning Disability Services

Several studies have indicated the importance of challengingbehaviour as a limiting factor on quality of life (Murphy et al., 1996;Brown and Thompson, 1997; Schwartz, 2003). This article presentsthe findings of research that aimed to investigate adults withlearning disabilities’ understanding and experiences ofwhat is perceived by staff and services to be challenging behaviour.This study was the final phase of research reported previouslyin this Journal (Hayden and Stevens, 2004). Interviews, groupdiscussions and observations were carried out with twenty-sixpeople with learning disabilities using social services’residential and day services. Participants were able to articulatecomplex responses about challenging behaviour, which is characterizedas a ‘moral web’: a complex network of antecedents,behaviours and consequences. Social care staff were seen byparticipants to play a key role: protecting people and ensuringthat appropriate (negative) consequences were suffered by instigatorsof challenging behaviour. These findings are interpreted withina positioning theory perspective, suggesting the importanceof understanding the ways that challenging behaviour is constructedthrough social interaction. Implications in the following areasare discussed: developing practice; the role of social carestaff; and the study of challenging behaviour as a social phenomenon.     

'Problematics of Government', (Post) Modernity and Social Work

Correspondence to Nigel Parton, Professor in Child Care Studies, The University of Keele, Keele. Staffordshire ST5 5BG. Summary This paper attempts to locate contemporary developments andtensions in social work within current debates in social theoryconcerning the problematics of government and (post) modernity.It argues that modern social work emerged in a period of ‘welfarism’which has now passed and that as a consequence social work hasnot simply been restructured in the era of neo-liberalism butis exposed as an activity particularly concerned with managingfamily life via the exercising of moral judgements and negotiatingresponsibilities. As a consequence the essential ambiguitiesof social work are more self evident than previously, and ratherthan constituting problems to be overcome, articulate the centralelements of what it is to do social work. The article concludesby, tentatively, outlining the implications of such an analysisand how it may help us to understand what is going on and howwe might proceed.     

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.     

Returning to Normality: Substance Users' Work Histories and Perceptions of Work During and After Recovery

Correspondence to Andreas Cebulla, National Centre for Social Research, 35 Northampton Square, London EC1V 0AX, UK. E-mail: a.cebulla{at}natcen.ac.uk Summary New service provisions designed to improve the employment prospectsof former substance users will enhance the roles and responsibilitiesof Drug Action Teams (DATs), Jobcentre Plus offices and otherproviders and co-ordinators of support services for substanceusers. This paper discusses the findings of a study of 30 currentand former drug and alcohol users, exploring past substanceuse histories and current employment aspirations. The researchinforms new policy initiatives designed to assist substanceusers’ entry or return to work. Differences in presentperceptions of work-readiness were observed, which reflectedusers’ perceptions of the nature of their addiction. Theattribution of blame for the substance dependency to either‘the drug’ or the individual’s psychologywas a critical influence on users’ work-readiness assessments.Work was perceived to benefit recovery from substance dependency.The evidence suggests that substance users’ return towork might be helped by their staged (re-) introduction to thelabour market as well as encouraging the primary labour marketto employ (more) recovering substance users. The research highlightedthe need for joint working between employment services and DATsto help substance users into work and to support their recovery.It also highlighted the need for mutual understanding and recognitionof each collaborator’s expertise.