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     

'The Integration of Theory and Practice': a Re-examination of a Paradoxical Expectation

Summary Social workers seem to agree that the nature of the relationshipbetween theory and practice is problematic. However, few ofus have asked what we really mean when we talk of these problems.This paper re-examines the meanings commonly attributed to eachnotion and to the relationship between them. As a result ofthis process the paradoxical nature of the current expectationof ‘integrating theory and practice’ is exposed.This leads to a proposal that we modify our way of framing themeaning of ‘integration’ and thus introduce a newdimension to questions we pose when trying to improve socialworkers' ‘integration of theory and practice’. ‘Wecan no longer explain a paradix by running away fromit; we muststand and look it in the eye’.     

The State of Welfare

Summary The word ‘welfare’ is difficult to define becauseit combines within it a range of ideologies and actions. Twoconclusions are drawn from this: first, that social servicesshould be regarded as contributors to, but not providers ofwelfare; second, that the study of social work and social administrationshould be concerned not only with the relationship of ‘service’to ‘need’ but also with societal movements and pressureswhich determine the emergence of both. The article reviews theprofessed values of the welfare state, particularly ‘socialequality’ and the problems associated with its achievement,namely public attitudes, and the discontinuity between intentionand practice in the welfare services. The implications for socialwork education and practice are considered.     

Technicality and Indeterminacy in Probation Practice: A Case Study

Correspondence to Department of Law, Crookesmoor Building, Conduit Road, Sheffield S10 1FL, UK. E-mail: g.j.robinson{at}sheffield.ac.uk Summary ‘Technicality’ is a theoretical construct which,in the context of professional practice, refers to those aspectsof the work which can be prescribed, ‘programmed’or subject to routine practices. This paper considers the purportedrise of technicality in probation practice, with particularreference to the relationship between increasing technicalityand perceptions of ‘professionalism’. The paperpresents a case study of one ‘technical’ initiativein the probation context: namely, a structured risk/needs assessmentinstrument. The case study examined the implementation of thisinstrument in two area probation services, with a view to establishingits impact both on the exercise of professional judgement (‘indeterminacy’),and on perceptions of professionalism among users and theirmanagers. On the basis of the case study it is argued that,contrary to many recent commentaries, neither significant reductionsin indeterminacy nor an inevitable process of deprofessionalizationcan be automatically ‘read off’ from attempts tointroduce greater structure and/or standardization to socialwork and probation practice. The tentative conclusion of thispaper is that the professional future lies not in a wholesalerejection of technicality, but rather in achieving a positive,workable balance between technical and indeterminate aspectsof practice.     

'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.     

Self-fulfilling Prophecies, Self-defeating Strategies and Change

Summary This paper sets out to describe and define ‘self-fulfillingprophecies’ and ‘self-defeating strategies’and discuss their relevance to understanding families. The conceptsare presented as a model for making sense of, and simplifying,the complex repeating sequences of behaviour seen in families.It is a model which has a behavioural and a cognitive componentand this may form a bridge between theories which concentrateon the ‘here and now’ and those which emphasizethe significance of history. Examples of the model are givenwith an analysis of the process of interaction. Certain featuresof self-defeating strategies are discussed, specifically howattempts to avoid a particular outcome can, in fact, precipitateit and how obsolete expectations can inhibit families from changing.Finally, some of the underlying assumptions of the model areexamined.     

The Abduction of Credibility: A Reply to John Paley

Correspondence to Liz Kelly, Child and Woman Abuse Studies Unit, Ladbroke House, 62-66 Highbury Grove, London, N5 2AD Summary This response takes issue with John Paley's paper ‘SatanistAbuse and Alien Abduction’ (this issue) in a number ofareas: his definition of Satanic ritual abuse (SRA); the parallelshe draws between SRA and alien abduction; his assertions thatthere is no evidence of SRA and that accounts of SRA can beviewed as urban legends; and his ‘temporal lobe connection’conclusion.     

Conceptualizing Community Social Work--a Response to Alan York

Summary This note takes further the task of conceptualizing communitysocial work begun by Alan York in his paper for the June 1984edition of this Journal. York's approach is criticised firstlyfor unhelpfully conflating ‘community work’ and‘community social work’ and, secondly, for developinga schema unable to satisfactorily theorise the range of communitywork approaches currently to be found within social work. Buildingupon York's suggestion that ‘dichotomous formulations’provide an appropriate way forward for analysing community practice,three, distinct, dichotomies are elaborated, and recommendedas a basis for locating and comparing current approaches tocommunity social work.     

The Best Interests of the Child

Summary The purpose of this article is to clarify the concept of ‘thebest interests of the child’. It is argued that its usehas often confused rather than helped debates on child careand family work, creating the illusion that ‘the bestinterests of the child’ constitute an objective fact. Different assumptions of ends and means in interpreting the‘best interests of the child’ are discussed followedby an examination of the issues of parental authority and influencein decision making, the rights of the child to have a voicein his or her own future, and the authority of professionalsto weigh and balance all the factors. It is argued that more attention should be given to the complexityof the decision-making processes, that decision making shouldbe shared between children, parents and professionals, and thatviews of ‘the best interest of the child’ are alwayscontingent, depending on the particular position and assumptionsof the person expressing them, as well as the objective circumstances.     

Some Implications of Legal Approaches to Welfare Rights

Summary Legal reforms to welfare systems are analysed as either involving‘legalization’, the formulation of rules, or ‘judicialization’,the improvement of procedures. The implications of these typesof reform for the supplementary benefits system are examined.It is suggested that there are likely to be severe drawbacksto ‘legalization’ which does not involve, in effectthe elimination of selectivity. Judicialization, on the otherhand, is seen to offer needed procedural reforms, but it issuggested that there has been a failure to recognize the inherentlimitations of innovations of this kind, where the poor mayneed so much more than merely the guarantee of a fair hearing     

The Trouble with Harry: Why the 'New Agenda of Life Politics' Fails to Convince

via e-mail: paul.garrett{at}nottingham.ac.uk Summary Harry Ferguson (2001), referring largely to Britain and Ireland,maintains that social work should be committed to a ‘newway of thinking’ which is rooted in ‘life politics’.This idea, uncritically grounded in the ideas of Anthony Giddensand Ulrich Beck, fails to convince because: the assertion thatwe are now living in a ‘post traditional order’is undermined by the resilience of key historical forms of regulationand control which continue, for example, to limit women's choicein the sphere of reproductive rights; identified changes inthe texture of family relations are not evidenced by research;the ‘life politics’ perspective places too greatan emphasis on human agency, choice and volition and not enoughon structural constraint; the structural location of the ‘lifepolitics’ proponents is not interrogated; the analysisis too stridently dismissive of the idea that ‘emancipatorypolitics’ should be social work's primary orientation.     

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.     

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.     

Probation Practice, Effectiveness and the Non-Treatment Paradigm

Correspondence to Dr Peter Raynor, Department of Social Policy and Applied Social Studies, University of Wales, Swansea SA2 8PP. Summary This paper reports interim and largely positive results fromthe continuing evaluation of ‘Straight Thinking on Probation’,a substantial intensive probation programme in Mid-Glamorganbased on the work of Robert Ross et al. (1988) in Canada. Thepotential effectiveness of this type of programme is then discussedin relation to the influential model of the probation service'srole advanced by Bottoms and McWilliams in their 1979 ‘non-treatmentparadigm’. Are such programmes ‘treatment’,based on a model of offender pathology and therefore in conflictwith the paradigm, or are they ‘help’, based ona model of empowerment? An attempt to answer this question alsorequires consideration of how far the ‘non-treatment paradigm’was itself a response to perceived ineffectiveness requiringrevision in the light of new evidence. It is argued that suchrevision need not threaten the underlying moral philosophy ofthe paradigm.     

Euthanasia: Israeli Social Workers' Experiences, Attitudes and Meanings

Correspondence to Dr Ronit D. Leichtentritt, Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel. E-mail: ronitl{at}post.tau.ac.il Summary Sixteen social workers in Israel were interviewed about theirexperiences with and attitudes towards various forms of euthanasia,as well as the meanings they ascribe to them. Using phenomenologicalanalysis, seven themes were identified, emphasizing individual,interpersonal, organizational, social and therapeutic considerations,and suggesting a holistic and integrative structure of the phenomenon.The themes were arrived at by identifying distinctions and similaritiesbetween different forms of euthanasia. Two themes suggestingsimilarities were revealed: ‘diminishing the value oflife’ and ‘a call for help’. Three themeswere found to distinguish between passive euthanasia (withholdingand withdrawing life-sustaining treatment) and active forms(active euthanasia and assisted suicide): ‘legality’,‘social acceptance’ and ‘concern for the sickand dying’. The last two themes distinguished betweenwithholding treatment and assisted suicide, on the one hand,and withdrawing treatment and active euthanasia, on the other:‘the involvement of others as executor’ and ‘thepublicity of the act’. Further research and training isrequired to better inform social workers in this ethical area.Given their unique position, social workers should activelyparticipate in legal, social and therapeutic discussions concerningend-of-life decisions, for the benefit of clients, their familiesand health-care providers.     

Decision Making in Child Protection

Correspondence to Dr Ray Jones, Director of Social Services, Wiltshire County Council, County Hall, Bythesea Road, Trowbridge, Wilts BA14 8LE Summary A survey was undertaken of 701 decisions in ‘child protection’;and ‘child-care’ cases within one local authority.Decision making at four filter points in case career was analysed.Filter 1 was when the case was initially referred to socialservices, Filter 2 was when consideration was given to holdinga case conference, Filter 3 was when a case conference was held,and Filter 4 was the review case conference following the initialcase conference. The major risk factors which determined decisionswere highlighted, and these were different at each filter level.The percentage of children who remained within the ‘childprotection system’ after decisions were taken at eachfilter level was analysed and recorded. The research found that,based on the risk factor weightings given by the independentauditors, workers were appropriately discriminating between‘child protection’ and ‘child-care’cases.     

Reforming Professional Training and Protecting Vulnerable Adults from Abuse: A Thematic Analysis of the New Social Work Degree's Prescribed Curriculum

Correspondence to Phil Slater, School of Health and Social Sciences, Middlesex University, Queensway, Enfield EN3 4SF, UK. E-mail: p.slater{at}mdx.ac.uk Summary This paper analyses the Prescribed Curriculum of the new Degreein Social Work in relation to the Department of Health themeof ‘protecting vulnerable adults from abuse’. Areview of post-war social policy first establishes the significanceof these terms, both individually and in varying combinations.Subsequently, the phrase as a whole provides the focus for acontent analysis of the three constituents of the PrescribedCurriculum, namely, the Secretary of State’s Requirementsfor Social Work Training, the employment-focussed National OccupationalStandards for Social Work, and the academically oriented BenchmarkStatement for Social Work. With the exception of ‘abuse’,the key terms are all registered, albeit unevenly. This presenceis subsequently enhanced via strategic considerations of ‘logicalimportance’ and ‘organising rubrics’. Finally,terminological variants of ‘abuse’ are traced, withparticular regard to the emerging language of ‘rights’.     

The Treatment of Enuresis amongst Child Clients of a Social Services Department

Summary The adoption of an ‘outpatient’ model of supervisingthe treatment of bedwetting amongst child clients of a socialservices department is described. The treatment technique usedwas the generally effective ‘enuresis alarm’, or‘bell-and-pad’. Fifteen out of a total of 25 concludedcourses of treatment were successful, with an average treatmentduration of 14.9 weeks. Both this outcome, and the rate of drop-outbefore completion of treatment (ten cases) are comparable withthose obtained with non social services clients, and the useof the enuresis alarm with children in care (including thosein residential establishments) was found to be quite practicable.A high relapse rate (43%) was, however, found for social servicesclients, relapse usually following a placement change or othermajor stress.