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.     

The Role of Assertiveness in Clarifying Roles and Strengthening Job Satisfaction of Social Workers in Multidisciplinary Mental Health Settings

Correspondence to Dr Claire Rabin, Tel Aviv University, Bob Shapell School of Social Work, Ramat Aviv, 69 978, Tel Aviv, POB 390470, Israel. Summary Eighty-seven social workers, working in nine different mentalhealth settings, were administered four questionnaires tappingthe following variables: assertiveness in daily life; assertivenessin the job setting; role clarity; and job satisfaction. Stepwiseregression analysis showed assertiveness in the job settingto be strongly correlated with role clarity. Assertiveness indaily life was also significantly correlated with role clarity.Assertiveness in the work setting was significantly correlatedwith job satisfaction, although it was riot as powerful a predictorof satisfaction as of role clarity. Number of years of job experiencewas the most powerful predictor of job satisfaction. The implications for social work training and supervision aredescribed in light of the importance of assertive communicationin maintaining job clarity and job satisfaction within multidisciplinarysettings.     

Adolescent and Young Adult Male-to-Female Transsexuals: Pathways to Prostitution

Correspondence to Dr Ronit D. Leichtentritt or Dr Bilha Davidson Arad, Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel. E-mail: ronitl{at}post.tau.ac.il Summary The current study aims to reveal the experiences of young male-to-femaletranssexuals who work as prostitutes in Israel, providing astage where the voice of this marginal group may be heard, aswe believe social workers need to know more about the realityof these young people’s lives before they can offer meaningfulresponses. The study was guided by two main questions: (1) Whataccounts do young male-to-female transsexuals who work as prostitutesprovide for their involvement in the sex industry? and (2) Whatare their experiences as young transsexuals engaged in prostitution?Using the life story interview and thematic analysis, two mainthemes were revealed: (a) what I ran away from or was thrownout of; and (b) why I became a prostitute, how I became professionalizedand why I continue to work as one. The first theme focuses ontranssexualism; the second on prostitution. Yet, these two themesare intertwined: from the respondents’ perspective, prostitutionis a price you must be willing to pay if you want to achievegender transformation at the beginning of the twenty-first centuryin Israel. Practical implications and further research are recommendedto better inform social workers assisting this high-risk population.     

Which Children are Registered at Case Conferences?

Correspondence to Terry Fisher, Department of Social Policy and Social Work, University of York, Heslington, York YO1 5DD. Summary A postal questionnaire to social workers was used to describethe characteristics of situations where children were the subjectsof child protection case conferences, to identify factors distinguishingthose registered from those not registered and to describe theaccounts given by social workers of the reasons for registration.The paper reports and analyses this information and raises somebasic issues about the relative importance in registration decisionsof evidence of physical or sexual abuse, characteristics ofthe adults involved, and a child's feelings and emotional state.     

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.     

Child Abuse, Social Anxiety and Welfare

Summary This article attempts to locate the ‘moral panic’concerning child abuse within the context of broader changesin the material conditions and ideological forces in Britainin the early 1970s. It argues that the development of a senseof social anxiety amongst certain sections of the populationand the appeal of the New Right were crucial in the processof establishing the problem as the major issue for social workers.As a consequence social workers have been constrained into amore punitive and interventive relationship with children andfamilies, particularly the poor. The analysis illustrates thatthe way social workers experience role conflict and tensionin this area of their work reflects much wider historical andcultural confusions and contradictions.     

The Beckford Report: A Critical Appraisal

Correspondence to Nigel Parton, Department of Behavioural Sciences, The Polytechnic, Queensgate Huddersfield HDI 3DH. Summary This paper provides a critical analysis of the Beckford Reportand its implications for social work and the personal socialservices. Four interrelated themes are explored: the relationshipbetween social work practice, statutory responsibilities andthe law; the attitudes of social workers towards children andfamilies; the social work skills required; and the assumptionsthat are made about child abuse and the role of social workers.This is then related to recent research findings in the areaof policies and decision making in child care. It concludesby arguing that the report is in great danger of misdirectingour attentions from the major issues concerned with social workwith children at risk.     

Social Workers and Child Welfare

Correspondence to Dr Gunvor Andersson, Lund University, School of Social Work, Box 23, 22100 Lund, Sweden. Summary What problems do social workers at social services offices haveto face in their child welfare work? How do they handle theproblems, and how important is the relation between the socialworker and the child's parents? The research project includes189 child welfare cases with 0–3-year-old children inten local communities in Sweden. The article shows that thesocial work can be categorized into four different types ofwork, where the work done, as well as the relation between thesocial worker and the child's parents, differ. (1) The socialworker is mediating help and support and has a positive contactwith the child's parents. (2) The social worker is exercisingcontrol and authority and has a negative contact with the child'sparents. (3) The social worker is doing treatment-oriented workand has a personal involvement and a relation to the parentsthat is important for the family and not exchangeable. (4) Thesocial worker is solely engaged in investigatory work with norelation to the child's parents, rather a neutral contact. Inthe categorization the concepts contact and relation are differentiated.Only in the treatment-oriented category, encompassing aboutone-fifth of the children, can one speak of a relation. In allcategories there are elements of both help and control, butdifferent ways of handling this doubleness.     

The Significance of Past Abuse to Current Intervention Strategies with Depressed Mothers in Child and Family Care

Correspondence to Professor Michael Sheppard, Department of Social Policy and Social Work, University of Plymouth, Drake Circus, Plymouth, Devon, PL6 7EW, UK. Summary There is now considerable evidence that a high proportion offamilies subject to child and family care social work interventioncontain depressed mothers. There is also evidence that the presenceof clinical depression is associated, amongst these clients,with child abuse. Vulnerability to both depression and childabuse have been traced back to the early child-care experiencesof those who are currently parents, expressed in child abusein terms of intergenerational transmission, although it is alsoclear for both that further factors also contribute to thisvulnerability. Despite the link between maternal depressionand child abuse, we have little evidence about the processesand mechanisms, based on social workers judgements about thesituation, by which families with depressed mothers are morelikely than other clients to be involved with intervention forchild abuse. This paper seeks to ‘map’ the pathwaysand the intermediate mechanisms which provide the link betweenthe experience of past abuse and social workers interventionstrategies. Drawing on theoretically significant factors, itfocuses on the following variables: the experience of past abuse,the mother's attributed character, attachment and bonding, childbehavioural problems and intervention strategy. The paper demonstratesa number of significant ‘paths’ through which familiesbecome subject to one or other intervention strategy. It showsthat, while an emphasis on needs assessment is to be welcomed(Department of Health, 1999), they need to be considered (i)within a theoretical framework which helps social workers makesense of, and respond to situations and (ii) through an understandingof longitudinal dimensions (key factors in mothers' earlierlife) which are aspects of this theoretical understanding.     

Avoidable and Unavoidable Mistakes in Child Protection Work

Summary This article argues that social workers and the general publicneed a clear understanding of the distinction between avoidableand unavoidable mistakes in child protection work. The publicis understandably distressed when a child dies and is rightto demand an inquiry to check the quality of help provided.But a child's death is not proof that any professional was incompetent.Our limited knowledge and the complexity of assessing risk meanthat professionals can only make the best judgement on the availableevidence. Analysis of forty-five inquiry reports shows thatinquiries appreciate this; in 42 per cent of them social workerswere not criticized. The analysis however also reveals one persistenterror: social workers are slow to revise their judgements. Psychologyresearch indicates that this error is widespread and by no meanspeculiar to social workers but it means that misjudgements aboutclients that may have been unavoidable on the limited knowledgeavailable when they were made continue to be accepted despitea growing body of evidence against them. Social workers needa greater acceptance of their fallibility and a willingnessto consider that their judgements and decisions are wrong. Tochange your mind in the light of new information is a sign ofgood practice, a sign of strength not weakness.     

Assessing Child Protection Risk

Correspondence to Lorraine Waterhouse, Lecturer, Edinburgh Centre for Social Welfare Research, 23 Buccleuch Place, Edinburgh EH8 9LN. Summary The article outlines a set of child protection criteria usedby social workers for the evaluation of risk in sexual abusecases. The criteria were distilled from research findings basedon a sample of 51 child sexual abuse cases drawn from ChildProtection Registers in Scotland in 1987/89. Criteria dividebetween two types: primary (child care) criteria which concentrateon assessing circumstances prevailing within the family home;and secondary (disclosure) criteria which serve to either substantiateor refute disclosure. Primary criteria include attitude of non-abusingparent to alleged perpetrator; access between referred childand alleged perpetrator; type of abuse; age of child or youngperson; attitude of alleged perpetrator to allegations; andparental attitude to social work investigation. Secondary criteriainclude belief or disbelief of child; psychological symptomsin child; physical signs of abuse; children's attitudes towardsremaining at home; and criminal or psychiatric history includingalcohol or drug abuse. In practice the criteria tend to be usedlike a set of building blocks: tall towers represent higherrisk; low towers lesser risk. Given the enormous stakes involvedin child protection decisions, front-line practitioners wereunder considerable pressure to ‘play it safe’.     

Narrating Love and Abuse in Intimate Relationships

via email: heather.fraser{at}rmit.edu.au Summary In this article, I use discourse analysis to explore the relationshipbetween love and abuse. I argue that Anglo-American social workhas been reticent to theorize love; and that when it does, theborders separating love from abuse are usually assumed to berelatively stable and readily apparent. After nominating someof the reasons for and repercussions of dichotomizing love andabuse, I suggest that knowledge about intimate abuse will expandif more attention is given to the study of love. I promote theuse of feminist discourses because they provide valuable insightsabout the operations of power in love relationships. Drawingideas from both structural feminism and post-structural feminism,I encourage social workers to move their analytical attentionback and forth between the micro-politics of intimate relationshipsto the wider cultural contexts within which they are staged.I conclude with the assertion that social workers will be betterplaced to understand the dilemmas that many ‘ordinary’women confront in their everyday lives, if they critically analysethe intersections of love and abuse.     

Social Work Influence on Juvenile Court Disposals

Summary A study was made of the contents of 120 social enquiry reportswritten by social workers in relation to a sample of 50 juvenileoffenders. The criterion for inclusion in the sample was thatthe offender was subject to a supervision order made during1977, in one social services department. The analysis of the contents of the reports indicated that thesocial workers, with their own individual differences of emphasis,adhered closely to the intended welfare values of the 1969 Act;they worked for, with and on behalf of the offenders and theirfamilies; their recommendations, particularly when argued withconviction, were listened to and acted upon by the magistrates. It appeared that there might be significant decision pointsin the career of a juvenile offender: the first court appearance,when either a welfare measure or deterrent measure might beused; and the later stage where a boy of 14+ years faced thecourt following a number of convictions and the failure of previousmeasures. At both points it seemed to be the social worker recommendationwhich was influential, and which could therefore have a significanteffect on the direction of a child's future.     

Children's and young people's experiences in various residential arrangements: a longitudinal study to evaluate criteria for custody and residence decision making

Summary The child's welfare or the child's best interest is, in manycountries, the court's paramount consideration for determiningcustody and residence of a child after parental separation ordivorce. This longitudinal study evaluates the custody criterionchild's relationships and residence preferences. Based on aqualitative study design including interviews with childrenand parents, the experiences of 62 children of separated ordivorced parents in various residential arrangements are analysed.The main findings are: (i) a residential arrangement in accordancewith the child's relationships and residence preferences accordswith the child's welfare and represents a positive living situationwith loved people in the family and social environment; (ii)the personal relationships of the child are in no way static,but demonstrate a noticeable dynamic as they change under theinfluence of internal and external factors. Therefore a timelychange of residence, which occurs in accordance with the changedemotion preferences of the child, is beneficial; (iii) a residentialarrangement contrary to the child's relationships and residencepreferences represents for the child involved a difficult situation,which can lead to one of three different processes: adjustment,a trajectory of suffering or initiatives to change the livingsituation. This means that some children adjust, others experiencetrajectory processes of suffering, and those in the remainingcases act as competent social agents, who can autonomously representtheir own interests and pursue them in order to initiate orcontribute to a change of their residence. Findings of the studyare discussed, and suggestions are offered for substantive andprocedural laws to guarantee the child's welfare in custodyand residence settlements and for further research.     

A National Survey of the Investigation of Child Sexual Abuse

Correspondence to Department of Sociology, University of Surrey, Guildford, Surrey GU2 5XH, UK Summary The article reports a national survey of social services andpolice arrangements for investigating child sexual abuse (CSA).It is now officially accepted as good practice for police andsocial workers to jointly investigate such allegations. To evaluateinvestigative practice, the survey aimed to (i) document existingarrangements for police/social services investigation and managementof CSA cases; (ii) identify the main organizational models informingsuch work, and (iii) explore the perceptions of police and socialservices managers of the key policy and practice issues posedby such work. The criteria for judging the benefits of jointwork were: reduction in the number of occasions children wereinterviewed, clarification of the role of professionals involved,increased coordination of service delivery, and establishmentof group support for difficult decisions. While there were signsthat some benefit was being achieved, there were also indicationsof the endurance of problems long associated with multiagencywork.     

Social Workers who Move into Private Practice: The Impact of the Socio-economic Context

Summary This paper is based on a doctoral research project, conductedin New Zealand between 1993 and 1999, that considered factorsin the movement of social workers into private practice (vanHeugten, 1999). The study employed a qualitative methodologyin which 33 private practitioners were interviewed using semi-structuredquestionnaires. All respondents had at least a first professionalqualification in social work. The research grew from a realizationthat there had been an upsurge in private practice since themid-1980s, during a time of increasingly right wing governmentpolicies, and free market philosophies. These policies and philosophiesled to a radical restructuring of government and not-for-profitorganizations that employed social workers. Some workers respondedto the changes by seeking alternatives to organizational employment.Concurrently opportunities for private practice were createdby the availability of third party payments for counsellingof survivors of sexual abuse and parties to marital disputes.A similar pattern of confluence of expanding social work privatepractice and free market ideology has been noted in countriessuch as Great Britain and Australia. The implications of thismovement into private practice are considered in relation toprofessional social work associations.     

Professionals' attitudes about victims of child sexual abuse: implications for collaborative child protection teams

In responding to victims of child sexual abuse, considerable attention has been given to multidisciplinary collaborative response teams. Recent evidence, however, suggests that team members may be divided by differences in attitudes towards victims and offenders and about the causes and consequences of abuse. This paper draws on a larger study of the various professionals who make up one child abuse response system in Newfoundland, Canada. In particular, the paper focuses on social workers, teachers and the police, and their views about the characteristics and credibility of sexual abuse victims, and the extent to which they attribute to the victim some responsibility for the abuse. Data for the study were collected in two stages: key informant interviews; and a survey of social workers, teachers and police. The analysis includes an interpretation of the role of gender, professional group membership and experience with cases. The most striking finding is the extent to which the child's age and behaviour appears to influence differentially attitudes about the victims' credibility. These differences complicate multidisciplinary collaborative initiatives since it would appear that those with the least real case experience, and the least knowledge about the relationship between abuse and behaviour, are the ones most likely to be the first point of contact for reports or disclosures.     

Understanding Adolescent Female Prostitution: A Literature Review

Correspondence to Dr Jill Jesson. Aston Business School, Aston Triangle, Birmingham B47 7ET. Summary Sexual behaviour and sexuality are currently topical issuesof concern for child care social workers. Social workers arespending more and of more of their time with children who comeinto care because of sexual abuse, or who have an involvementin the ‘rent’ scene or Prostitution. In additionmany teenage young women come into care because of social orparental concern over their lsquo;promiscuous’ behaviour.The review of research on adolescent prostitution offers severalexplanations for involvement in prostitution. which vary accordingto the discipline of the author. Explanations vary from pathologicaland personal psychology factors to the wider social aspectsof the family and local environment. This literature reviewwas used as a basis for research which examined the incidenceof female prostitution for a social services department. Thisis a relatively new field of interest and consequently thereis very little British research published on the issue of adolescentprostitution, or on under age (16) prostitution. There is nopublished research on girls in care and prostitution. We needto know much more about the reality of young people's livesbefore social workers can offer a meaningful response.     

Social Workers' Responses to Experiences of Fear

Correspondence to Martin Smith, EDT c/o Social Services Department, Easton Street, High Wycombe, Buckinghamshire, HP11 1NH. E-mail: msmith{at}buckscc.gov.uk Summary This paper follows on from the paper ‘Social workers’experiences of fear’, written by the same authors, reportingon a research study that showed how social workers interviewedexperienced fears of assault, death, losing control and rejectionfrom their seniors during their working hours. Now, from thesame study, examples are given that illustrate ways in whichparticipants were affected by, and responded to, these fears.Substantive quotations from in-depth interviews are providedshowing effects of fears as being physical, cognitive and emotionaland as manifesting themselves differently with the passing oftime. Also given are examples of what it was that participantsfound to be helpful, or unhelpful, when attempting to deal withtheir fears and particular attention is paid to supervisionin this respect. The paper argues that drama therapy literaturehas much relevance to the management of fear as participantsoften reported different parts of themselves performing roleswhen affected by and responding to fears. Implications for socialwork training are considered in this light. Generally, it isclaimed that the more social workers can learn about fear andits manifestations and implications in their work, the betterthey will be able to respond to it and deal with it.     

Legal Liability and Accountability for Child-care Decisions

Correspondence to Tom Guthrie, School of Law, University of Glasgow, Stair Building, University of Glasgow, Glasgow G12 8QQ, UK. Summary Although decisions taken by social workers in cases of suspectedchild abuse and in looking after children in their care maybe the subject of public enquiries and press comment, they willnot in general incur any legal liability to compensate childrenwho claim to have suffered as a result of these decisions. Thisarticle examines the reasons why such liability is excludedby the courts, as well as looking briefly at other mechanismsfor challenging social workers'decisions. It is argued thatthe grounds for excluding liability are speculative and thatintroducing liability to this area might encourage good practice.