Children's Welfare, Surrogacy and Social Work

Correspondence to Eric Blyth, Senior Lecturer in Social Work, University of Hudders-field, Queensgate, Huddersfield HD1 3DH Summary Although surrogacy appears to have been practised throughouthistory across a diverse range of cultural groups it has onlyrecently emerged as a significant social problem, posing legal,ethical, social and psychological dilemmas. Developments inmedical technology, legislative change and shifts in professionalpractices have combined to make surrogacy potentially a moreacceptable form of family creation for more infertile and involuntarychildless people. Hitherto social work involvement in surrogacy has been marginal.However a more explicit focus on the welfare of the child, togetherwith the likely increase in prevalence in surrogacy, imply amore central role in future for social work. The commitmentof the Government and the newly-created Human Fertilizationand Embryology Authority to keeping surrogacy under review isexpected to result in further policy developments. In the meantimethis paper begins the process of identifying those areas ofsurrogacy practice in which social work intervention could beeffectively and appropriately focused and considers the implicationsof these for both social work agencies and practitioners.     

Unasked Questions or Unheard Answers? Policy Development in Child Sexual Abuse

Correspondence to Julie Browne, 5 Belsize Crescent, London NW3 5QY Summary Despite an increase in both publicity on child sexual abuseand initiatives from government and voluntary agencies, it isby no means obvious that the position of the majority of sexuallyabused children has been significantly improved. Most sexuallyabused children still do not disclose the fact that they arebeing abused and it has been argued that new ways of approachingthe problem of child sexual abuse are needed. A study was madeof the policy development work being carried Out by the children'scharities and by survivors' organizations in this area. Individualsurvivors were also questioned as to the type of help they neededwhen children to enable them to end or escape the abuse. Itemerged that, in the main, the charities espouse pathologized/legalisticsolutions to the problem of child sexual abuse. In contrast,survivors' organizations tended to adopt a view of the problemwhich challenges societal attitudes, male sexual socialization,and the labelling of victims as passive and damaged. This articleattempts to find explanations for why these different approacheshave been taken and examines the implications for policy developmentin this area. It concludes that social workers and the children'scharities could benefit considerably from greater collaborationwith both survivors and survivors' organizations.     

A.I.D. and Adoption: Some Comparisons

Summary This paper is an attempt to put forward for discussion someof the similarities and differences between adoption and artificialinsemination by donor, as attempts to solve the problem of childlessness.The legal position and the view of the Church are briefly summarized.It is suggested that work already done in adoption, particularlywith reference to telling the child, has relevance for A.I.D.,and that there are implications for social workers.     

An Evaluation of Social Support Intervention 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 PL4 8AA, UK. Summary The significance of maternal depression to social work practicein child and family care has become increasingly apparent inrecent years. Social support, furthermore, is a concept (aswell as a reality) which provides a major focus for social workpractice. Indeed, social support, it is also clear, is of considerableimportance in helping prevent depression. This paper seeks toexamine social support work carried out by social workers inrelation to depressed mothers in child and family care. In particularit seeks to evaluate the quality of that intervention in thelight of key problem areas associated with high levels of supportneeds, the extent to which social workers target support needsthrough direct, indirect and informal supports, and the extentto which particular interventions are associated with a higheradequacy of support experienced by these depressed women. Thepaper finds a certain degree of haphazardness in social workers’targeting of support needs, although in some areas of indirectsupport, in particular, their targeting is reasonably accurate.There is little evidence of any one form of intervention beingassociated with more adequate support with one significant exception,relief care of children. The paper concludes that social workersneed to develop a keener awareness of support deficits so thatthey are targeted better; they need to monitor more carefullyinterventions carried out by other agencies and professionals;and they should look to relief care of children as a major formof intervention to support these women.     

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.     

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’.     

The extent and nature of known cases of institutional child sexual abuse

Summary The sexual abuse of children by persons who work with them -institutional abuse - is a focus of major concern among policymakers, practitioners and the public. Despite this, knowledgeabout it remains limited. This paper presents findings froma study of institutional abuse cases referred to social servicedepartments or the police in eight local authority areas. Whilesuch cases were relatively uncommon and constituted a smallproportion of all child protection referrals, some involvedlarge numbers of victims and abusers. Institutional abuse casesin the present study shared some characteristics with the majorityof (intrafamilial) abuse cases, but there were also importantdifferences, such as the proportion of male victims and theextent to which abuses used techniques of targeting and entrapment.Contrary to media representations, the institutional abuse reportedhere was not just a problem of children's homes, social workor the public sector, but occurred in a wide variety of settingsand sectors and was perpetrated by a range of occupational groups.If all children are to be protected, then policy and practicemeasures to prevent abuse need to be directed towards a muchwider range of institutions.     

Defensive Social Work

Correspondence to Nigel Harris, Department of Philosophy, The University, Dundee DD1 4HN. Summary Social workers with child clients face the possibility thatsome mistake or oversight of theirs could lead to a child abusetragedy, for which they may suffer opprobrium and blighted careers.How can they guard against such risks? This paper shows howsocial workers might use different types of ‘defensive’measure to protect themselves. These parallel the types of measureused by some doctors, particularly in the United States, facedwith risks of litigation on grounds of malpractice. Becausedefensive practices have undesirable consequences, it is importantto find ways to eliminate their use by protecting social workersby other means.     

Parents' Views on Social Work Interventions in Child Welfare Cases

Correspondence to Trevor Spratt, Lecturer in Social Work, School of Social Work, The Queen's University Belfast, 7 Lennoxvale, Belfast BT9 5BY, Northern Ireland. E-mail: T.Spratt{at}qub.ac.uk Summary This article reports findings from the third part of a three-partresearch project examining the potential for social workersto shift from a child protection to a child welfare orientationin their practice. Whilst social workers in the UK have beenencouraged to make such changes, they have been hampered byconcerns to manage risk. Findings reported from the earlierparts of the project, indicated that there was potential fora substantial proportion of child protection work to be redesignatedas child welfare work, but that where this was achieved in practice,there was evidence of the continued influence of child protectionprocesses as social workers sought to manage the risks inherentin child welfare cases. The study reported here sets out toascertain the views of parents who were subject to child welfareinterventions. The findings indicate that while parents feelapprehension with regard to contact with social workers, inthe majority of cases successful relationships are formed. Itis argued that social workers display considerable skill inmonitoring potential risks whilst engaging with families andthat the subtleties involved in such activity are not capturedby official measures of governance which concentrate on moreabstract indicators of performance.     

Allocating Blame in Social Work

Correspondence to Geraldine Macdonald, Applied Social Studies, Royal Holloway and Bedford New College, Egham Hill, Surrey TW20 OEX. Summary This article takes issue with those who assume that the responsibilityfor bad outcomes in social work, such as child deaths, is appropriatelylaid at the feet of individual workers. It examines the philosophicalorigins of such arguments, some recent applications within socialwork literature and their appropriateness to the realities ofsocial work practice. The author argues that a morality of socialwork must recognize the social and organizational context inwhich it occurs.     

Examining the Causes of Stress in Families with Severely Mentally Handicapped Children

Summary Though it is recognized that the presence of a mentally handicappedchild may be a source of stress for a family, less is knownabout precisely which impairments are particularly stressful.This question was investigated in a study of 200 families withseverely mentally handicapped children living in two healthdistricts in South East England. Interviews were carried outwith the people responsible for the day-to-day care of the childrenand stress was measured by means of the Malaise Inventory. Theresults suggested that the highest levels of stress were associatedwith the presence of a child with behaviour disorders or withmultiple impairments; the stressfulness of these conditionswas exacerbated by adversity. A regression analysis showed thatthe factors causing most stress in carers were, in order ofimportance: behaviour problems in the child, night-time disturbance,social isolation, adversity in the family, multiplicity of impairments,difficulty in settling the child at night, problems with thechild's health, problems with the child's appearance, and moneyworries. The article ends with recommendations for the developmentof services aimed at reducing stress in families with mentallyhandicapped children.     

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.     

The Influence of Child Protection Orientation on Child Welfare Practice

Summary This article reports the findings of the second part of a two-partresearch project examining the potential for social workersto make changes in their work with families and children. Whilstsocial workers in the United Kingdom have been encouraged toshift from a child protection to a child welfare orientationin their practice, such changes have been hampered by professionaland organizational concern to manage risk. The research exploresthe influence of a child protection orientation on practicein child welfare cases. The findings, from two file analysesand interviews with 26 social workers, indicate that such aninfluence is indeed apparent. This is evidenced in two ways;first patterns of practice in child welfare cases are similarto those in child protection cases. Secondly, while the majorityof social workers express an attitudinal desire to move towardsa child welfare orientation, they still prioritize the managementof risk in their practice. It is argued that social workersneed permission from their employing organizations to make changesin their practice. This, in turn, requires such organizationsto state clear goals in line with a child welfare orientationand develop holistic strategies to achieve these.     

Temporary Foster Care

Summary In order to improve outcomes in temporary foster care the authorbelieves there is a need to develop alternative models for practicethat would (a) define the social work task (b) specify in operational terms how that task would be accomplishedand thus would be amenable to empirical testing. (Temporaryfoster care is defined as the provision of substitute familylife for a child received into care, where there is a clearintention to re-unite the natural family at a future date). This article deals with the essential preliminaries to the developmentof a practice model. The first part surveys the relevant literature;part two develops a theoretical framework for practice aroundthree themes which are considered central to a considerationof foster care. These are the separation experience, the placeof the natural family, and role clarification. Other crucialvariables such as the age of the child, the nature of the problem,or the parents' potentiality for change are not dealt with withinthese papers, but are nevertheless seen as important issuesto be considered at the stage of designing a model for practice.     

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.     

Should any Child be Placed in Care? The Forgotten Great Debate 1841-74

Summary This paper first describes a system of Day Industrial FeedingSchools in the mid-nineteenth century known as the 'AberdeenSystem'. As originally conceived, it challenged the whole ideaof residential care of children. We argue that while SheriffWatson, with whom the schools are usually associated, is generallygiven a paragraph in histories of social work or of education,the social movement with which he was associated is entirelyoverlooked. This movement gave first importance to family ties,for religious reasons, and then argued on rational grounds theadvantages of a day care system. It attempted to meet withinsuch a system the needs of the whole child in his family andcommunity setting. It also sought to avoid the processes ofstigmatization, arguing that service provision should be basedon recognition of children's rights. We consider briefly theideological context of the movement and finally look very brieflyat some of the implications of the material for social serviceprovision today. We suggest that greater historical awarenesscould enhance opportunities for developing imaginative policiesin relation to the development of social work services     

Liberty and Respect in Child Protection

Correspondence to Sally Holland, Cardiff University, School of Social Sciences, Glamorgan Building, King Edward VII Avenue, Cardiff CF10 3WT, Wales, UK. E-mail: HollandS1{at} cf.ac.uk Summary The paper begins by introducing Isaiah Berlin's concepts ofpositive and negative liberty and the application of these conceptsto child protection. There is discussion of some recent debateson the social and political context of state social work andchild protection in particular. The authors then consider, inturn, the experience of children, parents and social workersin the child protection system. There is also a considerationof partnership and rights. The conclusion is that opportunitiesfor statutory child protection to be liberating are limited,but that there is more potential than the most pessimistic accountsmight allow. Rather than libertarian child protection, socialworkers can aim for child protection practice that is respectful.The paper concludes with some principles for respectful practice,based on the ideas of Richard Sennett. Most importantly, Sennett'sideas recognize the importance of relationships in social welfareand acknowledge the context of inequality within which socialwork takes place.     

The Conditioning Treatment of Childhood Enuresis

Summary Enuresis is described as a learning deficiency and conditioningtreatment discussed as the logical positive outcome. The processof conditioning treatment is described and compared, and commonobjections discussed. Explanation is given of the practicalapplication of conditioning treatment in social casework andresidential child care     

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.     

The Fieldwork Team Response: An Investigation into the Relationship between Client Categories, Referred Problems and Outcome

Correspondence to Peter C. Burke, Lecturer in Social Work, Department of Social Policy and Professional Studies, The University of Hull, Hull HU6 7RX. Summary This paper concerns a study of the outcome achieved followingfieldwork responses to referred client problems within particularclient categories. The evidence from the study demonstratesthat while referred client problems initiate the social workresponse, administratively assigned client groups were a betterdeterminant of outcome. It is shown that the category of a caseis more directly related to outcome than is the problem referred.If social work is to be predominantly based on client categorizationthen polarization will result, represented by an increasinglyprofessional child care practice and a more basic servicingrole for the worker with elderly and handicapped people. Thispresents dangers for the organization of teams, the allocationof resources, and the training of social workers. Taking accountof client problems as part of caseload management should reducethis effect.