Social Casework Ils 189

Noel Timms

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781135034375
• Edition: 1
• Topic: Scienze sociali
• Subtopic: Sociologia

First published in 1998. This volume is IX in the international library of sociology collection and focuses on social casework principles and practice. The text attempts to describe some of the main problems facing caseworkers as they both try to help their clients and to theorize about their methods and objectives to discern the knowledge they use and apply; and to appraise the significance of the social agencies in which they work.

Chapter One

THE CASEWORKER AND THE AGENCY

INTRODUCTION

THE need for a general textbook of British social casework practice is widely acknowledged in this country and the present work aims at satisfying certain aspects of this need. This is a time of fruitful and even exciting change in social casework and there is room for several different kinds of book on the subject, though the temptation perhaps is to try to encompass the range of possibility in one volume. In this book an attempt will be made to describe some of the main problems facing caseworkers as they try both to help their clients and to theorize about their methods and objectives; to discern the knowledge they use and apply; and to appraise the significance of the social agencies in which they work. The intention is not to present and justify an overall categorization of the casework process, for example, as treatment¹ or problem-solving,² but to explore casework operations on an eclectic basis, using as pivots in the discussion ideas of human relationships and of agency function.

British social workers have in the past relied heavily on American writings on social casework. In recent years the balance has been somewhat redressed by the production of original work in this country, but it remains true that our range is neither as extensive nor as comprehensive as the American. This is to be regretted. Obviously some aspects of social casework will be applicable in many countries and there is no necessity for each society to devise a completely fresh idea of casework for its own use. There is a great deal of fruitful thought in American work that can be assimilated by British social workers towards the solution of their theoretical and practical problems. No country needs to look constantly within its own boundaries for a unique inspiration on every topic. Such an insular approach is patently absurd. Equally mistaken, however, is the view that particular traditions, particular ways of making arrangements in a society are readily exportable and that they can be adopted by any other nation without translation or modification in the light of their own experiences.

This view is sometimes inflated into a general objection to American work on the grounds that its theorizing and practice are the product of a culture very different from our own. Exponents of this viewpoint seldom describe what they hold to be the essential differences. A sounder basis on which to judge the usefulness of American (or any other) ideas on social casework is provided by comparing their theorizing with our own social work experience. Social casework began in Great Britain, but despite the creative writing of individuals in the late nineteenth century and in more recent times, we have seldom paused to consider and appraise our own total experience in this field. Such a task is important at the present time, not simply because we can then assess the differences between American experience and our own, but also because we can be confident in our own contribution to a general view of the theory and practice of social casework.

Present American writing on casework is characterized by a considerable (and exaggerated) emphasis on certain aspects of egopsychology and by a marked (and unfortunate) insularity.³ British social work experience would seem to offer some remedy for the latter by offering a corrective for the former. This corrective, as will become apparent in the following pages, is mainly to be found in a deeper view of the significance of the function of the social agency, and of social relationships, and an appreciation of unconscious fantasy. (The distinction usually made between conscious ‘fantasy’ and unconscious ‘phantasy’ is not of fundamental importance in the present work, and I shall use the term ‘fantasy’ (except when quoting or discussing other people’s views of ‘phantasy’) because I do not wish to draw a rigid line between conscious and unconscious mental activity.)

The term ‘casework’ was first used about a hundred years ago, but until quite recently its circulation has been on the whole confined to social workers. It is to be found now in contemporary novels and in discussions of power and the professions in present-day society. Indeed the recent criticisms of casework by Wootton and others have publicly recognized the existence of casework in a way that has no parallel since the Fabian attack on the Charity Organization Society at the turn of the century. Yet within social work and in more public allusion, criticism or defence, casework has rarely been defined to anyone’s satisfaction. It remains elusive and even its sympathizers are forced to admit that attempts to describe it often reveal—to borrow a phrase of Oscar Wilde’s—‘all the utility of error and all the tediousness of an old friend’.⁴

Social workers will probably always have to accept a measure of uncertainty about the nature of their occupation, both generally and in regard to particular cases. This is partly because of the difficulty of making precise and detailed statements about interventions in the life of one human being by another—this will be discussed later. It is also because the identity of social work has to be thought anew as society and our conceptions of society change, and as the administrative structure, through which social work help is given, responds to the challenge of previously unseen or undefined need. In each individual case the social worker is concerned with establishing her identity for a particular client and with creating a function specific to the case, albeit within a framework of general identity and established function. Her ‘acts are nothing if not original, done afresh and thought afresh for the particular occasion, however they may depend … on training and good slowly-built method’.⁵

Undue concentration on uniqueness and individuality, however, has often prevented the social worker from formulating generalizations. A fear of intellectualization has sometimes hindered the critical appraisal of concepts in daily use. Thus, the present state of social work literature reveals mainly an accumulation of unassorted ideas. This seems particularly so for casework. In writing and in professional discussion casework can be ‘case work’ or ‘case-work’, it can be ‘scientific’, preventive, therapeutic, deep, or intensive. Yet beneath these variations it is possible to discover variations on a number of key themes. It is by concentrating on these that we can perhaps alter the characterization of much casework teaching in the past as ‘a benevolent casuistry and an interminable story-telling’.⁶

Some of the definitions of casework in this country and in America have been considered elsewhere,⁷ but Swithun Bowers’s fairly recent attempt has been widely accepted. After reviewing American definitions since 1915, Fr. Bowers offered the following: social casework is ‘an art in which knowledge of the science of human relations and skill in relationship are used to mobilize capacities in the individual and resources in the community appropriate for better adjustment between the client and all or any part of his total environment’.⁸ This definition represents a considerable advance on its predecessors, but is still open to a number of criticisms. It is deeply entangled with the art/science controversy in casework; it contains some heavily persuasive terms (science of human relations) and it does not avoid the misuse of the holistic approach found in much social work writing. What is an individual’s total environment except everything that is? It also fails to give sufficient emphasis to the different kinds of component in casework.

Caseworkers are coming to appreciate more clearly the complex structure of their discipline. One of the most succinct and lucid recent statements about it is to be found in Perlman’s recent description: casework ‘is complex by virtue of the varied knowledges which feed it, the ethical commitments which infuse it, the special auspices and conditions of its practice, the objectives and ends which guide it, the skills which empower it’.⁹ Clear distinctions are thus made between knowledge, general values, settings and goals. Until we distinguish in this kind of way the different assertions that can be made in casework, we cannot begin to be sure what we are saying.

An example of casework writing which does not observe clear distinctions between kinds of assertion may illustrate the advantages of consistent differentiation.

Social work rests ultimately on certain assumptions which cannot be proved, but without which its methods and goals have no meaning. These axioms are, for example; human betterment is the goal of any society; so far as economic and cultural resources can be developed, the general standard of living should be progressively improved; … the social bond between man and men should lead to the realization of the age-old dream of universal brotherhood. The ethic derived from these and similar axioms leads to two nuclear ideas which distinguish social work as one of the humanistic professions. The first is that the human event consists of person and situation, or subjective and objective reality, which constantly interact and the second that the characteristic method of social work incorporates within its processes both scientific knowledge and social values in order to achieve its ends.^*10

In this passage Hamilton presents an obscure progression—values (called indiscriminately ‘assumptions’ or ‘axioms’) lead somehow to an ‘ethic’ which in turn produces ‘ideas’, one of which purports to be about ‘method’ but is in fact a very generalized description of any practice that can be called professional. With this confused notion of the structure of casework it becomes exceedingly difficult to identify the different kinds of assertion and to describe their relationship to each other.

It is not my intention simply to advocate a rigid vocabulary in which ‘assumptions’ are never called ‘axioms’ and ‘propositions’ are never called ‘ideas’, but I do argue that we need to be clear about the kind of assertion we make. It is only then that we can look for appropriate ways of justifying the assertion. For example, some of the statements made by caseworkers refer to generalized values (e.g. respect for the individual personality). These value assumptions cannot be tested, but they can be criticized and attempts can be made to establish good reasons for their adoption. Other assertions refer to descriptions and explanations of human behaviour—for example, people coming to an agency are under stress (descriptive) because of cultural and psychological factors (explanatory). Such assertions can be tested, either within or outside the casework discipline.

The themes of casework can perhaps be more clearly seen if for a moment we abandon a discussion that must be, to some extent, abstract and examine a recorded interview. Many of the terms used in casework can be adequately appreciated only when the operations they are used to describe are made apparent.

Miss M., a single woman, aged 48, was in hospital with thyrotoxicosis. She asked to see the almoner in connection with her payments from the National Assistance Board. The almoner consulted the doctor: the thyroid condition was not severe and not of longstanding and it was hoped that, with rest and drugs in hospital, an operation could be avoided. The doctor considered that there could well be psychological factors contributing to its onset, but that the patient was probably too ‘neurotic’ to be helped by anyone. She had attended hospitals for different conditions for many years. He agreed that she seemed to need acceptance and support and that the almoner should see her as long as she wished it.

1st Interview

Miss M. spent the first interview telling the almoner how badly the National Assistance Board had treated her and how they had humiliated her on a number of occasions. The upsets were described in great detail. She felt it was because she was unlike their usual run of clients in that she always appeared well dressed. She explained that she was able to dress well because a sister, married to a doctor, gave her a lot of clothes.

In telling the almoner about the attitude of the Assistance Board, she brought out details of her circumstances. She explained that she was not married, but had had a child 12 years ago ‘the wrong side of the blanket’. This was said in a rather defiant fashion and she watched the almoner very closely for her reactions. The almoner tried to convey acceptance, but actually had very little chance to say anything at this interview at all as the patient spoke practically non-stop. For the past 7 years her health had not been good so she had been unable to work and for this time, she had been living in an old, very inconvenient bungalow where she had had to carry all her water. Interspersed with these other details, she spoke about all the people she knew in X and in the hospital through her brother-in-law who is a doctor. Several times, she tried to draw the almoner into personal discussion of people, mainly doctors, in the hospital. The almoner tried to stress that she understood how humiliating Miss M. would find her present position and that she also understood how important it was to her to have the good opinion of these people she had mentioned.

Miss M. did not appear unduly concerned about her health. She had obviously discussed it a great deal with different doctors and had a reasonably good understanding of it. She said rather casually that she thought worry had had a good deal to do with her present hospitalization. This was at the end of the interview so the almoner suggested that she might like to see her again to talk about these worries. She gave a brief description of the function of an almoner and said she would talk to the doctor about her. This did not appear to arouse any anxiety.

An examination of this brief record reveals a number of important elements. We see the caseworker (an almoner) working in a particular agency (the social work department) situated in a larger institution (the hospital), in collaboration with other staff (doctors etc.). A person has asked for help over National Assistance, but seems to be more concerned with other matters. The caseworker tries to understand what is troubling Miss M., explains the kind of service she can offer and, in fact, begins to be of service by communicating acceptance and understanding, by commencing some form of appraisal of Miss M. and her difficulties, and by avoiding the role of ‘friend’. These elements: the agency, with its organization, personnel and objectives; the client in some difficulty; the worker, with his or her knowledge and skill, have been the themes of casework throughout its history. I have elsewhere suggested that they could be combined into a definition of casework as ‘work on cases guided by certain principles and the use of knowledge and human relation skills with the object of fulfilling the function of a particular agency’.¹¹ It should perhaps be stated in addition that casework is one of the methods of social work; the others usually being described as group work and community organization. Ideally, the social worker should be able to use whichever method seems appropriate to the situation and there is evidence that those trained to practice primarily with individuals or with single families are attempting to develop their skills in working with groups.¹² However, the emphasis of most courses of training has been on either casework or group work; and the first of these was established so long before the second that social casework and social work have often seemed synonymous. Social work can now be exhaustively described in terms of its three main methods. To ask what social work is besides its methods (and their objectives), is like asking to meet the family after one has been introduced to each of its members.

The elements of casework and their interaction will now be discussed in some detail.

THE CASEWORKER IN A PARTICULAR AGENCY

The Agency

The term ‘agency’ has a misleadingly American sound, but it was used in British casework literature in the late nineteenth century. Present-day usage refers to the institution within which the caseworker practises; sometimes it is the larger institution that is intended (e.g. the local authority) and at other times it is the smaller social work microcosm (e.g. the psychiatric social work department in a mental hospital). The institutions in which caseworkers practice (child guidance clinics, children’s departments of the local aut...