108 61 6MB
English Pages 126 [132] Year 2016
P E N N S Y L V A N I A S C H O O L OF S O C I A L WORK Affiliated UNIVERSITY
with
OF
the PENNSYLVANIA
SOCIAL WORK PROCESS SERIES (formerly
JOURNAL OF SOCIAL WORK
PROCESS)
•
T R A I N I N G FOR SKILL IN SOCIAL CASE WORK
Previous Publications JOURNAL OF SOCIAL WORK PROCESS Volume I
THE RELATION OF FUNCTION TO PROCESS IN SOCIAL CASE WORK (Out
of
Print)
Volume II
METHOD AND SKILL IN PUBLIC ASSISTANCE (Out
of
Print)
Volume III
SOCIAL CASE WORK WITH CHILDREN (Out
of
Print)
P E N N S Y L V A N I A S C H O O L OF SOCIAL WORK Affiliated UNIVERSITY
with
OF
the PENNSYLVANIA
TRAINING FOR SKILL IN SOCIAL CASE WORK Edited by V I R G I N I A P. R O B I N S O N Pennsylvania
School
of Social
Work
U N I V E R S I T Y O F P E N N S Y L V A N I A PRESS Philadelphia
1942
Copyright 1942 PENNSYLVANIA SCHOOL OF SOCIAL WORK
Manufactured
in the United States of •
London Humphrey Milford Oxford University Press
Second Printing,
REPRODUCED
COLLEGE OFFSET 148-tnO
Ν
SIXTH
ST
1948
BY
PRESS
. PMILADEI.PH'A G
PA
America
CONTENTS Page INTRODUCTION
1
THE MEANING OF SKILL Virginia
P.
7
Robinson
CLASS ROOM AND FIELD WORK: THEIR JOINT CONTRIBUTION TO SKILL Goldie
32
Bäsch
THE FUNCTION OF THE PERSONALITY COURSE IN THE PRACTICE UNIT
55
JESSIE TAFT SUPERVISION OF FIELD WORK T H E FIRST-YEAR STUDENT
75
FAITH CLARK THE SECOND-YEAR STUDENT
87
MADELEINE MARIS THE RELATION OF FUNCTION TO PROCESS IN SOCIAL CASE WORK Jessie
100 Taft
THE AGENCY'S ROLE IN SERVICE Kenneth
L. M. Pray
117
CONTRIBUTORS Virginia P. Robinson, Professor of Social Case Work, Assistant Director of the Pennsylvania School of Social Work and Chairman of the Department of Social Case Work. Goldte Bosch, Assistant Professor of Social Case Work, in charge of the First-year curriculum in Social Case Work. Jessie Taft, Associate Professor of Social Case Work, in charge of the Second-year and Advanced curricula in Social Case Work. Faith Clark, Scholarship Counselor of the White-Williams Foundation, has supervised first-year students in the Pennsylvania School of Social Work for seven years. Madeleine Maris, Supervisor, Children's Bureau of Philadelphia, has had eight years' experience in supervising students from the School. Kenneth L. M. Pray, Professor of Social Planning and Administration, Chairman of the Department of Social Administration.
INTRODUCTION THE Pennsylvania School of Social Work was founded in 1910 by the social agencies in the city of Philadelphia in order that the workers in those agencies might gain a broader understanding of the work they were doing than experience in a single agency afforded. Executives of the agencies mapped out the curriculum and taught the classes while their staff workers constituted the student body. Although the School has since developed its own independent entity with a full-time faculty and student body and has affiliated itself with an educational institution, the University of Pennsylvania, it has consistently maintained its connection with its roots in the field of social work itself. This factor is of first importance in comprehending the pattern of training which characterizes the Pennsylvania School. This pattern began to assume the rough outlines of its present shape and form in 1928-29 when the need of more time for growing class content and for the student's learning in the field to become integrated and stabilized demanded an extension beyond a one-year to a two-year curriculum. In 1930, the first class of students, fifteen in number, completed this two-year training unit. During the subsequent ten-year period, in which this twoyear unit has been developed, the leadership in the faculty that determined curriculum building has remained stable and consistent. This does not mean that there have not been changes in faculty personnel, or movement and growth in the School as a whole. Nor is there any intention of minimizing the effect of change, radical and revolutionary, in the field of social work itself as it has reacted to the powerful social forces operative in this decade. But beneath these changes there has been a consistent faculty purpose, animating, directing, 1
2
SKILL IN SOCIAL CASE WORK
and organizing the development of the School program throughout this ten-year period. Two fundamental bases have carried the unity in this purpose: first, the conviction that practice rather than knowledge content determines the focus in curriculum building for a school of social work; second, the belief that skill growing out of practice in order to achieve professional status must have a generic base underlying its expression in specific situations. Our search for this generic base has led us to define and abstract a process of relationship which we have called "the helping process." Since the specific situations in which we work, our field work 'laboratories," are case-work agencies offering help within functional limits to individual clients who seek that help, we began our search for the meaning of skill within the limits of this helping process which develops between the representative of the agency and the client. But our understanding of skill has been carried beyond this worker-client situation through our recognition of the essential likeness of the learning process in which a student takes help from a supervisor or teacher to the case-work process. The effort to define skill in administrative and community organization processes initiated in the School several years ago and articulated in its summer school of 1941 will very likely absorb the major interest of the faculty for the next decade. It seems an appropriate time, therefore, to attempt to describe the pattern which has been evolved for the training of skill in the process of social case work. The two-year curriculum in social case work rests on three essential and interrelated elements known as the practice unit. These elements are: first, a class in social case work; second, a class in "Personality"; third, practice in a social agency. The two classes meeting two hours a week throughout the first three semesters fill one-half of the student's class program; the practice assignment continues throughout the two-year training period, three days a week in the first year and from three to four days a week in the second. In the final semester, the practice class gives way to the thesis assignment, in which
INTRODUCTION
3
the student works individually with the help of an adviser to integrate and organize in a formal statement what he has learned to understand and to do in his training experience. Obviously there is an abundance of curriculum content, from the field of social work and related fields such as medicine, psychiatry, law, government, and economics, which must be built into the student's program. A first-year student typically carries a class in medical information and the use of medical resources, another in labor problems or government and social work in his first semester in addition to the practice unit. A class in method and uses of research with a project based on his agency practice is an important requirement of the total two-year program. The content of these classes and their integration into the curriculum constitute important problems in a discussion of curriculum as a whole. But this volume will not attempt to discuss any elements of the curriculum beyond the practice unit. The grave responsibility for seeing that the three strands in the practice unit, the case-work class, the personality class, and field work, are held together and that the student's relation to them moves ahead in a progressively active and responsible fashion devolves upon the student's adviser. Since she is also the teacher of the case-work section to which he is assigned she is actually a part of this practice unit, in contact with the student's field work as he brings parts of it into the case-work class. It is she who must sustain the relationship between the student and the School as they are engaged in the student's training together. Some explanation must be given concerning the selection of field-work agencies to which students are assigned for so heavy a proportion of time. These agencies are the actual, operating, social agencies of Philadelphia and outlying Pennsylvania communities within commuting distance, of Delaware, and of Maryland. Some of these agencies are years older than the School itself, having participated in the creation of the School and have worked with it without interruption; others are young in experience and in years of work with the School. If an agency new to the School asks to be used for
4
SKILL IN SOCIAL CASE WORK
training students, the School looks to see that three conditions are fulfilled. First, it asks that the agency shall be doing a good professional job in its own field. Second, it asks for the student certain consideration as a student. He must have a trained supervisor who can help him learn how to offer the service of the agency and who will give him regular conference time. Finally, it asks that the supervisor work with the School on the student's training process. This means that she will be expected to take a class in supervisory practice herself if she has not had one and that she will meet with the student's adviser as often as is necessary to enable them to carry the student's training together. These three conditions demand a great deal of the agency as well as the School. Willingness to cooperate, time for conferences, and a process of learning to work together are necessary to insure a good experience for the student. Other schools of social work may wonder why we continue to use agency practice as we find it instead of controlling the training experience by placing supervisors from the School faculty in the agency. Our original connection with the agencies offers the obvious historical explanation. But more important is the fact that in using this existing school-agency connection we have learned to value the actual agency experience as an essential element in student training. His field placement gives the student from the beginning a responsibility as a functioning part of an agency offering service to clients, more real than is possible when he is placed in a training district set up and controlled by the School. This insistence on the integrity of the agency and our determination to hold to and make the fullest use of the factor of difference in the field experience has led to the discovery of the value of function in this training process, a discovery which I believe to be at once the most realistically practical and the most profoundly psychological for the understanding and control of student training. Once we have achieved the conviction of a generic basis in skill and the possibility of training for it in any functional agency, many troublesome questions about field work fall into
INTRODUCTION
5
a different focus. For instance, once we accept that it is our job to teach students how to use themselves professionally in a helping process rather than to impart the content of all the fields of social case work, we have no need to require a student to practise in several agencies. Our experience indicates that it usually requires a year of work in one agency for a student to absorb its function and become responsible for using it with clients. We do believe, however, that it is important for a student to leam to use more than one function during a twoyear training period. Experience with a new function is secured usually by a change of agency placement at the beginning of the student's second year. In a few cases, however, this may be accomplished by a change from one department to another in the same agency. The problem of time requirements for the completion of the curriculum as a whole and for its separate units in class content and field experience is for us, as it must be in all curriculum building, whether the school be academic or professional, a fundamental problem. What does the school require the student to have when he completes the curriculum? How much should he know when he receives the degree of the academic institution; what must he be able to do when he receives a vocational or professional degree? Within the accepted time limif: each school struggles with the sense of having more to teach than there is time in which to teach it. We have found no answer to this question that will have meaning for those who approach the problem from the point of view of content. We have, however, found for ourselves that an acceptance of the given unit of time and a firm holding to that unit brings out in the student extraordinary results in the development of his own understanding and capacity for thinking and action. It is development of skill rather than the acquisition of content that we expect of students. This can be evaluated and to a certain extent standardized, so that students know what is expected of them, as they move ahead: at the end of the first year if they are to be ready to go on to a second year, at the time when they apply to write a thesis, and when the thesis is completed and they come up for degree.
6
SKILL IN SOCIAL CASE WORK
While we value the pressure which our two-year time pattern exerts on students to bring out their best effort, we must constantly keep before us the fact that any pattern tends to fit the average and must be kept flexible to meet the variety of needs in any student body. With this in mind, we divide students in the practice unit into three sections in terms of their previous experience in social work. The youngest bring no previous experience, and for many in this group we have found it desirable that they work a year before going on to a second year of training. Others whose development warrants their going on to a second year may find the thesis assignment premature and be advised to defer it to a third year. Our most experimental use of time in the development of an advanced curriculum has grown out of our recognition of the needs of experienced workers—executives, supervisors, or senior case workers—who come asking for help in developing the task in which they are engaged. A few of these need and can use a new experience in a field-work agency and are advised to come into the regular two-year curriculum, but others cannot give over responsibility for the job they are engaged in but must do their learning there or not at all. For this group we have experimented with an abbreviated, intensive curriculum including the practice unit (one day a week of classwork throughout the year) and have offered an individual conference unit of a semester of conferences once a week with a member of the case-work faculty as the field work requirement. The use which students have made of this limited time has convinced us that it has possibilities for the training of skill far beyond what we have explored. The first five papers assembled in this volume, from members of the case-work faculty of the School and two field supervisors, describe the two-year practice unit in our pattern of training as it is in use in 1941-42. Two other articles by members of the faculty have been added because they contribute a clarification of three concepts, "function," "process," and "the service agency" essential to an understanding of skill. VIRGINIA P .
August, 1941
ROBINSON
THE MEANING OF SKILL Virginia P. Robinson IN THE critical era in which we are living, when democracy and all its values are on trial, the profession of social work must examine its contribution carefully for proof of its validity and usefulness in the democracy of the United States. Social work, though preeminently a democratic institution, a defender of human values, of the rights of the individual to health, economic security, and happiness, no longer carries a major responsibility for sustaining these values. The social security program, the national health movement, child welfare services, aid to farmers, labor legislation, all indicate the trend of government in the past eight years in accepting responsibility for safeguarding the rights and well-being of its people. The value of these social welfare programs to the people they are intended to serve will depend on the personnel which administers them, and it is far from clear as yet what forces will determine the quality and training of this personnel. The federal social security program has recognized social work training in its requirements for workers, but state and local set-ups in many places make no training requirement for personnel. Social work must ask itself what contribution it has to make to these programs. Does it possess any special and unique skills to bring to the performance of the tasks of the agencies set up to carry them out? Can these skills be described and demonstrated? Is the professional school equipped to teach them? The professional school has come to the task of defining skill and training for its development only recently and through a tradition in which ideals, purpose, and attitude, rather than skill, have been emphasized. In this tradition the words "philanthropy," or "social service," carry more accurately than "social work" the spiritual values, the ideals and attitudes, which 7
8
SKILL IN SOCIAL CASE WORK
have characterized this movement throughout its history. The cliangc of name from "social service" to "social work" has not altered the fundamental purpose and characteristic effort of this field of human endeavor. It is rooted firmly in an ethical ideology, in an immediate sensitivity to the other person, in a recognition of individual difference. The democratic state, because it accepts this fundamental reality of individual difference, must persistently and forever strive to balance innate difference by equalizing opportunity. Of all the various efforts to equalize opportunity for all citizens in a democracy, none has stood closer to the very heart of this problem of difference than social service. It has drawn into its circle of activity men and women whose sensitivity to injustice and inequality determined the devotion of themselves, their time and their means, to righting wrongs and alleviating suffering. Their passionate conviction created the social agencies in which the impulse-to-give of those who have could be organized and directed for the service of those who have not. These agencies rest for their support, psychologically and practically, upon this sensitivity to difference, this capacity to respond with feeling and with actual giving, to the other person's need. It might be said that the social agency let itself take over the role of the conscience of the community in the latter half of the past century. It kept itself close to the needs of the disadvantaged members of the community on the one hand, and on the other held itself responsible for stirring the complacency of the advantaged to respond to need by giving. Often this response went no further than a feeling of guilt which could be paid off in money, but a recognition of this superficial relationship should not obscure an acknowledgment of the deeper, more responsible connection which the private agency has fostered between those who have something to give and those who need this help. Private philanthropy was just moving into the somewhat greater objectivity of social service in its understanding and use of this giving and taking process at the turn of the century when the professional school came into existence to train workers to carry out the manifold activities developed by the
MEANING OF SKILL
9
social agencies in offering service to clients. While these tasks ran into great detail and differed widely from one social agency to another, they were held together by the tremendous sense of conviction of man's duty to man. It was this conviction, too, which expressed itself in the curricula of the first schools of social work. Around this core of conviction, courses were organized presenting the special knowledge gained by social workers in their contacts with clients and social problems, and actual practice was offered in the social agency in working with its clients. A student entering one of the early schools of social service, forty years ago, by his original choice of this field and by the devotion to service fostered in school and agency, took upon himself the total symbol and responsibility for service to his fellow men. The impulse which operated in this choice was similar to that which drew others into the ministry, and the dedication to the task and the field had some of the same meaning as a dedication to the service of the church. The student was identified in his own mind and the minds of others with the conscience of the community, its sensitivity to wrong, its passion to help. Perhaps this willingness to carry so much symbolically beyond what can be carried really is one explanation of the opprobrium which frequently attaches to social workers today. Whatever differences existed in these first schools*—and they were great—between content of curriculum, courses, and methods of teaching, they were united in attitude, spirit, and purpose as they represented the "field" of social work in which this one principle of unity, the ideal of service, operated. Other factors have come in since to influence the development of the professional curriculum, particularly in schools which originated in the university departments of sociology or economics where academic standards outweighed vocational influences. But the major influence has continued to be the field itself with its concepts of service and of practice. The twenty-five years of development of professional eduβ There were fourteen schools of social work when the American Association of Schools of Social Work was first organized in 1919, at the call of Porter Lee, of the New York School. In 1941 there are forty-one schools.
10
SKILL IN SOCIAL CASE WORK
cation for social work between the two world wars have seen two major emphases in curricula as curriculum making has followed the trend in social work itself. The first emphasis showed itself in a predominance of psychiatric content accompanying the popularization of psychiatry and the introduction of the mental hygiene movement after the first world war. As unemployment increased in the late twenties, the inadequacy of the resources of the private agencies to handle the need it created, forced upon the field and the schools the recognition of another area of content and a requirement for definitions of new tasks and for the development of new skills. Public programs began to take the place of private philanthropy, and the social security program written into law in 1935 clearly defined government's responsibility for taking over from the private conscience the burden it had been struggling to carry. In the curricula of the schools of social work, content from the field of economics, from the history of the labor movement, from political science, tended to decrease the emphasis on psychiatric knowledge. Examination of the curricula of schools of social work today, in 1941, cannot fail to bring the realization that there is no special content of knowledge peculiar to this field. Everything that can be known about social, economic, and political problems is told on the radio, spread in print in papers and magazines, acted out on the stage or the movie screen. These presentations bring human need before the eyes and ears of the public more vividly, more immediately, and more movingly than can be done by lecturers in a school of social work. Furthermore, it seems obvious that, in a world engaged in total war, social work can no longer carry the burden of social reform. If the world is to be reconstructed after the war into a place where human beings may live and grow and develop their capacities in peace, it will take the experience and the .knowledge, the judgment and the skill, of all those who care for human values. A new dedication will be required for this task and the name "social work" will not be sufficient to carry the depth and scope of its purpose and meaning. In this new era which social work and the professional
MEANING OF SKILL
11
school are facing in this country, no one can say whether there will be more or less recognized need for social workers. This depends on many factors over which social workers have no control, most important of all on the capacity of the public social programs to hold their own with the defense program. It depends, too, on whether there is recognition of the equipment of social workers as bringing a necessary contribution to the administration of social programs. I believe that this recognition of the contribution of social work can only be established if the profession of social work can separate itself from its identification with the social conscience and social reform and find a role for itself in a more limited and more effective relation to social problems. Can social work, itself, define and stay within its own area of competency, an area in which its knowledge and judgment supply something different from the contribution of other professions and where its practitioners can do something by virtue of their training which cannot be done without it? The grave question which the professional school of social work must answer today is not what should be the content of the courses in the curriculum, but are there unique skills in the practice of social work and has the professional school isolated and defined the situation and the methods by which these skills can be taught? Has the professional school comprehended a sufficiently generic and fundamental base so that these skills may be considered professional rather than merely technical in character? An equally pertinent question for the future of professional social work is: Are these skills recognizable by others than those who practise them? Ernest Bevin has been quoted as placing skill at the head of a nation's resources—a nation's wealth is not land, not machinery, but human skill. What, then, is skill? Skill implies first of all an activity, an ability to perform, and while it rests on knowledge it is clearly distinguishable from knowledge. W e speak in common language of knowledge about a "subject," of skill in handling an "object." One has a knowledge of the subject of mechanics, skill in handling a particular machine. This difference in the language is sugges-
12
SKILL IN SOCIAL CASE WORK
tive. For knowledge may remain in the possessor of knowledge, the knower, while the development of skill necessarily leads out into contact and engagement with an object. Achievement of skill demands that the object become known in its reality, its make-up, its ways of behaving, its capacity to respond to efforts to change its behavior. Most skills grow out of this engagement between a workman—a craftsman, a mechanic, or an artist—and his object around some point of change initiated by the workman. The nature of the object, its pliability and its resistance, sets the limits of the problem. All crafts, all trades, all mechanical work, all professions, and all creative activity, have their special, distinctive, and recognized skills. The sculptor carving in wood or stone, the scientist handling the elements in his experiment, the cook preparing a meal in his kitchen, the gardener tending his growing plants, learn, through training and experience, a skill in controlling the process in which they are engaged. It may be possible to accomplish the process and achieve a finished product without skill in the performance, this lack of skill expressing itself in awkwardness, bungling, poor timing, perhaps in mistakes which ruin material or tum out a defective product. The skilful workman, on the other hand, seems to move easily and with direction. We admire his efficiency, his timing, the perfect gearing of himself and his energies in the process. This skilful way of working obviously develops out of some relationship between the workman and the material in which he works. The force which will emanate from him to produce change in the material—his intention, his idea, his plan—starts the process in motion. His understanding of his material and his capacity to work with it, instead of against it, to utilize and not do violence to its essential nature, determine his ability to develop skill in his handling of the process. Skill might be defined, then, as the capacity to set in motion and control a process of change in specific material in such a way that the change that takes place in the material is effected with the greatest degree of consideration for and utilization of the quality and capacity of the material. It develops out of these
MEANING OF SKILL
13
two elements—the strength of the goal, purpose, aim, or idea in the workman, and his willingness both to struggle with and yield to the characteristics of the material with which he works. With increasing experience, as the workman learns how to handle his material, his skill becomes focused in himself. Hand, eye, self, and object, become one. The workman's skill is his way of working, natural and spontaneous. I recall a plasterer I have seen at work whose hands and body seemed molded by the process in which he was engaged. He worked in bricks and mortar with the loving care of an artist, building chimneys which could be depended on to draw and to ejidure, molding his own muscles into tools adapted to the task. When an individual makes a choice of a vocation, the areas within which he will relate himself to reality and the contacts in which his skill will develop are laid down. In a world as mechanized as the world of the twentieth century, processes are so finely specialized that a vocational choice may limit a man's use of himself to one field of activity, one kind of material, even to one part of a machine. Industrial processes are standardized and patterned by the machine, and the workman's skill becomes a matter of adjustment to the speed and operation of machinery. No creative impulse and purpose of his own can be expressed in these mechanized performances. The choice of a professional vocation, on the other hand, that of medicine, for illustration, may engage the whole of the individual in a life-long struggle to master the knowledge and develop the skill with which to treat illness. The extent to which the self becomes involved in the development of skill depends first on the strength and depth of the original purpose or creative drive, and secondly on the nature of the reality problem with which it engages. If the problem is slight, easy of solution, or partial, cut off from relation to other problems as in machine operation, the self is engaged only superficially and partially. Where the problem is complex, difficult, and related to other problems as in medicine or engineering, the self must be engaged more actively and more completely, and may be drawn into a field which constantly sets new and more challenging problems. It would
14
SKILL IN SOCIAL CASE WORK
seem that the fields which engage the individual most deeply are those in which the problems have the scope and nature of life itself, where the material is most human, most like in character to the self. Art, science, and some of the professions, especially medicine, nursing, and social work, involve those who engage in them in problems of life and death, of growth and change in the human being. Consequently, the skills that must be developed to work in these fields involve the commitment of the whole self, and necessitate the development and deepening of the self to the extent of its human capacity. In the development of skill the influence of the organized craft or profession made up of those who have acquired the skill on those who enter the field is an important factor. Here apprentice training or the professional school operates powerfully, setting standards and controls, creating conditions and situations within which skill can be learned. In no field of human activity except perhaps the arts can the individual develop purely individual skill without going through a learning discipline set up by others. Only the greatest individual genius can afford to learn in his own way wholly through his own experience because he contains in himself that which goes beyond the ordinary human experience. Even the creative genius, in spite of his capacity to develop an original contact with his material and to wrest his own skills uniquely out of his own experience, must recognize and make use of his connection with the world of art itself and with others who have created in the same medium. With these points in mind relating to the definition of skill and its development and training, we can ask ourselves the questions: What is the specific skill which social work has to offer? What change does it seek to effect? Through what processes does it work, and can these processes be described and taught? One must keep in mind the handicap the field of social work has been under in moving from its original identifications with goals beyond human capacity to achieve individually or in the span of a lifetime to an orientation to social problems suf-
MEANING OF SKILL
15
ficiently limited to permit of the development of skill. The traditional concern of social work, the human being in need and the ills of society, have proved too complicated for any influence social work could bring to bear, while realistic points at which effort can be exerted upon these problems are not easy to find. In one field of social work, the field of social case work, social workers have been forced to confine themselves within boundaries that define a point of operation and a relation to the material which are necessary for the development of skill. To the doors of the case-work agency comes every variety of human problem. They are brought by individuals, by individuals representing families, and this fact of individual presentation constitutes the basic point of approach on which case work has always relied. But one must wonder what assumption could carry the case worker into trustworthy activity in relation to the problems and circumstances of an individual in need of help. The impulse to help in response to need cannot always be relied upon to result helpfully to the other person. How different this problem of developing a skill is seen to be from the use of skill in industrial and mechanical operations! The mechanic or craftsman acts directly upon his material, but the case worker is faced with another person, a human being like himself, seeking help in an effort to change something in himself or his circumstances. Has the worker anything to contribute that is valid and useful? Can any control of his activity deserving the name of skill be developed? In the history of the case-work movement, one sees that the approach to this problem of how to help, in relation to a person's need to bring about change, has moved through two phases. The earlier effort was a direct attack on the client with the intent of making him over in the image of the case worker and for the good of society. In reaction against this will-tocontrol of his first efforts, we see the case worker in the next phase of the movement resigning his own activity in a passionate identification with the client, a need to understand him in his difference. Neither of these approaches could lead to an effective relation to the client's request for help. In the first
16
SKILL IN SOCIAL CASE WORK
the worker was caught in his own pressure to change the client; the second left the whole burden on the client's shoulders. Through neither approach could the case worker feel any confidence that the case-work contribution was effective in producing change. Results might be good in one case, bad in another, but to what extent these results could be attributed to case work was uncertain. No more difficult skill could be demanded—skill in setting up and controlling a process in which change" may take place in a human being. If even the beginnings of such a skill exist, why is it not more widely recognized? Certainly no skill could be more desirable; none would be more deeply feared. For man's fear of and resistance to change within is in proportion to his desire to produce it outside himself. The power to effect change in human beings directly is permitted only to parents and religious workers. Perhaps, then, the most fundamental and necessary basis for the development of any skill in effecting change in a human being is an understanding of human resistance to change and an appreciation of an individual's right to refuse any efforts directed at changing him. As long as social case work approached its clients with the intention of producing direct change, there could be no development since the other person could be involved in nothing but resistance. Social case work has long been in possession of this knowledge. Its literature abounds in assertion of its belief that the client must bring about his own change, make his own plan, participate in any effort to help him. But these are still words to a great extent. Young people continue to bring to training in social case work just this purpose, the will-to-change the other person, to make him better or happier, or to give to him what he ought to have or what the worker wants to give. How can the variable, temperamental nature of this impulse-to-give be disciplined into a steady reliable help which the other person can depend on, and how can the will-to-change the client directly be transformed into a willingness to play a part, to fit into what he is doing in his own behalf? These questions must be answered before the word "skill" is appropriate.
MEANING OF
SKILL
17
Now social case work has always operated in a reality situation which possesses to a singular degree the power to restrain the impulse and will of the worker from direct action on the client and redirect it in a way that permits the development of conscious skill in controlling a process in which the client can participate to effect his own change. But it has not recognized and made use of this situation consciously for the control of skill until recently. 0 This reality situation is the social agency and the defined, limited service it offers to clients. If this reality is accepted and used it stands between the person-to-person relationship of client and worker in a way that makes possible the seemingly impossible task of effective change. An obsolete definition of the word "skill" used as a verb is "to differentiate," "to separate." Certainly no skill in controlling a process of change can develop unless there is a separation between self and object, between the will-to-effectchange of the workman and the material with which he works. Where the material is another person, this first problem—to establish sufficient separateness so that the other person is not confused with the own self—seemed for a long time insuperable. The social agency with its purpose, its function, its services, its policies, structure, and procedures, effects this separation between worker and client. Since it offers a specific service it enables an individual to come seeking that service intending therefore in the natural, characteristic way of human beings to effect a change not in himself but in outside circumstance. "I want a job, or money to pay the rent, or help through an illness. I want to place my child, I want to leave my husband." These are some of the requests indicating the client's move to change his situation as he comes to a social case-work agency. The client is not asked to change himself or to accept change at the hands of a social worker. He is told what the agency has to offer for his need as he states it. He is told the conditions he must meet. In a public relief agency, for exam* In describing this conscious use of the agency in the development of skill and in the training process, I am describing the training of the Pennsylvania School and the majority of its field work agencies.
18
SKILL IN SOCIAL CASE WORK
pie, he is asked to establish his eligibility, and it is made clear to him that his continuing relation with the agency will be a continuing process of eligibility. Thus he does something about his own situation and something with the agency. He involves himself in working with the representative of the agency, takes a new kind of responsibility for the facts he presents, feels and expresses a new concern in looking for a job and in discussing his progress with another person. Actually he does change in relation to a limited area of his problem and through contact with a specific, objective, external factor, a social agency. Experience demonstrates that it is exactly these limitations which permit the client to venture into this dangerous area from which change may emanate, risk the fearful involvement with another person, and come through with some use for himself of what has been given him. What he brings away is new because the agency and the worker have given something, but it is his own since he has come to terms with it in the taking. The effect on the worker of the reality of the social agency is even more electric than on the client. A student, beginning field work in a social agency, makes his first contact with a client not in his capacity as a person, but in a new role as representative of agency. The implications of this are immediate and far-reaching. The natural impulse-to-give and the total will-to-change directed at the client are suddenly invaded by the agency's requirements. There can be no coming to terms with this simply. Any attempt to describe what happens here oversimplifies a complicated psychological process. It is as if an on-going force is broken in two parts, one part being diverted from its outward expression to be directed upon the self as object. Where the artist works upon his canvas, the mechanic upon his machine, both external objects, the student in training for social work must direct some of the creative energy, ordinarily directed outside, upon himself. An artist may recognize at some point that his own immaturity limits his conception, but he has no way of working on his growth process. In social case work, however, it is precisely with his own capacity to change and grow that the student
MEANING OF SKILL
19
must be concerned. Around the point where direct expression of impulse or will is checked by a supervisor in a training process, if this expression is internalized, change actually does take place in feeling and attitude. The student is brought up short before his own will, which perhaps he has never felt as such, detached from an object. He may feel himself convicted of error, of aggression, of meanness, of hostility, or of a generosity which proceeded only from his own need without consideration for the other person. With the help of the supervisor he can feel this force as something in himself with power to work harm to the supervisor, to the client, or the agency, unless he becomes responsible for it. Through this internalization, the conviction is established that the self is the tool with which he works in this process of helping another person, and that the tool must be formed anew in harmony with its chosen task. The process through which these new feelings and attitudes are assimilated into the self eventually follows the form and movement of a growth process, but it proceeds on a deeper level with more awareness of itself and with more capacity to see the other person as separate and different from the self than is the case in the ordinary growth process with its slow organic rhythm, moving unconsciously and always in some connection with natural human relationships. This new self, immediately the student feels it and takes any responsibility for it, calls itself "I" in the record. In sudden sense of its own separateness and strength, it often becomes aggressive and overbearing in its definition of difference, rigid in its adherence to the new-found support in agency function and structure. In this early phase of training, the student may be over-assertive of his professional role in his insistence that the client must carry responsibility for asking for help. He finds it easier, in the first flush of his own sense of separateness, to say "no" for his agency than to say "yes." Only teachers and supervisors who understand these attitudes as phases in a training process can bear with them and the harm they may do the agency and the client. Family and friends, particularly,
20
SKILL IN SOCIAL CASE WORK
react against these manifestations in training which seem to set the student apart from his natural human connections. This new professional self varies from student to student in relative strength and power to express itself outwardly and to develop inwardly. The structure of the self has been disturbed by this change. Reorganization will depend on the individual pattern, on time, and on the capacity to continue to take help from supervisor and teacher in a training process. The role of the supervisor is seen to be essential, first in understanding the value of agency in setting up this representativeof-agency role and making effective this point of differentiation between student and client. Even more important is her role in helping the student carry responsibility for the professional self through its first use of itself with clients until reorganization eventuates in a self that can carry its own strength with less and less dependence on the supervisor. Through this relation to the supervisor, in which the supervisor consistently maintains a difference from the student that supports his development while it checks his undisciplined expressions, the student learns how to use himself helpfully with his client." The student, once he has had this experience with a supervisor which differentiates him from his client and enables him to take in the function of the agency, understands the beginning of a professional training process. He learns, too, in the midst of his own uncertainties, to trust the experience of the School in accepting the fact that there will be development and eventration in this two-year training process. Can the student also have the experience of seeing the development of skill in shorter units of process than the two years of his own training? Can he engage in a process with a client and see it through to a point of ending? The word "skill" cannot be applied to anything less than this—the control of a process in which there is effective change. A student cannot have any real understanding or use of skill until he can feel himself present and active from the beginning to the end of a process of change and know that what he as β For a more detailed analysis of the supervisory process see Virginia P. Robinson, Supervision in Social Case Work, University of North Carolina Press. 193Θ.
MEANING OF SKILL
21
case worker put into the situation has been an effective agent in the client's response. This problem has presented such difficulties when case workers let themselves be confronted with the total life problem and total needs of the client that not even a step could be taken in the direction of teaching skill to a beginner. Only an experienced worker who alreadv understands the client's life problem and depth of need would be competent to try to help a client in these terms. But once the helping agency has accepted responsibility for offering to the needful client some specific service instead of total help, it is possible to see where a beginner can fit in, find a role, and define himself and his service to the client so that the client's response is specifically related to this offer. Here, then, is a unit of experience marked off in time by the conscious, deliberate act of agency and worker. Every contact with the client can become such a unit for training purposes. Responsibility for what the student puts in can be clearly defined, and the client's activity can be examined thoughtfully to see how it is connected with the student's activity. The student can bring an interview into case-work class and gain greater conviction of what went on between himself and the client as he discusses it with his fellow students and the case-work teacher. The d e a r definition of function, policy, and procedure in a public agency gives the beginner the kind of support he needs in taking responsibility for his activity with a client, and affords too the most satisfactory opportunity to see the effect upon the client of the worker's activity. In the space of a single interview, a student may be able to see his ability to clarify a policy with a confused client lead to a real change of attitude on the client's part. He may see that what he contributes in the interview in understanding a client's confusions and resistance and interpreting the agency's conditions has had the effect of enabling a client to establish his eligibility. Or, in other situations, the student may have to recognize that his own failure to bring out the client's real attitude or to be clear about agency requirements was an actual obstacle between the client and the relief check he needs so badly and for which he is eligible. Out of many such experiences where responsibility
22
SKILL IN SOCIAL CASE WORK
is fixed and the client's reactions to it recognized, the student leams the meaning of skill in the single interview. But the single interview is by no means all there is to a social case-work process, and while the beginning student is learning to analyze worker-client activity in these isolated units of experience, he must also be learning what makes for continuity and movement between interviews, in a series of contacts. Strange things happen. The client fails to appear when the student had set the date for the next appointment so carefully; he turns up with a job when the student was sure he was ready to accept a relief check. After expressing gratitude for an allowance worked out with him in one interview, he returns in the next to complain that it is inadequate for his needs. Just at the point where the student-worker has made all the preparations and gained the consent of the family to the muchneeded tonsil operation for a child, the child runs a temperature or the mother goes back on her decision. What do these changes in attitude on the part of the client indicate? "Is it due to what I have done or failed to do, or is there something else in the client's own movement which I must learn to expect?" the student asks. Again the student works on these questions with the supervisor and in the casework class. He learns that it is possible for the person who is giving help, if he holds to his responsibility for constantly defining and redefining what he puts in, to gain conviction about the relation of the other person's movement to what he has contributed. From a wealth of illustration provided by his own clients and those of his fellow students, and from his own experience with his supervisor and teachers, he learns to know that there are certain general characteristics of movement in a process where one individual takes help of another. It becomes obvious to him very soon that this movement rarely goes in a straight line. Rather it goes backwards and forwards, or with marked swings from side to side. Only a great deal of experience brings the sure knowledge that there is a general direction in this movement which seems at first so erratic. The supervisor and the teacher carry this conviction as to direction and outcome while the student struggles in the middle
MEANING OF SKILL
23
of the process. The phases of movement in time—the beginning, the middle, the ending—become familiar concepts to the student. The school year is patterned so that classes naturally bring an awareness of this patterning of movement and of the importance of recognizing and dealing with these differences in time phases. In all the field-work agencies of the School, the same concepts of movement in relation to a focus and the patterning of movement in time are in use. In addition to the understanding the student must achieve of the general characteristics of human movement in relation to a helping function—its ambivalence, its positive and negative phases, its direction and its rhythm in time—the student must also learn to appreciate that each person individualizes these general characteristics in a way that is unique to himself. The client whose way is most different from his own, who baffles him completely, will probably afford the experience in which the student learns most deeply. The case-work class in the school, and even more the class in the area of personality which accompanies his field work, will constantly supply additional illustration of different individual ways of reacting to and using help and will seek to build up and deepen the student's understanding of processes of change and movement in human beings. A second-year student must go further and deeper than the first-year student in his capacity to take in and carry the function of the agency and use it fully in helping the client. One second-year student, a man, with a year of experience in a public agency before he entered the professional school and his first year of field work in a private child-placing agency, began his second year of school in the same child-placing agency with a case load of older boys in foster homes. In the first month of school he brought to the practice class the case of a sixteen-year-old boy whom he had recently placed in a new foster home. The boy was behaving badly and the foster parents were asking for his removal. The student was approaching the problem de novo, seeing only a boy whose behavior problems he must understand and help. He felt himself to be understanding and helpful in his approach to the boy,
24
SKILL IN SOCIAL CASE WORK
and was baffled by the rejection of his offers. As the student worked on this case in class and with his case-work teacher and supervisor, he struggled through to a realization that his approach was subjective and superficial in that he was ignoring the reality of the boy's long connection with the agency. (He had been placed by them as a baby with a family which gave him its name and treated him as an adopted child; recently, after the death of the foster father, he was returned to the agency without explanation.) To comprehend the meaning of this boy's experience with the agency and accept responsibility for what had been done to him by the agency demanded of the student a deeper internalization of function than is achieved in a first year of training. To stand up to the hostility and bitterness which the boy harbored asked more strength than the student knew he possessed. This student was eventually able not only to help this boy express his bitterness and place it on him as worker-for-agency but to face some of his questions about his own mother and the cruel inescapable fact that she had deserted him when he was a baby. To see a boy through these realizations of feeling while placing and replacing him in homes which his behavior threatens to make unusable requires a firmness and sureness of role and direction to be expected only in an experienced worker. The support of agency, supervisor, and teacher was necessary here to enable the student to carry this process through the difficult struggle involved until the boy accepted placement and his relation to the agency. The student used his thesis to abstract the movement in this case, and reached his own understanding of the problem, the process, and his own part in it through separating himself from the living experience. It can only be regarded as amazing that any training could enable a student in his early twenties to help a boy of sixteen face and live with so painful and difficult a problem. There will be many who believe that such a problem could only be assimilated with the help of deep psychoanalytic treatment. That this boy would ever seek such treatment is highly unlikely. Failing the help which the student worker has given, his behavior would probably have taken him into a reform
MEANING OF SKILL
25
school. This help indeed is limited, limited to helping him live in a foster home and with the realities of foster parents, agency, school, and community. One could wish, of course, that a boy with so great a problem might have met the skill of the most experienced worker in the agency. Some bungling in the first contacts would have been avoided and the case might have moved more quickly and more directly. I do not believe, however, that this contact could have had any deeper reality or more satisfactory eventuation for the boy. For the essence of help is here, in this meeting of the boy's problem where it was, in feeling about himself and the agencv, and in moving with it through its struggle to express the bad and find something he could depend on in the agency and in himself. In seeking to understand the skill required to help a boy relive and assimilate sixteen years of experience, one needs another concept more comprehensive than the concept of movement in relation to a function. Only the concept of psychological growth can afford an adequate explanation of what is happening in this experience for the student, as well as for the boy, his client. Only a profound trust in this growth process enables the supervisor to stand aside at times and wait until a deeper development comes to pass rather than to exert her own pressure to force a result quickly. In the last analysis, it is on the understanding of growth and its slow time rhythms, different for each individual, that skill in supervising a training process, such as the one I have just described, depends. A young supervisor has not reached this understanding and must depend on the teacher in the school for the support which enables her to move ahead with this training process even when it goes beyond her own experience. Not only in the child-placing field, but in any social casework agency, the worker who stands as representative of the agency's service to the client must learn that he never operates de novo and as himself in beginning a case-work process. The client never comes de novo but brings inevitably, if not a continuing contact, as in the case of the boy just described, some relation to a previous contact or some attitudes from contacts with others who have used the agency. The worker must have
26
SKILL IN SOCIAL CASE WORK
a deep conviction of continuity to say to a client at the Intake Desk, after studying the agency's record, "You were here three years ago and you left without getting what you wanted from us. Why are you coming back now?" Skill here rests on an unequivocal identification with the agency, and a firm holding to its reality and meaning for the client through three years when he has not contacted it, in order to particularize and define with the client the different significance of his present turning to the agency. These three years may have been a period of disorganization, of disintegration, instead of constructive, directed movement and growth in the client's life. Perhaps his failure to get help from the agency when he came before was a factor in his inability to move ahead. The skilled worker must take some responsibility for that failure and utilize his understanding of it in order to strengthen any positive movement toward reorganization that this present approach to the agency may indicate. The worker cannot know all that has happened to this client in three years, but he must be aware, if he is to be of any use to him, of exactly what has happened to him as a result of contact with the agency. He may see it more clearly than the client, must hold to it and affirm it even against the client's denial, in order to utilize it for the client's movement. Skill that has reached this degree of firmness and sureness in its use of itself in the role of a particular helping function has the capacity to affect a client very immediately and very deeply. Not only does it individualize him in his difference from other clients, but it may actually create him as an individual in that it brings him together in his strivings and his confusions at last and enables him to feel himself whole in being met at this point by a responsible and responsive person. As he is met, too, with recognition of continuity that connects a past expression of himself with his present, he may be able to feel himself more really and responsibly present and persistent through changing circumstance. I should like to say here, parenthetically, that the recent emphasis of case work on starting with the present problem, while it has been necessary in order to extricate case workers
MEANING OF SKILL
27
from the involvement with the client's past which made action in the present impossible, has gone at times to the 'extreme of denying the validity of the client's past as it affects the present. For purposes of training this emphasis may be exaggerated in order to give the student his role in a present point of contact, and to help him get a sense of focus in agency function and the client's immediate relation to it. But the further the student goes in experience in helping processes, the more he realizes that a contact really focused in the present must handle all the forces that come together there. A focus introduces more struggle, more meaning, more sense of reality, more conviction of self in the present moment. This feeling of self in the present inevitably stirs up a sense of past selves, deepening instead of limiting the contact. In every helping process that goes below the surface of the immediate single use of a function, the need for recognition of the whole self must express itself at some time. This is most obvious in the supervisory process where the skilled supervisor knows that every student, in order to achieve a development of the disciplined professional self, must touch at some point in his learning process a bad, impulsive self that he may be giving up, a weak, fearful self that may be moving toward greater strength, or perhaps certain rich, creative aspects of the spontaneous self that are holding themselves aloof from the process. These aspects of the self may express themselves in any content from the student's experience, and the supervisor's skill lies in her capacity to include them through her understanding of their meaning in the process. By maintaining her focus in the process, in what the student is learning and she is teaching, she sustains the structure, the environment, as it were, in which his movement to professional development can find its own form and shape without denying his human and personal self. The criticism which some case workers have directed against a use of function as limiting, rigid, and negative grows out of a failure to understand the universal problem of creativity in its search for form. Fundamental in the problem of creativity is the need for limits, orientation, and focus. Without these, form cannot evolve.
28
SKILL IN SOCIAL CASE WORK
These considerations take us into problems of skill that go beyond what two years of training could be expected to compass. On the other hand, it is not possible to limit the client's use of help to the student's capacity to give help. The school has no power to limit what the student will be expected to do except by the selection of the field-work agency. In the public assistance agency the student's responsibility for function can be definitely limited. But even there, the use some clients make of that function will strain greatly the student's capacity to understand and handle himself in the process. In the private case-work agencies there are few field-work assignments which do not call at times for more than the student has learned how to give. Only skilled supervision and the integration of supervision with the practice class and the personality class in the school make it possible to handle these problems. While I am limiting this discussion of skill to the field of social case work where we have built up structure and method through which skill can be trained, I believe this skill which is developed so specifically is generic in its basis and applicable to any field of social work, to administrative processes as well as to the processes of case work and supervision. The familiar concepts of lines of responsibility and flow of work in administration imply that the same basic understanding of movement can operate here. In our experience in the Pennsylvania School we understand skill in classroom teaching to rest on the same basis as does skill in supervising and in helping the client. In generic terms this basis consists in definition of a professional role and an assumption of responsibility for carrying that role in a situation with full understanding and utilization of the other person's relation to it. The student's professional role in relation to his client, the supervisor's role in relation to the student, and the teacher's role in relation to the class are all different, all interrelated. The training movement develops soundly only if these definitions of the professional role are kept clear. The answer to the question whether this skill can operate and sustain itself in the public agencies lies in whether the public agency with its large case loads can permit enough
MEANING OF SKILL
29
sensitivity to the other person, and enough dedication to professional development, to ask for discipline of skill and professional training. If not, the relation to the client will be carried in routine procedures, while job security guaranteed by the union and by civil service will take the place of professional discipline. In my opinion, any service which calls for individualization of the clients to whom it is offered must make use of this skill if it is to render service effectively. If social work understands skill in these terms of setting up and controlling processes of movement in professional relationships it might indeed look forward to a broader field of usefulness than it has ever envisioned for itself. There should be a place for this skill in extending the use of any service, educational and health services as well as social, from any agency or institution. Wherever people come to get something they need, to which they may be entitled but to which their relation is not yet established, they require help in making use of it. If the service is to realize its greatest effectiveness, this understanding of the individual's problem in making use of it should be inherent in set-up and administration. Particularly it should be expressed at the point where the individual applies and at the point where he is ready to end his use of the service. This psychology of movement in relation to a function lies at the basis of the new skill which I believe is being created uniquely in the field of social case work today. It is difficult to teach because it cannot be learned from books or by the intellect alone, but must be comprehended through an experience in which the student risks himself really. Only courageous and able students will ma!:e the sacrifice which this professional development requires, will accept the discipline of the personal self which it entails. The school that undertakes to develop this skill must select its students carefully and must guarantee them a learning experience in which field work under skilled supervision and class work are set up and integrated through this understanding of the meaning of skill in social case work and the learning movement the student must undergo in acquiring it.
30
SKILL IN SOCIAL CASE WORK SUMMARY
In examining the question of the nature and meaning of skill in social work, I have used as a definition of skill the following statement: "Skill is the capacity to set in motion and control a process of change in specific material in such a way that the change that takes place in the material is effected with the greatest degree of consideration for and utilization of the quality and capacity of the material." The definition emphasizes the nature of the relationship which must exist between the workman and his material if skill is achieved, whether the workman be a laborer, a craftsman, a mechanic, a member of a profession, or a creative artist. The psychological task in the development of any skill was seen to lie in the discipline of the natural will-to-change the object into the will-to-create the object. For social work, whose traditional tasks have been to right social wrongs and to help the individual in need, there could be no definition and training of skill until these tasks were limited. I have pointed out that in the case-work field alone social work found a limitation of its task which makes possible a point of control of effective change. Examinations of the problem of change revealed it to be fundamental in living. It revealed the necessity to change opposed by an equal resistance to it. In struggling with the problem of how to produce effective change in clients and their situations, social case work has clung to one conviction that the client must produce this change himself through his own effort and by his own growth. This left the worker still without an effective role. The discovery of the use of the social agency as the reality which introduces a separating factor and an objective focus into the personal client-worker relationship has revolutionized our concept of case work and made possible the development and training of skill in control of a professional relationship. When the service agency carries the helping function and states the conditions under which it will give help, professional roles can be defined and professional relationships sustained. The skilful handling of professional relationships, whether
MEANING OF SKILL
31
it be a direct contact with the client or his connections, with a worker or student as supervisor, with members of the staff or board members as executive of an agency, necessitates an acceptance of professional difference, an understanding of the dynamics which this difference introduces, and the capacity to sustain the movement initiated in the other person until he reaches an end in his use of it. This understanding of dynamics and of processes of change and growth constitutes a special psychological knowledge. This knowledge cannot be taught academically but grows out of the student's experience in a process of change in the development in his own professional self and in his capacity to feel his client's movement and growth as like and different from his own. In this training process the will-to-change the object is transformed into a will-to-create the professional self and the process of relationship in which it works. In discussing the training of skill I have described three levels. First is the simple skill which the beginner can initiate and carry through in a single interview around a point of definition of function or explanation of a policy to a client. Second is the skill in controlling a process of movement in time where the student becomes responsible for his continuing part and for carrying the continuity of the experience with the client through to an ending. A third level of skill involves an understanding of growth as well as movement in relation to a function. The second level can be isolated only arbitrarily for purposes of training. Actually, as we have seen, any case-work process requires the use of skill on all three levels, and only with the help of the supervisor and teacher can the student sustain his role until he has attained a development which enables him to use himself skilfully. In the papers that follow, the three parts of the training unit through which we seek to develop skill in the Pennsylvania School of Social Work will be separated in order to show what is carried in the personality class, what in the practice class, and how class learning and practice are held together.
CLASS ROOM AND FIELD WORK: THEIR JOINT CONTRIBUTION TO SKILL Goldie. Bäsch IT IS agreed among social agencies and training schools that field work should accompany class instruction in the professional education of social case workers. That this practical experience should be closely coordinated with the school courses is considered essential to their combined worth as effective education. However highly valued this integration of theory with practice may be, it is nevertheless hard to define. The attempt to analyze it, and say how it functions in a given school, may quickly get lost in descriptions of the school's educational philosophy, administrative organization, curriculum, geographical location, and changing relationships with a variety of social agencies. Yet it is from these very working conditions of the professional school that the correlation of class and field must be derived, and from them may be distilled the great educational power inherent in student opportunity to connect action with thought. Of the School's training philosophy and practices, its relations with students and social agencies, which elements combine to create this integration of theory with practice? I believe some of these elements may be identified, however variable and complex the medium in which they operate. If we, as educators in social work, conceive of professional education as offering the student opportunity to develop a creative social philosophy rooted in responsible practice, to acquire the disciplined, conscious skills essential to far-sighted human administration of social resources; if we believe that such thinking and action can best be learned by engaging in 32
CLASS ROOM AND FIELD WORK
33
actual practice and by reflecting upon the significance of this practice—this conception of ours finds expression in all our curriculum building. Nowhere, however, is it more directly and fruitfully expressed than in our procedures with the student when we send him to a social agency for experience, and with the agency to which we send him. How this educational conception becomes procedure and working reality is again hard to describe—for its beginnings, with any given school, lie in the accumulated experiences of the school with its training agencies. Indeed, it is from these cumulative experiences that the school may determine the very size and make-up of its entering class. For example, how many field-work places are there? How many of these are suitable for beginning students? How many for those with previous experience? How many for men and for women? Thus the School's tie with its field-work agencies may affect the prospective student before he ever enters, and may even determine whether or not he is among the number who can be admitted. It is within these numerical considerations, however, that the promise and exaction of field-work experience most dynamically touch the early contact between school and prospective student. In the personal interview, preceding admission to the School, the discussion of the field-work plan offers rich opportunity for school and prospective student to gain the beginnings of mutual understanding and respect; for the school to evaluate the student's readiness, or lack of it, to take a beginner's place in a social agency; and for the student to test his urge to enter social work. For the person just finishing college and new to social work, the anticipation of beginning another educational course derives its difference and its challenge from the fact that here he will be doing actual work with human beings, the agency clients. The quality and degree of his curiosity, imagination, fear, courage, sense of responsibility; of his feeling for people; of his willingness to adapt himself to new requirements, to permit another person to share his thoughts—any or all of these may emerge when he is engaged in a discussion of the
34
SKILL IN SOCIAL CASE WORK
field work plans and their meaning to him. As these newly activated phases of himself emerge in response to a prospect so novel, he may make some highly significant moves toward or away from it. "They [the clients] don't throw pots and pans at you, do they?" was the fearful and sole question one young girl was able to ask in an attempted discussion of field work. "She [the supervisor] would be reasonable, wouldn't she, and help one understand what the agency expects?" asked another. After a little discussion of the answer to this question, she reflected for a moment, then observed: "It has been fine at college [from which she was just about to graduate], it's a beautiful place and nearly all my friends are there. But now I am ready to leave it." The experienced person contemplating training may be even more affected than the inexperienced one by the school's practice requirements, by the appraisal of its field-work program, as related to his individual background and interest. Discussion between school and applicant of the latter's feeling about entering a new agency and being supervised there; consideration of the kind of agency the applicant prefers for his field work, the reasons for his choice, the comparison of his choice with the school's actual resources for student experience in this field—these are some of the considerations which, under discussion, may be pivotal. Perhaps the applicant will decide that professional training is not for him, or anyway, not at this school. Perhaps he may, as a result of this interview, have clearer, more cogent reasons than ever for getting training; reasons that will go far toward sustaining him in the face of his natural fear of changing his ways of working, of being supervised, and of meeting academic demands upon him. If, in this admission process, the school has been candid about the type of field work opportunity it has to offer, has offered it with a clear conviction as to its worth, and with genuine feeling for the prospective student, for his preference in field work and for its significance to him; and if these plans are discussed with explicit understanding that the school—not the
CLASS ROOM AND FIELD WORK
35
student—assumes responsibility for the final choice of the actual assignment: if this process has taken place, something has occurred of far-reaching significance to school, agency, and student—experienced or inexperienced. For now the student has a relationship to the school, a sense of its candor, of professional standards respected and maintained, and of the school's warm interest in the student's move toward professional training. These developments will affect his initial attitude toward the training agency. And what of the agency and its readiness to receive from the school a strange young person—perhaps one who has never seen a client, or a case record, or felt the impact of serious responsibility? To find time and space for the student, to designate an experienced staff member for his supervision, actually to countenance the student's contact with clients whose pressing needs bring them to the agency—these require a belief in professional training and confidence in the professional school which evidently are great—for the students are placed with just this expectation of their reception in the agency. The source of this confidence on the part of the agency, and expectation on the part of the school, was referred to when earlier I mentioned the accumulation of mutual experiences between school and training agencies. Of the many professional connections between them, it surely may be said that none is more vital than their association in forming and realizing training plans. It would be impossible to set forth here all the considerations preliminary to the placement of a student with a social agency. A few, however, must be mentioned as basic to plans for the coordinated work of class and field. The number of students the agency can take, the kinds of students preferred, the supervisory personnel available and acceptable, the amount of their time required for supervision, the number of cases the students are to carry, the kinds of cases suitable for training and possible to assign to students, the actual quarters they may occupy, the written reports to be exchanged between school and agency—all these are matters for thoughtful
36
SKILL IN SOCIAL CASE WORK
discussion between school and agency, and for mutual reconsideration, through the years. About the individual student, the amount and kind of preliminary information to be shared between school and agency are questions of significance to everyone concerned. Certainly the agency is entitled to know the factual data about the student it is being asked to take—his name, sex, age, race, education, college record (if recent), previous job experience. But of equal relevance is the question: "What has he done, said, or been that indicates his willingness and ability to use our supervision?" The validity of this interrogation, spoken or unspoken, is essential for the school to acknowledge. And if the application procedure has been conducted in terms of such an acknowledgment, the question can be answered by the school in a way contributive to a good beginning of field work placement. "Mr. A. gave up a paid position in public assistance to get professional training. What he wants now is field work in public assistance, with more thorough supervision than he has had, for he intends to make public welfare his career." "Miss B. is just graduating from college, and has had only summer jobs at camp counseling. She realizes she knows very little about social agencies and is glad to have field work either in a children's or a family agency." "Miss C. has been for five years in the Family Welfare field. She would like student experience in School Counseling— partly because the new setting would enable her to take a fresh look at her own practice, and partly because in her home town an interesting job in a public school system may in the near future be available to a well-qualified person." For the school to have this kind of information about the student and to share it with the agency makes reasonable the request that the given agency receive the student. This is scant information to support so large a request. It can suffice only if offered with the understanding that, so far, it is as important as any knowledge we have about him. What else there is to know about him as a student of social work, we must each leam—student, school, and agency. For when he arrives to
CLASS ROOM AND FIELD WORK
37
begin his training, he will already be different from when he filled out the blank and had the interview; furthermore, he may reveal to the agency aspects of himself quite other than those revealed to the school. Perhaps his most vital learning will occur when these differences in himself are resolved by his growing ability to meet the new demands upon him. To such a resolution his case-work teacher and supervisor may contribute, but only if the student's progress—or lack of it—can be followed and understood between school and agency. This joint agency-school task is an enterprise to which each must contribute, and from which each may derive some of its most precise educational skills and soundest trainifig judgments. And this interchange requires of agency and school an organization of procedures clearly understood and responsibilities flexibly carried between them. The major responsibility for the educational leadership in this duality belongs to the school. In the period preliminary to the student's admission, this responsibility may rest with the person in charge of admissions. Upon the student's formal acceptance by the school as a member of the entering group, his faculty adviser may represent the school in its relation to the training agency where the student does his field work. The faculty adviser's function is variously defined in various schools. Here it will be described as carried by the person who also teaches the course in case-work practice. This combination of activities enlivens the coordination by the adviser's immediate contact with the student's class-room learning; it affords the teaching a realistic proximity to case work, to agencies and their problems; to both teaching and advising it offers the possibility of discerning the student's trends or blockings in progress, and of helping him. The potentialities of this teacheradviser job I shall indicate briefly in part. The student, as I have said, gets from his application interview a sense of the school's careful consideration of his agency placement. Upon his admission, his faculty adviser, either by correspondence or in the interview at registration time, will tell him of the actual assignment, and discuss it with him. Assuming that field and class work begin at very nearly the same
38
SKILL IN SOCIAL CASE WORK
time, the initial session of the case-work class may offer further opportunity for the student to find his beginning place with school and agency. "Exactly what does the agency do?" "What sort of person is my supervisor?" "What does she expect of me?" "Does she know I have had any experience in social work?" (Or "that I am not just a beginner"?) "When-does she tell the school how I am doing?" These, together with questions of geographical direction, expense arrangements, and many others, may arise in the initial interview between faculty adviser and student. In slightly differing forms, these same questions are likely to be voiced in group discussion, initiated by the instructor, during the first meeting of the class in case-work practice. "Do they [the agency and supervisor] mind having us there?" "What's the percentage of student failures?" Fresh from his individual student conferences, the instructor may know when and how to offer information, assurance, and opportunity for further questions. He will do so with a vivid feeling for their significance. They express the fear and confusion of the students—their need to gain footholds for themselves among these new complexities. As their situation takes shape and confronts them, it begins to have disquieting implications. One of these is the very fact that school and agency work closely together. At first sight, this looked only like an admirable educational plan. Now it may seem a combination of formidable strength, focusing upon the newcomers and their untried abilities. That their feelings find expression in the questions asked, and get sympathetic and (whenever possible) informative response, means much to students, as the instructor is well aware. His replies will come straight from his understanding that factual information may help, but not so much as the school's warm acknowledgment that school and agency know this adaptation is hard to make and will gear their expectations accordingly. Whatever the instructor's reply, its object is to leave the
CLASS ROOM AND FIELD WORK
39
students with some sense of their rightful and welcome places in the agencies to which the school is sending them, of the supervisors' competence and interest in what they bring to the job and hope to get from it; with some sense, too, that the supervisors will want to hear their questions about the agencies and give more explicit information than could the school. As to what is expected of the student at the very beginning, a clue may be offered by the instructor in this discussion, and the clue may convey to the student a similarity of demand to be made upon him by class and field: it is that a businesslike promptness and accuracy are required (in both places, agency and school), together with a willingness to consider each phase of his work carefully, to ask questions, to share his thinking, and try to let the results—both with clients and in class work—eventuate from these attempts. He is told, too, that he will be expected to make his field and class work mutually contributive, and that the case-work course will be planned to help him do so. From this discussion, the student hears that evaluations of his progress will be made by supervisor and instructor, and that each will gladly share these evaluations with the student. After this initial class session, the separate tasks of advising and teaching diverge and merge in ways some of which I shall try to describe. Always the object is to help the student use class and field to their maximum advantage for the development of his case-work thinking and skill. To achieve this aim, the adviser combines his relation to the supervisor with the relation to the student as known in occasional individual contacts and in class. If the case-work class is to be of live, realistic significance to the student's performance, he must make the kind of connection with it, and with the agency, which permits him to bring his own experience from one to the other. For this, two conditions must prevail: first, he must feel himself a real part of the agency, doing actual work to some extent acceptable there; second, he must feel sufficiently comfortable in class, with the group and instructor, to dare to—and want to—share the diffi-
40
SKILL IN SOCIAL CASE WORK
cult, vital practice he is engaged in. Both these conditions die adviser-instructor can help to establish and develop. The nature of this help, and of its basis in the adviser's relation to class, student, and supervisor, may best be indicated by illustrations. Immediately following the second session of the case-work class, Miss Hart came unexpectedly to my office. She began by saying : "I guess you found my paper pretty naive." (Paper written in response to class assignment, "What is good and what is poor case work in the mimeographed illustration?") I said No, it hadn't seemed naive; it seemed a clear record of her opinion. She continued, a little breathlessly, that she hadn't intended to ask me just this, but anyway, she would do so. She then described in some detail the first case assignment in her field work, and her question was 'What should she do or say?" Here was Timmie, aged thirteen, whom Miss Hart hadn't yet visited, demanding of the agency a new coat. Miss Hart described in animated detail how she intended to explain the agency's present inability to give a new coat. Miss Hart understood, she told me, parenthetically, what clothes mean to a thirteen-year-old boy. She intended to tell him the agency can give understanding, and meet its clients' essential needs, but can't give a new coat just now. "That's what I have in me to say to him, and that's all I have in me to say to him. But a thirteen-year-old boy can't understand anything like that—and do you think I am off on the wrong track?" I voiced my interest in her case, and her thinking about it; but before we went further, I wanted to know if Miss Hart had discussed with Mrs. Merritt, her supervisor, what the approach might be to Timmie and his demand. No, Miss Hart replied, she and Mrs. Merritt hadn't gone into this much detail, adding, "I guess she thinks I'm more experienced than I actually am." I observed that Miss Hart's responsibility here would be to discuss with her supervisor whatever would enable the case to get the best service possible; Mrs. Merritt would be needing a cue from Miss Hart, as to where the supervisor's help was required. This very morning in class Miss Hart had said something which was a big help to me, in knowing what she and maybe others were wondering about. I had asked the class if there were any questions or comments, now that all present had worked in their agencies for a week.
CLASS ROOM AND FIELD WORK
41
Miss Hart had spontaneously described to the class what a relief it was to her, when her supervisor had told her, "You're not expected to go and accomplish everything in one interview—if you discuss, and maybe clear up just one little question, that's enough for one visit." Miss Hart could see just what I meant—"but the thing is, how much am I supposed to rely on my supervisor, or how much will I perhaps get to rely on her—maybe too much?" Here we discussed the difficulty of knowing how much to manage independently, how much to take from another—especially when one is naturally a self-reliant person. From this we returned briefly to her case, I saying that ordinarily this would be the kind of thing to be discussed with Mrs. Merritt. As Miss Hart had observed, she knew just what she had in her to say to Timmie, and if I thought it was way off on the wrong track, I'd tell her so. The problem of how much of one's uncertainty to confess, how much one dares to acknowledge helplessness, and to take help—whether there is danger of losing oneself in the strength of the helper's greater assurance—surely this problem is recognizable here. To voice it, and to know that the School considers it a natural one to have, and to get a suggested definition of one's job responsibility is to find courage to enter into the experience one has been fearing. It is no sign of weakness on the agency's part, I believe, for a student to find it possible to voice at the School some fear of or difficulty with his work at the agency. Nor is it necessarily a sign of weakness on the School's part if the reverse should occur, and the student turn to his supervisor because of his concern or confusion over something arising at School. Rather, it is a strength of the dual training plan, that the student may turn to one for help with a phase of learning difficult in the other. If this is understood in both places, he will not be involved by one in an attempt there to solve the problem of the other; rather he will be offered support and encouragement to return to the place of his problem and there solve it by his own courageous action. This is more clearly brought out, I believe, in the following
42
SKILL IN SOCIAL CASE WORK
illustration, which begins with relevant sentences from the application interview: Miss Winn (the student) herself introduced the subject of her agency placement, referring spontaneously to some unsatisfactory supervision she has had in the past. . . . When the field work tentatively held for her was described (with Mrs. Lake of the X Child Placement Service), she liked the sound of it very much. She had heard good things of this agency. She asked many specific questions about its size, organization, and after the discussion she seemed quite pleased with the opportunity to work there. Seven weeks of the first semester had elapsed when there was a conference between Mrs. Lake and Miss Winn's faculty adviser. I quote from it in part: "Mrs. Lake has been troubled about Miss Winn's decidedly offhand, frivolous-seeming way of recounting her experiences with her clients—as though belittling the importance of everything the children and foster parents were saying to Miss Winn; and everything, in fact, that she herself was doing. These inconsequentialseeming descriptions have left Mrs. Lake uncertain as to the quality of Miss Winn's performance, but with the conjecture that it is probably better than Miss Winn's verbal account of it. Her recording has been acceptable—fairly selective and quite full. "A persistent tendency was earlier noticeable in conferences between Mrs. Lake and Miss Winn—the latter would question the way the agency was working—whether enough sources of information were being tapped, whether community resources were being thoroughly used, whether the parents of the children in care were being convinced of their parental duties. In consequence, these questions seemed to predominate to the exclusion of those pertinent to Miss Winn's service to her own cases. Mrs. Lake thought this tendency seemed less like a lack of interest in and ability to do the job, and more like an inexplicable need to avoid discussing Miss Winn's own part in it. "Quite recently, Mrs. Lake commented to Miss Winn upon the latter's way of discussing her cases, and how uncertain Mrs. Lake felt about the service being rendered the cases, and about Miss Winn's real attitude toward them. This conference seemed to leave Miss Winn somewhat uneasy. She embarked on a comparison of the difference between the work here and what she had previously
CLASS ROOM AND FIELD WORK
43
known as good case work—how she had, in her previous job, thought it necessary to encompass, and try to straighten out all the client's troubles. "I told Mrs. Lake of Miss Winn's comfortable-seeming, rather unquestioning participation in class discussions. How, when most other students were writing definitely questioning papers on their own work or related class assignments, Miss Winn's writing seemed general—though lengthy. [Here the current class projects were briefly described to Mrs. Lake.] "To Mrs. Lake, Miss Winn seems far from comfortable and complacent." Since supervisor and student were to see each other within a day or two, Miss Winn was then to learn that the expected conference between her supervisor and faculty adviser had taken place; she already knew either or both would be glad to share its essential content with her. About a week later, Miss Winn, upon her own initiative, went by appointment to the faculty adviser, and the following interview took place: Miss Winn remarked that she knew Mrs. Lake had talked to me, but hasn't had the chance to learn what we said. I replied by mentioning the account I had given of Miss Winn's conscientious, but rather generally worded response to written assignments; I said, too, that Mrs. Lake had mentioned to me what she had already told Miss Winn—namely that the latter's way of describing her visits left Mrs. Lake wondering how seriously Miss Winn was taking the job. I added that Mrs. Lake, from what she was able to discern so far, thought Miss Winn had real potentialities for learning the work. Miss Winn expressed surprise that Mrs. Lake said this—indeed she hadn't thought it mattered to Mrs. Lake whether she was there or not. As I would remember, Miss Winn had gone to the agency with eager expectations. It proved to be a "cold, grim place." Sometimes people say good morning and sometimes they don't. If they ever meet in one room Miss Winn doesn't know about it. Each person goes his own way. Miss Winn has never been able to find out why she got the cases assigned to her. She doubted it was to the best interest of these cases to have their worker changed at that time. She concluded that as she was there, something had to be handed over to keep her
44
SKILL IN SOCIAL CASE WORK
busy. And yet she hadn't been busy enough. Before she came here, she had an active job in an agency actively part of the community. Now the six children in four homes just didn't seem like much. If this agency has any connection with any other Miss Winn hasn't been able to find it out, though she has tried. Why it is only handling 150 cases is something that puzzles her, but no one will tell her why. There must be a lot of other children in the community that need assistance. Miss Winn herself doesn't know a soul in Marionville and she minds being in no sense part of the community. She looks forward to her days at School and this doesn't seem natural to her—"I have never been a scholarly person"—but here she feels more part of things. I certainly felt for Miss Winn in her sense of loneliness and told her so. I asked if she thought the agency's children were getting good care—"Wonderful, superior care, and when Mrs. Lake opens up she is just marvelous—she has so much to give. Maybe I just don't appeal to her as a person," Miss Winn added dejectedly. The inconsequential, superficial approach Mrs. Lake had told me about, Miss Winn now explained. "How was I to know what this agency considered important, and what not? So I just put everything on the same level when I talked to her." I teased Miss Winn a little about this, "You do, too, know what's important." She smiled mischievously and said, "Well, I did it partly to get a rise out of her. But I never got one." I expressed surprise that Miss Winn took all this. Why didn't she wade in and get something more for herself? "Well, I have never been what you might call a mouse; but I told myself—you are a student now—you better sit tight." Then Miss Winn asked me very earnestly whether a student is supposed to be at some later stage of her development before she wants to know the things Miss Winn is asking about the agency. I replied that Miss Winn's inquiries represent her own present stage of development and seem very good to me. I added that until she really feels part of this agency, I don't see how she can go out and represent it, and that she owes it to herself to get from Mrs. Lake what she needs in order to belong to the agency. I said ί wouldn't encourage her to be this demanding if I didn't know what Mrs. Lake is capable of putting into supervision—Miss Winn has glimpsed something of this from time to time. I thought that if Miss Winn could be anywhere nearly as spontaneous and sharing
CLASS ROOM AND FIELD WORK
45
with Mrs. Lake as she had been with me, her field work would be more worth while. We talked a little more about the agency—Miss Winn wondering why they didn't do more. I said if they are giving their 150 children good care they may feel that is all they can do with their present staff and budget. "Well, if somebody had even told me that much! I kept wishing they had more cases," Miss Winn exclaimed. I said, "You mean you keep wishing you had more cases." "It does tie up pretty closely," she admitted, smiling. She left with the determination to tell Mrs. Lake tomorrow just how things are with her. In these interviews, it is obvious that Mrs. Lake had reason to wonder how much there was, in Miss Winn's attitude, of natural curiosity about the agency, and how much of shrinking from the responsibility of her own case load. It may be questioned here whether or not the X Children's Center is doing a perfectly rounded community job, or has answered satisfactorily Miss Winn's legitimate queries about its scope. One may certainly ask oneself whether the longing to find warmth and friendliness in the new place was not an entirely human and justifiable need of Miss Winn's. What she finds missing may well represent actual shortcomings on the agency's part. But no social agency is perfect. Its very imperfections constitute reality, and so offer better experience to the student than if perfection could be found for him to work in. The point of this illustration is the School's conviction that there is something of essential worth for Miss Winn in the quality of Mrs. Lake's supervision; and that this worth is by no means lessened if it happens to be hard for Miss Winn to realize because of a difference between these two in temperaments and in years of experience. Mrs. Lake is closely focused upon the job and Miss Winn is by nature expansive, sociable, humorous. To be able to achieve, by deliberate effort, a productive working relationship with a person different from oneself is a typical demand upon a case worker. The adviser, operating in terms of this belief, offers Miss Winn help in put-
46
SKILL IN SOCIAL CASE WORK
ting herself more thoroughly into her field-work experience, getting a clearer idea of her agency's purpose and scope, with consequently heightened and sharpened interest in the casework class discussions, and her own part in them. This illustration alludes only cursorily to a function of the adviser which contributes vitally to the maintenance of coordination between class and agency practice—I refer to the interview with the supervisor, held for the purpose of discussing the student's progress. In return for the supervisor's description of the student's performance in the agency and his response to supervision, the adviser may offer an account of his progress in case-work class. Usually this is most graphic if given against a briefly sketched background of the class trends—the topics studied and something about the class discussion of them. This orientation to class content and progress is due the supervisor, and from it may be derived a useful sense of his student's attainments, as compared with those of others. Here is an indicative example of this process: Mr. Day spoke with discouragement to Mrs. Shepherd (his supervisor) about his inarticulateness in case-work class, and his feeling that some of the others were "just brilliant." Partly because the adviser learned this from Mrs. Shepherd, and partly because a written illustration from his own work submitted (with Mrs. Shepherd's permission) at about this time seemed a valuable one, Mr. Day's case was selected for discussion in class. Shortly after this, the conference between Mrs. Shepherd and Mr. Day's adviser included the following: I described to Mrs. Shepherd, Mr. Day's intelligent and objective presentation of the case, adding something about trends the discussion followed, as the group discussed Mr. Day's problem with a policy in general assistance, and how it affected his client's family. Mr. Day was the only one in the class who could see what the real difficulty in the interview had been. I told Mrs. Shepherd how, after class, he came to my office, and we had further talk about the session. He said he had been feeling slow in comparison with some of the other class members—• Miss Clare, for instance. I reminded him that in this morning's discussion, Miss Clare had worked hard on his case, but it was he, not Miss Clare, who had put a finger on the real difficulty and
CLASS ROOM AND F I E L D WORK
47
how it might be resolved. Mr. Day and I talked a little further about the undoubted value of this case discussion to the class. Mrs. Shepherd added to this account of mine, that Mr. Day now says he isn't afraid of Miss Clare any longer.
Here the adviser's task merges closely with the task as casework teacher. To both phases of the job as illustrated, one underlying conviction is so essential as to require statement. It is that the reality in which the agency operates, the policies and procedures through which its case-work services are administered, must also be the student's working reality. If the student is to carry in the field a case load in any way representative of the agency's job, he cannot long escape the experiences of change and readaptation so intrinsic to the present social scene. Sooner or later he must meet, if in a family agency, the redefinition of function in the case of the client to whom the agency cannot this year grant the kind or quantity of aid granted last year; if in public assistance, the student is early faced with the severe pressures represented by the case in which one must administer a policy visiting indisputable hardship upon the client; if in child-welfare services, he will doubtless find as part of his job at least one situation of longstanding child-neglect, just now to get attention in a complex of deficient community resources, local prejudices, and agency struggle to define its new place. To shelter the student from such cases (even if it were possible to do so) is to deny him his rightful experience of what social work actually is. To assign him work involving some of these realities, and to help him perform it responsibly in the midst of them, is to establish a training situation of significance, not only to him, but also to the relationship between School and agency. For it means a steadily maintained recognition in the School that the agency faces difficulties, must change and may develop with the times, cannot offer a setting of final perfection for student learning; and that the problems arising from this state of affairs are not regrettable extraneous incidents, but inherent in present conditions, and of mutual concern to School and agency in their training plan. But what consonance is possible between practice amid such
48
SKILL IN SOCIAL CASE WORK
shifting conditions, and principles taught in a class room? This valid query can be answered only by the assertion that one of the aims in the teaching of case work is to enable the student to discern the meaning, form, and direction of his varied experiences in the field. With such an aim, the instructor views as highly effective teaching material the agency cases carried under conditions imposed by reality. In Mr. Day's case, it was precisely his trouble in administering the depriving policy in public assistance that afforded the material for discussion of such matters as these: Are we as case workers supposed to submit passively to policies we resent for our clients? Can one administer a policy while inwardly disagreeing with its intent? By what means and where should the disagreement be expressed? How can one represent the agency and work understandingly with the client in such circumstances? Is anything gained or lost and for whom, if the worker's resentment of the policy prompts him to sidestep responsibility for it, in contact with the client? No more vivid sense of the changing social scene and the case worker's place in it could have been made perceptible to the class than was afforded by a case from the Child Welfare Services. It was one in which the sound and feeling work of an experienced student brought about the first positive contact possible with the confused mother of neglected children, in a community long resentful of her. This transpired in a setting bristling with difficulties characteristically met in Child Welfare Services, and for that very reason impressed the group deeply. The presentation and discussion of this case made manifest beyond doubt the effectiveness of a warm, understanding, yet dispassionate offer of agency service. Hardly a principle important to child placement could fail of lucid illustration in this case. Requisite to such class-room use of agency cases is the coordination between field and School already described—the careful selection of the student for the agency, the School's sympathetic view of agency problems as related to training, the exchange of thought about the student's performance in class and in practice. Without these aids to united effort in
CLASS ROOM AND FIELD WORK
49
training, its obvious complications multiply; for example: serious differences in case-work opinion between supervisor and instructor may confuse the student and set him helplessly adrift over controversial areas. In a medium of sound basic relationship between School and agency, such differences need not prove total or frustrating in their implications for the student. Furthermore, a well-maintained collaboration for professional training provides stimulus for fresh resolution of differences arising in thinking and practice, to the benefit of case-work practice. However closely related the values of class and field in their joint contribution to the student's development, their distinctiveness is equally real, and of equal importance to recognize. For example, twenty people in a class room, concentrated for a two-hour period upon an interview brought in by a group member, will of course think of something highly relevant to the case, which may not have occurred either to the student or the supervisor, in the stress of agency activity; and on the job, the client's actual predicament, and the way the agency must meet its obligations to him and to the community with all its pressures will present forcibly to student and supervisor contingencies overlooked by class group and instructor. This is but one of the differences between class and field offerings. Of the many others, the following seem worth noting here. While the agency provides opportunity to work with the individual client, in the setting of the one agency's function, the class discussions indicate how a series of such discrete experiences can assume meaningful form and yield guiding principles for future work. Responsible action taken by the student in a social agency establishes his identification of self with the one agency—with some of its strengths and weaknesses, its ways of working with other agencies. From the group, composed of individuals similarly identified with a variety of agencies, the student may form a beginning concept of the social work community of which his own agency is but one part. With his supervisor the student works closely, deriving a sense of support and understanding from the agency purpose
50
SKILL IN SOCIAL CASE WORK
common to both. A long step removed from the scene of the student's activity in the agency are the instructor and the group members; to them the student in class must make clear his purpose in a given case, his thinking and procedures. To use help from a group, or to oppose one's opinions to those of the group may have very different connotations for the student than to use or refuse the help offered him in supervision, and it may be that at one time he can use the group when he feels impelled to reject the individual help of supervision, and at another time the reverse may be equally true. These are but a few of the innumerable differences between the training values of class work as distinct from those of field work. To perceive them is to grant supervision and school instruction each its assured place, supporting but not encroaching upon the other, in the training plan. Furthermore, if each is clear as to the nature of his educational offering, he may also be clear as to whether and how the student is making use of it. Furthermore, such clarity reveals ways for school and agency to combine their separate observations of student learning into joint appraisal of his progress. In what terms is the appraisal made—what evidence of learning is sought as the characteristic result of this coordinated teaching effort? Realizing that the entire subject of evaluation is implicit in the question, I shall select, from the many possible indications of student learning, only two for comment here. They have already been referred to earlier, when I mentioned the student's identification of self with the agency's task, and his discovery of how his experience in class and in field may each enliven and give form to the other. This identification with agency and integration of theory with practice will be marked for each student by his individual attributes of intelligence, sensitiveness, and degree of experience. Indications of his development in these terms may be found in his class discussion, in his written work, and in his agency performance where they may be confirmed by his supervisor.
CLASS ROOM AND FIELD WORK
51
Here they may best be illustrated by quotations from students' papers. Commenting in review upon a series of class sessions in case work, one first-year student wrote, in part, as follows: Specifically, I think that the most significant phase of class discussion for me was that part which centered about the importance of a feeling for the person with whom you are dealing. My first reaction to this thought in class was "I would never use anyone as a means to an end." As I began to review past cases to myself, however, I could quite frequently recall instances when my concern for my client or patient, though very real in itself, allowed me to overlook the vital importance of feeling also for the various other persons with whom I necessarily had to deal. It came to me then quite forcibly how much a part of my present work this very principle was. I thought of Mrs. W. and the two children we have placed in her home. [There follows a description of student's visit to foster home, during which student and foster mother are silently antagonistic, and student wishes she could be left alone to visit the foster children.] . . . I began to grasp something that I had heard but had not thought out in practice. Not only must I work with the children, but also with the foster parents and sometimes with own parents. And then I thought about having a feeling for the person with whom you are dealing. I found I had built up a sort of defense against Mrs. W. I certainly had not thought of her enough as a person with the problem of being a foster mother. I had been thinking only of Betty and Dickie as children away from their own parents. This was not all that was needed. I began to think of Mrs. W. then as an individual. I re-read the record. I tried to understand what it must be to want children of your own and to have to share them with separated but interested own parents and an agency. I did not think Mrs. W. had yet been able to accept all of what boarding such children involves. How much help she needs and how much I can give her I do not yet know. The important thing is that I stopped unconsciously feeling toward her as someone who unluckily had to be there. Now my interest in her situation is a primary one. I have been there once since, and it is remarkable how helpful just this change in my own thinking proved to be.
52
SKILL IN SOCIAL CASE WORK
Regarding this same series of class discussions, another student working in a family agency wrote: The discussions in class helped to clarify somewhat a matter that had been perplexing me: to what extent must the relationship to the client be objective and professional—to what extent personal? [There follow several instances met in practice, with references to class discussions of similar experiences of other students.] . . . The personal comments may be used to divert you from the real issue—to get you to take sides with the client against the agency. One client generally managed to compliment me in some way during each visit. Although her effusiveness made me a bit uncomfortable, I had the feeling I was accomplishing a great deal in the case. But, influenced by the class discussion, I began to wonder. A talk with my supervisor gave me a hint as to the purpose served by these compliments. He [the supervisor] raised some specific questions about the present family make-up, their income, and the budget. When I attempted to question Mrs. K. about this situation, I observed that her compliments became more numerous. I found, moreover, that my previous unqualified acceptance of such thanks and praise now made it very difficult to approach the problem with the family. These personal references had tended to make me side with Mrs. K. against the agency, so that, when I had to refuse anything, I projected the blame upon the agency, rather than take it upon myself. The result was that for three months I denied the family the right to face an embodiment of my agency policy upon which they could vent their feeling about it, and with which they could work out the problem, making them so uncomfortable over a long period of time. Understanding this, and strengthened by discussing it with my supervisor, I was able to revise the budget, take responsibility for the ensuing reduction, and talk the whole situation over with the family. This interview opened with the same profusion of thanks, the same personal interest in me. However, fortified by my understanding, I was able to indicate clearly the function of the agency and the family's relation to it. Their reaction was one of anger and consternation. But when I accepted these feelings, let each of the K.'s say what she felt about the change, and when we talked over the entire situation, I felt they were relieved now that the matter was cleared up, and for the first time they knew where they stood with the agency. Although, in closing the interview, they addressed
CLASS ROOM AND F I E L D WORK
53
me more formally, the new relationship was one of far greater value to the family than the "friendly" one earlier existing. From still another paper, the following is an excerpt: When agency scope and function were first spoken of as tools, in class discussion, I understood only vaguely. I began to see more clearly during discussion with my supervisor, several days later. And here it must be said that it is exceedingly difficult to cut class discussion off as a separate piece. Something comes up in your agency that sets you thinking; you are driven to find the answer and you look everywhere. In class you find a hint in a discussion of something apparently quite unrelated. Later you talk with people who said in class the things you wanted said. You read, you think about your recent contacts with clients. Later perhaps your supervisor asks you how you are feeling about things, and in trying to put it into words, you gather together what you've obtained from all your sources. By having actual cases in class, I discovered how humbly one goes about this task, taking up perhaps one or two things at a single interview and realizing that much will be left unknown to you and unsettled. Thus in the visit to the delinquent girl in the institution [this was a case episode presented by one of the students], I was amazed how Miss Starr accepted the fact that she had accomplished so little, and how the class agreed matter-of-factly that the girl might never want to make use of her help. I could see, too, that maybe Miss Starr had not accomplished so little after all, in recognizing how homesick the girl was. Then there was Miss Starr's visit to the girl's home, and interview with the mother. I began to understand something in my own attitude toward the job that was at first sight quite unrelated. I had gone into homes where foster parents spoke of the children's behavior that worried them. I wonder at it myself, now, but I had believed I should know exactly why the child did each thing and be able to tell the foster parent what to do about it. From thinking over this last class discussion, I was able to look at it honestly, and to realize that I certainly didn't understand these children, and no ordinary person going into a home once or twice could be expected to understand what motives lay behind the children's acts, and of course couldn't tell the foster parents what to do about each thing.
54
SKILL IN SOCIAL CASE WORK
These points seem like small and simple matters, but they are so fundamental that they have carried me far forward, and I have a great deal of feeling about what I have glimpsed this week. It is a feeling of immense gratitude and relief, because I was trying to do so much in one cluttered interview, and was so concerned that I didn't know all the answers when a foster mother spoke to me about the children's problems. Of course, it also makes the work hard, because one must be able to help, even while acknowledging that he doesn't know all the answers. That is going to require skill and insight, but its basic connection with honesty and reality make the learning somewhat easier and the theoretical side more comprehensible. These quotations from students' papers demonstrate, I believe, their writers' identification with agency purpose, and use of integrated class and field learning. Together these two components of professional development form the matrix of immeasurable further growth. To attain them is to secure the beginnings of perspective, self-discipline, and insight that come only with the live experience one is able and willing to feel. The quality of such learning is possible only if the School values it enough to establish conditions favorable to it. Some indication of what these conditions may be I have tried to set forth in this description of relationships between professional school and training agencies, of the work with individual students, of the teaching aim, and the educational results hoped for. I am well aware of much that is fragmentary and much left unnoted in the foregoing pages. To surround the subject (even if it were possible to do so) with an air of well-roundedness and finality would be false to its essential nature. For the ties between the professional school and its training agencies are sensitively affected by all the changes and perplexities known to the agencies as they attempt to serve a profoundly troubled society. And this service urgently needs the vision, integrity and skill of all those who, in the words of Bergson, have learned to "think as men of action and act as men of thought."
THE FUNCTION OF THE PERSONALITY COURSE IN THE PRACTICE UNIT Jessie Taft THE term "Personality Course" has a history in the Pennsylvania School which doubtless parallels the history of case work in its relation to psychological understanding, first of the client, next of the worker; and of the helping process as defined by agency service; and finally of learning itself, as the process through which the student experiences first hand the meaning of taking help. The need for a deeper knowledge of human motivation, of human impulse and human behavior, could hardly fail to develop in a profession that exists only by virtue of some capacity not only to understand but to work with human nature as it presents itself, where there is no profit motive to produce an inevitably manipulative psychology, and no vested power or monopoly to compel the client to accept the service of a particular agency. True, the client has, or may have, a compelling need, but under the conditions that surrounded the early years of social work in the United States, there was choice and seldom a pressure so great as to create absolute compulsion in the use of a social agency. Nor did the social worker bring to bear the authority of an accepted profession—the spiritual influence of the clergy, the medical authority of the physician, the legal knowledge of the lawyer. The social worker at best had to meet the client with little backing beyond a limited service, a sensitivity to human need and a natural tolerance for human ways of trying to satisfy it. Out of such necessity arose the thirst for psychological insight, which found its first answer in a new understanding of behavior as interpreted by psychiatry, an understanding expressed by those great leaders of the early mental hygiene 55
56
SKILL IN SOCIAL CASE WORK
movement who were already in their prime before the first World War—Southard in Boston, Hoch and Salmon in New York, Meyer and Campbell in Baltimore, and White in Washington. It was this group of gifted men, of whom only Campbell and Meyer are now living, who turned the attention of psychiatry and social work in this country to the meaning of behavior, to the importance of developmental phenomena and early childhood, and the possibility of preventing the personality formations that might lead to mental breakdown in later life. To the social worker, this new insight was a life-giving spring at which to quench a thirst for knowledge about people that academic psychology had failed to satisfy. In this prewar era, however, the new psychiatry had little to offer the case-work practitioner beyond a better understanding of the client through interpretation of his developmental history. In specific treatment for psychological and social ills, it shared, on the whole, the environmental attack of the sociologist and the social worker, or the educational approach of the teacher. While psychiatry and the mental hygiene movement were supplying social work with understanding but no solution for practice, psychology had begun to shake off its academic restraints through the development of the psychometric test. Dulled by usage we forget what a thrilling possibility of control, of prevention of delinquency and maladjustment was envisaged in those first years of mental testing and the advent of the clinical psychologist. Here at last was a definite technical process with scientific results on which to base recommendations for the individual case or even a social program. Psychiatry and psychology, strengthened and inspired by this new tool, came together in juvenile courts, in schools, in state institutions for the criminal, the delinquent, and the feeble-minded to try out its diagnostic and treatment value. From such men as Walter Femald, William Healy, Η. H. Goddard, came powerful influences and practical suggestions for the treatment and prevention of many of the problems created for schools and courts by subnormal intelligence and the so-called psychopathic constitutional inferior. In looking over the earliest catalogues of the Pennsylvania
FUNCTION OF THE PERSONALITY COURSE
57
School, one finds a faithful reflection of this general development. At first, as early as 1908, the pressure to know comes chiefly from the insoluble problems of poverty, alcoholism, and juvpnile delinquency as they appear in the family- and childhelping agencies. One sees, along with the practical courses offered by the executives of the agencies themselves, a course in sociology to help social workers understand basic family structure and the meaning of poverty, and a course in psychology that by description seems to be quite academic and unrelated to the immediate issues. The place of psychology in a school of social work was explained as late as 1916, in the following remote terms: Social Science is concerned with consciousness and behavior of individuals. Psychology is the science of consciousness and behavior and is, therefore, one of the basic sciences upon which the profession of social service should rest. This course presents some of the elementary concepts of normal psychology with particular reference to physiological foundations and to those parts of consciousness that are chiefly evident in social relations; instincts, habits, emotions, volition.® This sounds more like a theorem in logic than a psychology belonging to the daily practice of the social worker, but it is true to the conditions as they were in the period when living psychology belonged to psychiatry and the only clearcut technique to laboratory psychology. It is obvious that however useful the definite diagnosis and the testing technique of the clinical psychologist, and however enlightening the interpretations of the psychiatrist, they afforded no solution for social work as such. Social work, to become a profession, had to learn how to do a particular task, to know and utilize consciously a specific skill. But how to get hold of its own practice, how to develop its own skill, was still only dimly perceived. While case workers in the social agency and in the training school continued to study the case material that recorded their efforts to help and thus were never completely unaware of their own operations, they were also impelled, both by theoretical uncertainty and the absence of * Catalogue of Pennsylvania School, 1916-17.
58
SKILL IN SOCIAL CASE WORK
conscious method and direction, to seek for clues to their problems in the assurance and scientific sanction of other professions, particularly psychiatry, whose relation to the individual seemed more akin to theirs than that of any other professional group. Just preceding the first World War, American psychiatry was already showing the influence of a new understanding of people, derived both from Kraepelinian psychiatry and Freudian psychoanalysis. But it was not until the aftermath of shellshock and war neuroses forced upon the medical men of this country the necessity for a psychological therapy that Freudian psychoanalysis came into prominence as a method of treatment not only for mental disorders, but for personality problems. It is not surprising that social case work, with its pressing need for a way to help that could be defined and depended on, turned more and more to the one profession that had discovered a psychological method for treating psychological problems, a definite technique for helping the individual whose chief obstacle to recovery lies, apparently, not so much in the environment as in his own make-up, his own inadequate or perverse relation to others, to reality. Social case workers had long since discovered the fallacy for them in over-emphasis on the environment and social betterment as remedies for immediate individual maladjustment. Since Freudian psychology offered a new insight into the causes of the wide variation in behavior that confronted the case worker within one neighborhood or one family, would it not also be able to furnish the key to treatment? The curriculum of the Pennsylvania School, like that of others in the East, registers quite accurately this developmental pre-war and post-war period in its effect on training for workers in the social agencies. Psychiatry took over, and became not only a required course, but the father of a new line, so-called psychiatric social work, which to this day maintains a separate identity in the National Conference as a specific field and, in some schools, as a specific method of doing case work. At first the fact of working under the guidance of psychiatrists in clinics, in hospitals, in institutions, was welcomed com-
FUNCTION OF THE PERSONALITY COURSE
59
pletely, as if it were not only a new area for case work, but the final and complete solution for all case work that pretends to psychological understanding and treatment. In so far as this ultimate way of working percolated into the traditional fields of family and children's work, it was designated by the term "intensive." Large agencies with heavy loads and no psychiatric social worker on the staff began to feel guilty and apologetic. They had no time to do "intensive" case work. Other more fortunate agencies added a psychiatrically trained worker or found a psychiatrist who would act as consultant or perhaps conduct a seminar. Meantime, in the curriculum of this School, there had crept in, along with the department of psychiatric social work and its courses in psychiatry, a new description of the course in psychology, which includes "the development of the instinctive life and the relation of emotion to conduct" (1919). The new emphasis on childhood as a place to begin, not only to understand but to treat and to prevent, was evidenced by specific courses on the behavior problems of children, on the mental and social life of the child, on the relations of parents and children, sometimes given by psychologists, sometimes by psychiatrists, sometimes by both, with social workers filling in. The Commonwealth Fund, with its five-year program to further the establishment of child guidance clinics, brought social workers, psychiatrists, and psychologists together in a cooperative undertaking that had a tremendous influence on all branches of social case work, and gave case workers a closer contact with treatment as the psychiatrist conducts it than they had ever had before. Moreover, these clinics were directly related to the social agencies from which many cases were referred, and to which they would be returned for follow-up in the community. The founding and rapid spread of child guidance centers with the parallel development of visiting teacher and child study associations and the various movements to organize and educate parents in mental hygiene, although tremendously stimulating to social work and to the social workers who participated, left the great bulk of agency activity untouched,
60
SKILL IN SOCIAL CASE WORK
waiting for a basis on which to be brought into relation with something that might be called professional. What was everyday case work doing? What had psychiatric social work to do with finding a foster home and placing a child in it, or giving relief to a family about to be evicted, or helping an unemployed man to find a job? These, after all, are the "basic tasks of social agencies, not to be relegated to diagnostic understanding or psychiatric treatment. Perhaps the fact that the Pennsylvania School literally grew out of these same agencies, long before the Philadelphia Child Guidance Clinic came into existence (1925), may in part account for the decision of its faculty to drop psychiatric social work as a unique discipline requiring a special kind of case-work training, and to regard as one the psychological understanding and practical skill essential for each and every specific branch of social work. This decision, while it left unaltered the courses that were being given by psychiatrists and psychologists, certainly required of the regular case-work faculty a new responsibility for defining or trying to define case work itself, as practiced in the field work agencies, and for relating to that practice whatever could legitimately be taken over from psychology and psychiatry. Thus, long before the Rankian influence had made itself felt in Philadelphia, the case-work department of the Pennsylvania School was attempting to establish the unique identity of case work and its right to be considered a distinctive professional discipline applicable to social work practice everywhere, psychiatric or otherwise. Up to this point, from 1908 to 1923, the case-work teacher had attempted to handle in the practice class every kind of problem associated with the student's experience in the field, the life history of his client, if he had obtained it, a study of the client's personality as well as an analysis of his social situation, some recognition of the student's personal reaction to particular clients and particular problems, occasional excursions into psychology of the instincts and emotions, sociological considerations regarding poverty and unemployment. Now, with the clarification and sharpened focus on case work resulting from this change of policy, the training burden is different!-
FUNCTION OF THE PERSONALITY COURSE
61
ated and divided between practice and psychological understanding. True, the same teacher carries both, but she no longer attempts to carry both at the same time. It is not surprising, therefore, to find in the 1922-23 bulletin, in place of the incidental course in psychology, a two-term course called "Human Behavior," specifically related to student experience in the agency. The weight of the responsibility that was being taken over by the case-work teacher is indicated in the description of the course: This course will follow the evolution of behavior from the tropisms of simple forms of life through reflex and instinctive responses to intelligence in order to reach a common ground for the formulation of a working point of view for students who are attempting to control and readjust behavior difficulties. It will take as its point of departure the individual adjusting to his environment showing the organization of impulses and responses from infancy to adulthood and social consciousness. The part played by instinct, desire and emotion in the individual's effort to adapt himself to a social environment will be stressed. Individual differences in capacity with a brief discussion of intelligence levels and measurements will be included. The course will be developed by illustrations from case histories of socially inadequate persons and an effort made to interpret their patterns of behavior. The point of view developed in this course will be correlated with material discussed in Social Case Work. In this beginning effort to give to the student what he needed for himself toward the development of his understanding of human nature apart from the actual doing was laid the foundation of the present-day personality course, which has evolved steadily for twenty years, utilizing every freshly discovered insight from psychiatry and psychology, but continuously disciplined and re-created by its impact with student need and student practice, and by the increasing clarification of its functional relation to the practice course and student training. The confusions introduced into social work by the post-war psychoanalytic invasion were manifold, but only two results were fundamentally disturbing. First, the authority and definiteness of psychoanalysis as a method of treating emotional
62
SKILL IN SOCIAL CASE WORK
problems compelled the facing of a fundamental doubt: Is case work something in itself, or must it become, as far as it is psychological, a modified or diluted form of psychotherapy? Second, whether case work be unique or derivative, does the new psychology apply only to the treatment of the client or must the case worker expose himself directly to its influence in order to utilize it professionally? It was in response to the challenge of the second problem as well as to the personal needs naturally acute in the individual who sets himself up as a helper without the inner discipline that professional helping necessitates, that case workers, particularly in the East, turned to various forms of psychotherapy and to the famous psychoanalysts who, from 1924 on, were beginning to be available in New York as well as in Vienna and Berlin; such men as Adler, Jung, Rank, and Ferenczi, to whom professional men and women were going for "didactic" analyses. It was because Rank, despite his youth and lack of medical degree, was considered by the progressive medical group in New York to be the most brilliant technician among Freud's followers,0 not because he was "Rankian," that two members of the faculty of this School, as well as several prominent social workers in Philadelphia, following the example of well-known psychiatrists, went to him to find out through their own experience what psychoanalysis meant and what it had to do with case work. That Rank was already beginning to work out his difference from his great teacher in practice, even before he himself was clear what this meant for theory, was quite unknown to those Philadelphia social workers until much later when they came to know him as a teacher whose interest "Otto Rank (Ph.D., University of Vienna) joined the Freudian group in Vienna in 1905 at the age of twenty-one and was associated with it for twenty years. He was editor of International Journal of Psa and of Imago from 1921 to 1924, and founder and director of International Psa Institute in Vienna from 1919 to 1924. In 1926 the development of his own method and philosophy brought about a removal to Paris. His association with Pennsylvania School began with a commencement address in June 1926. This was followed by lectures in 1927-28 and 1928-29. In 1935, when he settled in New York permanently, he became a member of the faculty in the advanced curriculum where the evening courses on the Nature of the Self, Growth, Learning and Change, and Symbols of Government, to which he contributed until his death in 1939, made a profound and lasting impression.
FUNCTION OF THE PERSONALITY COURSE
63
and insight extended beyond psychotherapy to the dynamics of all helping, including the educational process itself. One far-reaching result, for social work, of the stricdy Freudian psychoanalytic experience and teaching, particularly in family case work, has been increasingly to separate the practical problem which a client brings from the personality difficulties that the psychiatrically trained case worker perceives as the primary cause; thus, while meeting emergent needs realistically such a worker tends to concentrate effort wherever possible on some form of psychotherapeutic treatment for the emotional roots from which superficial symptoms spring. That such a separation rules out the administering of actual services as the core of a case work with its own authentic skill and goal and forces the worker to an unwarranted assumption of psychoanalytic diagnostic authority, seems obvious. In other words, the emphasis on psychotherapeutic treatment as a thing-in-itself and the only medium of helping tends to devaluate everything that social work stands for uniquely and concretely in the community. It leaves case work with nothing it can do in its own right, so that its only hope is to obtain the services of a psychiatrist or a highly specialized psychiatric social worker to direct the many case workers who lack special training and first-hand experience with psychoanalysis. Those few social workers who experienced something quite unlike classical psychoanalysis in their contact with Rank were saved in part from the tendency to put into practice with clients what they themselves had found helpful, by the fact that they were not at all sure what technique had been used with them. It was not anything they could grasp and formulate intellectually. Difference in themselves, something that felt like very swift intensive growth, they had certainly experienced and were still experiencing, but they were unable to pin it down to anything definite enough to be turned on the clients. They had learned that help comes from something more than intellectual knowing, that it goes beyond the facts or even the traumas of a life history, that it is a dynamic, present, swiftmoving experience with an ending; but what to do with it in case work could not be determined so easily. To this circum-
64
SKILL IN SOCIAL CASE WORK
stance, perhaps, as well as to its deep roots in the social agencies, the Pennsylvania School owes the fact that it was never tempted to make therapy of case work, or to desert its effort to train for skill in administering the concrete services of the social agency as intended by the community. Case workers of all persuasions shared a common problem in those first days of psychological case work, that is, how to comprehend the part played by "relationship" or, in Freudian terms, "transference." If—as the Freudian psychology implied —the cure is the making conscious of the unconscious drives that are creating problems for the client, what has the particular worker to do with it, beyond putting in his intellectual contribution and his capacity to recognize the meaning and see the connections that the client is naturally unaware of? Case workers knew from experience that their relation to the client —an intangible something—was of great importance. They felt instinctively that without it nothing would happen, but it was not easy to connect the living process with the intellectual effort of the analytic exploration and interpretation of material which too often felt like the imposition of the worker's will, like pressure or attack. The case worker with the Rankian experience, on the other hand, was not equipped with any conviction as to his right to explore and interpret apart from the reality problem presented in the client's request. He had some awareness that the moving force should somehow proceed from the client's need and effort, and that his role was better too passive than too active, but he also realized that much depended on relationship. Somehow the client, if he got help, would use his relation to the worker for moving ahead, and somehow, in a way at first not clearly comprehended, the worker had to carry active responsibility for this movement and his part in it. It is obvious that, for psychoanalytically oriented case work, there can be no solution to the problem of transference other than more psychoanalysis for the worker as well as for the client; for the worker a preliminary experience of being psychoanalyzed, followed by study of the theory and later by actual supervision from a psychoanalyst or psychiatric social worker
FUNCTION OF THE PERSONALITY COURSE
65
(although in reality few workers fulfill all three requirements); for the client, a gentle leading from his emphasis on the concrete help requested—and usually granted—to a course of psychotherapy for his underlying emotional conflicts. Thus the problem of relationship-as-transference is solved only by decreasing the distance between psychoanalysis and case work while, logically, the training for case work becomes a training for the practice of a form of psychotherapy.* The difficulty of deciding at just what point "depth psychology" goes too deep and invades the strictly medical psychoanalytic preserve, or how to keep the case worker from overstepping this intangible line except as she is safeguarded, if not by strict supervision of the psychiatrist, at least by ignorance and incompetence or by the inevitable resistance of the client, has not as yet been convincingly overcome. Fortunately for the survival of social case work as a process in its own right, and for the training relevant to its practice, the Rankian influence as expressed in this School, far from increasing dependence upon another profession, has led ever more convincingly to case work as such and to the essentials of a professional training for which schools of social work must become responsible. We have learned that neither psychoanalysis nor any other form of therapy, but the basic experience of taking help within a professionally controlled and limited relationship, is essential to the adequate training of students for practice in a social agency. Through the experience of being supervised by a supervisor who understands what it means to come under the discipline of carrying out the function of an agency, through the related experiences of practice class and personality class, whose teachers also understand and utilize the problems of growing into professional competence, the student of today, in this School, can undergo a fundamental inner and outer preparation for the practice of case work without benefit of individual therapy. He learns gradually, and often painfully, in his two years of effort to β See: Harry B. Levey, "Supervision of the Transference in Psychiatric Social Work," Psychiatry, Vol. 3, No. 3, Aug., 1940; David Levy, "Attitude Therapy," American Journal of Orthopsychiatry, Vol. 7, No. 1, Jan., 1937.
66
SKILL IN SOCIAL CASE WORK
reach the initial organization of a disciplined professional self and a beginning professional skill, what it means to take help, psychologically and realistically, for one's own growth towards a chosen goal.® He gains thereby a conviction about what it means to a client to ask help of an agency, because he, too, has gone through a "being helped" experience, for which he asked and whose conditions he has gradually made his own. Yet he has no temptation to project his own experience in toto upon the unsuspecting client as did those pioneer case workers who got their first comprehension of helping from therapy because, from the first moment of the training experience, he operates in a social agency where he leams to respect the difference that function makes and to become more and more responsible for carrying out the service of his agency under the conditions it sets up. Already he possesses a beginning psychology of helping, as he lives it every day, both as giver and receiver of help. He knows what courage it takes to admit his need of the supervisor, not once, but at every new stage. He knows how hard it is to ask, how necessary to resist the very help one has requested, to try to control the source of help, and finally, he knows that only of one's own choice and affirmation are the limitations, the alien conditions on which help is offered, to be accepted and utilized for a new attack on one's problem. Gradually the student learns to face the client at the point where the latter presents himself, to enter with him into the struggle of deciding whether or not this agency with all of its limitations is for him, whether the client is willing to take the responsibility that receiving any help entails. This, too, the student understands from his own training experience and can believe it has value in itself even though he makes no attempt to understand the client's "total problem" or to meet his "emotional need" except as they are related to this specific effort of trying to use or deciding to refuse the help of this particular agency. For this School, then, the solution to the problem of training professional workers for the practice of case work in a social β For development of this conception see Virginia P. Robinson, Supervision in Social Case Work, University of North Carolina Press, 1936.
FUNCTION OF THE PERSONALITY COURSE
67
agency, a case work that is clearly differentiated from psychotherapy, depends: first, on the recognition of a basic helping experience and process which is common to all professional helping but is to be controlled and made specific only in relation to the particular function that determines and directs it; e second, on the realization that the training of students for practice in a case-work agency is itself a profoundly potent form of professional helping, where psychological growth in a learning experience can be clearly realized and furthered through the dynamic of the training function in teaching and supervision. The personality class as it operates today in the Pennsylvania School is determined, not so much by a particular psychological content or required learning in intellectual terms, as by its functional relation to the experience of the student in this learning-growth process that is essential to the development of a disciplined professional worker.ββ In the agency, the student is related immediately to his supervisor who will go with him step by step in his efforts to assimilate the function and carry out specific tasks. The supervisor is humanly as well as professionally helpful and certainly must consider and wrestle with the student as a person again and again, but always she is held not only to her responsibility to student and school as a training supervisor, but to agency and the welfare of clients with whom the student is engaged. The student is important to her, but his purely personal experience as a learner can never come first, nor can she be to any extent the recipient of his "thinking about the relation of his past self to all this disturbing present and his efforts to gain a little conscious control through theoretical formulation. In the case-work class while the students, both individually and collectively, are the center of the teacher's interest, the focus is on their "doing," the actual recording of how they β See Jessie Taft, "Function as the Basis of Development in Social Work Processes," The News Letter, American Association of Psychiatric Social Workers, Vol. 9. No. 1. · · This emphasis does not exclude a carefully selected reading list with fairly heavy requirements, and assumes that the student will learn to grasp the significant aspects of a life history and to recognize the psychiatric ana psychoanalytic theories that determine current psychological interpretations.
68
SKILL IN SOCIAL CASE WORK
have worked with clients, their successes and failures in representing the agency, their mutual exchange of criticism and commendation, their learning about what case work is, and how to use the class and the experiences and opinions of their classmates. The case-work class is vitally related to every student's individual performance, and is always in the process of helping him to evolve, out of his experience and out of related reading, a steadily deepening comprehension of functional case work. It also provides an experience in itself, a weekly testing-out oi the reality of the student's efforts, not only to tolerate the differences he finds in other students, but to respect and learn from them. The case-work teacher as the student's adviser in the School is responsibly related to his progress both in class and in the field. She it is who evaluates his growth in skill, in responsibility, in the actual doing of the thing he has come to leam, and, together with the supervisor, holds him to the standards set by school and agency for satisfactory work at the level where he is. Throughout the year the case-work teacher, as adviser, holds up to the student the professional ideal, the goal he has set for himself in his decision to take training. His personal problems come in for consideration and analysis only in relation to their interference with his progress as a student. When his personality pattern or his personal problem presents so serious an obstacle as to indicate a need for therapy, the School accepts the situation as one no longer compatible with its program. The School does not try to train a student who at the same time wishes or needs to put himself into another process as demanding as therapy, nor does the School undertake to give to students personal help unrelated to the professional goal. A student is never "treated" either by case work or any form of psychotherapy. Whatever growth or change or progress he experiences is the direct result of the training process itself, in which the development that comes with fundamental learning is not only to be expected, but required. How does the personality course fit into this training unit? It is the balance wheel which rights the otherwise too strong emphasis on the professional goal, the agency, and the client.
FUNCTION OF THE PERSONALITY COURSE
69
The personality class, which accompanies the case-work class through three semesters, is geared to the need of the student himself, his right to explore the very experience he is undergoing, and his necessity to orient himself theoretically, both in relation to his impacts with clients and with supervision. He needs to understand himself, not completely, but as he is in this meaningful learning experience, and to formulate for himself a working psychology that holds true, not only for the client, but for himself, for his teachers and supervisor alike. Thus the first personality class for the beginner is called "Attitudes and Behavior." Its purpose is to help the student to become aware of and to weather his own reactions to these new situations, to consider the various ways in which one prepares for an important change like coming into an unknown school, what it means to accustom oneself to the reality one finds, to get used to classes that are disturbingly different, and to field work that exposes all of one's ignorance, fear, and helplessness. In content, this is carried by some appropriate reading, by asking the student to write briefly on various aspects of what he is undergoing, by bringing into class material from biography and fiction on which students may analyze experiences like their own, but sufficiently removed from the personal to leave them free. Into this class the student also brings some of his puzzling encounters with clients: attitudes he does not understand or will not tolerate; behavior he condemns or wishes to avoid. He is full of shock, surprise, disillusion with himself and the client. He has to grow into acceptance of his own emotions as vital expressions of living, in order to allow the client to feel as he feels. Here, together with others who are going through like experiences and a teacher who is able not only to accept him but to help him to go beyond these difficult beginnings, he finds that it is safe to put out in class the way he feels as well as what he thinks about what he is doing in agency and in school. There is no norm for the feelings he should have, no one has to agree with anyone else in ideas or emotions, but the student who wants to go on with training soon realizes that he has to "keep moving" and risk himself ever more deeply.
70
SKILL IN SOCIAL CASE WORK
The natural impulse to help, which has ultimately to be disciplined into skilful practice, may express itself in personality class in all its naivete and in that expression move on to a deeper level of awareness and desire to change. The personality class, then, is a focus for the personal change which the student undergoes, the process of accepting, step by step—or perhaps coming steadily toward a decision to reject—the amount and land of self-discipline which, it is evident, will be increasingly demanded of him if he is to become a social worker on the terms of this particular school. The first semester is an experience in itself, a measured stretch of time with an ending which has meaning in the school year. The student has come through a concrete experience of beginning. By this time he is ready to decide to follow through this beginning, or to conclude that its leading is not for him. At this point, the adviser brings together the student's threefold relation to training and helps him to leave or to continue, in the light of inner and outer evidence. The personality class that accompanies the second semester is called "Development of Personality." It is assumed that now the student is ready for a deeper plunge into the field he has chosen for himself. Hopefully he is past the upset and confusion, the unbearable newness and helplessness of his initiation. Now he wants to understand how his clients come to be as they are and above all, how he could have developed the many problems that the personal self presents, both to himself and the supervisor, in his efforts to relate skilfully to clients. The personality class allows him to work on this legitimate and passionate interest in his own psychology and what it means to experience a change in the very self as he now knows he must if he is ever to master this thing called case work. The Development of Personality uses as content the developmental crises in the life history that are common to all men in our culture and are determinative of personality because they are determinative of the individual's relation to the "other"; such as pregnancy, birth, nursing and weaning, talking, walking, toilet training, the birth of siblings, going to school, adolescence, and the like. While much is required here in reading
FUNCTION OF THE PERSONALITY COURSE
71
and accurate knowledge, the material is brought to life in terms of fiction, the student's impulsive feeling reactions, the teacher's basic comprehension of human development, and bits of experience, brought in by the class from their field work or their own lives. What they learn here of human behavior and human emotions is not something to be turned upon the clients as "technique." On the contrary, the only understanding that is sought is first of all an increased understanding and acceptance of themselves in relation to others with all the weakness, strength, and fear that are there to be faced—not erased or denied but utilized; an understanding that must be absorbed into blood and bone before it can contribute helpfully to the client-worker relationship. At the close of this second term of personality, the student who is learning has acquired some belief in internal change for himself and for clients as not only possible but necessary for living, and into the term "personality" he has begun to put vital content, a new conception of the process of becoming a self that goes back to birth, and a new appreciation of the capacity to enter into relationship with another, as fundamental to case work and to life itself. The final assignment for the term paper indicates what the teacher expects at this point:— Describe and analyze a relationship, personal or professional, between two people—preferably one in which you were one of the two participants, but at any rate one which you know intimately. It will be helpful to consider such questions as:— What brings two people together? What holds them together? What precipitates change in their relationship? What precipitates change in personal development on the part of either or both? How does such change take place and within what limits? What does it mean to become responsible for one's own part in a relationship? While the completion of the first year is a real ending for some students, it presents a critical period of evaluation and decision for all. For those who apply and are accepted, the second year necessarily becomes another beginning, as real and as problematic as the first, but on a different level. The second-year supervisor meets a student who has completed a stage in his training, who may have known himself as a
72
SKILL IN SOCIAL CASE WORK
responsible worker for several months. He feels that he has left that painful first-year struggle behind him and is in no hurry to put himself back, as it were, into the learning situation. As a second-year student, he is not so ignorant, not so helpless, not so afraid as when he entered, but he is proud of his newly achieved professionalism. Instinctively he resists the second plunge into uncertainty and the admission of unknown areas that remain to be conquered. As a rule the second-year case-work class, with its demand for material on a higher level of responsibility, upsets whatever is false in the assurance he has built up during the summer and initiates the dissatisfaction that finally leads to the deeper growth and command of skill that second year requires. Often a student breaks through into taking help from his supervisor only after a long struggle to do everything himself. "By this time, I ought not to rely on my supervisor as I did in my first year," is his justification for the period of resistance that has been indicated in various ways: conference periods not kept, dictation undone, cases that seem at a standstill for no good reason, all the myriad ways in which refusal-to-learn-throughsupervision may be expressed. But there is a difference. The second-year student knows something about beginnings, about resistance to learning, about his own relation to change. What he does not know and must learn in his own stubborn way, is that growth is a process not completed once and for all; that, in a training experience like this, every beginning, every ending, constitutes a crisis on which movement and reorganization take place. It has taken us all these twenty years of experiment with the personality class to comprehend its function truly as is evidenced by the fact that we have been willing to make our second year personality course called "Patterns of Growth," an elective, and to put it in the second semester after the casework class instead of with it. The students have known better instinctively, for they have never failed to elect this course and have consistently complained about taking it in their last semester. Finally, after these years of blindness, partly due to expediency, we have come to believe that what we knew was
FUNCTION OF THE PERSONALITY COURSE
73
true for first year is equally true for second. Actually, we found that the second-year case-work teacher as adviser had been attempting to carry, with individual students, the burden which the personality class rightfully took over in first year. Thus there fell upon both supervisor and teacher an undue responsibility for the student's personal struggle in adjusting to second year, and an imbalance was created that from now on we hope to remedy by making second-year personality a required part of the practice unit in the first semester. The content of this course consists of reading in psychological theory and in biography with the detailed study of several authentic life histories as presented vividly in autobiographical form. The purpose of the course is to follow through these lives patiently in detail in order to make real to students the stability of the individual's fundamental pattern in relation to change and growth crises, and to show, also, how truly he may use them for the freeing and reorganization of the ego on a new level of self-realization and creativity. Through both thoughtful and impulsive reactions, through identification, rejection, uncertain tolerance, to final serious effort to understand and bear the ways in which individuals strive for their own development, the students begin to comprehend the meaning of psychological growth as an irreversible organic process in time, and to affirm the newly won sense of a disciplined professional self that can be demonstrated in practice. In the last semester, field work takes on more and more the character of a regular job, carrying full responsibility to agency in everything but time. Seminars in specific areas of case work conducted by lecturers from the agencies are scheduled for the first half of the last semester, along with various electives, some of them in the personality area, but the true completion of the personality case-work teaching unit is reached only through the thesis seminar. Here the student takes over, to organize and put out for all to see, the evidence of his own growth, the proof of his professional competence in a presentation of his practice as it is. The thesis, then, authenticates the birth of the professional self, which has been forming over a two-year period and may now come forth convincingly. There is no
74
SKILL IN SOCIAL CASE WORK
student, in my experience, who does not feel that the thesis is the culminating point in his training experience, the bringing together of everything he has learned, transmuted into the precious metal of his own philosophy and practice. Through the thesis, the student begins his separation from the self that was dependent on teacher and supervisor, and assumes, as far as he is able, responsibility for what he thinks and for what he does as a social worker. Whether one can accept the role of the personality course as described in this paper depends on one's whole conception of the essentials for training students in social case work; whether such training is conceived of as primarily external and environmental, an imparting of definite content accompanied by a relatively detached 'learning-to-do" in a social agency, or whether, as in this School, one conceives of training as a unified process, a profound organic learning experience over a two-year span integrated by its purpose and direction, broadened and formalized by its connection with relevant background courses but sustained and balanced by the threefold division of the training unit and the shared responsibility of two teachers and a supervisor for the development of the student toward the professional goal.
SUPERVISION OF FIELD WORK The First-Year Student Faith Clark the supervisor teaches the field-work student about case work as it is practised by the agency forms, if not the core, certainly a vital part of his training for social work, for it is that part of it which is concerned with his actual performance on the job by which ultimately his success or failure as a worker will be judged. No matter how small the service or how slight the student's knowledge and experience, he must do the job to the best of his knowledge and skill, or the agency to that degree will fall short of its purpose in offering its service in the community. In the classroom, teaching takes place through group discussion under the leadership of the instructor; in the agency, teaching comes through actual case-work experience pointed up and interpreted by the supervisor. Classroom teaching invites discussion of material from many angles with the idea of broadening and deepening the students' understanding of it; field work teaching, while not confined in understanding, must be directed always to action, and action directly related to the agency and limited by its function. Thus for the time being the mastering of the agency's function becomes the content of a student's learning, as well as the field for his casework practice. WHAT
To bring about this knowledge on the one hand and skill on the other becomes the teaching responsibility of the supervisor—teaching not in theory, but related to specific and immediate issues in the reality situation between agency and community, worker and client. Although this method of teaching (through supervision) is not directly concerned with the theories of social work philosophy, case work, or personality 75
76
SKILL IN SOCIAL CASE WORK
development as such, it is concerned with their implementation into case-work practice, and on the supervisor to a large degree rests the responsibility for bringing this about and helping the student integrate these two aspects of his training to the limit of his interest and capacity. Therefore, while fieldwork placement is a primary concern of the School, the taking on of students for field-work training must be accepted by the supervisor with a full realization of die responsibility it entails. For the first-year student—and I am limiting my discussion to them—an agency with a rather specific service for a limited group seems to be a good placement, because here the young student can learn the actual agency processes more quickly and use them sooner and more surely than he could a more complicated set of services. For many years the Scholarship Department of the White-Williams Foundation has been used as such a field. Briefly its function is to offer scholarships— financial assistance—to boys and girls in high school who are doing good work in school and are anxious to continue, but find it difficult to meet the expenses of carfare, lunch, dues, clothes, etc. Eligibility for this help has thus two aspects: that centering in the child himself—he must do good work—and that lying primarily in the economic need of the family. If both eligibility requirements are met, the scholarship is granted and continued as long as the child does good work in school and needs it. During this time he has regular contacts with a worker, his counselor, from whom he receives his scholarship, and with whom he may consult upon anything that is of special concern to him. But if something happens that seriously affects his school work, or if the family situation changes, the worker is responsible for reviewing eligibility, and for discontinuing the scholarship if that seems indicated. While this seems simple enough and the needs met by agency comparatively slight, all the factors in the giving and taking of help, both financial and personal, come into play, although the clients are only adolescent boys and girls. To state specifically, in terms of case-work content, what I teach the student to enable him to administer this service as a "scholarship counselor" I find difficult. For while we have a
SUPERVISION OF FIELD WORK
77
very definite content which must be learned, this is seldom done, except in certain administrative details, merely as content, but rather in relation to case-work process and agency practice. In fact, content takes on new meaning through practice. If, therefore, I seem to consider the two together or interchangeably, I do so purposely, and because there cannot be complete differentiation between them. It may be taken for granted that the student is first made thoroughly acquainted with the essential facts about the agency, including the administrative details necessary to work in it, and with its place in the community. The very nature of our service implies a very close tie-up with high and vocational schools, and there is much that the student has to leam about them—how they differ, what courses they offer, what services are available, such as counseling, health, psychological, etc. For not only do the schools offer our chief source of intake, but cooperation with them is essential more or less constantly throughout our service. The services of other community agencies are generally learned directly and as a student needs to use them in his casework practice. It has been my experience that most first-year students come to the agency with some ready-made concept about helping a client, rather than carrying out an agency service. This makes the first introduction to case work with us somewhat difficult for them, as our clients are not "problem children," but unusually capable boys and girls who have come to us for help, not for themselves as persons, but for an end—school expenses. At first this is apt to be disappointing to the student— he feels he is not "doing" anything and questions whether it is his fault that the client does not "confide" in him—and how can he "help"? What he is really asking is "How can I make a place for myself where I can feel useful to the client and necessary to the agency?" He feels uncertain and inadequate enough anyway, and to have no spot at which he feels he can take hold seriously concerns him. It is at this point that I begin to instill first into his feeling and so into his practice some recognition of the fact that because case work represents merely the method by which the agency service is offered to
78
SKILL IN SOCIAL CASE WORK
the client, it has limitations as well as opportunities for helping, and these limitations the worker must try to accept as right and sound even though personally they may seem very frustrating. That is, I help the student to realize that he is working in the Scholarship Department of the White-Williams Foundation, not in a health clinic, or a psychiatric clinic, and that therefore his primary responsibility is to see that his client gets the scholarship in the amount and in the manner best suited to his particular needs, and for as long as he remains eligible. If, in the administering of that service, as his understanding grows and his skill develops, other needs arise for which the client seeks help, well and good. But whatever the nature of those needs and however expressed, they must be met by him as a worker in our agency, and his action must be directly related to the service we offer. As soon as a student can get even a glimmer of the meaning of this way of working, he loses that "rootless" sensation which means simply that as yet he is really not related to the agency at any point in his thinking and therefore has no place in it as a worker. Sometimes a student does not quite realize what is happening when, after a period of not knowing what he is there for, he suddenly has "so much to do." It is safe to say, however, that in most instances this taking hold more responsibly comes about only after he is no longer thinking simply in terms of what he can do, but rather how the agency can help. With regard to the make-up of the beginning case load, I have often wished that it were possible for a student worker to begin where it seems most logical to do so—with the application itself—because here the client comes with a request which the worker must do something about. Because this is not practical until the student gets some of that "feel" about the agency and about himself that I have described above, I try to do the next best thing, and assign a beginning load from children who have just been granted scholarships, but who are otherwise "new" to the agency. This gives, perhaps, the best possible chance for the building up of a case-work relationship that can have value for both client and worker. The following
SUPERVISION OF FIELD WORK
79
illustration is a very simple example of this very early case-work practice. Stephen had just been granted a scholarship after nearly a year's effort to make the grade scholastically. He certainly needed the help financially, seemed intellectually able to do the work (I.Q. 130) and showed his interest and desire for the scholarship in many ways. Yet one report period followed another and still he could not quite qualify. When he finally did so, it represented a real accomplishment in the achieving, by his own efforts, of something hitherto unattainable. Instead of recognizing this feeling when he came in for his first scholarship allowance, Miss M. ignored it entirely, was pleasant but very general, and because the boy responded likewise, questioned whether he really "appreciated" the scholarship. We discussed this thoroughly in our next supervision conference, with the result that Miss M. was able to make belated recognition of his attainment in her next interview with him, and succeeded in establishing a rapport which continued to the satisfaction of both. She saw readily that her failure to appreciate what he had done was due primarily to her lack of understanding of the conditions under which the White-Williams Foundation grants scholarships, although she did know about them, and in consequence his final meeting of the eligibility requirements and its importance for him had had little meaning for her. Another type of case which I have found helpful in giving a student a sense of participation before he has had much experience is one in which h e can share in the taking of a scholarship application. This may mean that he will interview the parent concerning financial eligibility while I am seeing the child, or will make the home visit if the parent cannot come in. In all such instances I assume the final responsibility for acceptance or rejection of eligibility, but his contribution is considered very definitely in reaching a decision, and if the child is accepted he then becomes the student's client. The following case illustrates such a joint sharing of responsibility. Hilda had been referred to us in the late summer, as a child who was doing excellent work when in attendance, but who had been absent so much that the school was finding it difficult to rate her. Explaining that her absences were due to the illness of her mother, Hilda assured us that she expected her mother to
80
SKILL IN SOCIAL CASE WORK
be better by fall, that she would then be able to attend school regularly, that she very much wanted and needed the scholarship. When school reopened in the fall, Hilda continued to be absent as much as she was present and still gave as an excuse to the school that her mother needed her. Miss H. and I discussed this carefully before she went to see the mother. She was to tell Mrs. P. that we could not consider Hilda for a scholarship at this time because her continued absence from school made it impossible for her to attain the necessary scholastic standing. Then if the situation seemed to call for it, she might present to her the possibility of another kind of help through referral to another agency—the Visiting Nurse Association, the Visiting Housekeeping Bureau, or the Family Society, whichever seemed to be indicated—as the Social Service Exchange listed none of these as being active. Great was Miss H.'s consternation when she found the trouble to be a baby, although Mr. P. had been dead a number of years. She was completely at a loss, and unable to carry out anything she had had in mind—even to explaining why we could not give Hilda the scholarship—because she could not account for that baby. Mrs. P. "implied" that it was a foster child, but Miss H. "feared" it wasn't and "didn't want to embarrass her" by asking directly. And if it was her own, of course Hilda had to stay home and take care of her mother—still in bed—it would have been heartless to have expected her to do anything else! So she left, proffering little but sympathy, and telling Mrs. P. she would come back again "when she was better" to talk about Hilda. By the time Miss H. came to conference, however, she had gone far in coming to grips with herself about where responsibility lay. She had decided that wherever the baby came from (and why shouldn't she have asked?) the situation as far as Hilda was concerned remained the same (she was still out of school)—and that she had a professional responsibility as a worker in the White-Williams Foundation to do something about it even though she might still be confused as to the facts in the home situation. Again we discussed it, and the next time Miss H. visited she told Mrs. P. definitely why Hilda was not eligible for a scholarship at this time, and that her continued absence from school would bring investigation from the school authorities. She also suggested tentatively that there were agencies from whom she might get help so as to make Hilda's return possible. Mrs. P. did not commit herself about what she would do (this
SUPERVISION OF FIELD WORK
81
was difficult for Miss H. to take) but did tell her that the baby is her own, but that she ho^es Hilda thinks it is a foster child. She has told Hilda this as she does not want her to be "ashamed." Miss H. heroically refrained from any comment and proceeded to discharge her final responsibility by going to the high school to tell the Home and School Visitor why White-Williams is dropping out and that the attendance department may have to take some action if Hilda is to return to school. Here it is clear that the student is helped out of her confusion by organizing her thinking around the agency function and then acting on it. By the time the student is able to accept full responsibility for applications assigned to him, except for a smaller case load and a closer relation to the supervisor, he is, to all practical purposes, a worker in the agency, doing just what the rest of them are doing—from taking applications to closing cases. In the carrying of any complete agency service, that is, from start to finish, the role of the worker changes somewhat. When he takes the application he must establish eligibility, while he is "administering the scholarship" he is acting in a counseling capacity, and when the child gives up the scholarship, whether voluntarily or on the agency's initiative, he is again establishing eligibility, but in reverse—that is, making use of the limiting aspects of the agency service. These distinctions are, of course, only general, since there are in reality no hard and fast lines between any stages in his work, though there are differences in emphasis. When a child applies for a scholarship, often he has not the slightest notion what it means—he just arrives at the office. If he has been sent by the school he usually knows that it has something to do with his good work there; if by an agency, something to do with "money to help him go to school." The student must clarify with him all along the line, as he takes the application, just what the child does and what we do. It takes real sensitivity and skill to put a frightened child at ease, and at the same time present the agency service simply and directly. He must recognize all the feeling that the youngster may have in coming—hope, fear, shyness, uncertainty—and
82
SKILL IN SOCIAL CASE WORK
yet not be trapped by it, nor must he add to the fear and confusion by his own uncertainty. Ben, for example, comes in with a fine school report, all "excellent" highly recommended by the school and very anxious for the scholarship because his father is dead and his mother cannot afford to give him carfare, etc. After the basis on which we grant the scholarship has been explained to him, he fills out an application blank with the help of the student, who arranges for a psychological and physical examination and then sees his mother, who has accompanied him (when parents come with the children we always see them separately, the child first). Mrs. C. flatly refuses to let Ben apply for the scholarship. In spite of very hard times she has never had to take "charity" yet and does not intend to do so now. She knows very little about any social agency but has no use for any of them. She goes into a tirade about all the trouble she has had—and ends by being indignant that Ben cannot walk off with the scholarship in his pocket. The student might easily be drawn into an argument here either in defense of social work or of Ben, but instead, recognizing that the mother's excitability may mean something quite different from the way it appears, he accepts her feeling about "charity" and by explaining carefully our service with its emphasis on achievement enables her to use it in spite of the fact that the scholarship is a form of financial assistance. But the situation is not always as simple as this—sometimes the child is not eligible for the scholarship, although the need is so great that he may have to leave school if he does not get it; or he may be eligible but unable or unwilling to accept it. Either of these situations is always difficult for a student to face. In the first instance he feels he just must do something to help and very often can by referring the child to the Junior Employment Office for help in getting a job—or back to school for NYA; in the second, it is always hard to understand how a client can turn down assistance which he so obviously could use "if he would only admit it." But in both instances he has to learn that fundamental to any case-work practice in the offering of assistance is the right of the agency to withhold its help where eligibility is not met, and the right of the client to choose for himself whether he will accept or reject the service
SUPERVISION OF FIELD WORK
83
offered, even when he is eligible for it, and even though in rejecting it he may deprive himself of something he really needs. This holds true equally, of course, with respect to personal as well as financial assistance. We have found that sometimes a child will accept a scholarship, not because he wants it particularly—it does imply considerable responsibility—but from family pressure. In such instances he may reject it later and much more painfully by failing in school, or in some other way making himself ineligible for it. It is in cases such as these that the student has to guard against confusion between his personal desire to help the client and his professional responsibility toward the agency. But let us return to Ben. As soon as he has been granted a scholarship the student's relationship with him shifts somewhat, as it is no longer concerned with establishing eligibility, but with maintaining it. He comes in every two or three weeks for his scholarship, and in these interviews with him the student has a chance of knowing him in a way that makes him seem very different from the picture he presented when he first applied; in fact, he is different, or at least shows a different side of himself. Just as his mother's antagonism covered up a real desire to get help for him, his good grades in school may cover up other concerns; he may lack friends, feel misunderstood, need health attention, opportunities for recreation, help with post high school planning, or just plain understanding around his difficulties of growing up. Practically all students have considerable book knowledge, at least, about the characteristics of this age group. They know that growth in all aspects of living is accelerated rapidly during this period and takes place unequally, bringing with it usually some degree of conflict within and without, especially with their families; but students comprehend this differently as they work with the adolescents themselves. Then their knowledge ceases to be merely intellectual. They really know David, who is doing brilliant work, but is embittered over the illness of his mother who is "sick" because "she has not enough money to live in a decent place and eat the right kind of food"; and Herbert, who altered his school marks—his teachers were un-
84
SKILL IN SOCIAL CASE WORK
fair to him because of "race prejudice"; and fearful and shy Marie who both wants and hates to have her mother come to the office with her; and Frank who has always such very good reasons for not getting on NYA that you don't knovtf whether to hold him responsible or not, etc., etc. All problems of adolescence take on new meaning as they crop up in various guises in his own clients. The student never knows to what degree or how the child may call upon him, but as long as school achievement continues to be satisfactory and there is financial need, it is his function in this counseling capacity to help the child to the limit of his skill and understanding. Sometimes the child may want nothing at all of the student, and completely shut him out; or may present needs that are beyond the student's ability to satisfy, or that fall without his province. Then he must be willing to refer the child elsewhere, if he can, whether to a boys' club for recreation, or to the Child Guidance Clinic for treatment. For he must leam to accept the fact that he cannot always supply within himself or through the agency the help that the client needs, but as he develops skill in case-work practice he can almost always do something to help just by taking hold of that thing immediately present in the situation which can be their mutual concern, even though it may leave the major problem untouched. Scholarships are discontinued for many reasons, most frequendy, of course, because of high school graduation. Here the child's greatest concern is over leaving the protection of school; apart from that, the loss of the scholarship has no special significance. School has often given him great satisfaction, and for that reason, although he is ready for a job or for college, as the case may be, he hates as well as wants to leave it. He has very much the same feeling about the scholarship and his relation to the agency and to his counselor. But conditions may arise, and often do, that make the discontinuing of the scholarship necessary while he is still in school. In such instances there is almost always considerable feeling involved. Even where the family circumstances have improved so that the children no longer need help, they may have definite resistance to giving up something that has come to have a value
SUPERVISION OF FIELD WORK
85
for them over and above the actual financial assistance. The White-Williams must conserve its funds for use where the need is greatest; how can the student help the child make the decision to relinquish the scholarship himself so that he will not feel that it has been "taken away," something done to him without his consent. After talking it over with the supervisor, the student may plan to continue the scholarship for a few weeks or even in extreme cases to the end of the term. This gives the child time to get used to the idea of giving it up, and usually by then he is quite ready to do so. The handling of the feeling involved during such a period becomes the student's chief concern and requires not only a close and real identification with the agency, but an acceptance by him as well as by the client of the value of any separation experience, in spite of its pain, as a necessary and important part of growth. But it is where there has been a breakdown in the child's school achievement that the highest degree of feeling is experienced. If it is difficult for the student at application to use the agency function to deny the assistance that a child wants and that the agency can give, because in some ways he fails to meet the requirements that have been set up, it is doubly difficult to make use of it in order to withdraw help after it has once been given. Especially when the breakdown in eligibility is due to failure in school, acceptance of it is often so difficult that at times both student and client will fight against it with all the feeling that they possess. The student feels that he must have failed somewhere in his case-work practice or this situation would not have arisen. The client has to admit failure, too, though he often denies responsibility for it. For both of them the application of the agency function is felt as pressure to which both will react with some kind of negative feeling which involves struggle. For example, the child may give all sorts of assurances that his work is improving, that he will study harder, or excuses that he has been sick, that the teachers do not like him. The student may take him at his word and "keep on giving him another chance" until he discovers that this method is not producing the desired result, but is perhaps bogging the child down even deeper.
86
SKILL IN SOCIAL CASE WORK
The supervisors responsibility here is to help the student realize that continuing the scholarship beyond the point where the child ceases to qualify for it will at the very least be a source of confusion, if not of actual harm, through the conflict that inevitably arises when one gives help that is not really wanted or that the client is no longer ready or able to take. In our own practice we have found it much sounder to accept the pressures that the limitations of our agency have put upon us—worker as well as client—and discontinue the scholarship after ample explanation has been given to the child well in advance as to why it will have to be done. After all, our clients are adolescents —with all that that implies—and we have found that most of them can take school failure and the loss of the scholarship as something temporary and not too disturbing if we can take it that way too, especially if at the same time we leave the door wide open for them to reapply when they again are eligible, and if they want to. What student and child need to realize is that inherent in the giving and taking of any form of help are limitations which are sound and right for both of them. For the client these limitations are what make the acceptance of help possible—help in a specific area which he has asked for and is eligible to receive. For the worker they make the giving of it possible; otherwise he would be the giving or depriving person and in either case be overwhelmed by his power or discouraged by the lack of it. This relating of case-work practice to an agency function requires a high degree of professional skill combined with a sensitivity to the client's needs and a self-discipline in the sphere of one's own activity in meeting them, that is finally attained only with long experience. A first-year student attains it only to a degree, but he has laid a solid foundation if he can finally come to accept for himself that whatever he does is sound and valid only as it is related to the agency service as well, as to the client's need, and that in this knowledge lies the source of both professional skill and sound case-work practice.
SUPERVISION O F F I E L D
WORK
87
The Second-Year Student Madeleine Maris THE social agency that offers field work for students in their second year of professional training finds itself embarked on an undertaking of unique challenge. These students come already thoroughly engaged in the process of their own professional learning, eager for the next experiences that will develop their skill further. The agency that accepts them must meet their need with a program carefully geared to their level and potentialities of development. This program must offer opportunities for the best of these potentialities, but it can do this soundly only as it remains rooted in and built out of established resources and structure in the agency itself. The agency's responsibility for service to clients, which underlies this structure, is the primary consideration in any training plan, entering into the choice of areas where students will work and the selection of cases which they will handle. Responsibility for service also determines the focus in evaluating field-work accomplishment, for student performance must meet the requirement of carrying out the agency's function of helping, and cannot be judged entirely by what the student gains from doing the job. This agency motivation in defining student work and in measuring achievement establishes the value of its field-work training as a potential learning experience. Only as it offers field work which is an integral part of the agency job, carried out by agency standards of case-work practice, does it give real opportunity for students to test and develop their ability to participate in a helping service. In the agency I am describing here,* whose function is foster placement of children, students take an active part in the program of receiving children into care, providing foster homes, and carrying responsibility for placement. The make-up of case load and the duties involved vary, depending on whether the student works in the Reception Department where applications * The Children's Bureau of Philadelphia.
88
SKILL IN SOCIAL CASE WORK
for care are considered and temporary placements are made, or in the Department of Long-time Care where children are placed for more extended periods. Wherever the student works, he shares in the agency responsibility to make foster-home care a helpful experience to the clients it serves. His contacts with children, parents, and foster parents are part of the procedure by which the agency meets this obligation and are judged by what they contribute to its fulfillment. In planning field work the agency takes into account what the student can be expected to do at progressive stages of his development, making a distinction between assignments for first and second-year students based on the degree of responsibility for agency service which they are ready to assume. In recognition of the problems which the student faces in working with the complicated function of child placement,* this agency assigns to first-year students cases in which they work only with one particular aspect of this function. Usually they supervise the foster-home care of children but do not carry contacts with parents. This limitation to the set-up of foster home, child, and agency without the added entanglement of parents' problems in relation to their children's placement, simplifies and clarifies the first-year student's part in the field-work job. Even here problems of identification—with the agency which cares for children apart from their own homes, with the child who struggles to find his place in this setting, and with foster parents who must work with the agency in providing care—are so complex as to tax the ability of a beginning worker to keep his balance in meeting their demands. But there is opportunity here as well, for in this situation where the clearly defined procedure of placement is carried out with child and foster parent, the student comes to grips with the necessity for taking responsibility as a representative of the agency charged with sustaining them both by its own stability. Before he can have a clear sense of his place in this field he must first achieve an equilibrium in his own adjustment to the painful realities involved in foster • See Dr. Taft's introduction to Journal of Social Work Process, Vol. Ill, No. 1.
SUPERVISION OF FIELD WORK
89
care, and out of this development emerges the beginning of ability to function on a responsible level. Students who have acquired from their first year of training a clear conception of their responsibility as workers and have manifested a readiness to move ahead in assuming it, need, in their second year, a field-work experience which demands fuller use of their capacity and new opportunity for growth. This we try to provide by making their assignments a more comprehensive share of agency work. In addition to supervising the care of children in foster homes, they work with parents on plans for placement and they make studies of new homes. Also in the second-year student's case load of children there are new problems for him to meet. He will have the task of making initial placements of children coming into care or of preparing children in temporary placement for the move to new homes where they will stay and of participating in the procedure of this transfer. He will have situations to handle which will require conviction and sensitivity in his use of agency procedure if he is to make the process helpful to the client, whether he be child or adult. His field work activity will call for greater security in using agency function, as well as a clearer integration of his facilities for helping. Problems in working with the complexities of placement are more sharply defined by the added demands of his job, but here, as in first-year field work, his growth as a responsible worker gains impetus from the nature of the field itself. The set-up of agency, child, and foster home, complicated still further by consideration of what parents want for their children, presents new problems of conflicting identification for the student which have a vital bearing on his development. The work assigned in this second year of training makes it necessary for the student to resolve his difficulties of personal affiliation and responsibility so as to move along in his development of a professional self which expresses his own individuality. The part which supervision plays in field-work training grows out of its place in agency operation. To supervisors the agency has delegated the task of helping its workers to carry out its philosophy of service in their contacts with clients, measuring the usefulness of supervisory practice by the worker's growth
90
SKILL IN SOCIAL CASE WORK
in doing the job the agency requires. The fact that student supervision is part of a training program emphasizes the actual process by which a supervisor helps a worker gain strength and sureness in working. Once field-work assignments are made, her part in training is to help the student attain the fullest possible use of his capacity in the limited area of his field-work assignment. The beginning student needs from his supervisor direction which will define his responsibility in field work, and support in his efforts to adjust himself to its demands. He needs help in arriving at a conception of his part in the case-work process, a conception based on recognition of the particular problems which he faces in assuming professional responsibility. The second-year student, who is further along in development, makes even greater demands on supervision. He sees more clearly his responsibility in working, but he is still in the process of determining what he has to give to case work. He has engaged himself in organizing and disciplining a personal self in order to become a professional person, and he is set on accomplishing everything possible in this last year of training. The problems inherent in this stage of becoming a worker, coupled with the student's drive for attainment, exert a pressure on supervision that challenges its validity as a helping process. The supervisor in meeting this challenge is called on to' maintain her responsibility for extending help and at the same time to hold the student to the requirement of assuming his own part in learning and growth. Since the experience of supervision takes place in the agency setting and is itself a part of what is happening there, the supervisor does not shape the conditions under which the student works. If we waited for ideal working conditions in the agency, student training would never get started, for every agency has, at all times, essential problems of organization and administration which grow out of its own process of development. A part of the student's training in field-work practice consists in learning to use the reality of the situation he finds in the agency. But if he is to use it constructively he must have support from his supervisor which she can give only as she feels secure in relation to what is taking place within the agency. Here are
SUPERVISION OF FIELD WORK
91
problems for the supervisor to face in her position of helping the student to utilize the weakness as well as the strength of what the agency can offer. Because of the circumstances under which I began supervising second-year students, I got the full impact of the challenge which their training presents. Two second-year students were given field-work assignments in the agency at a time when it was undergoing a period of reorganization necessitating changes in the set-up of departments and corresponding changes in policies and procedures. The students were assigned a group of children in long-time care which became the nucleus of a new department. I thought the state of affairs in the agency might make it hard for them to take hold of their field-work job. Contrary to my expectation, they seized on it with an eagerness that took my breath away. They wanted to be a part of what was happening in the agency and, since change was the outstanding feature in current agency experience, they became the zealous proponents of change. They raised questions about the basis of every procedure, and were bent on making sweeping changes in the handling of all their cases. Their enthusiasm knew no bounds, but their supervisor had to set some if the work of the agency was to continue on an even keel and if the students were not to be carried beyond their depth in what they tried to do. In this situation the students' demands on supervision were heightened because of the problems they faced, and, as a result, the issues involved for the supervisor stood out more sharply. It was clearly the responsibility of the supervisor to retain a sound working relationship already established with clients, even while carrying out necessary changes of agency policy. In organizing a new department there was also the responsibility for keeping it an integral part of the agency, well related to other departments so that they worked together in agency service. Finally, in the supervision of students, there was the responsibility for helping them get, from this hectic year of change, experience which would develop increasing capacity as workers. In casting up the assets and liabilities of this year's experience
92
SKILL IN SOCIAL CASE WORK
for them, I was painfully aware that they lacked the wellorganized setting in which to work, which acts as a control in defining the area of activity for student workers. I realized too that such rapid changes in procedures left the students without the support of an established way of operating which they could use as a basis for developing individual skill. The resulting spread of effort on the students' part impressed on me, as nothing else could have done, that students need stability from the agency where they do their field work. On the other hand, it could not be denied that what the students gained in development from this year's experience, as attested by the evaluation of the School as well as the agency, grew out of what was happening in the agency. They were very much aware of the shaping of new policies. The very fact that new procedures were emerging made them conscious of the basis on which they were formed, and they saw the case-work practices evolving as a clear expression of agency function. Putting these new practices into operation also served to point up the students' individual problems in working. In using procedures with which they were so thoroughly identified, it was a shock to discover that they still had difficulty in being helpful to clients. The conviction of their responsibility for what they were doing opened the way for discussion of the problems indicated by their recorded interviews and of the necessity for changes in their approach to clients. The result was movement on the students' part in recognizing the individual basis of their difficulties, and in developing in each his own way of using agency plans of procedure so as to be more genuinely helpful. In this experience I was struck with one quality which was characteristic of both these second-year students, although expressed very differently by the two people. Since then I have found the same quality apparent in the work of all second-year students with whom I have come in contact so that it has come to represent for me what students get from their first year of training. This is the student's ability to become identified with the agency's job and to make its requirement for service his own necessity for development. Such a relationship to his agency assignment distinguishes the way second-year students are able
SUPERVISION OF FIELD WORK
93
to take hold of field work as different from what can be expected of students in their first year of training. With a first-year student the problem in working centers is the question of whether he really wants to be a professional person. In beginning field work he finds what is required of him and throughout this first year struggles to determine whether he can and will give himself to the exacting process of becoming a case worker. The judgment whether he actually meets requirements rests with the School and his field-work supervisor, but the question whether he will do it the student alone can answer. With second-year students I find the decision has been made. They have chosen to engage themselves in this experience, fully aware of what is involved. Each student comes to his second year of training realizing his need for further development and eager for practice which will help him attain it. This will-to-beengaged in the training process, an achievement in itself, stands out as an indication of the student's readiness to use his whole self in becoming a worker. He can enter into his second year of field work and be a real part of it because it represents something he wants in terms of his own development. The second-year student's readiness to take hold of his fieldwork job and to experience all that it promises makes his supervision at the same time a gratification and a problem. It is gratifying to supervise a worker so set on progress, but his pressure on the supervisor for all the help she can give him, as speedily as possible, demands searching analysis of her part in this supervisory relationship. In work with students the supervisor's position derives its meaning from her affiliation with the school where the student receives his theoretical training as well as with the agency where he does his field work. The supervisor is related to the School through the student's adviser with whom she considers his field-work performance as a part of his training experience. The adviser's knowledge of movement and change, or the lack of it, in the student's work at the School helps to clarify for the supervisor the significance of what the student is doing in the field and enables her to see how his progress there fits into the picture of his whole development. From such consultations with the adviser the supervisor gains a per-
94
SKILL IN SOCIAL CASE WORK
spective on the student's problems and needs which gives direction to her efforts in helping him. As an agent of the School she draws support from its responsibility for training since the standards of professional growth which it maintains define her own responsibility in relation to the student. As a supervisor in the agency, she finds another source of strength in the integration of her function with the work of the organization as a whole. Help for the student is to be found, not in the relationship with the supervisor alone but in supervision as an instrument of the agency. Its process is concerned with his agency experience, and the supervisor's job is to help him use this experience to develop skill in working. What the agency offers for the student's use in learning to do case work is the structure which it has built up to carry out its particular function. An important part of its system of operation is its physical facilities such as the departmental organization of the agency, clinics, and other allied services, its equipment and routine for getting work done. All these aspects of agency set-up the student must adapt himself to, and the way he uses them are a legitimate concern of supervision. Much of his problem in working centers around these features of agency operation, and supervision must meet his need for help in their use. However, the phase of agency operation which is of vital concern, as content of supervision, is its case-work procedure. Here the administrative standards of what constitutes helpful service are expressed in a body of practice designed to carry out agency responsibility. This fundamental concern for helping maps a course of procedure for workers in their relationship with clients, and also acts as a guide for sensitivity of operation to preserve and fulfill its purpose. In helping students to use such a plan of work, the supervisor is supported by the definite form and intention of the plan itself. Its clarity is particularly valuable in defining what she can offer second-year students whose eagerness to explore a new field needs direction and focus. The agency's procedure enables the supervisor to set limits for the student's activity, and its standards of practice aid her in determining what is expected of him in performance. The supervisor's helpfulness in applying
SUPERVISION OF FIELD WORK
95
these agency requirements depends on her identification with them, but this quality alone is not enough to make her service helpful to the student. Her very identification with the agency may overwhelm him since he cannot share in this feeling. He must find his own meaning in the agency set-up, and in the experience of working there. The supervisor's recognition of this necessity affords him a place of his own in their relationship, as they consider together the student's work in the agency. Here the supervisor is faced with the problems which the second-year student finds in meeting the requirements of his field-work job. In his performance she sees every form of agency structure in the light of its meaning to a young worker struggling to find his place in the case-work process. She sees procedure, designed to fulfill the responsibility for helpful service, of uncertain value to a worker not entirely sure of his own ground in helping another person. The student's problems in using these agency resources reflect his problems in using himself, and manifest his need of help in this sphere. Here neither the agency nor the supervisor can provide a system to be carried out, for skill in working must bear the stamp of the individual. But supervision has a responsibility for helping the student realize his own potentialities as a worker since this is the goal of training. As supervisor and student work together in the agency setting, the student's development emerges not as a result of the supervisor's activity, but as the outcome of a process in which each has a part. The supervisor's job is to vitalize agency structure for the student by using it to guide and measure his work. The student's task is to build on this agency framework a way of working that is a valid expression of himself. Such a process is characterized by the pain and struggle that invariably accompany any growth experience. In beginning second-year field work the student must adjust to his new assignment, usually to a new agency and to a new supervisor. There are bound to be negative elements in his response to so much change, and the supervisor's recognition of the value and meaning in such expression plays a part in helping the student to feel secure enough in these negative reactions to deal with them. If she can accept the student's re-
96
SKILL IN SOCIAL CASE WORK
sistance to the newness in field-work setting and content as well as his problems in a new supervisory relationship, then she can help him face this initial difficulty and get past it to the point where he can utilize his own difference as a strength in working. She cannot accept, in a second-year student, continued resistance which becomes a defense against participating in agency operation, but must hold him to the discipline of making an adjustment which enables him to work responsibly. As the student gets deeper into field-work activity and feels the need for change in himself in order to do his job, there is an inevitable drawing back from experience which involves the self so completely. Each step he takes in moving forward professionally arouses feeling against the development required, in spite of the desire for it. The supervisor cannot soften the process without destroying its value but, by responsible fulfillment of her function as a representative of the School and of the agency, she can clarify the student's part in the process and support him in carrying it out. Since the student's progress is so dependent on this supervisory experience, it is important to consider what actually happens in its course. In assuming her own responsibility for presenting work to be done, the supervisor will not attempt to tell the student how to do his job, but will make him responsible for developing his own way of meeting its demands. The student, in his zeal to learn, may want much more direction than she can give, but if she does yield to his insistence and give definite advice about his approach, she will discover that her way of working does not have value for another person. Or she will discover that it means too much, and that the student continues to depend on her. She will not expect that her own appraisal of agency methods will determine their meaning for the student. She is there to uphold them, but the student's reactions to them are his own and have value for that reason. The student, as he meets the reality of agency requirements, will feel the limitation which they impose, but also the freedom his supervisor gives for individuality in their use. His work will be judged by the standard of what the agency expects, but also with respect for the quality of his effort. Whatever the student's
SUPERVISION OF FIELD WORK
97
feeling about agency operation, its regulations for working support and define his own job. If the supervisor can use them with conviction, but with regard for their meaning to the student, she can help him build, bit by bit, a sureness in working which is effective because it represents the unique character of what he, as a person, has to give. The supervisor, by requiring increasingly helpful service on the student's part, and by evaluating his performance on this basis, will provide the stimulus for movement by which the student himself achieves growth. In the evaluation of student work, supervision assumes the ultimate responsibility for its own function. 0 The task of appraising any worker's accomplishment calls for a strength on the part of the supervisor which involves taking stock of her own position. In the case of students, the supervisor is conscious that the measure of field-work progress must also be a gauge of what she has contributed to training. In such evaluation of her activity she does not take over responsibility for what the student is able to do, but sees even more clearly the student's part in training as distinguished from her own so that she is better able to judge how well he fulfills it. Evaluation of what the student is doing in the field is a continuous process, beginning when field work starts and having a place in every supervisory conference. The second-year student's absorption in working on a responsible level makes him more aware of what is happening in his case-work contacts so that he is able to evaluate his own work to some extent. However, the requirement of the school for written evaluations from the supervisor at the end of each term makes her responsible for estimating what the student has accomplished over a period of several months. Such a judgment of performance takes into account the whole of the student's adjustment to his field work job. Ability to meet the practical demands of the job, ease in organizing work and carrying out plans, the adequacy and promptness of dictation, and use of conference time,® * all indicate the responsibility of the student's β See Virginia P. Robinson, Supervision in Social Case Work, Chapter VI, "Evaluation." 0 0 Supervisors of students at the Pennsylvania School of Social Workers will recognize these items from the School's outline for field-work evaluations.
98
SKILL IN SOCIAL CASE WORK
performance. The student's case work is evaluated on the basis of the actual service given, the supervisor's conclusions being drawn from his case records and from discussion of his work in their conferences together. In evaluating the work of second-year students the supervisor pays particular attention to the development of individual skill which is evidenced in his performance, noting both the positive and negative qualities which mark the work of each student and the progress made toward incorporating these attributes into a form of professional expression that is responsible and helpful. The student knows in advance that this evaluation is to be made, and conference time is set aside for considering it with him. This gives opportunity for his own estimation of what he has gained and for his reaction to the supervisor's judgment. This is not a discussion of the student's development as an end in itself but is concerned with his acquirement of the means to function adequately in the field. Problems in working show up more clearly in this long view of student activity; they have a place in the supervisor's evaluation and in her discussion of it with the student. If they can be pointed out in relation to lack of movement in particular situations, then the criticism becomes a true expression of the supervisor's responsibility which does not impinge on the student's necessity to determine what changes he can effect in his working methods. The value in the supervisor's judgment of field work depends on her ability to perceive clearly what it shows of progress and of lag in the student's growth. But the meaning of this evaluation to the student depends on the supervisor's skill in placing squarely on him the responsibility for organizing himself to use it. In the School's requirement for evaluation of field work which involves measurement of the student's professional development by his agency practice, supervisor, student, agency, and school come together in a way which emphasizes and clarifies the relationship of each to the other and their interdependence in the training program. This whole experience of conducting field-work training contains positive values for both supervisor and agency, as well as for the student. The supervisor who represents the agency in
SUPERVISION OF FIELD WORK
99
carrying out the program gains a new conception of her responsibility, while the challenge of the student's response tests her ability to fulfill it. She acquires added conviction as to what she can offer workers and what they are able to take from her. In considering the question of what agency facilities, including supervision, can contribute to further the student's use of the program it has formulated, there is also entailed searching review of other phases of agency operation. In meeting this obligation, the agency discovers new strengths and weaknesses in its own resources. The student's testing of what the agency presents provides an incentive for evaluation and movement, bringing new life and meaning to established structure and ensuring a dynamic process for the agency itself.
THE RELATION OF FUNCTION TO PROCESS IN SOCIAL CASE WORK* Jessie Taft IN THE nine articles which compose the first number of this Journal with all their variety of agency background, professional experience, and personal viewpoint, one common factor stands clear, and that is a degree of accepted understanding and use of "helping" as a technical process basic to the exercise of every social work function. The taking and giving of help are seen as two opposite but complementary currents in a single complex process on which social work must base whatever it hopes to achieve in the way of effective understanding of the client and conscious control over its own procedures. There is a universal tendency in all human development to progress by extreme swings from object to subject, from the external, the physical and the social, to the internal, the psychological and the individualistic. This is evidenced in religion, in ethics, in art, in philosophy, and in social theory as well as in psychology and all our ways of working. At one moment we place all truth in the outside world where we try to analyze the object as a separate entity; again we turn upon the self, the doer, and study him in all his subjectivity. Either concentration destroys or ignores the reality that lies only in the living relationship between the two. Social case work has naturally not escaped this inevitable swing from outer to inner and back again. One trend follows the client as an external social problem, approaching him at * This article, which introduced the first number of the Journal of Social Work Process, published in November 1937 and now out of print, is reprinted here as it first appeared, with the addition of an occasional footnote or the insertion of an explanatory word or phrase to clarify points that have been misunderstood as evidenced by reviews and comments. References to the first Journal could not be eliminated without rewriting as they carried points essential to the argument. 100
RELATION OF FUNCTION TO PROCESS
101
first punitively, then benevolently but reformingly, and finally reaches the level of social planning and mental hygiene. The other trend is seen in the history of boards and social agencies from individual indulgence in charity to responsible private organization for helping on a more or less professional level, and finally to helping as a legitimate function of government; from the lady bountiful through the pioneer reformer, to the sociological social worker and finally to the psychoanalytic, psychiatric, highly trained professional of today who finds his own psychology even more important than the client's. At the moment, this dichotomy is evidenced in social work in several directions and is in a state of transition from one emphasis to the other. The intensely psychiatric, psychological, subjective phase of interest in both client and worker seems to be passing, along with the shift from intensive, indeterminate case work by the private agency to the highly functionalized administration of public money by governmental relief and assistance boards. Even within the area of so-called intensive case work, interest is being diverted from hereditary factors and individual social histories confined largely to family relationships, to the larger area of economic and cultural influences. The case worker is still subject to her personality handicap or her emotional problems, and may resort to psychoanalysis as a last step in professional training, but she is also being held to a more objective requirement in knowledge of economic and social conditions as well as psychological understanding of her client. Yet neither of these shifts from inner to outer, from the more subjective and personal to the more objective and social, holds the solution for a social work that intends to arrive at a technical grasp of its own practice. It is necessary to know and appreciate the economic, the cultural, the immediate social setting of those who constitute our clientele, it is essential to understand and accept tolerantly, but without evasion, the human psychology that is common to worker and client in our culture, but this is only the beginning. There is one area and only one, in which outer and inner, worker and client, agency and social need can come together effectively, only one area that offers
102
SKILL IN SOCIAL CASE WORK
to social workers the possibility of development into a profession, and that is the area of the helping process itself. Social case work has fallen into the no-man's land that lies between the scientific and the professional, between knowledge and skill. It has not succeeded as yet in developing enough of either to command the complete respect of other groups or to establish its own self-confidence. That social work cannot become a science is taken for granted by virtue of its practical basis. To establish truth, or to engage in scientifically valid research can never be its aim, since always whatever it does is vitiated for science by its avowed purpose, which is to help. Where helping human beings comes first, interest in furthering scientific observation must be sacrificed, for the one destroys the other. No man can serve two masters at the same time. This is as true for social work as it is for therapy. Even in the medical field, where research and practice are always encroaching upon each other, we know only too well that the good research worker does not make the physician. Does it follow, then, that social work must remain blind, haphazard, well-intentioned, and fumbling? Is there no professional skill possible, no assured knowledge of what one does or how to do it? I think, on the whole, it has been like that. I think the bewilderment of the student in his first year of approach to the practice of social work as he finds it, is an index, not only to the inherent difficulty of disciplining the self in terms of a professional standard, but to the actual confusion as to what case work really is, in the minds of his teachers and supervisors. Too often we have to admit we know not what we do. Is this confusion, this uncertainty, this lack of conscious skill, necessary because of the nature of the medium in which we work, or is it that we are not yet ready to grasp the solution, to face the implications of the way out of chaos? This seems to me to be the crucial problem of social work today: Do we know or can we know what we do and how and why we do it? To solve this problem will not make social work scientific, but it will put it on the level of a profession that can be taught, learned, and practised by those possessing the ability and the will to undergo its discipline.
RELATION OF FUNCTION TO PROCESS
103
I believe that there is a way out of our dilemma and that the papers in this beginning number of the Journal of Social Work Process have found the clue and have begun to move in a fruitful direction. They are all characterized by two attitudes, an ignoring of the static, the analytic, and a concentration on the dynamic, on the immediate interaction between the two participants in the activity of asking and offering help. This shift from the tendency to an ever deeper and more futile analysis of either side, subject or object, client or worker, to an attempt to grasp the nature of the process itself in all its relativity and immediacy, is as important for the advancement of our understanding of human psychology as it is for social work. It parallels in importance the transformation that physics experienced when it turned from a static analysis of substance to bodies in motion, and from the understanding of matter in general to the discovery of the laws of particular moving bodies in their relativity. What is now important to the investigation of dynamics is not to abstract from the situation, but to hunt out those situations in which the determinative factors of the total dynamic structure are most clearly, distinctly and purely to be discerned. Instead of a reference to the abstract average of as many historically given cases as possible, there is a reference to the full concreteness of the particular situations.·
Academic psychology is too removed from human need to feel the immediate responsibility of social work or to be subject in the same degree to the human resistance and refusal that determine the truth or falsity of the social worker's psychology so promptly and so pragmatically. Even the medical profession, with all its responsibility for human life, is protected in part from the consequences of its psychological as well as its medical failures, by recognized professional authority and legal sanction. Social work, on the other hand, with no authority and less sanction, must work in the full light of its own ignorance, continually exposed, as it is, by the practical results or • Quotation from Kurt Lewin, A Dynamic Theory of Personality, page 31, Chapter I, "The Conflict Between Aristotelian and Galileian Modes of Thought in Contemporary Psychology," McGraw-Hill Book Company, 1935.
104
SKILL IN SOCIAL CASE WORK
lack of them. That it has succeeded in getting by thus far, despite its slow blundering advance, is due not only to the fact that there was no better way of meeting the human needs it serves, but also to the fortunate circumstance that it has not been a money-making, but a money-spending enterprise, and that it has served chiefly the poor and ignorant who had often neither the wisdom nor the power to reject a service they could not pay for. But now that the state has gone into an area that social work claims as its own, now that vast administrative and economic problems are involved and huge expenditures of public money at stake, social work will have to meet competition from other groups who want to fill the big jobs, to handle the large sums, and even to grapple with the interesting complexities of the situations now facing us. Unless social work knows something about dealing with people that no other professional group has discovered, unless social work can really bring to bear a skill that outweighs its lack of administrative and business experience, it will not survive the tremendous demands and the public scrutiny involved in meeting the largescale social need of today. There is no escape, therefore, from facing the necessity to establish ourselves firmly, not merely on the basis of social need, but on a foundation of professional skill. In my opinion, we already have that basis if only we can relinquish a little of our too great sense of responsibility for the client and his need* in order to concentrate on a defining of what we can do and a refining of our knowledge and skill in relation to the carrying out of each specific and accepted function. This may seem to be nothing more than an argument on the practical question of single versus multiple function which has arisen as an immediate and momentary issue owing to the introduction of public relief and assistance, and the consequent struggle of private agencies whose functions have been undermined, to find a legitimate raison detre. In my opinion, the β This has been interpreted to mean that social need is not recognized by this writer as the focus of social work. From the viewpoint of general purpose and function, social agencies exist only because of social needs. But this does not alter the fact that the relation of worker to individual client rests professionally in case-work skill and agency function, not on client need, which is personal and free to change or develop in the individual's own terms.
RELATION OF FUNCTION TO PROCESS
105
present situation has merely pointed up a difference in approach and psychological understanding that is absolutely vital and determinative of professional development. Nor is this question confined to social work. It is fundamental to all human advancement, scientific as well as practical. In the most general terms, the problem reduces itself to this: on what aspects of living can man work fruitfully with his will and his intellect, and in what respect and in what areas must he accept limitation, the limitation of his own partiality and finitude? Something must be admitted as given, something with which he starts and on the basis of which he is free to construct and create to the limits of his human capacity. But always, what he does consciously and intentionally with his mind and his will has to do with meeting a problem set by nature, the given element in the life equation; set, it is true, because man himself puts out a need and must discover some way to make nature supply it. The human mind, as all psychology agrees, develops only in conflict, in necessity to defend the organism or to fend for it, to find an answer to need— outside or in. The human will likewise gets its organization and increase of power through continuous meeting of internal and external obstacles. It, too, is dependent on struggle, is therefore primarily negative in origin.® But need itself, the impulsive, involuntary energies that keep man breathing and eating, mating and reproducing, struggling to satisfy and maintain himself alive, are not within the area on which man is fitted to work consciously or to exercise a too complete and willful control. They are the given internally, the basic limiting forces within which, if he can submit to them, he yet has freedom to create, to organize, to develop, to refine and to expand—indefinitely. Needs and impulses are part, then, of the positive, creative forces found in the universe of our experience, and are the energies through which we are enabled to work, to think, to fight, to control, but they themselves are not subject to complete • For the development of this conception of will, see Otto Rank, Truth and Reality, Chapter IV. Alfred A. Knopf, 1937.
106
SKILL IN SOCIAL CASE WORK
human determination in the self or in the other, any more than are the basic physical forces of the universe. Inside and out, man may pit his strength only against or with them; he cannot use his will or intellect alone without them for positive creation. Without the element of voluntary submission, of yielding truly to the given, in himself as in nature and other men, he becomes sterile, no matter what his effort or his intent. To take upon oneself responsibility for complete determination of any life force in its expression, is to court failure or self-destruction. This may seem a far cry from the practical problems of the social worker, yet its truth if understood with conviction would transform much of our present practice, as science was transformed when it learned to put its effort on understanding the law of the process in a particular situation, not on objects as separate entities. The approach to social work via the needs of the individual applicant taken psychologically or subjectively is an approach that leads to inevitable failure and confusion, since it focuses attention and effort on something that can never be known exactly or worked on directly. Even the client, himself, can only discover what his need really is by finding out what he does in the helping situation. If, however, we limit our study of needs to the generally recognized categories as they emerge out of the larger social problems, and leave to the individual the freedom, as well as the responsibility, of testing out his peculiar needs against the relatively stable function of a particular agency, there remains to us a large and comparatively unexplored area for future development, an area in which to learn how to maintain our functions intelligently and skilfully and above all helpfully, and how to isolate whatever can be isolated from the particular situation, in terms of the law, the nature or the general pattern of the helping process. This knowledge, however, can never be applied to the control of the client, either of his needs or of his behavior, for they are always changing, but only to ourselves in the helping situation, to refine and reform our professional selves as well as increase our professional skill. In science the hypothesis, the problem, the experiment, the
RELATION OF FUNCTION TO PROCESS
107
controlled situation, are only various forms of putting up a manmade limitation to nature, to see what will happen and what characterizes the process. In social work, the limitation with which we operate is necessarily the function with its expression in agency policy, structure, and procedures. Certainly function is never completely static or inflexible, certainly it alters over a period of time in terms of changing social conditions or should alter, but relatively it is the known factor, the comparatively stable, fixed point about which client and worker may move without becoming lost in the movement. Every helping situation is an experiment for the worker and for the client. The worker sets up the conditions as found in his agency function and procedure; the client representing the unknown natural forces, reacts to the limitation as well as to the possible fulfillment inherent in the function, over a period of testing it out. He tries to accept, to reject, to attempt to control, or to modify that function until he finally comes to terms with it enough to define or discover what he wants, if anything, from this situation. The social worker, like the scientist, must be able to accept the results of the experiment, whether or not they go against his natural human desire to help or refuse to help. He must respect the process and the limitations inherent in work with other people whose needs and impulses are as "given" and as "unpredictable" as his own. He, too, must stick to the supporting function and the area in which he has a right to act, as a professional person, at the same time, meeting with respect and insight the client's feelings as well as his efforts to wrest from the agency what he needs on his own terms. For both worker and client, the function is a protecting as well as a limiting influence. By it each is defended against the tendency to encroach upon, or try to influence, ignore, or control the other. Through it, each is strengthened as well as curtailed. Without it, there is no fixed point, no focus, no spot from which to measure or to understand, however relatively, the very process on which social work is based. Why do we find this road so hard to follow, so difficult to
108
SKILL IN SOCIAL CASE WORK
admit as the only one? It seems to me the answer lies in a common human weakness and natural resistance, not only to any limitation but to admitting the inevitable negative at the basis of all man-made progress. We like to think of social work as a purely positive, benevolent, constructive influence in the community. As human beings, full of kindness and the positive impulse to help, we approach the client on the basis of identification with his need. We should like to make our function over to fit it if necessary. We are there to give, not to refuse; to fulfill, not to thwart. The client, then, is left with all the negative elements on his side—and negative elements there must be in any reality situation. He is forced to ungrateful, ungracious doubt, to refusal, to hesitation, to escape or evasion, or to a disguised struggle with the very help he sought. There can be no professional development out of such a purely natural human contact. For the professional situation, there must be one side at least able to meet the forces in a helping equation objectively and without the necessity to give or to refuse; one person who understands that the negative aspect of function is necessary and releases the client to the possibility of something positive and constructive; one person who can define himself in terms of what he is there to do and leave the other free not to know but to discover whether this is an answer to his need. Such a conception of helping, with the acceptance of the negative elements involved and the knowledge and skill to utilize them, makes of social work a potential profession. It is possible to know a function, to work on a function, to alter a function; it is also possible to learn to understand the helping process and to control helping situations in terms of function, and to train and develop the professional worker on the basis of accepted function. On the other hand, it is not possible, now or ever, to know a client as he is in himself—nor, for that matter, a worker either—except as part of a process in which, with one relatively fixed or known quantity, the other may be defined in terms of what it does; for "the ego itself is fundamentally temporal, it is not a time-independent state. It is always going somewhere and the stability of the ego
RELATION OF FUNCTION TO PROCESS
109
must, therefore, always be seen in relation to the direction in which it is moving."" The ego of the worker is stabilized into a professional self through identification with a function which is "given," "known," so that we do know of the professional person on his job what we cannot presume to know of him personally, the general direction in which he is going. The client, however, is first, last, and always a private person, unless he has become a professional asker for help, with a knowledge and skill of his own. The direction in which his ego is moving we can know only relatively and momentarily, in terms of his impact with the worker's direction, embodied in the function he represents. Unless we have the conviction and the strength to endure that impact and leam to utilize its negative, fearful, unpleasant elements, we admit at the outset that no professional action is possible. The help that occurs, if any, must be left entirely, instead of partially, to chance, or at least to the area of the unknown and the unpredictable. To wish to set up a function individually to suit each particular need is to throw the helping process into an activity in which nothing can be used as a point of reference, into a complete relativity. The application of function is open to all degrees of skill and creativity in terms of a particular situation, but unless one expects the client's need to remain fixed and stable, the only access to the helping process as a profession is through the utilization of a relatively fixed function with all its personal and professional limitation of the individual worker. It seems to me that case work has been thrown into confusion by its inability to find its place between pure therapy and public relief. The worker in the private agency has tended to identify himself with the therapist in a freedom to respond to individual need on an individual basis, in contradistinction to the public relief worker who responds to a category of need with a categorically rigid function. The worker in the field of relief, on the other hand, is struggling with the dilemma of • Quotation taken from Kurt Koffka, Principles of Gestalt Psychology, page 332. For the further development of this conception of ego organization, see the remainder of Chapter VIII.
110
SKILL IN SOCIAL CASE WORK
whether he should insist that relief is case work or whether he should repudiate case-work affiliation and perhaps put the carrying out of the relief function on a business basis. In teaching case-work classes, I have found that the student in the public agency, despite his desire to learn how to do case work, uses his function and the mass quality of his job to defend himself against what seems like an impossible responsibility for seeing the individual, in the exercise of a function involving so many people in a working day. To him, talk about a helping process going on in all the rush and turmoil of a relief application desk, seems mystical, theoretical, or, at least, out of his reach. Such fine points are for private agencies and child guidance workers who have time. According to his nature, he wavers between scom of such petty fiddling while Rome bums, and despair of his own impotence to do likewise, or perhaps a grim determination to find out sometime, somewhere, just what this case-work helping really is. I believe that the problem evidenced in student reactions is real, is serious, and demands of us who pretend to know what case work is, the clearest and most courageous thinking of which we are capable. Case work is not a magic. It is a process that can and does go on under conditions that remain human, but it cannot operate when the mass to be handled gets beyond a certain point. The worker who really understands this process of helping and who has back of him a clear-cut sustaining function can exercise it for a surprising number of clients in a day, but there is a limit. He too is human, and there is no machine to go on making the product accurately, when he gets too weary to see one more person or to care whether the client or himself lives or dies. The law of diminishing returns begins to be felt very promptly in all professions that depend on the quality and strength of the helping person to sustain himself as helper in feeling and interest as well as in determination or compulsion. The psychologist who has to turn out a dozen or more routine psychometric examinations a day will soon be little better than a machine. After he has responded with keen insight and warmth to five or six children, the others begin to matter less and less. This is inevitable—the psychologist's only recourse
RELATION OF FUNCTION TO PROCESS
111
is to rebel, to refuse to become an automaton, and this refusal cannot be merely to save himself, but to save himself for his client, as a real psychologist. The same is true for the psychotherapist. He can help only as many patients as leave him enough time to remain a human being, with interest, kindness, and strength, enough and to spare for the other's use. Therefore the student who trains in relief, unless he has a highly protected load, is right when he presents the problem of his own exhausted self. It may be that the relief field, except when specially set up for training, does not permit the worker to experience the reality of the helping process unless he has already learned to be a professional case worker elsewhere. But the more serious problem remains whether mass relief can be handled individually or on a case-work basis even by a trained case worker who accepts the philosophy of helping here presented and is skilful in practice. This, I think, is a real question, to be determined only by experiment—but there is no doubt in my mind that public relief on a large scale represents the extreme limit of the function that can be exercised by social case work on a helping level. Therapy as usually practised and in popular belief represents the opposite extreme from public relief with relation to case work, and is often reacted to by case workers with a similar scorn, repudiation, envy, or identification. There are case workers who feel themselves to be primarily therapists, just as there are those who feel inferior because they cannot lay claim to therapy, or those who would scom to relate themselves to it. It is at this point that the basis of differentiation changes from a difference in pressure of numbers to a difference in the desirability or inherent worth of the function itself. The therapist's function is assumed to require better training, greater skill, more responsibility than the case worker's, and is so far removed from public relief as almost to defy comparison. It is undoubtedly true that therapy, at its best, is more highly professionalized than case work. It does demand a longer training and preparation and a greater discipline. The therapist is required to take an individual responsibility for what he does that the case worker never knows and cannot know without
112
SKILL IN SOCIAL CASE WORK
ceasing to be a case worker. There are therapists, it is true, who rest upon institutional protection or belong to a sustaining group as a case worker rests upon his agency, but in the last analysis a therapist cannot be protected from his patient and his own individual responsibility for what he does in the relationship. The case worker's responsibility, on the other hand, real as it is, must first of all be to the agency and its function; only as agency does he meet his client professionally. However, for the case worker, the real differentiation between therapy, social case work, and public relief at the opposite extreme seems to me to lie not primarily in numbers or training or responsibility, but in what is conceived to be a more satisfying function as regards the relation to the client. The therapeutic situation is regarded as one in which the patient is given whatever he needs, without stint or refusal. It is a function the therapist can afford to identify with since, in such a view, it separates him hardly at all, or at least not for long, from an equally satisfactory identification with the needs of the patient. In other words, it seems to be largely a harmonious unity of purpose, the therapist's to give, the patient's to want and to take exactly what is to be obtained. Of course a little scrutiny would soon arouse the social conscience of any intelligent relief worker who would see this as an overweighting of the individual's rights and privileges at the expense of the common good and social adjustment. But the aspect which social case work needs to realize is quite other than this superficial criticism. It is the fact that actually therapy, from one viewpoint, might be thought of as the most niggardly and depriving of all the helping functions, since—no matter what happens—the wise therapist refuses to give tangible aid, even to the point of refraining from practical advice or helping in any way with the reality problems of the patient. The patient asks and thinks he wants every kind of reality response. He is kindly but firmly and consistently refused. The function of the therapist, then, requires him to maintain himself as a truly separate person who takes no material responsibility for the other and accepts no unfair treatment of himself, despite his understanding and tolerance of the consequent reactions.
RELATION OF FUNCTION TO PROCESS
113
The only thing a therapist gives to the patient is a deeper experience of self. He does this by refusing to inject his own personal interests, by constantly seeing, responding to, and accepting the self of the patient in so far as the latter learns to admit it and carry it responsibly; but at the same time—and this is the negative side of therapy—he continually resists and thwarts the patient's attempts to put the fearful or unwanted impulses upon him, in the form of blame, suspicion, hostility, or even of love and dependence. Despite—or shall we say because of—the hard-hearted aspects of such a helping relationship, there is no situation that requires greater discipline of the professional person and none that seems to the patient to give so completely, to the point that he knows he cannot pay for what he gets but must accept the fact that he has taken help. To the lay person, who thinks of giving in positive terms, the therapist would seem to be an inhuman monster since he has utilized to the full the negative aspects of helping to develop professional skill. Even to the untrained relief worker one would have difficulty in explaining why and how such a limiting experience could be therapeutic; it would seem to him almost as depriving as his own function. There is only one answer to this apparent paradox, and that is that the limitations of therapy if skilfully maintained are ultimately discovered by the patient to be human limitations, inherent in his very nature. Although he forces the therapist to uphold them while he rebels and accuses or tries to escape, ultimately it may be possible for him to experience them as belonging to his own make-up, although usually obscured and softened by their projection upon other persons and things. The therapist does not interfere with his patient in reality, either to give or to deprive; that is, the purely therapeutic relationship contains a minimum of outside reality; it is confined as much as possible to one person, the patient. The problem for the patient lies partly in this very fact. He gets too much of himself for once, and has to find himself again in real life, in relation to other people whose rights are as his own and who do not live for him, even for an hour a day. The difficulty with relief, on the other hand, aside from the
114
SKILL IN SOCIAL CASE WORK
administrative problems of any large-scale operation, lies in the inherent resistance to its function on the part of both worker and client. The power to give, to refuse, to limit the actual means of subsistence for other adult human beings who have been deprived through no fault of their own of the opportunity to maintain themselves, is a function that cannot be accepted as right or good by any thoughtful person. At best it can only be tolerated as necessary. For a young worker'to learn to bear professionally the punishment he must take in sustaining such a function, is no simple achievement. First of all he has to accept it for himself as, under the present conditions, the best the country can do. He does not have to approve it or want it to continue. But if he cannot decide to represent it as his agency function consistently and with self-respect, no matter what his sympathy with the client, he has no right to remain on the payroll. This is necessary not merely because it is fatal to do and keep on doing what one believes to be wrong, but also because the only chance a relief applicant has of getting something other than his check out of the experience lies in the relief worker's capacity to meet this impossible helping situation with the courage of his function and an understanding of the problem it creates for the recipient. As I have already pointed out, how possible it is for an untrained beginner to learn what helping means on such a function and with the added burden of great numbers is problematic. The disciplined worker can exercise even a relief function with understanding, but whether such a worker could or would continue to struggle with mounting numbers and a thankless function indefinitely is even more problematic. That there is a place for whatever social case work understands about how to help and what the need to take help does to people, in setting up policies and procedures all through the public relief and assistance programs, there is no doubt. It is evident that if the therapeutic situation is too unreal, public relief may be too real, too actually depriving and controlling for case work, as here defined, to operate to the best advantage. Social case work lies somewhere between these two extremes, always in the world of social and human reality,
RELATION OF FUNCTION TO PROCESS
115
and consequently always with the not-too-great limitation of some kind of defined, restraining function. To maintain its professional integrity it requires an area in which some choice remains to the client, in which refusal is possible without destroying the individual. The social case work agency meets real need, but the need it supplies is not absolute, is not the only one, and permits of more than one possibility of fulfillment. The relief applicant, theoretically, may choose to reject the allowance to which he is entitled if he cannot or will not accept the attendant conditions, but the case worker can hardly feel that a decision to starve, to beg, or to become a hobo in preference, is a valuable experience, although actually it may be so. Such life-and-death limitations, deprivation, and control, tend to go beyond the boundaries of the humanly acceptable situations on which all helping professions are primarily based. However, with all that can be said against relief as a case-work medium, tribute must be paid to the miracles of helping that can and do take place within these forbidding and inhuman limits when the case worker brings to his task a sincere belief that his function, however hard, is worthy of his support, and that the applicant has a right to the attitudes and emotions such a function necessarily arouses, and has the courage and kindness to see the process through on a professional level. The material in this volume is confined to those functions that not only permit but require professional skill and knowledge of the helping process for their effective exercise. They are characterized by moderate reality, if one may use the phrase. The function, however important, is permissive, not obligatory. The client may choose to meet its limitations or find another way out. Neither client nor worker is exposed to such a complete involvement and individual responsibility as in the therapeutic relationship. The worker's responsibility is mediated by the agency and what it can and cannot do. The client's risk is lessened by the fact that he is not putting out a life-and-death need but only a partial want, something he can work to obtain in more than one way, or even do without, if necessary. The importance of what can be done to utilize the dynamics of these partial and human helping situations when they are met on the
116
SKILL IN SOCIAL CASE WORK
level of professional understanding and skill is indicated in the papers that follow, but only indicated. As social case work learns to accept its own limited area of usefulness and concentrates on the process to which it has given its purpose and determination, its capacity for growth will widen and deepen to the extent of human ability to give and to take help constructively.
THE AGENCY'S ROLE IN SERVICE* Kenneth L. Μ. Pray is evident on all sides a steadily mounting concern among social workers—including many of those who have most earnestly advanced the cause of technical professional competency in the field of social case work itself—with the problems of agency structure and management. This growing awareness of the significance of the total agency as a factor in service is doubtless occasioned by the convergence of three dynamic forces affecting professional function and operation. The first is a movement within the ranks of social case workers themselves, in relation to their own technical practice. They are moving away from an overwhelming concern, that at times amounted almost to a total preoccupation, with the fascinating problems and possibilities in the use of a direct personal relationship between an individual case worker and another individual seeking help. This movement does not represent any loss of deep and abiding interest in the individual and in the mastery of the essential process of giving and taking individual help, nor is it due, certainly, to any belief that the potentialities of that relationship have been completely conquered and therefore no longer repay the most thoroughgoing study and disciplined practice. On the contrary, it is due to a new and far clearer awareness of the supreme significance of this personal relationship as the basic factor in the helping process, and a growing realization that this relationship itself is inherently bound up with and dependent upon factors of agency structure, function, and policy. THERE
These are coming to be seen as the indispensable supporting Based on a paper read before the Child Welfare League of America, Atlantic City, June 3, 1941, and reprinted by permission from a pamphlet entitled Problems of Agency Organization and Administration. Cnild Welfare League of America, September 1941. β
117
118
SKILL IN SOCIAL CASE WORK
framework, within which, and not otherwise, the individual worker can achieve and sustain a really sound professional relationship with the individual applicant or recipient of help, and through which, and not otherwise, the person seeking help can maintain that essential control over himself which makes any help genuinely acceptable and serviceable. The individual client-worker relationship, that is to say, is coming to be recognized and treated as a means rather than as an end in itself; it has found its rightful place in an agency setting, which is likewise recognized as an indispensable means to effective service. These two different kinds of means of service meet in that area which we have come to call "administration," where agency structure and policy share with technical operating method the vital interest and the definite responsibility of every professional worker. The second force steadily urging social workers to more specific and responsible concern for total agency structure and management presses upon them from just outside the boundaries of social case-work practice. The continual participation of lay citizens in the promotion and support of social work has been accompanied, especially under the economic pressures of recent years, by a steadily increasing anxiety on their part to measure more definitely the relative costs and the relative values of all the various social services they are asked to sustain. These citizens have exerted ever stronger influence upon us to scrutinize and standardize our performance from the standpoint of its business operations. These are matters that are far more familiar to the lay public than are the less tangible and less visible operations that comprise the technical professional functions of social case work. The degree of responsibility and discrimination which we exhibit in the use of agency funds, equipment, and personnel, through the creation and effective management of an agency structure calculated to exercise sound business controls, comes to be regarded as an evidence of our responsibility and efficiency in the area of other professional operations. Duplication of service, excessive overhead, red tape, overspecialization, undue possessiveness or competitiveness— all these are bugbears of which we are constantly reminded
AGENCY'S ROLE IN SERVICE by citizens who share our general purposes, but who are not so absorbed as professional workers are likely to be, with the details of the helping process. Painful as these urgent reminders have been at times, they have nevertheless been extremely salutary, in bringing social workers to a clear realization that administrative efficiency is a proper and necessary professional responsibility, and that it is a fully justifiable price to pay for the continued respect and confidence of a cooperating community. Finally, just as we face this problem of organization and administration with fresh anxiety and interest but without full understanding, as it presses upon us from both professional and lay influences in social work itself, we meet it in still more drastic form in the sudden emergence of government to a position of predominance in many areas of social work practice. Government is necessarily characterized in most of its operations by a concern for universal coverage and for the fairly uniform application of general objective rules, rather than by a consistent interest in the flexible and discriminating application of resources to the variable circumstances of individual situations. The far-flung operations of the public social services on the mammoth scale that has developed in recent years inevitably require structure and procedures of such magnitude and intricacy that these do tend to overshadow, at least in their formative stages, the more familiar issues of professional leadership and technical performance, both at the top, where total agency function and policy come to final formulation and expression, and at the bottom, so to speak, at that crucial point where individuals seek and obtain service. These problems, then, of agency organization and administration are no longer merely subsidiary factors in the context of our professional operations; they cannot be left any longer to the arbitrary or accidental decisions of others who happen to be interested in these problems and may be clothed with certain specific authority about them. They are practical and insistent challenges to all social workers; they are linked unavoidably with all others of their professional responsibilities, and they demand the application of truly professional know!-
120
SKILL IN SOCIAL CASE WORK
edge and discipline, for the principles and practices of administration converge directly upon those of competent professional performance in direct service. In the terms and outcomes of experiments in administrative organization and operation, every practising social worker has a stake. It makes a difference to every one of us what answers are given in our communities to such questions as these: What are the suitable and dependable tests of sound agency structure? Are they the same for all the different functional services? Are there reliable guiding principles by which the claims of specialization of function and of individual technical competency, at the point of contact between agency and client, can be reconciled with the claims of integration and sound business management in the over-all control of agency operations? How far can individualization and flexibility of service be added to, rather than supplanted by, wide coverage, simplicity of organization, and the maintenance of direct and stable lines of authority and accountability within the total agency? How does an acceptable solution of any or all of these problems relate to the past experience, the present status, and the prospective movement, in the thinking and feeling of the agency's sustaining constituency or of the total community of which it is a part? It is obviously impossible to attempt to answer, once and for all, even in the most tentative fashion, any of these or the flood of other intricate questions that at once appear in the complicated process of agency organization and administration, as these affect service operations. We can only try to underscore a few of the basic considerations that seem to have some weight in answering them all. First of all, we cannot afford to forget for one moment the fundamental fact that the sole object of social agency organization, the sole function of administration, the sole justification of all structure and policy, is to be found in the performance of a needed service to human beings, and that, furthermore, in the social case-work field, this service finds its mark ultimately, if at all, through a contact between two people —the helper and the recipient of help. In that basic relation-
AGENCY'S ROLE IN SERVICE
121
ship—in what happens at that spot where the recipient asks, takes, and uses help—are imbedded all the essential tests of administrative structure and operation, along with all the tests of professional technical competency of the individual worker. Whatever of organization and policy eventuates there in acceptable, usable service, is sound and efficient. Whatever of structure or policy, or the lack of it, obstructs or diminishes service at that crucial point, is inherently unsound, inefficient, and by the same token extravagant, whether measured by the tests of social service or by those of business management. No pattern of symmetry, simplicity, or coordination can save agency administration from that ultimate test of success or failure. For efficiency is demonstrated in the realization of purpose, not in any abstract tests unrelated to specified ends to be attained. But that sweeping principle is still not an adequate guide to action, though it may govern our approach to all other basic problems. For it leaves unsettled and undefined the acceptable criteria of service itself. There are three factors that converge at this testing point, and all three enter into the nature and quality of that service upon which depends the final evaluation of agency structure and policy. The first of these factors, and in many respects of course the most vital of all, is the want and the need of the person asking help. Next is the community's or the constituency's decision as to the kind and the extent of need which it will undertake to meet through this agency's service. Last, but not least, are the specific resources, personal and otherwise, which the individual worker must bring to the task of fulfilling the community's purpose in relation to the applicant's wants. It is the structure, policy, and management of the agency which brings these three forces into balance and integrates them in operation. Agency structure and policy, then, must be deliberately and thoughtfully addressed to the fullest possible recognition and fulfillment of all these basic factors in the performance of functional service. It must take into specific account the different roles of all three—client, community, and skilled professional worker—and it must encourage and facilitate the
122
SKILL IN SOCIAL CASE WORK
fullest possible discharge by all of them of their respective responsibilities. The client's responsibility extends beyond the mere presentation of a want or need, painful and burdensome as that decision and action in itself may be. If service is to eventuate in anything more than the mere exchange of words or of material things, without regard to its real meaning to the client as a person and as a participant in community life, if he is to be or is to become anything more than a submissive passenger in this journey toward a more desirable social situation, he must be helped to retain the largest possible measure of responsibility for defining and facing his own real needs which may be at the moment beyond his own present resources to meet, and, equally, he must be helped to remain responsible for mustering his own powers to carry and manage for himself the other problems that inevitably beset him. He must participate responsibly in assembling and verifying the facts that are decisive in determining the nature and extent of his need in relation to the help which the agency can give, and he must find in the situation he faces, in his search for help, not an invitation to throw himself and his whole life into the hands of too eager helpers, but rather the opportunity and the incentive to retain for himself the right and the duty to make reasonable and definable choices of his own. This right and this duty represent the maintenance of personal dignity and selfhood, as well as of independent citizenship. Unless the agency, in its own structure of policy and procedure, defines the kinds of service it offers and the prerequisite conditions of such service, which must be accepted or rejected by the applicant, it may undermine the very strengths which its help is theoretically designed to build and sustain. Here, it is clear, the administrative structure and process directly determine the service in operation, and the demands of the service must dictate, therefore, the forms of administration. The community's responsibility is equally vital. It must accept, planfully and consciously, the obligation to determine what standards of life it wishes to sustain; what needs of community members it will faithfully and continually meet; what
AGENCY'S ROLE IN SERVICE
123
use it will make of its own helping resources. We sometimes forget, I suspect, the community's right to make these decisions; we certainly often overlook its ultimate power and will to do so. Yet service, day by day, every day in every agency, faces the realities of these community decisions, sometimes expressed vaguely and by indirection, in the limitations of funds, whether voluntary or derived from taxation, sometimes expressed specifically and direcdy, in the shape of legal formulae or clearcut limitations of community cooperation. But in whatever form, and with whatever degree of precision, the agency in operation expresses at least its own conception of what the community— or that part of the community which sustains this agency—has agreed to do about certain needs of certain people. Agency structure and policy must obviously be such as will enable the community most effectively to register these decisions, not blindly, casually, or ignorantly, but thoughtfully, deliberately, in the light of accessible facts and of the agency's own continual experience. Not only does this mean that the agency's operations must be focused in definable areas of need, around problems that can be identified; it means also that the agency must have means of making clear to the community what it is doing about these problems and these needs, so that it is not operating behind a screen of words that mean one thing to its staff, another to its board, and still another, perhaps, to those who are providing the means for its operation. It is clear that coordinations and consolidations, or other administrative operations that obscure, rather than clarify, the actual differences of purpose and method and standards of performance of different agencies are not leaving to the community its real right of decision, but are effectually negating that right. Furthermore, they are discouraging, rather than promoting, the fulfillment of the community's basic obligation to know its own problems and to deal with them through the most effective possible instruments. Central to the whole problem of organization and administration must be the creation of instruments through which the agency is made continually and alertly aware of the community's basic attitudes and convic-
124
SKILL IN SOCIAL CASE WORK
tions about agency purposes, standards, and methods, and of the community's readiness or unreadiness to use and sustain, with increasing clarity and satisfaction, the services to which the agency is specifically dedicated. Agency organization and policy must be such, finally, as to encourage and facilitate the conscious use of the highest available knowledge and skill that is applicable to the service of the human needs that the community—that is, the agency constituency—has determined to fulfill through this agency. Structure or policy or modes of operation that shut off the use of specialized professional competency—either wholly, by substituting routine mechanical performance for the exercise of individual knowledge, skill, and discretion, or partially, by disregarding the values of specialized experience where real and valid differences in knowledge and skill are involved in different functional operations—again nullify the true purpose of the agency. From chief administrator down to student case worker, this awareness of the nature and scope of true professional responsibility, the values of professional disciplines, and the obligations these impose for the integral use of agency policy and personal competency, must dictate performance and must determine the relationship between lines of direct authority and accountability on the one hand, and the exercise of essential professional discretion on the other. This same basic problem underlies the structure and operation of staff and board relationships. Unless the professional ingredient in effective performance is distinguished, where it actually is distinctive, from the contribution of the socialminded lay citizen, responsibilities again are blurred, and the final eventuation of agency structure and policy in effective service is less positive and fruitful than it could be and should be. Policy formation cannot be wholly divorced from policy execution. The experience of the trained and disciplined worker, in the actual service of human beings, must find its way into the counsels of policy-making bodies and of administrative leadership. Without diminishing in the slightest degree the ultimate responsibility and obligation of the community,
AGENCY'S ROLE IN SERVICE
125
through representative boards and their chosen administrators, to determine structure and policy, this contribution of specialized professional knowledge and experience must be added to the pool of understanding out of which those decisions emanate. Agency organization and management that do not provide and consistently use mechanisms appropriate to the attainment of this end inevitably interfere with the effective discharge of the professional worker's essential share in the performance of agency function. In summary, we conclude that that structure and policy is sound—whether it combines in one agency or distributes among several the functional services dictated by different needs of people and by various community purposes—which leaves free and unconfused these three different lines and areas of responsibility—those of the client, the community, and the skilled professional worker. Administrative operations must embody, in spirit as well as in mechanisms, the positive appreciation of the essential part each of these factors plays in the provision of helpful, fruitful service, which can be attained only by the integrated fulfillment of all three. As professional people, having come finally to recognition of the role which administrative organization and policy play in the attainment of this goal, we cannot allow ourselves to be diverted from the first and paramount concern of every true profession—service. If our eyes are fixed upon that central goal, we shall find the way to meet and overcome the intricacies of administrative organization and management with the same sound and eager interest with which we have long faced the even more baffling secrets of individual human behavior. We shall learn to integrate in agency structure the professional qualities demanded in direct personal service with those required for effective leadership, efficient management, and helpful group cooperation—not by subordinating one to the other, or by substituting one for the other, but by bringing them all, with their essential differences, into harmonious and planful collaboration for the common end. This will be done—it can only be done—by measuring the
126
SKILL IN SOCIAL CASE WORK
validity of plans and processes and outcomes of administration and of all other professional tasks, not by different and separate sets of values, but by the same basic criterion—the production of service—service within an area, by a method, and to an end, that is accepted, agreed upon and understood by all.