Clarke A. Chambers, Editor

Contributors

Introduction – Clarke A. Chambers . . . . . . . . . . . . . . . .  . . . . . . . . . . . . . . .    1

Economic Independence  – Walter Trattner   . . . . . . . . . . . . . . . . . . . . .   9

Problems of Effective Functioning- James K. Whittaker   ……………… 21

Social Aspects of Health- Ralph E. Pumphrey  ………………………… 31

Leisure Time Needs- Guichard Parris ………………………………. 43

Provision and Management of Social Services- James Leiby ……………… 53

Societal Problems – Tamara K. Haraven  …………………………….. 66

Published by: National Conference on Social Welfare

It is  a  rare  thing  – for  a  person  or  an  organization  – to  celebrate  a hundredth birthday.  But the National Conference  on Social Welfare, a century  old this year, 1973, exhibits qualities that  make for both longevity and vitality. Since its founding it has been tough  in  spiritual  fiber,  quick  to  respond  to  new  concerns,  flexible  in  strategy,  and devoted to the renewal of life for all sorts and conditions of men.

The Centennial  will be marked  in many ways, among them the publication  of these critical historical essays which examine  the  traditions  of the serving professions during a “Century  of Concern.”  The  key word is “critical” – for these essays, as the reader will quickly  learn,  are meant  to  contribute   not  an official, “in-house” celebration  of social work  and  the  Conference  but  rather  an analysis, both  strict  and sympathetic, of what social  welfare  has  been,  where  it  is  today,  and  where  next  it  might go. Apart  from inspiring” the  volume  and  providing  encouragement  and  financial  support,  Conference officers  exerted  no editorial  guidance or supervision. As editor  of the volume, I offered suggestions and criticisms to each of the contributors, but  the final judgment was theirs; there  are continuities  of  analysis from  essay to  essay, but  divergence and even contra­ diction in evaluation  as well. The chapters,  then, exhibit  no single point  of view; each is the reflection  of  an expert  in the field. Each author  was invited to set forth  his remarks in whatever  fashion  and  with  whatever interpretations seemed accurate  and valid. The essays, in preliminary rough draft,  were used by the Program Committee of the National Conference in the fall of 1972 in planning the Atlantic  City convention  for May, 1973. With that  original use in mind, each essay was directed  toward a program section of the Conference  – Economic  Independence,   Problems  of   Effective  Functioning,  Social Aspects of Health, Leisure-time Needs, Provision and Management of Social Services, and Societal  Problems. Footnotes have not  been used, but readers may consult  the selective list of historical  readings at the end of the book.   The authors believed that they could best honor  practitioners  and shapers of social welfare with candid and critical accounts of social service in its several major fields. The volume is neither nostalgic nor sentimental;  it proposes  neither  eulogy  nor  obituary,  but  rather  a hard  look- with the long view of history  — at  present  perils  and  opportunities. We hope  it  may  provoke a careful  re­-examination of national priorities in the welfare fields.

*     *       *       *

Abraham  Lincoln once observed of the study  of history:  “If we can first know where we have been and whither we are tending, we may better know what to do and how to do it.” In a general way, of course,  that is surely the case, but  too often,  perhaps, extrava­gant claims are made for the usefulness of historical studies. We are all too easily inclined to declare — “History  proves …,” or “human  experience indicates …,” or “the  evidence before  us we have gleaned from  the  past suggests that ….” These essays do not, even implicitly, proceed from such crudely  pragmatic assumptions  about  the uses of the past. Yet  their authors  are not  unaware  that even if the past does not  provide easy and clear lessons, its  study  can enrich  our understanding  of our own age and inform  our present circumstance.

Historical study may, for example, remind us of experiments in social welfare or in the delivery of social services which we have forgotten   or  never truly  understood.  It may provide educators,  administrators,  and practitioners  with professional models drawn from the  past.  Apprentice  social  workers  especially,  I  imagine,  need  to  know  that  social concern  did  not  begin with themselves. Such studies will not serve a directly  pragmatic function  so much as an indirect,  but nevertheless profoundly  important philosophical function. A study  of  pioneer  social workers  two or  three  generations  ago – many  of whose lives and careers appear in these essays – will hardly inspire social workers today to go and do exactly likewise; social conditions  and options  in the last third of the 20th century  are not what they were a century  ago. But it is important  to sense in both heart and mind that  others have gone before, that one stands in a long and honorable  tradition of both social service and social prophecy, for many early social workers labored to serve those  in  need while, at  the  same time,  they  moved  to  elaborate  public policies which might  alleviate and  perhaps  even resolve the  complex  social problems  which  were the source of human need.

The study of history may also offer one way (among others) to transport  ourselves out of our own immediate  frames of reference – the only ones, after all, we can experience directly – and get inside other  minds and cultures,  to appreciate other values, to experi­ence vicariously  the  hopes  and  anxieties,  the  joys and  fears of  other  peoples in other times.  Through  history  we  can  confront what  some  have called  the “radical  other.” History  affords  an opportunity to  live with  others in affection,  judging not,  according neither  superficial praise nor condemnation. Florence Hollis, noted social work educator, once  observed that  one  mark  of a good social worker  was the “capacity  to understand and respect others  as they are.” Social workers have many  times declared their commit­ment  to variety and self-determination, to the virtues that  inhere in a pluralistic society. These  essays,  then,  may  nurture   all  those  cherished  goals; they  may  be an effective antidote  to parochialism; they may demonstrate  the great variety of contributions which different  segments  of  social service, in  different  eras,  have  made;  they  may  dissolve dogmas of all sorts. By so doing they  may also open our eyes to the persisting influence of social class in the elaboration of social policies.

Social  workers – especially those engaged in community  action,  administration,  and public  policy – need also to know about  social process. How better  to learn about  the processes of social change than  through  the study  of history?  This is not to declare that the past may provide a “blueprint” for the present. Continuity  of human experience may be one  tendency  the past exhibits,  but history  never repeats itself. The combination  of factors  that  made possible the enactment  of social security in the United States in 1935, for  example,  will never occur  again; in all likelihood  the nation  will not  suffer another depression  of  that  order,  and  no  new Franklin  Roosevelt is likely to appear again. But social workers concerned with the initiation  of a national health insurance program might consult  with  profit  the  long-run historical  conditions  and  forces  that frustrated  earlier schemes for  workmen’s  compensation,  unemployment   insurance,  old  age and survivors insurance, and medicare. Among them one would certainly  have to number the national ethos  of individualism  together  with  the  deep and all but irrevocable national  commit­ment  to work, and thrift,  and self-reliance as presumed sources of the peculiar American way of life. One would need to consider as well the unprecedented  (although  unevenly shared) material success of the American economy,  the relative lack of class-consciousness in this  country, the  heterogeneity  of the population, the openness of economic oppor­tunity,  the richness of natural  resources, the peculiar quality of a two-party system that put a high premium on the politics of compromise and accommodation  and tended to blur the programmatic  and philosophical differences between the parties. A profound concern for  the  full  historical  context  within  which social services and  social action  developed over the past century is a central consideration  in each of these essays.

Perhaps,  as Karl de Schweinitz has suggested, the social worker may gain that  all-important  sense of timing, which dictates  that  one “must  know when, as well as what, to do.”  And  unless one  appreciates  the  fundamental  “givens”  of a situation,  the long-run conditions  that  continue  to carry momentum  (or hold inertia), he will be unable to work with the whats and the whys and the whens and the haws of constructive social change. History may tell us as much of process as pathology, and both  are important.  If  this  volume  of essays can  begin  to fulfill  these criteria,  the contributors will feel justified in their efforts.

*      *      *     *

No single essay, or series of essays, can begin to encompass  the complex events that composed  three or four generations of historical developments. Appended to this book is a selected bibliography  of diverse works in the field which are still in print and available, therefore, to those who wish to pursue the subjects further. The topics pursued there, and in these essays, are as diverse as the field of social welfare itself and comprehend  policies and programs as varied as the concerns summarized in the title of the modern Department of  Health,  Education, and  Welfare. To  developments  of such complexity, these essays could be no more than a quick survey introduction of major trends and tendencies.

However prefatory  and preliminary they may be, there are a certain number of themes that weave in and out  of the separate essays, and there would be some virtue, perhaps, in attempting to identify some of those major and recurring themes.

One such theme has been the progression from what was essentially, a century  ago, an enterprise  dominated  by amateur  and voluntary  service to the delivery of social services by highly-trained,  professional technicians  working in a steadily  proliferating  number  of specialties.  However experienced,  intelligent,  or  well -meaning  leaders  and  delegates to early  conventions  of what  was then known  as the National  Conference of Charities and Correction  may  have been  – and  in fact  they were often  inexperienced,  cautious,  and unable to transcend class bias – the ranks of social servants were drawn from citizens who had  no  special  training  to  prepare  them  for  careers in  these fields. Indeed,  the  very organization  of  the  Conference  was intended  to  facilitate  the exchange  of information and  ideas  and  to  promote   the  mobilization   of  resources  for  the  more  efficient  and humane alleviation of human suffering. By the end of the 19th century  and the beginning of the new, in social service, as in so many other  aspects of American life, the need for professional education  and procedures  had become clear if some rational control were to be asserted over the drift of life. The complex of problems associated with rapid industri­alization  and  urbanization, with  the  swarming of immigrants  from  the  far  reaches of southern  and  eastern  Europe  as from  the  farms  and  towns  of America itself, with the crowding  together  of  citizens  in sprawling and  ugly centers  of  population  – all these demanded  social responses and  the  creation  of  social experts  trained  to  alleviate (and perhaps  to  resolve) the  social grievances that  arose from  these  conditions  and circum­stances.

The emergence of a profession of social work, then,  related to what one historian has called “the search for order” in American life. Ghettos  and slums, the plague of tubercu­losis, rising rates of crime, juvenile delinquency,  the lack of provision for sanitation  and public health,  the  social and  economic  dependency  that  arose from  uncertain  employ­ment,  industrial  accidents,  premature  old  age – these  constituted problems  that  good intentions  could never dispel. Social research and the creation  of special schools for the training of social servants constituted one response, and during the interwar years of the 1920s  and  ’30s  a large number  of  professional  schools,  most  of  them  associated  with universities,  were founded.  Of  equal  importance,   perhaps,  although   through   more informal means, was the initiation  of specialized magazines and journals, most notably the Survey and  Survey   Graphic, which  provided  technical  information   for  an  emerging profession   together  with  guidance  for  concerned   citizens  in  broad  policy  fields. The organization  of a National Social Workers’ Exchange in 1917 which, four years later, was transformed  into  the  American  Association  of Social Workers, a group whose primary objective  was to  define  and  secure  professional  standards  for social work, was another indication  of the deepening concern  for  professionalization. (So, too, was the decision in 1917 to shift  the name of the old National Conference of Charities and Correction  to the National Conference of Social Work.)

These movements to improve the technical competence  of social workers were assured­ly legitimate, and that higher standards of performance and the more efficient delivery of services took  place is unquestioned. But there were social costs to pay. In so far as social workers  focused  upon  new  methods  and  techniques,  especially  in casework and in the new and  exciting  field of psychiatry,  their attention came to concentrate  on procedure and on  the  adjustment   of  the  individual  to  his environment, rather  than on the trans­ formation  of the social environment  within which the individual lived. Where profession­alization  demanded  specialization,  the field of vision was invariably narrowed for all but the   most   discerning  and  most   broadly  concerned   workers.  Specialization   required objective  and  scientific  attitudes  toward  the  problem  areas  and  the  maintenance of “social distance”  between worker and client. The costs were evident in sterility, flatness, and  social  disdain,  in  the  growing alienation  between  those  who  stood,  for  whatever reason, in need and those professional practitioners  who presumed to serve those needs.

The  progression  from  amateur  to  professional  services rendered  by  trained  experts, paid  for  either  by  private  agencies or  public bureaus, was not simply linear, of course. During .the past decade  the move to involve the maximum  participation  of groups being served in the elaboration  and execution  of new social programs, the move to recruit social workers  from  among  traditionally   disadvantaged  segments  of society,  and the move to employ  persons uncertified  by professional schools of social work in positions of leader­0ship  and  responsibility  combined  to  give a new thrust  to social service and promised a more salutary  mix of leadership  and design. If the use of welfare programs as a means of social control  over the  lives of those who did not traditionally count constituted one major  flaw, the  relatively  recent  recognition  of  the  authentic  and  legitimate  nature  of cultures  and life-styles  which  do not  fit  traditional  stereotypes of what it was to be an “American” began to open real options  for self-determination  which had not previously been possible.

Another  related  and parallel theme that can be traced throughout the past century has been the gradual tendency  of welfare services to move from provision of simple charity, to assistance and  care, to preventive measures, and finally  to the promotion, by positive means, of a more abundant  life. This is not  to suggest that each level in its turn has been supplanted  by  the  next.  Care of  the  individual  client  remains  a central  and legitimate function  of social work.  To  provide  assistance  so that  the  client  and  his family could move  away  from  dependency   and  need  toward  independence  and  self-direction  is as legitimate  a service now as it was a half-century ago. Care and the removal of the causes of dependency  may require financial support,  provision of health or recreational services, vocational guidance and rehabilitation, family counseling, financial supplements,  a lead to a new job, an insight into  the sources of marital conflict,  two weeks at a vacation camp, the  placement  of  an illegitimate  child,  prolonged  psychiatric  sessions, or  a new set of teeth.  In  any  case the  focus  of  such work  is upon  helping  others  to  help  themselves, seeing them  through  a time of crisis when their own resources, financial or psychological, are  inadequate   to  the  demands  made  upon  them,  liberating  them  from  dependency, enriching their lives, or helping them to make satisfactory  adjustments  to their environ­ment or to reconstruct  it as far as possible. But over the years, added to these persisting concerns,  there gradually evolved the elaboration  of social policies aimed at rooting  out the causes of dependency  and discrimination. Social security,  medicare, urban  planning, the  campaign  to  establish  a  guaranteed  annual  income,  and  all the  statutes  aimed at softening  or eliminating  discrimination  based  on  race, religion, and  sex are counted  as attempts  to  create  social  conditions   in  which  traditional  sources  of  human  problems would  be weakened. In that  sense, the participation of many social workers in anti-war agitation  the past decade might appropriately be considered to be an integral part of their expressed concern for a reconstruction of social policies in the welfare fields.

Traditionally, then,  professional social work has exhibited  a responsibility  to society and to public welfare as well as to the individual in need. Even those workers whose daily routine necessarily forced a nearly exclusive concentration upon the adjustment of an individual to the “givens”  of his environment  have rarely been unaware of the direct and overwhelming influence  of the health  of society upon the health of the individual. Grace L. Coyle summed it up in her presidential  address before the National Conference at the end of the depression decade of the 1930s: “There  is no reasonable doubt,” she declared, “that poverty itself is responsible for increased illness, that unemployment breeds unemployability,  that crowded   housing  undermines  family  life,  that  undernourished children will grow into incompetent workers.”

So much is the common  sense of the matter; and yet painful tensions persist between social service, on the one hand, and social action  on the other,  between social work and social welfare, between  the efficient  delivery of services and the reconstruction  of social institutions, between  what  Porter  Lee identified  as the  “function” and the “cause” of social work.  Open  suspicion  and  hostility,  or at  the  best  uneasy  alliance, have most often  characterized  the relations between  the main body  of the profession, cautious and conservative, interested  in the immediate  case at hand, and those who insist that radical strategies  are  required  to  overcome  drastic  social  problems.  One  can  recall Grace L. Coyle’s complaint,  in 1937, against  those who continued  “to  pick up the pieces without ever  attempting  to  stop  the  breakage … The  real  situation which  faces us as social workers,” she continued, “includes  a society, potentially  rich but actually poor, wasteful of its material  and human  resources,  torn  by class and racial conflicts, its cultural life on the whole meager, vulgar and disintegrated.” Or we can remember  the tone of Harry L. Lurie’s protest against the failure of social work militantly  to seek social reconstruction in the depression era. The habit  of impartiality, the conservative influence of agency board members,  the fear that  change would disrupt  familiar ways – all these contributed to a peculiar  passivity. “As  a professional group,”  he wrote, “we are in general tied up with the reactionary  rather  than  the advancing forces of social change.” And, more recently, a social  work  leader  observed  that  for  all the  talk  of a “welfare  state,”  if the  country provided truly for the welfare of its citizens, many of what we classify as welfare services would no longer be necessary.

In emphasis, the Conference – like the serving professions themselves who constituted its membership  – has swung between  the  pleas of  social action  and  social service. Its presidents  have been  selected  from  among  those  who can best be understood  as social prophets  – Jane Addams and Whitney Young, for example – and from among those who had made technical contributions of surpassing importance  to the better service of health, education,  and welfare – Homer Folks, for example, and Dr. Richard Cabot. Its leaders­ Conference Presidents and Conference Secretaries alike, and all that great host of program committee  members, panel participants,  and executive officers – have most often, how­ever,  combined  a  concern  for  the  reform  of social evils with  a commitment   to  more effective service. Such persons engaged in attempts to create a synthesis between the two phases  on  the  grounds  that  they  were  not,  ultimately, mutually  exclusive or  contra­dictory, but mutually supportive and complementary.

Paul  U.  Kellogg,  editor   of  the  Survey magazine  in  the  years  of  its  greatness, 1909-1952,  and Conference President  in 1939,  summed up in his own life and career the best of both strategies. He knew that the sick demanded the best care that society could afford;  he knew  also that a sick society frustrated  all efforts  toward effective ameliora­tion. He had lived with the division between practitioners  and reformers his entire life and had come  to  feel  that,  in a sense, each strategy  taken in isolation was insufficient  and therefore  wrong.  Although  he  appreciated  how central  casework  services were  to  the whole profession of social work, too often, he felt, caseworkers saw their function  only in relation to their clients without  sufficient appreciation of their connection with and responsibility  to  the larger community. The  relationship  of  the social worker  and  the client, he wrote  in the mid-twenties,  was “not  that of an intruder-not that of a friend­ not  that  of a doctor  to  his patient-but that,  frankly  and  openly,  of the agent of the community  dealing with one of its members-on the ground that a person cannot  be as deep in distress as he pleases any more than he can be sick as he pleases; the welfare of one being the concern  of all.” It followed that these relationships were not to be cut and dried, but organically interrelated; the caseworker had an obligation  not only to provide the best services he could with the resources at his command but also, as an “observer and explorer  of human needs,” to educate  the community  and help lead it to recognize the need  for  wholesale measures of prevention  and constructive  action  to balance the retail provision of services. This “organic  process” which combined “individual  treatment with social action”  was, it  seemed  to  Kellogg, “the  real alternative  to  an ingrowing,  short­ sighted retailing on the one hand, or a highfalutin’  wholesaling on the other.”

Of larger importance,  perhaps,  was Paul Kellogg’s commitment to the self-determin­ation  of  all  persons  and  social   groups.  He  believed  that  social  work  would  have to dedicate  itself  to  making real the  promise for all human  beings-the right of each indi­vidual to  develop his own latent  powers and talents in accord with his own desires and will. Most especially he had sought ways for others to break out of the ruts which society assigned to persons and to groups and from which they were powerless, alone and by themselves, to escape or transcend. “We are all of us working in a web of circumstances not  of  our  own  contriving-trying to  make it  possible for  life  to come up through  its meshes with greater freedom and joy.”

The means might encompass both  the service and the action impulses of social work, but  the goal was self-determination. Early in his life he had been moved by a motto  he had  seen in a settlement  house  at  the  turn  of  the  century -“We are not our  brothers’ keepers;  we  are  our  brothers’ brothers.” It is better,  as he  saw it,  to  stand  with the disinherited,  the  needful,  and  the  oppressed  and  to  work with them  in the process of enabling, than to do things for them, or to them.

It is this democratic spirit that has characterized social work and the Conference when they have been most true  to their central dedication: the right of every person and every group to remain true  to their own value systems and to their own styles of life. That  is what Florence Kelley and her allies sought in the 1912 National Conference – the rights of working people to decent  employment, to fair wages, to security of income in hard times and in old age, and recognition of the right of labor to organize free of external restraint. That is what  the  pioneer  generation  of settlement  house leaders sought for their neigh­bors,  the  working  class  poor  whether  native  born  Americans  or  recent  immigrants­ recognition  of the cultural  integrity  of diverse social and ethnic  groups, and the elabora­tion  of  means by  which  the  disadvantaged  could  gain the  advantage  of  being able to achieve some larger  measure  of control  over their own lives. And that  is what so many other  groups  in American  society  and  within  the  social serving professions  have  been seeking in  recent  years – the right  to  a decent  existence,  yes; equal access to economic, political, and social opportunity, yes; and most importantly, the right to organize, free of artificial  restrictions,  and to move toward  a larger capacity  to determine  for  themselves the direction and quality of their common lives

The  task,  of course,  was never easy. The  sponsors  of social welfare  programs  were usually  solid,  middle-class,  native  Americans  who  enjoyed  a  secure  and  comfortable existence  and  who thought  and acted within  the framework  of middle-class proprieties. The “uplift” of  other  classes and races tended  most often  to be their chief motivation; and in  the  process of “helping” they  tended  to impose the standards  and style of their own class upon  those  who  they  perceived were not  as “fortunate” as themselves. Such providers of social services rarely considered  that  persons of other  races, or ethnic back­ grounds, or cultural  and religious traditions,  or classes might wish to adhere to their own value systems which were to them of equal validity to those of the majority  culture.

Ethnic and  racial minorities,  then, confronted  enormous  difficulties  in seeking  to overcome  the  burdens  of  poverty  and  second-class citizenship.  What Jorge  Lara-Braud said of Mexican-Americans before  the National Conference  in 1971  might well apply, in different ways and in different  degrees, to other Spanish-speaking minorities, to American Indians, to Blacks, and to Asian-Americans – they all suffered “less education,  less employment, less money, less food, less housing, less health, less justice, and less dignity than  others  who called themselves “American.” It was all the more difficult  to win the right to be self-determined  because of the forces of cultural imperialism.

The rights of the individual might  require, as Rabbi Levi Olan pointed  out  before  the Conference in 1971, “full  acceptance into the larger society without  any discrimination”; but strength  of personal identity , and cultural  richness demanded  the “structural separation” of these groups in order  that  a diversity of values and styles might endure and thus continue  to give meaning and direction  to the lives of millions of citizens. All the minori­ties, he said, “share  a conscious  thrust  toward  civil rights, freedom  and equality  for the individual  regardless  of  color,  creed,  or  national  origin. They  also disclose a common interest in the preservation  of their group identity.” These two aspects of self-determina­tion continue  to live in uneasy tension, and the serving professions (to say nothing of the American electorate  generally) have not  yet  fully and candidly confronted the dilemmas which have arisen from these considerations.

So, in  1973,  social work, with the nation, faced a condition  loaded both with  prob­lems and  opportunities. The  world’s  work  is to be done, no shortage of challenges: an affluent  society  as rich in  troubles  as in material  plenty; urban congestion  and sprawl; pockets  of  poverty  and  a hard , seemingly irreducible  core  of  unemployment;  tension between  races and  classes; crowded  schools  and  an educational  system many  places in shambles; asphalt  jungles; mayhem  on the highway; murder  on the  playground; national parks turned  into littered  tent slums; polluted lakes and rivers; smog-palled cities; costs of health care rising faster than  the meager resources of the aged and the poor could afford; a vast disparity  between wealthy nations and deprived nations, the latter advancing faster in population  than in the production  of necessities; an imperial war in which Americans have all but ceased to die but not to kill.