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Terminology Of Social Casework: An Attempt At Theoretical Clarification (1954)

The Terminology Of Social Casework: An Attempt At Theoretical Clarification (1954)

 

by Werner W. Boehm

Editor’s NoteWerner Boehm (1913 -2011) was a distinguished social work educator. He was the recipient of many awards and honors, including a Fulbright award (1969), the Rutgers Medal (1983), the National Association of Social Work’s Social Worker of the Year (1983), an honorary doctorate from the Tulane University School of Social Work (1992) and the Council on Social Work Education’s Significant Lifetime Achievement award (1995).

Werner W. Boehm
Werner W. Boehm

Many of us  tend to  attribute  the difficulties which we encounter in conveying the function of social casework to the lay public at least in part to the fact that our language is too technical. In doing so, we forget that the  development  of  a  special  vocabulary  is a necessary phase in the growth of a science and a scientific profession as it goes through  the process of  organizing its knowledge  into  a consistently  integrated  system. As terms which  at one time have  had  only colloquial or commonsense meaning  take  on  a  special  significance among  the  members  of  a profession,  a professional shorthand comes into being. This indicates  that conceptualization  of the knowledge which a profession calls characteristically its own has begun  or is m process.

We  may,  therefore,  ask  ourselves  this  question:  Why  is  it  desirable  to  examine  the vocabulary  of social casework? Do we not all speak the same professional language?

The  answer  is  that  basically  we  do.  However,  the  terms  we  use  in  our  professional language do not seem to have been defined with as much precision  as might be desirable for effective communication even among ourselves. Furthermore, even where meanings were clear at one time, the impact of  societal change and the influx of new knowledge from the sciences has  produced  new  developments  in  casework,  and  old  terms  have  been  infused  with  new meaning.

We have learned our professional language as children learn their social language (i.e., by association with one another) through communication and from context. We have not learned it through specific definitions of specific terms; hence much lack of precision in meaning was bound  to  arise.  This  presents  hazards,  since  imprecision  not  only  makes  accurate intraprofessional communication difficult but also retards theory creation, which is an essential step in the development of a profession, and dulls practice. Terms are shorthand designations of abstractions  or  generalizations;  in  other  words,  they  are  concepts.  The  development  and scientific testing of concepts are important tasks of a scientific profession, and it is suggested that  the  task  of  developing  concepts  must,  of  necessity,  precede  the  task  of  scientific verification.2

One of the ways in which the theory of social casework has developed is not so much by creating new concepts as by changing the meaning of old concepts under the impact of new experiences and new knowledge. For instance, when we mention the term “diagnosis,” we still understand  by  it  the  same  procedural  steps  which  Mary  Richmond  first  described,  namely, observation,  classification,  inference,  and  testing.  But  we  have  enriched  the  concept  of diagnosis to include the impact of psychic as well as social factors on human functioning.

It  seems,  therefore,  desirable  for  casework  to  examine its  terms  in  order  to  assess  their meaning, to account for inconsistent uses of terms in the professional literature, and to attempt clarification in the light of observable changes of the function of social casework in today’s society.

The  task  at  hand  obviously  is  an  arduous  one. It  exceeds  the  boundaries  of  a  paper  and requires the concentrated efforts of many members of the profession. Fortunately, there is a great  deal  of  interest  and  an  increasing  amount  of  activity  in  theory  development.  This  is revealed in the attempts of teachers of social work and practitioners to state the knowledge of the field in conceptual terms rather than being content with the description of practice. This paper is designed to add to the existing conceptual material in the field of social work in the hope that it will lead us to rethink some of our assumptions, reexamine some of our practices, and remodel some of our terms.

In order to avoid the dangers of private definitions which would hold only limited validity for the  field  as  a  whole,  two  complementary  methods  of  approach  are  suggested:  (1)  The assessment  of  social  casework  against  the  social  matrix  of  which  it  is  a  part  and  which influences its scope and function; this takes into account new meanings which terms derive from  new  social  conditions.  (2)  The  application  of  the  method  of  logical  inquiry  to  the definition of terms; this safeguards the rationality of the undertaking.

Both methods make discussion possible, for meanings will be stated explicitly rather than left implied.

Consequently, I shall take the following steps: (I) I shall state my thinking on the scope and function  of  social  casework  against  which  I  wish  to  examine  the  terminology  of  social casework. (II) I shall select from the vocabulary of social casework some terms which appear to me to be particularly in need of clarification and examine their meaning in a logically consistent way.

Before  proceeding  along  these  lines,  a  word  of  explanation  is  in  order.  We  hear  it  said
3sometimes  that  the  definition  of  a  profession  is  a  superfluous  task.  The  argument  is  that medicine, law, and the ministry, the old and well-established professions, are not defined by their members. I believe, however, that we require definition of our core activities (and not of the growing edge of our activities) in order to increase for us, for related professions, and for the public, the understanding of the role that we play in society. As this role, in contrast to the concept which most people have of the position of the minister or the lawyer, is frequently unknown or distorted, it behooves us to evoke a more precise picture of the social role of the social worker.3

Social Casework: Its Scope And Function In Today’s Society

Although it might seem presumptuous to encompass in a portion of a paper so vast a topic as the scope and function of social casework, it is necessary to attempt at least a sketch of this. The reason  is that social  casework is  in constant  flux.  As  it responds to two sets of  influences, changes in society and the findings of the social and biological sciences, it takes on a role which I believe makes it quite different from what it was twenty or thirty years ago.

An assessment of these two sets of influences, then, and their effect upon social casework practice may help us to reduce the cultural lag which tends to affect our thinking about the scope and function of social casework in modern society.

The influence of social change upon social casework.—In the past inevitable events such as migration,  economic  dependency,  unemployment,  catastrophic  illness,  and  the  social disorganization which came in their wake were among the major social factors which impinged upon individuals. People had to seek help in overcoming the effects of these forces upon their personal lives. One might advance the hypothesis that urbanization, which was made possible by the industrial revolution, gave birth to social work as a helping function, particularly in the area of economic insecurity brought about by unemployment and ill-health. As the feudal serf traded economic security  for  intellectual  freedom,  it  became  necessary,  in keeping with the Judeo-Christian tradition of charity, to develop a helping profession.

This may account, at least in rough outline, for the concern of social casework, which in the early period was synonymous with social work, with such problems as dependency and neglect. This also explains the interest in individuals as categories, such as the blind, the mentally ill, etc., the refuse of a fast-moving, burgeoning society which would pause on its onward, upward road only long enough to show grudging concern for those who fell by the wayside. However, the events of the eighteenth and nineteenth centuries and the beginning of this century do not begin  to  explain  either  the  scope  or  the  function  of  social  casework  today.  Today  social disorganization is less abrupt, operates in a more subtle fashion, and, contrary to yesterday, not only  affects  certain  vulnerable  groups  in  our  economy  but  makes  every  member  of  society subject to  its  pervasive  influence.  The  complexity  of  modern  society  is  the  most  important factor  in  this  process.  This  is  exemplified  by  our  being  exposed  to  vast  and  radical technological  changes  which  we  cannot  readily  understand.  They  leave  us  with  a  sense  of powerlessness as we realize that they will affect our lives without our participation. This is further evidenced by the role the United States is playing in international affairs, a role it cannot play effectively unless it has the support of a citizenry which is psychologically prepared for the thinking and doing which this new role entails. This is also shown in our increasing alienation from the processes of government and the source of events as they are portrayed by the mass media of communication. The feeling of being manipulated, of not being part of a process, can be  powerfully  reinforced  (by  national  and  international  events  as  well  as  national  and international policies) in a society in rapid transition where technological and political changes lead to a breaking-up of tradition. In such a society established value orientations no longer serve the purpose of providing the security of belonging. In such a society the search for new values  seldom  leads  to  security  and  often  only  to  unsatisfactory  substitutions.  This  kind  of subtle disorganization,4  which  is  an ongoing  process,  creates  a  new  kind  of  psychosocial dysfunctioning5  which  may  range  from  a  sense  of  personal  malaise  and dissatisfaction  to considerable psychic disorder, such as psychosis, or antisocial behavior such as delinquency.

If this analysis of the social matrix of present-day social casework be correct, it may be said that social dysfunctioning, a breakdown in an individual’s capacity to carry out his social role in a  personally  and  socially  satisfying  manner,  must  be  viewed  as  one  of  the  unavoidable vicissitudes  of  modern  life.  It  may  be  a  portion  of  the price  we  pay  for  living  in  a technologically  advanced  society  to  which  our  cultural,  social,  psychological,  political,  and economic apparatus has  not yet  learned to accommodate  itself. The often-stated function of social  casework  has  been  to  help  individuals  with  those  social  problems  which  they  are incapable of solving alone. If this function is reexamined in the light of present-day trends and present-day knowledge, it suggests a tremendous scope for social casework as a method of help which potentially is available to all people in all walks of life.

This view is reinforced by a look at the recent thinking in the social and biological sciences about man’s social functioning. The insights of sociology help us to understand better the effect of role, status, and power upon individual functioning. The insights of social anthropology help us to realize that behavior is partly determined by the subtle expectations of a family or a group or  a  national  culture.  These  insights  have  augmented  our  knowledge  of  the  psychodynamic growth-processes of the individual which we have gained from psychiatry. To this broadened picture of man as a sociocultural and psychological organism we have added the contribution of the biological sciences. They have taught us that the human organism is endowed with a wide range of problem-solving mechanisms which are necessary for the handling of all those factors which threaten his biochemical, physiological, psychological and social equilibrium.”6In the “problem-solving continuum” which is life, equilibrium failures sometimes occur, and, under  the  impact  of  the  social  forces  described  above,  man,  despite  his  ingenuity,  will  not always  be  able  either  to  avoid  disequilibrium  or  to  restore  equilibrium.  Therefore,  it  is suggested  again  that  the  function  of  social  casework  is  to  become  active  in  those  areas  of individual disequilibrium which either are caused by social factors or manifest themselves in social dysfunctioning.

An Examination Of Selected Terms Of Social Casework

Against this view of the role of social casework in the society of today I shall now proceed to examine some of the terms in our vocabulary. I shall choose two sets of terms: those which are frequently used without having originated within the do-main of social casework, namely, the terms “principle” and “concept,” the term “problem” and the term “social,” and those that are imbued with special meaning in social casework, namely, the terms “method” and “process,” the terms “technique,” “tool,” and “skill,” the term “service,” and the term “counseling.”

Terms which have not originated in social casework.—1. In the literature of social casework the terms “principle” and “concept” are frequently used interchangeably. However, there is an important difference. A principle is a rule for action or a guide for behavior, whereas a concept is  an  identification  in  abstract terms  of  a  series  of  observed  situations,  events,  or  activities which are thought to be related to one another. For instance, self-determination, respect for the human  personality,  participation,  and  confidentiality  are  among  the  principles  of  social casework. These principles dictate certain types of behavior on the part of the worker toward the client. Diagnosis, treatment, adjustment, in-sight, etc., are concepts (i.e., abstractions) which convey certain ideas about certain activities. They do not prescribe a given behavior or action.

There is a connection between principle and concept. For instance, the term “adjustment” will be used by most social workers to mean a process of social interaction of such a nature that societal norms with which a client is in disagreement are incorporated by means other than force. This view of the concept of adjustment involves the application of the principles of self-determination and participation. In other words, concepts are inclusive terms which describe situations warranting behavior guided by principles.

2. The term “problem” has frequently been used to connote certain states of physiological or psychological  pathology.  The  reasons  for  this  may  be  cultural  as  well  as  historic  and economical.  Some  of  them  have  been  suggested  above.  Etymologically  speaking,  problem means something that is “thrown out” for consideration, a question which requires an answer. If we think of life as a series of problem-solving opportunities and of man as having problem-solving capacities, we may be able to conceive of a problem, for purposes of social casework, as any state of disequilibrium which results in enough social dysfunctioning to cause the person so affected to be in need of or to seek outside help. This means that social casework can be concerned  with  any  kind  of  psychosocial  dysfunctioning.  It might  range  from  the  need  for financial  assistance  by  a  psychologically  perfectly  adequate  old  couple,  or  the  need  for  a homemaker  by  a  psychologically  perfectly  adequate  young  couple  when  the  wife  needs hospitalization for confinement, to the need for help with a psychologically disturbed child who is stealing because of a troubled relationship with his parents.

3. In the past there has been much loose use of the term “social.” It meant, by and large, environmental forces. In recent literature the term seems to have taken on a double meaning: it implies any factor or set of factors outside the client which in some way affect his interactions. This includes economic, cultural, political, and spiritual factors, conditions of health and illness, vocational factors and factors of housing, and relationships with members of the family and with society at large. Second, the term “social” connotes the outward expression through social functioning or dysfunctioning of psychic events within the client. This helps us to realize that the social functioning of people is different at different points in their lives. For a hospitalized patient who is in process of recovering from an operation, social functioning means the more or less effective way of playing his role as a patient, which includes interacting with the hospital personnel and with his family in a way different from a healthy person.

The value of this clarification for practice becomes apparent when the meaning of the term “social”  is  applied  to  the  psychosocial  diagnosis  which is  a  daily  undertaking  of  many practitioners. Psychosocial diagnosis means two things: the assessment of the impact of a vast array  of  factors  in  the  social  realm  upon  the  psychic  equilibrium  of  the  client  and  the assessment of the  impact of psychic  factors upon the social  economy of the client. A clear awareness of this relationship enables the practitioner to avoid viewing casework as an ersatz method which allegedly treats symptoms, whereas psychotherapy is supposedly concerned with causes.

Terms which have acquired special meaning in social casework.—The second set of terms which  I  want  to  discuss  has  taken  on  special  meaning  in  the  context  of  our  professional parlance. They are the terms “method” and “process,” the terms “technique,” “tool,” and “skill,” and the term “service.”

1. Casework  is often referred to as a  method of help as well as a  helping process. Both “method” and “process” are correct designations, but they do refer to different characteristics of casework. Casework as a method refers to specific activities which differentiate it from other activities directed toward a treatment goal. In casework the goal is to help people to cope with certain psycho-social problems. Method refers to the how and not the what of the caseworker’s operation, his way of thinking about the client and his problem, his way of operating to arrive at an understanding of the client, and his way of treatment, all of which must be characteristic and must  differentiate  casework  from  other  methods  of  helping,  such  as  group  work  or psychotherapy.

Process, however, refers to a specific element contained in the method of casework, namely, the  interaction  between  client  and  worker,  provided  it  takes  place  within  a  time  span  and involves a beginning and an ending and envisages the possibility of change. We can, therefore, speak of the process of diagnosis and the process of treatment. Both are component parts of the method  of  social  casework,  and  both  necessitate  the  kind  of  interaction  between  client  and worker which is time-bound and the intensity of which varies in relation to treatment goals and treatment methods.

2. In many instances the terms “technique” and “tool” are used interchangeably, although in recent  years  the  term  “tool”  is  less  frequently  encountered  than  “technique.”  Technique, according to Webster, refers to “the method of procedure or to the details of procedure essential to expertness of execution in any art, science, etc. “Tool” is defined as a means to an end. We will add to terminological clarity if we agree upon the use of the term “technique” only for those aspects of a given method of treatment which have been identified as being specific to this method. In other words, technique then would mean a specific procedure which together with  other  procedures  is  characteristic  of  a  given  method.  Much  of  the  literature  which addresses  itself  to  treatment  in  social  casework  uses the  terms  “technique”  and  “method” synonymously. Scrutiny, however, shows that usually when the term “technique” is used the meaning refers to a series of techniques which have certain elements in common. To describe a series  of  techniques  which  have  common  elements,  it  would  be  preferable  to  use  the  term “method.”

Some semantic confusion may arise from the use of the term “method” both to designate distinct groups of techniques of diagnosis and treatment and to describe the totality of the case-work  processes  as  different  from  other  methods  of  helping.  There  are  two  alternatives:  the avoidance of the term “method” to designate treatment techniques or the elimination of the term “method”  in  referring  to  casework  processes.  Either  course  would  probably  detract  from conceptual  clarity.  Usually,  the  context  in  which the  term  “method”  is  used  will  reveal  the meaning  which  is  attached  to  it.  This  may  have  to  suffice  until  a  more  advanced  stage  of conceptual development is reached.

The term “tool” might better be left unused in casework unless it be specifically applied to the interview and to recording, both being means of communication to the end of understanding the client and his problem and of being able to treat him.

One  might  also  argue  in  favor  of  the  application  of  the  term  “tool”  for  the  professional relationship between client and worker, for the professional relationship serves as the means to accomplish both diagnosis and treatment. I believe, however, that this would do violence to the all-encompassing  nature  of  relationship  which  makes  it  the  matrix  for  the  diagnostic  and treatment processes. The terms “climate” and “medium” describe this quality,  but they  lack precision. More efforts are necessary to describe relationship with reference to diagnosis and treatment.

Confusion  is  revealed  also  in  the  synonymous  use  of  the  terms  “skill”  and  “technique.” Technique reveals nothing about the degree of expertness. It has no qualitative connotation. Skill, however, refers to the ability to use one’s knowledge effectively; it connotes a quality of
9performance. Skill, then, would refer to the degree of proficiency with which a given technique is used.

3. In line with the orientation outlined earlier, I should like to propose that we reexamine the term “service,” that we reexamine our traditional division of services, and that we include in this term not only concrete services but also those activities which we commonly assign to the remedying of disturbed relationships. Above all, I suggest that we cease to think of casework as a  service  that  is  given  by  a  private  family  agency  and  of relief  as  something  not  always dignified by the name of service which is provided by the public agency.

We are far from being of one mind on this thinking, as is shown in the following edited excerpt from a letter which has recently come over my desk. It comes from an agency which is looking for staff.

The  type  of  client  with  whom  we  work  frequently  comes  from  the  upper  economic  and professional groups in the community. We currently have in treatment children of such per-sons as scientists and businessmen. Some of our most successful work in marital counseling has been done also with this group. The client who is deprived economically represents a very small portion of our casework. As of recently we are operating on a fee basis. Because of the type of client with whom we work, it is highly important that our caseworkers possess maturity as well as skill.

If  casework  is  a  method  which  helps  people  with  a  variety  of  problems,  financial  and nonfinancial, we can in strict logic speak not of casework services but only of services provided by the casework method. These services might be grouped under the following two headings: (a) concrete services and (b) relationship services.

Under  concrete  services  we  would  list  homemaker  programs,  debt-adjustment  programs, financial assistance, child placement, day-nursery care, etc. They involve the use of a resource out-side the client-worker relationship. Under relationship services we would list services of a nonconcrete  nature  such  as  the  ones  provided  by  the  methods  of  support  and  clarification, through  the  disciplined  interaction  between  worker  and  client  exclusively.  These  are  often thought  of  as  primarily  designed  to  improve  disturbed  relationships  of  parent  and  child, husband and wife, unmarried mother, etc.

While such a classification would underscore the use of the casework method for all types of services,  it  does  not  sufficiently  convey  the  idea  that concrete  services  may  also  serve  to improve  disturbed  relationships.  Such  a  classification  would,  however,  emphasize  that  both tangible and intangible services rendered through the casework method are designed either to maintain or to modify the adaptive patterns of the client because they free ego strength for use in  problem-solving.  Nevertheless,  this  classification  is  still  unsatisfactory,  for  it  equates treatment methods in one area with services in the other. In time a better classification may be devised as we become as specific and clear about the kinds of relationship services we pro-vide as we are about tangible services.

4.  The  term  “counseling”  came  into  existence  ostensibly  because  representatives  of  the functional school limited the use of the term “casework” to mean “a sphere of helping in which tangible service is predominant.” The term has penetrated the literature and is now widely used in functional and diagnostic practice alike, especially in the family field. In an article entitled “Casework,  Counseling  and  Psychotherapy,”  Herbert  Aptekar7  suggests  that  counseling  is  a method designed to deal with an externalized problem which is not amenable to change by the provision of tangible services but which can be remedied by the client himself through the help he derives from the relationship with a counselor. In the first version of her book, Theory and Practice of Social Casework, Gordon Hamilton equates counseling with direct treatment.8 In the second edition of her book Miss Hamilton lists a three-way classification of treatment types: (1) administration of practical service; (2) environmental manipulation; and (3) direct treatment. Counseling is listed as a sub-type of direct treatment; Miss Hamilton explains that counseling is used under circumstances similar to those listed by Mr. Aptekar, namely, in the presence of an externalized problem of which the client is aware. The main technique used is “clarification of the problem and feelings and attitudes toward it.”9 Miss Hamilton differs from Mr. Aptekar in that she sees counseling as part of the method of social casework and not different from it.

A major criterion for the introduction of a new term into a professional vocabulary should be that the term describes a characteristic procedure or a characteristic set of techniques which sets it apart from other designations. The literature reveals nothing specific about counseling which distinguishes it from the method of social casework. Further, it appears doubtful that counseling consists of a group of techniques sufficiently distinct to warrant being called a separate method of  treatment  within  social  casework.  The  use  of  the  term has  caused  an  already  insecure profession  to  become  more  insecure  by  permitting  it  to  hide  its  identity,  for  the  term “counseling” is used by many professions and by some whose skills are not professional at all. The  term  describes  a  great  variety  of  activities.  There  are  marriage  counselors,  vocational counselors,  guidance  counselors,  investment  counselors,  and even  swimming  counselors.

Despite the vagueness of the term and the fact that it hides more than it reveals, many an agency has  seen  fit  to  establish  counseling  units.  Some  caseworkers  who  are  primarily  engaged  in working  with  clients  who  suffer  from  disturbed  relationships  are  found  to  call  themselves counselors rather than caseworkers. Perhaps this is a public relations device. If so, it is probably doomed to failure, for misrepresentation which is ethically inadmissible and camouflage which is psychologically unsound do not add to professional security, nor are they helpful when the public finally finds out that it has been misled. Besides, a scientific profession cannot afford to sacrifice the truth for the sake of public acceptance. We do not find physicians giving the name “plastic surgery” to an appendectomy. Another consideration is that the term “counseling” tends to perpetuate the false notion of a hierarchy of treatment methods which places casework on the bottom, counseling in the middle, and psychotherapy on top.

The aforementioned ideas should serve to clarify our understanding of casework as a method of help and permit a sharpening of our comprehension of the ways in which casework is both similar to and different from other ways of help, such as psychotherapy. To recapitulate, the casework  method  involves the  interdependent processes of diagnosis  and treatment, each of which requires the use of numerous techniques in a skilful manner through the interaction or the medium of a professional relationship between client and worker. To the already great number of  casework  techniques  new  ones  are  constantly  added  through  the  invention  of  ingenious practitioners. It is desirable, for the sake of simplifying the transmission of the knowledge of social  casework,  to  arrange  for  groupings  of  related  techniques  by  identifying  the  major characteristic which several of them have in common. A most meaningful classification of the techniques  of  social  casework  has  been  undertaken  by  Florence  Hollis.10  She  distinguishes between  environmental  modification,  psychological  support, clarification,  and  insight development.

Modifying  the  environment  is  the  method  which  consists  of  the  steps  taken  by  the caseworker to change the environment in the client’s favor by the worker’s direct action through such  services  as  day-nursery  care,  foster  placement,  financial  assistance,  interpreting  to  an employer the illness of a patient, etc.

Psychological  support,  clarification,  and  insight  development  are  differentiated  by  Miss Hollis from the above-mentioned method because they “take place through contact directly with the  client.”11  The  distinguishing  characteristics  between  these  methods  lie  in  the  fact  that different levels of relationship are required,12 different levels of treatment are brought to the fore, and a different type of activity is required by the worker in each of the three methods.

Each of these “methods” as we would call them in the light of the foregoing remarks, can be broken  down  into  numerous  specific  activities  in  which  the  caseworker  engages.  They  are, however, not objectives in and of themselves. They are the means whereby the client is helped to  achieve  certain  objectives.  This  is  particularly  true  of  the  methods  designed  to  improve disturbed relationships. For example, the objective may constitute one of the steps on the road toward the treatment goal, such as reducing a client’s reluctance about applying for relief or in-creasing a client’s awareness of her part in the marital conflict. Or the objective may constitute the end product of the treatment process such as helping a client to obtain relief or mend a damaged  marital relationship. The objectives  may  be reached through the use of techniques which belong to such methods as clarification or psychological support or insight development or several of them in combination. “Objective” then becomes tantamount to “service” as it has been defined above.

It is evident now that, while this classification constitutes an important advance in the field, it does  not  distinguish  clearly  enough  between  service  and  method. The  first  method  in  Miss Hollis’  classification,  environmental  modification,  actually  is  characterized  by  the  services which are the objectives or the end result of environmental modification, but it does not identify the ways whereby this is accomplished. In contrast, the other three methods are clearly defined. This state of affairs may be explainable by the fact that they are similar to psychotherapeutic methods,  and  it  bespeaks  our  close  tie  to  psychoanalytic practice.  As  efforts  toward  the classification of social casework techniques continue, we may advance toward the identification of specific entities of social-psychological dysfunctioning and discover techniques appropriate to their diagnosis and treatment. In the  meantime we shall try to avoid a cleavage between social  intervention  and  psychological  intervention.  In  general  terms  our  objectives  are  to maintain, strengthen, or modify the adaptive powers of the ego.

This  signifies  that  we  work  with  the  intellectual  aspects  of  the  ego  such  as  judgment, planning, making decisions, and choosing alternatives as well as with those emotional aspects of the ego which are intact. This approach requires careful evaluation of the client’s past social functioning.  It  requires  determination  of  whether  his  present  dysfunctioning  is  the  result  of temporary  stress,  inner  or  outer,  or  both.  It  requires asking  the  question:  Is  this  a  state  of disequilibrium which the client can be helped either to bear or to remove? Or is it the result of a more or less well-established intrapsychic pattern which is not modifiable through help in an area of ego functioning? In the latter situation psychotherapy13 is required, and in the former casework treatment may provide the necessary relief.

The  differences  between  the  considerations  of  the  psychotherapist  and  of  the  social caseworker have been well expressed by Dr. Neubauer as follows: “The therapist is aware of biological and social cultural factors but he deals with them only as they are reflected and rep-resented  in  the  psychic  conflict.  Social  work  takes  a  different  position  in  this  regard.  It  is oriented  toward  the  psychic  forces  which  are  available  for  the  interplay  between  social experience and psychic reaction.”14

A  similar  point  of  view  is  taken  in  a  recent  Family  Service  Association  of  America publication  entitled  Scope  and  Methods  of  the  Family  Service  Agency.  This  report distinguishes between treatment aimed at “maintaining adaptive patterns,” and treatment aimed at “modification of adaptive patterns.”

Each type of treatment has one of three purposes: (1) to maintain ego strength; (2) to recover previously available ego strength that was lost under stress; and (3) to develop potential ego strength that so far has not been brought to bear upon reality situations.15

It is noteworthy also that this report does not distinguish between environmental modification and psychological services and lists among the “techniques used to maintain adaptive patterns” manipulation of the environment, reassurance, persuasion, direct advice and guidance, etc. Dr. Neubauer is even more specific in pointing to the strengthening effect upon the family as a psychological unit of the services of the homemaker, the agency nurse, etc.

Conclusion

The preceding examination of some of the terms of social casework helps us to realize that clear definition of terms has a direct bearing upon effective casework practice. We have also become aware that in the United States of the sixth decade of the twentieth century the subtle effects of social disorganization are no more avoidable for the individual than are the risks of accident or ill-health and that social casework can play a major role in the alleviation of these hazards. Therefore, continued effort to clarify terms takes on particular importance.

What about the future?

Social changes will continue to impinge upon us. Social workers are aware of the population
14changes that are giving us more aged, more children, and more working mothers. One writer has described the situation as follows:

The complexity of modern life with its strains and stresses showing up in such social indices as  illegitimate  birth,  divorce  rates,  juvenile  delinquency,  crime  and  suicide  rates  will continue. . . . Today eighty-five million Americans live in cities; by 1980 the number may reach one hundred and twenty million. And cities are a primary market for welfare services. . . . The rate of widowhood is growing persistently. . . . In spite of better care, better nutrition and higher standards of living, illness will continue to be a major cause of insecurity.16

This  means that by 1980,  in  addition to needing a great deal  more  financial  security  for millions of aged, widows, ill, and unemployed persons, we shall need many varieties of social services.

Because man is plastic and resourceful, he will find ways of mastering renewed challenges in his environment; but his mastery will not be without a price. Social casework can become a means to help keep this price within bounds. In the light of this trend it becomes even more urgent to develop the soundest possible practice. Theoretical clarification is one of the means whereby we can forge the tools for dealing with the problems of social dysfunctioning which social change and social disorganization inevitably wreak upon man.

School of Social Work University of Minnesota

Received June 3, 1954

Source: Boehm, Werner. The Social Service Review. Vol. 28, no. 4 (December 1954): 381-391.

Notes:

1 Paper read at the Eighty-first National Conference of Social Work, Atlantic City, New Jersey, May 12, 1954. I am indebted to my research assistant, Mrs. Eleanor Gorham Otterness, for the help she has given me in the preparation of this manuscript.

2 Some sociologists will argue that operational definitions are preferable because of their research ability. Others will prefer traditional logical definitions for two reasons: (1) the social sciences are not so precise as the physical sciences from which the vogue of operational definitions come and (2) traditional definitions refer to all the experiences which the term covers, and, therefore, there is less danger of leaving out important elements of the concepts. Cf. William J. Goode and Paul K. Hatt, Methods in Social Research (New York: McGraw- Hill Book Co., 1952), pp. 42-54.

3 For an elaboration of this point see Maurice F. Connery, “What Is Social Casework?” Minnesota Welfare, IX, No. 10 (May, 1954), 14-18.

4 Arnold M. Rose, Theory and Method in the Social Sciences (Minneapolis: University of Minnesota Press, 1954), chap, i, “A Theory of Social Organization and Disorganization.”

5 Isaac L. Hoffman, Toward a Logic for Social Work Research (St. Paul: Amherst Wilder Department of Research and Statistics, 1952), pp. 19-22.

6 Eleanor Cockerill, “The Contribution of Medical and Psychiatric Social Work to Social Work Practice,” in Social Work Practice in the Medical and Psychiatric Setting (Pittsburgh: University of Pittsburgh Press, 1954), p. 29.

7 Herbert Aptekar, “Casework, Counseling and Psychotherapy,” Jewish Social Service Quarterly, XXVII, No. 2 (December, 1950), 163-71.

8 She distinguishes between direct and indirect treatment: indirect treatment means working through other people and is tantamount to environmental manipulation, whereas direct treatment means accomplishing change through the client-worker relationship.

9 Gordon Hamilton, Theory and Practice of Social Casework (rev. ed.; New York: Columbia University Press, 1951), p. 241.

10 Florence Hollis, “The Techniques of Casework,” in Principles and Techniques in Social Casework (New York: Family Service Association of America, 1950), pp. 412-26.

11 Ibid., p. 415.

12 The nature of relationship, whether it be an object or transference relationship, does not necessarily say anything about its intensity. An object relationship may be very intensive; a relationship based on transference need not always be intensive. It is the origin of the feelings that determines the kind of relationship, and it is their meaning to the client that determines its intensity. A transference relationship can be shallow, it would seem, if the relationship to the parent from whom the feelings have been transferred was shallow. This matter is not clearly enunciated in the literature and warrants further examination with the help of psychoanalysts.

13 For purposes of this paper psychotherapy is defined as aiming at personality reconstruction such as is frequently provided by the psychoanalytic method. No doubt there is an area of overlapping between the methods and objectives of casework and psychotherapy. However, there is also a vast area of difference. It is with the latter, and specifically with the unique aspects of social casework, that this paper is concerned.

14 Peter B. Neubauer, M.D., “The Psychoanalyst’s Contribution to the Family Agency,” in Psychoanalysis and Social Work (New York: International University Press, 1953), p. 120.

15 Scope and Methods of the Family Service Agency (New York: Family Service Association of America, 1953), pp. 19-22.

16 John J. Corson, “Can We Afford Welfare?” Community, XXIX (March, 1954), 131-32.

Source: Werner Boehm Papers. Box 1. University of Minnesota, Twin Cities, Social Welfare History Archives. Minneapolis, MN.

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