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LYSIS OF PROCESSES IN THE RECORDS OF FAMILY CASE
WORKING AGENCIES

ia P. Robinson, Associate Director, Pennsylvania School for Social Work,

Philadelphia

der to limit this subject to something that may be presented at least in outteen minutes I am arbitrarily going to discuss only the processes by which hings done in treatment. It is in the treatment phase of its procedure that se work is most distinctive in its methods and technique. Like any profession s founded on scientific method social case work must move through three observation and assembling of its facts; hypothetical interpretation of these and control of the facts for new ends. To differentiate social case treatment technical sense from the more or less hapazard, unscientific, but kindly and very helpful "influencing,” “guiding,” “helping out" process which goes on ver human beings associate is a task in which case workers must make some way if case work is to take rank with the professions which are firmly founded ientific method.

The first characteristic that distinguishes the work of the social case agency 1 the efforts of the friendly unprofessional kind is the fact that the social agencies p a record of work done. To these records then we should turn for the processes which adjustment is accomplished. In this search for process in records it mportant to keep in mind clearly from the outset the distinction between processes at have a significance for treatment and those that have only a temporary value Mrs. Sheffield puts it in The Social Case History. The latter are details as to the echanical process of getting things done and have no bearing on the real developent of the case.

There are no set rules and no short cuts by which workers can be taught to listinguish between essential process and mere machinery. The ability to make this distinction in recording must grow out of the ability to penetrate to the fundamental problems in the case itself and to hold these clearly and vividly in mind throughout all the involved and often devious details of treatment. It requires the most constant vigilance and the clearest thinking to remember that the amount of time and effort consumed by the worker is not the criterion of the value of the detail but the bearing of the detail on the case problem.

Even though we find frequent remnants of machinery still clinging to our records there is among well standardized agencies fairly general agreement and steady effort to eliminate it. As to the recording of the significant processes, on the other hand, there is much difference of opinion. It would be wise to try to classify some of these processes before we discuss how much notice should be given them in records. One classification which may be made for conveniences of this discussion is into those processes that have to do with altering the material environment in order to meet the client's needs and those that have to do with re-education of the client's point of view or habits or attitudes or the changing of the attitudes of other people towards the client. Actually the two groups of processes are closely related in every case, and the treatment falls down unless they are kept so interwoven, but in the matter of recording we can make a distinction. If we discuss any piece of case work with the worker in reference to which side of the treatment was most important, that which

concerned itself with a re-education of attitudes and point of view or that which had to do with the securing of the material equipment for carrying out this re-education, she will say in almost every case that the re-education of the client or his associates was most fundamental. If there is any truth in this assupmtion that re-education of attitudes is the most important side of treatment, should we not expect to find the steps in this process as carefully brought out in the record as are the steps in the process of manipulating the environment.

I have been reading records with this definitely in mind for some time and have tried to get material from others who have been interested in looking for this sort of thing in records. In the records of family case working agencies I have found so few illustrations that one must conclude that these have slipped in by accident and that it is not the practice or the intention of the family agency to record any of the processes by which its work of re-education is brought about unless some manipulation of the material environment is made. The latter is recorded with scrupulous exactness. Is it that the processes of treatment are so clear cut and so well standardized as to be raised into the class of methods which need no description? Does it seem reasonable to believe that these varied processes are so generally accepted that there is no need to record them?

In the field of medicine, with a longer tradition and a wider experience than social work, there are certain commonly taught and accepted treatment processes for certain disease conditions. Case workers have as yet no common basis of knowledge or technique so that they can merely indicate a line of treatment in symbolic terms and expect that all case workers will understand by it what the worker was doing.

One very unusual illustration of recording of processes I should like to quote from the record of a family which a charity organization society has been supporting for several years through a series of illnesses of the man. The man is becoming more and more dependent on this support and more and more demanding. In July, 1910, the worker records an interview with him to the length of two pages and a half. First she lets him rehearse his whole life from the early care-free days before marriage, when he dressed as he pleased and had enough to spend for a good time besides, through the responsibilities of early married life, when children came rapidly and he had to sacrifice in order to pay doctor's bills. She lets him express his bitterness at his poverty and the things he has to go without to the full. And when some of this bitterness is out of his system she begins to come back in an effort to make him see himself in perspective. The interview should be given in full but there is time for only part of it.

Other people's children have good clothes; other people's wives dress up. Yet on the other hand Mr. B. has to confess that he himself is the dressiest member of the house. He is wearing this morning a silk shirt and a well tailored suit, silk stockings and a decent pair of shoes. He sees the humor in the situation but says he has not bought anything for himself since he has been ill. He "bought a bargain" when he got this suit, paying $2.00 a yard for the material and $14.00 for making the suit. Yet he sees that when he had any extra money at all it went into providing himself with a silk shirt and a good tailored suit and that his wife and children had no such supply to fall back on when their income ceased. He owns that he is selfish and yet his reaction is this: if visitor sees a dress that is better than her own, does she not immediately want to purchase something that is better looking herself? It is hard for him to see that there are many other things more worth while than appearance; that the satisfaction which visitor would get in living within her own income, no matter if she is more poorly dressed than some other people, is a satisfaction more real than knowing we have outdressed someone else; that after all the fun of making things meet is a real satisfaction; and that to make things meet, one certainly must look ahead. It is

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doubtful whether he sees, although he is frankly told, that one of the troubles with him is that he has grown to a man's responsibility with more or less of a boy's attitude. His reaction to this is a rather bitter feeling that there are so many people in the world that have money and that he has not. When he was well he worked hard from early morning to late at night; he loves his children and yet he hardly sees them; he gets home often so late that they are in bed, and yet work as hard as he can, he earns only enough for his simple maintenance, while other people roll about in automobiles and have much extra time; a working man ought to get more than just enough money to barely live on; it makes him "mad" that he has no brains to fight with people who have money; he has no education and they can do things to him and he never knows what it is, and if things continue in the future as they have in the past he will not have enough money to educate his children to be anything different. He expresses his attitude with a great deal of feeling. Visitor tries to make him see that this antagnoistic spirit toward things as they are does not get us out of our difficulties. That he is mistaken about the fact that he does not have a brain and that he still can become a much better educated man and in this way he will be able to think out his problems to a more satisfactory solution. He then says he has gone to night school and if he remains in town he will go to night school in the fall, realizing that this is the way to accomplish things rather than waste his energy in bitter feelings.

One wonders why this sort of recording is so rare in family case working agencies. We are so meticulous about recording any understanding that has to do with financial arrangement or with definite material steps to be taken.

I have come across a marked difference in the practice of recording of these processes of re-education between some specialized agencies and that of the family agencies. I have not read by any means enough records to generalize on this difference but offer the contrast as far as it goes as interesting and possibly significant. The two specialized agencies whose records I have studied are handling individual behavior problems, one of children, one of older girls. Both series of records show a very consistent effort to record the process. An illustration from an agency for girls will show this method. The worker is trying to give a new start to a bright, happy-golucky, attractive child of sixteen, who has had a shocking sex experience in her own home.

The girl tells the worker she is going to New York with a boy. The worker says, "she could not hear of such a thing; would not have her do it for anything." Alice said she would come in next day and tell her all about it. Next day Alice came in and gave a long story about Frank and the hoped-for trip to New York. Said she "had no faith in the future and did not think there was anything in it for her. Had made up her mind that for all she had suffered in the past, life owed her something. She planned to take everything as it came along and not miss anything. Intended to go the limit and just stop on the side of safety. Craved any excitement and must have it."

Worker told her that we were afraid that if she took that tack she would not get very far with her education. Alice did not resent visitor's attitude and acknowledged that the visitor had no authority over her except what she herself chose to give her.

Next day Alice came in office again wanting to know what she ought to do and if visitor would be angry with her if she decided to go to New York after all. Told her we would not be angry, in fact that we would rather have her go if, after having thought it over, she still thought it was the thing to do, than to stay at home simply because we said so. Alice was highly delighted at this and suggested that she would like to have visitor meet Frank. Makes plans for bringing him to see visitor and for getting a new hat. The visitor shows no disapproval though she still continues to feel strongly that the trip is unwise.

As I said before, I have read too few records to know whether this type of recording is peculiar to these two agencies and these few workers or whether it is characteristic of records dealing with specialized individual problems. We will agree, I think, that all case work is still in a very personal stage of development. The factor that we call personality, which I prefer to think of as the level of development or the adjustment which the worker herself has reached, is admittedly of as much importance as training. The worker's point of view, her philosophy of life, her own adjustment to

life, are an essential part of her equipment and constitute part of her method in every case job. But we are still in the stage of regarding these as personal factors in equipment and of wishing to exclude any recognition of them from our case records. A hang-over of self-consciousness restrains us from mentioning ourselves in the case record. Is not our refusal to recognize and analyze these personal factors an indication of the subjectivity and not the objectivity of our present level of case work and of record writing? We will never succeed in objectifying these personal factors by ignoring them but by trying to record and analyze them as impartially as we do all the other factors that enter into treatment. Only when we have objectified and analyzed them to the same extent that we have the methods by which we manipulate the environment, and when by so doing some of these processes have become standardized can we afford to eliminate them from our records.

PROBLEMS OF ORGANIZATION IN SMALLER
COMMUNITIES

A. THE FIELD WORK SIDE

David H. Holbrook, Executive Director, American Association for Organizing Family Social Work, New York

What problems? What communities? What is the field side? If I sense correctly the theme before us for discussion, it concerns, primarily the missionary aspect of family case work. What progress is being made in bringing to communities less socially conscious the professional case work experience of other and usually larger communities, a little farther ahead on the road?

At the outset let us not delude ourselves into imagining that these other communities, where resources of leadership, science, skill, and local support have been marshaled definitely, intelligently, and aggressively in the interest of more normal family lives, are free from problems of organization and concerned only in a further refinement of methods.

Neither should we overlook the very practical motive for extension work in such an interdependent field as family work. In supporting field work the vigorous, progressive community has not only the inspiration that goes with the sharing of ideals and experience but the added incentive of thereby improving in service and economy the work among its own families. Better case work in the smaller com munities means some happier families in Milwaukee, Chicago, Pittsburgh, Louisvill Baltimore, Denver, and New Orleans.

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The first and lasting impression made on everyone coming in contact with fiel.. work is: each community as individual as a case, with each its peculiar background, its characteristic tone and spirit, and its own expression of ideals. Says an early field report of one worker, "There seems to be no common problem font tanding importance in these eight places." And one agrees as he catches g⠀⠀ for secretaries to be trained; others trying to get along with souls in charge of limited relief programs; in a city calling size in the world" one organization attempting to do prac work in the community, including institutional, and doing no

in the throes of a centralization-of-agencies program; societies led by untrained workers of native ability and courage, but handicapped by lack of training; a departmental society with a loosely articulated program; a society facing a crisis due to the disbanding of another organization that had always provided the funds for relief; a community considering the establishment of a confidential exchange; another perfecting relationships with the county officials; another keen for a thoroughgoing survey, etc.

Truly this is a confusing picture alike to us and to the field worker as he first encounters these situations demanding attention. Instinctively he feels his need for a technique in approach, diagnosis, and treatment of communities as carefully worked out as that of the case worker. And when he undertakes his diagnosis of existing case work organization, then indeed does he summon all his ingenuity in the effort to approach most sympathetically those who must be assured sooner or later that the function of the outsider is not one of interference, but is rather to assist in a co-operative effort to join soul and vision with system and efficiency. The value of the advice and treatment will naturally vary in proportion to the experience as well as the ability of the field worker. It is hard enough to tell what is the matter, but it is still more difficult to know what needs to be done. Only constant dealing with field problems develops the ability to recognize real rather than superficial symptoms, and the knack of getting all concerned to take the next step with confidence.

One other early impression of the field worker that speedily develops into a settled opinion and later determines a policy is the influence of family social work established in one city, particularly if it be a large one, on the social work in neighboring communities. It is common experience to find organizations curiously similar in construction in certain parts of the country, whose names and structure may be traced to the society in the larger city in this particular area. Furthermore, the fundamentals and spirit of case work suffer if the work of the nearest large society is poor.

This very natural reaction between communities is at once a justification for organized field work and a basis for its strategy. For the interest of one community in the experience of others means fundamentally a desire to do things in the best possible way, and the true mission of the field worker is so to organize and direct that interest as to make it serve its real purpose. A settled policy of field work, therefore, particularly in the newer sections of the country, is to devote a considerable proportion of time to strengthening and undertaknig the initial development of family social work societies in communities which are strategic centers of influence over large areas of country. In real sense the problem of the small community must rge city.