Introduction to a Social Worker

The National Institute for Social Work Training

• Editorial: Routledge
• Año: 2021
• ISBN:
  9781000438185
• Edición: 1
• Categoría: Medicine
• Categoría: Health Care Delivery

Originally published in 1964, this was an introduction to social casework, that is social work with individuals and families. It was written for students at the beginning of their training and, while intended for the social worker, it would also prove useful to other students of the social sciences and interesting to the ordinary citizen who wanted to know what social work could offer either to people in trouble or to those who adopted it as a career.

The book was both authoritative and up-to-date at the time, in a field in which methods of training had evolved quite rapidly. To this its origin bears witness: the preparatory work was done by Miss Florence Mitchell, an experienced social worker and teacher of social casework. The book was shaped in consultation with other practitioners and teachers, including Dr Younghusband and Miss K. M. Lewis of the National Institute whose work had done so much to shape modern methods of training.

The first chapter gives a picture of people who need the social worker's help. It is followed by a brief survey of methods, by three chapters of case studies and by a final chapter on social work in the social services. The book thus combines a philosophy with practical guidance.

CHAPTER III SOCIAL WORKERS IN ACTION: MRS WHITE AND GORDON

This is a record by a hospital medical social worker (almoner). It shows how the situation developed at different dates over a period of two months and then summarizes subsequent developments. It is a record of work with a teenager threatened with blindness. He and his widowed mother both required help in adjusting to the boy’s disability and its consequences. It illustrates how the almoner adapted her way of working to meet their different needs; this meant to stand by Gordon in his efforts to come to terms with his blindness and to support his mother who was bewildered by the enormity of the affliction and felt helpless through not knowing how to behave towards her son.

December 29th.

The consultant physician asked me to see Gordon White, aged sixteen, who has an incurable eye disease. He can distinguish light and dark but for practical purposes he is blind. Last night Dr Fisher explained to Gordon that he would not improve and had told him that the almoner would discuss change of work with him. Dr Fisher will talk to Mrs White as soon as she visits next. Gordon may go home in a few days’ time and come to see the eye consultant as an out-patient to be examined for entry on the blind register.

The ward sister told me that Gordon had had a restless night, waking frequently in tears and needing a great deal of comfort from the night staff. This morning, however, he was very off-hand, cracking jokes, almost as though nothing had happened. The sister thought he must be under considerable strain and the sooner he could talk about his future the better. She would send Mrs White to me as soon as Dr Fisher had seen her.

Gordon is an exceptionally tall, handsome boy, who greeted me soberly as soon as I introduced myself. He was expecting me. His first comment was that he wished his mother did not have to know about this. He did not think she would be able to take it. His eyes filled with tears which he hastily stifled and seemed to welcome my more general questions about his family and work. He explained that he is an only child whose father died when he was an infant. He has many very old relatives living nearby, his mother being the youngest of a large family. Since leaving school a year ago he has worked for a firm of draughtsmen. He obviously cannot go on working there, but shrugged helplessly saying he had no idea what else to try. I agreed that this was a question needing a great deal of thought and not one about which any quick decisions could be made.

With no prompting from me, Gordon went on to speak with angry protest about missing his football, table tennis and athletics. He described how he has been losing at table tennis—a vivid description of being teased at missing the ball and not knowing whether to mention his eye trouble or not. He could imagine it sounding pretty feeble, as if he were making excuses. I agreed it was an awkward dilemma. He made his point about missing sport very emphatically.

Gordon then came back to whether his mother need know and finally commented that he supposed she guessed anyway. He seemed relieved that I intended to see her as soon as she had talked to Dr Fisher. We agreed that I would need to see him some more after he had gone home. There was too much to think about to decide anything quickly and it was too hard to think about blindness for any length at a stretch. I enquired about how he would get to hospital to see me. He angrily insisted that I need not worry about that. I supposed people would offer to help him and it would make him feel cross. He agreed gloomily. We left it that I would see his mother and fix a time for him to come to see me.

December 30th.

Mrs White came to the office. She is a dowdily dressed woman in late middle age, talking in a flat expressionless way. She spoke haltingly, frequently shrugging, and her sentences trailing off. She had talked to Dr Fisher last night and although she had visited Gordon afterwards they had spoken of his home-coming, not about his blindness. Mrs White spoke of the terrible thing this was for Gordon, how it had ruined his life and how she wondered why something like this had happened to Gordon who had everything to live for. She suspected this might happen, because their general practitioner had tried to warn her, but she was unable to believe it was true.

Mrs White said she was widowed when Gordon was four and had worked to support him with the help of her relatives who live nearby. She has been worried about work for herself recently as she found she could not keep up with the factory work she had been doing since her husband’s death. She was lucky to find an alternative job in an office with kind employers so that she will have an income for her later years. This job is in a neighbouring town with fares to pay but light and easy.

I told Mrs White of the services that were available for Gordon as a blind person. She knew something of this already but protested that she would not want to think of him with blind people and certainly would not let him go away anywhere for training. She pointed out in a simple unashamed fashion that he was ‘her world’ and she had nothing to live for except him.

Mrs White enquired about Gordon’s financial position. He still has pay from his work and sickness benefit but she will have to tell his boss that he cannot return and she doubts if she can support him on her wage of £7 a week. I told her that the National Assistance Board could be approached once his pay stops. She will tell me what happens about this.

Mrs White said she was relieved that I would explain things to Gordon. We arranged that Gordon would come to see me on the same day as he comes to see the eye consultant, Dr Page. She would like to see me again after she has taken Gordon home. She gave the impression of feeling cut off from him, perhaps even frightened of being alone with him, though she did not openly admit this.

January 4th.

Mrs White came by appointment. She complained of feeling depressed and of a barrier between her and Gordon. She would like to know what terms the doctor used when he told him he would not recover but she cannot bring herself to ask Gordon. He seems happy a great deal of the time and she does not want to be responsible for reminding him about his problem by introducing the matter in conversation.

Gordon is staying with Mrs White’s sister at present as otherwise he would be alone all day while she is at work. When he first left hospital he slept in their flat and went to his aunt’s day by day. Since the weather has been so bad they decided he had better stay at his aunt’s place. Although she did not say so, I think she is relieved not to be alone with Gordon because she does not know what to say to him.

Mrs White had a great deal to say about the enormous tragedy of all this, speaking with some anger about a fellow employee who is upset because his seventy-year-old mother has gone blind. While she thinks this is a bad problem for them to have, she resents being told about something that falls so far short of Gordon’s troubles.

We discussed whether Mrs White was willing for me to go ahead with plans for a worker in the local authority welfare department to see her and Gordon. She wished they could just stay as they are without having to think about the future, but acknowledged that for everyone’s sake active steps must be taken. She would be glad if I would go ahead with this.

I told Mrs White that I wanted to see her, not only to ask about registration with the local authority but also because she seemed to be so distressed about Gordon. She said that she appreciated this very much as there was no place she could talk about it. Although she seemed to be both angry and miserable she was not forthcoming about her feelings and was, I felt, forbidding me to get too close. Nevertheless she co-operated in making a further appointment. Gordon is to see Dr Page and me on January 9th and Mrs White would like to see me after that.

We had a discussion about whether she would like to come to the clinic with Gordon or not. On the one hand she is nervous about his going out alone, but at the same time she hesitates to speak to the doctor in his presence. If she did not come with him she would like to think he had a car. He would be impatient of this but she would like to insist that he have it. I thought it useful to encourage any positive steps she felt she could take as Gordon’s mother and agreed to order a car if she decided not to come with him herself. She wanted to think about this and telephone to me.

January 8th.

Mrs White telephoned. She has decided it would not be justified to take time off from work to accompany Gordon tomorrow, so I arranged for a car to bring him.

January 9th.

Gordon was seen in the eye clinic by Dr Page who thought there was some slight sign of improvement in his vision. He did not, at this point, want to make a final decision about his registration as a blind person giving his opinion that although cure was impossible some improvement might be hoped for. He therefore thought no decisive moves ought to be made at present, while he observes Gordon at monthly intervals. Gordon complained to him of feeling bored so the doctor wondered if I could help him do something about this. He would like him to be happily occupied but not doing anything too physically strenuous. If he is very careful crossing roads, Gordon should be able to travel by bus. Gordon asked him about this.

I saw Gordon today and again the following week. I wrote to Mrs White explaining that Dr Page wanted Gordon to wait a while before going ahead with work plans and confirming that the doctor had said that Gordon could travel by bus. Offered Mrs White an appointment for January 18th.

During our two interviews Gordon made good use of opportunities to discuss his situation. He mostly sat slouched in his chair, irritable and discontented and protesting quite belligerently at times. I tried to take up whatever he was saying to encourage him to go on and speak his mind. He had a lot to say about one doctor saying one thing and another something different. I agreed that this was what had happened and it was confusing and irritating. He wished he knew where he stood and had heard his mother saying the same thing to his aunts. I sympathized about having to wait for something so very important.

Another discontent was what to do with himself. He repeated at greater length his experience of being teased for losing at table tennis. People he used to be able to beat comfortably can now give him ten points and still win. He mimicked himself saying in a joking, deprecating way that he couldn’t see the ball and the others mocking him—‘Listen to White, full of excuses.’ I had the impression that all this was fairly good-humoured but Gordon could not take this well-intentioned banter. He has only been back to his club once since leaving hospital. He does not want to go just to talk. If the others are playing that is all he thinks about too. He went on to tell me that he won the local junior championship last year. The club was beaten by a team from a neighbouring town in the finals but this year he was sure they would have won if he had been in the team. As it is he thinks they will be beaten again. He went on to tell me about his football activities, his training and his half hope that he could be a professional. He knew this was never certain but it was the job he would have liked best to do. He was close to tears about this and accepted my sympathy in quite a simple fashion. We discussed listening to sports reports on the radio and having people to read to him from the newspapers. He likes being read to but hates asking his family to do it, though they seem to do it willingly enough.

Gordon complained of feeling ill at ease with his mother and aunts who fuss about him and help him unnecessarily. We had a long discussion about this. He recognized that being an only child among a lot of women he has to put up with fussing in any event. He paid less attention to it when he could see but now they make him feel like a baby. We recognized how uncomfortable this is and the fact that mothers and aunts tend to act this way. He dislikes too the way his mother and aunts tell everybody about him. He hates pity and special consideration. We agreed that he is receiving a lot of this and is having his temper sorely tried.

Gordon also told me that his mother gets on his nerves by giving him too many things. This is a problem not specially connected with his blindness but it is being brought home rather forcefully at present. Every Easter it has been his custom to have a new suit. His mother proposes to go ahead and get him one this Easter as usual. He discussed his dilemma about this. On the one hand he likes clothes and likes to look fashionable, but he feels guilty about his mother having to make special efforts for him as she is a widow and not earning much.

We discussed ideas about what he could do with himself while he waits about for the next few months. He discarded the idea of swimming with an instructor as it is too cold and he only likes the beach, not the baths. He showed more interest in having someone outside the family read to him about sport but was apprehensive about having some elderly person who would fuss over him and expect him to be interested in things he did not understand. He preferred that I did not do anything special about any of this for the time being.

As he was leaving at the end of the second interview Gordon, who knew that I was seeing his mother the following day, asked me not to tell her that he was feeling fed up with her. I told him I would talk to her about arranging his financial affairs as she would have to know about this as he is only 16. He accepted this. I told him I was very careful in a situation like this not to discuss his private affairs with his mother nor her private affairs with him. Rather awkwardly he said he thought this was a very good idea and useful that it could work like this.

January 18th.

Mrs White came. I gave her opportunities to say she was confused about the medical position. She responded in a rather depressed fashion knowing that conflicting opinions had been given but not reacting very strongly about it. She said that Gordon told her his sight was better and that he could go about on his own without needing the hospital car. She did not altogether believe this until she had my letter. She thinks that Gordon sometimes jokes and says silly things about his blindness, so she does not know what the exact position is. I had the impression that she was willing to let things drift for the time being, perhaps even relieved that no big decisions had to be made.

I enquired about Mrs White’s financial position. Gordon’s firm has stopped paying him now and has returned his cards to Mrs White. She would like to try and get an extra allowance for him. His clothes are very expensive and he eats far more than most normal adults. His sickness benefit (32s 6d) goes on his pocket money, dry cleaning and shoe repairs. Gordon offers her his cheque every week but she finds that she needs to give back that amount of money to him in any event so does not take it in the first place. I offered to enquire what hope there was of extra N.A.B. allowance. She would like to know exactly what to do before she asks for further time off to attend to this.

When I asked again about Mrs White’s own financial position she quickly and defensively said that she had told me once before that she earned £7 a week. I enquired if she also had a widow’s allowance at which she made a long speech about never having had any help from anywhere, never having broken the law, nor taken anything she was not entitled to. I commented that she did not have to discuss her affairs with me, but I thought she was unhappy and in difficulties and I would like to help if I could. Mrs White then explained that Gordon is illegitimate. It was difficult for her to speak about this and it was clear that she has years of pent-up resentment about it, which is largely unexpressed. She pointed out several times that she has made no pretence with the taxation authorities about her true position, has had no allowance or concessions to distinguish her from a single woman, though she calls herself Mrs White. Gordon knows nothing of this, though she expects that he may have to some time. She has had offers of marriage provided Gordon were cared for elsewere, but she decided that Gordon was her first responsibility and had to stay with her.

At no time did Mrs White speak easily of this matter. She was defensive, returning briefly to the subject and dropping it again. She was obviously uncertain of my attitude and not sure that she should have told me.

January 23rd.

Mrs White came to discuss the information I had from the National Assistance Board. Because Gordon is sixteen and has been at work he is considered an independent adult and his mother’s circumstances are irrelevant. Their allowance for a sixteen-year-old is 32...

Índice

• Cover
• Half-Title Page
• Title Page
• Copyright Page
• Original Title Page
• Original Copyright Page
• Preface
• Table of Contents
• I. People Who Need Social Work Help
• II. The Methods of Social Work
• III. Social Workers in Action: Mrs White and Gordon
• IV. Social Workers in Action: Mr and Mrs Upton
• V. Social Workers in Action: Mr and Mrs Bristoe
• VI. The Boundaries of Social Work