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UBC Theses and Dissertations

The private practice of social work : Vancouver, B.C., 1987 Thompson, Gail Patricia 1988

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THE PRIVATE PRACTICE OF SOCIAL WORK: VANCOUVER, B.C. 1987 by GAIL P A T R I C I A THOMPSON B.S.W., The U n i v e r s i t y o f B r i t i s h C o l u m b i a , 1986 A THESIS SUBMITTED I N PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SOCIAL WORK i n THE FACULTY OF GRADUATE STUDIES S c h o o l o f S o c i a l Work We a c c e p t t h i s t h e s i s a s c o n f o r m i n g t o t h e r e q u i r e d s t a n d a r d THE UNIVERSITY OF B R I T I S H COLUMBIA F e b r u a r y 1988 © G a i l P a t r i c i a Thompson, 1988 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. GAIL THOMPSON Department of Socia l Work The University of British Columbia 1956 Main Mai! Vancouver, Canada V6T 1Y3 Date \^j2^^dsUS J'.Z&T* - i i -A b s t r a c t The p r i v a t e p r a c t i c e o f s o c i a l work has b e e n e i t h e r c e n t r a l o r t a n g e n t i a l t o many h i s t o r i c a l a nd c o n t e m p o r a r y s o c i a l work i s s u e s . Over t h e y e a r s i t has b e e n i n h e r e n t i n d e b a t e s and d i s c u s s i o n s on p r o f e s s i o n a l i s m , c a u s e v e r s u s f u n c t i o n ( o r macro v e r s u s m i c r o ) , p u b l i c v e r s u s p r i v a t e ( o r p r i v a t i z a t i o n ) , e l i t i s m , c o n t r o l - o f - t i t i e , r e g i s t r a t i o n o r l i c e n s i n g and v e n d o r s h i p ( o r t h i r d - p a r t y p a y m e n t s ) . P r i v a t e p r a c t i c e h a s b e e n d e b a t e d and d i s c u s s e d a t two d i f f e r e n t l e v e l s . H i s t o r i c a l l y , i t was m a i n l y d e b a t e d a t a h i g h e r l e v e l — t h e l e v e l o f i d e o l o g i e s a n d p h i l o s o p h i e s w h i c h r e f l e c t e d v a r i o u s d e e p l y h e l d v a l u e p o s i t i t i o n s . More r e c e n t l y a s u p e r f i c i a l s h i f t h a s o c c u r r e d t h a t has moved t h e d e b a t e t o a l o w e r l e v e l and has f o c u s s e d t h e d i s c u s s i o n s on d e s c r i p t i o n s o f t h e c h a r a c t e r i s t i c s o f p r i v a t e p r a c t i c e . T h e s e d e s c r i p t i o n s a r e s o m e t i m e s c o n t r a d i c t o r y , s o m e t i m e s i n c o n c l u s i v e , and a l m o s t a l w a y s , o r i g n i n a t e f r o m t h e U n i t e d S t a t e s . N o n e t h e l e s s , t h e y t o o a r e u s e d a s a r g u m e n t s b o t h a g a i n s t and i n s u p p o r t o f p r i v a t e p r a c t i c e . On t h e h i g h e r l e v e l , t h i s p a p e r r e s e a r c h e d p r i v a t e p r a c t i c e i n t h e c o n t e x t o f i t s r e l a t i o n s h i p t o p r o f e s s i o n a l i s m and t h e o r i e s o f p r o f e s s i o n a l i z a t i o n . On t h e l o w e r l e v e l , t h r o u g h a s e l f - a d m i n i s t e r e d m a i l e d q u e s t i o n n a i r e , p r i v a t e p r a c t i t i o n e r s i n G r e a t e r V a n c o u v e r were s u r v e y e d i n o r d e r t o o b t a i n a n a c c u r a t e and c u r r e n t , d e s c r i p t i o n of p r i v a t e p r a c t i c e w i t h i n the d e f i n e d g e o g r a p h i c a l a r e a . Many of the d e s c r i p t i o n s r e p o r t e d i n the p r i v a t e p r a c t i c e l i t e r a t u r e were supported by t h i s sample and others were not. Due to the d e v e l o p i n g l e a d e r s h i p r o l e of p r o f e s s i o n a l s w i t h i n s o c i e t y , p r o f e s s i o n a l i z a t i o n was determined to be b e n e f i c i a l to the p r o f e s s i o n . P r i v a t e p r a c t i c e was found to be the d e l i v e r y model most c o n s i s t e n t with e a r l y c r i t e r i a of p r o f e s s i o n a l i z a t i o n . However, re c e n t authors ( A u s t i n , 1983; Popple, 1985) have r e j e c t e d some of the c r i t e r i a p r e v i o u s l y a s s e r t e d as needing to be f u l f i l l e d i n order to a t t a i n p r o f e s s i o n a l s t a t u s . I t was t h e r e f o r e concluded t h a t while p r i v a t e p r a c t i c e h i s t o r i c a l l y advanced the p r o f e s s i o n a l i z a t i o n of s o c i a l work, the continuence or the expansion of p r i v a t e p r a c t i c e i s not necessary i n order to e i t h e r a t t a i n f u r t h e r p r o f e s s i o n a l s t a t u s or to r e t a i n t h a t which has a l r e a d y been ach i e v e d . - i v -T a b l e o f C o n t e n t s p a g e A b s t r a c t i i T a b l e o f C o n t e n t s i v L i s t o f T a b l e s v i i i L i s t o f F i g u r e s x i A c k n o w l e d g m e n t x i i C h a p t e r 1. T h e H i s t o r y o f t h e I n f l u e n c e o f T h e o r i e s o f P r o f e s s i o n a l i z a t i o n o n S o c i a l W o r k 1 H i s t o r y o f t h e T e n s i o n 2 P r i v a t e P r a c t i c e \ 21 T h e P r o b l e m 28 T h e P u r p o s e 28 T h e O b j e c t i v e 28 O p e r a t i o n a l i z a t i o n s 29 2. C r i t i c a l I s s u e s I n T h e P r i v a t e P r a c t i c e D e b a t e . 31 R e s e a r c h Q u e s t i o n s 32 C h a r a c t e r i s t i c s o f P r a c t i t i o n e r s 32 C h a r a c t e r i s t i c s o f A s p e c t s o f S e r v i c e . . 43 C h a r a c t e r i s t i c s o f C l i e n t s 49 D e m o g r a p h i c a n d B a c k g r o u n d I n f o r m a t i o n . 53 L i m i t a t i o n s o f t h e R e s e a r c h 55 S c o p e 55 L e v e l s o f M e a s u r e m e n t a n d M a t u r i t y 55 -v-3. A Summary of The Research Model and Design... 58 Research Model 58 Design 58 Data A n a l y s i s 6 0 E t h i c a l C o n s i d e r a t i o n s 62 4. R e s u l t s : D e s c r i b i n g P r i v a t e P r a c t i c e 63 Demographic and Background Information. 64 C h a r a c t e r i s t i c s of P r a c t i t i o n e r s . 71 C h a r a c t e r i s t i c s of Aspects of S e r v i c e . . 95 C h a r a c t e r i s t i c s of C l i e n t s 103 Summary 108 Demographic and Background Data 108 C h a r a c t e r i s t i c s of P r a c t i t i o n e r s 109 C h a r a c t e r i s t i c s of Aspects of S e r v i c e . . I l l C h a r a c t e r i s t i c s of C l i e n t s 112 5. P r o f e s s i o n a l i z a t i o n , P r i v a t e P r a c t i c e , and the Future 114 Flaws i n the C r i t e r i o n Theory of P r o f e s s i o n a l i z a t i o n 115 The S i g n i f i c a n c e of the C r i t e r i o n of "Community S a n c t i o n " 121 Disadvantages of P r o f e s s i o n a l i z a t i o n 123 Advantages of P r o f e s s i o n a l i z a t i o n 128 I m p l i c a t i o n s f o r Future Research 132 Co n c l u s i o n 133 B i b l i o g r a p h y 136 - v i -Appendixes A. Covering L e t t e r and Q u e s t i o n n a i r e 142 B. E l a b o r a t i o n of Research Model and Design 154 Research Model 154 Research Design 155 U n i t s , Timing, S e t t i n g 156 Sampling 156 M e t h o d o l o g i c a l O r i e n t a t i o n 159 The Mailed Q u e s t i o n n a i r e 159 C. Mailed Q u e s t i o n n a i r e Methodology 168 Maximizing Response Rates and M i n i m i z i n g Response E r r o r s 172 Envelopes and Stamps 174 The Covering L e t t e r 174 The T i t l e 175 P e r s o n a l i z a t i o n 175 Sponsorship 175 Anonymity and C o n f i d e n t i a l i t y 176 I n c e n t i v e s 177 Time Cue 177 Return Date 178 A d d i t i o n a l M a t e r i a l 179 The Instrument 179 S a l i e n c e 179 Length 179 Format 181 Wording 182 - v i i -Q uestions 183 Follow-Ups ... 189 Strengths and L i m i t a t i o n s 190 Strengths 190 L i m i t a t i o n s 191 - v i i i -L i s t o f T a b l e s T a b l e page 1. Employment C h a r a c t e r i s t i c s b y Sex 65 2. F r e q u e n c i e s a nd P e r c e n t a g e s o f S o c i a l Work D e g r e e s A t t a i n e d 66 3. E d u c a t i o n a l B a c k g r o u n d b y H i g h e s t L e v e l A t t a i n e d I r r e s p e c t i v e o f D i s c i p l i n e 67 4. B e s t P r e p a r a t i o n f o r P r i v a t e P r a c t i c e . . 68 5. N o n - m u t u a l l y E x c l u s i v e L i s t o f S p e c i a l i z e d T r a i n i n g o f I m p o r t a n c e t o P r a c t i t i o n e r s . . . . 69 6. F r e q u e n c i e s , P e r c e n t a g e s a nd C u m u l a t i v e P e r c e n t a g e s o f G r o s s Income E a r n e d , 1 9 8 6 . . . 70 7. F r e q u e n c y o f I d e n t i f y i n g S e l f a s S o c i a l W o r k e r 74 8. A d v e r t i s i n g M e t h o d , by I n d i c a t i n g R e g i s t r a -t i o n , S o c i a l Work D e g r e e s , T h e r a p i s t o r C o u n s e l l o r 75 9. F r e q u e n c y o f P r a c t i t i o n e r s I d e n t i f y i n g S e l v e s a s S o c i a l W o r k e r s , b y L i s t i n g F a m i l y T h e r a p y a s " S p e c i a l T r a i n i n g " 76 10. F r e q u e n c y o f I d e n t i f y i n g S e l f a s S o c i a l W o r k e r b y Sex 78 1 1 . F r e q u e n c y o f P r a c t i t i o n e r s E n g a g i n g i n P r o f e s s i o n a l D e v e l o p m e n t 80 12. F r e q u e n c y o f P r a c t i t i o n e r s R e a d i n g P r o f e s s i o n a l J o u r n a l s 80 - i x -13. Frequency of Engaging i n P r o f e s s i o n a l Development by Employment C h a r a c t e r i s t i c s . . . 82 14. Frequency of Reading P r o f e s s i o n a l J o u r n a l s by Employment C h a r a c t e r i s t i c s 83 15. Percentages of Respondents Who Have Con-t r i b u t e d to the P r o f e s s i o n - L a s t Two Years 84 16. C o n t r i b u t i o n s to S o c i a l Work Research -Las t Two Years 85 17. Number of Works P u b l i s h e d - L a s t Two Years 85 18. Frequency of Involvement i n Community-L e v e l A c t i v i t i e s 87 19. Frequency of I s o l a t i o n , S t i m u l a t i o n , and Supportive R e l a t i o n s h i p s 89 20. C l i e n t Numbers and Income S a t i s f a c t i o n 90 21. Frequencies and Percentages of Most P o s i t i v e Aspects of P r i v a t e P r a c t i c e 91 22. Frequencies and Percentages of Most Negative Aspects of P r i v a t e P r a c t i c e 92 23. F r e q u e n c i e s , Percentages and Cumulative Percentages of P r a c t i t i o n e r s ' P r e f e r r e d Model of Payment f o r S e r v i c e s 94 24. F r e q u e n c i e s , Percentages and Cumulative Percentages of M a j o r i t y of R e f e r r a l Sources 95 25. Frequency of R e f e r r i n g P o t e n t i a l C l i e n t s 95 -x-26. Frequency of R e f e r r i n g to Another P r a c t i -t i o n e r Who i s Covered by Medical I n s . . . . . . . 96 27. Frequencies and Percentages of, Who Most F r e q u e n t l y I n i t i a t e s T ermination 99 28. Frequency of C o n s u l t a t i o n and E v a l u a t i o n 100 29. Method of Charging by Fees Charged i n D o l l a r s / H r 102 30. Frequency of S p e c i a l Groups Represented on Caseloads 103 31. Economic S i t u a t i o n of C l i e n t s 104 32. Non-mutually E x c l u s i v e L i s t of Most Commonly Presented Problems 105 33. Average Percentages of C l i e n t s i n Various Age Groups, by Sex 108 - x i -L i s t of F i g u r e s F i g u r e page 1. St r e n g t h of M o t i v a t i n g F a c t o r s f o r E n t e r i n g P r i v a t e P r a c t i c e , by Sex 72 2. Rank Order of C l i e n t U n i t s Seen 107 i - x i i -Acknowledgements Th i s t h e s i s would not have been p o s s i b l e without the a d v i c e , suggestions and encouragement of many people. Thank you to my a d v i s o r Dr. Anne Furness f o r making h e r s e l f so a v a i l a b l e to me throughout the e n t i r e process of t h i s work. I would l i k e too, to acknowledge the advice of P r o f e s s o r John Crane d u r i n g the e a r l y stages of t h i s r e s e a r c h , and to thank P r o f e s s o r E l a i n e S t o l a r f o r assuming the r o l e of r e s e a r c h a d v i s o r i n P r o f e s s o r Crane's absence. The hours P r o f e s s o r s Furness and S t o l a r have giv e n to r e a d i n g the d r a f t s of t h i s work, t h e i r d i r e c t i o n s , and t h e i r suggestions are a p p r e c i a t e d . Thank you too, to my f a m i l y and f r i e n d s and e s p e c i a l l y to Frank, T e r r i and Tania f o r t h e i r enduring understanding, support, and encouragement. THE PRIVATE PRACTICE OF SOCIAL WORK: VANCOUVER, B.C. 1987 The H i s t o r y of the I n f l u e n c e of T h e o r i e s of P r o f e s s i o n a l i z a t i o n on S o c i a l Work T h i s r e s e a r c h was undertaken to d e s c r i b e the c h a r a c t e r i s t i c s of s o c i a l work p r i v a t e p r a c t i c e i n the Greater Vancouver ar e a , and Is i n response to a s h i f t t h a t appears to have taken p l a c e i n the s o c i a l work l i t e r a t u r e on the s u b j e c t of p r i v a t e p r a c t i c e . Since the e a r l i e s t volumes, s o c i a l work j o u r n a l s have Included a r t i c l e s t h a t q u e s t i o n the a p p r o p r i a t e n e s s of the p r i v a t e p r a c t i c e of s o c i a l work. These q u e r i e s a r i s e from l a r g e r debates and d i s c u s s i o n s t h a t have been i n t e g r a l to s o c i a l work and have tended to r e f l e c t d e e ply h e l d value p o s i t i o n s c o n c e r n i n g cause versus f u n c t i o n (or macro versus m i c r o ) ; p u b l i c versus p r i v a t e , and i n s t i t u t i o n a l versus r e s i d u a l . T h i s study i n c l u d e s a review of these debates and e x p l o r e s the ways i n which the t h e o r i e s of p r o f e s s i o n s and of p r o f e s s i o n a l i z a t i o n have impacted upon the above i s s u e s and how both the i s s u e s and the t h e o r i e s continue to impact upon the d i s c u s s i o n s f o c u s s i n g on p r i v a t e p r a c t i c e today. A s u p e r f i c i a l s h i f t has occurred i n the l i t e r a t u r e i n r e c e n t years t h a t has taken the focus away from p h i l o s o p h i e s and i d e o l o g i e s and has turned i t toward d e s c r i p t i o n s of the c h a r a c t e r i s t i c s of p r i v a t e -2-p r a c t l t l o n e r s . There has been an I n c r e a s i n g range of assumptions appearing i n the l i t e r a t u r e t h a t d e s c r i b e s p r a c t i t i o n e r c h a r a c t e r i s t i c s . I t Is b e l i e v e d t h a t t e s t i n g some of these assumptions w i l l c o n t r i b u t e c l a r i t y t o the knowledge base of t h i s added dimension of the l o n g - s t a n d i n g , and p r e v i o u s l y "belief-dominated*', debate. On one l e v e l t h i s r e s e a r c h alms to c o n t r i b u t e to the a c c u r a c y of the knowledge base on p r i v a t e p r a c t i t i o n e r s from which f u r t h e r d i s c u s s i o n s may flow. (Even though t h i s r e s e a r c h has been g e o g r a p h i c a l l y c o n f i n e d , I t Is hoped t h a t t h i s s p e c i f i c p i e c e of r e s e a r c h w i l l a l s o c o n t r i b u t e to the g r e a t e r understanding of the c h a r a c t e r i s t i c s of p r i v a t e p r a c t i t i o n e r s In g e n e r a l . ) And on a higher l e v e l , t h i s r e s e a r c h alms to h i g h l i g h t the r e l a t i o n s h i p of these c h a r a c t e r i s t i c s to t h e o r i e s of p r o f e s s i o n a l i z a t i o n and t o t h e i r h i s t o r i c a l i n f l u e n c e s on s o c i a l work. H i s t o r y of the t e n s i o n Formalized s o c i a l work had two antecedents. The c h a r i t y o r g a n i z a t i o n s which organized and f o r m a l i z e d the e a r l y c h a r i t a b l e and p h i l a n t h r o p i c work p r e v i o u s l y done by the church; and group and community work t h a t was centered i n the s e t t l e m e n t houses. MNlnety-two c h a r i t y o r g a n i z a t i o n s were e s t a b l i s h e d In the major c i t i e s of Canada and the United S t a t e s between 1877 and 1892. These C h a r i t y O r g a n i z a t i o n S o c i e t i e s (COSs) are regarded as the forerunners of modern casework" -3-(Ency. of S.W. " H i s t " , p. 740). In the e a r l y stages the C h a r i t y O r g a n i z a t i o n s provided v o l u n t e e r f r i e n d l y v i s i t o r s , a sympathetic ear, moral guidance, and when a b s o l u t e l y n e c e s s a r y — r e l i e f i n k i n d . S e r v i c e s were based on a r e s i d u a l model. Only those d e s p e r a t e l y i n need r e c e i v e d r e l i e f or s e r v i c e s . The s e t t l e m e n t house movement was developed to help immigrants e s t a b l i s h themselves i n t h e i r new c o u n t r y . Settlement workers l i v e d among the people they served and "used p e r s u a s i o n to get l o c a l p o l i t i c i a n s t o provide b a s i c s e r v i c e s .... [ T h e i r i n t e r v e n t i o n took the form o f ] group work, community o r g a n i z a t i o n , and advocacy" (Ency. of S.W. " H i s t . p. 741). Both groups engaged i n some community work and i n s p i t e of t h e i r d i f f e r e n c e s the two groups cooperated. O c c a s i o n a l l y s e t t l e m e n t house workers were f r i e n d l y v i s i t o r s and COS workers l i v e d and v o l u n t e e r e d i n s e t t l e m e n t s . From the beginning of p a i d s o c i a l work, s o c i a l workers have been s t r i v i n g f o r p r o f e s s i o n a l s t a t u s . I t appears t h a t workers wanted e q u i t y with t h e i r p r o f e s s i o n a l c o l l e a g u e s , or as one author suggested when s o c i a l work moved i n t o medicine, " s o c i a l workers d i d not wish to assume the subordinate s t a t u s of nurses" (Ency. of S.W. " H i s t . " p. 742). Many of these i n i t i a t i v e s came from r e c e n t graduates from the new women's c o l l e g e s who were from middle or -4-u p p e r - c l a s s backgrounds; who were seeking c a r e e r s r a t h e r than t a k i n g on the t r a d i t i o n a l r o l e s of wives and mothers; but who were s t i l l l a r g e l y denied access to the e s t a b l i s h e d p r o f e s s i o n s of law, medicine and the c l e r g y ( A u s t i n 1983, p. 358). T h i s suggests t h a t they wanted a wage upon which they c o u l d l i v e independently and one t h a t was s u f f i c i e n t to m a i n t a i n the standard of l i v i n g to which they were accustomed. As a r e s u l t of the growing emphasis on r a t i o n a l i t y , s c i e n t i f i c e n q uiry, and r e s e a r c h and theory, In the l a t e n i n e t e e n t h c e n t u r y p r o f e s s i o n a l t r a i n i n g i n the United S t a t e s was l a r g e l y brought w i t h i n the u n i v e r s i t y system ( I n t . Ency. of Soc. Sc. " P r o f e s s i o n s " p. 542). At approximately the same time, Mary Richmond a leader In the COS c a l l e d f o r a t r a i n i n g s c h o o l i n a p p l i e d p h i l a n t h r o p y ( A u s t i n 1983 p. 375). The f o l l o w i n g year, "the f i r s t t r a i n i n g s c h o o l , the New York School of P h i l a n t h r o p y (now the Columbia U n i v e r s i t y School of S o c i a l Work) was s t a r t e d " (Ency. of S.W. " H i s t " , p. 742). Casework which began i n the COSs expanded i n t o m e d i c a l , p s y c h i a t r i c , and s c h o o l s o c i a l work. The f i r s t "formal p s y c h i a t r i c m a t e r i a l was o f f e r e d i n 1908 a t the Chicago School of C i v i c s and P h i l a n t h r o p y " (Ency. of S.W. " H i s t " , p. 743) and by 1912 a one year course In medical s o c i a l work was o f f e r e d a t the Boston School of S o c i a l Work. Community work evolved as the v o l u n t a r y w e l f a r e system (the forerunner of I n s t i t u t i o n a l i z e d s o c i a l w e l f a r e ) and r a t h e r than basing t h e i r a c t i v i t i e s on the " r a t i o n a l order i n welfare a c t i v i t i e s I they based them on] p o l i t i c a l a c t i o n and s o c i a l l e g i s l a t i o n to r e l i e v e the d i s t r e s s among the working c l a s s " (Ency. of S.W. " H i s t . " p. 746). Most set t l e m e n t house workers (the fo r e r u n n e r s of today's group workers) d i d not have s p e c i a l t r a i n i n g nor d i d they s t r e s s s o c i a l work p r i n c i p l e s . Rather, t h e i r I n t e r v e n t i o n was d i r e c t e d by the Immediate I n t e r e s t s and needs of the people they were s e r v i n g . "Between 1904 and 1912 when the New York School of P h i l a n t h r o p y added a second year to I t s program, an Intense debate occurred between the proponents of two approaches to the s o c i a l work c u r r i c u l u m . The f i r s t approach c a l l e d f o r an academic c u r r i c u l u m based on s o c i a l t h eory with an a n a l y t i c and reform o r i e n t a t i o n " ( A u s t i n 1983, p. 358). T h i s approach was supported by the d i r e c t o r of the s c h o o l and h i s c o l l e a g u e s who were p r o f e s s o r s of economics. One supporter of t h i s p o s i t i o n suggested t h a t , " s o c i a l work should focus on fundamental s o c i a l p o l i c y i s s u e s — w h o l e s a l e s o c i a l w e l f a r e — r a t h e r than on case by case a s s i s t a n c e — r e t a i l s o c i a l w e l f a r e " ( A u s t i n , p. 359). "The second approach c a l l e d f o r a s o c i a l work ed u c a t i o n c u r r i c u l u m based on p r a c t i c e wisdom with the o b j e c t i v e of p r e p a r i n g I n d i v i d u a l s to be 'case-workers' - 6 -f l r s t a n d ' s o c i a l I n v e s t i g a t o r s ' s e c o n d " ( A u s t i n 1 9 8 3 , p. 3 5 9 ) . The f i r s t a p p r o a c h was I n s t i t u t e d i n t h e 1911-1912 y e a r . However a t t h e end o f t h a t t e r m t h e d i r e c t o r l e f t t h e s c h o o l a n d f a c u l t y members w i t h s o c i a l work e x p e r i e n c e were e m p l o y e d . I n t h e end t h e s e c o n d a p p r o a c h won o u t , and e m p h a s i s was g i v e n t o c a s e w o r k o v e r c o m m u n i t y work ( A u s t i n 1 9 8 3 , p. 359) . I t a p p e a r s t h a t t h i s was p e r h a p s t h e f i r s t o f many c a u s e v e r s u s f u n c t i o n o r macro v e r s u s m i c r o d e b a t e s . I t i s s a i d t h a t " c a u s e " i s t h e why o f s o c i a l work w h i l e " f u n c t i o n " i s t h e what o r t h e how o f s o c i a l w o r k . M a c r o s o c i a l work a t t e n d s t o t h e c a u s e o f p r o b l e m s a t t h e l e v e l o f t h e e n v i r o n m e n t w h i l e m i c r o s o c i a l work a t t e n d s t o t h e r e s u l t o f p r o b l e m s a t t h e l e v e l o f I n d i v i d u a l s . R o b e r t R o b e r t s ( 1 9 6 8 ) s u g g e s t s t h a t s o c i a l work has two g o a l s — c h a n g e a nd I n t e g r a t i o n . " C a u s e " f a c i l i t a t e s c h a n g e - - o f s o c i a l c o n d i t i o n s , i n p o l i c i e s , a n d i n g o v e r n m e n t s ; w h i l e " f u n c t i o n " f a c i l i t a t e s i n t e g r a t i o n — o f t h e s e l f , w i t h i n r e l a t i o n s h i p s , w i t h i n f a m i l i e s , a n d w i t h i n o n e ' s c o m m u n i t y . By 1915 t h e e m p h a s i s on p r o f e s s i o n a l i z a t i o n m a n i f e s t e d i t s e l f i n s e v e r a l a d d r e s s e s g i v e n a t t h e N a t i o n a l C o n f e r e n c e o f C h a r i t i e s a n d C o r r e c t i o n . Abraham F l e x n e r , a famed c r i t i c a n d c o n s u l t a n t t o t h e m e d i c a l p r o f e s s i o n , was I n v i t e d t o a d d r e s s t h e q u e s t i o n , " I s s o c i a l work a p r o f e s s i o n ? " ( P o p p l e 1 9 8 5 , p. 5 6 3 ) . -7-Flexner s e t f o r t h s i x key elements i n h i s model of p r o f e s s i o n s . P r o f e s s i o n s i n v o l v e e s s e n t i a l l y i n t e l l e c t u a l o p e r a t i o n s with l a r g e I n d i v i d u a l r e s p o n s i b i l i t y , d e r i v e t h e i r raw m a t e r i a l from s c i e n c e and l e a r n i n g , t h i s m a t e r i a l they work up to a p r a c t i c a l and d e f i n i t e end, possess an e d u c a t i o n a l l y communicable technique, tend to s e l f - o r g a n i z a t i o n , and are becoming i n c r e a s i n g l y a l t r u i s t i c i n m o t i v a t i o n ( A u s t i n 1983, p. 363). Flexner a p p l i e d h i s c r i t e r i a of p r o f e s s i o n s to the c h a r a c t e r i s t i c s of s o c i a l work and answered the q u e s t i o n i n the n e g a t i v e . He argued t h a t w hile s o c i a l work was an i n t e l l e c t u a l a c t i v i t y , i t was "of a m e d i a t i n g [ r a t h e r ] than an o r i g i n a l agency". Rather than being " l i m i t e d and d e f i n i t e i n scope, ... the f i e l d of employment I i n s o c i a l work] i s indeed so v a s t t h a t d e l i m i t a t i o n i s i m p o s s i b l e " . . . . I t a l s o followed t h a t "the o c c u p a t i o n s of s o c i a l workers are so numerous and d i v e r s e t h a t no compact, p u r p o s e f u l l y o r g a n i z e d e d u c a t i o n a l d i s c i p l i n e i s f e a s i b l e " ( A u s t i n 1985, p. 363). In response to F l e x n e r ' s a d d r ess, Edward Devine presented a paper e n t i t l e d " Education f o r S o c i a l Work". In h i s address he suggested t h a t , the f i r s t p r i o r i t y among c u r r i c u l u m s u b j e c t s was "a course which d e a l s w i t h i n d i v i d u a l s and f a m i l i e s and - 8 -t h e i r c o m p l i c a t e d d i s a b i l i t i e s " , [ w i t h ! t h e n e x t I m p o r t a n t e l e m e n t b e i n g " t h e h i s t o r y and n a t u r e o f s o c i a l movements". I t was c l e a r a t t h a t c o n f e r e n c e t h a t t h e c o n t e n t o f s o c i a l work e d u c a t i o n had r e c e i v e d m a j o r a t t e n t i o n among t h e l e a d e r s h i p I n s o c i a l w e l f a r e , a n d t h a t t h e i s s u e was c l o s e l y t i e d t o t h e q u e s t i o n o f r e c o g n i t i o n a s a p r o f e s s i o n ( A u s t i n 1 9 8 3 , p 3 6 0 ) . A l s o i n r e s p o n s e t o F l e x n e r ' s a d d r e s s , a t t h e same c o n f e r e n c e , " J e f f r e y B r a c k e t t , G e o r g e M a n g o l d , a n d P o r t e r R. L e e a l l a r g u e d t h a t s o c i a l work must n a r r o w i t s f o c u s and d e v e l o p a n e d u c a t i o n a l l y c o m m u n i c a b l e t e c h n i q u e i n o r d e r t o become a c c e p t e d a s a p r o f e s s i o n " ( P o p p l e 1 9 8 5 , p. 5 6 4 ) . The i n f l u e n c e t h i s d i s c u s s i o n had on t h e p r o f e s s i o n o f s o c i a l work seems s u b s t a n t i a l . When one l o o k s i n t h e l i t e r a t u r e p o s t F l e x n e r ' s a d d r e s s , many d e v e l o p m e n t s i n s o c i a l work c a n be r e l a t e d i n some r e s p e c t , t o m e e t i n g e i t h e r F l e x n e r ' s c r i t e r i a o r t h o s e o f o t h e r t h e o r i e s o f p r o f e s s i o n s a n d p r o f e s s i o n a l i z a t i o n t h a t f o l l o w e d ( E n c y . o f S.W. " H i s t . " a n d P o p p l e , 1 9 8 5 ) . I t a p p e a r s t h a t b e c a u s e t h e t h e o r i e s s t a t e d t h a t i n o r d e r f o r s o c i a l work t o a t t a i n p r o f e s s i o n a l s t a t u s i t must n a r r o w I t s f o c u s a n d d e v e l o p a s t a n d a r d i z e d b o d y o f k n o w l e d g e , t e c h n i q u e , o r m e t h o d , an " e i t h e r / o r " q u a l i t y was i n s t i l l e d I n t o t h e d i s c u s s i o n s a n d a t e n s i o n d e v e l o p e d t h a t p e r s i s t s t o d a y . - 9 -I n t h e y e a r s f o l l o w i n g F l e x n e r ' s p a p e r , s o c i a l w o r k e r s e n g a g e d i n a f l u r r y o f a c t i v i t i e s a i m e d a t c o r r e c t i n g d e f i c i e n c i e s i d e n t i f i e d b y F l e x n e r . The number o f p r o f e s s i o n a l s c h o o l s i n c r e a s e d , a p r o f e s s i o n a l a c c r e d i t a t i o n b o d y was f o r m e d , p r e s s u r e was b r o u g h t t o b e a r t o s t a n d a r d i z e c u r r i c u l a , t r a i n i n g was a d v o c a t e d f o r a l l w o r k e r s , a nd a s e r i e s o f c o n f e r e n c e s was h e l d t o d e v e l o p a nd p r o m o t e t h e i d e a t h a t c a s e w o r k was a s i n g u l a r g e n e r i c s k i l l r e g a r d l e s s o f t h e s e t t i n g ( P o p p l e 1 9 8 5 , p. 5 6 4 ) . M i n d f u l o f F l e x n e r ' s c r i t e r i a t h a t e m p h a s i z e d i n t e l l e c t u a l a c t i v i t y , s c i e n c e a n d l e a r n i n g , a n d a c k n o w l e d g i n g t h e r e l a t i v e l y c a s u a l a g e n c y - b a s e d t r a i n i n g p r e d o m i n a n t among w o r k e r s ; g r a d u a t e a nd u n d e r g r a d u a t e p r o g r a m s were e s t a b l i s h e d i n w h i c h s t u d e n t s c o u l d r e g i s t e r p a r t - t i m e i n o r d e r t o f a c i l i t a t e a c a d e m i c t r a i n i n g . ( E n c y . o f S.W. " H i s t " p. 7 4 3 ) . The v a r i o u s f i e l d s o f s o c i a l work c o n s t i t u t e d d i f f e r e n t e d u c a t i o n a l t r a c k s . T h i s was n o t c o n s i s t e n t w i t h t h e p r o f e s s i o n a l m o d e l t h e r e f o r e t h e w i d t h a n d b r e a d t h o f s o c i a l work was d e a l t w i t h a t t h e M l l f o r d C o n f e r e n c e s b e t w e e n 1923 a n d 1929 when l e a d e r s f r o m v a r i o u s f i e l d s o f s o c i a l work u n d e r t o o k t h e t a s k o f d e v e l o p i n g a m o d e l f o r g e n e r i c c a s e w o r k ( E n c y . o f S.W. " H i s t " p. 7 4 3 ) . The q u e s t i o n o f w h e t h e r o r n o t s o c i a l work was a p r o f e s s i o n was r e - e x a m i n e d b y t h e p r e s i d e n t o f t h e A m e r i c a n A s s o c i a t i o n o£ S o c i a l W o r k e r s I n h i s k e y n o t e a d d r e s s I n 1925 and t h i s t i m e t h e q u e s t i o n was a n s w e r e d i n t h e a f f i r m a t i v e . " T h u s , s o c i a l w o r k e r s s e e k i n g p r o f e s s i o n a l s t a t u s h a d , u s i n g F l e x n e r ' s c r i t e r i a , n a r r o w e d t h e i r d e f i n i t i o n o f s o c i a l work t o p s y c h i a t r i c a l l y o r i e n t e d c a s e work a n d i n s o d o i n g , t h e y m i n i m i z e d o r c o m p l e t e l y e l i m i n a t e d , p u b l i c w e l f a r e , s o c i a l a n d l a b o r r e f o r m " ( P o p p l e 1 9 8 5 , p. 564) . C a n a d i a n s o c i a l w o r k e r s were a l s o g r a p p l i n g w i t h s i m i l a r i s s u e s a s t h e p r o p o s e d c o n s t i t u t i o n f o r t h e f o r m i n g C a n a d i a n A s s o c i a t i o n o f S o c i a l W o r k e r s (CASW) showed. "The A s s o c i a t i o n s h a l l s e e k t o p r o m o t e p r o f e s s i o n a l s t a n d a r d s , e n c o u r a g e p r o p e r and a d e q u a t e p r e p a r a t i o n s and t r a i n i n g , c u l t i v a t e a n i n f o r m e d p u b l i c o p i n i o n w h i c h w i l l r e c o g n i z e t h e p r o f e s s i o n a l a n d t e c h n i c a l n a t u r e o f s o c i a l w o r k . . . " ( C r o s s 1 9 8 5 , p. 3 0 ) . I n o r d e r t o a c h i e v e a n e d u c a t e d and u n i f i e d p r o f e s s i o n , g r o u p and c o m m u n i t y work n e e d e d t o be b r o u g h t i n t o t h e f o l d . I n 1927 " t h e t e r m g r o u p work was u s e d a s a p a r a l l e l t o c a s e w o r k a n d by 1937, t h i r t e e n I n s t i t u t i o n s - - t e n o f t h e m s c h o o l s o f s o c i a l w o r k - - w e r e o f f e r i n g g r o u p work c o u r s e s " ( E n c y . o f S.W. " H i s t " , p. 7 4 5 ) . Community w o r k e r s f o r m e d t h e i r a s s o c i a t i o n i n 1946. "The a s s o c i a t i o n had no e d u c a t i o n a l r e q u i r e m e n t s f o r m e m b e r s h i p , however l i k e g r o u p w o r k , i t moved i n t o t h e u n i v e r s i t i e s a n d by 1950 " s i x t e e n s c h o o l s o f s o c i a l work o f f e r e d a t l e a s t one b a s i c c o u r s e i n c o m m u n i t y o r g a n i z a t i o n ( E n c y . o f S.W. " H i s t " , p. 7 4 7 ) . As was n o t e d a b o v e , c o m m u n i t y work i s c o n s i d e r e d t h e f o r e r u n n e r o f I n s t i t u t i o n a l i z e d s o c i a l w e l f a r e . T h i s move t o u n i v e r s i t y e d u c a t i o n a n d t r a i n i n g h o w e v e r , was s u b s e q u e n t t o t h e a l r e a d y e s t a b l i s h e d a n d e x p a n d e d s o c i a l w e l f a r e f i e l d t h a t d e v e l o p e d t o a d m i n i s t e r t h e s o c i a l p o l i c i e s i n s t i t u t e d b y t h e New D e a l l e g i s l a t i o n o f 1 9 3 5 . The p r e c u r s o r s t o t h e New D e a l — W o r l d War I ( 1 9 1 4 - 1 9 1 9 ) a n d t h e G r e a t D e p r e s s i o n o f t h e e a r l y t h i r t i e s c o n t r i b u t e d t o a s h i f t i n a t t i t u d e s t o w a r d t h e d i s a d v a n t a g e d a n d t h e n e e d y . P o v e r t y was s e e n a s a s o c i e t a l a s w e l l a s a n i n d i v i d u a l p r o b l e m a nd t h e e f f e c t s o f p e o p l e ' s e n v i r o n m e n t s on t h e i r p r o b l e m s a s w e l l a s on t h e i r s o l u t i o n s were a l s o r e c o g n i z e d . A new p o l i t i c a l p r i n c i p l e w h i c h emerged d u r i n g t h e d e p r e s s i o n was, " t h a t t h e f o r t u n e s o f I n d i v i d u a l s were I n e x t r i c a b l y I n t e r l o c k e d ; t h a t we a r e a l l I n t h e same b o a t ; a n d t h a t i f a n y o f us f a l l i n t o d e e p t r o u b l e t h a t i t I s t h e j o b o f t h e r e s t o f u s - - n o t s i m p l y f a m i l y a n d f r i e n d s a n d n e i g h b o u r s , o r e v e n t h e l o c a l c o m m u n i t y , b u t t h e f e d e r a l g o v e r n m e n t i t s e l f i f need b e - - t o h e l p them" (N. Cohen 1956, p. 1 2 ) . R o o s e v e l t ' s New D e a l r e f l e c t e d t h i s s h i f t i n a t t i t u d e a s I t i n c l u d e d v a s t new s o c i a l p r o g r a m s w h i c h were l a t e r d e s c r i b e d a s t h e b e g i n n i n g o f t h e " w e l f a r e s t a t e " . - 1 2 -C a n a d a t o o was e n a c t i n g new s o c i a l p o l i c i e s . R.B. B e n n e t t , " i n a n n o u n c i n g h i s p l a n o f r e f o r m i n 1 9 3 5 , p r o v i d e d C a nada w i t h t h e s p e c t a c l e o f a C o n s e r v a t i v e p r i m e m i n i s t e r a s s e r t i n g t h a t h i s New D e a l 'means g o v e r n m e n t i n t e r v e n t i o n ... g o v e r n m e n t c o n t r o l a nd r e g u l a t i o n . I t means t h e end o f l a i s s e z - f a i r e 1 . " ( G u e s t 1 9 8 0 , p. 8 7 ) . T h e s e p o l i c i e s , b o t h I n Canada a n d i n t h e U n i t e d S t a t e s , were t h e c u l m i n a t i o n o f h a r d - f o u g h t b a t t l e s t o I n s t i t u t i o n a l i z e s o c i a l w e l f a r e . M a i n s t r e a m s o c i a l work w i t h i t s p r e v i o u s f o c u s on c a s e w o r k was i l l p r e p a r e d t o meet t h e demands o f t h e s o c i a l w e l f a r e s y s t e m . A l t h o u g h s o c i a l w o r k e r s had e x c e l l e n t c a s e w o r k s k i l l s what s o c i a l w e l f a r e c l i e n t s n e e d e d "was a d v o c a c y , b r o k e r a g e , a nd w e l f a r e a d m i n i s t r a t i o n a n d p l a n n i n g " ( P o p p l e 1 9 8 5, p . 5 6 5 ) . T h o u s a n d s o f new s o c i a l w e l f a r e w o r k e r s were h i r e d t o meet t h e n e e d s o f t h e p u b l i c a g e n c i e s . On t h e one s i d e were t h e m a i n s t r e a m s o c i a l w o r k e r s who p u r s u e d t h e i r t r a d i t i o n a l g o a l o f p r o f e s s i o n a l i z a t i o n . T h e y ... were e m p l o y e d i n p r i v a t e a g e n c i e s ; f o l l o w e d a n I n d i v i d u a l - c h a n g e , t h e r a p e u t i c m o d e l o f p r a c t i c e ; a n d a t t e n d e d g r a d u a t e p r o g r a m s .... On t h e o t h e r s i d e were s o c i a l w o r k e r s whose c a r e e r s were g e n e r a l l y a d i r e c t r e s u l t o f t h e c o u n t r y ' s e c o n o m i c p r o b l e m s . T h e y were m o s t l y e m p l o y e d by p u b l i c a g e n c i e s , were more i n t e r e s t e d i n -In-e f f e c t i v e l y I m p l e m e n t i n g p u b l i c w e l f a r e p r o g r a m s t h a n i n d o i n g t h e r a p y w i t h c l i e n t s , a n d , were s h a r p l y c r i t i c a l o f t h e f o r m e r g r o u p ' s p r o f e s s i o n a l a s p i r a t i o n s ( P o p p l e 1 9 8 5 , p. 5 6 5 ) . D e s p i t e t h e v a r i o u s p r a c t i c e m o d e l s ( c a s e w o r k , g r o u p w o r k , o r c o m m u n i t y w o r k ) , p r a c t i c e s p e c i a l i z a t i o n s ( m e d i c a l , s c h o o l , r e s e a r c h a n d p s y c h i a t r i c ) , a n d s e t t i n g s ( p r i v a t e o r p u b l i c a g e n c i e s ) , a t t e m p t s t o u n i t e t h e p r o f e s s i o n c o n t i n u e d . I n 1955 i n t h e U n i t e d S t a t e s s e v e n d i f f e r e n t p r a c t i t i o n e r o r g a n i z a t i o n s a m a l g a m a t e d t o f o r m t h e N a t i o n a l A s s o c i a t i o n o f S o c i a l W o r k e r s (NASW). The e x i s t i n g members o f e a c h o f t h e a s s o c i a t i o n s were g r a n d f a t h e r e d i n b u t new members were i n i t i a l l y r e q u i r e d t o have a g r a d u a t e d e g r e e . S u b s e q u e n t l y , i n 1969 m e m b e r s h i p was e x t e n d e d t o p e o p l e w i t h b a c h e l o r d e g r e e s ( E n c y . o f S.W. " H i s t . " p. 7 4 7 ) . The n a t i o n a l a s s o c i a t i o n i n Canada was f o r m e d much e a r l i e r a s t h e f i r s t m e e t i n g o f t h e CASW was h e l d i n 1928. However t h e y t o o were c o n f r o n t e d w i t h i s s u e s o f u n i t y a r o u n d t h e a p p r o p r i a t e f u n c t i o n s a n d r o l e s o f s o c i a l w o r k . U n i t y a n d n a t i o n a l a s s o c i a t i o n s h e l p e d s o c i a l work t o meet t h e g r o w i n g c r i t e r i a n e c e s s a r y f o r a t t a i n i n g p r o f e s s i o n a l s t a t u s . A l t h o u g h l i s t s o f c r i t e r i a d i f f e r , some o f t h e r e c u r r i n g c r i t e r i a a r e : ( a ) A s p e c i a l i z e d p r o d u c t d e r i v e d f r o m l o n g a n d s p e c i a l i z e d t r a i n i n g ( t h a t u s u a l l y t a k e s p l a c e i n a u n i v e r s i t y ) o f c o m p l e x m a t e r i a l -14-b a s e d upon a s c i e n t i f i c a nd t h e o r e t i c a l b o d y o f k n o w l e d g e f r o m w h i c h h i g h l y d e v e l o p e d s k i l l s a r e d e r i v e d ( b ) f u n c t i o n a l s p e c i f i c i t y , ( c ) a c u l t u r e , g r o u p i d e n t i t y / p r o f e s s i o n a l o r g a n i z a t i o n ( d ) m o t i v a t e d b y d e d i c a t i o n t o s e r v e s o c i e t y o r a l t r u i s m , ( e ) a c o d e o f e t h i c s , ( f ) a u t h o r i t y ( a c h i e v e d t h r o u g h c o m m u n i t y s a n c t i o n o f t e n I n t h e f o r m o f l i c e n s i n g ) , (g) i n d i v i d u a l r e s p o n s i b i l i t y / a u t o n o m y , ( h ) h i g h i n c o m e , ( i ) p r e s t i g e , and ( j ) power ( A u s t i n 1 9 8 3 ; C a r r - S a n d e r s 1966; C r o s s 1 9 8 5 : C u l l e n 1 9 8 5 ; I n t . E n c y . o f S o c . S c . " P r o f e s s i o n s " ; F o r s y t h & D a n i s i e w i c z 1 9 8 5 ; Greenwood 1957; G r o s s 1966; P o p p l e 1 9 8 5 ; & S t e i n e r e t a l . 1 9 8 4 ) . "The t r a i t t h e o r y o f p r o f e s s i o n s a s s umes t h a t i t i s p o s s i b l e t o d r a w up a l i s t o f c r i t e r i a f o r r e c o g n i z i n g a p r o f e s s i o n on w h i c h t h e r e w i l l be g e n e r a l c o n s e n s u s and t h a t by a p p l y i n g t h e s e c r i t e r i a , one w i l l be a b l e t o d i f f e r e n t i a t e b e t w e e n p r o f e s s i o n s and o c c u p a t i o n s . " ( P o p p l e 1 9 8 5 , p. 5 6 1 ) . O t h e r t h e o r i s t s s u c h a s T h e a d o r e C a p l o w a n d H a r o l d W i l e n s k y , p r o p o s e d what have b e e n c a l l e d p r o c e s s m o d e l s o f p r o f e s s i o n a l i z a t i o n . T h e s e m o d e l s assume t h a t p r o f e s s i o n a l i z a t i o n I s a p r o c e s s and b y e x a m i n i n g t h e h i s t o r y o f a p a r t i c u l a r o c c u p a t i o n , one c a n d e t e r m i n e t h e d e g r e e t o w h i c h I t h a s a t t a i n e d p r o f e s s i o n a l s t a t u s , o r a s N i n a T o r e n has s u g g e s t e d one c a n d e t e r m i n e i t s l o c a t i o n on a c o n t i n u u m b e t w e e n " t r u e " p r o f e s s i o n and n o n - p r o f e s s i o n ( P o p p l e , 1 9 8 5 ) . - 1 5 -I t i s h y p o t h e s i z e d t h a t , •'when a n o c c u p a t i o n d e v e l o p s i n t o a p r o f e s s i o n i t p a s s e s t h r o u g h t h e f o l l o w i n g s e q u e n c e o f s t e p s : becomes a f u l l - t i m e p a i d a c t i v i t y ; e s t a b l i s h e s u n i v e r s i t y t r a i n i n g ; f o r m s a n a t i o n a l o r g a n i z a t i o n ; r e d e f i n e s t h e c o r e t a s k s o a s t o g i v e " d i r t y w o r k " t o s u b o r d i n a t e s ; e x p e r i e n c e s c o n f l i c t b e t w e e n o l d - t i m e r s ( q u a l i f i e d t h r o u g h e x p e r i e n c e ) a n d new p e o p l e ( q u a l i f i e d t h r o u g h e d u c a t i o n ) who w i s h t o u p g r a d e r e q u i r e m e n t s ; e x p e r i e n c e s c o n f l i c t w i t h n e i g h b o r i n g o c c u p a t i o n s ; b e g i n s t o g a i n l e g a l p r o t e c t i o n t h r o u g h p o l i t i c a l a g i t a t i o n ; a n d d e v e l o p s a c o d e o f e t h i c s ( P o p p l e 1 9 8 5, p. 562) . C u l l e n ( 1 9 7 8 ) r e p o r t e d two t h e o r i e s t h a t h y p o t h e s i z e t h e r e a s o n f o r t h e p r o c e s s . The e x c h a n g e - s t r u c t u r a l t h e o r y s u g g e s t s t h a t t h e n a t u r e o f t h e t a s k s o f c e r t a i n o c c u p a t i o n s n e c e s s i t a t e s u c h f e a t u r e s a s " l o n g t r a i n i n g , e t h i c a l c o d e s , l i c e n s u r e , h i g h i n c o m e , a nd h i g h p r e s t i g e " ( p . 2) w h i l e t h e power t h e o r y q u e s t i o n s t h e u n d e r l y i n g m o t i v a t i o n s o f o c c u p a t i o n a l g r o u p s t h a t a s p i r e t o p r o f e s s i o n a l s t a t u s . "Power t h e o r i s t s h o l d t h e p o s i t i o n t h a t o c c u p a t i o n a l g r o u p p o w e r - - r a t h e r t h a n i n t r i n s i c t a s k - r e l a t e d c h a r a c t e r 1 s t i c s - - l s more I m p o r t a n t t o t h e a c h i e v e m e n t o f p r o f e s s i o n a l i z a t i o n " ( p . 2 ) . The e x c h a n g e - s t r u c t u r a l t h e o r y s u g g e s t s t h a t t h e d e g r e e o f p r o f e s s i o n a l i s m i s b a s e d on t h e c o m p l e x i t y o f t h e t a s k s o f a n o c c u p a t i o n a n d on t h e i r c o n s e q u e n c e s ; t h a t -16-l o n g a n d d i f f i c u l t t r a i n i n g I s r e q u i r e d b e c a u s e o f t h e c o m p l e x i t y o f p r o f e s s i o n a l t a s k s ; t h a t c o d e s o f e t h i c s a r e t h e m a n i f e s t a t i o n o f a p r o f e s s i o n a l s e r v i c e i d e a l ; t h a t t h e s p e c i a l i z e d n a t u r e o f p r o f e s s i o n a l k n o w l e d g e and t r a i n i n g n e c e s s i t a t e s p e e r e v a l u a t i o n a n d r e g u l a t i o n ; a n d t h a t l i c e n s u r e p r o t e c t s s o c i e t y f r o m " q u a c k s " ( C u l l e n 1978, pp. 6 3 - 6 9 ) . The power t h e o r y s u g g e s t s t h a t p r o f e s s i o n a l i s m i s b a s e d upon u n c e r t a i n t y ; t h a t t h e g r e a t e r t h e c o m p l e x i t y o f t h e t a s k s t h e g r e a t e r t h e c o m p e t e n c y gap b e t w e e n t h e s e r v e r a n d t h e s e r v e d ; t h a t l o n g a n d s p e c i a l i z e d t r a i n i n g i s u s e d a s a j u s t i f i c a t i o n f o r p r o f e s s i o n a l s t a t u s a n d f o r " s e l l i n g " t h e i r s e r v i c e s ; t h a t c o d e s o f e t h i c s c a n be a d o p t e d b y a n y o c c u p a t i o n i n o r d e r t o d e m o n s t r a t e i t s w o r t h i n e s s a s a p r o f e s s i o n a n d t h e y c a n s e r v e t o i n d u c e b e l i e f i n t h e e t h i c a l i t y o f i t s members when t h e r e i s no p r o o f t h a t i n d i v i d u a l p r o f e s s i o n a l s a r e a n y more e t h i c a l t h a n a n y o t h e r w o r k e r ; a nd t h a t l i c e n s i n g s e r v e s t o c r e a t e a m o n o p o l y t o r e d u c e s u p p l y , t h e r e b y i n c r e a s i n g demand and income ( C u l l e n 1 9 7 8 , pp. 6 3 - 6 9 ) . I n 1957 E. Greenwood e x a m i n e d s o c i a l work r e l a t i v e t o t h e p r o c e s s t h e o r y o f p r o f e s s i o n a l i z a t i o n . He s u g g e s t e d t h a t p r o f e s s i o n a l s e r v i c e I n v o l v e s u n u s u a l l y c o m p l i c a t e d o p e r a t i o n s , t h e m a s t e r y o f w h i c h r e q u i r e s l e n g t h y t r a i n i n g and s p e c i a l i z e d s k i l l s w h i c h a r e s u p p o r t e d by a f u n d o f k n o w l e d g e t h a t h a s b e e n o r g a n i z e d i n t o a b o d y o f t h e o r y ( p . 1 1 ) . -17-He f u r t h e r s u g g e s t e d t h a t , b e c a u s e u n d e r s t a n d i n g t h e o r y i s s o i m p o r t a n t t o p r o f e s s i o n a l s k i l l , p r e p a r a t i o n f o r a p r o f e s s i o n must be a n i n t e l l e c t u a l a s w e l l a s a p r a c t i c a l e x p e r i e n c e ( p . I D . To g e n e r a t e v a l i d t h e o r y t h a t w i l l p r o v i d e a s o l i d b a s e f o r p r o f e s s i o n a l t e c h n i q u e s r e q u i r e s t h e a p p l i c a t i o n o f t h e s c i e n t i f i c method t o t h e s e r v i c e - r e l a t e d p r o b l e m s o f t h e p r o f e s s i o n . The s p i r i t o f r a t i o n a l i t y g e n e r a t e s g r o u p s e l f - c r i t i c i s m a n d t h e o r e t i c a l c o n t r o v e r s y ( p . 1 2 ) , The e v o l u t i o n o f a p r o f e s s i o n i n c l u d e s r e s e a r c h e r s and t h e o r e t i c i a n s w h i c h c a n l e a d t o a d i v i s i o n o f l a b o u r b e t w e e n t h e o r y a n d p r a c t i c e and t e n s i o n i n i n t r a -p r o f e s s i o n a l r e l a t i o n s h i p s . However, i f r e s e a r c h e r and t h e o r e t i c i a n a r e i n t e g r a t e d , e . g . a s t h e o r e t i c i a n / r e -s e a r c h e r s , t h e r e i s a n a c c e l e r a t e d e x p a n s i o n o f t h e b o d y o f t h e o r y and " t h e s p r o u t i n g o f t h e o r e t i c a l b r a n c h e s a r o u n d w h i c h s p e c i a l t i e s n u c l e a t e " ( Greenwood 1957, p. 1 2 ) . The n e t e f f e c t i s t o l e n g t h e n p r e p a r a t i o n f o r e n t r y I n t o t h e p r o f e s s i o n h e n c e t h e r e I s a r i s e o f g r a d u a t e p r o f e s s i o n a l t r a i n i n g on t o p o f a c o l l e g e e d u c a t i o n . T h i s e x t e n s i v e e d u c a t i o n a n d k n o w l e d g e o f t h e o r y s e p a r a t e s t h e p r o f e s s i o n a l f r o m t h e l a y p e r s o n , h e n c e t h e p r o f e s s i o n a l a s s umes some a u t h o r i t y . The d i f f e r e n c e b e t w e e n t h e c l i e n t o f a p r o f e s s i o n a l and t h e c u s t o m e r o f a n o n - p r o f e s s i o n a l i s t h a t t h e c l i e n t o f t h e p r o f e s s i o n a l -18-" l a c k s the r e q u i s i t e t h e o r e t i c a l background, t h e r e f o r e the c l i e n t cannot diagnose h i s own needs or d i s c r i m i n a t e among a range of p o s s i b i l i t i e s f o r meeting them. Nor Is the c l i e n t a b l e to e v a l u a t e the c a l i b r e of the p r o f e s s i o n a l s e r v i c e he r e c e i v e s " (Greenwood 1957, p. 12). "The c l i e n t ' s s u b o r d i n a t i o n t o p r o f e s s i o n a l a u t h o r i t y i n v e s t s the p r o f e s s i o n a l with a monopoly of judgement [and] when an o c c u p a t i o n s t r i v e s toward p r o f e s s i o n a l i z a t i o n , one of i t s a s p i r a t i o n s Is to a c q u i r e t h i s monopoly (Greenwood 1957, p. 13). The community i s then asked to s a n c t i o n the p r o f e s s i o n a l s ' a u t h o r i t y . Some of the ways i n which i t can do so are through an a c c r e d i t a t i o n p r o c e s s , I.e. cohtrol-o£-title or l i c e n s i n g , and through l i m i t i n g admission to the p r o f e s s i o n . Because the l a y community cannot judge standards of p r a c t i c e drawn from a body of t h e o r y , e v a l u a t i o n and performance of p r o f e s s i o n a l s i s r e g u l a t e d by peers drawn from the p r o f e s s i o n a l a s s o c i a t i o n . T h i s i s an e f f e c t i v e process because p r o f e s s i o n a l e t h i c s preclude " a g g r e s s i v e c o m p e t i t i o n and a d v e r t i s i n g [ t h e r e f o r e ! c o n s u l t a t i o n s and r e f e r r a l s c o n s t i t u t e the p r i n c i p a l source of work to a p r o f e s s i o n a l . Since membership i n good s t a n d i n g i n the p r o f e s s i o n a l a s s o c i a t i o n i s a s i n e qua non of p r o f e s s i o n a l s u c c e s s , the p r ospect of formal d i s c i p l i n a r y a c t i o n operates as a potent f o r c e toward c o n f o r m i t y " (Greenwood 1957, p. 16). - 1 9 -P r o f e s s i o n a l s have a n " e t h i c a l c o d e t h r o u g h w h i c h t h e i r commitment t o t h e s o c i a l w e l f a r e becomes a m a t t e r o f p u b l i c r e c o r d , t h e r e b y i n s u r i n g f o r i t s e l f t h e c o n t i n u e d c o n f i d e n c e o f t h e c o m m u n i t y " (Greenwood 1 9 5 7, p. 1 4 ) . A f t e r c o n s i d e r i n g t h e p r o c e s s e s o f p r o f e s s i o n a l i z a t i o n a n d t h e c h a r a c t e r i s t i c s o f s o c i a l work Greenwood d e t e r m i n e d t h a t , s o c i a l work i s a l r e a d y a p r o f e s s i o n ; i t h a s t o o many p o i n t s o f c o n g r u e n c e w i t h t h e model t o be c l a s s i f i e d o t h e r w i s e . S o c i a l work I s however s e e k i n g t o r i s e w i t h i n t h e p r o f e s s i o n a l h e i r a r c h y , s o t h a t i t , t o o , m i g h t e n j o y maximum p r e s t i g e , a u t h o r i t y , a n d m o n o p o l y w h i c h p r e s e n t l y b e l o n g t o a few t o p p r o f e s s i o n s ( G r e e nwood 1 9 5 7, p. 1 9 ) . I t a p p e a r s t h a t a c c o r d i n g t o t h e r e c u r r i n g c r i t e r i a n o t e d i n t h e l i t e r a t u r e on p r o f e s s i o n a l i z a t i o n , t h a t : ( a ) The l o n g e r , t h e more t h e o r e t i c a l a n d t h e more s p e c i f i c t h e t r a i n i n g ; ( b) t h e g r e a t e r t h e f u n c t i o n a l s p e c i f i c i t y ( c l e a r d e f i n i t i o n s o f what s o c i a l w o r k e r s do i n l a n g u a g e t h a t c a n be c o m m u n i c a t e d t o t h e c o m m u n i t y ) ; ( c ) t h e s t r o n g e r t h e g r o u p c u l t u r e o r t h e p r o f e s s i o n a l a s s o c i a t i o n ; ( d) t h e more m o t i v a t e d b y d e d i c a t i o n t o s e r v e s o c i e t y o r by a l t r u i s m ; ( e ) t h e more e n t r e n c h e d t h e commitment t o a c o d e o f e t h i c s ; ( f ) t h e g r e a t e r t h e a u t h o r i t y ( a c h i e v e d t h r o u g h c o m m u n i t y s a n c t i o n s e . g . m a n d a t o r y r e g i s t r a t i o n , c e r t i f i c a t i o n , l i c e n s i n g ) ; ( g ) t h e more a u t o n o m y a c h i e v e d ; (h) t h e h i g h e r t h e Income; ( i ) t h e -20-more p r e s t i g e ; a n d ( j ) t h e g r e a t e r t h e power; t h e n t h e more p r o f e s s i o n a l , o r t h e f u r t h e r a l o n g t h e p r o f e s s i o n a l i z a t i o n c o n t i n u u m , a n o c c u p a t i o n w i l l be c o n s i d e r e d t o be ( A u s t i n , 1 9 8 3 ; C a r r - S a n d e r s , 1 9 66; C r o s s , 1 9 8 5 ; C u l l e n , 1 9 8 5 ; I n t . E n c y . o f S o c . S c . " P r o f e s s i o n s " ; F o r s y t h & D a n i s i e w i c z , 1 9 8 5 ; Greenwood, 1 9 5 7 ; G r o s s , 1 9 6 6 ; P o p p l e , 1 9 8 5 ; & S t e i n e r e t a l . , 1 9 8 4 ) . I t i s u n d e r s t a n d a b l e t h a t t h e t e n s i o n p e r s i s t s . One c a n s e e t h a t q u i t e d i f f e r e n t v a l u e s c o u l d be s e e n a s b e i n g i n h e r e n t i n t h e c r i t e r i a f o r , o r t h e p r o c e s s o f p r o f e s s i o n a l i z a t i o n d e p e n d i n g upon t h e v i e w one h o l d s o f t h e p r o c e s s . The " e x c h a n g e - s t r u c t u r a l i s t a p p r o a c h t e n d s t o i m p l y a f r e e - m a r k e t t o r c a p i t a l i s t ] m o d e l w i t h o c c u p a t i o n a l c h a r a c t e r i s t i c s o c c u r r i n g n a t u r a l l y , t h e power a p p r o a c h , [ c o n s i s t e n t w i t h a s o c i a l i s t p e r s p e c t i v e ] t e n d s t o s e e m o n o p o l i e s b a s e d on o c c u p a t i o n a l s e l f - i n t e r e s t . I f one h o l d s a n e x c h a n g e - s t r u c t u r a l i s t p o i n t o f v i e w , one w o u l d l i k e l y b e l i e v e t h a t t h e p r o c e s s , o r t h e "means" o f p r o f e s s i o n a l i z a t i o n ( p e r h a p s i t e m s [ a ] t h r o u g h [ f ] ) n a t u r a l l y , a n d i n d e p e n d e n t l y l e a d t o t h e " e n d s " ( p e r h a p s i t e m s [ g ] t h r o u g h [ j ] ) . I n s u c h a c a s e t h e means a r e p r i m a r y and t h e end s a r e m e r e l y a c o n s e q u e n c e o f t h e means. However, i f one h o l d s t h e p o i n t o f v i e w o f t h e power t h e o r i s t s , one w o u l d l i k e l y b e l i e v e t h a t t h e p r o c e s s i s m e r e l y t h e "means" t o t h e " e n d s " w h i c h a r e b e l i e v e d t o be t h e u l t i m a t e g o a l s o f pro£esslonalization--such a s p e r h a p s autonomy, but c e r t a i n l y high income, p r e s t i g e and power. In such a case the ends are paramount and t h a t i n f e r s q u i t e a d i f f e r e n t s e t of values inherent in the process of p r o f e s s i o n a l i z a t i o n . P r i v a t e P r a c t i c e F l e x n e r ' s c r i t e r i a f o r p r o f e s s i o n a l i s m were based on a model d e r i v e d from the study of the medical p r o f e s s i o n . Medicine and law are c o n s i s t e n t l y acknowledged as the two true p r o f e s s i o n s today. In North America both law and medicine began i n the form of p r i v a t e p r a c t i c e . I t i s t h e r e f o r e not s u r p r i s i n g that while s t r i v i n g f o r p r o f e s s i o n a l s t a t u s , some s o c i a l workers have chosen the p r i v a t e p r a c t i c e model f o r d e l i v e r i n g t h e i r s e r v i c e . N e i t h e r i s i t s u r p r i s i n g t h a t s o c i a l workers who have chosen the p r i v a t e p r a c t i c e model have ( e i t h e r c o r r e c t l y or e r r o n e o u s l y ) been seen as s t r i v i n g f o r p r o f e s s i o n a l s t a t u s . As was s t a t e d above, e a r l y casework was h e a v i l y i n f l u e n c e d by psychotherapy and s i n c e there was no p r o v i s i o n f o r the p r i v a t e p r a c t i c e of s o c i a l work w i t h i n the a u s p i c e s of the p r o f e s s i o n a l a s s o c i a t i o n s , most s o c i a l workers who p r a c t i c e d p r i v a t e l y , r e f e r r e d to themselves as p s y c h o t h e r a p i s t s r a t h e r than s o c i a l workers. P r i o r to the m i d - f i f t i e s there were v e r y few s o c i a l workers i n p r i v a t e p r a c t i c e but t h e i r numbers had been s t e a d i l y growing s i n c e the 1920s. Many of them had been s t r u g g l i n g f o r o f f i c i a l s a n c t i o n from p r o f e s s i o n a l - 2 2 -a s s o c i a t i o n s a n d when t h e NASW was f o r m e d t h e y p u s h e d f o r r e c o g n i t i o n . By 1958 a s p e c i a l c o m m i t t e e o f NASW r e c o g n i z e d p r i v a t e p r a c t i c e a s a n a p p r o p r i a t e p a r t o f s o c i a l work a n d i n 1961 and 1962 t h e B o a r d o f D i r e c t o r s and t h e D e l e g a t e A s s e m b l y r e s p e c t i v e l y , c o n c u r r e d . The CASW a n d t h e BCASW f o l l o w e d w i t h t h e i r a c c e p t a n c e s i n 1966 and 1968 r e s p e c t i v e l y . O v e r t h e y e a r s t h e p r i v a t e p r a c t i c e o f s o c i a l work has b e e n d i s c u s s e d , q u e r i e d a n d d e b a t e d . The e a r l i e r d e b a t e s f o c u s s e d p r i m a r i l y on p h i l o s o p h i c a l i s s u e s . Then t h e d e b a t e f o c u s s e d on some p r a g m a t i c i s s u e s s u r r o u n d i n g manpower, a n d most r e c e n t l y i t h a s f o c u s s e d on d e s c r i p t i o n s o f c h a r a c t e r i s t i c s ( W a l l a c e , 1 9 8 2 ) . The l i t e r a t u r e on p r i v a t e p r a c t i c e w h i c h I n c l u d e s d e s c r i p t i o n s o f p r a c t i t i o n e r c h a r a c t e r i s t i c s i s r e v i e w e d I n C h a p t e r 2 r e l a t i v e t o t h e s p e c i f i c r e s e a r c h q u e s t i o n s i n v e s t i g a t e d i n t h i s s t u d y . P h i l o s o p h i c a l c o n c e r n s . A l t h o u g h t h e p r i v a t e p r a c t i c e o f s o c i a l work u n d o u b t e d l y f i t t h e " p r o f e s s i o n a l m o l d " , a r g u m e n t s a g a i n s t p r i v a t e p r a c t i c e s u g g e s t e d i t was c o n c e r n e d o n l y w i t h f u n c t i o n a n d m i c r o l e v e l s o c i a l w o r k ; i t was n o t c o n s i s t e n t w i t h s o c i a l w o r k ' s m i s s i o n o f s e r v i n g t h e d i s a d v a n t a g e d a n d t h e p o o r ; I t d i d n o t f u r t h e r t h e c a u s e o f i n s t i t u t i o n a l i z e d s o c i a l s e r v i c e s , b u t r a t h e r u n d e r m i n e d t h e s t r u c t u r e o f t h e w e l f a r e s t a t e ; i t p r o m o t e d s p e c i a l i z e d r a t h e r t h a n g e n e r i c s o c i a l work e d u c a t i o n ; I t u t i l i z e d ( i f n o t s u p p o r t e d ) t h e f r e e - m a r k e t s y s t e m ; a n d i t - 2 3 -f o s t e r e d e l i t i s m , s t r a t i f i c a t i o n , a n d d i v i s i v e n e s s ( B a r k e r , 1984; B i s n o , 1 9 56; M e r l e , 1962 and S t o e s z , 1 9 8 1 ) . B i s n o ( 1 9 5 6 ) b e l i e v e d I t was s i g n i f i c a n t t h a t t h e c h a n g e o f e m p h a s i s f r o m c a u s e t o f u n c t i o n was f o r t h c o m i n g d u r i n g a t i m e when " e x t r e m e l y i n f l u e n t i a l c o n s e r v a t i v e i d e o l o g y was p r o c l a i m i n g a t h e o r y o f human n a t u r e b a s e d on t h e d o c t r i n e o f a b u s i n e s s e l i t e r e s p o n s i b l e f o r t h e b e s t o f a l l p o s s i b l e w o r l d s a n d a n i n d i v i d u a l i s t i c t h e o r y t h a t a ssumed t h e o n l y e f f e c t i v e method o f s o c i a l r e f o r m was one b a s e d on t h e c o n c e p t o f t h e m e t a m o r p h o s i s o f e a c h i n d i v i d u a l " ( p . 1 3 ) . M e r l e ( 1 9 6 2 ) t h o u g h t t h e p r i v a t e p r a c t i c e o f s o c i a l work was a c o n t r a d i c t i o n i n t e r m s . He w r o t e , " V a r i o u s p r o f e s s i o n a l e n d e a v o r s ( m e d i c i n e , l a w , n u r s i n g , a c c o u n t i n g , ' p s y c h o t h e r a p y ' , a n d / o r ' c o u n s e l l i n g ' ) may be p r a c t i c e d p r i v a t e l y , b u t s o c i a l work has a l w a y s b e e n t h e e x p r e s s i o n o f t h e c o m m u n i t y - - t h e c o m m u n i t y ' s i n s t r u m e n t " ( p . 1 3 ) . S i m i l a r l y , H e l e n P e r l m a n b e l i e v e d t h a t , "As a p r i v a t e p r a c t i t i o n e r w i t h o u t a n i n s t i t u t i o n a l c o n n e c t i o n , [ a s o c i a l w o r k e r ] c a n make no f o r m a l i z e d c o n t r i b u t i o n t o t h e d e v e l o p m e n t o f s o c i a l c a s e w o r k " ( B a r k e r 1 984, p. 6 ) . And, N a t h a n Cohen ( 1 9 5 6 ) w o n d e r e d w h e t h e r p r i v a t e p r a c t i c e s h o u l d i n d e e d be c a l l e d s o c i a l w o r k . F u r t h e r , i n r e g a r d t o p r i v a t e p r a c t i t i o n e r s b e i n g a p a r t y t o t h e most r e c e n t n e o c o n s e r v a t i v e p o l i c i e s t o -24-p r i v a t i z e s o c i a l s e r v i c e s , D a v i d S t o e s z ( 1 9 8 1 ) w a r n s us t h a t , The s t r a t e g y f o r c o n t a i n m e n t o f t h e w e l f a r e s t a t e i s t h e s y s t e m a t i c t u r n i n g o v e r o f s o c i a l w e l f a r e s e r v i c e s t o t h e p r i v a t e s e c t o r s , a s t r a t e g y t h a t i n v o l v e s a l t e r i n g t h e power r e l a t i o n s o f s t r u c t u r a l i n t e r e s t g r o u p s w i t h i n s o c i a l w e l f a r e . E m e r g i n g f r o m t h i s r e a l i g n m e n t i s a c o n s e r v a t i v e s o c i a l p o l i c y a n d p r o g r a m m i n g a g e n d a w h i c h i s n o t c o u n t e r p r o d u c t i v e t o t h e i n t e r e s t s o f many s o c i a l w o r k e r s , p a r t i c u l a r l y t h o s e w o r k i n g i n p r o p r i e t a r y s e t t i n g s ( p . 3 9 9 ) . C o u n t e r a r g u m e n t s i n s u p p o r t o f p r i v a t e p r a c t i c e a r g u e d t h a t c a s e w o r k done i n a p r i v a t e p r a c t i c e i s no d i f f e r e n t f r o m c a s e w o r k done i n a n y o t h e r s e t t i n g a n d t h a t p r o b l e m s a r e s i m i l a r l y v i e w e d a s p s y c h o s o c i a l ; t h a t s o c i a l w o r k ' s m i s s i o n was n o t o n l y t o s e r v e t h e d i s a d v a n t a g e d , b u t a l l o f s o c i e t y ; t h a t i t e x t e n d e d u n s t i g m a t i z e d s e r v i c e s t o a n o t h e r w i s e u n s e r v e d c l i e n t e l e ; t h a t w h i l e p r i v a t e p r a c t i c e i s a " f e e - f o r - s e r v i c e " m o d e l , p r i v a t e p r a c t i t i o n e r s c a n c o n t r i b u t e t o s o c i a l r e f o r m t h r o u g h o t h e r p r o f e s s i o n a l a c t i v i t i e s ; t h a t p r i v a t e p r a c t i c e r e q u i r e s h i g h l y honed s k i l l s b u t s p e c i a l i z a t i o n c a n t a k e p l a c e a t t h e g r a d u a t e l e v e l ( w h i c h I s r e q u i r e d ) ; a n d t h a t c l i e n t s do n o t e x p e c t o r a p p r e c i a t e e q u i t y w i t h someone t o whom t h e y a r e t u r n i n g f o r e x p e r t i s e ( B a r k e r , 1984; B u t r y m , 1976; S i p o r l n , 1 9 6 1 ; and W a l l a c e , 1 9 8 2 ) . Some e l a b o r a t i o n may be h e l p f u l . One of s o c i a l work's pioneer l e a d e r s , Mary Richmond, b e l i e v e d t h a t s o c i a l work's m i s s i o n was to serve a l l of s o c i e t y . She wrote t h a t s o c i a l work s k i l l s c o u l d , "be u t i l i z e d q u i t e as w e l l i n the homes of the r i c h as i n those of the poor, t h a t In the one as i n the other, p e r s o n a l i t y can be thwarted and r e t a r d e d , developed and e n r i c h e d " (Barker 1984, p. 3). I t has been demonstrated t h a t people from a l l economic s t r a t a do want to have access to s o c i a l work s e r v i c e s and to the degree t h a t they are w i l l i n g t o pay f o r them. This Is i n p r e f e r e n c e to the s e r v i c e s of other p r o f e s s i o n a l s whose s e r v i c e s they c o u l d have without d i r e c t c o s t due to coverage by an insurance or medical p l a n . I t has been suggested t h a t the preference i s o f t e n due to the lack of stigma att a c h e d to s o c i a l work s e r v i c e s over o t h e r s — f o r i n s t a n c e , p s y c h i a t r y ; and, to the lack of stigma att a c h e d to going to a p r i v a t e o f f i c e , over a p u b l i c agency (Wallace, 1982). With regard to f o c u s s i n g on casework and s u p p o r t i n g the f r e e market economy, Max S l p o r i n (1961) suggests t h a t to r e a l i z e the f u n c t i o n of s o c i a l reformer p r i v a t e p r a c t i t i o n e r s "can be a c t i v e as a community o r g a n i z e r i n s t i r r i n g up p u b l i c sentiment and o p i n i o n , as w e l l as through p a r t i c i p a t i o n and l e a d e r s h i p i n community c o u n c i l and other community a s s o c i a t i o n s to help develop and improve welfare s e r v i c e s " (p. 54). -26-And i n r e s p o n s e t o t h e a r g u m e n t t h a t p r i v a t e p r a c t i c e i s e l i t i s t a n d d i v i s i v e , B u t r y m ( 1 9 7 6 ) b e l i e v e s , " A t i t s most e x t r e m e t h e v i e w t h a t p r o f e s s i o n a l i s m i s i n t r i n s i c a l l y s o c i a l l y d i v i s i v e o v e r l o o k s t h e n e e d s an d t h e e x p e c t a t i o n s o f t h e c o n s u m e r s o f p r o f e s s i o n a l s e r v i c e s . T h e s e u s u a l l y e v o l v e a r o u n d e f f i c i e n c y , r e l i a b i l i t y a n d e x p e r t i s e , a n d t h e m a j o r i t y o f c l i e n t s o f s o c i a l w o r k e r s f a c e d w i t h a c r i s i s i n t h e i r l i v e s a r e n o t a n x i o u s t o v i e w t h e s e w o r k e r s a s t h e i r e q u a l s i n t h e c o n t e x t o f t h e i r p r o b l e m s o l v i n g . The p o i n t i s made t o e m p h a s i z e t h e d a n g e r o f p e r s o n a l i d e o l o g y m a s q u e r a d i n g a s t h e c h a m p i o n o f t h e r i g h t s o f o t h e r s ( p . 1 1 9 ) . Manpower c o n c e r n s , AS more and more p r a c t i t i o n e r s e n t e r e d p r i v a t e p r a c t i c e two a d d i t i o n a l c o n c e r n s a r o s e . F i r s t l y , t h e r e was c o n c e r n w h e t h e r t h e r e w o u l d be a manpower s h o r t a g e i n t h e a g e n c i e s and s e c o n d l y , t h e r e was c o n c e r n t h a t t h e most h i g h l y s k i l l e d w o u l d move i n t o p r i v a t e p r a c t i c e l e a v i n g t h e l e s s s k i l l e d a nd most r e c e n t l y t r a i n e d f o r a g e n c y e m p l o y m e n t . The r e s u l t o f s u c h s h o r t a g e s a n d movement i t was f e a r e d , c o u l d r e s u l t i n a t w o - t i e r e d s y s t e m o f s o c i a l w o r k . One f o r t h e m i d d l e and u p p e r - c l a s s e s and one f o r t h e d i s a d v a n t a g e d . M. Cohen ( 1 9 6 6 ) f o u n d t h a t s o c i a l w o r k e r s e n t e r i n g p r i v a t e p r a c t i c e were among t h e most h i g h l y e d u c a t e d and t h a t t h e y were among t h e most " p r o f e s s i o n a l i z i n g " members o f NASW. Cohen n o t e d t h a t p r o f e s s i o n a l i z i n g i s e x p r e s s e d - 2 7-" i n h i g h e r a s p i r a t i o n s and g r e a t e r o c c u p a t i o n a l i n v o l v e m e n t . . . " ( p . 7 0 ) . [And t h a t ] , "One m e a s u r e o f a s p i r a t i o n i s t h e e x t e n t t o w h i c h I n d i v i d u a l s s e e k p r o f e s s i o n a l a n d f i n a n c i a l g o a l s i n t h e i r c a r e e r s ( p . 7 5 ) , [ w h i l e o t h e r s ] a r e r e v e a l e d i n t h e i r p r e f e r e n c e f o r m a i n t a i n i n g d i r e c t c o n t a c t w i t h c l i e n t s a n d p r a c t i c i n g t h e i r b a s i c s k i l l s " ( p . 7 7 ) . D e s c r i p t i o n s o f c h a r a c t e r i s t i c s . As d i s c u s s e d a t t h e b e g i n n i n g o f t h i s c h a p t e r , t h e d e b a t e s , q u e r i e s a n d d i s c u s s i o n s on t h e a p p r o p r i a t e n e s s o f p r i v a t e p r a c t i c e h a ve s h i f t e d i n r e c e n t y e a r s . The l e v e l o f d i s c u s s i o n has c h a n g e d . The f o c u s o f t h e a r g u m e n t s , q u e s t i o n s a n d comments, a s s t a t e d a b o v e , have moved f r o m t h e l e v e l o f b e l i e f s t o t h e l e v e l o f r e s e a r c h a b l e , d e s c r i p t i v e , f a c t s ( F r i s m a n e t a l . , 1984; F r e e m a n , 1984; G o l d m e i e r , 1986; M a r t i n 1984; a n d W a l l a c e 1 9 8 2 ) . Some o f t h e l i t e r a t u r e on p r i v a t e p r a c t i c e i s c o n t r a d i c t o r y i n i t s d e s c r i p t i o n s o f c e r t a i n a s p e c t s o f p r i v a t e p r a c t i c e ; some r a i s e s q u e s t i o n s t o be a n s w e r e d ; and some r a i s e s c o n c e r n s t o be r e f l e c t e d u p o n . ( T h i s l i t e r a t u r e i s r e v i e w e d i n C h a p t e r 2.) I t seems u l t i m a t e l y i m p o r t a n t f o r t h e c o n t i n u a t i o n o f t h e d e b a t e ( t h a t i s a t t h e l e v e l o f c h a r a c t e r i s t i c s o f p r a c t i t i o n e r s ) t o be b a s e d upon a c c u r a t e d e s c r i p t i o n s t h a t a r e b a s e d on f a c t r a t h e r t h a n on o p i n i o n . The Problem P r i v a t e p r a c t i c e has b e e n c e n t r a l o r t a n g e n t i a l t o s e v e r a l o f t h e i s s u e s t h a t have f a c e d t h e p r o f e s s i o n i n t h e p a s t a n d i t a p p e a r s t h a t t h i s w i l l c o n t i n u e t o be t h e c a s e f o r s e v e r a l y e a r s t o come. I t a p p e a r s t o be i n e x t r i c a b l y i n t e r w o v e n w i t h p r i v a t i z a t i o n , p r o f e s s i o n a l i s m , e l i t i s m , c o n t r o l - o f - t i t l e , l i c e n s i n g , a n d v e n d o r s h i p o r t h i r d - p a r t y p a y m e n t s . To d a t e , t h e d e s c r i p t i o n s o f p r i v a t e p r a c t i c e have f o r m e d a n i n t e g r a l p a r t o f t h e a r g u m e n t s b o t h I n s u p p o r t o f a n d I n o p p o s i t i o n t o p r i v a t e p r a c t i c e . T h e y have r e f l e c t e d c h a n g e o v e r t i m e ; t h e y have s o m e t i m e s r e f l e c t e d p h i l o s o p h i c a l b e l i e f s a n d t h e y have p r e d o m i n e n t l y come f r o m A m e r i c a n r e s e a r c h e r s d e s c r i b i n g p r a c t i c e i n s p e c i f i c g e o g r a p h i c a l a r e a s t h a t have n o t i n c l u d e d a n y p a r t o f Canada o r , more s p e c i f i c a l l y , B r i t i s h C o l u m b i a . The P u r p o s e The p u r p o s e o f t h i s s t u d y was t o s u r v e y s o c i a l work p r i v a t e p r a c t i t i o n e r s i n t h e G r e a t e r V a n c o u v e r a r e a i n t h e s p r i n g o f 1 987, w i t h t h e v i e w t o be a b l e t o a c c u r a t e l y d e s c r i b e t h e c h a r a c t e r i s t i c s o f p r i v a t e p r a c t i t i o n e r s , t h e c h a r a c t e r i s t i c s o f a s p e c t s o f t h e i r s e r v i c e , a n d t h e c h a r a c t e r i s t i c s o f t h e i r c l i e n t s t h a t c u m u l a t i v e l y d e s c r i b e p r i v a t e p r a c t i c e . The O b j e c t i v e The o b j e c t i v e o f t h e s t u d y was t o s u b s e q u e n t l y p r o v i d e s u f f i c i e n t i n f o r m a t i o n t o e n h a n c e t h e p o s s i b i l i t y -29-t h a t d e s c r i p t i o n s of p r i v a t e p r a c t i t i o n e r s , t h e i r s e r v i c e s and t h e i r c l i e n t s , t h a t are o f f e r e d as arguments e i t h e r i n support of or i n o p p o s i t i o n to p r i v a t e p r a c t i c e i n f u t u r e d i s c u s s i o n s and debates i n B r i t i s h Columbia, w i l l be based upon a c c u r a t e , c u r r e n t , and l o c a l d a ta. A f u r t h e r o b j e c t i v e was to r e v e a l new data t h a t may be u s e f u l to a l l members of the p r o f e s s i o n e i t h e r as i n d i v i d u a l s , p o l i c y makers, educators or a d v i s o r s as they formulate t h e i r ideas on membership, p r a c t i c e , e d u c a t i o n and r e g u l a t i o n s ; and as they a d v i s e government on l e g i s l a t i o n p e r t a i n i n g to these very important i s s u e s . O p e r a t i o n a l i z a t i o n s S o c i a l work p r i v a t e p r a c t i t i o n e r s were o p e r a t i o n a l i z e d as "People who e i t h e r hold a u n i v e r s i t y degree i n s o c i a l work, and/or are R e g i s t e r e d S o c i a l Workers; WHO e i t h e r PART-TIME or FULL-TIME, p r a c t i c e t h e i r p r o f e s s i o n independently of any government or v o l u n t a r y agency: AND who s e t up t h e i r own c o n d i t i o n s of payment with c l i e n t s . " ( M o d i f i e d from the BCASW A p p l i c a t i o n For L i s t i n g On The Roster Of R e g i s t e r e d S o c i a l Workers In P r i v a t e P r a c t i c e In B.C.) The l a s t phrase i n t h e i r d e f i n i t i o n which s t a t e s "... and i d e n t i f i e s him or h e r s e l f as a s o c i a l work p r a c t i t i o n e r i n o f f e r i n g s e r v i c e s to the p u b l i c " , has been d e l e t e d because " p r o f e s s i o n a l i d e n t i t y " was one of the concepts that was researched, having been i d e n t i f i e d as c o n t r o v e r s i a l from the l i t e r a t u r e review which f o l l o w s i n Chapter 2. The G r e a t e r Vancouver a r ea was d e f i n e d as i n c l u d i n g the m u n i c i p a l i t i e s of Burnaby, D e l t a , C o q u i t l a m , New Westmins te r , Nor th Vancouver , Richmond, S u r r e y , V ancouver , and West Vancouver . -31-C r i t i c a l Issues In The P r i v a t e P r a c t i c e Debate In order t o f u l f i l l the purpose of the study, the p r i v a t e p r a c t i c e l i t e r a t u r e was reviewed f o r the purpose of I d e n t i f y i n g the c r i t i c a l i s s u e s . Twenty concepts were i d e n t i f i e d f o r i n v e s t i g a t i o n . T h i r t e e n were chosen because they were among the most f r e q u e n t l y d e s c r i b e d i n the l i t e r a t u r e , because they appeared to be the most c o n t r o v e r s i a l or q u e r i e d , and because they appeared to be concepts t h a t were i n f a c t , r e s e a r c h a b l e . In a d d i t i o n , another seven concepts t h a t were not r e p o r t e d as c o n t r o v e r s i e s or as q u e r i e s i n the l i t e r a t u r e were researched because i t was b e l i e v e d they were important both to the comprehensiveness of the d e s c r i p t i o n of the c h a r a c t e r i s t i c s of p r i v a t e p r a c t i c e and to the e l a b o r a t i o n of the data f o r meaningful a n a l y s e s . For c l a r i t y the concepts t h a t were researched have been organized i n t o four c a t e g o r i e s — C h a r a c t e r i s t i c s of p r a c t i o n e r s , C h a r a c t e r i s t i c s of as p e c t s of s e r v i c e , C h a r a c t e r i s t i c s of c l i e n t s , and Background and demographic i n f o r m a t i o n . When a concept appeared to be a p p l i c a b l e to more than one category, i t was a r b i t r a r i l y p l a c e d where i t was b e l i e v e d to be the most a p p r o p r i a t e . T h i s chapter i n c l u d e s the r a t i o n a l e f o r choosing the concepts as w e l l as the r e s e a r c h q u e s t i o n s d e r i v e d from the d i s c u s s i o n of each concept. In a d d i t i o n , the numbers of the q u e s t i o n s from the q u e s t i o n n a i r e t h a t were the i n d i c a n t s f o r answering each of the r e s e a r c h q u e s t i o n s are - 3 2 -noted so that r e f e r e n c e may be made to the q u e s t i o n n a i r e , which i s i n c l u d e d i n Appendix A. The Research Questions  C h a r a c t e r i s t i c s of P r a c t i t i o n e r s M o t i v a t i o n . Many f a c t o r s that motivate p r a c t i t i o n e r s to e nter p r i v a t e p r a c t i c e have been d i s c u s s e d i n the above mentioned l i t e r a t u r e . Among them are, autonomy, f l e x i b i l i t y , o p p o r t u n i t y f o r d i r e c t p r a c t i c e over a d m i n i s t r a t i v e t a s k s , economic improvement (more o f t e n i m p l i e d that s t a t e d ) , avoidance of b u r e a u c r a t i c c o n f l i c t s , d i s c r e t i o n over c l i e n t s (sometimes implying the d e s i r e to work with motivated c l i e n t s ) , o p p o r t u n i t y to s p e c i a l i z e i n an area of p a r t i c u l a r i n t e r e s t , and t e r m i n a t i o n from p r e v i o u s employment (Barker, 1982, 1984; Borenzweig, 1981; C a l l a h a n , 1984; Freeman, 1984; Mart i n , 1984; & Wallace, 1982) . There are however, some d i f f e r e n c e s of o p i n i o n . Freeman (1984) thought t h a t the o p p o r t u n i t y to s p e c i a l i z e i n an area of i n t e r e s t , autonomy, and f l e x i b i l i t y were s t r o n g m o t i v a t i n g f a c t o r s . The p r a c t i t i o n e r who d e s i r e s to s p e c i a l i z e i n working with couples, f a m i l i e s , groups or any other t h e r a p e u t i c c o n s t e l l a t i o n can do so without being concerned about agency p o l i c y , f u n c t i o n , or r e s t r i c t i o n s . [And], the p r i v a t e p r a c t i t i o n e r has the freedom to determine the number of hours and days to work i n a g i v e n week (p. 275). - 3 3 -A l t e r n a t i v e l y , M a r t i n ( 1 9 8 4 ) b e l i e v e d , The s o c i a l work p r o f e s s i o n i s w i t n e s s i n g a r e s u r g e n c e o f t h e m y t h o l o g y o f a d e c a d e ago t h a t p r i v a t e p r a c t i c e o f f e r s f r e e d o m t o p r a c t i s e i n t h e most i d e a l p r o f e s s i o n a l c o n d i t i o n s , f r e e d o m t o f o c u s s o l e l y on c l i e n t s ' n e e d s , f r e e d o m f r o m t h e c o n t r o l o f o n e r o u s p o l i c y , and f r e e d o m f r o m a c c o u n t a b i l i t y demands o f a n u n p r o f e s s i o n a l b u r e a u c r a c y ( p . 2 8 2 ) . W o r k i n g h o u r s a r e i n d e e d g o v e r n e d by t h e w o r k e r , who i s o n l y c o n s t r a i n e d b y t h e need f o r c l i e n t s and a c l i e n t ' s a v a i l a b l e t i m e . F l e x i b i l i t y o f p r a c t i c e m ethod may be more p r o b l e m a t i c . A g a i n , t h e p r o f e s s i o n a l ' s n e e d f o r c l i e n t s a n d income i s t h e g o v e r n i n g f a c t o r ( p . 2 8 4 ) . F u r t h e r , on t h e t o p i c o f a u t o n o m y and f l e x i b i l i t y , B a r k e r ( 1 9 8 4 ) r e p o r t e d , " S o c i a l w o r k e r s , a s w e l l a s members o f o t h e r p r o f e s s i o n s , c o n s i s t e n t l y r e p o r t t h a t t h e y a p p r e c i a t e t h e f r e e d o m f r o m o r g a n i z a t i o n a l c o n s t r a i n t s a s t h e most p o w e r f u l I n c e n t i v e f o r p r i v a t e p r a c t i c e " ( p . 6 0 ) . A d d i t i o n a l l y , B o r e n z w e l g ' s ( 1 9 8 1 ) s t u d y f o u n d , " T h a t p r i v a t e p r a c t i t i o n e r s s p e n t more t i m e i n d i r e c t work w i t h c l i e n t s , [ a n d t h a t ] t h e b u r e a u c r a t i c demands o f a g e n c y p r a c t i c e r e d u c e t h e amount ( a n d p e r h a p s t h e q u a l i t y ) o f d i r e c t c o n t a c t b e t w e e n t h e r a p i s t a n d c l i e n t " ( p . 2 4 3 ) . F r i s m a n e t a l . ( 1 9 8 6 ) , s u g g e s t e d t h a t f l e x i b i l i t y a n d a u t o n o m y may be a m a j o r i n f l u e n c e f o r f e m a l e -34-p r a c t i t l o n e r s . " D e l a y e d c h i l d b e a r i n g and c h i l d r e a r i n g among f e m a l e s o c i a l w o r k e r s a g e d t h i r t y t o f o r t y may I n f l u e n c e d e c i s i o n m a k i n g r e g a r d i n g p a r t i c i p a t i o n i n p r i v a t e p r a c t i c e , a work a c t i v i t y p e r m i t t i n g i n d i v i d u a l l y d e t e r m i n e d h o u r s and w o r k - s e t t i n g l o c a t i o n " ( p . 4 4 1 ) . F o r me, and I t h i n k i t i s r e a s o n a b l e t o assume t h a t f o r o t h e r s a s w e l l , t h a t q u i t e a d i f f e r e n t Image o f p r i v a t e p r a c t i t i o n e r s i s c o n j u r e d up ( a t l e a s t r e l a t i v e t o h i s t o r i c a l s o c i a l work v a l u e s ) i f one b e l i e v e s t h a t t h e s t r o n g e s t m o t i v a t i n g f a c t o r s f o r e n t e r i n g p r i v a t e p r a c t i c e a r e e c o n o m i c Improvement o r d i s c r e t i o n o v e r c l i e n t s r a t h e r t h a n p e r h a p s , a u t o n o m y and f l e x i b i l i t y o r more o p p o r t u n i t y f o r d i r e c t p r a c t i c e . I t t h e r e f o r e seemed i m p o r t a n t t o a s k , 1. What a r e t h e s t r o n g e s t m o t i v a t i n g f a c t o r s f o r pract i t ioners to e n t e r private pract ice? Q u e s t i o n s #4 and #24 were i n d i c a n t s . P r o f e s s i o n a l I d e n t i t y . One o f t h e c r i t i c i s m s l e v e l e d a g a i n s t p r i v a t e p r a c t i t i o n e r s has b e e n t h a t t h e y f a i l t o I d e n t i f y t h e m s e l v e s a s s o c i a l w o r k e r s — g e n e r a l l y i n f a v o r o f o t h e r t i t l e s s u c h a s s p e c i f i c t y p e s o f t h e r a p i s t s o r c o u n s e l l o r s . W i t h t h e e x c e p t i o n o f M a r t i n ' s ( 1 9 8 4 ) a r t i c l e , t h e l i t e r a t u r e d o e s seem t o r e f l e c t a t r e n d . B a r k e r ( 1 9 8 4 ) r e p o r t e d , " I n 1955 H e l e n P e r l m a n e s t i m a t e d t h a t t h e r e were v e r y few, i f a n y , p r i v a t e p r a c t i t i o n e r s who a c k n o w l e d g e d t h e i r s o c i a l work r o o t s . I f t h i s e s t i m a t e was t r u e i n 1 9 5 5 , I t I s c e r t a i n l y n o t t r u e now" ( p . 1 2 0 ) . I t seems reasonable that s o c i a l workers doing p r i v a t e p r a c t i c e before i t was o f f i c i a l l y s a n c t i o n e d by the p r o f e s s i o n a l a s s o c i a t i o n s would e l e c t not to i d e n t i f y themselves as s o c i a l workers. W r i t i n g In 1979, Kruzman s t a t e d , "There i s c e r t a i n l y a tendency f o r s o c i a l workers perhaps most o f t e n f o r those i n f u l l - t i m e p r i v a t e p r a c t i c e , to thin k of and c a l l themselves ' p s y c h o t h e r a p i s t s ' " (p. 365). He f u r t h e r suggested t h a t , "Their p r o f e s s i o n a l business cards and l e t t e r h e a d s o f t e n i d e n t i f y them s o l e l y as p s y c h o t h e r a p i s t s , with no r e f e r e n c e to t h e i r membership i n the s o c i a l work p r o f e s s i o n " (p.365). By the 1980s the change toward s t r o n g s o c i a l work i d e n t i t y was being r e p o r t e d . Borenzweig's (1981) study found t h a t indeed, "Post 1967 graduates were more secure about t h e i r s o c i a l work i d e n t i t y and s t a t u s and were much more prone to i d e n t i f y with the p r o f e s s i o n and to think of themselves as s o c i a l workers i n t h e i r i n t e r a c t i o n s , r e l a t i o n s h i p s , and o v e r a l l d e a l i n g s with c l i e n t s and other p r o f e s s i o n a l s " (p. 243). He a l s o r e i t e r a t e d t h a t , " e a r l i e r graduates were more l i k e l y than recent graduates to i d e n t i f y with n o n - s o c i a l work p s y c h o t h e r a p i s t s " (p. 243 ) . In 1982 Wallace conducted a nationwide study of p r i v a t e p r a c t i t i o n e r s and found that the l a r g e s t number ( f o r t y - f i v e percent) of respondents i d e n t i f i e d themselves as some kind of s o c i a l worker, another f o r t y - e i g h t percent -36-were d i v i d e d among p s y c h o t h e r a p i s t s , p s y c h o a n a l y s t s , p s y c h o l o g i s t s , and marriage or f a m i l y c o u n s e l l o r s , with a f u r t h e r seven percent using other d e s i g n a t i o n s (p. 265). However, the b e l i e f s on p r o f e s s i o n a l i d e n t i t y are not unanimous as was e x e m p l i f i e d i n Martin's (1984) a r t i c l e . " P r i v a t e p r a c t i t i o n e r s , on the other hand, not i n f r e q u e n t l y seem to accept some of the c u r r e n t demeaning of the p r o f e s s i o n by choosing to use t i t l e s such as c o u n s e l l o r , t h e r a p i s t , or c o n s u l t a n t to d e s c r i b e t h e i r s e r v i c e " (p. 286). I f the t r e n d r e p o r t e d by Borenzweig (1981) i s supported, i t may have been t h a t p r i o r to the 1960s p r i v a t e p r a c t i t i o n e r s d i d not r e j e c t s o c i a l work so much as s o c i a l work r e j e c t e d p r i v a t e p r a c t i t i o n e r s . I t appears that the i d e n t i f i c a t i o n of p r i v a t e p r a c t i o n e r s as s o c i a l workers has changed over time. A c u r r e n t d e s c r i p t i o n t h e r e f o r e needs to i n c l u d e the q u e s t i o n , 2. To what extent do p r i v a t e p r a c t i t i o n e r s i d e n t i f y themselves as social workers? Questions #25, #26, and #28 were i n d i c a n t s . P r o f e s s i o n a l Development. On one hand, i t has been suggested i n the l i t e r a t u r e t h a t p r i v a t e p r a c t i t i o n e r s not only engage i n p r o f e s s i o n a l development but t h a t they must. I t has been argued t h a t because c l i e n t s pay f o r t h e i r s e r v i c e s , i f they d i d not keep t h e i r s k i l l s "tuned" c l i e n t s would not r e t u r n . In d i s c u s s i n g p r o f e s s i o n a l development with regard to -37-p r i v a t e p r a c t i c e and a c c e p t i n g f e e s , L e v i n (1976) r e f e r r e d to Ruth F i z d a l e ' s study of a f e e - c h a r g i n g agency. The i n t r o d u c t i o n of fees made caseworkers begin to q u e s t i o n what they had to o f f e r and whether they were f u l l y prepared, and t h a t they took steps on t h e i r own to i n c r e a s e t h e i r knowledge and s k i l l s by ...reading the p r o f e s s i o n a l l i t e r a t u r e , [and] t a k i n g advanced t r a i n i n g courses (p. 358). Most of the p r i v a t e p r a c t i t i o n e r s s a i d they tended to c o n s u l t l e s s but to read p r o f e s s i o n a l l i t e r a t u r e more and to seek out s p e c i f i c e d u c a t i o n a l experiences to i n c r e a s e t h e i r e f f e c t i v e n e s s (p. 358). On the other hand, Borenzweig (1981) noted, "A number of respondents commented t h a t they read r e l a t i v e l y l i t t l e and depended p r i m a r i l y on t h e i r own l i f e e x periences as a knowledge base for t h e i r p r a c t i c e of therapy" (p. 243). M a r t i n (1984) f u r t h e r suggested t h a t , " I n d i v i d u a l s i n p r i v a t e p r a c t i c e may w e l l choose upgrading and competence checking as a p r a c t i c e r e s p o n s i b i l i t y , but p r i v a t e p r a c t i c e does not i n c l u d e a requirement to do so" (p.282). Since p r o f e s s i o n a l development Is inherent i n a c c o u n t a b i l i t y and s i n c e there Is no formal s t r u c t u r e to r e g u l a t e p r a c t i c e , I t i s important to ask, 3. To what extent do p r i v a t e p r a c t i t i o n e r s engage i n professional development? Questions #33 and #34 were i n d i c a n t s . -38-Pro£esslonal C o n t r i b u t i o n s . The d i s c u s s i o n s on p r o f e s s i o n a l c o n t r i b u t i o n s have r e f l e c t e d concerns about (a) p r a c t i c e i n n o v a t i o n s and e x p e r t i s e , (b) p r o f e s s i o n a l s t a t u s or p r o f e s s i o n a l i s m , (c) support of the p r o f e s s i o n through p r o f e s s i o n a l membership, (d) and c o n t r i b u t i o n s through r e s e a r c h and p u b l i c a t i o n s . L e v i n (1976) supported the idea that p r i v a t e p r a c t i t i o n e r s were making a s p e c f i c and important c o n t r i b u t i o n to s o c i a l work. He s t a t e d , " P r i v a t e p r a c t i c e i s i n the f o r e f r o n t of the p r o f e s s i o n - - n o longer i t s s t e p - c h i l d but i t s t r e n d - s e t t e r " (p.362). M a r t i n (1984) d i s a g r e e d . "On the c o n t r a r y , the trend s e t t e r s i n Canada, the sources of i n n o v a t i o n i n p r a c t i c e and of t h e o r e t i c a l i n s i g h t , are l a r g e l y i n academic, agency, or s e r v i c e systems" (p. 285). Borenzweig's (1981) study supported t h i s stand, "The r e s e a r c h e r s were s u r p r i s e d to d i s c o v e r that more i n n o v a t i v e m o d a l i t i e s were used by workers i n agency p r a c t i c e than by those i n p r i v a t e p r a c t i c e " (p. 243). As mentioned above, p r o f e s s i o n a l i s m has long been l i n k e d with p r i v a t e p r a c t i c e because p r i v a t e p r a c t i t i o n e r s u t i l i z e the f e e - f o r - s e r v i c e model used by other p r o f e s s i o n a l s such as d o c t o r s and lawyers. However M a r t i n (1984) contends t h a t , "For the advancement of p r o f e s s i o n a l s t a t u s the d r i v i n g f o r c e s are the p r o f e s s i o n a l a s s o c l a t i o n s . . . [ w h i c h are] not r e c e i v i n g unique l e a d e r s h i p from p r i v a t e p r a c t i t i o n e r s " (p. 286). -39-Others have im p l i e d t h a t the advancement of p r o f e s s i o n a l i s m by p r i v a t e p r a c t i t i o n e r s has been i n s e l f - i n t e r e s t , moving the p r o f e s s i o n toward r e g i s t r a t i o n , c e r t i f i c a t i o n and l i c e n s i n g . Wallace (1982) however, poin t e d out t h a t , "The c o n t r i b u t i o n of p r i v a t e p r a c t i t i o n e r s thus f a r has not been to the development of a p r i v a t e p r a c t i c e p r o f e s s i o n , but to the r e c o g n i t i o n of the p r o f e s s i o n a l s k i l l and e x p e r t i s e of s o c i a l workers i n and o u t s i d e a g e n c i e s " (p. 262). Membership by p r i v a t e p r a c t i t i o n e r s i n t h e i r p r o f e s s i o n a l a s s o c i a t i o n s was a l s o addressed by Barker (1984) and Borenzweig (1981). "A high p r o p o r t i o n (of s o c i a l workers i n the U.S.] are not NASW members, and many do not belong to any other s o c i a l work o r g a n i z a t i o n " (Barker, p. 143). And, i n comparing p r i v a t e p r a c t i t i o n e r s with agency workers Borenzweig found, "The respondents were s i m i l a r i n the number and kinds of p r o f e s s i o n a l o r g a n i z a t i o n s to which they belonged" (p. 243). Due to the c o n t r a d i c t i o n s , the f o l l o w i n g q u e s t i o n needed to be posed. 4. To what extent do p r i v a t e p r a c t i t i o n e r s c o n t r i b u t e to the p r o f e s s i o n ? Questions #27, #30, #31 and #35 were i n d i c a n t s . Community Involvement. References to community Involvement are o f t e n d i s c u s s e d as Involvement i n s o c i a l a c t i o n and s o c i a l p o l i c y . In t h i s study the focus was a r b i t r a r i l y changed from s o c i a l a c t i o n to community -40-i n v o l v e m e n t f o r t h e f o l l o w i n g r e a s o n . I t seemed u n r e a s o n a b l e t o e x p e c t t h a t a l l p r i v a t e p r a c t i t i o n e r s s h o u l d be i n v o l v e d i n s o c i a l a c t i o n o r c o m m u n i t y o r g a n i z a t i o n i n a s m u c h a s t h e r e i s n o t a s i m i l a r e x p e c t a t i o n t h a t a l l c o m m u n i t y w o r k e r s o r s o c i a l a c t i v i s t s s h o u l d c a r r y a c a s e l o a d . I t I s u n d e r s t o o d t h a t c o n c e r n f o r c o m m u n i t y and s o c i e t y has been a n i n t r i n s i c a n d h i s t o r i c a l s o c i a l work v a l u e f r o m w h i c h c o m m u n i t y o r g a n i z a t i o n and s o c i a l a c t i o n e v o l v e d . However, i t i s a l s o s u g g e s t e d t h a t , "The f i r s t , t h e o l d e s t and t h e most f a m i l i a r s o c i a l work a r e a , i s c a s e w o r k , [ w h i l e ] t h e t h i r d s o c i a l work method i s c o m m u n i t y o r g a n i z a t i o n ( M e n d e l s o h n & R i c h a n 1 9 7 3 , p. 25). I t was b e l i e v e d t h a t r e s e a r c h i n g r e s p o n d e n t s ' i n v o l v e m e n t i n t h e i r c o m m u n i t y w o u l d p r o v i d e a c l e a r e r d e s c r i p t i o n o f t h e d e g r e e o f t h e i r s o c i a l work v a l u e s t h a n w o u l d be p r o v i d e d b y r e s e a r c h i n g t h e i r i n v o l v e m e n t i n s o c i a l a c t i o n p e r s e . I t has been s u g g e s t e d t h a t , " P r i v a t e p r a c t i t i o n e r s t e n d e i t h e r t o r e l e g a t e s o c i a l p o l i c y a n d p r o g r a m d e v e l o p m e n t a s p e c t s t o o t h e r c o l l e a g u e s o r t o s e e t h o s e r e s p o n s i b i l i t i e s a s a s e p a r a t e p a r t o f t h e p r o f e s s i o n a l f u n c t i o n " ( K u r z m a n 1 9 7 6 , p. 3 6 5 ) . I n 1981 B o r e n z w e i g r e p o r t e d t h a t b o t h p r i v a t e p r a c t i t i o n e r s a n d a g e n c y w o r k e r s r e p o r t e d l o w i n v o l v e m e n t i n s o c i a l a c t i o n ( p . 2 4 1 ) . However, i n 1984 C a l l a h a n was s t i l l p o s i n g t h e q u e s t i o n , " A r e t h e p e o p l e a t t r a c t e d t o -41-p r l v a t e p r a c t i c e d i s i n t e r e s t e d In l a r g e r system change?" (p. 272). The q u e s t i o n t h e r e f o r e was asked, 5. To what extent are private practitioners involved in community-level activities? Questions #38, #40 and #41 are I n d i c a n t s . Job S a t i s f a c t i o n . Barker (1982) s t a t e s , "Job s a t i s f a c t i o n l's r e l a t e d p o s i t i v e l y to s e v e r a l c h a r a c t e r i s t i c s , i n c l u d i n g feedback from one's peers, s u p p o r t i v e r e l a t i o n s h i p s with c o l l e a g u e s , work s h a r i n g , time-outs from the work day, s o c i a l feedback, and smaller c a s e l o a d s " (p. 240). In a d d i t i o n , It i s n e g a t i v e l y r e l a t e d to i s o l a t i o n . Many authors r a i s e the concern that p r i v a t e p r a c t i c e sometimes leads to i s o l a t i o n . "One of the d i f f i c u l t i e s of p r i v a t e p r a c t i c e i n g e n e r a l , and f o r i n d i v i d u a l p r a c t i t i o n e r s i n p a r t i c u l a r , i s the ' p o s s i b l e c r i s i s of p r o f e s s i o n a l i s o l a t i o n ' " (Kruzman 1976, p. 364). Martin (1984) e l a b o r a t e d , "The p r i v a t e p r a c t i t i o n e r plagued by c o n s t r a i n t s of time and money, s u f f e r s from p r o f e s s i o n a l I s o l a t i o n unless I n t e r p r o f e s s i o n a l c o n t a c t i s i n i t i a t e d through i n d i v i d u a l i n i t i a t i v e and at a p e r s o n a l c o s t " (p. 28 4 ) . T h i s suggests t h a t not only i s i s o l a t i o n a component of job s a t i s f a c t i o n but perhaps time c o n s t r a i n t s and income may be f a c t o r s as w e l l . I t seems r e a s o n a b l e to b e l i e v e that one cannot at the same time e x p e r i e n c e job s a t i s f a c t i o n and burnout. -42-Therefore i f there are s t r o n g i n d i c a t i o n s t h a t a person's work s i t u a t i o n i n c l u d e s those elements t h a t c o n t r i b u t e to job s a t i s f a c t i o n , and a t the same time, t h e i r work s i t u a t i o n does not i n c l u d e those elements t h a t are known to c o n t r i b u t e to burnout, then i t seems reasonable to deduce an i n d i c a t i o n of job s a t i s f a c t i o n , or c o n v e r s e l y burnout, from those i n d i c a t o r s . Barker (1984) suggests t h a t burnout, "... i s a form of d e p r e s s i o n and apathy and i s r e l a t e d to boredom, i n t e l l e c t u a l s t a g n a t i o n , and nonmotivation f o r e f f e c t i v e c l i e n t s e r v i c e " (p. 47). Freeman (1984) suggested t h a t v a r i e t y i n one's work i s s t i m u l a t i n g and without i t , p r a c t i t i o n e r s o f t e n f i n d themselves becoming exhausted and burned out (p. 276). He f u r t h e r suggests that p r i v a t e p r a c t i c e o f f e r s such an o p p o r t u n i t y f o r v a r i e t y . Barker (1984) says the opposite i s so. "The p r i v a t e worker however, does e s s e n t i a l l y the same job throughout h i s or her c a r e e r . The o n l y chance f o r v a r i e t y i s to r e t u r n to agency p r a c t i c e or to change p r o f e s s i o n s " (p.47). Because of the c u r r e n t lack of mandatory s u p e r v i s i o n , r e g i s t r a t i o n , and t h e r e f o r e standards of p r a c t i c e ; and because job d i s s a t i s f a c t i o n or burnout c o u l d be p o t e n t i a l l y d e t r i m e n t a l to c l i e n t s , i t seemed important to ask the q u e s t i o n , 6. To what degree are Indicators of job satisfaction present among private p r a c t i t i o n e r s ? Questions #12, #23, -43-#36, #37, #39, #43 and #44 are i n d i c a n t s . C h a r a c t e r i s t i c s of Aspects of S e r v i c e There are l e s s r e f e r e n c e s In the p r i v a t e p r a c t i c e l i t e r a t u r e to the concepts d i s c u s s e d i n t h i s s e c t i o n but because they impact s t r o n g l y on s e r v i c e s to c l i e n t s , they were Included i n the study. R e f e r r a l s . Most of the d i s c u s s i o n s on r e f e r r a l s centre around two i s s u e s . Where do p r a c t i t i o n e r s get t h e i r r e f e r r a l s from? And, given t h a t " c l i e n t s are income", do p r i v a t e p r a c t i t i o n e r s r e f e r to others when i t i s a p p r o p r i a t e ? Wallace (1982) p o i n t e d out t h a t the m a j o r i t y of p r a c t i t i o n e r s are concerned with f i n d i n g new r e f e r r a l sources (p. 266). I t i s suggested t h a t t h i s need f o r r e f e r r a l sources i s a primary one and that I t may a f f e c t s e r v i c e d e l i v e r y . The p r a c t i t i o n e r may be working more fo r the r e f e r r i n g source than f o r the c l i e n t . On the t o p i c of r e f e r r a l s , M a r t i n (1984) wrote that p r a c t i t i o n e r s must ask, "What does my r e f e r r a l system want? and what c l i e n t s or c l i e n t problems w i l l enhance my s e r v i c e Image? A s o c i a l worker undertaking c o n t r a c t s f o r s o c i a l Impact s t u d i e s commented t h a t unless the c o n s u l t a n t p r e s e n t s f a v o u r a b l e r e p o r t s to a c l i e n t / e m p l o y e r , c o n t r a c t s are not renewed" (p.282). Both Goldmeier (1986) and Wallace (1982) found that the m a j o r i t y of c l i e n t s come e i t h e r s e 1 f - r e f e r r e d or r e f e r r e d by a c u r r e n t or former c l i e n t , a r e l a t i v e or f r i e n d . -44-I t h as b e e n s u g g e s t e d t h a t p r a c t i t i o n e r s may come i n t o c o n f l i c t b e t w e e n t h e t y p e o f s e r v i c e n e e d e d b y t h e c l i e n t , a n d t h e t y p e o f s e r v i c e t h a t t h e p r a c t i t i o n e r i s a b l e t o p r o v i d e . B a r k e r ( 1 9 8 4 ) s t a t e d , " I n t h e c o m p e t i t i v e m a r k e t p l a c e s i t u a t i o n i n h e r e n t i n p r i v a t e p r a c t i c e , some p r a c t i t i o n e r s a r e i n c l i n e d t o s e e a n y c l i e n t who s e e k s t h e i r s e r v i c e s , r e g a r d l e s s o f w h e t h e r o r n o t t h e y a r e c a p a b l e o f p r o v i d i n g t h e n e e d e d s e r v i c e " ( p . 23) . I n t h i s s t u d y r e s p o n d e n t s were a s k e d a b o u t t h e i m p a c t t h a t t h e c o s t o f t h e i r s e r v i c e had on t h e i r c l i e n t s and how t h e y w o u l d l i k e t h e i r s e r v i c e s t o be p a i d f o r i n t h e i r " i d e a l " w o r l d . E v e n t h o u g h p r a c t i t i o n e r s c o u l d n o t c h a n g e t h e s i t u a t i o n t o t h e i r " i d e a l " o v e r n i g h t , I t was w o n d e r e d w h e t h e r p r a c t i t i o n e r s were i n f l u e n c e d by t h e m e d i c a l c o v e r a g e o f o t h e r p r o f e s s i o n a l s when t h e y d i d d e c i d e t o r e f e r . S i n c e t h e s e q u e s t i o n s a r o s e a r o u n d t h e t o p i c o f r e f e r r a l s , t h e y were a d d r e s s e d i n t h e q u e s t i o n d e r i v e d f r o m t h e a b o v e . 7. F r o m whom do p r a c t i t i o n e r s g e t referrals, how f r e q u e n t l y do t h e y r e f e r a n d how f r e q u e n t l y do t h e y r e f e r t o p r a c t i t i o n e r s c o v e r e d by a medical plan? Q u e s t i o n s #17, #18, and #19 were t h e i n d i c a n t s . F r e q u e n c y / D u r a t i o n / T e r m i n a t i o n . As w i t h r e f e r r a l s , s i n c e t h e f r e q u e n c y , d u r a t i o n , a n d t e r m i n a t i o n o f I n t e r v e n t i o n o r t r e a t m e n t i s d i r e c t l y t i e d t o t h e p r a c t i t i o n e r s i n c o m e , q u e s t i o n s have been r a i s e d a s t o how -45-they impact on the c h a r a c t e r i s t i c s of those p a r t i c u l a r aspects of s e r v i c e . Goldmeier (1986) d i d a comparative study of mental h e a l t h workers on the c h a r a c t e r i s t i c s of t h e i r p r a c t i c e s . " F i n d i n g s on time i n treatment suggested t h a t r e g a r d l e s s of d i s c i p l i n e , p r a c t i t i o n e r s used a long-term treatment model and saw about t h r e e - q u a r t e r s or more of a l l p a t i e n t s for longer than twelve w e e k s — u s u a l l y on a weekly b a s i s " (p. 98). With regard to the Goldmeier study, i t should be noted that i n the s t a t e of Maryland vendorship l e g i s l a t i o n i s i n p l a c e and t h e r e f o r e p r a c t i t i o n e r s can r e c e i v e payment from insurance coverage. T h i s c o u l d impact on frequency and d u r a t i o n i n two ways. I t c o u l d i n c r e a s e or decrease the i n t e r v e n t i o n r e c e i v e d r e l a t i v e to the payment l i m i t a t i o n s of the coverage. It has a l s o been suggested that the p a t t e r n s of frequency, d u r a t i o n , and t e r m i n a t i o n may d i f f e r i n p r i v a t e p r a c t i c e s i n c e p r a c t i t i o n e r s are not c o n s t r a i n e d by agency p o l i c i e s . "The p r i v a t e p r a c t i t i o n e r has the freedom to determine the length of time spent with the c l i e n t , the s e t t i n g where the c l i e n t w i l l be seen, the frequency of c o n t a c t , and the l e n g t h of treatment r e q u i r e d to accomplish t h e r a p e u t i c g o a l s " (Freeman 1984, p. 276). Without s u p e r v i s i o n , t h i s c o u l d have e i t h e r p o s i t i v e or negative consequences f o r the c l i e n t , as Freeman (1984) a l s o suggested t h a t , " S u c c e s s f u l p r a c t i t i o n e r s may f i n d i t e a s i e r to a l l o w c l i e n t s to move i n and out of therapy, -46-[however] r e l i a n c e on p r i v a t e p r a c t i c e income may c l o u d o b j e c t i v i t y about when to terminate with c e r t a i n c l i e n t s " (p. 279). The q u e s t i o n d e r i v e d from the above d i s c u s s i o n was, 8. What is the frequency and duration of intervention and who decides when to terminate? Questions #9, #10, & #11 are the i n d i c a n t s . C o n s u l t a t i o n and E v a l u a t i o n . Because the r e g u l a t i o n of p r i v a t e p r a c t i t i o n e r s i s s t i l l e v o l v i n g and because i n Canada there i s very l i t t l e r e g u l a t i o n , the i s s u e s of c o n s u l t a t i o n and e v a l u a t i o n are very important. I t i s agreed that both c o n s u l t a t i o n and e v a l u a t i o n are necessary for optimum c l i e n t s e r v i c e . I t i s of p a r t i c u l a r concern because, " P r i v a t e p r a c t i t i o n e r s have fewer c o n t r o l s on t h e i r b e h a v i o r s , and t h e i r r e l a t i v e autonomy makes i t p o s s i b l e f o r them to a v o i d being s c r u t i n i z e d f o r competence by t h e i r c o l l e a g u e s " (Barker 1982, p. 22). In f a c t Kurzman (1976) suggested that c o n s u l t a t i o n i s of utmost importance. "Although i t i s h e l p f u l to keep c u r r e n t with the l i t e r a t u r e and to a t t e n d p r o f e s s i o n a l symposia, such a c t i t i v i t i e s may not be adequate s u b s t i t u t e s f o r the peer exchange and s t i m u l a t i o n that take p l a c e i n o r g a n i z a t i o n a l s e t t i n g s " (p. 364). M a r t i n (1984) b e l i e v e d that " A c c o u n t a b i l i t y i s s e l f - e v i d e n t to the agency employee, but i t i s out of s i g h t to the p r i v a t e p r a c t i t i o n e r u n t i l a c c o u n t i n g time" (p. 282). -47-Barker (1984) f u r t h e r noted t h a t , "Nowadays, a l l p r o f e s s i o n a l s , whether i n f e e - f o r - s e r v i c e arrangements or s a l a r i e d i n s o c i a l a g e n c i e s , are p a r t i c i p a t i n g i n q u a l i t y c o n t r o l e f f o r t s such as competency t e s t i n g , peer review, l i c e n s i n g and c e r t i f i c a t i o n , and c o n t i n u i n g e d u c a t i o n . P r i v a t e p r a c t i t i o n e r s i n s o c i a l work have been at the f o r e f r o n t of t h e i r p r o f e s s i o n ' s e f f o r t to upgrade these programs" (p. 58). Freeman (1984) suggests t h a t , " P r i v a t e p r a c t i c e p r o v i d e s the freedom to develop c o l l a b o r a t i v e r e l a t i o n s h i p s with other p r o f e s s i o n a l s " (p. 279). And f i n a l l y , Wallace's study of p r i v a t e p r a c t i t i o n e r s (1982) found, "Most of the p r a c t i t i o n e r s (90 percent) obtained case c o n s u l t a t i o n on an as-needed or r e g u l a r b a s i s , but 10 percent d i d not use c o n s u l t a t i o n a t a l l . A g r e a t e r percent used peer c o n s u l t a t i o n than for c o n s u l t a t i o n f o r which they p a i d (42 percent) (p. 266). In l i g h t of the f a c t that there i s l i t t l e , i f any, e x t e r n a l r e g u l a t i o n or e v a l u a t i o n of p r i v a t e p r a c t i t i o n e r s , and because there i s l i t t l e known about the p a t t e r n s of c o n s u l t a t i o n , i t was thought i t would be i n t e r e s t i n g to ask whether, and to what extent s e l f e v a l u a t i o n and c o n s u l t a t i o n i s t a k i n g p l a c e . The r e s u l t s may have i m p l i c a t i o n s f o r educators or p r o f e s s i o n a l a s s o c i a t i o n s In t h a t they may choose to I n i t i a t e c o n t i n u i n g e d u c a t i o n courses on e v a l u a t i v e methods or to f a c i l i t a t e and/or r e g u l a t e a c o n s u l t a t i v e network. In order to determine the c u r r e n t norms with regard to -48-e v a l u a t i o n and c o n s u l t a t i o n , the f o l l o w i n g q u e s t i o n was asked. 9. To What extent do p r i v a t e p r a c t i t i o n e r s consult with others on t h e i r caseloads and to what extent do they evaluate t h e i r work? Questions #29 and #32 were i n d i c a n t s . Fees. Two i s s u e s of i n t e r e s t r e g a r d i n g fees were r a i s e d i n the l i t e r a t u r e d e s c r i b i n g p r i v a t e p r a c t i c e , (a) whether or not fees are charged a c c o r d i n g to a f l a t fee or a s l i d i n g s c a l e , and (b) the amounts of the fees charged. In response to the concern t h a t , a f l a t fee would deny s e r v i c e s to many i n d i v i d u a l s , (Freeman (1984) suggested t h a t , "One way to a v o i d t h i s outcome i s to p r ovide p r i v a t e s o c i a l work s e r v i c e s on a s l i d i n g s c a l e to people who have f i x e d incomes and l i m i t e d budgets" (p. 277). L e v i n (1976) on the other hand, wrote, "Most s o c i a l workers o b j e c t to s u b j e c t i n g c l i e n t s to a 'means t e s t ' f o r s e r v i c e s , yet r e a d i l y go along with t h i s p r a c t i c e even i n f e e - c h a r g i n g agencies that have a s l i d i n g fee s c a l e r e f l e c t i n g p h i l a n t h r o p i c v a l u e s , with a l l the demeaning i m p l i c a t i o n s for the r e c i p i e n t s of p h i l a n t h r o p y " (p. 356). Barker (1984) summarized the s i t u a t i o n , S o c i a l Workers are not i n agreement about the p r e f e r r e d method of fee c h a r g i n g . Many f e e l i t i s u n e t h i c a l to vary fees from c l i e n t to c l i e n t . Other workers f e e l i t i s u n e t h i c a l not to use a s l i d i n g s c a l e because t h i s p o l i c y i s the o n l y way to remain a c c e s s i b l e to the l e s s a f f l u e n t . The NASW Code of E t h i c s , i n i t s statement about charges to c l i e n t s , says fees should be set "with due regard f o r the c l i e n t s * a b i l i t y to pay." To some p r a c t i t i o n e r s t h i s i s I n t e r p r e t e d as r e q u i r i n g workers to s c r u t i n i z e t h e i r c l i e n t s ' f i n a n c e s . The trend i n p r i v a t e p r a c t i c e i s toward the f l a t fee system f o r a l l c l i e n t s . Consumer groups say the s l i d i n g fee p o l i c y i s u n e t h i c a l and t h i r d - p a r t y o r g a n i z a t i o n s c o n s i d e r i t i l l e g a l ; and many c l i e n t s and workers f i n d i t c o n f u s i n g and u n f a i r . [The f l a t fee however], does not preclude a p r a c t i t i o n e r from p r o v i d i n g f r e e s e r v i c e on o c c a s i o n (p. 110). It was t h e r e f o r e b e l i e v e d t h a t f o r i n d i v i d u a l s o c i a l workers, f o r boards of r e g i s t r a t i o n or f o r p r o f e s s i o n a l a s s o c i a t i o n s , should they be I n t e r e s t e d i n f o r m u l a t i n g g u i d e l i n e s f o r f e e - c h a r g i n g , i t was thought i t would be h e l p f u l to ask the f o l l o w i n g . 10. What percentage of private p r a c t i t i o n e r s charge according to (a) a f l a t fee, and (b) a s l i d i n g scale and In each case, (c) what is the average charge? Question #22 was the i n d i c a n t . C h a r a c t e r i s t i c s of C l i e n t s S p e c i a l C l i e n t Groups. A common c r i t i c i s m l e v e l l e d a t p r i v a t e p r a c t i c e i s that the f e e - f o r - s e r v i c e model n e c e s s a r i l y excludes many members of s p e c i a l groups who -50-have t r a d i t i o n a l l y been the disadvantaged. "The poor, the marginal and unattached, the disempowered, the multi-problem, the depressed and d e s p a i r i n g , the m e n t a l l y and p h y s i c a l l y handicapped are not candidates f o r p r i v a t e p r a c i t i c e " ( Martin 1984, p. 283). Once again there are c o n t r a d i c t i o n s . "Shafer concluded t h a t the a v a i l a b i l i t y of help i n the form of p r i v a t e p r a c t i c e expanded the p o p u l a t i o n served by s o c i a l workers. N e v e r t h e l e s s , the concerns of those opposed to p r i v a t e p r a c t i c e because of t h e i r commitment to serve the d e v i a n t , the d i s e n f r a n c h i s e d , and the poor remain a l i v e " (Borenzweig 1981, p. 243). Frlsrnan et a l . (1986) r e p o r t e d both s i d e s of the argument. They r e p o r t e d t h a t Sherman Merle (1982) and Kurt Reicher (1982), "...expressed concern t h a t vendorship l i m i t s access to q u a l i t y care f o r low-income i n d i v i d u a l s and i n v o l v e s an abandonment of t r a d i t i o n a l s o c i a l work values and c l i e n t e l e s f o r the 'currency of the market p l a c e ' " (p. 437). Although, Fishman and Kasser (1976); and Meddin (1982), "...argued i n c o n t r a s t , t h a t vendorship permits g r e a t e r choice i n the s e l e c t i o n of mental h e a l t h s e r v i c e p r o v i d e r s and f a c i l i t a t e s freedom of c h o i c e i n p a r t i c u l a r f o r m i n o r i t y , female, and low-income c l i e n t s " (p. 438). F u r t h e r , Goldmeier's study (1986) found t h a t a group o f t e n thought to be n e g l e c t e d by p r i v a t e p r a c t i t i o n e r s , would indeed be s e r v e d . He r e p o r t e d an overwhelming -51-acceptance of d e a l i n g with c h r o n i c p a t i e n t s . I t i s important to r e c a l l however, t h a t Goldmeier d i d h i s study i n a s t a t e that has vendorship l e g i s l a t i o n . However s i n c e there i s c u r r e n t l y no vendorship l e g i s l a t i o n i n Canada i t seemed necessary to ask, 11. To what extent are s p e c i a l or marginal groups r e p r e s e n t e d on the caseloads of private p r a c t i t i o n e r s ? Questions #13, #14, and #15 were i n d i c a n t s . Economic S i t u a t i o n of C l i e n t s . There has been c o n s i d e r a b l e concern that p r i v a t e p r a c t i c e excludes the very t a r g e t group that s o c i a l work i n i t i a l l y s e t out to s e r v e . That i s the disadvantaged and poor. Here again the l i t e r a t u r e on p r i v a t e p r a c t i c e i s somewhat c o n t r a d i c t o r y . On one hand, i n 1962 Sherman Merle wrote that p r i v a t e p r a c t i c e , "does not p rovide s e r v i c e to those who are i n need but unable to pay" (Barker 1984, p.9). T h i s was supported i n Borenzwelg's (1981) study, "As expected, the p r i v a t e p r a c t i t i o n e r tended to serve m i d d l e - c l a s s and u p p e r - c l a s s n e u r o t i c i n d i v i d u a l s , and those of agency p r a c t i t i o n e r s tended to be Black, Chicano, A s i a n , and people of lower socioeconomic s t a t u s " (p. 243). On the other hand however, Barker (1984) adds, "The s e r v i c e s of p r i v a t e p r a c t i t i o n e r s have become a v a i l a b l e to a much wider p o r t i o n of the economic spectrum than i s g e n e r a l l y r e a l i z e d . . . . t a n d 1 with t h i r d - p a r t y f i n a n c i n g , many more c l i e n t s i n c l u d i n g the e c o n o m i c a l l y disadvantaged, are a v a i l i n g themselves of a p r i v a t e p r a c t i t i o n e r ' s s e r v i c e s " (p. 32). T h e r e f o r e the q u e s t i o n was asked, 12. What do p r i v a t e p r a c t i t i o n e r s b e l i e v e the economic s i t u a t i o n of t h e i r clients to be? Question #16 was the s o l e i n d i c a n t . P r e s e n t i n g Problems. D e s c r i p t i o n s of p r i v a t e p r a c t i c e o f t e n i n c l u d e d i s c u s s i o n s of the types of c l i e n t s t h a t are served r e l a t i v e to the s e v e r i t y of t h e i r problems. Some authors suggest that because p r i v a t e p r a c t i t i o n e r s can be s e l e c t i v e about whom they serve, t h a t they r a r e l y serve the unmotivated, the multi-problemed and the p s y c h o t i c . L e v i n (1976) o f f e r e d that from a mutually e x c l u s i v e , f i v e - c a t e g o r y schema that r e f l e c t s p r o g r e s s i v e degrees of r e l a t i v e dependence or p e r s o n a l i n c a p a c i t y , t h a t c l i e n t s a t "Levels A or B--and many at L e v e l C--could w e l l be served p r i v a t e l y " (p. 360). Borenzweig's (1981) study found t h i s to be the case, "The agency p r a c t i t i o n e r s saw more people who they l a b e l l e d as p s y c h o t i c than d i d respondents i n p r i v a t e p r a c t i c e ; most of the c l i e n t s seen In p r i v a t e p r a c t i c e were diagnosed as p s y c h o n e u r o t i c " (p. 241). Wallace (1982) found, " F o r t y - t h r e e percent of the p r a c t i t i o n e r s i n d i c a t e d t h a t the primary p r e s e n t i n g complaint they encountered was a p s y c h o l o g i c a l problem, and 25 percent p r i m a r i l y encountered m a r i t a l problems" (p. 265). Without making any judgement as to whom p r i v a t e p r a c t i t i o n e r s should see (with r e s p e c t to p r e s e n t i n g problems), I thought i t was of i n t e r e s t - - g i v e n the d i s c u s s i o n i n the l i t e r a t u r e , to ask 13. What are the predominant p r e s e n t i n g problems of the c l i e n t s of private p r a c t i t i o n e r s ? Question #8 was the i n d i c a n t . C l i e n t U n i t s . The r e c e n t l i t e r a t u r e t h a t d e s c r i b e d p r i v a t e p r a c t i c e i n c l u d e d i n f o r m a t i o n on the c l i e n t groups (or u n i t s ) that were seen. In every case the two c l i e n t u n i t s most f r e q u e n t l y seen were i n d i v i d u a l s and couples r e s p e c t i v e l y (Borenzweig 1981; Goldmeier 1986; and Wallace 1982) . To add to the comprehensiveness of the d e s c r i p t i o n of p r i v a t e p r a c t i c e , the q u e s t i o n was asked, 14. What are the most frequently seen c l i e n t u n i t s ? Question #6 was the i n d i c a n t . Demographic and Background Information Other i n f o r m a t i o n that was not debated or q u e r i e d i n the l i t e r a t u r e was c o l l e c t e d , because i t was b e l i e v e d the i n f o r m a t i o n was necessary f o r a comprehensive d e s c r i p t i o n and f o r meaningful data a n a l y s e s . Age and Sex of C l i e n t s . I t was noted by Borenzweig (1981) t h a t , " P r i v a t e p r a c t i t i o n e r s appeared to be l e s s l i k e l y than agency workers to have c h i l d r e n as c l i e n t s , [and] c o n v e r s e l y , they were more l i k e l y than t h e i r c o u n t e r p a r t s i n agencies to t r e a t young a d u l t s " (p. 241). -54-Goldmeler (1986) found, "more than h a l t of a l l p a t i e n t s were a d u l t s between 18 and 40, and the e l d e r l y (65 and older) as a whole were not well r e p r e s e n t e d , t h e i r p r o p o r t i o n s on p r i v a t e p r a c t i c e caseloads r a n g i n g from 1.7% to 6.3%" (p. 94). These s t u d i e s d i d not breakdown the percentages of c l i e n t s i n the v a r i o u s age groups by sex, but I t was thought to be of i n t e r e s t t h e r e f o r e the q u e s t i o n was asked, 15. What is the breakdown of the c l i e n t s of p r i v a t e p r a c t i c e by age and by sex? Question #7 was the i n d i c a n t . E d u c a t i o n a l Backgrounds of P r a c t i o n e r s . To perhaps c o n t r i b u t e i n f o r m a t i o n to s o c i a l work e d u c a t o r s , and p r i v a t e p r a c t i c e p o l i c y makers, the qu e s t i o n was asked, 16. What are the e d u c a t i o n a l backgrounds of p r i v a t e p r a c t i t i o n e r s ? Q u estions #48, #42, and #5 were the i n d i c a n t s . Employment Backgrounds of P r a c t i t i o n e r s . S i m i l a r l y f o r a c u r r e n t , a c c u r a t e , and comprehensive d e s c r i p t i o n , the q u e s t i o n was i n c l u d e d , 17. What are the employment characteristics of p r i v a t e p r a c t i t i o n e r s ? Q u estions #1, #2, and #3 were the I n d i c a n t s . Aae and Sex of P r a c t i t i o n e r s . 18. How do private practitioners break down by age & sex? Questions #45 and #46 were the i n d i c a n t s . -55-Income of P r a c t i t i o n e r s . 19. What were the gross annual Incomes of the p r i v a t e p r a c t i t i o n e r s , f o r the year 1986? Question #47 was the i n d i c a n t . " I d e a l World". A f t e r r e a d i n g the l i t e r a t u r e on p r i v a t e p r a c t i c e and a f t e r c o n t e m p l a t i n g the many arguments s u g g e s t i n g t h a t : P r i v a t e p r a c t i t i o n e r s have moved away from t h e i r h i s t o r i c a l p h i l a n t h r o p i c r o o t s ; t h a t p r i v a t e p r a c t i t i o n e r s do s o c i a l work f o r p r o f i t ; t h a t p r i v a t e p r a c t i t i o n e r s wish o n l y to serve the motivated and the advantaged; but conceding t h a t p r i v a t e p r a c t i t i o n e r s are a f t e r a l l a pa r t of the l a r g e r s o c i e t y w i t h i n whose s t r u c t u r e they must u l t i m a t e l y work, I b e l i e v e d i t was important to ask, 20. In t h e i r "Ideal World", how would practitioners l i k e to have their services p a i d f o r ? Question #20 was the i n d i c a n t . L i m i t a t i o n s of the Research Scope The scope of t h i s r e s e a r c h on p r i v a t e p r a c t i c e i s g e o g r a p h i c a l l y and p r o f e s s i o n a l l y l i m i t e d . To meet the c r i t e r i a to be i n c l u d e d i n the sample, s u b j e c t s had to be s o c i a l workers i n p r i v a t e p r a c t i c e . " S o c i a l workers i n p r i v a t e p r a c t i c e " as p r e v i o u s l y s t a t e d under O p e r a t i o n a l l z a t i o n (Chap. 1 p.29) were d e f i n e d as, people who e i t h e r hold a u n i v e r s i t y degree i n s o c i a l work, and/or are R e g i s t e r e d S o c i a l Workers; who - 5 6 -e l t h e r PART-TIME OR FULL-TIME, p r a c t i c e t h e i r p r o f e s s i o n independently of any government or v o l u n t a r y agency; AND who s e t up t h e i r own c o n d i t i o n s of payment with c l i e n t s . ( M o d i f i e d from the BCASW A p p l i c a t i o n For L i s t i n g On the Roster of R e g i s t e r e d S o c i a l Workers i n P r i v a t e P r a c t i c e i n B.C.). The r a t i o n a l e f o r using the above o p e r a t i o n a l i z a t i o n of the term, was t h a t there a p p a r e n t l y are people who i d e n t i f y themselves as s o c i a l workers and who p r a c t i c e p r i v a t e l y , but who i n f a c t would not be d e s c r i b e d as s o c i a l workers by the above c r i t e r i a . F u r t h e r , should s o c i a l workers get c o n t r o l - o f - t i t l e or mandatory r e g i s t r a t i o n , i t was b e l i e v e d t h a t only those people meeting the above c r i t e r i a would be covered by such r e g u l a t i o n s . L e v e l s of Measurement and M a t u r i t y The l e v e l s of measurement u t i l i z e d i n t h i s r e s e a r c h instrument v a r i e d from q u e s t i o n to q u e s t i o n ranging from nominal to r a t i o . Most of the non-demographic data was a t the o r d i n a l l e v e l . Higher l e v e l s of measurement are d e s i r a b l e f o r r i g o r o u s i n f e r e n t i a l s t a t i s t i c s but t h i s study was designed to use p r i m a r i l y d e s c r i p t i v e s t a t i s t i c s . In a d e s c r i p t i v e study such as t h i s , e s t a b l i s h i n g whether there i s more or l e s s of what i s being measured ( o r d i n a l data) a l l o w s one to conclude what Is dominant and t h e r e f o r e what can be s a i d to be c h a r a c t e r i s t i c . -57-A good number of the o r d i n a l l e v e l questions were on a f i v e p o i n t s c a l e , however t h i s was not c o n s i s t e n t throughout. I t may have been an improvement to d e s i g n a l l the m u l t i p l e choice q u e s t i o n s on a f i v e p o i n t s c a l e , but one must give c o n s i d e r a t i o n to the r e l e v a n c e of a l t e r n a t i v e s o f f e r e d , expected s i z e of the sample, the ways i n which one might want to c o l l a p s e the data f o r a n a l y s e s , and the degree of a c c u r a c y of the data to be e l l c i t e d . Another l i m i t a t i o n i n measurement was that i n some cases there was o n l y one i n d i c a n t f o r measuring each concept w i t h i n a r e s e a r c h q u e s t i o n . A f u r t h e r l i m i t a t i o n of the m a t u r i t y of t h i s study was the s i m p l i s t i c and sometimes r a t h e r vague wording of some of the I n d i c a n t s . However, as always, the c o s t / b e n e f i t s of c h o i c e s had to be weighed when c o n s t r u c t i n g the q u e s t i o n n a i r e . On the one hand, phrases such as " c o n s u l t on my c a s e l o a d " , "engage i n p r o f e s s i o n a l development", "am s t i m u l a t e d " , "am i s o l a t e d " , et c e t e r a may be so vague as to e f f e c t the v a l i d i t y of the r e s u l t s . On the other hand, to o p e r a t i o n a l i z e such phrases on an instrument c o n s t r u c t e d f o r p r o f e s s i o n a l s i n a p r o f e s s i o n where these words are r o u t i n e l y used and have common meaning, seemed s u f f i c i e n t l y p a t r o n i z i n g so as to j e o p a r d i z e the v a l i d i t y through non-responses. -58-A Summary of The Research Model and Design To maintain the focus of t h i s t h e s i s o n l y a curs o r y d i s c u s s i o n of the r e s e a r c h model, and the d e s i g n are i n c l u d e d here. For readers f o r whom these a s p e c t s are of more i n t e r e s t , an e l a b o r a t i o n of the r e s e a r c h model and the d e s i g n i n c l u d i n g sampling, v a l i d i t y and r e l i a b i l i t y , i s i n c l u d e d i n Appendix B; and an e x t e n s i v e d i s c u s s i o n of mailed q u e s t i o n n a i r e methodology, i n c l u d i n g s t r e n g t h s and weaknesses, i s i n c l u d e d i n Appendix C. Research Model T h i s study i s c l a s s i f i e d as a P o p u l a t i o n D e s c r i p t i o n p i e c e of r e s e a r c h . P o p u l a t i o n d e s c r i p t i o n s t u d i e s do not r e s e a r c h s p e c i f i c hypotheses nor do they i d e n t i f y dependent or independent v a r i a b l e s . Reid & Smith (1981) suggest t h a t the knowledge b u i l d i n g f u n c t i o n of d e s c r i p t i v e s t u d i e s i s to break the whole down i n t o " i n t e r c o n n e c t e d p a r t s to achieve as d e t a i l e d a p i c t u r e as p o s s i b l e " (p. 70). Design T h i s i s a c r o s s - s e c t i o n a l , n a t u r a l i s t i c study c a r r i e d out through a s e l f - a d m i n i s t e r e d mailed q u e s t i o n n a i r e which presumably took plac e at the m a i l i n g address of the respondents. The q u e s t i o n n a i r e gathered p r i m a r i l y q u a n t i t a t i v e data because of ease of responding, coding, and a n a l y s i s , and because other r e s e a r c h r e p o r t e d i n the p r i v a t e p r a c t i c e l i t e r a t u r e r e p o r t e d q u a n t i t a t i v e d a t a , i t was thought to be the most a p p r o p r i a t e to f a c i l i t a t e comparisons. A n o n - r e p r e s e n t a t i v e sample (a snowball sample) was used, but e x t e n s i v e measures were taken so t h a t the sample was b e l i e v e d to be v e r y c l o s e to the e n t i r e p o p u l a t i o n . (For d e t a i l s see Appendix B, Sampling.) V a l i d i t y and R e l i a b i l i t y An instrument i s s a i d to be v a l i d when i t a c c u r a t e l y measures that which i t s e t s out to measure, and when i t measures that which i t s e t s out to measure a c c u r a t e l y . An instrument i s s a i d to be r e l i a b l e to the degree that i t y i e l d s c o n s i s t e n t r e s u l t s . To those ends e x t e n s i v e steps were taken to f o l l o w the q u e s t i o n n a i r e methodology d i s c u s s e d i n Appendix C. T h i s i n c l u d e d a t t e n t i o n to Envelopes and Stamps, to the Covering L e t t e r ( t i t l e , p e r s o n a l i z a t i o n , sponsorship, anonymity, and r e t u r n d a t e ) , the Instrument ( s a l i e n c e , l e n g t h , format, wording, and types of q u e s t i o n s ) and Follow-ups. C o n s i d e r a t i o n was a l s o g i v e n to the comfort of the respondents In t h a t the q u e s t i o n n a i r e was designed using a s s e r t i v e r a t h e r than i n t e r r o g a t i v e statements. The instrument was p r e t e s t e d on f i v e n o n - p r a c t i t i o n e r s , i t was then submitted to t h r e e p r o f e s s o r s f o r feedback, and f i n a l l y It wa3 a g a i n p r e - t e s t e d by two p r a c t i t i o n e r s who d i d not meet the c r i t e r i a for the sample of t h i s study. - 6 0 -The f i v e p o i n t frequency s c a l e was b e l i e v e d to be a v a l i d measure f o r behaviour, as many widely used instruments u t i l i z e s i m i l a r s c a l e s — a n example i s Hudson's C l i n i c a l Measurement Package ( G r i n n e l 1981, p. 640). F i n a l l y the v a l i d i t y of the instrument should be supported by the f a c t t h a t many of the f i n d i n g s are s i m i l a r to the f i n d i n g s of other r e s e a r c h of p r i v a t e p r a c t i t i o n e r s and t h e i r p r a c t i c e s . Data A n a l y s i s The analyses began by coding the c l o s e d q u e s t i o n s and e n t e r i n g them i n t o a computer data base. The f i r s t run of analyses c o n s i s t e d of a p r i n t - o u t of one way t a b l e s of a l l the coded v a r i a b l e s showing f r e q u e n c i e s , marginal and cumulative percentages. The data were checked a g a i n s t the codebook to insure that no r e s u l t s f e l l o u t s i d e of the a p p r o p r i a t e range. Next, exhaustive l i s t s of non-mutually e x c l u s i v e answers to the f i v e open-ended questions were drawn up. Statements using the same words were then grouped together for the purpose of d e v i s i n g frequency t a b l e s . Frequency and percentage t a b l e s were c o n s t r u c t e d f o r those v a r i a b l e s best r e p o r t e d in' v i s u a l d i s p l a y s . The data were checked f o r skewness and v a r i a b l e s were coded a c c o r d i n g to t h e i r l e v e l of measurement. Where a simple statement of the measure of c e n t r a l tendency and of d i s p e r s i o n was b e l i e v e d to be the c l e a r e s t and most s u c c i n c t way of r e p o r t i n g the data, the a p p r o p r i a t e -61-measures of c e n t r a l tendency and d i s p e r s i o n were c a l c u l a t e d . Where bar graphs appeared to be the most Informative method of r e p o r t i n g i n f o r m a t i o n , they were c o n s t r u c t e d . B i v a r i a t e analyses were then undertaken to see whether a s s o c i a t i o n s i n the p r i v a t e p r a c t i c e l i t e r a t u r e would be supported by t h i s data, and whether any new a s s o c i a t i o n s c o u l d be found. Due to the s m a l l sample, c r o s s - t a b u l a t i o n s of the e x i s t i n g data i n most cases were impossible due to the f a c t that i n some cases the v a r i a b l e s had been coded as " a c t u a l " r e s u l t i n g i n an u n l i m i t e d range; and others had been coded a c c o r d i n g to a f i v e p o i n t s c a l e . The " a c t u a l " scores were then re-coded i n t o f i v e - p o i n t s c a l e s , and i n some cases were f u r t h e r re-coded i n t o t h r e e - p o i n t s c a l e s . Because of the odd number i n a f i v e p o i n t s c a l e , c o l l a p s i n g the data to none/some was impossible i n most cases n e c e s s i t a t i n g the three categor i e s . As mentioned above, because t h i s study d i d not use a r e p r e s e n t a t i v e sample, i n f e r e n t i a l s t a t i s t i c s c o u l d be used a t best f o r s p e c u l a t i o n and not f o r any proof of l e v e l s of a s s o c i a t i o n . T h e r e f o r e , while the c h i square t e s t was done on s e v e r a l c r o s s - t a b s - - a n d some a s s o c i a t i o n s were found; because of the low expected value f o r the c e l l s there i s some q u e s t i o n as to a p p r o p r i a t e n e s s or value of such t e s t s . In keeping with the goal o£ the r e s e a r c h , b l v a r i a t e and m u l t i v a r i a t e t a b l e s were then c o n s t r u c t e d as i t was b e l i e v e d they were the most a p p r o p r i a t e way of d i s p l a y i n g the r e s u l t s - - d e s c r i b i n g the c h a r a c t e r i s t i c s of p r a c t i t i o n e r s . E t h i c a l C o n s i d e r a t i o n s There were no s p e c i a l e t h i c a l c o n s i d e r a t i o n s when c a r r y i n g out t h i s r e s e a r c h . The nature of the study was s e l f - r e p o r t and because the design insured anonymity both for those who p a r t i c i p a t e d and f o r those who d i d not, p a r t i c i p a t i o n was completely v o l u n t a r y . R e s u l t s : D e s c r i b i n g P r i v a t e P r a c t i c e F i f t y - f o u r q u e s t i o n n a i r e s were mailed to the i d e n t i f i e d s u b j e c t s (see Appendix B, sampling). F i v e persons d i d not meet the sample c r i t e r i a and four persons c o u l d not be l o c a t e d . Q u e s t i o n n a i r e s were completed by 31 persons f o r a response r a t e of 63.3%. Therefore the maximum N tor any given response was 31, however, i n s e v e r a l i n s t a n c e s item non-responses accounted f o r Ns of l e s s than 31. When r e p o r t i n g the r e s u l t s where the N i s l e s s than 31, i t w i l l be noted. The m a j o r i t y of the c l o s e d questions u t i l i z e d a f i v e p o i n t s c a l e which asked respondents to i n d i c a t e the frequency of t h e i r b e h a v i o r s , b e l i e f s or f e e l i n g s . The responses were: (1) R a r e l y or none of the time, (2) A l i t t l e of the time, (3) Some of the time, (4) A good p a r t of the time, and (5) Most or a l l of the time. When questions using t h i s s c a l e were c o l l a p s e d , responses 1 and 2 were combined and 4 and 5 were combined with the new r e s u l t s r e p o r t e d as: (1) Less than some of the time , (2) Some of the time, and (3) More than some of the time. The r e s u l t s of t h i s study are predominantly r e p o r t e d i n v i s u a l d i s p l a y s . The s t a t i s t i c s t h a t are used are almost e n t i r e l y d e s c r i p t i v e because i n f e r e n t i a l s t a t i s t i c s r e q u i r e a p r o b a b i l i t y sample, which t h i s sample can not s t r i c t l y be s a i d to be. G r i n n e l l (1981) suggested t h a t a c l e a r l y d e f i n e d p o p u l a t i o n i n c r e a s e s the p r o b a b i l i t y of s e l e c t i n g a -64-r e p r e s e n t a t i v e sample, and that i f the sample i s r e p r e s e n t a t i v e of the p o p u l a t i o n , i t can be g e n e r a l i z e d to the e n t i r e p o p u l a t i o n . Because the p o p u l a t i o n f o r t h i s study was c l e a r l y d e f i n e d and because e x t e n s i v e measures were undertaken to reach everyone w i t h i n the p o p u l a t i o n , i t i s b e l i e v e d t h a t the sample may i n f a c t come very c l o s e to the e n t i r e p o p u l a t i o n . With t h i s i n mind, as mentioned i n Chapter 3, the c h l square t e s t was used to t e s t f o r a s s o c i a t i o n s but i t i s caut i o n e d t h a t a l t h o u g h the r e s u l t s are r e p o r t e d , they are not o f f e r e d as any proof but r a t h e r f o r r e f l e c t i o n and s p e c u l a t i o n . As T r i p o d i et a l . (1969) suggest, " I t i s b e t t e r to e r r on the s i d e of c a u t i o n i n making g e n e r a l i z a t i o n s but to be o v e r - c a u t i o u s i s to deny the advantage of t h i n k i n g of a p o p u l a t i o n i n the l i g h t of what i s known about d i f f e r e n t p o p u l a t i o n s " (p. 128). Demographic and Background I n f o r m a t i o n Age and sex of p r i v a t e p r a c t i t i o n e r s . The mean age of p r a c t i t i o n e r s was 42.21, SD 9.13. Since the ages were somewhat p o s i t i v e l y skewed, a c l e a r e r p i c t u r e i s presented by r e p o r t i n g the median which was 39, and the s e m i - i n t e r q u a r t i l e range (Q) which was 5.5 (n = 29). Respondents were almost e v e n l y r e p r e s e n t e d by both sexes. Of the 30 respondents who answered t h i s q u e s t i o n s , s i x t e e n were females and f o u r t e e n were m a l e s . E m p l o y m e n t c h a r a c t e r i s t i c s . o f the 30 p r a c t i t i o n e r s who responded to the q u e s t i o n on part-time -65-or f u l l - t i m e p r a c t i c e , e i g h t were f u l l - t i m e p r i v a t e p r a c t i t i o n e r s with the other twenty-two p r a c t i c i n g p r i v a t e l y only p a r t - t i m e . Table 1. shows the f r e q u e n c i e s and percentages of f u l l - t i m e and part-time (with part-time being d i v i d e d Into other employment, or no other employment) by sex. Table 1. Employment C h a r a c t e r i s t i c s by Sex Employment C h a r a c t e r i s t i c s n = 30 f % Sex M. F. F u l l time p r a c t i c e 8 26 .6 4 4 Part time p r a c t i c e : No other employment 5 16 .7 0 5 Other employment 17 56 .7 10 7 Of the p r a c t i t i o n e r s who were part-time and had no other employment, 100% were females. Frisman et a l . (1986), suggested that delayed c h i l d b e a r i n g and c h i l d r e a r i n g among female s o c i a l workers aged t h i r t y to f o r t y may i n f l u e n c e t h e i r d e c i s i o n s to enter p r i v a t e p r a c t i c e . (This w i l l be covered under m o t i v a t i o n to enter p r a c t i c e as w e l l . ) Here i t i s of i n t e r e s t to note that 80% of the above mentioned female p r a c t i t i o n e r s were i n f a c t between the ages of 35 and 40. Given the v a r i a t i o n s of f u l l - t i m e and part-time employment among the p r a c t i t i o n e r s , there was a vast range i n the number of hours per month t h a t they devoted to - 6 6 -p r i v a t e p r a c t i c e (184). The mean was 59.8, SD 55.9 with a median of 40, Q 30.6 (n = 30). The average number of years that p r a c t i t i o n e r s had been i n p r i v a t e p r a c t i c e was 5.6, SD 5.3; with a median of 3.5, Q 1.7 (n = 30). E d u c a t i o n a l C h a r a c t e r i s t i c s of p r a c t i t i o n e r s . Table 2 shows f r e q u e n c i e s and percentages with r e g a r d to a l l l e v e l s of ed u c a t i o n a t t a i n e d by the respondents s p e c i f i c a l l y i n social work. Table 3. shows o n l y the h i g h e s t level of e d u c a t i o n or c r e d e n t i a l a t t a i n e d by the respondents i r r e s p e c t i v e of the d i s c i p l i n e . Table 2. Frequencies and Percentages of S o c i a l Work Degrees Degree n = 30 f % R.S.W. 24 80.0 B.S.W. 10 33.3 M.S.W. 24 80.0 D.S.W. 1 3.3 -67-T a b l e 3. E d u c a t i o n a l B a c k g r o u n d by H i g h e s t L e v e l A t t a i n e d I r r e s p e c t i v e o f D i s c i p l i n e H i g h e s t e d u c a t i o n a l l e v e l f % Cum. % R.S.W. 3 10.0 10.0 B a c h e l o r d e g r e e 2 6.7 16.7 M a s t e r s d e g r e e 22 73.3 90.0 D o c t o r a t e 3 10.0 100 D e s p i t e t h e i r a c a d e m i c b a c k g r o u n d s , t h e g r e a t e s t number o f p r a c t i t i o n e r s b e l i e v e d what b e s t p r e p a r e d them f o r p r i v a t e p r a c t i c e , was t h e s p e c i a l i z e d t r a i n i n g t h a t t h e y had r e c e i v e d o u t s i d e o f u n i v e r s i t y . T h e r e was some d i f f i c u l t y w i t h t h i s q u e s t i o n however a s many r e s p o n d e n t s ' a n s w e r s c o u l d n o t be t a l l i e d due t o t h e f a c t t h a t t h e y c h e c k e d more t h a n one a n s w e r when t h e q u e s t i o n a s k e d t h a t t h e y c h e c k o n l y one. T a b l e 4 shows t h e r e s u l t s o f t h i s q u e s t i o n b u t i t s h o u l d be n o t e d t h a t i t i s b a s e d on an n o f 22 . Table 4. Best P r e p a r a t i o n f o r P r i v a t e P r a c t i c e Best p r e p a r a t i o n n = 22 f % S p e c i a l t r a i n i n g o u t s i d e of u n i v e r s i t y 10 45.5 Work experience 6 27.3 Academic t r a i n i n g 3 13.6 Other 3 13.6 I t i s I n t e r e s t i n g t h a t i n response to t h i s c l o s e d q u e s t i o n , academic t r a i n i n g r a t e d r e l a t i v e l y low as p r e p a r a t i o n f o r p r i v a t e p r a c t i c e . However i n response to the open-ended qu e s t i o n r e g a r d i n g s p e c i a l i z e d t r a i n i n g of importance to respondents i n t h e i r p r i v a t e p r a c t i c e , academic t r a i n i n g rated second h i g h e s t . These r e s u l t s are d i s p l a y e d i n Table 5 below. -69-Table 5. Non-mutually E x c l u s i v e L i s t of S p e c i a l i z e d T r a i n i n g of  Importance to P r a c t i t i o n e r s i n t h e i r P r i v a t e P r a c t i c e Tra i n i n g Times l i s t e d % of t o t a l Family therapy 12 Academic t r a i n i n g 11 S t r e s s mgt/biofeedback 8 autogenics/hypnos i s Work experience 4 S e x u a l / c h i l d abuse t r . 4 C o n s u l t a t i o n / s u p e r v i s i o n 3 membership org. Personal therapy 3 Others 24* (workshops/seminars/ p r o f . dev. on v a r i o u s i n t e r v e n t i o n models) 17. 4 15.9 11.6 5.8 5.8 4 . 3 4 . 3 34.8 T o t a l t r a i n i n g s s p e c i f i e d 69 Note. *Any one model or workshop in c l u d e d i n t h i s f i g u r e was not l i s t e d more than twice. The r e l a t i v e l y high number of responses i n d i c a t i n g f a m i l y therapy t r a i n i n g may have been i n f l u e n c e d by the P a c i f i c Coast Family Therapy T r a i n i n g A s s o c i a t i o n (P.C.F.T.T.A.) being l o c a t e d i n t h i s area, as seven of the twelve respondents c i t i n g f a m i l y therapy, s p e c i f i c a l l y mentioned t r a i n i n g from P.C.F.TiT.A. I t i s d i f f i c u l t to say how many of the other f a m i l y therapy workshops and -70-seminars that were c i t e d were made a v a i l a b l e through that a s s o c i a t i o n . I t would be of i n t e r e s t to see i f areas having t r a i n i n g i n s t i t u t e s with d i f f e r e n t o r i e n t a t i o n s would r e f l e c t a d i f f e r e n t f o c u s . Income. Approximately two-thirds (67.9%) of a l l p r i v a t e p r a c t i o n e r s earned l e s s than $35,000.00 (gross) i n 1986. However when part-time with no other employment was c o n t r o l l e d f o r , the percentage dropped to 62.5%, l e a v i n g 37.5% of p r a c t i t i o n e r s who are i n p r i v a t e p r a c t i c e e i t h e r f u l l - t i m e , or part-time but with other employment, ea r n i n g more than $35,000.00. Table 6. Frequencies, percentages and cumulative percentages of  Gross Income Earned In 1986 (Includes a l l respondents). Income n = 28 f % Cum % $ 0.00 - $14,999.99 4 14.3 14 . 3 15,000.00 - 24,999.99 5 17.9 32.2 25,000.00 - 34,999 .99 10 35.7 67.9 35,000.00 - 44,999.99 7 25.0 92.9 45,000.00 & over 2 7.1 100 The q u e s t i o n asked respondents to i n d i c a t e the i r t o t a l gross income f o r 1986. The i n t e n t i o n was to get the most p r e c i s e answers without g e t t i n g i n t o deductions et c e t e r a which comes with the r e p o r t i n g of net incomes. -71-There i s a problem with t h i s q u e s t i o n however i n that i t should have s t a t e d " p e r s o n a l " gross income s i n c e r e p o r t i n g the gross income of t h e i r p r a c t i c e before expenses, would r e f l e c t a t o t a l l y d i f f e r e n t p i c t u r e from r e p o r t i n g p e r s o n a l gross income. C h a r a c t e r i s t i c s of P r a c t i t i o n e r s S t rength of M o t i v a t i n g F a c t o r s . P r a c t i t i o n e r s were asked to i n d i c a t e the s t r e n g t h (on a s c a l e of 1 to 7) of each of the l i s t e d m o t i v a t i n g f a c t o r s f o r e n t e r i n g p r i v a t e p r a c t i c e . The q u e s t i o n n a i r e asked respondents to score the f a c t o r s from 1 ( i n d i c a t i n g a "Strong F a c t o r " ) to 7 ( i n d i c a t i n g "Not a F a c t o r " ) . The cumulative scores f o r each m o t i v a t i n g f a c t o r were averaged and reverse scored so that the s t r o n g e s t f a c t o r s would i n d i c a t e the h i g h e s t s c o r e s . F i g u r e 1 shows the r e s u l t s , broken down by sex. - 7 2 -F l g u r e 1. Strength of M o t i v a t i n g F a c t o r s f o r E n t e r i n g P r i v a t e P r a c t i c e  hy Sex. MOTIVATING FACTORS Note. a = Autonomy, b = F l e x i b i l i t y , c = O p p o r t u n i t y for d i r e c t p r a c t i c e , d = Avoid b u r e a u c r a t i c c o n f l i c t s , e = Provide b e t t e r s e r v i c e , f.= Avoid admin, t a s k s , g = Economic Improv., h = D i s c r e t i o n over c l i e n t s , i = More opp. f o r s p e c i a l i z a t i o n , and j = Terminated from previous employment. I t i s of i n t e r e s t to note t h a t both autonomy and f l e x i b i l i t y were s t r o n g e r m o t i v a t i n g f a c t o r s f o r females than they were f o r males i n view of Frisman e t a l . ' s (1986) hypothesis mentioned e a r l i e r r e g a r d i n g c h i l d b e a r l n g and c h i l d r e a r i n g among females. P o t e n t i a l f o r economic improvement was a s t r o n g e r f a c t o r f o r males than females with males o v e r a l l ranking i t as the f o u r t h s t r o n g e s t m o t i v a t i n g f a c t o r and females o v e r a l l r a n k i n g i t as the e i g h t h out of ten. When the rankings are combined economic improvement i s the s i x t h s t r o n g e s t m o t i v a t i n g f a c t o r . If economic Improvement was a high m o t i v a t i n g f a c t o r , one would expect t h a t respondents would have had a strong b e l i e f t h a t t h e i r p r a c t i c e was going to become more e c o n o m i c a l l y advantageous i n the next two y e a r s otherwise one would assume they would look to "some other form of p r a c t i c e . The moderate degree of importance given t o economic improvement as a m o t i v a t i o n seems to be borne out by the second q u e s t i o n a s k i n g respondents about the r e l a t i v e t r u t h f u l n e s s of the statement "I expect my p r a c t i c e to become more e c o n o m i c a l l y advantageous to me i n the next year or two." Fourteen (46.66%) respondents noted t h a t the statement was e i t h e r mostly, or completely t r u e while s i x t e e n (53.33%) respondents noted the statement was " p a r t l y true and p a r t l y f a l s e " , "mostly f a l s e " , or that they had "no e x p e c t a t i o n " . P r o f e s s i o n a l I d e n t i t y of P r a c t i t i o n e r s . Over 70% of p r i v a t e p r a c t i t i o n e r s i d e n t i f y themselves as s o c i a l -74-workers a "Good p a r t , Most or a l l of the time". Table 7. Frequency of I d e n t i f y i n g S e l f as S o c i a l Worker Frequency N = 31 f % Cum. % Most or a l l the time 19 61.3 61.3 A Good pa r t of the time 3 9.6 70.9 Some of the time 6 19 .4 90.3 A l i t t l e of the time 2 6.5 96 . 9 R a r e l y or none of the time 1 3.2 100 There was a p o s s i b i l i t y t h a t the responses to t h i s q u e s t i o n may have been b i a s e d . In the same is s u e of P e r s p e c t i v e s i n which the advertisement seeking p r a c t i t i o n e r s f o r t h i s sample appeared, there was a l s o a piece u r g i n g members to i d e n t i f y themselves as s o c i a l workers . However, the r e s u l t s were b a s i c a l l y supported by the second q u e s t i o n which asked respondents how they i d e n t i f i e d themselves on t h e i r v a r i o u s forms of a d v e r t i s i n g . Due to the s h o r t time between the a r t i c l e and f i l l i n g out the q u e s t i o n n a i r e , i t i s u n l i k e l y t h a t t h e i r a d v e r t i s i n g and t h e r e f o r e t h e i r responses, would have been i n f l u e n c e d by the a r t i c l e . In every form of a d v e r t i s i n g , a much gr e a t e r percentage of p r a c t i t i o n e r s i d e n t i f i e d themselves as s o c i a l workers (by v i r t u e of s t a t i n g t h e i r R.S.W. and -75-s o c i a l work degrees) than the percentage who i d e n t i f i e d themselves as e i t h e r c o u n s e l l o r s or t h e r a p i s t s . Table 8. A d v e r t i s i n g Method by I n d i c a t i n g R e g i s t r a t i o n , S o c i a l Work  Degrees, T h e r a p i s t , or C o u n s e l l o r Percents I n d i c a t i n g Advert i s ing Method n R. S . W S.W Dgrs Thera. Couns Yellow pgs. 7 71. , 4 71. 4 57. ,1 28. .6 Newsletters 2 50. , 0 100 0. ,0 50. , 0 P r o f . a s s c . r e f . l i s t s 14 78. . 6 85. 7 42 . .9 42. .9 Newspapers 5 80 , .0 100 60 , . 0 40 , .0 P e r s n l v i s . 10 60. . 0 70. 0 30 , . 0 40, . 0 F l i e r s 6 83 . . 3 83 . 3 50 , .0 50 , .0 Bus . cards 23 78 , . 3 73 . 9 34. . 8 43 , . 5 Note. n = number of respondents who use t h a t p a r t i c u l a r form of a d v e r t i s i n g . Of the eighteen respondents who d i d i n d i c a t e e i t h e r c o u n s e l l o r or t h e r a p i s t on t h e i r a d v e r t i s i n g , o n l y two (11.1%) d i d not a l s o i n d i c a t e t h e i r R.S.W. s t a t u s or t h e i r s o c i a l work degrees i f they indeed had them. T h e r e f o r e , p r a c t i t i o n e r s who i d e n t i f y themselves as t h e r a p i s t s or c o u n s e l l o r s do not appear to do so at the expense of i n d e n t i f y i n g themselves as s o c i a l w o r k e r s — a t l e a s t not on t h e i r a d v e r t i s i n g . -76-As r e p o r t e d In Table 7, respondents were not only asked whether they i d e n t i f i e d themselves as s o c i a l workers, but a l s o the frequency with which they d i d so. In a d d i t i o n , respondents were asked to note the " s p e c i a l i z e d t r a i n i n g " t h a t was important to t h e i r p r i v a t e p r a c t i c e . Because f a m i l y therapy was the most f r e q u e n t l y mentioned other t r a i n i n g , i t was decided to t e s t f o r an a s s o c i a t i o n between the frequency of i d e n t i f y i n g themselves as s o c i a l workers with l i s t i n g f a m i l y therapy as s p e c i a l t r a i n i n g of importance to them. The f i v e p o i n t "frequency of i d e n t i f y i n g s e l f as s o c i a l worker" was c o l l a p s e d i n t o a three p o i n t s c a l e , and a 3 x 2 t a b l e was c o n s t r u c t e d . Table 9. Frequency of P r a c t i t i o n e r s I d e n t i f y i n g Selves as S o c i a l  Workers, by L i s t i n g Family Therapy as " S p e c i a l T r a i n i n g " . Frequency L i s t e d Family Therapy  No Yes f % f % More than Some of time 17 80.9 4 44.5 Some of time 3 14.3 3 33.3 Less than some 1 4.8 2 22.2 100 100 A much l a r g e r percentage of respondents who d i d not l i s t f a m i l y therapy as " s p e c i a l i z e d t r a i n i n g " i d e n t i f i e d -77-themselves as s o c i a l workers "more than some of the time" than d i d those who l i s t e d i t . Therefore there does seem to be an i n v e r s e a s s o c i a t i o n between frequency of i d e n t i f y i n g s e l f as s o c i a l worker and l i s t i n g f a m i l y therapy as s p e c i a l i z e d t r a i n i n g of importance to p r i v a t e p r a c t i c e . Perhaps then, people who have taken a p a r t i c u l a r type of therapy t r a i n i n g , do tend to t h i n k of themselves l e s s f r e q u e n t l y as a s o c i a l worker, perhaps by t h i n k i n g of themselves to some degree as a t h e r a p i s t . F u r t h e r r e s e a r c h i s needed i n order to determine whether t h i s i s so. Kruzman ( 1 9 7 9 ) r e p o r t e d that p r a c t i t i o n e r s i n f u l l - t i m e p r i v a t e p r a c t i c e were more l i k e l y to think of and c a l l themselves p s y c h o t h e r a p i s t s . Therefore a t e s t was done to see whether i n t h i s sample, there was an a s s o c i a t i o n between employment c h a r a c t e r i s t i c s : F u l l - t i m e , part-time with other employment, or part-time with no other employment, and the frequency of i d e n t i f y i n g s e l v e s as s o c i a l workers. Although the percentages of f u l l - t i m e , and part-time p r a c t i t i o n e r s with other employment who i d e n t i f i e d themselves as s o c i a l workers "More than some of the time" were 7 5 % and 7 6 . 5 % r e s p e c t i v e l y while o n l y 40% of part-time p r a c t i t i o n e r s with no other employment d i d so, the r e s u l t of the t e s t f o r a s s o c i a t i o n between the two v a r i a b l e s was not s i g n i f i c a n t . I t was noted that the employment c h a r a c t e r i s t i c of -78-p a r t - t i m e w i t h o t h e r e m p l o y m e n t , a l s o had t h e h i g h e s t p e r c e n t a g e o f m a l e s , a s w e l l a s t h e h i g h e s t p e r c e n t a g e o f f r e q u e n c y o f i d e n t i f y i n g s e l v e s a s s o c i a l w o r k e r s . T h e r e f o r e a n o t h e r t e s t o f a s s o c i a t i o n was d o n e , c o n t r o l l i n g f o r em p l o y m e n t c h a r a c t e r i s t i c s a n d t e s t i n g o n l y t h e f r e q u e n c y o f i d e n t i f y i n g s e l f a s s o c i a l w o r k e r w i t h s e x . T a b l e 10. F r e q u e n c y o f I d e n t i f y i n g S e l f a s S o c i a l W orker by Sex F r e q u e n c y n = 30 Sex F M f % f % More t h a n some o f t i m e 8 50 13 92.9 Some o f t i m e 6 37 . 5 0 .0 L e s s t h a n some o f t i m e _2 12.5 _1 7.1 16 100 14 100 N o t e , . X 2 ( 2 , n = 30) = 7. 42, p<. 05. T h i s i n d i c a t e s t h a t m a l e s t e n d t o i d e n t i f y t h e m s e l v e s a s s o c i a l w o r k e r s more f r e q u e n t l y t h a n f e m a l e s . A f u r t h e r t e s t was t h e n done t o s e e w h e t h e r t h e r e was a n a s s o c i a t i o n b e t w e e n " l e n g t h o f t i m e i n p r i v a t e p r a c t i c e " a n d s e x . T h e r e a p p e a r e d t o be no r e l a t i o n s h i p a n d i n f a c t t h e a v e r a g e " l e n g t h o f t i m e i n p r a c t i c e " i s v i r t u a l l y t h e same f o r f e m a l e s ( 5 . 5 y e a r s ) a nd m a l e s (5.7 y e a r s ) . When p r a c t i t i o n e r s were a s k e d t o I n d i c a t e t h e l e n g t h of time they had been i n p r a c t i c e they were asked to r e p o r t the time " e x c l u s i v e of p e r i o d s when [they were] not a c t u a l l y p r a c t i c i n g " because the q u e s t i o n was asked i n order to get a sense of e x p e r i e n c e . A q u e s t i o n t h a t was not asked however, and i t may have been one t h a t would have shed l i g h t on the v a r y i n g f r e q u e n c i e s between the sexes of I d e n t i f y i n g themselves as s o c i a l workers, was whether i n f a c t t h e i r p r i v a t e p r a c t i c e had been i n t e r r u p t e d by p e r i o d s of l e s s or no p r a c t i c e , and i f so what the d u r a t i o n of those p e r i o d s had been. T h i s kind of q u e s t i o n perhaps would have t e s t e d the hypothesis that now comes to mind. Do males i d e n t i f y more s t r o n g l y as s o c i a l workers because t h e i r c a r e e r s have not been i n t e r r u p t e d due to c h i l d b e a r i n g which may have been a p o s s i b i l i t y f o r females? Such a q u e s t i o n could be of i n t e r e s t to f u t u r e stud i e s . P r o f e s s i o n a l development. Sixty-one percent of respondents i n d i c a t e d that they engaged i n p r o f e s s i o n a l development (P.D.) "A good p a r t " , "Most, or a l l of the time" with the remainder engaging i n P.D. no l e s s than "Some of the time" (see Table 11.) E i ghty-seven percent i n d i c a t e d t h a t they read p r o f e s s i o n a l j o u r n a l s monthly or more f r e q u e n t l y (Table 12.). -80-Table 11. Frequency of P r a c t i t i o n e r s Engaging In P r o f e s s i o n a l  Development. Frequency f % Cum % Most or a l l the time 7 22.6 22.6 Good p a r t of the time 12 38.7 61.3 Some of the time 12 38.7 100 Table 12. Frequency Of P r a c t i t i o n e r s Reading P r o f e s s i o n a l J o u r n a l s Frequency f % Cum. % More than weekly 2 6.5 6.5 Weekly 4 12.9 19 . 4 Two or three/month 12 38.7 58.1 Monthly 9 29.0 87 .1 Less than monthly 4 12.9 100 From the above i n d i c a t o r s i t would seem t h a t p r i v a t e p r a c t i t i o n e r s do engage i n p r o f e s s i o n a l development f a i r l y f r e q u e n t l y . Respondents were asked i n the i n t r o d u c t i o n to the q u e s t i o n n a i r e to answer a l l questions r e l a t i v e to t h e i r p r i v a t e p r a c t i c e . In s p i t e of t h i s however, i t was of i n t e r e s t to t e s t whether there was any a s s o c i a t i o n between p r a c t i t i o n e r s who had "other employment" and the frequency of p r o f e s s i o n a l development. I f there was a s t r o n g a s s o c i a t i o n i t cou l d i n d i c a t e t h a t the p r o f e s s i o n a l development was a f u n c t i o n of t h e i r other employment r a t h e r than of t h e i r p r i v a t e p r a c t i c e . The t e s t suggested there was no a s s o c i a t i o n between the two and i n f a c t the percentages of p r a c t i t i o n e r s who engaged i n p r i v a t e p r a c t i c e "More than some of the time" and "Some of the time", i n each case, whether they had other employment or not, were almost i d e n t i c a l (61.1 and 38.9% versus 61.5% and 38.5% r e s p e c t i v e l y ) . A s i m i l a r c r o s s - t a b was c o n s t r u c t e d and a c h i square t e s t was done to see whether there was an a s s o c i a t i o n between other employment and the frequency of re a d i n g p r o f e s s i o n a l j o u r n a l s . The r e s u l t s d i d not suggest an a s s o c i a t i o n , however 66.7% of respondents with other employment read j o u r n a l s more f r e q u e n t l y than monthly, while on l y 46.2% of respondents with no other employment d i d so. A f u r t h e r t e s t was done by c o n s t r u c t i n g a 2 x 3 c r o s s - t a b , breaking employment c h a r a c t e r i s t i c s i n t o the three c a t e g o r i e s of F u l l - t i m e p r i v a t e p r a c t i c e , Part-time p r i v a t e p r a c t i c e with other employment, and Part-time p r i v a t e p r a c t i c e with no other employment; by the two frequency c a t e g o r i e s of "More than some of the time" and "Some of the time". -82-Table 13. Frequency of Engaging i n P r o f e s s i o n a l Development by  Employment C h a r a c t e r i s t i c s F u l l time Part time/ other emp. P a r t no emp. time/ other Frequency f % f % f % More than some of the time 4 50.0 11 61.1 4 80.0 Some of the time 4 50.0 7 •38.9 1 20.0 T o t a l 8 100 18 100 5 100 A c h i square t e s t was done on t h i s c r o s s - t a b but no s t a t i s t i c a l l y s i g n i f i c a n t a s s o c i a t i o n was found. The degree to which p r a c t i t i o n e r s engaged i n p r o f e s s i o n a l development does not seem to be p r i m a r i l y a f u n c t i o n of other employment, however, the t a b l e does seem to i n d i c a t e t h a t i t c o u l d be a f u n c t i o n of a combination of a v a i l a b l e time and other employment. A s i m i l a r c r o s s - t a b was c o n s t r u c t e d f o r frequency of r e a d i n g p r o f e s s i o n a l j o u r n a l s and employment c h a r a c t e r i s i t i e s . - 8 3 -Table 14. Frequency of Reading P r o f e s s i o n a l J o u r n a l s by Employment C h a r a c t e r i s t i c s Frequency F u l l time Part other time/ emp. P a r t time/ no other emoloy. f % f % £ % More than monthly 4 57.1 12 70.6 2 66 . 7 Monthly or l e s s 3 42.9 5 29 . 4 1 33 . 3 T o t a l 7 100 17 100 3 100 Again, the c h i square t e s t showed no s i g n i f i c a n t a s s o c i a t i o n , but t h i s t a b l e i n d i c a t e s that r e a d i n g p r o f e s s i o n a l j o u r n a l s i s perhaps l e s s a f u n c t i o n of time, but more a f u n c t i o n of a v a i l a b i l i t y . I t would be I n t e r e s t i n g to ask p r a c t i t i o n e r s whether the j o u r n a l s they read are a v a i l a b l e through p e r s o n a l s u b s c r i p t i o n or through an agency through which they may have access to j o u r n a l s , perhaps due to "other employment". Tes t s were a l s o done to see whether frequency of engaging i n p r o f e s s i o n a l development or r e a d i n g p r o f e s s i o n a l j o u r n a l s was a s s o c i a t e d with l e v e l s of e d u c a t i o n . In each case no a s s o c i a t i o n was found. P r o f e s s i o n a l c o n t r i b u t i o n s . I n d i c a t o r s of " c o n t r i b u t i n g to the p r o f e s s i o n " were: Membership i n a p r o f e s s i o n a l a s s o c i a t i o n ; c o n t r i b u t i n g to s o c i a l work r e s e a r c h ; undertaking t h e i r own s o c i a l work r e s e a r c h ; and -84-having been p u b l i s h e d . In order to get a sense of c u r r e n t , r a t h e r than perhaps h i s t o r i c a l c o n t r i b u t i o n s , respondents were asked to answer the quest i o n s r e l a t i v e to "the past two ye a r s " . Table 15. Percentages of Respondents Who Have C o n t r i b u t e d to the  P r o f e s s i o n of S o c i a l Work In The Last Two Years C o n t r i b u t i o n n % Yes % No Membership i n P r o f e s s . Assoc: 31 *BCASW 80 . 6 19 . 4 *APSW 19 . 4 80 . 6 Both BCASW & APSW 9.7 90. 3 Neither Assoc. 9 . 7 90 . 3 C o n t r i b u t e d to other r e s e a r c h 29 65.5 24 . 5 Undertook own res e a r c h 31 25.8 74 . 2 P u b l i s h e d 31 45 . 2 54 . 8 Note. * At the time of the r e s e a r c h there were two p r o f e s s i o n a l a s s o c i a t i o n s i n B.C., they have s i n c e amalgamated. It appears from the above t a b l e t h a t p r i v a t e p r a c t i t i o n e r s do c o n t r i b u t e s u b s t a n t i a l l y to t h e i r p r o f e s s i o n . Under 10% d i d not belong to a p r o f e s s i o n a l a s s o c i a t i o n ; and, i n the past two years w e l l over h a l f c o n t r i b u t e d to s o c i a l work r e s e a r c h ; more than a quarter undertook t h e i r own r e s e a r c h ; and n e a r l y h a l f were p u b l i s h e d . The extent to which the p r a c t i t i o n e r s -85-c o n t r i b u t e d to s o c i a l work r e s e a r c h , and the extent to which they were p u b l i s h e d , i s d i s p l a y e d i n Tables 16 and 17 r e s p e c t i v e l y . Table 16. C o n t r i b u t i o n s to S o c i a l Work Research - Las t Two Years Number c o n t r i b u t e d f F i v e or more 3 15.8 Four 1 5.3 Three 5 26.3 Two 5 26 . 3 One 5 26 . 3 T o t a l 19 100 Table 17. Number of Works Pub l i s h e d • - Last Two Years Number p u b l i s h e d f % F i v e or more 2 14.3 Three or four 4 28.6 One or two 8 57.1 T o t a l 14 100 Again, because the study i s d e s c r i b i n g p r i v a t e p r a c t i c e and because some of the p r a c t i t i o n e r s have other employment, a 3 x 2 c r o s s - t a b of employment -86-c h a r a c t e r i s t l c s and whether or not they were p u b l i s h e d , was c o n s t r u c t e d to see whether t h e r e was an a s s o c i a t i o n . The c h i square t e s t sugges ted t h e r e was an a s s o c i a t i o n , but the a s s o c i a t i o n was not w i th o ther employment, but r a t h e r most s t r o n g l y w i th f u l l - t i m e employment. X 2 ( 2 , N = 31) = 5 .52 , p<.05 T e s t s of a s s o c i a t i o n were a l s o done on the v a r i a b l e s of employment C h a r a c t e r i s t i c s , wi th " c o n t r i b u t e d to s o c i a l work r e s e a r c h " , and w i th "under taken own r e s e a r c h " . In n e i t h e r case was there an a s s o c i a t i o n . L e v e l of e d u c a t i o n was a l s o t e s t e d fo r an a s s o c i a t i o n w i th whether or not p r a c t i t i o n e r s had p u b l i s h e d but the re was no s i g n i f i c a n t a s s o c i a t i o n f o u n d . There was a f a i r l y s t r o n g r e l a t i o n s h i p however between "Undertook own r e s e a r c h " and " p u b l i s h e d " . X 2 ( 1 , N = 31) = 4.84, p<.03. T h i s seems r e a s o n a b l e s i n c e p u b l i s h i n g i s s t a t e d as a p o s i t i v e outcome of the r e s e a r c h p r o c e s s . E x t e n t to which p r a c t i t i o n e r s are i n v o l v e d i n c o m m u n i t y - l e v e l a c t i v i t i e s . I n d i c a t o r s of c o m m u n i t y - l e v e l a c t i v i t i e s were: F requency of engaging i n v o l u n t e e r work; f r e q u e n c y of d o n a t i n g t ime or money to a p o l i t i c a l p a r t y ; and whether p r a c t i t i o n e r s had c o n t r i b u t e d to s o c i a l p o l i c y w i t h i n the l a s t two y e a r s . T a b l e 18 shows the f r e q u e n c y of Involvement i n the v a r i o u s a c t i v i t i e s . Table 18. F r e q u e n c y o f I n v o l v e m e n t i n Community L e v e l A c t i v i t i e s V o l u n t e e r D o n a t e t o C o n t r i b u t e p o l i t i c a l t o s o c i a l p a r t y p o l i c y F r e q u e n c y f % f f % M o s t o r a l l o f t i m e 2 6.5 3 10.0 2 6.5 Good p a r t o f t i m e 2 6.5 0 0.0 5 16.1 Some o f t h e t i m e 12 38.7 1 3.3 4 12.9 L i t t l e o f t i m e 3 9.7 6 20.0 7 22.6 R a r e l y o r n e v e r 12 38 . 7 20 66. 7 13 41.9 T o t a l s *31 100 *30 100 *31 100 N o t e . * = n f o r e a c h v a r i a b l e . T h e s e r e s u l t s a p p e a r t o s u p p o r t t h e s u g g e s t i o n s by K u r z m an ( 1 9 7 6 ) , and B o r e n z w e i g ( 1 9 8 1 ) t h a t p r i v a t e p r a c t i t i o n e r s a r e n o t g r e a t l y i n v o l v e d i n s o c i a l p o l i c y o r s o c i a l a c t i o n . I t w o u l d a p p e a r t h a t t h i s i s a l s o t h e c a s e f o r c o m m u n i t y - l e v e l i n v o l v e m e n t a s was s t u d i e d h e r e . I n a n a t t e m p t t o e l a b o r a t e on t h e s e f i n d i n g s , a s s o c i a t i o n s were s o u g h t b e t w e e n V o l u n t e e r work and D o n a t i n g t o a p o l i t i c a l p a r t y , t o s e e w h e t h e r some p r a c t i t i o n e r s ( f e w t h o u g h t h e y may be) may have been f r e q u e n t l y I n v o l v e d i n b o t h i f t h e y were f r e q u e n t l y i n v o l v e d i n one. A s i m i l a r a s s o c i a t i o n was s o u g h t b e t w e e n v o l u n t e e r work and c o n t r i b u t i n g t o s o c i a l p o l i c y . No a s s o c i a t i o n was f o u n d i n e i t h e r c a s e . -88-A f u r t h e r a s s o c i a t i o n was sought between donating to a p o l i t i c a l p a r t y and c o n t r i b u t i n g to s o c i a l p o l i c y . Here there d i d seem to be an a s s o c i a t i o n although i t i s q u e s t i o n a b l e as to whether one c o u l d say t h a t i t was s i g n i f i c a n t . X 2 ( l , n = 30) = 1.98, p<.08. I t would be of i n t e r e s t to know the d i r e c t i o n of the a s s o c i a t i o n . That i s whether c o n t r i b u t i n g to s o c i a l p o l i c y leads to p o l i t i c a l involvement, or whether p o l i t i c a l involvement leads one to c o n t r i b u t e to s o c i a l p o l i c y . I t would a l s o be of I n t e r e s t to know to what respondents would a t t r i b u t e t h e i r involvement i n e i t h e r a c t i v i t y , e.g. s t u d y i n g s o c i a l p o l i c y d u r i n g s o c i a l work education? Job s a t i s f a c t i o n . The I n d i c a t o r s of job s a t i s f a c t i o n were: Frequency of being I s o l a t e d ; frequency of being s t i m u l a t e d , frequency of having s u p p o r t i v e r e l a t i o n s h i p s with people who understand t h e i r work; preference f o r more or fewer c l i e n t s ; b e l i e f s on payment r e c e i v e d f o r work; most p o s i t i v e aspects of p r i v a t e p r a c t i c e and the most negative a s p e c t s of p r i v a t e p r a c t i c e . Table 19 shows the f r e q u e n c i e s of being I s o l a t e d , being s t i m u l a t e d , and having " s u p p o r t i v e r e l a t i o n s h i p s " . -89-Table 19. Frequency of I s o l a t i o n , S t i m u l a t i o n , and Supportive  R e l a t i o n s h i p s Ind i c a t o r s I s o l a t i o n S t i m u l a t i o n Supportive r e l a t i o n s h i p Frequency f % f % f % Most or a l l 2 6 . , 7 14 45. , 2 13 41. .9 Good p a r t 7 23. , 3 14 45. ,2 11 35. , 5 Some 12 40 . 0 3 9 . , 6 7 22. .6 L i t t l e 3 10 . 0 0 0 . ,0 0 0 . , 0 R a r e l y or never 6 20. .0 0 0 . 0 0 0. . 0 T o t a l 30 100 31 100 31 100 I s o l a t i o n i s n e g a t i v e l y a s s o c i a t e d with job s a t i s f a c t i o n while s t i m u l a t i o n and s u p p o r t i v e r e l a t i o n s h i p s are p o s i t i v e l y a s s o c i a t e d . T h e r e f o r e a lower percentage of p r a c t i t i o n e r s f e e l i n g i s o l a t e d a "Good p a r t , Most or a l l of the time" (30%) and a higher percentage of p r a c t i t i o n e r s f e e l i n g s t i m u l a t e d (90.4%), and having s u p p o r t i v e r e l a t i o n s h i p s (77.4%) a "Good p a r t , Most or a l l of the time" suggests a tendency towards job s a t i s f a c t i o n . Large c a s e l o a d s and f e e l i n g u n f a i r l y p a i d are i n v e r s e l y r e l a t e d to job s a t i s f a c t i o n . Respondents were -90-asked two q u e s t i o n s with regard to these v a r i a b l e s . Table 20. C l i e n t Numbers and Income S a t i s f a c t i o n I n d i c a t o r s N = 30 f % Cum % No. of c l i e n t s wanted: More 10 33.3 33.3 No change 15 50,0 83.3 Fewer 4 13.3 96.7 Undecided 1 3.3 100 B e l i e v e p a i d : Well 7 23.3 23.3 F a i r l y 20 66.7 90.0 Under 3 10.0 100 Only 13.3% of respondents s t a t e d they would p r e f e r to have fewer c l i e n t s , and o n l y 10% b e l i e v e d that they were underpaid. Conversely, 96.7% s t a t e d they were undecided, wanted no change or more c l i e n t s ; and 90% b e l i e v e d they were e i t h e r f a i r l y or w e l l p a i d . Therefore these p o s i t i v e i n d i c a t o r s of job s a t i s f a c t i o n appear to be s t r o n g l y p r e s e n t . Respondents were a l s o asked to l i s t the most p o s i t i v e and most negative aspects of p r i v a t e p r a c t i c e i n two open-ended q u e s t i o n s , the answers to which may be used as a check on, and an adjunct t o , the p r e v i o u s l y mentioned i n d i c a t o r s . Table 21 and Table 22 l i s t the f r e q u e n c i e s and percentages of those non-mutually e x c l u s i v e l i s t s . Table 21. Frequencies and Percentages of Most P o s i t i v e Aspects of  P r i v a t e P r a c t i c e P o s i t i v e Aspects n = 30 f % Autonomy & f l e x i b i l i t y 21 36.2 Freedom from bureaucracy 6 10.3 Motivated c l i e n t s 5 8.6 Freedom to f o l l o w p r o f , p u r s u i t s 4 6.9 F i n a n c i a l rewards 4 6 . 9 Opportunity f o r c r e a t i v i t y & fun 4 6.9 Challenge 3 5.2 Opportunity f o r d i r e c t p r a c t i c e 3 5.2 V a r i e t y 3 5.2 Others 5 8.6 T o t a l s 58* 100 Note. Number of non-mutually e x c l u s i v e responses to the open-ended q u e s t i o n . T h i r t y respondents noted 58 "Most p o s i t i v e a s p e c t s " . That was a 41% i n c r e a s e over the number of "Most negative a s p e c t s " l i s t e d . In ge n e r a l t h e r e f o r e , i t seems p r a c t i t i o n e r s b e l i e v e there i s more p o s i t i v e about p r i v a t e p r a c t i c e than there i s n e g a t i v e . Table 22. Frequencies and Percentages  P r i v a t e P r a c t i c e of Most Negative Aspects of Negative Aspects n = 30 f % I s o l a t i o n 10 24 . 4 F i n a n c i a l I n s t a b i l i t y 7 17. 1 Marketing s e l f & p u b l i c r e l a t i o n s 6 14. 6 Cost to c l i e n t s (lack of Insur.) 5 12. 2 Working e v e n i n g s / d i s r u p t s fam. l i f e 4 9 . 7 Lack of time/overworked 2 4 . 9 Legal & c l i e n t r e s p o n s i b i l i t i e s 2 4 . 9 Other 5 12. 2 T o t a l s 41* 100.00 Note. Number of non-mutually e x c l u s i v e responses. The most f r e q u e n t l y l i s t e d negative a s p e c t , was i s o l a t i o n with 24.4% of respondents l i s t i n g i t . C o n s i d e r i n g t h i s was an open-ended q u e s t i o n , t h i s was very c l o s e to the 30% who i n d i c a t e d they f e l t i s o l a t e d "A good p a r t , most or a l l of the time" to the c l o s e d q u e s t i o n on i s o l a t i o n asked p r e v i o u s l y . The remaining 70% however, f e l t i s o l a t e d o n l y "Some of the time, a l i t t l e of the time, r a r e l y or never". The o v e r a l l degree of job s a t i s f a c t i o n t h e r e f o r e seems to be q u i t e high, with i n d i c a t o r s of d i s s a t i s f a c t i o n , being r e l a t i v e l y low. " I d e a l " world. P r a c t i t i o n e r s were asked to choose from a l i s t of p o s s i b i l i t i e s of how they would l i k e t h e i r s e r v i c e s to be paid f o r i n t h e i r " i d e a l " world. The l i s t of p o s s i b i l i t i e s was as f o l l o w s : (1) Pay on a f e e - f o r s e r v i c e b a s i s . (2) Pay on a s l i d i n g s c a l e , r e l a t i v e to t h e i r [ c l i e n t ' s ] income, with the government s u b s i d i z i n g the balance. (3) Pay on a s l i d i n g s c a l e , r e l a t i v e to t h e i r income, with the p r a c t i t i o n e r s u b s i d i z i n g the balance. (4) Pay through c o n t r i b u t i o n s to a u n i v e r s a l insurance plan such as B.C. Medical S e r v i c e s P l a n . (5) Pay through taxes so t h a t s e r v i c e s c o u l d be u n i v e r s a l l y d e l i v e r e d upon reques t . Table 23 shows the r e s u l t s of t h i s q u e s t i o n . Table 23. Freq u e n c i e s , Percentages and Cumulative Percentages of  P r a c t i t i o n e r s ' P r e f e r r e d Model of Payment for S e r v i c e . P r e f e r r e d Model f % Cum % F e e - f o r - s e r v i c e 3 10 .0 10.0 S l i d i n g Scale/Gov't Subsidy 10 33 .3 43.3 S l i d i n g S c a l e / P r t n r Subsidy 4 13 . 3 56.7 C o n t r i b u t i o n s Univ. Ins. Plan 11 36 .7 93.3 Through taxes f o r U n i v e r s a l s e r v i c e upon request 2 6 .7 100 These r e s u l t s seem to show a d e f i n i t e preference on the part of p r a c t i t i o n e r s f o r a c o n t r i b u t o r y insurance plan and f o r a s l i d i n g s c a l e based on the c l i e n t ' s income, with the government s u b s i d i z i n g the balance. The most s o c i a l i s t i c of the models (pay through taxes) was the l e a s t p r e f e r r e d model, while perhaps the most o b v i o u s l y c a p i t a l i s t i c model ( f e e - f o r - s e r v i c e ) was the second l e a s t p r e f e r r e d . The two most p r e f e r r e d models seemed to r e f l e c t consumer r e s p o n s i b i l i t y , but without har d s h i p . While c o n t r i b u t o r y insurance plans can be seen as c a p i t a l i s t i c i n that the user pays through c o n t r i b u t i o n s , i t i s l e s s d i r e c t l y a s s o c i a t e d with the f e e - f o r - s e r v i c e model. On the other hand, the s l i d i n g s c a l e with government subsidy, r e f l e c t s a user-pay model but r e l a t i v e to t h e i r a b i l i t y to do so, with government i n t e r v e n t i o n l i m i t e d to a r e s i d u a l model which i s only s l i g h t l y s o c i a l i s t i c . C h a r a c t e r i s t i c s of Aspects of S e r v i c e R e f e r r a l s . The c h a r a c t e r i s t i c s surrounding r e f e r r a l s were i n d i c a t e d by source of r e f e r r a l s ; frequency of r e f e r r i n g ; and by frequency of r e f e r r i n g to p r a c t i t i o n e r s covered by a medical insurance p l a n . Tables 24, 25, and 26 show the r e s u l t s . Table 24. Frequencies, Percentages and Cumulative Percentages of  M a j o r i t y of R e f e r r a l Sources. Source n = 25 f % Cum.% S e l f , Fam. or F r i e n d 10 40 40 Another P r o f e s s . 7 28 68 Other *7 28 96 Don't know 1 4 100 Note. *Represents respondents who d i d not s p e c i f y the other s o u r c e ( s ) ind i c a t e d "Other" but Table 25. Freauencv of R e f e r r i n g P o t e n t i a l C l i e n t s Frequency f % Cum% Some of the time 10 34.5 34 . 5 L i t t l e of the time 13 44.8 79 . 3 R a r e l y or never 6 20.7 100 Table 26. Freauency of R e f e r r i n g to Another P r a c t i t i o n e r Covered by Medical Insurance Plan Frequency f % Cum % Most of a l l of time 3 10.0 10.0 Good pa r t of time 9 30.0 40.0 Some of the time 9 30.0 70.0 L i t t l e of the time 4 13.3 83.3 R a r e l y or none of time 5 16.7 100 From the above t a b l e s i t appears that the m a j o r i t y of c l i e n t s / p a t i e n t s come s e l f r e f e r r e d , or r e f e r r e d by f a m i l y members or f r i e n d s . F u r t h e r , almost 80% of p r a c t i t i o n e r s do r e f e r "some of the time" or "a l i t t l e of the time", with the remainder r e f e r r i n g r a r e l y or none of the time. I think i t i s reasonable to assume that p r a c t i t i o n e r s would not need to r e f e r "A good p a r t , most or a l l of the t i me". Since r e f e r r a l sources are important to p r i v a t e p r a c t i t i o n e r s , a c h i square t e s t was done to see whether there was an a s s o c i a t i o n between those p r a c t i t i o n e r s who i n d i c a t e d they used "personal v i s i t s to other p r o f e s s i o n a l s " as a way of a d v e r t i s i n g t h e i r s e r v i c e s , and those i n d i c a t i n g the m a j o r i t y of t h e i r r e f e r r a l s were from other p r o f e s s i o n a l s . No a s s o c i a t i o n was found. A c h i square t e s t was a l s o done to see whether there was any a s s o c i a t i o n between "wanting more c l i e n t s " and frequency of r e f e r r i n g . Again, no a s s o c i a t i o n was found. It seems that respondents r e f e r to p r a c t i t i o n e r s covered by a medical plan to a c o n s i d e r a b l e degree with 40% r e f e r r i n g "a Good p a r t , most or a l l of the time" and a f u r t h e r 30% doing so "some of the time". In another q u e s t i o n respondents were asked to check whether they b e l i e v e d the c o s t of t h e i r s e r v i c e s "prevented c l i e n t s from r e c e i v i n g them". F i f t y - e i g h t percent i n d i c a t e d , "Yes", t h e r e f o r e a c h i square t e s t was done to see whether there was any a s s o c i a t i o n between " b e l i e v i n g the c o s t prevents s e r v i c e to c l i e n t s " and the frequency of r e f e r r i n g to p r a c t i t i o n e r s covered by a medical p l a n . No s i g n i f i c a n t a s s o c i a t i o n was found. However, of the p r a c t i t i o n e r s who r e f e r r e d to p r a c t i t i o n e r s covered by a medical plan "A good p a r t , most or a l l of the time", 72.7% had a l s o i n d i c a t e d that t h e i r c o s t d i d prevent some c l i e n t s from r e c e i v i n g s e r v i c e . T h i s was i n c o n t r a s t to the onl y 27.3% who r e f e r r e d to p r a c t i t i o n e r s covered by a medical plan "A good p a r t , most or a l l of the time, but who d i d not b e l i e v e the cost of t h e i r s e r v i c e prevented c l i e n t s from r e c e i v i n g that s e r v i c e . The percent d i f f e r e n c e seems great enough to suggest that p r a c t i t i o n e r s who b e l i e v e cost i s a f a c t o r for c l i e n t s , may be i n f l u e n c e d to r e f e r them to p r a c t i t i o n e r s who have medical plan coverage. Frequency, duration,, and t e r m i n a t i o n . Respondents were asked what the average frequency of t h e i r i n t e r v e n t i o n was--either per week or per month (which ever a p p l i e d ) . During coding, f o r ease of analyses a l l responses were converted to i n d i c a t e the frequency per month. The mean frequency was 3.6 times per month, SD 1.41; with a median of 4, and a s e m i - i n t e r q u a r t i l e range (Q) of .5 (n = 24). S i m i l a r l y respondents were asked to i n d i c a t e the average d u r a t i o n of t h e i r i n t e r v e n t i o n i n e i t h e r weeks or months and then a l l responses were converted to i n d i c a t e the d u r a t i o n in weeks. The mean d u r a t i o n was 32.6 weeks, SD 31.3; with a median of 19, Q 11 (n = 23). With regard to t e r m i n a t i o n , respondents i n d i c a t e d the the f o l l o w i n g r e s u l t s as d i s p l a y e d i n Table 27. Table 27. Frequencies and Percentages of Who Most F r e q u e n t l y  I n i t i a t e s Termination Most F r e q u e n t l y I n i t i a t e s n = 30 f % P r a c t i t i o n e r I n i t i a t e s 0 .0 C l i e n t I n i t i a t e s 5 16 . 7 P r a c t i t i o n e r & C l i e n t decide together 21 70.0 Cont r a c t Ends 4 13 . 3 It i s c l e a r t h at i n the great ma j o r i t y of cases, t e r m i n a t i o n occurs when the p r a c t i t i o n e r and c l i e n t decide - 9 9 -t o g e t h e r . When "Whether p r a c t i t i o n e r s p r e f e r r e d to have More, Fewer, or No Change" i n the number of c l i e n t s on t h e i r c a s e l o a d , was t e s t e d f o r an a s s o c i a t i o n with who i n i t i a t e d t e r m i n a t i o n , i t was found that of the p r a c t i t i o n e r s who d i d not wish any change, or who wanted fewer c l i e n t s , only 11.76% suggested that most o f t e n i t was the c l i e n t alone who i n i t i a t e d t e r m i n a t i o n . T h i s i s i n c o n t r a s t to 33.3% of the p r a c t i t i o n e r s who i n d i c a t e d they would l i k e more c l i e n t s and who suggested t h a t most o f t e n i t was the c l i e n t alone who i n i t i a t e d t e r m i n a t i o n . T h i s percent d i f f e r e n c e may suggest t h a t wanting more c l i e n t s may i n f a c t i n f l u e n c e the lack of p r a c t i t i o n e r s ' i n i t i a t i o n of t e r m i n a t i o n . C o n s u l t a t i o n and e v a l u a t i o n . Table 28 shows the r e s u l t s of the two q u e s t i o n s which asked respondents to i n d i c a t e the frequency with which they c o n s u l t e d on t h e i r c a s e l o a d s , and used s p e c i f i c e v a l u a t i v e methods. -100-Table 28. Frequency of C o n s u l t a t i o n and E v a l u a t i o n C o n s u l t a t i o n E v a l u a t i o n Frequency f f % Most or a l l of time 1 3.3 4 13.8 Good pa r t of time 8 26.7 1 3.4 Some of time 10 33.3 6 20.7 L i t t l e i f time 8 26 . 7 7 24 .1 Rare l y , a l i t t l e or none of time 3 10.0 11 37.9 T o t a l s 30* 100 29* 100 Note. * = n f o r that v a r i a b l e . When the f r e q u e n c i e s are c o l l a p s e d the r e s u l t s show that p r a c t i t i o n e r s c o n s u l t and evaluate "Some, a Good p a r t , or Most or a l l of the time", 66.3% and 37.9% r e s p e c t i v e l y . I t appears that t h i s data supports concerns i n the l i t e r a t u r e t h a t the frequency with which p r i v a t e p r a c t i t i o n e r s engage i n these a c t i v i t i e s i s q u i t e low. These data a l s o support the f i n d i n g s of Wallace (1982) who a l s o found t h a t the percentage of p r a c t i t i o n e r s who d i d not c o n s u l t at a l l , was 10%. S i m i l a r l y t h i s study found t h a t 10% of respondents i n d i c a t e d they c o n s u l t e d o n l y "Rarely or none of the time". Both v a r i a b l e s were c o l l a p s e d and a c h i square t e s t was done on the 3 x 3 c r o s s - t a b s to see whether there was -101-any a s s o c i a t i o n between the f r e q u e n c y wi th which p r a c t i t i o n e r s used c o n s u l t a t i o n and the f r e q u e n c y w i th which they used e v a l u a t i o n . No s i g n i f i c a n t a s s o c i a t i o n was f o u n d . The four p o i n t s c a l e f o r " h i g h e s t l e v e l of e d u c a t i o n " was c o l l a p s e d to a two p o i n t s c a l e of "Undergraduate" and "Graduate" and t h i s was c r o s s e d w i th the t h r e e p o i n t s c a l e of " f r e q u e n c y of c o n s u l t a t i o n " . A g a i n , a c h i square t e s t for a s s o c i a t i o n was done on the 2 x 3 c r o s s - t a b but no s i g n i f i c a n t a s s o c i a t i o n was f o u n d . On the other hand, a s i m i l a r 2 x 3 c r o s s - t a b was c o n s t r u c t e d wi th the h i g h e s t l e v e l of e d u c a t i o n and f r e q u e n c y of e v a l u a t i o n . These two v a r i a b l e s do appear to be s i g n i f i c a n t l y a s s o c i a t e d . X 2 < 2 / n = 28) = 7 .78 , p<.02. The i n t e r e s t i n g r e s u l t was tha t t h r e e of the f i v e "Undergraduates" (60%) i n d i c a t e d they e v a l u a t e d "More than some of the t ime" wh i le o n l y 2 of the 23 (8.69%) "Gradua tes" i n d i c a t e d they e v a l u a t e d "More than some of the t i m e " . T h i s i n d i c a t e s t h a t "Undergradua tes" a re more s t r o n g l y a s s o c i a t e d w i th e v a l u a t i o n than are " G r a d u a t e s " . A q u e s t i o n f o r f u t u r e s t u d i e s might be to ask respondents to i d e n t i f y the methods or ins t r ument s they use f o r e v a l u a t i o n , as w e l l as where they l e a r n e d about them or how they came to u t i l i z e them. F e e s . F o u r t e e n (45 .2%) of the p r a c t i t i o n e r s charged a c c o r d i n g to a s l i d i n g s c a l e , and seventeen (54 .8%) -102-charged a c c o r d i n g to a f l a t f e e . Of those 17, three respondents charged a f l a t fee t h a t was not by the hour, but r a t h e r by the day, or by the c o n t r a c t t h e r e f o r e they were not i n c l u d e d i n the c a l c u l a t i o n s of the f l a t fees charged by the remaining 14 or (45.2%) who charged by the hour . Table 29. Method of Charging by Fees Charged i n D o l l a r s / H r . Fees Charged i n $/Hr . Method of Charging n Mean SD Med ian Q* * F l a t Fee 14 49.64 9.30 50.00 10.00 * S l i d i n g Scale Minimum fee 14 24.64 16.11 30.00 17.25 Maximum fee 62.14 19 .29 57.50 12. 50 Note. *. = S e m i - i n t e r q u a r t i l e range or q u a r t i l e d e v i a t i o n . Goldmeier (1986) found t h a t the average h o u r l y fee charged i n the United S t a t e s was $31.00 - $40.00. If an average of $35.00 i s converted to Canadian funds i t would be approximately $46.00. This i s j u s t s l i g h t l y lower than the mean f l a t fee charged by the respondents of t h i s study ( $49 . 64 ) . Respondents who charged a c c o r d i n g to a s l i d i n g s c a l e were not asked the frequency of c h a r g i n g fees at the lower, middle or upper end of the s c a l e . T h i s i n f o r m a t i o n would have been of i n t e r e s t i n order to d i s c e r n which of -103-the two methods of c h a r g i n g g e n e r a l l y r e s u l t e d i n higher fees to c l i e n t s . Perhaps fu t u r e r e s e a r c h w i l l address t h a t q u e s t i o n . C h a r a c t e r i s t i c s of C l i e n t s The frequency of r e p r e s e n t a t i o n of s p e c i a l or  marginal groups on the caseloads of p r a c t i t i o n e r s . Respondents were asked to i n d i c a t e the frequency of having members of v i s i b l e m i n o r i t i e s , people who are p h y s i c a l l y d i s a b l e d and people who are m e n t a l l y handicapped, on t h e i r c a s e l o a d s . Table 30 d i s p l a y s the r e s u l t s . Table 30. Frequency of S p e c i a l Groups Represented on Caseloads S p e c i a l Groups V i s . min . Phys . d i s . Men. hand i . Frequency f % f % f % Most or a l l 1 3 . 4 0 0 . 0 1 3 . 3 Good p a r t 2 6.9 1 3.3 1 3 . 3 Some 5 17 . 2 2 6 . 7 1 3 . 3 L i t t l e 12 41.4 7 23 . 3 4 13 . 3 Rarely/none 9 31. 0 20 66.7 23 76 . 7 T o t a l s 29* 100 30* 100 30* 10 0 Note. Frequency t o t a l s r e p r e s e n t the n f o r each v a r i a b l e column. -104-These f i g u r e s appear to suggest a very low r e p r e s e n t a t i o n of these s p e c i a l groups on the caseloads of p r i v a t e p r a c t i t i o n e r s . Recent s o c i a l work l i t e r a t u r e from the United States (Frisman et a l . , 1986; and Goldmeier, 1986) suggests t h a t vendorship has i n c r e a s e d the access of marginal groups to the s e r v i c e s of p r i v a t e p r a c t i t i o n e r s . The economic s i t u a t i o n of c l i e n t s . The r e s u l t s of the q u e s t i o n a s k i n g p r a c t i t i o n e r s to i n d i c a t e what they b e l i e v e the economic s i t u a t i o n of t h e i r c l i e n t s to be, are d i s p l a y e d i n Table 31. Table 31. Economic S i t u a t i o n of C l i e n t s S i t u a t i o n f % D i f f i c u l t 3 11.5 Manageable 11 42.3 Comfortable 12 46.2 The r e s u l t s of the q u e s t i o n a s k i n g p r a c t i t i o n e r s to i n d i c a t e what they b e l i e v e the economic s i t u a t i o n of t h e i r c l i e n t s to be, tends to support those who b e l i e v e p r i v a t e p r a c t i c e does not serve the poor. T h i s i s yet another aspect of p r a c t i c e t hat may be changing i n the United States due to t h i r d - p a r t y payments through vendorship, (Barker, 1984). We do not have vendorship l e g i s l a t i o n i n Canada t h e r e f o r e we must monitor the s i t u a t i o n here i f we are to a c c u r a t e l y d e s c r i b e the -105-p r a c t i c e s of p r i v a t e p r a c t i t i o n e r s which i n c l u d e s the people they s e r v e . Predomlnent p r e s e n t i n g problems of p r i v a t e  p r a c t i t i o n e r s ' c l i e n t s . Table 32. Non-Mutually E x c l u s i v e L i s t of Most Commonly Problems Presented by C l i e n t s Presented Problems f % Depress ion 16 14 . 2 M a r i t a l c o n f l i c t 16 14 . 2 R e l a t i o n s h i p problems 15 13 . 3 S t r e s s / a n x i e t y d e a l i n g with f e e l i ngs 15 13 . 3 C a r e e r / l i f e t r a n s i t i o n / p ersonal growth 9 8 . 0 P a r e n t - c h i l d c o n f l i c t s 6 5. 3 Substance a b u s e / a d d i c t i o n s 6 5. 3 Sexual abuse 5 4 . 4 Family v i o l e n c e 5 4 . 4 Communication/life s k i l l problems 5 4 . 4 Family of o r i g i n problems 4 3. 5 I n t e r n a t i o n a l adoptions 3 2. 6 E a t i n g d i s o r d e r s 2 1. 8 Others 6 5. 3 T o t a l s 113 100. 0 -106-Respondents were asked to l i s t the f i v e most commonly presented problems i n an open-ended q u e s t i o n . The r e s u l t s shown i n Table 32 tend to support the l i t e r a t u r e that suggests t h a t p r i v a t e p r a c t i t i o n e r s p r i m a r i l y see c l i e n t s who have been l a b e l e d p s y c h o n e u r o t i c r a t h e r than those who have been l a b e l e d p s y c h o t i c . C l i e n t u n i t s most f r e q u e n t l y seen bv p r i v a t e  p r a c t i t i o n e r s . Respondents were asked to rank order c l i e n t groups r e l a t i v e to the frequency with which they were seen. For ease of a n a l y s i s the items were reverse scor e d r e s u l t i n g i n the d e s i g n a t i o n of Ks 1 through 5 r e c e i v i n g a s c o r e of 5 through 1 r e s p e c t i v e l y . The scores were t a l l i e d to get the cumulative scores f o r the f i n a l o r d e r i n g . F i g u r e 2 below shows the r e s u l t s . F i g u r e 2. Rank Order of C l i e n t U n i t s Seen 120 R 100 A N K 80 O R D E R S C O R B 60 -40 -20 CLIENT UNIT8 Note. a = I n d i v i d u a l , b = Couples, c - F a m i l i e s , d = Groups, and e - O r g a n i z a t i o n s . These r e s u l t s are c o n s i s t e n t with the s t u d i e s of Borenzweig (1981), Wallace (1982) and Goldmeier (1986) with the e x c e p t i o n of O r g a n i z a t i o n s which were not mentioned i n the other s t u d i e s . Percentages of c l i e n t s i n v a r i o u s age groups bv sex. Respondents were asked to i n d i c a t e the percentage of t h e i r c l i e n t s who were male and female and the percentages of each that f e l l w i t h i n f i v e age c a t e g o r i e s . F i f t y - s e v e n percent of the c l i e n t s were female and 43 percent were male. The cumulative percentages of each sex In each age -108-group were averaged. Table 33. The Average Percentages of the Ages of C l i e n t s , by Sex Age % Female % Male Under 11 1.54 3.33 12 - 20 9.54 13.07 21 - 40 67.50 62.89 41 - 65 21.19 20 . 30 66 & over .23 . 41 T o t a l s 100 100 These r e s u l t s support the f i n d i n g s of Goldmeier's 1986 study that found the m a j o r i t y of p a t i e n t s [ c l i e n t s ] were between 18 and 40, and t h a t the e l d e r l y , on the whole were not w e l l r e p r e s e n t e d . I t i s a l s o c l e a r from these r e s u l t s t h a t - c h i l d r e n under the age of eleven are not o f t e n seen by p r i v a t e p r a c t i t i o n e r s . Summary Demographic and Background Data For ease of summarizing, the f i g u r e s i n t h i s s e c t i o n have been rounded o f f to the nearest whole numbers. The average age of the p r a c t i t i o n e r s i n t h i s sample was 42. The sample was almost evenly d i v i d e d with 53% being females and 47% being males. Twenty-six percent of p r a c t i t i o n e r s were i n f u l l - t i m e p r i v a t e p r a c t i c e while the other seventy-four percent -109-p r a c t i c e d p r i v a t e l y o n l y p a r t - t i m e , with 57% having other employment, and 17% having no other employment. E i g h t y - t h r e e percent of respondents' were "Graduates", 80% of whom i n d i c a t e d they were R e g i s t e r e d S o c i a l Workers; and 17% were "Undergraduates", 100% of whom i n d i c a t e d they were R e g i s t e r e d S o c i a l Workers. Approximately 63% of p r i v a t e p r a c t i t i o n e r s who p r a c t i c e e i t h e r f u l l - t i m e or who p r a c t i c e p a rt-time but who a l s o have other employment earn under $35,000.00 gross per year. Two respondents i n d i c a t e d t h e i r income was gr e a t e r than $45,000.00/year. C h a r a c t e r i s t i c s of P r a c t i t i o n e r s The s t r e n g t h s of the m o t i v a t i n g f a c t o r s f o r e n t e r i n g p r i v a t e p r a c t i c e were analyzed a c c o r d i n g to sex. S i m i l a r i t i e s between the sexes were that i n each case the three s t r o n g e s t f a c t o r s i n c l u d e d Autonomy, F l e x i b i l i t y and Opportu n i t y to s p e c i a l i z e ; and i n each case the two weakest f a c t o r s were Avoid a d m i n i s t r a t i v e t a s k s , and Terminated from previous employment. Males r a t e d o p p o r t u n i t y f o r economic improvement as the f o u r t h s t r o n g e s t f a c t o r while females r a t e d i t e i g h t h out of ten. P r i v a t e p r a c t i t i o n e r s r e p o r t e d that they do i d e n t i f y themselves as s o c i a l workers a good d e a l of the time and t h e i r advertisements c o n f i r m t h i s . In a d d i t i o n , males seem to i d e n t i f y themselves as s o c i a l workers more f r e q u e n t l y than females. P r a c t i t i o n e r s engage i n p r o f e s s i o n a l development to a -110-s u b s t a n t i a l degree. No respondent suggested that they engaged i n p r o f e s s i o n a l development on l y "A l i t t l e , r a r e l y , or none of the time", and 87% s a i d they read p r o f e s s i o n a l j o u r n a l s no l e s s o f t e n than monthly with h a l f r e a d i n g them two or three times per month. Respondents with perhaps more time, (that i s those who p r a c t i c e o n l y part-time and have no other employment) engage i n p r o f e s s i o n a l development the most, while respondents who perhaps have more access to j o u r n a l s (that i s they p r a c t i c e only part-time but who have other employment as w e l l ) , read p r o f e s s i o n a l j o u r n a l s the most f r e q u e n t l y . O v e r a l l p r i v a t e p r a c t i t i o n e r s appear to c o n t r i b u t e s u b s t a n t i a l l y to the p r o f e s s i o n . E i g h t y percent belong to t h e i r p r o f e s s i o n a l a s s o c i a t i o n ; and i n the past two years 65% have c o n t r i b u t e d to s o c i a l work r e s e a r c h , 26% have undertaken t h e i r own r e s e a r c h , and 45% have been p u b l i s h e d . On the whole, the frequency with which p r a c t i t i o n e r s engage i n community-level a c t i v i t i e s i s r e l a t i v e l y low. Approximately 50%, 87% and 65% i n d i c a t e d t h a t they engage in Volunteer work, donate time or money to p o l i t i c a l p a r t i e s and/or c o n t r i b u t e to s o c i a l p o l i c i e s r e s p e c t i v e l y , o n l y "A l i t t l e , r a r e l y or none of the time". P o s i t i v e i n d i c a t o r s f o r job s a t i s f a c t i o n were rep o r t e d with f a i r l y high f r e q u e n c i e s while negative i n d i c a t o r s were r e p o r t e d with f a i r l y low f r e q u e n c i e s . - I l l -N inety, and se v e n t y - e i g h t percent of respondents reported they were s t i m u l a t e d , and had s u p p o r t i v e r e l a t i o n s h i p s r e s p e c t i v e l y , "Most, a good p a r t or a l l of the time". Conversely, approximately 30% s a i d they were i s o l a t e d to th a t same ext e n t . To a great degree p r a c t i t i o n e r s were happy with the number of c l i e n t s they had, and they b e l i e v e d they were f a i r l y , or w e l l p a i d . O v e r a l l the l i s t of "most p o s i t i v e a s p e c t s " generated by respondents (with autonomy and f l e x i b i l i t y being the most f r e q u e n t l y c i t e d ) was s u b s t a n t i a l l y longer than the l i s t of "most negative a s p e c t s " (with i s o l a t i o n being most f r e q u e n t l y c i t e d ) . C h a r a c t e r i s t i c s of Aspects of S e r v i c e In t h e i r " i d e a l " world the g r e a t e s t percentage of p r a c t i t i o n e r s p r e f e r r e d payment through a c o n t r i b u t o r y insurance p l a n , with the next l a r g e s t percentage p r e f e r r i n g payment based on a s l i d i n g s c a l e with the government s u b s i d i z i n g the unpaid balance. The m a j o r i t y of c l i e n t s go to p r a c t i t i o n e r s through s e l f r e f e r r a l s , or through r e f e r r a l s from t h e i r c l i e n t ' s f a m i l i e s or f r i e n d s . E i g h t y percent of p r a c t i t i o n e r s r e f e r p o t e n t i a l c l i e n t s "Some, or A l i t t l e of the time", with o n l y 20% r e f e r r i n g "Rarely, or none of the time". And, p r a c t i t i o n e r s who b e l i e v e the c o s t of t h e i r s e r v i c e sometimes prevents c l i e n t s from r e c e i v i n g that s e r v i c e do tend to r e f e r predominently to other p r o f e s s i o n a l s who are covered by an insurance p l a n . The average frequency of i n t e r v e n t i o n i s three to four times per month. And the average d u r a t i o n of I n t e r v e n t i o n i s a p p r o x i m a t e l y seven months. In the m a j o r i t y of cases (70%), t e r m i n a t i o n is i n i t i a t e d by "the p r a c t i t i o n e r and c l i e n t t o g e t h e r " . Based on the assumption t h a t c o n s u l t a t i o n on one's caseload and the use of e v a l u a t i o n are b e n e f i c i a l on a continuous b a s i s , p r a c t i t i o n e r s Consult and e v a l u a t e r e l a t i v e l y i n f r e q u e n t l y . S i x t y - f i v e percent and e i g h t y - t h r e e p e r c e n t of respondents c o n s u l t and evaluate r e s p e c t i v e l y , o n l y "some of the time" or l e s s f r e q u e n t l y . The number of respondents who charge a c c o r d i n g to a s l i d i n g s c a l e and a c c o r d i n g to a f l a t fee are f a i r l y evenly s p l i t - - 4 5 % and 55% r e s p e c t i v e l y . The average s l i d i n g s c a l e ranges from approximately $25.00 to $62.00 while the average f l a t fee i s j u s t under $50.00. C h a r a c t e r i s t i c s of C l i e n t s The f r e q u e n c i e s with which v i s i b l e m i n o r i t i e s , m e n t a l l y handicapped or p h y s i c a l l y d i s a b l e d c l i e n t s were represented on c a s e l o a d s "A good p a r t " , "Most, or a l l of the time" were 10%, 7%, and 3% r e s p e c t i v e l y . C o n s i d e r i n g i t would on l y take one c l i e n t from the group to be on a p r a c t i t i o n e r ' s c a s e l o a d i n order for a group to be r e p r e s e n t e d , these groups are r e l a t i v e l y i n f r e q u e n t l y s e r v e d by t h i s sample. The vast m a j o r i t y of c l i e n t s ' economic s i t u a t i o n s were seen to be manageable or comfortable with o n l y 11% -113-seen to be i n an e c o n o m i c a l l y d i f f i c u l t s i t u a t i o n . Over h a l f of the p r e s e n t i n g problems c i t e d f e l l w i t h i n the four c a t e g o r i e s o f : Depression, M a r i t a l c o n f l i c t , R e l a t i o n s h i p problems, and S t e s s / a n x i e t y or d e a l i n g with f e e l i n g s . The most f r e q u e n t l y seen c l i e n t u n i t i s " I n d i v i d u a l s " . The r a t i o s of the f r e q u e n c i e s of s e e i n g i n d i v i d u a l s over couples, f a m i l i e s , groups and o r g a n i z a t i o n s are approximately 4:3, 2 1/2:1, 3:1, and 4:1 r e s p e c t i v e l y . F i f t y - s e v e n percent of c l i e n t s are female and f o r t y - t h r e e percent are male. Almost 90% of females and 83% of males are between the ages of 21 and 60. The most i n f r e q u e n t l y served age group for both sexes, was that of "66 years and over". - 1 1 4 -P r o f e s s i o n a l i z a t i o n , P r i v a t e P r a c t i c e and the Future In Chapter 1 i t was suggested that a c c o r d i n g to the r e c u r r i n g c r i t e r i a noted i n the l i t e r a t u r e on p r o f e s s i o n a l i z a t i o n , t h a t : (a) The longer, the more t h e o r e t i c a l and the more s p e c i f i c the t r a i n i n g ; (b) the g r e a t e r the f u n c t i o n a l s p e c i f i c i t y ; (c) the s t r o n g e r the group c u l t u r e or p r o f e s s i o n a l a s s o c i a t i o n ; (d) the more motivated by d e d i c a t i o n to serve s o c i e t y or by a l t r u i s m ; (e) the more entrenched the commitment to a code of e t h i c s ( f ) the g r e a t e r the a u t h o r i t y (achieved through community s a n c t i o n s such as l i c e n s i n g ) ; (g) the more autonomy achieved; (h) the higher the income; ( 1 ) the more p r e s t i g e : and ( j ) the g r e a t e r the power; then the more p r o f e s s i o n a l , or the f u r t h e r along the p r o f e s s i o n a l i z a t i o n continuum, s o c i a l work w i l l be c o n s i d e r e d to be. The great m a j o r i t y of p r i v a t e p r a c t i t i o n e r s have e i t h e r a masters or a d o c t o r a l degree. In a d d i t i o n , as a group they note that they have had a d d i t i o n a l t r a i n i n g o u t s i d e of u n i v e r s i t y and that they continue to engage i n p r o f e s s i o n a l development. These c h a r a c t e r i s t i c s f u l f i l l the c r i t e r i o n of long and s p e c i a l i z e d t r a i n i n g . L i k e w i s e , the c r i t e r i o n of f u n c t i o n a l s p e c i f i c i t y i s met by p r i v a t e p r a c t i t i o n e r s who tend toward s p e c i a l i z a t i o n as noted i n the s t r e n g t h of t h e i r " m o t i v a t i n g f a c t o r s " and i n t h e i r l i s t i n g s on the p r i v a t e p r a c t i c e r o s t e r of the p r o f e s s i o n a l a s s o c i a t i o n . The p r a c t i t i o n e r s i n t h i s sample can be s a i d to be a -115-p a r t of and to c o n t r i b u t e to a p r o f e s s i o n a l c u l t u r e , as e i g h t y percent of the p r i v a t e p r a c t i t i o n e r s belonged to a p r o f e s s i o n a l a s s o c i a t i o n and r e l a t i v e l y high percentages c o n t r i b u t e d to the s o c i a l work p r o f e s s i o n through c o n t r i b u t i n g to r e s e a r c h , undertaking t h e i r own r e s e a r c h and/or through p u b l i s h i n g . I t would be s t r i c t l y h y p o t h e t i c a l to i n f e r a l e v e l of a l t r u i s m or s e r v i c e o r i e n t a t i o n from t h i s study however there are some f a c t o r s that are of i n t e r e s t . On the one hand, for females, the m o t i v a t i n g f a c t o r s " o p p o r t u n i t y to s p e c i a l i z e " , " o p p o r t u n i t y f o r d i r e c t p r a c t i c e " , and "able to provide b e t t e r s e r v i c e " (which might be seen as being in the i n t e r e s t of t h e i r c l i e n t s ) were ranked stronger than " d i s c r e t i o n over c l i e n t s " or "economic improvement" (which might be seen as being i n s e l f - i n t e r e s t ) . However, for males, "economic improvement" and " d i s c r e t i o n over c l i e n t s " ranked higher than" provide b e t t e r s e r v i c e " or " o p p o r t u n i t y for d i r e c t p r a c t i c e " . In a d d i t i o n , the l i s t s of "Most p o s i t i v e and most n e g a t i v e " aspects of p r i v a t e p r a c t i c e , appeared to r e f l e c t c o n s i d e r a t i o n s of more consequence to the p r a c t i t i o n e r s than to t h e i r c l i e n t s ; although "cost of s e r v i c e to c l i e n t s " was ranked f o u r t h i n a l i s t of seven s p e c i f i c answers to the open-ended question--"most negative a s p e c t s " of p r i v a t e p r a c t i c e . P r i v a t e p r a c t i t i o n e r s were not asked s p e c i f i c a l l y t h e i r sense of commitment to t h e i r code of e t h i c s , however -116-the e i g h t y percent membership i n the a s s o c i a t i o n and the e i g h t y percent of p r a c t i o n e r s who are R e g i s t e r e d S o c i a l Workers, i m p l i e s a s e r i o u s commitment to the code of e t h i c s of the BCASW and subsequently the CASW. As was p r e v i o u s l y mentioned, community s a n c t i o n i s f o r m a l l y conveyed through l e g i s l a t i o n r e g u l a t i n g r e g i s t r a t i o n , c e r t i f i c a t i o n or l i c e n s i n g . The formal s a n c t i o n s o c i a l workers i n B r i t i s h Columbia have been able to o b t a i n i s the S o c i a l Workers ( R e g i s t r a t i o n ) Act governing r e g i s t e r e d s o c i a l workers only. By v i r t u e of t h i s a ct one may say that r e g i s t e r e d s o c i a l workers have in f a c t some community s a n c t i o n and s i n c e 80% of t h i s sample of p r i v a t e p r a c t i t i o n e r s are r e g i s t e r e d s o c i a l workers, i t appears that p r i v a t e p r a c t i t i o n e r s are at l e a s t to some degree sanctioned by the community. It seems reasonable to deduce from the s t r e n g t h of the m o t i v a t i n g f a c t o r s and from the questions on i s o l a t i o n and c o n s u l t a t i o n that p r i v a t e p r a c t i t i o n e r s have a great d e a l of autonomy. This meets yet another c r i t e r i o n of p r o f e s s i o n a l i z a t i o n . With regard to the incomes of p r i v a t e p r a c t i t i o n e r s , i t i s d i f f i c u l t to say whether they are g e n e r a l l y higher than s a l a r i e d p r a c t i t i o n e r s with the same c r e d e n t i a l s and years of t r a i n i n g . The r e s u l t s of t h i s study showed t h a t over t h i r t y percent of p r i v a t e p r a c t i t i o n e r s earned over $35,000.00 gross income i n 1986. The percentages of Government employees or of Family S e r v i c e s of Greater - 1 1 7 -Vancouver employees, who earn over t h i r t y - f i v e thousand per year, one would assume would be c o n s i d e r a b l y l e s s s i n c e the average annual wage of a s o c i a l worker "4A" (of whom there are r e l a t i v e l y few) i n the p u b l i c s e r v i c e i s approximately $35,100.00 (B.C.G.E.U. C o l l e c t i v e Agreement), and the average s o c i a l worker with f i v e years experience and the necessary masters degree f o r employment at Family S e r v i c e s earns approximately $30,000.00/year (Personal c o n v e r s a t i o n with r e s e a r c h e r S o c i o l o g y dept., Vancouver P u b l i c L i b r a r y ) . As no questions r e g a r d i n g power or p r e s t i g e were asked i n t h i s study, no comment can be made about p r i v a t e p r a c t i t i o n e r s r e l a t i v e to these c r i t e r i a of p r o f e s s i o n a l i z a t i o n . I t does seem a p p r o p r i a t e to deduce that on the whole, p r i v a t e p r a c t i t i o n e r s meet the conglomeration of c r i t e r i a g e n e r a l l y s t a t e d i n c r i t e r i a t h e o r i e s as necessary f o r a group to be seen e i t h e r as p r o f e s s i o n a l or as being well along the p r o f e s s i o n a l i z a t i o n continuum as set f o r t h by Flexner and by e a r l y s o c i o l o g i s t s . I t i s a l s o reasonable to deduce that r e l a t i v e to the c r i t e r i a s t a t e d above, that p r i v a t e p r a c t i t i o n e r s more c l o s e l y meet these c r i t e r i a than do s o c i a l workers i n g e n e r a l . That i s , p r i v a t e p r a c t i t i o n e r s have longer and more s p e c i a l i z e d t r a i n i n g ; they have more f u n c t i o n a l s p e c i f i c i t y ; the vast m a j o r i t y are i n v o l v e d i n t h e i r group c u l t u r e or p r o f e s s i o n a l a s s o c i a t i o n ; because of t h i s -118-e x t e n s i v e p a r t i c i p a t i o n and r e g i s t r a t i o n the m a j o r i t y of p r i v a t e p r a c t i t i o n e r s can be s a i d to have adopted and to be r e g u l a t e d by t h e i r code of e t h i c s ; they d e f i n i t e l y have more autonomy than the g e n e r a l p o p u l a t i o n of s o c i a l workers; and they appear to have s l i g h t l y higher incomes. Whether they can be s a i d to be more a l t r u i s t i c , or more d e d i c a t e d to s e r v i c e i s q u e s t i o n a b l e , and t h i s study provided no evidence on which to make a comment about t h e i r r e l a t i v e p r e s t i g e or power. Flaws i n the C r i t e r i o n Theory of P r o f e s s i o n a l i z a t i o n At t h i s p o i n t i t i s important to note that while s o c i a l work, and s o c i a l workers have been s t r i v i n g to achieve p r o f e s s i o n a l s t a t u s r e l a t i v e to these c r i t e r i a , (most of which o r i g i n a t e d with F l e x n e r ' s speech over seventy years ago) the c r i t e r i a have come under s c r u t i n y in r ecent years and have been d i s p u t e d . A couple of s p e c i f i c p o i n t s seem worth n o t i n g . The c r i t e r i a t h a t are presented as d e r i v e d from a comparative a n a l y s i s of a l l p r o f e s s i o n s are seldom a p p l i c a b l e i n f a c t to a l l of the 'recognized' p r o f e s s i o n s l i s t e d by a given author. In p a r t i c u l a r , law, the c l e r g y and u n i v e r s i t y f a c u l t y , while recognized as p r o f e s s i o n s from the e a r l i e s t s t u d i e s , f a i l to meet many of the c r i t e r i a used by Flexner or other s c h o l a r s ( A u s t i n 1983, p. 365). The reason for t h i s says A u s t i n (1983) i s because Flexner used f a u l t y l o g i c i n making h i s a s s e r t i o n s about - 1 1 9 -t h e c r i t e r i a n e e d i n g t o be met i n o r d e r t o be c o n s i d e r e d a p r o f e s s i o n . F l e x n e r a v o i d e d a n a l y z i n g t h e o t h e r p r o f e s s i o n s a n d s u g g e s t e d t o l e t t h e , " c a s e o f m e d i c i n e s u f f i c e . He t h e n p r o c e e d e d t o v a l i d a t e h i s s i x c r i t e r i a , e s s e n t i a l l y d e r i v e d f r o m h i s s t u d y o f m e d i c a l e d u c a t i o n , b y d e m o n s t r a t i n g , i n a c l a s s i c a l e x a m p l e o f c i r c u l a r l o g i c , t h a t t h e y w e r e c h a r a c t e r i s t i c o f m e d i c i n e " ( A u s t i n 1 9 8 3 , p. 3 6 5 ) . I t i s c l e a r t h a t b e c a u s e o f t h i s f l a w i n F l e x n e r ' s l o g i c , many g e n e r a l l y r e c o g n i z e d p r o f e s s i o n s w o u l d n e v e r h a v e m e t t w o o f F l e x n e r ' s c r i t e r i a . The c r i t e r i o n o f " l a r g e i n d i v i d u a l r e s p o n s i b i l i t y " w h i c h came t o b e r e f e r r e d t o a s a u t o n o m y , a r i d t h e c r i t e r i o n r e q u i r i n g t h a t t h e s c i e n t i f i c l e a r n i n g [ o f t h e o c c u p a t i o n ] be w o r k e d u p t o a " p r a c t i c a l a n d d e f i n i t e e n d " ( A u s t i n 1 9 8 3 , p. 3 6 3 ) . T h e s e c r i t e r i a a r e i m p o r t a n t t o t h e p r o f e s s i o n b e c a u s e t h e y h a v e h i s t o r i c a l l y b e e n s e e n a s i n h i b i t i n g f a c t o r s i n a c h i e v i n g p r o f e s s i o n a l s t a t u s . A l t h o u g h , a s r e c e n t a u t h o r s h a v e s h o w n , t h i s i s n o t t h e c a s e i n r e a l i t y . T h e f o r m e r c r i t e r i o n i s o f i m p o r t a n c e t o s o c i a l w o r k e r s b e c a u s e t h e v a s t m a j o r i t y o f s o c i a l w o r k e r s ( p a r t i c u l a r l y t h o s e i n p u b l i c w e l f a r e ) w o r k u n d e r s u p e r v i s i o n f r o m t h e i r e m p l o y e r s . T o d a y , m a n y p r o f e s s i o n a l s a r e e m p l o y e d i n b u r e a u c r a c i e s , i n s t i t u t i o n s a n d c o m p a n i e s . L a w y e r s a n d -120-engineers are o f t e n employed by governments and l a r g e c o r p o r a t i o n s . P r o f e s s o r s and s c i e n t i s t s , are employed by u n i v e r s i t i e s and d o c t o r s are o f t e n employed in l a r g e i n s t i t u t i o n s and t e a c h i n g h o s p i t a l s . I t c l e a r l y i s not the l o c a t i o n of one's work that determines h i s or her degree of p r o f e s s i o n a l i z a t i o n . N e i t h e r , i s p r o f e s s i o n a l i z a t i o n then dependent upon remuneration through a f e e - f o r - s e r v i c e model. The l a t t e r c r i t e r i o n i s important because of the vast scope of s o c i a l work. The " d e f i n i t e end", t h a t Flexner spoke of d i c t a t e d the n e c e s s i t y of a l i m i t e d and d e f i n i t i v e scope which s o c i a l work d i d not e x h i b i t . I t has s i n c e been p o i n t e d out t h a t many p r o f e s s i o n s have broad scopes, f o r i n s t a n c e : General p r a c t i c e , pathology, and p s y c h i a t r y w i t h i n medicine; ( C u l l e n , 1978) and tax, c o r p o r a t e and c r i m i n a l s p e c i a l t i e s w i t h i n law; e l e c t r i c a l , mechanical, and s t r u c t u r a l s p e c i a l t i e s w i t h i n e n g i n e e r i n g ; and the broad scope of knowledge, theory, and p r a c t i c e r e f l e c t e d i n the v a r i o u s d i s c i p l i n e s which u n i v e r s i t y p r o f e s s o r s r e p r e s e n t . I t appears t h a t a s i n g u l a r body of knowledge or l i m i t e d scope i s c l e a r l y not a r e q u i s i t e of p r o f e s s i o n a l s t a t u s , however as C u l l e n (1978) suggests " H i s t o r i c a l t r a d i t i o n s , s i m i l a r e a r l i e r t r a i n i n g before s p e c i a l i z a t i o n , as w e l l as i d e n t i f i a b l e ' c e n t r a l s k i l l s ' [Smith 1958, 414] a l l seem to p l a y a r o l e " (p. 32). -121-The S i g n i f i c a n c e of the C r i t e r i o n of "Community S a n c t i o n " What now appears to be the most e s s e n t i a l c r i t e r i o n f o r a t t a i n i n g p r o f e s s i o n a l s t a t u s i s "community s a n c t i o n " which i n t u r n i s l a r g e l y dependent upon some of the o r i g i n a l c r i t e r i a . T h i s i s the degree to which s o c i e t y s a n c t i o n s a g i v e n occupation to take on the r e s p o n s i b i l i t y f o r a p a r t i c u l a r problem or domain. This i s c o n s i s t e n t with the e x c h a n g e - s t r u c t u r a l i s t ' s p o i n t of view. C u l l e n (1978) wrote about community s a n c t i o n r e l a t i v e to the f u n c t i o n a l t h e o r y of s t r a t i f i c a t i o n and the exchange s t r u c t u r a l theory. He e x p l a i n e d t h a t , "the f u n c t i o n a l t h e o r y of s t r a t i f i c a t i o n and the e x c h a n g e - s t r u c t u r a l approach to p r o f e s s i o n a l i s m suggests an u n d e r l y i n g theme of ' r e c i p r o c a l l y f u n c t i o n a l i n t e r c h a n g e s ' [Gouldner, 1967:151] between s o c i e t y ' s members and the incumbents of v a r i o u s occupations or pos i t i o n s " (p. 4 8). Popple (1985) suggests, The o c c u p a t i o n and s o c i e t y are seen as r e a c h i n g an agreement, so to speak, f o r the purpose of problem management. S o c i e t y i s able to t u r n over the r e s p o n s i b i l i t y of handling a problem to an o c c u p a t i o n a l group that agrees to be held a c c o u n t a b l e . For i t s p a r t the occupation gains s t a t u s , power, and autonomy i n exchange f o r t a k i n g r e s p o n s i b i l i t y f o r a problem ( p. 570). Popple (1985) b e l i e v e s t h a t i n exchange f o r -122-p r o f e s s i o n a l s t a t u s s o c i a l workers have accepted the r e s p o n s i b i l i t y of c o n t r o l l i n g dependency. He f u r t h e r suggested t h i s r e c i p r o c a l agreement can be viewed from e i t h e r the consensus model or the c o n f l i c t model. "From a consensus approach, s o c i a l workers a c t to c o n t r o l dependency f o r the b e n e f i t of a l l members of s o c i e t y . From a c o n f l i c t approach, s o c i a l workers c o n t r o l dependency as s e r v a n t s of an e l i t e who want to r e s i s t s o c i a l change i n order to maintain t h e i r p o s i t i o n s of power and p r i v i l e g e " (p. 572). The c o n f l i c t approach i s c o n s i s t e n t with the power theory d i s c u s s e d i n chapter one. An example of t h i s r e c i p r o c a l arrangement might be the l i c e n s i n g of s o c i a l workers that Is spreading throughout the United St a t e s and the subsequent c o n t r a c t i n g out of s o c i a l s e r v i c e s to p r i v a t e p r a c t i t i o n e r s . The government s a n c t i o n s t h e i r p r o f e s s i o n a l s t a t u s through l i c e n s i n g and then turns over the r e s p o n s i b i l i t y of s o c i a l s e r v i c e s to the p r o f e s s i o n a l s many of whom become pa r t of the p r i v a t e s e c t o r . Maryland i s one of the. s t a t e s which has l i c e n s i n g l e g i s l a t i o n . That i s the s t a t e i n which Goldmeier (1986) undertook h i s study of " P s y c h i a t r i s t s , p s y c h o l o g i s t s , s o c i a l workers, and nurses i n p r i v a t e p r a c t i c e with a view to the f e a s i b i l i t y of r e f e r r i n g p a t i e n t s from the p u b l i c s e c t o r as p a r t of comprehensive mental h e a l t h p l a n n i n g " (p. 89). -123-Disadvantages of P r o f e s s i o n a l i z a t i o n O b v i o u s l y a l l r e c i p r o c a l agreements do not have to in c l u d e the p r i v a t i z a t i o n of otherwise p u b l i c s e r v i c e s but s o c i a l workers seeking p r o f e s s i o n a l s t a t u s must be aware of the p r i c e that c o u l d be pai d . Throughout the s o c i a l work l i t e r a t u r e on p r o f e s s i o n a l i z a t i o n , p r i v a t i z a t i o n and p r i v a t e p r a c t i c e , w r i t e r s have been a l e r t i n g us to the p r i c e t h a t may be paid f o r p r o f e s s i o n a l s t a t u s . I t i s suggested t h a t the p r i c e t h a t may be p a i d , i s that the mi s s i o n or purpose of s o c i a l work w i l l not be f u l f i l l e d . What i s not always made e x p l i c i t , i s t h a t the p r i c e may be paid through the predominently u n a r t i c u l a t e d but r e c i p r o c a l a s p e c t s of the s a n c t i o n s . Higher p r o f e s s i o n a l (and indeed any p r o f e s s i o n a l ) s t a t u s i s dependent upon the community s a n c t i o n that a t t r i b u t e s autonomy to the p r o f e s s i o n . The c o n t r a c t can be e i t h e r a c a s u a l c o n t r a c t enacted on l y by behavior and conv e n t i o n , or i t can be a formal c o n t r a c t r e g u l a t e d by law. Regardless of how the s a n c t i o n i s giv e n i t i s neces s a r y i n order f o r an occupation to a t t a i n p r o f e s s i o n a l s t a t u s . A u s t i n (1983) r e p o r t e d t h a t one of the reasons s o c i a l work has had d i f f i c u l t y a t t a i n i n g f u l l p r o f e s s i o n a l s t a t u s i s because women dominate the p r o f e s s ion and h i s t o r i c a l l y s o c i e t y has been r e l u c t a n t to bestow autonomy, power and p r i v i l e g e to women. Bisno (1956) c a u t i o n s us f u r t h e r . T h i s 'bestowing' of l o f t y s t a t u s i s p r i m a r i l y a f u n c t i o n of the dominant s o c i a l and economic segments of the community. T h i s then r a i s e s the q u e s t i o n as to what extent the s o c i a l worker must accept the dominant id e o l o g y as w e l l as the 'upper c l a s s e s ' d e f i n i t i o n of i t s proper f u n c t i o n as the p r i c e of p r e s t i g e (Bisno 1956, p. 16). Perhaps the values of the sanctioned group need not be the same as the 'bestowing' group but values w i l l be an issue and s o c i a l workers need to be extremely cognizant of t h e i r values and i n what ways they may be i n danger of being compromised. V a r l e y i n 1966 wrote, that the s a n c t i o n i n g of p r o f e s s i o n s by communities depends in part on the d e d i c a t i o n of t h e i r members to the s e r v i c e i d e a l and other a s s o c i a t e d v a l u e s . In her i n t r o d u c t i o n to "Conceptual Frameworks I I - - S p e c i a l Issue" of S o c i a l Work, 26(1) which in c l u d e d a Working Statement on the Purpose of S o c i a l Work and i t s o b j e c t i v e s , Anne Minahan (1981) a l s o a l e r t e d us to the n e c e s s i t y of being abundantly c l e a r on the purpose (not the mission) and o b j e c t i v e s of s o c i a l work. C a r o l Meyer (1981) e x p l a i n e d t h a t , The d i c t i o n a r y d e f i n e s 'mission' with r e l i g i o u s overtones--as a task with which one i s charged. I t i s p o s s i b l e t h a t the term mission i s too charged, too p r e t e n t i o u s , and too demanding and i s best l e f t to -125-, m i s s i o n a r i e s . Purpose, a more modest term, should evolve o r g a n i c a l l y from s o c i a l work's c a p a c i t y and e f f e c t i v e n e s s , governed more by s o c i e t y ' s c r e d u l i t y than by m y s t i c a l approbation (p. 73). With regard to " s o c i e t y ' s c r e d u l i t y " Minahan (1981) p o i n t s out, "At t h i s time of governmental, p o l i t i c a l , and p h i l o s o p h i c a l s h i f t s i n the country, s o c i a l workers must be able to i d e n t i f y c l e a r l y t h e i r purpose and o b j e c t i v e s i n order to show how t h e i r work i s r e l a t e d to the needs of people i n t h i s s o c i e t y " . Otherwise how could s o c i a l workers n e g o t i a t e a r e c i p r o c a l agreement with s o c i e t y without j e o p a r d i z i n g those purposes and o b j e c t i v e s or more imp o r t a n t l y the values inherent w i t h i n them. C a r o l Meyer suggested that s o c i a l work, r e q u i r e s a d e l i c a t e balance to maintain a p r o g r e s s i v e s o c i a l p h i l o s o p h y and to demonstrate e f f e c t i v e p r o f e s s i o n a l i n t e r v e n t i o n . The balance can be achieved but only i f s o c i a l workers r e a l i z e t h at they cannot p r a c t i c e s o c i a l p h ilosophy. There i s no s a n c t i o n f o r t h a t ; there i s no c o n s t i t u e n c y f o r t h a t . S o c i a l change comes about in m u l t i p l e t i e r s and mainly through s t r a i g h t f o r w a r d p o l i t i c a l a c t i o n . S o c i a l workers can be more p o l i t i c a l l y c onscious and a c t i v e , but p o l i t i c s o r d i n a r i l y i s not the domain of p r o f e s s i o n a l p r a c t i c e (Meyer 1985, p. 74). However, i f we are not c l e a r on the "means" of p r o f e s s i o n a l i z a t i o n , that i s , the r e c i p r o c a l nature of -126-community or more s p e c i f i c a l l y government s a n c t i o n ; and i f we are not very c l e a r on the v a l u e s , purposes and o b j e c t i v e s of s o c i a l work; the p u r s u i t of p r o f e s s i o n a l i s m and the necessary s a n c t i o n s to achieve i t may w e l l lead us to "ends" that were unforseen and unplanned as any p a r t of our g o a l . The welfare s t a t e such t h a t i t was i n North America began when governments assumed the r e s p o n s i b i l i t y f o r the "care of the unemployed p o r t i o n of the p o p u l a t i o n " (Stoesz 1981, p. 406) which i n c l u d e d the s i c k , the d i s a b l e d , the aged, and the disadvantaged. Conversely, when governments began to turn the r e s p o n s i b i l i t y of these groups over to p r o f e s s i o n a l s i n the p r i v a t e s e c t o r , the welfare s t a t e was undermined. There has been a swing to neoconservatism across North America i n recent years and i f s o c i a l workers are not c l e a r on t h e i r v a l u e s , purpose and o b j e c t i v e s when n e g o t i a t i n g s a n c t i o n s with these governments, David Stoesz' (1981) warning may become a r e a l i t y . To the extent that p r i v a t e - s e c t o r values coincide with professional values, neoconservatism will reflect priorities valued by professionals (emphasis mine). From t h i s p e r s p e c t i v e , neoconservatism may support p r o f e s s i o n a l s o c i a l work at the same time t h a t i t undermines s o c i a l w e l f a r e . T h i s i s not to suggest that s o c i a l welfare under neoconservative i d e o l o g y would disappear a l t o g e t h e r ; -127-r a t h e r , i t would become detached and i s o l a t e d from the main body of p r o f e s s i o n a l p r a c t i t i o n e r s who serve m i d d l e - c l a s s c l i e n t s . In t h i s s i t u a t i o n , those who could speak more a r t i c u l a t e l y and f o r c e f u l l y f o r welfare as a response to s o c i a l problems and unmet needs have been co-opted i n t o s i l e n c e , while the poor are l e f t to fend f o r themselves i n a downgraded system of r e s i d u a l p u b l i c s e r v i c e s and are ever more v u l n e r a b l e to the budgetary ax. It may be concluded then, t h a t i f neoconservative programs succeed i n a t t r a c t i n g a lar g e number of s o c i a l workers, the welfare s t a t e w i l l have r e t a i n e d a c o n s t i t u e n c y only l a r g e enough to d e l i v e r i t s eulogy (p. 408). This i s where the s o c i a l welfare system and s o c i a l welfare workers need e x t r a o r d i n a r y support. Through a st r o n g p r o f e s s i o n a l a s s o c i a t i o n s o c i a l workers from o u t s i d e the system can advocate f o r s o c i a l welfare without appearing to be a c t i n g i n s e l f - i n t e r e s t and without fear of r e p r i s a l . I t i s the r e s p o n s i b i l i t y of a l l s o c i a l workers to insure that s o c i a l welfare i s not undermined. Stoesz seems r a t h e r p e s s i m i s t i c about the p o s s i b i l i t y of h o l d i n g t r a d i t i o n a l s o c i a l work va l u e s , while at the same time h o l d i n g p r o f e s s i o n a l values but not n e c e s s a r i l y h o l d i n g neoconservative v a l u e s . Perhaps a disadvantage of p r o f e s s i o n a l i z a t i o n i s that d u r i n g the process, one may take on other p r o f e s s i o n a l values that are not c o n s i s t e n t with s o c i a l work va l u e s , but t h i s does not need to be the -128-case. S u r e l y i t Is p o s s i b l e (or even necessary) for t r a d i t i o n a l s o c i a l work values to be profess ional s o c i a l work va l u e s , and that those values n e c e s s a r i l y ought not be the values of neoconservatism or the values of any other p a r t i c u l a r Ideology. I t seems that t h i s i s the c h a l l e n g e of s o c i a l work e s p e c i a l l y i n l i g h t of the f a c t that s o c i e t i e s and t h e i r dominant i d e o l o g i e s are ever-changing. If s o c i a l work s u c c e s s f u l l y c h a l l e n g e s the disadvantages of p r o f e s s i o n a l i z a t i o n , there are s e v e r a l advantages to be gained. Advantages of P r o f e s s i o n a l i z a t i o n T a l c o t t Parsons b e l i e v e s that the " l e a d e r s h i p element" i n Western s o c i e t y has changed from r o y a l t y supported by a broad a r i s t o c r a c y (up u n t i l the i n d u s t r i a l r e v o l u t i o n ) , to u p p e r - c l a s s entrepreneurs ( f o l l o w i n g the i n d u s t r i a l r e v o l u t i o n ) , to p r o f e s s i o n a l s i n the present day. The fundamental o r i g i n of the modern p r o f e s s i o n a l system, has l a i n i n the marriage between the academic p r o f e s s i o n a l s and c e r t a i n c a t e g o r i e s of p r a c t i c a l men. These l a t t e r have taken r e s p o n s i b i l i t y , on a b a s i s more of s p e c i a l i z e d competence than of a d i f f u s e r e l i g i o u s or i d e o l o g i c a l l e g i t i m a t i o n , for a v a r i e t y of o p e r a t i v e f u n c t i o n s i n the s o c i e t y . We do not know what l i e s i n s t o r e f o r the next -129-phase of p r o f e s s i o n a l i z a t i o n . I suggest, however, th a t the p r o f e s s i o n a l complex has a l r e a d y not only come i n t o prominence but has even begun to dominate the contemporary scene i n such a way as to render obsolescent the primacy of the old i s s u e s of p o l i t i c a l a u t h o r i t a r i a n i s m and c a p i t a l i s t i c e x p l o i t a t i o n ( I n t . Ency. of Soc. Sc. " P r o f e s s i o n s " p. 546 ) . If the l e a d e r s h i p element i n modern s o c i e t y i s to be p r o f e s s i o n a l s , then i t i s most a p p r o p r i a t e f o r s o c i a l workers to embrace p r o f e s s i o n a l i s m with a view to f u l f i l l i n g the purposes and o b j e c t i v e s of s o c i a l work as s t a t e d i n the Working Statement on the Purpose of S o c i a l Work. The purpose of s o c i a l work i s s t a t e d as: To promote a mutually b e n e f i c i a l i n t e r a c t i o n between i n d i v i d u a l s and s o c i e t y i n order to improve the q u a l i t y of l i f e for everyone. S o c i a l workers hold the f o l l o w i n g b e l i e f s : --The environment ( s o c i a l , p h y s i c a l , o r g a n i z a t i o n a l ) should provide the o p p o r t u n i t y and resources f o r the maximum r e a l i z a t i o n of the p o t e n t i a l and a s p i r a t i o n s of a l l i n d i v i d u a l s , and should provide f o r t h e i r common human needs and f o r the a l l e v i a t i o n of d i s t r e s s and s u f f e r i n g . - - I n d i v i d u a l s should c o n t r i b u t e as e f f e c t i v e l y as they can to t h e i r own w e l l - b e i n g and to the s o c i a l welfare of others i n t h e i r immediate environment as w e l l as to the c o l l e c t i v e s o c i e t y . - - T r a n s a c t i o n s between i n d i v i d u a l s and others i n t h e i r environment should enhance the d i g n i t y , i n d i v i d u a l i t y , and s e l f - d e t e r m i n a t i o n of everyone. People should be t r e a t e d humanely and with j u s t i c e . C l i e n t s of s o c i a l workers may be an i n d i v i d u a l , a f a m i l y , a group, a community, or an o r g a n i z a t i o n . OBJECTIVES S o c i a l workers focus on person-and-envir omnent i n interact ion. To c a r r y out t h e i r purpose, they work with people to achieve the f o l l o w i n g o b j e c t i v e s : --Help people o b t a i n r e s o u r c e s . --Make o r g a n i z a t i o n s responsive to people. - - F a c i l i t a t e i n t e r a c t i o n between i n d i v i d u a l s and others i n t h e i r environment. - - I n f l u e n c e i n t e r a c t i o n s between o r g a n i z a t i o n s and i nst i t u t i o r i s . - - I n f l u e n c e s o c i a l and environmental p o l i c y . To achieve these o b j e c t i v e s , s o c i a l workers work wi other people. At d i f f e r e n t times, the t a r g e t of change v a r i e s - - i t may be the c l i e n t , others i n the environment, or both (Ency. of S.W. " H i s t " p. 751). And, t a k i n g the broad p e r s p e c t i v e — n o t o n l y f o r a t t a i n i n g s o c i a l work goals but f o r s o c i e t y i n g e n e r a l , p r o f e s s i o n a l i s m appears to be advantageous. Most p r o f e s s i o n s have codes of e t h i c s and/or conduct and the i n f l u e n c e of such codes on the l e a d e r s h i p element should - 1 3 1 -be b e n e f i c i a 1 . Carr-Sanders (1966) wrote, P r o f e s s i o n a l i s m has i t s problems of o r g a n i z a t i o n . I t has i t s weaknesses and i t s dangers. But t a k i n g a l l i n a l l , the growth of p r o f e s s i o n a l i s m i s one of the hopeful f e a t u r e s of the time. The approach to problems of s o c i a l conduct and s o c i a l p o l i c y under the guidance of a p r o f e s s i o n a l t r a d i t i o n r a i s e s the e t h i c a l standard and widens the s o c i a l outlook. There i s thus reason to welcome a development of which the r e s u l t w i l l be to inc r e a s e the i n f l u e n c e of p r o f e s s i o n a l a s s o c i a t i o n s upon c h a r a c t e r , outlook, and conduct (p. 9 ) . Th i s study has researched the impact of p r o f e s s i o n a l i s m on s o c i a l work and subsequently on p r i v a t e p r a c t i c e . I t has researched and d e s c r i b e d the c h a r a c t e r i s t i c s of p r i v a t e p r a c t i c e and has r e l a t e d those c h a r a c t e r i s t i c s to the c r i t e r i a theory of p r o f e s s i o n a l i z a t i o n . I t has explored an aspect of the c r i t e r i o n theory of p r o f e s s i o n a l i z a t i o n (community s a n c t i o n ) r e l a t i v e to a process theory of p r o f e s s i o n a l i z a t i o n ( e x c h a n g e - s t r u c t u r a l i s t ) . And, i t has d i s c u s s e d some of the disadvantages and the advantages of p r o f e s s i o n a l i z a t i o n f o r s o c i a l work and f o r s o c i e t y . In the process of t h i s work some questions have been answered, but others have a r i s e n that s t i l l need to be answered. -132-I m p l l c a t l o n s fo r f u t u r e r e s e a r c h With regard to the impetus toward p r o f e s s i o n a l i z a t i o n , i t would be of i n t e r e s t to ask s o c i a l workers d i r e c t l y where t h e i r m o t i v a t i o n to seek p r o f e s s i o n a l s t a t u s comes from, i n order to determine whether those motives support an e x c h a n g e - s t r u c t u r a l i s t model or whether they support the power t h e o r i s t s ' model. A l s o t h e i r p o l i t i c a l b e l i e f s could be surveyed to see whether there was i n f a c t a c o r r e l a t i o n between those, s u p p o r t i n g the exchange s t r u c t u r a l theory and c a p i t a l i s m , and those s u p p o r t i n g the power t h e o r i s t s p o i n t of view and s o c i a l ism. Another p o i n t of i n t e r e s t would be s p e c i f i c questions r e g a r d i n g the importance of power and p r e s t i g e to s o c i a l workers. These questions were not asked and again they may be of i n t e r e s t r e l a t i v e to both the process t h e o r i e s and the c r i t e r i a t h e o r i e s of p r o f e s s i o n a l i z a t i o n . With regard to the c h a r a c t e r i s t i c s of p r i v a t e p r a c t i t i o n e r s , more questions need to be asked of part-time females to determine whether c h i l d c a r e enters i n t o t h e i r employment p a t t e r n s and whether p o s s i b l e dual r o l e s enters i n t o t h e i r l e s s f r e q u e n t l y i d e n t i f y i n g themselves as s o c i a l workers. In l i g h t of the f a c t that s o c i e t y has h i s t o r i c a l l y not granted p r o f e s s i o n a l s t a t u s to occupations dominated by women, i t would a l s o be of i n t e r e s t to t e s t whether the gains toward p r o f e s s i o n a l i z a t i o n c o i n c i d e d with v a r i o u s - 1 3 3 -p e r i o d s when there has been an i n f l u x of males i n t o the p r o f e s s i o n , such as j u s t a f t e r the Second World War. Perhaps the p r o f e s s i o n a l i z a t i o n of s o c i a l work i s a l s o the m a s c u l i n i z a t i o n of s o c i a l work. Again with regard to the c h a r a c t e r i s t i c s of p r a c t i t i o n e r s f u r t h e r r e s e a r c h c o u l d be done with regard to "personal gross income" and " p r o f i t " . S o c i a l work that i s s a i d to be done in the p r i v a t e s e c t o r " f o r p r o f i t " needs, I t h i n k , to be examined. I t would be h e l p f u l to develop an understanding of what c o n s t i t u t e s p r o f i t . Do we b e l i e v e that p r o f i t i s s t r i c t l y the balance d e r i v e d from s u b t r a c t i n g expenses from income, or i s i t the balance d e r i v e d from s u b t r a c t i n g expenses and a c e r t a i n reserve f o r f u t u r e expenses such as: P r o f e s s i o n a l development, the a c q u i s i t i o n of equipment and s u p p l i e s (such as a computer or e v a l u a t i v e or measurement ins t r u m e n t s ) , a pension pla n , h o l i d a y pay, perhaps moving co s t s a f t e r a lease change, a d d i t i o n a l monies s u f f i c i e n t to enable the p r a c t i t i o n e r to take the e q u i v a l e n t of a s a b b a t i c a l every seven years or so. I t seems i t would be h e l p f u l not to speak of s o c i a l work for p r o f i t i n a derogatory way i f i n f a c t t h at " p r o f i t " a f f o r d s the p r a c t i t i o n e r nothing more than i s granted p r a c t i t i o n e r s who p r a c t i c e s o c i a l work f o r a s a l a r y . C o n c l u s i o n T h i s study found that Abraham Flexner and the c r i t e r i a theory of p r o f e s s i o n a l i z a t i o n that he u t i l i z e d -134-h a d a n e x t r e m e l y s t r o n g I n f l u e n c e o n s o c i a l w o r k o r g a n i z a t i o n , e d u c a t i o n , m e t h o d s , a n d t h e e v o l u t i o n o f p r i v a t e p r a c t i c e . I t a l s o f o u n d t h a t p r i v a t e p r a c t i t i o n e r s a r e a m o n g t h e m o s t h i g h l y e d u c a t e d a n d m o s t p r o f e s s i o n a l i z i n g m e m b e r s o f t h e s o c i a l w o r k p r o f e s s i o n , i f t h e d e g r e e t o w h i c h t h e h i s t o r i c a l c r i t e r i a a r e m e t , i s t h e m e a s u r e o f " p r o f e s s i o n a l i z i n g " . I t a l s o n o t e d t h a t r e c e n t s t u d i e s h a v e r e j e c t e d some o f t h e c r i t e r i a h i s t o r i c a l l y a s s e r t e d a s n e e d i n g t o be f u l f i l l e d i n o r d e r t o a t t a i n p r o f e s s i o n a l s t a t u s . T h e r e f o r e i t a p p e a r s t h a t w h i l e t h e m o d e l o f p r i v a t e p r a c t i c e h i s t o r i c a l l y a d v a n c e d t h e p r o f e s s i o n a l i z a t i o n o f s o c i a l w o r k , t h e c o n t i n u e n c e o r t h e e x p a n s i o n o f p r i v a t e p r a c t i c e i s n o t n e c e s s a r y i n o r d e r t o e i t h e r a t t a i n f u r t h e r p r o f e s s i o n a l s t a t u s , o r t o r e t a i n t h e p r o f e s s i o n a l s t a t u s a l r e a d y a c h i e v e d . T h i s s t u d y f u r t h e r f o u n d t h a t some o f t h e c h a r a c t e r i s t i c s o f p r i v a t e p r a c t i c e d e s c r i b e d i n t h e l i t e r a t u r e t h a t h a v e b e e n u s e d a s a r g u m e n t s i n s u p p o r t o f , a n d i n o p p o s i t i o n t o , p r i v a t e p r a c t i c e w e r e f o u n d t o be c o n s i s t e n t w i t h t h i s s a m p l e a n d o t h e r s w e r e n o t . I n g e n e r a l p r i v a t e p r a c t i t i o n e r s w e r e f o u n d t o be p a r t i c u l a r l y p r o f e s s i o n a l r e l a t i v e t o t h e c r i t e r i a d e s c r i b e d b y F l e x n e r . T h e e x c h a n g e - s t r u c t u r a l i s t p r o c e s s m o d e l o f p r o f e s s i o n a l i z a t i o n was f o u n d t o be o f i m p o r t a n c e d u e t o t h e i m p l i c a t i o n s o f t h e r e c i p r o c a l n a t u r e o f t h e "community s a n c t i o n " c r i t e r i o n . In l i g h t of t h i s r e c i p r o c i t y , the advantages and the disadvantages of p r o f e s s i o n a l i z a t i o n were d i s c u s s e d . I t was concluded that i f the purposes and o b j e c t i v e s of s o c i a l work and t h e i r inherent values are preserved i n the p r o f e s s i o n a l i z a t i o n process, that because of the p o s i t i o n of p r o f e s s i o n a l s and t h e i r b e n e f i c i a l i n f l u e n c e on the l e a d e r s h i p element of s o c i e t y , that the p r o f e s s i o n a l i z a t i o n of s o c i a l work w i l l reap p o s i t i v e rewards both f o r s o c i a l work and for a l l of s o c i e t y . B l b l i o a r a p h y A n a l y s i s o f a 96 P e r c e n t R e t u r n R a t e . I n D.C. L o c k h a r t ( E d . ) , M a k i n g E f f e c t i v e U s e o f M a i l e d Q u e s t i o n n a i r e s , ( p p . 5-18), S a n F r a n c i s c o : J o s s e y - B a s s . A r m i t a g e , A. (1978). I n K a m e r m a n , S. & K a h n , A. ( E d s . ) , F a m i l y p o l i c y : G o v e r n m e n t & f a m i l i e s i n f o u r t e e n  c o u n t r i e s . 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( E d s . ) T h e  e m e r g e n c e o f s o c i a l w e l f a r e a n d s o c i a l w o r k . I l l i n o i s : P e a c o c k P r e s s . T r i p o d i , T., F e l l i n , P. & M e y e r , H. ( 1 9 6 9 ) . E x e m p l a r s o f  S o c i a l R e s e a r c h . I l l i n o i s : P e a c o c k P u b l i s h e r s . T r i p o d i , T., F e l l i n , P., & M e y e r , H. ( 1 9 8 3 ) . T h e a s s e s s m e n t o f s o c i a l r e s e a r c h . ( 2 n d e d . ) . I l l i n o i s : P e a c o c k P u b l i s h e r s . V a r l e y , B. ( 1 9 6 6 ) . A r e s o c i a l w o r k e r s d e d i c a t e d t o s e r v i c e ? S o c i a l W o r k , 1 1 ( 6 ) , 8 4 - 9 1 . V i g d e r h o u s , G. ( 1 9 7 8 ) . A n a l y s i s o f P a t t e r n s o f R e s p o n s e t o m a i l e d Q u e s t i o n n a i r e s . I n D.F. A l w i n ( E d . ) S u r v e y  D e s i g n a n d A n a l y s i s C u r r e n t I s s u e s ( p p . 8 1 - 9 0 ) . B e v e r l y H i l l s : S a g e . W a l l a c e , M. ( 1 9 8 2 ) . P r i v a t e p r a c t i c e : A n a t i o n w i d e s t u d y . S o c i a l W o r k . 2 1 ( 3 ) , 2 6 2 - 2 6 7 . -142-A p p e n d l x A: C o v e r i n g L e t t e r a n d Q u e s t i o n n a i r e T H E UNIVERSITY O F BRITISH C O L U M B I A 6201 CECIL CREEM PARK ROAD V A N C O U V E R , B .C. , C A N A D A V 6 T 1W5 SCHOOL OF SOCIAL WORK F e b r u a r y 16, 1987. Dear . . , As you are p r o b a b l y aware, t h e r e has been a g r e a t d e a l of d i s c u s s i o n i n the s o c i a l work l i t e r a t u r e on the t o p i c of p r i v a t e p r a c t i c e . These d i s c u s s i o n s f r e q u e n t l y I n c l u d e d e s c r i p t i o n s of p r i v a t e p r a c t l o n e r s , t h e i r c l i e n t s , and t h e i r p r a c t i c e s . There 13 a problem w i t h the d e s c r i p t i o n s , however, i n t h a t t h e y a r e c o n t r a d i c t o r y . T h e r e f o r e , I am u n d e r t a k i n g t h i s s t u d y w i t h the purpose of be i n g a b l e t o de v e l o p an a c c u r a t e d e s c r i p t i o n of these c h a r a c t e r i s t i c s as they p e r t a i n t o s o c i a l workers i n the G r e a t e r Vancouver a r e a i n the s p r i n g of 1987. I t Is e s s e n t i a l to o b t a i n the n e c e s s a r y d a t a f o r such a d e s c r l p t i o n , from the p r a c t i t i o n e r s t h e m s e l v e s . T h e r e f o r e , w i t h a view t o c o n t r i b u t i n g to a g r e a t e r u n d e r s t a n d i n g of p r i v a t e p r a c t i c e , I am a p p e a l i n g t o you, as a s o c i a l worker i n p r i v a t e p r a c t l t l c e , t o p r o v i d e your knowledge and o p i n i o n s by an s w e r i n g the e n c l o s e d quest 1onnaIre. When c o n s t r u c t i n g the q u e s t i o n n a i r e , I t r i e d t o be c o n s i d e r a t e of the respondent's t i m e . P r e - t e s t l n g has shown t h a t I t ta k e s between 10 t o 20 minutes t o complete t h i s s u r v e y , depending upon the l e n g t h of responses t o the open-ended q u e s t i o n s . There are no i d e n t i f y i n g markings on the q u e s t i o n n a i r e , t h e r e f o r e s h o u l d you d e c i d e to p a r t i c i p a t e , you w i l l remain c o m p l e t e l y anonymous. P l e a s e keep i n mind t h a t t h e r e are no r i g h t or wrong answers and t h a t you have the r i g h t t o d e c l i n e t o complete the q u e s t i o n n a i r e and may l e a v e blank any i t e m which you f i n d u n a c c e p t a b l e . T h i s r e s e a r c h meets the e t h i c a l s t a n d a r d s and r e g u l a t i o n s of the U n i v e r s i t y of B r i t i s h Columbia. Upon c o m p l e t i o n a r e p o r t on the f i n d i n g s w i l l be s u b m i t t e d t o the B.C.A.S.W. and the A.P.S.W. and as p a r t of my t h e s i s , I t w i l l be a v a i l a b l e from the S c h o o l of S o c i a l Work l i b r a r y . P l e a s e complete the q u e s t i o n n a i r e and r e t u r n i t i n the e n c l o s e d s e l f - a d d r e s s e d stamped envelope by F e b r u a r y 27, 1987. Thank you v e r y much f o r your time and your c o o p e r a t i o n . Yours t r u l y , G a l l Thompson M.S.W. Student - • * - t- o „ I •» 1 U n r U - 1 4 3 -REQUESTED DATE FOR THE RETURN OF T H I S Q U E S T I O N N A I R E IS FEBRUARY 2 7 / 8 7 DESCRIBING PRIVATE PRACTICE D E F I N I T I O N FOR THE PURPOSES OF T H I S R E S E A R C H : S o c i a l Work P r i v a t e P r a c t i t i o n e r s : P e o p l e who e i t h e r h o l d a u n i v e r s i t y d e g r e e i n s o c i a l w o r k , a n d / o r a r e R e g i s t e r e d S o c i a l W o r k e r s ; WHO e l t h e r P A R T - T I K E o r F U L L - T I M E , p r a c t i c e t h e i r p r o f e s s i o n i n d e p e n d e n t l y o f a n y g o v e r n m e n t o r v o l u n t a r y a n g e n c y ; AND who t a k e s o l e r e s p o n s i b i l i t y f o r t h e l r p r i v a t e p r a c t i c e ; AND who s e t up t h e i r own c o n d i t i o n s o f p a y m e n t w i t h c l i e n t s . F o r e a s e o f r e s p o n d i n g , t h e q u e s t i o n s i n t h e q u e s t i o n n a i r e a r e p r e d o m i n a n t l y c l u s t e r e d a c c o r d i n g t o f o r m a t r a t h e r t h a n a c c o r d i n g t o t o p i c . A l l q u e s t i o n s , p e r t a i n t o t h e c h a r a c t e r i s t i c s o f y o u t h e p r a c t i t i o n e r , y o u r c l i e n t s , o r y o u r p r a c t i c e . T h e r e a r e a f e w q u e s t i o n s t h a t p e r t a i n p r i m a r i l y t o c l i n i c a l p r a c t i t i o n e r s , 1£ t h e y a r e n o t a p p l i c a b l e t o y o u r p r a c t i c e , p l e a s e i n d i c a t e by w r i t i n g N / A n e x t t o t h e m b u t p l e a s e c o n t i n u e , a s y o u r r e s p o n s e s t o t h e o t h e r q u e s t i o n s a r e v e r y v a l u a b l e . 1 . I h a v e b e e n d o i n g p r i v a t e p r a c t i c e : ( P l e a s e c o m p u t e m o n t h s o r y e a r s e x c l u s i v e o f p e r i o d s when y o u were n o t a c t u a l l y p r a c t i c i n g . ) YEARS MONTHS 2 . My p r i v a t e p r a c t i c e i s : ( p l e a s e c h e c k o n e ) a . F u l l - t i m e b . P a r t - t i m e I f P a r t - t i m e , Do y o u h a v e o t h e r e m p l o y m e n t i n a d d i t i o n t o y o u r p r i v a t e p r a c t i c e ? Y e s No t 3. On a v e r a g e , I s p e n d t h e f o l l o w i n g a m o u n t o f t i m e e n g a g e d In p r i v a t e p r a c t i c e : H r s . P e r M o n t h . -144-4 . One o f t h e m o s t s t r i k i n g a r e a s o f c o n t r o v e r s y , I s " m o t i v a t i n g f a c t o r s " f o r e n t e r i n g p r i v a t e p r a c t i c e . V a r i o u s p i e c e s o f l i t e r a t u r e , s u g g e s t some o f t h e f o l l o w i n g . P l e a s e i n d i c a t e t h e d e g r e e t o w h i c h e a c h was a f a c t o r f o r y o u . ( p l e a s e c i r c l e t h e m o s t r e p r e s e n t a t i v e n u m b e r ) STRONG FACTOR NEUTRAL a . A u t o n o m y b . F l e x i b i l i t y c . More o p p o r t u n i t y f o r d i r e c t p r a c t i c e d . A v o i d b u r e a c r a t l c c o n f l i c t s e . A b l e t o p r o v i d e b e t t e r S e r v i c e f . A v o i d a d m i n i s t r a t i v e t a s k s g . P o t e n t i a l f o r e c o n o m i c i m p r o v e m e n t h . D i s c r e t i o n o v e r w h i c h c l i e n t s t o work w i t h 1 More o p p o r t u n i t y t o s p e c i a l i z e In a r e a o f I n t e r e s t T e r m i n a t e d f r o m p r e v i o u s e m p l o y m e n t O t h e r ( s ) P l e a s e s p e c i f y k . 1 . 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 3 3 The s p e c i a l i z e d t r a i n i n g I h a v e t a k e n t h a t i s o me In my p r i v a t e p r a c t i c e , i s : ( p l e a s e I n c l u d e d u r a t i o n o f t r a i n i n g ) a. b. 5 5 5 5 5 5 5 5 5 5 5 5 6 6 6 6 6 6 6 6 6 6 6 6 NOT A FACTOR 7 7 7 7 7 7 7 7 7 7 7 7 i m p o r t a n c e t o o c a t l o n , a n d d . -145-In my p r a c t i c e , I see the f o l l o w i n g c l i e n t g r o u p ( s ) : ( p l e a s e rank o r d e r . 0 = not seen, 1 - most f r e q u e n t l y seen, 2 - second most f r e q u e n t l y seen, e t c . ) a. I n d i v i d u a l s b. Groups c. Couples d. F a m i l i e s e. O r g a n i z a t i o n s f . O ther: 7. Without g o i n g t o my f i l e s , my b e s t e s t i m a t e Is t h a t my c l i e n t s c o u l d be c a t e g o r i z e d as f o l l o w s : ( p l e a s e e n t e r p e r c e n t a g e s ) a r e MALES \ a r e FEMALES ie males of the females \ are 11 _ r s . or under \ are 11 Yrs . or under % a r e 12 - 20 Years Old % are 12 - 20 Years Old \ are 21 - 40 Years Old % a r e 21 - 40 Years Old % are 41 - 65 Years Old % a r e 41 - 65 Years Old are 66 and Older \ are 66 and Older 8. P l e a s e l i s t the f i v e most common problems t h a t c l i e n t s s t a t e as a reason f o r s e e k i n g your s e r v i c e s . a . b. ;  c. d. . e . 9. What Is the average d u r a t i o n of i n t e r v e n t i o n / t r e a t m e n t f o r c l i e n t s . ( P l e a s e f i l l i n the average t o t a l number of weeks or months) a. T o t a l Weeks b. T o t a l months c. Not a p p l i c a b l e d. Other: ( p l e a s e s p e c i f y ) , -146-10. What Is the average f r e q u e n c y of i n t e r v e n t i o n / t r e a t m e n t f o r c l i e n t s . ( P l e a s e f i l l i n the average number of app o i n t m e n t s , e t c . per week or month, whichever a p p l i e s ) . a. Times per week b. Tiroes per month c. Not a p p l i c a b l e d. Other: ( p l e a s e s p e c i f y ) _^ T h i s next s e c t i o n l a p r e d o m l n e n t l y m u l t i p l e c h o i c e . P l e a s e check ( ) the l i n e next t o the answer t h a t I s roost c o r r e c t f o r you p e r t a i n i n g t o your p r i v a t e p r a c t i c e . Where you are r e q u e s t e d t o check a l l t h a t a p p l y / i t w i l l be c l e a r l y s t a t e d . 11. With r e g a r d t o t e r m i n a t i o n , what most f r e q u e n t l y o c c u r s In my p r a c t i c e , i s : ( P l e a s e check one) a. ( ) The p r a c t i t i o n e r i n i t i a t e s . b. ( ) The c l i e n t i n i t i a t e s . c. ( ) The p r a c t i t i o n e r and c l i e n t d e c i d e t o g e t h e r . d. ( ) The c o n t r a c t ends. e. ( ) Undecided f. ( ) Other ( p l e a s e s p e c i f y ) 12. C u r r e n t l y In my p r i v a t e p r a c t i c e , I would p r e f e r t o have: a. ( ) More c l i e n t s b. ( ) Fewer C l i e n t s c. ( ) No Change In the number of c l i e n t s d. ( ) Undecided 13. I have c l i e n t s who are members of a v i s i b l e m i n o r i t y . a. ( ) R a r e l y or none of the t i m e . b. ( ) A l i t t l e of the t i m e . c. ( ) Some of the t i m e . d. ( ) A good p a r t of the t i m e . e. ( ) Most or a l l of the t i m e . 14. I have c l i e n t s who a r e p h y s i c a l l y d i s a b l e d . a. b. c. d. e. f. .) R a r e l y or none o f the t i m e . .) A l i t t l e of the t i m e . .) Some of the t i m e . .) A good p a r t of the t i m e . .) Most or a l l of the t i m e . .) Undecided I have c l i e n t s who are m e n t a l l y handicapped. «• ( ) R a r e l y or none of the time, t>. ( ) A l i t t l e of the ti m e . c. ( ) Some of the t i m e . d. ( ) A good p a r t of the t i m e . e. ( ) Most or a l l of the t i m e . I b e l i e v e the economic s i t u a t i o n of the m a j o r i t y of my c l i e n t s a. b. c. d. e. f . .) D i f f i c u l t .) Manageable .) C o m f o r t a b l e .) A f f l u e n t .) Other ( p l e a s e s p e c i f y ) . .) Don't Know The m a j o r i t y of my c l i e n t s are r e f e r r e d by: a. ( ) S e l f b. ( ) F a m i l y or F r i e n d c. ( ) Another P r o f e s s i o n a l d. ( ) Other ( p l e a s e s p e c i f y ) e. ( .) Don't Know Because of the n a t u r e of c l i e n t s ' needs, I f i n d m y s e l f r e f e r r i n g p o t e n t i a l c l i e n t s t o o t h e r s . a. ( ) R a r e l y or none of the t i m e . b. ( ) A l i t t l e of the t i m e . c. ( ) Some of the t i m e . d. ( ) A good p a r t of the t i m e . e. ( ) Most or a l l of the t i m e . The people who I r e f e r c l i e n t s to, a r e cov e r e d by a m e d i c a l p l a a. ( ) R a r e l y or none of the t i m e . b. ( ) A l i t t l e of the t i m e . c. ( ) Some of the t i m e . d. ( ) A good p a r t of the t i m e . e. ( ) Most or a l l of the t i m e . f. ( ) Don't Know -148-20. In my ideal world, receivers of my services, would: (please check one) a. ( ) Pay on a fee-for-service basis. b. ( ) Pay on a s l iding scale, relative to their income, with the government subsidizing the balance. c. ( ) Pay on a s l iding scale, relative to their income, with the practitioner subsidizing the balance. d. ( ) Pay through contributions to a universal Insurance plan such as B.C. Medical Services Plan. e. ( ) Pay through taxes so that services could be universally delivered upon request. f. ( ) Other (Please specify) _j_ 21. The cost of my services to clients sometimes: (please check a l l that apply and specify any other) a. ( ) Prevents them from receiving service. b. ( ) Is a factor in frequency of Intervention/treatment. c. ( ) Is a factor in the duration of Intervention/treatment. d. ( ) Other (please specify) e. ( ) Don't Know 22. My fee is:(Please enter fee, on appropriate l ine . ) a. ( ) A flat fee, which Is: (please state) s .00/ b. ( ) A s l iding scale, the range of which is: from 8 .00/ . to S .00/ c. ( ) Other: S .00/ t 23. I believe that In my private practice, I am: a. ( ) Well paid b. ( ) Fair ly paid c. ( ) Under paid d. ( ) Other (please specify) 24. I expect my private practice to become more economically advantageous to me in the next year or two. a. ( ) Completely False b. ( ) Mostly False c. ( ) Partly True & Partly False d. ( ) Mostly True e. ( ) Completely True Don't have any expectation f. ( ) -149-25. I use the f o l l o w i n g forms of a d v e r t i s i n g , ( p l e a s e check a l l t h a t a p p l y ) a. ( ) Y e l l o w pages of the te l e p h o n e book. b. ( ) N e w s l e t t e r s c. ( ) P r o f e s s i o n a l A s s o c i a t i o n R e f e r r a l L i s t d. ( ) Newspapers e. ( ) P e r s o n a l v i s i t s t o r e f e r r i n g p r o f e s s i o n a l s f. ( ) F l i e r s t o s p e c i f i c o r g a n i z a t i o n or groups g. ( ;) B u s i n e s s c a r d s h. ( ) Other ( p l e a s e s p e c i f y ) 26. My a d v e r t i s i n g , as i n d i c a t e d above: ( p l e a s e check a l l t h a t a p p l y ) a. ( ) I n d i c a t e s t h a t I am a R e g i s t e r e d S o c i a l Worker b. ( ) I n d i c a t e s my S o c i a l Work Degrees c. ( ) I n d i c a t e s t h a t I am a t h e r a p i s t d. ( ) I n d i c a t e s t h a t I am a c o u n s e l l o r e. ( ) Other ( p l e a s e s p e c i f y ) 27. I be l o n g t o the f o l l o w i n g p r o f e s s i o n a l a s s o c i a t i o n s : ( p l e a s e check a l l t h a t a p p l y and s p e c i f y any o t h e r s ) a. ( ) B.C. A s s o c i a t i o n of S o c i a l Workers b. ( ) A s s o c i a t i o n of P r o f e s s i o n a l S o c i a l Workers c. ( ) Other: .. d. ( ) Other: 28. I i d e n t i f y myself as a s o c i a l worker t o my c l i e n t s . a. ( ) R a r e l y or none of the t i m e . b. ( ) A l i t t l e of the t i m e . c. ( ) Some of the t i m e . d. ( ) A good p a r t of the t i m e . e. ( ) Most or a l l of the t i m e . 29. I c o n s u l t on my c a s e l o a d w i t h o t h e r p r o f e s s i o n a l s a. b. c, d. e. .) R a r e l y or none of the time A l i t t l e of the time Some of the t i m e . .) A good p a r t of the time .) Most or a l l of the time, 30. By f i l l i n g out t h i s q u e s t i o n n a i r e , you a r e c o n t r i b u t i n g t o s o c i a l work r e s e a r c h . How many o t h e r s o c i a l work r e s e a r c h p r o j e c t s (of any s o r t ) have you c o n t r i b u t e d t o i n the pa s t two y e a r s . ? a. ( ) O t h e r s : P l e a s e f i l l In the number. b. ( ) No O t h e r s . -150-31. I have u n d e r t a k e n one o r more s o c i a l work r e s e a r c h p r o j e c t s m y s e l f i n t h e l a s t two y e a r s . a . ( ) T r u e . b. ( ) F a l s e . 32, I use s p e c i f i c methods o r I n s t r u m e n t s f o r e v a l u a t i n g my work. a . ( ) R a r e l y o r none o f t h e t i m e b. ( ) A l i t t l e o f t h e t i m e . c . ( ) Some o f t h e t i m e . d. ( ) A good p a r t o f t h e t i m e . e . ( ) Most o r a l l o f t h e t i m e . 33. I engage i n p r o f e s s i o n a l d e v e l o p m e n t , a . b. c . d. e . .) R a r e l y o r none o f t h e t i m e .) A l i t t l e o f t h e t i m e . .) Some o f t h e t i m e . .) A good p a r t o f t h e t i m e . .) Most o r a l l o f t h e t i m e . 34. I r e a d p r o f e s s i o n a l j o u r n a l s . ( P l e a s e c h e c k one) a . ( ) More f r e q u e n t l y t h a n w e e k l y b. ( ) Weekly c. ( ) Two or T h r e e t i m e s a month d. ( ) M o n t h l y e. ( ) O t h e r ( p l e a s e s p e c i f y ) 35. In t h e l a s t two y e a r s I have had t h e f o l l o w i n g number o f l e t t e r s , a r t i c l e s , r e p o r t s , b o o k s , e t c . p u b l i s h e d , ( p l e a s e c h e c k one) a . ( ) None b. ( ) One or Two c . ( ) T h r e e o r F o u r d . ( ) F i v e o r More 36. I am s t i m u l a t e d In my p r i v a t e p r a c t i c e a . b. c . d . e. .) R a r e l y o r none o f t h e t i m e , .) A l i t t l e o f t h e t i m e . .) Some o f t h e t i m e . .) A good p a r t o f t h e t i m e . .) Most o r a l l o f t h e t i m e . -151-37. I am i s o l a t e d In my p r i v a t e p r a c t i c e . a . ( ) R a r e l y or none o f t h e t i m e . b. ( ) A l i t t l e o f t h e t i m e . c . ( ) Some o f t h e t i m e . d . ( ) A good p a r t o f t h e t i m e . e. ( ) Most o r a l l o f t h e t i m e . 38. I engage i n v o l u n t e e r work o r community s e r v i c e . a . ( ) R a r e l y or none o f t h e t i m e . b. ( ) A l i t t l e o f t h e t i m e . c . ( ) Some o f t h e t i m e . d . ( j A good p a r t o f t h e t i m e . e. { ) Most or a l l o f t h e t i m e . 39. I have s u p p o r t i v e r e l a t i o n s h i p s w i t h p e o p l e who u n d e r s t a n d my work a. ( ) R a r e l y or none o f t h e t i m e . b. ( ) A l i t t l e o f t h e t i m e . c . ( ) Some o f t h e t i m e . d. ( ) A good p a r t o f t h e t i m e . e. ( ) Most o r a l l o f t h e t i m e . 40. I d o n a t e t i m e a n d / o r money t o t h e p o l i t i c a l p a r t y o f my c h o i c e . a . ( ) R a r e l y or none o f t h e t i m e . b. ( ) A l i t t l e o f t h e t i m e . c . ( ) Some o f t h e t i m e . d. ( ) A good p a r t o f t h e t i m e . e. ( ) Most or a l l o f t h e t i m e . 41. I have c o n t r i b u t e d t o t h e d e v e l o p m e n t o r cha n g e o f s o c i a l p o l i c y w i t h i n t h e l a s t two y e a r s , e . g . p r e p a r i n g b r i e f s , l o b b y i n g , l e t t e r c a m p a i g n s , e t c . , t o I n f l u e n c e p o l i c y m a k e r s . a. ( ) R a r e l y o r none o f t h e t i m e . b. ( ) A l i t t l e o f t h e t i m e . c . ( ) Some o f t h e t i m e . d . ( ) A good p a r t o f t h e t i m e . e. ( ) Most or a l l o f t h e t i m e . 42. I b e l i e v e what b e s t p r e p a r e d me f o r p r i v a t e p r a c t i c e , was: ( P l e a s e c h e c k one) a . ( ) My a c a d e m i c t r a i n i n g . b . ( ) My work e x p e r i e n c e . c . (_ ) My s p e c i a l i z e d t r a i n i n g o u t s i d e o f u n i v e r s i t y . d . ( ) O t h e r : ( p l e a s e s p e c i f y ) -152-43. In my o p i n i o n , the most p o s i t i v e a s p e c t s of p r i v a t e p r a c t i c e a r e : 44. In my o p i n i o n , the most n e g a t i v e a s p e c t s of p r i v a t e p r a c t i c e a r e : T h i s s e c t i o n seeks demographic and background i n f o r m a t i o n . 45. Sex: Female . Male . 46. Age: At l a s t b i r t h d a y y e a r s o l d , 47. Income: P l e a s e I n d i c a t e your t o t a l g r o s s income f o r 1986 ( P l e a s e check one) a, b, c, d, e, $ 0.00 15,000.00 25,000.00 30,000.00 35,000.00 $14,999.99 24,999.99 29,999.99 34,999 .99 39,999.99 f. $40, 000 .00 - $44,999.99 g- 45, 000 .00 - 49,999.99 h. 50, 000 .00 - 59,999.99 1. 60, 000 .00 - 69,999.99 j . 70, 000 .00 and over 48. P l e a s e check a l l of the f o l l o w i n g t h a t you h o l d , and p l e a s e f i l l i n the b l a n k s where a p p l i c a b l e . a. (. ) R e g i s t e r e d S o c i a l Worker b. ( ) B a c h e l o r of S o c i a l Work Degree c. ( ) Master of S o c i a l Work Degree d. ( ) Doctor of S o c i a l Work Degree e. ( ) Other d e g r e e s : ( p l e a s e s p e c i f y degree and f a c u l t y ) 49. C o u n t r y or C o u n t r i e s where I r e c e i v e d my d e g r e e ( s ) : b. . d. JL - 1 5 4 -A p p e n d i x B: E l a b o r a t i o n o f t h e R e s e a r c h M o d e l a n d D e s i g n Some o f t h e i n f o r m a t i o n i n t h i s a p p e n d i x was c o v e r e d i n C h a p t e r 3--A S u m m a r y o f t h e R e s e a r c h M o d e l a n d D e s i g n h o w e v e r , f o r r e a d e r c o n v e n i e n c e a n d t o a d d t o t h e c o m p r e h e n s i v e n e s s o f t h i s a p p e n d i x , i t i s r e s t a t e d h e r e . The R e s e a r c h M o d e l T h i s s t u d y i s c l a s s i f i e d a s a m a j o r t y p e q u a n t i t a t i v e - d e s c r i p t i v e , s u b - t y p e p o p u l a t i o n d e s c r i p t i o n , p i e c e o f r e s e a r c h ( T r i p o d i , F e l l i n , & M e y e r , 1 9 6 9 ) . T h e p u r p o s e o f t h i s q u a n t i t a t i v e - d e s c r i p t i v e r e s e a r c h i s t o d e s c r i b e " q u a n t i t a t i v e r e l a t i o n s a m o n g s p e c i f i e d v a r i a b l e s " ( T r i p o d i e t a l . p . 3 4 ) . Th e o b j e c t i v e o f t h i s t y p e o f s t u d y i s t o m e a s u r e s p e c i f i c v a r i a b l e s i n o r d e r t o a n s w e r s p e c i f i c q u e s t i o n s t h a t h a v e b e e n p o s e d b y t h e r e s e a r c h e r . I t i s i m p o r t a n t t h a t t h e v a r i a b l e s c a n be q u a n t i t a t i v e l y m e a s u r e d a n d t h a t t h e i n d i c a n t s a r e r e l i a b l e a n d v a l i d . S t u d i e s t h a t s e e k t o a c c u r a t e l y d e s c r i b e c h a r a c t e r i s t i c s o f p o p u l a t i o n s a r e t y p i c a l l y d e s i g n e d t o a n s w e r s p e c i f i c q u e s t i o n s p o s e d b y t h e i n v e s t i g a t o r . " T h e s e s t u d i e s u s u a l l y c o n t a i n t h e u s e o f s u r v e y p r o c e d u r e s , a n d t h e y h a v e t h e p u r p o s e o f d e s c r i b i n g s i m p l e f a c t s a b o u t s e l e c t e d p o p u l a t i o n s , o r g a n i z a t i o n s , o r o t h e r c o l l e c t i v i t i e s " ( T r i p o d i e t a l . , p . 3 9 ) . T h e d i s t i n c t i o n b e t w e e n t h i s t y p e o f s t u d y a n d o n e t h a t p r i m a r i l y s e e k s t o d i s c o v e r q u a n t i t a t i v e r e l a t i o n s a m o n g v a r i a b l e s i s t h a t i n -155-th i s type of study the res e a r c h e r i s l i k e l y to use r e l a t i o n s h i p s to answer s p e c i f i c questions that have guided the r e s e a r c h , r a t h e r than to use them f o r fo r m u l a t i n g f u t u r e hypotheses. P o p u l a t i o n d e s c r i p t i o n s t u d i e s do not re s e a r c h s p e c i f i c hypotheses nor do they i d e n t i f y dependent or independent v a r i a b l e s . Q u a n t i t a t i v e - d e s c r i p t i v e s t u d i e s u s u a l l y (though not always) employ sampling techniques t h a t can c l a i m r e p r e s e n t a t i v e n e s s and they f r e q u e n t l y c o n t a i n a l a r g e number of v a r i a b l e s . Reid & Smith (1981) suggest that the knowledge b u i l d i n g f u n c t i o n of d e s c r i p t i v e s t u d i e s i s to break the whole down i n t o " i n t e r c o n n e c t e d p a r t s to achieve as d e t a i l e d a p i c t u r e as p o s s i b l e . " They add, that t h i s knowledge b u i l d i n g f u n c t i o n can only be served however, " i f l i m i t a t i o n s of sample, measurements and so f o r t h are made e x p l i c i t . Otherwise the d e s c r i p t i o n s may be mi s l e a d i n g " (p. 70). The Research Design This was a n a t u r a l i s t i c study undertaken through a s e l f - a d m i n i s t e r e d , anonymous, mailed q u e s t i o n n a i r e . I t was a f i f t y item, eleven page instrument. F i v e of the questions were open-ended or free-answer ques t i o n s and the remaining f o r t y - f i v e were c l o s e d or fixed-answer q u e s t i o n s . The questions were designed to e l i c i t responses that would d e s c r i b e the c h a r a c t e r i s t i c s of the p r a c t i t i o n e r s , - 1 5 6 -t h e c h a r a c t e r i s t i c s o f a s p e c t s o f t h e i r s e r v i c e , a n d t h e c h a r a c t e r i s t i c s o f t h e i r c l i e n t s , w h i c h t o g e t h e r w o u l d d e s c r i b e p r i v a t e p r a c t i c e . P r a c t i t i o n e r s w e r e a s k e d a b o u t f a c t s , b e l i e f s , b e h a v i o u r s a n d i d e a l s a s t h e y p e r t a i n e d t o t h e i r p r a c t i c e s . T h e q u e s t i o n n a i r e s w e r e m a i l e d t o i n d i v i d u a l s b e l i e v e d t o m e e t t h e c r i t e r i a f o r t h e s t u d y a s o p e r a t i o n a l i z e d i n C h a p t e r 1 ( p . 2 9 ) , t h a t i s t h a t t h e y w e r e s o c i a l w o r k p r i v a t e p r a c t i t i o n e r s p r a c t i c i n g i n t h e G r e a t e r V a n c o u v e r a r e a o f B r i t i s h C o l u m b i a i n t h e s p r i n g o f 1 9 8 7 . T h e q u e s t i o n n a i r e s w e r e m a i l e d o u t o n a s i n g l e o c c a s i o n w i t h t h e f i r s t f o l l o w - u p b e i n g m a i l e d e i g h t d a y s l a t e r w h i c h was s l i g h t l y a h e a d o f t h e p l a n n e d t e n d a y s b e t w e e n m a i l i n g s b e c a u s e o f a n a n n o u n c e m e n t o f a n i m p e n d i n g m a i l s t r i k e . T h e s t r i k e d i d n o t m a t e r i a l i z e a n d a s e c o n d f o l l o w - u p was s e n t o u t a f t e r a f u r t h e r t e n d a y s . U n i t s , T i m i n g , S e t t i n g I n d i v i d u a l p r a c t i t i o n e r s w e r e s u r v e y e d o n a s i n g l e o c c a s i o n , m a k i n g t h i s a c r o s s - s e c t i o n a l s t u d y , w h i c h p r e s u m a b l y t o o k p l a c e a t t h e i r m a i l i n g a d d r e s s e s . S a m p l i n g T h e r e i s no m a n d i t o r y r e g i s t r a t i o n o f s o c i a l w o r k p r i v a t e p r a c t i t i o n e r s i n B r i t i s h C o l u m b i a , t h e r e f o r e t h e r e was no c o m p l e t e l i s t o f p r a c t i t i o n e r s p r a c t i c i n g p r i v a t e l y f r o m w h i c h t o e x t r a c t a r a n d o m s a m p l e . B e c a u s e t h e l i m i t s o f t h e p o p u l a t i o n w e r e u n k n o w n i t was d e c i d e d t o a r b i t r a r i l y define geographical boundaries and through the snowball method of sampling, seek to c o l l e c t a sample that would as c l o s e l y as p o s s i b l e include the e n t i r e p o p u l a t i o n . Snowball sampling, i s p a r t i c u l a r l y u s e f u l i f a p r a c t i t i o n e r / r e s e a r c h e r i s i n t e r e s t e d i n a very s p e c i a l population of l i m i t e d s i z e and only knows of a handful of appropriate persons from that p o p u l a t i o n . The procedure i s simply to gather data from the known persons and to request information from them as to other appropriate persons ( G r i n n e l l 1981, p. 88). I t i s acknowledged however, that although the snowball method of sampling, "taps people who are involved in s o c i a l networks, i t can miss people who may be i s o l a t e d from such networks" (Monnette et a l . 1986, p. 129). The B r i t i s h Columbia A s s o c i a t i o n of S o c i a l Workers (BCASW) and the A s s o c i a t i o n of P r o f e s s i o n a l S o c i a l Workers (APSW) each had a ro s t e r of members who were engaging i n p r i v a t e p r a c t i c e and these were obtained and included i n the sample. Memos were sent to a l l the f a c u l t y at the school of s o c i a l work and students were p o l l e d for the names of any s o c i a l work p r a c t i t i o n e r s who were p r a c t i c i n g p r i v a t e l y . A l s o , an advertisement was placed i n the BCASW newspaper, Perspectives asking for the names and addresses of anyone who would meet the c r i t e r i a for i n c l u s i o n in the sample. -158-A d d i t i o n a l names were gathered from the yel l o w pages of the telephone book. Family S e r v i c e s of Greater Vancouver was contacted f o r p o s s i b l e s u b j e c t s and a resource o f f i c e of the M i n i s t r y of S o c i a l S e r v i c e s and Housing was contacted for r e f e r r a l s i n the event that some of the p r a c t i t i o n e r s to whom they r e f e r would meet the cr i t e r i a . Many names were d u p l i c a t e d , having been suggested by more than one source, and s e v e r a l were o f f e r e d by three or four sources. U l t i m a t e l y f i f t y - f o u r d i f f e r e n t names were accumulated from the f o l l o w i n g s ources: Eighteen from the B C A S W r o s t e r ; f i f t e e n from p r o f e s s o r s and students at the School of S o c i a l Work; seven from the advertisement i n Per s p e c t I v e s ; s i x from the APSW r o s t e r ; s i x from the Yellow Pages of the telephone book; and two from a p r i v a t e agency. Many advertisements i n the Yellow Pages do not designate academic d i s c i p l i n e s and because of the large number i n v o l v e d , only those p r a c t i t i o n e r s who were confirmed as meeting the c r i t e r i a were i n c l u d e d i n the sample to r e c e i v e the m a i l i n g s . Approximately t h i r t y - f i v e of the addresses were confirmed as c u r r e n t , but the remaining nineteen or so were mailed out unconfirmed. In view of the f a c t that the i n d i v i d u a l s i n the sample were, " . . . s i m i l a r i n re s p e c t to the s e l e c t i o n c r i t e r i a " , t h i s was a homogeneous sample (Reid & Smith -159-1981, p. 80). Metho d o l o g i c a l O r i e n t a t i o n A q u a n t i t a t i v e data g a t h e r i n g instrument was chosen for a couple of reasons. One, i t was thought that busy p r o f e s s i o n a l s were more l i k e l y to respond to a q u a n t i t a t i v e data g a t h e r i n g instrument than they would be to respond to a q u a l i t a t i v e instrument, i f only because of ease of responding and the subsequent investment of l e s s time. And two, other r e s e a r c h i n the l i t e r a t u r e r e p o r t e d q u a n t i t a t i v e data, t h e r e f o r e f o r ease of comparisons i t seemed a p p r o p r i a t e . The Mailed Q u e s t i o n n a i r e The methodology of mailed q u e s t i o n n a i r e s was chosen as the data g a t h e r i n g instrument f o r t h i s study f o r s e v e r a l reasons which are d i s c u s s e d below. A thorough d i s c u s s i o n of Mailed Q u e s t i o n n a i r e Methodology i n general i s i n c l u d e d as Appendix C. Many of the reasons f o r choosing a mailed q u e s t i o n n a i r e over other methodologies were r e l a t e d to anonymity. Due to the s e n s i t i v e nature of some of the q u e s t i o n s - - f e e s charged, income, r e g i s t e r e d s o c i a l work s t a t u s and membership i n BCASW, i t was thought the best way to ins u r e the g r e a t e s t response r a t e would be to gather the data through an anonymous, s e l f - a d m i n i s t e r e d , mailed q u e s t i o n n a i r e . T h e o r e t i c a l l y a l l p r a c t i t i o n e r s who belong to BCASW must be r e g i s t e r e d and approved by the p r i v a t e p r a c t i c e -160-committee before they can p r a c t i c e p r i v a t e l y . As was suspected, t h i s was not the r e a l i t y i n a l l cases. It i s understood t h a t anonymity i s not always necessary with surveys, and i n f a c t there i s very l i t t l e i f any d i f f e r e n c e i n the r e t u r n r a t e between anonymous and c o n f i d e n t i a l q u e s t i o n n a i r e s when they are a d m i n i s t e r e d to a general p o p u l a t i o n . However, Sudman (1985) suggests t h i s i s not the case f o r p r o f e s s i o n a l s who have g r e a t e r concerns about c o n f i d e n t i a l i t y t h e r e f o r e i n t h i s case the o p p o r t u n i t y f o r anonymity i s seen as a d e f i n i t e s t r e n g t h of the methodology. Because of the g e o g r a p h i c a l and p r o f e s s i o n a l parameters of the study, i t was thought that respondents may have been known to the a d v i s i n g f a c u l t y . I t was t h e r e f o r e b e l i e v e d that i n d i v i d u a l s may have had an even stronger d e s i r e to remain anonymous, and i n l i g h t of the personal nature of some of the q u e s t i o n s , i t was f e l t there was an o b l i g a t i o n to insure i t . In a d d i t i o n , item and u n i t non-responses I n h i b i t optimal v a l i d i t y , r e l i a b i l i t y , and data analyses thus attempts were made to l i m i t non-responses, agai n , by i n s u r i n g anonymity. Strengths and l i m i t a t i o n s . The general s t r e n g t h s and l i m i t a t i o n s of mailed q u e s t i o n n a i r e methodology are a l s o covered i n Appendix C, t h e r e f o r e o n l y a few s t r e n g t h s and weaknesses that r e l a t e d i r e c t l y to t h i s r e s e a r c h w i l l be mentioned here. A s p e c i f i c s t r e n g t h of the mailed q u e s t i o n n a i r e -161-methodology r e l a t i v e to t h i s study, i s that i t i s an extremely w e l l s u i t e d methodology f o r su r v e y i n g p r o f e s s i o n a l p o p u l a t i o n s for the f o l l o w i n g reasons: Time c o n s t r a i n t s on p r o f e s s i o n a l s u s u a l l y prevent p e r s o n a l i n t e r v i e w s ; p r o f e s s i o n a l s are l i t e r a t e t h e r e f o r e they understand the questions and can answer with ease; and because p r o f e s s i o n a l s are members of s p e c i f i c groups, surveys r e l a t i v e to those groups u s u a l l y have high s a l i e n c e . One of the l i m i t a t i o n s of mailed q u e s t i o n n a i r e s i s that when r e p l y cards are not used, (as was the case i n v t h i s study) non-responses can not be followed up on. When t h i s i s the case, i t i s not known i n what way the respondents d i f f e r from the non-respondents, and n e i t h e r i s i t known whether the non-respondents i n f a c t met the c r i t e r i a f o r the study. T h e r e f o r e , the ab s o l u t e s i z e of the p o p u l a t i o n (which must be known i n order to hypothesize about the sample's r e p r e s e n t a t i v e n e s s ) , remains unknown. A d d i t i o n a l l y , the r e s u l t s may be biased due to the f a c t that respondents may be more motivated and i n t e r e s t e d than non-respondents. Depending upon the number of the non-respondents who a c t u a l l y met the c r i t e r i a but who chose not to p a r t i c i p a t e , t h i s study may d e s c r i b e the c h a r a c t e r i s t i c s of some of the most motivated and i n t e r e s t e d p r a c t i t i o n e r s . -162-V a l l d i t y a n d r e l i a b i l i t y . No s t a n d a r d i s e d s c a l e s w e r e u s e d i n t h i s s u r v e y , h o w e v e r w i t h r e g a r d t o t h e q u e s t i o n n a i r e t h a t was d e v i s e d a n d u t i l i z e d , v a l i d i t y a n d r e l i a b i l i t y w i l l b e d i s c u s s e d . A s s t a t e d p r e v i o u s l y , a n i n s t r u m e n t i s s a i d t o be v a l i d w h e n i t a c t u a l l y m e a s u r e s t h a t w h i c h i t s e t s o u t t o m e a s u r e , a n d w h e n i t m e a s u r e s t h a t w h i c h i t s e t s o u t t o m e a s u r e , a c c u r a t e l y . S i n c e a n i n s t r u m e n t c a n o n l y b e a s v a l i d a s t h e a c c u r a c y o f t h e c u m u l a t i v e d a t a i t e l i c i t s , n o n - r e s p o n s e s i n s u r v e y r e s e a r c h d i m i n i s h t h e v a l i d i t y o f t h e i n s t r u m e n t ( M o n n e t t e e t a l . , ( 1 9 8 6 ) . T h u s a n y p r e c a u t i o n s t a k e n t o i n c r e a s e t h e r e s p o n s e r a t e c a n be s a i d t o e n h a n c e t h e v a l i d i t y o f t h e i n s t r u m e n t . S e v e r a l s t r a t e g i e s m e n t i o n e d i n A p p e n d i x C u n d e r M a x i m i z i n g R e s p o n s e R a t e s a n d M i n i m i z i n g R e s p o n s e E r r o r s w e r e u t i l i z e d d u r i n g t h e c o n s t r u c t i o n o f t h e q u e s t i o n n a i r e f o r t h i s s u r v e y w h i c h e n h a n c e d t h e v a l i d i t y o f t h e i n s t r u m e n t . M a n y o f t h e s e c o n s i d e r a t i o n s h a d t h e e f f e c t o f i n c r e a s i n g r e l i a b i l i t y a s w e l l . T h e c o v e r i n g l e t t e r i n c l u d e d a l l t h e i n f o r m a t i o n a n d s t r a t e g i e s t h a t h a v e b e e n f o u n d t o be e f f e c t i v e i n i n c r e a s i n g t h e r e s p o n s e r a t e o f q u e s t i o n n a i r e s . S u c h s t r a t e g i e s a s u s i n g l e t t e r h e a d s h o w i n g s p o n s o r s h i p ; i n c l u d i n g s t a t e m e n t s e x p l a i n i n g t h e p u r p o s e o f t h e r e s e a r c h a n d r e a s o n s why t h e r e s p o n d e n t ' s p a r t i c i p a t i o n i s i m p o r t a n t ; g i v i n g a t i m e - c u e s t a t i n g c o n s i d e r a t i o n o f t h e -163-r e s p o n d e n t ' s t i m e ; m e n t i o n i n g c o m p l i a n c e w i t h e t h i c a l r e g u l a t i o n s ; i n s u r i n g a n o n y m i t y ; i n c l u d i n g t h e n o t i f i c a t i o n o f w h e r e r e s u l t s c o u l d be o b t a i n e d , a n d a f f i r m i n g t h a t p a r t i c i p a t i o n w as s t r i c t l y v o l u n t a r y , w e r e i n c l u d e d i n t h e l e t t e r . F o r e a s e o f r e t u r n i n g t h e s u r v e y , s e l f - a d d r e s s e d s t a m p e d e n v e l o p e s w e r e I n c l u d e d w i t h t h e q u e s t i o n n a i r e a n d t h e c o v e r i n g l e t t e r . When c o n s t r u c t i n g t h e q u e s t i o n n a i r e c o n s i d e r a t i o n was g i v e n t o t h e l o g i c a l o r d e r i n g o f q u e s t i o n s ; t h e f o r m a t o f t h e q u e s t i o n s f o r e a s e o f a n s w e r i n g , a n d t h e r e l e v a n c e o f t h e q u e s t i o n s t o t h e p u r p o s e o f t h e r e s e a r c h . I t i s a s s u m e d t h a t v a l i d i t y was e n h a n c e d b e c a u s e t h e r e w e r e no f u n n e l q u e s t i o n s . F u n n e l q u e s t i o n s b e g i n w i t h b r o a d c o n c e p t s a n d w o r k down t o m o r e s p e c i f i c o n e s . I t i s s u g g e s t e d t h a t i f r e s p o n d e n t s r e a d t h r o u g h t h e q u e s t i o n n a i r e b e f o r e b e g i n n i n g , t h i s c a n b i a s t h e i r a n s w e r s . B e c a u s e t h e s a m p l e was t o be t h e e n t i r e " k n o w n " p o p u l a t i o n , i t was i m p o s s i b l e t o p r e - t e s t t h e i n s t r u m e n t on s o c i a l w o r k p r i v a t e p r a c t i t i o n e r s w i t h o u t c o n t a m i n a t i n g t h e i r a n s w e r s t o t h e f i n a l q u e s t i o n n a i r e . T h e r e f o r e t h e f i r s t p r e - t e s t i n g was d o n e w i t h f i v e n o n - p r a c t i t i o n e r s w h i c h r e s u l t e d i n c h a n g e s t h a t i m p r o v e d t h e w o r d i n g a n d t h a t r e s u l t e d i n t h e d r o p p i n g o f some l e s s r e l e v a n t q u e s t i o n s . N e x t , t h r e e p r o f e s s o r s w e r e a s k e d f o r s u g g e s t i o n s a n d s e v e r a l m o d i f i c a t i o n s w e r e made. F i n a l l y -164-two p r i v a t e p r a c t i t i o n e r s who d i d not meet the c r i t e r i a for t h i s study p r e - t e s t e d the q u e s t i o n n a i r e and the f i n a l changes were made. I t i s assumed that those steps enhanced the v a l i d i t y of the instrument. As a r e s u l t of p r e - t e s t i n g some questions a s k i n g respondents about dependent c h i l d r e n and t h e i r need to provide c h i l d - c a r e were dropped because i t was thought they lacked s a l i e n c e . The answers to those q u e s t i o n s would have been of i n t e r e s t however e s p e c i a l l y r e l a t i v e t o the f i n d i n g s of Frisman et a l . r e g a r d i n g the s t r e n g t h of autonomy and f l e x i b i l i t y as m o t i v a t i n g f a c t o r s for females e n t e r i n g p r i v a t e p r a c t i c e . To i n c r e a s e v a l i d i t y , the o p e r a t i o n a l i z a t i o n of " p r i v a t e p r a c t i t i o n e r " f o r the purposes o f the r e s e a r c h was c i t e d on the face of the q u e s t i o n n a i r e . T h i s was done to help insure that p r a c t i t i o n e r s who r e c e i v e d the q u e s t i o n n a i r e and t h e r e f o r e who were able to respond, a c t u a l l y met the c r i t e r i a f o r the sample. It i s b e l i e v e d that v a l i d i t y was a l s o enhanced by c o n s i d e r a t i o n given to q u e s t i o n order. Immediately preceding the questions on fees charged, respondents were asked how they would l i k e fees to be charged In t h e i r " i d e a l " world. This was an attempt to acknowledge that some p r a c t i t i o n e r s may w e l l engage i n the f e e - f o r - s e r v i c e model by d e f a u l t r a t h e r than by c h o i c e . The " i d e a l world" q u e s t i o n gave respondents an o p p o r t u n i t y to express whether that was the case f o r them, p r i o r to answering the - 1 6 5 -q u e s t i o n o n f e e s . C o n s i d e r a t i o n was a l s o g i v e n t o t h e c o m f o r t o f t h e r e s p o n d e n t s i n t h a t t h e q u e s t i o n n a i r e was d e s i g n e d u s i n g a s s e r t i v e r a t h e r t h a n i n t e r r o g a t i v e s t a t e m e n t s . I t was h o p e d t h a t t h i s f a c i l i t a t e d a s e n s e o f i n f o r m a t i o n g i v i n g r a t h e r t h a n a s e n s e o f b e i n g i n t e r r o g a t e d . B o t h o f t h e t e r m s " i n t e r v e n t i o n " a n d " t r e a t m e n t " w e r e u s e d w h e r e v e r n e c e s s a r y s o a s n o t t o a l i e n a t e a n y p r a c t i t i o n e r who may h a v e f e l t m o r e c o m f o r t a b l e w i t h o n e o f t h e t e r m s o v e r t h e o t h e r . T h i s was a l s o a i m e d a t e l i m i n a t i n g a n y p e r c e i v e d r e s e a r c h e r b i a s . I t was e x p e c t e d t h a t v a l i d i t y was a l s o e n h a n c e d b y t h e a t t e n t i o n t o d e t a i l i n t h e w o r d i n g a n d t h e o p t i o n s o f some o f t h e m u l t i p l e - c h o i c e q u e s t i o n s . I n a f u r t h e r a t t e m p t t o a c t u a l l y m e a s u r e t h e c o n c e p t t h a t was b e i n g m e a s u r e d , q u e s t i o n #16 a s k e d r e s p o n d e n t s w h a t t h e y b e l i e v e d was t h e e c o n o m i c s i t u a t i o n o f t h e i r c l i e n t s . I t was b e l i e v e d t h a t b e c a u s e i t was i n d e e d t h e e c o n o m i c s i t u a t i o n o f t h e c l i e n t s t h a t was o f i n t e r e s t , t h a t t h e u s u a l q u e s t i o n o f i n c o m e w o u l d n o t be a n a c c u r a t e m e a s u r e m e n t w i t h o u t k n o w i n g m u c h m o r e a b o u t t h e c l i e n t s w h i c h w o u l d h a v e r e q u i r e d s e v e r a l m o r e q u e s t i o n s . I n o r d e r t o d e r i v e t h e e c o n o m i c s i t u a t i o n o f a c l i e n t f r o m t h e i r i n c o m e o n e w o u l d a l s o h a v e t o k n o w how many d e p e n d e n t s t h e p e r s o n h a d , w h e t h e r t h e y w e r e s o l e d e p e n d e n t s , p e r h a p s w h e t h e r t h e y w e r e m a r r i e d a n d i f s o w h e t h e r t h e y s h a r e d f i n a n c i a l r e s o u r c e s w i t h t h e i r - 1 6 6 -p a r t n e r , a n d w h a t t h e i r e x p e n s e s w e r e , e t c e t e r a . I n t h e m a j o r i t y o f c a s e s , m u l t i p l e c h o i c e q u e s t i o n s u t i l i z e d a f i v e - p o i n t s c a l e . B o t h v a l i d i t y a n d r e l i a b i l i t y a r e e n h a n c e d b y t h e u s e o f a f i v e p o i n t s c a l e o v e r a t w o , t h r e e o r f o u r - p o i n t s c a l e . V a l i d i t y i s e n h a n c e d b e c a u s e t h e g r e a t e r t h e d e s c r i m i n a t i o n , t h e m o r e l i k e l y t h a t t h e r e s u l t s w i l l r e f l e c t a n a c c u r a t e p i c t u r e a n d o f f e r i n g a n e u t r a l c a t e g o r y a d d s t o t h e r e s p o n d e n t ' s c o m f o r t . R e l i a b i l i t y i s e n h a n c e d b e c a u s e i n c a s e s w h e r e t h e n e u t r a l a n s w e r i s t h e m o s t t r u t h f u l a n s w e r t h e r e s p o n d e n t m u s t be a l l o w e d t o c h o o s e i t . T h e f i v e p o i n t f r e q u e n c y s c a l e was b e l i e v e d t o be a v a l i d m e a s u r e f o r b e h a v i o u r , a s many w i d e l y u s e d i n s t r u m e n t s u t i l i z e s i m i l a r s c a l e s - - a n e x a m p l e i s H u d s o n ' s C l i n i c a l M e a s u r e m e n t P a c k a g e ( G r i n n e l l 1 9 8 1 , p. 6 4 0 ) . The v a l i d i t y o f t h i s i n s t r u m e n t s h o u l d be s o m e w h a t s u p p o r t e d b y t h e f a c t t h a t many o f t h e f i n d i n g s a r e s i m i l a r t o t h o s e o f o t h e r s t u d i e s on p r i v a t e p r a c t i t i o n e r s a n d t h e i r p r a c t i c e s . R e l i a b i l i t y r e f e r s t o t h e i n s t r u m e n t s a b i l i t y t o y i e l d c o n s i s t e n t r e s u l t s ( M o n n e t t e e t a l . , 1 9 8 6 ) . C o n s i s t e n t r e s u l t s a r e d e p e n d e n t u p o n t h e r e s p o n d e n t ' s o p p o r t u n i t y t o a n s w e r h o n e s t l y w i t h o u t i n t e r f e r e n c e . A n o n y m i t y i n c r e a s e s t r u t h f u l n e s s a n d d e c r e a s e s t h e e f f e c t o f s o c i a l d e s i r a b i l i t y t h u s e n h a n c i n g r e l i a b i l i t y . C l e a r l a n g u a g e a n d e x p l i c i t i n s t r u c t i o n s a l s o e n h a n c e u n d e r s t a n d i n g t h u s f a c i l i t a t i n g h o n e s t a n s w e r s a n d r e l i a b i l i t y . - 1 6 7 -Th e wording of one q u e s t i o n however, (#42) o b v i o u s l y f o r c e d a choice that many people could not make because although they were asked to "check one" and an a l t e r n a t i v e of "Other" was o f f e r e d , n e a r l y one t h i r d of respondents (9 out of 31), checked more than one. There were no c o n f u s i n g compound q u e s t i o n s , and no branching questions which c o n t r i b u t e d to the r e l i a b i l i t y of t h i s instrument. In a d d i t i o n , surveys d i r e c t e d at s p e c i a l i n t e r e s t groups have greater r e l i a b i l i t y because the respondents are g e n e r a l l y knowledgeable about the s u b j e c t being surveyed. Mailed surveys a l s o have equivalence r e l i a b i l i t y because to the degree t h a t the respondents have the same understanding of the q u e s t i o n s , they respond to the same survey. - 1 6 8 -A p p e n d i x C: M a i l e d Q u e s t i o n n a i r e M e t h o d o l o g y M u c h o f t h e l i t e r a t u r e o n m a i l e d q u e s t i o n n a i r e s i s e n c o m p a s s e d i n t h e b r o a d e r t o p i c o f s u r v e y r e s e a r c h . S u r v e y r e s e a r c h i n c l u d e s f a c e - t o - f a c e i n t e r v i e w s , t e l e p h o n e i n t e r v i e w s , a n d q u e s t i o n n a i r e s t h a t a r e e i t h e r a d m i n i s t e r e d i n a g r o u p i n t h e p r e s e n c e o f t h e r e s e a r c h e r , o r s e l f - a d m i n i s t e r e d h a v i n g b e e n s e n t t h r o u g h t h e m a i l . T h i s a p p e n d i x d i s c u s s e s s u r v e y m e t h o d o l o g y r e l a t i v e t o t h i s r e s e a r c h , t h a t i s s e l f - a d m i n i s t e r e d m a i l e d q u e s t i o n n a i r e s . S u r v e y s h a v e b e c o m e a w i d e l y u s e d m e t h o d o l o g y i n s o c i a l s c i e n c e r e s e a r c h . I n t h e 1 9 8 2 v o l u m e o f S o c i a l Work R e s e a r c h a n d  A b s t r a c t s , 10 o f t h e 17 a r t i c l e s , o r 59 p e r c e n t , r e l i e d o n s u r v e y r e s e a r c h a s a m e t h o d o f d a t a c o l l e c t i o n . L i k e w i s e , i n t h e 1 9 8 2 v o l u m e o f t h e J o u r n a l o f H e a l t h a n d S o c i a l B e h a v i o r , 78 p e r c e n t o f t h e a r t i c l e s w e r e b a s e d , a t l e a s t i n p a r t , o n s u r v e y d a t a ( M o n n e t t e e t a l . 1 9 8 6 , p . 1 3 9 ) . S u r v e y m e t h o d o l o g y h a s c u t " a c r o s s l i t e r a t u r e b a s e s i n e d u c a t i o n , s o c i o l o g y , p s y c h o l o g y , a n d p o l i t i c a l s c i e n c e . I t h a s b e e n u s e d f o r p r o g r a m e v a l u a t i o n , n e e d s a s s e s s m e n t s , g a t h e r i n g i n f o r m a t i o n f o r n e g o t i a t i o n s a n d c o n s u l t a t i o n ... a n d f o r s c r e e n i n g p o t e n t i a l m e m b e r s f o r t h e r a p y g r o u p s " ( R u s s o 1 9 8 4 , p . 1 9 ) . M a i l e d q u e s t i o n n a i r e s a r e l e s s s u c c e s s f u l w i t h g e n e r a l p o p u l a t i o n s b e c a u s e t h e i r l e v e l o f i n t e r e s t i n t h e s u b j e c t -169-may be l o w . H o w e v e r w h e n s u r v e y i n g l a r g e n u m b e r s a c r o s s v a s t g e o g r a p h i c a l a r e a s , o n e may h a v e n o o t h e r c h o i c e b u t t o u s e t h i s m e t h o d . " S u r v e y s t y p i c a l l y i n v o l v e c o l l e c t i n g d a t a f r o m l a r g e s a m p l e s o f p e o p l e , w h i c h m e a n s t h e y a r e i d e a l f o r o b t a i n i n g d a t a r e p r e s e n t a t i v e o f p o p u l a t i o n s t o o l a r g e t o be d e a l t w i t h b y o t h e r m e t h o d s " ( M o n n e t t e e t a l . 1 9 8 1 , p. 1 3 9 ) . S p e c i a l i n t e r e s t g r o u p s a r e g e n e r a l l y a g o o d t a r g e t g r o u p f o r m a i l e d q u e s t i o n n a i r e s . P r o f e s s i o n a l s s u c h a s p h y s i c i a n s , t e a c h e r s , l a w y e r s , a n d s o c i a l w o r k e r s f a l l i n t o t h i s c a t e g o r y . P r o f e s s i o n a l s a r e g e n e r a l l y w e l l e d u c a t e d , t h e y a r e u s e d t o f i l l i n g o u t f o r m s , t h e y a r e g e n e r a l l y k n o w l e d g e a b l e o n t h e t o p i c , a n d b e c a u s e t h e y l e a d v e r y b u s y l i v e s , t h e y a r e m o s t d i f f i c u l t t o p i n d o w n f o r f a c e - t o - f a c e i n t e r v i e w s " ( M o n n e t t e e t a l . , 1 9 8 6 ; S u d m a n , 1 9 8 5 ; Sudman & B r a d b u r n , 1 9 8 4 ) . T h e p e o p l e f o r whom m a i l e d q u e s t i o n n a i r e s a r e n o t a p p r o p r i a t e , a r e t h e l e s s w e l l e d u c a t e d , o r t h e e l d e r l y ( D i l l m a n , 1 9 7 8 ; L o c k h a r t , 1 9 8 4 ; S u d m a n & B r a d b u r n , 1 9 8 4 ) . T h e s e g r o u p s h a v e s o m e t i m e s f o u n d r e a d i n g a n d u n d e r s t a n d i n g d i f f i c u l t . T h e y may be a f r a i d o f m a k i n g m i s t a k e s a n d o f a p p e a r i n g f o o l i s h , a n d b e c a u s e t h e y may h a v e h a d l i t t l e o r no e x p e r i e n c e i n f i l l i n g o u t q u e s t i o n n a i r e s t h e y s o m e t i m e s t e n d t o be s u s p i c i o u s ( S u d m a n & B r a n d b u r n , 1 9 8 4 ) . To d e t e r m i n e w h e t h e r a m a i l e d s u r v e y w o u l d b e t h e m o s t e f f e c t i v e m e t h o d f o r g a t h e r i n g i n f o r m a t i o n , o n e m u s t c o n s i d e r t h e f o l l o w i n g . W i l l I be s a m p l i n g t h e g e n e r a l p o p u l a t i o n , o r a s p e c i a l i n t e r e s t g r o u p ? W i l l t h e p e o p l e i n my s a m p l e be c l a s s i f i e d a s " b u s y p r o f e s s i o n a l s " ? I s my s a m p l e l i k e l y t o b e w e l l i n f o r m e d o n t h e t o p i c s o f my q u e s t i o n s ? W i l l t h e y f i n d t h e q u e s t i o n s a s k e d , i n t e r e s t i n g ? W i l l t h e q u e s t i o n s a s k e d b e t h r e a t e n i n g t o t h e m ? W h a t i s t h e e d u c a t i o n a l l e v e l o f my s a m p l e ? What i s t h e a v e r a g e a g e o f my s a m p l e ? W h a t i s t h e g e o g r a p h i c a l d i s t r i b u t i o n o f m s a m p l e ? How much t i m e d o I h a v e ? What i s my b u d g e t ? The k i n d o f d a t a t h a t c a n be g a t h e r e d b y q u e s t i o n n a i r e s a r e v a l u e s , b e l i e f s , a t t i t u d e s , a t t r i b u t e s b e h a v i o u r s , a n d f a c t s . I n m a i l e d s u r v e y s c o n c e p t s a r e n o t t e s t e d d i r e c t l y b u t a r e c o n v e r t e d i n t o m e a s u r a b l e v a r i a b l e s b y o p e r a t i o n a l i z i n g t h e m . T h e d e g r e e t o w h i c h o p e r a t i o n a l i z a t i o n s a c t u a l l y m e a s u r e a b s t r a c t c o n c e p t s i s t h e d e g r e e t o w h i c h t h e c o n c e p t i s b e i n g t e s t e d . " T h u s , b o t h a n o v e r a l l s e n s e o f d e t a i l a n d a c o m m i t m e n t t o f u l l i n v o l v e m e n t i n t h a t d e t a i l s e e m t o be n e c e s s a r y c o n d i t i o n s f o r d e v e l o p i n g a n d i m p l e m e n t i n g a s u c c e s s f u l s u r v e y s t u d y " ( A l t s c h u l d & L o w e r , 1 9 8 4 , p . 1 5 ) Th e T o t a l D e s i g n M e t h o d (TDM) i s o n e p r o d u c t o f a t t e n t i o n t o d e t a i l t h a t s p e c i f i c a l l y d e l i n i a t e s a s t e p - b y - s t e p p r o c e s s o f c a r r y i n g o u t a m a i l s u r v e y . I t c o v e r s s u c h d e t a i l s a s t h e s i z e , w e i g h t , a n d c o l o u r o f - 1 7 1 -p a p e r ; t h e f o l d i n g o f t h e q u e s t i o n n a i r e a s w e l l a s t h e c o v e r i n g l e t t e r ; a n d i t d e t a i l s t h e n u m b e r s a n d t h e t i m i n g s o f f o l l o w - u p c o n t a c t s ( D i l l m a n , 1 9 7 8 ) . I t a p p e a r s t h a t w h e n t h e TDM i s f o l l o w e d r e s p o n s e r a t e s a r e h i g h e r . H o w e v e r , t h e r e a r e t w o p r o b l e m s w i t h t h e TDM. T h e f i r s t i s t h a t t h e p r e s c r i p t i v e p r o c e d u r e s a r e s o d e t a i l e d t h a t m a n y p e o p l e c a n n o t , o r d o n o t , f o l l o w t h e m a n d t h e s e c o n d i s t h a t a l l t h e p r o c e d u r e s h a v e n o t b e e n t e s t e d i n d e p e n d e n t l y . T h e r e f o r e i t i s n o t k n o w n p r e c i s e l y t o w h a t e x t e n t e a c h o r a n y p a r t i c u l a r p r e s c r i p t i o n i s r e s p o n s i b l e f o r t h e h i g h e r r e s p o n s e r a t e ( D i l l m a n e t a l . , 1 9 8 4 ) . I t t h e r e f o r e s e e m s a p p r o p r i a t e t o r e v i e w o t h e r r e s e a r c h a n d a l t e r n a t i v e s t o t h e TDM. A l l a u t h o r s a g r e e t h a t q u e s t i o n n a i r e s m u s t be d e s i g n e d w i t h c l o s e a t t e n t i o n t o d e t a i l . When t h i s i s d o n e , a n d "When m a i l q u e s t i o n n a i r e s a r e u s e d a p p r o p r i a t e l y , t h e y c a n be e x p e c t e d t o p r o d u c e r e s u l t s r a n g i n g f r o m a l m o s t a s g o o d a s t o s u b s t a n t i a l l y b e t t e r t h a n t h o s e t h a t c a n be o b t a i n e d b y m o r e c o s t l y m e t h o d s " ( S u d m a n & B r a d b u r n , 1 9 8 4 , p . 3 3 ) . A l t h o u g h t h e s e a u t h o r s a l s o a d d , t h a t n o o n e i s i n t e r e s t e d i n b u y i n g u n s a t i s f a c t o r y r e s u l t s no m a t t e r w h a t t h e p r i c e . I n o r d e r t o a c h i e v e r e s u l t s t h a t a r e a s a c c u r a t e a s p o s s i b l e , o n e m u s t d e s i g n q u e s t i o n n a i r e s f o r m a x i m u m r e s p o n s e r a t e s , a n d f o r m i n i m u m r e s p o n s e e r r o r s ( M i n d e l , 1 9 8 1 ) . -172-M a x l m l z l n g R e s p o n s e R a t e s a n d M i n i m i z i n g R e s p o n s e E r r o r s T h e r e s p o n s e r a t e o f a m a i l e d q u e s t i o n n a i r e i s d e p e n d e n t u p o n many f a c t o r s . S a l i e n c e ( t h e d e g r e e t o w h i c h t h e s u b j e c t m a t t e r i s o f i m p o r t a n c e t o t h e r e s p o n d e n t ) , t i m i n g , t h e n a t u r e o f t h e c o v e r a n d e n d o r s e m e n t l e t t e r s , p e r s o n a l c o n t a c t , f o l l o w - u p p r o c e d u r e s , l i m i t e d t i m e d e m a n d s , g u a r a n t e e d c o n f i d e n t i a l i t y a n d o v e r a l l a t t e n t i o n t o d e t a i l w e r e l i s t e d b y A l t s c h u l d a n d L o w e r , ( 1 9 8 4 ) . S p o n s o r s h i p , a t t r a c t i v e n e s s , c l a r i t y , l e n g t h , e a s e o f r e s p o n d i n g a n d m a i l i n g b a c k t h e q u e s t i o n n a i r e w e r e s u g g e s t e d b y S e l l t i z e t a l . (1976) i n a d d i t i o n t o s a l i e n c e a n d n a t u r e o f t h e c o v e r i n g l e t t e r . B a u m g a r t n e r & H e b e r l e i n (1984) a l s o f o u n d t h a t s p o n s o r s h i p a f f e c t e d r e t u r n r a t e s . I n t h e U n i t e d S t a t e s a n d C a n a d a , r e s e a r c h s p o n s o r e d b y m a r k e t r e s e a r c h o r g a n i z a t i o n s r e c e i v e d a t e n p e r c e n t l o w e r r e s p o n s e r a t e t h a n o t h e r s , w h i l e g o v e r n m e n t a n d u n i v e r s i t y s p o n s o r e d r e s e a r c h r e c e i v e d a t e n p e r c e n t h i g h e r r e s p o n s e r a t e . W i t h s o many d i f f e r e n t f a c t o r s a f f e c t i n g t h e r e s p o n s e r a t e i t i s n o t s u r p r i s i n g t h a t t h e r e a r e many d i f f e r i n g a v e r a g e r e s p o n s e r a t e s r e p o r t e d i n t h e l i t e r a t u r e . T h e r e s p o n s e r a t e s o f t h e g e n e r a l p o p u l a t i o n a r e g e n e r a l l y l o w e r i n l a r g e c i t i e s i n t h e U n i t e d S t a t e s d u e t o t h e h i g h p e r c e n t a g e o f n o n - E n g l i s h s p e a k i n g r e s i d e n t s a n d d u e t o t h e f a c t t h a t s u s p i c i o n i s h i g h e r i n l a r g e -173-c i t i e s than i n r u r a l areas (Sudman & Bradburn, (1984). On average, the r e t u r n r a t e s f o r general p o p u l a t i o n s are between 54 and 77 percent, while surveys of p r o f e s s i o n a l s r e p o r t e d average r e t u r n r a t e s of between 50 and 80 percent (Sudman & Bradburn, (1984). A study of the o v e r a l l r e t u r n r a t e s found "that the average r e t u r n r a t e for mailed survey s t u d i e s p u b l i s h e d between 1965 and 1981 was 47.3 percent" ( M c K i l l i p , (1984, p. 85) . "He b e r l e i n & Baumgartner (1978) re p o r t e d t h a t survey r e t u r n r a t e s vary between an average of 46 percent f o r one m a i l i n g and an average of n e a r l y 86 percent f o r four m a i l i n g s " ( A l t s c h u l d & Lower, 1984, p. 5). Depending on how one c a l c u l a t e s t h e i r response r a t e , i t may be improved by a s k i n g respondents who are not going to p a r t i c i p a t e to r e t u r n t h e i r q u e s t i o n n a i r e blank. Dillman (1978) re p o r t e d two response r a t e formulas. One, response r a t e equals the number of r e t u r n s d i v i d e d by the number of q u e s t i o n n a i r e s mailed out times 100, ( t h i s concurs with J o l l i f f e , 1986 who suggests that non-responses i n c l u d e 'wrong a d d r e s s e s ' ) ; and two, response r a t e equals the number of r e t u r n s d i v i d e d by the number mailed out minus ( n o n - e l i g i b l e plus non-reachable) t i me s 10 0. "In f a c e - t o - f a c e and telephone i n t e r v i e w s a r e f u s a l i s not co n s i d e r e d such u n t i l a co n t a c t i s made. In mail s t u d i e s however, the opposite i s assumed. That i s , a -174-n o n - r e s p o r i 3 e Is a r e f u s a l u n t i l proven otherwise" (Dillman, 1978, p. 50). In a d d i t i o n to the reasons mentioned above f o r not responding, others i n c l u d e timing and i n t r u s i o n i n t o p r i v a c y . Sudman (1985) suggests with regard to p r o f e s s i o n a l s that non-responses can be due to the f a c t t h a t they are busy; that the value of the survey to the respondent i s not c l e a r ; that they are concerned about c o n f i d e n t i a l i t y , or that questions appear biased or do not o f f e r a complete range of answers. I t i s c l e a r t h a t many steps must be taken to encourage as many people as p o s s i b l e to respond. Envelopes and Stamps The p o t e n t i a l respondent's f i r s t c o n t a c t with the researc h e r i s f r e q u e n t l y the mailed package. I t i s e s s e n t i a l that the envelope look important. Using f i r s t c l a s s mail i s advised (as i t w i l l be forwarded or returned should the respondent have moved) and commemorative or r e g u l a r stamps seem to have a p o s i t i v e advantage over business r e p l y envelopes or metered m a i l . As always, however one must weigh the c o s t / b e n e f i t s of using t h i s type of postage . The Covering L e t t e r Once r e c e i v e d , i f the p o t e n t i a l respondent opens the envelope, the next c o n t a c t made i s through the c o v e r i n g l e t t e r . Issues not d e a l t with i n the c o v e r i n g l e t t e r , but that are r e l e v a n t to i t are, the t i t l e of the study and -175-th e p e r s o n a l i z a t i o n of the l e t t e r . Issues g e n e r a l l y addressed i n the c o v e r i n g l e t t e r are sponsorship, anonymity or c o n f i d e n t i a l i t y , i n c e n t i v e s i f they are o f f e r e d , time cues, and the r e t u r n date as w e l l as how the respondent was s e l e c t e d , the appeal f o r c o o p e r a t i o n i n the study e x p l a i n i n g why t h e i r response i s important, the purpose of the study, and how the f i n d i n g s w i l l be u t i l i z e d and re p o r t e d (Baumgartner & H e b e r l e i n , 1984; Dillman et a l , 1984; Monnette et a l , 1986; Sudman, 1985). The T i t l e The t i t l e of the q u e s t i o n n a i r e should a l s o be mentioned i n the c o v e r i n g l e t t e r as the t i t l e has been c i t e d as another important determiner i n the repondent's d e c i s i o n to p a r t i c i p a t e or not to p a r t i c i p a t e . The t i t l e should d e s c r i b e the survey and i t should make the purpose c l e a r . In the case of surveys of p r o f e s s i o n a l s , i t should make the p r o f e s s i o n a l relevance c l e a r to the respondent (Sudman, 1985). P e r s o n a l i z a t i o n Research on p e r s o n a l i z a t i o n of the c o v e r i n g l e t t e r appears to be i n c o n c l u s i v e . Baumgartner & H e b e r l e i n , (1984) suggest t h a t p e r s o n a l i z a t i o n " i n t e r a c t s with other f a c t o r s , such as type of p o p u l a t i o n surveyed, the t o p i c of the survey, and the sponsor" (p. 71). Sponsorship When d e c i d i n g on whether or not to s t a t e the sponsor, one must decide whether the sponsor w i l l have a negative -176-or a p o s i t i v e c o n n o t a t i o n to the p o t e n t i a l respondent. Some r e s e a r c h e r s have found that "appeals emphasizing b e n e f i t s to respondents and to sci e n c e produced higher response r a t e s than appeals to help the sponsor", while others showed that "no a p p e a l " got the h i g h e s t response r a t e ( H e b e r l e i n & Baumgartner, 1984, p. 71). Anonymity and C o n f i d e n t i a l i t y When a d d r e s s i n g the i s s u e of c o n f i d e n t i a l i t y or anonymity i t may be h e l p f u l to e x p l a i n t h a t , "Anonymous" means t h a t no. one i n c l u d i n g the r e s e a r c h e r , can l i n k a p a r t i c u l a r respondent's name to h i s or her q u e s t i o n n a i r e . " C o n f i d e n t i a l i t y " means t h a t , even though the r e s e a r c h e r can match respondents to t h e i r q u e s t i o n n a i r e s , the i n f o r m a t i o n w i l l be t r e a t e d c o l l e c t i v e l y , and no i n d i v i d u a l s w i l l be p u b l i c l y l i n k e d to t h e i r responses (Monnette et a l , 1986, p. 147). There i s l i t t l e evidence that among the general p o p u l a t i o n , anonymity i n c r e a s e s the response r a t e over c o n f i d e n t i a l i t y ( H e b e r l e i n & Baumgartner, 1984; Monnette et a l , 1986). T h i s may not be the case f o r p r o f e s s i o n a l s however, as Sudman, (1985) suggests, " I t Is n e i t h e r s u r p r i s i n g nor unreasonable t h a t p r o f e s s i o n a l s may have g r e a t e r concerns about c o n f i d e n t i a l i t y than do members of the g eneral p o p u l a t i o n " (p. 356). A r a t h e r r e s p e c t f u l way of d i s c u s s i n g c o n f i d e n t i a l i t y was suggested by Sudman, (1985), "We s h a l l never present data i n such d e t a i l , e i t h e r i n p r i n t e d or computerized form, that i n d i v i d u a l s could p o s s i b l y be i d e n t i f i e d " (p. 356). I t has a l s o been shown t h a t s e n s i t i v e q u e s t i o n s are more h o n e s t l y answered when anonymity i s guaranteed. And that s e n s i t i v e questions are more h o n e s t l y answered on a mailed q u e s t i o n n a i r e than they are d u r i n g a f a c e - t o - f a c e i n t e r v i e w ( S e l l t i z et a l . , 1976). One problem with anonymity i s that you cannot f i n d out whether those who responded d i f f e r e d g r e a t l y from those who d i d not respond (Dillman, 1978). Another problem i s that you do not know to whom you should send follow-up n o t i c e s or replacement q u e s t i o n n a i r e s . Both these problems can be overcome by sending a card with the q u e s t i o n n a i r e to be returned s e p e r a t e l y , showing whether the i n d i v i d u a l p a r t i c i p a t e d and returned the q u e s t i o n n a i r e , whether they chose not to p a r t i c i p a t e , or whether they d i d not meet the c r i t e r i a for the sample. I n c e n t i v e s If the use of i n c e n t i v e s , by way of monetary payments or by way of g i f t s , are to be used, t h i s too should be addressed i n the c o v e r i n g l e t t e r . I n c e n t i v e s , both p r e p a i d and promised ( g e n e r a l l y of approximately a 25 cent v a l u e ) , have proven to moderately increase response r a t e s with surveys of the general p o p u l a t i o n . Time Cue Covering l e t t e r s sometimes inform the respondent -178-approximately how long i t w i l l take them to complete the q u e s t i o n n a i r e . In one study, except fo r the time cue, the same q u e s t i o n n a i r e was sent to three separate groups. One group was t o l d the q u e s t i o n n a i r e would take 20 minutes and the response r a t e f o r t h a t group was 41.5 percent. Another group was given no time cue and the response r a t e for that group was 31.5 percent, while the t h i r d group was give a time cue of 40 minutes, and the response r a t e for that group was 25.5 percent. It appears that i f the amount of time i t w i l l take to complete the q u e s t i o n n a i r e i s 20 minutes or under i t may be b e n e f i c i a l to mention i t . On the other hand, i f i t w i l l take upwards of 40 minutes to complete, i t would be b e t t e r not to mention i t . Return Date Another issue sometimes mentioned in c o v e r i n g l e t t e r s i s the d e a d l i n e for r e t u r n i n g the survey. " V i v i n o (1977) found no e f f e c t for a d e a d l i n e of l e s s than two weeks on a s i n g l e m a i l i n g . However, Roberts and other (1978) found that a three-week d e a d l i n e i n c r e a s e d responses to an i n i t i a l m a i l i n g and to the f i r s t f o llow-up" (Baumgartner & H e b e r l e i n , 1984, p. 71). In a d d i t i o n to those i s s u e s p e r t a i n i n g to the c o v e r i n g l e t t e r , t h o u g h t f u l c o n s i d e r a t i o n must a l s o be given to a d d i t i o n a l i n f o r m a t i o n to be i n c l u d e d with the q u e s t i o n n a i r e , t e c h n i c a l aspects of the q u e s t i o n n a i r e such as s a l i e n c e , l e n g t h , format, wording, types of q u e s t i o n s , -179-and follow-ups. A d d i t i o n a l M a t e r i a l Sudman, (1985) b e l i e v e s that when su r v e y i n g p r o f e s s i o n a l s one should send as much i n f o r m a t i o n as i s e i t h e r p e r t i n e n t or s u p p o r t i v e of the appeal. He suggests that the p o t e n t i a l respondent may be swayed to p a r t i c i p a t e i f he or she reads i t , and If they don't read i t nothing i s l o s t . One problem with i n c l u d i n g a d d i t i o n a l m a t e r i a l i s t h a t i n most cases the co s t of m a i l i n g makes i t p r o h i b i t i v e . The Instrument Sa1ience Al1 questions on a q u e s t i o n n a i r e should be r e l e v a n t (Dillman, 1978; Mindel, 1981; Sudman, 1985). "Borrowing" questions from other q u e s t i o n n a i r e s i s not advised unless they are a b s o l u t l e y r e l e v a n t . " W r i t i n g questions f o r a p a r t i c u l a r q u e s t i o n n a i r e means doing them f o r (1) a p a r t i c u l a r p o p u l a t i o n , (2) a p a r t i c u l a r purpose, and (3) f o r placement next to other q u e s t i o n s i n the q u e s t i o n n a i r e " (Dillman, 1978, p. 96). With regard to s u r v e y i n g p r o f e s s i o n a l s , "To the extent that the q u e s t i o n n a i r e s t i c k s to a s i n g l e p r o f e s s i o n a l t o p i c , i t confirms the respondent's b e l i e f t h a t the survey i s a l e g i t i m a t e p r o f e s s i o n a l a c t i v i t y " (Sudman, 19 85, p. 3 52). Length If the length of the q u e s t i o n n a i r e i s of concern to -180-the r e s e a r c h e r , she should s t a t e i t . It i s a l s o r e s p e c t f u l to mention your r e s o l v e not to burden respondents ( A l t s c h u l d & Lower, 1984). Sudman and Bradburn (1984) b e l i e v e mailed q u e s t i o n n a i r e s need to be s h o r t e r than telephone or f a c e - t o - f a c e surveys because there i s no o p p o r t u n i t y f o r a f f i r m a t i o n or feedback d u r i n g completion of the survey. I would agree that there perhaps i s not as much op p o r t u n i t y , and they t h e r e f o r e should be s h o r t e r , however one can b u i l d p o s i t i v e reinforcement i n t o the q u e s t i o n n a i r e . Because the s a l i e n c e of the q u e s t i o n n a i r e i s g e n e r a l l y q u i t e low when su r v e y i n g the general p o p u l a t i o n , i t i s agreed that i n such cases the instrument should be kept q u i t e s h o r t . On the other hand, for s p e c i a l i n t e r e s t groups with high s a l i e n c e , 20 pages i s p o s s i b l e (Sudman & Bradburn, 1984). "Although r e s e a r c h by Lockhart & Russo (1981) i n d i c a t e s t hat the e f f e c t s of length on r e t u r n r a t e are n e g l i g i b l e , the p e r c e i v e d length may have an e f f e c t on w i l l i n g n e s s to p a r t i c i p a t e ..." ( A l t s c h u l d & Lower 1984, p. 15) . In d i s c u s s i n g response r a t e s of surveys that followed TDM, Dillman (1978) repo r t e d that there was no a p p r e c i a b l e d i f f e r e n c e i n the response r a t e s of surveys that were l e s s than 12 pages or 125 items. "This suggests that i n c r e a s i n g length up to the l i m i t -181-of twelve pages or 125 items does not have an adverse e f f e c t on response r a t e s . It f u r t h e r suggests that the maxim of 'the s h o r t e r the b e t t e r ' may r e p r e s e n t an o v e r s i m p l i f i c a t i o n or even a myth" (Dillman, 1978, p. 55). Even though the most recent author, Monnette et a l . (1986) suggests, "... i t i s probably a good idea to keep the q u e s t i o n n a i r e l e s s than 5 pages long" (p. 148); the l a s t word on the s u b j e c t goes to H e b e r l e i n & Baumgartner (1978), The length of a q u e s t i o n n a i r e , i n number of pages, does not a f f e c t the f i n a l response r a t e u n t i l the e f f e c t s of i n i t i a l response, the number of follow-ups, the use of a s p e c i a l t h i r d c o n t a c t and the s a l i e n c y of the t o p i c are c o n t r o l l e d (p. 455). The length however, may increase s a l i e n c e and s a l i e n c e and c o n t a c t s account fo r 50.5 percent of the v a r i a n c e i n f i n a l responses (p. 451). Format Questions should be organized by t o p i c and format and they should l o g i c a l l y flow from one to another (Dillman, 1978; Mindel, 1981). Questions must a l s o be accompanied by e x p l i c i t i n s t r u c t i o n s . When you want the respondent to " C i r c l e " , "Check" or "X" one and only one, you must s t a t e that e x p l i c i t l y . To minimize a d m i n i s t r a t i v e e r r o r s , answers can be numbered and thus can be precoded. Coding l i n e s can be p r i n t e d o f f i n the r i g h t hand margin with cue numbers for -182-ease of checking that the answers are on the r i g h t l i n e f o r e n t e r i n g them i n t o the computer (Mindel, 1981). For ease of readi n g and f o r responding, q u e s t i o n s are normally s e t i n lower case l e t t e r s while answers are set i n upper case (Dillman, 1978; Mindel, 1981). The q u e s t i o n n a i r e should begin with a q u e s t i o n t h a t i s r e l e v a n t , easy, n e u t r a l , and i t should apply to everyone. T h e r e a f t e r , w i t h i n the above g u i d e l i n e s of grouping by t o p i c and format, questions should f o l l o w a descending g r a d i e n t of importance (Mindel, 1981). T r a n s i t i o n statements should be used when s h i f t i n g t o p i c s and when moving i n t o demographic i n f o r m a t i o n - -for example, " F i n a l l y , we would l i k e to ask you a few questions about y o u r s e l f f o r s t a t i s t i c a l purposes" (Mindel, 19 81). Word ing When c o n s t r u c t i n g the q u e s t i o n n a i r e , one should always maintain tense order and c o n s i s t e n c y , and with few exceptions one should use the present tense (Monnette et a l . , 1986). One should know the knowledge l e v e l of respondents and wording should be kept simple and items s h o r t (Mindel, 1981). Researchers should not overestimate the e d u c a t i o n a l l e v e l of respondents (Dillman, 1978; Mindel, 1981). Compound questions (asking two questions w i t h i n one statement) should not be used, (Are you i n favor of f i g u r e s k a t i n g or hockey on the community ice?) One should not t a l k e i t h e r "up" or "down" to - 1 8 3 -r e s p o n d e n t s , a n d d o u b l e n e g a t i v e s s h o u l d be a v o i d e d ( D i l l m a n 1 9 7 8 ; L o c k h a r t , 1 9 8 4 ; P a y n e 1 9 5 1 ) . Do you not agree that the president should not send anymore troops overseas?. Q u e s t i o n s s h o u l d be w o r d e d s o t h a t t h e y a r e t e c h n i c a l l y c o r r e c t , s o t h a t t i m e r e f e r e n t s a r e a p p r o p r i a t e a n d u n b i a s e d , a n d s o t h a t w h e r e p o s s i b l e , t h e same c a t e g o r i e s t h a t h a v e b e e n u s e d i n o t h e r r e s e a r c h a r e u s e d i n o r d e r t h a t c o m p a r i s o n s c a n be made ( D i l l m a n , 1 9 7 8 ) . Q u e s t i o n s O p e n - e n d e d o r f r e e - a n s w e r q u e s t i o n s . P a y n e ( 1 9 5 1 ) s u g g e s t s t h a t a n o t h e r w a y o f i n t r o d u c i n g new s u b j e c t s i s t h r o u g h w h a t he c a l l s " f r e e - a n s w e r " q u e s t i o n s , o r w h a t a r e m o r e c o m m o n l y c a l l e d , o p e n - e n d e d q u e s t i o n s . O p e n - e n d e d q u e s t i o n s a r e q u e s t i o n s t o w h i c h t h e r e i s a v a s t i f n o t a n u n l i m i t e d n u m b e r o f a n s w e r s . T h e r e f o r e t h e y a r e a s k e d , a n d s p a c e I s p r o v i d e d f o r t h e r e s p o n d e n t t o a n s w e r f r e e l y , o r a s P a y n e s t a t e s i t , " u n i n f l u e n c e d " . T h e r e a r e b o t h p o s i t i v e a n d n e g a t i v e a s p e c t s o f o p e n - e n d e d q u e s t i o n s . Some p o s i t i v e a s p e c t s a r e t h a t t h e y a l l o w s u b j e c t s t o p r o v i d e b a c k g r o u n d i n f o r m a t i o n f o r i n t e r p r e t i n g a n s w e r s t o o t h e r q u e s t i o n s . T h e y a l s o a l l o w r e s p o n d e n t s t o h a v e t h e i r own s a y , t o c o n v e y i d e a s t h a t a r e i m p o r t a n t t o t h e m a s w e l l a s o f f e r i n g a n o p p o r t u n i t y t o e v a l u a t e a r g u m e n t s , e x p l o r e k n o w l e d g e a n d m e m o r y ( P a y n e , 1 9 5 1 ) . -184-Open-ended questions are a l s o a c o u r t e s y o f f e r i n g respondents an o p p o r t u n i t y to t e l l the re s e a r c h e r i n f o r m a t i o n t h a t they b e l i e v e i s important but t h a t they have not had a chance to express i n any of t h e i r other answers. In t h i s way, they a l s o reduce respondents' f r u s t r a t i o n , which i n t u r n encourages them to respond (Dillman, 1978; Mindel, 1981; Monnette et a l . , 1986; Sudman, 1978). Open-ended questions a l s o need to a l l o w f o r s h o r t answers because i f too much space i s l e f t the respondent may s p e c u l a t e that a lengthy answer i s r e q u i r e d . People worry about s p e l l i n g and e x p r e s s i n g themselves, t h e r e f o r e they may not answer the q u e s t i o n n a i r e (Sudman & Bradburn, 1984 ) . As f o r the negative aspects of open-ended q u e s t i o n s , Payne (1951) acknowledges that open-ended questions take up p r e c i o u s space, and Mindel (1981) suggests t h a t they are d i f f i c u l t to code and t h e r e f o r e they can introduce e r r o r . Although c l o s e d q u e s t i o n s are e a s i e r to code, they too can introduce e r r o r . Closed questions are a p p r o p r i a t e where a l l p o s s i b l e a l t e r n a t i v e s are known, are l i m i t e d i n number, and are c l e a r - c u t ( S e l l t i z et a l . , 1976; Monnette et a l . , 1986 ). Closed or f i x e d - a l t e r n a t i v e q u e s t i o n s . Closed q u e s t i o n s take s e v e r a l forms. Closed questions are forced c h o i c e . When only two c h o i c e s are o f f e r e d they are c a l l e d -185-dichotomous q u e s t i o n s . One must be very c a r e f u l with t h i s type of que s t i o n to insure that when onl y two ch o i c e s are o f f e r e d t h at they are indeed the only two p o s s i b i l i t i e s . A good example of a l e g i t i m a t e dichotomous q u e s t i o n i s : Please Indicate your sex, place an "X" on the l i n e next to MALE or FEMALE. One must be c a r e f u l not to bi a s dichotomous or two-way questions when o n l y one h a l f of the q u e s t i o n i s asked, e.g. "Are you i n favor of Sunday shopping?" As Payne, (1951) p o i n t s out, some of the no's may mean that they are opposed, but others may mean they are not t a k i n g s i d e s . A b e t t e r way of s t a t i n g the qu e s t i o n would be, "Are you i n favo r of Sunday shopping, or not? Therefore i n such cases i t i s necessary to add a DON'T KNOW or a NO OPINION category. If one i s not sure whether there i s indeed more than two c h o i c e s i t i s always b e t t e r to add a DON'T KNOW, or NO OPINION categor y (Sudman, 1985). Closed questions with ordered c h o i c e s are the type of questions that a l l o w the respondent a range of answers on a s c a l e that r e p r e s e n t s a continuum. An example would be a frequency s c a l e going from NEVER to ALWAYS. Closed questions with unordered responses have the respondents choose from among " d i s c r e t e unordered c a t e g o r i e s and they have respondents s e l e c t the one that best r e f l e c t s h i s or her s i t u a t i o n " (Dillman, 1978). P a r t i a l l y c l o s e d questions o f f e r some c h o i c e s , but -186-the respondent has the o p t i o n of c r e a t i n g t h e i r own, e.g. a s e r i e s of options ending with "OTHER" category (Dillman, 1978). By using c l o s e d questions when a l l the a l t e r n a t i v e s are not known or not i n c l u d e d , b i a s e s the qu e s t i o n by suggesting some but not other responses ( S e l l t i z et a l . , 1976). "Fixed a l t e r n a t i v e questions however, have the advantage of being simple to administer and quick and r e l a t i v e l y inexpensive to a n a l y z e " ( S e l l t i z et a l . 1976, p. 312). F u r t h e r , they serve to " c a l l a l l the a l t e r n a t i v e s to each respondent's a t t e n t i o n and thereby put a l l respondents on the same f o o t i n g " (Payne (1951). Threatening q u e s t i o n s . Another issue we must be concerned with i n an attempt to maximize r e t u r n s while minimizing e r r o r s i s the is s u e of t h r e a t e n i n g questions or questions that are s u b j e c t to a s o c i a l d e s i r a b i l i t y b i a s . Threatening questions are those questions to which respondents f e e l that s o c i e t y has a " r i g h t " answer. Conversely, non-threatening questions are those f o r which there appears to be no " r i g h t " answer. Non-threatening questions are not a f f e c t e d by the a d m i n i s t r a t i o n of the q u e s t i o n n a i r e (Sudman & Bradburn, 1984). "Face-to-face i n t e r v i e w s have the hi g h e s t p r o b a b i l i t y f o r producing s o c i a l l y d e s i r a b l e answers, the telephone survey next, and the mail survey l e a s t " (Dillman 1978, p. 63) . When aski n g questions that are s u b j e c t to s o c i a l -187-d e s i r a b i l i t y , they are b e t t e r asked i n the t h i r d person, i . e . "Many people believe State a l l s i d e s of the issue and then ask With which statement do you most agree? P u t t i n g the q u e s t i o n i n context of the t h i r d person helps people overcome t h e i r o b j e c t i o n to the q u e s t i o n (Dillman, 1978; Payne, 1951). A l s o , s e n s i t i v e questions can be made l e s s o b j e c t i o n a b l e by a s k i n g people to check c a t e g o r i e s r a t h e r than a s k i n g f o r s p e c i f i c d e t a i l s . For instance r a t h e r than a s k i n g What was your family's t o t a l income l a s t year before taxes? S e v e r a l c a t e g o r i e s can be l i s t e d and the respondents can be asked to please check the ca t e g o r y that best r e p r e s e n t s t h e i r f a m i l i e s t o t a l income for the l a s t year before taxes (Dillman, 1978). Rank ordered q u e s t i o n s . E r r o r s can a l s o be introduced i n mailed q u e s t i o n n a i r e s through a misunderstanding of the q u e s t i o n . Rank order q u e s t i o n s are o f t e n s u b j e c t to m i s i n t e r p r e t a t i o n . Mindel, (1981) s t r o n g l y suggests a g a i n s t using rank order s t y l e of q u e s t i o n s , because by rank o r d e r i n g the means of a l l the p o s s i b l e answers, you get the same e f f e c t f o r the whole group . Funnel q u e s t i o n s . Funnel questions should a l s o not be used i n mail q u e s t i o n n a i r e s because the questions that f o l l o w , b i a s the previous ones when the q u e s t i o n n a i r e i s read through p r i o r to answering (Sudman & Bradburn, 1984). Branching q u e s t i o n s . Another source f o r i n t r o d u c i n g -188-e r r o r on mailed q u e s t i o n n a i r e s i s branching q u e s t i o n s . Questions t h a t branch any more than once are not a p p r o p r i a t e f o r mailed q u e s t i o n n a i r e s and depending upon the p o p u l a t i o n being surveyed, one branch may be a source of major e r r o r s . Sudman & Bradburn (1984) suggest one way around branching i s to send out two s e q u e n t i a l q u e s t i o n n a i r e s . One f o r s c r e e n i n g , and the other f o r s u b s t a n t i v e i s s u e s to the a p p r o p r i a t e respondents. Sleeper q u e s t i o n s . One way of checking f o r b i a s i s through s l e e p e r q u e s t i o n s . Payne, (1951) e x p l a i n s that a s l e e p e r q u e s t i o n i s a q u e s t i o n that asks about something f i c t i t i o u s In order to judge the amount of guessing that i s t a k i n g place on the q u e s t i o n n a i r e . Opportunity f o r n e u t r a l response. In Sudman's (19 85) r e p o r t on r e l u c t a n t p r o f e s s i o n a l s he suggests that most respondents p r e f e r a s c a l e of f i v e or seven items which i n c l u d e s a n e u t r a l c h o i c e . Where such s c a l e s are used i t i s cautioned to be sure that the s c a l e i t s e l f i s unbiased and that the middle o p t i o n i s indeed n e u t r a l . A t t i t u d e , a t t r i b u t e , behaviour and b e l i e f q u e s t i o n s . A t t i t u d e questions r e g i s t e r p o s i t i v e or negative f e e l i n g s about t h i n g s . These que s t i o n s g e n e r a l l y i n c l u d e options such as, "favour versus oppose, p r e f e r versus not p r e f e r , should versus should not, good versus bad, r i g h t versus wrong, or d e s i r a b l e versus u n d e s i r a b l e " (Dillman, 1978, p. 81). A t t r i b u t e questions ask f o r personal or demographic -189-c h a r a c t e r i s t i e s such as age, e d u c a t i o n , sex, race, and r e l i g i o n (Dillman, 1978). Dillm a n , (1978) b e l i e v e s t h a t behaviour questions ask people about what they are doing now. However, S e l l t i z et a l . (1976) b e l i e v e s that we can determine a persons past and the present behaviour because, "How a person has behaved i n the past i n a c e r t a i n type of s i t u a t i o n i s , i n the absence of c o n t r a d i c t o r y evidence, an i n d i c a t i o n of what the person's f u t u r e behaviour w i l l be i n s i m i l a r s i t u a t i o n s " (p. 307). B e l i e f questions are what a person b e l i e v e s to be t r u e or f a l s e . "There i s no i m p l i e d goodness or badness i n b e l i e f s , but o n l y an assessment of what one t h i n k s e x i s t s or does not e x i s t . Choices that are t y p i c a l l y i m p l i e d by b e l i e f q u e s t i o n s i n c l u d e c o r r e c t versus i n c o r r e c t , a c c u r a t e versus i n a c c u r a t e , and what happened versus what d i d not happen" (Dillma n , 1978, p. 81). Mindel, (1981) b e l i e v e s t h a t b e l i e f s can be reached by q u e s t i o n s such as: Under these c i r c u m s t a n c e s , would you be more l i k e l y to a ) , b), or c)? Follow-Ups Follow-ups are another very important s t r a t e g y f o r i n c r e a s i n g response r a t e s . Baumgartner & H e b e r l e i n (1984) r e p o r t that follow-ups are the best s i n g l e p r e d i c t o r of i n c r e a s e d response r a t e s . Each follow-up i n c r e a s e d t h e i r response r a t e by 7.4 percent. A l s o , e n c l o s i n g a second q u e s t i o n n a i r e had g r e a t e r e f f e c t i f i t was i n c l u d e d with -190-the second follow-up r a t h e r than with the f i r s t . "The T o t a l Design Method follow-up procedures i n c l u d e three c a r e f u l l y timed m a i l i n g s , each of which d i f f e r s s u b s t a n t i a l l y from the o t h e r s " (Dillman, 1978, p.180). The TDM a l s o i n c l u d e s e n c l o s i n g replacement q u e s t i o n n a i r e s i n the second and a l s o the t h i r d follow-up. Lockhart (1984) agrees t h a t follow-ups work w e l l , and more follow-ups work b e t t e r . Vigderhous (1978) adds, " I t may a l s o be suggested that the longer the time elapsed between m a i l i n g t h e - f i r s t q u e s t i o n n a i r e and the reminder, the l e s s e f f e c t i v e i s the reminder i t s e l f (the i n d i v i d u a l might f o r g e t that he r e c e i v e d a q u e s t i o n n a i r e or he might lose i t ) " (p. 88). S t r e n g t h s and L i m i t a t i o n s Strengths There are s e v e r a l advantages of mailed q u e s t i o n n a i r e s . They are a quick e f f i c i e n t method of c o l l e c t i n g data from l a r g e groups d i s p e r s e d over vast g e o r g a p h i c a l areas. The anonymity that can be o f f e r e d through mailed q u e s t i o n n a i r e s i n c r e a s e s responses to t h r e a t e n i n g questions and enhances v a l i d i t y due to the lack of a " s o c i a l d e s i r a b i l i t y " b i a s and due to i n c r e a s e d response r a t e s . S o c i a l d e s i r a b i l i t y i s the "tendency to give a favourable impression of o n e s e l f " when answering ques t i o n s ( G r i n n e l l 1981, p. 126). Response r a t e s are a l s o enhanced by the f a c t that mailed q u e s t i o n n a i r e s can be responded to at the s u b j e c t ' s convenience. -191-There i s no i n t e r v i e w e r b i a s such as the "halo e f f e c t " with mailed q u e s t i o n n a i r e s and there i s s t a n d a r d i z a t i o n to the degree t h a t each respondent understands the questions i n the same way. The "halo e f f e c t " i s the tendency of the i n t e r v i e w e r to be unduly i n f l u e n c e d by a s i n g l e favourable t r a i t or to l e t h i s or her g e n e r a l impression a f f e c t t h e i r r a t i n g s of a s i n g l e t r a i t or c h a r a c t e r i s t i c ( G r i n n e l l 1981, p. 126). The u n i f o r m i t y of the q u e s t i o n n a i r e a l s o r e s u l t s i n uniform measures which c o n t r i b u t e s to the ease of a n a l y s i s . T h i s g r e a t l y enhances the f e a s i b i l i t y of re s e a r c h when time and resources are l i m i t e d . In a d d i t i o n , mailed q u e s t i o n n a i r e s a l l o w respondents to r e f l e c t upon t h e i r answers and to look up i n f o r m a t i o n in order to answer f a c t u a l l y . That o p p o r t u n i t y may enhance the v a l i d i t y and the r e l i a b i l i t y of the study, as an instrument i s only v a l i d to the degree that i t a c c u r a t e l y measures that which i t se t s out to measure, and i s only r e l i a b l e to the degree that i t i s able to y i e l d c o n s i s t e n t r e s u l t s . L i m i t a t i o n s Mailed q u e s t i o n n a i r e s cannot a c c u r a t e l y and s u c c e s s f u l l y measure what they set out to measure i f the respondents do not respond. It i s imperative that respondents be i n t e r e s t e d enough to respond, that they are knowledgeable on the s u b j e c t being surveyed, that they be l i t e r a t e , t h a t they -192-have a c c u r a t e r e c a l l , and t h a t they understand the language i n which the q u e s t i o n n a i r e i s w r i t t e n . The q u e s t i o n n a i r e must be kept simple, and must be worded i n such a way as to make responding r e l a t i v e l y easy. As mentioned i n Appendix B, when r e p l y cards are not used one of the l i m i t a t i o n s r e s u l t i n g from i n s u r i n g anonymity i s t h a t non-responses can not be f o l l o w e d up on. When t h i s i s the case i t t h e r e f o r e i s not known In what ways the respondents d i f f e r from the non-respondents, and n e i t h e r i s i t known whether the non-respondents i n f a c t met the c r i t e r i a f o r the study. Having d i s c u s s e d the methodology of mailed q u e s t i o n n a i r e s , I t h i n k i t i s important to quote Dillman (1978), one l a s t time. The manner in which [ q u e s t i o n n a i r e s ) are used i s j u s t as important as whether they are used a t a l l . Unless they are used c a r e f u l l y , and with e t h i c a l concern, what now seems l i k e a boon to s o c i a l s c i e n c e may i n the end be an unfortunate and r e g r e t t a b l e boondoggle" (P. 237). 

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