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The use of professional time in relation to case content and services rendered : an exploratory analysis… Cornwall, Charlotte Elizabeth 1956

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THE USE OF PROFESS IO HAL TIME IN RELATION TO  CASE CONTENT AND SERVICES RENDERED. An Exploratory Analysis based on a Representative Group of Cases car r i e d by the Children*s A i d Society of Vancouver, and the Agency Time Study of June, 1955. by CHARLOTTE ELIZABETH CORNWALL Thesis Submitted i n P a r t i a l Fulfilment of the Requirements f o r the Degree of MASTER OF SOCIAL WORK In the School of S o c i a l Work Accepted as conforming to the standard required f o r the degree of iter of S o c i a l W5rk School of Sooial Work 1956 The University of B r i t i s h Columbia i i TABLE OP CONTENTS Chapter 1. Professional Times One Important Component Pag© i n the Provision of C h i l d Welfare Services Current demand f o r s o c i a l workers exceeds supply. Sound general c h i l d welfare services are e s s e n t i a l f o r community mental and s o o i a l health. The problem of achieving both coverage and q u a l i t y . The use of profession-a l time per se has received l i t t l e a ttention. The Children's A i d Society of Vancouver aeleoted f o r study* B r i e f h i s t o r y of the Society. Statement of function and services. Method used i n making study. 1. Ghapter 2*. The D i f f e r e n t i a l Approach to Caseload Literature on time studies and oaseloads. Children's A i d Society time study of June, 1955. Numbers of v i s i t s and interviews i n June 1955. Types of oases c a r r i e d - family cases, f o s t e r homes, adoptive applicants, children i n care, children on adoption probation. Findings regarding a c t i v i t y and I n a c t i v i t y . Time study findings compared to case f i n d i n g s . ........ •......... •...... •<•. •............... 20. Ghapter S* An Appraisal of Casework Services C r i t e r i a f o r Judging adequacy of service. Q u a l i t a t i v e ratings regarding service. Intake In the Children's A i d Society. Case examples of adequate, f a i r l y adequate and inadequate service. Relationship of a v a i l a b i l i t y of time to q u a l i t y of service. 48. Chapter 4. D i r e c t Service to C l i e n t s . D i s t r i b u t i n g the , Res p o n s i b i l i t y of the Professional Worker* Representative q u a l i t y of oase material on which study i s based. Evaluation of services rendered. Variables regarding the use of time. Percentage of time spent on v i s i t s and Interviews. Other factors influencing q u a l i t y of service. Caseload count. Recommendations. Suggestions f o r further res earch. Conolus ion. 84, Appendices: A. Survey Schedule f o r Family Gases. B. Survey Schedule f o r Foster Homes. C. Survey Schedule f o r Adoptive Applicants. D. Survey Schedule f o r Children i n Care. E. Survey Schedule f o r Children on Adoption Probation. F. Summary Sheet f o r Family Cases. G. Summary Sheet f o r Foster Homes. H. Summary Sheet f o r Adoptive Applicants. I. Summary Sheet f o r Children In Care. J. Summary Sheet f o r Children on Adoption Probation. K. Schedule used f o r C.A.S. Time Study, June 1955. L. Bibliography. i l l TABLES EE THE TEXT Page-Table 1. V i s i t s and Interviews by S o c i a l Workers: Children's A i d Sooiety-(Vancouver),-June 1955 24. Table 2. Types of Family Cases i n Sample Group ........... 27. Table 3. M a r i t a l Status of Parents, Humbera and Status o f C h i l d r e n ............ o. 29. Tabl© 4.. Comparison of Sample to 1©55 S t a t i s t i c s on-the B a s i s of Age Groups 36. Tabl© 5. I n d i c a t i o n s of Case Status and A c t i v i t y , ... = .= Chi l d r e n ' s A i d S o c i e t y (Vancouver), June 1955 ....... «..o............................ 45. Tabl© 6. Q u a l i t a t i v e Ratings on S e r v i c e s Rendered ........ 52. Table 7. Intake i n the Chi l d r e n ' s A i d S o c i e t y (Vancouver), 1955 55. Table 8. E v a l u a t i o n of S e r v i c e s Given and Time-Service Factors 83.A. Table 9. Summary of Adequacy of S e r v i c e and Time-S e r v i c e Ratings 83.Bo Iv ABSTRACT While I t i s generally accepted that b a s i c c h i l d welfare services are e s s e n t i a l , i n s u f f i c i e n t attention has yet been granted to the problems of (a) the shortage of p r o f e s s i o n a l l y q u a l i f i e d s o c i a l workers i n r e l a t i o n to the many types of need, (b) making the best use of professional personnel In r e l a t i o n to S p e c i f i c Job content, {©) s e t t i n g up c r i t e r i a on p r i o r i t y Indications f o r the d i f f e r e n t f i e l d s of s o c i a l work, which, In ft children's agency alone can be separated into many categories. As an approach to some of these patterns, a study was devised to review the main branches of the Vancouver Children's A i d Society caseload, using an administrative ''time study" made i n 1955 as a base. Aiming a t a group of cases representa-tive of an average worker's share of r e s p o n s i b i l i t y , cases were selected proportionately from f i v e main areas, (a) family cases, (Including services to unmarrled mothers), (b) fos ter homes, (c) adoptive applicants, (d) children i n care, and (e) children on adoption probation. (1) V i s i t s and interviews ca r r i e d out i n one month (June 1955) on behalf of these c l i e n t s , are tabulated and compared with those undertaken by the "average worker1* In th© agency time study, (2) service rendered i s q u a l i t a t i v e l y rated f o r each ease, and (3) case i l l u s t r a t i o n s are employed as a further a i d to evaluation. In a summary assessment, (4) the r e l a t i o n of a v a i l a b i l i t y of worker-time to the adequacy of service l a examined. Using a threefold r a t i n g of s e r v i c e , i t l a estimated that i n the 83 sample eases adequate or f a i r service was given In 66 eases. The q u a l i t y of service i n 45 cases was judged to be not affected by lack of worker-time, although i t was an important cause of l i m i t a t i o n of service i n the remaining 38. The proportion of t o t a l time revealed as spent on v i s i t s and interviews, 23 - 28 percent, i s s i m i l a r to that of the few other agencies which have studied this matter, but must be regarded as low i f d i r e c t service to c l i e n t s i s considered to be the chief r e s p o n s i b i l i t y of q u a l i f i e d s o c i a l workers. Possible methods of increasing time spent on v i s i t s and interviews are suggested, and subjects requiring further research are indicated. v Acknowledgements I wish to express my thanks and appreciation to all those whoso Interest and help have made this study possible. I am particularly indebted to Miss Cecil Hay-Shaw and Dr. Leonard C. Marsh of the Sohool of Social Work,,, university of British Columbia, for their sound advice, helpful criticisms and constant encouragement. I should also like to express my gratitude to Miss Dorothy L, Coombs* Executive Director of the Children*s Aid Society of Vancouver, and to her staff, for the co-operation and help ^hich were so freely accorded. THE USE OP PROFESSIONAL TIME • IN RELATION TO CASE CONTENT AND SERVICES RENDERED. Chapter 1. Professional Time; One Important Component In the Provision of  C h i l d Welfare Services. A v a i l a b i l i t y of professional s o c i a l workers, both as architects and as builders w i l l have decisive influence on the structure and adequacy of the welfare services of the future. Although numbers of s o c i a l workers have increased r a p i d l y since World War I, the tendency f o r demand to outrun supply has become so serious that continuing councils on education f o r s o c i a l work have been set up by l a y and professional bodies both i n Canada and the United States, i n order to t r y to f i n d a sol u t i o n to th i s p r o b l e m . I n the present s i t u a t i o n of intense competition f o r able s t a f f , and of rapid, and e s s e n t i a l l y unplanned development of s p e c i a l i z e d services, i t i s important that s o c i a l workers at l e a s t begin to consider the question of p r i o r i t i e s In the use of time and of personnel. I t seems safe to assume that there Is general agreement among lay and professional groups that basic c h i l d welfare services are among the most Important i n the community. Even a t the time of Socrates 2 wise men understood the s p e c i a l value and v u l n e r a b i l i t y of children. 1. Report on the Western Regional Workshop on S o c i a l Work  Education r Banff, Canada, January 20 and 21, 1955, p. 53. 2. Socrates, "Could I climb to the highest place In Athens I would l i f t my voice and proclaim 'Fellow c i t i z e n s , why do you turn and scrape every stone to gather wealth and take ao l i t t l e care of your children to whom, one day, you must r e l i n q u i s h i t a l l . ' " 2 However, i t is only in comparatively rooent times that experts have demonstrated in precise detail the direct relationship which exists between the affectionless, deprived child and the affectionless, anti-social adult, who in turn. Is unable to give love and care to his children, thus perpetuating the dreary cycle of mental Illness, delinquency and dependency. To quote John Bowlby, nThe proper care of children deprived of a normal home l i f e can now be seen to be not merely an act of common humanity, but to be essential for the mental and social welfare of a community. For when their care is neglected, as happens in every country of the Western World today, they grow up to reproduce themselves. Deprived children, whether in their own homes or out of them, are a source of social Infection as real and serious as are carriers of diphtheria and typhoid ... To those charged with preventive action the present position may be likened to that facing their predecessors responsible for public health a century ago. .....Let i t be hoped, then, that a l l over the world men and women in public l i f e w i l l recognize the relation of mental health to maternal care, and w i l l seize their opportunities for promoting courageous and far-reaching reforms1*1. 1. Bowlby, John, Maternal Care and Mental Health, World Health Organization, Monograph Series, Geneva, 1952, pp 157-8. 3 The b e l i e f that evaluative research i n the c h i l d welfare f i e l d Is not only possible, but b e n e f i c i a l , has been advanced by A l f r e d J. Kahn of the New York School of S o c i a l Work* He writes, "The effectiveness of c h i l d care services can be determined, given willingness to tackle d i f f i c u l t problems of research design and the courage to face the findings ... The very decision,to undertake evaluative studies i n agencies and research centres w i l l spark the f i e l d to formulate c l e a r questions and consider research plans, the consequent discussion and decision-making cannot but have a salutary e f f e c t on p r a c t i c e " * . The problem as to how the q u a l i t y of service can be blended with broad coverage has vexed the profession of s o c i a l work f o r some years, "The great modern dilemma i s the s i z e of program without loss of those human values and truths inherent i n basic p r i n c i p l e s , " ^ Many private agencies have been able to l i m i t t h e i r intake and accept no more cases than the number to which they believe t h e i r s t a f f can give good service. : However i n general, these decisions have been arrived at by the board, executive, and s t a f f ; o f i n d i v i d u a l agencies, often with l i t t l e reference to the needs of the community and the services rendered by other agencies. 1, Kahn, A l f r e d J , , "Can Effectiveness of C h i l d Care be Determined?" C h i l d Welfare, C h i l d Welfare League of America, New York. February 1954, Vol 33 p. 3. 2, Hutchinson, Dorothy - "Basic P r i n c i p l e s In C h i l d Welfare", Selected Papers i n Casework, National Conference of S o c i a l Work 1952, Raleigh N.C., Health Publications Institute I n c , (Copyright 1953) p. 121. 4 Ag a r e s u l t , i t l a possible to f i n d the anomalous s i t u a t i o n of t o p - f l i g h t agencies, which make available a s k i l l e d standard of service to a l i m i t e d c l i e n t e l e , operating i n the same community with public services wher© the standards are poor and where the s o c i a l work practice may a c t u a l l y create or perpetuate problems which can never be solved, or can be solved only at great expense. To quote Charlotte Towle "As one example of poorly co-ordinated planning, at the l o c a l l e v e l , mothers receiving assistance under A i d to Dependent Children programs were under pressure to go to work at the same time that expanded provisions f o r p s y c h i a t r i c treatment of delinquent and disturbed children were being projected"!. The questionable s o l u t i o n of l i m i t i n g intake, which i s possible f o r purely private agencies, cannot be adopted by a Children's Aid Society, which has a quasi-public function. Such an agency i s charged with carrying out a defined job within a c e r t a i n geographical area, and a l l c l i e n t s who f a l l within the categories designated f o r service, must be accepted. The r e s u l t i s , of course, that when demand f o r service increases, some adaptation takes place. E i t h e r s t a f f i s increased or the s t a f f works harder, or services s u f f e r . Sometimes a l l these things happen though not necessarily a l l at once. 1. Tbwle, Charlotte, "Looking Ahead In the F i e l d s of Orthopaychiatric Research", American Journal of Orthopsychiatry, American Orthopaychiatric Association Incorporated, Boston, January 1949. 5 The h i s t o r y of public s o c i a l work i n expanding communities has been a rather unequal struggle to keep pace with 1.) the natural Increase of need f o r service due to population growth, S o ) the Increased acceptance of and demand f o r s o c i a l services of a l l types i n many new f i e l d s and among new l e v e l s of society and 3 . ) the drive within the profession i t a e l f to improve standards consistent with new p s y c h i a t r i c and s o c i o l o g i c a l Insights regarding human needs and c l i n i c a l methods of influencing behaviour and a t t i t u d e s . Although t h i s new know-ledge has r e s u l t e d i n a marked advance i n the a b i l i t y of s o c i a l workers to help people with c e r t a i n kinds of problems, there remain huge areas of human need which have not been met. Por example, the profession s t i l l lacks much of the knowledge and s k i l l necessary f o r the successful treatment of the c h r o n i c a l l y dependent family and the delinquent. Translating accumulated c l i n i c a l and p s y c h i a t r i c wisdom into mass programmes f o r human welfare i s a d i f f i c u l t job, but i t i s a necessary job i f the profession of s o c i a l work i s to survive as a strong v i t a l force i n the community — as a profession which concerns i t s e l f with the welfare of people at large, not just with those who are "treatable" i n a rather narrow, c l i n i c a l sense. In h i s a r t i c l e "The R e s p o n s i b i l i t i e s of a S o c i a l l y Oriented Profession", Harry L. Lurie points out that, due to the current "decline of the philosophy of l i b e r a l i s m which believed i n progress, i n change, and In the p e r f e c t i b i l i t y of human nature and the s o c i a l order", s o c i a l work has temporarily l o s t much of i t s "dynamic q u a l i t y " with the r e s u l t that there i s a lack of "channels f o r developing and oarrying 6 through e f f e c t i v e programs of s o c i a l Improvementn. He warns that unless s o c i a l workers continue to "remain a l e r t to the implications of unsatisfactory mores and i n s t i t u t i o n s i n th e i r own l i v e s and i n the l i v e s of c l i e n t s they serve", they w i l l have no important part i n the s o c i a l engineering of tomorrow's society*. The problem of many public agencies and indeed of much of the whole of s o c i a l work, i s that of t r y i n g to do too much with too l i t t l e but on the whole, being a f r a i d to say so. "Caseworkers are dependent on the "charitableness" of governments and Individuals f o r t h e i r opportunity to p r a c t i c e . Yearly, s o c i a l casework agencies must s e l l a b i l l of goods to the public and the powers that be. There may be fe a r that any confession of f a i l u r e or exposure of weakness may r e s u l t In lowered appropriations or contributions ... the caseworker's economic r e l a t i o n to the public i s a major source of his anxiety and blocking over evaluative research .. ." 2 S o c i a l workers have tended to f e e l g u i l t y about f a i l u r e s and to believe they were due ei t h e r to some f a u l t i n case handling or else to the f a c t that the " c l i e n t was unable to.use help". The deeper, broader causes stemming from lack of s p e c i f i c knowledge or from defects i n s o c i a l structure and the organization of services, have not always been s u f f i c i e n t l y recognized and acknowledged. 1, Harry I». Lurle "The R e s p o n s i b i l i t i e s of A S o c i a l l y Oriented Profession", i n Kasius, Cora, ed., New Directions i n So c i a l Work, New York, Harper & Brothers pp. 47-51. 2. Blenkner, Margaret, "Obataoles to Evaluative Research i n Casework", S o c i a l Casework. Family Service Association of America, New York, February 1950, V o l . 31, No. 2, pp. 57-58. 7 Because of the rapid expansion of social work, i t has been d i f f i c u l t to achieve a comprehensive view of the total profession, i t s responsibilities and resources. Not only have social workers f a i l e d to see the total job, but they have f a i l e d to see the specific job, whole. Identification and description of actual 1 job content has, to a great extent, been lacking, except In relation to methods of 1 handling specific cases. Nor has the profession been explicit or clear about which services and methods of service were essential, and'which were merely desirable. In spite of the efforts of such standard setting organizations as the Child Welfare League of America, the United States Federal Children's Bureau and the Family Service Association of America there have been wide divergences, as between agencies, in the number of staff employed to give comparable services. On the whole agencies have started out on a small scale and have increased in a sort of "stimulus-response 0 pattern. When the pressure got too great another staff member was added, as soon as budget permitted. Professional time i s certainly a most Valuable resource. Yet, as a profession l i t t l e attention has been paid to the us© of time per se in relation to the amount of work for which each individual agency op worker is responsible. The literature on the subject seems to be limited to less than a dozen professional articles compared to the wealth of material on the most effective way of handling an individual case or group of cases. Neverthe-less, there Is reeent healthy evidence of increasing interest in the question of the most productive use of the limited professional time available, and in the development .of norms 8 f o r the use of time. This point w i l l be discussed i n Chapter 2. Information on this subject should be of v i t a l importance not only to planning bodies, whether public or voluntary, but also to agenoy administrators and boards, and to i n d i v i d u a l workers seeking to increase t h e i r professional competence. The study of the use of avail a b l e professional time i n r e l a t i o n to case-load content and services rendered i n the Children's A i d Sooiety of Vancouver, can, at beat illumlnat© only a small portion of the large evaluative question - "how much" of "what" oan a professional worker carry e f f e c t i v e l y ? I t i s worth noting that the Jewish C h i l d Care Association of New York studied the question f o r eighteen months without a r r i v i n g at a d e f i n i t e answer. S k i l l e d services are dependent on many factors besides the a v a i l a b i l i t y of time to work with c l i e n t s , but i t seems reasonable to assume that, unless there i s at l e a s t minimal time a v a i l a b l e , s k i l l e d service w i l l be lacking. I t does not follow, of course, that the q u a l i t y of service improves i n d i r e c t r a t i o to the amount of time spent. In an int e r e s t i n g a r t i c l e i n whloh he comments on this point, Louis H. Sobel, executive d i r e c t o r of the Jewish C h i l d Care Association of New York, states "We believe I t w i l l be generally agreed that there was, and i s , no need f o r objective documentation of the cle a r values i n lower caseloads i n agencies that s t i l l have f i f t y or more children per worker; or even f o r t y , or perhaps even somewhat l e s s . Under such circumstances there would probably be a cle a r c o r r e l a t i o n between lower loads and more e f f e c t i v e service. 9 T h i s stems f r o m the deep c o n v i c t i o n s o f the a g e n c i e s and wor k e r s who c a r r i e d the f i g h t f o r b e t t e r s e r v i c e t o the p o i n t o f p r e s e n t s t a n d a r d s . B u t o u t o f a n o t h e r and e q u a l l y deep c o n v i c t i o n a bout the b a s i c need f o r a t l e a s t b e g i n n i n g t o measure r e s u l t s , as w e l l as the p r e s s u r e s o f money and d e f i c i t s , we a r e l e d to make an o b s e r v a t i o n t h a t may sound h e r e t i c a l : t h a t under c e r t a i n c i r c u m s t a n c e s s t i l l l o w e r c a s e l o a d s may n o t  n e c e s s a r i l y mean b e t t e r s e r v l e e " ! Reason f o r S e l e c t i n g C h i l d r e n ' s A i d S o c i e t y o f Vancouver, B.C.  f o r S t u d y . The C h i l d r e n ' s A i d S o c i e t y o f Vancouver, i s t h e p i o n e e r c h i l d w e l f a r e s e r v i c e I n B r i t i s h C olumbia and i s s t i l l t h e l a r g e s t s e r v i c e d e v o t e d e x c l u s i v e l y t o c h i l d w e l f a r e w i t h i n the P r o v i n c e . W i t h I t s f o u r f o l d programme o f p r o t e c t i v e f a m i l y work, c h i l d placement ( b o t h wards and v o l u n t a r y p l a c e m e n t s ) , s e r v i c e s t o u n m a r r i e d mothers, and a d o p t i o n s , i t c a n be r e a d i l y seen t h a t the S o c i e t y o c c u p i e s an e x c e e d i n g l y i m p o r t a n t p l a c e among l o c a l s o c i a l a g e n c i e s , and t h a t the way i n w h i c h i t h a n d l e s problems o f c o v e r a g e , f i n a n c i n g and s t a n d a r d s o f s e r v i c e w i l l have c o n s i d e r a b l e e f f e c t upon the g e n e r a l w e l f a r e o f t h e community. The E x e c u t i v e , B o a r d and S t a f f o f the S o c i e t y a r e s t r i v i n g f o r the p r o g r e s s i v e Improvement O f s t a n d a r d s o f s e r v i c e and w i l l be I n t e r e s t e d i n the r e s u l t s o f the s t u d y as a p o s s i b l e g u i d e t o f u t u r e p l a n n i n g . 1. L o u i s H. S o b e l , "An A p p r o a c h t o E s t a b l i s h i n g C a s e l o a d Norms", C h i l d W e l f a r e . C h i l d W e l f a r e League o f A m e r i c a , New Y o r k , F e b r u a r y 1954, V o l 3 3 , No. 2., p. 12. 10 B r i e f History of Children's A i d Society The Children'a Aid Society of Vancouver,, B.C., a private agency, governed by a Board of Directors i n accordance with a constitution and set of by-laws,, was incorporated under the Societies Act by authority of a P r o v i n c i a l Charter granted on July 17, 1901, following the hurried passage of The Children's Protection Act i n the P r o v i n c i a l Legislature e a r l i e r i n the same year.. "Th© e a r l y years were an Incessant struggle to keep some sort of balance between Increasing numbers of children to care f o r and the c o l l e c t i n g of s u f f i c i e n t money to do so .,. ohildren from any part of the Province could be, and Were* committed to the care of the Society, and no one was under any statutory obligation to pay f o r t h e i r maintenance"* 1 Total p r o v i n c i a l contributions In 1905 t o t a l l e d #750. L i t t l e by l i t t l e the proportion paid by government was pushed up but i t was not u n t i l a f t e r the C h i l d Welfare Survey of 1926-27, that the Act was amended to provide f o r payment of f u l l maintenance($l,80 per week) by the m u n i c i p a l i t i e s responsible. Although the Society had pressed f o r the appointment since i t s inception, a P r o v i n c i a l Superintendent of Neglected Children was not appointed u n t i l 1924. During these years the Society i t s e l f had only one, poorly paid, s t a f f member, the Superintendent. 1. Angus, Anne Margaret, Children's A i d Society of Vancouver, B.C. 1901-1951, Vancouver B.C. (History printed 1951, occasion of 50th Anniversary) 11 The press of children needing care continued and standards of service f e l l . In 1926, following a p u b l i c scandal, the Board of Directors decided to c a l l on expert help and requested th© Canadian Welfare Council to make a survey of c h i l d welfare needs. The Survey was c a r r i e d out and i n 1927 the Society was reorganised under the leadership of the f i r s t trained s o c i a l worker i n B r i t i s h Columbia, Hiss Laura Holland, and of Mr. Herbert R. Glass, President of the Board of D i r e c t o r s . Emphasis was placed on protective family work and placement of children i n approved f o s t e r homes. The p r o f e s s i o n a l s t a f f has grown from three paid s o c i a l workers i n 1927 to 60 i n 1955. C l e r i c a l s t a f f numbering three i n 1930 has increased to 31 i n 1955. Since i t s e a r l i e s t days the Society has been struggling to meet ever-increasing demands f o r i t s services. T o u r directors'* the f i r s t annual meeting was t o l d , ttat the time of the Incorporation of the Society, expected to be c a l l e d upon to deal with some two or three cases during the year, but they regret to say that t h e i r work has, by force of the e v i l conditions e x i s t i n g i n the c i t y , been more extensive than could be imagined ...*** The present s i t u a t i o n i s not very d i f f e r e n t i n essence. The Society i s S t i l l s t r i v i n g to meet the needs of chil d r e n and f a m i l i e s who desperately require i t s help. Basic p r i n c i p l e s , th© b e l i e f In the worth and i n d i v i d u a l i t y of every c h i l d , and of his deep need f o r a family of his own, have not changed since the days of the founders, but they have been illuminated by new 1. Angus, Anne Margaret, Children's A i d Society of Vancouver B.C. 1901-1951. 12 knowledge and f o r t i f i e d by the gradual development of sound pr a c t i c e . As Dorothy Hutchinson says so aptly, " P r i n c i p l e s do not change. Their innate goals are never reached beoause once they are achieved they are given up f o r new ones". 1 The his t o r y of the agency bears eloquent witness to this truth. Out of the accomplishment of one objective, others, just as v i t a l , have emerged. For example, at one time the Society strove toward the objective of f i n d i n g a suitable adoption home f o r each one of i t s "adoptable" babies. The achievement of this goal and the success of the adoption programme i n general were p a r t i a l reasons why the agency has gradually changed i t s praotioe, so that the benefits of adoption may be made a v a i l -able to every c h i l d , even though handicapped, i f i t seems l i k e l y that he w i l l be able to p r o f i t by and contribute to family l i f e . The re-organization of the agency i n February 1954 from a two-department structure based on function, to an agency with f i v e units each giving generalized services, plus an adoption department and a home-finding department, has been a recent example of the Society's a b i l i t y to adapt i t s e l f to changing concepts regarding the most e f f e c t i v e methods of serving c l i e n t s . As the agency grew la r g e r , i t became obvious that at times the two-department structure "hampered wise, co-ordinated planning f o r the c h i l d and his family ... I t beoame increasingly evident that integrated planning ••• could 1. Hutchinson, Dorothy, "Basic P r i n c i p l e s In C h i l d Welfare" Selected Papers i n Casework, National Conference of S o c i a l Work 1952 Raleigh, N.C, Health Publications I n s t i t u t e , Inc., (Copyright 195ST. 13 best be handled by one worker* knowing both sides of th© situation." 1 F l e x i b i l i t y Is a necessary attribute of an agency which Is sensitive to community needs. Authority under which the Children's Aid Society operates. Purpose, Function and Services "The Children's Aid Society operates under the authority of the Protection of Children Act R.S.B.C. (passed March 18, 1943) and Its amendments, and the Provincial Charter granted July 17, 1901, which established the Society under the Children's Protection Act of Br i t i s h Columbia. The Charter states as Art i c l e 2, nthe business and objects of the Society shall b© the protection of children from cruelty and caring for and protecting neglected, abandoned or orphaned children and the enforcement by a l l lawful means of the laws relating thereto". The 1943 Act speaks of the Children's Aid Society as on© "that has among i t s objects the protection of children from cruelty, the safe-guarding of the young, the amelioration of family conditions that lead to the neglect of children, or the care and control of children in need of protection." These statements, together with the traditional scop© of children's services, indicate that the major responsibilities of a Children's Aid Society l i e in the f i e l d of active protection and car© of children in dangerous situations, described in some detail i n the Act. 1. Cornwall, Charlotte E., "Structure Change", Concerning  Families and Children, November 1954, Vol. 3 No. 4, Canadian Welfare Council, Ottawa. 14 A secondary purpose - "the amelioration of family conditions which lead to the neglect Of c h i l d r e n " Is broadly stated and, unless c l a r i f i e d and l i m i t e d by community planning and the functions of other agencies, could envelop almost the whole f i e l d of s o c i a l weIfare". The major f u n c t i o n s 8 of the Children's A i d Society are: I, Provision of servloes f o r the preservation and strengthening of family l i f e when the coimuunlty has expressed concern f o r the well-being of the children, p r o v i s i o n of services f o r the unmarried mother and her c h i l d , and p r o v i s i o n of voluntary placement services f o r the community i n accordance with defined p o l i c y . I I , Apprehension and presentation before the Family Court, of children considered to be i n need of protection, so that the Judge may decide, on the basis of the evidence, whether guardianship should be removed from the parents and vested In a Children's A i d Society. I I I . Provision of guardianship and care f o r children who have been . Judged to be In need of protection. 1. "Protective Family Services of Children's Aid Society i n Relation to Family Services of Other Agencies i n the Community" unpublished statement of p o l i c y December 23, 1955. (Prepared f o r discussion with Family Service Agency of Greater Vancouver). 2. "The Children's Aid Society of Vancouver, B.C. Its Purpose, Administrative Structure, Functions, Services". January 13, 1955 (Mimeographed material, unpublished). 15 IV. A u x i l i a r y Functions ares 1) P a r t i c i p a t i o n i n s o c i a l work edudation. 8) P a r t i c i p a t i o n i n s o c i a l research. 3) P a r t i c i p a t i o n i n community planning, s o c i a l aotlon, and Interpretation of c h i l d welfare needs and services to the community. As w e l l as basic casework ser v i c e , a number of s p e o i f i c s o o i a l services have been developed as an ad d i t i o n a l means whereby the Society seeks to f u l f i l i t s function. B r i e f l y these;;are': 1) Protective service to chi l d r e n and f a m i l i e s , 2) Services r e l a t e d to court procedures, 3) - Services to unmarried mothers, and to i l l e g i t i m a t e l y pregnant married women who request adoption f o r t h e i r children, 4) Poster home care and group care f o r children of long or short duration on a voluntary or committal b a s i s . 5) Private Boarding Homes (investigation and Supervision i n co-operation with C i t y of Vancouver Health A u t h o r i t i e s ) 6) Adoptions. 7) Special Investigations r e l a t e d to the Chi l d Welfare f i e l d . Method Employed i n Making t h i s Study. The central purpose of this study i s to examine a group of oases representative of th© amount of work assumed by an average worker, to see what kinds of oases ar© included In the work load, and to make & q u a l i t a t i v e analysis of the adequacy of the services rendered. 16 The amount of work done on these actual cases i s compared with the average amount of work done i h one month by an average worker, Insofar as this can be determined from the time study oarrled out by the Children's A i d Society i n June 1955. The main units of work selected f o r comparison are v i s i t s ^ and Interviews 2, held either, d i r e c t l y with c l i e n t s , or on t h e i r behalf. Inadequacies i n service are evaluated, and a judgment made as to whether th© inadequacy can be a t t r i b u t e d primarily to lack of time, or to other causes. : S election of cases f o r study was a central problem. I t was desired that they should represent a neutral sample of th© entire work of the agency as to type of oase and q u a l i t y of service, and that the number chosen should approximate, as c l o s e l y as possible, one worker's share of the t o t a l caseload of th© agency. , Th© f i r s t step was to exclude from the study a l l supervisors and part time workers and t h e i r caseloads, as these s t a f f members were not considered to be representative of th© average caseworker. Totals of a l l categories of cases open i n th© agenoy on th© l a s t day of th© month, January to June 1956 i n c l u s i v e , war© then obtained from th© remaining workers s t a t i s t i c s , t o t a l l e d , and averaged. 1. A v i s i t i s & c a l l outside th© o f f i c e , involving f a c e - t o -face contact, e i t h e r with a c l i e n t , or with another person; exclusive of agency s t a f f , d i r e o t l y on the c l i e n t ' s behalf, 2, An interview i s a faee-to-face contact within th© agency o f f i c e , c a r r i e d on e i t h e r with a c l i e n t , or with another person, exclusive of agency s t a f f , d i r e c t l y on the c l i e n t ' s behalf. 17 Th© number of workers (minus the excluded groups) who were employed by the agency during each of these same months were also t o t a l l e d and averaged. Prom the monthly average of workers employed and the monthly average of open cases. In each category, i t IS possible to ascertain the average number of cases i n each category f o r which one worker would have r e s p o n s i b i l i t y a t th© end of a month, i f cases :were evenly d i s t r i b u t e d from a numerical point of view. For example, the total' number of family cases open In the agency at th© end of an average month (January-June 1955) was 1060. When this f i g u r e i s divided by the average number of ©as©workers (46) employed i n one month, i t i s apparent that the average number of family oases f o r which the average worker was responsible i s 23 oases. Th© same procedure was used In order to obtain an average number of oases In a l l other categories. Categories included are: 1) family cases Including unmarried mothers, 2) f o s t e r homes (those approved and i n use or waiting, and those being studied), 3) waiting adoption homes (both those approved and waiting, and those being Studied), 4) oases of children i n care, and 5) children on adoption probation (exclusive of children i n care). The only type of case excluded from th© study was private boarding homes whioh are a l l c a r r i e d by on© worker, th© Supervisor of Private Boarding Homes, who was also excluded. On this basis the hypothetical caseload f o r which one worker was responsible at the ©nd of a month was composed as follows - 23 family oases, 24 children i n care, 15 f o s t e r homes, nine children on adoption probation, and eight adoptive applicants. 18 As th© Children's A i d Society had c a r r i e d out a time study during the month of June 1955, and the in t e n t i o n was to examine the work done on the cases i n r e l a t i o n to some of the time study fi n d i n g s , the case records were obtained from th© group of cases open In th© agency at th© end of June 1955. Workers' monthly reports were arranged i n alphab©tical order and every 46th case c a r r i e d over from, the end of June i955 Into July 1955 was selected f o r study. In order to make the sample caseload representative of the t o t a l cases open during the month of June 1955, every 46th case from th© t o t a l closed i n June 1955 was also added. This meant an ad d i t i o n a l four cases, one i n each category except f o r that of adoptive applicants. The f i n a l numerical count of cases studied was therefor© as follows, 24 family cases, 16 f o s t e r homes, eight adoptive applicants, 25 children i n care, and ten children on adoption probation - a t o t a l of 83. This f i g u r e of 83 cases does not represent a ease load i n the usual sense of the word. No aotual Children's Aid Society worker would have a caseload of this composition. Poster home studies ar© mad© almost e n t i r e l y by the Horn© Finding Department, and children on adoption probation ar© c a r r i e d , and adoptive home studios made, by the Adoption Department of th© agency. Since February 1954, when th© agency structure was changed, and generalized caseloads became the r u l e , a l l workers exoept home finders and adoption workers have c a r r i e d caseloads composed of varying proportions of family cases, children i n oar© and f o s t e r homes i n us©. 19 When quoting caseloads i t Is agency p r a c t i c e , i n l i n e with f; that of other c h i l d welfare agencies, to count as one case each family case, each c h i l d i n care, each c h i l d on adoption probation and each adoptive home whether ''approved and waiting" or "understudy". Except In the case of horns f i n d e r s , who are engaged i n Studying f o s t e r home applications,, i t i s notagency practice to count f o s t e r homes as oases. Thus i n terms of the agency's methods of counting, the number of. "oases" represented by the section of work under review was a c t u a l l y 67. This f i g u r e i s a r r i v e d at by subtracting the t o t a l number of f o s t e r homes being studied (16) from the t o t a l of 83 cases. The 83 cases were each analysed according to the attached schedules (Appendices A to E), sp e c i a l a t t e n t i o n being paid to the nature of th© case, the type of services rendered, and the number of v i s i t s and interviews. Workers were consulted v e r b a l l y whenever i t was necessary to c l a r i f y or supplement the information i n the case reeord. The material obtained was then compiled on summary sheets (Appendices P to J ) . Numbers of v i s i t s and Interviews carried on i n r e l a t i o n to the cases studied were compared to th© findings i n th© agency time study. Th© oases selected were evaluated as to adequacy of service rendered, and observations mad© regarding the re l a t i o n s h i p between th© a v a i l a b i l i t y and use of time and adequaoy of ser v i c e . S t a t i s t i c a l material and case examples used i n th© following chapters ar© derived from th© oases studied. In the case examples i d e n t i f y i n g information was, of course, disguised. Chapter 2 The Differential Approach to Caseload. Literature on Time Studies and Caseloads, The literature on time studies and methods of estimating caseloads which can be effectively served i n the working time available, is somewhat scanty. It has been d i f f i c u l t to compare findings because of work weeks of d i f f e r -ing length, and the fact that several studies included tele-phone calls to clients with v i s i t s and Interviews, without differentiation. Some writers quoted caseloads, others did not, and most seemed to have different ways of counting cases. One children's agency* reported, out of a 47|- hour week, an average of 15 hours a week, or 51.5$ of total time spent on client contacts, including telephone contacts, and thought this could be raised to 18|- hours per week (30$ of total time). No case-loads were quoted in this a r t i c l e . Another children's agency 8 quoted 13§ hours (37$) of interviewing time in a 36§ hour week, but did not say i f telephone contacts were included. This agency computed workable caseloads as follows, 18 mothers plus their babies in foster oar©, 1, Keith-Luoan, Alan, "A Tim© Study", (Its Use in a Child Car© Agency), Bulletin, March 1944, Vol. 23, No, 3, Child Welfare League of America Inc., New Tork. 2. Weed, Verne, "Method of Arriving at a Caseload Figure", Bulletin, May 1945, Vol. 24, No. 5, Child Welfare League of Amerioa Inc., New Tork. 21 or 24 c h i l d r e n i n adoptive homes I n c l u d i n g the home s t u d i e s , or 19 c h i l d r e n i n f o s t e r care p l u s t h e i r parents, f o s t e r home st u d i e s a l s o b eing Included. Other suggestions r e g a r d i n g reasonable caseloads composed of c h i l d r e n i n care plus t h e i r parents were 18 to 34 (agency average 25) c h i l d r e n per worker^, 31 c h i l d r e n per worker In a p u b l i c agency 8, and 23 c h i l d r e n per worker . In most eases r e s p o n s i b i l i t y f o r the home f i n d i n g was a l s o Included i n the work l o a d . I t was g e n e r a l l y agreed by these w r i t e r s that caseloads ought to be based on an a n a l y s i s of the s e r v i c e s r e q u i r e d i n each case, and tha t the numerical ease , count was u n s a t i s f a c t o r y . An 5.n teres t i n g method f o r weighting cases, according to estimated time r e q u i r e d f o r s e r v i c e , was suggested i n the a r t i c l e by Ruth Weisenbarger. 1. Weisenbarger, Ruth, ttAn Agency Experiments With Caseload Weightings". C h i l d Welfare. January 1955, C h i l d Welfare League of America Inc., New York, p. 6 , 2. Haremski, Roman L,, "Tho Caseload Standard f o r a C h i l d Placement Worker", C h i l d Welfare, October 1948, C h i l d Welfare League of America Inc., New York. 3. S o b e l , Louis H., "An Approach to E s t a b l i s h i n g Caseload Norms", C h i l d Welfare. February 1954, V o l . 3 3 , No. 2, C h i l d Welfare League of America Inc., New York, p. 12, 22 Other a r t i c l e s *•* * were concerned l e s s with s l s c of caseload, than with the d e s i r a b i l i t y of increasing d i r e c t c l i e n t contacts, and ways and means of doing so. O r v i l l e Robertson stated that h i s agency, a family agency, had accepted the standard of case workers spending 50$ of t h e i r time i n seeing c l i e n t s , and that they hoped to increase t h i s percentage even more* H i l l and Grmsby*, reckoned th© u n i t cost of the professional hour with c l i e n t s i n the Family Servic© Agency of Philadelphia, as #24.91, and I t can therefore be seen that methods of Increasing time with c l i e n t s , at the expense of other uses of time, would be desirable. Most writers were agreed that agencies Should engage In time studies, and c a r e f u l l y s c r u t i n i s e the value of time spent i n a c t i v i t i e s other than faee-to-face oontaot with c l i e n t s , such as committee meetings, d i c t a t i o n , s t a t i s t i c s and supervision. 1. Robertson, O r v i l l e , "More S t a f f Time f o r Seeing Clients'*, H ighlights, October 1952, V o l . IS, No. 8, Family Service Association of America, Hew York. p. 122. 2. Fr a n c i s , Blyth© W., "Los Angeles Time S tudv* 9 H i g h l i g h t s , May 1949, Vol. 10, No. 5, Family Service Association of America, New York. 3. *How E f f i c i e n t Are We•5* (No author noted), Highlights. October 1 9 5 6 , V o l . 13, No. 8, Family Service Association of Akoriea, New York. 4. H i l l , John G . , and Ormsby, Ralph, Cost Analysis Methed'• f o r Casework Agencies. Family Service of Philadelphia, Philadelphia, 1953• 23 Children's A i d S o c i e t y Time Study of Juno, 1955. During June 1955, In order to learn more about the use of professional time, p a r t i c u l a r l y i t s d i s t r i b u t i o n between services chargeable to the Community Chest and Council of Greater Vancouver, and those chargeable to p u b l i c funds, the Children's A i d Society of Vancouver c a r r i e d out a time study. A l l professional s t a f f , with tho exception of administration, f i l l e d i n d a i l y time sheets showing the precise use of time, i n minutes, under th© headings noted on th© D a i l y Tim© Sheet form. (Appendix E ) . From the completed time sheets i t was possible to ascertain the t o t a l numbers of v i s i t s and interviews held with, or on behalf, of c l i e n t s and th© time spent on this a c t i v i t y . Tim© spent on other parts of th© s o o i a l work Job, such as recording, casework supervision and t r a v e l l i n g could also b® computed from the time sheets but this study makes use of the material on v i s i t s and interviews only, as these were the units of work which could, most accurately, be i d e n t i f i e d and counted oh th© b a s i s of th© case-records. For the purposes of t h i s study th© v i s i t s and interviews mad© by the supervisors and workers i n th© excluded group, and th© amount of time spent on them, wore subtracted from th© agency t o t a l s . These f i g u r e s , on v i s i t s , interviews and time spent, would thus represent th© work of th© professional s t a f f from whose caseloads the sample oases were selected. For purposes of c l a r i t y those figures ar© set down i n Table 1. 24 Table 1. V i s i t s and Interviews by S o c i a l Workers; G a l l o o n ' s A i d Society (Vancouver), Jfun© 1955. units of C l i e n t Categories Totals j ! Service C ihildren i n Care Family Cases A l l Workers Workers \ Studied (a) I \ (number) (number) ! (number) (number) \ V i s i t s i i | C l i e n t 1426 399 f 1924 j . . . 1638 | Collateral . 1779 270 | 2049 1707 | Interviews i 1 | C l i e n t 499 811 710 648 Collateral 215 68 283 224 Tot a l v i s i t t > 3204 669 3875 344$ Tot a l Interview* i 714 279 1193 872 Time (hours) • (hours) (hours) (hours) v i s i t s 1006 296 1301 1186 interviews 367 181 548 447 (a) Excluding supervisors and part time workers. Average time spent: by a l l workers: 20 minutes ( v i s i t s ) 28 minutes (interviews) by workers studied: 21 minutes" ( v i s i t s ) 31 minutes (interviews) The "average1* worker i n the group studied c a r r i e d out 78 v i s i t s and 19 interviews ( i . e . one f o r t y - s i x t h of t o t a l v i s i t s and interviews f o r group studied). 25 Types of Cases Carried by the Children's A i d Society. The main categories of cases f o r which the Children's A i d Society of Vancouver assumes r e s p o n s i b i l i t y , may be c l a s s i f i e d as follows, family cases, f o s t e r homes, adoptive applicants, children i n care, and children on adoption probation. Family oases include: situations of c h i l d neglect • and of i l l e g i t i m a c y , p a r t i c u l a r l y cases of unmarried mothers, cases where some form of c h i l d placement i s requested, and a miscellaneous group of oases usually involving a f a i r l y b r i e f s ervice, such as custody investigations, services to out-of-town agencies, and services to transient c h i l d r e n . Intake figures f o r 1955, on presenting problem at r e f e r r a l , show the following proportions: i l l e g i t i m a c y , 41$, neglect, 23$, placement request, 18$, a l l other 18$. Foster homes are fa m i l i e s who board children f o r the agency. They are partners with the agency rather than c l i e n t s . They seek to care f o r a c h i l d rather than to obtain a service f o r themselves. In the l a s t a n a l y s i s , the degree to which they can give love and care to a c h i l d because he needs i t , rather than because they need him, w i l l be the measure of the i r value as f o s t e r parents. Included on f o s t e r home s t a t i s t i c s are homes studied and i n use, homes studied and waiting f o r children, and homes In the process of being studied. Adoptive applicants are couples who have applied to adopt a c h i l d . Their homes have been, or are being, studied by the agency but a c h i l d has not yet been placed with them. They can be distinguished from f o s t e r parents by the f a c t that they wish to make the c h i l d t h e i r own. People who apply f o r an 26 a d d i t i o n a l c h i l d , a f t o r an adoption has "boon l e g a l l y completed, ar© al a o counted i n t h i s category, u n t i l t h e i r homes have been re-evaluated and another placement made. C h i l d r e n i n care ar® c h i l d r e n ranging i n ag© from a few daya to twenty-one y e a r s , f o r whoa© care and maintenance the C h i l d r e n ' s A i d S o c i e t y i s r e s p o n s i b l e f o r one of three reasons: 1. ) The o h i l d r e n have been made wards of the S o c i e t y under the P r o t e c t i o n of C h i l d r e n A c t , or are before the Court. 2. ) They are non-wards i that i s t h e i r parents have v o l u n t a r i l y asked the S o c i e t y to take car© of them f o r a temporary p e r i o d , because of some misfortune which makes care apart from the parents necessary and d e s i r a b l e . 3. ) They ar© wards of other agencies, who have moved, u s u a l l y w i t h t h e i r f o s t e r parents, to th© C h i l d r e n ' s A i d S o c i e t y area of s u p e r v i s i o n , and f o r whom su p e r v i s i o n has been requested by the r e s p o n s i b l e agency. C h i l d r e n on adoption p r o b a t i o n are c h i l d r e n who are In adoption homes under the s u p e r v i s i o n of th© C h i l d r e n ' s A i d S o c i e t y pending l e g a l completion of the adoption. They may have been p l a c e d i n the adoption homes by th© C h i l d r e n ' s A i d S o c i e t y , o r another s o c i a l agency, they may b© n a t u r a l c h i l d r e n of on© spouse whom both are ap p l y i n g to adopt J o i n t l y , o r they may have been place d p r i v a t e l y i n th© adoption home e i t h e r d i r e c t l y by the mother, or through some t h i r d p a r t y . 27 Family Cases. Twenty-four open family oases were studied and of these, ten were " a c t i v e " and fourteen " i n a c t i v e " duping the month of June 1955. Six of the ten " a c t i v e " cases had e i t h e r v i s i t s or interviews; the other four received other kinds of service suoh as l e t t e r s and telephone c a l l s . V i s i t s to c l i e n t s t o t a l l e d eleven and there were no o f f i c e Interviews with c l i e n t s * There were also four c o l l a t e r a l "contacts", three of these being v i s i t s and one an o f f i c e interview. Of the " i n a c t i v e " cases, three were rated as "needing attention", four as " i n a c t i v e according to plan" and seven as "waiting c l o s i n g " . Of these seven, two were waiting transfer to " i n care" rather than closing aa the children had previously been made wards of the agency. The following table gives a pioture of the major types of oases and shows whether they were " a c t i v e " or i n a c t i v e " during June 1955. Table 2. Types of Family Cases i n Sample Group C l a s s i f i c a t i o n Active Inactive T o t a l Neglect 4 4 8 Unmarried Mother 2 4 6 Placement Request 2 4 6 Married Woman Asking Adoption 1 1 2 B r i e f Servioe 1 1 2 TOTALS 10 14 24 28 In .the sample the proportion of unmarried mothers works out to one quarter of the t o t a l group, while agency figures on cases open at December 31, 1955, show that unmarried mothers constitute one-third of the t o t a l caseload. Comparable agency figures on the other c l a s s i f i c a t i o n s are not a v a i l a b l e . Thus i t i s not possible to claim that the sample group i s more than roughly representative of cases open i n the agency. These cases involved a wide range of problems and services. Seven cases were concerned with the placement of a c h i l d f o r adoption. In four cases , where non-ward care f o r a c h i l d had been given, the major reason was i l l n e s s of the mother. There were also four si t u a t i o n s of serious negleot i n which oourt action, r e s u l t i n g i n the commitment of the children had been necessary. An addi t i o n a l four complaints of neglect of children had been investigated and appropriate services given. The remaining cases involved assistance to an unmarried g i r l p r i o r to confinement, requests f o r r e f e r r a l to a private boarding home, d i f f i c u l t i e s i n r e l a t i o n to a child's l e g a l status, and services to other agencies. Of the three oases rated by workers as being " i n a c t i v e , needing attention" two Were cases where another agency had requested a minor service and no action had, aa yet, been taken. The other was a complaint of neglect regarding the care an unmarried mother, previously known to th© agency, was giving her c h i l d , and although the complaint had been received at the end of May 1955, i t had not been followed up by the end of June. 2 9 Judging by sources of r e f e r r a l , the Children's A i d Sooiety i s giving service to a large number of people who make voluntary ap p l i c a t i o n . Out of tho twenty-four cases one-third (eight), wore s e l f - r e f e r r e d . Wine cases were referred by a v a r i e t y of other s o c i a l agencies., Other sources, each of whom referred one case, were r e l a t i v e , doctor, land-lady, private boarding home, p o l i c e , neighbour. There was also an anonymous complaint on a case already known to the agency. The f a c t s regarding m a r i t a l status of parents, numbers, and status of children are most c l e a r l y portrayed i n table form. >• . . ^ . Table 5. M a r i t a l Status of Parents, Numbers and Status of Children. M a r i t a l Status of Parent(s) Total f a m i l i e s Number and Status of Children Legitimate I l l e g i t i m a t e Total Children Unmarried Mother Married Couple Divorced Separated Unmarried Couple 8 6 4 5 1 17 4 6 1 2 3 3 S 12 17 7 9 5 TOTALS 24 27 23 60 In the ten active cases a l l but one required some form of c h i l d placement. Three cases involved non-ward care, there were two oases of adoption and two of ward care, one service f o r another agency i n r e l a t i o n to ward care, and one case Involving placement In a private boarding home. In the remaining case the problem was such that placement of the children was not considered. SG In the inactive group there were eleven plaoement oases out of a t o t a l of 14. Of these, f i v e involved adoption, and two ward care. There were also two placement requests whioh had not been followed up by the c l i e n t s , one non-ward case, and one request f o r service from another agency involving private placement. Thus SO out of the 24 family oases were concerned with some form of c h i l d placement. Degree of Urgency a t Time of R e f e r r a l . The number of cases r e f e r r e d i n which immediate action i s required constitutes one of the most d i f f i c u l t features of the work of a l l Children's A i d S o c i e t i e s . The family oases were therefore roughly rated according to their urgency a t the point of r e f e r r a l . Only cases where immediate attention was necessary ( i . e . , the same day, or the next day) were rated as urgent. Gases rated as f a i r l y urgent were those whioh required service ( i n addition to intake service) i n not les s than two weeks; oases rated as not urgent were those where speed was of no groat importance. The category " c l i e n t withdrew" represents cases where the c l i e n t , usually a f t e r making an urgent request e i t h e r with-drew the app l i c a t i o n or dealt with the problem independently. Exactly one t h i r d of the eases were urgent a t the time of r e f e r r a l and i n only a small proportion (one-eighth) was there no element of haste. In three eases the c l i e n t withdrew the request. In emergency situations i t i s often necessary to take quick, d e f i n i t i v e action, such as bringing children i n t o care, with l i t t l e or no information about the case, and with only an 31 uncertain appreciation of what t h i s move means In the l i v e s of the children arid parents concerned. Such action may have a ' profound e f f e c t upon evaluation and treatment. For example, i n one of the cases studied, a seven year o l d Indian boy?-, found downtown.without a place to go, was picked up by the p o l i c e , apprehended and brought i n t o the care of the Children's A i d Society that:same night. Investigation showed that conditions i n the parental home were unsatisfactory and he was mad© a ward. Although he w i l l receive protection, physical care, education, acceptance from agency s t a f f , and a l i m i t e d sort of community t o l e r a t i o n , i t i s questionable whether, i n the long run, he w i l l be as well prepared f o r adult l i f e as he would have been i f he had remained i n his own s e t t i n g , provided that h© managed to survive. , Through an incident of neglect which may not have been very d i f f e r e n t i n essence from what the boy had experienced before, he was extracted from his admittedly depressed c u l t u r a l m i l i e u . Having been removed I t d i d not seem possible f o r the authorities to give o f f i c i a l sanction to his return to conditions of which they could not approve. Although hasty apprehension does not always influence subsequent handling of a oase to suoh an extent, because of the urgency In some cases, a c t i o n , having f a r reaching consequences, must often be taken before an adequate diagnosis can b© mad©. Because of th© emergent nature of much of th© work of a Children's A i d Society, I t seems 1, Problems concerning the a s s i m i l a t i o n of Indians i n t o the population occurred several times i n the cases studied, suggest-ing that research Into this subject would be of value. 3 2 p a r t i c u l a r l y important that caseloads be s u f f i c i e n t l y manageable that workers and supervisors do not f e e l under undue pressure. Many c r u c i a l decisions must be made* and i f they, are to be made wisely, thought and care are e s s e n t i a l . Foster Homes* Of the 16 f o s t e r homes i n the sample, 13 were in use and three, a l l of which had at one time taken children, were vaoant, waiting e i t h e r re-evaluation or closing. Ho homes which were approved and waiting, or currently under study, were found i n the sample choeen. Of the 13 homes i n -use one had a c t u a l l y turned into an adoption homo by June 1955. These parents, who had previously adopted two children from the agency, had been able to accept an element of r i s k , and had taken a c h i l d , not yet l e g a l l y free f o r adoption, on a boarding b a s i s , u n t i l the l e g a l matters were cleared. Foster home annual s t a t i s t i c s f o r 1955 show that out of a t o t a l of 728 f o s t e r homes open at December 31, 1955, 484 or 66.4$ were In use and 244 or 33.6$ were vacant or waiting to be closed. In the sample chosen, out of a t o t a l of 16 f o s t e r homes, 13, or 81.2$ were In use and three, or 18.8$, were vacant or waiting to be closed. In this group of cases, therefore, the sample chosen i s not accurately representative of the t o t a l agency picture. Of these 16 homes, f i v e had been opened In 1955, three In 1954^.two In 1953, one In 1951, two i n 1948, and one each In 1947, 1946 and 1939. With the exoeption of the three vacant homes a l l had been used continuously since opening. 33 A l l f o s t e r parents In the sample were married couples. In one f o s t e r home the f o s t e r parents were both i n t h e i r twenties, and In seven homes both i n t h e i r 30*s. Of the other couples* three f o s t e r fathers and f i v e f o s t e r mothers vers i n t h e i r 40»s, and the two other f o s t e r fathers i n t h e i r 50*a. The couple who had been aotive f o s t e r parents since 1939 were i n th e i r 60's. In two cases, where homes were accepted f o r i n d i v i d u a l children known to them previously, but not used as regular f o s t e r homes, the age of the parents was not recorded. In eight of th© 16 cases, f o s t e r parents had from one to three natural children, and In a l l but one case these children were s t i l l l i v i n g at home. In two cases f o s t e r f a m i l i e s had already each adopted two children from th© agency. In another two cases f o s t e r parents had one natural and on© adopted c h i l d , as well as a f o s t e r c h i l d . In three cases they had no children of the i r own, and In on© case this information was not recorded. Of the thirteen homes where there were children, twelve had on© f o s t e r c h i l d each, and were therefor© used by only on© Children's A i d Society worker. The other home was being used f o r f i v e f o s t e r children, and being v i s i t e d by f o u r d i f f e r e n t workers. Th© f a c t that two of th© children were permanently placed, while three were temporarily placed, would account f o r this rather unsatisfactory s i t u a t i o n . Of the three vacant homes, each had cared f o r on© c h i l d only. Of th© seven-teen children In th© homes, one had already been placed on adoption probation, and two others had been placed with w a view to adoption 1*. 5 4 As a matter of i n t e r e s t , the workers c a r r y i n g the homes were asked to s t a t e t h e i r p r o f e s s i o n a l o p i n i o n of the q u a l i t y of th© 16 homes i n r e l a t i o n to the c h i l d r e n who had been placed. On t h i s b a s i s f i v e were r a t e d as "very good", s i x as "good1*, three as " f a i r " and two as "poor". Exoepfc f o r th© m a t e r i a l i n the o r i g i n a l home s t u d i e s , which were adequate i n eleven bases, and inadequate In f i v e , f o s t e r home f i l e s were hot very i n f o r m a t i v e . I n o n l y two cases, one of which was the home whioh had turned Into an -adoptive home, were progress notes meaningfully recorded. In the other cases, I n order to o b t a i n an e v a l u a t i o n o f a placement, and of the f o s t e r parents' a t t i t u d e s , i t was necessary to c o n s u l t the f i l e s of i n d i v i d u a l c h i l d r e n . I t seems probable that t h i s l a c k of e v a l u a t i v e m a t e r i a l on f o s t e r homo f i l e s hinders th© agency from u s i n g them to the best advantage. Interviews and v i s i t s w i t h f o s t e r parents were not counted. Th© reason f o r t h i s was that these f o s t e r homes are not the sam© ones which are earing f o r the 25 c h i l d r e n i n the " c h i l d r e n i n care" sample. V i s i t s w i t h the f o s t e r parents of these c h i l d r e n were counted as c o l l a t e r a l v i s i t s on b e h a l f of the c h i l d r e n and i t would not be c o r r e c t to count v i s i t s w i t h tuio groups of f o s t e r parents when attempting to a s c e r t a i n r e p r e s e n t a -t i v e monthly t o t a l s of v i s i t s and i n t e r v i e w s . Adoptive A p p l i c a n t s . Of the eigh t adoptive a p p l i c a t i o n s surveyed, o n l y on© was approved, t?hi l e seven were a t i l l under study. Of th© e i g h t cases, three war© " a c t i v e " , w i t h a t o t a l of one v i s i t and two 35 o f f i c e Interviews. In one of these cases the home was, following the home study process, approved f o r placement during June 1955; i n another the Intake Interview only was held, and In another the c l i e n t withdrew due to pregnancy. There were f i v e " i n a c t i v e " cases, a l l of which were rated as "in a c t i v e according to plan". Two of these were homes where successful f i r s t placements had been made. In one of these, where adopting parents were over f o r t y , and the f i r s t placement had been made seven years before, the adopting parents had not pursued t h e i r request a f t e r the i n i t i a l r e - a p p l i c a t i o n and the worker was undecided whether to follow-up or not. However she had not, as yet, closed tho oase, because " i t might be u s e f u l " . In the other case a young couple had just completed the adoption of an Infant In May 1955, and had applied f o r a second c h i l d . June 1955 was considered too soon to begin re-evaluation of the home i n respect to another placement. Tho remaining throe cases represented applications which had progressed l i t t l e * i f at a l l , beyond the intake interview and had not been followed up by the c l i e n t s . In one case where the ap p l i c a t i o n had been made in March 1955, keeping the case open seemed sound p r a c t i c e , but i n the other two cases, where the o r i g i n a l applications had been made In 1951 and 1954, I t appeared that the c l i e n t s ' eventual decision to withdraw should have been more r a p i d l y ascertained, and the oases olosed. This small sample suggests that a f a i r l y high percentage of adoptive applicants never progress to tha stags of f u l l home study and approval. In this group i t appeared probable that f i v e out of eight applicants would never 36 be used, not because of known u n s u i t a b i l i t y , but because of f a i l u r e on t h e i r part to pursue the a p p l i c a t i o n . Children i n Pare. Of these 25 cases, 19 were " a c t i v e " during June and; 6 were " i n a c t i v e " , four of these belhg rated as ^according to plan" and two as "needing attention". T o t a l v i s i t s In r e l a t i o n to these cases during June 1955 numbered 51j (25 c l i e n t v i s i t s , 26 c o l l a t e r a l v i s i t s ) and t o t a l interviews numbered 29. At Debember 51st, 1955, Children's Aid Society Annual S t a t i s t i c s show 1184 children i n care. The f o l l o w i n g table presents a comparison by age groups with the sample group of children In care. Table 4. Comparison of Sample to 1985 S t a t i a t i o s on the Baals of Age Groups. Age Group Children In Care Deoember 31/55. P.O. Children In Sample P.C. 0 - 5 337 28.4 - ' 9 36 6 - 12 369 31.1 8 32 13 - 21 478 40.5 8 32 TOTAL 1184 100 25 100 The sample seems to be p a r t i c u l a r l y representative f o r the 6 - 1 2 year-old group, but i s less so f o r the other two groups. 57 The sample group of 25 oases was composed as follows! 20 Children's, A i d Society wards, three non-wards and two wards of other agencies. Sixteen of the children * or Just over t h r e e - f i f t h s * had two placements or under* (ten had one* s i x had two), and of the remaining nine children three had three placements, and s i x had four* s i x , seven, ten, 12 and 14 placements each. The length of time the children had been i n care varied from admission i n June 1955, to 15 years, but a large proportion (ten) had been i n care under one, or between one and two years* Neglect was the single biggest reason f o r admission, accounting f o r 17 children. Four came l h because of i l l n e s s o f parent* two pending adoption, one because the responsible parent was working and could not manage the care of a large family, and another because of temporary parental incapacity. Appraisal of Adjustment. In working out a r a t i n g of the adjustment of the children aa good, f a i r and poor* tho following f a c t o r s , as recorded i n the f i l e s * , were taken i n t o consideration, along with the verbal judgment of the child's worker. 1, Health and general appearance of chlldo 2, School progress, use of i n t e l l i g e n c e , a b i l i t y to get on with peer group, and with teachers. 3, Apparent emotional health. 4, Acceptance of c h i l d i n fo s t e r home, and of fo s t e r parents by c h i l d . 5, Acceptance of c h i l d i n the community. 38 6. C h i l d 1 a understanding and acceptance of reasons f o r being i n care. 7. Child's understanding and acceptance of natural parents, 8. Child's r e l a t i o n s h i p with, and contact with, s i b l i n g s . 9. Child's concept of self-worth. 10. Presence of p o s i t i v e a t t i t u d e toward worker and agency. The following description i s a sketch of good adjustment. The c h i l d i s In good health or else i s reoeiving adequate medical attention. His progress at school i s within the normal range within his i n t e l l e c t u a l capacity, and he i s able to get along with both pupils and teachers. He does not ex h i b i t obvious symptoms of emotional disturbance such as s t e a l i n g , enuresis or excessive withdrawal. He i s loved and accepted by his f o s t e r parents having regard f o r the proposed term of placement. He Is accepted as a member of the community as judged by f o s t e r parents' observations and school reports. He knows and under-stands, within the l i m i t s of h i s capacity, the reasons f o r h i s being i n the care of the agency. He has been able to i d e n t i f y with parent persons, eit h e r his own, or the f o s t e r parents, and as a r e s u l t , he has a conoept of self-worth appropriate to his age. He Is l i v i n g with, or has meaningful contact, with his s i b l i n g s . He looks on his worker as a h e l p f u l f r i e n d and on the agency as a benevolent i n s t i t u t i o n . Where these faotors predominate, his adjustment i s rated as good. When several of these conditions are unsatisfactory, so that the c h i l d i s having d i f f i c u l t i e s Which hinder him from reaching his normal p o t e n t i a l , and which i n t e r f e r e with his happiness, but where there i s 39 l i k e l i h o o d that he can make use of the help a v a i l a b l e , h is adjustment i s rated as f a i r . A b i l i t y to funotion In the community without serious d i f f i c u l t y would be a condition of f a i r adjustment;* Where most, or a l l of these conditions are absent, and where the c h i l d shows marked maladjustment and trends toward^ delinquency, mental i l l n e s s or excessive dependency, his adjustment i s rated as poor. Obviously a l l the factors l i s t e d are not equal,In importance, and they w i l l vary considerably according to the ago of the c h i l d . I t i s also true that cer t a i n combinations of f a c t o r s , or" cer t a i n factors present to an extreme degree, have more bearing on the t o t a l concept of adjustment than do other combinations or extremes. For example, i t i s t h e o r e t i c a l l y possible f o r a c h i l d who has a completely negative a t t i t u d e toward the agency to make an adequate s o c i a l and personal adjustment, but I t would be highly improbable f o r him to do so i f h i s concept of self-worth were extremely low. These adjustment ratings are quite rough and valuable only as an Index of p r o b a b i l i t i e s . On this b a s i s , the adjustment Of tho twenty-five children studied was considered good i n eleven cases, f a i r i n eleven, and poor i n two. These two children had had twelve placements and fourteen placements re s p e c t i v e l y , and had been i n care eleven and nine years respectively. One of these was the most active of a l l the eases, the worker having noted eight v i s i t s and 17 Interviewa eit h e r with him Or on his behalf, during the month of Juno. One of the children whose adjustment was rated good, was a baby of 18 months who, a f t e r a period of observation 40 f o r a medical d i f f i c u l t y , was, i n June, successfully placed on adoption probation i n a home which was able to aooept the one to four p o s s i b i l i t y of the development of a hereditary eye defect* In the twenty-five cases the following contact witt i parents was'notedJ • Parents paying some maintenance, v i s i t i n g c h i l d and consulting agency. 2 oases Parent paying only. .^••••.•wy.-.. \. l case • Parent v i s i t i n g o h l l d and consulting agency. 4 cases Parent v i s i t i n g c h i l d only. 3 cases > Parent consulting agency only. i < 3 eases No parental contact f o r over 5 years of since commitment. 12 cases The l i v i n g arrangements of the twenty-five children present a composite picture of the various types of care provided by the ageney. throughout the month of June 1985, by f a r the lar g e s t number (14) were In f o s t e r homes on a boarding b a s i s . One c h i l d was placed from a f o s t e r home to an adoption home within the month. Two others were i n f r e e f o s t e r homes at the beginning of the month, but one of these changed his status to "adoption probation" by the end of the month, as his mother's consent to adoption had been f i n a l l y obtained during June. Three children were self-supporting, two of them having remained i n t h e i r f o s t e r homes, and the other being a ward of another agency who had oome to work on the boats running out of Vanoouver. There was one c h i l d placed In eaoh of the following situationss a subsidized baby home, an agency receiving home, a commercial group l i v i n g home f o r g i r l s , a commercial boarding home f o r 41': older boys and the Boys* I n d u s t r i a l School at Brannan Lake, B.C. Services rendered the children i n the nineteen a c t i v e cases covered;a wide,range. One c h i l d was;taken to the Provin-> c i a l C h i l d Guidance G l i n i c f o r a pre-adoptlon a p p r a i s a l ; several had medical examinations; camp arrangements and school reports were much In evidence i n this month; parents were interviewed and v i s i t s with the children arranged. One boy, who had recently been committed from a "skid-row 1* area, was taken back to the d i s t r i c t f o r a b r i e f v i s i t with his old f r i e n d s , was f i t t e d f o r new glasses, and paid a v i s i t to. his s i s t e r In her f o s t e r home, a l l i n one afternoon. He also used the time f o r discussing with the worker h i s concern over h i s mother 's recent committal to th© mental h o s p i t a l . The boy i n the I n d u s t r i a l School was v i s i t e d by the Children's A i d Society worker during June. Help to older children regarding summer employment was noted several times. One c h i l d was placed f o r two weeks on account of her mother's confinement. There was much discussion with f o s t e r parents regarding the adjustment and progress of children. On most v i s i t s , children too, were seen, and appeared to have sound, personal relationships with th© workers. Among th© children In car© ther© were s i x "Inactive® cases, four being designated aa "inactive according to plan" and two aa "needing attention". One of these cases was Mary North, described In Chapter I I I as an example of Inadequate se r v i c e , the other was a somewhat s i m i l a r case of a l i t t l e g i r l , placed i n a r i g i d , and rather unsatisfactory f o s t e r home. Both cases were badly In need of more ca r e f u l diagnosis and at t e n t i o n . 42 Children on Adoption Probation. ' The B r i t i s h Columbia Adoption Aot requires that persons wishing to adopt a c h i l d , must submit l e g a l notice of Intention to adopt to the Superintendent of C h i l d Welfare of B r i t i s h Columbia, at l e a s t six months before the adoption p e t i t i o n i s set down f o r hearing i n the Supreme Court of the Province. At the request of the Superintendent of C h i l d Welfare, the Children's A i d Society takes r e s p o n s i b i l i t y f o r supervising and making a report on a l l adoption placements within the Ci t y of Vancouver, and f o r agency placements and private placements i n North and West Vancouver. Agency placements are under super-v i s i o n f o r a year, but most private and r e l a t i v e placements are not ref e r r e d u n t i l the Superintendent does so a f t e r receiving the s i x months notice of Intention to adopt. Thus, i t i s necessary to make a study and prepare a report which w i l l be used by the Superintendent as a basis f o r her court report within a period of about s i x months. Of the ten cases selected f o r study, seven were a c t i v e . During the month there was d i r e c t service t o t a l l i n g f i v e v i s i t s and one Interview spread over four cases, and the other three cases had other forms of contact, such aa l e t t e r s and telephone c a l l s . There were three "Inactive* 1 oases, two rated as "accord-ing to plan" and one as "needing attention". Of the ten cases of children on adoption probation, f i v e were agency placements (two of these were second placements), one was a private placement, and four were r e l a t i v e placements where one of the adopting parents was also the child's natural parent. The ten cases Involved twelve children, as there were three i n one: family In one of the r e l a t i v e placements. Th© ages of th© children varied from on© month to 18 years» f i v e being under eighteen months ( a l l agency placements). In the remaining group of seven children, there wore children aged f i v e , eight, 15, 16, 18 and two aged nine. Th© singl© privat e placement had been mad© i n A p r i l 1947, and had not yet been ; completed because of i n a b i l i t y to secure the consent of the l e g a l father f o r th© adoption, Th© agency placements had a l l been mad© within sixteen.months or l e s s . In a l l the r e l a t i v e placements the children had always been with on© or other of th© parents. In this group, on© agency placement, where tsh© adopting mother was showing neurotic Symptoms, was a source of concern. Th© other cases were s t r a i g h t forward. In on© case a f i n a l v i s i t wa3 paid, and th© report prepared f o r the Superintendent} i n three, th© f i n a l report had already been sent i n and the agency was waiting confirmation of th© completed adoptions befor© closing th© f i l e s ; th© other cases, which a l l appeared s a t i s f a c t o r y , required pe r i o d i c supervision during the adoption probation period. The on© case which was "needing attention" was a case where th© adoption had never been l e g a l l y completed, which had been referre d f o r re-evaluation i n May 1955 and had not been followed up i n June. Summary of Findings Regarding A c t i v i t y and I n a c t i v i t y of Cases. Findings regarding a c t i v i t y and i n a c t i v i t y of cases, and a s t a t i s t i c a l count of services rendered are presented i n 44 Table 5, As previously explained, v i s i t s and interviews i n regard to the f o s t e r homes Studied were not counted and f o s t e r homes are therefore not included i n Table 5, Servieos rendered i n r e l a t i o n to c h i l d r e n i n care aeem s i g n i f i c a n t l y higher than Services i n r e l a t i o n to any other group. The f a c t that seven (29$) of the family cases i n the sample f e l l i n t o th© category "waiting closing™, may have biased th© findings i n r e l a t i o n to services to family cases. However i t indicates that the agency i s probably carrying, as open cases, a large proper tion of family cases which ought to b© closed s t a t i s t i c a l l y , thus unduly I n f l a t i n g caseload f i g u r e s . Of the 67 ©as©a studied, 39 were " a c t i v e " during June 1955 and 28 "Inactive". Only s i x of the "Inaotive" cases were rated by workers as "needing attention*. Table 5v Indications of Case-Status andAotlvityyCliilo^fen'B-AicL Society (Vancouver), June 1955. f©tal f o r ©7 Cases- i n Sample,;-Index ••;.; • ! (or Items) j Shildren In Care Children j on Adoption ] Probation Family Cases * Adoptive • Applicants T o t a l • • •• • A c t i v e ' 19 ' " '. r . s ^ .• 39 v A a l r e C l i e n t ' 25 '• 11 • • 42 C o l l a t e r a l 26 0 s 0 29 Interviews .... •-, •. C l i e n t 28 • - 0 ' 29 C o l l a t e r a l '-• ; ' : 5 • 1 • ' ' 4 Letters 5 ,; ' • • 32 Telephone C a l l s 14 ' i i 5 32 Other Services 19 1 7 0 27. Total(items of Service) 119 • 14 39 9 • 181 | Inactive According to plan 2 4 5 15 Waiting (a) 0 7 0 7 Needing Attention 2 , 1 3 0 Total (Inactiv Cases) 6 5 14 5 28 f i • - II Total oases 67, plus 16 f o s t e r homes of which 3 were not i n use. V i s i t s and interviews made to f o s t e r homes were not counted, (a) Awaiting c l o s i n g or transfer to **in care". 46 Time Study Findings Compared to Case Findings. The t o t a l number of hours worked by the group of workers whose oases are under study was computed roughly, rather than exaotly. Thus the number of workers, (46) was m u l t i p l i e d by the number of working days i n June 1955, (22) and the hours In a working day, (7), making a t o t a l of 7084 hours or 154 hours per worker. It i s l i k e l y that t h i s f i g u r e i s f a i r l y accurate, as absence of workers f o r holiday and i l l n e s s would, probably, be balanced by overtime and work done on night, and weekend duty. Using the f i g u r e 7084 hours f o r a l l the workers studied, and 1633 hours f o r the time spent by these workers on v i s i t s and interviews as shown by the Time Study (Table 1), i t was calculated that the proportion of worker time spent on this a c t i v i t y was 23 percent • During the month each worker spent 9.7 hours on 18.9 interviews and 25.8 hours on 74.89 v i s i t s , or 35§ hours on v i s i t s and interviews. Thus i n t h i s 22 day month a worker spent an average of one hour and 37 minutes per day on v i s i t s and interviews. Totals of v i s i t s c a r r i e d out by one worker as revealed In the Time Study ( i . e . 75) (Table 1) show a close p a r a l l e l to numbers of v i s i t s held on the 67 oases reviewed ( i . e . 71) (Table 5). 1. Other d i r e c t services to c l i e n t s such as telephone i n t e r -views and l e t t e r w r i t i n g , and "enabling s e r v i c e s " such as t r a v e l l -ing, supervision and case recording undoubtedly account f o r a large proportion Of the expenditure Of the remaining time. These necessary parts of the professional Job are not covered by t h i s study but some suggestions f o r fu r t h e r consideration are made i n Chapter 4. 47 Totals of interviews show a wide differenoe,. th© average number of Interviews being 19 according to th© Tim© Study, while the interviews held on the 67 cases reviewed t o t a l l e d 5 3 . However thi s discrepancy might be explained by the f a c t that one of the children i n care, i n the sample, had 17 interviews i n one month, which could not be considered t y p i c a l . Taking this f a c t into accoimt, the degree of s i m i l a r i t y between Time Study 'figures' aa'd'sample' f i g u r e s i s s t r i k i n g . Chapter 3. An Appraisal of Casework Services. The adequacy of service must be considered i n r e l a t i o n to the needs of c l i e n t s but also i n r e l a t i o n to the declared functions of the agenoy. What, however, do we mean by "needs"? It i s now well understood that needs can never be wholly met: a l l people have soma u n s a t i s f i e d desires, and the whole complex organization of sooiety i s mankind's attempt to meet human requirements and aspirations. S o c i a l welfare agencies are organized expressions of the public conscience, an attempt to meet need i n some s p e c i f i o area through appropriate s e r v i c e s . Of course, the f a o t that an agency has a defined function and programme of services does not free i t from the o b l i g a t i o n f o r recognizing other s o c i a l problems, and p a r t i c i p a t i n g i n planning and s o c i a l action f o r welfare purposes i n the community at large. But i t must do Its f i r s t Job f i r s t . The method of giving help i s also of importance. S o c i a l workers believe that the process of enabling the c l i e n t to make use of needed services through the medium of a professional r e l a t i o n s h i p w i l l , i n i t s e l f promote growth In the c l i e n t so that he w i l l be b e t t e r able to cope with h i s own l i f e . In evaluating agency services, therefore, i t i s necessary to consider three elements — c l i e n t s 1 needs, agency functions and services, and the q u a l i t y of professional r e l a t i o n s h i p s . 49 As Gordon Hamilton has s a i d "helping an i n d i v i d u a l to a v a i l himself of the s o o i a l program Of the community i s the chief business of casework",* and i n doing t h i s the goal of treatment i s "to support or maintain the clients» current strengths by helping him to mobilize oapacity and resources to meet his current l i f e s i t u a t i o n " * 2 While i t i s sometimes possible "to modify the c l i e n t s ' attitudes and patterns of behaviour by increas Ing his unders tanding of himself, of h i s problems and of his part i n creating them"**, casework of t h i s kihd requires a great deal of s k i l l and time, as Well as the active invdlvement of the c l i e n t . Many of the c l i e n t s of a Children's A i d Sooiety are not oapable of using t h i s kind of service, nor are they asking f o r i t . One or two of the oase examples w i l l i l l u s t r a t e s ituations where casework On this l e v e l might have been appropriate, but was not given f o r various reasons. Judgments regarding adequacy of service have been made on the basis of the t o t a l service rendered the c l i e n t during his contact with the agency rather than on the service rendered only i n June 1955. 1. Hamilton, Gordon, "The Underlying Philosophy of S o o i a l Casework" i n P r i n c i p l e s and Techniques i n S o c i a l Casework, Selected A r t i c l e s 1940-50, Kasius, Cora, ed.. Family Service Assoc-i a t i o n of Amerioa, New York. 1950 p. 11. 2. Scope and Methods of the Family Service Agency. Report of the Committee on Methods and Scope. Family Servioe Association of America, New York, 1953, p. 7. 3. Ibid 50 Thus, even though th© faot that a case whioh could have been closed* s t i l l remained open i n a s t a t i s t i c a l s^ense i n June 1955i thus i n d i c a t i n g some administrative weakness^ service l a not rated as inadequate I f , at the time the case was act i v e ; adequate service was given to the c l i e n t . On the other hand* i f Serious er r o r s ; a f f e c t i n g the whole conduct of a case; were mad© during the months p r i o r to June 1955; but adequate service was given i n that month; the case Is rated on the basis of the to t a l service given; Howeverj cases of children i n dare, opened years ago ; are also Judged i n terms of practice generally considered sound at that time* rather than by present day standards of p r a c t i c e . Present p o l i c y regarding adoption placement of children with handicaps i s a s t r i k i n g example of this kind of change. Although formerly i t was considered good practice to bring Up "unadoptable" children In ward care; t h i s p o i n t of view has changed during the past decade, and i t i s now judged e s s e n t i a l to make every e f f o r t to place those children who need f a m i l i e s , and who can b e n e f i t from and contribute to family l i f e , * with adoptive parents who can accept them, In spit© of th© l i m i t a t i o n s they may have. 1, Halllnan, Helen W., '"Who are the Children Available f o r Adoption 7** So o i a l Casework, Family Service Association of America, Hew York. A p r i l 1951, Vol, 32,, Ho. 4, p. 162, 51 With these c o n s i d e r a t i o n s In raind c r i t e r i a f o r adequacy of s e r v i c e were drawn up as follows?: S e r v i c e was considered adequate i f : 1) In e new case,- s e r v i c e was made a v a i l a b l e w i t h i n an appropriate time-'interval f o l l o w i n g applications?* I n an open ease, s e r v i c e was not s i g n i f i c a n t l y l i m i t e d through l a c k of time,. 2) W o r k e r - c l i e n t r e l a t i o n s h i p gave evidence of respect for,, and acceptance of the c l i e n t ; of a b i l i t y to make f i t t i n g use of a u t h o r i t y Where necessary; and of the worker*s d e s i r e to h e l p . 3) The treatment p l a n and s e r v i c e s rendered were appropriate to the p r e s e n t i n g problem. 4) There was evidence of c o n t i n u i n g p s y c h o s o c i a l d i a g n o s i s , w i t h corresponding m o d i f i c a t i o n of treatment plan,^ I f needed.^ Por many years c h i l d c a r i n g agencies were so absorbed i n the s t r u g g l e to achieve s a t i s f a c t o r y standards of p h y s i c a l care, s u p e r v i s i o n , c l o t h i n g , and medical s e r v i c e s t h a t they were almost i n a r t i c u l a t e on the sub j e c t of c h i l d placement as casework process. Only r e c e n t l y has i t been c l e a r l y recognized that c h i l d placement must be viewed not as an end In i t s e l f , but as a p a r t of a t o t a l treatment p l a n , developing out of a sound s o c i a l diagnosis» Inadequate planning can negate the r e s u l t s of the b e s t Standards of p h y s i c a l care. Thus In e v a l u a t i n g the c h i l d 1. The l e n g t h of an ^appropriate time interval™ would v a r y g r e a t l y w i t h the nature of the case. Some n e g l e c t complaints r e q u i r e immediate (same day) a t t e n t i o n , w h i l e the a p p l i c a t i o n of an adoptive a p p l i c a n t might be delayed to a month, or l o n g e r , provided th© lapse of time had been agreed upon. 52 placing programme of an agency* both standards of Care and adequacy of casework planning must be kept i n mind; Three r a t i n g categories were used* "adequate"* " f a i r l y adequate" and "inadequate"; In addition* the degree to which lack of time appeared to be a bause of l i m i t a t i o n of service was calculated under three headings, "main cause"* "contributing cause" and "not a cause"; Table 6: Qualitative Ratings on Services Rendered. Type of Case Quality of Service Limitation of service due to lack of time Total Cases Adequate F a i r l y Adequate Inadequate Main Cause Contribu-t i n g cause Not a Cause Family Cases 6 12 6 7 7 10 24 Children i n Care 10 10 5 5 3 17 25 Children on adopt, probation ! 6 4 0 1 2 7 10 Adoption Homes J 5 2 1 0 2 6 8 Fos ter Homes 3 8 5 9 2 5 16 TOTALS 30 36 17 22 16 45 83 S3 Coverage is one Important aspect of function and service. Because of the Children's Aid Society's statutary obligations, and also because of underlying philosophy, I t has been agency practice to accept for service a l l cases which f a l l within the agency's function and to make an effort to meet the most essential requirements In as satisfactory a )manner as possible, rather than to limit service In accordance with resources available. Obviously the "amelioration of conditions which lead to neglect" (of children) could, i f broadly . interpreted, embrace almost the whole f i e l d of health and welfare services. As a result, there has been a tendency for cases involving children for whom there i s no adequate programme in the community, to be referred to the Children's Aid Society, whether or not the services which have been developed in th© agenoy are adequate to meet the needs. Situations i n point might b© emotionally disturbed, or delinquent ohildren, hopefully referred by other agencies In the community, for "placement i n a good foster home" because no treatment centre was available or, beoause i t was considered the resources for delinquents might do more harm than good, and that a foster home should be "tried f i r s t " , Chronioally inadequate families presenting a constellation of sooial, psychological and economic problems, but also containing positive values for family members, have been shifted about uneasily among public assistance agencies, family agencies, and children's agencies. No agency considered i t s e l f equipped or was anxious to engage in the long term financial and casework help necessary to meet the needs of these clients. Nor 64 were a g e n c i e s p r e p a r e d t o c a r r y o u t t h e r e s e a r c h n e c e s s a r y t o a c h i e v e an u n d e r s t a n d i n g o f t h e most a p p r o p r i a t e methods o f t r e a t m e n t . A*number o f t h e s e eases a r e u s u a l l y i n c l u d e d i n C h i l d r e n ' s A i d S o c i e t y c a s e l o a d s , o f t e n b e i n g c a r r i e d l h c o - o p e r a t i o n w i t h o t h e r w e l f a r e a g e n c i e s , s u c h as t h e C i t y S o c i a l S e r v i c e Department. S e r v i c e s t o thes e f a m i l i e s h a v e, on t h e whole, been i n e f f e c t i v e . The needs a r e g r e a t , t h e r e s o u r c e s f e w , and t h e f a m i l i e s t h e m s e l v e s n o t making a c t i v e r e q u e s t s f o r h e l p * e x c e p t on ah emergency b a s i s . T h e i r needs f o r s e r v i c e >are o f t e n s u p e r c e d e d b y t h e more p r e s s i n g demands made on agency s e r v i c e s b y c r i t i c a l s i t u a t i o n s o f n e g l e c t , a b u s e , o r abandonment o f C h i l d r e n , t h e r e q u i r e m e n t s o f u n m a r r i e d m o t h e r s , o r cases where placement must be s p e e d i l y a r r a n g e d . Recent e f f o r t s have been made t o d e f i n e and c l a r i f y t h e a r e a s o f s e r v i c e a p p r o p r i a t e t o the C h i l d r e n ' s A i d S o c i e t y , i n terms o f t h e p r o p e r f u n o t i o n s and s e r v i c e s o f o t h e r community a g e n c i e s , s u c h as the F a m i l y S e r v i c e Agency.* The e x t e n t o f t h e p r e s e n t demand f o r s e r v i c e made b y the community, as r e f l e o t e d i n i n t a k e f i g u r e s f o r 1955, i s shown i n T a b l e 7. 1. " P r o t e c t i v e F a m i l y S e r v i c e s o f C h i l d r e n ' s A i d S o c i e t y i n R e l a t i o n t o F a m i l y S e r v i c e s o f o t h e r A g e n c i e s i n t h e Community. t t ( u n p u b l i s h e d s t a t e m e n t o f p o l i c y , December 2 3 , 1955. P r e p a r e d f o r d i s c u s s i o n w i t h F a m i l y S e r v i c e Agency o f G r e a t e r V a n c o u v e r ) . 55 Table 7. Intake In the Children'a A i d Society (Vancouver, 1985. New Cases Total Monthly Category Year Average Total:Family Cases 1718 143 (a) deferredj no case made* 482 40 • (b) accepted f o r service 1236 103 Adoption Applications 269 22 Foster Home Applications 341 28 j Children on adoption probation private or r e l a t i v e placements 178 15 To t a l accepted f o r service 2084'JttJ 168 ! Children Placed | Admitted to care 416 38 j Placed on adoption probation 164 14 Total 580 49 # Applications r e f e r r e d to other agency or resource. This f i g u r e excludes private boarding homes (not Included i n this study). 50 Evaluative C r i t e r i a t I l l u s t r a t i o n s : Ten case examples, representing approximately one out of every eight oases i n each category i n the sample group, were selected i n order to serve two purposes: the I l l u s t r a t i o n of t y p i c a l case content, and the description of practice i n the three groups of oases which had been rated as giving adequate, f a i r l y adequate and inadequate service. Three family cases and three children i n care showing adequate, f a i r l y adequate and inadequate service i n each category were chosen. Two f o s t e r homes, one adoptive applicant, and one c h i l d on adoption proba-t i o n , giving one example of adequate, and one of inadequate service, and two examples of f a i r l y adequate service, were selected. 57 Gases I l l u s t r a t i n g Adequate Services The e f f e c t i v e use of time Is i l l u s t r a t e d by the Eyre case,, On June 5 t h , 1955, a neighbour who I d e n t i f i e d h e r s e l f , telephoned a complaint that f o u r Eyre children ;were being neglected. The complainant stated the children were begging around the neighborhood f o r food,; and the mother Was not doing anything about the s i t u a t i o n . A l l the.money i n the family was c i t h e r "gambled or drunk away". The d i s t r i c t worker v i s i t e d on June 8 t h and found the home clean, though barely furnished, Mrs, Eyre, who seemed to be a capable woman, stated she was i n f i n a n c i a l d i f f i c u l t y as her husband had had very l i t t l e money to leave her, when he went out of town to work two weeks before, following several months of unemployment. They had not paid t h e i r l i g h t b i l l and e l e o t r l c i t y had been cut o f f . She denied the negleot complaint and stated she expected to receive money from her husband Immediately. The worker gave reassurance of the agency's Interest In enabling children to remain with t h e i r parents and recognized Mrs. Eyre's expressed desire to be a good mother. She was i n v i t e d to get i n touch with the agency i f she needed help. Two days l a t e r a s t a f f member of another s o c i a l agency, who knew the complainant, telephoned s t a t i n g the s i t u a -t i o n In the home was serious and the worker had not obtained f u l l information. The worker Immediately got i n touch with the complainant, who stressed the d i f f i c u l t y of the f i n a n c i a l s i t u a t i o n and the f a c t that there was no heat, l i g h t nor means of cooking, since the e l e c t r i c i t y had been discontinued. She also stated the mother was " a f r a i d " to apply f o r S o c i a l Assistance. 58 Two days l a t e r the worker c a l l e d at the school where the p r i n c i p a l described the two older ch i l d r e n , who were attending, as w e l l behaved and doing good work. He was aware of the f i n a n c i a l problem, and believed the mother was doing the best she could. The worker then v i s i t e d the complainant who repeated muoh of the same information. Her attitude appeared somewhat " s p i t e f u l 1 * , although there were elements of genuine concern. The complaint that the children were begging was not supported. The mother was then v i s i t e d , and, on this occasion, she was more ready to share her problems. She t o l d the worker she had f e l t a f r a i d of s o o i a l agencies as she had once been a "welfare c h i l d " . She expressed concern over the lack of e l e c t r i c i t y and the f a i l u r e of her husband to send money, though she was quite certain t h i s was not due to any f a u l t of h i s . The worker offered help with both these problems and also spoke of tho p o s s i b i l i t y of Sooial Allowance i f a l l else f a i l e d . The same day the worker was able to arrange with the B.C. E l e c t r i c Company that the e l e c t r i c i t y would be turned oh immediately. Though unsuccessful i n attempts to reach the cen t r a l o f f i c e of the husband's place of employment, the worker found, when v i s i t i n g the mother again the same day, that she had Just reoelved a substantial cheque from her husband. Before closing the case, a follow-up v i s i t was paid and the family found to be managing s a t i s f a c t o r i l y . They were planning to move up the coast to the father's place of employment. In this oase three v i s i t s were paid to the mother during June, and there were three c o l l a t e r a l v i s i t s , two f o r the purpose of assessing the s i t u a t i o n , and one with the p r a c t i c a l purpose 69 of having the e l e c t r i c i t y turned on.. There were also several telephone c a l l s . . A h e l p f u l r e l a t i o n s h i p was established,, even though contact was non-voluntary,, a tentative diagnosis made,, strengths supported, appropriate p r a c t i c a l assistance given, and the case closed promptly a f t e r further assessment,, It was not, i n essence,, a case of neglect but rather of generalized family d i f f i c u l t y , complicated by the mother's d i s t r u s t of s o c i a l agencies.. Th© case of Thomas Bryan,t bora January 1, 1954,. and f i n a l l y placed f o r adoption on June 17, 1955, i s a convincing i l l u s t r a t i o n of tho importance of integrated services to parents and children. One worker c a r r i e d both mother and c h i l d from the time th© case was opened In November 1953 u n t i l i t was closed December 1955, s i x months a f t e r th© chil d ' s adoption ., placement. Thomas, who was h a l f Hawaiian, and thus d i f f i c u l t to place f o r adoption, came Into th© car© of the Children's A i d Society on January 11th, 1954, as a non-ward pending adoption. He was placed i n a temporary f o s t e r home where he was Supervised from th© health standpoint by medical s t a f f . There was s l i g h t d i f f i c u l t y with th© formula adjustment In th© beginning, but h© soon progressed normally, and developed into a healthy, vigorous c h i l d . Thomas' mother, a b r i l l i a n t , but unstable woman i n her f o r t i e s , capable of earning a good salary, decided on adoption a f t e r considerable ambivalence, unfortunately, neither the Children's A i d Society nor the P r o v i n c i a l C h i l d Welfare D i v i s i o n , was abl© to o f f e r an adoption home which would meet mother's 60 request f o r s u p e r i o r standards, and a l s o be acc e p t i n g of a c h i l d of mixed r a c i a l o r i g i n . Before the r i g h t adoptive, parents were f i n a l l y l o c a t e d i n June 1955, no l e s s than t e n p o s s i b l e homos had been explored f o r t h i s c h i l d . Three'couples had been s u f f i c i e n t l y i n t e r e s t e d to v i s i t the c h i l d , but a f t e r , seeing him, had decided a g a i n s t t a k i n g him because of h i s r a t h e r dark c o l o u r i n g . , A f t e r the f i r s t two f a i l u r e s to p l a c e , of which the mother was aware because the c h i l d was a non-ward, the mother became discouraged and decided to remove her c h i l d from non-ward care, and place him i n a p r i v a t e boarding home a t her own expense. The worker helpod her to secure a s u i t a b l e home; I t was agreed t h a t the mother would continue t o work w i t h the agency, and th a t e f f o r t s to o b t a i n a s u i t a b l e adoption home would s t i l l go on. Thomas was discharged to the mother and placed i n the p r i v a t e boarding home a t the end of A p r i l 1954, when he was j u s t under f o u r months o l d . He continued to make good progress i n t h i s homo. The case was discussed w i t h the agency p s y c h i a t r i c c onsultant as the mother was making e n q u i r i e s regarding p s y c h i a t r i c help f o r h e r s e l f . I t was f e l t such help was i n d i c a t e d as the mother's p e r s o n a l i t y disturbance Seemed severe. The Importance of continued planning toward adoption was a l s o s t r e s s e d . The mother began treatment w i t h a p s y c h i a t r i s t and continued to work and pay f o r the c h i l d ' s care u n t i l she developed an aoute mental I l l n e s s i n September 1954. She went t o Crease C l i n i c and as her r e l a t i v e s d i d not wish t o continue t o assume r e s p o n s i b i l i t y , the agency was able to apprehend Thomas as being i n need of p r o t e c t i o n . Because of the acute nature of her I l l n e s s , 61 planning could not be discussed v i t h the mother at the time, and thus apprehension was the only possible course of acti o n . Fortunately Thomas did not have to be replaced, as the private boarding home parents were w i l l i n g and suitable to become agency f o s t e r parents. The mother made a s a t i s f a c t o r y recovery and was discharged from Grease C l i n i o at the end of December 1954. On March 7, 1954, the agency took oourt action f o r guardianship of Thomas a f t e r having gained the mother's somewhat reluctant agreement to this plan. I t was considered guardianship would o f f e r the c h i l d more protection, p a r t i c u l a r l y as no suitable adoption home had, as yet, been secured. Thomas remained In h i s f o s t e r home and continued to develop w e l l . The worker v i s i t e d him occasionally during t h i s period and also continued to see th© mother on a supportive b a s i s . Beside protecting Thomas from the p o s s i b i l i t y of eccentric a l t e r a t i o n of plans by the mother, the f a c t that he was a ward made i t possible to continue with the search f o r adoptive parents, without making the mother awar© of ©very move and thus contributing to her disturbance. F i n a l l y , i n June 1955, th© C h i l d Welfare D i v i s i o n located a suitable adoptive couple, who were attracted to Thomas as soon as they v i s i t e d him. At t h i s point the matter was discussed with the mother, who was pleased with the information about the home, and w i l l i n g to sign consent to adoption. The adoptive couple spent several days In Vancouver ge t t i n g to know Thomas i n his f o s t e r home, and he was able to go with them quite comfortably when he was transferred to t h e i r care on June 17th. A p a r t i c u l a r l y perceptive l e t t e r written to the f o s t e r mother by the adoptive mother i n September 1955, gave a thoughtful descrip-62 t i o n of ways i n which various problems of adjustment had been worked through and Thomas had become n n o t a dear l i t t l e baby, but our dear l i t t l e baby", . \ Adequate service was given this c h i l d , although there was only one concentrated period of work with him, whioh occurred at the time of his adoptive placement, This involved seven Interviews or v i s i t s with the mother or c h i l d and three c o l l a t e r a l v i s i t s to the f o s t e r parents and the doctor. The Children's A i d Society worker met the adoptive parents and went with them twioe to the f o s t e r home, but the r e s p o n s i b i l i t y f o r work with them rested with the C h i l d Welfare D i v i s i o n worker. Thus, the use of time i n d i r e c t r e l a t i o n to this c h i l d , although not very extensive, except In the month of June, was w e l l focused on the most Important aspects of the case. I t i s also clear i t would have been of l i t t l e value i f continued service to the mother had not been c l o s e l y integrated with planning f o r the c h i l d . 63 The Campbell adoptive home study i s also an example of adequate service. In the course of the study which continued over a period of s i x months, November 1954 to May 1955, Mr. and Mrs. Campbell were interviewed together three times, twice at . home and once i n the o f f i c e , Mr* Campbell Was Seen alone at the o f f i c e twice, and Mrs. Campbell alone at the o f f i c e once* There were also numerous telephone c a l l s , , several l e t t e r s and det a i l e d medical reports on both parents. Their natural c h i l d , Dawn, aged Six,' was seen with the parents on several occasions. Between raid-December and mid-March contact was s l i g h t as the Campbells were b u i l d i n g a house* BOth parents were interested i n the home study and highly co-operative i n sharing personal information about themselvesj t h e i r c h i l d and t h e i r own parent-child r e l a t i o n -ships* The Campbells were a s t r i k i n g l y good looking young couple i n t h e i r early 30?s, Both had professional or business backgrounds and had oome from happy, priveleged, though rather s t r i c t , homes* Both had s i b l i n g s with whom they maintained f r i e n d l y r e l a t i o n s . Parents of both were a l i v e and i n good health, with many i n t e r e s t s , and aotive In community l i f e * Mr. Campbell had unsuccessfully t r i e d to work with h i s father i n business but, i n spi t e of his withdrawal from the business, and his expressed resentment of his father's need to dominate, they continued to be fond of each other. Mr. Campbell seemed s l i g h t -l y less mature than his wife, with more need to assert him-s e l f , but the marriage was a very happy one and the partners' pe r s o n a l i t i e s complemented eaoh other. Mrs. Campbell had had repeated miscarriages a f t e r Dawn's b i r t h although she had 64 received expert medical attention. Otherwise, both parents were i n excellent health. Dawn was an a c t i v e , "highly-strung", i n t e l l i g e n t c h i l d with many f r i e n d s . During the early, part of the home 1study she was occasionally enuretio i n the day time. The parents a t t r i b u t e d this to disturbance caused by a recent move and the father's, change of employment. The parent-child relationships gave evidence of much a f f e c t i o n and Interest, and the worker came to the conclusion there was no basic d i f f i c u l t y between parents and c h i l d . By the time the home study was completed t h i s diurnal enuresis had disappeared. •Mrs, Campbell had had two years at University, and Mr, Campbell had a BSc. degree. He had been somewhat slow In s e t t l i n g into a permanent business p o s i t i o n , and while he had always maintained his family comfortably, and had f i n a n c i a l s e c u r i t y , he had changed Jobs several times, When the home study was completed he had been i n his Job several months and was pleased with i t . Like h i s father, Mr, Campbell had considerable drive to succeed., but he was, at the same time, a devoted family man who spent much time with h i s wife and c h i l d . Both parents f r e e l y discussed such matters as heredity, Illeg i t i m a c y and t e l l i n g a c h i l d of i t s adoption, and i n doing so gave evidence of f l e x i b i l i t y , tolerance and Informed a t t i t u d e s . They requested an infant " l i k e themselves" but made no demands regarding sex or background. In May the home was approved f o r an Infant of either sex. A suitable infant was discussed with them at the end of June 1955, and a placement made early i n July. The child's progress was excellent and the parents very happy with him. Dawn, too, was pleased with the c h i l d , and showed no 6 5 Jealousy or r e g r e s s i v e behaviour. The parents statements Of s a t i s f a c t i o n were confirmed by o b s e r v a t i o n d u r i n g s e v e r a l Supervisory v i s i t s . I t appeared there was no d i f f i c u l t y I n t h i s case In regard to a v a i l a b i l i t y of time. The paco was l e i s u r e l y , the r e c o r d i n g d e t a i l e d , and the worker seemed Intent on making an adequate study. S6 Gaaea I l l u s t r a t i n g f a i r l y Adequate Service. The case of Susan Ross, an unmarried mother of 23* Is an example of service* l i m i t e d to some extent by l a ok of time* but also by the worker's understanding of possible treatment goals. Susan* a healthy a t t r a c t i v e and i n t e l l i g e n t g i r l * f i v e months i l l e g i t i m a t e l y pregnant at the end of September 1954* applied to the Agency f o r help i n arranging adoption placement f o r her c h i l d , expected at the end of January 1955. Susan had been referre d by the woman In the s a t i s f a c t o r y work home which she had located f o r h e r s e l f . As Susan had had no medical care she was referr e d , a t her request* to a f r e e , p ublic c l i n i c . Susan's defenses seemed high and she gave an impression of poise and sophistications The intake worker gave assurance of the agency's desire to help and discussed the adoption programme In a general way. Although the d l s t r l o t worker telephoned Susan ten days following her a p p l i c a t i o n , an appointment was not arranged u n t i l November 5th. I t i s l i k e l y that pressure of work was at l e a s t p a r t l y responsible f o r t h i s delay. Prom November 15th u n t i l mid-January, Susan was seen i n the o f f i c e every two weeks f o r approximately an hour's Interview. Later on two v i s i t s were paid. Susan quickly r e l a t e d p o s i t i v e l y to the worker Who was obviously interested i n her and l i k e d her. The s u p e r f i c i a l defensive structure was not strong and Susan was able to br i n g out many things with her worker; her ambivalence about keeping her c h i l d , her mixed f e e l i n g s about the putative father to whom 67 she had been Intensely a t t r a c t e d , her r i v a l r y with a younger married s i s t e r who had had a baby, her fe a r of death i n c h i l d -b i r t h , her u n r e a l i s t i c need to deny negative f e e l i n g . The c h i l d , a healthy baby g i r l , was bom on January 19th without complications, and was placed f o r adoption on February 2nd, 195S. Although there was a b r i e f period of h e s i t a t i o n Shortly a f t e r the baby's b i r t h , Susan never r e a l l y f a l t e r e d In her request f o r adoption. This r e a l i s t i c plan was supported by her worker and Susan seemed f i r m l y resolved on adoption iat the time placement was made. Subsequent contact with the worker consisted of a telephone c a l l concerning Job placement and future plans. The c l i e n t made good use of the services offered, and there was some evidence of maturation In this case. However, the summarised record gave no i n d i c a t i o n of an attempt at diagnosis or conscious treatment process. The dynamics of much of the material seemed to have ©scaped the worker. Family h i s t o r y and r e l a t i o n s h i p s , which revealed a meaningful parental separation, were treated merely as "background information" f o r the baby. Although she was given considerable acceptance and freedom to express h e r s e l f , no apparent e f f o r t was made to have the c l i e n t see her current ambivalent f e e l i n g s more c l e a r l y , and r e l a t e these to patterns of behaviour and S©lf^understanding, There i s no evidence to suggest the c l i e n t acquired much under* standing regarding the f e e l i n g s which l e d to her l l l e g i t i m a t o pregnancy, so that she would be enabled to avoid a recurrence of the s i t u a t i o n . I t seemed evident from the record that the c l i e n t would have been w i l l i n g and able to use help of this kind, i f i t had been a v a i l a b l e . Such a l e v e l of casework would have required 68 weekly Interviews and considerable worker and s u p e r v i s o r y s k i l l . In the M i l l e r f o s t e r home the only eause of l i m i t a t i o n of s e r v i c e appeared to be l a c k of worker time. The home, which was f u l l y s t u d i e d during the months of November and December 1954, was put i n t o imediate use a t the beginning of January 1955. Tho emotionally d i s t u r b e d c h i l d p l a c e d a t that time r e c e i v e d e x c e l l e n t care and made u n u s u a l l y good progress. No other placements were made. The worker v i s i t e d o f t e n a t the beginning of the placement but l a t e r , had to c u r t a i l v i s i t s more than she f e l t was d e s i r a b l e . The f o s t e r mother valued, and mad© good use o f , the caseworker's support and h e l p . Because a good r e l a t i o n s h i p had been e s t a b l i s h e d In the e a r l y p e r i o d , the.us© of telephone contacts between v i s i t s whioh were p a i d ©very two months a f t e r the placement had become a©cur®, mad© p o s s i b l e a f a i r l y s a t i s f a c t o r y standard of s e r v i c e . The f o s t e r home was t h a t of a h a p p i l y married couple in t h e i r e a r l y t h i r t i e s . They had three n a t u r a l c h i l d r e n , a boy of e i g h t and a h a l f , a g i r l of seven, and a boy of two. A l l were happy, co n f i d e n t c h i l d r e n making s a t i s f a c t o r y progress. Th© marriage seemed e x c e p t i o n a l l y s a t i s f y i n g and the parents were able to d i s c u s s , r e a l i s t i c a l l y , the normal adjustment problems which they had s u c c e s s f u l l y worked out, Th© f o s t e r f a t h e r who was the head of a department In a l a r g e s t o r e , earned an adequate s a l a r y and they were buying t h e i r house, Th© atmosphere was comfortable and homelike and housekeeping standards were not r i g i d . The parents took an a c t i v e I n t e r e s t in community a f f a i r s , Parent Teachers A s s o c i a t i o n , and t h e i r c h i l d r e n ' s p u r s u i t s . They enjoyed t h e i r own c h i l d r e n immensely, and t h e i r 69 motive f o r wanting to take a f o s t e r c h i l d was to round out t h e i r own f a m i l y , arid a l s o to help a c h i l d . They had planned to have f o u r c h i l d r e n , but Mrs. M i l l e r had been a d v i s e d a g a i n s t another pregnancy as her three c h i l d r e n had been d e l i v e r e d by Caesarian s o c t l o n . The f a m i l y doctor confirmed that a l l members of the f a m i l y were i n good h e a l t h and t h e i r r e f e r e n c e s , I n c l u d i n g the a chool p r i n o i p a l and s chool nurse, spoke h i g h l y Of the home, p a r t i c u l a r l y of the q u a l i t y of f a m i l y r e l a t i o n s h i p s . Both parents had come from contented, middle c l a s s backgrounds, although Mr. M i l l e r f e l t " h e had been somewhat overprotected as a boy. R e l a t i o n s h i p s w i t h r e l a t i v e s were c o r d i a l . The M i l l e r s asked f o r a' g i r l of s i x , and f e l t they could accept a c h i l d who was e i t h e r s l i g h t l y r e t a r d e d or emotionally d i s t u r b e d , but d i d not want a c h i l d of mixed r a o i a l o r i g i n o r one w i t h a marked p h y s i c a l handicap. In January 1955, a s i x and one h a l f year o l d g i r l , who had been s e v e r e l y r e j e c t e d , and whose symptoms were s t u t t e r i n g , withdrawing and l a c k of s e l f - c o n f i d e n c e , was p l a c e d i n the home a f t e r s u i t a b l e p r e p a r a t i o n . She was w e l l accepted and a recent c h i l d guidance c l i n i c e v a l u a t i o n confirmed the worker's o p i n i o n that her improvement had been remarkable i n view of her degree of disturbance. In a case where such good i n i t i a l work was don©, and where the co n d i t i o n s f o r success are present, i t seems unfortunate that a c o n s c i e n t i o u s , c a r e f u l worker should be l i m i t e d * by l a c k of time, from g i v i n g th© maximum s e r v i c e she considers d e s i r a b l e . Although th© f o s t e r horn© study was adequately r e c o r d -ed, no progress notes regarding the c h i l d i n the home, w i t h th© exception of date and f a c t of placement, had been put In th© 70 f o s t e r home f i l e , although th© c h i l d had been In th© home f o r si x months In June 1955, Progress notes regarding the o h i l d were obtainable i n the child' s f i l e . Danny Lan© born September 30th, 1945, and his four brothers and s i s t e r s were brought Into the care of the Children's Ai d Society as wards i n June 1954. The father had requested permanent plaoement f o r the ohildreh when his wife f i n a l l y deserted with another man, following a ten-year pattern of occasional incidents of leaving home. E f f o r t s to improve th© marital s i t u a t i o n had f a i l e d . The father had t r i e d to car© f o r th© children f o r a time with th© help of e l d e r l y grandparents* but this d i d not work out, Th© children were poorly looked a f t e r p h y s i c a l l y , and also showed various signs of ©motional disturbance, such as exoossive worry, undue quietness, i n a b i l i t y to endure normal f r u s t r a t i o n , and occasional v i o l e n t temper outbursts. As the father worked out of town much of the time and f e l t unable to make a suitable plan f o r the children i n the foreseeable future, ward oare was mutually decided upon. The youngest o h i l d , aged one year, was plaoed, with th© father's agreement, i n a permanent home with a view to adoption. Danny, aged nine, and the other three children aged eleven, ten and f i v e , were plaoed together i n a rather low standard country f o s t e r home, which they had v i s i t e d once, p r i o r to placement. The f o s t e r parents were e l d e r l y , kindly and r e l i g i o u s l y motivated. The children s e t t l e d down f a i r l y w e ll but Danny was concerned about the placement of th© baby In a d i f f e r e n t home. The father v i s i t e d r e g u l a r l y and was well accepted by the f o s t e r parents. The mother and her man f r i e n d v i s i t e d occasion-71 a l l y , unannounced, and these v i s i t s appeared to upset the children who f e l t b i t t e r toward t h e i r mother. The children received the usual material benefits of being i n care, adequate clothing and medical and dental care, Christmas presents, camp outings. They were v i s i t e d i n t h e i r f o s t e r home approximately every two months and ca r e f u l enquiry was madei into each child's progress. D i f f i c u l t i e s i n adjustment were discussed with the foster.mother. The worker had a f r i e n d l y r e l a t i o n s h i p with the children; The father .continued to v i s i t and to take a constructive interest.; His r e l a t i o n s h i p with the worker 1was pleasant and cooperative* and he got i n touch with her about once a month, or whenever he came into Vancouver. The mother avoided a*Ll contact with the agency. The children were S t i l l i n the same f o s t e r home i n June 1955, and appeared, from observation, to be getting on reasonably w e l l . There was considerable improvement i n general appearance and behaviour. There had been no c r i s i s of any kind, nor was there any thought of change. The case had been transferred once, from the worker who plaoed the children and did the o r i g i n a l work with the family, to the regular country worker who also c a r r i e d both parents and children. This case had many s a t i s f a c t o r y aspects, the major ones being the acceptance of the four older children i n one fo s t e r home, the apparent s t a b i l i t y of the placement, the kindness and tolerance of the f o s t e r parents, p a r t i c u l a r l y the f o s t e r mother, and the continued constructive Interest of the fath e r . Considering the siz e of the current caseloads i n the agency, i t was, a creditable piece of work with attention and 78 e f f o r t being fooUSed upe-n the major e s s e n t i a l s H o w e v e r there were unsatisfactory aspects. The f o s t e r parents were too e l d e r l y to have the care of a c h i l d as young as the five-year o l d , there was a certain r i g i d i t y In the home and an undue emphasis on the r e s t r i c t i v e aspects of r e l i g i o u s b e l i e f . Because of the current shortage of f o s t e r homes, p a r t i c u l a r l y f o r large f a m i l i e s , the Worker would.have l i t t l e choice In t h i s respect. The main problem, however, ran deeper. Each of the children, with the possible exception of.the eldest, a boy, had experienced considerable a f f e c t i o n a ! and phy s i c a l deprivation and were s u f f e r i n g from emotional disorders of considerable se v e r i t y . Danny, f o r example, was effeminate, e a s i l y hurt, avoided the company of boys and sought out g i r l s , wss p a r t i c u l a r l y s o l i c i t o u s and fawning toward mother f i g u r e s . There was no p s y c h i a t r i c assessment, nor was one proposed, but judging from these symptoms, i t Is probable that supervised f o s t e r home placement alone, would not help Danny to achieve the s a t i s f a c t o r y degree of,adJustment which might be bis I f s k i l l e d , Intensive casework or, perhaps, p s y c h i a t r i c help, were possible, l o r e should be done to help these children with t h e i r f e e l i n g s around the breakup of their family, the rol e s of the parents, and the loss of the baby. Community resources to enable a f a i r l y adequate father to care f o r his children In his own home were a fundamental lack i n this case, but would be d i f f i c u l t to develop. In order to do the i n d i v i d u a l i z e d work with each c h i l d , which would l i k e l y be required f o r maximum r e s u l t s , much more time and more highly s k i l l e d s t a f f would be necessary. Possibly a f t e r the main problems had been worked out, there could be a 75 return t© a leas intensive type of contact. The Hutton-Taylor adoption, the case of an i n f a n t , placed f o r adoption by the Children's A i d Society, i n an approved adoptive home, was a cas© where the chief cause of l i m i t a t i o n of Service was due to lack of worker time. Although tii© recording was very condensed, the horn© study gave a c l e a r picture of an ordinary, working class couple* both aged 39, who maintained a modest, though comfortable home. They were fond of each other, i n good mental and physical health, and interested mainly In family, friends and r e l a t i v e s . In s p i t e of intensive treatment, Mrs* Hut ton had not become pregnant during seven years of marriage. An infant boy, i n good health, and of average working class background, was placed i n the home In October 1954. Supervisory v i s i t s were paid i n November 1954 and A p r i l 1955 and contact was also maintained by telephone. The c h i l d was well accepted by parents and th e i r r e l a t i v e s and h i s progress was Satisfactory and uneventful. He contributed much to th© happiness of both parents and his care, i n which both p a r t i c i p a t e d , gave them much pleasure, Service i n thla case was rated as f a i r l y adequate, because, while r e s u l t s were s a t i s f a c t o r y * th© supervisory v i s i t s could not be considered frequent ©nough to ensure s u f f i c i e n t help during the probationary p e r i o d . 1 1. Adoption Practices * Procedures and Problems, h Report of the Second Workshop Held i n New York C i t y under th© Auspices of the Child Welfare League of America, May 10 - 12, 1951. C h i l d Welfare League of America Inc., March 1952, p. 60, 74 I f a choice must be made, i t i s preferable to spend time on the home study, rather than on supervision a f t e r placement, but an adequate standard of service In both areas should be the goal. "After placement the aim Is to give support and (to) nurture the p o t e n t i a l i t i e s of the couple f o r good parenthood — a l l the answers w i l l not l i e i n the study » 1 and s e l e c t i o n of the home". I. Adoption Practices, Procedures and Problems, A Report of the Second Workshop Held i n New YOrk C i t y under the Auspices of the Ch i l d Welfare League of America, May 10 - 12, 1951. Chi l d Welfare League of America Inc. March 1982, p. 59. 75 Cases i l l u s t r a t i n g Inadequate Service. The Morgan case re-opened May 10th, 1954, and not recorded a f t e r May 31, 1954, was an example of a s i t u a t i o n where inadequate service seemed la r g e l y due to lack of time. On May 10th, 1954, Mrs. Morgan, a 24-year o l d woman separated from her husband, applied f o r private boarding home placement f o r her seven-week o l d baby, having been re f e r r e d by the Poster Day Care Association to whom she had gone f i r s t . She had been known to the Children's A i d Society as an unmarried mother, four years previously. She had been the eldest of f i v e children i n a home of r i g i d r e l i g i o u s standards from which the father had deserted. Mrs. Morgan had relinquished her i l l e g i t i m a t e c h i l d f o r adoption, although this had not been an easy decision f o r her to make. A few months p r i o r to re - a p p l i c a -t i o n to the agency, Mrs. Morgan had repeated the family pattern of separation. She had l e f t her husband and returned to the home of her mother and four younger s i b l i n g s . The grandmother was receiving Mother's Allowance which she supplemented by the odd day's work. Mrs. Morgan had also been i n re c e i p t of So o i a l Allowance f o r several months just p r i o r to, and a f t e r , confine-ment. However, i n l i n e with the p o l i c y of tho pu b l i c assistance agency, she had been advised to obtain work, and had been cut of f s o c i a l assistance at the end of A p r i l . Mrs. Morgan would have preferred to remain at home to care f o r her c h i l d , " f o r a time at l e a s t " . She reported that the c h i l d was t h r i v i n g and that she enjoyed looking a f t e r her, Mrs. Morgan's mother was not w i l l i n g to assume th i s r e s p o n s i b i l i t y because of her need to supplement Mothers' Allowance. The two agencies concerned 76 c o n s u l t e d each, other on tho telephone, but never h e l d a proposed conference, e v i d e n t l y due to changes i n s t a f f . A f t e r two i n t e r v i e w s w i t h the mother and s e v e r a l c o l l a t e r a l telephone c a l l s , the re c o r d ceases and the f o l l o w i n g i n f o r m a t i o n was gained by v e r b a l communication w i t h the worker. Mrs, Morgan found a job and the Chil d r e n ' s A i d S o c i e t y r e f e r r e d her to a p r i v a t e boarding home i n which she pl a c e d her c h i l d f o r s e v e r a l months. During t h i s time there was telephone contact between the mother and the worker but she was never i n t e r v i e w e d . The c h i l d was v i s i t e d o c c a s i o n a l l y by the Ch i l d r e n ' s A i d S o c i e t y p r i v a t e boarding home worker and a l s o by the p u b l i c h e a l t h nurse. The mother removed her c h i l d from the p r i v a t e boarding homo i n February 1955, p o s s i b l y because she had l o s t her job. In any case she was working again i n J u l y 1955 and had mad© some t e n t a t i v e e n q u i r i e s about placement which she had not pursued f u r t h e r . Developments were not f o l l o w e d up although the case remained open. From a s u p e r f i c i a l p o i n t of view t h i s mother's request f o r s e r v i c e was met, and a p r o p e r l y supervised p r i v a t e boarding home was made a v a i l a b l e . This I s an improvement over i n d i s c r i m -i n a t e placement of young c h i l d r e n , but i t f a l l s Short of a d e s i r a b l e standard of s e r v i c e i n r e l a t i o n to a placement request. "There i s agreement i n c h i l d placement agencies t h a t a p p r o p r i a t e Intake s t u d i e s ....... are needed to ensure that c h i l d r e n are separated from t h e i r f a m i l i e s only when I t has been determined that placement Is the needed s e r v i c e " . * 1. Welseribarger, Ruth, "An Agency Experiments w i t h Caseload Weightings", C h i l d Welfare. C h i l d Welfare League of America, New York, January 1955, p. 6, 77 In t h i s case i n t a k e study, d i a g n o s i s , and foll o w - u p s e r v i c e , a l l appeared inadequate. In a d d i t i o n , the p u b l i c agency's - • p o l i c y regarding'the i n e l i g i b i l i t y f o r assistance- of mothers -w i t h one c h i l d , seem3 to have been r i g i d l y a p p l i e d and there was i n s u f f i c i e n t attempt a t communication and. co-operation between agencies. Three agencies, Family Court, C i t y S o c i a l S e r v i c e Department, and C h i l d r e n ' s A i d S o c i e t y had been i n v o l v e d w i t h t h i s f a m i l y w i t h i n a p e r i o d of three months' time, and In s p i t e of-present knowledge concerning'the-young, c h i l d ' s deep need f o r a mother's care, and the c r i t i c a l importance of th© e a r l y y e a r s , these matters we're'at' best* given v e r y cursory a t t e n t i o n . I t would'not be s u r p r i s i n g i f t h i s c h i l d again appeared on th© caseload of a c h i l d guldano© c l i n i c or placement agency w i t h i n the next ten y e a r s , n o t as an i n f a n t , but as an emotionally d i s t u r b e d c h i l d . An e x c e l l e n t o p p o r t u n i t y to p r a c t i s e preventive mental h e a l t h was missed. Mary Worth born June 25, 1948 i s a t r a g i c example of a case of inadequate s e r v i c e . I t i s , p o s s i b l y , l e s s r e p r e s e n t a -t i v e than a case o f a d i s t u r b e d teen-ager, b u t , because I t i s t y p i c a l of the k i n d of case which can e a s i l y b© n e g l e c t e d by th© h e a v i l y burdened worker and s u p e r v i s o r , i t was chosen f o r c l o s e r examination. At three weeks of age, Mary, th© second i l l e g i t i m a t e c h i l d of a former.ward of the Ch i l d r e n ' s A i d S o c i e t y , who, i n t u r n , had been ne g l e c t e d by her p s y c h o t i c , e p i l e p t i c mother, was admitted to th© car© of th© agency on a ward b a s i s . H©r mother had requested adoption, but because of the pathology i n the background, and the f a c t that p a t e r n i t y had not been e s t a b l i s h e d , 78 tho c h i l d was not considered "adoptable". Mary was f i r s t placed In a s u b s i d i s e d baby home under the s u p e r v i s i o n of the n u r s i n g department of the agency, which, a t tha t time, c a r r i e d the cases o f a l l I n f a n t s up to. two years o f age. . When she was j u s t under three.months o l d , she was placed In a permanent boarding home w i t h "a view to adoption", where she remained, During her f i r s t f o u r t e e n months Mary was supervised q u i t e c l o s e l y by the n u r s e s l a r g e l y from th© standpoint of p h y s i c a l ; h e a l t h and development, Mary»s p h y s i c a l development was b e t t e r than average although she developed eczema a t about s i x months of age f o l l o w i n g her f i r s t i n o c u l a t i o n . Various danger s i g n a l s were noted In tho r e c o r d , such as tho observation that the f o s t e r mother was dominated by hor mother, anxious and unsure of h e r s e l f , that tho c h i l d was a . poor s l e e p e r , "nervous" and given to temper tantrums. The case remained In the nu r s i n g department u n t i l Mary.was three years of ag© because of the problem around .eczema which, a t times, was q u i t e severe. In June of 1951 i t was t r a n s f e r r e d to the d i s t r i c t worker, but r e c e i v e d no a t t e n t i o n u n t i l November 1951 p o s s i b l y bocause o f a r a p i d turnover of workers. From November 1951 u n t i l March 1952 a t r a i n e d , experienced worker v i s i t e d every two weeks and sought to e s t a b l i s h a h e l p f u l r e l a t i o n s h i p w i t h f o s t e r parents and c h i l d . Some progress was made but the f o s t e r mother gave evidence of co n s i d e r -able a n x i e t y , f e e l i n g s of perso n a l inadequacy, and d i f f i c u l t y i n the area of r e l a t i o n s h i p . The only way she f e l t she could c o n t r o l Mary was by spanking h e r , and th© o h i l d had frequent and sever© temper tantrums. F o s t e r f a t h e r was a m i l d pleasant man, a steady 79 worker, fond of Mary and much b e t t o r able to manage her. During t h i s p e r i o d the c h i l d was examined at the P r o v i n c i a l C h i l d Guidance C l i n i c f o r a pre-adoptIon a p p r a i s a l and found to be i n the s u p e r i o r group of general i n t e l l i g e n c e , " h e a l t h y , happy, a l o r t and independent'^. The f o s t e r mother wa3 seen as an "unhappy woman" and i t was noted "there was not as a f f e c t i o n a t e a bond between mother and c h i l d as one might d e s i r e " . H i s t o r y of maternal grandmother and other r e l a t i v e s known t o P r o v i n c i a l Mental Health S e r v i c e s was noted i n the r e p o r t and suggestions were made tha t the c h i l d should havo a b l o o d t e s t and t h a t i t might be d i a g n o s t l c a l l y h e l p f u l to arrange f o r an e l e c t r o -encephalogram. The c h i l d ' s medical sheet does not i n d i c a t e that e i t h e r suggestion was acted upon. The worker recorded t h a t she b e l i e v e d re-placement of Mary should not he considered u n t i l f u r t h e r e f f o r t s to help the f o s t e r mother work out the problem of temper tantrums had been made. This worker apparently l e f t suddenly, and there i s no r e c o r d i n g f o r a year and a h a l f . The next worker, who continued w i t h the case u n t i l June 1555, recorded i n summary form and the exact number of contacts was not noted* However, the impression was g i v e n that they were few i n number. A school r e p o r t showed Mary to be a good p u p i l , working to c a p a c i t y and e x h i b i t i n g no o v e r t behaviour problems. The worker heard a r e p o r t of m a r i t a l d i f f i c u l t y between f o s t e r parents but t h i s Was not d e a l t w i t h . The matter of Mary's adoption by the f o s t e r parents was " l e f t d a n g l i n g " and the c h i l d remained on a boarding b a s i s i n s p i t e of the f a c t that the mother signed s p e c i f i c consents to Mary's adoption by these f o s t e r parents during 1954. 80 The basic problem i n this ease, that i s , the uncertainty about which children can s a f e l y be placed f o r adoption at an early age, s t i l l troubles c h i l d welfare agencies and medical opinion oh the subject Is sharply divided. S o c i a l work practice I t s e l f , seems to be advancing answers on a pragmatic b a s i s , and more and more agencies are cautiously experlmentiiig with the early adoption placement of children with pathology In the back-ground. Such follow-up studies as have been done are encouraging, but there i s c r u c i a l need f o r more research i n this f i e l d . Another serious d i f f i c u l t y i n the present case was the apparent inadequacy of the foster home study. Although the "boarding adoption" has worked out s a t i s f a c t o r i l y In many cases*, the practice has been seriou s l y questioned on the ground that there must be strong neurotic components i n the p e r s o n a l i t i e s of f o s t e r parents Who are w i l l i n g to endure so much uncertainty as to the 2 ultimate outcome of adoption . Frequent s t a f f changes, the f a c t that these f o s t e r parents avoided, rather than sought, service from the agency, the Increasing d i f f i c u l t y of the problem as time went on, lack of worker time and of c a r e f u l supervision a l l appear to have been causes of the Inadequate service given i n this ease. 1. Wolkomir, B e l l e . "The Dhadoptable Baby Achieves Adoption." B u l l e t i n , C h i l d Welfare League of America, February, 1947. 2. Kahn, Margaret. "Adoption of Ghildren With firoblems.", C h i l d Welfare, C h i l d Welfare League of America, New York. V o l 0 28, No. 8., October 1949., p. 7. 81 In 1953 the Brown family had applied to the agency as f o s t e r parents. The ap p l i c a t i o n had been b r i e f l y studied and rejected because the f o s t e r mother was working part time, from noon to 6:30 p.m., and therefore was not suitable f o r the school age g i r l she was requesting. The family consisted of Mr. and Mrs. Brown, aged 44 and 40 and two boys of 18 and 16. The income was adequate, and the home comfortable i n a modest way. The motives f o r taking a f o s t e r c h i l d seemed mainly i n t e r e s t i n having a g i r l , and desire to help a c h i l d , Mrs. Brown gaveevidence of the warmth and understanding so necessary In a f o s t e r mother, and i t was with regret that the app l i c a t i o n was refused. The home study had not been completed, as Mr. Brown and the boys had not been Interviewed and no medical reports or references had been obtained. Some months l a t e r , one of the workers was faced with the problem of Immediate placement of a seventeen year o l d g i r l , f o r whom no approved home was a v a i l a b l e . The home-finding department remembered Mrs. Brown, and, although the home had not been approved, r e f e r r e d i t to the g i r l ' s worker with the understanding, that she would complete the home study, The worker v i s i t e d i n the home, l i k e d i t and arranged f o r placement of her g i r l there, f e e l i n g Mrs, Brown's working hours would not constitute a problem i n the case of a g i r l of this age. The home study was never completed but a b r i e f note on the f i l e indicated that this placement was s a t i s f a c t o r y . In May 1985, several months a f t e r the seventeen year old had l e f t the home, another worker was faced with obtaining a quick placement f o r a g i r l of 13 who had been rejeoted by her mother and step-father, and who was presenting 82 problems around staying out l a t e with boys and generally unsatisfactory school-work. The worker must have learned of this home through the f i r s t worker, since i t would not have been l i s t e d as a vacancy i n the central f o s t e r home index of the • agency e:s i t had not yet been approved. A f t e r one preliminary v i s i t , , i n Which she was favourably impressed, the second worker decided to use the home f o r her g i r l . The home Was v i s i t e d several times following placement and a good deal of work with ., the f o s t e r mother and g i r l was" done. Due l a r g e l y to the f a c t that this g i r l was s t i l l very much t i e d to her mother* and was not accepting of a f o s t e r home, this placement was not a success. A d d i t i o n a l reasons might well be the f a c t that the f o s t e r mother was working, as well as other s u b t l e t i e s i n family r e l a t i o n s h i p s which had not been evaluated, or, i n any case, recorded. The second worker ver b a l l y reported that she was we l l acquainted with the f o s t e r - f a t h e r and the boys and found t h e i r a t t i t u d e s h e l p f u l . She had not, however, recorded this Information In the f i l e . Also she had not, apparently, been aware that the home had not been properly approved, evidently taking i t f o r granted that, because i t had been used once, i t could be used again. Lack of worker and supervisory time, as w e l l as the necessity of f i n d accomo-dation quickly, a l l seem to have played a part i n this u n s a t i s f a c -tory s i t u a t i o n . Another unfortunate aspect of the ease was, that because the second placement was unsuccessful and discouraging, the f o s t e r mother decided not to take any more children from the agency, although i t was possible her home would have been valuable f o r older, more stable g i r l s . An incident of this kind creates unsatisfactory public r e l a t i o n s . It also Indicates one of the 85 most serious pressure points i n the agency programme ^ultahle placement f a c i l i t i e s f o r teen-aged children* ' Adequacy Ratings on Total Cases i n the Sample. In the 83 sample cases, service was rated as adequate i n 30 cases, as f a i r l y adequate i n 56 and as Inadequate i n 17. Lack of time was a main cause of l i m i t a t i o n of service i n 22 casesV a contributing cause In 16 and not a cause i n 45. The r e l a t i o n s h i p between lack of time and adequacy ratings Is presented l h Tables 8 and 9. From these tables i t appears tfoat services to f a m i l i e s , and In r e l a t i o n to f o s t e r homes, were more seriously c u r t a i l e d by lack of time than l n : any other categories. m ( A ) Table 8 . E v a l u a t i o n of Se r v i c e s Given and T i m e S e r v i c e F a c t o r s , (Sample Group, C l a s s i f i e d by k i n d o f Case) Rating of Services Given Analysis Adequate F a i r Inadequate Total A» Family Cases ... . . is . 6 •; 24 i Lack of time U (a) main cause 4 3 ' 7 | 1 (b) contributing cause •4. ••• • •• 3 7 (c) not a Cause 6 4 - 10 ] B, Foster Homes 3 8 6 16 ! 9 ! I"- Lack :of time ' 1 (a) main cause ''•» " 6 3 > | (b) contributing cause W 2 2 (o) not a cause 3 2 - ' 5 -; 1 G. Adoptive Homes 6 2 1 8 j Lack of time (a) main cause , » 1 1 2 (b) contributing cause ' <• m -(c) not a cause 5 1 6 J D. ChSBren i n Care 10 10 5 25 Lack of time (a) main cause , m 2 3 5 (b) contributing cause <• 3 m 3 (e) not a cause 10 s 2 17 E . Children on Adoption Probation 6 4 - 10 (a) main cause 1 1 (b) contributing cause 2 •- 2 (c) not a cause 6 1 7 TOTAL 30 36 17 83 83 (B) Table 9. Summary of Adequacy of Service and Time-Service Ratings. Analyaia Adequate F a i r or Inadequate T o t a l Lack of time a main or contributing cause. 0 38 38 A, Family Gases 0 14 14 B. Foster Homes 0 . 11 11 C. Adoptive Homes 0 2 2 D. Children i n Care 0 8 8 E. Children on Adoption 0 3 3 Probation Lack of time not a cause. 30 45 A, Family Cases 6 4 . 10 B. Foster Homes 3 2 5 C. Adoptive Homes 5 1 6 D. Children In Care 10 7 17 E, Children on Adoption 6 1 7 Probation Chapter 4.. Direct Service to Clie n t s 8 D i s t r i b u t i n g the Re s p o n s i b i l i t y of the Professional Worker. The Children's A i d Society of Vancouver provides a large and important section of the welfare services In the community. The agency receives an average of 208 requests f o r service each month*, and an average of 168 cases are accepted. In addition, 35 children are brought into care every month, and another 14 placed on adoption probation. These figures represent a considerable degree of r e s p o n s i b i l i t y and also of opportunity. I t i s generally accepted that the best place f o r a c h i l d to receive the a f f e c t i o n and secu r i t y he needs i s In his own home, and society has an obl i g a t i o n to preserve and protect t h i s Important b i r t h r i g h t . However, i t i s equally true that, f o r many chil d r e n , a home has never existed, or else i t has been damaged beyond hope of re p a i r . For these i t i s e s s e n t i a l to provide, as f a r as possible, the i n t e l l i g e n t , l o v i ng care which a "wise and good parent would desire f o r h i s own children" , 1, Including f o s t e r home applications and adoptive applicants• See Table 7. 2, Report on the Education of the Adolescent c i t e d i n Younghusband, E i l e e n "Is A l l Well With the Child?", Welfare. November 1, 1951, Vol . 27, No. 5, Canadian Welfare Council, Ottawa, 85 Case Material on whioh Study l a baaed. This study has been based on a group of eases open i n the Children's A i d Society of Vancouver during June 1955. The numbers of v i s i t s and interviews c a r r i e d out i n r e l a t i o n to these cases, considered to be roughly representative of one caseworker ; ,s share of agency r e s p o n s i b i l l t y , were compared with the number undertaken by the average worker as revealed i n the Agency Time Study of June 1955. There was s u f f i c i e n t s i m i l a r i t y between .numbers of v i s i t s and interviews counted i n the cases studied, and the number of v i s i t s and interviews ca r r i e d on by the average worker as shown. In •'the Time Study, to indicate that the cases i n the sample group aro f a i r l y representative of general-case content and agency p r a c t i c e . However, at l e a s t on© Important sub group i . e . f o s t e r homes under study, Is not represented i n the sample. The proportion of cases of Illegitimacy i n the sample group of family cases i s smaller than i t i s i n 1955 yearly s t a t i s t i c s . I t also appears that this sample group may be unduly weighted with cases "waiting,closing™. The sample group of ch i l d r e n In care Includes proportionately more children under school ag© and fewer adolescents than are shown by the yearly f i g u r e s , while the proportion of s i x to twelve year-olds i s almost exactly the.same. Although i t was r e a l i z e d that the sample of,one f o r t y -s i x t h of cases open i n June, was probably not large enough to bo e n t i r e l y representative, i t was thought an analysis, of these cases would throw some l i g h t on the quantity and q u a l i t y of agency service and the Influence of the a v a i l a b i l i t y and use of professional time on services. 86 Evaluation 'off Services Rendered. Out of th© 67 open :ebsida : , 8t i^'ed''t^<or0 : ,ill^^ service a c t i v i t y was counted- 39 cases were " a c t i v e " during June 1906, and 28 "inactive 1 8'. In the "Inactive" group, seven were "waiting Closing" or transfer to " i n care", 15 were c l a s s i f i e d as being "in a c t i v e according to plan", arid six were showh as "inac t i v e needing attention"nv''"'l3e&sur©m©ht:,of';thiS-''klnd; i s is imply a rough index of worker a c t i v i t y and bears l i t t l e r e l a t i o n to : th© q u a i l t y of work being don©. For example, the case which* i n June 1955, was the most active was1 rated as an instance of inadequate service* ; ' : ' / • • The f i g u r e s on service ratings show that out of the 2 83 cases Studied from the point of view *of q u a l i t y of service , adequate service was given i n 30 eases, and f a i r l y adequate service In 36. Thus, a t o t a l of 66 cases out Of 83 was r e c e i v i n g an acceptable standard of service, although there was room f o r improvement.. The seventeen cases where service was Judged inadequate, and the proportion of the t o t a l work Of the agency which these eases probably represent, must however, be considered a source of concern, not only to the agency i t s e l f , but also to the community. It i s d i f f i c u l t to know how best to make the public aware of the necessity of c l o s i n g this gap i n ser v i c e , without undermining confidence i n th© much larger constructive aspects of th© programme. 1. 2, Excluding f o s t e r homes (See Table 5, Chapter I I ) . Foster homes included i n t h i s group. See Table 6, Chapter 3. Q u a l i t y of S e r v i c e r e l a t e d to Time F a c t o r s . The extent to which the a v a i l a b i l i t y and use of -worker time a f f e c t e d the q u a l i t y o f s e r v i c e has been estimated as a c c u r a t e l y as p o s s i b l e . The f i n d i n g s were that a c t u a l l a c k of time was a ;major cause of •inadequate s e r v i c e i n 22 cases and a c o n t r i b u t i n g cause i n 16 but tfc4t l a c k of time, d i d not; appear 1 to a f f e c t q u a l i t y o f s e r v i c e . I n 45 of the'caSes . The r e l a t i o n -s K l p between l a c k of time and adequacy of s e r v i c e i s s i g n i f i c a n t 8 , in.';the SO cases where s e r v i c e wa's': r a t e d as adequate no l a c k of time was apparent, except that s e v e r a l f i l e s were too b r i e f l y recorded. I n l i n e 36 eases where s e r v i c e was r a t e d as f a i r l y \ adequate, l a c k of time'was a major cause of c u r t a i l m e n t of 1 s e r v i c e l h 14 cases, a c o n t r i b u t i n g cause i n 9 cases, but not a. cause i n IS cases. In the 17 cases where s e r v i c e was r a t e d Inadequate, l a c k of time was a major cause In ten cases, a c o n t r i b u t i n g cause i n f i v e cases, and not a cause i n two cases . Thus i n f i f t e e n cases, causes other than l a c k of worker time, were r e s p o n s i b l e f o r inadequate s e r v i c e , and, In an a d d i t i o n a l f o u r t e e n cases both l a c k of time and other causes combined to produce an u n s a t i s f a c t o r y r e s u l t . How i s l a c k of time to be measured? I t i s c l e a r that among members i n any p r o f e s s i o n a l group there are marked , d i f f e r e n c e s i n a b i l i t y to organise and make use of time to the be s t advantage. A l s o there are wide divergences as to the q u a l i t y 1, 2. 3. Table 6. Table 9. Table 8. 88 of service rendered within th© same, space of time, and as between one oase and another. Since the primary purpose of a children's a i d society Is d i r e c t service to c l i e n t s , and a l l other a c t i v i t i e s , administration, recording, supervision, committee work, s t a t i s t i c s , ar© merely means to this end, i t i s important to look at the amount of time spent on faoe-to-fac© contacts eit h e r with c l i e n t s , or on th e i r behalf. During the month 71 v i s i t s and 33 interviews were conduoted i n r e l a t i o n to the oases reviewed. Calculated on the same basis as the June Time Study, which showed that v i s i t s and interviews by workers averaged S l minutes and 31 minutes, respectively, the time spent on this a o t i v i t y was 43 hours per month or 27.9 peroent of working time i n a seven hour day, 22 day month. This f i g u r e d i f f e r s from the Time Study f i g u r e of 23 percent of working time spent on v i s i t s and Interviews by 4.9 percent, probably because the sample Included one non-t y p i c a l case where there were eight v i s i t s and 17 interviews on behalf of one c h i l d i n oar©. Though i t appears that 23 to 28 percent of worker time spent on faoe-to-faee contacts with c l i e n t s i s low, these figures seem roughly comparable with those of other agencies whioh have done time studies as described i n Chapter I I . True comparisons are not possible because most agencies include the time spent on telephone Interviews with the time spent on faoe-to-fac© interviews, and also work weeks are of d i f f e r i n g length. Although no figures on the amount of time spent are a v a i l a b l e , i t i s reported that i n 60 private family agencies with membership i n the Family Service Association of America, the number of f a c e -69 to-face Interviews and v i s i t s i n one month "ranged from 35 to 83 per p r a c t i t i o n e r with a median of 51."* Thus i t can be seen, t h a t as a general r u l e , the number: of face*to-face Interviews has reached a l e v e l which would be considered by most professional s o c i a l workers to be "dangerously low". Other F a c t o r s I n f l u e n c i n g Quality of S e r v i c e . As mentioned above, as well as lack of time, a number of other d i f f i c u l t i e s were a f f e c t i n g the a b i l i t y of workers to give adequate help to t h e i r c l i e n t s . Socio-economic problems such as poor housing, unemployment, low wages and a s s i m i l a t i o n of Indians Into the general population, were fact o r s i n a number of oases. Lack of f u l l y trained s t a f f , and considerable • v a r i a t i o n In the a v a i l a b i l i t y and q u a l i t y o f supervision were Important considerations. Gaps In community and agency resources, such as adequate s p e c i a l employment services, a treatment centre f o r emotionally disturbed children, group l i v i n g f a c i l i t i e s f o r adolescent children, the shortage of f o s t e r homes f o r large f a m i l i e s , and of both f o s t e r and adoption homes f o r children of mixed r a c i a l o r i g i n , were also noted. Another souroe of d i f f i c u l t y appeared to be the lack of common purpose among agencies. Several oases gave evidence of the d e s i r a b i l i t y of greater co-operation, understanding and Joint planning i f the needs of c l i e n t s ar© to be adequately met. 1, McCurdy, William B., S t a t i s t i c s of Family Casework. An » Analysis of 1954 Data from 6 0 F.S.A.A. Member Agencies, Family Service Association of America, New York, 1955. p. 18. 90 Considerations regarding Caseload Count. Most professional writers agree that caseload numbers mean very l i t t l e , and that the professional Job must be reckoned i n terms of the workload, as defined by the needs of cases. However, the caseload count continues to be used as a kind of measuring rod, and i t was therefore decided to attempt to estimate the number of cases, of the var i e t y described i n the sample, which one worker might be able to handle e f f e c t i v e l y . As a possible basis f o r estimating such a caseload the 67 cases where d i r e c t service was given were examined as follow s : Active Cases 59. Service adequate or f a i r l y adequate 54 Service inadequate 5 Inactive Cases 88. Service adequate or f a i r l y adequate 18 Service Inadequate 16 The eases where inadequacy of service was considered to be due to a time f a c t o r (7) or which were waiting s t a t i s t i c a l c l o s i n g (7) were then- excluded as follow s : a c t i v e , two; i n a c t i v e , twelve. This leaves 53 cases where service was considered adequate or f a i r l y adequate or where the inadequacy was not due to lack of time on the part of the worker. This f i g u r e suggests that S3 might be considered as a oaseload which could be c a r r i e d e f f e c t i v e l y by a trained s o o i a l worker with good supervision, 01 provided about 14 cases could appropriately remain inactive each month*. The f o s t e r homes of the children i n the group, which are not counted as cases, would be an a d d i t i o n a l r e s p o n s i b i l i t y , but workers would not be expected to do th© home-findlng. In considering a caseload of 53, i t would bo necessary to examine, a t the same time, what other r e s p o n s i b i l i t y a worker would have, and how much of this was necessary or desirable from the point of view of th© agency, th© community and th© professional development of tho worker. Recommendations to the Children's Aid Society of Vancouver. I t seems reasonable to assume that service to c l i e n t s could be Immediately Improved with e x i s t i n g s t a f f i f more worker time could be released f o r face-to-face contacts with c l i e n t s . Precise job an a l y s i s , leading to job c l a s s i f i c a t i o n , as recommended i n the recent Report of the Joint Committed on S o c i a l Work Education 8 would be of great value i n enabling the agency and the Individual to know to what extent t h i s goal Is possible and desirable. Accurate job analysis i s dependent upon f u r t h e r research In regard to the Job don© and the use of time. It would require the interested p a r t i c i p a t i o n of s t a f f i n developing methods of enquiry and evaluating r e s u l t s . In short, s t a f f should 1. Of the 67 eases examined where d i r e c t service was given, 39 were ac t i v e , 28 i n a c t i v e . (Table 5). 2. Report of the Sub Committee on Job Ana l y s i s , Report of Joint Committee on S o c i a l Work Education, November 16-19, 1955, Vancouver, B.C. (Mimeographed material, unpublished, presented at conference i n Vancouver November 18-19, 1955). 92 become more "time conscious"* Such a plan might Weil involve f u r t h e r b r i e f , periodic studies regarding the current us©s of time i n the agency, both f o r the purpose of determining trends, and also i i i an attempt to work out norms f o r the use of time i n terms of S p e c i f i c agency needs. A statement of the Job f o r which a worker i s appointed shouldheclosely r e l a t e d to th© time a c t u a l l y spent on the work described. Recommendation t e n 1 of the Joint Committee oh S o c i a l Work Education has already been p a r t l y carried• e/ufr'by ptJ»-agen cy time study and this t h e s i s . there ar© implications i n this f o r worker, supervisor, and administration. For the worker p a r t i c u l a r l y , requirements and practices i n r e l a t i o n to recording should be reviewed, ©specially i n regard to diagnostic statements, si g n i f i c a n c e of material In the running record, p e r i o d i c summaries and s t a t i s t i c a l c losing of f i l e s * Th© marked lack of current, evaluative recording on fos ter horn© f i l e s , sugges ts that the agency may not be using these scare© resources to the best advantage, or making s u f f i c i e n t e f f o r t to conserve them. The time spent on recording should also receive Close attention* Supervisory, consultative and s t a f f development programmes should be p e r i o d i c a l l y reviewed In terms of new thinking and practice, p a r t i c u l a r l y i n r e l a t i o n to th© us© of group supervision* 1, "That agencies be urged to study current practice i n the l i g h t of these reports} that time studies be mad© i n r e l a t i o n to c l i e n t contacts and a l l Job r o s p o n S i b i l i t i e s , and th© kinds of service rendered i n th© various f i e l d s of p r a c t i c e , keeping i n mind the place of volunteers and l e s s e r trained persons." 9 5 On the admi^istrativ© aide i t l a important to t r y to ensure that professional staff are not spending time on activi t i e s whichepuld he, delegated to c l e r i c a l staff. Lines of authority should be clear and administrative aids, such as- a complete• definitive, policy manual, should be available, Necessary procedures should be streamlined as much as possible, Attention should be paid to such: matters as av a i l a b i l i t y of interviewing rooms, dictation f a c i l i t i e s ; , f i l e s and cars so that frustration in relation, to working conditions Is cut tip a minimum, .-.<> <•••':>.'.':•••' .Continued c l a r i f i c a t i o n of Inter-agency policy and active participation; In coasmunity planning are particularly, necessary acti v i t i e s In view of the broadly stated aim?. of the Society and the existing pressure for services, frost.the', community. In view of the Agency's present, heavy responsibilities any proposals for expansion into new areas of service.,should be carefully examined.. Continued improvement of casework service and of agency resources in relation to types of cases already carried, appears to: be the current need. As a method of supplementing what appears to be a chronic shortage of trained social workers, and also as a means of re»involving interested members of the community in the operational work of social agencies, careful consideration should be given to the possible use of ease aides i n certain types of cases. To do this. Without threatening professional standards of service to the client, cases would need thoughtful study, and case aides would require careful selection, In-service training, and supervision. 94 The Children's A i d Society of Vancouver has already c a r r i e d out many of these suggestions or i s i n the process of doing so. Some of these objectives can, of course, never be f u l l y r e a l i z e d , f o r , as soon as s p e c i f i c goals are reached, new ones take t h e i r places. Suggestions f o r Further Research. The findings of this study, are that 72 to 77 percent of p r a c t i t i o n e r time i s spent i n a c t i v i t i e s other than face-to-face contacts with c l i e n t s . As suggested previously, i t i s undoubtedly true that most of the remaining time i s spent e i t h e r on other forms of d i r e c t service to c l i e n t s , or on enabling a c t i v i t i e s . For thi s reason i t i s suggested that research whioh would develop better understanding of a l l the uses of professional time, should be carried out not only by the Children's A i d Society but also by other s o c i a l agencies. Expenditure of time on various parts of th© professional job should b© evaluated In terms of t o t a l agency purpose. These other uses of professional time f a l l roughly Into s i x categories: 1. ) Other forms of d i r e c t service to c l i e n t s , including telephone Interviews, t r a v e l l i n g time, telephone or l e t t e r w r i t i n g on a c l i e n t ' s behalf, consultation with experts, or with other agencies, i n regard to a s p e c i f i c case handled by a worker. 2. ) "Enabling a c t i v i t i e s 1 * , such as supervision and oase recording, which are an e s s e n t i a l part of rendering adequate service to c l i e n t s , but which must never come to be regarded as ends In themselves. 96 3. ) Direot./public r e l a t i o n s , such as speeches, committee work, and professional w r i t i n g . ,, , :, 4. ), S t a f f development such as p a r t i c i p a t i o n i n s t a f f , meetings,^conferences, and agency; consultations not, r e l a t e d to the worker's own case. 5 . ) Research. 6. ) Student t r a i n i n g . An i n t e r e s t i n g avenue f o r enquiry was r a i s e d by the findings of the study regarding the r e l a t i o n s h i p between q u a l i t y of service and a v a i l a b i l i t y of worker time. In t&e cases examined, 45 d i d not appear to be adversely a f f e c t e d by lack of time, while i t was at l e a s t an important contributing f a c t o r i n l i m i t a t i o n of service i n the remaining 58 oases. Since the oases reviewed were drawn from 46 d i f f e r e n t caseloads, i t i s possible to i n f e r that the difference l a y In the Individual p r a c t i t i o n e r ' s use of time, or i n large d i f f e r e n t i a l s i n the time required to handle d i f f e r e n t caseloads. Another influence might be that some c l i e n t s are p a r t i c u l a r l y vocal i n demanding service, and i t i s well known that persistent requests are apt to get attention f i r s t . I t might also be true that decisions to allow s u f f i c i e n t time f o r certain cases, because of t h e i r p a r t i c u l a r importance or excellent prognosis, were c a r e f u l l y made by worker and supervisor. Enquiry into this subject might w e l l increase understanding of the most valuable ways of using professional time. Another relevant piece of research might be done on the numbers and types of cases most suitable f o r service from case-aides > combined with a study of the most e f f e c t i v e methods m of t r a i n i n g * * using .WuiA - > ,, , • l a the provision of c h i l d welfare services, as In any other worthwhile form of human endeavour, "a man1 s 1 reach must exceed his grasp". Vision,, courage, a b i l i t y to us© knowledge i n a d i s c i p l i n e d way; and an " i n f i n i t e capacity f o r taking pains", are -the esse n t i a l q u a l i t i e s which the professional worker must bring to the high adventure of serving children. 1. Volunteers ar© already used by the Children's A i d Society. 97 Appendix At Survey Schedule f o r Family Gases. Sample No. 1. Type of Case U.M. ... II.W. asking Adop. ... Neglect ... Placement Request .... B r i e f Service ...... Other ..... 2. Case No. 4. Last R e f e r r a l Date 3. Source of l a s t R e f e r r a l 5. Reason f o r R e f e r r a l or Request .............. 6. ; . j - — status ' ~ : ' ' Family Status i n Care Age Ethnic Occupation Income Father  Mother  Children (Rate as good, f a i r , poor) j L i v i n g jFamily Standards Health ! Adjustment « Phys. Emot. School Work Sooial Family j ! j Father Mother i [ Children . 2-7. B r i e f Summary of s i t u a t i o n when referred? 8. . V i s i t Int. T e l . Letter Other" | A c t i v i t y i n June 1955 L— . 9, Casework Service rendered (describe): 10. Needing According Waiting Attn. to plan Closing i n a c t i v i t y In June ;1955. , ..: 1 1 . S p e c i f i c lacks or inadequacies i n Agency or Community : R e s o u r c e s ? > . • ' - < v : . • •• • - f • - . ' ' * y '• r . 12. Limitation of service apparently due to time fa c t o r * 13. Comment on problem presented: 14e Comment on service rendered: 96 - :Appendix B: Survey Schedule for Foster Homes 1, Case Number &. Sample Number 3. . m use Approved Tftider Study Waiting & Waiting Closing Status of home June/65 [ " ." V i s i t or pate of last Interview contact by porker . • , Other-.. Yes , No 4. Investigation completed .,. .recorded. ..•adequate. . j 5. Date of la s t opening of home: 6. Family Group Father Mother Children 1* t ' • , . 2,. 3. 7. C,A.S. Children in Home •• • I June 1955 Boys g i r l s J&SL »thers 8. Number of CAS workers using home in June 1955 9. Describe contact in June 1955 10, Limitation of Service apparently due to time factor: 11, Comment oh Problems Presented: 12, Comment on Services rendered: IS, Worker consulted - yes: no: Appendix Ct' Survey Schedule For Adoptive Applioants ** Oase Harne 2. Sample Hiaraber 5. Status In June/56 Active Inactive 1 According Heeding Waiting^ to plan Attention Closing Approved i - • • • • • - •• • . Hot approved ;': ! , M : r''-Date openedi 6. Date of l a s t a c t i v i t y * 6. r V i s i t Int. T e l * Letter Other A c t i v i t y during June/56 7, Describe cilse^ork Services rendered i n Jura© 1055s 8. Limitation of Service apparently due to time factors 9, Comment on problems presented! 10, Comment on services rendered) 11. Discussion with worker - yest no: 100 • Appendix D i Survey Schedule For Ghildrenvin:flare.; 1, G&sol.No.-^#,..«. 2.- Sample'1 No. 3. General Information Ham© of ige under age-group (as Of June 30/55), /S^ 'tJUS'.,, fyp© Car© ©at© i. last • ad.to Ho. of piomts Jun Child 3 * 1 2-5 6-12 13-2lh Jun 1/55 Cap© ,.• I...;..,. , . : j ; ..., ; ; „.,, J " . . j REASONS FOR ADMISSION Nog- Pendg illness I l l n e s s Work- Other lect Adopt, of of ing v ; Parent. Child .Parent •. PARENTAL INVOLVEMENT INFJAftfllNtS Paying V i s i t i n g Consulting Child Agency Note Long Range Plan 4, Brief auaraary of s itua tion when child, cam© in to care S« Estimate of Child's adjustment to being in care - poor . • .-' f a i r good 6. Specific lacks or Inadequacies in Agency or Community Resources i 7* S j V i s i t Int. Tel. Letter Other Activity in Jun© 1955 8, Describe casework services rendered in June 1955: Inactivity in June 1958 Needing Attention According to plan (over) 10. Limitation of Service Apparently duo to time f a c t o r : 11. Comment on problems presented* 13. Comment on Services rendered: 101 Appendix Es Survey Schedule For Children On Adoption Probation 1. Caae Name: 2. Sample Number: 3. Type of Date c h i l d Date Case placement placed opened Agency placement Private placement Relative placement 4. B r i e f description of Case: A c t i v i t y during June, 1955. 5. V i s i t Int. Tele. Letter Other J 6. Describe Casework services rendered i n June, 1955: 7 # I n a c t i v i t y during June, 1955. Needing According Waiting Attention to plan Closing 8. Limitation of Service Apparently due to Time Factor: 9. Comment on Problems Presented: 10. Comment on Services Rendered: ios Appem&iSE->£• * Summary Sheet for Family Material was summarized from the schedules under a series of headings as follows. Active Cases Case Number 1 ;, Sample Number: Type of care« visits Last Opened: C l i e n t C o l l a t e r a l interviews e * J f n j C o l l a t e r a l % telephone Other x e t t e r s Services ) d t h e r •'tnadttive,.Case|t "' Case Numbers Sample Numbers Type of Care3 Date Last Opened; Sate of l a s t A c t i v i t y : Status? Needing Attention: According to Plan: Waiting Closings Des c r i p t i o n of Casework Service ? Limitation due to Time Factors: Limitation due to other Prbblems: Adequacy of Services Description of casework Service Li m i t a t i o n due to Time Factors: Limitation due to other Problems: Adequacy of Service: 105 Appendix G: Summary Sheet? f o r Fester Homest Material was summarised from the schedules under a series of headings as follows: Sample Humbert Case Numbers Status: In use: waiting c l o s i n g : inveatigatioh: completed: recorded : adequate s Date of l a s t opening: Age of f o s t e r parents fa t h e r : mothers Foster parents children: numbers age: Foster children number: age: Number of workers using homes Adequacy of Service: Limitation of Service due to time: Rating of Home: Progress Notes: 104 Appendix Et Summary Sheet f o r Adoptive A p p l i c a n t 6 . M a t e r i a l was summarized from the schedules under a s e r i e s of headings as f o l l o w s : A. Active cases Sample Number: Categoryt approved: understudy: B. Inactive Cases Sample Humbert Category: approved: understudy: V i s i t s : c l i e n t * , c o l l a t e r a l : ' Interviews: c l l e n t J c o l l a t e r a l : Other Services: telephone: l e t t e r : other: Inactive according to plan: needing a t t e n t i o n : waiting c l o s i n g : Casework Service given: Adequacy of Service: Description of Casework Service: Adequacy of Service: Limitation Of Service due to time f a c t o r : L i m i t a t i o n of Service due to time: Limitation due to other f a c t o r s : Limitation due to other f a c t o r s : 105 Appendix I s : Sum-jag*•Sheet f o r C h i l d r e n i n Care. M a t e r i a l was summarized from the schedules under a s e r i e s of headings a s - f o l l o w s 2 B. Inactive Cases Sample;Number* $ Inactive : = needing at ten felon? according to plant Limitation of Servlo© due to time factors A., A c t i v e : Casest Sample lumber:: V i s i t s ? c l i e n t s c o l l a t e r a l s Interviews c l i e n t t c o l l a t e r a l : Other Servicest telephone t l e t t e r : other: Limitation of Service due to other f a c t o r s : Description of Casework Present adjustment of c h i l d : Service: Limitation due to time f a c t o r : Adequacy of Service: Limitation due to other f a c t o r s : Present adjustment of c h i l d : Adequacy of Service: 106 Appendix J? Summery Sheet f o r C h i l d r e n on Adoption Probation, M a t e r i a l was summarised from the schedules under a s e r i e s of headings as f o l l o w s : """ ' A* Active Cases: Sample Number: Type of Placement: Agency: • . Private: R e l a t i v e : B. Inactive Cages: Sample Number: Type of Placement: Agency? Private: R e l a t i v e : V i s i t s : c l i e n t : c o l l a t e r a l : Interviews: c l i e n t : c o l l a t e r a l : Inactive: according to plan: needing a t t e n t i o n : waiting c l o s i n g : Other Services: Telephone: Letter? Other: Description of Casework Service: Adequacy of Service: Limitation of Service due to time f a o t o r : Description of Casework Service: Adequacy of Service: Limitation of Service due to time f a c t o r : Limitation due to other f a c t o r s : Limitation due to other f a c t o r s : 1 0 7 Appendix ti Schedule Used f o r O.A.S. Time Stmdy, June 1956. DAILY TIME SHEET - JUNE. 1955 (Please Return to Supervisor Each Evening) For June this sheet w i l l replace Daily Work Report. After information i s compiled by statistician, sheets w i l l be Worker Date June ,l?55 NAME Adoption Home Finding Family & PBH Children in Care __ Visits . Interviews Telephone Meetings Conferences (Time Spent) Travel Time Other (Specify) To For Time Spent To For Time Spent To For lxrae Spent (Time Spent] 9 a.m. - 11 a.m. I -11 S T . B I . - 1 p.m. -I p.m. - j} p.m. • _ — — '$ p.m. - i> p.m. after 5 p.m. j 108 Appendix ht Bibliography (a) General References Angel 1, Robert G. "A Research Basis f o r Welfare Practice". The S o c i a l Welfare Forum, 1954. Columbia U n i v e r s i t y Press, Hew York. B r i t i s h Columbia, Department of Health and Welfare. Annual Report of the S o c i a l Welfare Branch, C h i l d Welfare D i v i s i o n 1950. Queen»s Pri n t e r , V i c t o r i a , 1951. Carter, Genevieve W. "Problem Formulation i n S o c i a l Work Research". S o c i a l Casework. July 1985, Vo l . 36* No* 7. Family Service Association of America, New York. C r y s t a l , David. "What Keeps US from Giving Children What W© know They Need** Six Papers on C h i l d Welfare Problems. Ch i l d Welfare League of America, New York, 1953. Canada, Department of National Health and Welfare Research D i v i s i o n . Changes and Developments i n C h i l d Welfare Serviees i n Canada 1949-1953. General S e r i e s , Memorandum No. 7, Ottawa, September 1954, Canada, Department of National Health and Welfare, Research D i v i s i o n . A Study of the Functions and A c t i v i t i e s of Head Nurses In a General Hospital. General Series, Memorandum No. 5,, May 1954, Ottawa. de Schweinltz, K a r l . " S o c i a l Work i n the Public S o c i a l Services". S o c i a l Work Journal. July 1955, V o l . 36, No, 3., American Association of S o c i a l Workers, New York. Fink, Arthur E. The F i e l d of S o c i a l Work. Henry Holt and Company, Incorporated, New York. (Copyright 1942), Hamilton, Gordon. "The Role of S o c i a l Casework i n S o c i a l P o l i c y " . Selected Papers i n Casework National Conference of S o c i a l Work 1952. Health Publications I n s t i t u t e Inc., Raleigh, H.0. (Copyright, 1953). H i l l , Reuben. "Are We Expecting Too Much of F a m i l i e s 7 " S o c i a l Casework. A p r i l 1951, Vol. 32, No. 4 , Family Welfare Association of America, New York. Meier, E l i z a b e t h G. "Inter-relationships of S o c i a l Causes and Casework i n Child Welfare". S o c i a l Casework. March 1950, V o l . 31, No. S, Family Service Association of America, New York, 109: M i l l a r , Margaret W» "The ^ d i f f e r e n t i a t e d Caseload i n a Merged Agency". C h i l d Welfare. June 1955, C h i l d Welfare League of America, New York. Smith, Marjorie J . , Rural Casework Services. Family Welfare Aesooiation of Ameriea, New York. (Copyright, 1943'•)'•. Smith, Marjorle J., "People, Problems, and Professional Services". Canadian Welfare. December 15, 1951, V o l . 27; No. 6. Canadian Welfare Council, Ottawa; ?A Statement of Princi p l e s and P o l i c i e s on Public C h i l d Welfare", reprinted from C h i l d Welfare. December 1950. C h i l d Welfare League of America, New York. tMlted States, Department of Health, Education and Welfare, S o c i a l Security Administration, Children's Bureau. The  Training of C h i l d Welfare Workers f o r Placement R e s p o n s i b i l i t i e s ; Report of a Subcommittee of the C i t i z e n s ' Committee on Adoption of Children i n C a l i f o r n i a . 1953.: < (b) S p e c i f i c References " v" Adoption Praotloes, Procedures and Problems; A Report of the Second Workshop Held i n New York C i t y under the auspices of Tho C h i l d Welfare League of America, May 10-12, 1951. C h i l d Welfare League of America, Inc., New York, l a r c h 1952. Adoption of Children with Pathology In Their Backgrounds; Report of a Workshop held A p r i l 12, 1949 under the auspices of The C h i l d Welfare League of '!aiaai'rfcca. C h i l d Welfare League of Americay Inc., New York, 1549. Angus, Anne Margaret, Children's A i d Society of Vancouver, B.C. 1901-1951. Vancouver, 1951. ^ Browning, Lucie K, "A Time Study Of HomefInding". C h i l d  Welfare, June, 1951. Child Welfare League of America, New York. Blenkher, Ugargaret. "Obstaoles to Evaluative Research Casework"; S o c i a l Casework. February and March 1950, V o l . 31, Nog. 2 and 3" Family Welfare Association of Ameriea, New York, Bowlby, John. Maternal Care and Mental Health. World Health Organisation Monograph Series. Geneva, 1952. C h i l d Pro tec tion i n Canada. Canadian Welfare Council, Ottawa, 1954. .. ' Cornwall, Charlotte E. "Structure Change" Concerning  Families and Children. November, 1954, V o l . 3, No. 4. Canadian Welfare Council, Ottawa. 110 Francis, Blyth© ft, "Los Angeles Time Study". H i g h l i g h t s . Slay 1949, V o l . 10, H©. 6. Family Service Association of America, Hew York. French, David G, An Approach to Measuring Results i n  S o c i a l Work. Columbia Univ e r s i t y Press; Hew York, 1952. Hallinan, Helen W. *®ho Are the Children Av a i l a b l e f o r Adoption?" S o c i a l Casework. A p r i l 1951, V o l . 32, Ho. 4. Family Service Association of America, Hew York. Hamilton^, Gordon. ^TheV underlying Philosophy o f S o c i a l Casework", i n Raslus, Cora, ed. Pr i n c i p l e s and Techniques i n  S o c i a l Caseworkt Sela cted A r t i c l e s 1940-1950. FamilyServicO Association of America, Hew York, 1950. ' Harer^kl* Roman L. "Th© Caseload Standard f o r a C h i l d . Placement Worker". C h i l d Welfare. October 1949. The Child '• Welfare League of Amerlea, Ino., Hew York. : "How E f f i c i e n t Ar© W e ? " (no author). Highlights, Ootober 1952, V o l . 13, No. 8. Family Service Association of America, New York. • ' J " H i l l , John G., and Ormsby, Ralph. Cost Analysis Method  f o r Casework Agencies, Family Service of Philadelphia, Philadelphia, 1953. • JBut chins on, Dorothy. "Basic P r i n c i p l e s i n C h i l d Welfare". Selected Papers i n Casework. National Conference of S o c i a l Work, 1952, Health Publications I n s t i t u t e I n c . , Raleigh * N.C. (Copyright, 1953). Kahh, A l f r e d J . "Can Effectiveness Of C h i l d Care be Determined 7" C h i l d Welfare. February 1954, V o l . 33, No. 2. C h i l d Welfare League of America, Inc., Now York. Kahn, Margaret. "Adoption Of Children Wltih Problems C h i l d Welf are, October 1949, V o l . 28, No. 8. C h i l d Welfare League of America, Inc., New York. Keith-Lucas, Alan. "A Tim© Study"; Its Use i n a C h i l d Care Agency. B u l l e t i n . March 1944, V o l . 23, No. 3. C h i l d Welfare League of America, Inc., New York, Lurle, Barry L. "Th© R e s p o n s i b i l i t i e s of S S o c i a l l y Oriented Profession", i n Kasius, Cora, ed,, New Directions i n S o c i a l Work.' Harper and BrOs. New York, 1954. •'."' ' ' 1."" McCurdy, William B. S t a t i s t i c s of Family Caseworkt An Analysis of 1954 Data from 60 F.S.A.A.' Member Agencies. Family Service Association of America,- New York, 1955. I l l Ormsby, Ralph. "Inoroaslng the Plow of Trained So o i a l Workers.** Highlights, A p r i l 1952.» V o l , 13, Ho, 4, Family Service Association of America,, Hew York. Robertson, O r v i l l e . "More S t a f f Time For Seeing C l i e n t s . " Highlights, October 1952, Vol, 13, N©. 8, Family Service Association of America, Hew York, Scope and Methods of the Family Service Ageneys Report of the Committee on Methods and Scope, Family Service Association of America, New York, 1953. Shyne, Ann W. Analysis of Family Service Agency Opera tion i Casework S t a t i s t i c s : 1950. Family Service Association of America, New York, 1951, Sobei, Louie H. ttAn Approach to E s t a b l i s h i n g Caseload Norms,** C h i l d Welfare, February, 1954, V o l . 33 , No. 2. C h i l d Welfare League of America i n c . . New York. Towle, Charlotte, ^Looking Ahead i n the F i e l d s of Orthopsychlatric Research.* American Journal of Orthopsychiatry. January 1949, American Orthopsychlatric Association, Inc., Boston. Weed, Verne. "Method of A r r i v i n g a t a Caseload Figure. 1* B u l l e t i n , l a y 1945, V o l . 24., No. 5, C h i l d Welfare League of America, Inc., New York. Wolkomir, B e l l e . "The Ehadoptable Baby Achieves Adoption." B u l l e t i n , February 1947. C h i l d Welfare League of Ameriea, New York, weisehbarger, Ruth, **An Agency Experiments With Caseload Weightings." C h i l d Welfare. January, 1955, C h i l d Welfare League of America, New York. Younghusband, E i l e e n . "Is A l l Well With the Child?", Welfare, November 1* 1951, V o l . 27, No. 5, Canadian Welfare Council, Ottawa, (c) unpublished, mimeographed material. Report on the Western Regional Workshop On S o c i a l Work  Education, January 20 and 21, 1953, Banff, Canada. Report of the Subcommittee on Job A n a l y s i s : part of the Report of the j o i n t Committee on S o o i a l Work Training as presented at the Conference, November 18 - 19, 1955, Vancouver, B.C. 112 I^oteotlve'Family Services cf the Children'a Aid Society i n Relation to Family S e r v i c e s o f other Agencies i n the community. (Unpublished statement of p o l i c y f o r discussion, December 23, 1955). The Children's A i d Society of Vancouver, B.C. Its Purpose, Administrative Structure, Functions, Services, January 13, 1955. Excerpts from Standarda. f o r Children's Organlzations Provid-ing Foster Family Care. C h i l d Welfare League of America.• 

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