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Intake procedure in social assistance administration : a study of the casework implications of intake,… Hawkes, Ronald Ernest 1953

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INTAKE PROCEDURE IN SOCIAL ASSISTANCE ADMINISTRATION A Study of the Casework Implications of Intake, based on Four Comparative Intake Procedures i n So c i a l Service Settings and the C i t y S o c i a l Service Department of Vancouver by RONALD ERNEST HAWKES 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 i n the School of S o c i a l Work Accepted as conforming to the standard required for the degree of Master of Social Work School of Soc i a l Work 1953 The University of B r i t i s h Columbia. ABSTRACT This study involves a d e f i n i t i o n of sound intake pro-cedure and an analysis of the presently established intake procedure i n the Vancouver C i t y S o c i a l Service Department. The focus of the enquiry i s the effectiveness of the intake procedure i n meeting the needs of c l i e n t s who make ap p l i c a t i o n f o r s o c i a l assistance. The effectiveness i s measured i n terms of study, diagnosis, and treatment, and the need f o r s k i l l e d case handling at the f i r s t point of contact between agency and applicant. Five types of intake cases are distinguished and i l l u s t r a t e d . The r e f e r r a l process i s studied as a secondary focus, three types of r e f e r r a l being distinguished. Material for the study was gathered from current texts and a r t i c l e s on comparative intake procedures, interviews with the administrator, unit d i r e c t o r s and workers of the C i t y S o c i a l Service Department, interviews with the di r e c t o r s of ho s p i t a l and T.B. s o c i a l service departments, and by the analysis of representative and i l l u s t r a t i v e case material. This study substantiates the b e l i e f that casework can and should be done i n a public welfare programme. I t also shows through case analysis that casework i s required at the intake l e v e l , and the success of intake procedure depends upon the employ of s k i l l e d and q u a l i f i e d s o c i a l caseworkers. Other matters determining the success of intake procedure are suitable o f f i c e environment f o r the public, adequate stenographic aid for the s o c i a l workers, s k i l l e d use of interviewing time, and sound r e f e r r a l process. Many problems exi s t which prevent maximum service to c l i e n t s . Solutions to these problems are possible without major change i n the administration, structure, or budget, and are implications for p o l i c y change. The study f i n a l l y indicates the need for more adequate i n t e r p r e t a t i o n of policy change to the c i t y council and to the community i f the public assistance programme i s to enjoy public sympathy and understanding. ACKNOWLEDGMENTS For valuable assistance In obtaining information and case material which made t h i s study possible, the author wishes to acknowledge indebtedness to the ad-ministrator, the unit d i r e c t o r s , and the intake section d i r e c t o r and s t a f f of the Vancouver C i t y S o c i a l Service Department. The di r e c t o r s of the s o c i a l service depart-ments of St. Paul's Hospital, Vancouver General Hospital and T.B. Unit also provided additional information which was used i n t h i s study. The he l p f u l advice and d i r e c t i o n of the members of the School of Social Work of the University of B r i t i s h Columbia, are also g r a t e f u l l y acknowledged. TABLE OF CONTENTS Page Chapter 1. Intake Procedures i n Soc i a l Service Settings The goal of intake. I n s t i t u t i o n a l and agency intake. Intake interviews and intake procedure. Differences between agencies: public assistance; medical s o c i a l service; c h i l d guidance c l i n i c ; bureau for school children. Inter-agency intake. Generic aspects of intake. Aims of the present study 1 Chapter 2. Intake as an Opportunity for Casework Responsibility of the intake worker i n a public a s s i s t -ance agency. Limitations of intake interviewing. Casework at the intake l e v e l . Case examples: when f i n a n c i a l a s s i s t -ance i s granted, and when not granted. Problems facing the intake worker. Proposed method of analyzing intake procedure. The focus of the present study 17 Chapter 3« So c i a l Assistance Intake i n Practice Regulations and requirements governing C i t y S o c i a l Service Department. Intake methods of the Department. The effectiveness of intake procedure. C l a s s i f i c a t i o n of service and assistance. Case i l l u s t r a t i o n s and analysis 25* Chapter h. Referral i n Relation to Intake What i s r e f e r r a l ? Problems i n r e f e r r a l process. C l a s s i -f i c a t i o n of r e f e r r a l s : within Departments; with other agencies. Case i l l u s t r a t i o n s and analysis of r e f e r r a l : i n t e r n a l ; other resource; other s o c i a l agency; h o s p i t a l . *+8 Chapter 5. Implications for Po l i c y Function of the intake worker. Philosophy for service. Selection and supervision of s t a f f . Interpretation to S o c i a l Service Committee. Purpose of present intake design. S o c i a l work s k i l l s . Use of interview time. Comfort of the c l i e n t . Improved service to r e c i p i e n t s . Unmet needs. Improved i n t e r -pretation of needs and new programs ... 59 Appendices: A. P r i n c i p a l Regulations Governing S o c i a l Assistance, (as at 195D B. Intake Application Forms. C. Bibliography. INTAKE PROCEDURE IN SOCIAL ASSISTANCE ADMINISTRATION A Study of the Casework Implications of Intake, based on Four Comparative Intake Procedures i n Soc i a l Service Settings and the C i t y S o c i a l Service Department of Vancouver. Chapter 1 Intake Procedures In S o c i a l Service Settings Intake i s the front l i n e of s o c i a l work. I t involves personal contact between the c l i e n t and the s o c i a l service agency, and giving the most b e n e f i c i a l d i r e c t i o n to the c l i e n t to meet his needs. The goal of s o c i a l work agencies, i n trying to meet the needs of the c l i e n t , i s to help him f i n d a more s a t i s f y i n g and useful l i f e . But the picture of some intake procedures i n operation as recent as twenty-five or t h i r t y years ago i s not a t t r a c t i v e , and c e r t a i n l y must challenge any person who has an interest i n the well-being of his fellowman. I t i s now generally agreed that the almshouse i s out of date as an i n s t i t u t i o n , but the following s i t u a t i o n which existed i n a large American c i t y i n 1 9 2 6 may be used as an example. Admission to the almshouse could take place not only through the admission o f f i c e , but also by magistrate commitment, and by the p o l i c e i n emergency cases. The process of magistrate and police commitments made no allowance for recording a s o c i a l h i s t o r y , therefore, " t h i s information must be gotten at the i n s t i t u t i o n , and because of lack of funds to employ a q u a l i f i e d person, the records of emergency cases are taken by an inmate who i s eighty-six years old and a very remarkable 1 character." The intake procedure of t h i s almshouse brought to-gether, "homeless old people, respectable and disreputable; senile people who may have homes, but cannot be taken care of i n them; 1 Emily B. Randall, "Admissions and Records i n Almshouses", Proceedings of the Conference of S o c i a l Work. 1 9 2 6 , Chicago, University of Chicago Press, 1 9 2 6 , pp. 5 2 ^ , 5 2 5 . -2-feebleminded persons, young and old, who need to be safeguarded i n an i n s t i t u t i o n ; middleaged and old b l i n d people; c r i p p l e s , young and old with venereal disease, whom no other i n s t i t u t i o n w i l l admit; coloured pregnant g i r l s under the j u r i s d i c t i o n of the court, f o r whom there i s no other i n s t i t u t i o n ; drug addicts; 1 and transients awaiting transportation." In recent years there has been a general development of spe c i a l i n s t i t u t i o n s to give i n d i v i d u a l attention to such groups as mentally handicapped adults and children, p h y s i c a l l y handicapped adults and ch i l d r e n , the bl i n d , the aged, unmarried mothers, and delinquent c h i l d r e n . Many of these i n s t i t u t i o n s have been accepted as government r e s p o n s i b i l i t i e s . In many countries, f i n a n c i a l assistance for the aged and the destitute have been accepted also as government r e s p o n s i b i l i t i e s . This f i n a n c i a l assistance has usually taken the form of old age pensions, mothers* allowance, and s o c i a l assistance. A l l i n s t i t u t i o n s and agencies have some form of intake procedure, and many have improved t h e i r method of intake. However, there are s t i l l i n s t i t u t i o n s i n operation which have no r e s t r i c t i o n s on intake, or l i t t l e s e l e ction of c l i e n t s . These conditions may be found i n c e r t a i n hostels for men, and i n various homes f o r chi l d r e n . Regardless of any intake procedure i n use, a l l agencies, even those with defined and limi t e d e l i g i b i l i t y groups, must s t i l l face the question, "How can intake procedure be improved or modified to meet the needs of individu a l s and fa m i l i e s ? " Each agency or i n s t i t u t i o n has the r e s p o n s i b i l i t y of answering t h i s question by s e l f - a n a l y s i s or 1 idem, p. 525 -3-by research. Intake Interview and Intake Procedure. The essence of good intake depends on whether i t is recorded as an interview or a routine registration. Indeed, confusion may arise over the use of the terms "intake interview" and "intake procedure", although these expressions are not synonymous. An intake interview i s , or should be, "the intro-duction of the client to the caseworker and the casework process. It is concerned with diagnosis, classification of problems, acceptance of problem or referral to another agency, other case-1 work disposition, or rejection after a brief serviced The action here involved is a dynamic two-way process which involves both worker and client, whereby they unite their knowledge and experience to work out the i n i t i a l problem. The arrangement of their knowledge allows tentative diagnosis, and points the way to treatment. Intake procedure is the process that brings the client to the field caseworker or to the worker who is carrying the case load. A l l clients do not complete this process in any one agency because of rejection or referral at the intake interview level. There are two main differences between public and private agencies which may affect the intake policies of these agencies* Many private agencies, such as Childrens' Aid Societies and Family Welfare Bureaus, are supported by private funds, not by 1 LeRoy M.A. Maeder, "Generic Aspects of the Intake Interview", The Family. March, 1 9 * f 2 , p. ih. taxes co l l e c t e d from the public. The private agency i s not open, therefore, to the close scrutiny of the public or of governmental representatives. The public agency i s open to t h i s scrutiny at any time, and to f a c i l i t a t e t h i s review a •fetep by step" routine and structure must be developed. The steps involved are e a s i l y l a b e l l e d "red tape", and they often bring f o r t h c r i t i c i s m from c l i e n t s who complain of the many forms to be f i l l e d out and the length of time which passes before any action takes place to s a t i s f y the c l i e n t . However, c l e a r l y defined steps are e s s e n t i a l when there are continued investigations regarding the expenditure of public funds. The second main difference i s the greater freedom of experimentation permitted to the private agency. I f the private agency chooses to use t h i s freedom, i t may r e a d i l y modify i t s intake procedure i n an e f f o r t to improve service to c l i e n t s . In addition, the private agency may be more selective i n meeting needs i n the community, whereas the public agency, by i t s nature, i s responsible for granting aid to a l l i n d i v i d u a l s who are e l i g i b l e within the requirements l a i d down by law* Whether i n public or private agencies, intake procedure may d i f f e r because of agency setting, agency function, the people to be aided, the a v a i l a b i l i t y of funds, and - above a l l - the q u a l i f i c a t i o n s of the personnel. Each agency, i n e f f e c t , must develop an intake procedure which i s i n harmony with the conditions that surround the agency. By considering separately four agencies - a public assistance agency, a medical service department, a c h i l d guidance c l i n i c , and a school s o c i a l service the broad differences that may be found i n intake procedures may be e f f e c t i v e l y i l l u s t r a t e d . The procedures used have been taken from current l i t e r a t u r e , not from l o c a l agencies, (a) A Public Assistance Agency The structure of the intake procedure i s made up of reception, clearance interview, and a p p l i c a t i o n interview. The rec e p t i o n i s t determines whether the person i s an applicant or a recipient who wishes to leave a message. If he i s an applicant, the receptionist takes down the necessary i d e n t i f y i n g data and checks to see i f assistance has been given before. Any record i s read by the interviewer before the applicant i s seen. The clearance interview i s used to interpret the agency's function to the c l i e n t as i t a f f e c t s him, and the worker and c l i e n t determine whether assistance i s possible. The worker also explains to the applicant exactly what part of h i s l i f e experience the agency needs to involve i t s e l f with. Many cases are completed at t h i s stage but i f more material i s required a second appointment i s given. The second and other necessary interviews are termed a p p l i c a t i o n interviews. This procedure i s geared i n such a way as to l e t the applicant f e e l he s t i l l can be of use although he i s asking for assistance, to l e t him share the r e s p o n s i b i l i t y with the agency i n proving e l i g i b i l i t y , and thus to preserve within the c l i e n t , -6-1 as much as possible, the f e e l i n g of self-help and independence. I t i s noticeable i n t h i s procedure that a receptionist takes down the necessary i d e n t i f y i n g data; t h i s allows the caseworkers to concentrate on interviewing the c l i e n t , and thus to make most e f f i c i e n t use of t h e i r casework s k i l l s . Secondly, the services offered are a v a i l a b l e to anyone i n the general community who can comply with the e l i g i b i l i t y requirements. (b) A Department of Medical S o c i a l Service The Department here i l l u s t r a t e d operates as part of a **80-bed h o s p i t a l . I t has an Admitting D i v i s i o n and a Casework Di v i s i o n , both of which are under the supervision of the Director of S o c i a l Services. A l l the patients involved are out-patients, who number approximately 750 each month. The Admitting D i v i s i o n i s concerned with administration, e l i g i b i l i t y , f a c i l i t a t i n g physical examination and treatment, and admission to the h o s p i t a l i f necessary. The s t a f f consists of three s o c i a l workers and one stenographer. The Casework D i v i s i o n i s concerned with a l l services not handled by the Admitting D i v i s i o n . The s t a f f again consists of three s o c i a l workers and two stenographers. Each of the l a t t e r three s o c i a l workers has a private interviewing room. A l l r e f e r r a l s to the Casework D i v i s i o n contain the name 1 Sarah S. Marnel, "Intake i n a Public Agency", The Family. June, 19lK), p. 120. of the r e f e r r i n g physician, the ward, an outline of the medical problem, and the service required from the S o c i a l Service Depart-ment. These r e f e r r a l s are a l l brought to the intake worker, who reviews and c l a r i f i e s the problem by further consultation with the physician, family group, and possible conferences with other agencies interested i n the i n d i v i d u a l . When the intake worker finds that long-term casework treatment i s necessary, the case i s transferred to one of the two other workers. The intake procedure, i n summary, i s a period i n which the patient and the worker discover each other, the worker care-f u l l y evaluates her r o l e i n terms of what she can o f f e r and what the patient can u t i l i z e , and the patient and worker come to under-1 stand the proposed function of the worker. This procedure i s designed to meet the needs of c e r t a i n out-patients who are receiving physical treatment from the h o s p i t a l concerned. The intake worker, therefore, must ensure that a l l applicants f a l l within t h i s group of patients, must understand the medical problem and treatment, and must keep up a close l i a i s o n with the physician f o r the c l i e n t . Another d i s t i n c t i v e feature of t h i s procedure i s the contact between the intake worker and the c l i e n t s family. This contact i s necessary as the intake worker must have an accurate picture of the c l i e n t s 1 family s i t u a t i o n and a t t i t u d e before an adequate review of the c l i e n t s ' problems can be made. (c) A Child Guidance C l i n i c The example u t i l i z e d here i s t y p i c a l of Child Guidance 1 Eleanor C o c k e r i l l , "Intake Process i n a Department of Medical S o c i a l Service", The Family, October, 19*K), pp. 188, 189. -8-Clinic intake procedure. The parents seek help at such clinics largely of their own volition, although occasionally doctors, teachers, friends, or other social agencies have urged such action rather than suggested i t . In general, the purpose of the f i r s t interview is to provide the parent with an opportunity to present his problem, and for the caseworker to describe the agency function. The parent and worker then decide i f the agency can offer help. Despite the unquestioned advisability of listening to the parent's story, the intake worker guards against the parent giving too detailed a story, i f a further Interview is to be given for taking a social history by another worker, or i f the interview becomes highly charged with emotion. Intake places certain limitations on the clients who are to be helped. The clinic here described serves primarily an area from which comes the majority of its funds. Further, the clinic is most able to help children between the ages of eighteen months and seventeen years, and of superior intelligence. The clinic believes that the parent should make the f i r s t contact with the agency. If a child is under the care of a psychiatrist, then his permission must be given to the clinic to work with the child. If a social agency is making a referral, it is held responsible for a social history and casework. Prior to the f i r s t interview, a blank form is sent to the parents which asks for identifying data, occupation and schooling of parents. This information permits clearance with the Social Service Index. A pamphlet explaining the clinic function is enclosed with a letter confirming the time and date of the - 9 -appointment. The intake procedure i s shared by three members of the s o c i a l service s t a f f i n the c l i n i c . The f i r s t interview i s regarded as very important because i t concerns the beginning and continuation of a useful treatment programme for parents 1 and children. (d) A School Setting In the example u t i l i z e d here (from the New York public school system) a Bureau of Child Guidance handles the r e f e r r a l s of school children» and the casework i s done by i t s s o c i a l workers. The agency believes that most intake involves diagnostic and interviewing s k i l l s , and as the school p r i n c i p a l s are not q u a l i f i e d to do t h i s , special consideration i s given to a l l cases. School casework i s p a r t i c u l a r l y challenging because the worker must decide who i s the c l i e n t - the educator, the parent, or tiie c h i l d . Most r e f e r r a l s are made by the p r i n c i p a l s , and a few by the Board of Education, the Bureau of Attendance, vocational guidance workers, and by v i s i t i n g teachers. E l i g i b i l i t y must be established i n a l l cases. In the New York System four c r i t e r i a are used. The c h i l d must be on the school r e g i s t e r s . The c h i l d must have an I.Q. over seventy-five. The c h i l d ' s case must not be active with another agency or not i n need of r e f e r r a l elsewhere. F i n a l l y , the c h i l d i s studied only when written 1 Dorothea McClure, "Intake P o l i c y i n a Child Guidance C l i n i c " , The Family. December, 19^0, pp. 253 - 259. = 1 0 -consent i s given by the parents. Intake interviews are designed to help answer the question, "What does the c l i e n t want?" This 1 i s very d i f f i c u l t because of the teacher-parent-child c o n s t e l l a t i o n . It i s clear from these examples that intake procedures of necessity vary i n r e l a t i o n to agency setting and function. In a l l four procedures the intake worker must decide whether the c l i e n t i s e l i g i b l e f o r help. The public assistance agency o f f e r s f i n a n c i a l and casework services to the general public, therefore, intake l i m i t a t i o n s are found i n terms of residence and d e s t i t u t i o n . On the other hand, the c h i l d guidance c l i n i c and the bureau of c h i l d guidance are primarily concerned with treatment of emotional problems, therefore, intake l i m i t a t i o n s are found which help to ensure successful treatment. A further r e s t r i c t i o n i s revealed i n the intake procedure of the c h i l d guidance c l i n i c . In general, the services of the c l i n i c are available primarily to persons who reside i n the area from which comes the majority of the c l i n i c ' s funds. The ef f e c t of one agency's philosophy on intake i s seen i n the case of the c h i l d guidance c l i n i c . This agency believes that the parent should undertake a great deal of r e s p o n s i b i l i t y . As a r e s u l t , the intake procedure begins with the sending of various forms to the parent who i s responsible for t h e i r completion and return. The completion and return of the forms i s necessary before further service i s offered by the c l i n i c . In the i l l u s t r a t i o n s 1 Shirley Leonard, "Intake P o l i c i e s i n a School Setting", The Family. December, 19*+1> PP. 2 6 3 - 2 6 9 . -11-used, the intake procedures are designed to allow the intake worker to explore the problems which usually cause the f i r s t contact between the c l i e n t and the agency. In the public a s s i s t -ance agency, the intake worker would f i r s t explore the c l i e n t ' s f i n a n c i a l s i t u a t i o n . In the c h i l d guidance c l i n i c , the intake worker would f i r s t explore the behavior of the c h i l d or c h i l d r e n when they are involved. In the department of medical s o c i a l service, the intake worker would explore the physical condition of the c l i e n t and the s o c i a l problems related thereto. In the bureau of c h i l d guidance f o r school children, the intake worker would f i r s t explore the school s i t u a t i o n and the child-parent-teacher c o n s t e l l a t i o n . These i n i t i a l investigations by the intake worker are useful i n three ways. They help to es t a b l i s h the a b i l i t y of the agency to a s s i s t the c l i e n t , to focus the problems of the c l i e n t , and to allow the worker to begin where the c l i e n t i s situated at the f i r s t contact with the agency. Most s o c i a l agencies are concerned with "screening" c l i e n t s to ensure they have approached the most suitable place for assistance with th e i r problems, or to make a r e f e r r a l to another agency i f necessary. Although most agencies are aware of r e f e r r a l , there i s a danger that too much stress may be placed upon the protection of agency function. The ultimate function of intake procedure should be not only the "screening" for the most expedient use of i n d i v i d u a l agency function but also the best use of inter-agency functions. I f each agency* s intake procedure does not serve a l l the agencies i n any one area or c i t y , then i t f a l l s "short of the mark". -12-A gap may occur between the intake procedure and function of separate agencies so that a c l i e n t may f i n d that he i s not e l i g i b l e for aid by any agency, and h i s needs go unmet. Further gaps i n inter-agency relationships develop out of mis-understanding and non-acceptance of each other's function and l i m i t a t i o n s . I t i s e s s e n t i a l that inter-agency r e l a t i o n s h i p s f o s t e r intake co-ordination between agencies. However, i t i s not e s s e n t i a l that a l l intake be concentrated i n separate agencies. It i s not impossible to have a "central intake" bureau to service several agencies which have a common int e r e s t . Such a bureau was organized i n New York c i t y f o r serving a group of i n s t i t u t i o n s 1 f o r dependent children. The central Intake procedure developed as a part of a federation of agencies i n t h i s area. The federation does not control agency p o l i c i e s but acts as a co-ordinating body which operates to develop a higher standard of work and better community planning. This " o v e r a l l service" by Intake procedures w i l l help to foster understanding, co-operation, and e f f i c i e n c y between agencies, and consolidate resources i n serving the c l i e n t and the community. The generic aspects of professional s o c i a l work and intake should f a c i l i t a t e t h i s . Generic Aspects of Intake Whatever the s o c i a l agency, c e r t a i n functions and 1 Edith May Holmes, "Intake P o l i c i e s for Children's I n s t i t u t i o n s " , The Family. October, 19^1,.pp. 185 - 192. -13-methods of procedure are es s e n t i a l to good intake. The c l i e n t approaches any agency, whether by s e l f - i n i t i a t i v e or r e f e r r a l , because a problem or problems exist for him. Regardless of the nature of the problems, i t i s the function of the intake procedure to "screen" the c l i e n t s to find i f the agency can f u l f i l their needs; or, i f r e f e r r a l i s necessary, to make the r e f e r r a l . D i f f i c u l t y a r i s e s because the c l i e n t cannot be r e l i e d upon to present h i s r e a l problem i n i t s e n t i r e t y or i n terms of hi s basic d i f f i c u l t y . He may expose only that part of hi s problem which causes him the greatest discomfort, or perhaps the part which causes him the least embarrassment. The intake worker must begin where the c l i e n t begins, but must move to discover the r e a l problem, the scope of t h i s problem by a c a r e f u l test and exploration of the c l i e n t ' s point of view, and any proffered solution. The worker may need to extend his leadership to guide the c l i e n t i n h i s exposition of the problem, and a l l i t s pertinent information and d e t a i l . In addition, the worker must be aware that many complexities may exist i n the c l i e n t himself. The c l i e n t may have f e e l i n g s of anxiety, g u i l t or aggression; may be inhibited because of shyness, shame, or need for a f f e c t i o n or 1 approval; or suffer under such mechanisms as repression, regression, r a t i o n a l i z a t i o n , projection, and denial. I t i s essential to have a vehicle to carry the c l i e n t through such complexities i n order 1 A l i c e R. McCabe, "Meeting the Emotional Needs of Our Children", The Family, October, 1950, p. 337. to ensure progress. This vehicle i s known as rapport, and the development of rapport between the worker and c l i e n t must be held as one of the primary aims of the worker. With rapport established, the worker may help the c l i e n t move toward an objective view of the problem, toward a desirable solution, and convince the c l i e n t whether he wants or does not want the assistance of the agency. The intake worker, however, should not explore too deeply into the problem nor encroach too f a r into the treatment process. He should t r y to gain enough accurate material to support the o r i g i n a l tentative diagnosis, to decide i f the problem f a l l s within the scope of the agency, or to make a r e f e r r a l i f t h i s i s necessary. Given the recognition that the agency can meet the needs of the c l i e n t , the agency function can then be explained to the c l i e n t i n a clear manner. This explanation should concern only the section or sections of agency* function which correspond to the problem of the c l i e n t . Further explanation can be made as i t i s necessary and expedient i n helping the c l i e n t . This w i l l help to prevent the formation of confusion i n the c l i e n t , and w i l l f a c i l i t a t e casework. The casework approach has recognized two important facets i n i t s attempt to help people to a better s o c i a l adjustment. This approach i s concerned with the psychological aspect, to decrease the individual's emotional burdens, and increase his inner capacity to meet l i f e ' s f r u s t r a t i o n s and to make use of i t s opportunities; and the s o c i a l aspect, to intervene i n the environ-ment i n the interest of the c l i e n t . Whether the breakdown occurs i n -15-employment, finances, health, school work, general s o c i a l r e l a t i o n -ships, or intimate family relationships, the casework approach must weigh the r e l a t i v e importance of both Inner and outer pressures and t h e i r i n t e r - r e l a t i o n s h i p , and then make f u l l use of both en-vironmental changes and psychological methods appropriate to the case within the competence of the worker. This twofold approach necessitates a p o s i t i v e knowledge of the ego strength i n c l i e n t s . The whole network of forces i n -cluding those of the c l i e n t , worker, agency, and community which may aid the c l i e n t , w i l l be useful i n r e l a t i o n to ego strength and how i t may be increased. Therefore, i f intake i s accepted as the beginning of the casework process, i t i s imperative that the intake worker be able to measure ego strength i n order to plan the t r e a t -ment which Is most advantageous to the c l i e n t . In a l l casework there should be continuity of study, diagnosis, and treatment. " L o g i c a l l y we should study, diagnose, and treat i n that order; a c t u a l l y these steps are not performed i n l o g i c a l sequence but weave i n and out, often p a r a l l e l i n g one another Therefore, the intake Interview i s the beginning of study, diagnosis and treatment because we study while inquiring into the c l i e n t ' s s ituation, we diagnose In making a tentative appraisal of the problem, and we treat i n establishing rapport. This process i s continuous and f l e x i b l e and "we are engaged i n study as long as we 2 know the c l i e n t " . The success of intake interviewing w i l l depend a good deal upon the intake worker's a b i l i t y to carry out study, diagnosis, 1 Gordon Hamilton,"Theory and Practice of Social Case Work", New York, Columbia Press, 19^ 7* p. 35 2 Ibid. p. 35. - 1 6 -and treatment, and the opportunity he i s afforded by agency p o l i c y and structure to do so. These c r i t e r i a w i l l be used to show intake as an opportunity f o r casework i n a public assistance agency. I t i s proposed to study e s p e c i a l l y the Vancouver C i t y S o c i a l Service Department; to analyse d i f f e r e n t kinds of s o c i a l assistance intake and i l l u s t r a t i v e case material; to take account of related r e f e r r a l s ; and to review c e r t a i n general implications for p o l i c y . -17-Chapter 2 Intake as an Opportunity for Casework A s o c i a l assistance program i s based on the b e l i e f that i n d i v i d u a l s have the r i g h t to receive f i n a n c i a l and other aid when i n a position of need r e s u l t i n g from circumstances over which they have l i t t l e or no contr o l . Such a program must be supported by public funds, therefore, i t i s open to public review and c r i t i c i s m at a l l times. This places the intake worker i n a key po s i t i o n as he must handle the f i r s t contact between thei c l i e n t and the agency. The intake worker has the r e s p o n s i b i l i t y of protecting the right of the i n d i v i d u a l as well as protecting public funds. He must prove or disprove the e l i g i b i l i t y of the client'without creating a negative f e e l i n g i n the c l i e n t towards the agency. This r e s p o n s i b i l i t y , and the l i m i t a t i o n s of intake interviewing, indicate the high degree of knowledge and s k i l l the intake worker must have i f the public assistance program i s to be successful and accepted by the people who support i t and who use i t s services. Limitations of Intake Interviewing The intake worker must work within a network of government regulations concerning e l i g i b i l i t y , and f i t h i s interviews into the busy schedule of the agency without placing t h i s pressure on the c l i e n t . The intake worker must also prepare the c l i e n t f o r the next worker i f the case i s to be continued or referred, explain any other investigation, and help the c l i e n t accept r e f u s a l of assistance, or to co-operate i n reporting any future change i n circumstances which would a f f e c t e l i g i b i l i t y . -18-Sound casework practice also places c e r t a i n l i m i t a t i o n s upon the intake worker. When the intake worker explores the c l i e n t ' s s i t u a t i o n , he does not probe deeply into any problem but l i m i t s h i s enquiry to a survey of the t o t a l p i c t u r e . I f the intake worker becomes involved i n any problem of the c l i e n t , then i t becomes d i f f i c u l t for the c l i e n t to transfer to a fieldworker. Secondly, the intake worker, i n making a tentative diagnosis, i s attempting to formulate a description of the c l i e n t and his problems. Although the diagnosis of an experienced intake worker may be accurate, the worker should not encourage the c l i e n t to t a l k excessively i n order to build up an accurate diagnosis. Thirdly, the intake worker must necessarily develop rapport with the c l i e n t but the worker does not develop such a strong r e l a t i o n -ship that the c l i e n t w i l l f i n d i t d i f f i c u l t to transfer to another worker. The r e l a t i o n s h i p between the c l i e n t and the intake worker i s not formed to f a c i l i t a t e intensive treatment but to f a c i l i t a t e an introduction of the c l i e n t to the agency, and to assure the c l i e n t that people are interested i n him, and help i s a v a i l a b l e . The above l i m i t a t i o n s do not necessarily hold i n a l l intake situations. I f i t i s possible f o r the intake worker to continue with the person who i s f i r s t met at intake, then he has more freedom In his handling of the s i t u a t i o n . On the other hand, the intake worker may f i n d that he cannot control the flow of information that the c l i e n t divulges. In t h i s s i t u a t i o n the worker must explain to the c l i e n t that he may f e e l g u i l t y or angry because he has revealed so much information, and that i t -19-i s a l l right to f e e l t h i s way. Also, the worker must prepare the fieldworker for the p o s s i b i l i t y that the same f e e l i n g s w i l l e xist i n the f i r s t interviews with him. With t h i s forewarning„ the fieldworker i s able to give the c l i e n t the opportunity to "drain o f f " h i s f e e l i n g s . These two p o s s i b i l i t i e s reveal the f l e x i b i l i t y that i s demanded of the intake worker. It can be argued that the caseworker who c a r r i e s a caseload must be equally f l e x i b l e . This statement i s true, but does not take into consideration the fact that the intake worker must function within the l i m i t a t i o n s of one interview i n most instances. The intake worker who i s not s k i l l e d i n intake i n t e r -viewing may make s u f f i c i e n t errors so that the c l i e n t w i l l not return to the agency. However, the caseworker involved i n long term treatment has a strong r e l a t i o n s h i p with the c l i e n t which w i l l help to overcome any error on the part of the caseworker. A s o c i a l service agency, therefore, must c a p i t a l i z e on the intake interview i n order to carry out adequate study, diagnosis, and treatment of i t s c l i e n t s , or, i n short, to carry out casework and off e r maximum service. This i s p a r t i c u l a r l y true for public agencies i n view of e l i g i b i l i t y requirements and public review. Casework at the Intake Level The many l i m i t a t i o n s placed upon the intake worker of a public assistance agency gives r i s e to an important question. Is casework possible i n an intake interview i n a public assistance agency? Cases have been discussed by writers i n recent years - 2 0 -which reveal that casework i s not only possible but also desirable. This i s i l l u s t r a t e d i n the case of Mr. S. and Mr. T. The f i r s t 1 case reveals acceptance as offered by the intake worker to the c l i e n t , and shows how maximum aid can be offered i n a short interview. Mr. S., an unattached man of twenty-five, was asking for help a f t e r being discharged from the c i t y hospital's tuber-cu l o s i s ward. He said that he needed assistance pending ad-mittance to a sanatorium. In discussing current budget ex-penses, the interviewer found that his rent was $ 3 . 2 5 a week including a l l f u e l expenses. Since he was too weak to look for a cheaper room, even i f one might be found, the i n t e r -viewer enquired how he f e l t he could manage on the remainder of his I 1 * .80 cheque. He said he didn't know, but guessed i t was the best we could do for him. The interviewer discussed with him the use of supplementary aid from a private agency. He seemed quite surprised that we were interested In helping him; he said no-one had seemed to care how he l i v e d u n t i l he was admitted to the sanatorium, and he had f e l t that he "just didn't matter to anyone." A private agency was consulted, and i t agreed to a s s i s t with diet and clothing help. Several weeks l a t e r the young man returned to the a p p l i c a t i o n depart-ment and l e f t a note for the interviewer which mentioned his appreciation for the interest shown and stated i f he regained h i s health and could get a job, he would return a l l the money given him. Although t h i s interview i s short, the worker i s able to give t h i s withdrawn youth some warm-hearted inter e s t and, i n recognizing the scope of the problem, was able to suggest other help which resulted i n diet and clothing aid. This i n t e r e s t and proffered solution by the worker enabled the c l i e n t to move outside himself and so he l e f t the note of appreciation. F i n a l l y , the worker's awareness of the i n a r t i c u l a t e needs of the c l i e n t provided both material and emotional strength, supplied a l e v e l of diet which was needed, and made possible a mental and physical 1 Sylvia Sacks, "Public Agency Intake and the Case Work Goal", The Family, A p r i l , 19^2, p. 6 5 . 21-r e h a b i l i t a t i o n which was evident i n the youth 1s desire to regain h i s health, to work, and to repay the money. Casework i s important not only i n cases accepted by the agency but also i n cases rejected by the agency. The follow-1 ing i l l u s t r a t i o n i s taken from a case where f i n a n c i a l aid was not possible. Mr. T., aged f i f t y - f i v e , t a l l , t h i n , neatly dressed, Of Swedish-American stock, nervously explained as he took h i s seat that he was coming here as a l a s t resort, without hi s f a m i l y 1 s knowing, and that he had never applied f o r public or private "charity". After working t h i r t y years s e l l i n g foodstuffs, averaging about f o r t y d o l l a r s per week, he was l a i d off a year p r i o r to a p p l i c a t i o n . Since that time he had exhausted unemployment compensation benefits, insurance cash value, c r e d i t with friends, grocer and landlord. In h i s home, besides h i s wife, he kept h i s daughter, Mary, h i s son-in-law, Tom, and t h e i r baby, Marie, without asking any contribution from them over a period of three years. His son-in-law's income was twenty d o l l a r s a week and used f o r clothes and personal medical attentions, Mary being pregnant. Further discussion revealed the family to be a cl o s e l y related u n i t . However, the family was i n e l i g i b l e f o r assistance because of the son-in-law's income. Mr. T. was rejected when informed that he was i n e l i g i b l e , and argued he would become a burden and a l i a b i l i t y to the household. The worker saw that the problem was not just f i n a n c i a l but was complicated by Mr. T's heartbreak and l o s s of status i n the household. The worker thus proceeded to review h i s method of seeking employment, advocated r e g i s t r a t i o n f o r unskilled work at the State Employment O f f i c e , and suggested use of the free services of the medical c l i n i c s a v a i l a b l e . However, the worker recognized that the problem of asking h i s son-in-law to shoulder 1 Ibid, p. 66. -22-more r e s p o n s i b i l i t y was very serious for Mr. T., and was beyond the present treatment l e v e l and time av a i l a b l e . Therefore, the worker suggested a discussion of the problem with an interested person i n a private agency. Mr. T. thought t h i s might be of help since "even th i s t a l k had helped", and he asked the worker to make an appointment for him with the family agency. Although Mr. T. could not be helped f i n a n c i a l l y , the value of the case i s revealed by the fact that he was able to discuss other f a c t o r s i n hi s problem, could review his job-finding methods, could discover other community resources which he might use and, although rejected, he s t i l l r e a l ized the worker was interested i n him. Both these cases i l l u s t r a t e that casework can be used to determine e l i g i b i l i t y , to diagnose the t o t a l problem, to i n i t i a t e a therapeutic program i n co-operation with the c l i e n t , and make r e f e r r a l s to other agencies which can aid i n helping the c l i e n t . The handling of public funds i n s o c i a l assistance, i f uncontrolled, can destroy morale and self-respect. However, with the aid of good casework services i t can develop strength, self-confidence, lead to independence and build stronger com-munities. The interest of the taxpayer and the s o c i a l worker are e s s e n t i a l l y the same - "the prevention of human di s i n t e g r a t i o n , 1 and the rebuilding of self-sustaining f a m i l i e s ? Rosemary Reynolds, "Do We S t i l l Believe Casework Is Needed In A Public R e l i e f Agency?", Casework i n Public R e l i e f . New York, 1935 - 1939. p. 6. -23-The foregoing cases reveal i n some measure how a trained caseworker can function i n public agency intake. A review of some of the problems that an intake worker must face i n public agency intake w i l l help to c l a r i f y the amount of s k i l l and knowledge required to give maximum service to c l i e n t s . In many cases the intake worker must r e l i e v e the c l i e n t of f e e l i n g s of anxiety and insec u r i t y i n order that the c l i e n t can focus on e l i g i b i l i t y requirements, and see his problem as i t r e l a t e s to the agency function* The intake worker must have an understanding of the ramifications of i l l - h e a l t h , f i n a n c i a l s t r a i n , emotional needs, and the i n t e r - r e l a t i o n s h i p of each i n the t o t a l pattern. The intake worker must r e a l i z e also that i n d i v i d u a l s vary i n the i r choice of food, clothes, place of residence, and a c t i v i t i e s i n accordance with t h e i r habits and standards of l i v i n g . Secondly, the intake worker must be aware of the government-made conditions under which assistance may be granted, and he must keep within these l i m i t a t i o n s . L a s t l y , the intake worker must have knowledge of ce r t a i n intangible needs of the i n d i v i d u a l . "Those elements that feed a manrs morale, sustain his self-respect, encourage hi s i n i t i a t i v e , give him a fee l i n g that he i s worthwhile as a person, have to be ascertained i n d i v i d u a l by i n d i v i d u a l . Our concern with meeting physical needs and safeguarding r e l i e f funds i n no way controverts an - equal concern with conserving those i n d i v i d u a l and s o c i a l values which are indispensable i n helping r e c i p i e n t s of public assistance to l i v e l i v e s as nearly normal as 1 may be, both now and In years to come" The intake interview, i f i t i s r e a l l y constructive, should represent the f i r s t i n a possible series of events which w i l l help the c l i e n t to a better adjustment i n l i f e . Therefore, any intake procedure must be developed so that the many possible l i m i t a t i o n s do not prevent sound intake interviewing. Proposed Method of Analyzing Intake Procedure In analyzing intake procedure i n s o c i a l assistance administration i t seems desirable to do so i n two phases, although many methods may be used. The f i r s t phase w i l l be concerned with Intake structure and procedure, and the second phase with the r e f e r r a l of c l i e n t s . In both phases case material w i l l be used to reveal the casework implications of intake. The effectiveness of these phases i n meeting the needs of the c l i e n t , who approaches the Vancouver C i t y S o c i a l Service Department f o r s o c i a l assistance, i s the focus of t h i s study. 1 R.H. Kurtz, ed., 'Public Assistance Worker", New York, Russel  Saee Foundation, 1938, p. 101. - 2 5 -Chapter 3 So c i a l Assistance Intake In Practice The Vancouver C i t y Social Service Department (CSSD) i s bound by C i t y Council and P r o v i n c i a l regulations and l e g i s l a t i o n concerning s o c i a l assistance. The s o c i a l assistance that i s granted by the CSSD may be defined as f i n a n c i a l aid for maintenance and l i v i n g accommodation. The f i n a n c i a l aid may be accompanied by casework t r e a t -ment when necessary. The Vancouver C i t y Council defines the e l i g i b i l i t y requirements with which an i n d i v i d u a l must comply i n order to receive s o c i a l assistance. These r e -quirements are concerned with unemployability and d e s t i -tutions as i l l u s t r a t e d i n appendix A. There i s also a residence q u a l i f i c a t i o n which i s based on the B r i t i s h Columbia Residence and Responsibility Act, 19^8. These regulations and requirements are the i n t e g r a l part of the intake procedure. The CSSD has two methods of intake procedure. One method i s followed i n the Intake Section which i s attached to the Centre Unit or headquarters of the CSSD; the other method i s followed i n the East, South, and West D i s t r i c t Units of the CSSD. The Intake Section uses permanent intake -26-workers, while the three D i s t r i c t Units use a worker rotation system. In the D i s t r i c t Units, each worker i n turn i s made responsible for a l l intake for one day and handles a l l en-qu i r i e s that are made during that time. Each D i s t r i c t Unit has Its own system of worker rot a t i o n . Each D i s t r i c t Unit i s primarily responsible f o r helping applicants i n I t s area. The Intake Section, however, serves applicants from a l l areas i n the c i t y . In both procedures a card i s f i l l e d out with i d e n t i f y -ing data and, i f the c l i e n t i s e l i g i b l e f o r soc i a l assistance, a record i s made of the case and a home v i s i t i s completed by the fieldworker. The complete record i s cleared through the Records Section and the Voucher Section at main o f f i c e . A voucher i s made for the case, and an interim cheque i s made out for the c l i e n t . This interim cheque prevents a delay i n the receiving of the money by the c l i e n t . Further cheques are made out by the automatic cheque-writing machine at the C i t y H a l l . In emergency cases where the c l i e n t i s completely destitute, the whole procedure may be completed so that the c l i e n t may receive his s o c i a l assistance cheque within a few hours. In cases of doubtful e l i g i b i l i t y , a staff committee w i l l be held to decide the action to be taken i n the situ a t i o n . The Unit Intake Procedure Although the D i s t r i c t Units do not have workers who specialize i n intake procedure, experience shows that the rotatio: - 2 7 -of workers on Intake duty maintains some balance between the demands of the f i e l d worker's caseload and the demands of the new cases. Likewise, the d i s t r i c t o f f i c e s are handicapped by lack of private interviewing f a c i l i t i e s , with the possible exception of West Unit which has three private o f f i c e s for intake. However, the D i s t r i c t Units are more f l e x i b l e i n t h e i r handling of problems i n intake that cause emotional stress within the applicant. The intake worker, when he finds i t i s d i f f i c u l t for the c l i e n t to discuss personal problems due to the lack of o f f i c e f a c i l i t i e s , may ref e r the case to the f i e l d worker who may make a home v i s i t to discuss the problem i n privacy. In a l l Q i i t s , two main problems are apparent. F i r s t l y , the lack of s k i l l e d case workers for intake interviewing minimizes the amount of study, diagnosis, and treatment given to the c l i e n t . Secondly, the lack of proper o f f i c e f a c i l i t i e s reduces the e f f i c i e n c y of the intake procedure and r e s u l t s i n more expense to the C i t y because of the time spent i n intake interviewing. With proper Intake o f f i c e f a c i l i t i e s and more s k i l l e d intake workers, each hour used for intake would be more p r o f i t a b l e i n determining the needs of c l i e n t s , and i n f u l -f i l i n g these needs. The Intake Procedure of the Intake Section The intake procedure of the Intake Section i s divided Into clearance of e l i g i b i l i t y at the intake desk, and an i n t e r -view f o r r e g i s t r a t i o n of the case; t h i s i s termed record and r e g i s t r a t i o n . The worker at the intake desk w i l l f i l l out a •"28"* card with i d e n t i f y i n g data and w i l l discuss unemployability, residence, and the possible existence of unemployment insurance benefits with the c l i e n t . I f the worker has time, then he w i l l also check the residence h i s t o r y . (The actual addresses of residence and the time spent at each address are l i s t e d . ) I f the applicant seems to be e l i g i b l e , then an appointment w i l l be given to the c l i e n t so that a record and a r e g i s t r a t i o n of the case may be made. This appointment may be given within an hour, a day, or a weekend, depending upon the pressure of work and the day and hour of a p p l i c a t i o n . However, a l l cases of d i r e Emergency are handled immediately. The card for the c l i e n t i s then cleared through the records section to f i n d any f i l e on hand for previous s o c i a l assistance. The c l i e n t who cannot establish e l i g i b i l i t y at this point of intake, i s advised of the action necessary to prove e l i g i b i l i t y and i s told to return when such action has been taken. The c l i e n t who i s d e f i n i t e l y not e l i g i b l e i s so advised and, i f indicated, a r e f e r r a l i s made to the Salvation Army, Family Welfare Bureau, Department of Veterans' A f f a i r s , Veterans' Poppy Fund, Y.W.C.A.* Jewish Welfare, the Catholic C h a r i t i e s or various churches. In general, t h i s i n i t i a l contact with the CSSD can be an upsetting experience f o r the c l i e n t because e l i g i b i l i t y and other problems are discussed across an open counter and i n view and hearing of any other c l i e n t s who are waiting t h e i r turn. This problem i s enhanced by the small and uncomfortable intake room. In many instances, long delays occur while the c l i e n t i s -29-proving e l i g i b i l i t y or an existant record i s being c a l l e d i n from another area i n the province. Such happenings are indeed trying for the c l i e n t , when he i s upset, r e s e n t f u l , g u i l t y and without funds. During the record and r e g i s t r a t i o n interview, the intake worker and the c l i e n t together f i l l out the registered Social Assistance application, assets and income form, and a bank statement form. The worker then traces the residence history u n t i l l e g a l residence i s established. This procedure appears simple but i t represents only a part of the interview. The intake worker must t r y to f i n d d e t a i l s of the t o t a l problem and apply casework to a c e r t a i n degree. If the intake worker can present a good picture of the problem and give a tentative i n d i c a t i o n of needed casework, then the fieldworker who contacts the c l i e n t , i s better orientated to the c l i e n t ' s needs. However, the pressure of work i n this interview i s usually such that the intake worker has l i t t l e time f o r exploring the problems or doing i n i t i a l case-work. On a majority of days, the intake worker r e g i s t e r s an average of six cases, writes up each case by longhand, sets up the f i l e , and places i t i n the hands of the one stenographer. More time could be spent In helping the c l i e n t and i n doing i n i t i a l casework i f the intake desk worker was able to record the residence history of the c l i e n t , and i f s u f f i c i e n t c l e r i c a l s t a f f could set up the f i l e and take the Intake worker's record and r e g i s t r a t i o n i n shorthand. -30-The Effectiveness of Intake Procedure The effectiveness of the intake procedure of the CSSD Intake Section depends mainly upon the intake worker's tr a i n i n g and s k i l l , his a b i l i t y to function within the structure of the CSSD, and his knowledge of the c l i e n t s and the problems that they bring to the CSSD. There i s a great variety of c l i e n t s who come to the CSSD f o r s o c i a l assistance, but f o r convenience they may be described i n terms of the service needed by them; minor service, major service, and special service. (a) Minor Service. A minor service i s given to a c l i e n t when there i s a temporary lack of income but no need for treatment. This service i s given to persons waiting for old age pension, to marginal income groups when the breadwinner i s temporarily unemploy-able and no other resource i s available, to persons whose work-men^ compensation benefits are below the s o c i a l assistance l e v e l , and to persons waiting f o r workmen's compensation benefits, or who have been refused compensation benefits but are unemployable. (b) Major Service. A major service given to a c l i e n t includes not only f i n a n c i a l aid but a l s o casework treatment f o r emotional or personality problems. Further aid i s given by counselling, d i r e c t i o n , and helping the c l i e n t to formulate plans f o r the future. This service i s given to unmarried mothers, deserted, separated, or divorced women with young children, to a large group of single unemployable men, and to those people who require nursing or boarding home care. -31-(c) Special Service* Special services may or may not include casework treatment, but are categorized thus because they reveal a progressive trend i n the p o l i c y of the GSSD. Special services include aid to wives or f a m i l i e s when the bread-winner i s confined i n Oakalla, i n the Penitentiary, i s i l l with venereal disease or tuberculosis, and to persons whose workmen's compensation benefits have been discontinued because of phy s i c a l complications. ( A man with an injured leg may develop a r t h r i t i s and so become crippled. Because the man i s unemployable, his compensation benefits are discontinued and social assistance i s granted.) In a l l these cases the applicant must be d e s t i t u t e . These categories are not a f i n a l grouping i n any manner, and do not reveal the many combinations of services that may exist. Further, they do not include the cases that are r e -jected at intake. An applicant w i l l be refused s o c i a l assistance because he i s employable, he has s u f f i c i e n t income or resources, he has no residence i n Vancouver or B r i t i s h Columbia, he i s being repatriated » and he i s addicted to alcohol. In the l a t t e r s i t u a t i o n some al c o h o l i c s do receive s o c i a l assistance when i t i s advisable f o r a s o c i a l worker to administer the cheque. However, a l l applicants that come to the CSSD for s o c i a l assistance are met with a standard intake procedure, therefore, any d i f f e r e n t i a t i o n i n service given i s based on the degree of need of the applicant and on the intake worker's handling of the case. Meeting the C l i e n t ' s Needs The effectiveness of the intake procedure may be -32-ascertained only by a c a r e f u l analysis of several cases that have been given attention by the intake workers of the CSSD, To f a c i l i t a t e t h i s analysis i t i s desirable to term these cases as aid without s o c i a l assistance, f i n a n c i a l s o c i a l assistance, case-work s o c i a l assistance, and misused s o c i a l assistance. (a) Aid Without So c i a l Assistance. This type of case may be described as one i n which the c l i e n t i s not e l i g i b l e f o r s o c i a l assistance but the intake worker i s able to help him f i n d a solu-t i o n f o r his problem. (b) F i n a n c i a l S o c i a l Assistance. This case i s one i n which the c l i e n t i s e l i g i b l e f o r s o c i a l assistance but the intake worker i s unable to do more than prove e l i g i b i l i t y ; further aid i s prevented by pressure of work, or the need to supply a s o c i a l assistance cheque to the c l i e n t with as l i t t l e delay as possible. (c) Casework Social Assistance. This case i s one i n which the c l i e n t i s e l i g i b l e f o r s o c i a l assistance, and the intake worker i s able to begin study, diagnosis, and treatment. (d) Mis-used S o c i a l Assistance. This case i s one i n which the c l i e n t i s e l i g i b l e f o r s o c i a l assistance, but the granting of s o c i a l assistance only succeeds i n maintaining the c l i e n t ' s problems and h i s dependency. Aid Without S o c i a l Assistance. Many c l i e n t s come to the intake desk for s o c i a l a s s i s t -ance when theyare not e l i g i b l e f o r i t and whdn i t i s not the answer to t h e i r p a r t i c u l a r problem. When the intake desk worker has time and s u f f i c i e n t s k i l l he can explore the c l i e n t ' s problem -33-and o f f e r g solution. The intake worker was able to help Mrs. A. i n t h i s manner. Mrs. A. applied for s o c i a l assistance because her husband had passed away and she required f i n a n c i a l aid pend-ing the settlement of the W i l l . Mrs. A.'s lawyer had i n -formed her that i t would take several months to do t h i s . The intake worker i n his interview with Mrs. A. discovered that the l a t e husband had a t o t a l of i^OOO invested i n two stock market firms. The worker advised Mrs. A. that she could receive an emergency allowance, and recommended she engage another lawyer of her choice. Mrs. A. approached the new lawyer and subsequently was able to obtain an emergency allowance which solved her problem u n t i l the W i l l was set t l e d . The intake worker was able to offer Mrs. A. an opportun-i t y to discuss her problem and r e l i e v e some of the tension that had resulted from the bereavement, and the confusion over the le g a l s e t t l i n g of the W i l l . The solution offered by the intake worker was a simple one but offered great support and s a t i s f a c t i o n to the c l i e n t i n her time of need. The confusion that i s caused i n a c l i e n t by his problems i s often so great that he becomes un-r e a l i s t i c , aggressive, and involved i n a stormy interview with the intake worker. The case of Mrs. B. i l l u s t r a t e s t h i s confusion and the solution offerred by the worker. Mrs. B. applied at Intake Section for the f i r s t time l a t e one afternoon i n the autumn. She was a Finnish woman of approxi-mately 30 years of age and had been i n Canada 10 years. She was separated from her husband due to incompatibility and had a baby boy 18 months old for which she was paying board and care. She had recently been supporting herself by doing housework and l i v i n g i n for which she had been receiving $70.00 per month plus room and board. Her health was good, she was clean and neat i n appearance and appeared to be of an aggressive type. When she applied to the intake worker she was i n a highly excitable state i n s i s t i n g that she must have assistance immediately as she had no where to l i v e that night due to her work terminating, and also the people • with whom her c h i l d was boarded were i n s i s t i n g that she remove him from t h e i r home that night. -3^ Due to the l a t e hour i n which she had applied the worker explained that no assistance could be given that night and a stormy interview ensued. At t h i s point the worker referred the matter to a higher authority and upon further enquiry the following factors were ascertained. Mrs. B., as previously stated, was of a f i e r y temperament, had an argument with the people who were boarding her c h i l d over payment of board and the discussion reached the point where they in s i s t e d Mrs. B. take her c h i l d out of t h e i r home immediately. As Mrs. B. could not bring her c h i l d to the home where she was employed and had no friend with whom she could leave i t , she endeavoured to secure other employ-ment where the c h i l d might possibly be permitted, but had unfortunately given notice where she was presently employed and at the time of Interview at Intake was without work, money or a place to stay, having stayed the previous night with a friend who could not continue the arrangement. Upon further enquiry regarding the r e l a t i o n s h i p with the people who were boarding the c h i l d , Mrs. B. admitted they were *very nice people", cared for the c h i l d very w e l l and had been looking a f t e r him f o r several months, but she f e l t the husband did not want the c h i l d i n the home. She also said she did have a p o s i t i o n to go to and was to interview the lady that evening, but due to t h i s c r i s i s would have to forget i t . As the interview progressed Mrs. B. became calmer and i t was suggested that she telephone the people who were boarding the c h i l d regarding continuance at l e a s t on a temporary basis. This she agreed to do and i n the presence of worker 'phoned the woman. It was quite evident from the conversation that the dispute was of a t r i v i a l nature, but had no doubt been aggravated by applicant's temperament. After discussion the boarder of the child said she was quite w i l l i n g to carry on looking a f t e r the baby i n d e f i n i t e l y as long as Mrs. B. was s a t i s f i e d that she had not been done an i n j u s t i c e . Mrs. B. grudgingly said she would forget the dispute and leave the c h i l d there. Mrs. B. then asked worker what she would do about herself as she had no job and i t was suggested that she rphone her prospective employer to see i f the p o s i t i o n was s t i l l a v a i l a b l e . This she did and from the conversation i t was quite evident that the prospective employer was agreeable to postponing the interview to the following day. I t was then suggested to Mrs. B. that she approach her friend with whom she had stayed the night before to see i f she could accommodate her one more night, and i t was agreed that t h i s could be done. -35-This whole interview took a comparatively short time but Mrs. B. l e f t the intake o f f i c e quite happy and secure i n the knowledge that a l l was well and straightened out, and showed no signs of her previous tears. She has not re-applied f o r s o c i a l assistance. Again the worker was able to help Mrs. B. discuss her problems and give her the opportunity to release the tension and emotional s t r a i n which had prevented her from thinking c l e a r l y about her problems and finding a desirable solution. A l l cases of I n e l i g i b i l i t y unfortunately do not receive the counselling and aid that i s shown i n the foregoing two case i l l u s t r a t i o n s . This f a c t poses an important question f o r which there i s now no answer. What resource exists for such people i f the public agency refuses aid? However, regardless of the type of agency that might exi s t for counselling and aid, the personnel involved should be s k i l l e d s o c i a l workers. The case of Mrs. B. indicates the value of s k i l l e d case handling at the f i r s t point of contact. I t cannot be over-stressed that i n c e r t a i n cases greater progress can be made during the i n i t i a l interview than at a l a t e r date. Mrs. B. was i n need of supportive treatment which would enable to f i n d a solution to her immediate problems. The granting of s o c i a l assistance i n t h i s case would only result i n the intake worker helping the c l i e n t to avoid her problems and maintain her dependent po s i t i o n . F i n a n c i a l S o c i a l Assistance Many c l i e n t s who approach the Intake Section do not require any great amount of casework help but only require f i n a n c i a l assistance. Mr. C. required f i n a n c i a l aid i n the form of s o c i a l assistance pending the granting of his pension* - 3 6 -Mr. C. i n o f f i c e requesting assistance u n t i l his pension became e f f e c t i v e . He had intended to do odd jobs u n t i l h i s pension was granted, but due to an attack of influenza he has not been able to work and has used the l a s t of his savings f o r p e n i c i l l i n i n j e c t i o n s , costing 02 .00 each. His only earnings i n the past month were from washing a few windows f o r which he received $*+.00. Since atta i n i n g the age of 60 years he states he has never had enough insurable employment to be e l i g i b l e f o r unemployment insurance b e n e f i t s . Mr. C. pays $5 .00 per week for a housekeeping room and his rent i s two weeks i n arrears. Mr. C.'s main problem was his l o s s of earning power which would be overcome when he received the old age pension. There was no i n d i c a t i o n of mental or physical i l l n e s s or d i f f i c u l t y i n ad-justing to old age and retirement, however, s o c i a l assistance i n the form of f i n a n c i a l aid was necessary to bridge the gap between h i s a p p l i c a t i o n for old age pension and h i s receipt of a pension cheque. Some cases may be termed f i n a n c i a l s o c i a l assistance because the pressure of work does not allow the intake worker to do more than investigate the c l i e n t ' s f i n a n c i a l resources and places of residence, as i n the case of Mrs. D. Mrs. D. i n o f f i c e requesting assistance as she i s 61 years of age, i s unable to work, and the son who had been supporting her i s now married and unable to continue main-tenance. Mrs. D. has never worked outside her home since her marriage. After the death of her husband i n 19^7» she kept home f o r her son, who owns the house i n which she i s l i v i n g . Her son was married recently to a widow with two children. They wish to move into the house which consists of four rooms only and w i l l not be large enough to accommodate the applicant. Her son does earn enough to contribute to h i s mother's support now. Mrs. D. did not seem noticeably d i s -turbed by her son 1s marriage and the changes i t necessitates with her l i v i n g arrangements. Mrs. D. states she has been i n poor health and under the care of her doctor for some time. She suffers from b r o n c h i t i s and had pneumonia recently. Although the intake worker did mention that Mrs. B. did not seem noticeably disturbed by her problems, the worker has not -37-given reasons for t h i s action by the c l i e n t . The record i s very short and businesslike with no evidence of warmth or understanding on the part of the worker, which would give the c l i e n t l i t t l e f e e l i n g of acceptance by the worker and freedom f o r any emotional expression. With f u l l consideration to the l i m i t a t i o n s of the intake interview, the intake worker can make more use of cartharsis and begin a strong r e l a t i o n s h i p between the c l i e n t and the agency. The impersonal approach of the intake worker i s again i l l u s t r a t e d i n the case of Mr. E. Mr. E. applying f o r assistance as he i s unemployable because of cornorary s c l e r o s i s . He had a heart attack l a s t A p r i l while working f o r a logging company i n B.C. He was employed by t h i s company for two and one-half years and the heavy l i f t i n g involved i n his work aggravated an a l -ready serious condition. He has been In Vancouver and unable to work since then. He has used up a l l his unemploy-ment insurance benefits. Mr. E. separated from h i s wife i n I9325 he came to Vancouver and his wife remained i n Ontario. U n t i l her death he contributed $*+0.00 per month to her main-tenance while he was working. He has never returned to Ontario to make a home there. During the depression he sold a r t i c l e s from door to door i n Vancouver f o r a l i v e l i h o o d . His rent of $5.00 per week f o r a housekeeping room i s paid up to A p r i l 11/1951. He i s out of heart p i l l s which he i s r e -quired to take d a i l y , and now cannot afford to buy more. He had to s i t up a l l l a s t night as he could not sleep with the pain. This record seems to indicate a "question and answer" period rather than an interview between a c l i e n t and a s k i l l e d s o c i a l worker. It further indicates that the intake worker i s doing nothing more than recording c e r t a i n information about the c l i e n t , which i s to be given to the fieldworker. The intake worker does not contribute any of h i s own thinking, diagnosis, or recommendation f o r meeting the c l i e n t ' s needs. This lack of -38-contribution i s again evident i n the case of Mrs. F. Mrs. F. i n o f f i c e applying f o r assistance as ehe i s f i v e months pregnant and no longer able to work. Mrs. F. separated from her husband i n 19^5 by mutual agreement af t e r h i s return from service overseas. She made an attempt to gain support from her husband but gave up the task as she experienced l i t t l e success. She does not know of h i s wherea-bouts at present. She stayed with her father i n a small town u n t i l 19*f9 and worked i n various hotels to support herself and her son. She has worked i n a department store i n Vancouver up to the present. She has applied f o r unemployment benefits but has been refused. Mrs. F. states she has been to the CAS regarding the adoption of her expected c h i l d , and a foster home f o r her son during the period of her confinement. She has not been able to contact the putative father of the expected c h i l d since she told him of her pregnancy, and seems to have accepted his lack of interest only with great d i f f i c u l t y . Mrs. F. stayed with her s i s t e r f o r a short time but was forced to leave because her brother-in-law would not condone her actions. Her father i s remarried so she cannot go and l i v e with him now; and he i s not able to help her f i n a n c i a l l y . Mrs. F. has boarded her son for over one year at a rate of I^O.OO per month. She owes fl^.00 on the l a s t months' board b i l l and also owes a small grocery b i l l . Her rent of $16.00 i s paid up to A p r i l 19. The only i n d i c a t i o n of any emotional s t r a i n i n the c l i e n t , that i s suggested by the intake worker, i s the f a c t that the c l i e n t has found i t d i f f i c u l t to accept the putative father's lack of interest i n the expected c h i l d . Other than t h i s , the record indicates no other contribution on the part of the intake worker, i n terms of diagnosis and treatment. There i s no recording of the c l i e n t ' s behaviour during the Interview, and no tentative assessment of personality or the a b i l i t y of the c l i e n t to handle the problem. In the foregoing three cases, the intake worker has only succeeded i n carrying out one aspect of casework; that, of study. The other aspects of diagnosis and treatment are neglected to a great degree which minimizes the benefit to the c l i e n t and aid to the f i e l d -worker i n meeting the needs of the c l i e n t * The amount of t r e a t -ment offered to the c l i e n t , i n terms of the establishment of rapport, w i l l often determine the manner i n which the c l i e n t w i l l accept the fieldworker, the impression the c l i e n t w i l l have of the service of the agency, and the way the c l i e n t w i l l interpret the worth and i n t e r e s t of the agency to h i s friends or others i n need. Further pressure i s placed upon the intake worker because of emergency cases that require immediate attention. A case w i l l be treated as a d i r e emergency when the applicant i s completely destitute and perhaps has been without food f o r several days and has no l i v i n g accommodation. In these cases the intake worker w i l l rush through the a p p l i c a t i o n as quickly as possible and r e f e r the case f o r an emergency cheque issue. The case of Mr. G. was treated as such an emergency. Mr. G. i n o f f i c e requesting assistance as he i s suf-f e r i n g from a fractured right leg, Is wearing a cast and w i l l be unemployable for at least six weeks. Mr. G. l e f t Hamilton i n Mar/1951 f o r Vancouver as a f r i e n d had advised him of a good deal of work available with a Vancouver company. While changing busses i n Seattle he slipped crossing the street and fractured h i s ankle. A f t e r treatment i n h o s p i t a l he proceeded to Vancouver i n March, but yet had another blow - h i s bag was stolen i n the bus depot. It contained a l l his.possessions including the shoe for his fractured foot. Mr. G. has worked on the mess end of construction jobs fo r many years and f e e l s sure he w i l l have no trouble i n ob-taining employment when he i s able to work. His l a s t employ-ment other than casual work was with a c i r c u s i n the mess and e l e c t r i c a l departments. When he arrived In Vancouver he had $k.00 l e f t i n his savings. The Poppy Fund gave him a $3.00 meal t i c k e t as he had served i n WW2. He has no pension or other benefit from service, however. F i l e to be transferred to the Centre Unit D i r e c t o r . Mr. G. referred to v i s i t o f f i c e number 917 at 1:30 p.m. f o r emergency s o c i a l assistance issue. The record indicates that the intake worker can only be concerned with proving that Mr. G. i s e l i g i b l e for s o c i a l assistance i f a cheque i s to be Issued the same day. I f there i s any delay i n obtaining the f a c t s to prove e l i g i b i l i t y and i n the f i l e being transferred to the Centre Unit Director then Mr. G. may be without the f i n a n c i a l means to purchase food and lodging u n t i l the next day. This pressure to meet the immediate need of the c l i e n t does not allow the intake worker to begin diagnosis or treatment to any degree. However, the f a c t that the intake worker i s able to produce immediate aid i n the form of a s o c i a l assistance cheque would f o r e s t a l l some f r u s t r a t i o n on the part of the c l i e n t and perhaps begin a good rela t i o n s h i p with the agency. Casework S o c i a l Assistance. A good number of c l i e n t s who apply for s o c i a l assistance, and are e l i g i b l e , also need a good deal of casework or other services i f r e h a b i l i t a t i o n to an independent state i s to be obtained by them. The intake worker found Mr. H. to have t h i s need. Mr. H. In o f f i c e applying f o r assistance as he i s handi-capped by a mid-thigh amputation and may be considered temporar-i l y unemployable. Unemployability confirmed by the medical section. Mr. H. states he has been i n and out of hospitals most of his l i f e . He had " p o l i o " which resulted i n the eventual amputation of his l e g . He was also i n bed for a year at one time with a cardiac condition. He wears heavy glasses f o r extreme nearsightedness which frequently causes errors i n judgment re s u l t i n g i n f a l l s when walking with h i s crutches. He fractured h i s shoulder i n a f a l l l a s t October and required nursing home care as he could not use his crutches at that time. Mr. H. has also been unfortunate i n business. His father was the head of a business firm and when he died the applicant became the d i r e c t o r . As Mr. H. had never agreed with h i s brother on investment p o l i c i e s and without the mediation of t h e i r father i t soon became apparent that one or the other of the brothers would have to s e l l his share. As applicant could not afford to buy out his brother, he sold h i s share for $ 1 8 0 0 . 0 0 cash plus the assumption of a l i a b i l i t y to the f i r m of $ 3 2 0 0 . 0 0 . (Letter of f i l e to confirm t h i s ) . Mr. H. f e e l s very antagonistic towards Ihis brother and states that he does not even speak to him. Mr. H. has been no happier i n his marital l i f e . When he arrived home on the evening of August 31» 1 9 5 0 , he found hi s wife, c h i l d and furniture gone. He had mo idea of the whereabouts of his family u n t i l recently when a fr i e n d advised him of seeing them i n V i c t o r i a where his wife was said to be working f o r a government agency. She had been •working i n town i n a dress shop before leaving applicant and apparently was the main supporter of the family. Mr. H. seems to have l i t t l e i nsight into the seriousness of his present f i n a n c i a l condition. He has been borrowing money from h i s friends since his discharge from h o s p i t a l with l i t t l e thought of how he would repay the loans. He had a room i n a downtown hotel f o r $ 1 0 . 0 0 per week u n t i l A p r i l 1 , 1 9 5 1 -when the hotel was sold and the new owner raised the room rents. Since then he has stayed with friends who l i v e i n other hotels. Neither of these hotels had an elevator, a necessity to him. He intends to t r y to make arrangements with a friend to share expenses for a hotel room or a ground f l o o r suite. Nothing remains of the $ 1 2 0 . 0 0 he borrowed i n the past month to pay hotel, doctor, dental, and l i v i n g expenses. He spoke of having an i n t e r e s t i n a brewery which i s being b u i l t at Whitehorse, Yukon, but l a t e r admitted that he had no money involved i n the project and that, i n f a c t , a company had not yet been formed nor building started. V i s i t o r w i l l l i k e l y have a d i f f i c u l t task helping t h i s man to adjust to a lower standard of l i v i n g and encouraging him to find employment. As applicant does not know just where he w i l l be spending the weekend, we have referred him to the cheque issue o f f i c e , at 8 i ^ 5 a.m. on Monday. In t h i s interview, the intake worker has been able to explore with the applicant many of the problems facing him. While exploring these problems, the intake worker has accepted the applicant, given him a chance to express some fe e l i n g con-cerning his problems, and has produced a good deal of information which w i l l be most useful to the fieldworker. The intake worker has begun diagnosis i n making the observations concerning the applicant's lack of insight into the f i n a n c i a l circumstances and the possible d i f f i c u l t y of adjusting to a lower standard of l i v i n g and to some form of employment. From the record the fieldworker also w i l l be aware of the p o s s i b i l i t y that the applicant may blame hi s brother for the circumstances i n which he f i n d s himself. The intake worker has not only begun study, diagnosis and treatment but also expressed some fee l i n g f o r the c l i e n t which helps to produce a word picture of a human being and not just a c o l l e c t i o n of f a c t s . Evidence of the beginning of diagnosis and an in d i c a t i o n to the fieldworker of the possible need for special treatment i s again seen i n the case of Mr. I. Mr. I. i n o f f i c e requesting assistance as he i s temporarily unemployable. Unemployability i s confirmed on the attached medical sheet. Mr. I. has l i v e d and worked i n the c i t y and the lower mainland area since 1905. His l a s t employment out of town was i n a pulp m i l l from A p r i l to September, 19^9. Since his return to the c i t y he received unemployment insurance u n t i l March, 1950, when he began work as a painter f o r a c i t y firm. Because of the weather conditions the employment was not steady but he worked p e r i o d i c a l l y u n t i l October, 1950. Since t h i s time he had been receiving further un-employment insurance which has now expired. Mr. I. was quite r a t i o n a l and l u c i d during the above phase of the interview, but interrupted his flow of thought several times to t e l l the worker of h i s ailments. He stated that "they" could not help him at the hosp i t a l as they did not know what was wrong with him, but Only he himself knew his ailments. He also stated he did not want to see the "foreign woman doctor" again (according to the medical sheet t h i s woman was the p s y c h i a t r i s t who had seen him). Mr. I. complained that his hands had turned to water and his eyes were covered with a f i l m of water also, that he was f u l l of chemicals because of the beer he used to drink, and that he has noticed h i s f r i e n d s ' hands became sticky and trans-parent from drinking too much beer. A f t e r the interview the case was discussed with the medical section, who advised that a worker at the CNIB had had a somewhat similar conversation with a person who ap-peared to be the applicant. The CNIB worker f e l t that t h i s man was more of a psychiatric case and the medical section worker i s of the same opinion. The medical section worker intended to make an appointment at the psychiatric c l i n i c f o r applicant but i t was f e l t that the applicant would not keep h i s appointment. However, we f e e l he w i l l go now as he enjoys discussing h i s symptoms with any new l i s t e n e r . The record of the interview with Mr. I. reveals an adequate picture of the applicant which provides a basis for a tentative diagnosis. The intake worker has found the applicant to have a great concern over h i s ailments which were bi z a r r e enough to indicate the need f o r psychiatric treatment. The intake worker has also noted that the applicant f e e l s that no-one can t e l l what i s wrong with him. The fieldworker or psychiatric consultant w i l l be aware from this notation that the applicant may be hiding behind imaginary i l l s to defend h i s dependent po s i t i o n . The intake worker has begun study by obtaining the f a c t s to prove e l i g i b i l i t y and to present a good picture of the applicant; treatment by l i s t e n i n g to the applicant i n a sympathetic manner even though the applicant continually referred to his ailments; diagnosis by revealing the applicant's over-concern f o r his health, his possible need to use h i s ailments as a defense against r e a l i t y , and h i s apparent need for psychiatric help. Mis-used Social Assistance. There i s a group of persons who continually re-apply for s o c i a l assistance. Many of these persons have been "on and of f " s o c i a l assistance for some years with no progress toward r e h a b i l i t a t i o n . This absence of progress would seem to indicate a lack of appropriate casework or other treatment services needed by these i n d i v i d u a l s i f they are to become useful and happy c i t i z e n s . A summary of the record of Mr. J . i l l u s t r a t e s this lack of adjustment. Mr. J . i s *+8 years old and a painter by trade. This case was re-opened on March 2 0 t h , 1950, because the man was unemployable as a result of i n f e c t i o n i n an Injured hand. Mr. J . injured his hand while under the influence of alcohol. This man has a record of intermittent s o c i a l assistance since September 2 0 t h , 1939. Mr. J , re-applied for s o c i a l assistance on Ju l y 1 0 t h , 1950, but was refused because of his a l c o h o l i c s d i i c t i o n , and h i s frequent j a i l sentences i n Oakalla. S o c i a l assistance was granted to t h i s man on December 1 5 t h , 1950, as the Salvation Army was w i l l i n g to receive and to administer the s o c i a l assistance cheques for him. Mr. J . has received s o c i a l assistance intermittantly since 1939 and has served numerous sentences i n Oakalla for drunken-ness. I t i s apparent that the c l i e n t has mis-used the f i n a n c i a l s o c i a l assistance and some of the money has been used for the purchase of alcohol. Mr. J . has been going through cycles of unemployment, s o c i a l assistance f i n a n c i a l aid, Intoxication, court hearings and j a i l sentences. The record indicates that t h i s pattern has existed f o r several years and Mr. J . seems unable to improve his p o s i t i o n without special treatment or help. His i n -a b i l i t y to use any s o c i a l assistance cheque fo r food and shelter i n a proper manner resulted i n the r e j e c t i o n of his r e - a p p l i c a t i o n for s o c i a l assistance on J u l y 1 0 t h , 1950. This action i s j u s t i f i e d i n terms of the r e s p o n s i b i l i t y of the CSSD to use public funds apportioned to i t i n an appropriate manner. However, i n terms of treatment of the c l i e n t i t presents a negative picture, For a period of years the issuing of s o c i a l assistance cheques to Mr. J . has only resulted i n the maintenance of his dependent po s i t i o n and dissolute habits. F i n a l l y , when the CSSD r e a l i z e s that It cannot meet the r e s p o n s i b i l i t y of treating the basic problems of Mr. J.,hs i s refused even f i n a n c i a l a i d . Nevertheless, the CSSD did arrange to have the Salvation Army administer the s o c i a l assistance cheques so that Mr. J . would have at least food and s h e l t e r . : The mis-use of s o c i a l assistance fend the necessity of delegating the r e s p o n s i b i l i t y of administering s o c i a l assistance cheques i s repeated i n the case of Mr. K. Mr. K. was granted s o c i a l assistance on December 1 6 , 1 9 ^ 6 , because of an arm injury. From 1 9 ^ 6 to date the case has been repeatedly opened. This man refused to keep ap-pointments f o r treatment at the Out Patients' Department. He was repeatedly confined i n Oakalla on charges of drunken-ness and vagrancy. Mr. K. applied f o r s o c i a l assistance on January 2 6 t h , 1 9 5 1 * but was referred to the F i r s t United Church to ascertain i f the Minister would administer h i s s o c i a l assistance cheques. On February 1 s t , 1 9 5 1 * s o c i a l assistance was granted and the cheques made payable to the Minister of the F i r s t United Church for administration. In the case of Mr. K. i t i s again evident that the issuing of s o c i a l assistance cheques did not aid i n the r e h a b i l i t a -t i o n of the c l i e n t . On the contrary, i t succeeded i n maintaining Mr. K. i n h i s pattern of l i v i n g ; t h i s pattern consisting of un-employment, s o c i a l assistance f i n a n c i a l aid, vagrancy, intoxication, and j a i l confinement. The i n a b i l i t y of Mr. K. to improve his circumstances i s evident as the foregoing pattern existed from 19*1-6 to 1 9 5 1 . His i n a b i l i t y to use f i n a n c i a l aid i n a proper manner i s evident as no cheque would be issued unless some reputable person would undertake the administration of the cheque. Although the administration of the cheques by the Minister of the church would ensure food and shelter, i t did nothing to provide the treatment that Mr. K. needs. I t did l i t t l e to safe-guard the dignity of the i n d i v i d u a l and to help him f i n d a more useful and s a t i s f y i n g l i f e . For these reasons the s o c i a l as-sistance was mis-used. The investment of public funds without the provision of appropriate treatment i n cases such as that of Mr. J . and Mr. K. i s not an economy, and i s not consistent with the philosophy of service which must underly any successful social assistance program. As previously i l l u s t r a t e d the CSSD methods of intake procedure can be defined r e a d i l y , and reveal e f f i c i e n c y , i n that an intake section with f u l l time intake workers can s t a b i l i z e routine and lessen the time between the c l i e n t s ' a p p l i c a t i o n and the receipt of a s o c i a l assistance cheque. However, the case analyses reveal a lack of attention to the emotional or personality problems of the c l i e n t . The issuing of f i n a n c i a l aid has primary importance, whereas i t should be considered i n many cases as a temporary measure that i s used to enable treatment of emotional or personality problems. This would help to ensure more success i n the r e h a b i l i t a t i o n of the c l i e n t , and points up the need f o r study, diagnosis, and treatment at the intake l e v e l . The lack of attention to the problems of the c l i e n t , other than f i n a n c i a l d i f f i c u l t i e s , and the apparent primary importance placed upon agency routine can be seen also i n many cases of r e f e r r a l involving the CSSD Intake Section. -US-Chapter h Referral i n Relation to Intake A standard dictionary meaning of the word ref err a 1 i s , "to d i r e c t or send for information or other purpose". This d e f i n i t i o n , however, does not indicate the ove r a l l significance of r e f e r r a l when considered i n a setting such as the CSSD Intake Section. In t h i s setting, r e f e r r a l implies a purposeful channelling of a c l i e n t f or two main reasons. F i r s t l y , the needs of a c l i e n t have been accurately assessed and one agency finds that i t i s unable to meet the needs of the c l i e n t . Secondly, the c l i e n t i s referred to the agency which can best meet his needs. The focus of r e f e r r a l i s then placed upon the needs of the c l i e n t and how to meet these needs most adequately. Problems i n the Ref e r r a l Process In terms of treatment i t i s essential that r e f e r r a l s be made i n an accurate manner. A l l agencies involved i n the r e f e r r a l process must necessarily understand the function and purpose of each other. Consideration must be given to the timing of r e f e r r a l s , clearance by n o t i f i c a t i o n to the agency being r e f e r -red to, and to s p e c i f i c agreements among the agencies concerned. This consideration w i l l exist i f inter-agency co-operation i s fostered by conferences on r e f e r r a l , and by n o t i f i c a t i o n by any agency of any po l i c y change which w i l l e f f e c t other agencies. It i s not inconceivable that an agency could change i t s policy so that a c e r t a i n service would no longer be available to those i n need of i t . N o t i f i c a t i o n of any such change would prevent needless seeking of aid by a c l i e n t who has been referred for the discontinued service. Perhaps the two largest problems which retard the development of good r e f e r r a l process are the inaccurate d e f i n i t i o n s of agency function, and the ins e c u r i t y i n agencies which seems to prevent a free flow of ideas and understanding between agencies. CSSD Intake Section Referrals The r e f e r r a l s that pertain to the CSSD Intake Section may be c l a s s i f i e d as primary, secondary and t e r t i a r y f or convenience of d e f i n i t i o n . This c l a s s i f i c a t i o n involves s o c i a l assistance cases only. (a) Primary Referrals Primary r e f e r r a l s are those that are made within the Vancouver CSSD Units. (b) Secondary Referrals Secondary r e f e r r a l s are those that are made from the CSSD to other agencies or organizations when the c l i e n t i s not e l i g i b l e f o r s o c i a l assistance. (c) T e r t i a r y Referrals T e r t i a r y r e f e r r a l s are those that are made to the CSSD Intake Section from agencies and i n s t i t u t i o n s such as hospitals and P r o v i n c i a l S o c i a l Welfare Branch O f f i c e s . Primary Referrals A l l s o c i a l assistance cases accepted by the Intake - 5 0 -Section are referred to the CSSD F i e l d Unit which I s responsible f o r the area i n which the applicants reside. These r e f e r r a l s are made with a minimum of delay so the f i e l d worker can make the i n i t i a l home v i s i t and the s o c i a l assistance cheque can be issued promptly. The actual records are cleared to the F i e l d Units d a i l y and i n cases of dire emergency a home v i s i t can be made on the day the record i s referred. A second type of primary r e f e r r a l i s made when a so c i a l assistance r e c i p i e n t returns to the Intake Section for some additional advice or service. Such r e c i p i e n t s are referred to the unit fieldworker because the case i s active and therefore outside the function of the intake worker. This type of r e f e r r a l should be avoided. The necessity for t h i s type of r e f e r r a l indicates that either the intake worker taking the application, or the fieldworker, has not made i t c l e a r to the rec i p i e n t which unit he should turn to f o r further a i d . Proper clearance with the recipient of t h i s matter would lessen the number of these r e f e r r a l s , would lessen the cost of transportation for the r e c i p i e n t , and speed s a t i s f a c t i o n for the needs of the re c i p i e n t . A third type of primary r e f e r r a l i s sometimes made from the Intake Section to the D i s t r i c t Units, when the intake worker f i n d s that the problems of the c l i e n t cannot be discussed adequately without private interviewing f a c i l i t i e s . Upon r e f e r r a l of the c l i e n t to the D i s t r i c t Unit a home v i s i t can be arranged so the problems can be discussed i n privacy. This - 5 1 -type of r e f e r r a l cannot be used to any great degree as the D i s t r i c t Unit fieldworkers are under much pressure from high caseloads and therefore have a minimum of time for these home interviews. However, t h i s type of r e f e r r a l would not be necessary i f the intake workers had s u f f i c i e n t private i n t e r -viewing room at the disposal of themselves and the c l i e n t s . Secondary Referrals The CSSD Intake Section makes many r e f e r r a l s to other agencies because applicants are not e l i g i b l e for s o c i a l assistance but do have a need for help. There i s no set pro-cedure for these r e f e r r a l s other than the intake worker's explanation to the c l i e n t that such resources exist and aid may be forthcoming. In cases of dire need the intake worker may telephone the agency being referred to, and complete arrange-ments for the c l i e n t to contact the agency. These r e f e r r a l s are made under a "gentleman's agreement" between the CSSD Intake Section and the other agencies. This agreement has been developed as a part of inter-agency co-operation as fostered by the CSSD Administration. This type of r e f e r r a l was made i n the case of Mrs. L . Mrs. L . i n o f f i c e requesting assistance as she was recently deserted by her husband and has not yet been able to make plans f o r the support of herself and her three year old c h i l d . Mrs. L . was married on Nov. 2 7 t h , 1 9 ^ » i n an eastern province. She and her husband l i v e d here f o r one year and then moved to the eastern United States to l i v e with in-laws. While there the applicant had a quarrel and l e f t her husband taking t h e i r youngest c h i l d and leaving the older c h i l d behind. She came to Vancouver on Jan. 1 2 t h , 19^9, - 5 2 -to stay with her mother. The applicant gained employment with a hotel as a chambermaid from March, . 1 9 ^ 9 , u n t i l March, 1 9 5 0 . Her husband came to j o i n her i n Sept., 1 9 U 9 , and a r e c o n c i l i a t i o n was effected. Mr. L. d r i f t e d from job to job and drank heavily while i n Vancouver. As he did not support Mrs. L. she continued working u n t i l she had a miscarriage because of worries and too heavy work. Mr. L. went to a town up-coast i n March, 1 9 5 0 , and l e f t there for the Yukon i n May, 1 9 5 0 . Thinking that he might have settled down, Mrs. L. joined her husband i n the Yukon i n July, 1 9 5 0 , and was supported by him u n t i l Feb., 1 9 5 1 * when she states the RCMP deported him to Alaska and advised her to return to her mother i n Vancouver. Mr. L. i s an American c i t i z e n as he was born of American parents and chose American c i t i z e n s h i p when he became 2 1 years of age. He had entered Canada i l l e g a l l y and was deported as he had been the source of a great deal of trouble to the police because of h i s cruelty to h i s wife. She believes he i s mentally deranged and states there i s a history of insanity i n his family. Mrs. L.'s mother sent her a sum of money which was used to pay Mrs. L.'s fare to Vancouver. Her mother, a former chambermaid for a Vancouver Hotel, i s not i n good circumstances nor i n good health. She suffers from rheumatism which at the present time prevents her from caring f o r her daughters' c h i l d , while the applicant works. Mrs. L. has had no sp e c i f i c t r a i n i n g f o r employment and has found chamber-maid work too hard for her. She i s s t i l l too upset to make adequate plans for her future and would seem to require support and encouragement. As Mrs. L, was not e l i g i b l e for s o c i a l assistance because her husband lacked B.C. residence, she was referred to the Catholic C h a r i t i e s for help i n making arrangements f o r her ch i l d s ' care and becoming re-established. Mrs. L. has an immediate need for f i n a n c i a l assistance so that she can provide food and shelter f o r herself and her c h i l d . As noted by the intake worker, Mrs. L. w i l l also need considerable casework help i n re-establishing herself and over-coming the problems facing her. However, the la c k of residence q u a l i f i c a t i o n prevents Mrs. L. from receiving not only-f i n a n c i a l assistance but also casework assistance. This lack of residence q u a l i f i c a t i o n must be accepted as reason enough fo r not granting f i n a n c i a l assistance but should not prevent the c l i e n t from receiving casework help or counselling. I f the c l i e n t i s referred to an agency that can provide f i n a n c i a l aid but not casework aid then the CSSD should make provision within i t s policy so that casework services would be av a i l a b l e . T e r t i a r y Referrals The movement of s o c i a l assistance r e c i p i e n t s within the province should not cause undue hardship for them when the movement from one place to another i s j u s t i f i e d . However, because of poor r e f e r r a l s , many re c i p i e n t s find themselves without funds f o r long periods of time. This period may extend from a few days to a few weeks. This delay i s seen i n the ease of Mrs. M. Mrs. M., an 18 year old mother, and her 1-1/2 year old c h i l d were on s o c i a l assistance i n Vancouver because the husband was confined i n Oakalla. The mother informed the CSSD that she planned to move to an i n t e r i o r town where some of her r e l a t i v e s were l i v i n g . Consequently the CSSD forwarded an outline of the case to the p r o v i n c i a l o f f i c e , as well as a n o t i f i c a t i o n that Vancouver would s t i l l keep the re s p o n s i b i l i t y f o r the s o c i a l assistance. The woman received s o c i a l assistance upon her a r r i v a l i n the i n t e r i o r town and no problem arose. Mrs. M. l a t e r decided to return to Vancouver. After her a r r i v a l i n the c i t y she re-applied f o r so c i a l assistance at the CSSD. I t was necessary to clear the date of the l a s t cheque issued i n the i n t e r i o r town i n order that the CSSD could continue s o c i a l assistance. On the date of the r e - a p p l i c a t i o n at the CSSD a l e t t e r was sent to the i n t e r i o r town requesting the date of the l a s t cheque issue. The information was not forthcoming so a second request was made 10 days l a t e r . The information s t i l l did not arrive so the only recourse of the CSSD was to re f e r the mother and the c h i l d to the Salvation Army for interim assistance u n t i l the date of the l a s t s o c i a l assistance was confirmed. The lack of proper r e f e r r a l from the i n t e r i o r town to the CSSD made i t impossible f o r the CSSD to issue Mrs. M. with s o c i a l assistance and she was consequently without the means to purchase food and accommodation. The sudden l o s s of f i n a n c i a l support greatly increased the concern of the c l i e n t who was already upset over the s i t u a t i o n of her husband. Further, any p o s i t i v e r e l a t i o n s h i p with the agency would be threatened as Mrs. M. was refused s o c i a l assistance not because she was i n e l i g i b l e but because of a poor r e f e r r a l . The intake worker would be hard pressed to interpret t h i s s i t u a t i o n to the c l i e n t with any degree of success. F i n a l l y , the fact that Mrs. M. was forced to accept "charity" i n her dependent position increased the trauma of her general s i t u a t i o n and so made any adjustment on her part more d i f f i c u l t . A l l r e f e r r a l s from P r o v i n c i a l S o c i a l Welfare Branch Offices and from other m u n i c i p a l i t i e s are not made i n the above manner. Nevertheless, such r e f e r r a l s are of s u f f i c i e n t number to warrant a p o l i c y which would minimize any delay i n the granting of s o c i a l assistance to a c l i e n t who has a new place of residence. The s o c i a l worker who f i n d s that a s o c i a l - 5 5 -assistance r e c i p i e n t has moved without notice cannot avoid a c e r t a i n delay i n forwarding information to the welfare o f f i c e requiring i t . However, the s o c i a l worker, who i s aware that a s o c i a l assistance c l i e n t i s planning a move, should discuss the r e c i p i e n t ' s plans f o r the movement. The re c i p i e n t should understand whether s o c i a l assistance w i l l he available i n the new place of residence, understand the cost of trans-portation, renting, food or other necessary expenses. The so c i a l worker should ensure that the welfare o f f i c e , i n the new place of domicile, has the information for the granting of assistance before the a r r i v a l of the re c i p i e n t , i f possible. F i n a l l y , the rec i p i e n t should know where to apply for s o c i a l assistance i n the new area. Another type of t e r t i a r y r e f e r r a l i s necessary because the CSSD i s authorized to grant s o c i a l assistance to d e s t i t u t e patients who have been discharged from Vancouver hospitals but who require a period of convalescence. The period of con-valescence gives the patient a status of unemployability for medical reasons and he i s e l i g i b l e f o r s o c i a l assistance. However, the patient may experience considerable hardship i f he i s referred to the CSSD without proper clearance by the h o s p i t a l . The hardship caused by a poor r e f e r r a l i s seen i n the case of Mr. N. Mr. N. i s single and h8 years of age. He came to B.C. i n 1928 and worked i n various logging camps as a fireman and as a laborer u n t i l 193^. From 193* u n t i l October, 19^0, he worked i n various P r o v i n c i a l R e l i e f -56-Camps when not employed as a casual laborer. In October, 19^0, he applied to the CSSD for Soc i a l Assistance as he was unable to work due to "varicose ulcers" on both legs. From that time to the present he has been i n receipt of so c i a l assistance or h o s p i t a l i z a t i o n almost continuously. In July, 1950, he was admitted to a Vancouver h o s p i t a l with a diagnosis of "post p h l e b i t i s " . He underwent a l e f t lumbar sympathectomy i n J u l y and underwent a similar operation on the r i g h t side i n the same month. P r i o r to his h o s p i t a l admission he had been i n receipt of s o c i a l assistance. In September, 1950, the h o s p i t a l s o c i a l service department informed the CSSD medical section that t h i s man was to be discharged, that he would be attending the out patients' department, and he would be unemployable i n d e f i n i t e l y . This information was received the day the man was discharged. The man applied at the Intake Section f o r s o c i a l assistance and am emergency f i n a n c i a l issue was made. Mr. N. was again admitted to the hos p i t a l i n August, 1951, for further medical treatment. In October he was discharged and on the same day the CSSD was n o t i f i e d of the discharge and the mans* need for s o c i a l assistance. Mr. N. applied f o r s o c i a l assistance at the Intake Section the day afte r h i s discharge. He informed the intake worker that he had found i t necessary to borrow $5.00 to obtain rooming accommodation for the f i r s t evening he was away from the h o s p i t a l . S o c i a l assistance was granted. The r e f e r r a l of Mr. N. from the hos p i t a l to the CSSD reveals the lack of proper timing i n r e f e r r a l and the lack of consideration for the c l i e n t s ' need and physical condition. In both r e f e r r a l s the ho s p i t a l social service department n o t i -f i e d the CSSD that Mr. N. would require s o c i a l assistance on the day of his discharge. This short notice does not allow the CSSD Intake Section to make an appointment f o r the c l i e n t when there i s interview time available, as the Intake Section usually -57-has a l l appointment times f i l l e d for two or three days i n ad-vance. At the time of the f i r s t r e f e r r a l , the Intake Section found i t necessary to make an emergency issue because of the man's dire f i n a n c i a l need. This emergency issue increases the pres-sure of work on the Intake Section and as i t Is the r e s u l t of a poor r e f e r r a l , the rel a t i o n s h i p between the Intake Section and the h o s p i t a l s o c i a l service department tends to become a negative one. At the time of the second r e f e r r a l , i t i s apparent that Mr. N. was unable to reach the CSSD i n working hours and he found i t necessary to borrow s u f f i c i e n t money to find accommoda-t i o n for the night. The dignity of the c l i e n t or h i s physical condition are given l i t t l e consideration when he i s discharged from the hos p i t a l as destitute and at a time when he cannot apply for s o c i a l assistance. Mr. N. was forced to r e l y on the charity of others for f i n a n c i a l aid when he was e l i g i b l e for assistance, and although i n poor physical health he had to undertake the t r i p from the hospital to the CSSD which would cause needless physical s t r a i n when he was In need of convalescence. In the foregoing discussion of r e f e r r a l s i t Is evident that poor r e f e r r a l procedure often r e s u l t s i n needless physica] s t r a i n upon the c l i e n t because of un-necessary v i s i t s to the Intake Section. This i s p a r t i c u l a r l y true for the c l i e n t who returns to the Intafe Section for further service instead of contacting the f i e l d unit responsible, and for the c l i e n t who i s discharged from a h o s p i t a l setting. Poor r e f e r r a l procedure may also cause a temporary cancel l a t i o n of s o c i a l assistance, or a delay i n the receipt of s o c i a l assistance, which forces the c l i e n t to accept charity or go without food and shelter. This cancel l a t i o n or delay i s i n no way consistent with the right of the i n d i v i d u a l to receive f i n a n c i a l aid when he i s e l i g i b l e f o r i t . A l l the poor r e f e r r a l s i l l u s t r a t e d are the r e s u l t of an inadequate r e f e r r a l procedure, and not the resu l t of a lack of co-operation by the c l i e n t . The improvement of the r e f e r r a l procedure, therefore, i s the r e s p o n s i b i l i t y of the CSSD and the other s o c i a l agencies involved, and should be effected by a co-operative e f f o r t . The study of intake focused upon the CSSD of Vancouver reveals many gaps i n the application of desirable philosophy and e f f e c t i v e methods of procedure. Both i n terms of casework and i n meeting the needs of c l i e n t s most e f f e c t i v e l y , i t i s clear that the current intake procedure i s inadequate. They r a i s e , as a f i n a l question, the need to find ways i n which the intake procedure could be improved. - 5 9 -Chapter 5  Implications for P o l i c y The preceding analysis of the CSSD structure, intake po l i c y , r e f e r r a l s , and case material reveals the existence of many d i f f i c u l t i e s which prevent maximum service being given to c l i e n t s . The majority of these d i f f i c u l t i e s could be overcome with s l i g h t delay and l i t t l e change i n department structure or p o l i c y . P r o v i n c i a l l e g i s l a t o r s , c i t y aldermen, and the CSSD administrator build the structure through which s o c i a l assistance may be granted to those i n need. Although the intake worker must function within t h i s structure, his rol e i s clear; he i s responsible f o r covering the structure with warmth and understanding to enable the applicant to find s a t i s f a c t i o n for his needs with as l i t t l e hardship as possible. The success of the intake worker i n carrying out this r e s p o n s i b i l i t y w i l l depend a great deal upon the • philosophy under which he seeks to be of service to others. Philosophy f o r service to others should embody the b e l i e f that every c l i e n t has some i n t r i n s i c worth, and has a right to be afforded acceptance and di g n i t y . The aim of this philosophy should be to help the c l i e n t to a more useful and sa t i s f y i n g l i f e ; and should be integrated by the knowledge that "physical, mental, economic, and emotional needs are int e r r e l a t e d , and even the most p r a c t i c a l program for human 1 welfare must be undertaken with regard f o r human personality". 1 Gordon Hamilton, "Psychotherapy i n Child Guidance", Columbia Press. New York, 19M3, p. 5 . -60-Two means of maintaining t h i s aim are found i n the c a r e f u l selection and supervision of intake s t a f f . Careful selection of s o c i a l workers f o r the intake s t a f f i s of paramount importance. The intake worker should be a highly s k i l l e d caseworker so that study, diagnosis, and treatment w i l l be u t i l i z e d to a maximum i n intake interview-ing. The intake worker must be thoroughly acquainted with e l i g i b i l i t y requirements, with a l l the available resources i n the c i t y , and be able to bring t h i s information to use at any time during an intake interview. Although doubtful cases of e l i g i b i l i t y may have to be discussed with the Director of the Intake Section, the intake worker should be able to clear a majority of problems with his own knowledge and s k i l l . I t i s apparent that the Director of the Intake Section i s forced to spend considerable time and e f f o r t i n solving small problems of e l i g i b i l i t y , i n correcting errors i n case recording, and i n supervision of intake workers. The provision of a supervisor for the intake workers, and a c a r e f u l selection of s k i l l e d caseworkers, who are f u l l y understanding of intake procedure, would allow the Director to more p r o f i t a b l y use his time i n problems of administration, i n defining unmet needs discovered at the intake l e v e l , and i n developing l i a i s o n with other agencies i n the c i t y where aid may be forthcoming for applicants, whether e l i g i b l e or i n e l i g i b l e f o r s o c i a l assistance. The Director would be able, therefore, to focus his attention upon the o v e r a l l -61-planning concerning the development of the Intake Section, and h i s role of leadership would be c o r r e c t l y established„ However, the findings of the intake Director and of s t a f f committees w i l l be of l i t t l e value to anyone i f the needs discovered are not interpreted to the S o c i a l Services Committee and then to the people of the c i t y . Interpretation of Needs to the S o c i a l Services Committee The amount of in t e r p r e t a t i o n that the CSSD i s able to carry on with the Social Services Committee i s indeed small and i n s u f f i c i e n t to bring about any action which would help to meet the unmet needs that are discovered. This lack of i n t e r p r e t a t i o n i s a d i r e c t r e s u l t of the ad-ministrative system of the Vancouver C i t y Council. The Cit of Vancouver has long used the committee form of administra t i o n t To carry on the business of the C i t y , eight standing committees are i n operation, which hold by-monthly meetings A l l committee meetings are completed within a period of two days which seems to indicate a good degree of e f f i c i e n c y but a further analysis disproves t h i s . The Aldermen who form the various committees are, i n the main, very active business men who are under a great pressure of work. This pressure of private and public business severely l i m i t s the time that i s available for adequate consideration of c i t y problems* As a r e s u l t the committee meetings are rushed through, one a f t e r another, i n a period of two days, with -62-only a minimum of business given a t t e n t i o n . The S o c i a l Services Committee seems more interested i n the number of. so c i a l assistance cases on the CSSD rol e s and the cost to the C i t y , than i n answering questions of need. How can intake be improved? What are the unmet needs that come to the attention of the CSSD Intake Section? How can these needs and the function of the CSSD come to the attention of the people of the City? What resource can be i n s t i t u t e d to give counselling and d i r e c t i o n to those i n d i v i d u a l s who are not e l i g i b l e f or s o c i a l assistance but require aid? Such questions are not given adequate attention so that solutions may be found and service to c l i e n t s improved. If service i s to be improved then consideration must be given also to e f f i c i e n t and s k i l l e d use of interviewing time, to the comfort of the c l i e n t , and to improved service to present r e c i p i e n t s . Any recommendation to improve the present intake procedure w i l l be p r a c t i c a l only i f i t i s consistent with the purpose of the Intake Section design. Purpose of the Present Intake Section Design The present Intake Section was designed to meet the pressure of large numbers of c l i e n t s applying f o r s o c i a l assistance with some uniformity i n intake procedure. This has been accomplished inasmuch as f u l l time intake workers have been able to meet the pressure more e f f i c i e n t l y and have lessened the delay between the c l i e n t ' s a p p l i c a t i o n for aid -63-and h i s receipt of a s o c i a l assistance cheque. Neverthe-l e s s , the applicants are so numerous that the intake workers are forced to be concerned primarily with proving e l i g i b i l i t y i n order to meet the pressing f i n a n c i a l need* This r e s u l t s i n a lack of study, diagnosis, and treatment at the intake l e v e l , and gives r i s e to an important question. Can the task of the Intake Section be carried out by well-trained re c e p t i o n i s t s , or i s there a need f o r f u l l y - q u a l i f i e d s o c i a l workers? When the emotional condition of the average c l i e n t applying f o r s o c i a l assistance i s considered there i s not much doubt as to the answer. Two main considerations must be recognized. (a) Many c l i e n t s who approach the Intake Section are making application f o r help as a l a s t resort. These c l i e n t s are labouring under f e e l i n g s of f r u s t r a t i o n , g u i l t , l o s s of personal worth and independence, and are doing t h e i r utmost to maintain some degree of human dignity. When question-ed about t h e i r e l i g i b i l i t y f o r s o c i a l assistance they often give vent to th e i r pent-up f e e l i n g s and these must be aired i f f i n a n c i a l and casework help are to be made a v a i l a b l e . The intake worker, therefore, must be s k i l l e d i n the best technique of " c a r t h a r s i s " i f the interview i s to be successful and the c l i e n t helped adequately. (b) Secondly, many c l i e n t s are confused by th e i r problems, and are reti c e n t to discuss personal matters: yet -6*f-these must be known by the intake worker before s o c i a l a s s i s t -ance can be granted. These c l i e n t s require understanding, acceptance, and support from the intake worker i f a sound rel a t i o n s h i p i s to be established with the agency at the f i r s t point of contact. This r e l a t i o n s h i p controls to a great extent the ease with which the fieldworker w i l l make his f i r s t home v i s i t and continue to help the c l i e n t l a t e r . The a b i l i t y of the intake worker to make a tent a t i v e diagnosis of the c l i e n t and to suggest any special treatment necessary w i l l greatly help the fieldworker to understand and help the c l i e n t . I f the intake worker i s not s k i l l e d enough to begin study, diagnosis, and treatment then the fieldworker has l i t t l e knowledge of the c l i e n t before making the f i r s t home v i s i t . The f i r s t home v i s i t must then become the intake interview and i t may be much more d i f f i c u l t i f the c l i e n t becomes h o s t i l e and frustrated i f attention to hi s needs i s delayed. The need f o r s o c i a l work i s again evident when c l i e n t s are not e l i g i b l e for s o c i a l assistance and consideration i s given to the method of r e f u s a l and the possible r e f e r r a l to other agencies. The task of interpreting to the c l i e n t why he i s not e l i g i b l e i n a sympathetic manner and i n a way which w i l l gain h i s acceptance requires the utmost i n s k i l l and understanding on the part of the intake worker. The c l i e n t who i s referred to another agency must be helped to contact the new agency, and must be convinced he w i l l be received - 6 5 -i n a desirable manner and be given the help he requires. The techniques needed to accomplish these ends successfully are properly the tools of the professional s o c i a l worker. The successful use of s o c i a l work s k i l l s i s seen i n the case handling of Mrs. A. and Mrs. B. (Chapter 3)« Both these c l i e n t s , who believed that s o c i a l assistance would solve t h e i r problems, were given r e d i r e c t i o n without finan-c i a l aid but placed on the way to a solution. The s k i l l e d intake worker was able to c o r r e c t l y assess the s i t u a t i o n of the c l i e n t s and o f f e r a solution which was used by the c l i e n t s . In these two b r i e f interviews the intake worker acted sympathetically but remained objective enough to help the c l i e n t s s a t i s f y t h e i r needs. The time consumed i n each interview did not exceed half-an-hour, which suggests that successful casework at the intake l e v e l does not require a great deal of time but rather a more e f f i c i e n t use of interview time. Use of Interview Time The pressure of applicants f o r s o c i a l assistance, and sound s o c i a l work practice, both must be considered i n estimating the length of time the intake worker may p r o f i t a b l y use i n interviewing the c l i e n t . The information gained i n the present study suggests three directions In which improve-ments might be sought. (a) S u f f i c i e n t professional s o c i a l workers should be recruited for the Intake Section to handle the current - 6 6 -number of applicants f o r s o c i a l assistance. To f i n d the number of intake workers necessary would require i n i t i a l surveys, to indicate the monthly averages of applicants, and also the time needed to interview them with a minimum of delay. Monthly averages would probably be needed to compensate for the seasonal f l u c t u a t i o n s i n the numbers of applicants. (b) Adequate supervision should be available f o r the intake workers to allow immediate clearance of e l i g i b i l i t y problems, and to ensure the use and development of sound interviewing and recording techniques. (c) The provision of s u f f i c i e n t c l e r i c a l ^ s t a f f would allow the intake workers to dictate t h e i r recording and would r e l i e v e them of the manual task of setting up the applicant's f i l e . This saving of the intake worker's time, although a matter of minutes, f o r each case, would allow longer and les s pressured interviews. A ten minute extension of a t h i r t y minute interview i s an increase of 33% and would do much to prevent the transfer of work pressure to the c l i e n t . This would bring ease to the interviewer and comfort to the c l i e n t . The Comfort of the Clien t The o f f i c e environment of the present Intake Section contributes l i t t l e to the comfort of the c l i e n t and r e f l e c t s - 6 7 -a lack of consideration f o r the d i g n i t y of the c l i e n t . This s i t u a t i o n could be improved i n three simple ways. (a) Comfortable seating accommodation should be supplied so that c l i e n t s do not have to stand up while waiting t h e i r turn to be interviewed. (b) Suitable i n t e r i o r decorating i n r e s t f u l colors would change the present drab and severe o f f i c e s into a more comfortable and welcoming environment both for s t a f f and c l i e n t . (c) The addition of appropriate wall pictures and magazines would supply the c l i e n t with some int e r e s t and occupation while waiting. Such provisions are found i n waiting rooms f o r doctors and dent i s t s and t h e i r lack i n the Intake Section does not help to overcome the f e e l i n g of "welfare stigma" which many c l i e n t s have i n applying for s o c i a l assistance. These improvements and adequate private interviewing o f f i c e s are of great importance i n the design of any new building which might be considered by the CSSD, and a f f e c t a l l c l i e n t s whether they become re c i p i e n t s of s o c i a l assistance or not. Improved Service to Present Recipients The analysis of case material (Chapter h) indicates a need for improvement i n methods of r e f e r r a l . It i s es s e n t i a l that the CSSD consider long range plans to improve -68-the r e f e r r a l process. However, at the present time the Department may begin the improvement of t h i s process by means within the present structure and budget l i m i t a t i o n s . (a) A c i r c u l a r l e t t e r should be sent to a l l o f f i c e s or agencies which may be involved i n the r e f e r r a l of r e c i p i e n t s , as was i l l u s t r a t e d i n the case of Mrs. M. (Chapter h). This l e t t e r should outline the best method of r e f e r r a l , and the disadvantages placed upon the r e c i p i e n t i f proper clearance i s not carried out when a c l i e n t moves from place to place within the province. This l e t t e r would serve as a part of a defined and written inter-agency p o l i c y and could be referred to by any worker at any time. (b) The number of r e c i p i e n t s who return to the Intake Section f o r further a i d , instead of v i s i t i n g the F i e l d Unit i n t h e i r d i s t r i c t , could be lessened by a more car e f u l i n t e r p r e t a t i o n by the intake worker. This i n t e r -pretation should appear i n the recording of the intake interview. Secondly, the f i e l d worker responsible for the supervision of the r e c i p i e n t should issue c e r t a i n printed material for the r e c i p i e n t ' s use. This material could be i n the form of a pamphlet and should embody the worker's name, the F i e l d Unit address and telephone number, and some simple explanation of how to make appointments f o r i n t e r -views. Other information could be included i n t h i s " r e c i p i e n t s ' handbook" i f the fieldworkers find that practise -69-Indicates the need for additions. (c) The problem of poor r e f e r r a l of c l i e n t s from c i t y hospitals to the CSSD Intake Section has long caused concern among the intake s t a f f . The negative e f f e c t upon the c l i e n t i s shown i n the case of Mr. N. (Chapter *f). The poor timing of these r e f e r r a l s causes physical s t r a i n upon the c l i e n t who needs s o c i a l assistance i n order to convalesce from physical i l l n e s s . Needless and f r u i t l e s s t r i p s to the Intake Section and the delay i n the receipt of s o c i a l assistance tend to cause additional physical break-down and possible return to the h o s p i t a l for further t r e a t -ment. The policy of the CSSD should not require these c l i e n t s to apply personally at the Intake Section i f s o c i a l assistance i s to be granted. The a p p l i c a t i o n could be taken r e a d i l y i n the h o s p i t a l setting before the patient i s d i s -charged. The CSSD, therefore, should assign a v i s i t i n g fieldworker to each h o s p i t a l who would be responsible for completing the application, for ensuring the c l i e n t has accommodation, and f o r the delivery of the s o c i a l assistance cheque to the place of residence i f t h i s i s required by the physical condition of the c l i e n t . The CSSD cannot avoid i t s r e s p o n s i b i l i t y to Improve services to meet the needs of these c l i e n t s more adequately. Unmet Needs of C l i e n t s The s t a f f of the Intake Section i s confronted from -70-day to day with applicants who desperately require f i n a n c i a l and casework assistance but who must be refused because they f a i l to comply with some e l i g i b i l i t y t e c h n i c a l i t y . The CSSD must be concerned with an accurate assessment of e l i g i b i l i t y requirements and proposed improvements i n p o l i c y so the needs of these c l i e n t s may be met. A special study of the changes i n e l i g i b i l i t y and current p o l i c y needs i s being made by Mr. D. Williams as an M.S.W. thesis (University of B r i t i s h Columbia). However, there exists a group of rec i p i e n t s who have been granted s o c i a l assistance but l a t e r declared i n e l i g i b l e because of t h e i r i n a b i l i t y to use the f i n a n c i a l aid i n an acceptable or proper manner. This group of reci p i e n t s i s formed of in d i v i d u a l s who are dependent, unstable, and addicted to alcohol. The Director of the Intake Section has been keenly aware of t h i s problem and has taken interim action to meet i t . This has taken the form of " t h i r d party administration" of the s o c i a l a s s i s t -ance cheques, as i l l u s t r a t e d i n the case of Mr. J . (Chapter 3). The CSSD has begun the study of t h i s problem i n an ef f o r t to f i n d a permanent solution. The solution must involve the treatment of these c l i e n t s by the establishment of a treatment centre or a treatment farm u n i t . This i s the subject of a second M.S.W, thesis study by Mr. A . Wescott (University of B r i t i s h Columbia). The success of the CSSD i n developing such a new treatment centre w i l l -71-depend upon i t s acceptance by the people of the community and the in t e r p r e t a t i o n given to them of the advantage of such a resource. Interpretation of Needs and New Programs The CSSD administrator i s handicapped i n developing any new program due to the lack of opportunity to interpret CSSD problems to the Social Services Committee and to the community. The method of operation of the S o c i a l Services Committee previously outlined i n t h i s Chapter reveals the extremely limited time t h i s committee has for considering any improvement i n the CSSD program. This concludes that some provision should be made f o r the consideration and implementation of improvements i f the CSSD program i s to progress. This provision can be made by the CSSD i f an Advisory Committee i s formed. The members of t h i s committee should be drawn from the general community and should include interested l a y and professional persons. At l e a s t one of these members should be an old age pension r e c i p i e n t who could present valuable experience from the r e c i p i e n t ' s point of view and provide l i a i s o n with the existing pension groups. The function of such a committee would be twofold. It would co-operate with the CSSD administration i n study-ing problems and improvements i n program, and i n making appropriate recommendations for the consideration of the Ci t y S o c i a l Services Committee. Secondly, i t would provide - 7 2 -l i a i s o n with the Community Chest and Council S o c i a l Planning Committee, and i t would provide a d i r e c t channel through which public r e l a t i o n s and in t e r p r e t a t i o n of the CSSD program to the public could be accomplished. The success of t h i s function i s e s s e n t i a l , as a public welfare program w i l l only progress i f i t enjoys public understanding and support. The CSSD public assistance program, therefore, must have the support not only of public finances but also of public sympathy. It i s necessary that the CSSD intake procedure be improved i f more adequate services are to be offered to the c l i e n t s applying for s o c i a l assistance through the Intake Section. This need has been emphasized i n the study. It also has been i l l u s t r a t e d that casework can and should be done at the intake l e v e l i n a public agency, and the ro l e of an intake worker i s properly that of a professional s o c i a l worker. I t i s apparent that the CSSD intake pro-cedure has passed through an i n i t i a l experimental stage with some success. E f f i c i e n c y has been accomplished by the development of an intake structure which allows intake workers to give some attention to the large number of s o c i a l a s s i s t -ance applicants. However, i t i s now imperative that case-work, i n terms of study, diagnosis, and treatment, be i n t r o -duced i f the intake procedure i s to become more than a routine reception of c l i e n t s . To move forward Is not impossible, and the means to implement improvements are c l e a r . Appendix A P r i n c i p a l Regulations Governing Social Assistance (As at 195D 1. Exemption of Cash Assets (Feb. 15, 195D In an a p p l i c a t i o n f o r s o c i a l allowance, Unit Directors may exempt cash assets up to the normal amount of Social allowance applicable to the group. Further exemptions may be made up to $150.00 for a single person and $300.00 f o r a married person through presentation to staff committee and at the d i s c r e t i o n of the administrator. In a request for Boarding or Nursing Home placement, Unit Directors or the Senior Voucher Clerk may exempt cash assets up to the monthly cost of the type of care to be provided, i . e . Boarding Homes - $ 55.00 Nursing Homes - $105.00 A memo, giving a b r i e f outline of the case, i s to be forwarded at the time the case i s opened, to the Voucher Section, f o r Staff Committee minutes. 2. Betermination of D e s t i t u t i o n (Sept., 3, 19^2) In determining the e l i g i b i l i t y o f an applicant for assistance from the viewpoint of d e s t i t u t i o n , the following general p o l i c y w i l l be observed as from t h i s date: (a) When the applicant i s a dischargee from h o s p i t a l , and i s c e r t i f i e d by that i n s t i t u t i o n as requiring a s p e c i f i c period of convalescence or rest (not to exceed six months), he may be granted an exemption of any funds i n h i s possession i f they do not exceed the casual earnings exemption for the period set f o r t h , i . e . , i f the applicant i s c e r t i f i e d as requiring s i x months care, and i s a single person, he would be granted an exemption of any amount up to $30.00. (b) An applicant i n any other category may be held to be destitute i f h i s funds do not exceed the casual earnings exemption for the period of one month applicable to the group i n question. 3. Statement of D e s t i t u t i o n and Employment (Nov. 20, 1931) Commencing on November 30th, no assistance w i l l be granted to any person except upon the production of the form S 2 requiring statement of d e s t i t u t i o n and employment. (See Appendix B). The worker receiving t h i s form, w i l l ask the applicant, "do you thoroughly understand the meaning of t h i s statement?" If the answer i s "no", the worker w i l l make the necessary explanation. The form must be signed i n the presence of the worker. If already signed, the worker w i l l require i t to be signed again, and w i l l then witness the signature. The forms w i l l be sorted alphabetically by months and sent to the main o f f i c e on the 3rd of the following month. I n i t i a l Home V i s i t before Assistance i s Granted (Feb. 22 , 1933) Except i n extreme emergency, no issue of assistance i s to be made to a new applicant u n t i l there has been a home v i s i t . The i n i t i a l home v i s i t would be made within h8 hours of the time of applicat i o n . 5. V i s i t s A v i s i t i s to be made on a l l active cases at a maximum i n t e r v a l not to exceed six months. In any case where, through mental or some other condition of the applicant, i t i s inadvisable to make thi s v i s i t i n a routine manner, the reason i s to be noted i n the f i l e and i n i t i a l l e d by the Director responsible. 6. S o c i a l Assistance Rates (July 1, 19^8) E f f e c t i v e on July 1 s t , 19^8, s o c i a l allowances are increased to the following maximum monthly amounts: Group Support Shelter Total 1 $ 25.00 $ 10.00 $ 35.00 2 38.00 12.00 50.00 3 M f . 5 0 l * f . 0 0 58.50 *f 51.00 16.00 67 .00 5 57.00 18.00 76.00 6 and up 6^.00 2 0 . 0 0 8*+.00 When the r e c i p i e n t has free quarters no shelter a l -lowance w i l l be paid. Where there i s a re n t a l problem, the whole shelter allowance w i l l be issued, except i n cases where a group share communal quarters. In the event of communal quarters, the shelter allowance w i l l be limited to the share of each i n d i v i d u a l . Property owners' w i l l be granted the f u l l shelter allowance and w i l l i n future be required to make th e i r own arrangements for payment of taxes. 7. Exemption on Income (July 28, 1933) By Council r e s o l u t i o n of Ju l y 2 7 t h , 1933* the 110.00 a month exemption on income of re c i p i e n t s w i l l not be applicable when the income i s i n a form of a pension or compensation allowance. In such cases the f u l l amount w i l l be taken into consideration i n determining s o c i a l assistance. A P P E N D I X B  I N T A K E - A P P L I C A T I O N FORMS ORIGINAL: Retain in local office. # • A p p l i c a t i o n f o r S o c i a l Si A s s i s t a n c e . THE GOVERNMENT. OF THE FWMNa Of BRITISH COLUMBIA DEPARTMENT OF H E A L T H AND WELFARE S O C I A L W E L F A R E B R A N C H A P P L I C A T I O N F O R S O C I A L A L L O W A N C E Place of Residence—O.T. U.T. • Hospital Insurance and Medical Identity Card No.. 1. Name 2. Address-Male Female (Street.) (City.) 3. Place of birth_ 4. Nationality. Date of birth _ 5. Marital status.. (M., S., Wid., Dlv., Sep., C.L., Deserted.) Married at.. Date.. DEPENDENTS Name (Show maiden name of wife.) Rel. Sex Date of Birth Place of Birth Occupation Disability Day Mon. Year Other Members of My Family at Home 7. Monthly income of myself and dependents 8. Monthly income of non-dependent members of my family at home 9. Total assets of myself and dependents: Cash on hand . Bank account. 10. Securities .. Other assets . 11. Real property—value (assessed) Encumbrance _. 12. Date moved to B.C To Canada Military service-13. Reason for application . 14. Date and place of previous assistance received. 15. DECLARATION OF APPLICANT i , - - : , of. . in the Province of British Columbia, solemnly declare as follows:— (1) That, in the event of this application being granted, I will notify the administering office immediately of any change that may occur in the financial condition of myself or my dependents, or any change in my marriage status, residence, or number of my dependents. (2) That the statements and allegations contained in the foregoing application, which I have read or have had read to me, are true and correct to the best of my knowledge and belief. (3) That no information required to be given has been concealed or omitted. (4) That I have been duly warned of the penalty of the law for any person who by fraud obtains or attempts to obtain social assistance, which is an offence against the " Social Assistance Act," chapter 310 of the " Revised Statutes of British Columbia, 1948." And I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath and by virtue of the " Canada Evidence Act." Declared before me at 1 in the Province of British Columbia, this.. dayol 1 — : , 19.. (Signature of applicant) 16. RESIDENCE (Show in reverse from present date to point where responsibility can be determined under the " Residence and Responsibility Act.") A D D R E S S D A T E S F r o m T o * 17. Responsibility of. 18. Checked by 2 0 M ( 5 0 ) - 1 3 2 - 2 5 8 0 ( 2 ) . o c . . MU?« Statement of De s t i t u t i o n and Employment C A U T I O N ~m > R E A P C A R E F U L L Y B E F O R E C O M P L E T I N G T H I S S T A T E M E N T NOTE—All revenue from wages, sick benefit, superannuation, pension, compensation, rents, roomers, boarders, agreements, allowances, remittances, loans, commissions, fees, book debts, collections or other source whatsoever received by any member of the family must be clearly shown on this form. Any increase or decrease in the number of dependents or members of the family must also be clearly shown on this T O M ' C I T Y O F V A N C O U V E R SOCIAL SERVICE D E P A R T M E N T . Case N o . Date. Name Address I ask for assistance for myself, dependents and all members of my family because I, and they, have income only as shown below, and have no other money and no other means of obtaining the necessities of life, and are therefore destitute. T H E O N L Y E M P L O Y M E N T D U R I N G T H E P A S T T H I R T Y D A Y S O F M Y S E L F , D E P E N D E N T S . A N D T H E V A R I O U S M E M B E R S O F M Y F A M I L Y H A S B E E N A S F O L L O W S : Name of Person Employed B y Whom Employed (Give Name and Address) At What Salary or "Wages When Paid (During Last SO Days) Dates Amounts e Neither myself, my dependents, nor any other members of my family have had any other income or received any money from any other source during the past thirty days except:— There has been no increase or decrease in the number of dependents or members of my family for the past thirty days except: Witness Signature T O C L E R I C A L S T A F F : Please make your notifications on the back when necessary. See that Applicant correctly fills out dates and names of dependents and members of family who have any income. 3. Identifying Data (Sample) Soc. 523M. Date F i l e No. Name Address Social Status Birthplace Date Assets (cash - bank account - stocks - bonds - etc.) Income or Earnings ( t o t a l f amily).. Present d i s a b i l i t y Ever applied for or received assistance Domicile - ( c l a s s i f i e d ) . . . Accepted - date and time of appointment f o r record Rejected - state reason • Last pay and date *f. Bank account statement (Sample) Soc S 8 M C i t y of Vancouver SOCIAL SERVICE DEPARTMENT F i l e No. Date ... We ( I ) , the undersigned, and our (my) dependents, applying to the City of Vancouver f o r s o c i a l assistance, do hereby declare that neither we (I) nor our (my) dependents have had any bank account since (Signed) , Applicant since (Signed) wife Witness V i s i t o r 5» Authorization to check Bank account (Sample) Soc S 7 M C i t y of Vancouver SOCIAL SERVICE DEPARTMENT P i l e No. Date ... « 9 • e e e Bank Branch C i t y Dear S i r s : - Account No. ................ This w i l l be your authority to permit any accredited member of the Ci t y of Vancouver Social Service Department to inspect and check over my account with you and to take a copy of the same. Yours t r u l y , (Signed) •• (Address) Appendix C BIBLIOGRAPHY 1 . "Case Work i n Public R e l i e f " , A Reprint of Nine A r t i c l e s from The Family. New York, Family-Welfare Association of America, 1 9 3 5 - 3 9 . 2 . "Co-operative Case Work", A Reprint of Sixteen A r t i c l e s from The Family. New York, Family Welfare Association of America, 1 9 3 5 - 3 9 * 3 . "Common Human Needs", Federal Security Agency. U.S. Government P r i n t i n g O f f i c e , Washington, D.C, 1 9 ^ 5 . h. " D i f f e r e n t i a l Approach i n Case Work, Treatment", American Association of Ps y c h i a t r i c S o c i a l  Workers, National Conference of So c i a l Work, 1936, New York, 1 9 3 6 . 5 . Garrett, Annette, Interviewing I t s P r i n c i p l e s and Techniques. New York, Family Service Association of America, 1 9 ^ 8 . 6 . Hamilton, Gordon, Theory and Practise of S o c i a l Case Work. New York, Columbia University Press, 1 9 ^ 0 . 7 . Kurtz, Russell H., The Public Assistance Worker. New York, Russell Sage Foundation, 1 9 3 8 . 8 . Randall, Emily B., Admission and Records i n Almshouses. National Conference of S o c i a l Work, 1 9 2 6 , Chicago, University of Chicago Press, 1 9 2 6 . 9 . Swift, Linton B., New Alignments Between Public and Private Agencie's. New York, Family Welfare Association of America, 1 9 3 ^ . 1 0 . White, R. Clyde, Administration of Public Welfare. New York, American Book Company, 19M-0. 1 1 . Wisner, Elizabeth, Education for S o c i a l Work. S o c i a l Work Yearbook, 1 9 3 7 . P e r i o d i c a l s 1 . C o c k e r i l l , Eleanor, "Intake Process i n a Department of Medical S o c i a l Service", The Family. October, 1 9 > f 0 . 2 . Holmes, Edith May, "Intake P o l i c i e s for Children's I n s t i t u t i o n s " , The Family. October, I9U1. 3. Leonard, Shirley, "Intake P o l i c i e s i n a School Setting", The Family. December, 19^-1. U. Maeder, LeRoy M.A., "Generic Aspects of the Intake Interview", The Family. March, 19^2. 5. Marnel, Sarah S., "Intake i n a Public Agency", The Family. June, 19^0. 6. McCabe, A l i c e R., "Meeting the Emotional Needs of Our Children", The Family. October, 1950. 7. McClure, Dorothea, "Intake Policy i n a Child Guidance C l i n i c " , The Family. December, I 9 U 0 . 8. Sacks, S y l v i a , "Public Agency Intake and the Case Work Goal", The Family. A p r i l , 19^2. 

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