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The social worker in the school : an experimental study of the liaison and service functions of the social… Thomson, Mary 1948

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3 37 /?•?•£. /pa-r's) • THE SOCIAL WORKER IN THE SCHOOL An Experimental Study of the Liaison and Service Functions of the Social Worker in a Vancouver Elementary School Thesis presented in partial fulfilment .of the requirements for the degree of Master of Social Work, University of Brit i s h Columbia (Mrs.) Mary Thomson University.of B r i t i s h Columbia September 1, 1948. ABSTRACT The accompanying thesis, written as part of the requirements for the Degree of Master of Social Work, and entitled "THE SOCIAL WORKER IN THE SCHOOL - An Experimental Study of the Liaison and Service Functions of the Social Worker in a Vancouver Elementary School", is primarily concerned to establish a case for the integration of the Social fork and Education professions through the appointment of School Social Workers. Based, for i t s practical aspects, on a ten-week experiment i n a Vancouver Elementary School, i t discusses the child problems encountered and the problems of relationship with other school personnel, with, parents, and with the other professions and community agencies involved. The theoretical aspects include an analysis of educational trends to indicate the extent to which the inclusion of social work principles and techniques are a logical, as well as a socially desirable, next step. It is also pointed out that the school occupies an unrivalled, strategic position for the early detection of emotional disturbances and social maladjustments. The role of the School Social Worker is described in i t s historical development and some attention given to the training and personal qualifications desirable for the efficient performance of this function. The administrative problem is also discussed, some practical proposals, applicable to the Vancouver situation, being offered. TABLE OF CONTENTS THE SOCIAL WORKER IN THE SCHOOL An Experimental Study of the Liaison and Service Functions of the Social Worker i n a Vancouver Elementary School PART I FRAME OF REFERENCE Chapter 1, Chapter 2. Chapter S. Changing Society, Changing Schools Individualized services to children. "Progressive education'*; advance and retreat. Contemporary social setting. The contribution of social work. History of School Social fork Fi r s t steps: early American experiments. Visiting-teacher becomes school social worker. Setting standards. Current trends. The Canadian Scene: Winnipeg's visiting-teacher services; Vancouver's services to the school ch i l d . The Project: Motives and Methods Aims of present project. Determining the approach. Preliminary survey. Tentative findings. A ten-week experiment. PART II RELATIONSHIPS ON THE JOB Chapter 4. Chapter 5. Chapter 6. Chapter 7. Assisting the Principal T The Principal's Office. Assistance with surveys. Community relationships. Summary. Attendance Problems Absenteeism: whose responsibility? The child with early psycho-somatic symptoms. The child with family demands. The child with symptoms of neglect. The problem fiamily. Conclusion. School Mental Hygiene Services Description. Preparation of cases: examples of steps.necessary. Follow-up work: case examples. The preventive emphasis. Cooperating with the Public Health Nurse Defining areas of function and cooperation. Liaison with the home. Case examples. Chapter 8. Support to the Teacher The teacher's focal position. Case examples. Teacher-Social worker team. Training workshops for parent,teachers and social workers. Chapter 9. The Child and His Home Goals of counselling. Methods of counselling. Types of interviews. School to home and back again. Counselling the parents. Chapter 10. Bridge to the Resources of the Community Well-Baby c l i n i c . Case-work agencies. Case examples A Vancouver Family in Trouble. Group-work agencies. Parent-Teacher association* PART III THE EMERGENT PATTEBN The Implications of the Study T&e question of nomenclature. Who Is the client? School children i n trouble. Findings ani interpretation. Coordinating function. Consultative function. Alter-natives. Some proposals. Tool8 for the Job The school team and the conference method. Model procedure. The parents' position in respect to confer-ences. Records and how to use them. Chapt er 13. The Worker?s Role: In the Community and as individual. ...Community Organization. Principles and orientation. The school as a neighborhood focus. Personal q u a l i f i -cations - new attitudes and old school patterns* exemplifying the new discipline, standards without p erfectionism. APPENDICES A. Record Forma B. Case Summaries C. Bibliography. Chapter 11. Chapter 12* Note of Error: Page numbers jump from 15 to 22. and from 88 to 100. This is a typing error; no pages of the text are missing. *» Acknowledgements I wish to acknowledge great indebtedness to the following whose courteous cooperation greatly f a c i l i t a t e d the preparation of this thesis and the successful completion of the associated project: Mr. H. H. MacQorkindale, Superintendent of Vancouver Schools; Principals W. P. Howston, D. E. Harvey, L. H. Robb, R. P. Steeves; Miss M. Campbeil, Attendance Officer, Vancouver Schools; Members of the staffs of Henry Hudson School and of the Metropolitan Health Committee; Miss Margaret Gilchrist, School Social Worker, Winnipeg. I take particular pleasure in acknowledging the continuous helpfulness of Mr. W. H. I. Hardwick, Principal of Henry Hudson School, and Sr. Leonard Marsh of the Department of Social Work, both of whom gave most generously of their time throughout. many weeks of their extremely busy lives* PART I FRAME OF REFERENCE Chapter 1. Changing Society, Changing Schools Chapter 2. History of School Social Work Chapter 3. The Projects Motives and Methods. CHAPTER ONE CHANGING SOCIETY, CHANGING SCHOOLS "The responsibility of the School Board does not end with the provision of schools and the attendance of pupils. Many unsatisfactory home conditions detrimental to the welfare of children come to the attention of the schools f i r s t through the truancy of the children. Dealing with these conditions either directly or by referral to the proper agency i s definitely the responsibility of the School Board. .. Therefore we ask that additional atten-dance officers be.appointed and that among them be per-sons with guidance and welfare training." (Extract from Brief presented by the Vancouver Parent-,Teacher Council to the Vancouver School Board, 1944.) " To give individual study to a greater number of cases w i l l require the services of another psychiatrist, or as a more logical and earlier step, more preliminary counselling and sorting out of cases by school medical officers and students' counsellors." (Extract from the Annual Report of the Mental Hygiene .Division, Vancouver, Dr. CH. Gundry, 1947.) "They have met with, considerable success i n their work with juveniles i n Victoria and surrounding municipalities, and much credit i s due the staff of the Vi c t o r i a ! agency and the probation officers i n that area.,.. They...present a unified approach to the problem,' and, as a result, are able to help a great number of the children. Magistrate Hall hopes to see this community effort strengthened through the development of v i s i t i n g teachers i n schools. (Miss Ruby McKay, Supt. of Child Welfare, B.C., reporting, ,in B.C. WELFARE, Magistrate Hallls address to the Conference of B.C. Magistrates, January, 1948.) 2, .."There should he conferences of school, court, parents, and such other agencies as may he involved in an attempt to prevent delinquency where i t may he foreseen. The said conferences should he called by any of the agencies concerned. .. In instances where the case is dismissed on a technicality, but a behaviour problem is known s t i l l to exist, there should be contact by the probation officer with the school as to whether further follow-up work is necessary.** (Recommendations made by the Social Welfare Committee of the Vancouver Principals* Association, 1947 Report.) "Maintenance men i n B.C. schools, attending a two-day conference, claim students seek their friendship faster than that of teachers. Confidences between the older men and the children are greater than between teachers and students, because compulsions in student-teacher relaion-ships do not exist between maintenance staffs and students, one engineer explained. Dave Alsbury says he is 'both engineer and g i r l s ' counsellor! at Britannia High.School. (News item, Vancouver SUN, April 3, 1948.) Individualized Services to Children The preceding quotations indicate a growing awareness of children's problems on the part of educators and others in the community. Prom a variety of specialized agencies comes a sincere concern to find solutions. It is precisely because the agencies which serve children are (1) so varied and so specialized that a coordinating and integrating factor i s required. This coordination might take the form of a Children's Bureau, or a Community Child Council. It i s the present thesis that "Visiting Teacher" or"School Social Work" services are an important contribution to (1) School services which include teacher, principal, school nurse, psychologist, psychiatrist, special teachers and stspervisors etc. Community services which include those of case-work agencies, group-work agencies, courts, parent-teachers' association, church etc. 3. a solution of the problem of how to achieve integrated services to children which w i l l be of a high standard in knowledge and effectiveness. School Social Work means the provision of trained counsellors in elementary schools available to children, their teachers and their parents. It means also tiiat the need for coordination is met by the elementary school counsellor (or social worker, or visiting-teacher) functioning as a liaison agent in order to obtain the best specialised service for the child and i n order to prepare the child to use the service. Many people who are aware of the need in i t s human aspect are not equally aware (or, in some cases, convinced) of the contribution that the Social Work profession i s ready to make toward f i l l -ing that need. To provide a further j u s t i f i c a t i o n for the role which, a qualified social worker can perform i n the school requires, f i r s t , some interpretation of the changing function of education in a rapidly changing society and secondly, some discussion of what the modern social work pro-fession can offer. Traditionally, the primary function of the school has been to give instruction, and the primary medium has been the instructor vis-a-vis (and in authoritarian relationship to) a class. Yet present needs and trends has challenged both these central features of the tradition. They question whether instruction i s in fact the most important task of the school; and /whether the class, rather than the individual child," i s the proper unit' on which educational attention should be focussed. The concern of the school, especially of the class-room teacher, for the individual child, i s by no means a new one. There have always been educators who have sought ways in which they could meet the needs of 4. certain individual children, - "both the gifted and the under-privileged. There have always "been the more rare school teachers who, "because of their a b i l i t y to recognize and accept individual children, have been able to establish a friendly relationship with them. The result was that these fortunate children f e l t the concern, interest, and support of their teacher not just as an instructor, but as a guide and friend. As a result, they were stimulated and freed to even greater achievements. With compulsory mass education, the provision of individualized services naturally became more d i f f i c u l t . Among the millions of school children on this continent, i t has been found that thousands were unable to take advantage of their educational opportunities. Separate programs have been organized to serve at least two classes - (l) those with serious physical handicaps, and (2) those with mental handicap. "More recently, however, as the growth in school attendance emphasized the constantly expanding range and diversity of pupils' needs and a b i l i t i e s medical specialists, psychologists, school nurses, and other specialists were introduced into school staffs to assist school o f f i c i a l s and teachers in the.adjust-ment of intellectual, physical, and emotional d i f f e r -These were fillowed by attendance branches wilk their staff of attendance officers; guidance programs with educational and vocational counsellors (i n most centres, including Vancouver, confined to the senior school system); treatment c l i n i c s held by psychiatrists; medical and health services. At present, these services are organized i n a number of different ways and. are in various stages of completion as to functions and practices. It has usually happened that one or two of the four services to children which TT) Visiting Teacher Services, Leaflet No. 75, U.S. Office of Education. had been established earlier, has assumed the functions of the others. In practice there i s frequent overlapping. Nevertheless, in spite of a l l these extra services (or " f r i l l s " , as each one was apt to be considered i/iien f i r s t introduced), "educators were s t i l l thwarted by large numbers of pupils who, although, not truants, physically i l l , or lacking i n normal intelligence, nevertheless did not behave or learn well in school." ^ With a l l the specialized and professional services i n schools and community, i t might be expected that a majority of young people could be found to demonstrate that they had received an adequate preparation for li v i n g . But a shock came with the revelations of the war records. The numbers disqualified for war service "because of i l l health, i l l i t e r a c y , or emotional disturbance is.sufficient evidence of neglect in providing preventive and remedial measures at an age when they would have been most, i f not f u l l y effective. Recent studies indicate that many of the same physical defects discovered but not remedied during the elementary school years were those for which the men concerned were rejected by the Selective Service. Emotional disturbance, another p r o l i f i c cause of rejec-tions, may prove,io have a similar history when studies are available." We might well ask the questions j Wherein are we failing? What i s s t i l l lacking? Progressive Education? Advance and Retreat. From another direction also came a broadening of the scope and a loosening of the traditional methods of education which, nevertheless, as with the development of individualized services, failed to produce some of the hoped for results. The "progressive education'1 movement has been a succession of attempts to achieve a reorientation of school purposes and methods which " t r l — S o c i a l Work iear Book, IU4b, page 428. • (2) Op. c i t . 6 . can'"be characterized as follows: 1. To see the whole child as he "behaves in a learning experience - to he aware of his attitudes and patterns of reaction as well as his level of achievement. 2. To meet the child's needs as a social as well as an intellec-tual "being, "by relating the curriculum to his environment. 3. To give him a guided experience in l i v i n g as well as training to make a li v i n g . 4. To introduce into the traditional methods and relationships of the class-room, which are authoritarian in essence, arnew type of group experience which gives practice in the methods and personal relationships of democracy. In practice, this involved a radical break-away from old r i g i d -i t i e s i n the physical arrangements of the class-room, i n the supply and use of equipment, i n teaching methods, and i n relationships between teacher and pupil. The very nature of the learning process was subjected to re-valuation. Sid not learning also occur in the exchange of knowledge, experience and feeling i n groups of equals? Was not the discipline of group-discussion an integral feature of the "discipline of democracy." Sr. Bduard Lindeman, Professor of Social Philosophy at Columbia University, speaking at the University of Br i t i s h Columbia, under the auspices of the Department of Social Work, i s reported as follows* There is discipline in controversy, although by and large people must lose the habit of possess!veness of their own ideas. The man who listens to what his fellow has to say - rather than the man who has his own ideas at the tip of his tongue and his mouth open to speak them even while the other is talking - is the man who can make use of the other's idea - adapt i t , or even accept i t as better than his own." (1) "The Disciplines of Democracy',1 B r i t i s h Columbia's WELFARE, March, 1948. 7. It became experimentally verified! that "free" group-experience (with only the minimum guidance of an observant adult) could be made to work, and to produce results in the "fundamentals" of instruction, but s t i l l more in the development of a social sense, even at the pre-school level. Many teachers have found these newer educational goals rich in stimulation and inspiration. They have adopted these goals, and have sought new ways of achieving them. They have experimented in giving children more opportunity for using their own i n i t i a t i v e and for assuming wider ranges of responsibility. Yet, much of this eager experimentation of ten to fifteen years ago has been abandoned and much of what remains operates under a cloud of discouragement. Why? Perhaps too much was demanded of the teachers. They f e l t the heavy responsibility of training the whole child, since>.this meant giving him not only f a c i l i t y with the tools, but social competence i n the process of learning. And when the child did not easily f i t in with the group, a further obligation emerged: that of discovering and, i f possible, correcting his personality defect, or healing his more serious emotional disease. Our culture and educational system has not yet produced a s u f f i -cient number of teachers who can be guides i n this fundamental educational and democratic purpose. Nor is the community outside the school ready to consistently endorse and reinforce such purposes. The question i s , whether the schools should retreat to the superficially easier and simpler forms of the traditional order of instruc-tion and of class-room relations, or brace themselves for a concerted advance into the sast, unknown territory which individualized services, progressive-education objectives and f u l l e r democratization open up before 8. them. T 0 take the forward course means parent-education as well as child-education. It means more psychiatric, as well as vocational counselling. It means more consistent and organic relations with community organizations and resources i n recreation and hobbies* Within the school i t means more of the f l e x i b i l i t y which can so easily be,or seem to be. disorder. Ho wonder the teaching profession has halted dismayed and per-plexed. No wonder i t has been inclined to glance backwards instead of resolutely facing this complex and onerous future. Those who are most de-termined that the only real way shall be forward are those most convinced that to move in that direction means that the resources of the school and the teaching profession must be supplemented by new resources not at pre-sent incorporated f u l l y into the school system. Can Social workers";, help? It i s the purpose of the present study to demonstrate the help that a social worker can give*, Contemporary Social Setting Actually, for the school today there i s no way back. Regression to the older r i g i d i t i e s and authoritarianism i n the schools, may, i f i t is drastic enough, repress symptoms; i t w i l l not remove the causes of the trouble, for these l i e outside the school. The old pattern was part and parcel of an earlier cultural form which, even though p a r t i a l l y overlaid with democratic institutions,was s t i l l basically authoritarian. The authority of the father in the home, and of the teacher ( i n loco parentis) in school was stable and accepted because behind i t stood an established and accepted authority in church and state. 9» The character of the school as an institution was also related to the general cultural pattern in it s isolation and compartmentalization. It was (throughout the nineteenth century and into the twentieth) an example and a victim of the general fragmentation of Western society. Industry was one thing; education was something else again. The community was here; the school, behind those forbidding, walls was over there. Teachers were paid to do their specialized job of instruction (evaluated by their pupils' success i n competitive examinations) and to keep their young charges "under control." The social context within which our specific school problem has to be seen is of the undermining and breakdown of a complete cultural pattern. The home is no longer the place of reliable and sufficient emo-tional security for a child. For better or for worse, the old authoritar-ianism has lost Its ultimate sanction. Furthermore, the traditional division of l i f e and education into too separate compartments, unbalanced by an equal emphasis on integration, has had disastrous human and moral consequences. To clear for ourselves a way through the flux and uncertainties of the present transitional period into a secure and f u l f i l l i n g future, decisions must be taken and clear directions set. The chief decision must surely be that to achieve the new goals, the most appropriate and efficient tools are the new tools. To support the old authoritarian system, i t was appropriate to invoke the dogmas of an authoritarian religion and the primitive sanctions of the principal's strap. To support the new social pattern - in the school or in the community - i t is appropriate to invoke the understandings and techniques of the social sciences - psychiatry, 10 . psychology, and sociology. If the modern situation has created deeper social and personal tensions and more complex behavior problems in adults (and therefore also in children), i t has also brought about discovery of some of the knowledge and s k i l l s required for the solution of them. The schools can now find these aids by seeking; out the school psychiatrist. The appointment of school social workers forms the intermediary link necessary to integrate these new and saving resources with the school organism i t s e l f . Bot one iota of the purposes and ideals of progressive education should be surrendered. Education must be of the whole child, and must therefore take into account his home situation and his community environ-ment. Education must be for emotional maturity as well as for intellectual competence, and therefore must see the child with an eye trained to recog-nize desirable and undesirable behavior-patterns and in knowledge of their probable origins. Education must be for competence in social l i v i n g as well as for individual success, and therefore must aid the child to build around himself the necessary netv/ork of cooperative and creative relation-ships. To accept these goals is once again to recognize that they cannot be attained by the present resources within the school and the teaching profession. The reports quoted i n the beginning of this chapter indicate that both specialists and laymen of the community feel the need and are willing to take on further responsibility. The situation c a l l s for early diagnosis of deviations from healthy physical, mental and emotional states. The situation c a l l s for a pooling of al 1 understanding and resources for treatment in the community. Many conferences are necessary between a l l 11. the people who contribute to the l i f e of a single child - parents, teacher, principal, nurse, special teacher, psychologist, psychiatrist, case-worker, group^worker, representative of the child's church. The direction indicat-ed is that of a community c h i l d council. The w i l l is there but at present the available time, the trained personnel, and the coordinating machinery assuredly is not. To meet the demands of the situation f u l l y , a long-term program of teacher-training in the social sciences and of parent and community education is indicated. Nothing of that willbe prejudiced by immediately incorporating teacher-social-workers i n the school system to meet the urgent needs of the present. Contributing their particular knowledge and techniques of assisting people, they would work with the child, the parent, the teacher and principal and the nurse as well as with community personnel. In addition to the particular role of assistance, they would be the focal point around which there would be conferences which would result i n greater integration of child services. The Contribution of Social fork The profession of social work has much to offer the child, the home, the school and the community in the services of personnel trained in individual case-work methods, group-work techniques, and methods of community organization. As a profession, social work has moved forward from the old emphasis on giving material aid and friendly counsel out of a lady-bountiful benevolence to the application of s c i e n t i f i c knowledge in helping people. It has moved from sentiment and reforming zeal to a 12. skilled and constructive aid. It has moved from the practice of giving belief to the process of enabling people to retain or regain the i n i t i a t i v e and responsibility to use their own and the community resources. In the case-work services, where help and counselling is given to individuals, the social worker i s guided and personally disciplined by concepts which are basic to the preservation and strengthening of the positive factors in personality. Important among these concepts aret (l) essential respect for human personality and i t s potentiality for growth, with an accompanying acceptance and desire to understand the individual as he i s ; (2) seeing the individual as an individual rather than as some one belonging to a category (race, profession, economic class, religion, cultural standard); (3) helping the individual person retain his self-respect and by increasing his understanding, keep the a b i l i t y to control his own l i f e . In group-work services, where a trained social worker iB the leader or supervisor, he or she w i l l apply the principles of self-determin-ation rather than imposition of goals and program. The leader's assistance and direction w i l l be given out of understanding the inter-relation of the members of the group, and the relation of the individual to the collective. He is trained to assume the responsibility of a leadership that i s not dictatorial. Because he i s respectful of personality, he encourages the operation of democratic principles and is sensitive to the points at which they have broken down. In the f i e l d of Community Organization,.the profession of social work is developing standards, and training personnel to apply the c r i t e r i a of social work to the intricate pattern of community relationships. In 13. "both the volunteer and professional work of Community councils, neighbor-hood houses, Young Men's and Young Women's Christian Associations, Recreation Qouncils, and in the various types of experiments under the new community center movement, trained social workers are finding s i g n i f i -cant work to do. In a l l three areas of social work, knowledge of the emotional foundations of human behavior is a basic requisite in training. And throughout a l l three functions the social worker i s trained to a profess-ional use of relationships as a means of bringing about stronger and more creative inter-communication and understanding. The social worker is trained i n personal and professional disciplines which enable him or her to be aware of the underlying, unconscious motivations as well a;s conscious purposes of individuals and groups. As the profession advances, the community as a whole can have increased confidence in i t s sound concepts, s c i e n t i f i c principles, standards and professional code. what is social work's particular contribution in the school? In large city systems, more than i n rural areas, many departments of ser-vices have been organized for thewelfare of the school pupil. Yet, many have been for him rather than with him. Here i s an important distinction. The child has a multiplicity of relationships to make with many different professional adults, not a l l of whom convince him of their genuine concern for him; their helping often feels to him like pressure and imposition. It is a basic concept of social work that the most precious thing one can do for a human being is to grant or, i f necessary, restore to him his self-responsibility and s e l f - i n i t i a t i v e . For many, a beginning can be made in the restoration of these two qualities through a relationship with 14, someone who accepts him and supports his own a b i l i t y to take steps to help himself. Through experience in that one relationship, the child may be helped i n a l l his relationships. Edith M. Everett has expressed the purpose of social work as related to the school child, as follows t "Ho matter how much knowledge one may have about an individual, that in i t s e l f is of no value in helping him. He can be helped only through an experience which he can himself take on, making of i t something which i s his own, important or unimportant as i t may seem to someone else. The dynamic that i s needed to start movement and change in anyone l i e s in the intro-duction of some new element that has meaning for him. In case work this dynamic i s to be found in what happens Ic'Ii ;o between the two people involved, in the a b i l i t y of one really to take the help he seeks and the s k i l l of the other in knowing how much to give, and how to give i t . • • • • "We are a l l inclined to react to one part of a person as i f i t were the total person. The teacher reacts to the class-room child as i f i t were the whole child. .. Recognition of other sides of him gives her a balance that relieves her own pressing need to change him and leaves him free to bring more of himself to her. Parents are apt to see only the home child, an extension of themselves often too much understood and often restless and defiant under parent pressure. There is always a third child - what he is to himself." What can be a new factor in the situation is a child's relation-ship to the social worker. However brief, i t is a relationship with a person who, according to the principles of the profession, shows a dis-position to accept him rather than merely to change him. This acceptance brings new confidence. Miss Everett further describes the purpose of social work as the "reinforcement of the strength and wholeness, the foundation for which l i e s in every human being, however young and however handicapped. .. It i s in helping parents and teachers to believe in this strength, to recognize i t , and give itt a chance to operate constructively 1. Edith M. Everett, "The Importance of Social Work in a School Program," The Family, March.1938. 15. for the individual and the group, that I believe the social worker finds her real function in the school." 1 In many instances, of course, the teacher or principal has been performing the function of guidance. Beginning in the elementary school, a more specialized guidance service i s now needed on personal adjustment problems, because the more sensitive the teacher becomes to the individual needs of the children in her group, the more she welcomes the help of another, different person. Miss Everett explains -"The Social worker is her support at the points where individual children show need for special understanding and help. Neither can do the other's job. Together they can do much to make the school experience a positive, constructive one for a l l children, one in which each child has a chance to grow to the limit of his a b i l i t y . " ** Social work training provides the most recent knowledge regarding the emotional foundations of human behavior. An important part of the social worker's job is to help: the parent and the teacher in their under-standing of why children behave as they do, and what is the meaning of such behavior to them; also how to help children avoid failures and achieve the success that i s essential to healthy personality development. The United States Office of Education Bulletin suggests that the school social worker "helps to locate with the child, teacher, parent-and sometimes with the community, the factors inter-fering with the child's use of the school. She helps ih. the child to take responsibility for himself in school; helps the parent to share with the school responsibility for the child; makes necessary contacts with appropriate community agencies; and assists with whatever family, financial, health or other problem may be interfering with the best use of the child's opportunities. She g represents the school in community social we If are ..activities." 1. op. c i t . 2. op. c i t . II 3. "The Place of Visiting Teacher Services i n the School Program, Bulletin 1945, N 0. 6, U.S. Office, of Education. 22 CHAPTER TWO HISTORY OF SCHOOL SOCIAL WORK Fir s t Steps: Early ABBrtcan Experiments The beginnings of the Visiting Teacher Movement are interesting because- of the variety o f o r i g i n s and the question which arises as to where primary responsibility l i e s . Is i t with the school, the home or with a more inclusive community organization? Naturally, there are s t i l l many today who want to be assured that the service of the v i s i t i n g teacher i s not an added " f r i l l " but something which f i l l s a need. Visiting teacher work developed during 1906 and 1907 i n Boston. New York Oity and Hartford, Connecticut. In New York City the work originated i n the settlement houses, because the workers f e l t the need of knowing the teachers of the children who came to the settlements. Three vis i t o r s were-appointed to v i s i t schools and homes. Then a Committee was formed to maintain emd develop the work. In 1913, the New York City Board of Education took over the program. In Boston, the i n i t i a t i o n of v i s i t i n g teacher work was privately sponsored by the Woman's Education Association, a group comparable to the contemporary Parent-Teacher Association. Administratively, the Boston program was dissociated from the o f f i c i a l school system; the motive was a social service one and so i t has remained. The reasons why this and other public-spirited organizations i n Boston provided v i s i t i n g teachers i n both elementary schools and high schools have been stated as follows: 23. Lack of understanding between home and school often results i n loss, sometimes serious injustice to the child. ... To meet this d i f f i c u l t y , a committee of the Woman's Education Association employed a social worker ... and she has attempted by working i n both home and school to bring about greater harmony be* tween the two and so make more effective the educa* tion of the child." 1 In Hartford, the i n i t i a t i v e earns from the Director of the Psychological C l i n i c . "The vi s i t i n g teacher assisted the psychologist i n securing the history of children and in carrying out the recommendations of the c l i n i c i n regard to social service, physical treatment or school 2 adjustment. w Rochester was the f i r s t c i t y to empljry a visiting teacher supported and controlled by the Board of Education. After seven years of groundwork done by one ^vtsiting teacher, a department of v i s i ting teachers was established i n 1920. The schools had now recognized visiting-teacher service as one of the functions which helped to achieve their educational purpose. Between 1920 and 1930 some extensions of the idea were made. After the National Committee on Visiting Teachers a f f i l i a t e d with the Publie Education Association and then received support from the Commonwealth Fund, there followed a large nation-wide demonstration. The training of v i s i t i n g teachers was first.provided under the auspices of the Commonwealth Fund and the White William Foundation in Philadelphia, the latter develop-ing philosophy- and standards. The o f f i c i a l public school system of the States concerned have now assuiiEd the responsibility of training. The depression brought a l u l l i n further expansion. During the second world war there was a mushroom growth in isolated experiments 1. "The Place of Visiting Teacher Services i n the School Program, Bulletin 1945, No. 6, U.S. Office of Education. 2. i b i d . 24. where i n new factory towns the school took on added services for the t o t a l dally l i f e of the child. At present, there are again evidences of speedy expansion. State-wide programs have-been set up. In 1945 the United States Office of Education made a survey and published the findings 1 i n a special bulletin.. One of the interesting points of this authoritative survey reveals that at least f i f t y different names are used for v i s i t i n g teacher services. It also outlines the types of \rork«toich v i s i t i n g teachers are called upon to do and t h e i r r elationship to the other services i n the schools. Florence Poole, President of -the National Association of School Social . Workers says of the survey, "Any study of v i s i t i n g teacher service i n the schools brings out sharply the wide diversity i n organization and admini-stration of the service which now exists. This i s easily understood when one considers that i t is a service that has been added to an already functioning organization." She adds thafother studies need to be made in the areas of function, qualifications, organization and administration." Visiting-teacher becomes School Social Worker The new and growing profession of social work made i t s impact on the v i s i t i n g teacher movement -when vis i t i n g teachers came to seek training. As their functions became^more c l a r i f i e d , they recognized the value of basic training i n casework methods. Graduates of schools of social work traininghave- taken leadership i n t h e visiting-teacherimovemsnt and i n the professional organizatLon, the National Association of School Social Workers. 1. "The Place of Visiting Teacher Services i n the School Program,n Bulletin 1945, No. 6, U.S. Office.of Education. 2. Florence Poole,, "National-wide Developments in School Social Work", The Bulletin of the NASSW.-Maach 1947, Vol. XXII, No. 3. 25. In 1919, the American Association of Visiting Teachers was formed. It has since become the National Association of School Social Workers. It is now taking leadership in establishing professional standards and develop-ing an understanding of school social work. Two meetings are held annually, one in connection with the American Association of School Administrators which i s a branch of the National Education Association, the other with the National Conference of Social Work. In her discussion of national-wide developments i n school social work, Florence Poole states: "We see deeper incorporation-and integration of individual services to children within our educa-tional system. The professional trainning and qualifications for effective v i s i t i n g teacher service have'become .more and more c l a r i f i e d as essentially including preparation in social work in contrast to some of the earlier beliefs that a good teacher with friendly interest i n children was adequately qualified." 1 The recognized standard of professional training i s at present threefold. (a) Teaching experience i s defined as sufficient courses i n education, and educational experience to meet local or state re (b) One year of graduate social work training i s required in an approved school of social work, (c) One year of experience-or supervised f i e l d work i n this area i s necessary, preferably i n a child guidance c l i n i c . Setting Standards The most explicit standards which have been enunciated to date are those set up by the conference called by the Commission of Education, and held i n Washington, B.C., June 1945. The Committee on Duties and Responsibilities submitted a report which was revised by the conferees. 1. op. c i t 26. In the context of general purposes and responsibilities made in the intro-ductory statement, 1 a l i s t of specific duties was outlined. The following statements are a summary of the eleven points of the conference committee with additional suggestions from the practical experience of Minneapolis where a more extensive development has been made in the program of vi s i t i n g teachers. The Minneapolis contribution i s reported by Miss Alma Laabs in an a r t i c l e entitled "When a School Child i s in Trouble," i n the December number of The Child, 1947. Broadly speaking, the administrative job i s to organize a v i s i t i n g teacher program. Primarily, the social worker's services are to children i n both elementary and secondary schools who are not adjusting effectively to their school experience. -Miss Laabs describes the aim as helping each "individual child find a personally satisfying and socially effective place in the school and in the community." Perhaps the greatest challenge to the social vrork counsellor i s to help nthe children assume responsibility for 2 their own problems and work toward ultimate improvement.W 1. 11} The responsibilities and duties of v i s i t i n g teachers are, to a con-siderable extent, influenced by the number of v i s i t i n g teachers employed, the resources of the school, and the community which each services. (2} The general function of the v i s i t i n g teacher is to serve individual pupils who need special understanding and help i n problems of social ad-justment so that they may derive the utmost benefit from their school ex-periences, and to assist those iresponsible to make adjustments in school experiences, where necessary, to meet each pupil's needs and help him find opportunities to continue his educational program to the maximum of his capacity and adjustment. (3} The work of the v i s i t i n g teacher augments and supplements rather than replaces the help given by the classroom teachers, the school psycho-logist, and the educational counselor. The success of the v i s i t i n g teacher service depends, to a large degree, upon adequate preparation of personnel to do the job, as well as the sympathetic understanding of the to t a l school program on the part of the whole school personnel, the child and the parents and upon the mutual understanding of how each can u t i l i z e the services of the others." ("Visiting Teacher Services", publication of the U.S. Office of Education, page 8.) 2. i b i d . . 27. An important service to the child as well as to the parents i s the interpretation which the social worker can make of the child's school problem to his mother and father. Parents need consistent interpretation of the purpose and program of the school and some help in making a positive and constructive relationship of acceptance and understanding with the school. Many adults need help to outgrow their attitudes to school and the authority which i t may represent to in em - attitudes which they have held since their own school days. It frequently happens that the parents require help i n the delicate business of improving and-using their relation-ship with the child who is in trouble, in order that he can make the best use of school and become a more effective person. The child requires interpretation of his problem to his teacher At the point of understanding the child's needs, the social worker can help the teacher and other school personnel to plan ways and means of meeting the needs of a particular child and his teacher i n the class-room and in the total school program. Here again the teacher may welcome some help i n trying out new patterns of relationship. A larger area of service i s to the staff and administrators. The report on Specific Duties recommends cooperation with the staff " i n stimu-lating t o t a l faculty planning on the problems of children, to assist i n adjusting the program to individual needs, and/or assist the children to adjust themselves to sociably acceptable programs." Included in the to t a l job of the social worker in the school i s the important function of setting up an adequate system of records. The report on Specific Duties requires what may be called liaison and coordinating services with other community agencies. The social worker 28... assumes responsibility for referring to appropriate agencies children and their families who need the particular help which these other services have to offer. Some acquaintance with a l l the agencies, local and pro-vi n c i a l , which serve children, would be required. In Vancouver, B r i t i s h Columbia, this function would involve a knowledge of provincial, national and local agencies, public and private agencies; group-work as well as case-work services. The educational duty of the social worker is one which she would be called on to perform every day i n her many contacts. She should also seek opportunities to render a more complete interpretative service where needed. This might well include the interpretation of the purpose and pro-gram of the school to the child or to the parents, to the representatives of various social agencies or to the lay community. It might be necessary to act as a resource person for parent-teacher groups and conferences. It might be important to promote an understanding of the emotional basis of human behavior among parents, teachers, administrators and members of agencies* In addition to, and perhaps as a result of, the duties and respon-s i b i l i t i e s already mentioned, the social worker might find opportunity in what could be described as the f i e l d of social action. Several spearheads of activity are described in the report. One is to work with school o f f i c i a l s to achieve a community-wide understanding of the school and the community agencies and how they are related i n their functions. A second area of action i s to work with parents, community agencies, and individuals to modify whatever conditions are necessary to meet the problems of c h i l -dren. Thirdly, i t is important through cooperative effort of a l l interested groups to stimulate the development of such necessary services 4e children as are not available at the present time. Miss Laabs, i n her a r t i c l e 29. referred to above, states the importance of stimulating the school and the community to recognize a responsibility to children for adequate f a c i l i t i e s in education and other'welfare services as needs become apparent. '4'he school social worker wi l l find those children who are unable to make effect-ive use of the school, or whom the school is not able to help effectively because of lack of resources. Current Trends ihe f i r s t trend to be noted is that, because the v i s i t i n g teacher can handle only a fraction of the individual problems referred to her, she la becoming more of a diagnostician and liaison worker between the school and other community agencies. More children can benefit from the services of family and children's case-work agencies and child-welfare cli n i c s i f directed there by the school social worker. Teachers, trained to be more sensitive to the symptoms which mean that the child is crying out for help, are more li k e l y to solve the problem after a consultation with the social worker. Many children can be helped by the cooperative effort of parent, teacher and social worker. A second development in many school systems is that a l l the extra-classroom services to cb.ildeen are being coordinated under one department and the v i s i t i n g teacher services are connected with this integrated admin-istration. These coordinated departments are variously termed the Bureau of Child Guidance, department of Child Services, and so forth. The top administrator may be known as the Director or Coordinator of Services. Thirdly, there is an increasing amount of group and community work. Some examples arei cooperation with and education of groups of par-ents; cooperation with leisure-time leadership, especially with leaders of gsjqpsf 30 who also seek understanding-of'"the individual c h i l d and his needs; increas-ed understanding between the school and community agencies serving families and children. Miss Poole further describes some of the modern trends as she writes i n her ar t i c l e on national-wide d evelopments. "As schools have advanced in their understanding of, and f a c i l i t i e s to meet individual needs, the work of the v i s i t i n g teacher has .. inevitably changed correspondingly. Visiting teachers now, beside the basic s k i l l of individual therapy, must take their places in the school and in the community as persons aware of possibilities inherent in good group work or the group approach, as well as the individual approach. They must be able to interpret social and economic changes and, as relationships among community agencies are better recognized, they must play an effective part not only in f a c i l i t a t i n g the interchange between schools and other agencies interested in children, but participate also in creative social planning for the continued development of a l l agencies designed to improve the level of citizenship." * The Canadian Scene: Winnipeg's vialting-teacher service. In Winnipeg since February 1944, a vi s i t i n g teacher service has been operated under the coordination and supervision of the Child Guidance C l i n i c . As there is fulldaescriptive material available on t h i s program i n a report prepared by the Child Guidance C l i n i c , and supplementary material has^beenagbtained from a member of the v i s i t i n g teacher staff, i t i s valu-able to record this Canadian development in the present survey. Quoting from the Report w i l l help to set out clearly the type of organization used i n Winnipeg. "As an integral part of the division of Child Guidance Services within •fche schools, the v i s i t i n g teacher program shares the concept of education which recognizes and accepts individual 1. Florence Poole, "National-wide Developments in School Social Work." The Bulletin of the NASSW, March 1947, Vol. XXII, No. 3... 31. differences among children, and "believes i t is the right of every child to have the best possible education f i t t e d to his needs." At present there are six v i s i t i n g teachers, two of whom are trained social workers and for-mer teachers. Each v i s i t i n g teacher i s assigned a block of schools with a population of 1500 to 3000, and works under the direction of the principal of the. school. In the schools served only by an attendance officer, the social workers do the psychiatric social work (i.e., social histories and follow-up work for the Child Guidance Clinic.) The Eeport states that "the two trained social workers each act as vis i t i n g teachers for two schools only, while the other v i s i t i n g teachers are responsible for five or more schools. This permits the trained workers to work i n closer connection with the C l i n i c , taking social histories which are required for individual case studies, doing more intensive work with pupils and parents who require greater assistance, or doing follow-up treatment when diagnosis has been made by the psychiatrist. ... While the v i s i t i n g teacher program is closely coordinated with the Child Guidance Services, yet each v i s i t i n g teacher's a c t i v i t i e s are directed by the principals of the particular so schools to which they are assigned." ''Thus the v i s i t i n g teacher becomes a school social worker and i s a liaison between home and school and a coordinator between the school and social agency." The relationship of the vi s i t i n g teachers with other social agencies i s excellent. They do not register cases with the social service exchange (due to la^ck of office f a c i l i t i e s more than to policy) but for a l l but the most superficial cases they c a l l the exchange, and i f some other agency i s active, confer with their worker before any action i s taken. Many referrals and re-referrals are made to social agencies, the v i s i t i n g teacher interpreting to families the services available and the steps necessary to 32. secure them. In the light of the closer relationship with the Juvenile Gourt which is recommended by Vancouver principals, i t is interesting to find such a development i n Winnipeg. There, before any cases are brought up before the judge, the juvenile court worker calls the school social worker to get a school report. (The provincial c l i n i c does the pBychometries and psychiatric studies for court cases.) together with the provincial child guidance c l i n i c , the c l i n i c system of Winnipeg shares the services of psychologists and psychiatrists, space for interviewing; and the school social workers benefit by these cooperative relationships. The description which one school social worker has given of her day-to-day work shows how theory and practice become integrated. She ex-plains that the job includes, at the outset, home vis i t i n g to discover why children are absent or late. It i s recognized that these are symptoms which frequently lead i n to -case-work service to families. But there i a a danger in becoming so over-loaded with cases of the type (for which there i s pressure to treat superficially and get quick results) that there i s not time to do really effective work. It has been demonstrated that trained social workers are better equipped to emphasise two other aspects of the job. One is the training required of teachers to recognize emotional mal-adjustment and to cope with i t by use of a mental health approach, to look for causes of behavior instead of curing symptoms, and to help chiMLren develop good social relationships. The second is the public relations and interpretative function.. Besides the usual s t a t i s t i c a l and short-form records, i t i s important to work out a policy with regard to more detailed records. In Winnipeg, the use of records depends on whether or not the visiting-teacher is a trained social worker, and, i f she i s , to what degree she has educated 33. the teachers .into the professional use of confidential information. Where the worker, has insisted on time enough to do a more thorough and professional job, a copy of a brief social history or report i s l e f t i n the school. It i s not a, detailed account of an interview but rather a summary of the pertinent f acts that have cone to light and that w i l l make sense to the school staff as causative factors. This record is usually under three headings - problem, home conditions, suggestions and follow-up. (See Appen-dix IB) It is valuable to compare the experience i n Canadian schools with that of United States. The Winnipeg report made by the Child Guidance Clinic as part of a comprehensive educational survey gives a thirteen-point summary of the main functions of the v i s i t i n g teacher program)"which may be compared with the standards of the United States Office of Education as outlined cearlier; iri this^Schapteiu-* :-„;:•» 1. Dealing with attendance problems by the case work method so as to eliminate court room procedure i n the majority of cases. Improving home and school relationships by home vi s i t a t i o n and inter-pretation of the one to the other. Helping with the adjustment of personality and behavior problems with a view to improving the child's attitude toward home and school. Cooperating with social agencies i n family and child welfare problems so that the child may receive assistance necessary to his well-being, i.e. cloth ing, food, home. Cooperation with other branches of the Guidance department so that children may be examined, and receive special therapy when that i s required. Cooperation with Public Health nurses in order that children may be kept in the best physical condition. Interviewing and counselling of students who require assistance i n adjusting to the school program. Consulting with principals regarding class placement of problem children. Maintaining a f i l e of case records of individuals studied. Following up children who withdraw from school at an early age to seek employment. Speaking to Home and School groups or other community organizations or study groups. Serving on professional committees. Supervising students from school of social work. (Outline of Child Guidance Clinic, page 2 4 . ) Vancouver's Services to the School Child 34, In Vancouver City, the School Board has an Attendance Branch and a Bureau of Measurements (psychometric c l i n i c ) ; there is also the Mental Hygiene Division of the Metropolitan Health Committee, which provides service for mental and emotional problems and employs a f u l l time psychiatrist. Each of these i s administered from a central office, and in the case of the Health Department from d i s t r i c t offices. In the school, the principal i s the in-take worker. In attendancecases he works with the teacher where no unusual feature is involved, with the school nurse i f there are health factors, and with the attendance officer i f i t is a case of serious truancy. In serious cases of delinquency and maladjustment or i n social problem cases, the prin-cipal does the preliminary investigation and usually refers the child to the school psychiatrist, i n which event the nurse prepares the social history because of her closer touch with the family. The nurse is the home v i s i t o r and in some cases interviews the child i f the problem is one centered i n the home. Social service cases (that i s , those who are clients of an agency) are referred to the particular agency by the principal or nurse. The principal calls on the Bureau of Measurements for intelligence tests and for the services of the social worker employed there to v i s i t homes i f this i s necessary i n connection with mentally handicapped children. A staff of travelling teachers is maintained to go to homes and hospitals to teach children who are confined there for f a i r l y long periods of il l n e s s . It is evident that v i s i t i n g teachers may work i n several different administrative relationships to the school system. It may be, as i n Rochester, in a coordinated child service department; i t may be, as in Winnipeg* in the framework of a well-developed Child Guidance C l i n i c ; i t may be i n connection 35. with one or more of the Attendance Department, the Health Department, the Mental Health or Psychiatric C l i n i c , and the guidance program, which in the case of Vancouver would require extension from the senior to the elementary school. A significant conclusion from this review i s that i f there i s not a unified administration of a l l counselling services to children, one of the important functions of the v i s i t i n g teacher or social worker i s to find effective working relationships with a l l the departments inside the school system as well as with a l l relevant agencies outside the school system. Besides i t s other functions, school social work is a community organization joo. 36 CHAPTER THREE THE PROJECT: MOTIVES AM) METHODS Aims of Present Project Although the classroom experience i t s e l f can he a mental-hygiene factor where children are given objective tasks and goals of achievement, many children suffer such serious emotional disturbance that this does not operate therapeutically. As teachers become more aware of the insights of modern psychology, they suffer a mounting frustration from the realization that the conditions of their class rooms and the heavy demands of the courses of study make the application of this knowledge impracticable. Furthermore, progressively-thinking teachers and parents are impressed by the greater effectiveness of aaking such knowledge and services available to the child and his parents within the school organization, as distinct from having them available only at some outside point. Determining the Approach A practical study in this f i e l d can hope to throw some light on three different aspects of the subject. F i r s t , i t can help to show the need for an integrated*- relationship between the professions of Education and Social Work. Secondly, i t can define the role of the social worker in the school (a) towards the child and (b) i n relationship with other school personnel. Thirdly, i t can define the relationship of the school social 37. worker with other factors and agencies, tooth in the home and the community, which are necessary for the fu l l e s t possible well-being of the child. To these ends, several alternative forms of investigation seemed appropriate. One possible approach might be an intensive study of a number 1 K of cases referred from schools over a certain period. It seemed that a com-plementary study was necessary and valuable, which would provide an oppor-tunity for coming closely to grips with some of the practical aspects of the? every-day job, and with the professional relationships which would necessar-i l y arise from introducing a new service into a system already functioning. The practical project consisted ofs (1) a preliminary survey of five schools i n Vancouver; (2) ten-weeks' work as a temporary and voluntary member of the staff i n one school i n close cooperation with the principal, taking the cases as they presented themselves in the course of an ordinary school day. This section of the project involved: (1) meeting the child who i s i n trouble, as revealed to the teacher and principal; (2) discovering the functions of other school personnel who give personal service to the child in trouble; (3) discovering p o s s i b i l i t i e s of teamwork with others already on the job - this involving a particular quality necessary on the part of the social worker in order to act i n an assistance role and to develop constructive relationships; (4) finding child needs that were not at the time being f i l l e d . Preliminary Survey In order to get close to the problems as they arise in the actual 1. Such a study is currently being made by Miss Evelyn Roberts, grad-uate student of the department of Social Work, University of B r i t i s h Columbia. It i s based on the work of the mental hygiene services as such. s e . setting of the school, the writer was able, with the approval of the Superintendent of Schools, to discuss the po s s i b i l i t i e s and problems with principals who were interested in exploring the f i e l d . The Superintendent introduced the writer by letter to five principals whom he recommended, to help in surveying the Vancouver f i e l d . The schools were chosen in repre-sentative areas. In each case, the principal was extremely helpful i n describing the type of community which was served by his school, and the methods he used to solve the children's personal and educational problems. In the f i r s t interview with each principal, and subsequently with school nurses and teachers, the project was defined i n general. Discussion showed a good deal of agreement on certain points: (a) Family l i f e and relationships, i t was agreed, are suffering from the increasing complexities and insecurities of l i v i n g . Strains and maladjustment i n the parents are caused both by society's maladjustment as a whole, and by any personal inad-equacies they may have. At any rate, the strains and maladjustment i n the home are reflected i n the children. And, of course, each individual case is apt to be a different and unique combination of factors, (b) The "prob-lems", most of which are emotionally charged, are concentrated in the school for five hours each day. The principal and teacher carry the burden of these emotional strains and they, too, are victims of the increased pressures and strains of modern li v i n g , (c) Currently, social and emotional problems are multiplying. At the same time there i s an increasing awareness of them on the part of teachers, parents and members of the community. The school, which is the f i r s t and largest agency in the community to which parents have given responsibility for thetraining of their children, must discharge that responsibility at ever higher levels of understanding. The school must convince the parents that i t i s doing a job that i s up-to-date, with 39. contemporary s c i e n t i f i c knowledge-of education and tne-development of the human personality. It i s significant that more parents are voluntarily seeking help with the training-and-behavior-problems of their children, (d) Many principals find an increasing number of problem children in grades one and two. A survey of the facts may explain this disturbing trend. These are the children born i n 1941, 1942, and- 1943, nurtured and trained in that d i f f i c u l t period of war; through the, transition from war conditions to c i v i l i a n and so-called normal period; through the period of -unsettlement with-parents moving from one place-to another, from one unsatisfactory housing arrangement to another; through the period of re-adjustment and more re-adjustment, which a l l too often ended i n maladjust-ment, (e) The school is-the logical place for the detecting and screening of maladjusted children. The school i s a natural place for the parent to look ;l > for counselling^ chiefly because no other agency i s so unquestionably accepted i n the community. The teacher is in a most advantageous position to see the d i f f i c u l t i e s of the child, as he makes his f i r s t major adjustment away from the home, (f) The sohool,if in good working relationship with the home, can be a curative and preventive agency, .(g) The school i n re-lationship with the community can provide supplementary services which give the child further opportunity for growth, (h) The school is the one agency that serves a l l children of whatever race, class or creed. The worker's approach to the •ppoaont school personnel was to explain that she wished in cooperation with the principal, teacher and nurse to find the answers to certain questions. How would a principal use an added member of his team of workers who was a trained social worker? How would a Public Health Nurse use a social worker a§ §L. corW.Qrk.er? How would a teacher use a social worker as aa co-worker? How would a parent use the services of a social worker? How could a social worker help the 40, individual school child who is in trouble? tentative Findings Of the five principals, three were sure at the outset that another member of the team who had social-work training would he very help-f u l . This was perhaps due to the particular school communities i n these cases, which included more problem children from economically and socially underprivileged homefe. The others f e l t that there were not enough "social service cases" in their classes to warrant further staff, a conclusion which was explainable by the fact that social work is often equated with welfare 1 and r e l i e f services. The general attitude among the public health nurses was that the pressure of their timetable meant that home vi s i t i n g was not adequate and there were areas of their work which were not being developed, notably the mental hygiene work. Where social histories were necessary for truancy and delinquency cases, the total problem was outside the area that they f e l t could be coped with effectively. The general reaction of teachers was that they have many problems. In the cases where the principals f e l t there were few problems, or none, especially i n the lower grades, the teachers* estimate was that there were many but they did not regard aost of them as social work cases. Again, this reflected the limited under-standing of social work as being concerned only with problems of socially and economically underprivileged families. 'ihe mental hygiene personnel of the school system voiced the need of a lia i s o n person working in the f i e l d of child services. Some principals f e l t the reed of an assistant i n intake, screening and preliminary diagnosis. Many teachers naturally were not willing to commit themselves without a 1. 'i-'here i s no evidence from guidance c l i n i c s or scie n t i f i c nursery schools that "problem children are not to be found in well-to-do homes. 41. demonstration of results, 'i'he parents without exception were glad of help-f u l counsel. Without a doubt, the children needed a counsellor who could act as a coordinator and interpreter of services to them. Work with the children also showed their need of experience i n making constructive relationships with a counsellor. It would seem that the original purpose of the Woman's Education Association of Boston i n 1907 can he understood and accepted by both the teachers and the parents as a great and present need. A re-statement of that purpose seems completely up-to-date. "Lack of understanding between home and school often results i n loss, sometimes serious injustice to the c h i l d . " ..The purpose of the social worker is "by working in both home and school, t o u r i n g about greater harmony between the two and so make more effective the education of the child." She most superficial observation reveals that we are s t i l l far from achieving this goal of closer relation-ships between home and school enunciated more than forty years ago. In many educational systems the way has not yet been f u l l y explored, and neiiter the parent nor the teacher can have a clear conception of how a v i s i t i n g teacher w i l l effect this purpose. A Ten-week Experiment At the conclusion of the preliminary survey i t was decided that the most significant results would be found in a concentrated experiment conducted i n one or more schools. It was f i n a l l y arranged that two and a should be half days each week we»e spent at one elementary school, which seemed par-ti c u l a r l y suitable for the pnrpose. A summary of the interviews (below) w i l l indicate the nature and scope of the work which was thus undertaken. Summary of Recorded Interviews and Visits Description No. Discussions with personnel within the shhool system on behalf of children (Metropolitan Health, Junior High. School Counselling Department, Bureau of Measurements 20 Discussions with social agencies on behalf of children 16 Visits to homes on behalf of cMldren (mostly interviews with parents) 27 Visits to classrooms on behalf of children 7 Interviews with school nurse on behalf of children 10 Interviews with teacher and-or principal on behalf . of children 41 Interviews with children 30 Visits to community agencies and organizations 7 Vis i t s connected with preparing, administering and compiling results of surveys 3 Total v i s i t s and interviews . 161 # Many short interviews with nurse, teacher, i principal, etc., unrecorded. PART II RELATIONSHIPS ON THE JOB Chapter 4, Assisting the Principal Chapter 5. Attendance Problems Chapter 6* School Mental Hygiene Services Chapter 7. Cooperating with the Public Health Nurse Chapter 8. Support to the teacher Chapter 9. The Child and His Home Chapter 10. Bridge toethe Resources of the Qommunitiy 43. CHAPTER POUR ASSISTING THE PRINCIPAL The Principal's Office The principal is the focal point of the school's services to the child. He is the administrator of teaching services, attendance laws and disciplinary measures. He often has extra-curricular relationships with individual children i n such projects as a school lunchroom, concerts, money-raising ventures etc. At present he i s a "social worker" i n the school i n that he assesses the needs for such materials as free hooks, free lunches, and clothing, and supplies them to children who require such assistance. Together with the school nurse, he decides which families should he referred to the attendance branch oC.to social agencies because of their need or neglect of their children, and which children require the services of ,the psychologist or psychiatrist. The teachers bring to the principal their more serious problems in discipline and in lack of normal educational progress. He has opportun-i t i e s to discover the individual needs of students anddecides on the most effective treatment. But in most instances, he has not enough time to know a l l the facts which are influencing the child's l i f e in school and at home, nor has he always the time necessary to consider and prescribe a method of treatment. 44. Accordingly, the school social worker begins her work i n the principal's office, in consultation with him and as assistant to him. She becomes primarily the intake worker for the school. Her f i r s t task i s to screen the problems as they come i n and decide i n which department of the school services the child may be helped. He may need a v i s i t to his home for some understanding of why he is absent and late. He may need a review of his school program and the services of the Bureau of Measurements for an accurate measure ol his mental a b i l i t y . He may need the services of the school psychiatrist to achieve a change in his farents' (or his teacher's) attitude to him, or his to them. He may need the help of the medical and dental departments, or of a family counselling service to strengthen the whole family structure. He may need help with his social relationships -with his teachers, with other adults, or with children of his own age. He may need a friend, a counsellor who is not associated i n his mind with any of the areas of his l i f e i n which he feels himself a failure, but to whom he can talk and state hia problem i n his own way and as i t appears to him. Assistance with Surveys In addition to individual interviews, over-all surveys give valuable supplementary information and a general perspective in which some-times the l i f e of the children can be seen more intelligently. In the school in which the experimental study was made, the worker assisted the principal i n preparing and vadminstering three such surveys. They added to the general knowledge of a l l the children, but were often particularly use-f u l when a child showed deviation from his usual behavior and achievement. For example, when Dimitri'a school achievement and morale were in a serious condition, a reference to the survey about employment revealed that he 45. 1 sometimes worked as many as thirty hours per week. A survey of out-of-school employment was made for the purpose of getting information as to the kinds of work for which the children were receiving a form of wage, and the hours and times of work during which they were engaged. (See Appendix!A). A table of information about parent occupations gave useful information regarding the occupation of the father, and was particularly helpful i n assessing the situation of families i n which the mother was also a wage-earner and a financial contributor to the home, wdthu conse-quently added problems of child supervision. (See Appendix IB) A questionnaire about leisure-time ac t i v i t i e s yielded valuable information about each child, as well as about the services available i n the oommunity. It provided material which could be used in further studies (e.g., radio programs which are favorites with thechildren). Each i n d i v i -dual child's sheet of answers to the questionnaire is a contribution to a more thorough understanding of the child and may be kept in general f i l e s , or contribute to an individual f i l e for each child. I 3ee Appendix 1C) Community Relationships The principal appreciated that his duties and responsibilities included a knowledge of the community and a working relationship with others who were providing services to the same children and their families. But l i k e many other principals, he did not have time to keep in touch with other organizations as often as he would l i k e . In exploring these areas of working relationships, v i s i t s and conferences were planned with a wide 1. See page 66 for the story of Dmitri. 46. range of people. They included a d i s t r i c t supervisor and a d i s t r i c t case-worker of a family counselling agency; a d i s t r i c t case-worker of the Children'a Aid Society and a case-worker of the Catholic Children's Aid Society. In the group-work f i e l d , conferences were arranged between the worker and the Boys' Work Supervisor of the X.M.C.A., the Director of a Neighborhood House, the Supervisor of Boys' work, the club leader, and the Supervisor of the Nursery School, a l l of the Neighborhood House. Other contacts were with a private volunteer sponsor of a branch of the Provincial. Recreation program, the Boy-Scout and Cub Master of church troops, and a parents' cooperative play group for pre-school children. •4 very valuable source of cooperation for the social worker to explore proved to be with the parent-teacher association of the d i s t r i c t . It was very easy to develop good working relationships with the women of the association who gave voluntary service in the lunch-room, and later with the executive. In the short time of the experiment i t was evident that early opportunities would arise for the social worker to explain her work to the total membership of the parent-teacher group. In fact she would seek such an opportunity, because one of the most significant aspects of her work is to help broaden the area of understanding between the home and the school. Very soon the social worker would be recognized as a valuable "resource person" for leadership i n study groups and at general meetings. It is clear that with such contacts, the social worker not only assists the school principal with the responsibility of intake and diagnosis of the personal problems of the children but relieves him of the pressure of keeping in touch with a variety of community agencies: and personnel. 47. The latter is then able to expand his particular function of administra-tion and also to refine the educational services of his school. She individual child who needs particular help w i l l benefit by these refine-ments in organization and teaching techniques which w i l l also provide larger opportunities for a l l children. 48. CHAPTER FIVE ATTENDANCE PROBLEMS Absenteeism: lapse responsibility? In the elementary school, regular attendance is a matter which involves the child, the teacher and the parents. This i s one of the two areas of responsibility (the other being cases of neglect) where the State claims rights over the parents i n the welfare of children. These are ex-pressed i n a series of regulations, which i t is the duty of the school system to enforce. One of the unfortunate results i s that the principal and the attendance officer appear as agents of authority in the minds of the parents and the child. From a social work point of view, absenteeism is often an indi-cator of disturbance on the part of the child or of complications in his family l i f e over which he has l i t t l e or no, control. This attitude to ab-senteeism has been adopted by most attendance branches including that of Vancouver. The teacher and principal work as a team to record absences carefully and observe any patterns which might be enlightening. Their information as to the reason for absence is obtained from other members of the family at school, or from children who live nearby, or by telephoning to the home. A letter may be sent to the home showing the record of absent-eeism and requesting a better standard of attendance. If there is a case of obvious i l l n e s s , the nurse makes a v i s i t to the home. But she is not able to investigate i n cases of irregular attendance due to such a common cause as colds. The common cold i s an illness which baffles teacher and parent 49. alike because of the psycho-somatic aspects of minor illness and the close relationship-of "cold" symptoms'to the general economic, psychological, and social well-being of the family. When there are added factors such as inadequate-housing, or irregular-supervision, or any form of i n s t a b i l i t y in the home, the issues can become very mixBd. A case example w i l l i l l u s t r a t e . The Child with Early Psycho-somatic Sfcmptoms School Problem: Donald, a grade one pupil was not progressing in school. His frequent absences f e l l mostly on.Mondays and Thursdays, often for half days only. The teacher and pr i n c i -pal wondered what this pattern could mean. From the Parents 1 Occupational Survey, i t was known that Donald's mother worked odd days. The principal f e l t that there might be some rela-tionship between Donald's absences and his mother's working days. From a f i r s t interview, the worker got a picture of how the problem f e l t to Donald's mother. The worker visited Mrs. M., who had received a letter from the principal regarding Donald's absences. She found Donald under the doctor's care. His symptoms were frequent colds, i l l n e s s . i n the morning but better by noon, pains in the legs, loss of weight and appetite, need of an abnormal amount of sleep. The doctor thought of rheumatic fever but found no clear evidence of any disease. Not finding any marked physical defect, he had inquired i f Donald was under any strain at school. Mrs. M. had not been sharply aware of Donald's school l i f e except that he was not progressing as she had hoped. But she remembered with what tension he arrived home, took a piece of paper from his pocket to show her the word he got wrong that morning, begging her to help him. He was also worried about getting stars. She f e l t i t significant that Donald began school at age 5 years 8 months and at the time she f e l t that perhaps he wasnlt ready but was anxious to have the two children in school. She pointed out that Donald was 22 months younger than his sister who was just one year ahead in school, showing no comparable strain. The f i r s t question to settle was whether this was a case for the nurse, or whether after consultation with the principal, nurse and teacher, the social worker should take primary re-sponsibility. The nurse not being available, the worker con-sulted with the principal who raised the question as to the su i t a b i l i t y of the particular teacher for the grade one job. There had been other evidences of strain on the part of the children which in turn was f e l t by the parents. One v i s i t to the classroom did not convince the worker that the teacher was "high-strung", but i t seemed possible that she was not able to make warm relationships with the children. There was l i t t l e evidence of any positive feeling between teacher and pupils. The work was done in a wooden manner. Possibly those who were babied and over-protected at home and those who were immature missed the warmth and protection of a mother, and suffered most, with resulting retardation. Donald's absenteeism was a complicated problem which included (l) i n i t i a l immaturity for grade one work; (2) a mother who had protected him and at the same time was s u f f i -ciently aware of this to be in conflict about i t ; (3) a teacher who was not able to support him as much as he needed; (4) a physical weakness which could be called on i n time of strain so that the two became interrelated; (5) a suspicion on the part of the school staff that this might be a child neglected by a working mother - a generalization applied too quickly and without f u l l understanding of the circumstances, t i n the interview with Mrs. M. i t became clear that the pattern 51 . of Monday-Thursday absences was not coincident with Mrs. M. *s working days, which were Tuesday and Friday.) Mrs. M. would welcome the combined understanding and help of the principal, teacher, nurse and social worker to determine whether Donald should be allowed to stay out the remaining part of this year, or whether he might be subjected to less pressure in the classroom, or whether he could enter the special class, or change rooms or return to kindergarten for the last three months. As she is the adult most sensitive to Donald's needs at this time, i t would be hoped that her feelings would carry equal weight i n the conference so that a decision would be reached for the greatest benefit to Donald. The worker planned to arrange the kind of conferences which would be most helpful. Donald's problem is a case where a conference of the school team (teacher, principal, nurse and social worker) might be a valuable preventive measure at this point, perhaps obviating the need for a later conference with the psychiatric c l i n i c . The subject of conferences w i l l be discussed more clearly and thoroughly in a later chapter. But i t might be said here that in the school conference the social worker would represent the parent as well as she could, and, i n conference with parents, would represent the combined thinking of the school personnel. In most instances, i t would be an unwise technique to have the parents come to the school for a conference; at such a disadvantage most parents easily lose confidence, and with i t ca their a b i l i t y to discuss their children without going on the defensive* But the social worker could make careful preparations for a conference i n which the parents would meet one or two of the school staff and thereby feel on a relatively more equal footing. 52 Two case examples w i l l show the effects of heavy family respon-s i b i l i t i e s on children who then sustain the tension of conflicting loyal-ties-?- to the home and to the school. The Child with Family Demands School Problem: Ellen B. had been absent one to three days a week £dr.-six weeks. She was tired and l i s t l e s s i n school and had regressed i n her work to the extent that she was in danger of f a i l i n g her grade six year. The principal had spoken to Mrs. B. on the phone, c i t i n g the regulations of the Attendance Act. Mrs. B. tried to explain her need to have Ellen at home. The principal had no way to aid Mrs. B. in solving her problem and f e l t he could only say what the law required, and that she would have to find other solutions that would enable Ellen to attend school. Worker interviewed Ellen who appeared pale, thin and worried looking. Ellen described her problem. There was a new baby at Christmas time and three-year-old twins. Her mother had been i l l and Ellen had to stay with the children while her mother went to the doctor each week and did her shopping. Ellen's father workjds during the day and again at night; consequently he is no help at home. Ellen doesn't want to f a i l as a l l her relatives have passed, but when she comes home from school there is a lot of work to do. She would like to go to bed at 8:30 but i t is often 10 or 10:30 before she does. Her mother says she is slow but she gets tired sonstimes. She has the responsibility of waking up the family i n the morning. Her brother Roy seems to Ellen to be the favorite. He gets a cent a day for being good, while she gets nothing for "just being good naturally." Mother helps him complete his jobs so-that he won't be punished by the father. Ellen feels her father is on her sidej having given her no spanking since she was six years old, he doesn't want to break the record. Knowing that her work is weak, she says that others get the. same marks on tests but their reports are better and she wonders how that i s . Ellen recognized her mother's problem and could perhaps meet i t more r e a l i s t i c a l l y and effectively i f there were not the mixed emotions with regard to her brother and centered around her position in the family as the oldest child. But she feels unfair treatment i n the home and this feeling easily carries over into the school situation, as she wonders why others have better reports. One can detect her feeling of being discrimin-ated against. She is confident her mother w i l l help her get to school regularly, but is s t i l l anxious about the work and the late hours, The record continues: Ellen hasn't much time for play. She has a school friend who lives too far away to play with after school. She says that she doesn't play with neighbors because they are rough and use bad language. Ellen was apprehensive at the point that the worker suggested she v i s i t her mother. Ellen didn't want theworker to think she was complaining and perhaps reveal this to her mother. The Worker assured her that she would go only with the idea of finding ways to help her mother. Ellen readily said that what her mother needed was help with "those twins" and asked what we could do about i t . Ell e n must have f e l t herself i n conflict between her school obligations and loyalty and her home obligations and loyalty. When pressure came from the principal, she would not know whether she were the guilty one or whether i t was her parents who were guilty. If the worker had visited the home without gaining Ellen's confidence in her, Ellen would have f e l t as i f l i f e were "ganging up on her." As itvsas, she had. a need and a right to be heard. Then she was part of the plan, and i t was neces-sary for the worker toigive her a part i n i t that could,be her responsibility. / The second interview, two weeks later, showed some progress. 54. Ellen hadn't missed a day this month. Today she had a cold but.decided to come to school even when her mother suggested she stay home. There doesn't seem to be quite as much strain about getting to bed-earlier. She spoke of her father being restless end unhappy, saying she was like him as she gets annoyed and upset when things go wrong or people don't do as she wishes. She told of their plan to put i n a garden and f i x up their house. When worker mentioned how nice i t was to be so near a beach i n the summer. Ellen said that too many awful things can happen. There followed the account of their removal to Vancouver from a nearby town after the tragic death of her small blonde sister, murdered by a mentally unbalanced youth. Ellen feels that they had the new baby, also a blonde g i r l , to take the place of the sister who.was k i l l e d . Ellen would have rejected a boy as she doesn't like l i t t l e boys. (The twins are boys). She correspondes with a g i r l from the town where the tragedy occurred who t e l l s her that perhaps the murderer w i l l not always be i n mental hospital; i n fact he comes horns for holidays. Ellen's father says that her poor school work must be due to too l i t t l e sleep. In answer to worker's question, Ellen said she didn't think i t could be due to the worry of the tragedy.. She said they try to flcrget, but you can't altogether. Every l i t t l e g i r l ' s picture i n the paper reminds her - they are usually blonde. Ellen says her father talks of going away to the States. ... This i s perhaps a rather dramatic example of the fact that the so-called obvious and simple problem of absenteeism may reveal much deeper and more serious problems. Certainly, Ellen w i l l need the constant help of teachers, principal and counsellor who w i l l understand the basis of her fears, anxieties and tensions. When she goes on to a larger school, much farther from home, careful follow-up work should be done by passing on to the Qounsellor i n the junior high school the information which would enable her to observe effectively Ellen's needs and t r y as f a r as possible to meet them. Ellen herself needs encouragement to grow in relation-ships with her own age group and have companions who w i l l help to build her confidence i n people. 55. Ellen's teacher reported a definite improvement in her school work. On this positive note and the cooperative action of her Mother, worker v i s i t e d the home. Mrs. £• was glad of a chance to explain how rea l l y pressed she had been when i l l and of her unsuccessful attempts to get help. She described her main problem now as being the training of the twins and the strain on her of having them a l l day long. Worker told her of two po s s i b i l i t i e s of nursery schools. Mrs. B. was interested and asked worker to find out the names of the people she should get in touch with. Ellen's need of friends or perhaps a club were also discussed. Mrs. B. told of some misunderstanding she f e l t with the principal, when Ellen reported that he had put a note from her mother into the waste-basket, and that they hadn't been any too cordial on the telephone. Worker was able to give her the information that the principal kept a l l notes i n a f i l e because he f e l t they were important to the children. Worker explained how Ellen might have been mistaken, but at the same time assured Mrs. B. that the actual facts could be checked. The seemingly small incident of the note could be important . because of Ellen's tendency to f e e l that she was being discriminated against. For her sake and iter remove the cause of Mrs. B's misunderstanding about the principal, i t would be well to clear the facts. Worker telephoned the information regarding the nursery school to Mrs. B., who appeared grateful. To the mother's delight, worker was also able to report further progress i n Ellen's school work. Further contacts with the home might lead i n one or more of several directions:-i strengthening the mother's decision to do something about the nursery school for the twins; strengthening her feeling of relationship to the community through association with nursery school mothers or the parent-teachers association; detection of added strains in the home great enough to warrant encouraging the parents to apply for counsel i n a family agency. 56. It was later discovered that Mrs. B. had been a client of tae "family counselling agency and was s t i l l In a state of indecision i n relationship to her husband. The school social worker would wither develop cooperative work with the family agency or with-draw, except for keeping up a supporting relationship with Ellen. By keeping some continuity of relationship with Ellen, the worker would hope to assist her growth out of timidity and fear, by helping her to have successful experiences with groups; and to enlist her parents' cooperation i n the special planning necessary for their oldest child. Through her own contact or by means of records, the worker would be able to keep alive in Ellen's subsequent teachers a continuity of understanding about the particular things in the background of the family that might effect her educational and personal success and achievement. In general, because of the school social workers, teachers w i l l tend to be more aware of the significance of deviations in conduct or in school performance. They w i l l be more disposed to see the importance of early detection of trouble, w i l l become more sensitive in suchhdetection and ready to seek aid from other sources for early treatment. The Child with Symptoms of Neglect School Problem: Keith was referred by the principal as another child who was being kept home by his mother to help look after younger children. The teacher reported no progress in school and l i t t l e application to work. When Keith was absent or late, his mother would send a note stating reasons other than the fact that he was looking after his sister. When the teacher asked Keith i f 57. he was looking after his sister he would usually say "Yes." The school nurse reported d i f f i c u l t y with the Kerr family. The three boys at school had frequent colds and skin troubles. She would send them home but they would return the following day with the skin infection not cleared. It seemed to the school personnel that because the mother was working, there was l i t t l e or no super-vision of the children and the absence of i t created a problem., for the school especially when they needed to be sent home. The nurse f e l t that the father was sometimes supposed to be in charge but the children begged not to be sent home in case he would be angry. Home picture: Worker visited the Kerr home, finding Keith end his 4-year old sister there. He had been home a l l day from school. Keith wasn't sure nh ich reason to give for being home. He said that he was i l l and also that he was needed to look after Marilyn. He gave worker the name and address of his-mother's place of work. Worker visited the mother and heard her story. Mr. K. had not had regular work during the winter, but now that spring had come he would be working regularly as a painter. It was necessary for Mr. K. to work. She said she f e l t this was necessary f o r a l i t t l e wa il e yet u n t i l they got caught up. She would prefer to be home because she knew the children were not being supervised and also she had too much work to do after she got home. Her hours at work were from 9 a.m. to 5:30 p.m. every day except Sunday, as cook i n a coffee shop. She had had several plans for having Marilyn looked after, each one of which had broken down during the last couple of weeks. The father was going out to work steadily; the two neighbors who were helping were unable to do so due to i l l n e s s . In regard to^Keith, Mrs. K. said that of the three boys he was most often i l l with colds and she planned to have his tonsils out this summer. When worker tried to determine how urgent this was, she f e l t that Mrs. K. would be handicapped financially and mentioned this, wondering i f i t would mean postponement. Mrs. K. said she would very much appreciate knowing any financial help she could get for hospitalization and treatment. 58. It seemed that from this point, the problem was primarily one for the school nurse - to determine how-urgent i t was for Keith to have his tonsils out and i f necessary to refer Mrs. K. to the oup patient's department of the hospital for hospitalization. When Keith again reported to his teacher that he had to stay home to take care of his sister, the principal f e l t that the cooper-ation of the Children's Aid worker might be obtained. The school worker had the social service index information that the family had been clients of the Children's Aid Society. Their worker offered to talk the problem over with the school personnel. It was agreed that the children's worker v i s i t the home and i f possible find ways to strengthen the family base for Keith and the other two boys vibo attend the school. In the meantime i t was the worker's plan to know Keith better. She reported her infor-mation to the teachers of the three boys and observed them in their class rooms - particularly David who is in the special class. The Kerr family are a "nuisance" from the point of v iew of the school. The boys are not d i f f i c u l t behavior problems. But i t seems to the principal, teacher and nurse as i f the parents are wilf u l l y neglecting the children probably because they don't care. Obviously the children cannot RI make as effective use of the school and find Asatisfaction i n achievement as they would i f the family were strengthened to the point where they could be cooperating agents with the school for the benefit of the children. A very important aspect of the problem i s again the conflict of loyalties i n the child's feelings, resulting in training in deception and confusion of moral values. The worker must find the answer to certain questions. How much can the family be encouraged or forced to conform to accepted 59. standards of child care? What approach should be made - threaten with the authority of the Children's Aid Society under the Protection of Children Act or with the authority of the school attendance law? How much can be done to help the mother of this family? Is i t e stablished that she does n not want help but prefers to leave the family in this situation? The "Problem" Family School Problem; Chronic absenteeism had been the trouble with the Morgan family for years. It seemed so serious that the school was instrumental in having the family allowance discontinued. An older sister had caused trouble i n the community when she was in grade s i z because of sex delinquency. The parents appeared uncooperative and even defiant and their relationship with the school became steadily worse. The nurse had refused to go to the home any more. Mildred was repeating grade 6 because of poor school progress due to frequent absences. tke-Home picture; In a v i s i t to the home-worker sought obvious and underlying causes for such a long and continuing period of poor attendance. Worker found the horns in the poorest d i s t r i c t and with very unhealthy conditions caused by water underneath and around the house. An older si s t e r was caring for three sick c h i l -dren and Mrs. M who has succumbed to the ' f l u . Inside the house was clean and warm and the children seemed well cared for. They were under a doctor's care and his advice was to have their tonsils removed very soon. The baby had been threatened with pneumonia. Worker was not able to see the mother but the sister asked i f anything could be done about the allowance, saying that her mother really wants the children to attend school but there seems to be so much i l l -ness. They never seem to be free of i t . As an immediate practical help, the worker and principal adked the nurse's help i n calling the department of Health and Sanitation to drain the water from around the house. Worker interviewed Mildred 60, when she returned to school. Mildred appeared clean, attractively dressed and well-cared for. She talked easily and frankly about their problem. She said her mother had asked the doctor to make the arrange-ments for the tonsilectomies during the Easter holidays. She said she f e l t as i f she were just beginning to make some progress at school and didn't want a further set-back. Later developments we»e reported by the principal. He said that Mildred l e f t two weeks before the holiday to have her tonsils out. He looked for her back the week before Easter, hoping that she would be able to write the tests. On investigation* he found that she was absent from school a week before her operation and was not expected back u n t i l after Easter. He f e l t that Mildred had "put one over" on the school. Also she was evading the exams, following an old pattern of absenteeism on the days of tests. At this point he f e l t i t necessary to refer Mildred to the Attendance of f i c e r . Lack of communication between this family end the school had resulted i n each one being completely i n the dark as to the motives behind the actions of the other. Almost any third person or agency would l i k e l y be able to help somewhat i n restoring a basis of understanding between them. It i s also possible that the trouble has been Atoo long standing with resulting hardening of attitudes. The school worker wauldat this point cooperatewith the attendance officer to find the best solution. Conclusion The principal recognized the absenteeism of Keith, Donald and Mildred as a symptom-which represented a more complicated problem at home or in school. The social worker's job was to discover the factors i n the home 61. and school situations which are the basic cause of failure i n adjustment and achievement. Where necessary, as for Keith, the worker seeks addition-a l resources to strengthen the family base. In cases like the Morgan family which feel somewhat hopeless, the social worker is an additional resource to the home, and to school personnel. In some cases, as for example that of Donald, the worker and principal may detect a problem i n i t s earlier stages and by sound treatment prevent more serious d i f f i c u l t y later. 62. CHAPTER SIX SCHOOL MENTAL HYGIENE SERVICES Description The mental Hygiene Division was set up in 1936 as part of the school public health services under the Metropolitan Health Committee. Recognizing the inter-relationship of physical and mental factors, the service i s carried on by the public health nurses with the assistance of a psychiatrist as Director. School Mental Hygiene Referrals, Greater Vancouver, 1947. Source of Referral Four.City.. Units School Area Others Total Schools: Health Services 31 Principals 56 Bureau of Measurements & Attendance 19 Officer Parents 28 Agencies 17 Private Physicians 13 14 24 Total 164 7 7 54 45 80 19 25 24 15 218 63. In the schools, a referral may be the result of a previous conference of the school team (teacher.principal and nurse) or may arise on the i n i t i a t i v e of any one or two of these people. Once the child has been referred to another branch of the school system (such as the Bureau of Measurements for testing, or the Attendance officer because of serious truancy) the referral to the Mental Hygiene fllinic may be made from that department. In the annual report of 1947, the Mental Hygiene Division de-clares the focal point of the work to be conferences of "parents, teachers, nurses, o f f i c i a l s and physicians. .. The f i r s t objective is to share the results of our different opportunities to observe children, and of our various special types of training and experience, so that we can come to a f u l l e r understanding of how children develop strong, or anxiety-ridden personalities, and creative or destructive patterns of social adjustment." The Division uses the conference method when the case reaches a level of seriousness requiring the services and diagnosis of the psychia-t r i s t . I f a social worker happens to be working with the family because of the family's connection with a social agency, she w i l l be able to con-tribute to these deliberations her knowledge of the family's history and present condition. Where an agency is not involved, the public health nurse, as the person who is usually closest to the home, does the home vis i t i n g , gets the social history and does follow-up work. As far as her time and training allows, the nurse usually performs the function end thus substitutes for the services of the social worker. In some cases, the principal may interview the parents. , 64. It i s relevant to note the difference, from the point of view of the c h i l d and his parent, between his experience at the c l i n i c and his earlier interviews with the teacher, principal, or public health nurse. Each of these members of staff has a f u l l , program of duties and specific functions to perform. It is d i f f i c u l t for a person who sets standards for the child and the family to establish the kind of relationship which would make them fe e l as i f their total needs were recognized. Both the child and his family are l i k e l y to have a sense of pressure in relation to the members of the school staff. When they appear as failures by f a l l i n g below the standards, they often react defensively. The child can't c a l l a confereneeof the people who are the specialists and experts in his l i f e and who in most instances serve him well. Nor is there any ready procedure by which the parents can c a l l together a l l the experts who could advise and help him in his problem. In the same annual report of 1947, the Director of the Jfental Health Division made an estimate of the future of the c l i n i c . He said: "We w i l l not be able to go on increasing the number of easesjstudies annually because of limitations of time, under our present system. To give, individual study to a greater number of cases w i l l require the ser-vices of another psychiatrist, or as a more logical and earlier step, more preliminary counselling and sorting out of cases by school and medical officers and students' counsellors." Given the addition of a social worker to the staff of the elementary school, the work of - the student counsellor could - in fact should properly - be done by her. In any con-sideration of the child's problem, i t is necessary to get as clear a pic-ture as possible of the £BC*OT.St^6n$rlb»t±i® to his whole development, and i t is this service f o r waich a social worker i s particularly trained. 65. The home should also be well represented, both at the level of consulta-tion with the school psychiatrist and at earlier stages of the problem when adequate knowledge is important. The social worker could thus be the agent to effect "more preliminary counselling and sorting out of cases" and other functions as well. The social worker would be able to ini t i a t e conferences between the school personnel at an early stage in the presenta-tion of the problem. The teacher and parent could be kept closely in touch with the development of the facts and share in the tentative diagnosis. The social worker would, in short, act as liaison between the different department s of the school system, as well as with t he social agencies and the ho:ge. Besides making for better understanding between the school system and parents, i n many cases this would certainly result i n treatment at an earlier point. The Mental Hygiene Division reports that an increasing number of cases are being referred by parents. This i s an encouraging sign of the general awareness of the public and the growing willingness to ask for help not only in physical sickness, but in mental and emotional d i f f i c u l t i e s . To encourage more parents to apply for help, two developments are s t i l l essential. It w i l l be necessary to augment the services of the Mental Hygiene Division by the employment of liaison people who besides helping to prepare oases, can do follow-up work by supporting and helping the parents and children build new patterns of behavior and relationships. Secondly, a treatment center w i l l be neededwhere more intensive treatment can be given to children who reqiire psychiatric observation and therapy over a period of months. This latter step should, of course, be taken i n cooperation with provincial services such as the Child Guidance C l i n i c . 66. The most recent report shows that the relationship of follow-up work to new cases i s less than one to four (59 follow-up cases, 218 new cases). At present, the service calls for a follow-up v i s i t within six months of the consultation. The companion study to the present one, which has already been referred to, shows the need of augmenting the services to do the necessary close work with parents and teachers, supporting them i n any change of attitude or method they are attempting, and also evaluating the effectiveness of their efforts. Preparation of Cases: Example of Steps Necessary. The work done to help Dmitri M., age 12, grade 5, a child of Yugo-Slav Parents, w i l l i l l u s t r a t e the variety of tasks necessary to build up a case before i t s presentation to the Mental hygiene Qlinic. The symptoms leading to the discovery of the problem were: (l) Serious regression in school work, especially reading d i f f l e n i t i e s ; (2) Dmitri was deeply discouraged and consequently had a defeatist a t t i -tude to his work; (3) He was frequently absent and late, especially on Monday mornings, and at a l l times seemed exhausted; (4) The employment survey, referred to i n the previous chapter, showed that Dmitri worked as much as twenty-five to t h i r t y hours a week and u n t i l twelve midnight on Sundays. The procedure adopted was as follows and may be set out initwelve steps. F i r s t , the worker and principal conferred to outline the problem. (The teacher would be included as a rule when this procedure was administratively planned.) Secondly, from the Social Service Index, the worker found that the family was an active case with the family counselling agency. Thirdly, the worker got in touch with the family agency and gained knowledge about Dmitri's home background. It was found that his father had died a year ago, leaving his mother, an older brother and Dmitri with a home and a small street-vendor candy business. Since the death of the father, there have been violent emotion-a l upsets i n the home. The mother, who speaks very l i t t l e English, i s overwhelmed by the responsibility of the business and the care of her sons. Dmitri is a victim of the quarrels between his mother and brother-, who was referred by hss school counsellor to the family agency and after further d i f f i c u l t y to the court. The brother l e f t school, took a job, leaving Dmitri to help his mother in the business. This seemed to be the time when Dmitri f e l t the pressure of home responsibilities conflicting with school obligations. While he was the favored helper of his mother, his relationship with his brother became worse. The fourth step was an interview with Dmitri by the worker. He described himself as being in a trap and was utterly depressed and discouraged. The worker suggested that together they could find a way out of the trap. Dmitri undertook to discuss his problem at home and worker undertook to explore the possibility of getting help for his reading d i s a b i l i t y . A telephone conference with the family worker was the f i f t h s&ep. It was decided that i t would be unwise for the school worker to v i s i t the home, as more than one v i s i t o r would con-fuse and upset Mrs. M. The presentation of Dmitri's school 6 8 . problem to his mother was undertaken by the family worker, who at the outset was doubtful as to the effectiveness of her v i s i t be-cause i t was d i f f i c u l t for the mother to accept counsel. The family worker reported attempts to find other solutions so that Dmitri would not have to work such long hours, but was doubtful i f Mrs. M. would follow through on any plan. As the sixth step, the worker interviewed Dmitri's teacher, who undertook to give-him the encouragement of her willingness to help him with extra homework, but she was puaaled as to how to help him effectively in his reading. The seventh snap was a second interview with Dmitri when the worker found him more de-pressed than ever. Whereas he talked readily (perhaps a l i t t l e hopefully) i n the f i r s t interview, he was less able to describe his problem or see hopeful places of action the second time. In a further conference with the teacher which was the eighth step, the teacher stated that she f e l t Dmitri had been plunged into deeper discouragement by the investigation into his problem and would show less disturbance i f the problem was l e f t dormant. Step nine was when the principal reported no improvement in attendance on Mondays. It was f e l t that, because there were emotional, possibly neurotic factors in the home relationships, the effective thing to do for Dmitri would be to refer him and his family problem to the c l i n i c . * At this point i t was necessary to bring the public health nurse in on the case of Dmitri because i t was her function to arrange a pre-1. The implications in the relationship between the school and the social agency and the effect on the c h i l d of a decision such; as this, w i l l be discussed in the chapter "Bridges to the Resources of the Community." 69. c l i c physical examination and to prepare the social history. The eleventh step was to hold a conference between the nurse, d i s t r i c t supervisor of nurses, and worker as to the most effective way to proceed with the case. It was decided that worker prepare the history from the report of the family worker, again saving the mother from unnecessary interviews. An appointment was made with the c l i n i c for a date two months ahead. The worker got in touch with the family worker again and arranged for a social history to be forwarded, this being the twelfth step. In the meantime, worker looked for resources to give Dmitri constructive help. A good diagnostic reading a b i l i t y test and remedial exercises might be of use to him. But as there did not appear to be these resources for this service, any help in the interim period had therefore to depend on the good w i l l , re-sources and s k i l l of the teacher. The story of Dmitri illustrates several points where help to a child could be strengthened. Whether i t i s the teacher or the p r i n c i -pal who detects the child's problem and initiates the considdratiita. of i t , from the beginning there should be conferences of the combined school team consisting of teacher, principal and school nurse with the desirable addition of the social worker. It may be that decisive action can come out of this group. But i f the family is i n touch with a social agency, any action that involves home v i s i t s should be after reference to the family worker, or court worker, or whoever i t may be, who should be included i n conferences as soon as possible. It is a mistake for the principal or social worker to ask for the help of the teacher or the nurse at a later stage unless they are a part of the-consideration and the plan from the 70. beginning. Poorrelationshipscan.be established between different school personnel very easily. I f constructive measures are taken during the two months before the c l i n i c appointment, the waiting period can be valuable; otherwise, i t can be-highly destructive' i n effect. The school might have gained further knowledge- andunderstanding of Dmitri from the family case worker which would have helped i n the interim period. The question which arises i s : Would the closest kind of cooperative work between the school and family workers have helped i n a significant way, perhaps to the extent of a c l i n i c a l examination not being necessary? What happened was that the shhool worker lost touch with Dmitri as his counsellor i n the attempt to discover where responsibility actually lay. fiaxiia±sjmx«uadcscrx Several services were brought to Dmitri but, as they were uncoordinated, action was taken without sufficient knowledge end Dmitri found himself being managed by agents without being a participating factor i n the decisions so impor-tant to his whole l i f e and future. Follow-up Work: Case Examples Some examples w i l l show how great is the need to follow up even after a child has been brought to c l i n i c a l examination. The two boys referred to in the following examples, were seen by the psychiatrist at the c l i n i c , both having been referred by the same teacher. It w i l l become ob-vious that a v i s i t sometime within the next six months would be an inade-quate follow-up to meet the needs of these two families. Robert, age 6 years 5 months has an estimated intelligent quotient of 100 and was in grade one. Early symptoms of his trouble were those of immaturity. He showed practically no progress or interest i n learning. He liked playing but avoided work. He snowed resent-ment of a l l correctionto the extent of kicking the teacher. For a period of a year he had'shown aggressive tendencies - impulsive and unpredictable behavior-with slight provocation. During his kindergarten year he stripped and jumped on a small-girl. Recent-l y he threw a stone point-blank into a boy's face. These instances have resulted in the community looking on him as a menace. In the home his father i s high-strung,' impatient and aims for perfection. Hjs mother i s slower, patient, even-tempered. His grandfather i s an authoritarian, stressing the play-touch and hit-back lessons. His brother, Frank, two years older, finds his school work easier, and is more easily trained at home and consequently better liked. The parents have let Robert know that they think Frank i s better. At home and at school, Robert likes to be the center of attention. Clini c Recommendation of the c l i n i c was that Robert should earn his promotion at home and at school. Let him see that i f he can do the work he w i l l pass and i t w i l l not be because anyone praises him or likes him for i t . It should f e e l to him that growing up and achieving advances in school and at home i s an impersonal matter, not related to whether he is liked or not. It was suggested that what appeared as a sex act be regarded as not too serious, the result of f a i r l y normal curiosity. Teddy H., a grade one pupil i s 7 years and 11 months old at the time of the examination. He is in the average group i n intelligence. His mental a b i l i t y was probably mistaken as he rated much higher i n the group test (Detroit F i r s t Grade 72. Intelligence Test) than he did In the individual one (Stanford Revision of the Binet Test). He appeared to be out of his depth. His progress was almost n i l . He had no interest in learning and would not pay attention. He seemed pleased when praised, but failure does not seem to bother him. He looks extremely immature, so much so that his birth certificate was checked. The only child of a second marriage, he is-idolized by his mother and father. They are over-indulgent and have "spoiled" him, according to his mother's opinion. He has received no training at home in jobs and responsibility which indicates that he has had l i t t l e encouragement to grow. At school he has played rather than attempted to solve his problem of learning. At the c l i n i c , the recommendation was made that in both areas of home and school Teddy should be helped to take more responsibility and take the consequences of his own actions. His parents were encouraged to expect more of him at home. Given the benefit of a conference with the psychiatrist and sound counsel from him, parents are usually unable to translate the instructions from generality into the hundred specific situations which arise each day. If the advice involves a radical change in attitude on the part of the parents, they very much need the contact with a supporting person with v&xom they can check their successes and failures. This function could be and sometimes w i l l be performed by the worker of a family counselling agency. Or i t could be a worker from the school who would assist the family and would also be close to the child i n the school aspect of his l i f e . She would help considerably to bring the two areas closer 7 3 . together in understanding and help. This i s an opportunity to help the child to fee l that his l i f e i s all-of-a-piece. Two people who have a major part i n his l i f e , namely, parent and teacher, might have entirely different and conflicting attitudes 4b him so that he might well wonder whether his school personality or his home personality were his real s e l f . The school social worker can help the parent and the teacher to achieve common attitudes and standards with which they meet the child and be consistent i n them. In the every-day contacts and problems that arise the child should have an environment that, because of i t s consistency and concern, feels secure to him. This is an essential contribution to his mental health. In Robert's case, i t happened that the worker visited his class-room for another reason. A spontaneous conversation occurredwfcith Robert. His work, which he was doing at his seat, was not taking his thoughts away from the demanding considerations in his own mind. He was "day-dreaming". Suddenly he said to the worker, "My brother burned me so I burned him too. I only meant to burn his finger but I burned his whole hand. I Just put his finger in but i t was a l l over his hand. My brother and I used to sleep with my mother. I was on one side and he was on the other." The worker who i s trained i n psycho-analytic concepts can recognize i n such a casual contact and conversation important and significant information which further enlightens the problem of Robert and his family. The worker would not be in a position to treat such symptoms, but, recognizing that they were significant and that they indicated that Robert was a more disturbed child than was originally thought, would be able to urge strongly that follow-up work be done and a review of Robert's case be made in much less than the six-month period. 74. A few days later, Robert's teacher called in the worker because she was puzzled by his behavior. In the feelings of most of the children, something very special was happening. They were going to make Easter baskets. But Robert refused to perform his usual task of helping t o dis-tribute the material, then in a defiant and troubled tone said that hewasn't going to do i t and teacher couldn't make him do i t . Then-he broke down and cried as i f broken-hearted. The teacher l e f t him to get over this emotional c r i s i s . She f e l t she needed the help of someone to decide whether this was the wise treatment at the moment or whether she should have made an issue of i t , or tried to get to the bottom of the trouble. The teacher f e l t that this was of sufficient s i g -nificance to be added to the record of the study of Robert for purposes of. accurate understanding. The worker noticed that the teacher had placed Robert in the front seat and i n the row that was nearest to her. There i s even further indication of serious-trouble here, suf-ficl e n t to suggest to the worker that Robert's case-should be moved forward in time and priority i n order to bring help to him as soon as possible. Two other experiences i n actual follow-up work for the c l i n i c reveal a need for clower work with the parents not only immediately after the c l i n i c but several months later. Rita H's. problem began as non-adjustment to school in grade one. The recommendation to the parents particularly was to en-courage Rita to a greater degree of self-confidence, and to help her to avoid feelings of shame, fear, and excessive regard for people's opinions as motivation to avoid the danger of developing unwholesome tendencies. U^se. parents decided to put Rita i n a private school as a day pupil, at considerable cost i n relation to their means. The worker made a follow-up v i s i t eleven months after Rita's family had received c l i n i c service. The worker discovered that Rita's problems were essentially the same. ,.~ '. She was weak in reading and was s t i l l unable to concentrate. In addition i t was evident that Rita was following her mother's pattern. Like her mother she showed in a b i l i t y to make friends, timidity and fear of people, particularly of the opposite sex. Cecil P's post-clinic history was more encouraging. This grade four boy had experienced a strong rejected feeling due to the simultaneous occurrence of the birth of a baby sister, the departure of his father overseas, and illness and strain on the part of his mother. Cecil's problem was bullying, yet undue timidity when feigning belligerency. Recommendations included encouragement and companionship particularly by his father, who was back in-the home, and a group experience at the Neighborhood House. The parents made attempts to change their attitude. Cecil's group experience (as reported from the Boys' leader) was not as positive as that of his mother who became a member of the Mothers' Club at the House. When the worker got in touch with the leader of the Mothers' Club she found that consideaable help had been given to both Mr. Mnd Mrs. P. by the consultant-psychiatrist. Cecil's mother is a happier person and she feels that there i s definite improvement, but reports that Cecil s t i l l i s cruel to his sister. At school he i s an attention-seeker and s t i l l exhibits his old pattern at times. Mrs. P. has been receiving encouragement and confirmation of her efforts with Cecil from her group and the leadership provided there. The teacher and school personnel might have been included so that they too could have the same attitudes to Cecil and plans for him. It would appear 76. that Cecil's needs called for an intensification of efforlj and the school in cooperation with the group-work agency might have helped to provide t h i s . The four cases described above demonstrate a great need for the services of a social worker to act as counsellor to the parent in the every&day problems of treatment, evaluation of their efforts, support i n the d i f f i c u l t task of changing attitudes, and more refining of the problem of discipline i n the home. In every case, the mothers admitted that many times a day they were puzzled as to whether they had treated a particular incident wisely or not. The social worker cannot do the total job of parent education but again may be the supporting person to the parent, and the one who by her liaison function can use established services or establish new ones, whether the social worker should be on the staff of the school, or whether the s chool should have very close relati ons ( so close that the effectiveness is assured) with a family counselling agency, is secondary to an acceptance of the present needs viiich indicate that a l l resources possible should be used to f i l l the gaps just described. The combined services of the schools and the child guidance c l i n i c may not be sufficient f o r Warren B., an eight-year-old boy i n grade one whose intelligence i s rated as d u l l normal. The account of Warren's case is presented from the f i l e s of the Mental Hygiene C l i n i c . A.1 Much of his school behavior was f e l t to be symptomatic of more serious trouble. He avoidsttalking with adults, daydreams and takes small objects from the children. His taciturnity and impulsive actions suggest serious disturbance. At home he has taken money from his mother's purse. His parents describe him 77. as stubborn, slow to obey, frequently disobedient and evidently not concerned. Warren's real problem centers around the home situation. His mother basically rejects Warren and is resentful of the work involved in the home. There is a bed-ridden grandmother, a bossy aunt and a six-year-old sister who has nocturnal enuresis. Another sister age ten is in a g i r l ' s boarding school because she is d i f f i c u l t to manage Warren's training includes spanking with considerable ceremony and threatening with the devil i f he doesn't say his prayers. The c l i n i c recommended that Warren be placed in the special clas and given individual attention at school. Further recommendations included encouragement and reassurance both at home and at school; a change in the home arrangements; a change in his mother's attitude; and treatment in a psychiatric institution for children i f there were one. The school was able to implement i t s part of the recommendations bgrcause i t has the added f a c i l i t i e s of a special class where i t is possible to give more individual attention, particularly in the regular school lessons. Five-months later, with no records of any follow-up work done in respect to the home situation, one wonders what progress there has been with such d i f f i c u l t recommendations, and what Warren's fate w i l l be. Without the SaJelp of a v i s i t i n g teacher of social worker as li a i s o n person, he may not profit from any further services and resources of the community. It would be the worker's function to explore the avenues of further help and assist the parent to make the move for further help, which may come from treatment resources at the Child Guidance Clinic or from a private doctor. 78. The Preventive Emphasis The social worker i s particularly interested i n discovering where preventive work can be done. It has been generally accepted that grade one is the happiest year in a child's school l i f e . This may be true for c h i l l -dren without any major d i f f i c u l t i e s in adjustment but far those who have problems this f i r s t year of school may be the beginning of a long period of maladjustment to school l i f e . It is worthwhile repeating that there i s an increasing number of emotional problems among the children who are just beginning school. This i s the f i r s t test of their maturity or immaturity in which another institution than the home makes demands and sets standards for them. Therefore, there i s no place as valuable as grade one or kinder-garten in which to detect weakness, the remedy of which prevents major trouble later on. Donald M's. problem illustrates how serious a trouble can become even at the grade one level. His case was described i n chapter five on attendance problems and again i n Appendix B. A brief summary i s given here. Donald's problem was detected as absenteeism with the additional application of his teacher for help with his poor school achievement. Immaturity, poor school performance, and physical i l l n e s s became inter-twined, the one affecting the others. These psycho-somatic complications brought con-fusion into his home l i f e as well as into his school l i f e . Donald must have f e l t confused as to whether his trouble was physical disa b i l i t y or failure at school. His mother was also confused u n t i l the physical disorders became so serious and obvious that they took p r i o r i t y . 79. A conference of the parents, teacher and principal at this point would result i n an understanding and plan of action which might help Donald to have a more successful experience at the beginning of his school l i f e . A decision, commonly arrived at, understood and accepted, might be to leave Donald i n school but reduce the pressure on him or to take him out of school before the term i s over. This would mean that he would repeat grade one, a fact which his mother w i l l accept. If this minimum of understanding were not arrived at, two things might happen. Either Donald would rmain at school, where the teacher would carry on i n her normal way, including,as time f o r promotion came, added pressure which most of the children are able to take; or he could be referred to the attendance department which would mean unnecessary pressure on parents-who did not require i t . In either case, Donald's failure and further strain would u l t i -mately affect his present health and his whole future school career. It would not be long before he would be a case for the c l i n i c and possibly more serious disturbance would, warrant psychiatric treatment. The presence of a school social worker at the point where Donald's trouble f i r s t appears,^ makes i t possible to give assis-tance to the parents at the desirable earlier stage before the problem deepens and the complications become more serious. The central aim of the Mental Hygiene program is to reach as many children as possible at waatever stage their problem has developed. It is designed as a public service to a l l children and consequently needs the organization and staff which can deal with problems at a l l levels of 80. •Intensity. The social worker who comes close to the child and his problem when i t f i r s t appears w i l l bring resources to him at whatever level of intensity of treatment is needed.^/Phe c l i n i c needs a supplementary staff to screen cases so that only those whoj require special t^reatment [are brought to the psychiatrist and so that the cases whftch are brought to c l i n i c are done so after a period of careful preparation. The school needs the help of trained case-workers who can prepare social histories. Teh parents need a counsellor at this point to make this experience one in which they do not f e e l inadequate and insecure but one which M i l have positive and constructive value for them.- Above a l l , the child who i s to receive the services of the c l i n i c for himself and his family needs a counsellor who can interpret the experience to him so that he becomes a participating and contributing client i n the whole procedure. 8 1 . CHAPTER SEVEN COOPERATING WITH THE PUBLIC HEALTH NURSE Defining Areas of Function, and Cooperation In the Vancouver School system, the public health nurse i s the main lia i s o n person with the home. Within the limit of her time-table, she makes v i s i t s to the home on purely health matters, i n cases where there i s a mixture of health and other factors, and for the purpose of getting a social history for Mental Hygiene Cl i n i c cases. As a result she i s familiar with the home conditions of a large number of children. However, the public health nurse does not make home v i s i t s i n connection with absenteeism un-less the case is clearly a matter of health or sanitation. Nor i s she asked to make home v i s i t s arising out of school learning or disciplinary problems. The teacher and principal do what they can when iMisinecessary-V xaxardaxxto interview the parents. When the social worker comes into the picture, there i s l i t t l e d i f f i c u l t y in defining her function as an assistant to the principal and the teaching staff. But there can be overlapping (and consequent f r i c t i o n i s possible) with the work of the nurse unless the two functions are clearly defined. This can be true especially in psycho-somatic cases. Not realizing the exact nature of many absentee cases, the principal or the social worker may v i s i t a home and discover the essential cause to be a health problem. The fact that a representative of the school has already 8 2 . interviewed the parent or been to the home makes i t d i f f i o u l t for the nurse to make her contact with the family. Besides, she may have had some previous contact and have a history of the school's relationship to the family. There is a simple answer, however. The criterion for decision on matters of function and jurisdiction must be the welfare of the child end his family; i t is not the status of either profession. Just as there needs to be the closest coordination of services between two or more case-work agencies which come in contact with one family, or between a case-work and a group-work agency viiich happen to serve one particular child, so also the closest cooperation is required of the various departments of the school and the personnel who have relationships with the child and his family. In the school setting the situation i s the same as i f there are several agen-cies, and the term 'social work' i n effect broadens to include a i l the services given by t h i s public institution to the child, not merely as a pupil but as a whole person. There is a known -Instrument of cooperation; i t is the conference method. The point at viiich i t should be used i s before any action of any kind i s taken. After a conference, the ensuing action contains more under-standing of the case and i s taken with the knowledge of a l l concerned. This is particularly important in the work of the social worker and the public health nurse. Liaison with the Home The public health nurse is an accepted person in the community and her functions are understood. She is a member of a profession which 83. has survived beyond i t s period of probationship i n the estimation of the community. Doctors and nurses are welcome assistants to parents. Chil-dren, like their parents, can understand the concern of the community, teachers, and nurses for their physical health. The school nurse has a natural opening with each child and home and is often able to use the occasion f o r gaining enlightenment into other aspects of the child's or family's l i f e . A conference with the nurse before any home v i s i t is made may make the social worker's, or teacher's v i s i t unnecessary, or may give i t greater pointedness of purpose. It may be decided that as the nurse i s planning a v i s i t soon i n regard to another matter, she can include the purpose of the social worker's v i s i t , or vice versa. It is never wise to have families f e e l too much pressure from the school. It may be decided that i t would be valuable to have a second v i s i t o r go to the home, because the needs of the family warrant i t or because new knowledge and a new approach i s needed. It may be that the problem of this particular child i s definitely the concern, of the nurse or of the social worker only. What is important is that there should be common knowledge of the problem and of the actions taken. And as the older profession and the newer profession as related to the school program work together, over a period of time the functions of each w i l l be f i r s t defined and then refined to the point where more efficient handling of children with specialized problems is achieved. Case Examples A few examples w i l l show the need of taking the utmost care in regard to the relationship of the school nurse and social worker and i n the 84. relations of these two and the principal to the family. The following four cases have already been outlined i n chapter five and f u l l details of the case of Donald M. i s in Appendix B. They are recorded here for the purpose ofi demonstrating the cooperative work of the social worker and the nurse i n the attempt to define their functions in the interests of the chi l d . The principal having reported that the nurse had refused to v i s i t the Morgan family any more, the social worker visited the home about the absentee problem. She found the problem to be largely a health one - tonsils, " f l u , for which they were under the care of a private doctor. There was water a round and under the house, which was a matter for the c i t y sanitation and health department. In conference with the nurse (who was new on the-staff and did not know the family) i t was decided that because there was an additional reason for a v i s i t from the nurse, (namely, in connection with the services of the B e l l Baby C l i n i c ) , i t would be wise for her to make the next c a l l on Mrs. M. This v i s i t would f e e l to Mrs. Morgan a logical development in view of the fact that the social worker had already mentioned the possibility to her. In conference about Dmitri M., i t was decided t hat as the social worker had had the i n i t i a l , contact with Dmitri on the question of his employment and school progress, she should con-tinue her relationship with him and help prepare him for the experience of the c l i n i c . She was also to keep i n touch with the family worker i n cooperation with whom the social history 85. would be gathered i n preparation for the c l i n i c . In Keith K.'s case there were a number of complicated prob-lems. These included absenteeism, due to i l l health and the need at home for supervision of a small s i s t e r because of the mother working outside the home. When the school demanded higher stan-dards of attendance, the result would be conflict and emotional disturbance in the boy. In conference i t was decided that the social worker would try to see the mother at her place of employ-ment. The next step involved the nurse to determine how urgent the tonsilectomy was and to refer Keith to the outpatients' department of the hospital. Due to circumstances that could not be helped, the nurse was not able to follow through on this plan. As there were sufficient indications that the K. family needed the services of the Children's Agency which had been in touch with the family previously, and as help toward hospital services could be obtained there, referral was made to the agency. But this was done without a sufficient relationship being established be'tw-eeh'MrsS'K.fand Ihe school personnel. As an explanation for this, i t might be said that when a family's problem shows up through the children in school the repercussions are so strong throughout the school, that there i s an urgency to get action for solving them. The psycho-somatic nature of Donald M.'s problem might result in either the social worker or nurse working with the family. As an effective plan for Donald must include a decision about his school career, i t is important that the kind of conferences be had with the teacher, principal and nurse which w i l l include the feelings and gain the cooperation of Donald's parents. The social worker would perform such a role. With the knowledge that is at hand about Donald, i t i s possible that one conference between the parents, teacher and principal and some careful counselling,will save Donald further years of illness and fa i l u r e . Even when a l l concerned are convinced of the value of the i n i t i a l conference (as well as further conferences) between the school team of workers, i t w i l l s t i l l be d i f f i c u l t to effect administratively. Each has a f a i r l y r i g i d time-table; i t w i l l take clear understanding and a strong desire to do cooperative work to enable a l l three or four of the school staff to achieve the simple physical deed of getting together. As jrhe administrative head of the school, the principal i s an important agent in arranging or ignoring conferences. 87 CHAPTER EIGHT SUPPORT TO THE TEACHER The Teacher's Focal Position It is a simple truth, but one which needs re-saying, that the teacher is next in importance to the parents in every child's l i f e . This is not merely because of the number of hours spent together, nor merely because of his contribution to the child's intellectual growth, but because, through him, the child's general attitude to the adult world i s being b u i l t . It is true that the teacher may be a mental hygiene agent i f she can accept the child who has a pattern of negative relationships with adults already established. If she understands the background of the nega-tive attitude and does not allow herself to react in such a way that she i s rejecting the child, she can profoundly alter the child's psychological pattern. She may be the f i r s t one who consistently gives the child a positive and non-judgmental acceptance that w i l l at least cause him to f e e l that a l l adults are not the same as those through whom his earlier negative attitude was established. In a school social work program, the teacher i s the focal point. Next to the parent, and more easily, because she is less (at f i r s t , not at a l l ) emotionally involved with the child, she can be the one who detects incipient trouble and becomes the preventive agent before the maladjustment reaches serious proportions. 88. The majority of teachers are concerned with the t o t a l welfare of each child i n their rooms. In the f i r s t years of teaching they often have the energy to be aware of many aspects of the child's l i f e , and to explore his background and interests outside of school. But, not having the time to keep up an intimate knowledge of each pupil and becoming more and more preoccupied with the demand s of the curriculum and the newer methods of teaching, many have to give up some of their more varied interests in the lives of the children. Even so, the teacher is often aware of a l i t t l e know of emotional tension sitting there i n the class-room. But, unable to give the help i n each case that she would want to give, she feels discouraged and then some-times resentful 4f the continuing problem seems to be a threat to the smooth to running of the group and her Astatus with i t . The most discouraging aspect of the problem child in the classroom is the fact that the problem seems to be continuous and always with her, to face day after day. L i t t l e Johnny who is weak in reading or who daydreams in November i s s t i l l weak in reading and daydreams in May. Sometimes the teacher sends her problem to the principal, but often just to the back seat. Here i t won't be too near the teacher's notice, where i t hurts because there doesn't seem to be any movement toward the solution. The remark has not b s s n infrequently been made by an experienced teacher: T used to worry about dirty ears and absences and poor effort, but now I just don't bother any more and go ahdad every day teaching the best I can." Teachers often feel inadequate when faced with parents who are worried about their children and helpless to see a real solution which both of them can tackle together. Sending homework home is a gesture of cooper-100. ation but the teachers know that in many cases this creates new problems rather than solves the old ones. The result i s that one hears teachers say "I don't want to see the parents of my children. When I do, I find that instead of seeing the child, I am seeing the parent." Perhaps the teachers should not be expected to have a relationship with parents, but when one lookss at this from the child's point of view one knows that i t means a lot to him to have the two most important adults i n his l i f e know each other and be friends rather than be separated to such a degree that he feels conflicting loyalties. The ten-week period of experiment and demonstration in this study did not show the teacher to be the focal point of the school social worker's job. But th i s was because of the limited time only. The worker must prime a r i l y be an assistant to the teacher and the teacher is necessarily the point of i n i t i a t i v e i n referring insi pient as well as f u l l y demonstrated problems. It takes time to build up the required relationship of confidence between the two members of this important team of workers in the service of the c h i l d . The social worker must a t f i r s t prove herself to be en effect-ive assistant and work with the attitude that she serves the teacher rather than make the teacher f e e l she (the teacher) is the one who gives information to build up the worker's picture of the child while often not permitted to get the total picture herself. It w i l l take time for the worker to help the teacher understand the kind of symptomatic behavior which can be detected by her, referred to the worker and then understood together as they learn the meaning of the behavior to the chi l d . It may appear to the teacher who has a very real interest i n the individual child and who would do individual work i f she had time, that the worker i s en-croaching on her territory and she may be resentful of thi s . This i s par-101. t i c u l a r l y n l i k e l y i n those frequent cases where there i s unconscious mother-emotions from the teacher to the c h i l d . The desirable and sound working policy i s to build up confidence by getting some movement i n the problems that are school-centered or home-centered rather thanc lass-room-centered; or by helping to solve the prob-lems that the teacher finds are too much for her and which she has referred to the principal; or watching for the occasions when the teacher asks, perhaps casually, for help in something that i s puzzling her and using this opening to promote team work. Case Examples Some case examples show the type of problem for which the teacher and worker needed e ach other's help and sought a working relationship. Among Dimitrl's problems ( case outlined in chapter six) was hi his poor a b i l i t y in reading and related subjects and his nervous panic on tests. He f e l t the need of extra coaching from his teacher. Failing to get for him sci e n t i f i c diagnostic treatment of his reading d i s a b i l i t i e s , and feeling that he needed some encouraging help and the good w i l l that goes with i t , the worker considered these needs with Dimltri's teacher. But as this was the worker's f i r s t and only planned interview with the teacher, there was no progress toward a continuous teamwork that would benefit Dmitri. The teacher later f e l t that Dmitri had been upset and that his hopeless discouragement was a greater d i f f i c u l t y for him and for her in the classroom. Craig S.'s grade three teacher asked the worker to help her solve a mystery which concerned her but which she had not time to investigate herself. Craig had the name "S.1* i n school records but his mother went by "M." He had been absent with pneumonia and returned with a note from his doctor giving him the name of "IF, and a note from his uncle which was signed with a different name again. He stated that he was now staying at his grandmother's home which was not i n the school d i s t r i c t . Such a confusion of addresses and identity is sl i g h t l y annoying to most teachers with the result that the child is looked on with some suspicion and is often hurriedly subjected to ques-tions, a performance which shakes his security. Often there i s no damage done i f the teacher or principal have the particular type of personality that i s warm and sufficiently slow in tempo to give the child assurance. The social worker is trained to consciously use these qualities as her professional equipment. Seven year old Jerry D. was in the Special Class. He and his two older brothers had been seen by the psychiatrist at the c l i n i c . The recommendation for Jerry was that he be placed i n a temporary foster home placement in the country. This decision was based on the fact that the home was an unstable one partly because of the mother working f u l l time. The children have inadequate supervision but his brothers did not show the symp-toms of disturbed personality that Jerry d i d . The Children's Aid Society who referred the family to the c l i n i c assumed the responsibility for carrying out the suggested treatment. 103. When vi s i t i n g the classroom two months after the c l i n i c a appointment, the worker found the teacher concerned about the future of Jerry. She wondered i f any moves had been made toward placing him in the country. She reported that Jerry had no playmates because he i s unreliable and rough. He does not work well with a group, i s unwilling to share and likes to dominate. He goes to great lengths to be in the limelight (even to deliberately scratching his finger) especially when visitors are present. Recently he has formed a clinging attachment to a small g i r l in the class. Besides being curious about the sequel to the c l i n i c report, the teacher f e l t i t might be important to consider Jerr's condi-tion two months later. She f e l t fthat she had valuable knowledge about Jerry that the social agency working with the family could well use. It was the social worker's job to arrange a closer pooling of these resources for the benefit of Jerry. Robert D.'s teacher asked the worker to consider with her the audden outburst of emotion that Robert demonstrated in the class-room. He had burst into tears and defiantly refused to p a r t i c i -pate i n a gay class project of making Easter baskets. Knowing that he had been to the c l i n i c , the teacher was careful to be aware of symptoms that would indicate the subsequent state of Robert's mental health. She was puzzled about the meaning of such behavior and questioned whether her treatment of the episode had been sound. Teacher-Social worker Team It w i l l be a step further than the one l a t t e r l y described which w i l l demonstrate the basic function of the social worker in the school. 104. It w i l l come about when the teacher has sufficient confidence and security both in the relationship with the social worker and in her own knowledge of the type of indicative behavior to refer. Depending on the administra-tive set-up, the teacher w i l l refer her problem through the principal or to the counsellor directly. She w i l l be the key person in the f i r s t con-ference and w i l l be kept in close touch with the knowledge about the child and his family as i t i s developed by the worker. No action w i l l be taken u n t i l there i s joint decision on the part of the teacher, principal, nurse and social worker who w i l l represent the home team, the child and his parents. Further along in the developing relationship between the social worker and the teacher, i t w i l l be possible f o r the worker to present some of the children's d i f f i c u l t i e s with and resentments toward their teachers. The more one works with children, the more one i s amazed at the lui-ga number and magnitude of the misunderstandings that can worry them. De-pending on the individual situation, the worker may discuss the particular child's problem with his own teacher, or she may deal with the matter generally by presenting i t in a course of training or workshop for teachers and social workers. Many of the children's statements should be ignored or kept confidential; some of them should be checked carefully as there may be some valid i t y i n their c r i t i c i s m of certain teachers or some gross misunderstanding; some of them should be studied and interpreted i n light of the child's history at home and elsewhere of his relationship to adults. Arlene F. (case outlined i n chapter nine) has a history of antagonism toward adults which began in her home. Some aspects of her resentment toward teachers should be seen in this 105. perspective. The following statements may i l l u s t r a t e . "I don't like the way Mr. T. yells at us. His voice gets louder.and louder i f we can't understand what he is talking about." The worker explained that a teacher is a human being and when he or she is disappointed that some work i s not clear to his class, perhaps he has to show some feeling; he isn't perfect nor i s he a machine without feelings. Arlene.said that some teachers bang the book shut or bang i t on the desk and that is better. (It should be noted that Arlene reacts to shouting and that Arlene's mother has high-pitched tones i n her reprimands of her daughter.) Some resentment was expressed toward a teacher who seemed to b e l i t t l e the efforts of Aclass, as Arlene questioned, "Why does she want us i n the play i f we are so bad?" Another teacher called forth resentment which w i l l be very d i f f i c u l t to erase when she said on an occasion when the pupil was not prepared with the required equipment, "Oh, I know your family, they are a l l the same," (with the obvious implication to the child that they were a l l bad). The pupil said to the worker, "Miss D. doesn't know my . family. She has never met my mother and father." It i s a common f a i l i n g of teachers to throw out thoughtlessly the b e l i t t l i n g or negatively c r i t i c a l remark which i s destructive rather than the carefully chosen worS of encouragement given to each individual child at his own level of achievement unrelated to the higher standards which the teacher has set and which other children can attain. It i s a common d i f f i c u l t y of teachers to find the opportunity to speak to each individual child even once a day in a way that makes him f e e l recognized and included. Training Workshops for Parents, Teachers and Social Workers In a program of education which would include both parents and teachers, i t w i l l be the aim of the social worker to include topics of common errors i n attitudes of adults to children, and point up the con-structive att itudes which i f practised i n common by the two or three most important adults in-his l i f e , w i l l provide the greatest security for a chi l d . 106. Some of the simplest but unconscious and destructive attitudes might be included. An example i s that of two adults discussing the child in his presence and over his head, physically and metaphorically speaking. This can happen i n any casual conversation between the worker and the mother, the worker and the teacher, or the teacher and the mother. State-ments such as, - "He always puts his answer down before he thinks," or 'Dbhnny is a good l i t t l e boy but he won't concentrate," are made hundreds of times daily. The child is immediately affected by this estimate of him and from then on a limitation i s set for him. A frequent mistake is that of having the child think that the love and approval of his parents or teacher depends on his achievements. "I don't like l i t t l e boys who make up words when they are reading," "Mummy doesn't like l i t t l e g i r l s who are untidy or who dirty their clothes," are examples. Commonly, the child i s praised ("You're a good boy, Jimmy") instead of the job he has done ("That's a grand pile of wood there, Jimmy"). This has disastrous consequences when the time comes, as i t surely w i l l , that Jimmy forgot his job of piling the wood or did a hurried one that was a f a i l u r e . A| such a time he w i l l f e e l that the disapproval of his father and mother is disapproval for his 'whole person, just as he had been previously te en approved as a good boy. Adults unconsciously throw out negative remarks toward children which are destructive. "I'm surprised he is as good as he i s " , is not the most adequate comment to make in the presence of a small boy who has tried his best. These and many other illustrations of a basically negative attitude to children can be understood by teachers and by parents. But 107. the opportunity for interpretation and easement i n particular cases are not l i k e l y to he met i f time and personnel are lacking. By making her contribution to the resources of knowledge available to the teacher and the parent, the social worker in the school would hope to assist in pro-viding the child with a more secure emotional environment in which he can grow. 108. CHAPTER NINE THE CHILD AND HIS HOME Goals of Counselling It i s in the relationship of the social worker with the i n d i v i -dual child that some long-term goals of the program w i l l become evident and where effectiveness w i l l be developed over a period of years. How far can the goals of this relationship be generalized? The following appear to be valid, general considerations: (l) to help the child become free of the dominance of impulse in his l i f e and to gain i n -creasing control of his own feelings and actions; (2) to help him become aware of his own mechanisms of behavior and gain sufficient insight to become increasingly his own guide; (3) to help him become an active, i n i t i a t i n g and responsible agent i n his own l i f e and to become an active agent aver more in control of his environment rather than a passive person who i s pushed around by circumstances} (4) to use his relationship with the social worker in such a way that he w i l l be able to make positive use of other relationships in has l i f e ; (5) to encourage the child's articu-lacy and expressiveness about his feelings rather than to repress them to the extent that he becomes inarticulate and taciturn. The methods to these ends, that the social worker w i l l use w i l l be determined by the degree of awareness and acceptance of these goals by our culture and more particularly by the personnel of the school. :om. In the primary grades, undisturbed and even somewhat disturbed and neurotic children st i l l have the ability to relate quickly to an adult who is open and friendly. Their relationship with their teacher can he a natural and easy one i f the teacher sets the tone this way. With a minimum of encouragement, depending on the time and ability of the teacher to listen to him, the child will state his feelings. The teacher will be able to bring significant knowledge to any conference which has the child's reeds under consideration. The social worker's relationship to the child will widen the child's experience with adults and supplement the knowledge of him gained by the teacher. The aim with all children, but particularly with the younger children, will be to increase their experience of confidence in adults. Methods of Counselling The social worker will use two methods in her work of helping the children. One is the direct face-te-face interview. This will be more successful if a spontaneous and friendly relationship is established earlier, The second method is to establish the more natural relationship through the child and the worker meeting in a situation where there is some equal par-ticipation. It is extremely important that the child should feel the work-er to be a friendly person, and a friendly counsellor rather than a judge or investigator when he is in trouble. During the present experiment it was evident that in a few months a development could take place in the dir-ection of the children initiating interviews with the counsellor rather than waiting until the counsellor found reasons to call them for an interview. Some examples will illustrate the kind of approach the worker tried, in her first contacts with the children. 1 1 0 . • Robert D. (oase outlined i n chapter six) was not known by the worker before his referral to the psychiatrist. She was introduced to the grade one class by the teacher, as a friend who was interested i n children and a l l that they were doing. Robert's disturbance was sufficiently severe that he was able (perhaps 'impelled' i s more accurate) to t e l l his troubles on f i r s t acquaintance. He told of bnrning his brother's hand and of the good times he used to have when he and his brother slept with his mother. In the kindergarten room, the worker found an apportunity to heip the teacher with an Easter party project and thereby learned more about several children and particularly observed the two most recent newcomers to the class and noted their adjustment. The worker's attention was called to the unusual behavior of a child i n the lunchroom. She had been the topic of much dis-cussion among the mothers who were on duty i n the lunchroom. On the days when she took her lunch at school, she brought forty cents, ordering 3 servings of lunch and three or four cups of cocoa or other drink. She would eat i n a grasping and greedy manner at firs-Jj then leave much to be wasted. The worker had not been able to study this case but saw an opportunity to do so, not by using the direct interview method at f i r s t , but by establishing a relationship with the g i r l in the lunchroom, when the worker could be eating her lunch too. It was evident that a working relationship with the supervising mothers of the lunch-room would be very helpful to some children and mutually beneficial to both the metiers and the social worker. 111. When a rrember of the school staff i s trained to know the meaning of symptomatic behavior(like Robert's day-dreaming preoccupations and sudden emotional outbursts,or the eating habits of the l i t t l e g i r l in the lunch-room), she w i l l be aware of the meaning of this pattern to the child and be able to interpret i t to the teacher or supervising parent. Perhaps she w i l l need the information to add to her interpretive picture of the child, which she is building up for purposes of diiagnosis, referral, or treatment. Types of Interviews A case example w i l l i l l u s t r a t e the importance of the f i r s t con-tact which the worker has with any child. An i n i t i a l relationship was made with Tommy Yen, a Chinese boy in grade f i v e , for the pmtpose of getting the information for a survey of the employment of children attending school with which the worker had assisted the principal. When Tommy was invited to the worker's interview room, he was delighted to talk about his new paper route. In the course of the conversation, Tommy gave significant and useful information about himself and his family. He spoke of his father as a natural member of the home and the worker made a note of the fact because the school's last knowledge of the family had been that Tommy's ijiother was divorced. Tommy gave evidence more than once during the talk that he was extremely sensitive about his race and sometimes suffered at the hands of his companion paper boys. He and another young boy go early to the supply hut so that they avoid the bigger boys who intimidate them. Tommy told of the help and support of his mother who gets up at four a.m. to give him a cup of hot cocoa and stays up unti l he comes back from the supply depot to help him fold his papers. Tommy got into trouble. Complaints were l a i d by a mother about his experimenting with sex language and gestures and making rude suggestions to the g i r l s in his room. The worker f e l t that 112. a sufficiently positive relationship had been established during her f i r s t contact with Tommy j so that a direct interview with him would not immediately cause him to go on the defensive. Tommy's a b i l i t y to talk out his problem held through this interview and he was willing that the worker should see his mother and make plans together with her. The sequel was that the worker visited Tommy's mother, gained understanding about her il l n e s s and her second marriage and learned that she was a former pupil of the school and wanted very much to be a participating member of the pa rent-teacher organization. The worker was able to modify the shock to Mrs. Y. that such reports always have for parents, with the result that she would not meet Tommy with an attitude of complete shame and disapproval. Mrs. Y. undertook to get Tommy the information he needed in regard to sexual matters with the aid of the family doctor. The worker took r esponsibility to get information about the Y.M.O.A. program for boys, seeking the experience for Tommy in vhich he would f e e l accepted by a number of boys, because his mother's real worry was that he did not easily mix with children his own age. The direct interview method can be used immediately with older children, and with a l l children as they become gradually accustomed to i t . During the present study, i t was clearly demonstrated that there was progress i n the second and third interviews i n respect to the ease of the child and his degree of articulacy about his problem. Two edbamples w i l l show this progress, which i s sometimes quite slow. 113 Ellen Brown (case summarized i n chapter five) was able to describe her feelings about her problem extremely easily i n the f i r s t interview, so much so that the worker f e l t that the problem was f a i r l y clear to her. It was during the second interview that new and major factors were brought out when Ellen described the tragedy of the death of her small s i s t e r and the effect on the different members of the family, including her father and herself. Douglas 0. had been referred by the principal for petty pilfering after having been involved in some stealing episodes in the community. The principal had suspected him of taking lunch tickets. But he had no conclusive evidence and Douglas denied everything. The one bit of evidence that was sure was that the. principal found Douglas going through the pockets of the coats in the cloakroom after everyone had gone out at recess* In Douglas1 f i r s t interview with the worker, there was no recognition of the problem. He was quite inarticulate, justanawering Yes and No to whe worker's statements, or more often "I don't know." Knowing that he was a member of a Cub pack ( information gained from the survey of leisure time activities, described i n chapter four), the worker used this as a starting off point. Douglas described his situation, voluntarily, in connection with Cubs as "I don't think I am doing so well." The worker approached the school problem as a matter of building up the confidence and trust of other people i n him. Douglas said he wanted that. Worker helped him to see and express that his actions of snooping around in places that belong to other people would not help toward' that end, and suggested that she would help him to f i n d ways to be i n control of such desires. She suggested that he could feel free to come to the worker's room at any time. Perhaps he would have a week when he f e l t that people could trust him. He could come and t e l l the worker that. Or perhaps he would f e e l that he had made some mistakes. He could come then too i f he wished. She gave him a particular time to see her. 114. During the second interview, Douglas didn't have any report to make one way or the other but was able-to t e l l the worker something about the episode he had been involved i n when some boys took some army supplies. Douglas did not come voluntarily but only when the worker.saw him in the h a l l and encouraged him to come again. The. worker made more definite arrangements with Douglas, and his teacher so that he fe l t freer to come the next time. But in the meantime, the principal- sent him for an interview, which took place i n the principal's o f f i c e . Douglas was not so tight-mouthed and s t i f f l y on the defensive. He was more relaxed and could look directly at the worker as he talked. He said that talking was easier now than during the other interviews. The worker knew from a talk with the family agency v i s i t o r that there was d i f f i c u l t y i n the home - the father an alcoholic and with uncertain employment, whose relations in the home were weak. Douglas' mother was cooperative i n her attitude but did not know how to cope with her family of three boys, ages ten, twelve, fourteen and two g i r l s , ages four and fif t e e n . The school worker found that the mother is encouraged by and relies on other community resources such as the Boy Scouts and the school to help with the training of her children, and she does a l l that she knows to f u l f i l her responsibility to these agencies. Realizing that Douglas' stealing might have deeper pscyo— logical significance, the worker f e l t that a l l the positive resources might be t r i e d f i r s t before any direct treatment. She got in touch with Douglas' Cub leader i n order to gain co-operation from him so that they together might plan situations where Douglas' positive wish of being trusted could be supported and practice given to him to strengthen his trustworthiness. The worker's plan for Mrs. 0. was that she be brought i n to the 115. plans for Douglas and that she be encouraged to become more closely related to the school through the parent-teacher organ-ization, including the lunehproom a c t i v i t i e s . Arlene a grade six pupil was within a month of being fifteen years old. She was referred to the worker because of her extremely poor relationships to the teachers and schoolmates, and for her influence on other children by talking and writing on the subject of sex. She was making no effort i n school and would be sent on to Junior High only because of her age and unsuitability to stay on with younger children. She was anta-gonistic toward the teachers and i t seemed to them as i f she tried to be deliberately rude, by talking and disturbing the classroom. She was put off the school volley-ball team. One lady teacher was concerned because she had heard that Arlene and her friends attended public dances regularly. Arlene*s antagonism to a l l adults was intense. Yet i n two interviews, the worker gained her cooperation to the extent that Arlene welcomed the idea of the worker v i s i t i n g her parents. It so happened that her mother had a severe heart attack the day before the v i s i t and Arlene had to be kept home u n t i l other arrangements were made. When the worker called, Arlene said, "I was thinking you might be coming today." The worker thought this statement indicative of confidence and that Arlene showed further trust when she said that she f e l t she could be friendly enough withthe worker to make plans together for her future. The worker's plans to help Arlene included: cooperation with her club leader at the Neighborhood House; assistance to her and her parents i n making plans for the immediate months ahead which involve decisions as to whether Arlene should f i n i s h the school term, quit school, get some vocational'training or go to her brother's ranch. The last was:..the planopreferred by Arlene but the il l n e s s of her mother has introduced a new consideration. A l l plans would be secondary to the importance of working on the basic problem of Arlene's relationship to people, by helping her to a new experience with an adult who in the role of a friendly counsellor w i l l use the relationship consciously to assist Arlene in re-shaping her attitude to adults. « * M Sheila A., age six years seven months, had been in grade one for six months. She i s an only child of parents who have connec-tions with the educational world through relatives. Her parents -interviewed the principal because they were disappointed and dissatisfied with Sheila's progress, feeling that the teacher had some responsibility in the matter. In school, Sheila was described as inattentive, with poor study habits, seemingly immature, disturbing others by talking and leaving her desk. The worker visited the classroom, finding Sheila i n the back seat,-her desk a hopeless mess so that she was unable to proceed with her work. Sheila asked the worker who she wa s i and when the worker explained that she was someone who visited mummies and daddies, Sheila immediately asked i f she would [<pb to see her mummy. ' The worker promised that she would. The ensuing v i s i t to the home revealed the need of careful counselling to the parents, because of their overprotectiveness 117. of Sheila, their only child and also because of the pressure of their ambitions for her. The worker f e l t that soloe adjustment was desirable in the school situation. Sheila's needs were not to be ignored, but to be given more warmth and even more protection. Theaaim would be to create a greater balance, - progressively less protection at home and a sufficient degree of protection in the school situation to carry Sheila forward to the next step of responsibility and maturity. Douglas* and Arlene's cases show the possibilities i n a progressing relationship of the children to their counsellor (as the social worker i s to them at this point). It i s a new experience for most c h i l -dren, and they need to be helped slowly and gradually to use this relation-ship constructively. It cannot be taken for granted that they w i l l be able to make effective use of i t immediately. Sheila's case shows the f i r s t steps i n the building of a counselling relationship with any chi l d . It is a common experience for Children to have things happen to them for which they have had no explana-tion. The basis of a successful relationship with a child i s to give him the security of knowing "what the score i s . " Starting from the school situation, an error can be made in giving the child the feeling that the school i s against his home. It is important to recognize that the family bond i s the stronger one and there must be no sign of criticism u n t i l the child i s free enough to see the needs of the family and welcomes help. A further error is to have the worker seemingly a l l y himself with a l l adults against the child. It i s important to fi n d the techniques of including the child i n feeling and inccooperative planning. 1 1 8 . If the social worker in the elementary school does his job of counselling well, the students w i l l be better prepared to accept and use the counselling services of the junior and senior high schools. At this level, the student is i n a stage of development where his incipient inde-pendence from parents leaves him more on his own resources. He wishes that the relationship of his teachers and parents were of a different kind and less intense; he must therefore be mature enough himself to make use of the counselling servioe. This growth toward being ever more responsible for his own actions should be encouraged by the approach of the senior counsellor to each ch i l d . Each individual child's needs w i l l be different. Some children, who because of emotional immaturity have been more protected i n the setting of the elementary school, w i l l sometimes break down toder the demands of the new, more varied and complicated environment of the senior school. Elementary school principals are concerned with those who are promoted because there is no other specialized educational service to offer them more suitable to their needs. As the elemtary school counsellor or social worker builds up knowledge a?out the strengths and weaknesses of students and their families, such knowledge can be invaluable to the counselling program of the senior school. School to Home and Back Again Many referrals to the social worker by the teacher or principal are for the purpose of gaining greater understanding of the child's home background. Where there are greater needs in the home that the parents can take care of, the child i s often put i n the position of being torn 119 between two loyalties, especially when there i s lack of understanding between his home and his school* Both home and school suffer when the one or the other draws a tentative conclusion based on insufficient information. Some instances of this w i l l point out the value of the liaison service between home and school. Donald M.'s mother has worked as many as two days a week. In other families with working mothers, the result has been neglect of the children. Conclusion: This i s li k e l y one of those mothers who don't or can't provide proper supervision for her children. The fact was that there was supervision provided. Donald's absence was due to factors in has school l i f e as well as in his home. It was possible that instead of neglect, he was suffering from over-protection, a conflict about which the mother needed help. It was rumored that Arlene attended public dances. Com-bined with her over-age for her grade and her general maladjustment to school and teachers, the supposition remained unchecked that Arlene was experiencing unsuper-vised night l i f e . The fact was that Arlene attended regularly the supervised dances of the Neighborhood House and once went to another youth center. Mrs. Grant was discounted as a decent mother because i t was believed that she frequented down-town hotels and beer-parlors. In the community, both Mr. and Mrs. G. were known as "alaoholics". A relative fact was that an older daughter disappears from home periodically and is thought to spend her time in the ways described. This i s an added worry to the mother and father who have made repeated attempts at the rehabilitation of their family. Alcohol has played i t s part; at present the parents are members of Alcoholics Anonymous. It was known that Tommy Y.'s mother had divorced her hus-band. When another man was known to be in the home i t could easily be supposed by the school people that Mrs. Y'. might be living in common-law relationship with him* knowing that Mrs. Y.'s mother, an Irish immigrant, had married a Chinese. The fact was that Mrs. Y. had married, a second time, a Chinese with whom she hoped to build a normal home for her two boys, and who was contributing to the home and taking responsibility as a father and husband. This was a happy relationship for Mrs. Y. who was forced to give up her own work because of chronic i l l n e s s * 120. Most teachers and principals treat a l l their pupils with equal respect and consideration except for the unconscious factors that creep i n . But when there is trouble and certain children are involved, such misconceptions as cited in the above examples often go on too long and the attitude to the child .is colored, with sometimes devastating results. We have to consider that even when teachers manage to see the child just as he i s to them, and have an attitude to him that i s unmodified by background knowledge of his home, the experiences of the child lead him to expect discrimination. Children have a very strong sense of justice and are sensitive to the slightest injustices. They often feel as i f they or their families have been treated unfairly. Bothethe home and the school benefit by some interpretation of the school problem and methods to the parents. The following incidents are from the writer's experience during the period of the reported experi-ment. The quotations a re from conversations with three different mothers. "The teacher said i t might help Donald i f I could help him with his reading and spelling at home. But I don't know how they teach Beading these days. I've heard i t is different from the way we were taught. I don't f e e l as i f I'm rea l l y doing anything for him just having him repeat his work." "My two older children never seemed to need help. But Carol brings her Social Studies home and begs me to help her. She says that is her lowest subject and she wants to do well but she doesn't seem to understand what the teacher is getting at. We didn't have that subject when I went to school and when I try to help Carol says that that isn't the way to do i t . What is this Social Studies anyway? I hate to f a i l my child by not being able to help her when she asks for i t . " 'When the principal phoned ms and said i t was my responsi-bulity to solve my problem some way other than to keep Ellen home, I knew he was right but I wanted him to realize how many things I had t r i e d . I was so i l l myself that when a l l else fa i l e d , I just had to keep her home. When 121. Ellen came home she said that the principal had never read my note but that she had seen him put i t in the waste-paper basket. It is hard to believe that he would do that." The f i r s t two d i f f i c u l t i e s indicate a need for a general inter-pretation of the course of studies and up-to-date approaches in education to be explained to the parents. Some of this interpretation can be done to individual parents, but this could be more effective i f i t were preceded by a wide-spread attempt to bring such understandings to the parents by means of large and small group discussions. Again, parents and teachers and children would benefit greatly from much more interchange of every kind between parents and teachers. Seemingly small misunderstandings can be readily cleared when there is an avenue of communication for that purpose. For example, in the case of Mrs. B.'s and Ellen's worry about her absence from school and the misunderstanding about the note, the worker was able to assure them that the principal f i l e s a l l notes and could show i t to Ellen. incidentally, the observation might be made here that i f the parents knew how important notes were as means of communication between them and the school, and that the school staff f e l t them of sufficient importance to keep them on f i l e , they might take greater care i n the writing of them. In the present experiment, there were more examples of the social worker bringing understanding from the home to the school than vice versa. The reason may be that these misunderstandings are on more specific prob-lems. But the job of interpreting the school and i t s purposes and goals to the home is one that is more d i f f i c u l t , and at least equally urgent. It has been neglected for such a long time that parents are often completely in the dark. The problem ca l l s for a discovery of new and effective 122. methods of "letting the parents in on the job" of the school, the nature of the curriculum, and the d i f f i c u l t i e s the teachers and principals have in reaching their goals, and in feeling their efforts to be effective. The Parent-Teacher Association is the most important agency fo r this purpose. Discussion of this organization w i l l be found later in the re-port of this study. Counselling the Parents. > To what extent and in what reppects should the social worker be a parent counsellor? This question cannot be answered u n t i l the function i s explored further and the findings of a larger body of experience are assembled and evaluated. It w i l l be answered in reference to the other counselling services that are provided in the community and in reference to the needs and where they arise. In the present study, there are strong indications that in a l l four problem situations arising i n the school, there is the accompanying factor in the home of a mother (or both parents) who is confused as to what action to take or who is under such a degree of strain that she needs helpful suggestions and support toward action. The situations which arise out of the school and can be handled by the social worker may be enumerated. (1) In a l l instances of absentee-ism and illness, the mothers admitted that they were in conflict as to the real needs of the ch i l d . (2) In post-clinic cases, parents needed the assurance that they were on the right track; or specific interpretation of the c l i n i c suggestions into every-day actions and attitudes toward the child; or more specific help from another social agency. (3) In cases of poor adjustment to learning, the parent was puzzled as to the relative respon-123. s i b i l i t i e s of tne school and the home for the problem. In five instances of registration for kindergarten, orci grade one, parents needed the knowledge of what level of maturity is required for their child to have a reasonably successful f i r s t year at school. (5) Parents need to be shown how, to help their children with school work and J/provided^v.en':-with..the^requiredinterpretation3Xi of the school curriculum and program. (6) The most recurrent and continuous need of a l l parents i s guidance in the matter of training and discipline. Counselling has not yet been accepted by parents on this supposedly private matter. The need is there and the social worker w i l l have many opportunities to give immediate assistance, or to arrange more organized methods such as study groups and lectures, or to refer the parents to other sources of help. What agency i s to carry the main responsibility of parent counselling (the school, the family case-work agency, the group-work agency, or a new form of community-centre organization) i s not yet deter-mined. The need arises in many forms and places. There is a gap in ser-vices at present and the need i s so great that wherever the opening comes is the place to function. The school social worker could not supply a l l the necessary services of family counselling but she can use her liaison function with other resources; she can use her knowledge of community organization and her responsibility for social action to work for new areas of service. In the meantime she has sufficient training to be of help on the spot when needed and to give counselling service at points where i t is requested as a natural outcome of her relationship to the parents. 184. CHAPTER TEN BRIDGES TO THE RESOURCES OF THE COMMUNITY During the period of the present study, the worker from her position in the school was aware of several areas of service that could have been explored if more resources of time and experience had been avail-able. Those that were tackled in more detail will be described, and others will be listed for further investigation. The Well-Baby Clinics of the Metropolitan Health Committee use the facilities of the schools in some communities. Once a month about one hundred mothers and babies are seen during the afternoon. The nurse has an excellent opportunity to advise mothers in matters where factors of train-ing, discipline, attitude and emotions get mixed up with feeding and elim-ination. Here is an opportunity to help the mother know the sound attitude to take to illness and convalescence (especially in those instances where the illness is of a subtle psycho-somatic character such as asthma, excema, allergies). The mother can be aided to keep uppermost the positive factors for the future mental health of the child. Social workers trained in the emotional dynamics of personality development could make a valuable contri-bution to the team of workers on the public Health staff. This would not necessarily be the job of the school social worker but would be a valuable supplementary service. 125. Baby-Clinic days are busy days for the teachers in the school. The worker noticed that when the mothers were in the school at the c l i n i c , they soriBtimes took this opportunity to see a teacher of one of their older children, often at the teacher's request. To avoid a complete disruption of the class-room program during the afternoon, i t would be necessary for the teacher to set a conference time for parents after school hours. Even when teachers are willing to do th i s , i t is often d i f f i c u l t for both the teacher and the parent to express the particular worry or issue that either feels about the child. In fairness to the teachers, they should not be expected to do such a volume of counselling, but at the same time parents should be encouraged to exercise the right and privilege to confer with the school personnel on behalf of their children. The teachers should be pro-tected from the f i r s t "blast" of the parentis worry and disappointment or disapproval should this be the case. Yet the parent should be encouraged to bring i t out into the open. The job of the social worker would be to act as an intermediary for the principal and teacher, and to sort out the rele-vant and pertinent factors in the problem. The result of this preliminary work might be a planned conference with parent and teacher or principal. Such a conference, called for a specific purpose, might be more constructive than the present hurried talks betweea parent and teacher. The time that the child enters school, either into kindergarten or grade one, is another opportunity for the combined services of a social worker and a psycholgist from the Bureau of Measurements. The worker found in the cases of s i x children an immaturity which, when combined with over-protection and indulgence at home, handicapped them in making this new and important step in ih.eirgrowth -. %Siradjustment to the school and the learning process. This would suggest the need for careful screening, even at the 126. kindergarten le v e l . The most valuable time for the team of psychologist and social worker to evaluate the emotional and mental maturity of the* child i s in the early grades. From kindergarten or grade one, some c h i l -dren who are more immature because of the possible eight or nine months difference in chronological age or for other innate or acquired reasons, could be directed into a Special Class, for grade one's only, while the more mature students could be together. This would assist the teacher in her organization of the class which she has to do now in terms of three levels of a b i l i t y . The children are well aware of this classification and speak of "being in the dumb row." This is also a time of opportunity to assist the parents, in cases where the emotional factors are influencing the growth of the children. As explained earlier, the social worker can't presume to do the total job of parent education, but,-, she can assist where the need arises and can help to arrange education on a group as well as on an individual basis. Parents need more specific information about the stages of growth and development in children and about what can be expected of them at any particular stage by the home and by the school. This could be done by having parent study and discussion meetings around each specific age and grade l e v e l . Besides taking responsibility for counselling service to the parent and child at the pre-school and kindergarten level, the school can take responsibility for counselling the child as he crosses the bridge to the senior school or, as i t sometimes happens, as he leaves school to train for or enter his vocation. It is the more immature pupil who w i l l require some help as he enters the next stage of schooling. This help the prin-cipals try to give by sending on a record which includes a personality 127. appraisal. The individual child's educational record, which is kept through-out his school career, could be supplemented by attaching a record of his family and social history. Case-Work Agencies In the cases of eight families i t was necessary to confer with representatives of case-work agencies. For Dmitri (case outlined in chap-ter six) the conference served the purpose of preventing duplication in home v i s i t i n g and a further duplication i n making out a second family his- . tory when one had already been completed for the Child Guidance C l i n i c . It also gave some added knowledge of the family situation to the school worker. If there had been closer contact than by telephone - i n other words, i f there had been a f u l l conference between the family, school and court worker ( the latter being counsellor to Dmitir's older brother) - a more coordinated plan might have been arrived at. As i t was, the principal talked with the court worker, the family worker, talked with the mother, the school worker talked with the boy and his teacher. No sufficiently effective results occurred at any of these points, and Dmitri had to wait two months for his appointment at the psychiatric c l i n i c . Another oppor-tunity was lost for the family and school workers to get together when the request went from the school for the social history. The family agency preferred to forward i t through the mail. A case-work agency, when in touch with the school about another family, asked how Marilyn R. was getting along at school, because they f e l t that her record would p rhaps indicate whether or not the mother needed and might be able to accept more service. The worker in conference 128. with, the teacher prepared a report for the agency, offering to have a conference about the case, or to send the f u l l report in writing. The agency worker preferred to receive the report over the telephone and i t was decided to refer the mother to the school, the case-worker feeling that perhaps a new parson might find a fresh approach with the mot is r that might result in effective action. The agency did not send any information or summary of the case,with the result that the worker and the teacher had no knowledge of the factors in the child's family background. At the end of ten weeks nothing further was heard from either the mother or the agency, and the school personnel f e l t helpless to solve Marilyn's obsrious malad-justment . For the problem of Keith K. (case outlined in chapter five) and his family, a conference was suggested with the Shildren's Agency. The conference was held and a plan made. The school asked for a progress re-port from the agency worker, but none came within a period of five weeks. In the course of conferences, i t was demonstrated that the school had information which was supplementary to that of the agency and which often enlightened dark places in the family picture. In one case, an agency worker asked the principal about the waifare and progress of a young boy who was a former pupil. The principal asked the worker i f the boy's father were s t i l l in j a i l . The worker said that he had been working with the family f o r some time but hadn't known that fact about the father. The school has a great fund of information about families which would be of great assistance to case-work agencies in building up their records. When a whole family i s in serious trouble, one would wish for the combined services of as many agencies as can be of help, ffihe G-. family i s case i n point. A Vancouver Family in Trouble Vera, age ten and in grade four, and Charles age twelve and in grade five, were two children who would be described as attractive, well-mannered, and with no serious school problems. The worker's f i r s t v i s i t to the G. home was to offer what help the school could give in the event of Vera (along with three other g i r l s ) experiencing court proceedings, having been involved with an adult sex delinquent; and to ask the cooperation of the parents in trying to keep the a f f a i r from becoming too drama-tized both for the g i r l s ' sake and for the welfare of the whole school. The worker found that this event in the G. family, (although of great concern to them because of their ten-year-old daughter) was almost incidental beside the number and complication of other problems i n the home. Listed b r i e f l y these were as follows The mother was i l l and helpless in a cast because of a broken ankle and knee. The father, employed only at add times, was needed at home; consequently the family finances depended on fourteen dollars per week unemployment insurance. Hospital and doctor b i l l s were unpaid and, although Mrs, G. needed further service, she did not want to apply for i t . The accused i n the above mentioned delinquency case had been an accepted boarder in the G. home on whom they depended for extra money. The son Charles was enuretic. The worker got i n touch with the case-work agency which had been active several months earlieir. Poor communication resulted , i n no action. Five weeks later, the school worker visited again concerning the absence of both Vera and Charles. The situation had worsened. Mrs. G.'s condition had deteriorated u n t i l she was suffering from insomnia and was i n a seriously strained nervous condition. She knew that she had to have her leg rebroken. Her daughter had come home to look after her but had staged one of her disappearing acts. (She had been a ward of the court since she was fifteen years of age, at this time being nineteen years old.) The additional worry about the older daughter had tbrown the whole family into a deep depression. Mr. G. who had in the meantime got a job, lost i t because of liquor smelled on his breath. Mrs. G. said that alcohol was one of their problems but she and her husband were now members of Alcoholics Anonymous and she f e l t that the last episode was due to worry about her and particularly about their daughter. The worker got in touch with Mrs. G.'s former case-worker who was concerned at the turn events had taken because she had f e l t that the family were making progress toward rehabilitation. The agency worker said that she would v i s i t Mrs. G. Three weeks later, there having been no interim report or conference, the principal received a note from home saying that Charles and Vera could not attend school because they had no clothes. The principal f e l t that i f the social agency was not able to help or the family was not able to receive help, whichever the ease might be, his next step was to refer them to the attendance officer and invoke the aid of the authority of the school law. 1 3 1 . What constructive comments can he made from such a case study? The social worker in the school has definite limitations to her sphere of action. Her i n i t i a l entree into a family is from a school situation and from that only. Her function primarily is to help the child make the most effective use possible of the education services. Her job is to find the social services that the family needs but not to provide them herself, when there are other resources and other agencies already involved. We have spoken of the difference in tempo which characterizes the school efficiency program and the approach of the social worker. For the G-. family situation, which included some positive as well as s o many negative factors, the combined services of school and social agency were not meeting the needs. Some tentative conclusions which arise from the evidence cited are offered. F i r s t , methods need to be found of closer cooperation between the school and social agencies. Secondly, case-work agencies do not seem to realize that a school is another social agency where valuable informa-tion could be gained for the benefit of the family in which both are interested. Thirdly, case-work agencies are reluctant to share their knovrledge of families. This is understandable i f there is not a profess-ionally trained person in the school situation. The majority of principals are professional in their attitude and those who are not need the experience of working close with social agencies in order to cultivate the profession-a l attitude. In the present experiment there was a professionally trained social worker. Fourthly, Again, the conference would be the efficient instrument to use and/develop. 132. Group-Work Agencies As a preparation for cooperation with group-work agencies, the principal and the worker made a survey of leisure-time a c t i v i t i e s among 162 pupils of grades four, five and six. (See Appendix C) A general report of the survey shows the following: Attendance at mass programs (Youth .center, Neighborhood House, Pro-Rec) Number who attend church clubs (including Scouts, Cubs and G i r l Guides) Number who attend church or sunday-school Attendance at other clubs (not within a churoh) Number who take private lessons (music, dancing etc.) Members of sport teams (other than school teams) Number who attend movies regularly Number who lis t e n regularly to radio programs 43 69 84 44 39 27 93 131 Attempts at cooperation were made for the purpose of helping individual children. The Boy Scout leader was asked to confer with the school worker about Douglas 0, whose problem was pilfering, and his two brothers. The worker had three motives: to assist the principal i n establishing relationship with such club leaders; to assess the value and effectiveness of such coumunity resources for a family like the 0. family where the mother relied on help outside the home for the character-building of her children; for Douglas particularly, to discover with the Scout leader the ways in which he could be given training in trustworthiness. The services of the Y.M.C.A. were explored for Tommy Y. the Chinese boy. It was hoped to find there the association which would give him 133. more assurance that he was accepted regardless of race, and to discover possible means of supplementing Tommy's knwoledge about sex. One club at the Neighborhood House included five g i r l s from the school, four of whom had become known to the social worker - Mildred M. with her problem of sickness and absenteeism (case outlined in chapter five); Arline F. and Marjorie H. with their antagonisms to adults and teen-age problems; Marilyn S. with her employer-relations problem in the business of baby-sitting. The worker planned a v i s i t to the club and conferences with the Leader. The worker was invited by the leader of the Mothers' Club to v i s i t the club at the Neighborhood House. Mrs. P. (case outlined i n chapter six) was a member of the club, and the consultant-psychologist of the group of mothers had detailed knowledge about the P. family, including Mr. P.'?> Both-,' the psychologist and the leader were glad to know about the record of Cecil's school experiences. Among the g i r l s ' a c t i v i t i e s reported in the survey there was a friendship group which was the important club in the feelings of ten g i r l s . The worker planned to look for an opportunity to v i s i t t his group,which seemed to be a spontaneous one with no adult leadership. Three families were referred by the worker to kindergarten and nurseryschool services in the community. There is excellent opportunity to recruit members for the parent-teacher's association and inter to help find the place where their interest brings them into active participating membership. 134. An outstanding volunteer project in the community includes as members f i f t y boys of the school. The a c t i v i t i e s sponsored by a business-man of the d i s t r i c t include woodwork instruction, foot-ball teams and ?ro-Rec gjmmasium program. It began when a group of boys broke into shops of the d i s t r i c t causing considerable vandalism. Instead of having a charge la i d against them, the boys were invited to instruction classes and later the program was expanded to include gym and sport a c t i v i t i e s . The principal of the aschool estimated that since the project was set up, the number of court cases has decreased noticeably. It was the wish of the principal that a social worker on the school staff would be able to help him keep in touch with a number of such volunteer efforts, to lend any help required and to estpress the appreciation of the school principal and teachers for the work of the sponsors. Because these a c t i v i t i e s whioh OJO in the community anrrounding the school are of such importance to the effective use of the educational services by the children, i t i s desirable that the school personnel have as close a relationship as possible with the leaders so that cooperative plans of action may be made when they might be of help to individual children. Parent-Teacher Association The Parent-Teacher Association, or Home and School Association as i t is i n some provinces, i s the organization which has grown directly out of the need for the school and the home to come closer together. As the v i s i t i n g teacher or social worker in the school has the same reason for 135. being, i t would seem that one of the foremost tasks i s to work out ways and means of active collaboration between the two. It is a challenging aspect of the job of the social worker in the school who is interested i n 1 community organization. Begun in 1922 in British Columbia, the history of the organization in many c i t i e s and towns is significant. Where i t was begun on the i n i -t iative of the schools, often by a well-meaning principal, i t has quite frequently been short-lived. Where the ini t i a t i v e was taken and retained by the parents, i t has sometimes died from non-support on the part of the schools. The soundest organizations have been those in which the parents retain the i n i t i a t i v e and »esponsibility and at the same time receive solid support from the school. The executive personnel reveals the working relationahip between the teachers and the parents. In some cases, an interested teacher is a member of the executive, often holding the office of secretary. In other cases the principal is the onlyrepresentative of the teachers and i s automatically a member of the executive. A number of associations, in addition to planning regular monthly meetings and money-raising events, have, in their desire to get closer to the l i f e of the school, found areas of participation for parents who make valuable contributions to the school services and to the raising of general standards of equipment. Schools have, on the whole, welcomed these voluntary services of the parents and, i f this participation of the parents in school services continues to grow, the school w i l l have the same advan-1. The writer of this study suggests that in the event of a social work program being set up in any school system, the relationship with the parent-teacher organization would warrant a further study and research project. 136. tages and problems as other social agencies have with their volunteeer programs, not the least of which is the problem of training. What better opportunity for adult education can be found than that which grows out of the active participation of parents in the school program? Some of the areas of participation are interesting to note: assisting with special events such as the Christmas program, sometimes by making costumes; raising money for donations to school needs such as sports equipment, or books for the library; providing money and volunteer services for a school lunch program. Here and there, an imaginative principal w i l l find further ways to make use of the contribution that many parents are only too willing to give. After a fatheist night at a regular meeting of the parent-teachers' group, i t was- arranged that the boys' base-ball practice should f a l l on Wednesday afternoon so that a father, who was free from has regular job that day, could assist with the coaching. With some of the money raised for library purposes, one association supplied a shelf of books for parents. A parent became interested in the library to the extent that she volunteered to assist the teacher in charge, with the supervision and administration of the library. In elementary schoolsf there i s usually no full-time librarian. One teacher includes that function with her^regular classroom duties. The added volunteer services of a committee of parents made i t possible to have the library open to students more hours of the day when they could browse and enjoy periods of reading which are not so closely supervised. In some schools i n United States, the parents have regular days on which they assist the teacher with whatever she needs. They specialize i n . t e l l i n g stories to the children, in nature talks, or they assist in 137. some of the routine jobs of marking and records. Some of these suggestions would not be readily accepted in many schools. These forms of cooperation can only grow organically out of deepening mutual experience. In some school systems they would be premature; the teachers would feel that the parents were "moving i n " on a f i e l d which was not legitimately theirs. During the time of the present study, the worker was able to attend parent-feeacher general meetings and one executive meeting. She was a guest speaker at one Association meeting, a Fathers' Night. The following tentative observations were made out of general impressions of these occasions: In the ffirst place, the social worker in the school, who has training in group-work and community organization, could make a valuable contribution to the liaison work between the parents and the school, between the organized parents* association or council and the education experts who serve the community. The worker might well be a member of the executive of the parent-teachers' association. Secondly, in addition to the closer relation of parents and school personnel (through a c t i v i t i e s such as those described where the parents participate), from the child's point of view there i s a need which has not yet been met. His feeling of security depends f i r s t upon the strength of his emotional home base with his parents. Later, his l i f e includes primarily the home and the school. At this stage, his feeling of security w i l l depend on the common understanding between the people who represent these two areas in his l i f e . If there is ignorance or disapproval on the part of one regarding the aims and methods of the other, i f the child is forced into the position of conflicting obligations, he becomes confused and his security is shaken. The best service we can render the child i s that the teachers and the parents (the significant adults i n his-, l i f e ) hold, In common agreement, the same constructive attitudes towards children, and so build a consistent environment in which the child can experiment and grow. Parents and teachers can learn together, "what adults should knww about children." This knowledge w i l l include: how to accept and respect children not as inferior beings; how to handle our ambivalent feelings toward children so that they are loved but not "spoiled"; what to do, generally and specifically, about the fpeedom-and-discipline problem; how to apply the constructive attitudes and knowledge to actual every-day situations in the home and in the school? A third observation " i i s in respect to study groups. Some associations have active study groups which include the topics just mentioned. Some associations weight their program with general meetings in which the parents come to the school and, in the same setting as they knew as a child, re-live their childhood experiences in an institution which f e l t , and may s t i l l f e e l , to them authoritative and discouraging. It was noted at one general meeting and one executive meeting that the report of the study-group convenor was not given; or it was thought that this branch of the association's work didn't get organized because there was insufficient time and would be looked into the following year. A suggestion to form home-classroom groups had been made, but there had been no progress, although i t was s t i l l thought to be an excellent idea. Such a development would require greater cooperation from each teacher and i t is a question whether many of them are ready to give their whole-hearted support. The social worker could hardly f a i l to find an interest here; and a function, which would be one of organization and leadership. PART III THE EMERGENT PATTERN Chapter 11. She Implications of the Study Chapter IS. Tools for the JOB Chapter 13. The Worker's Role. In the Community and as Individual. 139 CHAPTER ELEVEN THE IMPLICATIONS OF THE STUDY The Question of Nomenclature Changing a name indicates a change i n function. What is now termed "School Social Work" has gone through changes of function and name. The topsy-like growth of this social service to the school child has re-sulted in as many as f i f t y different names being applied to similar work, which indicated over-lapping and confusion of function. When the bulletin entitled "The Place of the Visiting Teacher Services in the School Program" was published i n 1945, i t was found that three terms were favored, namely,-vi s i t i n g teacher, school social worker and school counsellor. It has been recommended that these be used synonymously, though each i s definitive of some special emphasis and some limitation. Nevertheless,confusion of terms means confusion in nhe mind of the public, and conversely, c l a r i f i c a t i o n of terms means c l a r i f i c a t i o n of function to those whom one wishes to serve. In the present study, i t was found that the use of the term "social worker" meant a definite circumscribing of function in the minds of many teachers and some principals. The same has been true of beginning visitingteacher services elsewhere as the following statement indicates. "In the beginning of a v i s i t i n g teacher service, the problems referred are usually behavior problems. Ad-verse home conditions, physical defects, and mental deficiency also appear frequently i n these early re-fer r a l s . The tendency, i s , however, i n a community 140. where the service becomes better established, for the referrals to become less concentrated on these overt and obvious d i f f i c u l t i e s and to include more personality d i f f i c u l t i e s which may show themselves in withdrawn or unhappy behavior, failure to accom-pli s h i n school commensurate with a b i l i t y , and other less outwardly disturbing, but equal l y serious sym-toms of d i f f i c u l t y . " During the present demonstration experiment, the terms "v i s i t i n g teacher" and "elementary school counsellor" were used interchangeably with, and often i n preference to, the term "school social worker" because the former two f e l t less alien and meant more to the school personnel and to parents alike. Just as i t i s a one-sided emphasis when the v i s i t i n g teacher i s a teacher with only a summer course i n counselling, so i t i s a one-sided emphasis i f a counsellor with social work training tries only to do liaison work on behalf of the child between his parent and his teacher, without some orientation i n the f i e l d of education. When one understands that this implies a thorough knowledge of the philosophy and methods of education* one can accept the fact that the best preparation for this i s teaching exper-ience. It i s i n the interests of the school that the visiting teacher should have teaching experience, and this i s now recognized as a pre-requisit e for the job of social work in the schools. She can be of greatest service to the child i f she understands his school as well as his home problems. Who i s the Olient? When they f i r s t begin their work, many vi s i t i n g teachers wonder whom they are serving primarily, - the child, the parent, or the teaching staff. The worker in the present experiment f e l t that c l a r i f i c a t i o n on 1. EDUCATION FOB VICTORY, vol.3, no. 13, Jan.3, 1945. Or Beprint EDUCATION FOR VICTOBY. . ' 141, this point was necessary early i n the study in order to avoid some con-fusions that might easily arise. F i r s t , i t is necessary to establish that i t i s the child who is the primary concern of the social worker and in the specific aspect of his a b i l i t y or lack of a b i l i t y to use the school services. At earlier stages of the elementary school, perhaps, the child alone cannot be considered the client, because, compared to an adult, he is less able to make decisions about his l i f e and environment. It w i l l be the function of the social worker to coordinate services to the child and his family, giving whatever aid (including counsel to his parents) is necessary to meet the needs. The worker w i l l also help the teacher as another person in the child's environment, and her help w i l l be acceptable only when she gives i t by cooperating with the teacher for a commonly understood and explicit purpose - namely, the welfare of the child. The parents and teachers may be considered as secondary clients when they apply for specific help. Increasingly, the child w i l l become the client, as he grows i n understanding, in responsibility and in a b i l i t y to use counselling services. It is the social worker's job to help him use counselling service to an ever greater extent so that he grows in objective awareness of himself, his environment, and the extent to which he can make, and take responsibility for, his own decisions about his own l i f e . When he passes on to the senior schools, the social worker may be s t i l l a coordinator of services, but more and more he w i l l become a teacher of human relations and an assistant to the child in how to use the opportunities of school and community. 142. School Children In Trouble The results of this sample study have to be assessed from several angles. It is helpful f i r s t to ask whether the school social worker, vis-a-vis the principal, the teaching staff, the public health nurse, the mental hygiene c l i n i c , and, perhfps, other persons or ggencies, has a specific delimitable function. The c l a r i f i c a t i o n of this matter requires an analysis of school situations, and of the underlying problems of which those situations are the symptoms, with a view to determining which of them can be dealt with e f f i c i e n t l y only by a social work approach and social work methods. The sum t o t a l of the varying situations met with in the course of the study may be broadly grouped as follows: TABLE 1. General Classification of Cases Situations or \ c h i l d r e n Symptoms >Referred 1. Behavior Deviations 13 2. Doubtful admissions or promotions 11 3. D i f f i c u l t i e s in learning 8 4. Absenteeism 7 5. Child employment 5 6. Other 3 Total 4 7 A l l referrals were channelled through the principal. A few require some explanation. Category two includes follow-up reports on children who were promoted to grade seven with some misgivings since they showed emotional immaturity combined with slightly below average mental equipment; this group also includes admissions or proposed admissions to 143. kindergarten and grade one. " D i f f i c u l t i e s in learning" were principally those due to emotional immaturity rather than to mental retardation. .Only one case in category five, "Child employment" was a serious matter; in four cases the interview was for the purpose of completing information for the employment survey. This seemingly routine informational quest, however, became a successful means of gaining understanding abbut^the child and his family and of establishing a friendly relationship. It was found that when the i n i t i a l interview with the child is on a positive matter, rather than a negative problem, or something which is neutral in the sense that i t does not c a l l up ideas of school work, a sound basis is l a i d for future counselling,. It is a common experience that in the beginning of a v i s i t i n g teacher or school social work service the problems referred are usually the more advanced behavior problems, and those which relate to the school standards - absenteeism, children of families which have been considered problems over a long period, and gross misconduct in class. This was not so evident in the present experiment as i t might perhaps have been, due to the fact that the principal had had long experience in screening and referring problem cases, and also because he cooperated to the extent of giving the worker a range of sample problems. None the less, when the cases were investigated further, i n the course of one or two interviews, such things as adverse home conditions, physical defects, and mental deficiency appeared frequently in the early referrals. Naturally, i t i s only in a community where the service has become established that the referrals can become less concentrated on the overt d i f f i c u l t i e s and can therefore penetrate to the less obvious problems. Experience w i l l , of course, serve also to establish "patterns" of the personality d i f f i c u l t i e s which show 144. themselves later i n withdrawn or unhappy behavior, failure to accomplish results in school commensurate with a b i l i t y , and other less outwardly dis-turbing, but equally serious, symptoms of maladjustment. In the current study, due perhaps to a limited acquaintance with the connotations of "social work" and an inadequate idea of vi s i t i n g teacher services, the teachers f i r s t looked for cases where the families were in need of the services of a social case work agency. They were concerned about children of families requiring financial aid and hoped that the worker could do something about children who appeared to^%uffering from lack of care and supervision to such an extent that they were a continual worry in the classroom, often because of lack of v i t a l i t y . However, just as teachers a s well as principals in Vancouver are becoming more conscious of the importance of mental and emotional health and have learned to use the help of the Mental Hygiene Division, i t i s altogether possible that they could learn to collaborate with and benefit from the social worker in the school system. Findings and Interpretation The central findings of the demonstration-experiment are summed up in the accompanying tables. 3 - Six types of school situations were respon-sible for the referral to the worker of 47 children. After one or two interviews or other forms of investigation, the original six symptoms were analyzable as sixty-three different factors which are either further symptoms, or real problems in the sense of being basic and causative matters. Where a category recorded in Table 2, might appear to be includable under 1. See Table 1. page 142; Table 2, page 146, Table 3, page 147. 145. one of the headings (such as "behavior deviations") of Table 1, i t means that, in the cases concerned, that symptom was not part of the original school situation i n i t i a l l y causing referral. As each of the sixty-three problems occurred more than once, the total problem load came to two hun-dred and sixty-seven, each case revealing, as a rule, several accompanying or underlying problems. The facts brought together in the three tables led the observer to make two broad conclusions. F i r s t , the "trouble" as i t comes to the attention of the teacher and principal &s only symptomatic; and i t i s symptomatic of the greatest variety of real problems in the physiological or psychological structure of the child or in his home environment. Furthermore, even i f there is awareness of the real problem (as distinct from the surface manifestation) on the part of the teacher, the school nurse, or the principal, adequate resources of time and training are not available i n the school at present to get the necessary shift of attention from symptom to cause. Coordinating Function An examination of the desirable or necessary remedial services show that i n some cases, namely those r e q u i r i n g the liaison services of the social worker (Table 3) the case goes beyond the social worker to an appropriate existing scBaool aid or outside agency. In these cases, some functional questions have to ba naswered. Who is to be responsible for: 1. The c r i t i c a l investigation, 2. the decision as to remedial action 3. the preparation and support of the child or parent for whatever action is taken, TABLE 2: Scope of Problems Covered in Total Survey Situations and Sjimptoms Children with this Problem Physical and Social Environment Poor housing Poor district-Community antagonism Racial prejudice Home-School Relationship Lack of cooperative relationship Child suffering lack of supervision Child Mtkinonflict of obligation . Family allowance cut Home Mother, strained and confused Home no support to the child Dubious support from the father financially and in relationships Mother working outside the home Financial need Father deceased or out of the home Sibling jealousy Child uncontrollable Rejection Negative relationship with adults Alcoholism (father) Unemployment (father) Responsibility for younger children Only child <bn large family parent cold and r i g i d School Mental a b i l i t y below normal Poor adjustment to learning Poor relationship to teachers Unsatisfactory promotion or admission ' Stealing Breaking school rules (disobedience) Health and Personal Tonsils Qhronic (possibly psycho-somatic illness) Enuresis Aggressive to extent of bullying Antagonistic, uncooperative poor relati&n witheequals sex exhibitionism tired, l i s t l e s s attention getting discouraged speech defect masturbation fire-setting  32 11 15 5 1 21 7 7 5 2 77 14 10 10 7 7 6 3 3 3 2 2 2 2 3 3 t C i . £± 10 7 6 6 3 3 38 4 8 2 4 6 5 3 4 2 2 1 1 1 147 TABLE 3: Scope of Service and Liaison Functions, Total Study. . Type of Service . Number Liaison or Referral Case-work Agency; help to family Group-work AfeSncy: help to family Service of Mental Hygiene Clini c Service of City Dept. of S a n i t a t i o n Service of Community Resource (Nursery School) Service of Special Class and Bureau of Measurements Information to Social Agency Counselling and Advisory Counselling children Consultations with parents Advisory, teachers Conferences, principals: Assistance, nurse 5 5 12 1 5 2 12 19 9 23 6 3 4 70 Total 104. (continued from page 145.) 4. the summoning of the appropriate existing agency to the aid of the particular child or family, 5. calling conferences and maintaining the relation-ship with these auxiliary agencies in order to get the best coordinated help for the child. The answer seems to be that for functions 1,3,4,5, and partly for 2, the school social worker i s the proper and necessary agent. The present exper-iment demonstrates the fact that one worker could handle more than one school. But i t would depend on the type of d i s t r i c t , the breadth or l i m i -tation of function she assumed, and what relationship such a service would have to the guidance program of the senior schools of the d i s t r i c t . 148. Consultative Function For the second group of services designates as consultative (See Table 3) the school social worker (where and when she exists) i s l i k e l y to be the only available person with the necessary time and training. The findings of the present survey answer the question: By the addition of a social worker to the staff of school personnel, what services are available to the child, the teacher, the principal, the nurse, the parents and the community, that further help the children to use effectively what the school offers? The emphasis throughout is on the child i n the school setting and on helping him to use his school experience to his ful l e s t capacity with the purpose of removing the barriers to their educational progress. Meeting the needs of children,in the ten-week period during which the study was made, involved the following: A. .Helping his Family 1. Counselling with one or both parents 2. Preparing the child and parents to use other services. 3. Bringing psychiatric help to the child and parents from the Mental Hygiene Division. 4. Modifying the attitude of adults to the child in the home. B. Helping in the School Situation 1. Assisting the principal by bringing home and school closer in understanding 2. Supporting and giving advisory help to the teachers; helping them to detect early symptoms. 3. Modifying attitudes of the adults to the children 4. Changing the pupil's school situation 5. Searching for remedial aid in subjects, and using the resourc of the Special Class 149. C. Coordinating knowledge and planning with other agencies in the community for the child or his family - case-work group-work, court, parent-teachers, pre-school groups. 1. Putting the child and his family in touch with new resources. 2. Establishing relationship to result in greater under-standing of the child and family needs, and coordinator-ing plans to meet the needs. D. Counselling the child 1. Encouraging him to self-responsibility. 2. Encouraging him to participate in planning for self-help. 3. Gradually developing the a b i l i t y to vocalize and communicate about his feelings. 4. Getting psychiatric help when required. Besides case-work and counselling services to individuals, the third function of the school social worker i s as a group worker, community organizer and adult educationist. Opportunities showed up in the present study which, i f there had been time to develop more permanent relationships, pointed in the directions outlined as follows: A. Interpretation and understanding offered to the school staff through'. 1. staff meetings;, 2. work-shops for teachers, social workers and nurses, 3. interpretation to principals' association. 4. guidance in smaller groups of the parent-teacher association, composed of parents and teachers of a certain room, grade or age-group of children; guidance to parents of pre-school children and of those just entering school. 150. B. Service to the community by interpretation and c l a r i f i c a t i o n of the developments in educational thinking and in school policies. 1. Interpretation to agencies (children and family, court, group-work), 2. Interpretation to groups of parents (parent-teacher association) as well as to individual parents. Alternatives A further question needs to be asfead. What alternative ways are there of meeting the demands of such situations as have been reviewed, which might be as effi c i e n t , or more so, and as practicaMe, or more so, as the addition of a school social worker to the resources of the educational system? One suggestion i s that the principal and children and fiamily agency workers might cooperate closely in regular conferences. This has been t r i e d i n Vancouver, and achieved a measure of success. But the help was limited to "social service" (as school phraseology usually puts i t ) and i t was often d i f f i c u l t f o r the teacher to have a significant place in the conference. It was also d i f f i c u l t for the principal to refer families, who needed help but wsre not clients of an agency, to agencies in a way that would bring constructive results. The main d i f f i c u l t y and cause of distance and misunderstanding between principals,as they represent the schools, and social workers in agencies i s the difference in tempo between the two as to their methods of working. The child's problem impinges on the personnel of the school daily, and often noticeably affects many others. Consequently there i s a desire for and a compulsion toward faster action. To the school, the social work . . . 151. agency i s too slow, and the social agency finds that the school goes ahead impatiently with unilateral actions. The school feels that once the social agency takes charge of a case, they get-vfew*.tff• any/'-i/ progress reports} the social agency i s sometimes overly cautious in giving significant infor-mation to the school staff. Secondly, the public health nursing service to schools might intensify their social work services to children and families. But they have a very f u l l program which leaves the nurses l i t t l e time or opportunity for training in counselling services to parents and children, or i n cooperative work with group-work agencies and community organizations. Thirdly, social workers might be added to the schools through an enlarged attendance branch. This was the department of the school i n other c i t i e s which f i r s t saw the need of supplementary help to the work of officers of the law, and which used the services of social workers or v i s i t -ing teachers. Vancouver's parent-Teacher Association has petitioned the school board for this purpose (See chapter <hne). But this department i s only one among several which requires home v i s i t i n g and counselling. A fourth alternative might be to have the Mental Hygiene Division enlarge i t s services and employ social workers to prepare cases, do preliminary ssceening and do follow-up work with parents and school staffs. This, too, would be desirable but not inclusive enough. Fift h l y , teachers might be better trained i n psychology and psychiatry and the emotional basis of human behavior. This would come closest to the ideal solution i f i t were reasonable to expect that teachers could acquire a l l such knowledge besides the other s k i l l s they must have; 152. were mature and experienced enough to apply i t ; and had classes of not more than twenty pupils; and f i n a l l y , had time to v i s i t and know the home background of each pupil. Many teachers are becoming sensitive to the child's emotional needs and can cater to some of these i n the classroom 1 situation. They and the children would be greatly helped and supported i f the home were to adopt the same remedial measures. It i s not f a i r or reasonable to expect the school to do the total job of helping the child make a happy and effective adjustment. The parents must be helped to see that the child often loses out educationally because of what he brings with him from home in worry, conflict and insecurity. Tne identity of aim, attitude and treatment plan for each child between home and school w i l l give him a consistent environment - one which makes sense and feels secure in what i t expects of him. The inadequacy of these alternate solutions i n some cases l i e s i n the fact that the services come from outside the school and not from someone who both from her own teaching experience and her integral relation-ship to the staff can "get close" to the teacher, to the child i n the classroom situation and to the child in his home. 1. A film ("Meeting Emotional Needs in Childhood; The Ground Work of Democracy, N.Y.U. 1947, produced by the DepartnBnt of Child Study, Yassar College as one of a series entitled "Studies of Normal Personality Development) shows a sensitive treatment of children's personal problems by a teacher, who had a class of about twenty, and who was a mature and experienced person. But she couldn't deal effectively with the basic causes of the child's d i f f i c u l t y which were in his home; consequently, her treat-ment was to provide for the child the things and attitudes which he needed but which were lacking in his home. 153. Some Proposals The f indingssoff'thas experimental study point to certain administrative arrangements and relationships, for which the following proposals are offered. 1. The establishment of a social work department to be part of a Qoordinated Shild Service Bureau of the Vancouver schools, the workers to be in liaison and assistance role to the combined specialized departments (Mental Hygiene Division, Public Health, Attendance Branch, Bureau of Measurements). 2. Each worker shall be assigned one, two, or three schools depending on the nature of the d i s t r i c t , to work under the direction of the principals. 3. Each worker shall be in close touch with the guidance program of the senior schools of her d i s t r i c t to provide continuity of knowledge about, and service to, the children and families of the d i s t r i c t . 4. Failing a total program, that a demonstration and experim-ental program be set up under the jurisdiction of the school board. Money for such an experiment,,: may be sought from c i t y School Board, Provincial Department of Education, Parent-Teacher Asseoiation, Community Chest Child Welfare Division, Child Welfare Division of the Provincial Department of Social Welfare. 5. Failing a Vancouver experiment, that the provincial government sponsor such a demonstration centered at the normal schools. 6. That such a program shall i n time become a field-work place-ment for students of the School of Social Work, University of Br i t i s h Columbia, who are preparing themselves to become school social workers. 154. CHAPTER TWELVE TOOLS FOR THE JOB The School Team and The ConferBace Method Sufficient evidence has now been brought forward to convince even the most sceptical of the crucial importance of the conference method. The present team of workers in each school is already, or should be, composed of the teacher, the school nurse and the principal. The social worker i s an added member of the team. Her primary role i s as assistant, and her primary method is that of the conference. As has been pointed out, the time-table of each of the three (teacher, nurse and principal) i s such that i t i s a major administrative hurdle to arrange conferences. Those in connection with the Mental Hygiene Clinic are at present held after school hours. Conferences are equally important in the school setting. Other-wise i t is almost impossible to have each member of the team know what the other i s doing in connection with any one child or family, and many uni-late r a l decisions are made and acted upon. During the comparatively short period of the present investigation and on account of the temporary nature of the social worker's position on the staff, i t was not possible to develop the, conference as an integral technique and central method as i t should be. Had i t been possible, some of the mistakes could have been avoided. It is possible to suggest, however, what a desirable procedure would be. 155. Model Procedure The f i r s t conference is held i n order that the teacher, principal or nurse may present the i n i t i a l problem with regard to the c h i l d . The other members of the conference team w i l l provide any information they may have to round out the picture. A decision w i l l be made as to each person's job before the neat conference. For examples, one or more of the following may be necessary: that the nurse bring a f u l l health record; that a check by made on the child's intelligence score by the principal or worker in cooperation with the Bureau of Measurements; that a home v i s i t be made by either the nurse or the worker; that the worker interview the child; that the worker of a social agency with viiich the family is connected be brought into consultation by the school social worker. Decision for action may come out of the second conference. The same school team meets and has the supplementary information gathered in the interim period. It may be necessary to ask an additional person, such as the family agency counsellor, to be present, both as a resource and as an important assistant with the family. If so, he or she also should know the whole story and the proposals for solving the problem. Conference three is called to report progress or lack of progress; to confirm the previously determined course of action, or decide on a new onej or decide that the problem goes beyond the scope of this i n i t i a l school team to solve. Further conferences w i l l be called for the purpose of hearing progress reports which, i t is hoped:- w i l l indicate movement in a positive direction toward a solution. 156. The Parents' Position in respect to Conferences Before Conference number two, there has l i k e l y been an interview with one or both parents, and possibly a v i s i t to the home. At this con-ference, i f the worker has done her job well, the parents' point of view i s represented. On f i r s t thought, i t may seem unjust to have conferences about the child without the presence of the parents, who have the? f i r s t right to intimate knowledge and plans about their child. At any point, i t may be considered advisable to have the parents present. But to be out-numbered by the school staff by four to one, i s to be placed at a severe disadvantage. At f i r s t , ' the social worker w i l l be the liaison between the school and the home. When i t seems wise or when the parents request i t , conferences can be arranged with any desirable number of the school team. When a child has been referred to the Mental Hygiene Clin i c , the psychiatrist usss the conference method as between principal, teacher, nurse and social worker. He himself interviews the parents and helps them to f e e l that their view of the problem i s included, besides giving them helpful advice. Many of the parents vant to be included at an earlier stage of the problem than at the time of the c l i n i c examination. Many others could be encouraged to have such an active relation to the school, in the interests of their children. The.role of the social worker is clearly indicated - as liaison and as assistant to the principal in pro-moting conferences. Records and How to UselThem It is important to work out a policy with the principal and teachers with regard to the use of records. In. an established service, 157. there w i l l he a f i l e for each child, which w i l l include progress records, health history, social and family history, and copies of personal answers to questionnaires. It w i l l be wise to keep such confidential material in locked f i l e s . The f i r s t question to decide is to whom these f i l e s shall be open, There i s l i t t l e question about the fact that the principal and the social worker shall have access to them. Shall the teachers have unlimited access to the f i l e s ? Ideally they should. But there i s apprehension and mistrust on the part of the trained professional worker - a feeling shared by principals who have long practice in keeping confidential matters to themselves - to reveal such material to the layman, who, because he cannot f u l l y understand i t , may misinterpret and misuse the information. The teachers are considered laymen in this respect and w i l l be u n t i l they receive training. The degree to which this situation w i l l improve among teachers, w i l l depend on the measures taken to educate teachers to achieve professional standards in their use of confidential information. To the extent that this is done, teachers may be included in the group who are' giving professiinnal services to children. The social worker in the school has a responsibility for records and also for guidance to teachers as to how they should be used. In the present study, the worker came to conclusions i n agreement with the experience in Winnipeg. If the ohly report to the teacher from the worker i s an oral one, the teacher remembers i t vaguely and ofgen incorrectly, whereas i f i t i s written down in the school f i l e s , she is li k e l y to refresh her memory by re-reading i t the next time she has to cope with Johnny; and furthermore, a study done when Johnny i s in grade three is available - and often useful - when he is in grade f i v e . 158. The type of report which seems valuable both as a record and as material designed for the purpose of the professional education of teachers, i s the short social history. It is not a detailed account of an interview but rather a summary of the pertinent facts that have come to light and that w i l l make sense to the school staff as causative factors. Sample records, one from the Winnipeg visiting-teacher f i l e s and one from the present experiment, are included i n Appendices IB?and] 2B. A card-index system was designed for the immediate purpose of the present study. It may be compared to the loose-leaf record used i n Winnipeg. A modified type of card system might be found useful in a regularly constituted program. (See Appendix 4&) The more detailed'ireferral card which i s used when children are interviewed at the Bureau of Measurements and the Mental Hygiene Clinic, may be compared with the type of card used in the Child Guidance Clinic in Winnipeg. (See Appett4ixes5$1: and 711). The value of carefully prepared and adequately f i l e d records i s the value which accompanies objectivity rather than subjectivity. In working with human beings, i t is important to use such a tool as records in the attempt to achieve as great a degree of objectivity as possible, as well as to k*ep a continuity when the job expands and is passe.de; from one worker to another. It is a l l too easy for anyone to be the kind of worker who "keeps i t a l l i n his head" ; the fact that he does so i s sometimes due to lack of time or training, and sometimes due to his personal and subject-ive attitude to his job. 159. CHAPTER THIRTEEN THE WORKER'S ROLE; IN THE COMMUNITY, AND AS INDIVIDUAL Community Organization The school having accepted as i t s responsibility the welfare of the child i n i t s wholeness, the question arises: What i s the appropriate and desirable relationship between the school and the other institutions and agencies in the community which profess the same concern and are therefore, presumably, working to the same end? The church, with i t s Sunday School and boys* and g i r l s * clubs, i s one such institution. So also are some at least of the group-work agencies, and the child welfare ser-vices of casework agencies, and various service departments of governments. An alternative form of the same question i s : Towards what pattern of community organization should the school and the social worker aim as best satisfying the agreed criterion - the total welfare of the whole child? Principles and Orientation The following considerations, arising from discussions stimu-lated by the experiment, set the framework of general organization and help to establish basic orientation. 160. No conceivable pattern of organization can f u l l y implement the objective of "the total welfare of the whole child", since some aspect of human personality always escapes into a sphere beyond organization as such. The only institution which has approximately achieved this objective i s the primary group - in modern times, the family. Even though the family has, by general agreement among sociologists, lost much of i t s capacity to f u l f i l this primary-group function i n recent decades, i t nevertheless has a central and primary role in this matter of the child's wholeness - his welfare as a-..-cJaild - which cannot satisfactorily be substituted or dele-gated. The other institutions which concern themselves with the agreed objective - churches, Y.M.C,A. etc. - cannot claim to do so in respect of a l l the children of the community. From a Protestant church, Catholics are excluded. Towards a Y.M.C.A., Jews or Sikhs are l i k e l y to be lufiewarm. The school is in fact the only institution in the community which, by virtue  of i t s inclusiveness, can be the nucleus of the type of community organi- . zation which i s directed towards the to t a l welfare of the child; and not one particular child, but a l l the children of the neighborhood. Although the home and the individual family unit may have dis-integrated i n some degree, under the stresses of modern l i f e , i t s rein-statement i n a new form may be possible through the more conscious consid-dration of parental problems by groups of parents. The school social worker, in association with parent-teacher groups, may encourage parental responsibility by way of cooperative responsibility for the total welfare of the children of the neighborhood. Within that general framework,, a number of practical rulings can be seen. F i r s t , the school social worker w i l l support and gladly cooperate 161. with, any agency in the community which i s able and willing to work towards the greater welfare of even one particular child. No issue of jurisdiction or institutional priority should; conflict'.with :this^agreed objective, and a l l such issues can be precluded by a steadfastness of pur-pose and at times a simple approach on the part of the school social worker. Secondly, the school social worker, w i l l regard a l l the agencies (including herself) at present working for child welfare,as essentially in loco parentis, working for the day when an awakened body of neighbor-hood parents w i l l assume the i n i t i a t i v e and the central responsibility. A l l government offices, welfare agencies, teachers, social workers con-cerned with the total personal welfare of children hase an essentially inadequate'relationship to their job and to each other, u n t i l such asser-tive citizenship and co-parenthood comes into existence. To bring i t into existence - via community center and community council projects, or parent-teacher associations, or parent-cooperative nursery schools - should be-come one of the constant interests of the school social worker. No pattern of community organization can be considered t r u l y valid - especially from the point of view of over-all child welfare - except that in which a l l experts, specialists, bureaucrats and "professionals" are given their proper subsidiary place by a democratically-developed body of citizen-parents. The School as Neighborhood Focus Looking at the community scene with this orientation, the school social worker w i l l be keenly aware of the significance of the school as a natural focal center of the neighborhood. Many progressively-minded 162. Town Planning Commissions and contemporary Parks Boards give the school this role, especially i n suburban neighborhoods. Not only do more families in any neighborhood have necessary connection with the school than with any other single institution; but also more barriers (of national origin, culture, creed etc*) can be broken down by the common interest i n children and their welfare than over any other concern. Modern society divides and sub-divides in regard to every other major interest - p o l i t i c s , religion, art and so on - but the school can, at least potentially, draw a l l but the childless families together. It i s the real melting-pot of our culture. This suggests that the community center of the near future may be in, or close to, the school, using the plant already there and adding supplementary plant and equipment. The volunteer workers under trained leadership w i l l be parents and others interested in children. The center w i l l encourage participation of the whole families* The day of the million-dollar community center with whole-family members hip and creative activity for every age level, is not yet. The day of the neighborhood council strong enough to put doctors and psychia-t r i s t s and social workers and recreation experts to work, i s not yet. In social l i v i n g we are s t i l l at the pioneer stage. It is the day of free and often too-rugged enterprise, but i t is also the day of the small spontaneous deed. Miss H. and her amateur dramatic group; the father whose wood-working shop in the basement became the center for the boys and g i r l s of the block who loved woodcraft; the mother who took the trouble to learn the »pficial s k i l l of square-dancing so that her rumpus room be-came the center for the just-tteen-year-olds who were shyly making their way into that new area of social development; - these are what the school 163. social worker w i l l look for, and cherish when she finds. Coordination for Child Welfare The school social worker, seeing the neighborhood surrounding her school in this organic way, w i l l be aware of her unusual opportunity and responsibility. If school and community are to become integrated in the necessary way, her own role, as a member of the school staff privileged to v i s i t homes and keep in touch with community organizations of a l l kinds, is an important means by which that desired result w i l l be brought about. It i s in this aspect of her work that some vision of the emergent social pattern is v i t a l l y necessary - to give her a sense of re-lative values and of direction through the organizational maze. It w i l l keep her sensitive to the value of the spontaneous effort of so many types on the part of those who like children; prompt in passing from the counselling of a mother to the promoting of the local parent-teacher group; active i n encouraging the parent-teacher group to raise their sights, and see their role i n i t s f u l l e s t significance. A typical immediate objective w i l l be to promote the coordination of existing services which are concerned with child welfare. This serves a double purpose in that i t i s both a step in the direction of neighbor-hood integration, and a necessary move towards greater efficiency in aid-ing the individual child. Just how this i s to be brought about w i l l de-pend on the circumstances in each case. The Child Welfare Division of the Community Chest and Council might be encouraged to take the i n i t i a t i v e i n bringing together, and acting as center of reference for such groups as provincial child welfare services, 1he family Welfare Bureau, the 164 , Children*s Aid Societies, the Child Guidance C l i n i c , Parent-Teachers * Associations, and so on. The division might encourage sub-councils in each d i s t r i c t as a step toward integration. Whatever the organizational set-up, care w i l l be taken to en-courage the layman citizen and the parent to assume maximum, centrality and respons i b i l i t y . Personal Qualifications As with many other branches of social work, the main desideratum in the personality of the school social worker w i l l be her aptitude in the art as well as the science of human relations. This is not only because her usefulness to the child with a problem depends on her a b i l i t y to secure his confidence: which means approaching him with such acceptance and affirmation as to reduce his 'on the defensive' attitude. It is also because the formation of positive and cooperative relations with other members of the school staff - principal, teachers, public health nurse -is a prior condition of successful work. The school social worker w i l l undoubtedly find herself surrounded and inhibited, at the very outset of her work, by some degree of incompre-hension. (There'might even be ho s t i l i t y , though i t need notb be acute and would be due to unconscious factors). In such a situation, her tempera-ment must support her training in enabling her to maintain an objective-* non-reacting, quietly positive attitude. To be f a i r to teachers, some of the i n i t i a l unwillingness to cooperate may not be mere professional 'vested interest'. Some of i t may be due to unconscious maternal possess iveness. Such a teacher resents the presence of some one who is li k e l y 165. to "be as serviceable to a particular child as she would l i k e to be herself. It would be hard to say tfiether greater f l e x i b i l i t y , finesse and restraint is necessary in forming serviceable relationships with the surrounding adults,or i n forming creative relationships with "children in trouble." The latter may be suspicious of a l l adults; or closed and unresponsive; or already adept i n tricks of deception and pseudo-friendliness. There i s , of course, no "rule of thumb". In general, the social worker's effectiveness w i l l derive from her a b i l i t y to make accurate appraisals and her stubborn patience in upholding, reaffirming and building upon the positive factors i n the child's personality and situation. The school social worker (again, like many other kinds of social worker) has to have a nice combination of opposite qualities, akin to those suggested i n the Roman proverb - fortiter i n re, suaviter i n modo. That is to say she has to be a principled person, but no perfectionist. Her principles, to which she must be inwardly, constantly loyal, are not ethical so much as s c i e n t i f i c and professional. She stands for an a t t i -tude towards human beings in general and children in particular which i s completely irreconcilable with the authoritarian, censorious or punitive attitudes - of which, unfortunately, she is li k e l y to find some traces i n almost any school. But she w i l l , i n practice, admit the necessity of compromise with the old system of "discipline", i n order to sustain good working relations with other members of the staff on which her continued usefulness depends. The school social worker w i l l not be "against discipline." Quite on the contrary. But the type of discipline which she w i l l be for, and in her 166. own personality exemplify, w i l l be the new discipline of inner control and emotional maturity. In respect of that quality, the school social worker w i l l be peculiarly tested, not merely as a person but as a representative of a newer profession working alongside members of older and more established professions. Immature individuals of these professions w i l l react toward the "interloper" with the "new-fangled jargon" i n such a way as to rouse a corresponding emotionalism in any immature representative of the new profession. Any school social worker who has failed to attain, from her training or her l i f e experience, the necessary degree of self-awareness is l i k e l y to identify herself with her profession - unconsciously or other-wise - i n such a way as to bring her into competitive, power-striving relations with the other professions around her. That way failure l i e s . Only psychological maturity and self-discipline w i l l enable the school social worker to maintain the necessary and creative humility i n a l l her working relations. This w i l l not be, as i t might seem to the super-ficially-minded, a letting-down of the prestige of her profession. On the contrary, i t w i l l be the sign of her great desire to win for i t the only type of prestive which would be valid and lasting - aamely, that which i s the consequence of human services effectively rendered. 1A. Form for Survey of Child Employment CHILD EMPLOYMENT SURVEY Grade " Age ^" Name address i \. Type of work Weekly schedule No. hours Starting and f i n i s h ing time (days of work) -(continued) CHILD EMPLOYMENT SURVEY "age per -hour Name of|Employer or Firm 1 Addressj •Reason for Working Remarks re LHealth possible Behavior effects onv. Attendance pProgres s 1 ' 1 2A. Form used for Survey of Parent Occupations PARENT OC CUPATIONAL SURVEY • . . . Name Address father's Occupation Where (out .of Vancouver?) Mother's Occupation Where (continued)' No. days j per week Mother works Mother's Hours away from home Responsibility Person to get i n for Child while tttraeh with i n parents away case of Emergency Name, Address, phone 3A Form used for Survey of Leisure Time Activities Name description of Program Address (distance from home) days of -week Hours 1. I go to a center (like Burrard Lion's, Pro-^ec; Neighborhood.House). £. I go to Church, or Sunday-school on Sunday. 3. I go to a Club on week days (not i n connection with a church, 4. I go to a Club on week days (in connection with a church). 5. I take lessons in Music, 6. I play on a team -(outside of school). 7. I go to the Movies. -8..I spend time i n out-door play. 9. I spend time at home -(work, hobby, reading, ). -10. Other things not mentioned i n points 1 to 9. 11. My favorite radio programs are: -(use other side of page) 1 4A Copy of card-record used i n present study Name; MORGAN Donald Addresst Phone: Family: Mother Vera Father Walter G. Siblings, Grace, 8 yrs.Gg.2. Others i n home - Uncle S.S. Record n i l School ^rade 1 Room 2 (from kindergarten) 4ge 28.11.41 IQ Det.Beg.lC-Y) Stan. Rev Present School Record Standing V Reading D School History Kindergarten C. Absences - 4 3 . Personality Rating ""ttitude B. Immature, lacks oconfidence, fearful. Child Immaturity possibly due to Mother's protectiveness Strain i n school perhaps not ready for grade Loss of weight, pale under doctor's care PROBLEM seen from Parent(Home) Mother puzzled and con-fused by psycho-somatic symptoms - interrelation of Donald's physical condition.to strain at school. Feels teacher and school pressure too great; feels lack of understanding of problem by school School frequent absences-•i|day3. pattern Mon-days and Thursdays Suspect mother working I possible neglect) progress poor seemingly immature For purposes of analysis, the statement of PROBLEMS was modified as shown below: School Symptoms frequent absences-Jdays pattern -Mondays and Thursdays possibly working mother seemingly immature progress discouraging Problems Donald under doctor's care - run down health-no marked physical basis possible psychosomatic link with strain at school immaturity, possibly due to mother's protective-ness and beginning school too early Service Cleared misconception that mother's working meant possible neglec School conference re changing Donald's school situation Counsel to parents re Donald's future. ( 5A Referral Card used for the Winnipeg Child Guidance Clinic FAMILY NAME Date Address PUPIL'S GIVEN NAME Pate of Birth Birth Place Referred by Name of Parent or Guardian Problem Social Status..... Language Spoken at Home Occupation of Father..... .Racial Origin of Father.. .Mother.. Siblings School. Grade...... .General Progress Other Schools Attended ...., Individual I.Q Date I n i t i a l s . . .Group I.Q. ...Test Date Med ical History .Defects............Present Status Physical Examination Date ..Doctor's I n i t i a l s . . . . Social and Emotional Adjustment Clinic Referral D ate ....Pile No. Visiting Teacher's Name SCHOOL DISTRICT OF WINNIPEG (The whole of the reverse side of the card is reserved for the visiting-teacher's notes.) 'IB S a m p i e of Short Social History used in Winnipeg •V Be: Dick and Charles HARGREAVES Problem: The Hargreaves twins came to Lord Roberts from St.Lukes in September. The school wanted to know something of their background in order to decide whether i t would be best to separate them and whether demotion for Charles or promotion for Dick would be preferable. Home conditions: This is a working class home. Mrs. H. has a limited education but is interested i n her children and eager to cooperate. She said that the twins had started school when they were 5 years and 4 months old. Dickie was the more fragile of the twins, had been babied more, and seemed less mature than Chuck in some ways: for instance, he t e l l s tales, likes quieter games, even plays hopscotch with the g i r l s rather than tough rugby with the boys. Chuck is completely different, real boy, on the tear.all the time. He finds i t hard to s i t s t i l l and concentrate at home, or at school. If he is fond of a teacher, he wi l l break his neck to please her. He is loyal and devoted, fights his own battles and takes his punish-ment, never t e l l s tales, i s hurt deeply by criticism. Suggestion after Conference: To separate the twins October 9th: Home v i s i t . Mrs. H. had never thought about the effects of having both twins in the same room, but the more we talked about i t , the more convinced she became that i t would be a good idea to separate them, especially for Chuck's sake. Mrs. H. was concerned about nine-year-old Ann too; her teacher would not allow her to go out for recess unless she had 100% in arithmetic, and there had been occasions when right answere> had been marked wrong. V.T. assured Mrs. H. that these impressions must be the result of a misun-derstanding somewhere, and undertook to mention the matter to Miss B. Epilow-up: Later: Dick was promoted to Miss M's class. Mrs. H. visited Miss B. 2B fihp^t social history for use i n school records MORGAN Donald i- • • Grade 1. Room 2. Problem: Donald has been absent frequently, noticeably half days and often Mondays and Thursdays. School wish to know i f this has any connection with thefact that Mother works one or two days a week. School Report: Donald making no progress, seemingly immature and fearful, Weak i n reading. Home conditions; Donald under doctor's care, because of serious cough, loss of weight, pains in legs and drowsiness. Doctor, finding no marked physical basis ,wondered about Donald's school situation. Mother noted difference between sister Grace's ease of learning and adjustment to school and Donald's evident strain a and lack of progress. Wondered what age factor had to do with i t . Grace was 7 yrs. old and Donald 5 yrs. 10 months when they entered Grade one. Mother also feels she might have been over-protective of Donald during the time his father was absent on war service. She is in conflict respecting her care for the children, not knowing when she keeps them home from school i f i t is pampering or good health praeitice. She feels that possibly school is too great a pressure i n Donald's present condition and that there i s lack of understanding of the problem by the school. She had an appointment with Teacher to get extra help for Donald for the Easter holidays. • School Conference: It was decided to consider with the parents the advisability of taking Donald out of school for the rest of the term, transferring him to another room or to kindergarten; also the value to Donald of being in Grade 1 next year with the new opportunity of a year of more successful achievement. Follow-up: V.T. to arrange a conference of parents and principal. SB sample copy of more detailed account of interviews used i n cases . in which Social Worker is giving consultative service in-volving diagnosis and preliminary treatment MORGAN Donald Grade 1. Age. 28.11.41 IQ,. D et. Beg. (C-Y) S.R Prohiem; Absences frequent. Is there connection with Mother working? Progress poor, seemingly immature and fearful. 16.5.48. Visited. Mother out; male frissnd of family was staying with Donald who was under Doctor's care for cough and general run-down condition. 16.5.48. Letter sent from Principal, outlining the extent and pattern of Donald's absences. 17.3.48. Visited. Mother and Donald home. Mrs. M. had received letter. She explained Donald's condition and symptoms - many colds with serious cough, loss of weight, pains in legs and abnormal need for sleep. Doctor considered possibility of rheumatic fever; gave Donald f u l l examination. When he could not find any out-standing physical defect, doctor asked i f Donald was under any strain at school. M f i r s t , Mrs. M. did not think so. She followed doctor's direction about the need for longer periods of giving cpd-liver-oil i n Vancouver than in some other places. She said that often Donald would seem i l l in the morning, by noon appearing well enough to return -to school. (The Monday and ThSKsday pattern was a coincidence from her point of view. Mrs. M. works the odd day clerking but these f a l l on Tuesdays and Fridays and she always has someone to supervise the c h i l -dren. ) Mother is i n conflict respecting her care for the children (sister Grace age 8). She doesn't know whether keep-ing them home when they have.a l i t t l e cold is pampering them or is a good health practice. She has considered asking the School Nurse's help at the point ofdecidirg when they are a menace to the rest of the children. Nurse has sent them home on occasions. M present Mrs. M. is convinced that Donald's health has reached a sufficiently low point that i t comes f i r s t . He sleeps a great deal - 3 or 4 hours in the afternoon besides a f u l l night sleep beginning at 7 p.m. Worker inquired about Donald's school l i f e . Mrs. H. recalled her feeling of last September that he was not quite ready for school and mentioned this to Mr. M. Grace is 22 months older and in grade 2. She has adjusted more easily. Mrs. M. recalled Donald being panicky about the words he difin't know, pulling a s l i p of paper out of his pocket to show the word he got wrong, asking his mother to help him. He worries a lot about getting stars... Mrs. M. was seeing the teacher, Miss L. the same day to get extra help APPENDIX C B I B L I O G R A P H Y General References Books Pink, A.?., The Field of Social Work, New York, Henry Holt and Company, 1942. Witmer, Helen L., ed., Psychiatric Interviews with Children, The Commonwealth Fund, New York, 1946. Robinson Virginia, "The Meaning of S k i l l " , Twining for S k i l l in Social Case Work, University of Pennsylvania Press, P h i l , 1942. Aptekar Herbert H., Basic Concepts in Social Case Work, University of North Carolina Press, Chapel H i l l , 1941. T'aft, Jessie, "The Relation of Function to Process in Social Case Work? Training for S k i l l in Social Case Work, University of Pennsylvania Press, Philadelphia, 1942. T'aft, Jessie, The Dynamics of Therapy in a Controlled •Relationship, MacMillan, New York, 1933. Reynolds Bertha, An Experiment in Short-Contact Interviewing, Smith College Studies in Social Work, Vol. I l l , No. 1, dept. 1932. Pamphlets, Articles, Reports Learning to Live, Publication of the Canadian Broadcasting Corporation, King's Printer, Ottawa, 1946. "Parent Education and Child development", Social Work Year Book, 1947. Director of Educational and-Vocational-Guidance, -"ept. of Education, Province of British Uolumbia, Victoria, Guidance Bulletins Nos. I l l , IV, 1945; Guidance Extracts Nos. 3, 7, 8, 1945. Specific References Smalley tfuth, "The School Social Worker and the social Development of the Child'-, Proceedings of the National Conference of Social  Work, 1945. Smalley, Ruth, "Helping children "Use What the School Offers - the Bole of the Visiting Teacher", Reprint Education for Victory, U.S. Office of Education, Sept., 1944. Laabs, Alma, "Development of Social Work in Education", The Compass, March, 1945. •-.-"'" , Laabs, Alma, "When a School Child i s in Trouble - School Social Worker Joins Hands with Teacher in Solving Children's Problems," The Child, Dec, 1947. . Laabs, Alma, "Coordination of School and Social Agency Resources", Reprint Education for Victory, U.S. Office of Education, Sejjj.1944. Everett, Edith. M., "The Importance of Social Work in a School Program, The F amiiy, March, 1938. Leonard, Shirley, "Intake Policies i n a School Setting", The Family, d e c , 1941. ~ . Janvier, Carmelite, "The School Program in Casework with Exceptional Children," Proceedings of the National Conference of Social Work, 1942. Palmeter, H., "The Visiting Teacher Prepares a Child for Placement," The Family, November, 1940. Poole, Florence, "The Function of the School Social Worker in the Pittsburgh Public Schools", Reprint Education for Victory, U.S. Office of Education, Sept., 1944. Hundley, Mrs. Margaret, "The S chool*s Social Responsibility to Children," Reprint-Education for Victory, U.S. Office of Edu-cation, sept., 1944. Cook, K.M.,"Visiting Teacher Services in the Administrative Organization of City School Systems," Education for Victory, Vol. 3, Jan. 1945. "Some Recent Developments i n School Social Work," Education for Victory, Vol. 3, Jan. 1945. "Social Work in the Schools", Social Work Year Book, 194S. '•National Association for School Social Workers", Social Work Year Book, 1947. -"Social Case Work in Public Schools", pub. by American Association of ~ Visiting Teachers, 1941. ; " Government Publications "The Place of Visiting Teacher Services i n the School Program," Bulletin 1945, U.S. Office of Education, federal Security.Agency, 1945. ' -"Visiting Teacher Services", (Report of a Conference Called by the Cornmissiioner o* Education and held in the U.S. Office of Education, Washington, D.C., June 1945), Leaflet No. 75, Federal Security Agency, 1945. Bulletins THE BULLETIN of the National A g S O C i a t i o n of School Social Workers, " Vol. XXII, No. 3, March,-1947. THE BULLETIN of the Rational Association o f School Social Workers, Vol. XXII, No. 4, June, 1947. Reports Report of Winnipeg Child Guidance C l i n i c , 1948. "Report of the Committee on Social Welfare Work and i t s relation to the Schools" - to the Vancouver Principals' Association. Gundry, C.H., M.D.., Annual Report to the Metropolitan Health Conmittee of Vancouver, 1947. McKay, Ruby, %eport of Magistrates' Conference", B.C. Welfare, pub. by Social Welfare Branch,-Dept. of Health and MeIfare, B.C. 

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