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Intake priorities and criteria in a Family Service agency : a survey of waiting list cases and administrative implications. Porter, Eva Mildred

Abstract

Present trends and stresses in family service agencies are related to external and internal demands for more effective service for an increasingly diversified clientele. In the face of these demands, the device of the "waiting-list" has become widely prevalent in family service agencies throughout North America. This represents a backlog of accepted applicants who cannot be given immediate- service, and it inevitably necessitates giving some applicants priority over others, on the basis of relative urgency. The waiting-list developed as a result of efforts to protect the quality of casework service to families, but it does pose some serious questions about the quality as well" as the quantity of service to the community. What is urgency? What happens to those who wait for service? What is the relationship of the waiting-list and priority decisions at intake to the changing constituency of the family service agencies? This study examines some of the questions that arise when there is a waiting list in a family agency, by focusing on certain aspects of the waiting-list of one agency. This is an exploratory survey of the waiting-list of one agency (The Family Service Agency of Greater Vancouver), as it is reflected in a block of 95 cases accepted for service during a two month period -of 1958. It includes a statistical survey of the applicants and their families and the main problems they presented at the time they approached the agency. The sample is then divided into two main groups - .brief service and continued service cases (according to the Family Service Association of America-definition). Statistical information about the length of the waiting period, opening status, length of service, and main presenting problems is related to each of these groups, and also to cases which received priority service and those which did not get this consideration. Case study of brief service cases is focused on evaluation of services they received, and particularly on the effects of the waiting period and priority decisions. Study of continued service cases includes statistical information about the total items of service provided to this group, and the family members who received direct service. For the purpose of case study the continued service cases are divided into three groups according to the length of service they received, and described as short-term, medium-term and long-term cases. Case examples give a picture of the range of the clientele and services provided to these three groups. Although three-quarters of the initial applicants were women, in continued services cases the male marital partner was usually involved and men received a substantial amount of direct service. The employment of the male bread-winners in the sample was mainly lower middle class and upper working class in status, but there was representation from groups of higher and lower status. However, information about the applicants’ family groupings, interpreted in the light of current literature, suggests that most of them are identified with the so-called "middle class values" of family life, and this is supported by examination of case material. Among adult clients, particularly those who received service over long periods, there appears to be a high incidence of personality disorders. Others, particularly among the new applicants, are persons easier to help by casework methods. The study points up the importance of new applicants, and the need for giving them greater consideration at intake if new clientele are to be reached in any numbers. The most positive fact revealed by the study is that "loss" of cases in the process of intake is almost entirely a problem of "engaging", the new applicant. It is suggested that when there is a waiting-list, personal intake interviews should be offered to all who are making a first application. Apart from the need for more consideration for new applicants, extension of effective service appears to be related to the quality of intake service, rather than to any concrete rules for priority determination.

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