So-called "hard core" cases have long been known to welfare agencies and to communities; but proper definition and understanding is still often lacking, while attention has not been sufficiently directed to the problems of adequate diagnosis, early recognition, treatment and prevention and the social or community aspects as well as the personal or single-agency implications. The present study is an exploratory analysis, examining data and methodology, of such groups in a particular but strategic setting - the family service agency. After (a) considering popular and more acceptable definitions of "hard core" cases, it (b) reviews briefly some of the statistical indications of long-term cases in the Family Service Agency of Greater Vancouver, and proceeds to (c) a detailed analysis of a small selected group who manifest all the characteristics of chronic dependency and maladjustment. The systematic exploration of all the complex elements in the pattern of multi-problems dependency is the main theme of this study. Despite gaps in information- it proved possible to list these factors within three subdivisions:- (a) Socio-economic factors and presenting problem, (b) physical and mental health, and (c) premarriage history. A significant number of common elements were shown to be operating within each family. These elements were studied in conjunction with family behaviour patterns and a further correlation between them and the behaviour patterns seemed apparent. In spite of the complex inter-relationship of personality and environmental factors, it is possible to advance the view that multi problem families and potentially chronic cases are susceptible of relatively early identification. This would be a major step towards more effective diagnosis and treatment planning for the multiproblem family. Effective treatment planning and possible preventive techniques however, raise the essential issue of adequate community and agency resources. A Family Mental Health Centre is one special medium, as are some of the environmental services developed in such countries as Sweden and Great Britain. The tentative conclusion favours a balance between the American "mental health" approach, and that of coordinated social and environment services. As an exploratory study, it does not minimize the urgent need for further research. / Arts, Faculty of / Social Work, School of / Graduate

The treatability of social problems by social casework method needs study for two reasons: (1) the obligation of the profession to those it serves, to always refine and develop its services; (2) the practical consideration of achieving optimum economy of service. Among the factors enumerated by authorities in the field of social casework as components of treatability are: the scope of social casework, the development of the profession, agency function, community resources, the skill of the caseworker, the problem, the reality situation and the client. Of these only the latter has been singled out for independent study. The purpose of the study was to survey professional literature for criteria, necessary for recognition and assessment of this factor, which could be submitted to the test of empirical research for validity and reliability. The potentialities of individuals for personal change is not a new concept in the profession, but one which has only recently begun to receive special consideration. Personal potential, as defined within this thesis, is the ability of the individual to solve his personal problem by means of casework treatment, the problem being defined as the inner difficulty underlying his symptomatic difficulty, and solution being considered as an inner and positive change in relation to the problem. Evaluation of this factor, therefore, presumes a clarity of diagnosis, which points up the need for developing more satisfactory diagnostic classifications than exist at present. Professional literature offering criteria of personal potential was found to be limited in quantity and generally incidental to other subject matter, and therefore not thoroughly or systematically considered. On the other hand, the quantity of criteria suggested was proportionately large. The number and nature of criteria varied widely among the authorities, as did the form in which they were presented. It was at first hoped to be able to sort and classify these. However it became apparent that the ambiguity and inconsistency with which terms were used would make such classification a highly subjective task. The criteria found did not possess generally accepted or precise definitions, and could not be measured statistically. A subjective appraisal of the criteria in terms of validity suggested that of the two main categories into which they seemed to fall, namely, level of adjustment and motivation, there was some theoretical and practical basis for considering motivation as essential for personal potential, and for considering level of adjustment as helpful and as an indication of the level at which treatment should start. There was also the suggestion that all people can be helped. The findings indicated that current criteria need to be reduced to items which can readily be defined, detected and measured for validity and reliability. Until such time as criteria are developed, practitioners will continue to rely on clinical judgements. In view of the hypothesis that all people can be helped and that motivation is of prime importance, there is reason for evaluating the adequacy of casework diagnostic and treatment skills and for clarifying how treatment goals are established. / Arts, Faculty of / Social Work, School of / Graduate

The present study is an exploratory one to examine how far casework practice at the Vancouver Child Guidance Clinic recognizes socio-cultural factors in the etiology of the child's problem, where the parents belong to particular ethnic groups. The method is a composite one using both survey and case-study techniques. From a reconnaissance group of forty cases, representing families from sub-cultural groups, ten cases are selected for intensive study and analysis. These ten cases fall naturally into two groups, of five eases each, one of which is a fairly homogeneous group of families with predominantly Jewish cultural backgrounds, while the other is a heterogeneous group of families from various European cultural backgrounds. A schedule is used to select diagnostic statements from the diagnostic study period of the case records according to the predominant orientation: that is, psychological, psychosocial, or socio-cultural. Classifications are made of recorded socio-cultural diagnostic statements, and statements referring specifically to culture. A case-study is used to examine how far casework practice recognizes socio-cultural factors in both the diagnostic and treatment periods. A questionnaire, filled in by the caseworkers, is used to show the intellectual orientation of casework practice at the Vancouver Child Guidance Clinic. The findings suggest that casework practice in this setting is predominantly oriented towards a psychological interpretation of the child’s problem with a consequent under-evaluation of the role social and cultural factors play in determining human behavior. There is a need for clearer recognition of social and cultural factors in the etiology of human adjustment and maladjustment. Although there are indications that other areas of knowledge are considered important by some caseworkers, there is evidence of need for better integration of relevant social science concepts with the skills and techniques of casework practice. This holds implications for social work education on both graduate and under-graduate levels. / Arts, Faculty of / Social Work, School of / Graduate

The purpose of the thesis is (1) to determine the social and psychological needs of a group of "more reformable" inmates of the type who will eventually make up the population of the new Haney Correctional Institution at Haney, British Columbia, and (2) to determine how custodial and casework staff might best meet these needs through the medium of counselling. In order to accomplish these objectives, a sample group of seventeen inmates from the Westgate Unit in Oakalla Prison Farm was selected on the basis of certain criteria set up by the Planning staff of the Haney Correctional Institution. These inmates were studied intensively by widely varied methods, including personal interviews, group sessions, review of case files, and interviews with staff. This research technique proved to be unusually effective and it was possible to get a very complete picture of each of the men studied. The findings indicated that most of the inmates had serious social and psychological problems that seemed to call for a concentrated programme of treatment. The custodial officer who has close daily contact with the prisoner was seen to be the 'key' person in the helping process. It was seen, too, that although the main share of counselling inmates must fall on the social caseworker, some inmates are not amenable to casework help but do need some kind of counselling. The custodial officer is the best person to give such lay counselling, which should therefore be considered a most important part of his job. Nevertheless, it was seen that he needs training, experience and supervision to play this role effectively. The need for team work of the highest order between the custodial officer and the social caseworker was seen as vitally important. / Arts, Faculty of / Social Work, School of / Graduate

This study involves a definition of sound intake procedure and an analysis of the presently established intake procedure in the Vancouver City Social Service Department. The focus of the enquiry is the effectiveness of the intake procedure in meeting the needs of clients who make application for social assistance. The effectiveness is measured in terms of study, diagnosis, and treatment, and the need for skilled case handling at the first point of contact between agency and applicant. Five types of intake cases are distinguished and illustrated. The referral process is studied as a secondary focus, three types of referral being distinguished. Material for the study was gathered from current texts and articles on comparative intake procedures, interviews with the administrator, unit directors and workers of the City Social Service Department, interviews with the directors of hospital and T.B. social service departments, and by the analysis of representative and illustrative case material. This study substantiates the belief that casework can and should be done in a public welfare programme. It also shows through case analysis that casework is required at the intake level, and the success of intake procedure depends upon the employ of skilled and qualified social caseworkers. Other matters determining the success of intake procedure are suitable office environment for the public, adequate stenographic aid for the social workers, skilled use of interviewing time, and sound referral process. Many problems exist which prevent maximum service to clients. Solutions to these problems are possible without major change in the administration, structure, or budget, and are implications for policy change. The study finally indicates the need for more adequate interpretation of policy change to the city council and to the community if the public assistance programme is to enjoy public sympathy and understanding. / Arts, Faculty of / Social Work, School of / Graduate

This study of resistance of the adolescent to casework services was undertaken in an effort to determine if any relationship existed between the resistance shown and the emancipatory efforts and psychosexual conflicts of this age. Thirty adolescents showing resistance throughout their casework contact at the Child Guidance Clinic of Vancouver were used in this connection. These thirty adolescents showed four main patterns of resistance. The majority of 50%, showed progressive resistance over their contact with the agency. The next largest group of 20% showed swings in resistance; generally manifesting more resistance initially and terminally than in the exploratory period of casework. The third group of 16 2/3% showed consistent participation or resistance throughout their clinic contact and evidenced little movement during this time. The last group of 13 1/3%, were decreasingly resistant as casework proceeded and appeared to be the group who externalized and worked through their initial resistance most successfully. Of the thirty adolescents who were diagnosed as in need of intensive casework treatment; only four continued treatment at the clinic. Three other youngsters were referred elsewhere for help; and 23 ceased treatment of any kind as a direct result of their resistance. This resistance seemed intimately connected with the adolescent stage of development. Emancipatory efforts, interfered with treatment in 60% of the cases. Oedipal attachments to parents complicated the treatment relationship in 30% of the cases; and inability to relate precluded use of treatment in 10% of this group. The fact that these adolescents all came from homes in which parent-child difficulties predominated meant that the normal solution of adolescent problems were hindered. It leads us to believe that resistance to casework is an almost inevitable consequence of such distorted family settings. To cope with such resistance implies that we must first of all be alert to resistances, which may be overt or latent, in our first contact with the adolescent client. Use of the peer group in treatment settings needs to be explored further. Increased integration of community resources is vital if full use is to be made of existing sources of help by the adolescent in need of assistance. Also, new resources; such as a residential treatment center; professionally led parent education groups, etc., must be established to reach the difficult group of clients. More attention must be given, also, to the caseworker dealing with these resistant clients; if her own anxiety in the face of the client's withdrawal is not to increase such tendencies in the adolescent. A follow-up study of the results of casework help to such resistant adolescents needs to be done if we are to know the value of spending our time with these difficult clients. / Arts, Faculty of / Social Work, School of / Graduate

This study is concerned with non-voluntary referrals of school children with family problems to the Family Welfare Bureau of Greater Vancouver. Because the children's difficulties arose mainly from disorganized family situations, help was sought from the Family Welfare Bureau. The study deals only with referrals in which the clients did not participate. Not only did the clients not ask for help from the agency, but in many cases they were not even notified by the schools of the referral. The clients' first contact with the Family Welfare Bureau was, therefore, through a letter or a visit from the agency worker. The study is based on case records of the families concerned, over a two-year period (June 1947-June 1949). Forty-six out of fifty-nine cases were utilized, the remainder having been erroneously marked "school referrals", or relating to clients who made their applications for service personally. The cases studied were grouped into three categories in terms of the types of problems which had caused the school referrals: (1) behaviour of the child at school; (2) family discord brought to the attention of the school personnel; (3) apparent economic need. Twenty-five cases were analyzed in detail to find out what actually happened to the clients in the process of their contact with the Family Welfare Bureau. Examination showed that it would be unsatisfactory to use this classification for an analysis of outcome. The sample was, therefore, grouped into four new categories in accordance with the clients' response to the service offered by the agency: (1) direct rejection of help; (2) passive resistances (3) use of environmental help; (4) use of help for changing family relationships. There is evidence that a major number of unsuccessful school referrals (seventeen out of twenty-five cases) was caused both by an inadequate referral process and by confusion on the part of the agency worker in her initial contact with each client. The study bears out, particularly, the importance of the first contact between the family and the worker, showing that a worker who has certainty of purpose, warmth, understanding, and respect for the client's right to refuse the agency service, can often make that service acceptable to the client in spite of both an inadequate school referral and a strong initial resistance on the part of the family. On the other hand, there are indications that neither the Family Welfare Bureau nor any other social agency can meet all the needs of the child with school problems. Consequently, there is urgent need for the establishment of social work service within the framework of the schools. / Arts, Faculty of / Social Work, School of / Graduate

Investigation of referral practices between agencies offering casework services and agencies providing leisure-time services is the essential subject of this thesis. To meet the criterion of success, which was established in the study, a referral should be planned and carried through only when an individual's needs are thereby more adequately met. In the past, referrals often fell short of this standard, but since roles of the workers, and the nature of the referral process itself were not clear, factors promoting failure were unidentified. To clarify these matters was an objective. An additional objective was an evaluation of experimental attempts to provide casework services in leisure-time agencies. This fusion of casework and group work services and the needs hereby met are examined. In the study twenty-nine case and group records, chiefly from Vancouver agencies, are used. Both adults and children are considered in the cases, but children's problems frequently stemmed from relationships with parent figures. Thus, helping the parent was an integral part of help for the child's difficulty. The findings deal with phases in the referral process. The burden of the evidence shows the outcome of referral to be problematic if workers try to deal with a child alone. If a worker recognizes and deals with parents' resistances and problems, thereby enlisting their co-operation, probability of successful referral is increased. Nevertheless, when workers have no clear idea of their respective responsibilities, any activity is of doubtful service to the individuals. The implication is that a joint casework-group work staff conference offers the best framework within which to define roles, to evaluate information about a situation and to form a social plan. Later review of this plan is usually essential; then workers may modify their approach or withdraw from the process. Lack of group records constitutes a specific weakness in evaluation of the group worker's role; moreover, it was often difficult to learn from case records how the caseworker had functioned. This discloses the need for better recording. New insights into the nature of referral show it to be a joint casework-group work function requiring (a) careful attention to each case on an individual basis, (b) close collaboration between caseworker and group worker, and (c) a capacity of parents to modify their attitudes to children needing referral. Additional criteria for good referral are given. / Arts, Faculty of / Social Work, School of / Graduate

This study concerns itself with the social worker's contribution to the services of the Provincial Child Guidance Clinic in Vancouver. The focus is on the interviewing methods of the worker as a factor in treatment. The analysis is derived from case records of 141 patients admitted for service in 1948 and 1949, as well as from one case record admitted for service in 1950 which illustrated the worker's methods in interviewing. A preliminary review was made of the evolution of social case work interviewing over the last 20 years and 13 methods were derived. The integration of social case work and mental health services is drawn from literature on social case work and child guidance published in the United States. The nature of interviewing by social workers at the clinic is seen in relation to the clinic's program of diagnosis and treatment. The examination of records for a two year period indicate that diagnosis was a large part of the clinical program. About 38 percent of 141 cases discontinued their contact with the clinic immediately after the diagnostic conference. About 89 percent of interviewing carried out by social workers was on a short-term basis and the proportion of treatment interviewing on an advanced intensive scale was five percent. The study of selected cases indicates that the social worker could contribute more to the services in the area of intensive casework interviewing. Limitations on his capacity to do so may have been imposed by imperfect physical facilities. Mothers received 41 percent of the interviews in 141 cases as compared with 31 percent with the child and nine percent with fathers. There is a need for greater interpretation to fathers of their importance to the child's emotional development. The type of case work interviewing being done with some adults seems to indicate that future development in the program might well include them within its focus. A suggestion is made that more purpose and direction may be given to treatment if workers are more conscious of their skills. The agency would be able to meet its responsibilities to community more successfully if increased appropriations were made. / Arts, Faculty of / Social Work, School of / Graduate

In recent years a considerable amount of research has been done on the subject of the multi-problem family. The realization that some families were utilizing most of the communities services, time and money and still showing little change lead social agencies to study and experiment with new ways of serving these families. In 1959 the Community Chest and Councils of Vancouver recommended that a special project be developed in one area of the city to demonstrate co-ordination and integration of services to the multi-problem family. From this proposal the Area Development Project of Vancouver was established. This project has co-ordinated health, welfare and recreational services to families with complex problems. One part of the project is concerned with direct treatment of multi-problem families and this part of the program is called Integrated Family Services. Five caseworkers provide service to 100 families selected on the basis of chronic and multiple agency use. Each worker provides basic welfare services to the family as a whole and carries out functions delegated by several agencies. The second part of the service is carried out by two social workers and views the neighbourhood as the focus of service. In addition to the demonstration services provided by the project, there is a strong research component. The experimental design calls for 100 families in the treatment group, and 200 families in two control groups, in order to test the assumption that the demonstration services of the project are more effective in improving the functioning of families with complex problems than the "usual services" of health and welfare agencies. The present study is intended to study changes in social functioning between the treatment and control group of the Area Development Project and to measure the effects of selected family characteristics on the changes in social functioning. Although definite conclusions cannot be reached as the writers touched on only a limited area of the total project we feel that the observations and proposals deserve closer consideration. The introductory chapter gives a brief, summary, of the problems the community encounters in dealing with the multi-problem family and the rationale Behind experimental projects designed to study these families. In Chapter II a summary of several studies and projects on the multi-problem family in the United States offers a means of comparison to the local scene. It also illustrates the various approaches that can be taken toward the families with complex problems and defines the term "multi-problem" as utilized in this study. The purpose of the study, its scope, and the methods utilized are outlined in greater detail in Chapter III. In Chapter IV, the research data are classified and presented in table form where appropriate. A brief analysis of the data is also presented. The chapter also contains observations on the research project and its findings as a whole. The thesis concludes by presenting some implications and outlining further areas of study based on the findings of the thesis. This area of study was suggested by the staff of the Area Development Project and it was hoped that the findings of the thesis would provide added implications and observations for their project. / Arts, Faculty of / Social Work, School of / Graduate