Psychiatric Social Work
- Author:
French.
rublisned by the Commonwealth rund, 1940. 13s. 6d.
This is, I believe, the first book to be devoted wholly to the subject of psychiatric social work. It is to be expected that it should come from America, where the experience of psychiatric social work extends over a period of thirty years and whose workers still are more articulate concerning the trends of their work and their essential roles than we are here in Britain. Much of the book is devoted to a historical survey of psychiatric social work, dealing with the developing role of the workers, not only in the specialized field of Child Guidance Clinics, State Mental Hospitals and Mental Hygiene Clinics, but also their influence on general social work. This is a theme of first importance to us in these days of wartime, when psychiatric social workers have so often left their old relatively well-defined spheres and have been called on to fill posts of ever-increasing responsibility in work created by wartime stresses. We need constantly to remind ourselves of the discipline imposed by our specialized approach.
A chapter in Miss French’s book is devoted to ” Social Work in Relation to Psychiatry “? a subject of renewed interest to us to-day, when social workers are so often being forced to deal with mental health problems with little or no guidance from or collaboration with psychiatrists. There is a danger in this situation; without this active collaboration and under the pressure of work, the psychiatric social worker may tend to neglect her psychiatric function, falling back on practical adjustments, or on the other hand she may attempt to assume the responsibility for therapy even in cases of gross disturbance. The psychiatric social worker, as Miss French’s book clearly shows, is a therapist, but her sphere is limited.
Miss French shows how the mental health training of workers who were returning to other fields of social work has influenced and modified the modern approach to general case work. Yet, as she points out, a specialized technique is not necessary or applicable to every case. Not every case arises from or is blocked by emotional disturbances or personality difficulties and many will respond to a removal of obstacles or to practical assistance given. I think it can be allowed, however, that psychiatric social work has made a real contribution to social work in general by the increased respect it gives to the individual client.
Probably the most interesting and relevant section of Miss French’s book to British psychiatric social workers is the one dealing with ” Some Trends in Social Treatment ” (pp. 199- 241). She discusses the early conception of treatment through study of the data, diagnosis and plan of treatment, which was carried out mainly through the interview where the chief function of the worker was “to make the client see.” She shows how the frequent failure of this method with the resultant closing down of cases as ” unco-operative ” challenged workers to evolve new techniques. We are perhaps too diffident to speak of our efforts in the same direction as “attitude therapy” or “relation therapy ” but the terms represent something every worker will have experienced in her own social work development, an increasing need to allow the client to be self-determining, to act as an instrument through which he can clear himself of emotional blocks and can then go forward to making his own plan. A quotation from Miss Marcus makes this point succinctly : she says, ” He (the client) is accessible to treatment only of problems which he himself feels and has an urge to work out. Whatever the personal or social consequences may be, the client controls, or more accurately, is unconsciously controlled by, his own problems, and therapy may assist him in solving them only in the way and to the extent his own desire and his own capacity dictate.” N.A.
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