Problems of Social Workers
The Psychological Clinic Copyright, 1911, by Lightner Witmer, Editor. Vol. V, No. 1. March 15, 1911.
- Author:
Anna Cooper Campion,
Head Social Worker.
The social service department of the Psychological Clinic was opened October 1, 1909. The necessity for establishing a personal relationship with the families of the children seen at the Clinic, created an imperative demand for social work with its attendant records of home conditions.
The duties of a social worker are both complicated and delicate, connected as they are with mental or physical suffering, conditions which require the nicest understanding and the most tactful and sympathetic attitude. In connection with the Psychological Clinic these qualities of mind and heart are peculiarly essential because the cases handled are those of children suffering from mental or moral, as well as physical defects. Acting usually upon the advice of a physician, school principal, or teacher, parents bring their children to the Psychological Clinic as to a place of last resort, in the hope that the Clinic will offer some suggestion as to the school or class where they may receive the necessary treatment or training. Disappointed at first to find that there is no school connected regularly with the Clinic, they are comforted to know that this first visit is not final, that their home will be visited, the school teacher interviewed, and a link formed between the home and the source of help. The need of social service will be seen from the following summary of cases from October 1, 1909, to January 1, 1911: A. Cases under observation, requiring visiting, medical attention, etc 135 B. Visits paid to homes, schools, hospitals, and physicians 729 C. Number of children placed in hospitals 25 Number placed in boarding schools 2 Number placed in hospital schools under direct care of social worker 5
In addition to visiting homes, institutions, and clinics, the social worker must keep up card files and records, make appointments, and assist in the Clinic by receiving cases referred to the social service department. The children who are the wards of the Clinic during their special training come frequently under her care. One of the volunteer workers visits almost every day the homes where these children are boarded, and supervises the carrying out of medical or surgical treatment advised by physicians, as well as the diet, baths, exercises, and other measures of constitutional treatment connected with the children’s physical welfare. To these duties is added the study of institutions. The need of placing certain of these children in suitable institutions, requires a thorough study and familiarity with their purposes, methods, and conditions of entrance. As this is frequently accomplished through the aid of some charitable organization, a knowledge of charitable societies is another requisite. Most of this must be gained from personal experience, as well as by the collection of catalogues, reports, and statements issued by institutions. Since the beginning of the Psychological Clinic a large number of children brought for examination from public schools and institutions have been incorrigible boys, ranging in age from six to sixteen years. These boys have been found to improve under the care and supervision of the social service department. When it was determined to organize a class for troublesome, adolescent boys during the Summer School of 1910, the selection of the pupils was left to the discretion of the social worker. It was not difficult to find thirteen boys of the desired type. The class began July 5, 1910, with thirteen boys, from eleven to fifteen years of age. During the preceding months six of the boys had been examined in the Psychological Clinic and referred to the social worker for observation. She had visited their homes many times, so that on the opening day these boys did not come to the class as perfect strangers. One came from the Children’s Bureau, one from the Juvenile Aid Society, and two from parents who had read an announcement of the class in the papers. Of the thirteen, all but four had been expelled from the regular schools because of incorrigibility. From the day the summer session began the entire class exhibited a strong attachment to the social workers in the department, and a desire to be courteous and generous, often bringing them small gifts of flowers, candy, ice cream cones, etc. Owing to the size of the class and its incorrigibility, the two instructors found it impossible THE SOCIAL WORKER. 3 to control the boys without help, so the social worker and her assistants were called into service some part of every day, taking the boys to luncheon and sitting at table with them, and occasionally helping them to make up school work which they had refused to do in the school room.
Six of the boys came to the Clinic with histories of dishonesty, and during the first three weeks of the school more than ten dollars was taken from different coats, desks, and handbags in and around the clinic room and laboratory. Because of the social worker’s knowledge of the boys’ histories and home conditions, this matter was turned over to her department for investigation. A request was made that each boy come to the social worker’s office on a certain day and make a personal statement privately as to whether he had taken anything from the department. The boys came without hesitation, and each one,?those who had taken money and trifles as well as those who had not,?made frank confession and showed a certain loyalty by carefully avoiding any statement which might implicate other members of the class, although several of them had been witnesses to one boy’s going through a desk. Outside of the building, however, they failed to show this consideration, and such names as ‘crook’ and ‘thief’ were frequently used.
One boy who had opened the social worker’s desk and taken seventy-five cents from the handbag belonging to a physician, when asked why he had not taken any money from the bag of a certain social worker, replied, “Oh, I would not take money from lier.” Another boy, when asked if he had been in a desk in one of the offices replied, “I have not been in that desk yet.” A third boy acknowledged taking five dollars from a wallet belonging to one of the members of the department. He had two of the five dollars left, which he returned at once on coming to the office. He displayed a watch and fob and a policeman’s badge which had been purchased from a pawn shop on Vine street. He was taken by the social worker to the pawn shop where he made confession to the man in charge and the money was refunded and the articles returned to the owner. All the boys who had taken money made an effort to return the amount, some bringing one or two cents daily.
At the beginning of the school, the teachers adopted the method of sending boys who became unruly to the office of the social worker for correction. Owing probably to the fact that she was not a stranger to them and that she had spent much time in handling street boys, and perhaps also to the natural chivalry of the boys toward the opposite sex, it soon became apparent that many members of the class were not averse to being sent from the class room to the office of the social service department. The office of the social worker became in effect an additional school room. Under her instruction, the manners of the boys improved greatly. They grew more considerate about removing their hats and opening doors, always saying, “Ladies first,” and lowering their voices upon approaching the department, where they knew no quarrelling or roughness of any kind was permitted. The punishment for any lapse in this direction was going without baseball, gymnasium work or swimming.
During the six weeks of the class every boy underwent a mental and physical examination. Ten boys went to the Eye Dispensary of the University Hospital, or to an oculist for eye examinations ; six of these had drops in their eyes for three days, during which time it was thought best not to allow them in the class room as, being unable to take part in the class work themselves, they only disturbed the others. These days they spent in the social service department where drops were put in their eyes and general supervision given them. Dr Lippert who had general medical supervision of the boys gave each one a thorough examination at this time. One boy had an attack of heat prostration, his temperature rising to 103? F. It was necessary to keep him in the social service department the greater part of one day. After’ this experience, it was difficult to get him to stay in the class room. He was constantly hunting around the building for his benefactress. Coming from a particularly poor home, he had probably never received much sympathy or personal attention, and his devotion to the worker was touching. There was one case of abscessed ear with mastoid swelling, and this lad went to the Ear Clinic daily. The most obstreperous boy in the class had a dislocated finger, having come in contact with an automobile on his way to school. He also was a dispensary case, going almost daily. Theso facts are mentioned to illustrate how constantly the members of the class came under the jurisdiction of the social service department. In addition to the above mentioned casualties, there were numerous cases of cuts, requiring dressing. During the six weeks of the school, a weekly visit was paid to the home of each boy by one of the workers or a written report sent in by parents. These reports varied from week to week, and during the school period they were not very encouraging so far as the boys’ conduct at home “was concerned. The parents were supposed to state in their report what studies the boy liked best, whether he liked his teachers, and if he looked forward each morning to going to school. A very typical report was given in the case of one of the boys who had told his mother that the branches he liked best were “swimming and eating.” The general report was that they were fond of their teachers, liked to come to school, but did not care for the other members of the class. After much consideration, observation, and association with this class of adolescent boys, I came to the following conclusions: First, that such a class of boys, outcasts from regular schools and polite society, or such society as their more virtuous brothers and sisters are admitted to, cannot be handled by the ordinary teacher, who is accustomed only to the normal school boy. Also, that more than two teachers are necessary to control a group of thirteen boys of this type. Secondly, that there must be some knowledge of the boys’ family history and home environment. Thirdly, that the teachers in charge, whether men or women (and I am strongly in favor of men), must decide upon a reasonable plan of discipline and punishment, corporal or otherwise, and then all agree to administer certain punishments for certain offences. The street boy,?and the summer class for adolescent boys was composed almost entirely of this type,?cannot be shifted from one form of discipline to another with satisfactory results. The class proved a most interesting experiment, and another summer, aided by the mental picture of each boy in his home environment, and profiting by our past mistakes, very important results may be expected. Since the Clinic opened again in the fall, we have received a report from each of the thirteen homes and from several schools. With one exception, from every mother and teacher comes a report of improved conduct. Several of the boys have visited the Clinic or have been seen on the streets. They have all shown the greatest interest and have expressed the hope that they can return next year. The boys of this special class lived at home, but it is often impossible to do much for the difficult or abnormal child if it is left in its home environment. Take for instance a case like that of Edith G. She was discovered by an agent of the S. P. C. C., sitting stolid and apathetic in a dark and dirty room of a wretched slum district. Though the child looked about four years old, the agent found upon inquiry that Edith was twelve. Both parents were drunkards, and the home conditions could not have been worse. Certain signs of abnormality in the child made the agent’ telephone to the Clinic and arrange a time when she could be seen. From this time, about the middle of December, until the present date, Edith has been under the care of the Psychological Clinic. She has been one of the wards of the social service department, and her progress has been watched with the most vivid interest. From being so repulsive in appearance that no one could bear to touch her, she has been transformed into a nicelooking little girl with pink cheeks, curls, and bright hair-ribbon. She has lost her apathy, talks and sings and is happy. At first, only with great difficulty could she be induced to give a monosyllabic answer. iSTow she speaks in connected sentences. Iier first sentence was an amusing shock to the woman who has her in charge. Edith had choked on a fish-bone, and Miss B. having removed it, showed it to the child, saying, “Look, Edith, what a big bone that was!” “Yes,” said the hitherto silent one, “that’s a son of a gun of a fish-bone!” The good hygienic condition of Edith’s present home, the baths and massage, medical treatment and mental training, have all had their share in this improvement; and in the work of reconstruction, to which many agencies are contributing, the social worker is an indispensable element.
Another case, which showed wonderful improvement in a short time, was that of a little lad of three, who was unable to speak. The boy was a bright, attractive child, perfectly normal physically, and keenly interested in everything about him. When he was spoken to, he made an unsuccessful effort to reply. The history of the child disclosed the fact that at the age when a normal child begins to speak, this boy had been left alone in a room with another child, even younger, while the parents went out to work. After an examination it was thought he could readily be taught to speak, and it was decided to keep him under observation in a temporary home connected with the department, and have him attend the speech class. He has now been in the care of the Clinic for only four months, and in that time has acquired a vocabulary which is readily understood.
Perhaps no better case could be found to illustrate the need of just the kind of personal relationship often established by the social worker, than that of Harry M. This boy, aged fourteen, had got completely beyond the control of the school and family. Truth-telling was for him a lost art. He constantly purloined small articles and sold them for a few cents, the climax being reached when he stole sums of money from the neighbors. The early home influences were unfortunate. He lost his own mother at the age of five, and two years later came under control of a step-mother, between whom and Harry there was continual warfare, without sympathy or understanding on either side. All methods of discipline proving useless, he was handed over to the Juvenile Court and put on probation. This treatment failing to bring the desired results, frequent incarcerations in the House of Detention were tried without success. Next, he was sent to a special school, and finally as a last resort, brought to the Psychological Clinic. His conduct had been growing steadily worse. At school he was noisy, irrepressible, undisciplined, and utterly careless of consequences. At home he was disobedient, irritable and stubborn. When permitted to go out on the street at night, he forgot everything, and either returned at his own pleasure or was brought home by his father.
It was not until he was taken to the Dental Clinic that the chief source of his nervousness and irritability was made clear. The condition of his mouth and teeth must have been a cause of constant and almost unbearable irritation. On account of the dental work, as well as an eye weakness which required an oculist’s care, Harry was not sent back to the public school.’ Through the Psychological Clinic, a private school was found where the boy could receive the intelligent and individual training he needed. Under this new regime his demeanor rapidly became that of a normal, healthy boy. He was put upon his honor and trusted in numberless ways, and in every case lie justified the expectation of his teacher. His nervousness gradually abated, and his manners and temper both improved. In September, 1910, he was placed in a country school near Philadelphia. At first the outdoor work, such as farming and work around the stable, did not interest him, but after he was promoted to being an office-boy and general assistant to the principal of the school, he made rapid progress. Only in the last month an opportunity has opened to Harry which may change his whole future life. A well-to-do man desires a boy of intelligence and refinement who will be a companion to his son, who will go to school and college with him, and whose expenses will be paid until he is twenty-one. If Harry continues to improve as he has been doing, the offer will probably be accepted for him.
If this piece of good fortune should fall to Harry’s share, there is no one who would rejoice in it more than the social worker. From the first day that Harry came to the Clinic until the present time, he has shown a marked attachment to her. On that memorable day when his first outgrown tooth was pulled, bringing in its train relief of body and mind, he had turned to her on the way back from the Dental Clinic and unburdened his mind on many points. The confidential relationship then established has grown with time, and the social worker has been to him the mother he hardly knew, and the friend he never had. He spent many hours with the social worker during his attendance at the private school, talking over with her his difficulties and bringing to her his triumphs. Physically he was a different boy, but health was not the only element of morality in his case, and it is not too much to claim that his pride in well-doing came from the stimulus of their friendship.
In some instances the home seems to need the social worker as much as the child does, and the family is dependent upon her even after the child is removed. This happened in the case of Margaret S., eight years old, who lived in one of the poorest neighborhoods in the northwestern part of the city. The social worker’s assistance was asked by the principal of the school which the child was attending, chiefly because of very noticeable physical defects and bad moral tendencies. The principal stated that if she sent notes of complaint to the child’s home, Margaret would return to school bearing on her small body the black and blue marks of a hard beating. The mother was not cruel. She was merely responding in her feeble, ignorant way to the teacher’s plea for co-operation.
On the first visit to the home it was found to be orderly and comfortable. The father was a man rather past middle age, a driver of a produce wagon; the mother, some years older, had already had a stroke of paralysis, but tried to do her share in keeping up the household by taking in washing. At the time Margaret was removed from her home both the father and mother were ill in bed, the father with an acute attack of rheumatism from which the physician did not think he would recover, and Mrs. S. from a second paralytic stroke. There were five children. The two oldest were daughters living away from home, who contributed in no way to the household. One of them, it is said, gave birth to a colored child after her marriage to a white man. The eldest boy, twenty-one years old, had spent four years in the House of Refuge and was still a ne’er-do-well, not having been benefited by the training which he received in that institution. The next son, seventeen years old, was a frail, over-worked boy, who earned five dollars a week by driving for a contractor. His hours of labor were from six in the morning until six at night, the distance from his home being so great that he was obliged to leave at five o’clock. The youngest child was Margaret.
Mrs. S. said that both she and her husband were religious people, and that they could not see why all of their children, with the exception of Harry, the seventeen year old son, should give them so much trouble. As a matter of fact, Margaret’s moral deficiencies included everything from impertinence and profanity to immoral practices which could not be successfully checked either on the street or in the school. The principal said that she only kept the child because she knew that if she were not in school she would be on the streets. The policeman on the beat informed the social worker one day that if she did not take the child he would, as her conduct was such that she could not be left at large. Margaret at this time was running wild, having been transferred to another school where she was on half-time and where neither the principal nor the teacher were able to cope Avith the situation. Some time before this the child had been examined at the Psychological Clinic, and after the complaint from the policeman it was decided to place the child under observation in a temporary home, at least until the home conditions were more favorable. At first both the father and mother objected, particularly the father, an honest, independent man, who even in his illness felt they should be able to manage their own affairs and care for their own children. However, as the days passed, and he still continued ill, both parents at last consented to Margaret’s being taken away. She was first sent to a hospital where she spent several months under treatment for enuresis and general ill health. She has been tried with unsatisfactory results in several homes, and at present she is being cared for in a school outside of Philadelphia, from which she is threatened with dismissal for immoral practices with boys.
Since the removal of this child from her home, it has been found almost impossible to drop the family. Having once entered a home and made its inmates feel the need and desire for co-operation, it does not seem right for a social worker, after the removal of the child, to desert the needy family. The one in question was particularly dependent because of the feebleness of its members. The Society for Organizing Charity contributed largely and willingly to their support and comfort, assisting them with the rent, food, and fuel for several months until both father and mother improved and were again able to take up their work. During this period the married daughters did not assist in any way. The older boy was away from home and could not be located. Harry was suffering from a dislocated collar bone. Shortly after these members of the family had recovered and had again taken up their daily work, the ne’er-do-well, who had secured work as a brakeman in West Virginia, was thrown from his train and killed. Almost immediately upon the notification of his death, an appeal for the worker was sent to the Social Service Department, that she might advise, comfort, and assist the family. Probably the best description of this family’s attachment and dependence upon the department can be given in the words of the mother, who introduced the worker to assembled neighbors with, “This is my friend who never leaves or forsakes me.” From the time this case first came to the department in October, 1909, until the present date, scarcely a week has passed without some communicaton having been received from the family.
The question in social work as to the proper period when a cnse may be closed, is an unsettled one in the mind of all workers who have the interests of humanity at heart. At this moment it can truthfully be said that everything done for this family has made them more self-respecting, better citizens. The daughters, seeing the interest displayed by strangers, have at last shown a desire to co-operate. The amount paid to the family by the railroad company enabled them to give their son a decent burial, and the remaining money has been expended for arrears in rent, and other small amounts of indebtedness. The second son, who has always been industrious, is back at work, the father and mother are in better health, and during the last few months they have needed no assistance or attention. Their last communication, a postal card, reads as follows: “I have not needed you for anything, but I am always thinking about you and cannot help sending you these few lines.”
The two great events of the Social Service Department during its existence were the Christmas parties. That of 1909 was held in the Laboratory of Psychology. Considering that there was a blizzard that day, quite a number of the staff, parents, and children were present. There was an attractively trimmed tree, beneath which were dolls, toys, and candies,?gifts for all the children. Owing to the growth of the Clinic, the number of children this year being almost twice as large, it was impossible to entertain them in the same way. A card of remembrance was sent to sixtyfive children, gifts to many, and a dinner party given at the home of one of the caretakers on Monday, December 2Gth, to a group of children under special observation. The children were dressed in white, with fresh hair ribbons. There was a Christmas tree laden with all the Christmas “goodies,” and piled beneath it on the floor were dressed dolls, fat stockings, baby coaches, scrap books, trains, and other toys. The table was a vision to brighten the eyes of any child. Old Kris holding the centre of the table was surrounded by such things as children dream of,?candies, fruits, nuts, and bon-bons containing caps, which were immediately perched upon each small head. The good things rapidly disappeared. One small guest, desiring more freedom for gastronomic feats, asked that she might have her belt unfastened. After dinner there were games, recitations and singing by the children. Several friends deeply interested in the Clinic children came in to see them. In this group Edith, the little girl already described in this article, enjoyed her first Christmas. It was touching to see the happiness of this little one, whose face wore one perpetual smile. Since this memorable event the phrase continually in the mouth of these children, “I shall never forget Christmas,” has become familiar to all the workers in the department. The most delightful outing afforded a large group of the Clinic children was a matinee given by Keith’s to the children of the -city on December 31, 1909, the invitation being extended through the Public Ledger. Only those who witnessed the joy of the children on that afternoon and who saw the entertainment furnished especially for them, as well as the extreme beauty of the last Christmas scene when the children without any disorder filed upon the stage to receive gifts of toys and candy, can appreciate what* a tremendous event this must have been in their lives. We are particularly indebted for the care of children, to the Woman’s Hospital, Howard Hospital, Philadelphia Hospital, German Hospital, Children’s Hospital, Presbyterian Hospital, University Hospital, the Mary Drexel Home, and the Phoenixville Hospital.
Among the outings, made possible through the generosity of friends, was the entertainment of the thirteen summer school boys and their instructor at the camp of Mrs. Albert Clark, at Laurel Springs, K J., where they spent a most delightful two days. A summer outing of ten weeks at Ocean City was arranged by an interested friend for one of the children. Another child spent ten days at Seaside Park, N. J., with a friend connected with the Clinic and a third child camped three weeks with Mrs. Clark, at Laurel Springs.
In addition to these outings, the following contributions were made: 1909-10 Interested friend, to be used for special care for two children $87.50 1909-10 Interested friend, for temporary board of child and Christmas donations 32.60 1909 Interested friend, Christmas donation 1-50 1909 ” ” 1-00 1909 ” ” 1-00 1910 ” Summer outing for child 50.00 1910 ” Christmas donation 2.00 1910 ” ” 1.00 $176.66 1909-10 Daniel Weston for many pairs of free glasses, reduced rates and careful attention at all times. 1909&10 Stephen Whitman and Sons, Christmas, 1909, 50 boxes of candy; 1910, 100 boxes. 1909 Interested friend, Christmas donation, 10 dolls, 10 .< pairs of filled stockings. 1909 Interested friend, Christmas donation, toys. 1909 ” ” tree. 1909 ” ” tree decorations. 1910 City Mission. Orthopedic apparatus.
The recital of our indebtedness should not close without mention of Miss A. Haines, Miss Anna Clark, Miss Elsie Douglas, Miss Kathryn Crane, Miss Marion Kohn, Miss Tanna Alex, Mrs. Albert Clark, Miss P. Hirsch, Miss McCall, Dr Sarah Shuey and Mrs. Wood, who generously contributed their services as volunteer social workers during the last eighteen months. As head of the social service department of the Psychological Clinic for the preceding months, it is with the greatest pleasure that I remember the extreme interest and enthusiastic co-operation of the volunteer workers, financial contributors, and the loyal assistant who has kept the records of the Clinic in such order that it has been possible to write the foregoing report.
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