Adequate Standard of Living 

The argument that an “adequate standard of living” is a constitutional right, endowed by the Creator in the rights of life, liberty and the pursuit of happiness; has been debated since humans first assisted other humans. The historical position on the interpretation of this has shifted numerous times.  Present your position on the level of assistance appropriate in providing services to move toward self reliance.  Include in your position; how to fund, and deliver, and the ultimate goal of the assistance. Provide a specific example taken from real life, in your discussion post.  For example, use examples that might fall under the Community Mental Health Act or the Temporary Assistance for Needy Families (TANF) program.  Respond to two of your classmates’ posts.

 Domestic Violence Statistics 

Review the National Coalition Against Domestic Violence webpage on

Domestic Violence Statistics: Prevalence of Domestic Violence (Links to an external site.)

which gives statistics among various categories of race, age, gender, ethnic background, etc.  After reviewing this article, post a statement of how the role of the human service professional can be effective in this situation.  What was your personal reaction to the vast array of statistics for this crisis? 

 Supportive Services 

In Chapter 10, the author discussed three major types of supportive services.  Give two examples of situations you might encounter as a human service professional that would fall under these categories.  What services would you recommend and what benefit would you expect they would provide? 

 

Required Reading

1. Read from the text, Human Services: Contemporary Issues and Trends:

• Chapter 1: Basic Concepts and Definitions of Human Services
• Chapter 2: Historical Roots of Human Services
• Chapter 4: Empowerment: Theory and Practice
• Chapter 5: Human Services: Necessary Skills and Values
• Chapter 6: Techniques and Skills in Interviewing

1. The National Coalition Against Domestic Violence (NCADV). (n.d.). Domestic violence statistics: Prevalence of domestic violence (Links to an external site.).  Retrieved from https://ncadv.org/statistics
2. Lee, R. M. (2018). Interviewing, social work, and Chicago sociology in the 1920s. Qualitative Social Work: Research and Practice, 17(5), 639–658. https://doi-org.proxy-library.ashford.edu/10.1177/1473325016680727

 
Required Reading

1. Read from the text, Human Services:  Contemporary Issues and Trends:

• Chapter 7: Helping Services for Groups
• Chapter 8: National Community Support Skill Standards Project
• Chapter 10: The Child Welfare Delivery System in the United States
• Chapter 11: Child Maltreatment and Abuse
• Chapter 12: Youth and Human Services

1. The National Coalition Against Domestic Violence (NCADV).  (n.d.). Domestic violence statistics: Prevalence of domestic violence (Links to an external site.).  Retrieved from https://ncadv.org/statistics

Required Multimedia

1. Centers for Disease Control and Prevention.  (2017).  When closeness goes wrong (Links to an external site.) [Podcast].  Retrieved from http://www2c.cdc.gov/podcasts/player.asp?f=7993

CHAPTER 1 BASIC CONCEPTS AND DEFINITIONS OF HUMAN SERVICES

PAUL F. CIMMINO

This chapter is dedicated to the development of basic definitions that describe and identify human services. However, any attempt to define human services in one sentence, or to use one description, is doomed to fail. According to Schmolling, Youkeles, and Burger, there is no generally accepted or “official” definition of human services (

1993

, p. 9). Human services is a multidisciplinary profession that reflects complex human interactions and a comprehensive social system. To understand human services, it is important to develop ideas that construct an organized perspective of the field. In this chapter, three general questions about human services are incorporated into the text. First, “What is it, and what isn’t it?” Second, “Who is helped and why?” Third, “How is help delivered and by whom?” These fundamental questions tend to exemplify the basic concepts and definitions in human services. This chapter proceeds to introduce important terms, definitions, subconcepts, and concentration areas in human services, which are expounded upon by a host of authors who have contributed their expertise to create this book.

The professional field of human services can be reduced to three basic concepts: intervention (needs and services); professionalism (applied practice and credentialing); and education (academic training and research). Each basic concept comprises important aspects of the human service field and identifies primary areas of the profession. The supporting background that nourishes intervention, professionalism, and education in human services is the history of the human service movement (Fullerton, 

1990

). The formal development of human services in society is located in the legislative, training, and service history of the field. This chapter attempts to offer a collective understanding of these important areas related to the professional development of human services. In this chapter, basic concepts and definitions converge to generate a comprehensive and theoretical notion of human services in forming an overview of the field. To further assist the reader in developing thoughts about the human service profession, and to avoid ambiguity in the field, a medley of contemporary definitions of human services is presented later in the chapter.

Finally, an important letter written by Dr. Harold McPheeters in 1992, which addresses the basic question of what comprises human services, is presented to close the chapter. McPheeters’s letter was sent in response to a manuscript written by me in 1991. The paper proposes an idealistic model that defines human services in terms of its purpose and professional responsibility in society. Later in the chapter, the central ideas are summarized, providing an orientation to the thoughtful feedback from Harold McPheeters. In my view, his written response conveys landmark perspectives in development of the emerging human service field. Thus, the ideas stemming from my paper and McPheeters’s response invite a judicious overview of this chapter for the reader’s developing knowledge of human services.

THE BASIC CONCEPT OF PURPOSE IN HUMAN SERVICES

Human services is a term that reflects the need for society to help its members live adequate and rewarding lives (Eriksen, 

1977

). The human service field encompasses a variety of functions and characteristics. Human service activity is the act of people helping other people meet their needs in an organized social context. Thus, the human service function is a process of directed change taking place as the result of interaction between human service workers, clients, and organizations. Ideally, the changes human service workers attempt to facilitate are intended to assist clients in achieving optimum human potential. In order to help a variety of people in this fashion, the human service worker trains as a generalist and must be familiar with various approaches in the helping process (Schmolling, Youkeles, and Burger, 
1993
, p. 146).

The human service orientation to helping people recognizes that clients are an intricate part of their environment. Today, the need for human services in society is obvious. Human services has emerged in response to the increase of human problems in our modern world (Mehr, 

1988

). The complications of living in a rapidly changing society causes massive stress on human beings. Often people are unable to meet their own basic needs due to harsh social conditions and oppression (Ryan, 

1976

). Socialization for many individuals is deprived or detrimental relative to basic life needs. The problems people experience can be rooted in family backgrounds, education, economics, disease, disability, self-concepts, or legal matters. The human service model acknowledges these conditions as primary factors in human dysfunction but not necessarily predictors of a person’s capacity. The human service ideology of helping people focuses on the immediate needs and presenting problems of the client. This approach does not prejudge clients and recognizes that any person in need of human services is a legitimate consumer of services. By the same token, human services practice attempts to relieve human suffering while promoting independence from the human service system.

The conceptual evolution of human services as a professional helping process stems from historical movements in the field. The history of the human service movement is addressed in a later chapter. However, it is useful to mention the significance of this history in the development of a functional human service concept. The predecessors of today’s human service and social welfare systems were social reforms in England, which were particularly established in the Elizabethan Poor Laws of 1601. Prior to this legislation, the church assumed responsibility to relieve the poor and served in the capacity of a public agency (Woodside and McClam, 

1994

, pp. 38–43). Legislation stemming from the Elizabethan Poor Laws, and the Law of Settlement added sixty years later, initiated the idea of compulsory taxation to raise funds to help the needy and established eligibility requirements for recipients (Woodside and McClam, 
1994
, pp. 42–43). These early developments in English social reform and legislation more than 350 years ago are bridges to contemporary human services in the United States.

The impact of social and legislative changes during the 1950s, 1960s, and 1970s fostered the creation of human services as it exists today (Woodside and McClam, 
1990
, p. 41). The response to deinstitutionalization in the 1960s, coupled with influences of the civil rights movement along with a series of related legislation, resulted in the creation of a new “human service worker.” Examples of important legislation in the development of contemporary services are the Manpower Development Training Act of 1962, the Mental Health Study Act of 1955, the Social Security Amendments of 1962, the Scheuer Sub-professional Career Act of 1966, and the Community Mental Health Centers Act of 1963. Such legislation promoted the human service movement of the 1960s and 1970s, whereby a process ensued creating opportunities for training programs and progressive development in human service education. Consequently, a blend of agency services, social policies, academic programs, professional practice development, and people working together for social change formulate the helping process called human services.

HUMAN SERVICE INTERVENTION

·  Human Services Intervention is defined as a broad field of human endeavor in which the professional acts as an agent to assist individuals, families, and communities to better cope with crisis, change and stress; to prevent and alleviate stress; and to function effectively in all areas of life and living. Human Services Practice is conducted in the broad spectrum of human services in a manner that is responsive to both current and future trends and needs for human resource development, and committed to humanitarian values (Montana State University–Billings: Catalog 1991–93, Sexton, R., 1987).

The preceding definition of human service intervention reflects the functional role of the field in society. The amount of public support for human service programs is determined by the state of the economy (Schmolling, Youkeles, and Burger, 
1993
, p. 24). Since sufficient funding for human service programs is inconsistent, fulfilling the mission of effective intervention in helping clients often fluctuates. Thus, the delivery capability of human services to the public is unpredictable and frequently inadequate in providing resources to sufficiently help clients. In spite of this condition, human service intervention remains committed to reflecting the values and priorities of society (Eriksen, 
1977
, p. 10).

Human service intervention is the bridge between people and various subsystems in society (Eriksen, 
1977
, p. 10). The intervention philosophy of human services reflects humanitarian values. Eriksen identified the following philosophical principles as fundamental to the delivery of human services:

· 1. Human services are the embodiment of our national commitment to building a just society based on respect for people’s rights and needs.

· 2. Every individual in our society is entitled to services that will prevent his/her pain, maintain integrity, enable him/her with realities, stimulate personal growth, and promote a satisfying life.

· 3. Prevention of people’s problems and discomforts is as important a part of human services as restitution and rehabilitation after the fact.

· 4. The integration of human services is crucial to their effectiveness.

· 5. Human services are accountable to the consumers.

· 6. Human services tasks and goals:

·  The paramount goal of human services is to enable people to live more satisfying, more autonomous, and more productive lives, through the utilization of society’s knowledge, resources, and technological innovations. To that end, society’s systems will be working for its people, putting people before paper (Eriksen, 

1977

, pp. 10, 11, 12).

The three primary models in the helping professions are the medical model, public health (social welfare) model, and human service model. Of these recognized interventions, the human service model is unique in its view of people, services, and the social environment as integrated entities. The medical model and public health models, on the other hand, have an individualistic orientation to causation relative to people’s problems. For instance, the medical model concentrates on the individual, views clients as needing help because they are sick, and refers to people as patients. The medical model engendered the discipline of psychiatry at the end of the eighteenth century, and its history is closely related to the development of the human service profession. The public health model contends that individuals have problems that are also linked to social conditions and views disease as multicausal (Woodside and McClam, 
1994
, p. 89). Hypothetically, both these models are based on determinism, suggesting that disease and social problems are an individual’s responsibility, not society’s, and if controlled they 
would have less effect on the human condition. The human service model expects disease and social problems to always affect the lives of people and focuses on providing services to help individuals deal with problems stemming from these conditions. Similarly, by using these models to describe and approach the problem-solving process, the human service worker is able to expand resources and systems for service delivery and intervention.

THE GENERALIST ROLES OF THE HUMAN SERVICE WORKER

The basic roles human service professionals play in the helping process were initially developed by the Southern Regional Education Board (SREB) as part of an effort to produce functional comparisons to other established professions. The project also defined four levels of competence (discussed later in this chapter) to correlate with role functions. The SREB identified thirteen roles that human service workers perform that were derived by evaluating the needs of clients, families, and communities (SREB, 1969). These roles include the following:

· 1. Outreach worker—reaches out to detect people with problems and can make appropriate referrals for needed services.

· 2. Broker—helps people get to existing services and provides follow-up to ensure continued care.

· 3. Advocate—pleads and fights for services, policy, rules, regulations, and laws for client’s behalf.

· 4. Evaluator—assesses client or community needs and problems, whether medical, psychiatric, social, or educational.

· 5. Teacher-educator—performs a range of instructional activities from simple coaching to teaching highly technical content directed to individuals and groups.

· 6. Behavior changer—carries out a range of activities planned primarily to change behavior, ranging from coaching and counseling to casework, psychotherapy, and behavior therapy.

· 7. Mobilizer—helps to get new resources for clients or communities.

· 8. Consultant

—works with other professions and agencies regarding their handling of problems, needs, and programs.

· 9. Community planner—works with community boards, committees, and so on to ensure that community developments enhance self-actualization and minimize emotional stress on people.

· 10. Caregiver—provides services for persons who need ongoing support of some kind (i.e., financial assistance, day care, social support, twenty-four-hour care).

· 11. Data manager—performs all aspects of data handling, gathering, tabulating, analyzing, synthesizing, program evaluation, and planning.

· 12. Administrator—carries out activities that are primarily agency or institution oriented (e.g., budgeting, purchasing, and personnel activities).

· 13. Assistant to specialist—acts as assistant to specialist (e.g., psychiatrist, psychologist, or nurse), relieving them of burdensome tasks.

The framework of the helping process in human services is characterized by the role functions and structures listed above and not restricted to frontline workers who provide direct services; administrators and supervisors also facilitate service delivery.

THE SOCIAL IDEOLOGY OF HUMAN SERVICES

Eriksen’s principles represent a social ideology about human services that parallels the needs of an individual living in society. Social policy advocates who hold humanitarian perspectives contend the previously mentioned conditions are individual rights that should be afforded to all people. Many of these scholars argue that an adequate standard of living is a constitutional right. However, the U.S. Constitution does not specify living standards for citizens. To a large extent, the life standards developed by humanitarian scholars are actually postulations drawn from language in the U.S. Constitution, the Declaration of Independence, the Bill of Rights, and a variety of subsequent federal and state civil rights legislation. For instance, the opening remarks (second paragraph) of the Declaration of Independence include this statement: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain inalienable rights, that among these are life, liberty and the pursuit of happiness.” Similarly, the U.S. Constitution, Amendment XV, Section 1, states, “The right of citizens of the United States to vote shall not be denied or abridged by the United States or by any State on account of race, color, or previous condition of servitude.”

One can see how expanding the meaning of this language from both documents can imply the right to be afforded a certain quality of life in American society. The degree of social obligation held by the government in promoting social equity or empowering people to become self-sufficient has been a controversial topic among social policy makers and scholars. To a large extent, the present model of social welfare and human service delivery systems is not functionally consistent with the idea of society taking responsibility for the problems of its members. However, the notion of society taking partial responsibility for its members’ hardships parallels the professional ideologies promoted in this chapter (Schmolling, Youkeles, and Burger, 
1993
, p. 18). To date, social policy relative to human services remains guided by an ideology of individualism and community derived from traditional perspectives. Conservative American values continue to place emphasis on hard work, perseverance, and self-reliance. Thus emerges the concept of Americans as rugged individuals who can pull themselves up by their bootstraps, a concept that remains deeply embedded in our society. This attitude translates into a community model of social services that supports programs dealing only with immediate situations (human problems) and generally opposes programs that go beyond meeting basic survival needs (Schmolling, Youkeles, and Burger, 
1993
, pp. 18, 19).

Proactive Human Services

The concept of human services supports the empowerment of people to become self-sufficient and capable of meeting their own needs without assistance from human services. Therefore, human services aims to provide clients the kind of direct support that facilitates eventual emancipation and prevents a state of dependency on the system. This kind of assistance is referred to as the proactive approach to human services. This form of intervention utilizes strategies that invest in the prevention of problems and stabilization of client systems into the future. Ideally, planning beyond the problem to help the client become socially self-sufficient is the heart of the professional human service model. However, a crisis-oriented, pluralistic society that has recently come to recognize the concept of multicausality and the impact of psychosocial stress cannot be expected to change from traditional (reactive) perspectives on human problems to a prevention model or proactive perspective in a short period of time.

Human service intervention is based in theory on fundamental values about human life that are woven into the fabric of American heritage and more specifically identified in civil rights legislation. Professional perspectives of service delivery to clients recognize a standard of living for all people that promotes self-reliance, social perseverance, and a sense of personal gratification in social life. Linked to these values or life conditions are social values emphasizing certain essential human needs. Since the human service worker is an agent of society who advocates for the psychosocial advancement of the individual, it follows that the human service model is closely associated with civil rights legislation aimed at helping deprived population groups. Consequently, the identification of essential human needs is important for definitions of human service intervention and the development of basic problem-solving processes.

THE HUMAN SERVICE IDEOLOGY OF THE INDIVIDUAL

The general notion that problem behaviors are often the result of an individual’s failure to satisfy basic human needs is a fundamental principle underlying human service practice. The human service model places a portion of responsibility on society for perpetuating social problems that reduce opportunities for people to be successful. The human service worker seeks to assist clients to adequately function in the same system that impairs them. A client may be in need of shelter, medical attention, transportation, education, food, emotional support, or legal services. Therefore, as an agent of a larger system (macrosocial system), the primary focus of the human service worker is fulfilling the needs of the individual client (microsocial system). In this sense, the human service worker becomes an agent of change in the client system, placing the person first in the value system of the helping profession (Cimmino, 
1993
).

The focus of human service intervention on human needs is an essential aspect of service delivery. There are numerous concepts in the literature that propose definitions of human needs. One concept, developed by Abraham Maslow (

1968

), is a self-actualization theory that outlines a hierarchy of human needs and is applicable to the human service model.

The hierarchy Maslow conceptualized consists of five levels. At the base are physiological needs for food, shelter, oxygen, water, and general survival. These conditions are fundamental to life. When people satisfy these basic survival needs, they are able to focus on safety needs, which involve the need for a secure and predictable environment. This may mean living in decent housing in a safe neighborhood. After safety needs have been fulfilled, the need for belongingness and love emerges. This includes intimacy and acceptance from others. When these three lower-level needs are partly satisfied, esteem needs develop in the context of the person’s social environment. This level involves recognition by others that a person is competent or respected. Most people desire appreciation and positive reinforcement from others. At the top of the hierarchy exists the need for self-actualization, having to do with the fulfillment of a person’s innate potential as a human being. Maslow perceived self-actualized people as possessing attributes that are consistent with highly competent and successful individuals.

Although Maslow is considered a primary figure in humanistic psychology, there has been subsequent research to test the validity of his concepts. Follow-up research studies have produced mixed results; some results demonstrate support (Neher, 

1991

), while others refute the hypotheses (Schmolling, Youkeles, and Burger, 
1993
). Nevertheless, most people do live in a network of social relationships in which they seek external gratification in attending to their needs.

Another perspective on human needs is defined by Hansell’s motivation theory (Schmolling, Youkeles, and Burger, 
1993
). This theory contends that people must achieve seven basic attachments in order to meet their needs. If a person is unsuccessful in achieving each attachment, ultimately a state of crisis and stress will result. Listed below are the seven basic attachments, accompanied with signs of failure of each one:

· 1. Food, water, and oxygen, along with informational supplies. Signs of failure: boredom, apathy, and physical disorder.

· 2. Intimacy, sex, closeness, and opportunity to exchange deep feelings. Signs of failure: loneliness, isolation, and lack of sexual satisfaction.

· 3. Belonging to a social peer group. Signs of failure: not feeling part of anything.

· 4. A clear, definite self-identity. Signs of failure: feeling doubtful and indecisive.

· 5. A social role that carries with it a sense of being a competent member of society. Signs of failure: depression and a sense of failure.

· 6. The need to be linked to a cash economy through a job, a spouse with income, social security benefits, or other ways. Sign of failure: lack of purchasing power, possibly an inability to purchase essentials.

· 7. A comprehensive system of meaning with clear priorities in life. Signs of failure: sense of drifting through life, detachment, and alienation.

Both Maslow’s and Hansell’s ideas about human needs provide a practical purpose for 
human service intervention. Essentially, human service workers attempt to find ways to help the client satisfy his or her unmet needs. The definition of the client situation or presenting problem generally involves evidence of failures indicated above. Similarly, the identification of problems such as poor housing, lack of food, fear of neighborhood, detrimental relationships, and low self-esteem suggests a physical, social, or psychological crisis that blocks the development of a person and the ability to function, as implied by Maslow’s and Hansell’s theories of self-actualization and motivation.

CRISIS INTERVENTION

When human service intervention is required as the result of a sudden disruption in the life of a client precipitated by a situational crisis or catastrophic event, crisis intervention is the consequence. Often, in these circumstances, even those people who do not expect to become consumers of the human service system suddenly find themselves clients. The practice of delivering crisis intervention services is supported by crisis intervention theory. Studies and research in crisis intervention theory and practice are primarily the domain of sociology, psychology, social psychology, social work, community psychiatry, and social welfare policy. The practice of crisis intervention in human services was developed by a variety of clinical practitioners in areas such as nursing, psychology, medicine, psychiatry, and clinical social work (Slaikeu, 
1990
). The application of crisis intervention methods is a recent development based on various human behavior theories, including those from Freud, Hartmann, Rado, Erickson, Lindemann, and Caplan (Aguilera and Messick, 

1978

; Slaikeu, 
1990
). Slaikeu (
1990
) cites the Coconut Grove fire on November 28, 1942, where 493 people perished when flames devoured the crowded nightclub. According to Slaikeu:

·  Lindemann and others from the Massachusetts General Hospital played an active role in helping survivors and those who had lost loved ones in the disaster. His clinical report (Lindemann, 

1944

) on the psychological symptoms of the survivors became the cornerstone for subsequent theorizing on the grief process, a series of stages through which a mourner progresses on the way toward accepting and resolving loss (p. 6).

The evolution of community psychiatry and the suicide prevention movement of the 1960s marks an important historical development in crisis-intervention human services. An important figure in crisis theory and the associated approaches in service delivery was Gerald Caplan, a public health psychiatrist. Some of his contributions are discussed by Slaikeu (
1990
):

·  Building on the start given by Lindemann, Gerald Caplan, associated with Harvard School of Public Health, first formulated the significance of life crisis in an adult’s psychopathology. Caplan’s crisis theory was cast in the framework of Erik-sen’s developmental psychology. Caplan’s interest was on how people negotiated the various transitions from one stage to another. He identified the importance of both personal and social resources in determining whether developmental crises (and situational or unexpected crises) would be worked out for better or for worse. Caplan’s preventative psychiatry, with its focus on early intervention to promote positive growth and minimize the chance of psychological impairment, led to an emphasis on mental health consultation. Since many early crises could be identified and even predicted, it became important to train a wide range of community practitioners. The role of the mental health professional became one of assisting teachers, nurses, clergy, guidance counselors, and others in learning how to detect and deal with life crises in community settings (pp. 6–7).

The formal emergence of community mental health programs in the United States became a way to implement recommendations from the U.S. Congress Joint Commission on Mental Illness and Health (1961). With strong support from the Kennedy Administration to provide mental health services in a community setting (not restricting them only to hospitals), crisis intervention programs and the outreach emergency services were established as an integral part of every comprehensive community mental health system and a prerequisite for federal funding.

A person who is experiencing a crisis faces a problem that cannot be resolved by using the coping mechanisms that have worked in the past (Aguilera and Messick, p. 1). According to Wood-side and McClam (
1990
):

·  An individual’s equilibrium is disrupted by pressures or upsets, which result in stress so severe that he or she is unable to find relief using coping skills that worked before. The crisis is the individual’s emotional response to the threatening or hazardous situation, not the situation itself. Crises can be divided into two types: developmental and situational. A developmental crisis is an individual’s response to a situation that is reasonably predictable in the life cycle. Situational or accidental crises do not occur with any regularity. The sudden and unpredictable nature of this type of crisis makes any preparation or individual control impossible. Examples are fire or other natural disasters, fatal illness, relocation, unplanned pregnancy, and rape. The skills and strategies that helpers use to provide immediate help for a person in crisis constitute crisis intervention (p. 217).

People in crisis require immediate help and are in desperate situations. The human service philosophy (idealistically) is consistent with established crisis-intervention theory, which places the client’s needs as a priority in the value system of the helping profession. For the human service worker, the value of putting people first is an important professional orientation, not just something that happens as the result of a crisis. In a crisis situation, the human service worker must quickly establish a working relationship and positive rapport with clients. The worker’s knowledge and skills are important in supporting the client’s sense of hope and eventual return to self-reliance (Woodside and McClam, 
1990
, p. 223). In most cases, there is more than one worker helping the client. Generally clients are involved in a social network of supportive programs that involve different agencies and stem from an assortment of referrals. Collectively, the human service system coordinates efforts that are designed to return the client to a pre-crisis state of functioning. This objective is usually accomplished as the result of well-coordinated service delivery and effective problem-solving skills.

CLIENT SYSTEMS IN HUMAN SERVICE INTERVENTION

To continue discussions about the basic concept of human service intervention, it is important to understand the total view of the practice field. Much like social work, human services is directed toward the resolution of client problems that are part of a larger and dynamic social system. The nature of the service delivery system encompasses two distinct levels of interaction: providing direct services (face-to-face) and encompassing the acquisition of services from larger social systems. The client system is the immediate condition of the client’s psychological and social life circumstances. Client systems comprise many components, such as family relationships, social and cultural attributes, economic status, age, gender, employment, physical and mental health, legal issues, education, living conditions, religion, and self-esteem. In short, the client system involves the immediate environment as the most significant influence on the client’s life and behavior.

Micro- and Macrosocial Systems in Human Service Practice

The human service worker provides direct services to the client and is working simultaneously with the client system. For example, a worker who is assigned to an individual client may also work with the person’s spouse, family members, other workers, and agencies in the client system. In this context, the human service worker is engaged in two distinct systems called micro- and macrosocial systems. A great deal has been written about the roles of micro- and macrosocial systems in the process of delivering human services. However, a brief review of the concept can help the reader understand the basis of human service intervention in the social environment.

Every client lives in both micro- and macro-social systems. The human service worker is enmeshed in these two systems. Microsocial systems include individuals, small groups, families, and couples. Macrosocial systems involve large groups, organizations, communities, neighborhoods, and bureaucracies. Whittaker (
1977
) explains:

·  The goals in macro intervention include changes within organizations, communities and societies, while micro intervention aims at enhancing social functioning or alleviation of social problems for a particular individual, family, or small group. Macro intervention relies heavily on theories of “big system” change (formal organization theory, community theory) drawn from sociology, economics and political science. Micro intervention tends to be based on theories of individual change drawn from psychology, small group sociology, and human development. Finally, we can distinguish differences in the strategies of macro and micro interventions. Macro intervention uses social action strategies, lobbying, coordination of functions, and canvassing; micro intervention typically relies on more circumscribed strategies directed at individual change: direct counseling, individual advocacy actions, and crisis intervention (p. 44).

Human service intervention is closely associated with micro- and macrosystems in relationship to the notion of social treatment. From a human service practice perspective, social treatment includes all those remedial efforts directed at the resolution of a client’s problems within the context of the social environment (Whittaker, 
1977
). Theoretically, the client and worker move through micro- and macrosystems in a dynamic process, each bound by their social roles. By the same token, their relationship formulates a unique set of mutual needs and values as a result of the common objectives they share in problem solving and service delivery. In this sense, theoretical distinctions between macro- and microsystems are consistent for both worker and client. However, their circumstances in the social system are different in that one is in the “client system,” while the worker functions in the “human service delivery system.” Each operate and negotiate within the boundaries of micro- and macrosystems of society. For example, a client system may include family relationships, housing, legal issues, and behavioral problems, whereas the human service worker as a provider must meet the needs of both the client system and the human service system.

Acting in a formal capacity, the human service worker must adhere to employment conditions (job description), social policy, professional ethics, and administrative aspects of service delivery. Human service providers operate in a maze of agency dynamics and organizational structures. This level of activity in the human services is generally in the scope of macropractice. In this context, the worker also deals directly with the client. Human service workers are most often face-to-face with clients either interviewing, counseling, working with the family, or doing something else to help them. This kind of intervention is called micropractice. The client system and the workers’ system together set up a situational framework for professional human service intervention at micro and macro levels. This dualistic nature of professional practice is fundamental to the working model in human services. Further, it underscores how comprehensive and complex human service work in contemporary society really is.

INTRODUCTION OF THE SOCIAL HEALTH GENERALIST CONCEPT

Today’s human service worker must possess special knowledge of the human service delivery system as well as client systems and understand the impact of various environmental influences on human behavior and communities. Annexed to this knowledge base is the need for the worker to have competent communication skills so as to be effective with a variety of clients and to operate comfortably in different agency roles. Such demands upon the modern worker produce the notion of a social health generalist in contemporary welfare, mental health, and human service systems (Cimmino, 
1993
). Compared with the mental health generalist concept of the 1960s and 1970s (McPheeters and King, 

1971

), the social health generalist sharply reflects the need for the human service worker in modern society to be prepared for today’s challenges, which stem from rapid social change and related programmatic influences on economic restructuring of human service delivery systems. To work effectively in any human service agency today, the worker must possess a functionally broader knowledge base of community resources, case management strategies, behavior, social policy, political influences, and human factors that affect the delivery of human services. Joseph Mehr (
1988
) elucidates the social health generalist notion when he discusses current conceptions of human service systems and bases his book on a generic human services concept (Mehr, 
1988
, p. 11). In contrast, the mental health generalists of the past were primarily trained to focus on microsocial systems by providing direct assistance in institutional or closed settings. The social health generalist’s basic training and professional orientation must address a wider spectrum of client conditions and support human service systems that conceptually go beyond the immediate client and agency environment.

The generalist concept is historically rooted in mental health technology systems. However, modern life demands that the provision of human services reach beyond the mental health field. Therefore, the profession must expand the generalist concept to reflect what human service workers actually do in modern society. This condition was illustrated earlier in the discussion of generalist roles the human service worker performs in the formal helping process. The academic and practice training in recognized human service programs today are designed to prepare a different generalist worker from that of the past. According to Schmolling, Youkeles, and Burger (
1993
):

·  Many educators feel that the term ‘paraprofessional,’ widely accepted in the past, no longer accurately reflects the knowledge, abilities, skills, and training of graduates in recognized undergraduate human service programs of today. They feel graduates of such programs should be considered professional human service workers. The work roles and functions of generalist human service workers vary greatly. Generalist workers represent the largest number of workers and usually have the most contact with those in need. In some instances, the duties of the generalist workers are similar to those of professionals (p. 182).

The social health generalist human service worker is capable of adjusting to a variety of settings in the human service field. Similar to the mental health generalist, the primary focus remains helping “target persons,” either directly or indirectly. These target groups can be individual clients, families, small groups, or a neighborhood or community (McPheeters, 
1990
). Target groups refer to identified persons (clients) in need of human service intervention. However, the expansion of the term human services to include a wider spectrum of social, health, and welfare systems is a significant distinction from past concepts of the mental health generalist. For example, human service workers in a mental health setting are required to understand other service-delivery systems and social dynamics outside the place where they are employed. This includes a knowledge base that integrates client needs with external and internal forces that influence service delivery, such as insurance requirements, diagnosis, and legal, community, or administrative complications. In today’s human service industry, the frequency of worker contact with clients and their families, as well as interagency collaboration, is steadily increasing for a variety of reasons. The framework of practice today reflects the notion that all clients are consumers and have the right to access an empowering process by way of the human service system (Halley, Kopp, and Austin, 

1992

). Thus, the professional role of the contemporary human service worker scales the wall of institutional framework by comprehending conditions outside agency boundaries and must engender an enormous level of social awareness and professional skill. Consequently, the decision-making capacity of the generalist in today’s human service field requires a working knowledge of micro- and macrosystems within the social treatment model (Whittaker, 
1977
).

McPheeters and King (
1971
) describe the generalist as possessing the following characteristics:

· 1. The generalist works with a limited number of clients or families (in consultation with other professionals) to provide “across the board” services as needed.

· 2. The generalist is able to work in a variety of agencies and organizations that provide mental health services.

· 3. The generalist is able to work cooperatively with any of the existing professions.

· 4. The generalist is familiar with a number of therapeutic services and techniques.

· 5. The generalist is a “beginning professional” who is expected to continue to learn and grow (McPheeters and King, 
1971
).

McPheeters’s characteristics are generally applicable to the notion of the new social health generalist. However, several important modifications to his previous description of the generalist concept are proposed to effectively address contemporary frameworks of service delivery and justify the neologism social health generalist.

In his article, McPheeters (
1990
, p. 36) places emphasis on the differentiation between the generalist and the specialist. He asserts that it is not based simply on division of labor. Rather, the generalist is concerned with all the problems surrounding the client or family, whereas the specialist focuses on a particular skill or activity. McPheeters’s characteristics describing the generalist can generally apply to the new social health generalist concept. However, there are some important adjustments necessary that offer theoretical criteria for consistency with the contemporary human service field. The first concern is that McPheeters’s second characteristic, “agencies and organizations that provide mental health services,” must expand to include a larger view of the human service system. Replacing the term “mental health services” with human services or human services and related subsystems seems more appropriate and fitting to today’s human service worker. Similarly, his fourth characteristic states that “the generalist is familiar with a number of therapeutic services and techniques.” The focus here reflects a limited perspective in comparison to the practice framework and related concepts of the modern human service worker. Recognition of the need for a broader knowledge base involving multidisciplinary services and other theoretical frameworks is essential for human services to effectively operate in modern society. A professional knowledge base to include social systems, personality theory, and social treatment intervention strategies can more accurately point to the scope of information that today’s worker must possess. With these two modifications, the mental health generalist concept can continue to provide professional foundations for today’s social health generalist worker.

Dr. Harold McPheeters Responds

At the 1992 National Organization for Human Services Education Conference in Alexandria, Virginia, I had the distinct privilege of hearing Dr. Harold McPheeters give the keynote address. At the conclusion of his presentation, I spoke with him about his views on human services. During our conversation, I asked if he would be interested in reading my manuscript and commenting on the ideas it developed (Cimmino, 
1993
). He agreed. Several weeks later, I received his four-page written response. I was very impressed with his articulation and depth of reaction to the content of my study. Dr. McPheeters’s response to “Exactly What Is Human Services” offers an expansion of insight to contemporary thinking about this relatively new field from its most noted professional figure and pioneer.

CHAPTER 2 HISTORICAL ROOTS OF HUMAN SERVICES

JOEL F. DIAMBRA

Writing from Knoxville, Tennessee, home of the late Alex Haley, author of the epic novel and made-for-television mini-series, Roots, it seems only appropriate to begin this book by reviewing our professional roots. Indeed, it is prudent and necessary to review the recent history of human service work prior to propelling ourselves into prophetic speculation and prognostications of times to come. History and future are juxtaposed with the forever-fleeting present, sharing an ever-present boundary that quickly vanishes into the past. This makes the past and future unusual relatives: two stepsisters, both twins to a third sister, the present. Confounding and more dynamic than sisters, one becomes the other as cyclical time passes: future becomes present, present becomes past, and the past predicts the future. This chapter will review the twentieth-century historical roots of human services. The focus is a macro rather than micro review, enabling the reader to place into historical perspective the contents of the upcoming chapters.

The history of human services struggles to clearly identify a “big-bang” origin. Its inception is subject to more than one interpretation. However, human service history is clearly developmental in nature, with evolutionary roots. From inauspicious beginnings to its professionally tailored and internationally collaborating present, recent developments in human services will be briefly reviewed in this chapter.

So why does a book entitled Human Services: Contemporary Issues and Trends, which is clearly focused on present and future events in human services, include a chapter dedicated to a recent historical review? Students often complain and express their dislike of history. The traditional excuse that it has no relevance on the events of today may be heard echoing through the cinderblock halls of public and private institutions of higher learning. In these same halls, the vernacular may be more commonly stated as “Let’s get on with it.” You, too, may be internally voicing like sentiments.

But before you dive into the following chapters, remember that many of the upcoming projections for the field of human services will someday be historical events. They will not simply be bygone events to be quickly dismissed and discounted, but events that have shaped tomorrow’s future of human service delivery—so read with renewed interest and appreciation. Accurate predictions will become the future, the future will become today, and today will become a past full of rich stories and events that once predicted and defined human services for tomorrow.

Before beginning to retrace the recent historical path of human services, an operational definition is required. Harris and Maloney (

1996

) broadly defined human services as “a process of negotiating social systems to respond in the best interest of people in need” (p. 13). Burger and Youkeles (

2000

) identified the common denominator of all human services as meeting people’s needs. Specific to the human service worker, Woodside and McClam (

1998

) defined the professional as a generalist able to work side-by-side with a variety of other professionals. Neukrug (
2000
) points out that human service professionals must be skillful at wearing many professional hats as they play a number of roles to encourage client growth and change. Simply put, human services is about facilitating clients’ efforts to grow and change while also effectively negotiating the service system in order to meet their needs.

A BLEND OF PROFESSIONS

Human services, as a bona fide profession with a defining mission and distinctive history, emerged from a blend of disciplines. The fields of social services, psychology, and counseling have provided the preeminent material to form a new hybrid species: human services. It may be more accurate to say that the human service profession borrowed from many of its sister professions and eclectically broadened its perspective by inclusion rather than exclusion. Social services provided a sense of mission and genuine compassion from its earliest roots. Furthermore, contemporary policy has been strongly influenced by social services. The disciplines of psychology and mental health contributed a theoretical and scientific component to the profession. Later, vocational and school counseling furnished human services with a contemporary perspective full of practical tools and helping strategies. Let us review these perspectives to see specifically how each influenced the development of human services as we know it today.

Social Service Roots

The human service literature is replete with historical accounts written from a social service perspective. A few significant historical events pertinent to social services highlight the genuinely humane response to the plight of others displayed by early social service workers.

The 1890s brought a more devastating depression than that felt during the 1870s. Social unrest caused by unemployment and racial tensions stimulated the need for social services. These early social and human service workers, through exposure to the conditions of their “clients,” began to understand that poverty was a complex problem and more difficult to resolve than they had been led to believe. Effective assistance required dedicated, paid professionals trained to remain objective and perform a variety of skills in systematic fashion.

One of the most significant developments of this period was the settlement house movement. Settlement social workers, out of their genuine concern and compassion, saw themselves more as neighbors than as professionals. This posture allowed them to empathize with the daily struggles of the people to whom they provided assistance. The English and American settlement house movements had many similarities, but they had a few distinct traits as well. American social workers’ religious orientation was subtler than that of their British counterparts, and the British movement had more men involved than did the American movement. Women, usually young, college-aged women, were predominant figures in the settlement house movement within the United States. Two of these remarkable young women, Jane Addams and Ellen Gates Starr, started the most famous American settlement house: Chicago’s Hull House. Prejudice was also a typical profile common to both sets of social workers. Driven by a strong desire to help others, many remained ignorant of their own personal biases and consequently accepted popular stereotypes.

Forced by overwhelming client needs, social workers began to look beyond themselves and their immediate neighborhoods. Determined to create a more efficient and effective organizational system, social workers initiated a plan to improve the lives of women and children on a broader level. These efforts resulted in a national Children’s Bureau headed by Julia Lathrop from Chicago’s Hull House in 1912 (Council on Social Work Education, 
2000
). Influenced by the Children’s Bureau research efforts, the “Widow’s Pension” was a proposal recommending that children be supported in their natural homes rather than institutional settings.

Beyond the scope of the settlement house movement, social work stretched its wings and entered into a number of fields new to social services: medical social work, psychiatric social work, school social work, occupational social work, and family social work. Professional schools of social work, guided by the Association of Professional Schools of Social Work (APSSW), emerged. In the 1930s, the APSSW adopted increasingly stringent curriculum guidelines and accreditation requirements. Social work has clearly identified itself as a unique entity and field with dual approaches, commonly referred to as micro (clinical) and macro (administrative) foci. Today, the field embraces service provision focused on encouraging individual change in concert with bringing about social reform and systemic intervention.

Compassionate and genuinely concerned for the welfare of others, early social service workers paved the way for human services by constructively exercising compassion for their fellow human beings, creating practical services to meet client needs, developing organized programs, and instigating and lobbying for social policy reform.

Psychology and Mental Health Roots

As professions, psychology and mental health have contributed greatly to the human service profession by providing workers with a host of theories to better understand the human condition and practice skills to intervene when challenges arise. A cursory review of these two fields is provided.

Clifford Beers first entered the mental health field as a patient. He used his unique experience as a patient and later as a professional helper to shape the human service profession. Beers’s most enduring legacy may be his advocacy of the principle that people are to be treated humanely, regardless of their condition or circumstances. After suffering a mental breakdown, he was confined to an asylum for three years where he received harsh treatment. After his recovery, Beers published his autobiography, based on his experience in American psychiatric institutions, in 1908. His account aroused public concern about the care of people with mental illness. Beers continued his campaign by founding the Connecticut Society for Mental Hygiene, the National Committee for Mental Hygiene (later becoming the National Association for Mental Health and known today as the Mental Health Association), and, years later, the International Foundation for Mental Health Hygiene. Human service educators strive to instill Beers’s message that people with mental illness are to be treated with respect and dignity, regardless of their circumstances.

The fields of psychiatry and psychology emerged at about the same time. There are so many prominent early figures that it is not possible to describe them all within this context. Two familiar key figures include Sigmund Freud (1856–1939) and Wilhelm Wundt (1832–1920). Of the two, Freud enjoyed the widest acceptance for his psychoanalytic theory focused on the dynamics of the inner person and the resulting human behavior. His influence is still felt today within human services, psychological treatment, and counseling. Wundt is best known for his establishment during the late 1870s of the first experimental psychological laboratory in Germany (Capuzzi and Gross, 

1997

). Wundt focused on researching how the mind is structured and did so by asking clients to self-reflect aloud. William James (1842–1910) adapted Wundt’s approach and focused on the functions of the mind. His work in the United States attracted a great deal of attention, and he and his followers were labeled as “functionalists.” G. Stanley Hall (1844–1924) is considered the “father of American psychology” by many and is credited with organizing the American Psychological Association (APA). Hall believed that the means of resolving social problems could best be discovered via empirical research. He collected information on children and their mental characteristics. Hall established the first psychological laboratory in the United States at Johns Hopkins University in 1883.

Significant contributions to the development of mental health counseling were also made by founding behaviorists such as Edward Thorn-dike (1874–1949), John Watson (1878–1958), and B. F. Skinner (1904–1990). Thorndike studied educational psychology and the psychology of animal learning. Thorndike is remembered for his stimulus response “laws” of effect, readiness, and exercise. Watson established an animal research laboratory where he became known for his behaviorist approach. He later applied his work on animals to human behavior and is well remembered for his classical conditioning of Albert by associating a loud noise with the presence of a white rat. Watson helped us to understand how conditioning may affect fears, phobias, and prejudice. He also coined the term “behaviorism.” B. F. Skinner is perhaps the most influential learning theorist. Using basic principles of reinforcement, Skinner’s operant conditioning theory is found in a wide array of successful human service interventions (token economies, programmed instruction, behavior modification, etc.) and is used with a variety of human service clientele (adolescent offenders, chronically mentally ill, mentally retarded, etc.).

Human service professionals use principles of educational psychology and learning theory to help clients change maladaptive behaviors, identify compensatory strategies, cope with the daily stresses of life, and function in our cyber-paced world. Behavioral theory is highly regarded in the human service arena today because of its emphasis on measurable outcomes and interactional strategies. Many interventions used in modern-day human service programs can trace their ancestry to behaviorally based theory and practice.

Historical events also influenced the development of the fields of psychology and mental health. War played a large part in advancing both of these fields. The U.S. armed forces used standardized assessment to place servicemen and women in military and industrial positions before and during World War II. Uncle Sam used psychologists and counselors to select and train military personnel for special assignments (Capuzzi and Gross, 
1997
). Mental health services were also needed to deal with the mental anguish soldiers were experiencing from battle and to help those who returned to their homes in need of vocational guidance. Picchioni and Bonk (

1983

) credited the government for inviting the counseling profession into the community by noting that a government official indicated that counseling is counseling, whether it is conducted in homes, schools, business or industrial settings, or churches. Human service professionals who provide services across these environments and more are still celebrating this induction today.

Following World War II, the National Institute for Mental Health was established in 1946, authorizing monies for research and demonstration focused on assisting persons with mental illness in the areas of prevention, diagnosis, and treatment. A series of political steps involving psychology and mental health followed, influencing the human service profession. The Mental Health Study Act (1955) initiated the existence of the Joint Commission on Mental Illness and Health. Also, a 1963 landmark decision led to passage of the Community Mental Health Centers Act (CMHCA). This legislation had a considerable impact on the expansion of the human service profession by mandating that outreach, counseling, and service coordination be offered in the community through more than 2,000 newly created mental health centers (Capuzzi and Gross, 
1997
). Human service professionals are contemporary front-line workers who are still implementing the services inspired 37 years ago through the CMHCA.

The list of key people and critical events from the psychological and mental health arena that influenced human services is too lengthy to cover within the confines of this chapter. These disciplines have advanced our understanding of human behavior and developed health services within communities. Human services, based on the work conducted in the mental health centers, have capitalized on the fruits of their labor by using theoretical approaches and adopting strategies for helping people. Suffice it to say that human service professionals attempt to help the client reflect inward to self and outward toward the environment to identify areas needing adjustment or change. Theoretical constructs provided by psychology and mental health leaders have provided an eclectic foundation from which human service professionals are able to draw in their work with a variety of people. This foundation has provided an integral understanding of client behavior in a multitude of settings.

Vocational and School Counseling Roots

Human service professionals can be found assisting school-aged clients and those transitioning from school to school, school to work, or job to job. School and work are two primary aspects of client life and often provide the opportunity to change current living conditions and address the associated challenges. Therefore, human service workers rely on the learning and practices that resulted from the fields of vocational and school guidance. Whether it be assessing client aptitude and vocational skills through rehabilitation case management, building client skills in vocational readiness workshops, job coaching in competitive employment settings, or assisting students of all ages to seek out appropriate educational experiences, human service professionals have benefited from vocational and school policy and research.

In 1881, Lysander S. Richards published Vocophy, a slim text that described a system whereby individuals could identify a vocational calling best suited to their abilities (Capuzzi and Gross, 
1997
). The profession of guidance was on the map. Frank Parsons, considered the “father of guidance,” shared similar views. Parsons was active in social reform and focused his efforts toward assisting people to make good occupational choices.

Later, Jesse Davis was credited with bringing vocational guidance into schools. After being extensively questioned by one of his Cornell University professors regarding his career plans, Davis realized that others were in need of this same guidance. Over his career, he introduced his developing guidance plans to schools in Detroit and Grand Rapids, Michigan. Using Social Darwinism as a foundation, two other individuals influenced the guidance movement from opposite coasts. In New York, Eli Weaver realized that the students with whom he worked were in need of vocational guidance. Even without additional monies, Weaver began recruiting teachers to spend time with students and help them identify their own skills and abilities and match them to the needs of the current job market. In Seattle, Anna Reed took a more commercial route toward guidance, urging that the world of business be used as a model and goal for upcoming students. She believed that students ought to focus their energies on making money. Reed also felt schools should direct young people to enter vocations whereby they could earn money.

Due to the increasing interest in vocational guidance, in 1906 the National Society for the Promotion of Industrial Education (NSPIE) was established. At the third national convention in 1913, the National Vocational Guidance Association (NVGA) was founded. Two more recent events that greatly influenced vocational services include the creation of the Dictionary of Occupational Titles, first published in 1946, and the Vocational Rehabilitation Act (1954), which recognized persons with disabilities as having unique needs for specialized services.

Sputnik is a familiar term to those who have studied vocational and school guidance history. In the 1950s, the Russians successfully launched Sputnik, the first artificial Earth satellite, into orbit. Fearing that the United States would be left behind in the race to space, the U.S. government mobilized. The goal was to identify promising young people who could be guided into studying mathematics and the sciences in preparation for careers that would develop the space program. The National Defense Education Act (NDEA) is considered a landmark in terms of establishing vocational and school guidance programs. Capuzzi and Gross (
1997
) recount that NDEA appropriated monies to pay for primary- and secondary-level school counselors and developed training programs to produce qualified public school counselors. Over the years, guidance has established itself as a profession and offers training programs within most universities. The field has adopted ethical guidelines, written professional competencies, and published a number of journals dedicated to the profession. Although professional organizations at the national level have split and changed names numerous times and school guidance programs have been under fire on occasion, the effects of NDEA are still evident today.

Human service professionals work alongside school guidance counselors in full-service schools, as tutors and counselors within Upward Bound programs, in residential settings with on-campus schools, and as colleagues when representing community agencies working with troubled youth. On the vocational track, human service professionals are employed as vocational rehabilitation case managers (with master of arts or master of science degrees), employment specialists, and in work-related capacities. Understanding school and work environments, negotiating steps to successfully transition within and across these domains, and being familiar with the tools of the trade (e.g., Occupational Outlook Handbook, Dictionary of Occupational Titles, and computer-based interest and aptitude assessment programs) are within the human service professional’s capacity. Human service professionals offer kudos to early vocational theorists and school practitioners for clearing the vocational and school guidance forest to create the path evident today.

The combined fields of social services, psychology, mental health, and school and vocational guidance have contributed greatly to the development of human services. Compassion for the human condition, theoretical constructs, practical interventions, and assessment practices are some of the benefits human services have received from these sister vocations. After reviewing the roots of human services, it is important to look at contemporary perspectives.

CONTEMPORARY PERSPECTIVES ON HUMAN SERVICE HISTORY

The human service movement began when the Mental Health Study Act was passed and a shortage of qualified human service workers emerged in the 1960s. This shortage prompted an increase in training programs for generalist human service workers at two- and four-year colleges (Burger and Youkeles, 
2000
). An increased emphasis on mental health care, proliferation of social service agencies, an ongoing shift to community-based services, and greater demand for more highly trained professionals, coupled with the social strife evident in the 1960s, all had a part in the emergence of the human service field. During this period, Harold McPheeters received a National Institute of Mental Health (NIMH) grant to support his proposal to develop a human service curriculum at the community college level, culminating in an associate’s degree. Neukrug (
2000
) recounts that because of McPheeters’s initiating efforts, he is often regarded as the “founder” of the contemporary human service field. Added to McPheeters’s efforts is the timing and direction taken by the sister fields of psychology, counseling, and social work. While these already-established disciplines began to focus their attention on graduate-level training, the need for qualified entry-level human service professionals continued to grow. And, while these sister disciplines became more specialized and arguably more exclusive, human services remained broad-based and inclusive.

·  As we look into the programs that are in this organization (

NOHSE

), we will see an extremely wide variety of different orientations, professions. Not just social work, psychology or sociology, but also nursing; education; corrections; drug, alcohol, and substance abuse programs; gerontology; health sciences; allied health professional sciences; etc. (Maloney, personal interview, October 28, 1999).

Human services filled a niche that had been created by a variety of circumstances and has continued to the present day.

Two legislative acts spurred the development of the new field of human services. The 1964 Economic Opportunity Act and the 1966 Schneuer Sub-professional Career Act provided federal funds to recruit and train entry-level human service workers. These changes were necessary due to the predicted shortfall of qualified human service workers resulting from the deinstitutionalization and decentralization movements that began in the 1950s. Neukrug (
2000
) recounts that McPheeters, supported by an NIMH grant, began developing human service training programs at the associate level. Around this same time, four-year baccalaureate degree programs began emerging. During formal training, students learned the skills necessary to work with a variety of clients and other health professionals. Many of the routine and time-intensive duties that kept more highly trained practitioners from diagnosing and treating clients were perfectly matched to the skills of the newly trained human service workers. The involvement of human service workers helped to broaden the treatment focus from the individual client to include systems or forces surrounding the client. Systems included the client’s family, environmental factors such as living conditions and work, larger systems such as community supports, and ultimately, societal constraints or supports. Human service workers observed and interviewed clients, making initial assessments. Gathering individual and family histories, directly observing clients, connecting individuals and families to community resources, working with other professional helpers and community groups, and developing resources when they did not already exist were some of the tasks undertaken by the first human service workers. Maloney (Maloney, personal interview, October 28, 1999) asserted, “They [human service programs] can specialize and attract students to given areas within the field, namely drug and alcohol, for instance, and working with [persons] with mental retardation or the mentally ill.” However, initially, human service workers are most aptly considered generalists who may go on to specialize in a specific genre of human service work once they enter the field.

After McPheeters’s grant from the NIMH identified the need to train mental health workers, institutes of higher education responded. Purdue University created the first associate’s degree program in 1965. By 1975, 174 associate and baccalaureate programs had been started, and by 1991, the Council for Standards in Human Service Education (
2000
) directory included 614 human service programs.

As more human service graduates joined community efforts, more highly trained professionals from sister fields began to question the competency of the less-trained human service workers. Likewise, competent human service workers confirmed their own ability to effectively accomplish tasks traditionally completed by their more highly educated counterparts. Tension and controversy ensued and continues to exist today, with education requirements, competency criteria, job titles, and delineation of professional tasks and responsibilities still unsettled.

The legitimacy of human services as a profession has been debated. This discussion has provided some of the impetus behind important aspects of the contemporary history of human services: professional identity, organization, and representation.

PROFESSIONAL IDENTITY

Human services’ historical professional amalgam provides wonderful strength to the profession, yet this interfusion has also made it difficult to delineate a clear professional identity. Revisiting client needs by analyzing the responses to strategic research questions in the late 1960s, the Southern Regional Education Board (SREB) identified thirteen roles for the human service professional:

· 1. Administrator

· 2. Advocate

· 3. Assistant to specialist

· 4. Behavior changer

· 5. Broker

· 6. Caregiver

· 7. Community planner

· 8. Consultant

· 9. Data manager

· 10. Evaluator

· 11. Mobilizer

· 12. Outreach worker

· 13. Teacher/educator

Within these generalist roles, human service professionals must adhere to an acceptable standard of practice guided by a set of essential skills defined by competencies.

In addition to competencies, in the early 1980s, the two leading organizations in human service education determined that a set of ethical standards unique to human services needed to be developed for guidance and accountability purposes. On the basis of research followed by a committee process, ethical standards for the human service professions were written, revised, and adopted and are known today as the Ethical Standards of Human Service Professionals.

With professional roles defined and a standard of conduct tailored to the human service profession, a measure of competence remained undetermined. Taylor, Bradley, and Warren (
1996
) provided competencies extracted through job analysis research efforts. They found that human service professionals must be able to perform skills in the following twelve broadly defined competency areas, listed alphabetically:

· 1. advocacy

· 2. assessment

· 3. communication

· 4. community and service networking

· 5. community living skills and supports

· 6. crisis intervention

· 7. documentation

· 8. education, training, and self-development

· 9. facilitation of services

· 10. organizational participation

· 11. participant empowerment

· 12. vocational educational and career support

Through much effort, human services has emerged as a respected and unique profession. Human service professionals have positioned themselves as generalists performing numerous skills in frequently changing roles while serving a variety of population groups with different problems and in diverse settings. This generalist title encompasses many similarities and some differences of opinion.

Three leaders in the human service field—two past presidents and the then-current president of NOHSE—were interviewed in October 1999 during the NOHSE and

CSHSE

conference held in Baltimore, Maryland: David Maloney, Frank-lyn Rother, and Lynn McKinney, respectively. Maloney differentiated the field of human services from one of its sister professions by stating, “It is separate and different from social work in….that our (human service) students are generalists and can face the demands and challenges of a much wider variety of human service work.” Rother pointed out that human services has maintained a strong integrity to the concept of empowerment as one of its main components. McKinney added that human service professionals are practitioners and that human service education programs have a heavier emphasis on field internships than many of their counterparts, especially at the associate’s and bachelor’s degree levels (Diambra, 
2000
).

To further establish the professional identity of human service workers, a collaborative national effort between two- and four-year educational programs is needed to provide a smooth continuum of educating and training students and practitioners desiring to further develop their skills (Diambra, 
2000
). Building a strong aggregate of human service professionals through existing national organizations ensures that the issue of professional identity will be successfully resolved.

PROFESSIONAL ORGANIZATIONS

As credentialing standards and accountability become paramount in newly established programs and professions, a national body that would identify these standards soon became necessary. In the mid-1970s, the National Organization for Human Service Education (NOHSE) was formed shortly after degree programs were offered. Soon afterward, the Council for Standards in Human Service Education (CSHSE) was established. While the mission of NOHSE was to provide students and human service workers with a national organization for continued education through the unity of regional groups, CSHSE acted primarily as a standard-setting, program-credentialing, and competency-establishing body (Clubok, 
1990
). However, it is important to note that regional human service organizations were being established separate from one another around the same time that the national organization effort was initiated.

Since their early formation and initial growing pains, CSHSE and NOHSE have blossomed into full-fledged sister organizations working side-by-side, providing continued education, standards for practice, program-development guidelines, workshops and annual conferences across the country, together with a code of ethics to which all human service workers and educators can refer (Neukrug, 
2000
).

NOHSE

The National Organization for Human Service Education was founded at the Fifth Annual Faculty Development Conference of the Southern Regional Education Board in St. Louis, Missouri, in August 1975. Its mission was to draw together all interested parties and establish an ongoing dialogue to promote best practices for preparing human service workers.

NOHSE has identified for itself four main purposes:

· 1. Ensure a medium is available for collaboration and cooperation among students, practitioners and their agencies, and faculty.

· 2. Improve the education of human service students and professionals by cultivating exemplary teaching and research practices and by curriculum development.

· 3. Abet and provide assistance to other human service organizations at local, state, and national levels.

· 4. Champion creative means to improve human service education and delivery through conferences, institutes, publications, and symposia (National Organization for Human Service Education, 
2000
).

NOHSE is made up of six regional organizations: New England (founded just prior to NOHSE in the spring of 1975), Mid-Atlantic, Southern, Midwest, Northwest, and West. Each regional organization defines its own mission and agenda. The interdisciplinary makeup of NOHSE and regional membership reflects the multidimensional needs found within the human condition. Members are direct-care professionals, students, educators, administrators, agencies and institutions, and supervisors.

CSHSE

The Council for Standards in Human Service Education was established in 1979 via impetus from the National Institute for Mental Health grant. Three years earlier, the Southern Regional Education Board did a national survey of 300-plus training programs in human services. The purpose was to identify baseline data on program content and characteristics from which informed decisions and planning would occur in order to determine program standards (Council for Standards in Human Service Education, 
2000
). It was discovered that training programs had a number of overlapping variables: training aimed at generic skills for working in human services, faculty from a variety of disciplines within one program, common program policies, and student field (i.e., internship or practicum) experience requirements. A task force used these commonalities to create format and content area recommendations for accrediting human service education programs. Human service faculty, graduates, and providers were surveyed to ensure acceptability and appropriateness of each standard.

CSHSE lists five functions:

· 1. Applying national standards for training programs at the associate’s and baccalaureate degree levels.

· 2. Reviewing and recognizing programs that meet established standards.

· 3. Sponsoring faculty development workshops in curriculum design, program policymaking, resource development, program evaluation, and other areas.

· 4. Offering vital technical and informational assistance to programs seeking to improve the quality and relevance of their training.

· 5. Publishing a quarterly bulletin to keep programs informed of Council activities, training information and resources, and issues and trends in human service education (Council for Standards in Human Service Education, 
2000
).

CHAPTER 9 DOMESTIC VIOLENCE, BATTERED WOMEN, AND DIMENSIONS OF THE PROBLEM

MARIA MUNOZ-KANTHA

Throughout history, society has disregarded family violence and its implications on the family system, regardless of the fact that earlier theorists made attempts to bring it to the attention of the public. Benjamin Wadsworth, an influential seventeenth-century New England writer on marital ethics, wrote:

·  If therefore the Husband is bitter against his wife, beating her or striking her (as some vile wretches do), with unkind carriage, ill language, hard words, morose peevish, surely behavior; nay if he is not kind, loving, tender in his words and carriage to her; he then shames his profession of Christianity, he breaks the Divine Law, dishonors God and himself too, the same is true of the Wife too. If she strikes her Husband (as some shameless, impudent wretches will) if she’s unkind in her carriage, give ill language, is sullen, pouty, so cross that she’ll scarce eat or speak sometimes; nay if she neglects to manifest real love kindness, in her words or carriage either; she’s then a shame to her profession of Christianity . . . the indisputable Authority, the plain Command of the Great God, required Husbands and Wives, to have and manifest very great affection, love and kindness to one another (quoted in Morgan, 

1966

).

This social issue presents a serious problem for society because violence against women and children has increased in the last twenty years. The physical abuse of women is increasingly recognized as a serious, widespread community problem that must be addressed by the medical, legal, law enforcement, academic, corporate, political, religious, and human service fields. Every year in the United States, three to four million women are beaten in their homes by their husbands, ex-husbands, boyfriends, lovers, or family members. These women often suffer severe emotional suffering and physical injuries that can be serious enough to result in death.

The last three decades since the 1960s witnessed a new national awareness of violence faced by women and children. Prior to the 1970s the focus was on rape by strangers or acquaintances. Violence in the family system was viewed as an intrapsychic issue rather than a societal widespread problem. In the past fifteen years, much data on violence against women has been gathered with regard to prevalence and outcome in the area of advocacy, medical care, mental health, criminal justice, and academic communities (Browne, 

1986

; Schechter, 

1982

). Major feminist movements, research, and policy initiatives now address aggression within the family system. Rape laws have been amended to protect victims of assault by marital partners. Nearly every state has passed legislation addressing domestic violence.

In 1972, the first refuge for battered women opened in Britain. Others soon opened throughout Britain (Sutton, 
1978
) and other parts of Europe, the United States, Canada, and Australia (Warrior, 
1976
), as activists traveled throughout countries sharing ideas and providing support for opening and expanding new refuges.

The battered women’s movement has now extended throughout much of the world, providing shelter and support and working for social change. Although several books have been published on the topic of wife assault and family violence, few researchers considered the impact of this behavior on the children who were exposed to this violence. Most of the early literature focused on the incidence of violence against women and society’s inadequate response represented by community agencies, justice, health, and social service systems (e.g., Gelles and Straus, 
1988
). The impact of the violence on the child was not considered unless the child was physically abused as well.

Early studies on shelters for battered women began to identify the needs of children admitted to the shelters with their mothers. At least 70 percent of all battered women seeking shelter have children who accompany them, and 17 percent of the women bring along three or more children (MacLeod, 

1989

). Shelter staff pointed out that the women were most vulnerable and that the children presented themselves with a number of emotional, cognitive, and behavioral problems that required immediate intervention. However, at the times when the children had the greatest need for nurturance, the mothers were unavailable as a result of their own overwhelming needs related to their victimization.

Given the complex nature of this problematic public issue, how do human service workers deal with battered women and their children? Both societal and intrapsychic determinants of reactions to “battered women” may determine how human service workers respond and intervene in providing services.

Utilization of human service workers has expanded rapidly over the past three decades. Today the single largest category of personnel providing direct services to children and families are paraprofessionals. The most recent trend has been the development of bachelor’s degree programs in human services. Despite the degrees, we are finding gaps and problems with curriculum development. Students are confronted with their own reactions to societal problems and are requesting more training in identifying issues, dynamics, and interventions.

Extent of Domestic Violence

· 1. According to FBI statistics, wife beating results in more injuries that require medical treatment than rape, automobile accidents, and muggings combined in this country. Statistics for 1984 indicated that 2,116 spouses were killed by their mates. Another study conducted in 1988 by Stark and Flitcraft revealed that spouse abuse occurs in 20 to 30 percent of all families.

· 2. Family violence calls constitute about 25 percent of all calls to most police departments.

· 3. Eighty-six percent of injuries received by police officers are reported to be caused by calls involving domestic violence (confrontations with the batterers).

· 4. Violence against women and children is pervasive and does not discriminate; it cuts across lines of income, color, class, and culture. There are many variations, ranging from the most subtle and indirect to the most blatant, including psychological, emotional, and verbal abuse. These variations include sexual harassment, rape, incest, prostitution, economic deprivation, genital mutilation, murder, and oppression. Testimonies from an international hearing on violence against women held on February 13, 1993, at the Church Center in New York emphasized the need for society to recognize violence against women as a human rights violation rather than a private family matter. They estimated that 1,000 women per year are killed by their husbands or partners. Women from all over the world testified and revealed their inner pain within a cultural context. Women within many different cultures are seen as property of the husbands. In fact, wife beating is expected when a woman “steps out of line,” in spite of religious and cultural taboos against violence.

Sources of the Problem

· 1. Alcohol—Alcohol is involved in at least 60 percent of domestic violence cases. However, alcohol is not the cause; it is only the excuse or defense level of rationalization for violence (Fitch and Papantonio, 
1983
).

· 2. Sex Role Stereotypes: Power Issues—Men are taught and conditioned that to be masculine is to be powerful, and to exert control is normal. It is common in many homes to stress values and beliefs that designate the man as the authority figure and the woman as subservient. Of course, not all women in these relationships experience abuse, but a traditional marriage does tend to reinforce certain gender roles. Many women are also taught early in their development that to be feminine is to be helpless, dependent, and vulnerable.

· 3. Cultural Values and Norms—Our cultural values, social norms, family expectations, and psychological processes work together to encourage men to be abusers and women to be abused. Historically, women have been oppressed and beaten with the acknowledgment of their families, friends, and community. Within my own clinical practice, I have treated battered women from various socioeconomic levels, cultures, religions, and races involved in cases in which family members interrupted acts of violence but facilitated its continuation by keeping it a secret for the sake of not shaming the family.

· 4. Cycle of Intergenerational Abuse—A wife- or woman-batterer has often learned from his father (identification with the aggressor) that a real man expresses his anger by using his fists, not by crying or verbalizing his frustrations. In this process, the male also learns to disrespect women and the woman learns to inherit her mother’s passivity by watching her get exposed to years of abusive behaviors. For some couples, there seems to be a pattern of violence that is repeated from generation to generation. Some families perceive violence as normal; it is internalized to the point that defenses like denial, aggression, suppression, anxiety, and identification with the aggressor play an important role. In some families the abuse takes place among siblings as well as between parents and children, therefore creating blurred boundaries within the contextual family system.

· 5. Low Self-Esteem—A wife-beater usually feels inferior and powerless in other areas of his life. It does not matter whether he has an excellent job or is unemployed—he feels unsuccessful, angry with himself, and worthless. The batterer displaces and projects his own anger onto his wife or partner. A woman who endures this kind of abuse internalizes inferiority, hopelessness, worthlessness, and a temporary form of helplessness.

· 6. Economics—Many battered women are housewives with no money of their own, no work skills, and dependent children. However, it is important to note that there is a high number of professional women who stop working to take care of their children, later finding themselves trapped in an abusive situation. Women in these situations usually tend to get depressed and lost in the shadow of the “super woman” (the woman who performs all of the roles of the traditional stay-at-home mother, while working full time). Often, this depression is correlated to the experience of living with extreme emotional and physical stress and deprivation for an extended period of time.

· 7. Specific Causes of Violence—In a domestic violence situation, anything can precipitate abuse: a bad day at work, a delayed dinner, unpaid bills, an affair, or accusations of infidelity. Often, there is little awareness or insight into the level of abuse to come at the time that the abuser starts to abuse. His vision is microscopic, not macroscopic.

· 8. Societal Denial—The last three decades have been marked by a growing public awareness of wife assault or wife beating. The belief that all family life is safe and secure is shattered by the alarming frequency of reported violence. Yet, this topic that was once considered a family secret or acceptable behavior seems to be interwoven with the very fabric of society’s attitudes and values. Extensive data in this area remain shocking to society while our statistics on violence continue to rise. Denial continues to be a major problem. An example would be the famous and controversial case involving the great football player O. J. Simpson, America’s all-American football hero, a mentor to many and a model for all. Prior to the 1994 murders and subsequent trial, in spite of his long problems with domestic violence toward his ex-wife, O. J. continued to be idealized, protected, supported, and rallied around; there seemed to be more public sympathy for him than for his victimized ex-wife.

CHARACTERISTICS OF ABUSE

Abuse has several dimensions. It can be emotional, physical, or sexual. It can occur every day or once in a while. It can happen in public places or in the privacy of someone’s home. Abuse can leave a woman with bruises and bumps on her body or inner emotional pain that no one else can see. Here are some common characteristics of abuse.

Physical Abuse

Does her partner:

·  Hit, slap, shove, bite, cut, choke, kick, burn, or spit on her?

·  Throw objects at her?

·  Hold her hostage?

·  Hurt or threaten her with a weapon such as a gun, knife, chain, hammer, belt, scissors, brick, or other heavy objects?

·  Abandon her or lock her out of her house or car?

·  Neglect her when she’s ill or pregnant?

·  Endanger her and children by driving in a wild, reckless way?

·  Refuse to give her money for food and clothing?

Emotional Abuse

Does her partner say or do things that embarrass, humiliate, ridicule, or insult her? Does he say:

·  You are stupid, dirty, crazy.

·  You are a fat, lazy, ugly whore.

·  You can’t do anything right.

·  You are not a good mother.

·  Nobody would ever want you.

·  You don’t deserve anything.

·  Your mother is a whore.

Does he:

·  Refuse to give her attention as a way of punishing her?

·  Threaten to hurt her or the children?

·  Refuse to let her work, have friends, or go out?

·  Feel threatened by her assertive and competent friends?

·  Force her to sign over property or give him her personal belongings?

·  Take away gifts that he gave her when he becomes angry?

·  Brag about his love affairs?

·  Berate women?

·  Accuse her of having extramarital affairs?

·  Manipulate her with lies, contradictions, promises, or false hopes?

·  Hide money from her and the children?

Sexual Abuse

Does her partner:

·  Force her to have sex when she does not want to?

·  Force her to perform sexual acts?

·  Criticize her sexual performance?

·  Refuse to have sex with her?

·  Force her to have sex when she is ill or when it puts her health in danger?

·  Force her to have sex with other people or force her to watch others having sex?

·  Tell her about his sexual relations with other people?

·  Have sex that she considers sadistic, or sex that is painful?

Destructive Acts

Does her partner:

·  Break furniture, flood rooms, ransack, or dump garbage in her home?

·  Throw food and pots out of the window?

·  Slash tires, break windows, steal, or tamper with parts of the car to break it down?

·  Kill pets to punish or scare her?

·  Destroy her clothes, jewelry, family pictures, or other personal possessions that he knows are important to her?

WHAT IS DOMESTIC VIOLENCE?

According to Evelyn White (

1985

), the terms abuse and battering are used interchangeably to describe a relationship with a partner who hurts a woman physically and/or emotionally. However, there are some differences in their meaning. This awareness can be helpful to the human service worker when providing assistance to a victim of domestic violence. White defines battering as a means of punching, hitting, striking, or the actual physical act of one person beating another. Abuse may include physical assault, but it also covers a wide range of hurtful behavior. Threats, insulting talk, sexual coercion, and property destruction are all considered forms of abuse.

Domestic violence is a general term used to describe the battering or abusive acts within an intimate relationship. For example, a shelter worker, counselor, social worker, psychologist, or legal advocate who helps battered women and their children might say that she or he works in the field of domestic violence.

Physical abuse, emotional abuse, sexual abuse, and destructive acts are all dimensions of domestic violence. Some forms of abuse are considered serious offenses that can be prosecuted; others are simply behaviors that no one should tolerate. A woman’s partner has no more right to hit, threaten, or hurt her than to assault a stranger in the community or streets. A woman has a right over her body, mind, and soul; it is to be respected and should not be violated or demeaned.

Battered Woman

The term “battered woman” was first described by a women’s movement in Britain. It was a powerful phrase. The everyday word “battered” had been successfully used to describe persistently abused children; much later the phrase was utilized by the movement to convey the traumatic experience of persistent and severe violence against women. Many believed that the problems associated with violence are primarily perceived as contextual, associated with violent repression of women by men. Therefore, allowing women to escape this predicament and release themselves from violence and its consequences is vital (Dobash and Dobash, 
1992
).

How Does Battering Begin and Continue?

Battering can begin at any time during a relationship and continue throughout it. It can happen in a companion relationship, on a first date, on a wedding night, and after good and bad times. Statistics show that many men are under the influence of alcohol or drugs when they become violent or abusive. However, it is important to note that substances do not cause the abuse. In some families it is repeated from generation to generation and can start at any interval.

The Cycle of Battering

Dr. Lenore Walker describes the cyclical pattern of battering as a process that can only be ended when the batterer takes responsibility for his abusive behavior. Only he can change or learn how to control his behavior. Within the cycle of violence the first stage refers to the process by which a man is irritable, uncommunicative, and quicktempered. He may claim to be upset about his job and have a short attention span. He breaks dishes, throws objects, has shouting fits, but then quickly apologizes. It is during this period that the abused woman may report feeling as though she is walking on eggshells. She repeatedly tries to pacify him in order to prevent him from having another explosive episode. When there are children involved, quite often they, too, learn quickly to pacify their father’s violent behavior. An adolescent child in my private practice described her feelings:

·  I had to help my mother because she was afraid, I felt I needed to protect her, it was so frightening, while I was in school it was difficult to concentrate because I always feared coming home to a dead body. I remember life at home as extremely violent, my father cut my older brother’s arm with a machete while my brother protected my mother. Following this, he threw my older sister down the stairs and knocked out my other brother’s tooth. It was a nightmare. Now I am a victim of abuse; I let my boyfriend beat me, at times I feel I deserve it.

The second stage is what Dr. Walker describes as an increase in the tension leading up to physical or verbal explosion. It can be precipitated by a disagreement, traffic ticket, late meal, or misplaced keys. The event can trigger the batterer into a violent rage that can result in his attacking the person he is closest to. During this stage an abused woman may be beaten for seemingly minor or nonexistent reasons. Another woman in my practice reported that her husband beat her following a dinner party they held for some business associates. He accused her of being provocative and too outspoken. He criticized her clothing and also accused her of wanting him to lose the business deal.

Dr. Walker refers to the third stage as the “honeymoon phase.” The batterer becomes extremely loving, gentle, kind, and apologetic for his abusive behavior. The client described above stated two days later in her session: “He loves me, he is genuinely sorry. I think it was the alcohol and cocaine that did it, after all, he just bought 
me that beautiful house in Rye, NY. . . . He promised me that he would never hit me again. . . . After all now he feels successful and just like his father. . . . You know his father is just like him. . . . My mother-in-law puts up with it. I’m sure we’ll be fine.” The battered woman believes these promises because she doesn’t want to be beaten again, nor does she want to lose what appears to be a caring and nurturing provider. In this stage her partner romances her, brings flowers, buys gifts, takes her out to dinner, and spends extra time with the children. She believes that her household has been magically transformed into the classic happy family. She enters a period of denial and repression, overlooking the previous dynamics. Another client reported, “he lost his job because of his temper; upon his return home, he beat me so badly that my children begged him to stop while they cleaned up the blood off my body. One more time we were forced to go on welfare. He became enraged at any little thing like the children making a little noise. I was forced to work nights in a cleaning company. One evening I returned home to find my eight-year-old boy tied up to the bed post, beaten and scared. I found my husband crying in the living room, begging for mercy. I felt sad for him, he apologized and said he would never do it again. I believed him; his sadness and tears manipulated me. For the next few weeks he was wonderful to me and the children. Another incident occurred when I came home early and found him in bed with my ten-year-old daughter. I was devastated it was my fault, you know things would be better if he found a job. We eventually dropped welfare and had two incomes. I believed him.” In reality the honeymoon phase wanes. It presents the battered woman and her children with a dilemma; they fall gradually from power, prosperity, or influence.

CHANGING ATTITUDES

The recognition of domestic violence as a deeply rooted problem in our society has come from several sources, most notably the women’s movement and antirape organizers. Grassroots activists and human service professionals have borrowed counseling and organizing principles from the rape crisis movement to illustrate and address the similar plight of the battered woman. As public consciousness about sexism and its violent impact on all women’s lives began to grow, shelters for battered women and their children opened, and social and legal reforms began to take place. Abused women took flight and organized supporters across the country.

Although it continues to face many cultural and economic challenges, the battered women’s movement is here to stay. Abused women should be made aware that there is no need to feel shame about domestic violence. They should be educated about the physical, emotional, and sexual abuse counseling programs that are working to change the attitudes of battered women, their children, and batterers.

Given the complex nature of this problem, theorists have developed interventions and techniques that have been helpful to the counseling professionals working with battered women and children. The optimal goal in dealing with domestic violence is to keep the abuse from ever happening again, to prevent the explosive elements in a potentially abusive family system.

STRATEGIES AND INTERVENTIONS

Battered women who leave their homes frequently stay at the house of a relative, friend, or neighbor for a few days or months. There they hope to get support, comfort, safety, and distance from the batterer. Others choose to contact a battered women’s hotline, where they get help with immediate intervention and referrals. A woman usually makes the first contact with the shelter by calling a twenty-four-hour hotline. She may have read about the shelter or gotten the number from a friend, doctor, church, social service agency, library, school, police officer, or a public service announcement or newspaper. During the hotline call the staff member evaluates the needs of the woman and the ability of the shelter to provide services. Usually women who have significant chemical dependencies or severe mental health problems are referred to more appropriate services where there are professionals to help via an interdisciplinary approach. Those who have been abused and are in need of shelter discuss their current situations with staff members and review the services available for shelter placement. If admission is indicated, a staff member will review the circumstances and make a decision whether to admit. If there is no room, a referral is made to another shelter. Once a decision to admit has been made, the living arrangements, fees, and guidelines are reviewed. However, no woman is rejected because of income or status. The woman is then asked to participate and cooperate in shelter life. Once an agreement has been made, travel arrangements are made either by giving the victim specific public transportation directions to the shelter or by arranging pickup by the shelter staff. When the woman and her children arrive at the shelter, they are greeted and oriented by a member of the staff who assures them safety, makes an assessment, and reviews shelter rules and routines. The family then meets the other families. Within twenty-four hours, the client is assigned a counselor who will continue to obtain information for intake and necessary services. These goals may include a methodology to include legal services, finances, school arrangements, Medicaid, emergency funds, and support counseling for all members. Some shelters refer to a case manager as the primary counselor and advocate for the family.

Services Available

·  Counseling—Short-term therapy, crisis intervention, assessment of the psychological needs of women and children is provided.

·  Support Groups—Group discussions revolve around each member’s perceptions, peer support, and role modeling, especially in the area of problem solving and conflict resolution. Activity groups are provided for relaxation as well as the enhancement of everyday living skills.

·  Family Sessions—Family sessions are provided to help the client and children have a better understanding of family violence, current crisis, relocation, and conflict resolution.

·  Legal Services—A legal advocate will be available to provide information on a woman’s legal rights and options. Clients will also be informed about family court laws and acts.

·  Outreach Services—Outreach services are also provided to the community whereby an assessment can be done in the area of need, advocacy, counseling, and referrals to appropriate facilities.

·  Empowerment—Each woman will be oriented to the cycle of battering and intergenerational patterns of abuse and their impact on the family system. They will become empowered to work through their issues in a therapeutic environment with the appropriate support staff, volunteers, and advocates.

·  Children’s Program—This program provides a fun, safe place for children to play and explore their feelings through the course of play and artwork. The counseling component provides the children with individual sessions to work through their feelings of aggression, anger, sadness, and trauma.

·  Community Education—Domestic violence programs conduct presentations and seminars to community groups, professional associations, civic clubs, schools, training institutes, parent groups, and other institutions about family violence and related issues. They promote awareness of the scope of the problem, provide concrete information about available services, and offer information on recruiting volunteers and advocates for legislation and lobbying.

Leaving the Shelter

The average stay in a shelter for battered women is ninety days. When the family prepares to leave the shelter, an exit interview is conducted and follow-up contacts are made. Referrals to transitional housing, appropriate agencies, or to non-residential service programs are made to provide support for the woman and children as they readjust to life outside the protected environment. If the woman returns home to the abuser, she is advised to seek nonresidential counseling with her abuser. The goal of the shelter staff is to assist the woman in whatever choice she makes without judging that choice, regardless of personal opinion.

Counselor Intervention and Self-Awareness

Treatment of a battered woman and her children is extremely difficult for the family, counselor, and community. The thought of someone being abused presents conflict for all involved. It is important for counselors to be aware of their feelings while working with battered families. Dr. Kim Oates (
1986
) refers to the battered professional as one who identifies with the client in a nonproductive way. Sometimes they are not aware that their feelings of anger lead them to overidentify with the battered client. In situations like these, Oates advises that counselors seek their own counseling to work through these feelings prior to making an attempt to work with battered families.

Last, human service workers must be ready to make an assessment and work with the battered family in a productive fashion to promote a healthier and a more positive environment.

CONCLUSION

It is quite difficult to realize that although public awareness and understanding of domestic violence in our society has greatly advanced over the last two decades, statistics on battered women and children continue to rise. In spite of the challenge, we recognize that it is our responsibility to raise and develop healthier families. We hope to guide our children and their families to safety, success, and challenging endeavors, without having to expose them to personal and familial violence. The pain caused by domestic violence is multilayered and can, in a sense, create a fragmented self, family, and society, which are not easily repaired.

The achievements of the battered women’s movement are massive and inspiring. The goal of social change is macroscopic, with serious implications for the improvement of the institution of family, gender issues, and the psychological development of children. The achievement of such goals relies on the commitment of staff, community, public policy, legislation, advocates, educators, human services, volunteers, criminal justice system, and community-based programs. At the very least, their collaborative efforts have shown support for women throughout the world and have brought the issue to the public arena.

CHAPTER 10 THE CHILD WELFARE DELIVERY SYSTEM IN THE UNITED STATES

DAVID S. LIEDERMAN

MADELYN DEWOODY

MEGAN C. SYLVESTER

Child welfare is a field of human services that focuses on the general well-being of children. It incorporates services and efforts designed to promote children’s physical, psychological, and social development. Child welfare and social service agencies offer a range of services to children and their families to ensure the health and well-being of children.

The general principle is that child welfare is the responsibility, first and foremost, of the child’s family, with human services supporting and complementing the role of the family. There are situations, however, when families encounter difficulties meeting the needs and fostering the development of their children. These difficulties may be so severe as to put the children at risk of physical, emotional, or developmental harm. The federal government has organized a system of child welfare services specifically designed to assist children and their families, supporting the strengths of families whenever possible, and intervening when necessary to ensure the safety and well-being of children. Child welfare services may be provided by public and private nonprofit agencies and usually are provided by social workers. They may take many forms, depending on the child’s and family’s situation and needs.

THE CORE CHILD WELFARE SERVICES

In general, child welfare services fall into four core categories:

· 1. Services to support and strengthen families

· 2. Protective services

· 3. Out-of-home care services

· 4. Adoption services

Services to Support and Strengthen Families

For many children and their families, child welfare services involve supportive services that are provided to assist the family in remaining together. These services are designed to support, reinforce, and strengthen the ability of parents to meet the needs of their children. When a child welfare agency provides services to support and strengthen families, it does not assume the responsibilities of the parent. Instead, the agency supports parents in protecting and promoting the well-being of their children and strengthens parents’ ability to solve problems that may result in the abuse or neglect of their children.

There are three major types of supportive services: family resource, support, and educational services; family-centered services; and intensive family crisis services.

Family Resource, Support, and Educational Services.

These services, which are broad and often overlap, assist adults in their roles as parents. Resource services are varied and include, as examples, providing referrals for services needed by the family and helping with transportation. Support services are likewise diverse and include, as one example, parent support groups, often facilitated by the group members themselves. Educational services seek to develop parenting skills and often involve parenting classes where parents learn, among other things, children’s stages of development.

Family-Centered Services.

These services help families with problems that threaten the well-being of children and the family as a whole. They are designed to remedy problems as early as possible. These services can include the following:

·  Family counseling;

·  Parent education programs designed to enhance parents’ knowledge and skills;

·  The identification and use of social support networks that include individuals, groups, and organizations;

·  Advocacy to obtain services for families when services do not currently exist;

·  Case management services to facilitate access to needed services and coordinate multiple resources.

Intensive Family-Centered Crisis Services.

These services are designed to assist a family when a crisis is so serious that it may result in the removal of the child from the home. Intensive family-centered crisis services attempt to ensure the safety and well-being of the child and strengthen and preserve the family in order to avoid the unnecessary placement of children outside the home. Services may include crisis intervention counseling, alcohol and drug treatment, and parenting education.

Three specific services that can support and strengthen families are child day care, housing, and adolescent pregnancy prevention and parenting services. Child day care responds to the needs of children, families, and communities. Child day care can be provided in family day care homes, group child day care homes, and child day care centers and may be offered for part of the day, full days, or, in the case of respite care, twenty-four hours a day. Adolescent pregnancy prevention and parenting services have become an important component of child welfare services as the rate of teenagers giving birth to children has increased dramatically over the last decade. Child welfare services include education and referral services related to preventing pregnancy and services for parenting teenagers, such as parenting education and assistance in locating child care and completing their education. Housing services have become increasingly important as the number of homeless children and families in America and the number of children who live in substandard conditions have risen. Child welfare agencies help meet the housing needs of children and their families by linking them to public housing resources and social services and by advocating for more and better affordable housing.

Protective Services.

Protective services are designed to protect children from abuse or neglect (sometimes referred to as maltreatment) by their parents or caregivers and to improve the functioning of the family so that children are no longer at risk. The specific types of maltreatment to which child welfare services respond include the following (Katz-Sanford, Howe, and McGrath, 

1975

):

·  Physical abuse: physical injury to a child;

·  Sexual abuse: sexual maltreatment of a child;

·  Emotional abuse and neglect: emotional injury to a child or failure to meet the child’s emotional or affectional needs;

·  Deprivation of necessities: failure to provide adequate food, shelter, or clothing;

·  Inadequate supervision: leaving children for long periods of time without access to an adult who can meet their needs and protect them from harm;

·  Medical neglect: failure to seek essential medical care for the child;

·  Educational neglect: failure to enroll a child in school or indifference to the child’s failure to attend school;

·  Exploitation or overwork: forcing a child to work for unreasonably long periods of time or to perform unreasonable work;

·  Exposure of a child to unhealthy circumstances: subjecting a child to adult behavior that is considered “morally injurious,” such as criminal activity, prostitution, alcoholism, or drug addiction.

Protective services are provided by the public agency—often referred to as child protective services (CPS)—mandated by law to respond to reports of child abuse and neglect and to intervene to protect children.

Protective services are offered to accomplish several purposes: to strengthen families who are experiencing problems that can lead or have led to abuse or neglect; to enable children to remain safely with their parents; to temporarily separate a child at imminent risk of harm from his or her parent; to reunify children with their parents whenever possible; and to ensure a child permanency with another family when the child cannot return to his or her parent without serious risk of harm (Association of Public Child Welfare Administrators, 
1988
).

Protective services include the following:

Case Finding and Intake.

The agency receives reports of child abuse and neglect. Reports received by protective services agencies generally fall into two categories: problems in the parent-child relationship, such as physical abuse, neglect, abandonment, the absence of the parent, or conflict between a parent and an adolescent; and problems that a child is experiencing, such as emotional difficulties, runaway behavior, failure to attend school, or physical problems.

When a report of abuse or neglect is made, the child protective service agency is responsible for investigating the situation. Contact is made with the family, others with knowledge of the situation, and the child. The agency will determine whether abuse or neglect has occurred (often referred to as “substantiation” of the report) and whether there is a substantial and immediate risk to the child that would warrant taking steps to remove the child from the home to a setting of safety.

Case Planning.

The agency assists families after abuse or neglect is reported and substantiated. At the heart of protective services is work with the family to prevent further abuse or neglect and to correct the problems that led to maltreatment of the child. The needs of the parents and the child are addressed through a range of services, such as extended day care centers and crisis nurseries to prevent further maltreatment; homemaker services; counseling services; and emergency caregiving services.

Court Involvement in Protective Services.

Decisions are made by the courts regarding where a child will live and the changes that a family must make. Protective service agencies seek court action when parents are not able or willing to make the changes needed for their child’s well-being or the situation presents a danger to the child so that the child can be protected only by placing him or her outside the family. In these situations, the court will order the child to be removed from custody of his or her parents and placed in out-of-home care. Only about 20 percent of the cases reported to protective services agencies require court action.

Out-of-Home Care Services for Children

Out-of-home care services are utilized when the situation presents such a risk to the child that the child must be separated from his or her parents and placed with another family or in another setting. In these situations, the public agency responsible for protecting children will seek court action to authorize placement of the child outside the home. There are three major types of out-of-home care services: family foster care, kinship care, and residential group care. These services, provided as twenty-four-hour-a-day care, are designed as temporary services for the child while the agency works with the family to correct the problems that led to placement of the child.

Out-of-home care in all settings also includes services to meet the social, emotional, educational, and developmental needs of the child:

·  Family foster care. Family foster care is provided by adults who are not related to the child and who are licensed or approved as foster parents by a child welfare agency.

·  Kinship care. Kinship care is the placement of children with relatives. Many agencies consider relatives as the first choice for out-of-home care because remaining with family members is often less disruptive for the child.

·  Group residential care. Group residential care is composed of a variety of services. One type is group care, that is, living facilities located within residential communities that care for a small group of unrelated children, usually four to eight in number. Residential care, another type of care, is usually provided to a larger number of children or adolescents and involves highly structured, intensive, and planned therapeutic interventions for children and adolescents who have significant emotional or behavioral disorders.

Adoption Services

Adoption is a child welfare service that provides a new permanent family for children whose birth parents are unable or unwilling to provide them with the love, support, and nurturing they need. Adoption services meet the needs of three groups of children who need adoptive families: (1) healthy infants; (2) children with “special needs,” such as children with disabilities, older children seeking permanent families, and sibling groups of children to be placed together with an adoptive family; and (3) children from other countries.

Agencies that provide adoption services identify prospective adoptive parents for children awaiting adoption; assess the ability of prospective parents to meet the needs of children waiting to be adopted; prepare the child and birth parent(s) for adoption; place the child with the adoptive family; assist the adoptive family in finalizing the adoption; and provide postadoption support services, such as casework services, linkages to community resources, and parenting groups.

EMERGING CHILD WELFARE ISSUES

Pediatric AIDS and HIV Infection

Child welfare professionals are confronting a new reality in the form of acquired immunodeficiency syndrome (AIDS) and the human immunodeficiency virus (HIV) that causes AIDS. Growing numbers of children are acquiring HIV from mothers who are themselves infected with HIV and, as a result, their lives are medically, psychologically, and socially threatened. Some of these children are “boarder babies,” in hospitals awaiting homes because they are ready for discharge, but their parents are unable to take responsibility for them or bring them home. Other children who have been infected with HIV live with their parents, who cannot provide for them. In many instances, their parents are also involved with drugs, which compounds the problem. In addition to children with HIV infection, there are children who are not infected with HIV whose parents are dying, leaving them orphaned by AIDS. Child welfare agencies must be prepared to help through such services as placing the children with extended families or by finding adoptive families to care for them.

Child welfare agencies provide a range of services to meet the needs of children and families who are affected by HIV/AIDS. Some programs are community based and provide services to ensure that children who are infected with HIV receive the therapeutic, developmental, and educational services they need; help parents understand and manage the child’s illness; and support the efforts of the child and the family to deal with the grief and bereavement issues that accompany the disease. Specific services may include information and referral for needed financial, medical, mental health, and social services; crisis intervention services when the immediate needs of the child place stress on the family; family therapy; and case management and coordination of medical and psychological treatment. For children whose families are not available or able to care for them, child welfare agencies provide specialized foster care—twenty-four-hour-a-day care by foster parents who are specially trained to meet the special needs of these children. Children who are healthy or who have been infected with HIV and have lost their parents to AIDS likewise need child welfare services. Child welfare agencies work with the extended family to prepare them to care for children who are attempting to cope with the loss of their parents from AIDS and provide ongoing supportive services to both the child and the family after placing the child. For other children, child welfare agencies recruit and train adoptive parents, offering a broad range of education and supportive services to ensure that adoptive families understand and can meet the significant psychosocial needs of these children.

Children with Incarcerated Parents

As our country’s rate of incarceration escalates, child welfare professionals are encountering growing numbers of children who have parents in prison. We currently estimate that 1.5 million U.S. children have an incarcerated parent, and many thousands of others have experienced the incarceration of a parent at some point in their lives. As a result of parental incarceration and the criminal behaviors that precede it, many of these children experience disrupted and multiple placements, decreased quality of care, and an ongoing lack of contact with their parents. They are at increased risk for poor academic performance, truancy, early pregnancy, substance abuse, delinquency, and adult incarceration.

The growing number of children with parents in prison has serious implications for the child welfare system. Approximately 42,000 children with parents in prison currently live in out-of-home care, and we suspect that many more of these children have intermittent contact with child welfare services. The children of incarcerated mothers are particularly vulnerable because these mothers are often the sole caregivers and sole support of their families. Although most children of incarcerated mothers live with grandparents or other relative caregivers, they are at risk of placement in the child welfare system if fragile family caregiving relationships deteriorate.

Until recently, few statistics on children of offenders and very little research have been available. As their numbers increase, though, child welfare professionals are recognizing that this is a particularly vulnerable group of children. Consequently, there has been a recent movement to develop policies and practices that address their special needs. In particular, child welfare agencies are beginning to consider ways of identifying and gathering information about the children in their caseloads who have parents in prison, strengthening reunification and permanency planning services to those families, and providing specialized training to improve caseworkers’ and foster parents’ capacity to help children and families separated by incarceration.

Cultural Competence

Cultural competence is a personal and organizational commitment to learn about one another and how individual cultural differences affect how we act, feel, and present ourselves. The purpose of cultural competence is the sharing of knowledge about all aspects of culture (gender, religion, age, sexuality, education, and socioeconomic level), not just the racial/ethnic culture of people of color. Cultural competence is an enrichment process that allows everyone to share and learn. Cultural competence is part of best practice. To efficiently and effectively carry out all the processes that are encompassed by best practice, the cultural implications should be identified and integrated into organizational operations. These processes include the planning, organization, and administration of social work services; the establishment of state and local regulations; content training and teaching in schools of social work; in-service training and staff development; board orientation and development; fiscal planning; and community relations.

The child welfare field is currently undergoing rapid and dramatic change as it struggles to provide quality services to children and their families. One of the most critical challenges the field faces is the need to understand and respond effectively to striking changes in the multicultural nature of American society—changes brought about by the mixture of racial, ethnic, social, cultural, and religious traditions of the children and families who make up our diverse society. These changes, coupled with the demands of a more outcome-driven environment, a more punitive outlook by society on the families served in child welfare, an anti-immigration sentiment, and the impact of managed care, challenge today’s leaders. Child welfare executives face the dilemma of whether to include striving toward cultural competence as an organizational goal, given the range of pressures that impact their agencies.

Currently, children of color are disproportionately represented in the child welfare system, particularly in out-of-home care and the juvenile justice system. Unfortunately, children of color remain in these systems for longer periods of time and are less likely to be reunited with their families than children of European descent. Children of color in the child welfare system are ethnically diverse and include mainly those of Latino, African American, Asian American, and Native American cultures.

A common characteristic among children and families served in child welfare is poverty. One in five children in America is poor. The ramifications of poverty—unemployment, inadequate education, inferior or nonexistent health care, substandard housing, and welfare dependence—all increase the likelihood that children in poor families will at some point need the services of the child welfare system.

A crucial issue raised by the increase in the number of people of diverse cultures in the child welfare system is the degree to which current policies, programs, and services are relevant to the cultural values, traditions, needs, and expectations of the populations served. The child welfare system faces a challenge to extend itself in support of the premise that provision of effective child welfare services is directly related to the knowledge and understanding of, as well as sensitivity and responsiveness to, the culture of the client population. This, as well as the formidable task of recruiting and retaining a qualified, diverse staff, presents not only challenges but also opportunities for more effective leadership, management, and service delivery.

Child welfare agencies respond to issues of cultural diversity in many different ways. Many child welfare agency management teams are aggressively shaping an organizational agenda that encompasses a broadened vision, expanded goals and objectives, and modified policies, procedures, and programs to better meet clients’ needs. The management teams of these enlightened organizations are also attempting to raise their individual comfort levels by gaining an understanding of their own cultural backgrounds and biases, the cultures of others, and multicultural organizational behavior. These management teams are learning how to positively manage the impact of diversity in their organizations—indeed, how to celebrate and enjoy the benefits of cultural diversity.

Conversely, many child welfare agencies and management team members are reluctant to develop a personal and professional agenda regarding the diverse populations of children and families served by the systems they administer. Many see no need to address the subject of cultural diversity, often because of a belief that acknowledging cultural difference could appear to condone discrimination. This “one size fits all” approach denies the existence of the current pluralistic society in the United States, the changing face of child welfare, and the resulting cultural diversity that is an inevitable part of the day-today experience.

As child welfare professionals, it is our responsibility not only to understand but also to build a consensus around the best way to develop programs, policies, and practices that recognize and support cultural differences. Through the development and implementation of appropriate and responsive programs, policies, and practices, we can effect systemic change. The number of people of color living in this country will drastically increase in the next few decades. The problems we currently face in the child welfare system will only be exacerbated if we do not take the necessary steps to stem the tide of children of color into the system.

Substance Abuse

As the abuse of alcohol and other drugs has continued to escalate and growing numbers of women have begun to use illegal drugs, child welfare agencies have observed a significant relationship between alcohol and other drug abuse and the well-being of children. Dramatic increases in the number of child abuse reports and in the number of children entering foster care have been specifically tied to parental alcohol and drug abuse. Child welfare agencies are responding to record numbers of child protective service referrals concerning drug-exposed infants, many of whom may also have been infected with the AIDS virus and who may be medically fragile, and older children who have experienced abuse or neglect because of their parents’ substance abuse. In all age groups, growing numbers of children who have been affected by their parents’ alcohol and drug problems are entering foster care.

Child welfare agencies are called on to respond to the needs of families who require immediate and intensive help in resolving their alcohol or drug dependency. Agencies must also help families correct the problems that alcohol and drugs create for their children. Child welfare agencies provide services to prevent and intervene early in situations involving child abuse and substance abuse, such as outreach to newborns and mothers; referrals for needed financial, housing, and social services; child day care; and coordination with community alcohol and drug treatment services. Special services may be needed by pregnant women who are abusing alcohol or other drugs. Early detection, proper prenatal care, and medical and substance abuse treatment services can be mobilized to reduce the damage that alcohol and drugs can cause for both the mother and the fetus.

Child welfare agencies also meet the needs of infants and toddlers who were prenatally exposed to alcohol and other drugs and older children whose parents, because of substance abuse, have not provided the psychological, social, and developmental environment that children need for healthy growth. Child welfare agencies, through child protective services, assess the risk to children posed by parental substance abuse; determine whether the child may remain safely at home with the parent or should be placed away from the parent to ensure the child’s safety; and provide or coordinate the range of health, educational, and developmental services that children need. Substance abuse, which is often a complex and long-standing problem, presents the child welfare system with special challenges to protect children, provide effective services to parents and to children who may have significant health and developmental needs, and plan for permanent families for children whose parents are unable to care for them because of substance abuse.

INSTITUTIONAL SYSTEMS

Child welfare services are provided by agencies in both the public and the private sectors. Services to support and strengthen families, out-of-home care services, and adoption services are provided by public child welfare agencies and private nonprofit agencies in the voluntary sector. Public child welfare agencies often combine the way in which they provide these services, directly providing some services and contracting with private nonprofit agencies to provide other services. Private nonprofit agencies may provide a range of child welfare services or may specialize in certain services such as adoption or residential care for children with serious emotional disturbances.

Protective services traditionally have been undertaken only by government agencies charged by law with the protection of children—child protective services (CPS) agencies located within public welfare departments; law enforcement agencies; and the courts. Although CPS agencies and law enforcement agencies both investigate reports of child abuse and neglect, CPS and law enforcement investigations differ. The CPS agencies are concerned only with child protection; their efforts focus on determining whether a child has been mistreated and whether the child can remain safely with his or her parents. Law enforcement agencies focus on whether criminal charges should be filed in response to child maltreatment. Family and juvenile courts consider cases arising from CPS and law enforcement investigations. The courts will, when appropriate, declare a child in need of protection; remove custody of the child from the parent(s) and place the child in the custody of the CPS agency, and approve the child’s placement in out-of-home care. When the court has made such decisions, the court will periodically review the progress that is being made toward resolving the problems that led to the child’s placement and the progress that is being made toward finding a permanent family for the child. When criminal charges are filed, the court with jurisdiction over criminal matters may also become involved in the case.

CHILD WELFARE LAW

Child welfare services are shaped largely by federal and state law.

Federal Law

The Child Abuse Prevention and Treatment Act (CAPTA) of 1974.

This federal legislation, enacted in response to growing public concern about child abuse, provides financial assistance to states and communities to prevent, identify, and treat child abuse and neglect. To receive funds, states must designate an agency with responsibility for investigating abuse and neglect; establish a reporting system for all known or suspected instances of child abuse and neglect; enact laws that protect all children under the age of eighteen from mental injury, physical injury, and sexual abuse; and develop a system that provides a guardian ad litem who represents the interests of abused and neglected children when their cases go to court.

CAPTA was amended in 1996 (P. L. 104–235). Highlights include provisions for the establishment of citizen review panels to evaluate state child protection policies and procedures, provisions for termination of parental rights in cases of abandoned infants, and provisions for public disclosure of information in fatalities caused by child abuse and neglect.

The Indian Child Welfare Act of 1978.

This legislation was designed to expand the services available to support and strengthen Native American families and to put safeguards in place regarding the custody and placement of Native American children. The law directs agencies to work closely with Native American children, families, and tribes when there has been a report of child abuse or neglect and requires the placement of Native American children who have been abused or neglected with Native American families whenever possible. Importantly, the law also recognizes the authority of tribal courts to handle Native American child welfare matters.

The Adoption Assistance and Child Welfare Act of 1980 (PL 96–272).

This legislation, also known as Public Law 96–272, is considered the most important child welfare legislation enacted over the past several decades. Public Law 96–272 provides federal support for children in foster care, requires that states have in place a planning process designed to ensure that children who are placed out of their homes will have a permanent home in a reasonable period of time, and provides a subsidy program to meet the special needs of children who are adopted. The law sets forth certain standards for child welfare services that states must meet to receive federal funds. These standards, which have significantly affected the way that child welfare services are provided, include the following:

·  “Reasonable efforts” must be made to keep children with their families whenever possible. States are expected to have in place prevention, intervention, and crisis services such as day care, crisis counseling, and access to emergency financial assistance.

·  Permanency planning services are to be provided to children and their families when children have been removed from their parents’ custody because of abuse and neglect. These services include “reasonable efforts” to reunite children and their families whenever possible. When reunification is not possible, alternative permanent plans are required, such as placement with extended family or adoption.

·  Out-of-home placements are to be made in the “least restrictive setting.” When children are placed in out-of-home care, the type of care selected for the child must be in the most “family-like” setting appropriate to the child’s needs and in close proximity to parents. Generally, a child will be placed with extended family or in family foster care. If the child has special medical, mental health, or developmental needs, a group or residential care setting may be most appropriate.

·  Detailed case plans and regular case reviews must be prepared to help ensure that the child has a permanent home as soon as possible after being placed in out-of-home care.

The Independent Living Initiative Title IV-E of the Social Security Act.

This legislation funds services for adolescents in out-of-home care who will not be reunited with their families and who will leave care at age eighteen to live on their own. Services must be designed to teach basic living skills, provide educational and job training opportunities, and assist youth in locating housing.

The Omnibus Budget Reconciliation Act of 1993 (PL 103–66).

The 1993 OBRA established a new subpart of Title IV-B of the Social Security Act titled Family Preservation and Support Services. This program provides funding for (1) community-based family support programs that work with families before a crisis occurs to enhance child development and increase family stability; (2) family preservation programs that serve families in crisis or at risk of having their children placed in out-of-home care and provide follow-up services, including family reunification; and (3) evaluation, research, training, and technical assistance in the area of family support and family preservation. The law targeted nearly $1 billion for the five years (1994–98) for which the Family Preservation and Family Support Program was authorized.

Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PL 104–193).

This act eliminated the federal guarantee of a basic floor of economic security for every family. The law abolished Aid to Families with Dependent Children (AFDC), the primary federal cash aid program for families, and created a block grant program, Temporary Assistance to Needy Families (TANF), for low-income families with children deemed eligible by the states. Under the TANF program, states receive a fixed level of resources for income support and work programs without regard to subsequent changes in the level of need in a state. The law established a sixty-month lifetime limit on TANF assistance for each family, although states may set a shorter state time limit. The law also tightened eligibility for the Supplemental Security Income (SSI) program, thereby denying cash assistance to thousands of disabled children.

As a result of the welfare overhaul, vulnerable families may be at increased risk for entering the child welfare system. A loss of income or support—caused by such factors as a TANF time limit, an insufficient supply of decent jobs, or state eligibility restrictions on cash assistance—may prevent families from providing basic food and shelter for their children and may result in hunger, homelessness, child neglect, or other family crises. Severe economic problems also heighten stress in families and in some cases may lead to child abuse or other forms of family violence. In addition, families that lose SSI benefits for children with disabilities may be forced to seek assistance from the child welfare system.

Multiethnic Placement Act of 1994 (PL 103–382).

This act addressed the issue of trans-racial adoption by prohibiting discrimination in foster and adoptive placement on the basis of race, color, or national origin. It also required agencies to engage in diligent recruitment efforts to ensure that children needing placement are served in a timely and effective manner. The original MEPA statute contained specific language explicitly allowing agencies to consider a child’s cultural, ethnic, or racial background and the ability of foster and adoptive parents to meet the child’s needs.

MEPA was amended in 1996 (PL 104–188) to omit the original language that explicitly allowed agencies to consider a child’s cultural, ethnic, or racial background. MEPA’s recruitment provisions remain unchanged, however, and states must continue to seek out potential adoptive families who reflect the ethnic and racial diversity of children needing placement.

State Law

Each state addresses child welfare services in its statutes. In most states, the law does the following:

·  Directs that services be available to help strengthen and support families;

·  Defines the conduct that constitutes child abuse and neglect;

·  Identifies the agency responsible for receiving, screening, and investigating reports of child abuse and neglect and protecting children;

·  Identifies the court that has jurisdiction over child abuse and neglect cases and that has the authority to remove the custody of children from their parents;

·  Specifies the duties of the agency in working with children and families toward preserving and reunifying families;

·  Sets forth the conditions under which parental rights can be terminated and a child freed for adoption; and

·  Describes the procedures for adoption.

PUBLIC POLICY

Child welfare services also include efforts to ensure that government decision-making is based on what children and their families need. It involves clearly defining child welfare issues and analyzing the merits of various approaches to enhancing the strengths of children and their families and meeting their needs. There are a number of child welfare policy issues that have been and will continue to be debated, including the proper role of the federal and state governments in protecting children, the balance between protecting children and preserving families, determinations about when in-home services are most appropriate and when out-of-home care should be used, and the extent to which resources should be allocated between prevention and treatment services.

THE CHILD WELFARE LEAGUE OF AMERICA, INC.

The Child Welfare League of America, Inc. (CWLA), the largest and oldest membership organization for child protection in North America, represents the public and voluntary child welfare sectors. The CWLA supports its more than 800 member organizations through policy, practice, and research initiatives within seven major program areas: adolescent pregnancy services, child protection, services to support and strengthen families, family foster care and kinship care, group care, adoption, and child day care. In addition, CWLA has eleven special initiatives: cultural competence, HIV infection and AIDS, chemical dependency, youth services, child and youth care credentialing, housing and homelessness, recruiting and retaining competent staff, state commissioners’ roundtable, performance evaluation, child welfare and the law, and rural child welfare services.

CWLA is the world’s largest publisher of child welfare materials. Its Publications Division reaches more than half a million professionals annually through its production and distribution of books, monographs, research reports, newsletters, a quarterly magazine, and a scholarly professional journal.

A major component of CWLA’s work is its advocacy on Capitol Hill on behalf of children. Its Public Policy Division is committed to significantly improving the full array of federally funded services and supports needed to address the escalating crisis facing at-risk children and families and the child welfare system itself.