One of the most striking facts with regard to the conscious life of any human being is that it is interwoven with the lives of others. It is in each man's social relations that his mental history is mainly written, and it is in his social relations likewise that the causes of the disorders that threaten his happiness and his effectiveness and the means for securing his recovery are to be mainly sought.

-DR. JAMES JACKSON PUTNAM

No matter how mean or hideous a man's life is, the first thing is to understand him; to make out just how it is that our common human nature has come to work out in this way. This method calls for patience, insight, firmness, and confidence in men, leaving little room for the denunciatory egotism of a certain kind of reformers. It is more and more coming to be used in dealing with intemperance, crime, greed, and in fact all those matters in which we try to make ourselves and our neighbors better.

-CHARLES HORTON COOLEY

Only the sham knows everything; the trained man understands bow little the mind of any individual may grasp, and how many must co-operate in order to explain the very simplest things.

-HANS GROSS

F

PREFACE

IFTEEN years ago, I began to take notes, gather illustra

tions, and even draft a few chapters for a book on Social

Work in Families. In it I hoped to pass on to the younger people coming into the charity organization field an explanation of the methods that their seniors had found useful. It soon became apparent, however, that no methods or aims were peculiarly and solely adapted to the treatment of the families that found their way to a charity organization society; that, in essentials, the methods and aims of social case work were or should be the same in every type of service, whether the subject was a homeless paralytic, the neglected boy of drunken parents, or the widowed mother of small children. Some procedures, of course, were peculiar to one group of cases and some to another, according to the special social disability under treatment. But the things that most needed to be said about case work were the things that were common to all. The division of social work into departments and specialties was both a convenience and a necessity; fundamental resemblances remained, however.

With other practitioners-with physicians and lawyers, for example there was always a basis of knowledge held in common. If a neurologist had occasion to confer with a surgeon, each could assume in the other a mastery of the elements of a whole group of basic sciences and of the formulated and transmitted experience of his own guild besides. But what common knowledge could social workers assume in like case? This was my query of fifteen years ago. It seemed to me then, and it is still my opinion, that the elements of social diagnosis, if formulated, should constitute a part of the ground which all social case workers could occupy in common, and that it should become possible in time to take for granted, in every social practitioner, a knowledge and mastery of those elements, and of the modifications in them which each decade of practice would surely bring.

This narrowed my proposed topic to the beginning processes of case work, but at the same time widened it enormously in demanding for its treatment an experience of all the various types of such work. As the executive head, in those days, of a large family agency, I had little time for study, so the task was set aside for nearly nine years.

More than six years ago, however, after I had become a member of the staff of the Russell Sage Foundation, it was again taken up. Meanwhile, the wider usefulness of social evidence, social diagnosis, and social treatment, both in their own special field and in the other professions, even when these latter dealt with people who were neither dependent nor delinquent, had begun to dawn upon me. It was evident that social case work could supplement the work of justice, of healing, and of teaching. Groups of workers in some of our American cities, moreover, were doing notable things in the regular social agencies; they were developing quietly a diagnostic skill in dealing with the difficulties of human beings which should be given ample opportunity, especially in its formative period, to grow to the full stature of social technique, untrammeled by long established professional traditions, whether of courts, hospitals, or schools.

I turned to this task in the winter of 1910-11 for the second time, therefore, with a quite different outlook from that of earlier days and with the determination to push my inquiries as far beyond the limits of my own personal experience as possible. Mr. Francis H. McLean, who was my colleague in the Foundation at the time of this second beginning and who has rendered invaluable assistance throughout the undertaking, had already invited a group of social case workers (most of them but not all connected with charity organization societies) to prepare short papers describing informally their methods and experiences in taking the steps which, in their work, preceded the development of a plan of treatment. This group was added to later, and some of their papers-on such subjects, for instance, as present neighborhood sources of information, relations with employers in the study of a work record, methods of conducting a first interview, etc.-were privately printed and given a limited circulation among their fellow workers in charity organization. This was done partly for

the purpose of getting the benefit of criticisms. The papers were too experimental for publication. They contained passages of great value, however, of which free use has been made, with credit given, in Part II of this book.

The next step was to engage two case workers of experienceone in family and one in medical-social work-to study original case records for a year. Their case reading was done in five different cities. No attempt was made to arrive at an average of the case work in these cities. On the contrary, our aim was to bring to light the best social work practice that could be found, provided it was actually in use and not altogether exceptional in character. In addition these case readers held many interviews with case workers, all of which were carefully reported. As my own experience had been so largely in the charity organization field, especial pains was taken to center most of this case reading and interviewing in the child-helping and the medicalsocial agencies. A large part of the illustrative material used so freely in Part II is drawn from the much larger stock of case notes and of reports of interviews prepared by these two case readers, though use has also been made of notes from my own case reading and of the field memoranda of my colleagues in the Charity Organization Department of the Foundation.

As this Department had been interested from the time of its organization in the teaching of case work in the various schools for social workers, it began to edit a group of original records, most of them current cases, to be used in the class room. These were printed in full with all their sins upon their heads (bad work is almost as instructive as good) and were used in class conferences by a small, accredited group of teachers of case work. Criticisms and comments based upon certain of these records were also gathered from a number of specialists. As noted elsewhere, the experiment of printing the records of cases could not be a public one, because their subjects were real people whose confidences had to be respected. Even when all names had been changed, there were few things more identifiable, we found, than a full social case record. The experiment, limited though it had to be, has brought to light many valuable suggestions which are used in these pages. For the most part the subject of social diagnosis defies statistical

treatment, though as a means of getting started and to arrive at a rough quantitative measure of the relative frequency with which the various outside sources of information and co-operation were consulted, a brief statistical study was made. Fifty-six social agencies engaged in a number of different forms of social case work in three cities were persuaded to let us list the outside sources consulted by each in fifty cases. The results of this study are given in Part II and in one of the Appendices.

One of the minor methods of study adopted was to correspond with or interview social case workers who had changed from one type of case work to another-from work with families to child protection, from settlement work to probation or medical-social service in order to learn the changes of method and the shiftings of emphasis made necessary by their change of task.

The foregoing methods supplied the data for Part II; and the sifting of these data and the interpretation of what was significant in them have been the work of such portions of several years as could be spared for the task. The errors that were found have been frankly commented upon in this book. Since methods in case work are rapidly improving, these may now belong to the past in the particular places in which we found them. Nevertheless there is always a chance that they are surviving somewhere else.

For the variations in the processes leading to diagnosis, still another method of gathering data was tried. How could these variations, many of them made necessary by the different types of social disability, be indicated comprehensively enough and compactly enough to be of daily service for reference? The plan was hit upon of gathering in from many specialists suggestions for a series of type questionnaires-not to consist of questions to be asked the case worker's client, not schedules to be filled out, but lists of suggestive queries which, at some time in his inquiry, the case worker might find it worth while to ask of himself. Such a battery of interrogations as is presented in Part III is sure to be misunderstood by somebody; it is confessedly a clumsy device, but no other way has occurred to me or my colleagues of giving the case worker, in small compass, a bird's-eye view of the possible implications of a given disability. It will be seen that some