some embarrassing questions and touch a nerve that is sore. It is most important, where this has been the case, that in the last five or ten minutes of the interview we dwell upon hopeful and cheerful things, and leave in the mind of the client an impression not only of friendly interest but of a new and energizing force, a clear mind and a willing hand at his service. Dr. Meyer is quite right. If we know how to do it, the patient's statements can usually be obtained not only fully but with an actual feeling of relief on his part,1 and a distinct gain in the relation between client and worker.

6. Emergency Interviews. There are cases of severe illness or other emergency in which action is too urgently necessary or the conditions are too unfavorable to admit of more than a hasty First Interview. Two of these are described by Miss Helen B. Pendleton:2

You cannot stop to find out whether the young Slav lying ill with typhoid in the filthy lodging house came over in the North German Lloyd or the Red Star Line, or whether he embarked from Trieste or Hamburg. Uncle Sam must get along without this particular bit of information,3 but while you are making things happen, do not forget your clues. You must know if Peter Novak has any relatives here or whether he belongs to any church or fraternal order. And once poor Peter is provided for today, in a hospital if he will go or at home if he will not-he is too ill to be argued with-and you have these clues for the work that ought to be done on the case tomorrow, you will be justified in going on to your next interview.

Another story illustrates this matter of clues. . . . The police had telephoned a case of destitution. Police cases are always said to be destitute, but as soon as the street and number were given the district worker knew that she should find some sickening form of human suffering. The house was a rear tenement containing three apartments of two rooms each. One of the three she knew as a disreputable resort; in another three children had been ill with diphtheria the summer before; and in the third two consumptives had lived and died in succession. In these rooms she found a young man, scarcely more than a boy, in the last stages of consumption. He was in a sullen state of despair and weakness and would not talk. He had no people, he said—a brother somewhere but he did not know where he He had no friends and no one to care about him. He had made his bed and would lie in it.

was.

Just here nine charity workers out of ten, perhaps, would have hurried away, after seeing that food was provided for the present need, to send a doctor and the district nurse, and to order milk and eggs to be sent to the poor fellow every day

1 See p. 115.

2 In one of the short, unpublished papers referred to in the Preface.

This refers to the preparation of schedules for a Federal Immigration Commission.

until he died. This particular charity worker did nothing of the kind. It was growing late and she had several other visits to make, but how could she leave this poor fellow with no knowledge of him but his terrible present? Even in the midst of filth and the ravages of disease she could discern that somewhere in the past which he refused to disclose he had known the comforts of a good home. This was a case for slow persistence and searching question; the social surgeon must not falter. At last the name of a former employer slipped out. The young man learned his trade there. Good! That former employer carried on a wellknown business and would know the youth without doubt. Forty-eight hours after that interview, the sick boy was under his father's roof. His parents were respectable, well-to-do people, who had tried to bring up their son in the right way. He had fallen into bad company and evil ways, and two years before had left home in a violent passion after some of his wrong-doing had been discovered. Lately, his people had heard a vague rumor that he was ill and had telephoned to the different hospitals in the city, but had given him up for lost. When last seen by his interviewer, he had been given the best room in his father's house, a room with the sun in it all day; his people were giving him all the milk and eggs that he needed and would be glad to have the nurse call. Surely it was worth while to take time for such a result. . . . These instances are mentioned because emergency interviews are the ones which we are most apt to bungle-as interviews. We do the right thing for the emergency, but too frequently we do not discover the clue that will lead to our case's becoming something more than an emergency case.

An agent of an S. P. C. C. describes a visit to a home for the purpose of conducting a First Interview with the mother of the family. When she arrived at the house there was no one to be seen, but hearing voices, she walked through the kitchen to the door of the next room, where she saw two women caring for a young girl sick in bed. She asked, "Is someone sick here?" The mother replied, "Yes, Alice." Without another question, and behaving as though she had known Alice all her life, the agent soon had a physician in to examine the girl, an ambulance there to take her to the hospital, and an operation performed for appendicitis-all this without a word of protest from the mother or a single inquiry as to who she was or how she had come.

SUMMARY OF THIS CHAPTER

1. There are many circumstances that may modify the method of a First Interview. Among these are

(a) The nature of the task about to be undertaken, whether probation work, family work, protection from cruelty, etc.

(b) The origin of the application or request for service; whether from an agency or individual already interested, or from an applicant on his own behalf.

(c) The place of the interview, whether in the client's own home or at the social agency's office.

(d) The recorded experience available. Any possible previous record in the agency's files concerning either the person applying or others of his family. (Search should be made for such a record before the First Interview and again after its close.)

Any possible previous records of other social organizations that show relations with the person applying. (Where there is a confidential exchange, it should be consulted for this information both before the First Interview and after.)

2. The First Interview should (a) give a fair and patient hearing; (b) seek to establish a good mutual understanding; (c) aim to secure clues to further sources of insight and co-operation; (d) develop self-help and self-reliance within the client's range of endeavor.

The interview must not be hurried, therefore; it must be held in privacy, and with every consideration for the feelings of the one interviewed, though always with a definite goal in view.

3. Many questions have been answered before they are asked; these need not be asked by a good listener. Necessary questions should be so framed as to make truth-telling easy. Questions that can be better answered by someone else are not necessary ones.

4. The clues most frequently needed from the initial interview are (a) relatives, (b) doctors and health agencies, (c) schools, (d) employers, past and present, (e) previous residences and neighborhoods.

5. The client's own hopes, plans, and attitude toward life are more important than any single item of information.

6. Note-taking during the interview is often not wise, though this depends upon the nature of the request and upon the place of the interview.

7. Advice and promises should be given sparingly until there has been time to know more and to plan more thoughtfully.

8. The last five or ten minutes of the interview should emphasize the interviewer's desire to be helpful, and prepare the way still further for future intercourse.

9. Emergency interviews call for special skill, because, though time presses, certain essential clues are more important than usual.

A

CHAPTER VII

THE FAMILY GROUP

DISCUSSION of theories of society and of the organiza

tion of the family is no part of the plan of this book. The social worker's convictions about the family, even when they are those of the extreme feminist Left or of the extreme reactionary Right, will be clarified and to some extent modified, however, by a type of case work which follows wherever the facts and the best interests of his clients lead. It is true that his theories will influence his work, but more and more, if he is in earnest, will his work influence his theories. Our only concern here is with family life as a present-day fact.

It is a sobering thought that the social worker's power of influence may extend, through his daily acts, to many whom he has never seen and never, even for a moment, had in mind. This is peculiarly true of all the members who are unknown to him in the Family Groups1 of his clients. For better or worse he influences them and they, in turn, help or hinder the achievement of the ends that he has in view.

As society is now organized, we can neither doctor people nor educate them, launch them into industry nor rescue them from long dependence, and do these things in a truly social way without taking their families into account. Even if our measure were the welfare of the individual solely, we should find that the good results of individual treatment crumble away, often, because the case worker has been ignorant of his client's family history. Suddenly and usually too late, the social practitioner is made aware of this, when tendencies that have long been hidden become operative. The following statement illustrates the diagnostic importance of family background. It appears in a singularly frank and

1 The term Family Group as used in this chapter and later includes all who share a common table, though the parents and children-usually the most important members of the group-will receive most attention here.

intelligent study of a child-placing agency's work, made by the agency itself:

On the reception-inquiry side we found that we had accepted children in very critical need of special kinds of care without knowing the particular defects in heredity which made certain of our treatments unwise or dangerous. For example, we had one exceedingly nervous girl in charge for several years before we discovered that she had an insane grandmother; that her father and mother had both died insane, and that this strain of insanity explained certain characteristics which we had most incorrectly interpreted. We also discovered during the study that another none too robust girl suffering with congenital syphilis had three generations of ancestors with almshouse records, a grandmother who was insane and at one time a state ward, and a mother who was both epileptic and an imbecile. The need of a most protective kind of care, expressed in quietness, careful medical supervision, and freedom from strain were indicated as clear essentials; yet in one instance we were planning to put the child under very great discipline because she seemed stubborn.

After giving a number of instances, of the same general tenor, the agency adds: In no instance would it have been easy for us to have secured all this information when the children were first received; but that we learned much of it years afterwards is proof that in some cases we could, and should, have had it from the start.1

The foregoing experience was that of a placing-out agency; lest it be inferred that institutional work for children can more safely ignore home conditions than can placing-out, the story of Pittsburgh's institutions, as told by Miss Florence L. Lattimore, should be noted also. In her recapitulation she says:

Every time an institution had allowed a family to break up or sink, without seeing that intelligent effort was made to save it (if it were not already too late), and every time it had returned a child to a home that was unfit, it had strengthened the forces that had created the application. Every time it had placed out a child without adequate home study of the family to which he went and without adequately supervising him after placement, it had run the risk of canceling all its previous efforts to help him. Many of the children were like dropped stitches in a knitted garment, and the whole family was likely to unravel unless the trouble was caught up at the start. It was often a children's institution which received the first hint of a situation which, if unheeded, later on involved several households."

A report from a hospital social service department describes a first interview held with a sickly wife at work over the washtub. She explains that her husband has been living with his mother ever since he lost his work, and the interviewer at once promises to secure extra milk for wife and children, without attempting to see the

1 Ruth W. Lawton and J. Prentice Murphy in National Conference of Charities and Correction Proceedings for 1915 (Baltimore), p. 167.

2 "Pittsburgh as a Foster Mother" in The Pittsburgh District, p. 427.