man. As health workers carry their services of many kinds more and more into the home, it becomes increasingly important that they learn to think of the family as a whole. Unless they do, their service will be short-circuited—an unrelated and unrelatable specialty.1

The need of keeping the family in mind extends beyond the period of diagnosis, of course. "I will return," says Dubois, "to this necessity of not confining one's therapeutic effort to the patients alone, but extending it to those who live with them. This is often the one way to obtain complete and lasting results."

As stated in the preceding chapter, the first interview is often held in the client's home and with members of his family present. To this extent the two separate processes of making our first contacts with the client and with his family can and often do overlap. It is impossible to lay down any hard and fast rule about their combination or separation. For the highly individualized diagnosis and treatment needed for a delinquent, however, it is evident that such conditions of privacy as Dr. Healy describes are necessary in the first interview. No third person must be present, nothing must distract the client's attention or interrupt the development of his story. Even then, not all will be revealed at this one time or in this one way, as Dr. Healy recognizes more fully than anyone who has yet written upon his subject. "It is in each man's social relations that his mental history is mainly written”

1 "To keep a promising boy at school after the legal working age, to provide costly treatment for a sick girl, to force a well-to-do relative to support his kinsfolk, to punish a deserting husband, to withdraw wage-earners from unwholesome workmay each represent to some specialist the supreme duty of organized social work in one family where each of these needs is apparent. It may not be possible to meet them all at once, and it may be that some cannot be met at all without sacrificing other important factors in the family welfare. It is just as true in the economy of the family as it is in the economy of society at large that the interests of the individual-for his own good or for society's must be adjusted to the interests of the whole. The recognition of this by specialists is necessary if we are to avoid danger in social treatment. Here evidently clear thinking and honest discussion are called for. This conflict can only be avoided if we are willing to study the whole problem of family responsibility. Prejudice in favor of one's own specialty must be abandoned and the matter decided in each individual case disinterestedly by the agencies concerned, on the basis of all the facts obtainable.”—Porter R. Lee, in Proceedings of National Conference of Charities and Correction for 1914 (Memphis), p. 97.

2 Psychic Treatment of Nervous Disorders, p. 44.

* Quoted on p. 129.

4 "We have been surprised to find that one of the most particular portions of the work was the interviewing of the relatives."-The Individual Delinquent, p. 46. Dr. James Jackson Putnam. See motto of this volume.

and no attempt to help a human being which involves influencing his mind in any degree whatsoever is likely to succeed without a knowledge of the Family Group of which he is a part, or without definite co-operation with that group. In some forms of social work, notably family rebuilding, a client's social relations are so likely to be all important that family case workers welcome the opportunity to see at the very beginning of intercourse several of the members of the family assembled in their own home environment, acting and reacting upon one another, each taking a share in the development of the client's story, each revealing in ways other than words social facts of real significance. As regards group versus individual, home versus office interviews, the tendency has been for each form of social work to establish one unvarying procedure. Better results could be had, probably, from a discriminating use of all the different methods of approach.

In any case, it is evident that the relation a diagnostician has with his client's immediate Family Group is somewhat different from his relation with the sources of evidence and service which lie outside the family. A former creditor or the custodian of a medical or a birth record may give him information of the first importance, and never reappear thereafter in the treatment which is to follow; whereas the co-operation of the immediate family may have to be sought again and again at successive stages of the treatment, even when the social problem revealed is an individual one. For instance, take the peculiarly individual problem presented by pathological lying, a disease in which the affected person has "very little sympathy for the concern of others, and, indeed, remarkably little apperception of the opinions of others." Yet Dr. Healy emphasizes for its treatment the need of adequate cooperation in the home or from someone outside with influence over the individual.1

I. THE FAMILY AS A WHOLE

The remaining pages of this chapter must be taken as belonging with certain of the questionnaires in Part III and with several of the chapters on outside sources. The health of the family, its educational opportunities, the occupations of its members, 1 1 Pathological Lying, Accusation, and Swindling, pp. 253 and 272.

are all matters of fundamental importance, but it has seemed more convenient to treat each of them in a separate chapter in connection with sources. As regards the relation of the family make-up to certain outstanding social disabilities, such as recent immigration, desertion, widowhood, inebriety, and child neglect, these matters are emphasized in the questionnaires in Part III devoted to the particular disabilities named. The less formal discussion here of the family as a whole, of the husband and father, wife and mother, children, and other members of the household, may be taken as introductory to the questions relating to the family in these questionnaires.

1. The Main Drift of the Family Life. One who has learned, in the details of a first interview, to keep the "combined physical and moral qualities," the whole man, in view, will appreciate the importance of applying this same view to the family. The family life has a history of its own. It is not what it happens to be at some particular moment or "in reference to some particular act," but it is what it is "on the whole." What will help to reveal this trend? What external circumstances over which the family had no apparent control, and what characteristics of its membersphysical, mental, temperamental—seem to have determined the main drift?

Revealing things are any signs of affection and consideration in the relations of its members to one another. Again, what does the family admire? What are its hopes and ambitions? Has it shown initiative at any time? What part has religion in the home life? What ability has the home developed in its members to resist temptation? What do they do with their leisure time? Do they seek amusement together or apart? What were the two homes like from which the parents came to make this third one? A visit or two will not answer all these questions; the answer to some will come from outside sources and to others only gradually, but the worker who ignores these aspects and is entirely preoccupied with names and ages, number of rooms occupied, sanitation, in

1 See Chapters X, Medical Sources, XI, Schools as Sources, and XII, Employers and Other Work Sources.

2 Jowett, Benjamin: Sermons, Biographical and Miscellaneous, p. 80. Ed. by W. H. Fremantle. New York, E. P. Dutton and Co., 1899.

come and outgo, school attendance, etc., will never win lasting results in social case work.

Nothing can interfere more effectually with a large and well balanced view than preoccupation with some picturesque minor incident. The writer remembers a family history of years ago which was made more painful than it need have been by a series of social treatments which lost all grasp of the main issues involved. These failures were due to the striking circumstance that the father of the family, which lived in great squalor, had named his youngest child Thomas Carlyle. The literary members of several charities were unduly impressed by this interesting incident in the life of a gambler.

2. The United and the Unstable Family. There is a distinction, made first by Le Play, which will help us to a better conception of the family as a whole. With reference to their power of cohesion, we shall find that families range themselves along a scale, with the degenerate family at one end and the best type of united family at the other. Whatever eccentricities a family may develop, the trait of family solidarity, of hanging together through thick and thin, is an asset for the social worker, and one that he should use to the uttermost. "It is not merely a question," says Mrs. Bosanquet (whose book, The Family, more especially Part II, should be known to every case worker), "of how long the members of a family continue to live together in one house; superficially the two types may be much alike in this respect. It is one of the proofs of the strength of the modern family that it is able to send its sons and daughters far over the face of the earth without in the least impairing the bond which unites them; while it is one of the proofs of the weakness of the degenerate family that there is no bond to hold them together at all, or a bond so slender that removal into the next street is enough to sever it. The real nature of the distinction can only become clear as we study the characteristics of the modern family at its best." These characteristics are admirably developed in the second half of Mrs. Bosanquet's book, but American readers will have to bear in mind that it records the traits of a homogeneous population, of one that has been exposed to no sudden changes of environment, and no over1 The Family, p. 193.

whelming temptation of newly found freedom. We find in this country many signs of disintegration due to these surface causes, even in families in which there is, at bottom, strong family feeling, and we cannot understand the evils that beset them unless we are at some pains to study the racial and national traditions that cling. so tenaciously around certain of the foreign Family Groups exposed to American ideas, and that crumble away too quickly from certain others.1

Whenever serious estrangement occurs between husband and wife, or parent and child, the first thing to study is the differences, if any, in racial, national, and community background, with the resulting differences of custom, convention, religion, and education. Next to disparity of age, to marriage or remarriage for economic reasons, and the interference of relatives, differences of nationality, race, or religion are the most fruitful causes of trouble between man and wife, and varying degrees of adjustment to the new world environment are fruitful causes of trouble between parent and child.

It is difficult to illustrate briefly what is meant by dealing with the family as a whole with a clear conception of the main drift of the family life always in mind, but the following criticism of a case record of a deserter and his family will give some conception of the point of view:

The record comes from a charity organization society, and describes the efforts of the society to find Mr. Angus Doyle, a Scotch ship fitter who had left his ScotchAmerican wife, Kate, and four children, the oldest a girl of fifteen, going off this time, as was usual with him, when another baby was expected. He was a good workman, but a hard drinker and abusive. By energetic correspondence and the aid of a similar society in another state, Doyle was found, his employers were interested, and the man was induced to send $7.00 a week regularly to his family. After the fifth child was born, he came home and was overheard telling one of his mates that it made no difference where a man went in this country now, he was found out and made to support his family.

So far so good, and the critic of the record comments upon the good work of both societies in influencing the man through his employer. Sometimes such an approach simply means that the man drops his work and goes elsewhere; but there are not many shipyards in the United States, the wife was in no physical condition at the time to push through a court prosecution, and the societies probably reasoned that their best chance was to see the man in the presence of his superintendent, and appeal to him to make weekly payments.

1 Some of these traditions are suggested in the introduction to the Immigrant Family Questionnaire, p. 384.