Resource Articles // A social work career offers a variety of roles and ways in which you can positively influence the lives of adults, children, and families. As you chart your career path, one question to consider is, will you become a licensed clinical social worker (LCSW), working with individuals and families to address personal challenges, or a direct service social worker, helping to troubleshoot client issues and connect them with the services and resources they need?  Learn more about these social work career options to see which practice aligns with your interests and educational and professional goals: Direct Service Social WorkersAccording to the Social Work Guide, “Direct service social workers will perform intake and initial screening to determine what services their client should be connected to. A direct service social worker’s responsibilities often vary from case to case. Some of their responsibilities include making referrals, performing case management, determining program eligibility, counseling, and mediation.”1 You’ll find these social work career professionals in positions such as case manager, care coordinator, and school social worker. Direct service social worker jobs serve diverse populations that may include military families and clients receiving hospice care. Educational requirements vary, but for some social worker jobs—like case manager or care coordinator—the minimum degree requirement is a Bachelor of Social Work (BSW).2 Clinical Social WorkersThe National Association of Social Workers (NASW) defines clinical social work as “a specialty practice area of social work which focuses on the assessment, diagnosis, treatment, and prevention of mental illness, emotional, and other behavior disturbances. Individual, group, and family therapy are common treatment modalities.”3 In this social work practice, LCSWs work in settings that include private practice, hospitals, addiction recovery centers, and social service agencies. Clinical social workers must hold a Master of Social Work (MSW) degree. In most states, in order for graduates to obtain licensure, their MSW programs must have Council on Social Work Education (CSWE) accreditation. Advance Your Social Work CareerEarning an MSW from an accredited university can provide the tools and training to prepare you for licensure—and to expand your social work career opportunities. Walden University’s online social work degree program has CSWE accreditation and offers you the flexibility to work and earn a degree at the same time. When you choose Walden to earn an MSW online, you’ll:
Walden’s online master’s in social work degree program offers further flexibility with three online degree completion options to accommodate your lifestyle and goals. With the Standard option, you’ll take one or two courses each term. The Accelerated option is an ideal choice if you can dedicate yourself to your studies full time, as you’ll take three courses in most terms. Finally, the Advanced Standing option is for students who have a BSW from a CSWE-accredited program and graduated with a minimum GPA of 3.0. Walden’s Master of Social Work degree program offers four start dates throughout the year, so when the time is right, choose the concentration that supports your professional interests and prepare to make a difference with a social work career. Walden University is an accredited institution offering a Master of Social Work (MSW) degree program online with four concentrations. Expand your career options and earn your degree in a convenient format that fits your busy life. 1Source: www.socialworkguide.com/clinical-v-direct-social-work/#:~:text=Direct%20service%20social%20workers%20work,or%20provide%20any%20professional%20treatment Walden University is accredited by The Higher Learning Commission, www.hlcommission.org. Walden University’s Master of Social Work (MSW) program is accredited by the Council on Social Work Education (CSWE), a specialized accrediting body recognized by the Council for Higher Education Accreditation (CHEA). CSWE's Commission on Accreditation is responsible for developing accreditation standards that define competent preparation for professional social workers and ensuring that social work programs meet these standards. Note on licensure: The minimum academic credential required to obtain licensure to practice as a social worker in most states is a Master of Social Work (MSW) from a program accredited by the Council on Social Work Education (CSWE). Walden University’s MSW program is accredited by CSWE. State licensing boards are responsible for regulating the practice of social work, and each state has its own academic, licensure, and certification requirements. Walden recommends that students consult the appropriate social work licensing board in the state in which they plan to practice to determine the specific academic requirements for licensure. Walden Enrollment Specialists can provide information relating to the state-by-state requirements for licensure. However, it remains the individual’s responsibility to understand, evaluate, and comply with all licensing requirements for the state in which he or she intends to practice. Walden makes no representations or guarantee that completion of its coursework or programs will permit an individual to achieve state licensure, authorization, endorsement, or other state credential as a social worker. On the first centenary of professional social work education in the United States, there are several ways of celebrating social work's contribution to society. We can remember the profession's pioneers and praise the advances made in theory and research. Alternatively, we can examine everyday practice and what clients say they value about our efforts. This latter approach reveals the importance of indirect work, social work's "unsung hero" (Grinnell, 1973). Historically, indirect work has referred to the clinical social worker's intervention in clients' environments and collaboration with others in bureaucracies or clients' social networks in an attempt to alleviate clients' difficulties. Grinnell and Kyte (1975) succinctly defined the two components of indirect work. The first is concrete assistance, that is, the provision of practical or tangible help whereby the social worker uses "resources or opportunities that exist or are potentially available for the benefit of the client" (p. 314). The second is sociopsychological intervention, that is, "the modification of the attitude or behavior of significant others within the client's social . . . environment" (p. 314). "Direct work," in contrast, has referred to what is achieved "mind upon mind," to use Mary Richmond's phrase, through the relationship between client and social worker. Indirect and direct work frequently appear in tandem. For example, the social worker may collaborate with other professionals in the client's presence (Weissman, Epstein, & Savage, 1983). Why Examine Indirect Work? A historical analysis of indirect work traces the thinking of many social work theoreticians and therefore enriches our understanding of the profession. In addition, an examination of indirect work has conceptual, ethical, and practical relevance. I will argue that indirect work helps define conceptually social work's professional jurisdiction - that is, an area in which social workers exhibit both competence and expertise (Abbott, 1988). Ironically, the social work literature has neglected indirect work and, sadly, history reveals that some practitioners have also. This neglect is worrisome given that social work's ethical mandate is to meet people's "basic human needs" and to give special attention to "environmental forces" (NASW, 1996, p. 1). Contemporary social problems, for example, fragmented medical and welfare services, require indirect work. Social work has made some progress in classifying distinct components of indirect work, but there is a need to develop practice principles grounded in empirical research. In addressing these themes, this article traces the development of the idea of indirect work through the works of Flexner, Richmond, Reynolds, and Hollis and comments on social work's ambivalence toward this work. The article also discusses research on indirect work and clients' views of it. In addition, the article examines modern portrayals of indirect work that include the wider political arena and offers recommendations for practice and research. Indirect Work: History of an Idea History reveals recurring themes and ideas. A few years ago, Andrew Abbott, sociologist, stated that "probably the vast majority of what people with the title 'social worker' actually do in the United States is indeed connecting together services provided largely by other professions and other institutions" (Abbott, 1995, p. 559). How similar is this depiction to the one made by Abraham Flexner some 80 years earlier? Flexner In 1915 Flexner, a prominent developer of medical training programs, delivered a lecture entitled "Is Social Work a Profession?" at the annual session of the National Conference of Charities and Correction (a precursor of the National Conference of Social Work) (Flexner, 1915). The question addressed in Flexner's speech may have been premature, as social work was in an embryonic stage. Settlement houses had existed for more than 25 years (Addams, 1990), but professional social work training was relatively new. Summer courses began in 1898, and full-time social work training in 1904 (Meier, 1954). Mary Richmond's Social Diagnosis (1917b), although in preparation, had not yet been published. Although no expert on social work, Flexner perceptively stated that "the social worker mediates the intervention of the particular agent or agency best fitted to deal with the specific emergency [the client] has encountered" (Flexner, 1915, p. 585). In addition, Flexner stressed that social workers do not work independently of other helping professions and are in frequent contact with them. The social worker "pieces out existing professions; breath[e]s a new spirit into them; and binds them together in the endeavor to deal with a given situation from a new point of view" (p. 586). Flexner described many aspects of indirect work, including collaboration and matching client to resources. His portrayal describes indirect work as it is currently practiced by social workers in hospital discharge planning. The social worker is a pivotal link between hospital and client's community. The social worker matches the client's unique needs, revealed in assessment, to appropriate resources (for example, home care). Collaborative efforts may involve lengthy negotiations with outside agencies to secure a community referral, persuading hospital staff to delay a discharge if community services are not yet available, and liaison between client's relatives and hospital staff. Interestingly, Flexner did not emphasize direct work; he plainly believed that social work's strength was intervening in the client's environment. However, the social worker's tendency to refer clients to experts and others outside the field of social work meant, for Flexner, that social workers had no expert knowledge or techniques of their own, and he concluded that social work was not a profession. This pronouncement had long-lasting negative effects on social work's self-image (Austin, 1983). Flexner's logic was unquestioned at the time and escaped rigorous examination (Netting, Kettner, & McMurtry, 1998). Surprisingly, the question why indirect work could not also be a professional activity was not raised (Germain, 1994; Wootton, 1959). Richmond Mary Richmond, who is credited with offering the first conceptualization of social casework (Richmond, 1917b; Siporin, 1969), heard Flexner's speech and commented on it two years later (Richmond, 1917a). Richmond agreed with Flexner's depiction of case workers' activity. She acceded that acting as "middlemen" described routine practice. But unknown to Flexner, Richmond said, aims and methods were being developed that would raise agency practice to a level above that of a "clearing house." Developing on her thinking on social diagnosis, that is, the collection of facts that point to intervention (Richmond, 1917b) and, no doubt responding to Flexner's implicit challenge to show that social work could become a profession, Richmond went on to write What Is Social Case Work?(1922). In this book Richmond identified the need for indirect work, but placed it within a wider range of knowledge and action than was described by Flexner. Richmond analyzed case material to classify the processes and skills evident in casework. These processes and skills fell into two broad categories, insight and action, each with two subdivisions (Table 1). Richmond posited that good casework practice requires insight into the person and the environment. Knowledge about the client's needs and personality must be complemented by knowledge about the client's social and physical environment and the resources within it. In a similar vein, direct action, the use of the relationship "mind upon mind," to which the social worker brings honesty, absence of official attitude, patience, and loyalty should be accompanied by indirect action, that is, modifying the environment. For Richmond, direct work did not define casework, because she found similarities in face-to-face work offered by ministers, physicians, and caseworkers. This was a perceptive observation. Subsequent research shows that counseling offered by social workers, psychologists, and other helping professionals is similar in method and content (Specht & Courtney, 1994). Richmond stressed the combination of insight and action along all four dimensions. Table 1 Richmond's Classification of Insight and Action Insight Action Individual and personality "Direct action of mind upon mind" Resources and social "Indirect action environment through the social environment" Adapted from Richmond, 1922, pp. 101-102. Knowledge of resources and the need for linkage through action on the social worker's part were at the heart of Flexner's description of social work. Flexner highlighted the importance of liaison in the widest sense (Johnson, 1997). Richmond greatly expanded on Flexner's analysis. Nevertheless, Richmond concluded that indirect action is "more exclusively within [the social worker's] field than are some of the other approaches" (Richmond, 1922, p. 110). Turning Away from Indirect Work Despite Richmond's prescription that theory and skill related to both ends of the person - environment spectrum should operate together, by the 1920s there was a growing tendency in social work to focus only on direct work. Indirect work was nearly forgotten for the next 40 years - at least in the social work literature. Several reasons have been suggested to explain why social work turned away from Richmond's indirect work and instead focused on interviews with clients and what could be achieved through the client-social worker relationship. A comprehensive history of social work's incorporation of concepts and practices drawn from psychiatry and psychoanalysis is beyond the scope of this article and has been well discussed elsewhere (Klein, 1968; Specht & Courtney, 1994; Woodroofe, 1966). Briefly, it has been argued that social work did not have its own theories of human development and personality, and psychiatry and psychoanalysis filled this theoretical vacuum (Robinson, 1930). Others argued that social work theoreticians focused on psychoanalytic phenomena (for examples, transference and unconscious processes) in an attempt to increase social work's professional stature (Specht & Courtney, 1994). These explanations appear sound, but historical analysis rarely reveals single causes, and often puzzles remain. And there are many puzzles in the history of social work practice and theory. That indirect work was neglected during the 1930s, during the Depression, is difficult to fathom (Kirk, Siporin, & Kutchins, 1989). Important to point out, however, is the possibility that social work texts, psychoanalytic in emphasis and by inference the professional training associated with them, did not reflect agency practice (Alexander, 1972; Butrym, 1976; Field, 1980). No doubt many of our predecessors spent a lot of time in indirect work, despite the literature's emphasis on clients' psyches. It is also important to remember that there were critics of social work approaches that focused only on direct work. Reynolds Bertha Reynolds was one critic who drew attention to the neglect of indirect work between the 1920s and 1950s. Reynolds had questioned Richmond's approach, in which the caseworker was the apparent expert, taking control of the intervention. By the 1930s Reynolds's fear was that social workers had gone to the opposite extreme. The onus for change appeared to lie with the client alone. Reynolds (1934) wrote, 'After all, it is the client's problem' sounds as if the social caseworker were about to receive a well-earned rest. Clients now go about to assemble their own work references, they hunt their own apartments . . . and even come to the office for interviews . . . . Are social case-workers to become fat and obsolete? Where is their professional skill if they only sit by while the client does as he likes? What does the community pay them for? (p. 101) Reynolds (1934), as the title of one of her books Between Client and Community indicates, thought social workers should meet clients halfway and intervene together with clients, and, if necessary, on their behalf. Indirect work was necessary, she argued, because clients' lives can be "made impossibly bad sometimes, not by the client but by others over whom he has no control" (Reynolds, 1951, p. 129). She further argued that indirect work was not insulting to client self-determination, as social work theory using psychoanalytic concepts suggested. Beginning Classification of Indirect Work By the 1940s theoreticians, sensing that the focus on the psychological was not being complemented by indirect work, emphasized the need to view the person in his or her environment (Hamilton, 1940). Nevertheless, in the 1960s Hollis - well known for her incorporation of ego-psychology into social work - would write that "not since Mary Richmond's time have we given the same quality of attention to indirect as to direct work" (Hollis, 1964, p.77). Why an interest in indirect work resurfaced after such a long time is an interesting question. Beginning doubts about the effectiveness of what could be achieved through talking therapies (Gellner, 1985), a growing interest in family work, deinstitutionalization of people with mental illness into the community, and social unrest evidenced in the civil rights movement may explain the re-ignition of interest in the environment. Hollis Hollis proposed a classification of communicative techniques used in indirect work. This classification stemmed from her empirical research on direct work. Having analyzed the content of case notes of social workers' interviews with clients, Hollis hypothesized that "the principles involved [in indirect work], if not identical, certainly are remarkably similar to those involved in direct treatment" (Hollis, 1964, p. 76). She justified this hypothesis on the grounds that "environmental work also takes place with people and through psychological means" (Hollis, 1964, p. 77). Following is Hollis's (1964) "classification of techniques" used in indirect work with examples in parentheses: * sustaining procedures (indicating interest) * direct influence (offering advice, professional opinion) * ventilation (aiding the articulation of painful feelings) * reflection on current situation 1. encouraging thought about situation (economic, health, social network) 2. discussion of client's behavior and possible courses of action 3. discussion of client's feelings and beliefs about situation, treatment or agency; social worker's explaining treatment, agency function, or response to client * provision of material assistance by social worker's agency and/or the mobilization of resources in the client's community (Readers might wish to apply them hypothetically, in their minds, to communication with a professional colleague or client's relative, to bring the examples alive and to test their appropriateness in indirect work.) Hollis's typologies for direct and indirect work are very similar. The only differences are that in direct work, the last category above is omitted and replaced by another that includes encouraging the client to reflect on psychodynamic (transference) issues, and a sixth is added: encouraging client to see patterns in behavior from a historical perspective. Hollis's typology of communicative techniques used in direct work has merit because it offers a conceptual framework with which to view indirect work. However, a major question emerges: Does it make conceptual sense to define indirect work within the context of direct work? Hollis argued that successful indirect work is achieved through psychological means similar to those used in direct work. The social worker's use of self at client, organizational, and policy levels probably cannot be reduced to that used at the first level, that is, with the client (Garvin & Tropman, 1998). For instance, the social worker uses mediation and collaboration in therapeutic work, however, on an organizational level, the social worker as "advocate . . . is always ready to use pressure and conflict when mediation and collaboration fail with those who control the resources clients need" (Weissman, Epstein, & Savage, 1983, p. 165). In later years Hollis added further depth to her conceptualization of indirect work (Hollis & Woods, 1981). Hollis identified six important roles assumed by the social worker in indirect work: (1) provider, (2) locator, (3) creator of resource, (4) interpreter of client's need to collateral, (5) mediator between client, and (6) advocate (aggressive intervention) (Hollis, 1972). Hollis's classification of roles bears similarities to subsequent formulations (Weissman et al., 1983; Wood & Middleman, 1989; Woods & Hollis, 1990). Empirical Research on Indirect Work Hollis's conceptualization of indirect work provides a framework within which hypotheses can be formulated and research can be conducted. Surprisingly, there appears to be no empirical research testing the validity of Hollis's communicative techniques in indirect work. Social work research has tended to examine therapeutic work, ignoring everyday practice (Macdonald, Sheldon, & Gillespie, 1992) and environment-centered intervention (Kagle & Cowger, 1984). This said, there is a small body of research on indirect work. The major areas examined are social workers' descriptions of their work and clients' views of social work. Social Workers' Own Reports on Their Workloads Research examining how social workers distribute their time on different activities is scant. Interest in this topic appears to have begun in the 1950s and culminated in the 1970s. I include the findings because, from an historical perspective, the studies provide empirically grounded evidence that indirect work is not only time consuming but also and more importantly requires skill and expertise. Why much of this research occurred in the 1970s and has not been adequately developed is a question to which I will return. When social workers in health care settings and family services agencies were asked to provide reports on, or write detailed diaries of, their activities, a major pattern emerged. Direct, face-to-face work with clients accounted for 20 percent to 25 percent of social workers' time (Carver & Edwards, 1972; Hill & Ormsby cited in Wood & Middleman, 1989). Activities associated with indirect work (for example, case conferences, letter writing, telephone calls, and collateral contacts) accounted for the bulk of remaining time. These findings concur with more recent depictions of what agency-based social workers do in everyday practice (Gibelman, 1995). An important point must be stressed, however. The most recent NASW membership data (although by no means reflecting the profession as whole) indicate that, although the majority of social workers describe their primary employment as social services or health care settings, there is an increased number in private practice. In 1995, 14 percent of NASW members reported their primary employment as private practice, compared with 9.3 percent in 1988 (Gibelman & Schervish, 1997). Because many social workers who enter private practice cite as their motivation a desire to move out of a bureaucracy and away from many aspects of indirect work (Gibelman, 1995), findings on how agency-based social workers distribute their time cannot be safely generalized to private practitioners. Over and above the time consumed by indirect work, there is evidence that expertise and knowledge are required that have been overlooked in the literature. Grinnell and Kyte (1975) examined one aspect of indirect work, concrete environmental manipulation, defined as "the provision of specific services such as money, referral, food, shelter" (p. 313). Written reports of 88 instances of environmental manipulation were analyzed. Their study revealed sophisticated procedures on the social worker's part. The provision of this help involved meetings lasting on average 49 minutes and attended by three or more people. Aside from the length of the meetings, the management of group meetings suggests great skill on the social worker's part. This expertise is not accounted for in the dismissal of indirect work as simply "collateral contact" (Grinnell & Kyte, 1975). Although not the major focus of Reid's (1978) study of-task-centered casework, Reid's analysis of 44 student practitioners' records of collateral contacts revealed collaboration with others occurred for myriad reasons that require distinct skills. Communication took place to elicit information on resources, clarify clients' needs and others' expectations of the client, convey information on the clients' progress, address conflict between clients and organizations, and initiate referrals (Reid, 1978). There is a growing literature on case management, and the reader might wonder in what ways indirect work, as depicted by social workers' workloads mentioned earlier, and case management are the same or different. There is much debate in social work about whether case management is simply "old-fashioned social work" in new clothes (Moore, 1990) or "a new paradigm" (Rothman, 1994). One difficulty in resolving this issue is that case management is not well defined (Rothman, 1992). Although components of case management (accessing of services for clients, connecting clients to resources) overlap with indirect work, there are major differences. Case management is frequently considered a service primarily offered to clients who require long-term monitoring in the community (for example, frail elderly people and people with severe mental illnesses). Indirect work is not limited in this way. Also, case management is prominent in managed care - that is, the provision of health care services by large organizations whose major aim is cost containment and, in some cases, profit. The rationing of services, based on cost rather than need, does not sit comfortably with social work values. Indirect work as it has been defined historically, based on social work ethics, is at odds with some case management practices. This said, research on case management confirms the time-consuming nature of many of the activities associated with indirect social work. Clients' Views on Indirect Work Clients' perceptions and evaluation of social work were the focus of rigorous study in the 1970s and 1980s. Clients' feedback suggested, contrary to Hollis's emphasis on the psychological, that the social worker's actions speak louder than their interpretations. Mayer and Timms (1971), in their classic study of clients' views of social work, interviewed in depth 61 clients who had used a family services agency. Clients who experienced interpersonal difficulties were satisfied with the service if advice was forthcoming from the social worker. However, when advice was not given, clients tended to be dissatisfied. Clients with unmet material needs were gratified when concrete assistance was given. When material help was not provided, clients described frustration and frequently described social workers as being "obsessed" with feelings (Mayer & Timms). These findings indicated that the clients desired a proactive approach on the part of social workers. Some clients would have liked more information on how others dealt with similar relationship problems. Indirect work in the form of a referral to a self-help group might have helped. The findings also confirmed the importance clients attach to concrete assistance. More recently, Rees and Wallace (1982), in a comprehensive review of the literature on clients' views of social work, found that clients appreciate the presence of an empathic, friendly, nonjudgmental social worker, but a relationship characterized by these qualities is not sufficient for success. Indeed, "when promises or even expressions of interest are not followed up by some action, clients' initial satisfaction turns to dissatisfaction" (Rees & Wallace, 1982, p. 44). Much in agreement with Reynolds's earlier reminder that indirect work is needed and does not incapacitate clients' free will, research indicates that indirect work results in clients feeling neither helpless nor inadequate. On the contrary, indirect work shows that the social worker cares about the client and is willing to act on the client's behalf. Practitioners have tended to view the relationship between client and social worker as being a major avenue for change, underestimated the influence of the client's environment (Maluccio, 1979), and have been reluctant to provide tangible assistance (Reimers & Treacher, 1995). Restated, clients value indirect work to a much greater extent than social workers do. Theoretical Developments General systems theory (GST), a scientific approach that views phenomena holistically, and ecology, a branch of biology that examines the organism within its surrounding environment, have been embraced by many social workers (Germain & Gitterman, 1996; Hartman, 1970; Meyer, 1983; Pincus & Minahan, 1973). GST and ecology both stress the interconnectedness of social systems, and therefore the importance of the environment and social workers' intervention on it. However, for indirect work they have weaknesses. Everything appears to be related; change in one part of a system, that is, "a complex of interacting elements" (von Bertalanffy, 1968, p. 55) affects other parts, and sometimes in an unpredictable way. For example, systems with similar conditions may reach different ends, and, conversely, systems with different initial conditions, similar final states. The social worker is not given clear guidance on what course of indirect action to choose. Also, some argue that both GST and ecology do not account for oppression, "the realities of power" (Cloward & Piven, 1975; Gould, 1987; Wakefield, 1996). I wish to include radical social work approaches because they have not only influenced the profession's current incorporation of feminist and culturally sensitive approaches, but recommend indirect action on the political front. To say an appreciation of the political arena is entirely new would be misleading, because both Jane Addams and Mary Richmond, in their different ways, were involved in bridging the gap between every day practice and policy. What is new, however, is that the state is no longer viewed as something benevolent, caring paternalistically for its people; radical social workers see an adversarial relationship between state and client (Gaylin, Glasser, Marcus, & Rothman, 1978). For example, state programs may serve the professionals who work in them rather than the clients they were created to serve. Viewing indirect work from a radical perspective involves the social worker doing the following. First, the distribution and allocation of resources must be seen in a political light (Richan & Mendelsohn, 1973). Cloward and Piven (1975) argued that if social workers cease to look for psychological and family pathology, "it will become clear that adjustment depends in the most fundamental way on resources" (p. xxvi). Important points raised by radical theorists are that clients' concrete needs are frequently depoliticized, and indirect work directed at meeting them has been demoted to social work drudgery (Epstein, 1995). Second, the radical social worker will adopt a "bi-directional position" (Pritchard & Taylor, 1978) between the client and society. This position is tension filled, because, although social workers are sanctioned by society, they also question its policies and the ways less-privileged members are treated. If the bidirectional position is accepted, indirect work includes more than linking individual clients to resources and collaboration with others - indirect work involves attempts to eliminate oppression on a macro level, using political tactics to do so. Radical approaches to direct and indirect work are less prominent today than they were 20 years ago (Bailey, 1989). This is a loss to the profession on several fronts. Advocacy - pleading another's case - runs the risk of becoming apolitical (Haynes & Mickelson, 1997). In addition, radical thinkers offer a perspective by which to view capitalist societies. It is all too easy, for example, to view for-profit health maintenance organizations as givens and not challenge their existence (Witkin, 1997). Discussion History reveals that indirect work has received intermittent attention from theoreticians and researchers. On the basis of the historical pattern that emerges, it seems that when social work is asked to clarify what makes professional social work distinct from nonprofessional activity, there is a turning inward and examination of everyday practice. Flexner's statement that Social work was not a profession resulted in Richmond's articulation of the importance of both direct and indirect work. In addition to the renewed focus on the environment in the 1960s, Hollis's conceptual work and others' empirical research on indirect work also can be understood in the light of other events. In the 1960s and 1970s, fears about a future shortage of qualified social workers led to an examination of social work workloads. One aim of this research was to ascertain that which could be delegated to unqualified staff (Barker & Briggs, 1968). The findings of the research which revealed that indirect work, on the part of qualified social workers, was pervasive and more sophisticated than previously thought, did not provide easy answers on how to employ differentially qualified and unqualified staff. Last, a centennial of the profession is another occasion when we examine what social workers do and ask what makes social work special (Witkin, 1998). However, it is important to remember that although indirect work is remembered at various times - some of them crises for the profession - social workers have not been unanimous in their praise of indirect work. My argument is that only when forced to examine social work activity in its entirety does indirect work surface as component of practice worthy of study. With the aim of strengthening an interest in indirect work, I propose the following recommendations for thinking about social work's domain, as well as practice and research. Recommendations for Conceptualizing Social Work's Domain Social work's stated focus is person-in-environment, and many argue that this perspective distinguishes social work from other helping professions (Payne, 1991). The person-in-environment construct directs the practitioner to take into account the individual client and the client's situation. However, for indirect work the phrase has drawbacks. Person precedes environment. Person:environment, the colon symbolizing the mutual transactions between the two, has been introduced (Germain & Gitterman, 1996), yet person continues to precede the environment. What does this connote? Should social workers attend to the person as the first unit of attention and the environment second? History appears to confirm that this has been the case. Although attempts are underway to create a classification of problems with which social workers deal (Karls & Wandrei, 1995), the environment is still second on the list. In my view the person-in-environment focus does not distinguish social work from, say, medicine. A good doctor will examine the patient and then look at the environmental context. What might be special about social work is that practitioners have the ability to look to the person within the environment but in addition "act," through indirect work, on the environment (Wood & Middleman, 1989). Might there be any benefit in reversing the wording in the phrase person-in-environment in everyday practice? "Environment-person" certainly highlights the importance of indirect work, and this may be appropriate for social work. Some might retort that the social worker has an ethical duty to attend to, and respect to the utmost, the individual. The rephrasing, does not, in my view, interfere with this ethical obligation to individuals. Indeed, by attending to the environment first, the social worker might be serving people to a greater extent than if it were ignored, and offering a culturally sensitive practice to those clients who reject both individualism and the Western separation of self and community. Recommendations for Practice Clients frequently seek our help when resources in their physical and social environments are nonexistent or have been depleted. Practitioners and students might fruitfully consider first environmental factors and the ways in which the social worker might intervene indirectly before contracting to engage in direct work with clients (Wood & Middleman, 1989). One suggestion for teaching is that students write process recordings of indirect work and direct work. For instance, verbatim accounts of negotiations with collaterals in obtaining shelter for a family might offer useful learning material about knowledge and communication skills used. These efforts may raise the profile of indirect work and help counter MSW students' preference for counseling, family and marital therapy, psychotherapy, casework and group work over case advocacy, brokerage, and case management (Rubin, Johnson, & DeWeaver, 1986). To fuel an effort to give ample attention to indirect work, practice texts need to reflect, and prepare students for, the demands of indirect work. Direct work has been celebrated throughout social work's history. There are many texts describing theory and skill required for helping clients in direct work; practice texts on interviewing and forming relationships with clients abound. These texts are useful, and the aim of this article is neither to decry direct work nor to devalue its merits. Rather, as social work enters its second century, I would like the profession to develop a balanced theoretical and technical framework within which all of our activities are included and valued. Practice texts often give the impression that the bulk of the social worker's time is spent in individual, family, or group interviews and counseling. Research on workloads suggests that this is an inaccurate portrayal of everyday practice. Also, the emphasis on skills needed in direct work with clients suggests that once these have been mastered all other practice skills, including those needed for indirect work, will fall into place (Pine & Healy, 1994). This appears to be a questionable assumption. Last, continued dialogue between practitioners, academicians, and students is needed on the status of case management in social work. One concern I have is that activities associated with indirect work will be compartmentalized and deemed a case managing adjunct to social work practice. Another is that social workers, failing to articulate their expertise in indirect work, will lose this important facet of social work altogether. Recommendations for Research To my knowledge, Hollis's typology of communicative techniques used in indirect work, developed more than 35 years ago, has not been empirically tested. Research on the adequacy of Hollis's typology might reveal useful practice-relevant knowledge that could be translated into action principles for indirect work. Second, in responding to recent calls for increased collaboration between researchers and practitioners, indirect work may be a good place to start. Observational studies examining practitioners' communication when advocating, mediating, or collaborating within interdisciplinary teams have the potential to yield information on the skills necessary for successful indirect work and add an empirical foundation to the conceptual formulations of social work's many roles. Last, more ambitiously, I suggest cross-disciplinary collaboration with urban historians, geographers, and sociologists to develop research and theory on the environment. Every day, social workers, in their indirect work, help clients negatively affected by hostile environmental factors (Gorey, 1995), and their experience would be a useful addition to the building of knowledge on the environment. The fruits of a cross-disciplinary effort might develop theory and research on the environment that would complement the expansive knowledge bases on the other end of the person-in-environment spectrum, namely the person. Conclusion The history of indirect work both as an idea and as the very stuff of everyday practice has been given uneven attention. Often, it has been viewed as activity unworthy of professional status and "unworthy of serious analysis" (Hollis, 1964, p. 77). Interestingly, prominent among those who have sung the praises of indirect work are nonsocial workers: a creator of medical training (Flexner), a sociologist (Abbott), a magistrate and social scientist (Wootton), and, most importantly, our clients. Social work, I believe, has much to gain in the next century if it re-examines indirect work, and clients have much to lose if the profession continues to deem this work unimportant. Much in agreement with Richmond and Reynolds, I believe that indirect work helps define social work practice, is an important factor in alleviating social problems, and assists us in distinguishing social work from other helping professions. 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Johnson, MSc, CSW, is an instructor, School of Social Work, Rutgers University, The State University of New Jersey, 536 George Street, New Brunswick, NJ 08901 and a PhD candidate, School of Social Work, Columbia University, New York; e-mail . The author thanks Elizabeth DiLauro for comments on this article and Professors William J. Reid and Edward J. Mullen for their advice. |
Direct and indirect methods of social work
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