Original work

Contents:

Research and Ideas – An Overview

Social Work Theory – Conceptualising Social Work

        General Theory of Social Work

            Theory of Emergent Understanding & Social Work Knowledge

Empirical Research and concepts

            Judgement Based Practice

            Use of Quantitative Research as an Evidence Base

            Knowledge & the Evaluation of Social Work Practice in Mental Health

            Development and Use of Social Science Based Assessment Schedules

            Maternal Depression and Child Care Social Work: converging realms

            Prevention and Coping in Child and Family Care

            The Preventive Process in Children’s Social Work and Social Care

            Prevention and collaboration with health professionals

            Other work

References

Social Work Theory – Conceptualising Social Work

General Theory of Social Work.

[1] [5] [8] (Note references in text are in square brackets & refer to the corresponding number in the References section)

An underlying conceptual theme of my work has been to establish a social work as an intellectually defensible academic discipline, as well as area for practice, one that does not leave it vulnerable to capture by mere policy diktat (what e.g. if such diktat required profoundly unethical behaviours?) nor simple personal preference [5 ch 2] This ambitious theme was reflected in key questions.

Can we construct a conceptualisation of the Nature of Social Work? One that transcends personal ideology or mere social policy application? Can it be established as a discipline as well as a practice?

In responding to these questions I sought to create a framework through which a general conceptualisation of social work could be achieved. This also provided the framework through which my empirical research could be understood.

This work first sought to establish some initial conditions for the establishment of a ‘Nature of Social Work’ theory (one with an analogous relationship with practice to that of Jurisprudence to Law). These included developing concepts which both unified elements within it but distinguished it, individually and collectively, from other activities (eg counselling, politics etc); that were not the ‘prisoner’ of particular policy forms or systems; that did not merely reflect the personal predilections of the author; and that were intelligible.

The Interactional-Interface conceptualisation of social work was developed [1, partic Ch 1-4]. The underlying feature here is the establishment conceptually – for the first time – specifically of the social location of social work as between social exclusion and inclusion. The general sense of social work’s interest in social exclusion was not in itself new. The exclusion-inclusion interface conceptually understood for its social location and in relation to other key conceptual facets, however, was. 

One consequence of this is that social work is socially defined and socially focused, and not merely (for example) a sub-area of health. This social exclusion-inclusion interface is a necessary but not sufficient condition for social work’s social location: social work must also be conceptually understood as interactional and operates on other interfaces, between public and private concerns, role and person, socially defined and personally constructed etc 

This interactional-interface conceptualisation however cannot explain all forms in different societies. Only some socially excluded groups are the focus for social work in any given society. It is, in this respect, socially constructed, the result of social processes where issues  of public concern, whose meaning content has been broadly settled, are placed in its orbit. Social work is carried out under social auspices, where it’s legitimacy comes from directly or  indirectly delegated authority. These may coalesce in terms of Social Authorisation for the focus of social work – a general acceptance of the problems legitimately a concern for social work, and of their nature and meaning.   This explains different emphases in different social and cultural contexts – the focus on different problems and needs and enacting different modi operandi.

The concepts of Need, Authority and Choice (and their consequent practice response) furthermore emerge in social work from implicit notions of rationality, in which social work seeks to bring rationality to the irrational and give choice to the rational [1, Ch 6 & 7; see also 5, ch 7] Thus, for example, the obvious relevance of rationality to mental health, and the consequent authority role with compulsory admissions, and the notion of the “reasonable parent” to judge quality of parenting, also the basis for the authority role (where social workers seek to bring rationality (“reasonable” parenting) to the irrational). Outside this authority role social workers enable choice in circumstances where rationality is not an issue.

Social work assumes humans – as a manifestation of human nature – to be capable of purposeful action, to have unconscious and preconscious determinants for action, to be innately social but to have limited rationality. In process and outcome, contra to confused and contradictory claims on Empowerment, social work may be understood as facilitating Coping.

Underlying this is an assumptive world – a Paradigm if you will – of Limited (epistemological) Objectivism, a core (though not necessarily exclusive) Micro Social (societal) Focus and Limited Voluntarism (the capacity for autonomous decision making)  as a conceptualisation of humans [1, ch 14; 5, ch 10]. The significance of the micro social represented an inversion of my earlier critique of social workers’ predominant individualism with child protection [8] 

Social work assumes an ontology of objective reality of which human understanding means we have limited grasp [1, ch 6 ff; 5, ch 10] . Ethical relativism is unintelligible in terms of social work because it fails to give the morality underlying its actions a privileged status [1, ch 5] . The foundation moral commitment to the “dignity and worth of humans” is, for social work only intelligible as a categorical imperative, and indeed underlies the commitment to anti discriminatory and anti racist practice. Paradoxically that is the case in the assumptive world of social work, despite its focus and actions being generated in social context. These assumptions allow social work to happen, both in terms of individual action, social work practices and policy imperatives. Its form, however reflects not just the dynamics of practice interaction but the processes of this interaction, which may be systemised and classified as a knowledge form.

Social Work as an Academic Discipline: 

[1]  [2] [5] [45] [49] [52] [70] 

 These underlying core assumptions together formed my concept of the Practice Paradigm of social work ‘the commonality of perspective that binds practitioners together in such a way that they may be regarded as operating within the same broad ‘world view’’  [1, ch 14; 5, ch 10] The Practice Paradigm concept underlay that of Practice Validity – the extent to which a knowledge form is consistent with the underlying assumptions of social work, its nature and purpose. Together with other theoretical features: particularly Interactional-Interface conception, and informed also (as we shall see) by the Theory of Emergent Understanding [1, ch 10-12; 5 ch 9] these concepts provided the basis for, and boundaries of, social work as an academic discipline [1, ch 14; 5, ch 10; 49] , rather than just a form of practice.

A number of academics responded to, and drew on this work to debate and develop their own ideas. These include the extent to which we can ascribe essentialism to social work, levels of analysis in the accounts of social work, the validity of criteria to choose between different narratives of practice (and hence the limitations to objectivism), the consequent degree to which boundaries to the discipline may be set and so on.

Theory of Emergent Understanding & Social Work Knowledge 

[1] [2] [5] [45] [52]

is another area of original conceptual development which both describes social work activity and provides the basis for developing its knowledge. It is therefore both a part of a general theory of social work, yet an important focus in its own right. In particular the development of a notion of ‘process knowledge’ came with the Theory of Emergent Understanding [5, ch 9, 45, 52]. It emphasises an underlying process of what was termed ‘Reflexive Eclecticism’ – broadly the capacity to reflect, but also rationally speculate, both on themselves as psychosocial actors and the service users, in social context, with whom they work. This gave primacy to understanding and classifying the thinking and reasoning processes over mere knowledge application (the flawed and conceptually limited notions of Evidence Based and  Evidence Informed Practice) which can only occur in the context of these processes. The relationship between on the one hand process knowledge and specific methodological approaches and on the other, process knowledge and the limits to the ways in which findings based on these methods may be employed, were explored in the light of the “assumptive world” of social work previously noted.

Conceptual heuristic devices were developed by analogy with the science of discovery and methodology of social science, through which categories of rigorous processes could be developed. These included, for example ‘comparative hypothesis assessment’ and ‘progressive hypothesis development’[52] These occur as a process in which clarification is an emergent property of that process. Drawing on Popper, the probabilistic nature of social science and the uncertain and emerging understanding of individual interactions the principle underlying choice of explanation and intervention was to choose that which was “least likely to be wrong” in the specific circumstance or instance [52]. This was a notion of Judgement Based Practice rather than Evidence Based practice (the latter of which necessarily has a subordinate, or secondary place to the former) [1, p 244 ff]. This has profound implications for the understanding of the practice of social work. 

It is arguable – as suggested for example by Professor Sue White (1997), p 740 in her critical analysis- that this work solved what had hitherto been widely regarded as the most fundamental problem for social work knowledge and education –  the supposed tenuous relationship, bordering on unbridgeable gap,  between ‘theory and practice’ (or social work and its social science knowledge base) [White, S. (1997) ‘Beyond retroduction – hermeneutics, reflexivity and Social Work practice’, British Journal of Social Work, 27, pp 739-54]. From it emerges the idea of social workers as scientists of human life or practical social researchers, and these provide a basis for assessing rigour in practice.

Empirical Research and concepts

Judgement Based Practice (researching the Theory of Emergent Understanding)

[9] [10] 12] [15] [16] [32] [38] [40] [74] [77] 

The theoretical work underlies the empirical research. Most obviously this relates to the development of Process Knowledge/Judgement Based Practice. This was a two stage process of research based concept development and empirical evaluation. It involved the development and classification of reasoning processes in practice including evidence of their variability through in depth abductive qualitative work with experienced practitioners through the Cognitive Processes Interview method, using ‘think-aloud protocols’ producing 60 case examinations subject to in-depth analysis [32; 38; 40] The findings enabled the development of concepts/classification of the cognitive processes utilised in practice, including for example, Focused Attention, Partial and Full Case Hypotheses, Speculative Hypotheses, and Substantive and Application Rules [40; 77], as well as means for understanding and assessing depth and complexity [38]. In addition some examination of variations in the use of these processes as between practitioners was undertaken, showing considerable differences in the comprehensiveness depth and flexibility of their case analysis.

This raised questions about the consistency of the quality of thinking and acting in social work. In response to this a subsequent examination was undertaken of what is colloquially referred to as the “Heart and Head” of social work. This refers to the interrelated reasoning and interpersonal abilities and skills of social workers. This was undertaken through quantitative research using instruments with high levels of reliability and validity. It was conducted with a large cohort in a six-centre study involving 407 participants and including both cross sectional and longitudinal design – showed high interpersonal scores, but huge variation in reasoning scores (the “heart” and “head” of practice) [9; 10; 12; 15; 16]. This variation is alarming for practice suggesting a considerable difference of quality for its conduct is liable to be manifest in different social workers, and mean that major differences in competence and quality of practice is endemic in social work [9] At its best it is liable to be of the highest class, but based on this research, this was far from the case with many practicing social workers. In this respect the findings, though now authoritative,  were consistent with the earlier findings from the qualitative study.

It also showed evidence that educational processes do on the whole, develop these capabilities in practitioners in some areas of reasoning and interpersonal capacities. However there was institutional variation in the capacity to educate for these capabilities, and these education processes were more effective in some areas than others [12]. Overall these results show wide variation between individual practitioners in, and considerable variation between educational institutions in facilitating, reasoning and interpersonal capabilities underlying the quality of practice. These are core elements of Judgement Based Practice which requires greater consistency of  standards for rigorous social work and therefore has major, indeed fundamental, implications for social work generally

Practice/Educational Relevance (examples) include

  • Concepts developed (focused attention, speculative hypotheses, rule use etc) provide a basis for educating for rigorous thinking in practice and for developing means for evaluating practice rigour
  • There is a need for ensuring greater levels of critical thinking in social work graduates who are poorest in this capability, and improving overall levels
  • There is a need to ensure HE institutions more consistently ensure adequate progress in critical thinking capabilities in the qualification process

These are capabilities fundamental to analysis, judgement and decision making in practice

Use of Quantitative Research as an Evidence Base

Knowledge: Use of Quantitative Research as an Evidence Base. 

[11] [13] 

An emphasis on the primacy of Judgement Based Practice does not undermine the continued importance of the evidence base for social work. Quantitative research is a major contributor (and potential contributor) to this. However, the problems of numeracy in the social sciences and practice generally is widely known and can potentially inhibit the beneficial use of quantitative findings. The detailed study of 10 years of publications of the major British based international social work journals  examined 1490 articles for the nature range, scope and impact of quantitative research. In these respects it provided data not previously available and, particularly in relation to impact, employed novel methodologies.

It employed multivariate data analysis including novel approaches to the evaluation of impact. Amongst the key findings were that quantitative research was a clear poor relation to, in particular, qualitative research in terms of output, and although output was increasing over time, the gap remained as wide as it had ever been [13]. However, in terms of impact – which was quantitatively analysed – there was little difference, on a study by study basis, between quantitative and other forms of research [11] . Indeed, there was no diminution of impact with the complexity of statistical techniques used. This complex and nuanced situation paints a less serious difficulty with quantitative research than was previously suggested, though this had been through opinions of key academics rather than, as with my work, objective analysis of output.  However, it is not clear that the academic impact as outlined here was reflected in its practice impact (and therefore on the real world of practice). 

Practice/Education Relevance (examples): 

  • For quantitative research to have the impact required on practice, there is a need for both the development of numeracy skills and a mediating mechanism, whereby the findings from quantitative studies can be digested – accurately – into a form where their implications can inform practice. 
  • An Evidence Base for practice requires mechanisms and a workforce that is able to understand and use these findings. This includes more extensive statistical training on qualifying courses and digests/meta analysis by experts of findings from multiple studies

Knowledge and the Evaluation of Social Work Practice in Mental Health

Mental Health Work in the Community. This research, also relevant to my conceptual ideas, shifted the focus from knowledge development to examining the extent to which knowledge forms distinctive to social work were reflected in distinctive practice, and therefore also the relationship between knowledge and its social location. Its methodology facilitated this through a comparative technique involving a contrast of mental health social workers with community psychiatric nurses [6, App 1]. It maximised the possibility for the falsification of social work having a distinctive place by (a) comparing with an occupation whose roles most closely resembled mental health social work (b) who were based in the same setting (c) who were subject to the same referral process. It was, of course also central to our understanding of mental health social work, and given its community focus, the way in which social location is enacted in the context of Prevention (of which more later)

This research project examined and evaluated the contribution of knowledge to the practice of crisis intervention in mental health work, through a 4 way comparison of: the practice of mental health social workers and community psychiatric nurses (CPNs) in the light of the two professions’ dominant knowledge forms. The key questions were: how far were knowledge forms dominant in social work distinctive from those of CPNs? And to what extent were these reflected in intervention process and outcome including the experience of service users? It did so through a comparison of social workers and CPNs based in the same setting and subject to the same referral process, involving participants from over 300 cases.

Social workers conducted practice in a way that reflected the distinctiveness of their knowledge forms [6, ch 2-5; 62; 82 ].They were more likely to define their cases in terms of social problems rather than the mental health framing of CPNs; they worked more in a wider community context – CPNs were more individualistic; undertook more long term work and had a greater emphasis on psychodynamic work. Social work clients, by comparison with CPN clients identified more skills and less frequently suggested intervention made little or no positive difference [6, ch 6-9; 55; 61; 62]. They were more likely to agree with social workers in their definitions of their problems. 

Overall social workers manifested a more coherent integrated psychosocial philosophy of practice and, both in terms of professionals’ and service users’ accounts and displayed, with more positive effect, psychodynamic skills. They were then, on the whole, more capable of engaging with the psychodynamic and social systemic elements of service users’ lives [6, ch 10]. In both respects this reflected the focus, depth and coherence of the underlying professional knowledge forms.

Practice relevance (examples)

  • The extent to which the knowledge base is reflected in the practices of social work indicates training is effective in producing psychosocial professionals.
  • Social workers’ distinctive psychosocial knowledge base gave them a distinctive place in mental health, not reproduced in CPNs their closest professional ‘cousin’. Their place in the mental health team was not, therefore, easily substituted (are we thereby shortchanging service users when we substitute other professionals for social workers in carrying out social work tasks?)
  • Mental health service users with psychosocial problems more positive response to social work involvement (again in real world comparative context) indicate their skills make them the preferred option for a range of service users. This points to increasing their involvement, rather than seeking to substitute them with other professions.

Compulsory Admissions  

[7] [34] [57] [60] [63] [64] [65]

This research also had a twofold function, focusing this time (1)  further on the issue of knowledge through the process of knowledge development in social work, and (2) for the first time, a detailed examination of the ways in which assessments for compulsory admission to mental hospital were undertaken by Approved Social Workers (now allocated to Approved Mental Health Professionals). It further helped the empirical examination of key conceptual dimensions from my theorising such as social location, authority role and interactional dimensions of social work. It also made a further contribution to the relationship between social location and prevention process.

It was a three stage process involving detailed examination first of over 120 compulsory admissions focusing on the way ASWs constructed and defined [7, see also 60; 63; 64; 65], in practice the ‘health and safety/protection of others’ criteria. From these an assessment schedule (the Compulsory Admissions Assessment Schedule [CASH]) was developed, and subsequently evaluated in relation to 71 assessments. 

Theoretically ASWs were understood as concerned with mental health as a social problem, rather than a mental health problem per se; with authority delegated by the state; and as rule enforcers operating within the ‘open texture’ of law focusing, sociologically, on residual rule breaking. The focus on the ‘health and safety’ criteria enabled the classification of how these were constructed in practice and the identification of a ‘threshold of risk’ at which compulsory admission was pursued.

This provided the basis for the construction of CASH, alongside key concepts of risk: Hazard, Danger and Overall Risk. CASH  was used also to identify key characteristics that would need to be possessed by rigorously developed social science based assessment schedules generally. It was a fully structured instrument designed to inform and reflect a clear assessment of the nature and degree of risk presented by the patient. 

Evaluation of CASH showed it promoted consistency between ASWs through a narrower rather than wider interpretation of the law relating to health/safety/protection of others, emphasising threats of death, injury and serious illness.  It was practical to use, generally seen positively by ASWs and was considered particularly helpful where decisions were difficult to make. Overall it encouraged the development of a Social Risk orientation in contrast to a Mental Health orientation facilitating a distinctive knowledge based role for ASWs separate from, but complementary to, medical practitioners.

Practice relevance (examples)

  • It is important for policy makers to recognise the appropriate distinction between ‘social risk orientation’ and ‘mental health orientation’ (and the need for both) in the compulsory admission process
  • CASH provides an effective knowledge based tool for undertaking compulsory admissions, channeling social risk assessment and reducing the ‘threshold of risk’ thereby increasing consistency of judgements, and should be used 
  • These assessments were undertaken by ASWs, not, as currently, AMHPs. In the light of these findings, and those in the comparison with CPNs, we cannot assume that non social workers produce a social risk orientation that complements the mental health orientation of medical practitioners, one that is important in balancing the needs and human rights of patients

Development of Social Science based Assessment Schedules for Social Work: further development of knowledge forms for social work

The need to bring findings from rigorous social research closer to practice has been a consistent and major feature of attempts to develop social work’s Evidence Base. However, those attempts made have been in many respects unsatisfactory. A theme of my research has been to establish and increase the relevance, specificity and appropriateness of the instrument based process of bringing research to practice through development of social science based assessment schedules

While there have been attempts to systemise recording of practice by seeking to construct evidence informed schedules for practice eg the Integrated Children’s System, these lack the rigour of systematically developed and evaluated instruments characteristic of, for example, psychology and have been criticised for their unfitness for purpose even by influential early enthusiasts, such as a Lord Laming in his report on the death of (baby) Peter Connelly. 

The potential, therefore, and importance, of rigorously developed social science assessment schedules for social work – that reflect both the purposes of social work and its psychosocial frame – is clear. I have developed three, including some general underlying principles. 

Each of the instruments developed focused on an area of first rank important for social work practice: assessment for compulsory admission to psychiatric hospital (mental health sections); assessment of quality of partnership between service user and social worker in child and family care; assessment and outcome evaluation of child and family psychosocial functioning in children’s social work and social care. They took different forms which I developed as follows

​Primary Research Based instrument

​Concept based instrument

​Pre Existing Empirical Research Based instrument

Underlying general principles. CASH was an early example of these. It’s development enabled the identification of three key features required: those of Comprehensiveness (any schedule should strive to be as comprehensive as possible regarding the particular area being assessed), Efficiency (it should nevertheless seek to be as efficient to use as possible) and Specificity (they should be precise in their focus and classification).  These underlying principles obviously have a potential tension between them, and any instrument should seek to maximise each of these while paying adequate regard to the other principles.  

Primary research based instrument: Compulsory Admissions Assessment Schedule [7] [21]: CASH has been described. It’s development process reflected one approach to a social science base for these instruments – one where the primary research was carried out (rather then drawing on a review of previously undertaken research) in order to yield the classification from which the domains and categories of the instrument could be elaborated. Overall this was undertaken in relation to nearly 200 compulsory admission assessments (mental health sections). It was then evaluated for the extent to which it was considered usable and useful in practice, helped clarify processes and decisions, and the extent to which it both reduced the threshold of risk and inconsistency in decision making (in relation to which findings were positive)

Practice relevance (examples)

  • CASH should be used by the AMHP in all Compulsory Admission Assessments. It provides a clear focus and criteria for making decisions, increases consistency between practitioners and enables accountability.
  • If used that way CASH enables authority-wide monitoring of practice with compulsory admissions without compromising anonymity. This increases visibility and accountability at local level and provides a basis for improving practice
  • In the light of the above CASH provides  a way of helping ensure the human rights of highly vulnerable patients

Concept based instrument: the Quality of Partnership Instrument (QoPI)[37] was developed to assess the quality of partnership between practitioners and service users. This is an example of a concept based instrument – one developed from unpacking the key dimensions to a particular concept (rather than drawing upon empirical research), in this case Partnership – and developing domains and categories reflecting these that would enable the assessment of its quality.

The work focused on the design and development of an instrument for assessing the quality of partnership with mothers in child care social work – a key area of policy and practice importance. It first identified (by examining the relevant policy documents and practice literature) the key conceptual elements of Partnership: role, role relationship, and power. The key dimensions of Partnership, those generally agreed, were identified and related to the conceptual elements. These were operationalised (and this process described and discussed) and the use of the instrument was evaluated with 221 participants (with 591 children). The findings showed the instrument has gone some way to achieving full reliability and validity when considered in the context of practice and that it may be used in both research and practice.

Practice relevance (examples)

  • QoPI provides a systematic way of ensuring service users views on the processes of intervention by child care social workers are recorded and made clear 
  • As a result it helps amplify the voice of the service user in social work
  • QoPI can be used to monitor developments and changes in the quality of partnership over time if used, for example, at case reviews
  • QoPI can provide information that can help social workers to act, where appropriate to improve the partnership with, and involvement of, service users

Empirical Research Based Instrument: Parent Concerns Questionnaire [20] [22] [39] [51] [53] [54] [58]. This was an example of an empirical research based instrument: one developed by drawing on extensive findings from published empirical research. The Parent Concerns Questionnaire (PCQ) was developed and evaluated with nearly 700 participants. Like the other instruments the PCQ was developed through a multi phase process. Initially it was developed drawing on existing published research on social factors associated with maternal depression in general populations, through which the classification of categories (ultimately 37) through which the assessment of family psychosocial functioning could be undertaken. Its domains reflected the Common Assessment Framework of Child Development, Family and Environmental factors, accentuating it’s potential use for practice. This was piloted first with social workers, then with service users before being adopted for evaluation in its own right. It was evaluated at 4 levels of prevention: service users referred for, but not receiving social work support, children centre users, non child protection social work cases, child protection cases

The PCQ was shown to have face, concurrent and construct validity, and internal and test-retest reliability in child and family social care populations. It was subsequently compared with the well established Parenting Stress Index to examine it suitability relative to another major instrument for its use with child and family social care populations. Undertaken with around 300 service users in four children’s centres, the PCQ was shown to have a greater capacity than the PSI (which was more narrowly constrained to the psychological) to assess the psychosocial inter relationship of problems and needs in family psychosocial functioning. 

Because if it’s suitability for these child and family social care populations and extensive reliability and validity, it had a number of uses for both research and practice. It was suitable for assessment of need in both individual cases and practice populations (eg users of children’s centres) and for the evaluation of outcome in individual cases and practice populations. It was also suitable for use in a variety of settings and levels of Prevention in child and family social work/social care.

Practice Relevance (examples)

  • The PCQ is an easy-to-use instrument with high levels of reliability and validity and wide applicability to child care social work and social care
  • It provides a way of giving the service user a clear ‘voice’ about their needs when child care work is undertaken
  • It can be reliably used to monitor need and evaluate outcomes precisely on an individual case basis
  • It can be reliably used to monitor need and evaluate outcomes precisely on a local authority wide basis.
  • It can be, used as a constant data base for continual monitoring and service improvement
  • PCQ can be used flexibly, for example by focusing on particular target problems or target groups, and provide rich information, including that gained by comparison with other groups

Children’s Review Schedule (CRS) [21] [42] [79 (as precursor)] is another empirical research based instrument, developed in collaboration with Cornwall Children’s Services. Its aim was to develop a consistent, reliable and valid way of measuring needs both in relation to individual cases, and sets of cases (eg of an area or district team).  Its  conceptual base was the differentiated operational concept of need I developed with Johanna Woodcock, in which measurement of need focuses on 3 dimensions of problems, supports and resources [42].  The CRS itself was developed in a similar way to the PCQ, but was a practitioner rather than service user instrument. It was evaluated in relation to 424 cases, comprising access and early intervention, family support and looked after children cases and findings focused on problems, objectives and actions [21] It was found to have Cronbach’s alpha and split half reliability, face and concurrent validity, and is coherent in terms of the three dimensions of the Framework for Assessment of Children in Need and their Families. There was a clear relationship between case objectives and problems identified, concurrent relationships between primary problem and problem domain scores and primary area for intervention. 

Practice Relevance (examples)

  • The CRS can be used to identify needs, and clearly state objectives and actions on an individual case basis. 
  • It can therefore improve clarity and supplement narratives in case management. It can assist in clarifying the rationale for social work actions
  • The CRS can be used on an authority wide basis to monitor practice, including levels of need in case managed work
  • This clarity and precision can enable service users by providing clear information on social work assessments throughout the life cycle of intervention. Service Users are thereby in a better position to put their own case and argue for preferred case directions

Maternal Depression and Child Care Social Work: Converging different realms of practice

This was the first major study of the impact of maternal depression on the conduct of mainstream child care social work. It reconstructed our understanding of much of child care social work practice and the significance of maternal depression within it. It provides a direct illustration from the consequences of the concept of Social Authorisation central to my theoretical work: as it underlies the very definitions, narratives and practices undertaken, which provide a social work process distinct from psychiatric diagnosis and terminology. It included further themes of social location, social construction of practice under social auspices, authority and choice and the interactional dimensions of social work.

A series of research publications focused on the multi site  maternal depression/child care in social work project involving over 300 families, as well as their social workers, as participants [4; 32; 33; 34; 35; 36] This emerged from (a) clear evidence of relationships between respectively gender and disadvantage and depression (b) the disabling impact of depression and (c) the tendency to create ‘silos’ of different areas of practice (mental health, child care, older people etc) [43; 44; 46; 48; 53; 54: 56].

The findings showed very high rates of maternal depression in child care social work caseloads (three + times that of postnatal depression), yet a very hit-and-miss capacity to identify or overtly to act on it. 

Further exploration explained this. The social construction of the women and their families’ situation was not one that gave primacy to psychiatric but rather to social narratives. This had profound implications for the conduct of practice.

This was the case with key participants, meaning that the reality as experienced by them was primarily socially rather than psychiatrically defined. In the case of the women their mental state was part of their social circumstances and relationships, rooted in their own personal social history which often involved longstanding, frequently horrific, narratives.

Likewise social workers did not construct depression in a conventional psychiatric way. Depression’s psychological markers were constructed as part of a psychosocial matrix meaningful in terms of legal responsibilities for child protection. The meaning of cases, from a theoretical point of view, therefore, related directly to Social Authorisation, in turn directly affecting practice behaviour. This did allow them to target generally those cases with maternal depression but responses occurred primarily according to assessment of dangerousness. Thus it was possible to group cases according to these narratives (troubled and troublesome, stoics and genuinely “depressed”) in a way that made sense of the intervention that took place, including the difference between child protection and other caseload cases. This I termed  a Psychosocial Matrix approach to the interaction of mental health and child care concerns [4; 43]. Innovative additional work I undertook with Dr Graham Crocker, responding to these key findings that social work did not construct depression in a conventional psychiatric way,  showcased a statistical approach to identify depression cases – in social work practice – within this psychosocial matrix. [43]. This used a combination of principle component and cluster analysis.

While, therefore, it was possible to identify the presence of depression – and of course it did not lose its pernicious effects, as evidenced in the research – practice was not carried out primarily with this in mind. Highest rates of maternal depression occurred in child protection. Indeed maternal depression, even in these high need families, was related to higher rates of psychosocial problems generally, often of long standing and reflected in their personal histories. But the absence of the centrality of depression in narratives meant that many families with depressed mothers did not get the support needed.

In general Children’s Services social work cases of families with depressed mothers were more likely to be more tenacious and difficult, present more danger to the children, and have poorer outcomes. There were often quite fundamental differences of perspective of the nature of problems and conduct of practice by social workers and mothers and this could generate anger and conflict. The presence of maternal depression was associated with poorer quality of partnership undermining the potential for good outcomes. This, in part, reflected the impaired coping capabilities of mothers with depression (compared with those without depression) which had a pernicious effect on them. In turn however, an intervention both relevant for depression and characteristic of practice – assessment and use of social support – was inconsistently and arbitrarily applied in these cases. Supports, and their lack were not always identified and generally applied haphazardly. 

Overall the findings showed these often to be hugely complex cases and amongst the most difficult in child protection.Two key underlying practice recommendations were made (amongst many detailed ones). First greater effort for the merging of mental health and child care expertise was necessary given the very high rates of maternal depression. Second the mother should be a greater focus for intervention. The interpretation of “welfare of the child is paramount” often meant a neglect of the needs of the mother even where she was the child’s last best hope. This is an unhelpful implicit ‘conflict of interest’ (between mother and child) assumption which could actually be counterproductive for both child and mother welfare.

Practice Recommendations (examples)

There were a host of recommendations. Among the more important were:

  • The prevalence of depression, and its pernicious effects on families, in child care social work cases is so high that departments should make specific provision to deal with it. 
  • Greater effort for the merging of mental health and child care expertise was necessary given the very high rates of maternal depression in child care social work practice
  • Ways of doing this include additional mental health training of child care social workers or seconding mental health social workers to child care teams
  • The interpretation of “welfare of the child is paramount” is an unhelpful implicit ‘conflict of interest’ (between mother and child) assumption (derived from a preoccupation with inquiries into child deaths. In practice the majority of cases involved no such level of threat. This often meant a neglect of the needs of the mother even where she was the child’s last best hope. This could actually be counterproductive for both child and mother welfare. Retraining of social workers to recognise when this ‘conflict of interest’ assumption is justified, and when not, would improve practice 
  • The mother should be a greater focus for intervention. As a woman with needs in her own right this should be expected. But additionally she is often the child’s last best hope, so helping her appropriately can help the child better. 
  • Depression damages the quality of partnership between mother and social worker. This is one of the many consequences of depression for which social workers should be prepared and able to counter

Another indicator of practice relevance – and influence – of this work came with the report I authored, at the request of the Irish High Court, of a very high profile family tragedy: Report for High Court Dublin. Inquiry into events leading to the Death of Catherine, Jennifer (aged 9) and Louise Palmer (aged 7) – while Catherine Palmer was under Psychiatric Care which led to its referral to the Irish Medical Council [90]

Prevention and Coping in Child and Family Care.  [3] [23] [24] [27] [28] [30]

This research project, carried out firstly with 102 participants, took the highly innovative approach of examining the issue of prevention at a stage before it was previously thought to commence, and encapsulated in its deceptively simple central question: when they have no available institutional support how do mothers cope in adversity? It does this by drawing upon intellectual traditions from two separate disciplines: Prevention (from social policy) and Coping (from Psychology). It both fundamentally expanded our conceptualisation of prevention as a process but also its nature by placing the women, their narratives and solutions centre stage (prevention was no longer simply about the provision of services for mothers but also that which mothers did unilaterally for themselves). It therefore profoundly changed the meaning of Prevention through its emphasis on women as active agents rather than mere service recipients. 

Regarding its relationship to my conceptualising social work, it related to the interactional-interface conception, in particular that between role and person, the former, as service applicant (role), the latter through the evocation of women as active agents (person). Likewise it explored empirically social work’s social location by identifying where, in practice, thresholds of need were such that families were not taken on to caseloads.

The research demonstrated first, the very high threshold of need and risk operating in order to gain access to social work services. Those not gaining access largely had multiple interacting psychosocial problems, and depression was a feature in a significant proportion of service applicants. A combination of in depth interviews and quantitative methods were employed with over 100 women referred but given no access to children’s services. Their  key focus was on child emotional and behavioural problems for which they blamed themselves (inducing a sense of low self worth), the father and the social environment. They were very aware of contextual factors impairing their coping. 

Women largely regarded direct coping (that done by themselves) as the most significant but this could mean mobilising relevant support. It took two forms, child controlling (crudely behaviourist in orientation) or child responsive (enabling the child to feel more secure and understood). Details of these coping strategies were examined and classified. 

Women had to cope not just with the problems (problem focused coping) but their feelings about them (emotion focused) as they were placed under considerable emotional strain. Their two main strategies were Avoidance (including denial and disengagement) and Adjustment (including acceptance of the situation, positive reinterpretation and growth).

Social support could be important, with its engagement generally originating in the actions of the mothers themselves. Informal support (friends, family, acquaintances) were one type. Some women had very depleted informal support and as a result had little to engage, while conflict could provide further problems. An important factor in soliciting support was the extent to which supporters agreed with her fundamental perceptions of the situation: disagreement often meant non engagement. Mothers (maternal grandmothers)  were the key informal supporters. Formal supports (institutions and agencies) tended to be seen as sparse or difficult to access and were far less utilised than informal. They constructed their own narratives, and judgements, of these. 

Women appraised their coping in different ways: outcome oriented judgements, as an ongoing process, a character issue (how good or bad they were), capacity to use supports and personal growth. 

Evaluation of outcomes (scale of problems, depression in the mother)  – with 69 participants- at 6 months follow up found that the majority of families situations had improved significantly without formal support, although a minority did not, or actually deteriorated [23] [24] [27] [28]. Good outcomes were associated with the availability of support networks, particularly the maternal grandmother, who was often a key supporter. However a key to this was the active engagement by the mother of these supports. In other words the mother was frequently the initiator of this support, and this strategy of Active Coping on her behalf was a key ingredient for improvement. 

The findings generally give clear indications of the best ways services may develop to to help these mothers cope, in particular engaging ways to develop her active coping capabilities (including personal growth and tackling depression) and finding ways to develop and engage social support – primarily informal.

A number of conceptual developments were made based on the findings and the fusion of concepts of prevention and coping. The most important of these was the concept of ‘Proto Prevention”. Prevention had previously been seen as actions taken by others on behalf of the women, with four levels, from primary to quaternary. This research introduced an earlier level, the surprisingly revolutionary focus on actions women undertook for themselves. As well as adding to our understanding of Prevention, this placed women at the centre, as conscious actors working on and influencing their own environment, rather than mere recipients of services.

Practice Relevance (examples)

  • The most fundamental point is the recognition of women as active agents in their own right. Even in adversity their resilience in the face of difficult problems is made manifest. Where engaging with women as service applicants practice should at core emphasise engaging their own coping capabilities, enabling them to define the issues and their resolution rather than the mere provision of services.
  • The findings generally give clear indications of the best ways services may develop to to help these mothers cope, in particular engaging ways to develop her active coping capabilities (including personal growth and tackling depression) and finding ways to develop and engage social support – primarily informal.
  • At the referral stage social workers should systematically establish the nature strength and reliability of the woman’s social supports. Where these are absent, particularly the absence of the maternal grandmother, they should be aware of the greater likelihood of deterioration (and hence likely re-referral  in a worse situation)
  • There is good evidence for recognising many of these women’s competence in finding ways of resolving their own problems. Particular attention to their sense of capability to gain control of their situation should be given when making assessments
  • Assessment of coping techniques can be made more systematically using frameworks derived from Coping theory and research. This should focus not just on problem focused coping, but emotion focused, which can play important parts in problem resolution 

The Preventive Process in Children’s Social Work and Social Care [14] [17] [18] [19] [25] [29] [30] [41] [44] [47] [50]

A persistent theme has been the examination of levels of Prevention – a context in which to place the roles of social workers and thresholds to which they operate. The Social Location of social work – the way it operates in practice, the way it is socially constructed in its operation, can be understood better in this context. In mental health this is reflected so far in the contrast between compulsory admissions and the community based work of mental health centres. In child care this is evident in the contrast between “unsuccessful” referrals and Proto Prevention in the Prevention and Coping project, and the tertiary and to some extent quaternary prevention in the depressed mothers study. The very high thresholds operating with tertiary and quaternary services makes examination of work at earlier stages of considerable importance.

In child care two key studies showed this “stepladder” [14; 18]. The comparison of innovative Education based Behaviour and Education Support teams with the work of social work children’s services covering the same area, and involving over 500 cases, showed the former (overall) to have a quicker response, to deal with child problems at an earlier stage, to be more child focused than  the more parenting focused children’s services. The therapeutic potential of social work was apparent from a repeat measures control trial of class based social work led social skills group designed to promote resilience in 9-10 year olds. This study, with E and C groups each of 40 children demonstrated the preventive potential of social work at early stage intervention with clear and sustained improvements in friendships and prosocial behaviour

Another context for earlier stage intervention is the work of children’s centres (CCs), where the focus was pre school, rather than school age focus of BESTs [19; 26]. Here the issue of access of vulnerable families to (secondary) preventive services was a key issue. This showed how the complex interplay between managers and existing service users influenced this access. A study of managers of over 20 CCs showed their culture and operation were affected significantly by the ‘preventive orientation’ of managers heavily influenced the type of service offered on one hand and on the other the gate keeping behaviours of existing service users, often from less vulnerable families, which could operate to limit or enhance the engagement with the more deprived target families.

The rung(s) of the ‘ladder’ of prevention on which social work is situated – therefore fleshing out the conceptual idea of the Social Location of social work – became apparent through a series of studies of maternal depression and associated psychosocial problems in different contexts [44; 47; 50 ]. A study involving over 800 women comparing social work with health visitor clients covering the same geographical area, showed the growth in incidence of depression from (1) lowest with women in families with no abuse concerns to higher with those with abuse concerns; (2) with seriousness of psychosocial problems;  and (3) transition from health visitor to social work caseload to child protection cases. The study of 701 health visitor clients showed the clear relation between maternal depression and child abuse and behavioural problems liable to bring them into the ambit of social workers. This was emphasised by the key social factors associated with depression: social and economic disadvantage, family size and history of family disruption. 

An ‘emerging gap’ between health visitors and social work services was identified. This effectively commended the work of CCs and BESTs. This was further confirmed by a study of 323 service users of four children’s centres [17]. Maternal depression was found to be a feature of a significant minority of service users (higher than health visitor caseloads but lower than that of social workers) and parenting stress and psychosocial problems were significantly greater in the depressed group. All told – from these and the maternal depression and prevention and coping projects – it is apparent that there is a clear hierarchy of both levels of maternal depression and psychosocial functioning problems as we ascend the ladder of Prevention from 11-13% on health visitor caseloads at one extreme to more than 40% on social work caseloads [25]. The ascending incidence is as follows: health visitor>family centre>referral to children services >social work caseload>child protection.

Practice Relevance (examples)

  • The gap identified in the HV study, between health visitor and children’s social work services means that BESTs and CCs provide a potentially crucial prevention role, complementary to those HV and children’s social work services
  • Evidence from CCs show significant rates of depression and associated psychosocial problems, higher than that in primary care HVs caseloads, providing an important potential setting for preventive work. In particular CCs provide a setting for combating maternal depression, a key health target, through social interventions. In view of its association with child care problems, this can improve the familial environment for children
  • This is consistent with CCs “mission” to target disadvantaged and vulnerable families. However they are likely not always to operate optimally because of the variability in managers preventive ideology and the restrictive gatekeeping of key service users. Therefore
  • Steps should be taken by relevant organisations to ensure the preventive ideology, and consequentially work of CC managers is consistent with provision of services to target groups
  • CC managers should work with key CC service users to ensure the CC culture is such that it encourages access for target group
  • BESTs form an important service tackling child care needs of school age children not dealt with by mainstream Children’s Social Work Services. Their widespread adoption would widen considerably the scope and relevance of services for children and families in need
  • There is evidence here that social workers undertaking class based social skills group work with 9-10 year olds have a positive impact, enhancing relationship, pro social skills and resilience. This indicates a preventive therapeutic social work role in this respect is appropriate and would help increase resilience in children. This is important and we should look to further initiatives and research to supplement this pathfinding work.
  • CCs and BESTs provide settings potentially at least as important as primary care for preventive work combating depression in mothers as well child care problems.

Prevention and collaboration with health professionals [6] [17] [25] [34] [60] [62] [63] [64] [65] [66] [67] [68] [69] [71]

The process of prevention and access to social work is also a feature of interactions with health professionals in primary care and mental health. What social workers do as an aspect of their Social Location, of its conceptualisation as Interactional, is influenced by how other key actors see them. Comparing the views of 118 health care workers (GPs, health visitors and district nurses)  there was general acceptance of the social work role, though at times ill informed in content, but frequent criticism of performance [66; 67]. However occupation and client group predominantly served were significant factors in perceptions held. Likewise GPs who had experienced attachment schemes (where social workers worked from the surgery) were more positive about social work and had a wider understanding of its role [66; 69; 71]. Research on over 180 general practitioners’ referrals where attachment schemes did not operate showed gaps in expectation and collaboration, in which details in GPs’ referrals were frequently considered lacking and the quality of inter professional collaboration was influenced by how positively social workers considered GPs viewed them [71].

Primary care also provides a key setting specifically for managing mental health problems relevant for social work. How this influences social workers’ social location is also influenced by setting . A comparison of 103 GP referrals to a mental health centre with 116 from informal supports showed GPs to emphasise medical problems and assessment, informal groups to emphasise therapy and advice [59; 62]. The pathway to care was different, with GPs’ referrals more likely to access psychiatrists and informal referrals social workers and CPNs. Occupational culture and philosophy of practice provides an understanding for social worker ongoing communication and collaboration with GPs. In a study of 120 GP referrals to a mental health centre social workers were less likely than CPNs to contact GPs routinely, but when contacted by social workers, GPs exerted greater influence on social work case management [62]. The contrast was made between the ‘routine’ in CPN engagement with GPs and the ‘purposeful ‘ characterising social work.

Social work involvement in compulsory admission assessments also crucially involves interaction with health professionals (at the time Approved Social Workers rather than Approved Mental Health Professionals were applicants). The study of 131 cases comparing GP referrals with other sources of referral showed where section assessments were the issue, psychosis, a history of mental disorder and more psychosocial problems were generally more apparent than in other GP referrals to the mental health centre [60; 64; 65]. The outcome, perhaps surprisingly, was that GPs’ referrals were less likely to result in admission. Admission tended to occur when problems were more unequivocally psychiatric, though not all psychotic patents were compulsorily, or even informally, admitted. There was some suggestion that GPs may have insufficiently explored alternatives to compulsory admission before making a referral.

Further examination of 120 cases showed that GPs referrals were consistent with a ‘mental health orientation’ noted earlier, whereas particularly from agency (rather than general public) referrals the issue of social insecurity in terms of support and deprivation was more prevalent [60]. Both emphasised the need for skills in psychosocial assessment in ASWs. This was emphasised in the apparently genderised nature of GP referrals who referred more women, with less emphasis on more severe (psychotic) problems and who were more frequently diverted from compulsory admission [63]. This raised the issue of the alarming possible use of sections for the social control of women. This need for gender awareness on the part of ASWs further embellishes understanding of both their social location and social work’s (multiple) interactional dimensions.

Practice Relevance (examples)

Much of this research is three decades old, so its lessons for practice, alongside that of others’ research, is generally well known.Three that arise specifically from this research

  • Social workers’ purposeful contact with GPs with mental health cases is an efficient approach but might be usefully complemented by routine information for GPs who have routine responsibility for individuals’ health care even as social workers are no longer involved
  • Social workers psychosocial assessment capabilities are crucial for the human rights of the patient and the professional quality of compulsory admission assessments, particularly in the light of GP referrals. The move to a wider involvement of AMHPs might be predicted to be counterproductive in this respect
  • Social work understanding of gender is a significant element of this professional assessment as the evidence suggests the possibility of GPs using compulsory admission referrals as a means for social control. This gender awareness and response must be a key aspect of social work practice with mental health sections.

 Other work

[71] [72] 

Rather left-field. Historical work on the electoral performance of the early Labour Party and the Electoral System within which it operated, with a novel focus on municipal elections. With routine turnouts of over 60% in the early 20th century, this entailed much higher participation than is the case today, and occurring annually, arguably gave considerable insight into the general popularity of political parties on a year by year basis. This (in the 1970s!!) was an innovative use of municipal elections as a means to indicate the electoral advance of a party

References

Books, 

1. Sheppard, M. (2006) Social Work and Social Exclusion: The Idea of Practice, Aldershot, Ashgate.

2. Sheppard, M. (2004) Appraising and Using Social Research in the Human Services: An Introduction for Social Work and Health Practitioners, London, Jessica Kingsley.    

3. Sheppard, M. (with Myrka Grohn) (2004) Prevention and Coping in Child and Family Care: Mothers Coping in Adversity with Child Care, London, New York, Sydney, Jessica Kingsley.

4. Sheppard, M (with Narkyza Kelly). (2001) Social Work Practice With Depressed Mothers in Child and Family Care, London, The Stationary Office.

5. Sheppard, M. (1995) Care Management and the New Social Work. London. Whiting and Birch. Social Care Association Education Series.

6. Sheppard, M. (1991) Mental Health Work in the Community: Theory and Practice in Social Work and Community Psychiatric Nursing. London. Falmer Press.

7. Sheppard, M. (1990) Mental Health: The Role of the Approved Social Worker. Sheffield. JUSSR. University of Sheffield Press.

8. Sheppard, M. (1982) Perceptions of Child Abuse: A Critique of Individualism.  Norwich. Social Work Monographs. University of East Anglia Press.

Original articles in learned (refereed) journals (most recent first).    

9. Sheppard, M., Charles, M., Rees, P. Wheeler, M. and Williams, R (2018) Interpersonal and critical thinking capabilities in those about to enter  qualified social work: a six centre study. British Journal of Social Work, 48,7, 1855-1873

10. Sheppard, M. and Charles, M. (2017) Personality in those entering social work training in England: comparing women and men, European Journal of Social Work, 20:2, 288-296, DOI: 10.1080/13691457.2016.1185700

11. Sheppard, M (2017) The impact of quantitative research in social work, European Journal of Social Work, 22,1,4-15 

12. Sheppard, M. and Charles, M. (2017) A longitudinal comparative study of the experience of social work education on interpersonal and critical thinking capabilities. Social Work Education, 30, 7, 745-57

13. Sheppard, M. (2016) ‘The nature and extent of quantitative research in social work: a ten year study of publications in social work journals’, British Journal of Social Work, 46 (6): 1520-1536

14. Sheppard, M. (2015) ‘Preventive therapy and resilience promotion: an evaluation of social work led skills development group work’, Child and Family Social Work, 20,3, 288-99 

15. Sheppard, M and Charles, M. (2015) ‘Heart and Head: An Examination of the Relationship between the Intellectual and Interpersonal in Social Work’ British Journal of Social Work, 45(6), 1837-1854

16. Sheppard, M. and Charles, M. (2014) ‘Editor’s Choice: Critical Thinking and Interpersonal Dispositions in Those Commencing Social Work Training’, British Journal of Social Work  44 , 7,: 2057-2066 

17. Sheppard, M  (2014) Identification of depression in children’s centre users’, British Journal of Social Work, 44, 1, 117-26 

18. Sheppard, M. (2013) ‘An examination of the preventive process: a comparison of Behaviour and Education Support Team work with Children’s Services’, Child Abuse Review, 22, pp 116-26

19. Sheppard, M. (2012)  ‘Preventive orientations in children’s centres: a study of centre managers’, British Journal of Social Work, 42, 2, pp 265-83  

20. Sheppard, M. (2010) ‘The Parent Concerns Questionnaire: A Reliable and Valid Common Assessment Framework for Child and Family Social Care’, British Journal of Social Work., 40, pp 371-91

21. Sheppard, M. and Wilkinson, T. (2010) ‘Assessing family problems: an evaluation of key elements of the Children’s Review Schedule’, Children and Society, 24, 2, pp 148-59

22. Sheppard, M., McDonald, P. and Welbourne, P. (2010) ‘The Parent Concerns Questionnaire and Parenting Stress Index: comparison of two Common Assessment Framework-compatible assessment instruments’, Child and Family Social Work, 15, 3, pp 345-56

23. Sheppard, M. (2009) ‘High thresholds and prevention in children’s services. The impact of mothers’ coping strategies on outcome of child and parenting problems: six month follow up’, British Journal of Social Work. 39, 1, pp 46-64.

24. Sheppard, M. (2009) ‘Social Support Use as a Parental Coping Strategy: Its Impact on Outcome of Child and Parenting Problems—A Six-Month Follow-Up’, British Journal of Social Work, 39, pp 1427-1446

25. Sheppard, M. (2009) Social Work and Social Care Research Contribution to the Health Agenda: Mental Health. London, Social Care Institute for Excellence. https://www.scie.org.uk/events/healthagenda09/Sheppard2.pdf

26. Sheppard, M., McDonald, P. and Welbourne, P (2008) ‘Service users as gatekeepers in children’s centres’, Child and Family Social Work, 13, 1, pp 61-71

27. Sheppard, M. and Crocker, G. (2008) ‘Locus of control, coping and Proto prevention in Child and Family Care’, British Journal of Social Work, 38, 2, pp 308-322

28. Sheppard, M. (2008) How Important is Prevention? High Thresholds and Outcomes for Applicants refused by Children’s Services: A Six Month Follow Up’, British Journal of Social Work, 38, 7, pp 1268-1283

29. Sheppard, M. and Clibbens, J. (2007) ‘Are Children with Learning Disabilities Really ‘Children First’? A Needs and Outcome Evaluation of Policy’ Social and Public Policy Review. Online journal 

http://www.plymouth.ac.uk/files/extranet/docs/SSB/Sheppard.pdf.

30. Sheppard, M. (2005) Mothers’ coping strategies as child and family care service applicants, British Journal of Social Work, 35, pp 743-759

31. Sheppard, M. (2004) ‘An evaluation of social support interventions with depressed mothers’ British Journal of Social Work., 34, pp 939-960 

32. Sheppard, M. and Ryan, K. (2003) ‘Practitioners as rule using analysts’, British Journal of Social Work, 33, 2, pp 157-77 

33. Sheppard, M. (2003) The significance of past abuse to current intervention strategies with depressed mothers in child and family care. British Journal of Social Work., 33, 6, pp 769-87

34. Sheppard, M. (2002) Mental health and social justice: gender, race and psychological consequences of unfairness’, British Journal of Social Work, 32, pp 779-97

35. Woodcock, J. and Sheppard, M. (2002) ‘Double trouble: maternal depression and alcohol dependence as combined factors in child and family social work’, Children and Society, 16, pp 232-45

36. Sheppard, M. (2002) Depressed mothers’ experience of partnership in child and family care, British Journal of Social Work, 32, pp 93-112

37.  Sheppard, M. (2001) The design, reliability and validity of an instrument for assessing the quality of partnership between mother and social worker in child and family care, Child and Family Social Work, 6, 1, 31-47 

38. Sheppard, M., Newsetad, S. Di Caccavo, A., and Ryan, K. (2001) ‘Comparative hypothesis assessment and quasi triangulation as process knowledge assessment strategies in social work practice’, British Journal of Social Work, 31, pp 863-85

39. Sheppard, M. & Watkins, M. (2000) The Parent Concerns Questionnaire: evaluation of a mothers’ self report instrument for the identification of problems and needs in child and family social work, Children and Society, 14, 194-206

40. Sheppard, M., Newstead, S., Di Caccavo, A., and Ryan, K. (2000) Reflexivity and the development of process knowledge in social work:  a classification and empirical study, British Journal of Social Work, 30, pp 465-88

41. Sheppard, M. & Crocker, G.(1999) Care management and information provision: towards a reasoned method of assessing the range and extent of problems and needs in child care social work, British Journal of Social Work, 29, 1, 69-97

42. Sheppard, M. (1999) Need as an operating concept: the case of social work with children and families, Child and Family Social Work, 4, 1, 67-77. 

43. Sheppard, M. (with Crocker, G.) (1999) The psychosocial ‘diagnosis’ of depression in mothers: an exploration and analysis, British Journal of Social Work.29, 3, 601-621

44. Sheppard, M. (1998) Social Profile, maternal depression and welfare concerns in clients of health visitors and social workers: a comparative analysis. Children and Society, 12, 125-35

45. Sheppard, M. (1998) Practice validity, reflexivity and knowledge for social work, British Journal of Social Work, 28, 5, 763-83

46. Sheppard, M. (1997) Double jeopardy: the link between child abuse and maternal depression in child and family social work, Child and Family Social Work, 2, 2, 91-109.

47. Sheppard, M. (1997) Depression in female health visitor consulters: social and demographic factors, Journal of Advanced Nursing, 26, 921-929

48. Sheppard, M. (1997) Social work practice in child and family care: a study of maternal depression. British Journal of Social Work, 27, 6, 815-47

49. Sheppard, M. (1997) The preconditions for a distinctive discipline of social work. Issues in Social Work Education, 17, 1, 82-89

50. Sheppard, M. (1996) Depression in the work of British health visitors: clinical facets, Social Science and Medicine, 43, 11, 1637-1648

51. Sheppard, M. (1995) Postnatal depression, child care and social support. Social Work and Social Sciences Review, 5, 1, 24-47.

52. Sheppard, M (1995) Social work social science and practice wisdom, British Journal of Social Work. , 25, 265-93.

53. Sheppard, M. (1994) Maternal depression, child care and the social work role, British Journal of Social Work. 24, 33-51

54. Sheppard, M. (1994)  Child care, social support and maternal depression: review and application of findings. British Journal of Social Work. 24, 287-310

55. Sheppard, M.(1993) Client satisfaction, extended intervention and interpersonal skills, Journal of Advanced Nursing, 18, 246-259

56. Sheppard, M. (1993) The external context for social support: towards a theoretical formulation of social support, child care and maternal depression, Social Work and Social Sciences Review,4,1, 27-59

57. Sheppard, M. (1993) Theory for Approved Social Work: The Use of the Compulsory Admissions Assessment Schedule, British Journal of Social Work, 23, 231-57

58. Sheppard, M. (1993) Maternal depression, child care and social work: the significance for research and practice. Adoption and Fostering, 17, 2, 10-17

59. Sheppard, M. (1993) GP and informal network referrals to a community mental health centre: an examination of the pathway to psychiatric care, Social Work and Social Sciences Review, 4, 3, 232-255

60. Sheppard, M. (1992) Referral source and process of assessment: a comparative analysis of Mental Health Sections, Practice, 5, 4, 284-299

61. Sheppard, M.  (1992)  Client satisfaction, brief intervention and interpersonal skills, Social Work and Social Sciences Review, 3, 2, 124-150

62. Sheppard, M (1992) Contact and collaboration with general practitioners: a comparison of social workers and community psychiatric nurses, British Journal of Social Work, 22, 419-436

63. Sheppard, M. (1991) Social work, general practice and mental health sections: the social control of women, British Journal of Social Work, 21, 662-684

64. Sheppard, M. (1991) General practitioners’ referrals for compulsory admission under the Mental Health Act, 1: comparison with other GP mental health referrals, Psychiatric Bulletin, 16, 3, 138-140.

65. Sheppard, M. (1991) General Practitioners’ referrals for compulsory admission under the Mental Health Act, 11: the process of admission, Psychiatric Bulletin, 16, 3, 141-143

66. Sheppard, M. (1987) Dominant images of social work: A British comparison of general practitioners with and without attachment schemes, International Social Work, 30, 77-91

67. Sheppard, M. (1986) Primary health care workers’ views about social work, British Journal of Social Work, 16, 459-469

68. Sheppard, M. (1985) Communication between general practitioners and a social services department, British Journal of Social Work, 15, 25-43

69. Sheppard, M. (1984) General  practitioners’ use of social services. Update:  The Journal of Postgraduate General Practice, 1431-1439.

70. Sheppard, M. (1984) Notes on the use of social explanation to social work, Issues in Social Work Education, 4, 27-42

71. Sheppard, M. (1983) Referrals from general practitioners to a social services department. Journal of the Royal College of General Practitioners (now British Journal of General Practice), 33, 33-40

72. Sheppard, M. (1981) The effects of the franchise provisions on the social and sex composition of the municipal electorate, 1882-1914, Bulletin of the Society for the Study of Labour History (now Labour History Review), 42, 19-26

73. Sheppard, M. and Halstead J. (1979) Labour’s municipal election performance in provincial England and Wales, 1901-1913, Bulletin of the Society for the Study of Labour History (now Labour History Review), 39-63.

Chapters in Books.   

74. Sheppard, M. and Ryan, K. (2015) ‘Practitioners as Rule Using Analysts: A Further Development of Process Knowledge in Social Work’ in  Social Work Research edited by Ian F Shaw (University of York, UK, University of Aalborg), Mark Hardy (University of York, UK) and Jeanne Marsh (University of Chicago), London,  SAGE Publications 

75. Sheppard, M., Huxley, P. and Webber, M. (2009) Mental Health Social Work’, in Briar-Lawson, K., Orme, J., Ruckdeschel, R. and Shaw, I. (eds) The Sage Handbook of Social Work Research, London, Thousand Oaks, California Sage. 

76. Sheppard, M. (2008) ‘Social Exclusion’, Editorial Board: Eduardo Bonilla-Silva, Philip Costanzo, Patrick L. Mason, Paula D. McClain, David Scott, Theresa Singleton International Encyclopaedia of the Social Sciences, New York, Macmillan.

77. Sheppard. M (2007) ‘Assessment’ in J. Lishman (ed) Handbook of Theory for Social Work Practice. London. Jessica Kingsley.

78. Sheppard, M. (2002) Mental health and social justice: gender, race and unfairness’. In Francis J. Turner (ed) Social Work Diagnosis in Contemporary Practice, New York, Oxford University Press

79. Sheppard, M. (1999) The Depression Social Assessment Schedule: design, development and use of an instrument for research and practice. In Ulas, M. (ed) Mental Health and Social Work. London. Jessica Kingsley.

80. Sheppard, M. (1997) The psychiatric unit. In Davies, M. (ed) The Blackwell Companion to Social Work. Oxford. Blackwell.

81. Sheppard, M. (1996) Primary health care: roles and relationships. In Watkins, M., Hervey, N., Carson, J. and Ritter, S. (eds) Collaborative Community Mental Health Care. London. Arnold

82. Sheppard, M. (1990) Social work and community psychiatric nursing. in Abbott, P. and Wallace, C. (ed) The Sociology of the Caring Professions. London. Falmer Press. 

83. Sheppard, M.  and Corney, R  (1989)  Social work, child care and general practice.  in Hart J and Bain, R. (ed) Child Care in General Practice. Third edition. London. Churchill Livingstone.

Articles in professional journals.   

84. Cooper, J, Sheppard, M. (2011) ‘What’s the score?’ Community Care, 7th July, pp 20-22

85. Sheppard, M. (2004) ‘Internal Affairs’, Care and Health Magazine. 65, May 11th, pp 25-6

86, Sheppard, M. (2000) ‘The depression factor’, Community Care, 23 Dec., pp 28-9.

87. Sheppard, M. (1991) Approved Social Work: Walking the Tightrope. Community Care, Dec. 5th. Supplement.

88. Sheppard, M (1990) ‘Society’s representatives’: social work and the Mental Health Act. Community Care, 19th June, 28-29. 

89. Sheppard, M. (1987) GPs’ reactions to social workers. Community Care, 23rd September. 19-20

International Report

90. Report for High Court Dublin.

Sheppard, M. (2001) Inquiry into events leading to the Death of Catherine, Jennifer (aged 9) and Louise Palmer (aged 7) – while Catherine Palmer was under Psychiatric Care. This led to its referral to the Irish Medical Council.

Edited Volumes: Learned (Refereed) Journals

Issues in Social Work Education

[91-112] Co-editor/Board of Editors 1990-2000: 22 editions of a length of about 130 pages. 

Social and Public Policy Review 

[113-124] Co-editor from July 2008-12: 12 editions

Practice:

Associate Editor:  1998-2003

Articles in professional journals

[125] Cooper, J, Sheppard, M. (2011) ‘What’s the score?’ Community Care, 7th July, pp 20-22

[126] Sheppard, M. (2004) ‘Internal Affairs’, Care and Health Magazine. 65, May 11th, pp 25-6

[127] Sheppard, M. (2000) ‘The depression factor’, Community Care, 23 Dec., pp 28-9.

[128] Sheppard, M. (1991) Approved Social Work: Walking the Tightrope. Community Care, Dec. 5th. Supplement.

[129] Sheppard, M (1990) ‘Society’s representatives’: social work and the Mental Health Act. Community Care, 19th June, 28-29. 

[130] Sheppard, M. (1987) GPs’ reactions to social workers. Community Care, 23rd September. 19-20

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