First draft (in progress): Jan. 5, 2015
***
“The difficulties of firing incompetent social workers, especially from public agencies, are too well-known to require extensive discussion. Many agencies rationalize or accept poor performance in terms of a worker's personal emotional situation. I have seen workers commit the most gross acts, miss work, and otherwise not perform. The only comment their supervisor made was that the worker was having a difficult time in analysis. Finally, social work's problems with evaluation are legion.” [Harris Chaiklin, “Honesty in Casework Treatment,” 1973, p. 273; full citation below]
“The difficulties of firing incompetent social workers, especially from public agencies, are too well-known to require extensive discussion. Many agencies rationalize or accept poor performance in terms of a worker's personal emotional situation. I have seen workers commit the most gross acts, miss work, and otherwise not perform. The only comment their supervisor made was that the worker was having a difficult time in analysis. Finally, social work's problems with evaluation are legion.” [Harris Chaiklin, “Honesty in Casework Treatment,” 1973, p. 273; full citation below]
***
1) Categories of VR Clients that are "Overlooked" or Under-served
1) Categories of VR Clients that are "Overlooked" or Under-served
The title phrase "Who Deserves to be Overlooked? (Within the
Vocational Rehabilitation Client Population)" was chosen to be deliberately provocative. All would agree that there is no person in this population who
“deserves” to be overlooked – though all would agree that there are individual
clients as well as classes of clients that are inadvertently (rather than
deliberately) overlooked. Yet, as I will argue, there are indeed categories of clients that
are quite deliberately treated as undeserving by a great number of Vocational
Rehabilitation practitioners. There are, of course, excuses and ideological
“justifications” available to be proffered for the bias that occurs.
It is natural that the seemingly
“most needy” and
“endangered” cases would attract special attention and given priority,
and that
those cases perceived by practitioners as requiring only slight
attention would
be categorized as lower in priority. It is also an obvious fact that the
total
population of persons in need of Vocational Rehabilitation services
exceeds the
resources that are currently in place. But there is a great hazard
inherent this state off affairs. There is an incentive to de-prioritize
classes of clients and this incentive can very well lead to unjust and
superficial interpretation of case types resulting in improper
marginalization of such classes or case types leading to direct and
substantial harm to clients that fit the category in question. Further,
incompetence of practitioners and even overt bias by them can be allowed
free reign to treat certain types of clients dismissively when they
fall into the "low priority" segment of the client demographic.
This article argues that there exist widespread problems in the
attitudes and perceptions of a large share of Vocational Rehabilitation
practitioners that create de facto categories of clients that are in effect are
misunderstood and misidentified as having slight needs for VR services and even
treated as persons presenting what is erroneously considered as pathological
mindsets when in fact the very mindset that is deemed improper or abnormal
should rather be seen as positive, healthy and normal.
In brief, the claim presented here is that social work
practitioners are liable in many instances to exacerbate the very problems they
are charged with offering solutions to. In particular the issue of stigma is
discussed here with the argument given that the client who is classed as “disabled”
under a variety of systems (including Social Security disability) is often
caused to have his or her stigmatization (in the perception of others as well
the client’s own) by the Vocational Rehabilitation process.
2) Vocational
Rehabilitation: Stigma Below the Surface
The problem of stigmatization has long been recognized as a
serious barrier for persons with disabilities, interfering their chances of
becoming both socially integrated and financially self-sustaining. A 2002
academic article describes the problem succinctly:
“Many people with serious mental illness are challenged
doubly. On one hand, they struggle with the symptoms and disabilities that
result from the disease. On the other, they are challenged by the stereotypes
and prejudice that result from misconceptions about mental illness. As a result
of both, people with mental illness are robbed of the opportunities that define
a quality life: good jobs, safe housing, satisfactory health care, and
affiliation with a diverse group of people. Although research has gone far to
understand the impact of the disease, it has only recently begun to explain
stigma in mental illness.” [Patrick W Corrigan And Amy C Watson, “Understanding
the impact of stigma on people with mental illness,” World Psychiatry. 2002 Feb; 1(1):
16–20.]
One might be surprised to hear the claim
that what we might can “non-serious” mental illnesses carry a damaging stigma
in certain contexts as well, which prevent successfully adaptive or recovering
and recovered persons with diagnoses of kinds that are not permanently
undermining of productivity from re-entering the workforce and re-establishing
financial independence.
3) Stigma
Expansion
Stigma expansion is the result of the inappropriate
influence on a client through the actions and behaviors of uninformed,
unqualified, incompetent and/or even pathological [note C, below] social
workers on clients. Stigma expansion results in worsening of both institutional
stigma (the reinforcement of social and economic barriers) as well as the
destructive phenomenon known as “self-stigma.”
Disability classification is, as we can all understand, a
stigma. VR professionals are aware that stigma is itself a barrier that can be
overcome only when perception is altered.
***
4) Categories of
Stigma Expansion
Here are several types of bias against VR clients by VR practitioners that have been observed by the author.
►Ambition
– A client's desire to maximize the use of proven and demonstrable aptitudes is met with
barriers, such as responses of superficial assessments, using, unjustifiably
and incorrectly when not based on careful and appropriate testing and interviewing)
such boilerplate labels as "grandiose," "pretentious,"
"unrealistic," and in the context of the popular "social
justice" ideology, as signs of "undeserved privilege" and
politically incorrect "entitlement."
►Intrinsic
aptitude (talent, IQ, generalist abilities) – An authoritarian and overly
bureaucratic mindset, common among government and "not for profit"
employees, prompts the reinforcement of the fallacy that
"credentials" and resume-backed experience are the definitive and
exclusive proofs of capability and vocational potential. The It is a
simpleminded notion – and a shockingly common one – that academic achievement
correlates with the “taking” of a certain number of college credits combined
with passing exams resulting from test-cramming and memorization skills,
without having, however, authentic and deep understanding and enduring learning
(which, by definition involves permanent devotion to learning backed by
personal curiosity and real aptitude).
►Nuanced
critical thinking – in a VR client is regarded as a sign of eccentricity and prompts less
qualified social workers to reach for autism spectrum diagnoses out of
confusion and lack of comprehension of high cognitive competence ("fluid
intelligence").
►Standards
– A VR client having strong work ethic, high standards of quality and execution, and using
careful detailed descriptions in order to insure accurate communication of work
requirements, are taken by many social workers (who are very frequently notably
lacking in careful and professional standards and in providing, timely,
properly documented and properly measured good quality results) are often
treated with the same response as those described in the "Ambition"
entry above.
5) Conclusion
5) Conclusion
It seems necessary to clearly identify and label the VR
practice problem (or group of related problems) that is touched on in this
article in order to counteract the VR practitioners’ inclination to engage in the
“overlooking” mindset described here – a mindset based on prejudice and
ignorance – which not only bars VR clients from receiving appropriate and
timely services that produce objectively desirable results but also increases
the clients objectively observable stigma (poor prospects for suitable, “maximizing,”
employment), but also can exacerbate self-stigma, leading to loss of trust,
withdrawal, and increased loss of self-esteem.
The distrust that is fostered in the heart of the client through experiences in the VR process is most likely, it goes without saying, liable to deepen distrust for the social welfare system in general and, when a client has repeatedly experienced poor treatment from incompetent and sometimes even hostile and openly biased (through the bias may be of a “politically correct” variety) from several practitioners, the client may develop extreme responses such as alienation, profound pessimism, alienation, withdrawal, and may even develop novel anti-social attitudes that previously did not exist or that are of a regressive (relapse) nature reversing previous gains in personal development (such as successful therapeutic gains).
The distrust that is fostered in the heart of the client through experiences in the VR process is most likely, it goes without saying, liable to deepen distrust for the social welfare system in general and, when a client has repeatedly experienced poor treatment from incompetent and sometimes even hostile and openly biased (through the bias may be of a “politically correct” variety) from several practitioners, the client may develop extreme responses such as alienation, profound pessimism, alienation, withdrawal, and may even develop novel anti-social attitudes that previously did not exist or that are of a regressive (relapse) nature reversing previous gains in personal development (such as successful therapeutic gains).
The newly coined labels used here ("overlooked," "stigma expansion") are merely provisional first thoughts,
meant only as a vehicle to assist in pointing to the problem under discussion, to
give a focused image allowing the argument to be put forth clearly, and to
facilitate its exploration and description. In other words, this is a first
look at a question that may well be improved upon and elaborated by others who
may offer better terms and a better description and analysis.
***
NOTES:
Quotations from
professional publications:
A) From Corrigan
et al, 2014
[Patrick W. Corrigan, Benjamin G.
Druss, and Deborah A. Perlick, “The Impact of Mental
Illness Stigma on Seeking and Participating in Mental Health Care,” APA
(Association for Psychological Science), Aug. 1, 2014]
Self-stigma
– These displays of discrimination can become internalized, leading to the
development of self-stigma: People with mental illness may begin to believe the
negative thoughts expressed by others and, in turn, think of themselves as
unable to recover, undeserving of care, dangerous, or responsible for their
illnesses. This can lead them to feel shame, low self-esteem, and inability to
accomplish their goals. Self-stigma can also lead to the development of the
“why try” effect, whereby people believe that they are unable to recover and
live normally so “why try?” To avoid being discriminated against, some people
may also try to avoid being labeled as “mentally ill” by denying or hiding
their problems and refusing to seek out care. [Corrigan et al, Aug. 2014]
Structural stigma
(i.e., stigma that is part of social and institutional policies and practices)
presents additional large-scale barriers to mental care by undermining
opportunities for people to seek help. A lack of parity between coverage for
mental health and other health care, lack of funding for mental health
research, and use of mental health history in legal proceedings, such as
custody cases, all present structural reasons that people might not seek
treatment. [Corrigan et al, Aug. 2014]
An intriguing
comment on the above: “Will overcoming associated stigma produce meaningful
results if the majority of “professional” care providers continue to be
ineffective at best and incompetent at worst? Please. The field is full of
flakes who need treatment as much or more than their clients / patients. I have
been a CADC since the late ’80s, an MFT since the late ’90s, and a Psy.D. since
the late ’00s. I have spent way too much time cleaning up messes made by
others, many of whom graduated from waaaaaay less than ethical degree mills.
Unless or until the “profession” catches up with the late Arthur Deikman et al,
I don’t see this changing.” [Not Moses ]
***
B)
From Official Proceedings, National
Conference on Social Welfare, 1973:
Pages 272-73: Goode's analysis of
the social utility of incompetence notes several factors that increase the
protection of ineptitude. External factors are: (1) a high demand for people to
fill a role; (2) a low supply of people to fill a role; (3) a sociopolitical
structure that keeps demand low; and (4) an organizational structure in which
incompetence does not reduce the administrative head's power. [8] Social work fits
this paradigm. It is chronically short of qualified people to fill its budgeted
positions. Except for certain subgroups in our society, the social worker's job
is not a highly valued position. The political structure does little to expand
the demand for social work. And few agency heads have ever lost their positions
because they had incompetent staff; conflict with the board is a more likely
reason. According to Goode, the following internal processes lead to the
support of incompetence:
1. The inept create a floor that protects the mediocre.
2. It is difficult to replace personnel, even the
incompetent, and this gives them bargaining power.
3. There are a variety of social circumstances in which less
than optimum output is acceptable.
4. "The less able are protected more in those types of
performances that are difficult to evaluate." [9] [notes 8 & 9; William J. Goode,
"The Protection of the Inept," American Sociological Review, XXXII
(1967), 5-19.]
Here too, social work closely
conforms to the model. Social work is an oversupervised profession. The usual
standard of one supervisor for as few as five workers not only testifies to the
inability of these workers to perform independently but means that many of the
most experienced workers do not see clients. Direct service is the core of any
profession, and its most competent practitioners should be thus engaged. This
is not the case in social work. The difficulties of firing incompetent social
workers, especially from public agencies, are too well-known to require
extensive discussion. Many agencies rationalize or accept poor performance in
terms of a worker's personal emotional situation. I have seen workers commit
the most gross acts, miss work, and otherwise not perform. The only comment
their supervisor made was that the worker was having a difficult time in
analysis. Finally, social work's problems with evaluation are legion.
***
p. 274 – This discussion began with talking about honesty in treatment and ends with talking about competence. The reason is that honesty in treatment is the basis on which the profession can build competence. Goode notes that "person professions" require mutual trust to accomplish their task and that to establish this trust requires professional autonomy.12 Clients and workers must be freed from the rigid bureaucratic structures and false behavioral slogans which protect the incompetent. When honesty returns to treatment, competent professionals will have little difficulty in demonstrating effectiveness. The clients will tell us and they will show us by their behavior.
[Harris Chaiklin, “Honesty in Casework Treatment,” pp. 266-274, in: Official proceedings of the annual meeting: 1973; National Conference on Social Welfare., National Conference of Social Work (U.S.), National Conference of Charities and Correction (U.S.), Conference of Charities and Correction (U.S.), Conference of Charities (U.S.), Conference of Boards of Public Charities (U.S.), American Social Science Association.]
***
p. 274 – This discussion began with talking about honesty in treatment and ends with talking about competence. The reason is that honesty in treatment is the basis on which the profession can build competence. Goode notes that "person professions" require mutual trust to accomplish their task and that to establish this trust requires professional autonomy.12 Clients and workers must be freed from the rigid bureaucratic structures and false behavioral slogans which protect the incompetent. When honesty returns to treatment, competent professionals will have little difficulty in demonstrating effectiveness. The clients will tell us and they will show us by their behavior.
[Harris Chaiklin, “Honesty in Casework Treatment,” pp. 266-274, in: Official proceedings of the annual meeting: 1973; National Conference on Social Welfare., National Conference of Social Work (U.S.), National Conference of Charities and Correction (U.S.), Conference of Charities and Correction (U.S.), Conference of Charities (U.S.), Conference of Boards of Public Charities (U.S.), American Social Science Association.]
C) From:
“Pathological or Inept Social Workers,” Direct
Social Work Practice, 2013.
“Despite educational preparation, some practitioners
demonstrate behavior that lacks the basic tenets of a helping relationship, for
example, a lack of empathy or being in tune with those seeking their help; a
lack of genuine and authentic concern; a lack of appreciation of different beliefs,
lifestyles, and values. Their inept behavior may be attributed to anxiety, a
lack of skill or experience, dealing with a problem beyond their scope of
practice, or an inability to build collaborative relationships with clients.
Ineptness and ethical practices on the part of social workers, such as
abrasive, egotistical, controlling, judgmental, demeaning, patronizing, or
rigid behavior can cause an appropriate negative reaction from clients.
In these interactions, clients’ reactions can become a cycle of escalating
conflict. For instance, a practitioner demeans an individual, an individual
reacts, and so forth. It is not unusual for the professional to attempt to
control by exerting his or her power and authority, which of course tends to
cause another reaction from the client. Being habitually late or unprepared for
appointments, appearing to be detached or disinterested, and under-involved are
further indicators of troubling behavior. Most people will react to behavior
that they view as disrespectful or unprofessional. In many cases, a
practitioner would not tolerate similar behavior in a client.
“Ineptness is a serious concern which calls for corrective
behavior on the part of the practitioner, through supervision, skill
development, or self-reflection. Pathological behavior on the part of the
social worker in which there is a sustained pattern of repeated errors,
insensitive behaviors can cause psychological damage to clients.”
[Dean Hepworth, Ronald Rooney, Glenda
Dewberry Rooney, Kim Strom-Gottfried, Direct Social Work Practice: Theory and Skills, 9th Edition (Brooks/Cole Empowerment Series), Brooks/Cole, 2013, pp.
556-7] (emphasis added)
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