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The male breadwinner model, which puts an emphasis on the household as the woman’s sphere and the workplace as the man’s sphere, no longer defines how most families divide labor between men and women (Crompton 2006). The increased participation of women in the labor market, along with technological change and globalization, have dramatically changed the structure of the labor market, and have most likely changed how workers balance their life between work and family. (copy)

Good as well: flexible working practices brought upon by an increasing need for work-life balance which have been largely if not wholly due to external forces that are beyond the control of organisations. However, all organisations operate and seek to support in the environments that are continuously subjected to change. These changes can have a marked effect on an organisation, its performance, even its survival. Meanwhile, time after time, organisations react to the drivers of change by taking short-term or knee jerk decisions that predictably have an effect on the way work is organised.

What is work life balance?

“Work life balance is employment based on emergent new values, which doesn’t discriminate against those with caring or other non- work responsibilities, and which provides an opportunity for people to realize their full potential in work and non work domains”. Lewis (1996:1)

According to a recent study by Georgetown University, employee stress from trying to find time for their children correlates with decreased productivity and increased absenteeism. The study found that unplanned absences were costing some businesses nearly $1 million a year.

Thus, HR specialists are trying in many attempts to help employees reach work-life balance by introducing new working strategies. One of these strategies is flexible working time. Flexible scheduling allows employees to adjust the time or place their work as completed. It can mean compressing 40 hours into four days, starting and ending workdays at different times, or doing some of your work at home. The reason may be as simple as wanting to better manage a long commute. Some parents choose to arrive at work later so they can take their children to school. Some companies may offer these options to retain female employees who might consider leaving their jobs after having children. But is it really that flexible time always helps to achieve work-life balance? Does employee prefer to manage his/her time or like to be committed to a specified timing because he/she may not be able to manage time, which leads to a more mess and imbalance? And which of these two options will increase the productivity?

This research brings together material from diverse sources to provide an overview of recent research, current thinking and future debates on the key work-life policy issues, especially those which affect organizations in Bahrain.

To build an informed policy debate on work-life balance issues in Bahrain, more Bahraini based research is essential.

Chapter Two – Literature review:

2.1 Work-life balance:

The (phrase) Work-Life Balance was originated as a consequence of the Family Friendly Policies that were introduced in the 1970s and 1980s in UK, primarily as a retention tool for women, and since then it has become a widespread concept. With this, they were for women and about women. To avoid the pitfall of being viewed as discriminatory and the need to bring a more, all-inclusive significance into these policies, they were renamed as work-life balance policies. Since the 1970’s, the UK Government has introduced several governmental changes to strengthen and to protect the rights of workers. In response to these changes, demands from employees as also from customers who want a larger “business window” a large number of organizations in the UK, have today introduced varied and innovative Work-life balance policies. The Government continues to play a key role in ensuring that (WLB) continues to gain momentum through legislation, financial incentives and support and promotion of best practices (Milburn, 2003).

** DTI (2003) Work and Parents: Competitiveness and Choice’ Department of Trade and Industry, London.

2.2 What is Work life Balance?

Meanwhile, the definition of ‘Work-life balance is about people having a measure of control over when, where and how they work (DTI, 2003). This is achieved when an individual’s right to a fulfilled life inside and outside paid work is accepted and respected as the norm, to the mutual benefit of the individual, business and society.’

work life balance emphasizes on the adjustment of working patterns, and it focuses on the need for everyone, regardless of age, race or gender, to find a pace (that suits them) to help them combine work with other responsibilities or aspirations. Work-Life Balance has an important underlying implication that Work-Life Balance is for everyone, not just for mothers or families and is critical in not just developing policies but also in reviewing them and their impact on employees (Alexandra, 2003), that’s why the idea that employers should enhance flexibility has been promoted recently.

Within the UK, The Prime Minister Tony Blair launched the Work-Life Balance campaign, in March 2000. The aim of the campaign was in two-fold. First, to convince employers of the economic benefits of work-life balance (this was done by the employment of real-life case studies). Secondly, to convince employers of the need for change (DTI, 2003).

Work-life concerns are simply added to an organization’s bundle of practices that are designed to benefit competitive strategy – to aid attraction and retention in tight labor markets, reduce high levels of absenteeism, and establish long-term relationships with employees based on commitment and productivity.

2.3 The need for a work-life balance

As individuals, are all expected to play multiple roles, i.e. employee, boss, spouse, parent, child, sibling, friend, and community member. In turn, each of these roles imposes demands on us that necessitate time, energy and commitment to fulfill. The conflict of work-family or work-life happens when the cumulative demands of these many work and non-work life roles are miss-assorted in some respect so that participation in one role is made more difficult by participation in the other role (Duxbry and Higgins, 2001). Duxbry and Higgins conceptualize work-life conflict to include areas such as, role overload (RO) (having too much to do and too little time to do it in) as well as role interference (when incompatible demands make it difficult, if not impossible, for employees to perform all their roles well).

Additionally, role interference can be divided into two factors: family to work interference (FTW) and work to family interference (WTF). With the first case, interference occurs when the roles and responsibilities of the family hinder the work related responsibilities (i.e., a family illness prevents attendance at work; conflict at home makes concentration at work difficult). With the latter case (WTF) interference occurs when work demands make it harder for an employee to fulfill their family responsibilities.

2.4 Background to Flexible Working Rights

In April 2003 employees in the UK were first given the right to request flexible working. In the modern work environment, the introduction of these new rights helped to point up that traditional working patterns could no longer be sustained by employers and that there was a need to address the work/life balance. Organizations – already facing skills shortages – would find recruitment and indeed retention made harder if a more flexible approach to working patterns was not adopted.

Suite of Rights

The flexible working rights which were established were significant in themselves, however, they formed part of a new set of rights which sought to create a more ‘family friendly’ work environment. Until April 2003, individual parental rights were primarily limited to maternity leave for a new mother giving her the right for a leave, the right for parents to take emergency time off for dependants (not just limited to children) and to take up to 13 weeks’ parental leave, which had been introduced in December 1999.

In April 2003, however, the following new rights were introduced:

The right to maternity leave was extended considerably so that, for the first time, all employees (regardless of their length of service) were entitled to 26 weeks’ maternity leave and those with more than a year’s service acquired the right to 52 weeks’ maternity leave.

Fathers also gained rights, albeit limited to 2 weeks’ paternity leave, on the birth of their child.

Extraordinary new rights were given to those seeking to adopt, with statutory adoption leave and statutory paternity leave, giving rights reflecting maternity and paternity leave, for adopting parents.

It is significant (and perhaps indicates the extent to which this Government is keen to support working parents) that the next item on the flexible working agenda, announced in 2004, is the possibility of allowing flexible maternity leave between parents; instead of only a mother having the right to take up to 52 weeks’ maternity leave, there is the vision of some limited swapping of the right to maternity absence as between the mother and father of the child.

Before these revolutionary new rights in 2003, the ability of any employee to work flexibly or indeed part-time was very much limited to circumstances where an employer agreed through good will or good practice to such an arrangement. Critics of the flexible working rights argue that the new provisions have not moved this position forward because all they provide is a right to request and to have that request considered seriously. Before they existed, however, there were only two circumstances where flexible working patterns of any sort could be enforced:

Firstly, where an individual was a disabled employee and could demonstrate that some form of adjustment to their working hours or duties and working arrangements amounted to a reasonable adjustment which their employer was grateful to make in accordance with the disability discrimination.

Secondly, and only as a way of challenging a refusal, female employees could argue that in respect of part-time working, a refusal to agree to part-time work was contrary to the sex discrimination. This is on the basis that it can be shown that a practice within an organization prohibiting part-time working (or indeed a practice allowing only full-time working) operates to the greater disadvantage of women than men and thus falls within the concept of indirect sex discrimination.

Why was it Implemented?

The history that reflects the flexible working laws introduced in 2003 goes back a number of years. In June 2001, the UK Government established a Task Force whose role was to consider specifically the issues which working parents face; in particular the Task Force was to consider how to assist parents in meeting their desire for flexible working patterns, whilst at the same time remaining compatible with the need for business efficiency and requirements.

The establishment of the Task Force was against the background of a voluntary campaign and Government funding to encourage employers and businesses to address work/life balance issues. In March 2000, the Prime Minister launched a campaign known as the Work/Life Balance Campaign with a view to persuading organizations to improve the lot of working parents in such a way as to nevertheless continue achieving business and customer requirements. The original campaign was not in fact focused upon parents, but looked at all employees regardless of whether they had caring responsibilities or not. It was significant, however, in recognizing that the attitude, culture and philosophy of workers had moved on considerably from the ambitious society of the 1980s and 1990s.

According to information from the Department of Trade and Industry, the Work/Life Balance Campaign was accompanied by a test fund which, in the run up to the introduction of legislative requirements and legal obligations, encouraged employers to introduce and develop innovative working arrangements. By helping to fund consultancy support, projects were undertaken with work/life balance in mind, including the introduction of new working patterns as well as specific recruitment projects. Over the three years from 2000 to 2003, the Work/Life Balance Challenge fund benefited employers to the sum of ?10.5 million.

In its report on 19 November 2001, the Government Task Force made nine recommendations to the Government, many of which were translated to form the basis of the new legislation.

In addition to the campaign and the recommendations of the Task Force, the Government had also informed itself of the views of the working population, through the issue of a green paper: Work and Parents: Competitiveness and Choice. This consultation paper was issued in December 2000. The responses to the consultation paper made clear that whilst improving maternity and indeed paternity rights (such as parental leave) would be of benefit to working parents, by far the most popular and indeed significant benefit was improved flexibility to meet childcare and work responsibilities. Armed with these responses and the Task Force report About Flexible Working, the Government tabled parts of the Employment Act 2002 which resulted in implementation of significant new flexible working rights, implemented through an amendment to the Employment Rights Act 1996 and two sets of regulations.

Demographic Changes

Demographic changes have played a significant role in impressing the need for organizations to develop more varied and non-traditional working patterns:

With the ageing population, many more people are finding that they have caring responsibilities such as looking after elderly or disabled relatives.

As we are all living longer, more individuals are becoming disabled, according to the Employers’ Forum on Disability in UK.

With the move away from extended families and as people become more mobile, so they are not living close to relatives and parents, those with children are less able to rely on grandparents or other relatives to help with child care responsibilities.

The percentage of women who have taken up employment has increased.

The trend for life expectancy, although different for men and women, has increased by roughly five years.

The Business Case

So much for the demographic changes, but there are also business benefits for organizations which offer new or more flexible working arrangements, particularly given the high skills shortage in the UK and more older people who themselves are keen to work but may prefer or indeed require more flexibility.

Employers may be surprised to know that for some individuals the ability to work flexibly is more important than the pay or benefits that a particular job may provide. In an online poll carried out by Reed Recruitment in conjunction with the Department of Trade and Industry in UK as part of its Work/Life Balance Campaign 2002, a third of those polled (out of 4,000 people) expressed a preference for having the opportunity to work flexibly, rather than having a ?1,000 pay rise (Reed.co.uk). Over 43% of the men who responded to the poll selected flexible working as the benefit they would most look for in a new job, compared to 13% who would look for a company car, and 7% who considered gym membership to be the priority.

Adopting family friendly and flexible working policies has the following advantages for employers:

Retention of staff is the key to the stability and knowledge of the organization. Knowledge is lost when somebody leaves and networks are broken. This can be critical in a small business where major customers can go elsewhere when an employee, who understands their needs and whom they trust, moves on to a competitor.

The typical recruitment costs of replacing an individual have been estimated at an average ?3,500, ranging from ?1,000 for an unskilled manual worker to over ?5,000 for a professional employee. These costs do not take account of the investment made in training (both formal and informal training) which is lost if skilled employees leave the workplace, as well as lost time and experience. Consequently, it makes commercial sense to try and retain staff rather than recruit new staff [Labor Turnover, Chartered Institute of Personnel and Development, October 2000].

Savings in absenteeism. Absenteeism costs approximately ?500 per employee a year. A quarter of employers rank home and family responsibilities as one of the five main causes of sickness absence.

Employers that help their employees to balance their work with their family lives see improvements in business performance (Cheibl, L. and Dex.S, 1998). It enables businesses to benefit from a greater contribution from the workforce and maximizes the contributions that working parents are able to make to their employers.

A strong track record in work/life balance can be a selling point to potential employees who consider that such a balance is important.

Many employers sees benefits from flexible working and leave arrangements including:

improved employee satisfaction and motivation

improved retention rates and recruitment benefits

increased employee productivity

reduced labor turnover

improved reputation

Reduced absenteeism.

All of which provide improved business results.

After having introduced the new rights for parents in 2003, a survey was conducted and analysis of how successful the new rights have been within the UK (Employment Relations Occasional Papers: Results of the First Flexible Working Employee Survey, Tom Palmer, Department of Trade and Industry). The outcome of that report demonstrated that one million parents had made requests for flexible working. That is only a quarter of those who are eligible, meaning that three million who could have made such a request have not done so. Perhaps significantly, it seems that employers when faced with such requests do not have any major difficulty acceding them. 80% of those employees requesting flexible working had their request agreed. The shortfall of those pursuing their new rights and the three million who have not, may be explained by the survey’s statistics which demonstrate that 52% of parents who are eligible are unaware in the first place that they have the right to request flexible working.

The Government has declared an intention to extend these new rights beyond parents with children under six. However, the success and significance of new rights such as these can only be measured when individuals become fully aware of their abilities. The fact that 10% of employees without dependent children were reported in the survey to have requested flexible working, suggests that there is a need on the part of individuals without children to gain this benefit. In organizations where requests were made, despite that individuals did not always have the statutory right, the reasons for the change warrant examination:

13% quoted work life balance

11% cited family responsibilities

11% simply because they wanted more free time (i.e. voluntary and not driven by childcare or family pressures)

7% because of travel arrangements

7% to meet the caring needs of relatives or friends

6% due to health problems.

As these statistics demonstrate therefore, an organization’s ability to offer flexible working arrangements provides a significant benefit to an extremely wide pool of actual or potential employees.

This may, however, just be the tip of the iceberg. What the survey does not analyze is how many individuals simply do not pursue a request. In the Equal Opportunity Commission’s Annual Report for 2003-2004 (available at www.eoc.org.uk) four in ten mothers, one in ten fathers and one in five carers have left an organisation or refused a job because of caring responsibilities. This suggests that there are many who do not have confidence in their organization’s willingness to accommodate them.

What Can be Requested?

The statutory request for flexible working, which must be in writing and must be dated (Regulation 4), can request a variation to the individual’s contract in one of the following ways:

a change to the hours of work;

a change to the time when the work is required (for example, the same eight hour day but an early start and early finish);

a change to the place of work as between home and place of business.

The statutory provisions do not go beyond these fairly focused and limited flexible arrangements. Nothing within any of the provisions appear to prevent the employee seeking a change to more than one of the above, for example to reduce hours and work from home.

What other scholars said:

Given the competing demands of work and life, it is unsurprising that many employees experience conflict between the two domains. Work-life conflict can affect any employee but people with care responsibilities are more likely to suffer most because of the greater demands on their time. Research has tended to find that mothers, particularly those with young children, are less satisfied with their work-life balance than other groups of workers (Saltztein et al. 2001).

Feelings of work-life conflict have been associated with, psychological and physical health problems; marital and family relationship problems, increased sickness absence and decreased life and job satisfaction (Evans and Steptoe 2002; Crouter et al. 2001;Westman 2001)

The effects of work-family conflict on organizational outcomes have been well documented in the management and psychology literatures. According to Netemeyer, Brashearaˆ‘Alejandro, and Boles (2004), work-family conflict is an inter-role conflict where job expectations interfere with family-related responsibilities.

The detrimental effects of work- family conflict on job satisfaction, employee retention, and psychological well-being have also been addressed (Brough, and Kalliath 2004).

Related to work-family conflict, identity theory suggests individuals possess certain life roles (i.e., work-family roles) that may conflict, thus creating a “spillover” effect (Thoits 1991).

When role clash occurs, the more valued role (i.e., family) takes precedence, and individuals are likely to instill protective measures to safeguard valued roles against potential damage.

According to identity theory, these defense mechanisms may be implemented at the risk of abandoning the conflicting role(i.e., work) (Thoits 1991). Consistent with this notion, a study based in the retail sales industry indicates that when salespeople encounter conflict between two salient roles (work and family), they tend to withdraw from the less salient work role through higher turnover in order to maintain the more valued family role (Netemeyer, Brashearaˆ‘Alejandro, and Boles 2004).

Work-life conflicts are seen to have a potentially detrimental impact on productivity, personal effectiveness, marital relations, child-parent relationships and even child development (Gornick and Meyers, 2003).

A review of the role conflict literature indicates that studies proposing links between work-family conflict and job satisfaction have also witness a dramatic increase. For instance, the majority of studies have shown that work-family conflict is associated with decreased levels of job satisfaction (Adams and King 1996).

Employers do realize that employee stress is partially due to the challenges in balancing work and family (Matusicky 2003). A good balance between work and family life has been said to benefit employers, as it is linked to better life satisfaction and subsequently to workers being more productive, creative and efficient (Zelenski, Murphy and Jenkins 2008).

Numerous studies have demonstrated that employees who are dissatisfied with their jobs are more likely to engage in organizational deviance behaviors such as working less hard, absenteeism and company theft (Lau, Au, and Ho 2003). A recent meta-analysis on the effects of ethical climate suggests that job dissatisfaction poses a significant threat to organizations due to its intensifying effects on dysfunctional behavior (Martin and Cullen 2006).

Drew et al.,(2003) believes that a number of factors might encourage employers to adopt policies to promote work-life balance. These include the business case for such polices such as a lower staff turnover, reduced absence and improved productivity, as well as changes in human resource management and changes in technology that enhances opportunities for working from home. Another key factor is increasing demand for greater flexibility from employees.

All reviewed research results show positive effects of flex-time on the work-family balance. Flex-time workers with children under the age of 18 report “lower levels of time pressure”, and a “higher level of job and life satisfaction” than do their non-flex counterparts (Zuzanek 2000). Flexible work hours are associated with more satisfaction with family life (Jekielek 2003) and a reduction in perceived time stress (Tausig and Fenwick 2001). Analysts Comfort, Johnson and Wallace (2003) also found flex-time to be related to increased job satisfaction, increased satisfaction with pay and benefits, and a reduction in paid sick days. All of these relationships appeared slightly stronger for women.

Over one-third of Canadian employees report having flex-time schedules (Comfort, Johnson and Wallace 2003).The proportion of those who reported having flex-time arrangements is higher among men than among women and is mainly found in small establishments, non-unionized settings, low-skill occupations, retail and commercial industries.

A research on flexible working in Ireland has found these arrangements are more common in the public than in the private sector and that, women make use of them more frequently than men (Drew et al., 2003). Gender and the public/private sector distinction are two key factors in the analysis of the effects of flexible working.

The measure of work-life conflict captures tensions between work and family commitments. In this research I want to investigate whether flexible working arrangements facilitate a work-life balance and reduce work pressure.

This budget has the Healthcare For All Hospital Trust in good standing at the end of the next fiscal year. Potential problems could arise however, if the macular degeneration developments do not come to fruition. In that case, the hospital would have a choice: meet the target cuts, and be in debt, or do not aim to make the hospital’s target cuts. Small cuts could be made for the fiscal year of 2010-2011, while developing other revenue-generating projects such as the macular degeneration facilities.

This report deals with the financial implications of creating a more sustainable way of providing health care to individuals with learning disabilities, as highlighted in Sir Jonathan Michael’s 2008 report into access to healthcare services by people with learning disabilities, entitled ‘Healthcare for All’. This report aims to briefly review a variety of issues on sustainable funding for healthcare, both from the point of view of a local Primary Care Trust (PCT) as well as the central Health Care for All hospital trust. The first section of this paper, entitled ‘Changes in Healthcare Demand’ focuses on the changes in patient demands for services, especially those instigated by the Payment by Results and Patient Choice reform measures. The paper then moves onto a section entitled ‘Possible strategies for managing demands,’ which examines what possible strategies exist for managing those changing demands. Potential systems for sustainable healthcare funding are then examined in the section entitled ‘Sustainable Healthcare Funding,’ where these issues are addressed form both the PCT and Healthcare for All points of view. The consequences for budgeting for these programs are examined under a section entitles ‘The Behavioural Aspects of budgeting and performance management.’ The final section examines how financing could be altered to produce a more long-term fiscal health in the NHS, entitled ‘A More Sustainable Way of Funding the NHS’. Through this summary, this report, using financial and qualitative analysis, aims to provide an overview on ways in which a variety of problems within the UK health sector could be solved.

People with learning disabilities have traditionally not been thought of as a group that needs special access to healthcare. However, recent research has demonstrated that this sub-group of society often finds it more difficult than others to access the care they need.

‘The health and strength of a society can be measured by how well it cares for its most vulnerable members. For a variety of reasons, including the way society behaves towards them, adults and children with learning disabilities, especially those with severe disability and the most complex needs are some of the most vulnerable members of our society today. They also have significantly worse health than others. The Inquiry has found convincing evidence that people with learning disabilities have higher levels of unmet need and receive less effective treatment, despite the fact that the Disability Discrimination Act and Mental Capacity Act set out a clear legal framework for the delivery of equal treatment’. (Healthcare for All 2010)

New research shows that many people who have learning disabilities find it more difficult than other people to access the facilities where they can have treatment and assessment performed for general health problems, those that are not directly related to their disability. New demands to solve this problem include increasing support that these people have in accessing equal treatment, as required by the Disability Discrimination Act. Adjusting whenever necessary communication patterns in case such an individual demonstrates a difficulty in understanding, or exhibits apparent anxieties about their treatment.

This is seconded by people who work within the secondary care providing industry, who claim that their opinions are often ignored by healthcare professionals, despite the fact that they have the best information about the people they support. These practitioners are not offered the same support as hospital workers are, and they are often required to provide care beyond their personal

resources.

Health service staff, particularly those working in general healthcare, appear to know only limited amounts about learning disability, not understanding how this could affect the way healthcare is accessed and delivered. They are often unfamiliar with the regulations framework, and often they do not understand that a right to equal treatment also entails a right to equal access and equal understanding. Communication problems, and cognitive impairment that is often associated with learning disabilities are now on the fore front of reorganization schemes in the NHS.

Emerging demands include simple training to increase and facilitate communication between patients suffering with these problems and doctors and other practitioners. Healthcare for All hospital trust and local PCTs may approach these new demands differently.

Possible strategies for managing demands

Payment by Results

Payment by Results (PbR) aims is to provide a regulated, transparent, system that paying trusts employ. In theory, PbR will reward efficient work, as well as support a variety of patient choices and will work to encourage waiting time reductions through sustainable measures. In this model, payment is adjusted to the activities engaged in, and is then adjusted for each casemix. This system ensures a fair and equalized basis for the distribution of hospital funding rather than relying principally on the negotiating skills of particular individual managers.

In July 2000 the NHS introduced the Government’s intention to establish link in the fund allocation process between the treatments they perform and the funds they receive. In order to ensure that patients and hospitals receive the best from available resources, major changes were and still are necessary for improving the way that money flows through the NHS, accounting for things such as differentiation between routine surgeries and emergency admissions.

In this model, hospitals will now receive payment based on the elective surgeries they choose to perform. These reforms of the financial system offer incentives that reward good performances while sustainably reducing variables such as waiting times, and other hindrances that shorten capacity.

Traditionally, hospitals have been paid in block contracts. This means that a fixed sum of money is delegated for a broadly specified type of service, rather than for the number of services performed itself. This meant that there was no incentive for healthcare management to increase numbers of services offered, because they would get no additional funding. In this newer system, hospitals are encouraged to perform more procedures, more tailored to patients’ needs.

Patient Choice

The Government is developing programs whereby patients have more choice and control over their treatment practices and care. In the NHS Constitution this is referred to as ‘patient choice,’ which now designated that patients have the right to choose a health practitioner based on a first referral, to any consultant service for elective healthcare.

For patients with long-term conditions, this need for more choice is particularly relevant. The different results include enabling the individual patients to identify whichever of their specific needs should be regarded, and agreeing in advance as to desired outcomes, care arrangements and personalized attention. This entails bringing patients in during the planning process, and ensuring that the pre-agreed care plans allow individuals to self care, including those who opt for supported living or tailoring other social care needs in order to maintain independence.

Sustainable Healthcare Funding

How can all of these adaptations for increased care and provisions be funded in a realistic way? An adequate budget assessment is the first step to assessing this situation.

Zero-based budgeting is a technique that involves planning and decision-making, reversing the working process of more traditional budgeting techniques. Unlike using the incremental approach of traditional budgeting zero-based budgeting would require a total overhaul of each individual departmental budget, examining them all ‘from scratch’. Because each dollar is laid out across an entire organization, and budgeted funds can be moved across departments to meet targets, it provides a more holistic approach to mega-organisations, such as the NHS.

This budgeting technique works best for the needs of the NHS, which would allow for a more efficient allocation of all resources across all regions and departments. Managers of each department and hospital could look broadly to find cost effective ways to improve operations. Inflated budgets are more easily noted when they are examined in a group rather than independently. This system is also particularly useful for service departments where the output is difficult to identify, and looking across budgets could show where these shortfalls lie.

In theory, one of the results of zero-based budgeting would be an increase in staff motivation. This is because it provides greater opportunity to demonstrate and develop initiative and responsibility in decision-making. Communication and coordination across diversified institutions can also be encouraged by being forced to come together to create an annual budget. Outsourcing can be easier to implement than it would be, if it were done on a per-department basis. Overwhelmingly, zero-based budgeting forces organizations to centralize and identify their mission and their relationship to overall goals.

But there are disadvantages to this method of budgeting as well. Zero-based budgeting can present difficulties for defining ‘the units of decision-making’ because it is so time-consuming and exhaustive. This method also makes it necessary to train managers in a particular format. Because it must be clearly understood by all different managers at various levels in order for it to be successful. In a large organization, such as the NHS, the sheer amount of documentation may be so excessive that no single overseer could read it comprehensively.

Budgetary slack could be a helpful tool; by overestimating costs and underestimating available funds, it should require a tight budget for the new fiscal year. referring to budgetary bias, is a common process where an implementer intentionally underestimates revenue or overestimates expenses in the tight budget. Managers may attempt to create budgetary slack in three ways.

The Behavioural Aspects of budgeting and performance management

The behavioral aspects of budgeting make up a highly important factor in successful ¬?nancial management. It is important for managers to develop the skills and techniques that help to develop and sustain e¬ˆective control over the people involved in budgeting, and the budget itself, including income and expenditure.

Effectively managing budgetary controls can use a system that relies heavily on individuals within a particular organization. The human aspects of developing, controlling and implementing a particular budgetary system can be nearly if not more complex than the financial aspects of managing a budget, but they are essential. All processes related to spending organizational money, and budgeting those expenditures involve relationships between the di¬ˆerent people who work within the organization. These can be managers, general employees as well as directors of the whole organization. Chadwick (1993) writes that budgets are actually best approached as models ‘designed to a¬ˆect people’s behavior,’ and they cannot be separated from this aspect.

A More Sustainable Way of Funding the NHS

Whether the NHS continues on into the future or not will depend on choices that the government makes. These choices relate to funding, and efficiency. Changes to the present system that is in place could present challenges, but they would still be possible with more resources being spent in producing a greater understanding of both the national and the regional effects of NHS policies. This could result in health authorities being given increased amounts of responsibility in managing their money. This would need to go along with a system of penalties for those who failed in making their facilities more efficient. This would work if policies that check the cost effectiveness of new developments and equipment were used at the facilities. The central NHS planners and policy makers could attempt to reduce the demands from the unrealistic expectations clients and patients demonstrate, by implementing spaces and venues for public debate focusing on establishing priorities and the availability of all healthcare resources, including private health care.

There is much emphasis on how the supply side of the NHS affects the cost, and very little on how managing demand will improve the system. Increasing the number of people who use the NHS as well as increasing the speed at which they are seen is simply unfeasible. aˆ?The cost to the NHS of bad habits related to health choices amongst its users amounts to between 5 and 60 billion pounds a year, depending on whether loss of productivity and other factors are accounted for. This cost is largely preventable, but only in looking at the NHS as part of a wider context. It is in everyone’s interest, especially the NHS staff whose jobs may be in threat, to find ways of helping to reduce these costs. So while much of this report has focused on inter-NHS practices, there is an emerging focus on managing people’s health outside of the healthcare facilities. aˆ?

The NHS Alliance has found 3 key points to affect health costs and budgeting. 1.

‘Effective local delivery requires effective participatory decision-making at local level. This can only happen by empowering individuals and local communities, to which we would add local frontline staff.aˆ?aˆ?2. Create fair employment and good work for all…one of the most effective ways of increasing productivity is by valuing the workforce and improving their health through greater security and flexibility in employment.aˆ?aˆ?3. Increase availability of long-term and sustainable funding in ill health prevention across the social gradient. Let’s have a focus on landscape gardening rather than short-term bedding plants.’aˆ?aˆ?(NHS 2010)

Conclusion

The NHS is one of the biggest government institutions on the world, and deals with the health and healthcare provisions of millions of people each year. With constantly developing technologies, as well as government economic crises, it is very difficult to develop a system through which this huge machine could successfully be funded, without bringing about any debts.

This research considers the application of feminist thought in social work practise. Specific areas of consideration include the gap from social workers’ personal acceptance of feminist constructs and their use of such constructs in daily practise, the effects of perpetuation of hegemonic gender roles by social workers, and domestic violence victims perceptions of the effectiveness of social work based on the perspectives of their social workers as considered above. This research further describes a focus group of college social work students who are also domestic violence victims.

It records their perceptions of social workers’ worldviewsand the impact of such on service. Conclusions include that there is asignificant gap between the understanding or acceptance of feministconstructs amongst social workers and its application in daily fieldpractise, that social workers are often likely to perpetuate hegemonicgender roles, and because of such perpetuation view domestic violencesituations as individual occurrences rather than part of a greatersocietal pattern of oppression, and that domestic violence survivorsfeel best served when work with them uses a feminist theoreticalframework.

INTRODUCTION

Feminism and social work have been associated for many years; however,although many social workers personally espouse working from a feministperspective, the systems of social work still favour work from atraditional or patriarchal perspective. This research, therefore,seeks to first consider findings from previous study regarding thisphenomenon and the theoretical frameworks for both social work andfeminist thought. In this light of information gleaned from thesefindings, it became apparent that hegemonic gender roles, a commontopic of feminist research, play a relevant part in work with survivorsof domestic violence. Specifically, domestic violence survivors areoften directed, either explicitly or implicitly, that their situationis personal and should be considered and dealt with from a personal andpathological perspective rather than applying the tenets of feministthought that view such situations as manifestations of structural andpower problems in our greater society.
This study then seeks to document whether this gap between social worktheory supportive of feminist worldviews and social work application ofpractise exists, and if so, how prevalent a gap it is. This isaccomplished through use of a focus group of college students, all ofwhom have taken at least one course in social work theory and arethemselves domestic violence survivors who have been served, towhatever level of quality, by social workers. Discussions within thefocus group involved ideas of gender roles and social worker advocacyof hegemonic gender roles, whether explicit or implicit. The focusgroup then built on this foundation to consider group participants’experiences with social workers and whether they presented anindividual / pathological perspective of domestic violence, or whetherthey presented a perspective that consider the wider influence ofsociety and its systems. This was further related to the effect ofsuch perceptions on the understanding of and service to groupparticipants at the time of intervention.

LITERATURE REVIEW

Feminism has emerged in the past thirty years as a viableworldview. Dietz (2000), quoting Bunch (1980), defined feminism as“transformational politics that aims at the dismantling of allpermanent power hierarchies in which one category of humans dominatesor controls another category of humans” (372). “In the feminist andempowerment traditions, the personal is political, and individualchange and social change are seen as interdependent” (Deitz 2000,372). Feminism contends it is not adequate to simply include women inthe world’s political and power systems, as these were designed by andfor men and therefore favour a highly masculinised mechanism forresponding to issues and require women working within these systems todo the same (Scott 1988, Moylan 2003). Simply including women is notenough; society must give women’s experiences equal time andconsideration, eventually recasting the very meanings of the topics itconsiders (Scott 1988). Rather, feminism argues women must be engagedin both the system development and decision-making processes that shapeour society (Moylan 2003).
Consequently, one area where feminism has particularly challengedtraditional views is in the area of gender roles. For example,Dominelli and McLeod (1989) examine the way in which social problemsare defined, recognising gender as particularly important inunderstanding client groups, and stress egalitarian relationshipsbetween therapists and clients. Gender is also an importantconsideration of social work due to the patriarchal society that stilldominates most of our world. This power framework rests on a basis ofhegemonic masculinity (Cohn and Enloe 2003). Connell (1995) createdthe term ‘hegemonic masculinity’ to describe the valued definition ofmanhood in a society. He argues that whilst there are multiplepossible masculinities in a culture, only one or a few are most valuedor considered ideal (Connell 1995). This gender definition isconstructed both in relation to femininity and to other, subordinatedmasculinities, and is used to justify both men’s domination of women,and the hegemonically masculine man’s power over other men (Cohn andWeber 1999).
Whilst women are increasingly being included in world systems, thesystems themselves still were designed for and operate by and for men. Therefore, women who participate within the system must do so from maleparadigm, even if it is sometimes at odds with their own preferencesfor how to go about dealing with a situation (Cohn and Enloe 2003).
Feminism historically is a “critique of male supremacy, the belief thatgender order was socially constructed and could not be changed” (Cott1989,205). Masculinity is often defined as what is not feminine, andfemininity as what is not masculine, although understanding thedynamics of one requires considering both the workings of the other andthe relationship and overlap between the two (Cohn and Enloe 2003). Masculine definitions are often based on strength, domination andviolence, whilst feminine on weakness, nurturing, compassion andpassitivity (Rabrenovic and Roskos 2001). The result is pressure onmen adhering to a hegemonic definition of masculinity to view forms ofaddressing conflict other than a physical or “masculine” response asfeminine and a threat to their manhood (Moylan 2003).
The popular concept of gender holds that “masculinity” and “femininity”are unchanging expressions based on the chromosomal male and femalebodies (Butler 1990). “Gender is assumed to be ‘hard-wired,’ at leastin part” (Hawkesworth 1997). Masculine actions and desires for men andfeminine actions and desires for women alone are normal, thesemasculine and feminine traits are not a matter of choice, and allindividuals can be classified as one or the other (Hawkesworth 1997). However, whilst our society men are considered strong and dominant, andwomen passive and nurturing, “the meanings of male and female bodiesdiffer from one culture to another, and change (even in our ownculture) over time” (Connell 1993, 75). For example, there have been“periods in Western history when the modern convention that mensuppress displays of emotion did not apply at all, when men wereeffusive to their male friends and demonstrative about their feelings”(Connell 1993, 75). “Masculinities and feminities are constructed oraccomplished in social processes such as child rearing, emotional andsexual relationships, work and politics” (Connell 1993, 75).
Feminism, however, contends gender is a constructed by each culture,and as a social practice involves the incorporation of specificsymbols, which support or distort human potential (Hawkesworth 1997). Gender is created through “discursively constrained performative acts,”and the repetition of these acts over time creates gender for theindividual in society (Butler 1990, x). People learn to “act” likewomen or men are supposed to; women are taught to behave in a femininemanner, men are taught to act in a masculine manner. This is oftenreinforced by authority figures, such as social workers. Barnes (2003)cites a number of studies which find social workers often assume the“disciplinary gaze” of notions of “what and how to be woman,”perpetuating traditional gender roles (149). “Armed with rigid codesof gender appropriate behaviors, social workers often sought toregulate and mediate women’s interactions with the social, economic,and political world” (Barns 2003, 149).
Feminism and social work share a number of similarities. Both believe“in the inherent worth and dignity of all persons, the value of processover product, the appreciation of unity-diversity, the importance ofconsidering the person-in- environment, and a commitment to personalempowerment and active participation in society as a means to bringabout meaningful social change” (Baretti 2001, 266-267). Similarly,both feminism and social work address multiple approaches to handlingsituations, challenging the institutionalized oppression common in manypower structures and supporting “the reconceptualization andredistribution of that power” (Baretti 2001, 267).
It follows that one impact of feminism on social work practise is theconsideration of issues from a societal rather than personalperspective. For example, this might include viewing a domesticviolence situation not from the perspective that the family isdysfunctional, but from the perspective of the society that created thefamily. The psychology-based focus of clinical social work “oftenleads to individualizing social problems, rather than to viewing themas the result of relations of power, primarily oppression and abuse”(Deitz 2000, 369). As such, individuals experiencing such difficultiesare “taught” that their particular experiences are inappropriate,rather than addressing the systems that created the difficulties in thefirst place (Deitz 2000, 369).
Dominelli and McLeod (1989) re-evaluate social work practice from afeminist perspective, considering the functions of social work such astherapy, community interaction, and policy making not from apathological standpoint but from one of defined roles endorsed bysocietal conditions. As such, they contend that working from afeminist perspective allows the social worker to address the causes ofsocial issues, rather than the symptoms played out in individual’slives (Dominelli and McLeod 1989).
One area of difference in social work practise between those operatingfrom a feminist framework and a traditional framework is the concept ofdistance. Traditionally, the “patriarchal bias against relationalityand connection” is intended to lead to “connection without harm, lovewithout power abuse, touching without sexual abuse in psychotherapy”(Deitz 2000, 377). Unfortunately, in practise it often results in“power over” relationships where those receiving services feel “lessthan” those providing them. “Healing happens when someone feels seen,heard, held, and empowered, not when one is interpreted, held at adistance, and pathologized” (Deitz 2000, 377). Deitz (2000) finds thatsocial workers often institutionalize a “power over” stance fromprofessional training and discourse that constructs the identities ofclients as somehow disordered, dysfunctional or impaired. “Whetherbetween parents and children; physicians and patients; social workersand consumers of services; Whites and Blacks; or heterosexuals andlesbians, gays, bisexuals, and transgendered persons, power overrelationships give the dominant partners or group the right to definethe meanings of subordinates’ experiences (including their resistance)and thus their opportunities for self-affirmation” (Deitz 2000,373).This creates professional relationships that ignore theenvironmental, historical, and social contexts of the problem, discountpeople’s strengths and resilience in assessment and intervention, andlead “to the objectification of people as diagnoses, rather than toempowerment” (Deitz 2000, 370). “The keys to empowerment in feministmicro practice are reconnection and transformation through politicalactivity; survivors of oppression and abuse experience reconnectionthrough relationships based on mutuality, collaboration, andtrustworthiness” (Deitz 2000, 376).
Theories from social work, psychology, and particularly developmentalpsychology describe empowerment as primarily a process, with thepersonal transformation of the individual becoming empowered at itsfoundation (Carr 2003, 8). Barriers to empowerment and problems ofdisenfranchisement caused by powerlessness are primarily political,rather than psychological. Powerlessness is defined as the inabilityto effectively manage one’s emotions, knowledge, skills, or resources;it is “derived from the absence of external supports and the existenceof ontological “power blocks” that become incorporated into a person’sdevelopment” (Carr 2003, 13). As such, many survivors also work toreconnect to others in their communities, often seeking politicalactivity that “emphasizes the empowerment of others, such as byorganizing Take Back the Night marches or speak-outs, volunteering forcrisis hot lines, seeking legislative changes, or becoming socialworkers or human service professionals” (Deitz 2000, 376).
For example, feminist work with abuse survivors “emphasizes therelationship between abuse and oppressive social relations (Deitz 2000,374). On the other hand, the dominant clinical social work approach tooppression and abuse relocates the problem of oppression in victims.Psychological theories are typically employed, which “locates pathologyin individuals, rather than in oppressive relationships and systems,and considers the long-term effects of oppression to be symptoms ofindividual pathology” (Deitz 2000, 374). Unfortunately, whilst manysocial workers have been exposed to or even personally supportoperating from a feminist framework, the systems in which they workprevent them from actively utilising feminist insight in their dailypractise.

RESEARCH PLAN

This research seeks to study the prevalence and impact of traditionaland feminist practitioner constructs from the perspective of thoseserved. Specifically, a focus group study will be conducted with agroup of college students, all of whom are currently studying socialwork and therefore have some concept regarding social work practice,feminist and traditional worldviews. In addition, all students in thefocus group will have experienced domestic violence and have beenprovided the services of a social worker in some form during theirteenage years.
Three areas of discussion will be undertaken by the group. These willbe provided to individual group participants in writing several daysbefore the group in order for students to have time to consider whatthey would like to share regarding their opinions and own experiences. The first group activity will involve creating definitions of“masculine” and “feminine” from the perspective of a typical socialworker based on the students’ teenage experiences. Students will thenbe asked to discuss where, if at all, they personally feel they andtheir family members who were involved in the domestic violencesituation(s) “fit” regarding these preconceived definitions. It isanticipated some students will have been uncomfortable with societalconstraints they or their family experienced as teenagers. As all arestudying social work, they are also anticipated to make moreconnections between societal power issues, hegemonic gender roles, andtheir influence on domestic violence than a focus group without suchbackground. The third area of discussion will centre on how thestudents’ perceptions of their social worker(s) understanding of genderroles influenced their and their families reception of adequateservice.
The researcher will both tape record and take notes on the groupdiscussions. Data gathered from the group will then be compiled andanalysed. In addition, students from the focus group will be given theoption to write a response to the group activity, if they so desire. These will be further included in the group data.

METHODOLOGY

Data collection involved four means. Prior to the group starting,each participant was given a questionnaire (see Appendix 3) to gatherbasic demographic information. The questionnaire also asked for abrief summary of their abusive situation. Regarding data collection ofthe group proceedings, as described above the focus group session wastape-recorded and the researcher took notes to supplement the recordingof group discussion. The recorded sessions were then transcribed intoprint form, with research notes added in at the chronologicallyappropriate points of the transcription to provide a more completewritten overview of the focus group discussion. In addition, groupparticipants had an option to write a response the group to be includedin the group data. Four participants wrote responses, which wereconsidered with the group data following analysis of the focus groupdiscussion. Participants were provided with the three areas of groupdiscussion several days prior to the actual focus group meeting. Theywere not given any directions or guidance regarding the optionalwritten responses to the group activity.
Data analysis first involved dividing and coding group data. Responsesto the first topic of discussion were divided into three categories: those representing a traditional worldview, those representing afeminist worldview, and those that did not clearly represent eitherworldview. From these groupings, overall findings regarding theworldviews typically experienced by the group participants weresummarised. This was then further compared with the definitions oftraditional gender roles identified by the group.
Data from the second topic of discussion were also broken down intothose representing a traditional worldview, those representing afeminist worldview, and those that did not clearly represent eitherworldview. It was important to then note participant perceptions andemotional responses to these codings, and in which worldview groupingthey and their families were reported to feel best served andempowered.
Data from the specific discussion regarding service were then similarlyanalysed, and combined with previous findings to present a picture ofthe impact of traditional versus feminist worldviews on social workpractise, emphasising work with teenage domestic violence survivors andtheir understanding of gender roles in society.
It was anticipated at the conclusion of such research, a view could beasserted as to whether feminist perspective has a significant impact onthe practise of social work as it is currently undertaken and whetherthis impact, if any, leads to improved service.
As the focus group involved a relatively small number of participants(nine total) and data from their interactions were primarilyqualitative in nature, it was decided not to perform any complexstatistical analysis on focus group data. It was felt that such typesof analysis would neither reveal findings that could be consideredstatistically significant nor provide a more accurate understanding ofthe issues under consideration than a more qualitative analyticalapproach. In consideration of space and relevance portions of thediscussion were used to support conclusions in the findings andanalysis sections of this dissertation, whilst an overall summary ofthe most relevant portions of the discussion are included in Appendix2.

IMPLEMENTATION OF PROJECT

Nine students meeting the criteria laid out in the research planagreed to participate in the focus group. They were primarilyorganised by one group participant, who had discovered other domesticviolence survivors through classroom discussions and throughparticipation in a survivors’ group in the local community. All ninestudents were currently studying social work or had taken at least onesocial work course as part of a related course of study, such aseducation or criminal justice. There were six women and three men,ranging in age from nineteen to twenty-seven. Racially, seven wereCaucasian, one was Black, and one was Asian. All present as comingfrom upper working class to middle class backgrounds. All hadexperienced domestic violence as teenagers, making their experiencesfairly recent and therefore providing a relatively current depiction ofsocial work practise. Five students (three women, two men) had beenremoved from their biological parents at some point during theirteenage years. All had been involved in interventions into the familyby a social worker representing either a government organisation, or inthe case of one woman, a local church.
Some of the participants previously knew each other and were somewhataware of each other’s experiences, which should be considered in groupanalysis. Five regularly participated in a survivors’ support group inthe community. One man and one woman were cousins. In addition, twoof the men had known each other as teenagers from intervention throughthe school system.
Jennifer, a twenty-four year-old Caucasian woman, was chosen to be themoderator, as she had been the one who had assisted the researcher byarranging for most of the participants to become involved in thestudy. The group then moved almost immediately into discussion of thetopics provided. The group had been provided a whiteboard for its use,which Jennifer implemented to organise individual comments and ideas. It is surmised that the easy manner with which the group undertook thediscussion was based on the fact that they were all students andtherefore used to having study groups, group discussions, and the like,and that all of them had at least publicly shared their experiencespreviously, either as part of a classroom discussion or survivors’group, or both, and were therefore more comfortable in engaging in suchdiscussion than might be typical for a focus group dealing with suchexperiences.

FINDINGS AND ANALYSIS

The first finding of this research is that the majority of socialworkers in service or domestic violence survivors to not consistentlyemploy feminist constructs in practise, despite the likelihood ofhaving been exposed to such constructs. This manifested itself inthree significant ways. First, families were overwhelming dealt withas individuals with problems. That is, the abuser was described asmaking poor choices or having some type of pathological issues that ledto his or her decision to abuse (in one participant’s family, bothparents were abusive). As such, the abuser was described from apsychoanalytical standpoint by the social worker(s), and his or herbehaviour labelled as individually deviant.
The survivors of the domestic violence situations, particularly themothers, as the majority of abusers from the groups’ experiences weremale family members or boyfriends of the mother, were also reported tobe consistently dealt with from an individual perspective. In thissense, their behaviour was also reported to be categorised by thesocial workers involved as unhealthy, pathological, and coming fromsome sort of unresolved personal issues, such as low self-esteem. Inthe case of only one participant did the social workers involved ineither intervention or therapy consistently relate the domesticviolence situation to broader issues of oppression, societal powerstructures and the related hegemonic gender roles, or patriarchal normsof society. It is of note that this participant received service froma progressive women-helping-women organisation, rather than atraditional government-organised social work programme.
Group participants also repeatedly described their family situationsas unhealthy, and they certainly were, but from the perspective thatboth the abuser and abused were reacting or displaying emotioninappropriately, rather than that the motivation or norming behind thebehaviour was at fault. For example, Trent described his mother asdrawn to violent, alcoholic men. “She always seemed to go for theseguys that didn’t know how to express anything except by breaking stuff,yelling, hitting, you know.” His further descriptions of his mothers’boyfriends indicated an assumption that if these men had been raisedwith or taught proper means of dealing with their frustrations andemotions, the abuse to him and his mother would have been lessened oreliminated. This idea was supported by at least one social worker, whosuggested counselling for Trent, his mother, and the then boyfriend asone possible way of addressing the abusive situation.
Several participants did bring feminist theory and thought into groupdiscussion, pointing out, for example, that dominance or aggression bymen in any form was unhealthy, and questioning why it was only seen asunhealthy by most of the social workers they had encountered, and byothers they knew in the community, when physical violence was actuallyinvolved.
There was a related discussion, albeit brief, about the unwillingnessof neighbours, relatives, and others in the community, such as membersof the same church, to intervene in the domestic violence situation. Participants indicated their perception that whilst this was often dueto a fear of getting involved or knowing how to help the situation,there were repeated occurrences in everyone’s experience where anunwillingness to intervene derived from others’ implications that theman of the house had some right to choose the way in which thehousehold operated, or that he had a right to discipline his wife /girlfriend and children as he saw fit. Wendy reports hearing an auntstate “Well, its his family, their kids, she wants to stay with him,”and dismiss the ongoing violence as therefore an acceptable familylifestyle, or at least one in which none of the rest of the familyshould be expected to intervene. Participants then acknowledged thisand several other systemic situations that perpetuated their abuse,such as reluctance of authority figures to continue questioning wheninitially told nothing was wrong, and unwillingness of police tointervene repeatedly.
Similarly, regarding gender roles, discussion indicated a belief bymost participants that their social workers believed a traditionalstereotype of what was appropriate behaviour for a man and a woman, andthat these behaviours were different. There were reports of acceptanceof physical response as an appropriate masculine reaction, but thelevel of physical response not being considered appropriate. Maleparticipants were encouraged to talk about their experiences, butreport never being given permission to express fear, or an emotionalresponse such as crying. One male participant reported starting to cryas part of a group experience, and being discouraged rather thanencouraged to continue, whilst female members of the group were allowedto and even supported in such emotional expression. There were similarreports of various hegemonically feminine expressions, such as crying,fear, and nurturing behaviours, being supported and encouraged bysocial workers for male family members but not female, as well as anacceptance or assumption of weakness on the part of adult females whochose to remain in an abusive situation.
The discussion then moved to the effect of traditional and feministperspective on social work service. Participants overwhelminglyreported feeling better served when social workers sought to empowerthem and their families. This did usually involve practise of methodsderived from a feminist view, such as the use of reflective journalingand support groups, as well as encouragement from the social workers tothe mother that she could, indeed, survive and prosper outside thedomestic violence situation, that she did have the inner reserves toaddress the situation and move to a healthier lifestyle, and thatsocietal pressure to be with a man, either as a romantic partner or asa father / father-figure for children was not necessary for asuccessful life. Participants also report feeling personally empoweredby such encouragement, and therefore able to support their mothers inattempts to leave relationships.
From their own study in social work theory, focus group participantswere able to briefly discuss the ramifications of the patriarchalsocietal power structure on a woman’s decision to stay in a violentsituation. One issue brought up included the perception that societywill view a woman as a failure and undesirable if she does not have aromantic relationship with a man in her life. A number of womenparticipants in the group reported feeling similar pressure to maintaina romantic relationship with a man in their life, regardless of theirother commitments or interests, and an expectation that they would notbe successful women if they did not ultimately get married and havechildren. When questioned by other participants, the three maleparticipants reported not feeling such pressures. Another issue raisedwas the mothers’ perception that they needed a father figure tosuccessfully raise children, particularly boys. This was perpetuatedin the life experiences of group participants even though the menoccupying these roles were viewed by the male participants asdestructive, rather than constructive, influences. Issues of supportin disciplining children and managing household operations were alsoindicated, as was the financial support provided by the batterer. Thegroup indicated all these issues were societal, rather than individual,and lack of addressing of them affected the effectiveness of the socialservices they had received.
Overall, the participants were generally positive about at least onesocial worker with whom they had a relationship during their teenageyears. Participants typically felt feeling most encouraged and bestserved by those social workers who did not present themselves as beingdistant or above the participants and their families, and who did notoverly emphasise their family’s issues from a perspective of individualdysfunction. These findings indicated that a feminist interactiveconstruct, which avoids “power over” methods and practise is perceivedto be most effective by domestic violence survivors.

RECOMMENDATIONS

It is recommended from findings of this study that social workersare first provided greater exposure to and training in feminist methodsand theory as it relates to their practical, day-to-day practise. Forexample, all participants reported some positive experiences inresponse to reflective methods such as reflective journaling andsurvivor support groups. Considerations of ways to more greatlyinclude such methods in typical practise are therefore indicated.
Of greater concern are the systems in which social workers operate. Whilst most of the social workers in these focus group participants’experiences had some familiarity with feminist theory or methods, asindicated by their emphasis on empowerment or use of specificstrategies, there is something within the government-sponsored socialservices structure that prohibits practise truly based on feministtenets. A sharp contrast was provided by the young woman served at aprogressive, private service, where feminist theory was the obviousframework on which service was based. She was by far the most positiveabout her experiences and workers, and reported insights, understandingand empowerment to change not consistently reported by other focusgroup participants.
It therefore recommended that more research be pursued as to whatfactors constrain social workers from functioning from a more feministframework. Issues such as time (many social workers have far morepeople to see and serve than they would like to have, or often feelthey can serve effectively), lack of material resources such asappropriate space, lack of effective training, or discouragement insuch regards from supervisors or others in power. Specificallyidentifying relevant factors could then form a framework forprogressing with change in social work practise within a typicalgovernment service organisation.
It is further recommended that individual social workers consider whatconstraints they persona

Substance addicted fathers fail to provide a safe environment that focuses on the needs of their children. While inebriated, fathers may believe they are being attentive to their children, while in reality, they tend to act on their own feelings and disregard their children’s needs and become unpredictable. Sometimes a substance addicted father will have periods of presence and periods of absence from his child’s life. At one moment, he may provide his child with security, and another, he may inflict fear. Paternal substance abuse undermines the ability to give adequate care to children and overall, the ability to support his family. Fathers with a drug addiction are judged to be irresponsible and deemed incompetent as parents. The wives of these men are implicitly left with the responsibility to care for their children with some help from child welfare services. Although, fathers exist in the lives of women and children involved with child welfare authorities, they are rarely seen by the child welfare professionals themselves. Substance abusing men tend to avoid social services due to lack of paternal responsibility, cross gender communication, and hyper-masculinity.

In the article “Engaging Fathers in Child Welfare Services: A Narrative Review of Recent Research Evidence”, Social Workers Nina Maxwell, Jonathan Scourfield, Brid Featherstone, Sally Holland, and Richard Tolman found that only thirty-three percent of mothers identified the father when asked (163). Fathers are reluctant in participating in social cases, therefore may threaten the mothers to leave them out of it. Mothers may withhold the father’s identify out of fear about letting the father know that child welfare services are involved, fear that the father may be incarcerated, and fear of the father’s reaction, especially in cases involving domestic violence. These fears reinforce the idea that women are subordinate to men. Since she is fearful of her child’s father to be able to reveal his identity, the mother cannot receive the much needed, proper assistance from her social case worker. Even if the mother were to reveal the identity of her children’s father, it is likely for him to evade contact from child welfare.

Fathers avoid contact with child welfare staff. In a focus group study, Maxwell and her colleagues found that these fathers had a wide range of explanations for the avoidance. These included fear that they cannot be good fathers for their children, fear that the involvement with the child welfare system will worsen their problems with the criminal justice system, fear that relationships with current partners not related to the child would be affected, and a perception that the system is not there to help them (164). The concerns expressed by these fathers are a prime example that substance-abusing fathers are selfish because they are only interested in fulfilling their own desires, rather than meeting their children’s needs. Social policy makers have been trying to involve fathers more in their children’s lives by increasing child support payments, but it is done so in the best interest of the child.

Over the past few years, social policy makers have made an effort to increase the participation of fathers in their children’s lives, by providing child support to the children’s mother. The income of a father, who is not living with his children, can by affected by child support obligations in several ways. For example, if a father recently received an additional income of five hundred dollars a month, his child support payments might increase by one-hundred and twenty-five dollars (Lerman 69). Increased incomes have higher taxes and when combined with increased child support orders, it lowers a fathers’ profit each month, causing them to reduce their work effect. It is found that rigorous enforcement by the child support system could cause fathers to shift from formal to informal or underground work, which makes it more difficult for the government to track true income.

Child welfare professionals acknowledge that some fathers are committed to their children, many others are not. In her study “Child Welfare Professional’s Experiences in Engaging Fathers in Services”, Professor Mahasin F. Saleh found that sixty percent of substances abusing men associated in social services cases lack paternal responsibility (126). The lack of father responsibility includes father absence, denial of paternity, alcohol or drug abuse, blaming the mother, incarceration for various reasons, and maltreatment. One child welfare professional recalls, “They don’t believe. They took the paternity test and then it’s ‘I want a blood test’. And some of them disappear because they feel like they’re not the father. That’s hard, too, getting them engaged when they don’t want to believe” (Saleh 126). This example exemplifies a lack of father responsibility. Substance addicted men deny responsibilities that come with paternal identity, because they view the responsibilities as a burden, and often want nothing to do with it. This father figure is self-absorbed, abusive, and driven by addiction and carelessness.

Child Welfare Professionals have shared that fathers who neglect their children are found to be more verbally abusive and threatening during counseling (Saleh 127). Fathers view social counseling as a vehicle for women to process their emotions and that “strong” men do not attend counseling. Hyper-masculinity causes a man to maintain a rigid gender role script (Guerrero 137). The hyper-masculine man is prepared to challenge any real or imagined taunts from other men with violence. Men have a high sense of pride when it comes to his manhood. In 2013, the National Association of Social Workers conducted a membership workforce study and reported that eighty-two percent of social workers working full time were female (Whitaker & Arrington 9). Since a majority of social workers are female, a father is reluctant to comply and subject to the words of a woman. Masculine fathers do not like to hear something from women, and they may get angry when working with female social workers, because they feel like women are trying to tell them what to do. A hyper-masculine man’s attitudes towards women are usually those of sexual or physical subjugation. A female social worker from Saleh’s case study recalls multiple times that she had to deal with male clients who had expressed romantic interests in her (130). Experiences similar to these make it difficult for female case workers to deal with a situation professionally. There are many instances when the social worker is confronted with a father that has not only has neglected his kids through his ignorance. Most of the time, they never admit they are at fault.

Fathers exist in the lives of women and children involved with child welfare authorities, and yet, they are rarely seen by child welfare. These fathers are seen as deviant, dangerous, irresponsible and irrelevant, and even further, how absence in child welfare is inevitably linked to blaming mothers. In failing to work with fathers, child welfare ignores potential risks and assets for both mothers and children. Social workers are encouraged to focus on mothers as being the protective parent, whereas fathers are considered as risks and damage potential, due to neglect, abuse, and substance addiction. In the article “Manufacturing Ghost Fathers: the Paradox of Father Presence and Absence in Child Welfare”, Leslie Brown, Marilyn Callahan, Susan Strega, Christopher Walmsley, and Lena Dominelli reveals that over sixty percent of fathers associated with child welfare are identified as a risk to children and are not contacted. Similarly, fifty percent of these men were not contacted when they were considered ricks to the mothers (26). Mothers are responsible for the care and protection of children even when they are victims of domestic violence. Child welfare holds mothers responsible for monitoring the behavior of the men in the children’s lives, essentially contracting out the surveillance of men to mothers (Chuang 457). They are expected to fill the role of both parents and further expected to mediate the relationships between children and fathers, as well as between fathers, and professionals.

While inebriated, a father may believe he is performing his fatherly duties to the best of his abilities, but in reality he is oblivious to what is happening in the environment around him, including his children. The appearance of a social worker at his home is detrimental to his mental state as a father. In a way, he may view it as insulting. The father may not realize the dangers that he put his children in as a result of his negligence. The father is too proud to realize his mistakes and may want to blame outside sources. Unfortunately, this results in an agitated and distraught way of thinking, which could result in more negligence and abuse to their families (Burrus et al. 212). Substance abusing fathers often lose custody of their children. With help from social services, mothers are able to collect child support from their children’s fathers. Since a majority of social workers are female, males feel like their manhood is undermined when they speak to these women. These fathers try to avoid any instances of conference with social workers, because they feel it may affect their life that is unassociated through relations with the child. This shows how selfish and incompetent substance-abusing fathers are. Mothers are subordinate to fathers due to fears of reactions of the fathers finding out the involvement of social services (Brodie et al. 36). Many substance abusing fathers are invisible when it comes to their children. The lack of insight to his own problems causes a father to become invisible to himself and his child’s needs. If a man cannot handle his own feelings and problems, there is no chance he will be able to handle and resolve a child’s or be able to see his development. In the state of intoxication, fathers become self-absorbed and forgetful about what happens in the world around them. Substance abusing fathers are associated as being neglecting, abusive, destruction, and often insignificant. Fathers struggle to fulfill the role of the ideal role model to his children.

Mrs. Chan has a family of four including a son and a daughter. She first came for help because of the bad father-son relationship in her family. During the interview, she disclosed the fact that she has been suffered from domestic violent for about one year.

Four interviews were conducted by the worker. The purpose was to help assess the situation and set up an intervention plan to dismiss domestic violent in the family and create a harmony family atmosphere.

Background information

The client, Mrs. Chan, is a housewife and her husband runs a grocery store. They have an 11-year-old son and an 8-year-old daughter. The financial status of the family is adequate.

Problem assessment

Client’s perception of the problems

During the interview sessions, Mrs. Chan explained her views on the problem.

Mrs. Chan worried about the bad father-son relationship in the family. For example, they seldom talk to each other. The son’s school work was getting work and had strange behaviors.

Mrs. Chan told the worker that she was abused by her husband and tolerated it for about one year. She had mentioned if her husband took out a knife, she could not stand it. When this happened, the client worried about she and her two children’s safety.

Work’s perception of the problems

According to Family-Centre Approach (Waldegrave , 2005), the family system would be disturb if there is one problem in the family. It suggest to focus on one problem and to regain the balance step by step. The worker observed that the family have several problems . The family members tolerated them but not tried to solve them, they lacked of focus on the problems.

Domestic violent

Mrs. Chan suffered from domestic violent since last year. Mr. Chan abused Mrs. Chan and even took out a knife to threat. The worker observed that the client and her children’s safety were at risk.

Spousal relationship

The unsolved domestic violent would trigger the other problem in the family (Waldegrave , 2005). The worker found that Mr. Chan was not respectful enough towards Mrs. Chan. He abused his wife and did not consider her physical hurt and trauma. Mrs. Chan tolerated it for a long time and never asked for help. Tolerate is not help for problem solving.

Father-son relationship

The family is the fundamental resource for the nurturing of children and parents should be supported in their efforts to care for their children (Waldegrave , 2005).

The domestic violent affected the father-son relationship. The children witnessed the father beat the mother, this arouse the hatred of them towards the father.

During the interviews, the worker found the client had suffered from domestic violence for a long time. She had many worries and hard to decide the arrangements, for example, financial concern and children’s school issue.

Agreed view of the clients and the worker

The client and the worker agreed that safety is the first concern. We thought that Mrs. Chan and her two children’s were in a dangerous situation. The domestic violent led to other problem in the family, such as the father-son relationship and the son’s behavior problem. Based on Mrs. Chan determination to change, it was hope that the domestic violent could be dismiss and a more harmonious atmosphere would be create in the family.

Priorities of problems

Domestic violent

Spousal relationship

Relationship of father and son

Intervention phase

The Inter-Agency Committee on Collaboration of Services for Families Where Wife Assault Occurs (1990) suggest that unless the batterer acknowledged his violent behavior and finished his own intervention plan, the worker should not bring the couple together for counseling. In this case, the client and her family member were separate for different individual intervention.

Objectives

Short-term:

Ensure safety

To dismiss violence in the family

Improve spousal relationship

Improve father son relationship

Long-term:

Create harmony and supportive atmosphere in the family

Strategies and rationales

Residential Services for Abused Women

Lowenberg and Dolgoff (1996) developed an Ethical Rules Screen which place the protection of safety as the most important principle. So the worker’s first concern was the client’s safety. Refuge centers provide temporary accommodation to females and their children in face of domestic violence or family crisis. The social worker would refer the client for the Harmony House for safety concern. She can have a safe place to stay and think about what to do next.

Domestic violence support group

Many women think that telling others or reporting to the police of the violence is betrayal and disloyal to the husband, she is also breaking the trust and friendship between the two (Towns, Adams and Gavey, 2003). According to the case, Mrs.Chan was reluctant about telling the abusing problem at first and informed that she had never told others before. So it is good for her to communicate with others in the same situation and face the problem not tolerate it. This interaction would benefit her decision making.

Emotional management and interpersonal relationship workshops

Mrs. Chan indicated that Mr. Chan was not good at controling his emotion and got hot temper. These workshops are conflict resolution trainings that help abusing men deal with their emotions in a healthy manner. The workshops emphasize empathy, forgiveness, and understanding. Through the course of the workshops he will be able to control anger .

Counseling with the children

Kolbo(1996) suggest the negative effects of witnessing domestic violence on children’s emotional and behavioral development. The domestic violent behaviors had bad effect on the children. The son worse in study and hate his father. It is necessary counsel the children for further intervention.

Apply family therapy

Use risk assessment to evaluate two of the couple are ready for the family therapy, and the safety monitoring is ongoing. In the condition that the husband was conscious that his violence was irrational and the wife was willing to counsel with the husband. The family-centre approach believe that families who seem hopeless can grow and change (Boone, 2002). All family member is responsible to the harmony of the family.

The purpose of this article is to illustrate the importance of boundary setting during parental conflict. Often children are incorporated both voluntarily and involuntarily in dyadic confrontations that involve the parents. This research shows the long term and short term effects on both the parent and child psychologically and physiologically. Boundary setting is important for the growth, development and current maintenance of a family. Involving children in arguments is not only detrimental to the parents’ marital relationship, but also damaging to the parent-child relationship. This paper illustrates cause and effect consequences of triangulation.

Family Conflict and Triangulation

Familial conflict is inevitable. A multitude of quantitative and qualitative data has been accumulated in order to improve familial relationships. Numerous studies and focus groups spotlighted adolescents and their parents to find more data on triangulation and its negative effects on families. According to Franck and Buehler (2007), a triangulation study was conducted on 506 teens and their mothers. The study focused on conflict properties, cognitive appraisals of threat and blame, emotional insecurity, and triangulation to determine the possibility of a direct relationship between adolescent behavior problems, marital distress, and maternal depression (Franck and Buehler 2007). After thorough research, it was found that marital hostility and distress were associated with adolescent behavioral problems and familial stressors (Franck & Buehler 2007). This paper will focus on parental and child triangulation and its effect on both the adolescent and the adult.

Triangulation can be defined in a multitude of ways. Some may use the term mathematically, while others use it psychologically. Fosco and Grych (2008) broadly described the psychological term for triangulation as the involvement of a third person in a dyadic conflict. Triangulation is not possible with two people; it has to involve at least three people triangulate the conversation and ensure one or more of the parties agrees with his or her opinion. Buehler and Welsh (2009) stated that “triangulation occurs when two people in a family bring a third party to dissolve stress, anxiety or tension that exists between them.” Often feuding parents might involve their children in the conflict to “gang up on” the other parent. A more in-depth definition that better describes the target group focused on in this paper illustrates a family and child triangulation as children’s direct participation in parental disagreements and their subjective sense of feeling caught in the middle (Fosco and Grych, 2008).

Due to ignorance, some parents may be unaware that they are involved in triangulation. Some statements a child might say if he or she is involved in a triangulation situation are “My parents make me feel caught in the middle when they argue” “my mom always asks if I notice how my dad starts the fights” “mom and dad always ask me questions when they are in the middle of an argument” “after an argument with mom, dad always comes to me and explains his point of view” “I hate it when mom and dad involve and ask me questions when they are arguing”. Parents should be more cognizant of accidentally or purposely involving children in marital disputes because it can be detrimental to the child.

Efforts to better understand the impact of interparental disagreements on children have identified a number of factors that may elude to the fact that exposure to continual hostile and poorly resolved conflict can cause adjustment problems. (Fosco and Grych 2008). Behavior issues may become more frequent when boundaries are not set between parental arguments and children. According to Fosco and Grych (2008), appraisals reflect children’s opinions on parental conflict. Parental conflict can be detrimental to the child’s well-being or the functioning of the family unit; therefore, the child may hold himself or herself responsible and believe that the disagreement was caused by his or her conduct. Parents who involve children in marital confrontations fail to realize how detrimental involvement can be to their child. Specifically, appraisals of threat and self-blame, emotional reactivity and distress, and triangulation into parental discrepancies each have been made known to play a key role in the relationship involving parental discord and child maladjustment, thereby making the child feel responsible for ending or resolving the conflict. (Fosco and Grych 2008).

The effects of parental triangulation on the child can cause long term damage. According to Buehler and Welsh (2009) “Parental conflict and tension are proposed to induce emotional arousal in children, triggering emotional and physiological responses. Involving children in arguments can be both mentally and physically exhausting for the child. “Families that show patterns of triangulation have emotional, and physiological, responses that tend to have difficulty differentiating when not to ‘turn off’ than in families with better boundary maintenance” (Buehler and Welsh 2009). Often parents will include the child in arguments forcing the child to choose a side. Franck and Buehler focused on triangulation that occurs when parents bring a child into an argument by using the child as a messenger or buffer between the parents; as a confidante or counselor about issues with the other parent, the child is forced to ally against the other parent during marital disputes. By allowing children to get involved in domestic disputes, not only is the child negatively affected, but the involvement is also detrimental to the marriage.

Triangulation amplifies adolescences’ risk for disruptive behavior because this process impedes with numerous prospective strategies that have been found to shield youths from the potential harmful effects of marital hostility (Franck and Buehler 2007). Research shows that repeated exposure to parental conflict can affect a child’s experience, expression and control of emotion (Fosco and Grych 2008). Children subjected to constant triangulation can experience major emotional tribulations as well. It was found through trauma theories that recurring exposure to affectively disturbing events undermines a child’s ability to regulate his or her emotions (Fosco and Grych 2008). When a child is unable to regulate his or her emotions it becomes difficult for them to maintain control.

With this information, it can be concluded that a child from an argumentative family may display a greater sensitivity to his or her parent’s conflicts (Fosco and Grych 2008). Children who are exposed to tumultuous relationships and constant triangulation by parents are not as thoroughly researched as other topics that have been researched that involve family conflict. Beuhler and Welsh (2009) stated “Triangulation into parents’ disputes has received much less empirical attention than has verbal and physical interparental aggression; however, some evidence exists that triangulation places youth at risk for adjustment problems, particularly internalizing problems such as anxiety, depressive symptoms, and social withdrawal” (2009).

Triangulation does not just occur during an argument between parents with a child present. It also occurs long term when a child is made a confidante. Franck and Buehler (2007) found that when parents get upset they have a tendency to bring children into the argument by making them messengers between the parents.

Triangulation can be caused by a number of different reasons. Martial conflict and depression have been named to be some of the main reasons triangulation occurs. Parents involved in domestic disputes have a tendency to want a witness to validate their argument. Counselors, friends, family members, and children have been known to get pulled in to the dispute. Scholars found data proving that parents that involve people in their domestic disputes may be depressed (Frank and Beuhler 2007). Parents feel validated when loved ones and friends side with them in the domestic dispute. Frank and Beuhler (2007), searched even deeper and found that a mother’s depression is more closely related to internalizing disruptive behaviors in children than fathers. Frank and Beuhler (2007) felt that a father’s depression is more closely related to poor cognitive functioning in his children than internalizing problem behaviors.

Studies show that triangulation affects both the parent and the child’s relationships in a negative way. “One of the mechanisms by which marital conflict becomes a risk factor is the triangulation of the child or adolescent into parental disputes such that youth feel ‘caught in the middle’ and torn between divided loyalties” (Buehler and Welsh 2009). During an argument, parents feel that their point is more validated if the child agrees with them. Unfortunately, the long term affects of adolescent affirmation during parental altercations are detrimental to the marital relationship. “Although their involvement in a parental disagreement may be effective in deflecting attention from problems in the marriage, it may intensify the impact of parental conflict on children’s functioning by making them the target of parental anger or disrupting their relationship with one or both parents” (Fosco and Grych 2008). Studies show that it is pertinent that the children be left out of parental conflict. “It is clear that triangulation of adolescents also is harmful to adolescents in married families. Thus, clinicians and others who work with families need to assist parents with keeping marital problems within the martial dyad. Adolescent children need to be left out or blocked from parents’ marital issues; Parents need to improve their ability to cope with and handle the anxiety associated with martial conflict in ways that do not involve their children” (Buehler and Welsh 2009).

In addition to disrupting marital stability, triangulation can cause long term issues in the growth and development of the family. Fosco and Grych (2008) stated that when children perceive conflict as a threat to themselves or the family, they tend to worry about the stability of the family relationship. Running a family requires order, with no stability, there is no foundation; and with no foundation it tends to be less order. Parents should lead by example when teaching children. Often children mimic their parents and learn from observations. “Parents who frequently resort to triangulation as a means of managing their disputes may be less prone to teaching or modeling adaptive conflict resolution to their children” (Fosco And Grych 2008).

Avoiding the involvement of children can be very difficult for some parents. Not only does triangulation temporarily diffuse marital arguments, but it can also allude to the vindication or validation of a parents actions. Fosco and Grych (2008) found information proving that triangulation could shape the impact of parental discord in children. When the child feels caught in the middle and observes that the attention of the argument is deflected from the parents and reverted to them, they may make a habit of involving themselves and marital disputes. If disruptive behavior is effective at distracting attention from marital problems, children may develop more stable patterns of acting out in stressful circumstances.

Triangulation can occur both consciously and subconsciously. Unfortunately, if in the familial setting boundaries are not in place, detrimental repercussions can occur. Triangulation can occur in many different forms. Whether it includes the parent and child, grandparent and grandchild or siblings and parent, an unconstructive outcome is almost inevitable. The need to want to be right and acquire support is human nature and understandable. However, when you engage children in tumultuous relationships and put them in the middle of altercations, serious repercussions may occur for the child and adult. Rather than involving relatives and friends in conflict, it is important that families seek out counseling to secure the growth and stability of the family structure.

Therapists can utilize a number of different techniques and or approaches to help families partaking in triangulation. Due to the difference of upbringing, social, cultural, and economic levels, it is best that the counselor incorporate an integrative approach to families who are involved in a triangulation conflict. An integrative approach incorporates all of all the approaches. It allows the therapist to utilize the “best fitting” approach for the client to obtain optimal results. Conflict is inevitable and felt to be manifest, but if familial conflict involves triangulation it is sure to end unconstructively.

CHAPTER 1

INTRODUCTION

Family is a small social system made up of individuals related to each other by reason of strong reciprocal affections and loyalties, and compromising a permanent household that persists over years and decades.It is the most significant primary unit of human society. It is the earliest institution of humankind that is mainly depends upon man’s biological and psychological needs. Without family, no other social institution like religion or government can exist. The sustainability of family is vital to the development and progress of the society. The term family has been derived from the Latin word ‘familia’ which means a house hold establishment.It indicates to a number of individuals staying and living together during important phase of their life time and they are bound to each other by biological, social and psychological relationship. It may be the joint family or an individual family in the modern society.

Famous sociologist M.F Nimkoff defines family ‘as a joint effort of husband and wife either with child or without child’. The existence of family is very significant. Family plays a major role in the society. Family generates human capital resources and also it has the power to influence single individual, each household and the behaviour of the community (Sriram, 1993).Hence family is being studied as the most basic unit in the different branches of social science. Human developments, Psychology, anthropology, economics, social psychiatry, social work are examples. Family is a major resource for the various needs of human beings. It is the family plays a major role in the nourishment of children and meeting their most basic needs such as emotional bonding, health, development and protection.There is enormous potential lies within the family and it proves it during the trouble times by providing stability and support.The growth of an individual and the society mostly depends upon this basic unit of the society. (Desai, 1995a). Culture to culture and society to society, families and family dynamics varies and they cannot be interpreted without the context of cultural factors. Culture determines the roles of family members and it explains families’ ways of defining problem and solving them.

The family in India is known as an ideal homogenous unit with strong coping mechanisms. In a large culturally diverse country like India have plurality of forms in the families that varies with class, ethnicity and individual choices. Collectivism is an important dimension of Indian culture that affects the family functioning. In other words, the basic aspects of human life such as economic, philosophic are given the outlook of interdependence amongst persons. Family cohesion, cooperation, solidarity, and conformity are the major values of collectivistic society like India. Indian joint families are considered Strength, stability, closeness, resilience, and endurance are encouraged in the Indian joint families where family loyalty, family integrity is given priority than individual choices. These unique dimensions of Indian families help the families to overcome difficult situations that they face over the course of time. When an individual in the family is struck with a disease or any other troubles, the entire community helps that individual to face that situation.

What is Family support?

Family support can be defined as the benefits a person receives from the family and friends such as physical emotional and material benefits. Positive social support helps one to improve in the ability to make healthier choices in life. Family or social support would also means being able to access people that a person can rely upon if needed. In an individual’s life, family support is essential at all times. Good support from the family enhances the individual to excel in his or her field of interest. On the contrary, poor support results in poor performance. A person hailing from a lower socio economic strata s considered to be

Mental Health and family support

Health is the most important aspect of human life. According to WHO Health is a state of absolute physical, mental and social well-being and not only the absence of disease(World health Organisation,2001) Mental health is another area where family support is an inevitable factor. In a situation where resources for mental health are scarcely available families form a valuable support system. Mental health is defined as state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to her or his community ( World Health Organisation, WHO includes social support as one of the key determinants of health. Mental illness is medical condition that affects an individual’s thinking, emotions, ability to relate with others and daily functioning. Just as any other physical conditions, mental illness are medical conditions which results in poor capacity for coping with the demands of life.

Mental illness is considered the most pathetic condition of a human life. Indian traditions considered a mentally ill person as an outcast since he or she was labelled as cursed by gods. The presence of mentally ill in a family brings huge implications. There will be only a handful in the family who will be willing to take care of the patient namely the mother or wife. When one person is ill in the family, the entire course of the family gets changed. Because society would label the family as cursed and this would bring a wide range of problems especially if the family hails from a lower social and economic strata.

On the contrary, Indian families are the key resources for the mentally ill. There are mainly two reasons for this position. First, it is mainly because of the traditional practice of collectivism and concern for the relatives in adversities. As a result, most Indian families do not hesitate to be significantly involved in all aspects of care for their relatives. The tradition of involvement of family in the care of mentally ill has always existed. Secondly, since there is a long gap between the need and thus the clinicians mostly depend on the family. Thus having adequate family support becomes the need of the patient, clinician and health administrators.

INVOLVEMENT OF FAMILY IN THE MENTAL HEALTH SERVICES IN INDIA

In the pre independence era, mental health care services in India were not organised. Usually persons with mental illness were taken care by family members or religious institutions. In other cases they roamed free.’ Mental asylums’ were introduced by Britishers where unwanted dangerous mentally ill were kept behind shut doors. Though it was initially for their soldiers, later Indian population also received the services. T was in Bombay in 1745 the first mental asylum was established. The second in Calcutta in 1781, the third in Madras in 1794 and the fourth in Monghyr, Bihar in 1795. Globally there were changes taking place in the mental health scenario, which involved ‘moral treatment’ and comprehensive community mental health approach. However, not all these changes in Europe and America made any impact on the Indian scene. Approach of the Government until 1946 was to establish custodial and no therapeutic centres.

In 1957, there was a shift in the mental health field when Dr.VidyaSagar the then superintendent of Amritsar Mental Hospital, took initiative to involve the close relatives of the mentally ill in the treatment. The family stayed in the hospital campus along with the patients in open tents. This in fact aided the speedy recovery of the patients in comparison with those patients who did not stay with the families. Christian Medical College,Vellore established family wards in the psychiatric setting which followed many advantages such as accelerated rate of recovery, low relapse rates.

Many family members started helping the community by identifying the psychiatric patients and providing the guidance. The close relatives of the patients were asked to stay with the patients in the open wards .at NIMHANS.Using family as a major resource in the process of recovery of mentally ill has the advantage of relieving the professionals.Community care has been a paradigm shift for psychiatric treatment worldwide.

Recovery in mental health

Recovery in mental health cannot be easily defined. This significant aspect depends upon many factors. A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential (Samhsa, August 2011). Recovery from mental illness is a long term process. It involves the experience of healing and transformation and by which the person learns to live a purpose oriented life in the society. He or she would learn to make use of his or her potential in the very journey of healing.

Bipolar disorder is a recurrent and long-term mental illness that can seriously affect the lives of patients and their families. Bipolar disorder is a common psychiatric disorder that includes periods of extremely elevated mood and periods of depression and periods of full or partial recovery. The cycles of high and low mood states and well periods may follow an irregular pattern. The treatment of Bipolar disorder cannot be limited to pharmacotherapy alone. Psychotherapy, psycho education, peer group support also play major role in the process of recovery.

Bipolar affective disorder

Bipolar disorder is a chronic, severe illness that can impose significant impairment on multiple aspects of a patient’s life including interpersonal relationships, occupational functioning and financial stability (APA, 2002). Globally it has been ranked the ninth highest cause of years of life lost due to death or disability and the 12^th most prevalent cause of disability among individuals aged between 15 and 44 years (World Health Organization, 2004).The distress and impairment caused by bipolar disorder is a wide spread and important issue. Globally the lifetime prevalence of all forms of the illness, often referred to as bipolar spectrum disorders, has been estimated to be 5% in the general population. Ganguli (2000) reported that the national rate of affective disorder in India as 34 per 1000 population.

This disorder significantly affects the functional capacity of the person. Apart from regular medication, support from the near and dear makes a large difference in the recovery process. The practice guideline of The American Psychiatric Association (APA) for Bipolar Disorder treatment suggests the use of certain psychotherapies which includes family therapy as well(American Psychiatric Association,2002) So there are high chances that by the sincere involvement in the care of these patients they may improve in their psychosocial functioning and also to cope with their own struggles due to the illness.

Conclusion

Unlike the institutionalized care, in the community based care for the persons with mental illness, the role of family is very important. The bio medical, socio economic, psycho- spiritual and every integral dimension of the society is necessary in the recovery process. Family being the smallest unit of the society therefore is of much importance in rebuilding the life of the persons with mentally ill. Family is pivotal to catering to the persons with mental illness as they function as the primary care givers. In short, The involvement of family is the need of the hour.

Abuse, whether it be physical, emotional, or sexual, can infiltrate a family setting and alter the dynamics greatly. Within a family there are different relationships and bonds, and each one of those relationships may have a different motive and form of abuse within it. A type of abuse within a family that does not receive much attention from society is abuse by siblings. In general, abuse within a family is thought of as a parent abusing a child and asserting their authority in such a way, but the matter of abuse by a sibling is also very important to understand and there are many implications of such abuse. This research paper will address the importance of sibling relationships to further understand the implications that come about from abuse within them, what healthy sibling relationships should look like, the commonality of different relationships of siblings having incest, types of family configurations where sibling abuse is present, and the treatments of siblings that abuse and are victims of abuse. Four articles will be used to understand the issue, “Sibling Family Practices: Guidelines for Healthy Boundaries” (2009) , “Sibling Incest: Reports from Forty-One Survivors” (2006), “Making Sense of Abuse: Case Studies in Sibling Incest” (2006), and “Treating Sibling Abuse Families” (2005).

Abuse is a very powerful word that comes with many connotations. The actual definition of abuse has problems with it because it is not universally accepted and the perceptions of abuse from individual to individual vary greatly. Everyone has their own personal opinion on what abuse consists of and in general it is typically thought of as causing harm to another person. Abuse is an issue that has many intersecting factors and many layers that are rooted deep in relationships. One type of abuse that is of great importance, as are the others, is sibling abuse. Sibling abuse is abuse that is perpetrated by one sibling to another and may be physical abuse or sexual abuse, known as incest. The importance of this type of abuse is that it is not given much attention in society and it is difficult to comprehend. Society does not recognize sibling abuse as easily as it will recognize abuse between intimate partners or even abuse between parents and their children. Due to the lack of awareness it is very important to understand what a healthy sibling relationship is, cases of sibling abuse, and treatments of the siblings. By looking at four articles, a view of the issue will come into focus and some light will be shed on the issue of sibling abuse.

In Johnson, Huang, and Simpson’s research, “Sibling Family Practices: Guidelines for Healthy Boundaries,” (2009) surveys help conclude what is socially acceptable and what is not within a family. The survey was taken of five hundred people and their opinions generally corresponded. The research showed that when it came to hygiene, bathing together is acceptable for children younger than five if they are of the same gender. If the children are of different genders, the research shows that it is acceptable for children younger than four to bathe together. Showering is a similar issue, being acceptable for same gendered siblings that are younger than six and acceptable for different gendered siblings younger than four and a half years. The data also reflects adults’ opinions regarding affection, with the statistics on kissing being “37% saying siblings should never kiss on the mouth and 23% of people saying they should kiss at all ages.” (Johnson, Huang, Simpson, 2009). Hugging is widely accepted between siblings. Caffaro and Caffaro address healthy sibling development in “Treating Sibling Abuse Families” (2005). Caffaro and Caffaro lend a look at the development of sibling relationships, explaining that “sibling ties begin in childhood with parents writing the script.” (Caffaro & Caffaro, 2005). It is common for parents to assign roles for their children without actively meaning to do so. Siblings are often raised being in a natural competition with their sibling and trying to live up to the label that has been placed upon them by their parents. An example would be labeling a child as “the smart one” and their sibling as “the polite one”. These two children would compete against each other to keep their title from the other and would also strive to maintain their title, forming it into their self-identity.

Carlson, Maciol, and Schneider conducted research in “Sibling Incest: Reports from Forty-One Survivors” (2006) in order to get a concise picture of sibling sexual abuse. The research was conducted using thirty-four women and seven men and the majority of the forty-one participants were of white. The study conclusions found that three of the males initiated sexual behavior with their sisters and the other men were victims of sibling incest that was brought on by brothers of theirs. Four women of the study were victims of sibling incest because of their sisters and the other thirty women were sexually abused by brothers. The research from this article clearly shows that males are the most common perpetrators of sibling incest and women are more likely to be the victims, but men are also sometimes the victims of sibling abuse brought on by brothers. Corresponding with this data, Caffaro and Caffaro found that sixty-three percent of the women in their study were victims of incest due to their brothers’ sexual assault. In contrast to the prior study, “Treating Sibling Abuse Families” (2009) found that the second most common form of sibling incest is from one brother to another, the next most common being sisters sexually abusing their brothers, and the least common form being sisters sexually abusing their sisters. (Caffaro & Caffaro, 2005).

As discussed earlier, it is difficult for society to see all of these cases as abuse and incest because of the difficulties there are in defining abuse and there are also different views between families of what is acceptable and normal. In “Making Sense of Abuse: Case Studies in Sibling Incest” (2006), Bass, Taylor, Knudson-Martin, and Huenergardt discuss the possibility of abuse being seen as normal within a family. The research done in the article is case studies that follow two Latin American families where sibling incest was present. One of the families viewed abuse as normal and used secrecy as a way to maintain the abuse. Also, the family did not see outside systems as positive and held the opinion that the systems were invading their personal lives. The second family in the research differed from the first in the way that they viewed abuse as a mistake and unacceptable and they used secrecy to protect rather than perpetuate abuse. The second family also differed in seeing outside systems and legitimate and, although the systems caused some hardships, they saw them as appropriate and not intrusive as the first had. (Bass, Taylor, Knudson-Martin, Huenergardt, 2006).

Treatment for sibling abuse may begin with what is referred to as a Sibling Abuse Interview, or SAI for short. (Caffaro & Caffaro, 2005). The SAI functions by asking questions of all family members about the relationships that are currently between the siblings and also the history of those relationships. The SAI asks questions that deal with abuse and trauma and also points out areas of family resilience. Treatment is usually similar to treatment of other forms of abuse, but the therapy is slightly modified. There are two different perspectives when it comes to sexual abuse of children and they are the Child Protection Movement and the Feminist Movement. The Child Protection Movement holds the philosophy that the child victim is the most important at that time and that the entire family is responsible for protecting that child and providing them safety. The ultimate goal of the Child Protective Movement is to reunite the family with a healthier way of living. The Feminist Movement favors advocacy over all others. This perspective feels that it is necessary and most beneficial for the victim to have an advocate on their side that is determined to establish protection for that child in the present and the future as well. The Feminist Movement supports family reconciliation, but it does not hold it as a top priority. (Crosson-Tower, 2010). These two theories produce different forms of treatment and have different strategies for treating the victims of incest. Both hold the victim’s protection above all else but they differ in terms of what is best for the child, whether it be healthy family practices or advocacy for the victim.

The four studies discussed help to give a broad understanding of sibling incest, from the healthy sibling relationships that are used as basis, what sibling incest can be interpreted as in terms of common types, family influences on sibling incest regarding their mindsets, to the treatment and outcomes of sibling incest. The studies were largely consistent and all painted pictures that corresponded with one another. There were some minor discrepancies in findings, such as the commonality of different forms of sibling incest, but in general the larger messages were all the same. The implications of the research presented is a better awareness of sibling incest and the ability to recognize red flags when they are present. Sibling incest is more prominent than society likes to think and without understanding sibling incest, it is difficult to prevent it from happening. With understanding, family structures that allow for incest can be recognized and sibling incest can hopefully be diminished.

Abuse, whether it be physical, emotional, or sexual, can infiltrate a family setting and alter the dynamics greatly. Within a family there are different relationships and bonds, and each one of those relationships may have a different motive and form of abuse within it. A type of abuse within a family that does not receive much attention from society is abuse by siblings. In general, abuse within a family is thought of as a parent abusing a child and asserting their authority in such a way, but the matter of abuse by a sibling is also very important to understand and there are many implications of such abuse. This research paper will address the importance of sibling relationships to further understand the implications that come about from abuse within them, what healthy sibling relationships should look like, the commonality of different relationships of siblings having incest, types of family configurations where sibling abuse is present, and the treatments of siblings that abuse and are victims of abuse. Four articles will be used to understand the issue, “Sibling Family Practices: Guidelines for Healthy Boundaries” (2009) , “Sibling Incest: Reports from Forty-One Survivors” (2006), “Making Sense of Abuse: Case Studies in Sibling Incest” (2006), and “Treating Sibling Abuse Families” (2005).

Abuse is a very powerful word that comes with many connotations. The actual definition of abuse has problems with it because it is not universally accepted and the perceptions of abuse from individual to individual vary greatly. Everyone has their own personal opinion on what abuse consists of and in general it is typically thought of as causing harm to another person. Abuse is an issue that has many intersecting factors and many layers that are rooted deep in relationships. One type of abuse that is of great importance, as are the others, is sibling abuse. Sibling abuse is abuse that is perpetrated by one sibling to another and may be physical abuse or sexual abuse, known as incest. The importance of this type of abuse is that it is not given much attention in society and it is difficult to comprehend. Society does not recognize sibling abuse as easily as it will recognize abuse between intimate partners or even abuse between parents and their children. Due to the lack of awareness it is very important to understand what a healthy sibling relationship is, cases of sibling abuse, and treatments of the siblings. By looking at four articles, a view of the issue will come into focus and some light will be shed on the issue of sibling abuse.

In Johnson, Huang, and Simpson’s research, “Sibling Family Practices: Guidelines for Healthy Boundaries,” (2009) surveys help conclude what is socially acceptable and what is not within a family. The survey was taken of five hundred people and their opinions generally corresponded. The research showed that when it came to hygiene, bathing together is acceptable for children younger than five if they are of the same gender. If the children are of different genders, the research shows that it is acceptable for children younger than four to bathe together. Showering is a similar issue, being acceptable for same gendered siblings that are younger than six and acceptable for different gendered siblings younger than four and a half years. The data also reflects adults’ opinions regarding affection, with the statistics on kissing being “37% saying siblings should never kiss on the mouth and 23% of people saying they should kiss at all ages.” (Johnson, Huang, Simpson, 2009). Hugging is widely accepted between siblings. Caffaro and Caffaro address healthy sibling development in “Treating Sibling Abuse Families” (2005). Caffaro and Caffaro lend a look at the development of sibling relationships, explaining that “sibling ties begin in childhood with parents writing the script.” (Caffaro & Caffaro, 2005). It is common for parents to assign roles for their children without actively meaning to do so. Siblings are often raised being in a natural competition with their sibling and trying to live up to the label that has been placed upon them by their parents. An example would be labeling a child as “the smart one” and their sibling as “the polite one”. These two children would compete against each other to keep their title from the other and would also strive to maintain their title, forming it into their self-identity.

Carlson, Maciol, and Schneider conducted research in “Sibling Incest: Reports from Forty-One Survivors” (2006) in order to get a concise picture of sibling sexual abuse. The research was conducted using thirty-four women and seven men and the majority of the forty-one participants were of white. The study conclusions found that three of the males initiated sexual behavior with their sisters and the other men were victims of sibling incest that was brought on by brothers of theirs. Four women of the study were victims of sibling incest because of their sisters and the other thirty women were sexually abused by brothers. The research from this article clearly shows that males are the most common perpetrators of sibling incest and women are more likely to be the victims, but men are also sometimes the victims of sibling abuse brought on by brothers. Corresponding with this data, Caffaro and Caffaro found that sixty-three percent of the women in their study were victims of incest due to their brothers’ sexual assault. In contrast to the prior study, “Treating Sibling Abuse Families” (2009) found that the second most common form of sibling incest is from one brother to another, the next most common being sisters sexually abusing their brothers, and the least common form being sisters sexually abusing their sisters. (Caffaro & Caffaro, 2005).

As discussed earlier, it is difficult for society to see all of these cases as abuse and incest because of the difficulties there are in defining abuse and there are also different views between families of what is acceptable and normal. In “Making Sense of Abuse: Case Studies in Sibling Incest” (2006), Bass, Taylor, Knudson-Martin, and Huenergardt discuss the possibility of abuse being seen as normal within a family. The research done in the article is case studies that follow two Latin American families where sibling incest was present. One of the families viewed abuse as normal and used secrecy as a way to maintain the abuse. Also, the family did not see outside systems as positive and held the opinion that the systems were invading their personal lives. The second family in the research differed from the first in the way that they viewed abuse as a mistake and unacceptable and they used secrecy to protect rather than perpetuate abuse. The second family also differed in seeing outside systems and legitimate and, although the systems caused some hardships, they saw them as appropriate and not intrusive as the first had. (Bass, Taylor, Knudson-Martin, Huenergardt, 2006).

Treatment for sibling abuse may begin with what is referred to as a Sibling Abuse Interview, or SAI for short. (Caffaro & Caffaro, 2005). The SAI functions by asking questions of all family members about the relationships that are currently between the siblings and also the history of those relationships. The SAI asks questions that deal with abuse and trauma and also points out areas of family resilience. Treatment is usually similar to treatment of other forms of abuse, but the therapy is slightly modified. There are two different perspectives when it comes to sexual abuse of children and they are the Child Protection Movement and the Feminist Movement. The Child Protection Movement holds the philosophy that the child victim is the most important at that time and that the entire family is responsible for protecting that child and providing them safety. The ultimate goal of the Child Protective Movement is to reunite the family with a healthier way of living. The Feminist Movement favors advocacy over all others. This perspective feels that it is necessary and most beneficial for the victim to have an advocate on their side that is determined to establish protection for that child in the present and the future as well. The Feminist Movement supports family reconciliation, but it does not hold it as a top priority. (Crosson-Tower, 2010). These two theories produce different forms of treatment and have different strategies for treating the victims of incest. Both hold the victim’s protection above all else but they differ in terms of what is best for the child, whether it be healthy family practices or advocacy for the victim.

The four studies discussed help to give a broad understanding of sibling incest, from the healthy sibling relationships that are used as basis, what sibling incest can be interpreted as in terms of common types, family influences on sibling incest regarding their mindsets, to the treatment and outcomes of sibling incest. The studies were largely consistent and all painted pictures that corresponded with one another. There were some minor discrepancies in findings, such as the commonality of different forms of sibling incest, but in general the larger messages were all the same. The implications of the research presented is a better awareness of sibling incest and the ability to recognize red flags when they are present. Sibling incest is more prominent than society likes to think and without understanding sibling incest, it is difficult to prevent it from happening. With understanding, family structures that allow for incest can be recognized and sibling incest can hopefully be diminished.

What factors leads male young people aged 11 – 18 years old into taking illicit drugs in the UK?

Abstract

Statistical data has shown that an increasing number of young people aged between 11 and 18 are using illicit drugs either experimentally or habitually. This study examines a small sample of males aged between 11 and 18, and through unstructured interviews ascertains the reasons for their drug use. The study aims to identify ways in which prevention could be better facilitated for this particular age group.

Introduction

In men and women the misuse of illicit drugs has increased dramatically over the last 50 years (Zerbe, 1999). Research has shown that the particular age when young people begin using alcohol, tobacco, and other illicit drugs is a predictor of later alcohol and drug problems. For example, 40% of young people who begin drinking at age 14 or younger develop alcohol dependence, compared with 10% of youth who start drinking at age 20 or older. (Ericson, 2001. In Laursen and Brasler, 2002: 181). It has been long-established that users of one drug are more likely to use other drugs than non-users (Gove and Geerken,1979) and that the use of correlates with the onset of psychiatric symptoms. Contemporary research suggests that amongst girls, tobacco use is often a strong indication that other drugs will be used in the future, and in males, alcohol use has been described as a ‘gateway to other drugs.’ (In Laursen and Brasler, 2002: 181). Reasons for young people experimenting or regularly using drugs are varied, and include pressure from peers, stress and emotional factors, a desire to break convention, and the process of individualisation. Research into the consequences of divorce on young people has shown that negative consequences are most common shortly after a parental divorce (Frost and Pakiz, 1990). While research by Laursen and Brasler recorded the following responses as to why drugs were used:

“to numb the pain of abuse and neglect,”
“to be accepted,”
“peer pressure,”
“to take control of my own life,”
“for relaxation and pleasure”
“to chill”
“to improve my self-image”
“because I’m curious, stressed, or bored”
“to assert myself.” (Laursen and Brasler, 2002: 181)

Social work practice is reliant upon research in order to find the most effective ways to deal with social problems (Chavkin, 1993). The National Institute of Mental Health ( 1991) proposed that social work research is invaluable because it ‘describes the work domain of social work as touching on a multitude of human problems that inflict pain and suffering on millions of individuals and families.’ (Chavkin, 1993: 3).

As children develop into adolescence, they experience a series of dramatic changes, both physical, psychological , and psycho-social. Independence and identity are sought – often through the need to belong to a group or more general movement. Substance use increases in adolescence (Johnston, O’Malley, & Bachman, 1998. In Laursen and Brasler, 2002: 181) as ‘smoking, drinking, and other drugs become a way to appear mature while fitting in with peers.’ (Laursen and Brasler, 2002: 181).

Methodology

A qualitative research method was decided to be most appropriate. Darlington and Scott (2002) highlighted the three most prominent research methods as being:

In-depth interviewing of individuals and small groups
Systematic observation of behaviour
Analysis of documentary data (Darlington and Scott, 2002: 2)

In-depth interviewing of individuals was chosen for this project, and it was proposed to interview five individuals between the ages of 11 and 18 within the young people’s service, using a random sampling method. As suggested by Darlington and Scott (2002: 3):

‘Research methods such as in-depth interviewing and participant observation are particularly well suited to exploring questions in the human services which relate to the meaning of experiences and to deciphering the complexity of human behaviour.’

This approach also offers far more potential for establishing a greater rapport with the individual, where a more trustworthy and detailed account of personal experiences might be achieved – as opposed to observation techniques which might only offer relatively superficial or ambiguous evidence of inner thoughts and feelings. The interviews were taped; this ensured that the information was accessible, and facilitated more accurate and reliable research. For ethical reasons it was necessary to obtain the consent of the individuals being interviewed. It was made clear to participants that their information might be reproduced and possibly published as part of the study. It was necessary to obtain their consent prior to conducting the interview in case they objected to any later use of the information. In cases of younger respondents the permission of their older siblings or parents was asked prior to the interview. As the sample was chosen randomly the researcher did not have any influencer over the identity of the interviewees. Ten males were selected, of the ages: eleven, fifteen, sixteen, seventeen, and eighteen. All respondents were interviewed in their homes by trained interviewers. Data was collected primarily through interview, and also through self-reports which aimed to establish the presence of any emotional instabilities.

The present study made use of the interview format undertaken by researchers in the study by Vandervalk et al (2005) into the relationship between family problems and the behaviour of adolescents. In the 2005 study researchers used a shortened version of the General Health Questionnaire, which measured the extent to which psychological stress and depression had recently been experienced. On a 4-point scale, the respondents indicated the severity of their symptoms (e.g., feeling tense and nervous, feeling unhappy and dejected) during the past 4 weeks (1: much more than usual to 4: not at all). This was replicated for the current study. Youngsters indicated on a 4-point scale whether they had considered committing suicide during the last 12 months (1: never to 4: very often) (Diekstra et al., 1991).

To distinguish between internal and external factors the 2005 model study used an

‘Adolescent Externalizing Behavior’ approach that measured the following:

Risky habits, measuring the degree to which adolescents were involved in risky or unhealthy behavior. Self-report data on the use of cigarettes, alcohol, and soft drugs were used. On 8-point scales, youngsters indicated if and to what extent they smoked, drank alcohol, or used soft drugs
Delinquent behavior was assessed as the number of delinquent acts the respondents reported over the past 12 months. The delinquency measure consists of 21 items pertaining to 3 types of delinquent behavior: violent crime (e.g., “Have you ever wounded anyone with a knife or other weapon”?), vandalism (e.g., “Have you ever covered walls, buses, or entryways with graffiti?”), and crime against property (e.g., “Have you ever bought something which you knew was stolen?”).
Educational attainment of adolescents and young adults was assessed by asking youngsters about their current level of education or about the highest level of education achieved, in case they no longer participated in the educational system.

(Taken from Vandervalk et al (2005: 533)

Results

As the interviews were unstructured it was not possible to identify all of these factors for each individual. However, each interview did touch on these areas, and it was left to the individual concerned as to whether they wished to discuss these factors as potential reasons for their use of substances. A list of factors can be found in Appendix One.

5 out of 10 respondents said that a lack of money in their family had, on one or more occasions, led them to become involved in anti social behaviour. All of these respondents affirmed a positive link between anti social behaviour and drug taking. One male, aged fifteen, said that he would take drugs in a group, but never alone, in order to gain enough confidence to ‘cause trouble’ in their local area.
9 out of 10 respondents believed that their age group was not catered for enough in the local area and that they took drugs for ‘something to do’ rather than being forced into it by emotional or stress factors.
However, one respondent, aged eighteen, said that he used cocaine regularly because it ‘made his stress go away.’ When asked about the nature of the stress involved he said that he felt under pressure to achieve at school. He expressed concern that if he didn’t achieve then his family would continue to struggle financially. An added stress in this case was that the withdrawals he experienced from his use of the drug were negatively affecting his relationship with his family, and reducing his ability to complete his school work.
When asked about the amount and regularity of drug use, more than half of respondents said that they used drugs more than occasionally. 3 of those said they used regularly ‘for something to do.’ And another said that they used ‘whenever they were bored.’
Major positive correlations were found between the respondents’ self-reports, where negative thoughts and stress prevailed, and the number of occasions that they confessed to using drugs. Although this link appears to be a significant one, it is possible that some interviewees did not give a completely accurate account of their use patterns, possibly in fear of being ‘found out’ by parents.
More than two respondents said that they were attracted to drug taking because of its associations with criminality

Results were consistent with the premises of the Social construction approach to defining and explaining the use of drugs in young people. Past research has defined drug use by minority youth as ‘a dysfunctional effort to escape problems stemming from poverty and racism or as an alternative means of making money in the face of underclass isolation from legitimate economic opportunities’ (Merton, 1957; Cloward and Ohlin, 1960; Finestone, 1957; Williams, 1990; Harrell and Peterson, 1992; Currie, 1993. In Covington, 1997: ) However, Covington criticises the social construction of drug problems amongst young people as too easily explaining away reasons for use through emphasis on individual differences – as opposed to collective conditions. She suggests that trends in minority and majority drug use should receive separate treatment.

Conclusion and Recommendations

Future prevention through social work practice needs to focus on the areas of inclusion. A high percentage of respondents said that they used drugs recreationally, and that this had contributed to their developing addiction. That there exists positive associations with criminality reflects the need for social work policy to adapt to find more ways of addressing the needs of young people in particular areas. The findings of the Hidden Harm report commissioned by the government found that children of drug users are one of the most vulnerable groups within society, and as part of the Government response to the report it was suggested that ‘the voices of the children of problem drug users should be heard and listened to.’ (Department for Education and Skills, 2005:4). Research into this minority and publication of results could potentially help social work policy to deter young users from taking drugs, and might also deter young users from bringing up children around drugs. Future research might include a more socially diverse sample, including a greater variety in terms of race and background. Externalising factors might also include social trends and political changes, as these greatly affect the nature and accessibility of service provision within a local area.

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Zerbe, K.J, (1999), Women’s Mental Health in Primary Care. Philadelphia, PA: W. B. Saunders

Appendix One

Unstructured Interview:

To identify the presence of influence of the following factors:

Internalizing behaviour Adolescent age

Individual-level Factors Adolescent Education

Externalizing behaviour

Family-level Factors Family Structure

Family Income