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Table of Contents

Title Page

 

 

Abigail Vanessa Dulmus

1983–2007

Daughter, sister, and friend…Abby, you were the best and we all miss you!

Preface

The profession of social work spans more than 100 years. Over this period, the profession has changed in scope and depth. Despite the varied functions and methods of our profession, it has always been committed to social justice and the promotion of well-being for all. The profession has made great strides and is experiencing a resurgence of energy, commitment, and advancement as we face new global realities and challenges and embrace new and innovative technologies. The Profession of Social Work: Guided by History, Led by Evidence provides students with a comprehensive, yet contemporary, overview of the profession that grounds them in our historical roots as well as our values and ethics.

This book is designed as an introduction to the profession of social work for undergraduate and graduate students in social work programs. The text provides a broad overview of the profession of social work, its scope, its values and ethics, and its organizational framework. This book addresses the Council on Social Work Education (CSWE) required competencies for accreditation. Specifically, the book addresses the following required accreditation competencies:

The 10 chapters that comprise this edited text provide the core material that would be offered in the foundation year of a professional social work program. Whether at the undergraduate or graduate level, the material covered in this text provides students with a broad, yet comprehensive introduction and overview of the social work profession. Chapter offerings include topics on social work history and social work education, professional credentialing and regulations, social work organizations, values and ethics, and the strengths perspective. With additional chapters focusing on evidence-based practice and improving the scientific base for social work practice, the concluding chapter on contemporary issues in social work clearly reflects the totality of this text.

This edited work is written by leading social work scholars who provide an overarching question at the beginning of each chapter to spur students' critical thinking. At the end of each chapter a list of key terms, review/critical thinking questions, as well as relevant online resources are provided. In addition, a supplementary teaching manual is available to the instructor that includes learning objectives, test questions, and PowerPoint slides that provide an overview and key points for each chapter.

In considering how the field of social work has evolved over the past century with the resulting explosion of new knowledge and technologies it seemed imperative to create a text that provides a current prospective on the profession of social work. The content in this book is contemporaneous and is reflective of demographic, social, political, and economic current and emerging trends. Authors have paid close attention to contextual factors that shape the profession and will have a future impact on practice.

As editors, we have endeavored to provide a contemporary work firmly grounded in social work values and ideals with which to introduce you to the profession of social work. We would like to thank our team of distinguished chapter authors who have contributed to this book. Their expertise and hard work has culminated in a substantial and relevant text. Students are indeed fortunate to have such esteemed social work scholars introduce them to their profession of social work. As social workers, we invite you to consider making social work your profession too.

Catherine N. Dulmus
Karen M. Sowers

About the Editors

Catherine N. Dulmus, PhD, is professor, associate dean for research, and director of the Buffalo Center for Social Research in the School of Social Work at the University at Buffalo and Research Director at Hillside Family of Agencies in Rochester, New York. She received her baccalaureate degree in social work from Buffalo State College in 1989, the master's degree in social work from the University at Buffalo in 1991, and a doctoral degree in social welfare from the University at Buffalo in 1999. As a researcher with interests that include community-based research, child and adolescent mental health, evidence-based practice, and university-community partnerships, Dr. Dulmus's recent contributions have focused on fostering interdependent collaborations among practitioners, researchers, schools, and agencies critical in the advancement and dissemination of new and meaningful knowledge. She has authored or coauthored numerous journal articles and books and has presented her research nationally and internationally. Prior to obtaining the PhD, her social work practice background encompassed almost a decade of experience in the fields of mental health and school social work.

Karen M. Sowers, PhD, is professor and dean of the College of Social Work at the University of Tennessee, Knoxville. She is the University of Tennessee Beaman Professor for Outstanding Research and Service. Dr. Sowers received her baccalaureate degree in sociology from the University of Central Florida, and her master's degree and PhD degree in social work from Florida State University. Dr. Sowers serves on several local, national, and international boards. Dr. Sowers is nationally known for her research and scholarship in the areas of international practice, juvenile justice, child welfare, cultural diversity, and culturally effective intervention strategies for social work practice, evidence-based social work practice, and social work education.

Contributors

James G. Barber, PhD
Office of the Vice Chancellor
University of New England
Armidale, New South Wales, Australia

 

Donna DeAngelis, LICSW, ACSW
Association of Social Work Boards
Culpeper, Virginia

 

Jessica Holmes, MSW
Council on Social Work Education
Alexandria, Virginia

 

June G. Hopps, PhD
School of Social Work
University of Georgia
Athens, Georgia

 

Leslie Leighninger, DSW
School of Social Work
Arizona State University
Phoenix, Arizona

 

Gary R. Lowe, PhD
College of Agricultural, Consumer & Environmental Sciences
New Mexico State University
Las Cruces, New Mexico

 

Tony B. Lowe, PhD
School of Social Work
University of Georgia at Gwinnett
Lawrenceville, Georgia

 

Mary Jo Monahan, LCSW
ICON Institute of Florida
Tampa, Florida

 

Danielle E. Parrish, PhD
Graduate College of Social Work
University of Houston
Houston, Texas

 

Roberta Rehner Iversen, PhD
School of Social Policy & Practice
University of Pennsylvania
Philadelphia, Pennsylvania

 

Allen Rubin, PhD
School of Social Work
University of Texas
Austin, Texas

 

Dennis Saleebey, PhD
School of Social Welfare
University of Kansas
Lawrence, Kansas

 

Terry L. Singer, PhD
Kent School of Social Work
University of Louisville
Louisville, Kentucky

 

Kimberly Strom-Gottfried, PhD
School of Social Work
University of North Carolina
Chapel Hill, North Carolina

 

Julia M. Watkins, PhD
Council on Social Work Education
Alexandria, Virginia

 

Stanley L. Witkin, PhD
Department of Social Work
University of Vermont
Burlington, Vermont

Chapter 1

The History of Social Work and Social Welfare

Leslie Leighninger


To what extent and in what ways is modern social work a product of the experiences of the past?

Religious Origins of Social Work

Social work as a profession grew chiefly out of the development of social welfare policies and programs in the United States, Europe, and Muslim countries. Judeo-Christian and Muslim practices and beliefs underlie many of the early attempts to provide help to the poor, the sick, widows, orphans, the “insane” and “imbeciles” (as those with problems of mental illness and developmental disability used to be called), and the elderly. This history begins with a discussion of the development of social welfare in Middle Eastern and European countries and then moves to the transfer of social welfare policies and practices to the New World of the American colonies. We then discuss the transition from the work of government officials and “people of good will,” who both helped and regulated those who were needy, to the creation of the profession of social work as we know it today.

Islam

Two thousand years before the birth of Christ, a ruler of Babylonia named Hammurabi made the protection of widows and orphans an essential part of his code. The Ancient Greeks and Romans were similarly concerned about helping the needy. The Greek philosopher Aristotle (384–322 BC) described man as a social animal who should “cooperate with and assist his fellow men.” He also said it is more blessed to give than to receive. As the social welfare historian Walter Trattner notes, “the words ‘philanthropy’ and ‘charity’ and the concepts for which they stand—love of mankind, love

of humanity, brotherhood—are of Greek and Latin origin” (Trattner, 1999, pp. 1–2).

The Arab world has also contributed to charitable traditions. Islamic thought draws a distinction between social justice and charity. The faith has a strong tradition of social reform, based on the Prophet Muhammad's advocacy on behalf of women, children, and the disadvantaged. This tradition is operationalized through the requirement that all Muslims who are financially able shall contribute 2.5% of their net wealth each year for support of the needy. This practice, called zakat, is not considered to be charity but rather an act of social justice through the redistribution of wealth. Any contributions in addition are seen as charity, or sadaqah, which is one of the five pillars of Islam. The Koran lists eight uses for charitable contributions: aid to the poor, the needy, those who collect the contributions, “those whose hearts must be reconciled,” debtors, wayfarers, the redemption of captives and, “for God's cause” (Al-Krenawi & Graham, 2000; Augustine, 2002; Canda & Furman, 1999, pp. 137–138; Stillman, 1975).

Judaism

Trattner emphasizes the importance of Jewish tradition in the development of modern philanthropy. Ancient Jewish doctrines, he notes, teach the duty of giving and “equally important, the right of those in need to receive.” Throughout the Old Testament, we find commandments to give to others, particularly the old, the sick, those with handicaps, and the poor. As in Islam, this giving is not a matter of charity but a matter of justice. Not only do the Scriptures state that “one might break off his iniquities” (or acts of wickedness) by showing a compassionate face to the poor, but they also go on to command that “thou shalt not harden thy heart nor shut thy hand” to the unfortunate. “It is forbidden,” according to the Scriptures, “to turn away a poor man…empty-handed.” And in a phrase that social workers would appreciate, people should give such aid “with a friendly countenance, with joy, and with a good heart” (Trattner, 1999, p. 2).

The Jewish philosopher Maimonides set out the following eight degrees of charity:

Give, but with reluctance and regret. This is the gift of the hand but not of the heart.
The second is to give cheerfully, but not proportionately to the distress of the sufferer.
The third is to give cheerfully and proportionately, but not until we are solicited.
The fourth is to give cheerfully and proportionately, and even unsolicited; but to put it in the poor man's hand, thereby exciting in him the painful emotion of shame.
The fifth is to give charity in such a way that the distressed may receive the bounty and know their benefactor, without being known to him.
The sixth, which rises still higher, is to know the objects of our bounty, but remain unknown to them.
The seventh is still more meritorious, namely, to bestow charity in such a way that the benefactor may not know the relieved persons, nor they the name of their benefactor.
The eighth and most meritorious of all is to anticipate charity by preventing poverty; that is, to assist a reduced person so that he may earn an honest livelihood and not be forced to the dreadful alternative of holding up his hand for charity (Macarov, 1978, p. 6).

From these ideas and principles, the Jews developed many social welfare practices. These included the education of orphans, burial of the dead, consolation of the bereaved, visitation of the ill and infirm, and the care of widows, divorcees, and the aged. Provision for the poor was made primarily through various agricultural practices, which included “gleanings,” or the practice of leaving grain dropped during the harvest which could be picked up by the hungry (Lowenberg, 2001).

Christianity

Christianity carried on the charitable tradition, adding a particular emphasis on love and compassion. The founders of the Christian Church were Jews, so it is not surprising that many parts of the New Testament focused on charity. The basic principle underlying early Christian approaches to social welfare was similar to the Hebraic idea that poverty was not a crime. Even though discretion should be observed in giving aid, and rules set up for discriminating among the various classes of poor people, evidence of need was still the paramount factor in offering help. It was assumed that need came about as a result of misfortune for which society should take responsibility.

At first, charity was an informal system of help, but as Christianity became more established as a religion, the Church fathers felt it was important to set up a more formal system of charities. Beginning in the sixth century, monasteries began to serve as basic agencies of relief, particularly in rural areas. Some monastic orders were organized with a particular mission of serving the needy. These orders received income from donations, legacies, and collections, and used this to provide help to the poor who came to their doors. They also, in a forecasting of what we might now call “community outreach,” carried food and other provisions to the sick and needy in their communities (Trattner, 1999).

During the First Crusade in the 11th century, which called for the abolishment of the Muslim states, military monastic orders were developed to care for and provide protection for pilgrims and the sick. These orders were well-organized associations of devout Christians who cared for pilgrims, nursed the sick, and even eventually took part in the military defense of the “Crusader States.” Once Jerusalem had been “reclaimed” by the Crusaders, there was a dramatic increase in the numbers of Christian pilgrims making their way to the Holy City. These pilgrims were often old and ill, coming to die in the same city where Christ had died. One of the first formal orders of those ministering to them was the Hospitallers. The order set up the great pilgrim hospital in Jerusalem. In what we might now call a “multicultural” approach, they sometimes employed both Jewish and Muslim physicians to care for the sick (Jordan, 2001).

Other monasteries expanded on the work of the Hospitallers, providing a medieval system of hospitals for the sick poor, including lepers. These hospitals did not solely provide for the sick, however. They also housed “weary wayfarers,” pilgrims, orphans, the elderly, and the destitute. Like the “community-based social services” of today, hospitals were found along main routes of travel and later in cities. Eventually, these hospitals were taken over by municipal authorities, creating a link between religious and secular charity. Trattner notes that by the middle of the 1500s there were more than 1,100 hospitals in England alone. Some took care of up to several hundred people (Trattner, 1999).

Government Enters the Picture

The evolution of feudalism in Europe in the 11th century provided a system of government, which, at least theoretically, dealt with poverty or distress among the population. By the late 11th and 12th centuries, most “common” people in Western Christian countries lived on feudal estates as serfs to the lords who owned the estates. Although they had little freedom, serfs were to be protected by the landowners against the hazards of illness, unemployment, and old age. At the expense of individual freedom, serfs were thus provided a form of social insurance against the challenges of life. This might be considered a primitive form of social insurance (Trattner, 1999).

Those who were not serfs, and who lived in cities, were often helped by social, craft, and merchant guilds. Like labor unions today, guilds provided benefits for their members. They also provided some assistance to the town poor, such as the distribution of corn and other food and the provision of free lodging for poor travelers (Trattner, 1999).

The Deserving and the Undeserving Poor

As early as the Middle Ages, people were developing a distinction between the “deserving” and the “undeserving” poor. Monks praised poverty, generally meaning the voluntary poverty of those in religious orders. But they also spoke of the “blessed poor”—presumably meaning those who had not volunteered to be destitute. They saw people who worked hard, and yet still suffered deprivation, as worthy of pity. People who begged, did not work, or “drank themselves into torpor,” and women and men who “hired out their bodies for sex” were the undeserving poor (Jordan, 2001, pp. 191–192).

The Black Death, or bubonic plague of the mid-1300s, and similar epidemics in the next two centuries, brought poverty and death to new heights in Europe and the Islamic world. The plague bacterium is a pathogen carried by fleas. The rat is the preferred host of fleas, and in the Middle Ages the plague spread to Europe and Asia through the fleas on shipboard rats. Once the host rat died of the disease, the fleas sought other hosts, such as cats or humans. The death rate from the disease, particularly in crowded urban areas, was extremely high. The Black Death, which occurred in England in 1348 to 1349, killed almost a third of the population. During the years of the plague, strangers who earlier might have been granted relief were seen as vagabonds “to whom the State prohibited almsgiving under pain of imprisonment” (Herlihy, 1997; Jordan, 2001; Trattner, 1999).

The Statute of Laborers

The Black Death, as you might expect, created a lack of labor. Surviving workers were in a position to demand higher wages. Landowners put a stop to this with the Statute of Laborers enacted in 1349. It set a maximum wage and compelled workers to work for whomever needed them. It forbade laborers from traveling, and made it illegal for an able-bodied man to beg. Punishment for begging included whipping for several days and having one or both ears cut off. Social welfare historian Blanche Coll notes that in this period, “those seeking work at better wages and under freer conditions…were deemed criminal.” In other words, poverty among the able-bodied was beginning to be seen as a crime, and people should deem themselves lucky to get any job available (Coll, 1969; see also Quigley, 1996). This set the tone for welfare legislation of centuries to come. Poverty was blamed on unwillingness to work, so people should be forced to work at whatever wages were offered. Contemporary emphases on “workfare” and on the prevention of welfare cheating continue this Medieval thinking.

Subsequent centuries brought new challenges and problems. In England, the feudal system was declining, mercantilism (or commitment to commerce and trade) was rising, new trade routes were being opened, and new industries were being developed. As the New World began to open up, the potential for increased prosperity grew. Systems like serfdom, however, which at least offered some protection to individuals by the lords of the land, went into decline. With the coming of industrialization and urbanization, many people no longer had any rights to the land they lived on nor to their dwellings. To make things worse, the Protestant Reformation brought about the expulsion of the Catholic Church from England in 1536. This meant the demise of the system of monasteries and their hospitals, which had carried much of the responsibility for helping the sick, the old, the traveler, and the poor in general (Popple & Leighninger, 2011).

The Elizabethan Poor Laws

Following the Statute of Laborers, various laws were passed that proposed to deal with the problems of labor, begging, and crime. These acts were eventually collected in one major piece of legislation, the Elizabethan Poor Law of 1601. This major law established “the first secure basis for public assistance to the poor.” It required each parish or town to provide for the poor through levying taxes on property held within the jurisdiction. The Elizabethan Poor Law, which would stand with only minor changes for almost 250 years, defined three major categories of dependents. These were the vagrant, the involuntary unemployed person, and the helpless. The law established ways for dealing with each. It also established the parish, “acting through the overseers of the poor appointed by local officials, as the administrative unit for executing the law” (Coll, 1969; Quigley, 1996; Ziliak, 2005).

Indoor and Outdoor Relief

In a system that might seem familiar today, the parish was given the power to use the tax revenues to build and maintain almshouses, to supply help to the aged, the sick, and handicapped, and other helpless people in their own homes, and to “purchase materials with which to put the able-bodied unemployed to work.” The law held parents, if they had the means, responsible for the support of their children and grandchildren. In turn, children were liable for the care of their “unemployable parents and grandparents.” Those children whose parents could not provide for them “were to be set to work or bound out as apprentices.” Finally, vagrants and able-bodied people refusing to work could be committed either to a “house of correction,” a workhouse, or a common jail. Putting people into almshouses (or “poorhouses”), workhouses, or other institutions was considered “indoor relief.” “Outdoor relief” referred to providing some sort of help to people in their homes. As we will see, these terms were later transplanted to the American colonies, and lingered in the parlance of the American social welfare system for some time (Coll, 1969; Marx, 2004).

Most of the institutions for indoor relief, even orphanages, were unpleasant, often punishing places. Many were not much more than sheds divided into tiny rooms with little heat. Sanitation facilities were rudimentary, and food was inadequate. Watery gruel was a staple. Those who refused to go into workhouses were harshly dealt with. Vagrants “not willing to work,” could be sent to an institution, whipped, branded, stoned, or even put to death. Clearly all able-bodied, and thus “undeserving” poor were to be strictly and punitively controlled (Day, 2000; Dolgoff & Feldstein, 1998; Trattner, 1999).

Although it sounds like their work could be grim and often punitive, the overseers of the poor constituted an antecedent to modern-day social workers. Theirs was the job of identifying the poor, the vagrant and homeless, the unemployed, and others who were having difficulty surviving. They then decided what should happen with each of these groups of people. Moreover, they were part of a system that said that the government had an obligation to help people (at least the “deserving” ones) who could not provide for themselves and a responsibility to control the other groups in some way. As “government administrators,” they might be compared to contemporary child welfare social workers and social workers in the criminal justice system.

By the 1800s, dissatisfaction with the Poor Law system was growing in England. The effectiveness and equity of the system were being questioned. The system of parish responsibility for responses to the poor often led to unequal and inadequate standards. A body of “unpaid, untrained, and often incompetent overseers of the poor…did not make for effective administration.” Perhaps even more important, many of the poorer areas had “a higher proportion of needy residents and less money to spend on relief than the more prosperous ones.” Thus, not only was treatment of the poor unequal from parish to parish, but “the communities that could least afford it usually had the highest poor rates,” or taxes. And taxes went up even for richer parishes. Between 1760 and 1818, “poor relief expenditures throughout England increased sixfold, while the population about doubled” (Trattner, 1999).

The Speenhamland Law

This happened in part due to a law related to poor workers that was enacted in the late 1700s. During a period of economic distress in England in the mid-1790s, a new policy changed the sense of the Elizabethan Poor Law. This was an allowance system set up by what became known as the Speenhamland Law. In 1795, during a particularly bad period of poverty, the justices of Berkshire met at an inn in Speenhamland and declared that subsidies to help poor workers and their families should be based on the price of bread. When a “gallon loaf” of bread cost one shilling every “poor and industrious person” would receive a relief allowance of three shillings weekly, based on his own or his family's labor. He would also receive one shilling, six pence for the support of his wife and other family members. If the cost of bread rose, he would receive proportionately more money. The system was financed by taxpayers. Although never made a formal law, this practice was soon instituted throughout most of the countryside, and even in some manufacturing areas. By the 1830s, middle-class critics saw this as an obstacle to the new capitalistic economy, and brought about the system's demise. However, as Trattner points out, the Speenhamland approach was actually a “forward looking measure that provided financial aid to the destitute according to need as determined by the cost of living” and family size (Polanyi, 1976; Trattner, 1999).

The Rise of the Market

At the same time, the Poor Law itself was coming under attack by classical economists as well as by the manufacturing interests that were gaining power in England. The economists had come to believe that poverty was the natural state of the working class. They argued that the possession of property and wealth was a “natural right,” not to be interfered with by the state. The Poor Law was an artificial creation of the state that taxed the well-to-do for the maintenance and care of the needy. Earlier proponents of the poor law system, members of the old landed aristocracy, had a sense of social responsibility and reasoned that the stability of the state required public action to regulate the affairs of mankind, including the discouragement of labor mobility. The rise of a business class and the emergence of a capitalist economy that substituted the price mechanism for the state in determining the status of labor led to the belief that interference with the normal operations of the market, which included a fluid labor force controlled by supply and demand, would threaten, if not overturn, the economic order. In essence, the Elizabethan Poor Law was being replaced by a self-regulating market economy (Trattner, 1999).

Under the poor laws, another important approach to the deserving poor was for families to take them in. For example, a widow might be sent to live with a family. Sometimes this was on a rotational basis: 2 weeks with one family, 2 weeks with another, back to the first, and so forth. Another practice was to place poor people with families, where they could help with farming, caring for children, or similar tasks. The town or other local government body would reimburse the family for the poor person's care. Consequently, unlike the practice of a normal auction, the care and services of the person being auctioned went to the lowest bidder—the family that could feed and clothe them for the smallest amount (Trattner, 1999).

Social Welfare Institutions

Just as in the Old World, as time went on, states and communities turned to the use of various institutions, or indoor relief, to respond to the problems of the poor, sick, elderly, “idle beggars,” and others with particular needs. Where previously they were run out of town, able-bodied beggars were sent to the poorhouse, or almshouse. The goal of this new practice was to decrease the expense of pauperism by establishing cheaper care; another advantage of this cheaper, less pleasant treatment was that it would discourage people from applying for help. One estimate was that the annual cost of a poor person on outdoor relief was $33 to $65 (even more if the person was sick or old). In contrast, the cost of sending that person to a poorhouse would be only $20 to $35 (Trattner, 1999).

Poorhouses would also build character. Work, especially farm labor, was required of all able-bodied inmates. Idleness and alcohol were prohibited. According to officials, pauper children would receive “an education to fit them for future usefulness.” While conditions in the poorhouse might have constituted some improvement over the practice of auctioning individuals off to the lowest bidder, it was still basically a repressive system with the goal of deterring people from seeking relief except in cases of dire need (Trattner, 1999).

Another institution, the orphanage, has a long history in America. The Ursuline Convent in New Orleans established the first orphanage in 1727. This was set up to provide a home for children whose parents had been slain in an Indian raid. The next, and more permanent orphanage was Bethesda, founded in Savannah, Georgia, in 1740 by a priest. The first public orphanage was created in South Carolina 50 years later. Between 1860 and 1880, about 250 orphanages were founded, most by Catholic and Protestant organizations. Although an improvement over the poorhouse and other ways of dealing with orphaned children, these new institutions tended to be large structures in which rigid schedules and daily routines were stressed. Conjuring up pictures of Dickens' Oliver Twist asking “Please, sir, I want some more,” the orphanages of the 1800s practiced harsh discipline and strove to suppress individuality among the children (Katz, 1986; Trattner, 1999).

Responses to those with mental illness also played a major role in the development of institutions. As early as 1689, the residents of Braintree, Massachusetts, agreed to finance the construction of a small house in which a man in the community could “secure his sister and goodwife” since both were “distracted.” This decision was based on a Massachusetts statute that empowered town Selectmen to take care of unruly and distracted persons so that they would not “damnify [or annoy] others.” But it was not until the well-publicized campaigns of Dorothea Dix that institutionalization of the mentally ill began in full force (Trattner, 1999).

Dorothea Dix

Dix's campaign and its results are an excellent example of the phenomenon that one era's solution to a social welfare issue can deteriorate into another era's catastrophe. Dix is credited with the first major campaign to get the national government to provide funding for institutions that would provide for the mentally ill. In fact, when we ask students in a beginning social work or social welfare class to name important historic figures in the profession, the first name is often Dorothea Dix, the second Jane Addams. Dix was born in Maine in 1802 and moved at age 12 to Boston to live with her grandparents. There she received a good education and went on to become a teacher. After opening a private school for girls, and then a free school for poor children, she suffered a “mental collapse” in 1836. After her recovery, she became a Sunday school teacher for women inmates in the East Cambridge jail. During this life-changing experience, she witnessed the cruel treatment of prisoners, especially those who were mentally disturbed (Katz, 1986).

As Trattner (1999) notes, “Horrified by what she saw [Dix] apparently experienced a tremendous emotional reaction which led her to embark upon one of the most remarkable crusades of the century” (p. 64)—a campaign to ensure better treatment of the mentally ill. Since at the time private hospitals for those with mental illness were small, selective, and expensive, many of those deemed insane were placed in almshouses and jails. Others were held, often chained, in cabins, closets, and pens.

Eventually, individual states began taking on more responsibility for those with mental illness. Mental institutions were established in a number of states, and in 1890, the state of New York took over the complete care of all its “insane” poor. Much of this activity in the states was inspired by Dix, who was instrumental in the improvement of the state mental institution in Massachusetts and went on to inspire and cajole state legislatures to found hospitals for the mentally ill in nine other states. A genuine pioneer, she journeyed “by train, stagecoach, lumber wagon, and foot over muddy roads and swollen rivers” to get to remote facilities for those with mental illness (Katz, 1986).

Based on Dix's broad and detailed research, a Bill for the Benefit of the Indigent Insane was introduced in Congress in 1848 to provide millions of acres of land to the states to help pay for the construction of more state mental institutions. Dix lobbied hard for the bill, which had to be reintroduced a number of times and was not passed by Congress until 1854. Many prominent citizens, clergymen, and public and private organizations had lobbied for the measure. However, the measure was vetoed by President Franklin Pierce, on the grounds that he could not find any authority in the Constitution for making the federal government the great almoner of public charity throughout the United States (Crenson, 1998; Trattner, 1999).

Mothers' Pensions

Following the development of such institutions as orphanages and mental hospitals, the country began to swing back to more individualized approaches such as the “placing out” of poor and orphaned children and organized charity work with the needy. Matthew A. Crenson has developed a fascinating narrative of the connection between the abandonment of the orphanage and the development of a mothers' pension system that eventually led to the creation of the federal Aid to Families with Dependent Children (AFDC) program (Crenson, 1998; Trattner, 1999).

Crenson's thesis is that the states' creation of public orphanages or their subsidization of private orphanages made them responsible, either directly or indirectly, for the religious upbringing of their wards. “A generation of tense maneuvering…led to a general search to sidestep these hazards.” A potential solution was the development of mothers' pensions, which would enable destitute mothers to keep their children at home through state payments for financial support. While this approach was not carried out in most places until the New Deal, reformers concerned about the needs of neglected children developed programs in which foster families were paid for caring for children, and systems for supervising these families (Crenson, 1998).

Weaknesses of Institutions

By the end of the 1800s, state and local institutions no longer seemed the most effective way to deal with problems of poverty and dependency. The system of state mental institutions championed by Dorothea Dix was an important improvement over its antecedents. Yet, in the 1870s, these institutions went into a dramatic decline. Patients were increasingly subjected to restraints and punishments and ordered routines of care broke down. Part of the change stemmed from underfunding, part from the basic difficulty of “curing” mental illness. In addition, the patient population was changing from the acutely mentally ill to the chronically mentally ill and the aged (Crenson, 1998).

Concerns about the effectiveness of large institutions swung the pendulum back toward individual approaches to dealing with poverty, dependency, and other social problems. Each of these movements had a major impact on the development of social work as a profession. The first was the development of the Charity Organization Society (COS), which was first established in England and then transported to the United States in 1877 (Katz, 1986; Trattner, 1999).

The Charity Organization Society

The COS in England was inspired in part by the work of a Scottish clergyman, Thomas Chalmers, who set up a district plan to organize relief in his Glasgow parish in the 1820s. Chalmers put the poor relief work of each district under the direction of a deacon. The system stressed “friendly visiting” with the poor and based the giving of alms on the needy person's “reformation of character.” A similar organization, called the “London Society for Organizing Charitable Relief and Repressing Mendicancy” had been established in England in 1869 (Sapiro, 1990; Trattner, 1999).

Impressed by the work of the London Society, S. Humpreys Gurteen, an Episcopal clergyman in Buffalo, proposed the formation of a similar agency in his city. The Buffalo Charity Organization was established in 1877. Gurteen told the citizens of the city that charity organization was the solution to the city's problems of “indiscriminate relief policies” in which overlapping systems of private charities and municipal relief led to indolence, pauperism, and fraud (Crenson, 1998, pp. 240–250).

The idea of “organizing” charity spread widely throughout the United States in the late 1800s. The New York Association for Improving the Condition of the Poor, for example, set up a system of home visiting by volunteers, who would attend to the “moral deficits” of poor families as well as their economic needs. Basically the goal of the Association was to ensure investigation of every appeal for assistance, to distinguish between the deserving and undeserving poor, and to blend this “with a judicious mixture of moral exhortation.” The organization placed each city ward under the responsibility of an advisory committee which would coordinate provision of relief through a system of friendly visitors (Crenson, 1998, pp. 250–251).

Spokespeople for the new system saw it as a new benevolent gospel. They pictured charity organization as a “crusade to save the city from itself and from the evils of pauperism.” Leaders of the movement saw themselves as missionaries in a holy cause. As the New York Charity Organization (which grew out of the Association for Improving the Condition of the Poor) put it, “if we do not furnish the poor with elevating influences, they will rule us by degrading ones” (Popple & Leighninger, 2011, pp. 71–75).

The COS movement reflected a conservative interpretation of the causes of poverty. According to one of its leaders, Josephine Shaw Lowell, individual dependency was one of the greatest evils of modern industrial life. Lowell was a reformer who came from a wealthy Boston family. She stressed that the poor were in need “largely because of their own shortcomings, including drunkenness and idleness.” Haphazard charity must be avoided, as it contributed to their dependency. The solution to the problems of poverty and dependency was to provide patient, skilled visiting of the poor by “dedicated volunteers.” Lowell felt that well-to-do visitors, generally women, could bring not alms, but “kind action,” and could serve as good moral examples for the poor. Visitors should avoid giving money, but to provide loans and assistance in finding jobs to “deserving” families (Katz, 1986; Popple & Leighninger, 2011, pp. 67–68).

Charity organization societies spread quickly among American cities in the late 19th century. However, the original goals of COS leaders proved difficult to sustain. Individual approaches to the complex problem of poverty failed to stop its growth. There was also an insufficient pool of volunteers to carry out an effective system of friendly visiting. Increasingly, charities turned to the use of paid staff to investigate applications and visit the poor (Lubove, 1969).

These paid agents were a major forerunner of professional social workers. Like the earlier charity volunteers, they were chiefly women. They also tended to be Protestant, white, and middle class. The job of charity worker offered an outlet for college-educated women at a time when taking care of a family “took center stage and career possibilities for women were few and far between.” Charity work was a relatively acceptable job for women because it used traditional feminine characteristics such as caring for others (Lubove, 1969; Muncy, 1991).

Josephine Shaw Lowell was a good example of such a woman. Her parents had a strong interest in social reform, imbuing in Lowell a belief in the importance of public service. The Lowells were abolitionists, and Josephine joined a women's relief organization that provided aid to Union soldiers. Widowed at a young age, Lowell turned to even greater involvement in social reform. Her work with the New York Charities Aid Association, including a statewide study of pauperism, led to her appointment by the governor of New York to the Commission of the State Board of Charities. She was the first female member of the board (Lubove, 1969; Popple & Leighninger, 2011).

Although she dressed in black and seemed the symbol of a self-sacrificing reformer, Lowell was also tough, shrewd, and pragmatic. She held strong views about the causes of poverty and the appropriate remedies for dealing with it. Many of her principles and ideas can be found in her book, Private Charity and Public Relief, published in 1884. Although sometimes portrayed as exhibiting a punitive, moralistic attitude toward the poor, Lowell had a mixture of values and beliefs regarding dependency. She viewed idleness as a major defect of the poor and government aid as a disincentive to honest work. Private charity, with its approach of friendly visiting, was necessary to elevate the moral nature of the poor. She had little sympathy for drunkards, vagrant women, and mothers of illegitimate children (Beatty, 1986).

Whose Fault, the Individual or the Market?

Lowell also believed, however, that certain groups of people, including orphans, widows, and the sick, were poor through no fault of their own. In these instances, she felt public responses, such as institutions and widows' pensions, to be appropriate sources of relief. She realized that low wages were one source of poverty, and she fought to improve working conditions for women. During the depression of 1893 she also came to realize that even hard-working people could find themselves unemployed. Yet, while she appreciated the importance of environmental factors in poverty, Lowell also tended to apply such insights only to the “deserving poor,” such as those clearly demonstrating a desire to work. In essence, she was convinced that personal character was the most significant element determining a person's position in life (Popple & Leighninger, 2011).

Charity organization workers such as Lowell were a major forerunner of professional social workers. Elements of the COS system, such as investigations by caseworkers and one-to-one work with mothers of poor families, also made their way into state and federal child welfare programs. The National Conference of Charities and Correction, founded by state boards of charity in 1874, was a precursor of the American Association of Social Workers, one of the organizations that helped found today's National Association of Social Workers (NASW; Popple & Leighninger, 2011).

Jane Addams and the Settlement House

Another forerunner of modern social welfare programs and professional social work was the settlement house. Like the COS, this was an idea imported from England. However, unlike the charity movement, with its stress on individual defects, the social settlement focused chiefly on the environmental factors in poverty.

While Jane Addams' Hull House is regarded as the inspiration of the settlement house movement in the United States, the first U.S. settlement was actually founded in New York City by an organization of graduates from Smith College in 1887. But it was Addams' accomplishments in a poor immigrant community in Chicago's West Side that captured the imagination of American reformers (Popple & Leighninger, 2011).

Addams grew up in a comfortable home in the small town of Cedarville, Illinois. Her parents were part of the second wave of pioneers in America; her father came to what was then the frontier “to organize and develop what others had discovered and settled.” He bought a sawmill and gristmill, and in an effort to help build a community, he planted the hill across from his mills with the seeds of Norway pines. He invested in railroads and banks and became a wealthy man. John Addams believed in hard work and had a strong religious faith. He served for many years as a Republican in the State Senate and was instrumental in the improvement of prisons, insane asylums, and the state industrial schools (Popple & Leighninger, 2011).