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Uirginf Iqjiy V , ,lro," *-'' v" UirginfIqJIY their applicatronrn PT]BLICHEALTH SOCIAL WORK ,:'tt q7 J . .,j2 C 1959 -i:{:- Provided by the Maternal and Child Health Library, Georgetown University 1.. - i...r !irgli',iairi';' conceptsof "l i MENTAL HEALTH '..,^f, ,,.,t and ,,.44 'l r1i tti CONSULTATION their application rn PUBLIC HEALTH SOCIAT \?'ORK by GERALDCAPLAN, M. D., D.P. M. AssociateProfetsor of Mental Health Schoolof Public Health Haraard. Uniaersity with supplemefltarychapters in public health socialwork by VIRGINIA INSLEY, M. S.$tr. Cbief, MedicalSocial Work Section, Dittision of Healtb Sertticcs Children'sBureau U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE SocialSccurity Administration . Children'sBurcau ' 1959 _g:. Provided by the Maternal and Child Health Library, Georgetown University Ifor salc by thc Supcrintendcnt of Docunents, U.S, Goverment Prilting Omce Washington 25, D.C. Price $1 lia.^ Provided by the Maternal and Chitd Health Library, Georgetown University FOREWORD A11 the helping professions practice consultation and are con- cerned with its improvement. All these professions are concerned with mental health conceptsas they can be used to make consultation moro meaningful. Although the focus of this publication is on con- ceptsof mental health and consultation,particularly in their appiica- tion to public health social work, it carries implications for consultants in many fields. This publication, Corwepts of Mental, Heal,th and, Consul,tatinm, brings together papers presented at two institutes sponsored by the Medical Social lMork Education Project in Public Health held at the University of California in Berkeley in the summers of 1955 and 1957. The institutes themselves wero a cooperative endeavor of tho Schools of Social lMelfare and Public Health at the University of California and the California Department of Public Health. Finan- cial support came from a grant by the Children's Bureau. Dr. Gerald Caplan, Associate Professor of Mental Health, Har- vard School of Public Health, led both institutes. He presented the material which forms the major portion of this book, Mental Health Aspects of Social Work in Public Health, at the first institute. At the secondinstitute in 1957,he presented a paper embodying his later ideas on the subject of consultation entitled "Mental Health Con- sultation" and this is included in the present volume. Miss Virginia fnsley, Chief, Medical Social Work Section, Division of Health Serv- ices, Children's Bureau, served as co-leaderof the secondinstitute and presented a paper on "Social lMork Consultation in Public Health." Another paper by Miss Insley, "Program Consultation in Public Health Social lVork," rvas made available to the members of this institute and is included here becauseit fills out the picture of tho social work aspectsof this topic. Those who were invited to attend these two institutes included all the social workers employed in public health departments in the Western region; tho social work interns in public health at the Univer- sity of California, School of Social Welfare; and a few medical social workers interested in seryicesto mothers and children. lu :i-1. Provided by the Maternal and Child Health Library, Georgetown University The papers presentedat these institutes proved to be so valu- able and unique that the members were agreed that they should be rnacleavailable to a wide audienceof people in priblic health and social welfare and most particularly to public health social workers. With the publication of this volume, the content of these institutes becomesavailable on a national basis to both education and prac- tice in public health. The University of California to this end generously glanted the Bureau permission to bring the material together in this volume. To the university and to the membersof the committeewho planned these institutes, the Children's Bureau is grateful. Karunnrxre B. OnrrrNcnn, Chief , Chiklren) s Burean. lv t",- Provided by the Maternal and Child Health Library, Georgetown University VirginialnsleY CONTENTS Pag€ lntroduction vii Mental Health Aspects of Social Work in Public Health (Gerald I Caplan) I CHalrnn I-An Overview ) Cueprsn Il-Ingredients of Personality and Personality Devel- oPment 8 CnaprBn Ill-Ecological Ideas Regarding Mental Health and Mental Ill-Health 37 CHeprBnlV-Emotional Implications of Prcgnancy 44 Cseprnn V-Origin and Developntent of Mother-Child Rela- tionships 57 Cneprsn Vl-Mother-Child RelationshipsDuring the First Year of Life Cneprrn VII-The Family Health Clinic 110 Cnaprrn Vlll-{onsultation. 119 Mental Health Consultation (Gerald Caplan) 181 Social Work Consultation in Public Health (Virginia Inslev) 213 Program Consultarion (Virginia lnsley) 233 Appendix 247 Provided by the Maternal and Child Health Library, Georgetown University This page is blank in the original document. rfl Provided by the Maternal and Child Health Library, Georgetown University INTRODUCTION During the years since the passageof the Social Security Act in 1g35,the demand.for medical social workers in public health pro- public grams directed towards the preservation and improvement _of health and the prevention of illness and physical handicap has steadily increased. As programs got underway, funds made available to States under this Acl uttd. ud-ittistered. by the Children's Bureau of the U. S. Department of Health, Bd.ucation, and trVelfare, made it possible for State and Territorial departments of public health to establish social work positions. The need for more adequateheaith services at the local Gvel soon becameapparent and the demand for medical social workers increased as public health departments developed and ex- tended.their programs. The question of how to meet the d.emand for professionally trained. social workers is of great concern to tho social work profes- sion. The public health field poses a parbicular dilemma' Social workers in lnis field require professional surenessancl skill gained through practice under supervision following completion of the two- year graduato coursein a schoolof social work. The social worker in a public health program in some instances works directly with individuals, groups' and communities. But many social workers in these progr&ms employ their professional knowledge and skill through the method of consultation to members of other professional disciplines, who themselYesare in a helping re- lationship to people. The Children's Bureau has contributed to the recruitment of qualified persorurelby making funds available through State deparb- ments of public health to some schools of social work located in difrerent regions of the country to prepare social workers for practice in the field.of publichealth. The medical social work education project in public health at the School of Social Welfare, Ilniversity of California, Berkeley, is one of these educational programs. \4rith a portion of the Chil- Bureau grant, the project sponsors an annual institute for dren's 'Western social workers employed in public health settings in the States, Alaska, and Hawaii. fn this way, the project takes some vlt Provided by the Maternal and Child Health Library, Georgetown University respollsibility for improvementoI plactice in public health by bring- ing together social workers already employed in the field for discus- sion of theoretical concepts,common problems, and ways of meeting theseproblems. The fnstitutes on rvhich this publication is basedwere the first and third annual institutes under the auspices of the project. fn 1955 the Institute on I\{ental Health Aspects of Social Work in Public Health devoted considerabletime to a discussion of consulta- tion. Ilecauso of the increasing need for social work consultatiou in relation to child health conferences,prenatal clinics, and parents' groups the institute focuseclon: (1) Presentationof theoreticalcon- tent essentialto an understandingof maternal and child health; and (2) the social worker's application of this knowledge through the method of consultation. Becausoso many workers wanted to know more about the application of the specializedtechniques described by I)r. Caplan to the job of the public health social worker, the 1957 fnstitute placed more emphasison the social worker's responsibilities in public health. Since the 1955 and 1957 Institutes representeda continuing considerationof the processof consultation,the two fnsti- tutes havebeen combinecl intothis publication. The proceedingsof the 1955Institute basedon a transcription of the fnstitute were originally published in 1956bv the University of ('Mental Califomia Pressnnder the heading llealth Aspectsof Social Work in Public Health." This volume has been completely revisecl and is included as the first sectionof the pt'esentvolume. RUTH COOPER Associate Professor JEAN HOODWIN I'ectu,rer SclLool,of Social Welfure IJnirersity if Catiforniu vul _l{1 Provided by the Maternal and Child Health Library, Georgetown University MEI{TAL HEALTH ASPECTSOF SOCIAL WORK IN PT]BLIC HEALTH GERALD CAPLAN, M. D., D. P. M. Atnci.ate Profetsorof Mental Healtb Haraard,School of Public Health _l- Provided by the Maternal and Child Health Library, Georgetown University This pageis blank in the original document. e. Provided by the Maternal and Child Health Library, Georgetown University CHAPTER I An Oueru'iew In planning for this institute, the committee believed that, on the whole, those attending would be most interested in the applica- tion of mental health principles to public health social work, and that
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