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Psychiatric Social Work

   The leading edge of social casework in the 1920s was the practice of psychiatric social work. In 1918, Smith College started the first training program for psychiatric social workers. While the program's first efforts were aimed specifically at soldiers and their families, psychiatric social work rapidly spread to other fields of practice. Psychiatric social work received another advance due to a general increase in mental health awareness generated by the activities of the National Committee On Mental Hygiene.

   The National Committee was first formed by Clifford Beers in 1909 and largely dedicated itself to an educational campaign designed to heighten public consciousness of mental illness and mental deficiency. The committee was ably led by a number of leading psychiatrists such as Adolf Meyer and   were advocates of both social psychiatry and psychiatric social work.

   The National Committee played an important role in establishing psychiatric services for members of the armed services and consequently enjoyed high prestige in the early 1920s. One of the National Committee's war programs was the establishment of training programs for psychiatric social workers within the Red Cross. In 1921 there were at least eight Red Cross chapters that offered psychiatric social work services to veterans and their families. By 1926, the Red Cross had organized social service departments in federal hospitals.  This in turn led to the establishment of a nationwide system of social services attached to Veterans Administration clinics, outpatient departments and hospitals.

   Another major vehicle that helped push psychiatric social work into a prominent position was the development of child guidance clinics. Early child guidance clinics were initially created out of a concern about juvenile delinquents.  Through this work early clinic professions became concerned over the lack of social and psychological services for all children.  As a consequence, child guidance clinics rapidly broadened their mission to include children with mental and emotional problems.

   In 1921, The New York School of Social Work and the National Committee On Mental Hygiene convinced the Commonwealth Fund to support a number of "demonstration" child guidance clinics.  These clinics were based on  earlier efforts which were committed to advancing the role of the psychiatric social worker. The child guidance clinic model quickly spread and by 1927 there were more than a hundred programs scattered around the country.

   The influence of the child guidance clinic quickly permeated early social work. The clinics operated under the "team" concept  involving psychiatrists, psychologists and social workers. In the child guidance clinic team, social workers participated in both the diagnostic and treatment phases of the program.  The clinic's predominant theoretical foundation became Freudian theory, a set of ideas so new they were not even mentioned in Social Diagnosis.  The psychiatric social worker, using Freudian theory to build a therapeutic relationship with predominately middle-class patients, became a new model for the profession.

Sigmund Freud

Adapted from

Special thanks to the late Professor Dan Huff and Boise State University School of Social Work

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