The aim of this case study is to use knowledge of human growth and development to critically discuss the theories a social worker might employ to assess a family and better understand their behaviour. These theories will be applied to two members of the family, Molly (13-years old) and Elsie (65-years old), and critiqued in terms of how they might assist social workers in making informed, anti-oppressive assessments. Any limitations to the theories will also be discussed.
Anti-oppressive practice will underlie the critique and has been defined as “a form of social work practice which addresses social divisions and structural inequalities in the work that is done with ‘clients’ (users) and workers” (Dominelli, 1993, p. 24). It is a person-centred approach synonymous with Rogers (1980) philosophy of person-centred practice. It is designed to empower individuals by reducing the negative effects of hierarchy, with the emphasis being on a holistic approach to assessment. Practising in an anti-oppressive way requires valuing differences in lifestyle and personal identities. By recognising the power imbalance present between social workers and clients, especially between social workers and children or oppressed older adults, theory and knowledge can be utilised to challenge oppression and discrimination (Dalrymple and Burke, 2000). How this can be achieved is demonstrated throughout this case study.
The two theories of human growth and development to be applied to Molly are Attachment Theory and Life Course Theory.
Attachment Theory is a psychological theory based on the premise that children require an attachment relationship with at least one consistent caregiver within their lives for normal social and emotional development (Bowlby, 1958; Ainsworth et al., 1978). For Molly, the development of an attachment figure was likely to have been compromised during her early developmental years. When she was between 1 and 7-years old, her mother was addicted to drugs and alcohol and thus was emotionally and physically unavailable (Eiden et al., 2002). Despite living with her father and paternal grandparents for a period of time, the overall insecurity within her family unit is likely to have impacted her ability to attach to others (Barrow, 2011). The possibility that Molly has developed multiple attachments also needs to be considered as Molly lives within a context of shared caregiving (Kelly and Lamb, 2000). This is where the theory is limited in its application within this family since it does not provide insight into the dynamics and implications of multiple attachments. It also fails to acknowledge the impact of losing multiple attachments (Ainsworth et al., 1978).
There are a number of significant changes that have occurred in Molly’s life and that involve potential attachment figures. For example, Molly’s father, whom Molly remained close to even when her parents were separated, has become marginalised and distanced in an effort to avoid arguments with Molly’s mother (Markiewicz, Doyle, and Brendgen, 2001). When he is at home, the tension is likely to impact the duration and quality of time spent with Molly. Marital conflict has been found to influence adolescents’ attachment security by reducing the effectiveness of parenting (Markiewicz, Doyle, and Brendgen, 2001). Given the family history, Molly might be fearful of her parents separating again, the extent of which cannot be underestimated (Lewinsohn et al., 2008). A recent article in the news reported on the potential long-term impact of divorce on children and their life course, including a reduction in earning potential and less stable relationships (Barrow, 2011). The implications of this are that Molly is not only being negatively impacted in the present, but might experience a continuation of these problems into adulthood. Long-term impact cannot, however, be assumed and consideration of individual differences such as personality, resilience, coping style, and stage of development can provide the context for assessing the impact of changes in attachments. Another criticism of attachment theory is that such individual differences are not accounted for (Ainsworth et al., 1978).
Molly has already lost one of her attachment figures, her grandfather, and thus loss is a reality for Molly. Molly’s grandmother’s behaviour is likely to have changed as she comes to terms with her own loss, and the impact that this might be having on Molly’s already fragile micro-system (Bronfennbrenner, 1977) needs to be part of Molly’s assessment. All of the key attachment figures in Molly’s life are either emotionally or physically unavailable at present. Molly’s recent problems at school might be the result of a lack of secure attachment figures. Indeed, being racially abusive towards her peers would indicate difficulty in developing attachments outside of the home, a frequently reported problem among children who do not have a secure family attachment from which to learn (Allen and Land, 1999). Furthermore, research with feral children has shown that children raised without the attention of a consistent caregiver can display anger, distress, and detachment in the short-term and aggression, clinging, detachment, and psychosomatic disorders in the long-term (Siegler, 2006).
Harris (1998) would argue that the theory neglects to account for Molly’s developmental stage, with adolescence being a time when children are influenced more by their peers than their parents. This might especially be the case with Molly, whose dual ethnicity means she is likely to be experiencing more pressure to fit in among her peers. Evidence within the literature has shown that adolescents of dual heritage report more ethnic exploration, discrimination, and behavioural problems than those of single heritage (Ward, 2005). The level of attention Molly gains from her family during this challenging time is likely to be limited by her brother’s disability, which requires extra time and effort from Molly’s caregivers. This might be depleting their energies and reducing their capacity to support Molly (Opperman and Atlant, 2003). Social workers are responsible for ensuring that non-disabled siblings within a family are not overlooked (Children Act, 1989; Every Child Matters, 2003). Furthermore, Adler’s theory of birth order can alert social workers to a phenomenon termed ‘dethronement’ (Leman, 2004), which describes the removal of attention from the first child to the second child. Molly could be feeling the sense of inferiority that is often associated with dethronement, a factor that cannot be explained by biological theories of human development.
Life Course Theory
Life Course Theory has been defined as a “sequence of socially defined events and roles that the individual enacts over time” (Giele and Elder, 1998, p. 22). During adolescents, Gonadotropin, Luteinising, Follicle Stimulating, and Adrenocorticotropic hormones strongly influence mood swings and extremes of emotion (Corwin, 2008), which might explain Molly’s difficulty controlling her anger at school. The teenage brain is only about 80% developed, with the white matter that signals the release of these hormones increasing substantially during this time (Jensen, 2005).
According to Erickson’s 8 stages of human development, Molly is in stage five, which is characterised by a conflict between identity versus role confusion (Erickson, 1998). Risks to Molly’s social development include poor parental supervision and discipline, family conflict (Beinart et al., 2002), and any identity conflict she might be experiencing around her dual heritage (Ward, 2005). Molly is only one-quarter Asian and thus her identity is very ambiguous as her outward appearance is only 25% Asian extraction. There is the possibility that she may resent her mother for looking Asian and that her racial abusiveness at school is transference of this anger. There is also the issue of whether Molly’s mother has cultured any part of her Asian heritage onto Molly.
In assessing Molly via this theory, it is important to recognise the inevitable power imbalance between a social worker and an adolescent who is in an insecure home environment and struggling with the hormonal changes that come with being a teenager (Sakamoto and Pitner, 2005). By recognising this power imbalance, the social worker can redress any imbalances by reflexivity and becoming aware of their own preconceived ideas about adolescents (Dalyrmple and Burke, 1995). It would be easy to limit the involvement of Molly in the assessment in an effort to shield her or protect her due to her young age. However, since adolescence is a time when individuals are developing their own unique identities, such action would merely act to oppress and disempower Molly. She is already experiencing a lack of control within her current environment and thus it is crucial that the assessment by the social worker does not remove further control by being based on stereotypes and assumptions. For example, the hormonal changes that impact the mood of adolescents can lead to stereotypes of the moody, anti-social teenager, with such assumptions resulting in teenagers being an oppressed group portrayed as a social ‘problem.’ The additional pressure to fight this oppression and prove they are good people can make this developmental phase an even more challenging time.
Additional biological factors involved in Molly’s current sense of well-being might include issues around body image since this is a time when she will be making the transition from child to adult. Difficulties around relationship development and sexual attraction and orientation are all potential contributors to Molly’s low mood (Levinson, 1978). One of the limitations of biological theories of adolescence, however, is whilst they facilitate an understanding of adolescent development, they do not take into account the psychological factors associated with adolescence, such as identity development and role confusion. Considering Molly’s behaviours in light of psychological, social and cultural factors is important in gaining an accurate assessment of her social care needs. For example, Molly’s efforts to find her own identity whilst grappling with the physiological effects of adolescence is likely to be complicated by her dual heritage, which will be strongly linked to her sense of identity. There is the possibility that Molly is finding it difficult to fit in with her peers or that she is being bullied at school; being racially abusive might be an unconscious effort to raise the attention of adults towards discrimination she might be experiencing. This supports psychodynamic approaches and the notion that actions and experiences are influenced by unconscious motivations (Freud, 1923). Unless Molly is treated as an individual as opposed to a homogenous member of the adolescent group, a social worker will not be able to accurately assess and understand the core issues underlying Molly’s current behaviour. In turn, this will only act to further marginalise this oppressed group. Without the specialist knowledge and skills that can be gained from theories of human growth and development, it could be argued that social workers should not be allowed to work within the field of child protection (Laming, 2009).
The two theories of human growth and development to be applied to Elsie are Ecological Systems Theory and Disengagement Theory.
Ecological Systems Theory
Bronfenbrenner’s (1977) Ecological Model of human development posits that in order to understand human development, an individual’s ecological system needs to be taken into consideration. This includes their microsystem (i.e. immediate relationships), mesosystem (i.e. different parts of the microsystem working together), exosystem (i.e. systems that the individual is not directly part of but that affects them), macrosystem (i.e. the larger, more distanced social world such as government and culture), and their chronosystem (i.e. a system of change). The microsystem and macrosystem are likely to be of most impact to Elsie, the former in terms of current family insecurity and the latter in terms of culture and stereotypes associated with ageing.
Elsie’s ecological system has been continually changing for many years, especially her immediate surroundings, which are likely to have greater impact on her well-being. There has been very little environmental stability within Elsie’s life, at least over the last 7-years or more. She has recently lost her husband, experienced continually fluctuating environmental conditions, and is now living in a tense atmosphere due to issues within her son’s marriage. Part of working with Elsie in an anti-oppressive way is to recognise the harsh realities of her current ecological system. It is also important to note that, children’s behaviour and personality can also affect the behaviour of adults; Elsie’s behaviour and sense of well-being might be negatively affected by her granddaughters struggle through adolescence and her grandson’s disability. Taking into consideration Elsie’s ecological system highlights the importance of not making assumptions that Elsie’s increased forgetting is a sign of dementia; her symptoms might be the result of stress within her environment.
Despite the relevance of this theory to understanding Elsie’s situation, the critique does highlight limitations in its operationalisation (Wakefield, 1996). In particular, since past experiences and future anticipations are likely to impact Elsie’s current well-being, lack of inclusion of this element of human growth and development within the Ecological Model is a serious limitation in terms of assessing Elsie. For example, Elsie’s social systems today are extremely different to when she was younger. Indeed, Elsie has lived through two world wars, which is likely to have impacted her perceptions of herself and her social world.
Another limitation to the theory its emphasis on adaptation, which it has been argued can be used to encourage individuals to accept oppressive circumstances (Coady and Lehman, 2008). Social workers using this theory in their assessments ideally need to be aware that oppression and injustice are part of the environment that needs to be considered in an ecological analysis. With this consideration, the theory offers social workers a way of thinking about and assessing Elsie holistically, within her environment and social context.
The most drastic change in Elsie’s ecological system is the death of her husband. The possibility that Elsie is struggling with the bereavement of her husband needs to be taken very seriously. Elsie’s current cognitive problems might be reflective of depression associated with one of the purported stages of bereavement (Kubler-Ross, 1989). This is often characterised by feelings of guilt, lack of purpose in life, and a sense of loss. The threat of losing even more in her life, such as her role as caregiver to her grandchildren might be exacerbating the depression and any feelings of lack of purpose. The current tension within the family might also be raising concerns about losing the family, which is her primary source of support. Such fears are likely to hinder Elsie reaching a period of ‘restoration orientation,’ where she can focus on building a future without her husband (Worden, 2003). Being a widow means that Elsie is likely to have a unique sense of the contribution that being in a relationship or being alone has to personal identity; this might be strengthening any concerns she has about losing other relationships within her ecological system. This sense of self in later life has been referred to as ‘the mature imagination’ by Biggs (1999). If Erickson’s theory of life stages were to be utilised by the social worker, they would understand that this search for identity is a very important time for Elsie and could lead to either integration or despair (Erickson, 1998).
An understanding of demands and resources is important when working from the ecological perspective, an understanding which the theory itself lacks to emphasise (Coady and Lehman, 2008). For Elsie, demands within her life include coping with the loss of her husband, being responsible for collecting Mason from school, and dealing with any concerns she might have about her son’s marital problems. Elsie is also likely to be worried about her forgetfulness, perhaps attributing it to signs of dementia, which is frequently perceived as an inevitable part of the ageing process (ref). In terms of resources, Elsie does not have the support of her family as they are preoccupied with their own problems. Elsie’s demands drastically outweigh her resources, making it particularly important that social workers consider the disempowerment that Elsie is currently experiencing. Reflexivity is essential in ensuring that Elsie is assessed not based on preconceived ideas about older people, but on the reality of her difficult social circumstances (Dalrymple and Burke, 1995).
Social Disengagement Theory
Social Disengagement Theory has been described by Cumming and Henry (1961) as “an inevitable mutual withdrawal . . . resulting in decreased interaction between the ageing person and others in the social systems he belongs to” (p. 227). It could be argued that Elsie is preparing to disengage via the manifestation of memory problems that impact her ability to collect Mason from school and which has caused tension between the family. On the other hand, this cannot be assumed as this risks encouraging unwanted disengagement or creating a sense of obligation to disengage. If Elsie starts to feel like a burden, she might choose to disengage in order to prevent the tension she is witnessing before her. This illustrates how old age is just as much a social construction as a biological process (Estes et al., 1982). In order to work in an anti-oppressive way, social workers need to be aware that Elsie might be experiencing a sense of obligation to disengage rather than a biological need to disengage. Whilst her forgetfulness might be a step towards disengagement, it could just as equally be the result of a self-fulfilling prophecy resulting from stereotypes of old age. Equally, it could be the signs of dementia, with cognitive functioning likely to decline rapidly if it is a sign of Alzheimer’s disease (Teri et al., 1995). Again, this cannot be assumed, however, as despite being seen as a natural consequence of ageing, only a minority of people develop the condition (Stuart-Hamilton, 2006).
A key concern with disengagement theory is that there needs to be a move away from viewing older people as an homogenous group characterised by passivity, failing health, and dependency (Leont’ev, 1978). Placing Elsie within a category of ‘older people’ would be oppressive and would ignore Elsie’s individuality, including her own personal wants and needs in terms of engaging or disengaging from society. It might be that Elsie is ready to take a step back from the responsibility of collecting her grandson from school, hence the manifestation of forgetfulness. On the other hand, it might be that Elsie’s identity and sense of well-being rely on the joy she gets from collecting him from school. The latter is likely if Elsie’s past is taken into consideration. Elsie lived through two world wars, and in order to maintain continuity of personality (Atchley, 1989), it is plausible that Elsie’s sense of worth is based on hard work, productivity, and social contribution. The notion of continuity of personality has been supported within the literature (Reichard et al., 1962; Haan, 1986).
The theory is also limited in that it does not examine sociocultural differences. In the case of Elsie, whilst she might no longer be working and she no longer has the role of ‘wife,’ a social role has been established for her (Hochschild, 1976) – primarily as a support to her family, whether that be collecting her grandson from school or providing financial and emotional support them. This is supported by Activity Theory (Neugarten, 1977), which posits that a healthier approach to older age is to be active and socially engaged by replacing roles from earlier in the life trajectory with alternatives, which is exactly what Elsie has attempted to do. Activity theory is supported by the finding in several studies that active older adults show higher levels of life satisfaction and morale (Boyd and Bee, 2006). Furthermore, Activity Theory is by its very nature anti-oppressive in that promotes positive images and involvement and places a value on participation and relationships (Dalrymple and Burke, 1995). This highlights the importance of being mindful of the fact that, frequently, individuals who lose their partner in later life do not tend to start dating or looking for another partner. Elise could still have another 25-years to live, but is disengaging herself from the role of lover or wife by burying herself in her family.
To utilise disengagement theory within Elsie’s assessment risks being ageist and making assumptions based on her age. This in turn could result in Elsie becoming socialised and disengaging from society. This is also in line with Social Exchange Theory, which posits that social life is structured around reciprocal exchange and that disengagement from society or relationships is brought about by inequalities in the exchanges available to older people (Dowd, 1980; Nelson, 2000; Hendricks, 2004). Social workers can help establish any power imbalances between an older person and their social networks by acting as an advocate and thus actively preventing further oppression (Nelson, 2000). This involves not treating older people as children by using what the Americans have termed ‘elderspeak’ (i.e. calling older people ‘dear’ or ‘sweetie’), which can be perceived as patronising and disrespectful (Wigmore, 2008). Such practice also acts to create a power divide, where the older person is infantilised and treated as a dependent person. This can be discriminative in that it is a demeaning exercise of power (Thompson, 1997).
Family relationships are complex and effective support for individual members requires the utilisation of theory and knowledge pertaining to human growth and development. Evidence-based practice via the use of theories within social work is demonstrative of best practice, especially within a social world of continually changing contexts and social norms (Fook et al., 2000; Smith, 2004); however, flexibility and an eclectic approach need to run alongside established knowledge if discrimination is to be prevented. Theory needs to be embedded in practice so that social workers continually strive to develop the theory inductively via reflexivity and the challenging of personal thoughts and feelings that might create a power imbalance (Argyris and Schon, 1974). Social workers are a powerful social group whose practice can maintain discrimination if they do not remain aware of personal and social prejudices (Payne, 1997). Working according to Thompson’s (1997) PCS framework can facilitate anti-oppressive practice, whereby assessment of a family such as this one comprises an awareness of personal, psychological, practice and prejudice (P), values and norms that are internalised through socialisation via, consensus and conformity (C), and a socio-political understanding that discrimination is part of society (S). This framework is especially important when working with vulnerable adults and children such as Elsie and Molly.