.

The men came to him in a predicament. That is precisely what brings people to the case worker, whether the predicament be called trouble, distress, a situation or misfortune; whether it be a prison record, truancy, poverty or sickness; whether the case worker be a representative of the court, the children's society, the society for organizing charity, or the hospital social service department. What the soldier did and what the case worker must do are basicly the same. The soldier, first of all, told the men just what their predicament involved; they could not enter the army because they were suffering from hernia. Second, he pointed a way out of the difficulty-the hospital. Third, he suggested various motives which might help the men to take that way. He appealed to their sense of economy, or rather to that fundamental desire to get something for nothing which seems to be part of everybody-"If you weren't going into the army (the operation) would cost you $120." He aroused their sense of fear on the one hand-they might wake some morning and find themselves dead--and he allayed it on the other the operation "doesn't amount to much more than taking an anesthetic." Study of almost any record of successful case treatment will show a procedure similar in its rudiments to that which the soldier observed.

Consider, for example, the predicament of the family of Herbert Jones. They were without food. Nearly all of their furniture had been sold. Mrs. Jones and one of the children were sick. Mr. Jones was out of work. He had been arrogant toward his fellow workmen, so arrogant that the union to which he had belonged was unwilling to help him. He was drinking heavily. He abused his wife and had been brought at least once before the Domestic Relations Court. The case worker discovered that Mr. Jones was an extremely sensitive man who craved friendship and affection. As often happens with such men his arrogance was the unfortunate result of fear of injury to his feelings and of his unconscious efforts to protect himself. He had taken to drink because he thought that in that way he could become a good fellow among the men of the neighborhood. He abused his wife partly because of remorse for his intemperance and partly because he was jealous of what he thought was her too great devotion to two children whom she had had by a former marriage.

The first step in treatment was to show the man and the woman

what was involved in their predicament. The case worker interpreted the husband to the wife, helping her to see that the man's abuse and his jealousy were really caused by his affection for her. Next came the suggestion that, were the source of irritation to be removed, the family life could become happy once more. The way out lay in an arrangement to have the stepchildren live with their grandparents, and the woman's desire for a happy association with her husband provided the motive for doing this.

With the man, treatment involved a frank facing of the facts of his situation. His baseless jealousy and the unpleasant effect which his arrogance had upon those who knew him were made plain to him. His predicament was himself. The remedy lay in a struggle against himself. The social worker offered him assistance in this struggle. His home would be reëstablished. His wife would be helped back to health. The union officials would be placated so that he could once more obtain work. The motive suggested to the man was the possibility of achieving the kind of family life and companionship among his fellows for which he longed. Accompanying this was the encouragement and the sense of assurance afforded by the interest of the case worker in his welfare.

The method of treatment here was precisely the method of the soldier in dealing with the two volunteers. First, the case worker showed the family what was involved in their predicament, second, she pointed to the way out, third, she supplied a motive.

Often the steps in this method follow each other so closely as to render analysis almost impossible. Thus the realization of the predicament may furnish the motive. Again, the man or the woman may have decided upon the remedy but may need motivation; or realizing their predicament they may need both a way out and a motive to inspire them to take that way.

A teamster who liked horses too much to want to learn how to operate a motor-truck, found himself reduced to such odd jobs of driving as he could find. Gradually he became accustomed to irregular work until unemployment became a habit. He realized what was wrong but knew no remedy, and even if he had known one he lacked initiative enough to lift himself out of his predicament. The solution lay in a job on a stock breeding farm and the motive which led him to take this solution was the adventure of going to a new and a rural environment.

Although it may not always be necessary to show a man either directly or by implication the elements of his predicament it is essential, of course, for the case worker to understand them. This means investigation, and after investigation diagnosis. The method of investigation is well defined. The importance of the first interview, the value of seeing relatives, former employers, and the other factors in this phase of case work are admitted. Social workers, however, must do more than follow these steps. They must take them without for a moment forgetting that the end of investigation is diagnosis and that diagnosis is the beginning of treatment. Treatment depends for its success upon an investigation conducted with this in mind.

Diagnosis, moreover, is made primarily, it should be remembered, for the benefit of the person under treatment, not for the information of the case worker. Here, again, inspiration and suggestion can be obtained from study of the methods of the medical profession. The tendency among physicians, evidenced by the increasing stress which is being laid upon personal hygiene, is to make the patient understand his trouble in order that he may adjust his life so as to overcome his disease of course, with the help of what therapeutic or surgical assistance may be necessary. This also must be the method of social case treatment.

The way out or the ways out which are opened to the family or the individual after they have been shown the implications of their predicament are really opportunities to develop the kind of personal equipment and environment that will enable them to reëstablish themselves. The job in the country was not the solution for the teamster who had acquired the habit of unemployment. It was merely the offering of a new environment in which he could reach. the solution. The solution itself lay in the development of character, of the habit of industry, of a greater measure of initiative. The removal of the stepchildren to their grandparents and the obtaining of a job for the man who had been abusing his wife was not the solution. He had had many different jobs before and conceivably the stepchildren might have left his home without producing the desired result. The ultimate solution lay in his victory over himself. The job and the change in domestic arrangements served merely to provide him a more favorable environment.

The elements involved in securing such an environment and in

making possible the development of a better personal equipment are as well defined as are the processes of investigation. They are health, education, mental hygiene, home economics, work, play, spiritual influence. These things are the means which the case worker uses in administering social treatment. They must not be considered as ends in themselves but only as influences in helping the family and the individual to readjust their lives.

Case work agencies which in their annual reports list the number of people for whom they have obtained jobs or hospital care tell only a small part of the story. Indeed, better case work is implied when a man secures employment for himself than when the social worker finds the job. The purpose that the job or the other element in treatment is to serve is the important consideration. Thus, a family is persuaded to move to another neighborhood in order that the oldest boy may be better able to resist the temptation to join a street gang. The boy is invited to become a member of a settlement club so that he may be provided with a legitimate outlet to his desires. His mother is induced to take more care in the keeping of the house that he may find the home more interesting. The school teacher is asked to find what studies appeal most to the boy in order that opportunity for development in a congenial direction may be given to him. These efforts are all designed to enable the boy to grow to be a useful citizen. They are not ends in themselves, desirable though they may be.

Again, the administering of social case treatment does not mean that the case worker must fulfill the function of nurse, teacher, clergyman, or housewife. To open the opportunity of health to a man one need not be a physician or do the work of a physician. Recognizing the importance of health to the well-being of the individual, the case worker's task is to help the family to realize this also, and then if necessary to suggest the place where the essentials. of health may be obtained. Similarly, the case worker by introducing the clergyman or the friendly visitor endeavors to provide the spiritual and personal influence which her diagnosis shows that the man, or the woman or the family needs. It is not necessary for the case worker to be able to teach a housewife how to cook or to scrub. Case workers have scrubbed floors and cooked meals for families under treatment, but when a case worker has done this it has not been for the purpose of teaching the family how to do these

things but for the influence which such an action might have upon her relationships with the household.

This must not be understood to be an underestimating of the. importance of health, education, mental hygiene, work, play, home economics and spiritual influence as ends in themselves. To obtain them is so important that more and more attention must be focused upon them if social case treatment is to realize its opportunities. Indeed, it is most desirable that effort be made to change the method of recording case work in order that the need for these things may be emphasized even more clearly. Porter R. Lee has criticized the case record as being too much a diary of how the case worker has spent her time and too little a statement of facts upon which treatment is being based. It might well be rearranged so as to segregate the various steps that are necessary to develop the personal equipment and the environment of the family under care. Thus the case worker in looking over the reports of her work would be able to see at a glance whether or not the need for work, play, health, and the like had been supplied.

The opportunities which may make it possible for the individual to readjust his life having been pointed out to him there remains the last element in social treatment-motivation. Often the strongest motive operating upon a man is the misery of his own predicament. This motive may be the knowledge that someone cares, that there is someone interested in seeing him make good. There is not one of the myriad impulses which influence men to action that the social worker is not called upon to use. The supreme art of treatment is knowing what motive to use in a particular situation. Perhaps the best preparation for a proper choice at such a time lies in a study of the daily experiences that mark the course of case work. What is it, for example, that caused a family to become self-supporting after years of dependence on the gifts of neighbors? Why is it that a man who has been a drunkard since his youth suddenly decides not to touch alcohol again and holds to his decision? What has caused a woman who has neglected housekeeping to take a new interest in the care of her home? What induced the truant to return to school, the deserter to support his wife, the consumptive to go to the sanatorium which he had been resolved to see no more? Study in other fields should also prove suggestive. Whatever vocations have to do with the art of dealing with people can make a con