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COLLEGE

IBRARY

THE OUTLOOK
FOR WOMEN
■

Artt/

SOCIAL CASE WORK
IN A PSYCHIATRIC
SETTING
Social Work Series
Bulletin No. 235-2
U. S. DEPARTMENT OF LABOR
WOMEN S BUREAU

UNITED STATES DEPARTMENT OF LABOR
MAURICE J. TOBIN, SECRETARY

WOMEN’S BUREAU
FRIEDA S. MILLER, DIRECTOR

The Outlook for Women
in
Social Case Work
in a Psychiatric Setting

Bulletin of the Women’s Bureau No. 235-2
Social Work Series

U. S. GOVERNMENT PRINTING OFFICE
WASHINGTON : 1950

For sale by the Superintendent of Documents, U. S. Government
Printing Office, Washington 25, D. C. Price 25 cents

This bulletin is No. 235-2 in the

SOCIAL WORK SERIES
No. 235-1
No. 235-2

The Outlook for Women in Social Case Work in a Medical
Setting.
The Outlook for Women in Social Case Work in a Psychiatric
Setting.

LETTER OF TRANSMITTAL
United States Department of Labor,
Women’s Bureau,

Washington, May 31,1950.
Sir : I have the honor of transmitting this report on the outlook for
women in psychiatric social work. It is the second of a series resulting
from our study of the need for women in the social services.
The study was planned, directed, and written by Marguerite W.
Zapoleon.
Grateful acknowledgment is made to the many individuals and
agencies who cooperated so generously in supplying information and
helpful criticism.
Respectfully submitted.
Frieda S. Miller,

Hon.

Director.

J. Tobin,
Secretary of Labor.

Maurice

in

WiiP

Figure 1.—A social case worker (second from the left) in a mental hos­
pital participating in a clinical team conference with a psychiatrist,
a psychologist, an occupational therapist, and a nurse.

FOREWORD
The social well-being of our people, like their health, has received
growing attention over the years. Of the increasing numbers in our
economy engaged in rendering professional social service, two-thirds
or more are women. The story of their progress and the current and
future needs for their services have been the subject of a Women’s Bu­
reau study which will be reported in a series of bulletins of which this
is the second.
Those which follow, like the first report on social case work in a
medical setting and this report on social case work in a psychiatric
setting, will describe the employment outlook for women in areas of
specialization within the field of social work. The final bulletin in the
series will describe the outlook for women in the entire field of social
work, showing its relation to other professions of women and compar­
ing the specializations within the field. Unlike the usual monograph
which describes an occupation in detail at a particular point in time,
this study, like the earlier Women’s Bureau series on occupations in
the medical and health services and in the sciences, is concerned prima­
rily with changes and trends.
Although more than 2,200 books, articles, or pamphlets have been
culled for information, the principal information for this series has
been obtained from professional organizations, public and private
social agencies, schools of social work, and individual social workers.
The following sources have contributed to the study thus far:
37 National professional organizations. For help on this particu­
lar report, the Bureau is indebted especially to the American
Association of Psychiatric Social Workers.
49 Schools of social work and other colleges and universities.
87 Agencies employing social workers, including 23 community
chests and councils of social agencies, the American National
Red Cross, and 15 non-Federal hospitals.
37 Government agencies concerned with social service programs
or employment in this field, including international, State, and
local agencies, and such Federal agencies as the Bureau of
Labor Statistics and the United States Employment Service
in the United States Department of Labor; the Bureau of
Public Assistance, the Children’s Bureau, the Office of Educa­
tion, and the Office of Vocational Rehabilitation in the Fed­
eral Security Agency; the United States Civil Service Commis­
sion ; and the United States Veterans’ Administration. The
National Institute of Mental Health of the Public Health
Service in the federal Security Agency was especially helpful
in supplying statistics for this report.
To these contributors the Bureau is indebted for the raw material
which made this report possible.
The Bureau is also grateful to the following for the illustrations

VI

FOREWORD

used in the bulletin: Alexandria (Va.) Mental Hygiene Clinic, The
Evening Star, and the board member of the clinic whose child was
substituted in the cover picture for a clinic patient; the American
National Red Cross (fig. 19); the Atlantic City Press and Central
Studios (fig. 16) ; the Brockton (Mass.) Public Schools (fig. 18);
Children’s Hospital of the District of Columbia (fig. 7); Massachu­
setts Department of Mental Health, Division of Mental Hygiene
(figs. 10, 12) ; National Defense Agency (fig. 9—an employee of the
hospital is posed as a patient) ; St. Elizabeths Hospital, Washington,
D. C. (figs. 2, 3, 5, 6,11,13,17,20—persons shown are authentic, except
patients and relatives of patients, who are posed) ; Veterans’ Adminis­
tration (figs. 1, 4, 8, 14, 15—persons shown are authentic, except
patients and relatives of patients, who are posed).
The reader will recognize gaps in our statistical knowledge of em­
ployment in psychiatric settings and the unsurmounted difficulty of
distinguishing always individuals who are fully qualified for the pro­
fession from those who are not. But it is hoped that she will find
here a useful synthesis of existing knowledge on an important field
of work in which more women are needed.

CONTENTS
Page

Letter of transmittal
Foreword
Definitions________________ _________________________________________
Section I
The psychiatric setting
The outlook
Demand and supply in 1949
Psychiatric clinics
13
Psychiatric hospitals
14
Other institutions and organizations
15
Consultation and mental hygiene education___________________
Private practice
20
Teaching
20
Research
21
Geographic variations in employment
22
Supply
24
Training
25
Scholarships, fellowships, and other student aids_______________
Earnings, hours, andadvancement
30
Organizations----------------------------------------------------------------------------Suggestions to those considering training for psychiatric social work-.
Section II
37
Employment before World War II
37
In psychiatric hospitals
37
In psychiatric clinics
38
In preventive work
41
Wartime changes in employment,
Volunteers and paid aides
47
Appendix:
Minimum requirements for beginning position as psychiatric social
worker at St. Elizabeths Hospital in the United States Public
Health Service and in theDistrict of Columbia Government______
Minimum requirements for beginning position as psychiatric social
worker for duty in the United States Veterans’Administration____
Minimum requirements for membership in the American Association
of Psychiatric Social Workers
49
Essential elements in a training program approved by the American
Association of Psychiatric Social Workers, 1949_________________
Schools of social work approved by the American Association of
Psychiatric Social Workers, January 1950
Sources to which reference is made in the text
53
Tables:
1. Type of employment of 874 members of the American Association
of Psychiatric Social Workers, 1948I_________________________
2. Geographic distribution of psychiatric social workers compared
with that of psychiatrists and the general population__________
3. Type of employment of 418 members of the American Association
of Psychiatric Social Workers, December 1942________________
VII

in
v
ix
i
1
4
13

18

27
33
34

42

48
49

50
51

12
23
46

VIII

CONTENTS

Illustrations:
Page
1. A social case worker (second from the left) in a mental hospital
participating in a clinical team conference with a psychiatrist, a
psychologist, an occupational therapist, and a nurse_________
iv
2. A social case worker in a mental hospital___ _________ _______
3. A social case worker in a mental hospital•
4. A social case worker sees patient in veterans’ ncuropsychiatric
hospital_________________________________
5
5. A social case worker in a mental hospital greets a social worker
from a community agency
6
6. A scene in a teaching hospital, ,
9
7. The psychiatrist, the psychiatric social worker, and the psycholo­
gist discuss the finger painting of a psychiatric clinic patient-II
8. A social case worker preparing for her first interview with a pat lent
in a mental hospital____________________________ _ _ ____
15
9. A psychiatric social work officer at an Army general hospital
17
interviewing a patient_____
10. A social case worker connected with a State mental hygiene divi- '
sion conferring with a troubled mother,,
________________
19
11. Using psychodrama in a teaching hospital, a case worker directs
a student in interviewing a depressed patient______
21
12. A social case worker with the Massachusetts Department of
Mental Health, Division of Mental Hygiene___ _____________
22
13. A psychiatric social work supervisor in a mental hospital conferring
with a social v'ork student ________________
26
14. An experienced case worker in a veterans’ neuropsychiatric
hospital sees patient in her office____
__ ____ __ _
29
15. A social case worker in a mental hospital interviews patient’s wife.
31
16. The president of the American Orthopsychiatric Association
(center) conferring with speakers at the twenty-seventh annual
convention of the association _
_____ _ ______
34
17. A psychiatrist in a mental hospital opening conference to discuss
a convalescent patient about to leave the hospital___________
35
18. A psychiatric social case worker interviewing a parent at a child
guidance center_______
40
19. A Red Cross psychiatric case worker visits patients____________
43
20. A social case worker and an occupational therapist in a mental
hospital observing a patient-,.
_____________________
45

Psychiatric Social Worker, as Defined in the Dictionary of
Occupational Titles {65)
A Case Worker who “Performs duties in organizations, such as hos­
pitals and clinics, concerned with assisting persons suffering from
nervous or mental diseases or serious emotional maladjustments: In­
vestigates case situations and gives Psychiatrist supplementary in­
formation on patients’ environment, behavior, and personal history.
Interprets psychiatric treatment to patients’ families and suggests
means of expediting recovery of patients. Assists patients and their
families in developing mental and emotional adjustments to illness.
Attempts to eliminate fear, prejudice, and other attitudes that are
obstacles to acceptance of psychiatric care and continuation of treat­
ments. Assists patients to regulate their lives so that treatments will
be most effective. Arranges for institutionalization of patients if
recommended by proper authorities. Assists patients in making ad­
justments to community life during treatment or on discharge from
institution.”

Case Worker (Professional and Kindred) 0-27.20, as Defined in
the Dictionary of Occupational Titles (65)
“Performs any one or a combination of the following social serv­
ice duties, usually requiring a college degree and applying tech­
niques acquired through postgraduate training in social service work,
in pursuance of a welfare program organized by a public or private
agency or organization: Studies physical and social environment of
a family, person, or persons in order to determine and execute prac­
tical plans for alleviating existing undesirable conditions. Visits
persons in need of assistance or receives clients at intake desk of
agency. Interviews clients to ascertain nature of their problem.
Diagnoses problems, considering factors involved, and plans treat­
ment. Makes necessary contacts to ascertain background and needs
of clients and their eligibility for financial, medical, and material
assistance. Helps clients understand their situations more clearly
and assists them to reach satisfactory solutions for their problems.
Refers clients to community resources, such as hospitals, clinics,
recreational facilities, and schools, which may assist in rectifying the
maladjustments. Endeavor’s to foster self-development of individ­
uals in order that they may successfully meet social exigencies. Fol­
lows progress of cases beyond solution of immediate problems. Keeps
case histories and other records.”

Psychiatric Social Work, as Defined by the American
Association of Psychiatric Social Workers (5)
“Psychiatric social work, for the purpose of Association usage in
determining eligibility for membership, shall be defined as social
work undertaken in direct and responsible working relation with
psychiatry. Psychiatric social work is practiced in hospitals, clinics
or under other psychiatric auspices, the essential purpose of which
is to serve people with mental or emotional disturbances.”
890477—50------ 2

IX

Having the first of several case
work interviews with a
newly admitted patient.

With the psychiatrist, interpret­
ing the patient’s condition to
her husband.

Consulting with occupational
therapist about patient.

' • * r. \\
4, , H w

i

Figure 2.—A social case worker in a mental hospital.

THE OUTLOOK FOR WOMEN IN
SOCIAL CASE WORK IN A
PSYCHIATRIC SETTING
Section 1
THE PSYCHIATRIC SETTING
More than 1,500, possibly 2,000, social workers were assisting psy­
chiatrists in the prevention and treatment of mental illness in 1949.
More than 85 percent of them were women. Like all other social case
workers, they were trained to deal with individuals in need to help
them to understand what they need and to obtain the help indicated.
Like all social workers, they were also skilled in seeing the individual
in relation to his family and all the circumstances of his environment
and in using community resources to help him work out his prob­
lems (oJj). But, unlike the family case worker and the child welfare
worker, the case worker in a psychiatric setting worked constantly
with those whose mental or emotional disturbances had reached the
stage where the help of a psychiatrist was called for.
The usual psychiatric setting is the psychiatric hospital or clinic
where mental and nervous illnesses are diagnosed and treated. But
psychiatric social workers may find employment wherever a psychia­
trist doete, for example, in a general or children’s hospital, in a court
or correctional institution, in an industrial plant, in a school or college,
or in private practice. In a psychiatric hospital, the woman who
works as a social worker obtains, records, and interprets facts about
the patient’s background and his environment that reveal the social
problems involved in the illness and will aid the psychiatrist in diag­
nosis and treatment. She helps the patient’s family to understand
the nature of the illness, to deal with the problems it creates for them,
and to cooperate in the patient’s recovery. She helps patients to
adjust to the hospital environment and encourages them to follow the
recommendations of the psychiatrist. She assists those who are ready
to leave the hospital for convalescence at home and helps them to re­
establish themselves in the community; she visits later to see that
progress is being made or to arrange for further treatment. She also
sees that such necessary services as transportation and medical attenl

2

OUTLOOK FOR WOMEN

tion are made available to patients. In carrying on her work, she
makes wise use of her skill in interviewing and of the confidence the
patient and his relatives may have in her. She works with the psycho] ogist, the nurse, the dietitian, the therapist, the teacher, the vocational
counselor, and all others who are assisting the patient to recover.
In this work she uses her case work skills as a member of a hospital
team which is directed by the psychiatrist.
In a mental hygiene or child guidance clinic, patients vary markedly
in the degree of their mental disturbances. A young child may be
referred by his parents because of unexplained lying or temper tan­
trums; an adult may seek help in finding an emotional cause for an
illness foi which no physical basis has been found; an adolescent may
be referred by a probation officer to find the reason for his repeated vio­
lation of the law. The minimum clinic team for solving the problems
presented usually includes a psychiatrist, a clinical psychologist, and
two psychiatric social workers. A physician for medical consultation
and a nurse are sometimes on the staff, and, in a few clinics, a social
group worker is employed.
In 1948 more than three-fourths of 327 agencies participating in a
study conducted by the American Orthopsychiatric Association, Inc.,
lepoited that they had the traditional clinical team of psychiatrist,
psychologist, and social worker. The relations and functions of the
members of the team varied. In some the traditional pattern was
followed, m which the psychologist tested the patient, the social
worker studied the home and environment, and the psychiatrist treated
the patient, alter the team had arrived at a diagnosis based on the
reports of the psychologist and social worker together with interviews
of the psychiatrist with the patient. The social worker carried out
those phases of the treatment which involved changes in the environ­
ment of the patient or case work with his family. In other clinics,
the services were so organized that each member of the staff partici­
pated according to the need of the patient and called in other staff
members only when necessary. In only two-fifths of the 192 agencies
reporting on this item were more than half of all patients seen by
all three members of the team—the psychiatrist, psychologist, and
social worker. One-fifth reported that none of the patients was seen
by all three (46). However, in most clinics it is customary for the
social worker to handle problems involving community relations, while
the psychologist tends to specialize in diagnostic and evaluative testing
and research, and the psychiatrist in therapv (®5).
In general hospitals, the psychiatric social worker works closely
with the medical social worker, but usually specializes in work with
patients m the psychiatric ward or clinics. (See Bulletin No. 235-1
m this series for further information on the social worker in a medical
setting.)

Talking with psychiatrist about
patient leaving the hospital.

Seeing the patient off as she
leaves to live at home with
her husband.

■jaa»

Visiting the patient in her
home.

Figure 3.—A social case worker in a mental hospital.

4

OUTLOOK FOR WOMEN

Some family and child welfare agencies have psychiatrists on the
staff, usually in a consulting capacity; some employ persons with train­
ing and experience in a psychiatric setting to serve as case workers
on their regular staffs. More than one-fifth of the members of the
American Association of Psychiatric Social Workers were employed
by such agencies or in case work with veterans not using clinics
or hospitals in 1948. (See table 1, p. 12.) This type of work, however,
when a psychiatrist is not employed to direct it, is no longer purely
“psychiatric.” Although these social workers are no less competent,
their setting is not psychiatric, despite the fact that consultation with
a psychiatrist may be periodically provided (#<5).
This bulletin is concerned primarily with those case workers who
work directly with psychiatrists in a psychiatric setting. It excludes
a growing number of socal group workers who work with patients
in mental hospitals and other psychiatric settings. The relation of
the group worker to the case worker in a mental hospital has been
described in detail in a recent thesis based on the program at the
Crile Hospital in Cleveland, Ohio (SO). The group worker and the
case worker have been cooperating in group therapy in a child guid­
ance clinic in Pittsburgh for some years (H). Group therapy will
be described in a later bulletin in this series on social group work.
THE OUTLOOK
Employers of psychiatric social workers, educators who train them,
and groups concerned with mental health needs were unanimous in 1949
in their reports that the demand for psychiatric social workers was
growing rapidly and would continue to outstrip the supply for some
years to come. Other evidence confirmed these reports: unfilled posi­
tions; the postponement of the opening and expansion of clinics and
other psychiatric services because of lack of personnel; the employ­
ment of part-time personnel because of the inability to obtain full­
time persons; and the high turn-over among psychiatric social workers
induced by multiple job choices.
The public interest in helping servicemen to recover from mental
illness contracted during World War II has resulted in a continuing
demand for more and better mental health services. The popular de­
mand is reflected at the national level by the development of a psy­
chiatric social work program in the Army, the expansion of neuro­
psychiatric hospital and clinic facilities in the Veterans’ Adminis­
tration, the inauguration in 1946 of a National Mental Health Pro­
gram under the direction of the Mental Hygiene Division of the United
States Public Health Service with funds for assistance to State and
local agencies and for training mental health personnel, and the exten-

SOCIAL CASE WORK, PSYCHIATRIC SETTING

5

Figure 4.—A social case worker sees patient in veterans’ neuropsychiatric
hospital, at his request.

sion of the Vocational Rehabilitation Act to cover persons with mental
as well as physical disabilities. States also increased appropriations
for mental health programs. Mississippi and Montana in 1948 made
their first appropriations for noninstitutional mental health services
(63). New York State was expected to spend nearly 103 million dol­
lars for its Department of Mental Hygiene and its mental institutions
in 1949-50, an increase of nearly 62 million dollars over its comparable
expenditures for 1942-43. Programs in schools and colleges and the
increase in the number of individuals who seek psychiatric help in
handling their emotional problems indicate a growing public under­
standing of and support for increased expenditures for psychiatric
services.
The need for additional services is unquestioned (^5). Physicians
report that 40 percent to 70 percent of their medical patients are in
need of psychotherapy in relation to physical medical problems (34).

6

OUTLOOK FOR WOMEN

Figure 5.—A social case worker in a mental hospital greets a social worker
from a community agency who has come to confer regarding the care
of a patient’s children.

A spokesman for the Public Health Service lias said that by conserva­
tive estimate more than 8 million persons in the United States are
suffering from some form of mental or nervous illness (21). The
executive secretary of the American Psychiatric Association estimated
in 1947 that at least 12 million need help to enable them to adjust to
life situations.
The Public Health Service has figured that, for an adequate mental
hygiene program, the long-range goal should be 1 psychiatric social

SOCIAL CASE WORK, PSYCHIATRIC SETTING

7

worker for 10,000 people {62). This would mean 16,000 psychiatric
Social workers for the population in I960 which the Bureau of the
Census estimates will be 160 million. The achievement of a more im­
mediate goal of 1 psychiatric social worker for 20,000 persons by 1950
would reduce the number needed to 7,500. This lower figure is far
greater than the estimated 1,500 to 2,000 available in 1949. In 1947
only one State, New York, and the District of Columbia had a member
of the American Association of Psychiatric Social Workers for every
50.000 of its people; and only California, Colorado, Connecticut, Mas­
sachusetts, and Rhode Island had 1 for each 100,000, according to the
Public Health Service.
The need for additional mental hospital facilities has been empha­
sized by reports of the badly overcrowded conditions existing in most
of these hospitals. A normal growth in population and the increas­
ing number of the aged among us create additional needs. The ad­
missions of senile patients by mental hospitals in one State were esti­
mated to have increased sevenfold in a decade. In 1948 the Group
for the Advancement of Psychiatry stated that the American Psychi­
atric Association’s estimate that there should be 1 psychiatric social
worker for every 100 new admissions to mental hospitals each year
was too low. It suggested 1 to every 80, in addition to at least 1
psychiatric social worker for every 60 patients in convalescent or
family care status (26). This would mean, on the basis of 305,000
new admissions in 1948, that the minimum required would be 3,800
psychiatric social workers, plus those needed for the growing number
of convalescent and home care patients. At least 3,050 would be needed
if the 1 to 100 ratio were used. This lower figure is about 5 times
the number of social workers employed in mental hospitals in 1947.
The need for additional clinical facilities was also great. The
Mental Hygiene Division of the Public Health Service in 1948 esti­
mated that there should be 1 psychiatric clinic for every group of
100.000 people. In this year there were fewer than 850 clinics in
the United States, many of which were only partially staffed and
offered only limited service. On the basis of the Public Health Serv­
ice estimate, the need is for 1,500 full-time, completely staffed clinics.
The minimum staff for a clinic includes 2 social workers in addition
to a psychiatrist and a psychologist (62). The load in the existing
psychiatric clinics, excluding the 140 or so in mental hospitals, indi­
cates that the estimate of the Public Health Service is conservative.
They report a demand that already doubles and triples the number
they actually can serve.
As the needs for additional clinical facilities are met, more clinics
designed to meet special problems rather than to serve a general
population group or community will also be created. Increasingly,
890477—S'

3

8

OUTLOOK FOR WOMEN

the need for psychiatric service for those who are brought into court
is being recognized (13) (12). A clinic responsible for the diagnosis
and treatment of the psychiatric, medical, and dental needs of resi­
dents was declared by the United States Office of Education to be an
essential service in training schools for delinquent youth (60). The
requirement of a psychiatric examination before probation or parole
is arranged has been frequently urged not only for the well-being
of the offender but for the protection of the public. Undoubtedly
there will be a growth in psychiatric social service in correctional
work, both with, young people and adults, although relatively few
psychiatrists have been employed in criminology in the past (33).
Along with education, industry, and the military services, it is one
of the fields in which there is likely to be a steady future growth in
the demand for psychiatric service.
Preventive work with young children is one of the areas of psychiat­
ric work in which expansion may also be expected. Although the
experiences in the early years of a child’s life are generally considered
to determine in a large measure the ease with which he makes later
adjustments, few children below school age have had psychiatric
attention. Psychiatric service in a few nursery schools and chil­
dren’s hospitals has demonstrated its value and indicated a latent
demand among parents for such services to their children. The work
of child-guidance clinics, which for the most part have dealt with
school-age children, has convinced parents and others of the need
for early attention to disturbances of children. The need for psy­
chiatric services for children placed in foster homes and for those
who do not attain normal mental development has also been for the
most part unmet, except in isolated communities. Eesident childtreatment centers, in existence in some 20 communities in 1949, have
demonstrated their usefulness and will grow in number.
Teachers of psychiatric social work will be needed to prepare the
increasing numbers required for social work in a psychiatric setting.
Added to this, a growing number of teachers will be instructing social
work students in the basic principles of psychiatric social work. The
extensive belief that all case workers should be oriented to social
psychiatry and the tendency for personnel workers, school teachers,
and others working with individuals to take courses in mental hygiene
and psychiatric social work will tend to augment the teaching load
in schools of social work and other university departments and the
need for psychiatric social workers who can teach.
The demand for more psychiatrists and for more training in psy­
chiatry for all physicians also will require additional related train­
ing in the social aspects of psychiatry for which the social service
department in the teaching hospital is responsible in part. A similar

SOCIAL CASE WORK, PSYCHIATRIC SETTING

9

trend is likely in the teaching programs for nurses, dietitians, and
other hospital personnel. This load, combined with the field super­
vision of students of social work, already a full-time position in some
hospitals, is likely to increase the need for full-time psychiatric social
work personnel to assist the head of the social service department in
the teaching program. Obviously, for such positions teaching skills
as well as case work skills are required.
Research into the causes and care of mental illness and emotional
disturbances will also offer opportunity to a small but growing num■■

iiiasi

Figure 6.—A scene in a teaching hospital in which students are being
taught by a skilled case worker how to interview the upset parents of a
patient, whose roles are assumed by two assistants.

ber of social workers. They will usually work with a psychiatric
team on a group project in a hospital, clinic, or research agency,
or organize student research in a school of social work. The other
area of research to which more psychiatric social workers will prob­
ably give time in the future is that of analysis of the methods and
processes by which they can improve their skills in helping patients.
The extent to which social workers are used in psychotherapy in
the future will also affect the demand for the case workers trained
to work in the psychiatric field. In 1949 there was some difference

10

OUTLOOK FOR WOMEN

of opinion as to the exact meaning of psychotherapy, which in turn
affected opinion as to whether it should be included among the func­
tions of the psychiatric social worker. The Committee on Psychiatric
Social Work of the Group for the Advancement of Psychiatry recom­
mends that the practice of psychotherapy be limited to the medically
trained psychiatrists. It lias defined psychotherapy as—
* * * any considered and competent medical endeavor, directed toward the
improvement of the emotional health of the individual, based upon the under­
standing of the psychodynamics involved and of the needs of the individual
under treatment. Psychotherapeutic endeavor may include adjunctive pro­
fessional services under the supervision of the psychiatrist. An essential of
psychotherapy is found in the interpersonal relationship existing between two
people, one asking for help, and the other assuming the authority and having
the competence to give help in an area involving a personal problem which is
handled through a psychological process (26).

According to this interpretation the social worker in a psychiatric
clinic would continue to be primarily responsible for the, social and
community relationships involved in the treatment of the patient
and for assisting him in adjusting to his environment, but not for that
part of the treatment which involved basic emotional changes within
himself. On the other hand, psychiatric case workers sometimes en­
gage in therapy (3), and one authority on social work describes
psychotherapy as “a specialization * * *, within the larger field
of social work” (£9). There are also those who recommend fur­
ther graduate specialization for psychiatric social workers who wish
to become therapists. The extent to which social workers aided in
psychotherapy during the war in work with servicemen and the con­
tinuing shortage of psychiatrists have suggested the need for prepar­
ing psychotherapists with less training than that of the psychiatrist.
Trained psychotherapists have also been suggested as a means of meet­
ing the needs of individuals who do not have access to psychiatrists
and would not seek that sort of help because they do not realize their
need for it (£9). But it is likely that the psychiatric social worker
will continue to specialize in the field in which she is making a unique
contribution to social adjustment, and that psychotherapy will be
closely directed by psychiatrists, who will place limits on the extent
to which others participate. One well-known psychiatrist has said,
“* * * in all cases the social worker becomes not only an investi­
gator but invariably a therapist. His therapy is primarily directed
toward helping the individual accept the situation, modifying the
external factors insofar as this is possible.” The psychiatrist, on the
other hand, attempts to change the structure of the personality (39).
Fortunately, the interest in psychiatric social work developed dur­
ing the war resulted in increased enrollments and applications for

SOCIAL CASE WORK, PSYCHIATRIC SETTING

11

training in psychiatric social work and offered some hope that ulti­
mately those trained would be adequate for the demand. In 1949
nearly 500 students who specialized in psychiatric work were graduated
from schools of social work. Although this was more than double
the 1944 number, it was only half of the number that will be needed an­
nually during the early fifties to staff psychiatric programs already
planned in the United States (So).
Unless these new graduates work in psychiatric settings, however,
they will help to increase the total supply of social workers without

Figure 7.—The psychiatrist, the psychiatric social worker, and the psy­
chologist discuss the finger painting of a psychiatric clinic patient at
a children’s hospital.

reducing the shortage of psychiatric social workers. Follow-up
studies of the graduates of schools of social work do not offer much
promise for the future in this respect, unless there is a marked change
from the past. In one school where half the graduates in the period
from 1936 to 1945 specialized in psychiatric social work, only onefourtli of these specialists reported that their first jobs were in mental
hospitals, clinics, or other psychiatric units.
The fact that there is an increasing variety of psychiatric settings
and that salaries in many agencies have increased in recent years may

12

OUTLOOK FOR WOMEN

induce more graduates to remain in the field. Only 60 percent of all
psychiatrists were employed in State mental hospitals in 1948, as
compared with 80 percent 20 years before (39). Mental hospitals
ranked third in size as an employer of members of the American Asso­
ciation of Psychiatric Social Workers in 1948. (See table 1.) Of
21 graduates from one school of social work in 1948 who entered
psychiatric settings, only 7 were in psychiatric hospitals or the
psychiatric departments of general hospitals, while 8 were in child
guidance clinics, 4 in other psychiatric clinics, and 2 in diagnostic
homes. Although almost three-fourths of all the alumnae of that
school who in 1948 reported employment in psychiatric work were
in hospitals or clinics, others reported that they were engaged in
private practice, teaching in a school of social work, court work,
mental hygiene work, or administrative and counseling work. Of 14
jobs listed with Social Workers’ Placement Service of the California
Department of Employment in a 3-month period in 1947-48, for which
psychiatric social worker training was required, only 5 were in hos­
pitals or clinics. The remainder were in schools, children’s or other
case work agencies, membership organizations, or in a court or a
church.
The demand for social workers trained for psychiatric specializa­
tion is likely to continue in nonpsychiatric agencies as well as in
psychiatric settings. But the predictable demand in psychiatric set­
tings is so great that those who take training in this field are urged
to utilize it to the fullest in service to the mentally ill.
Table 1.—Type of Employment of 874 Members of the American Association of
Psychiatric Social Workers, 1948
Type of employment
Total.____ ________________________________ ______________
Clinics______ ____________________ ______ _____________
Social case work agencies 2_______
_
Hospitals____ __________________________
Teaching in social work school, undergraduate college, or nursing school
Mental hygiene associations or bureaus______ ______________________
Schools, working with pupils_____________
Consultant______________________________________
Institutionsr except hospitals________________ _ _
...
Medical social work___________________________________
Public welfare agencies__________________________ _ .
’’
Private practice___________________________________ ”
Vocational rehabilitation______________________
_
Courts___ _____________________ ________________________
Group work agencies
"
Miscellaneous related work. ____________ _______________ _______’
Occupation other than social work or work in a social agency ... ..___
Unclassified__________ _________________________________

Number

Percent

1874

100.0

243
179
177
75
30
27
23
21
20
14
6
4
1
3
39
10
2

27.8
20.5
20.3
8.6
3.4
3.1
2.6
2.4
2.3
1.6
.7
.5
.1
.3
4.5
1.1
.2

1
addltional 182 members did not state employment, and 27 were employed outside the United States.
2 Nonchnieal work with the Veterans' Administration is included here, whereas work in Veterans’ Admin­
istration clinics or hospitals are reported under clinics and hospitals respectively.
Source: Tabulation made from August 1948 membership list of the A. A. P. S. W.

SOCIAL CASE WORK, PSYCHIATRIC SETTING

13

DEMAND AND SUPPLY IN 1949
Psychiatric Clinics

The largest demand for psychiatric social workers in 1949 was in
psychiatric hospitals and clinics. Some 800 were employed in clinics
alone in 1948, according to the United States Public Health Service,
538 in full-time clinics and 302 in part-time clinics. About 300 other
social workers without psychiatric specialization were also employed
in these clinics. Some 200 psychiatric social workers were working
in 1949 in the 59 mental hygiene clinics of the Veterans’ Administra­
tion. A rather high percentage, possibly one-fourth, of these were
men. Another large group were in some of the 510 mental hygiene
clinics operated by hospitals of all types in 1949, according to the
American Hospital Association (9). Some of these clinics in general
hospitals served out-patients, but even these were limited directly to
the intake of the hospital and seldom gave community-wide service
(2-5). Some of the 143 clinics in mental and allied hospitals included
in the hospital clinic group served entire communities, but usually
their major load consisted of residents and out-patients still under
hospital treatment.
Some of these 800 psychiatric social workers were employed in the
300 or more child guidance clinics, most of which operated part time
(6J/,). A few worked in the growing number of specialized clinics for
those suffering from alcoholism or venereal disease. In San Fran­
cisco, for example, psychiatric social workers were helping promiscu­
ous and potentially promiscuous young men and women at a venereal
disease clinic (17) . And in many large cities, as well as in some State
clinics, they were employed in clinics for alcoholics (52). The de­
mand for clinics open to all persons in the community was stimulated
by the Nation-wide clinical services opened to veterans and by the
National Mental Health Act of 1946 which provided funds to States
for programs of mental hygiene including services to communities.
In 1948 more than 100 clinics were organized or expanded in 34 States
under this program. In 1949 the demand for additional service was
great. One city clinic, for example, which served 100 patients in 1
year reported more than 900 potential patients whom it could not
accept because of lack of staff. As clinics go, it was well-staffed with
9 full-time professional persons (including 5 psychiatric social work­
ers) and 6 part-time psychiatrists.
The largest number of openings, in psychiatric social work, reported
to the American Association of Psychiatric Social Workers in a 6month period in 1948-49 was in the clinical field. The 70 positions
ranged from junior psychiatric social workers and members of travel­
ing clinics to directors of clinics; from openings in child guidance

14

OUTLOOK FOB WOMEN

clinics to those in clinics for alcoholic patients and others in com­
munity clinics.
Under the mental hygiene program authorized by the National
Mental Health Act, increasing emphasis is being placed on prevention.
In the newest demonstration clinic, for example, 30 percent of the
work is treatment of emotionally disturbed persons, but 70 percent
is preventive work with such agencies as prenatal and other clinics
and the public schools.
Psychiatric Hospitals

About 600 additional social workers were employed in psychiatric
hospitals in 1949. In 1947 the Bureau of the Census reported 613
social and field workers in State mental hospitals, which house 87
percent of all hospitalized mental patients in the United States.
Some of these may not have been fully trained social workers, and
some may have been working primarily in clinics and so may be
included among the 800 persons reported as working in full-time or
part-time clinics. However, probably at least 300 of them were psy­
chiatric social workers not otherwise reported. In addition, in 1949,
there were 215 psychiatric social workers employed in 33 veterans’
neuropsychiatric hospitals and 56 psychiatric social workers employed
by the American Red Cross for work in military hospitals. In other
Federal hospitals such as St. Elizabeths Hospital and the marine and
narcotics hospitals operated by the United States Public Health Serv­
ice, there were 17 positions for psychiatric social workers.
The need for additional social workers in mental hospitals was enor­
mous. In all State mental hospitals, there was an average of only 1.4
social workers per 1,000 resident patients in 1947. Although this vras
an improvement over the 1.1 ratio in 1946, it was far below the nnmber required for adequate social service. Nine States had no social
workers in State mental hospitals. Less than half of the 504 mental
and allied hospitals listed in the 1949 directory of the American Hos­
pital Association reported having a social service department (,9).
In 1947 only 1. State, New Jersey, met the standard recommended by
the American Psychiatric Association of 1 trained social worker for
each 100 admissions. The average for the United States as a whole
was 0.47 social workers for 100 admissions.
Wide variation existed not only in the ratio of patients to social
workers but in (he type of services rendered. Service to convalescent
patients who report to clinics, follow-up services to those who have
gone home from the hospital, and family-care programs for patients
placed during convalescence with families other than their own were
in some cases added to the usual treatment of newly admitted and
resident patients. Such services require a higher proportion of social

SOCIAL CASE WORK, PSYCHIATRIC SETTING

15

workers. The Group for the Advancement of Psychiatry, for exam­
ple, which recommends 1 social worker to 80 newly admitted patients,
adds that 1 social worker for 60 convalescent and home care patients
is needed (£?6‘).
Twenty-eight psychiatric social work positions in mental hospitals
listed with the American Association of Psychiatric Social Workers
in a 6-month period in 1948-49 indicated the extent of the demand
for trained social workers in mental hospitals. These positions varied
from those of case workers with in-patients or out-patients and rela-

Figure 8.—A social case worker preparing for her first interview with
a patient in a mental hospital.

f ives of patients, to those of directors of social service departments.
Directors were expected to integrate the department with the total
hospital program, to administer in-patient, clinic, and family care
programs, and to supervise and train social workers. Some directors’
positions also involved the teaching of medical students.
Other Institutions and Organizations

Some large school systems, like those in New York and San Fran­
cisco, operate psychiatric clinics, and others employ psychiatrists on
a consulting basis. For example, one city has a psychiatrist who
890477—50

-4

16

OUTLOOK FOR WOMEN

serves as a consultant to school administrators, to teachers, and to
a considerable number of school social workers. (The school social
worker will be discussed more fully in the bulletin on social case work
with children.) Most school systems, however, refer children needing
psychiatric service to clinics under other auspices in the community.
Study homes where very disturbed children live while receiving psy­
chiatric help are growing in number (37) (47). In New Jersey, for
example, there is a State-supported resident child-treatment center to
which such children may be referred. Connecticut and New Hamp­
shire have authorized such programs, and probably 20 communities
in 1949 had facilities of this sort employing possibly 50 psychiatric
social workers.
In 1947 one authority estimated that only 10 or 15 colleges and
universities employed full-time psychiatrists but that at least an
equal number were seeking psychiatrists for mental health counseling
in the student health service.
More than half of 300 colleges replying to a 1947 questionnaire
reported that mental hygiene counseling was available to students,
and almost half reported psychiatric consultation available through
the student health service (38). That psychiatric social workers are
used as mental hygiene counselors in colleges is indicated by a request
to the American Association of Psychiatric Social Workers in 1948—40
for a man with a master’s degree in psychiatric social work and clinic
experience to counsel students on personal problems, in association
with a psychiatrist working on a half-time basis. In Wisconsin a
psychiatric social worker was employed in 1948 at a State teachers’
college under the State mental health program (€3).
In the Army, too, there is a definite program of psychiatric social
work, initiated during World War II. A lieutenant colonel in the
Army in 1949 headed the Psychiatric Social Work Branch of the
Psychiatry and Neurology Consultants Division in the Surgeon Gen­
eral’s Office, which was responsible for developing psychiatric social
services for servicemen and their dependents for whom assistance was
being made available through Army general hospitals, training cen­
ters, and the psychiatry and sociology divisions of disciplinary bar­
racks. Eight Begular Army officers were taking graduate social work
training in civilian schools for this program in 1948-19, and selected
officers and enlisted men were being trained in the Army at the sub­
professional case aide level to assist in the program, because of the
shortage of trained social workers (15).
Psychiatric services are also being utilized in criminal and juvenile
courts. In 1947 about 10 adult criminal courts and a large number of
juvenile courts employed psychiatrists full or part time, and some
actually operated a full-time psychiatric clinic. Another group of
40 full-time and 43 part-time psychiatrists were employed in 1945,

SOCIAL CASE WORK, PSYCHIATRIC SETTING

17

according to the Bureau of the Census, in Federal or State prisons
and reformatories {38). All Federal penitentiaries and detention
homes are authorized to have a full-time psychiatrist, but the jobs
are not always filled {39). There is no report available on the number
of psychiatric social workers employed to work with these psychiatrists.
They are probably few in relation to the probation and parole officers
employed in correctional work, whose work will be discussed in another
bulletin in this series.
The need for psychiatric service in all penal and corrective institu­
tions and the need for psychiatric study of children awaiting court
mmm

Figure 9.—A psychiatric social work officer at an Army general hospital
interviewing a patient in an out-patient clinic.
disposition has been demonstrated, but only a few centers have devel­
oped adequate services. Wisconsin was one of the States which in
1949 was recruiting psychiatric social workers to assist in the treat­
ment of delinquent girls in limited security institutions and of defec­
tive children in training schools.
Psychiatric service in most business, industrial, and Government
personnel departments is limited. Usually employees needing psy­
chiatric help are referred to outside services. In 1947 there were,
according to a prominent psychiatrist, probably six or eight psychia­
trists employed full time by a business or industrial organization to

18

OUTLOOK FOK WOMEN

serve employees (30) and an additional number served as consultants
to the personnel or medical staff of the organization. A trained
psychiatric social worker is employed at the diagnostic clinic of the
Medical Health Center of the United Auto Workers of Detroit,
which serves members of the union. Social workers are also employed
by the United States Public Health Service in a mental hygiene clinic
included as part of its medical service for Federal employees in
Washington; no information was available on psychiatric services
offered by other Government units.
Consultation and Mental Hygiene Education

With the development of mental health programs and the emphasis
on psychiatric problems in other programs, the demand for psychi­
atric consultants has increased. In 1949 the National Institute of
Mental Health of the United States Public Health Service employed
three women psychiatric social workers as regional consultants in
addition to the division head and an assistant, who were men. Besides
several assigned to hospitals or clinics, as noted earlier, there were
three additional openings for consulting and demonstration work
under the National Mental Health Act, which authorized grants-inaid and consultation services to the States and demonstration clinics.
The Children’s Bureau and the Office of Vocational Rehabilitation
each employed one consultant in psychiatric social work in connec­
tion with their respective programs. Four of the Veterans’ Admin­
istration headquarters staff in social service were also psychiatric
social workers by training and experience, as were many of those
employed in the regional and area offices of the Administration to
offer consultation to case workers.
The largest group of consultants were employed in State agen­
cies, where mental health programs were growing rapidly. All but
2 of the 53 States and territories of the United States had such
programs in 1949. as compared with only 15 in the preceding year.
According to the Public Health Service, 209 psychiatric social work­
ers were employed in these State mental health programs, which is
twice the number employed in 1948. Not all of these were consultants,
because many were engaged in direct case work in institutions or
clinics in the State. However, some were engaged in such work as
consultants in community mental health education and in the devel­
opment and supervision of homes for out-patient treatment, or as
liaison workers between child guidance clinics and teachers in rural
and urban schools, where they served as consultants in mental hygiene
programs with children.
I hat there is a real need for such programs, which encourage and
promote mental health, is evident from hospital and clinical expe­
rience and from records of soldiers who served in two wars (51).

SOCIAL CASE WORK. PSYCHIATRIC SETTING

19

Leadership in this field has been taken by the National Committee
for Mental Hygiene and State and local mental hygiene societies.
About 3f> State and local mental hygiene societies were in existence
in 1949. Of this number, about 1(> had paid executives! about half
of whom had training and experience in psychiatric social work.
Also, two other psychiatric social workers were known to have non­
executive positions on the staffs of these mental hygiene societies.
An opening for an educational director of a local mental hygiene
association reported to the American Association of Psychiatric Social
Workers in 1948 specified experience in speaking and in organizing

Figure 10.—A social case worker connected with a State mental hygiene
division conferring with a troubled mother.

and developing programs. Only one or two States in 1948 had any
sort of program for (lie prevention of mental illness, because the
psychiatric program in most States was still limited to the supervision
of State mental hospitals <■/■'>). However, an opening for an assistant
director of a State division of mental hygiene in 1948, for which a
psychiatric social worker with 5 to 6 years of clinical and hospital
experience was sought, stressed ability to educate professional groups
and serve as a consultant to community organizations. Public rela­
tions and community organization experience and training are as
important as knowledge of psychiatric social work in positions of
this kind, where so much work with lay and professional groups is
involved.

20

OUTLOOK FOR WOMEN

Private Practice
Only six members of the American Association of Psychiatric
Social Workers in 1948 reported themselves in private practice work.
One of these did psychiatric social work for a private psychiatrist
in New York. Another was employed as a consultant in psychiatric
social work several hours a week at various agencies in California.
Over the years, more than 30 members have been engaged in private
practice for brief intervals, although the number at any one time did
not exceed half a dozen. The need for standards and licensing pro­
vision for social workers engaging in private practice was emphasized
in 1948, after an exploratory inquiry into private practice by mem­
bers of the American Association of Psychiatric Social Workers (//8).
Teaching
Most of the full-time teachers in the field of psychiatric social work
are on the faculties of graduate schools of social work, especially those
offering specialization in psychiatric social work as approved by the
American Association of Psychiatric Social Workers. In 1948-49
20 women were teaching psychiatric social work full time in graduate
schools of social work, and an additional 35 women and 11 men were
teaching psychiatric social work part time in these schools. Of the
latter, 13 women and 5 men were full-time faculty members but gave
only part time to the psychiatric specialization. More than 100 physi­
cians also gave part-time instruction in psychiatric information and
problems. At least 6 full-time psychiatric social work teaching posi­
tions in schools of social work were open in 1948-49, varying from that
of supervisor of psychiatric social work students and instructor to that
of an assistant professor. For 1949-50 the American Association of
Psychiatric Social Workers announced 3 faculty openings for the
teaching of psychiatric social work and 3 additional openings for
teaching case work for which psychiatric case workers were required.
A larger group of psychiatric social workers were also supervising
students of social work part time in the psychiatric setting in which
they themselves were employed in the practice or supervision of psy­
chiatric social work. Members of the staff of the social service depart­
ment in teaching hospitals also were engaged part time in the teaching
of medical students. Although in most medical schools psychiatry
was not given more than 2 percent of the teaching hours and never more
than 4 or 5 percent, the trend was toward an increased number of hours
devoted to this teaching (39). The National Mental Health Act has
encouraged the expansion of psychiatric departments by supplying
funds for expansion. It has also provided funds for and stimulated
the training of additional psychiatrists in postgraduate courses at

SOCIAL CASE WORK, PSYCHIATRIC SETTING

21

medical schools. The increase in this type of training, and the corre­
sponding increase in psychiatric emphasis in the training of nurses and
occupational and physical therapists has steadily added to the teaching
load of psychiatric social workers employed in hospitals. More and
more, other professions are seeking instruction in the relationships of
psychiatric and social problems. Many theological schools now ar­
range internships in psychiatric hospitals for their students {39).
The desire for background in mental hygiene has extended to the
—■

Figure 11.—Using psychodrama in a teaching hospital, a case worker
directs a student in interviewing a depressed patient, whose role is
assumed by an assistant.

undergraduate college level, too. Ninety colleges out of three hundred
replying to a 1947 questionnaire offered courses in mental hygiene for
college credit {39).
Research

Very few persons were engaged in full-time research in psychiatric
social work in 1949, although a few were participating part time in
research related to their regular work in a psychiatric setting. More
research was encouraged when the National Mental Health Act of
1946 authorized the creation of the National Institute of Mental Health

22

OUTLOOK FOR WOMEN

in the United States Public Health Service as a research and training
center with full-time staff. In addition, it authorized the United
States Public Health Service to foster research in the causes, diagnosis,
and methods of treatment and prevention of mental and nervous dis­
orders through grants in aid to universities, hospitals, laboratories,
and other public and private institutions, and to individuals. By 1948
88 research projects had been approved and 19 fellowships had been
granted for the fiscal year 1948 (20). Although most of the research
involved medical and psychiatric personnel, psychiatric social workers

Figure 12.—A social case worker with the Massachusetts Department of
Mental Health, Division of Mental Hygiene, receiving a request for
service from a social agency.

participated in some of these projects. At one hospital, for example, a
member of the psychiatric social service staff was borrowed for 1 year
to work full time on a research project directed by a psychiatrist on the
hospital staff.
Geographic Variations in Employment

All available information indicates an uneven distribution of psy­
chiatric social workers in relation to need. Agencies which employ
on a Nation-wide scale, such as the Veterans' Administration and the
American Red Cross, report that a relatively larger supply of trained
psychiatric social workers is available in such centers as New York

23

SOCIAL CASE WORK, PSYCHIATRIC SETTING

City, Washington, D. C., Scan Francisco, and Los Angeles; while in the
States west of the Great Lakes and in the Southeastern States, it is
difficult to find qualified people to fill vacant positions.
Almost half the members of the American Association of Psychiatric
Social Workers in 1949 were in the Northeastern States, more than
one-fourth in New York State alone.1 (See table 2.) This is under­
standable in view of the heavy concentration of psychiatrists there.
Half the psychiatrists listed in the 1944 directory of the American
Psychiatric Association were in those States. In relation to popula­
tion, the Public Health Service in 1949 reported that California, Colo­
rado, Connecticut, the District of Columbia, Kansas, Maryland,
Massachusetts, New Jersey, New York, and Rhode Island were best
Table 2.—Geographic Distribution of Psychiatric Social Workers Compared With
That of Psychiatrists and the General Population

Region

Members
Estimated
Social work­ Psychiatric Psychiatric
of the
population
social
social work­
Members ers and field
of the
workers in workers in ers in State American
of the
mental
Psychiatric
United
A.A.P.S.W., State mental psychiatric
States,
clinics,
health pro­ Association,
hospitals,
1949 >
grams, 19491
1943-44 2
1948 3
1948 1
1947 i
Num­ Per­ Num­ Per­ Num­ Per­ Num­ Per­ Num­ Per­
ber
cent
ber
cent ber cent ber cent ber cent

United States.

1,181 100.0

Northeastern States-----North Central States---South West_______________

587
261
173
ICO

49.7
22.1
14.6
13.6

613 100.0

840 100.0

293
180
69
71

386
231
97
126

47.8
29.3
11.3
11.6

209 100.0

46. 0
27. 5
11.5
15.0

79
60
55
15

37.8
28.7
26.3
7.2

2,196 100.0
1,091
504
419
182

49.7
22.9
19.1
8.3

Percent
100.0
26.8
30.0
30.4
12.8

1 National Institute, of Mental Health, U. S. Public Health Service.
Directory of the American Psychiatric Association.
3 IT. S. Bureau of the Census (55).

2

supplied with psychiatric social workers, each having 1 or more mem­
bers of the American Association of Psychiatric Social Workers per
100,000 population, as estimated in 1948. Alabama, Idaho, Maine,
Mississippi, Montana, Nevada, North and South Dakota, Oklahoma,
West Virginia, and Wyoming were poorest in this respect.
In all the principal types of mental health agencies except State
mental health units, where the distribution was less askew, unevenness
in relation to population is repeated, according to information assem­
bled by the United States Public Health Service. (See table 2.)
' Regions as designated in U. S. Census reports are used throughout—
Northeastern States—Connecticut, Maine, Massachusetts, New Hampshire, New
Jersey, New York, Pennsylvania, Rhode Island, Vermont;
North Central States—Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Mis­
souri, Nebraska, North Dakota. Ohio, South Dakota, Wisconsin ;
South—Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia.
Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South
Carolina, Tennessee, Texas, Virginia, West Virginia ;
West—Arizona, California, Colorado, Idaho. Montana, Nevada. New Mexico, Oregon.
Utah, Washington, Wyoming (58).

81)0477—50-----5

24

OUTLOOK FOE WOMEN

Nearly half of the psychiatric social workers in clinics as well as in
mental hospitals were concentrated in the Northeastern States. New
Jersey, Illinois, New York, Michigan, Maryland, Delaware, and New
Hampshire, in 1947, had the highest number of social workers in State
mental hospitals in relation to patients residing in them; Alabama,
Florida, Kansas, Nevada, New Mexico, North and South Dakota, Ten­
nessee, and Wyoming had no social workers in State mental hospitals.
Some of this maldistribution may have stemmed from an early con­
centration in the Northeastern States of training centers offering
specialization in psychiatric social work. However, in 1949-50 the
schools were more evenly distributed than the workers. Only 9 of the
22 schools of social work offering an approved curriculum in psychi­
atric social work were in the Northeastern States; 5 were in the North
Central States; 5 in the South; and 3 in the West.
Supply

The supply of social workers qualified to work in psychiatric settings
can only be estimated. Unlike doctors and nurses, social workers, even
those who work in medical settings, are not required to have licenses.
Only one State, California, provides for the voluntary registration of
social workers. However, the desirability of licensing psychiatric
social workers has been recognized by psychiatrists as well as by social
workers (86). Until such time as the several States provide for licens­
ing, the standards set up by the American Association of Psychiatric
Social Workers for membership are the chief controlling influence on
supply in this field. (See appendix, p. 49, for membership require­
ments.) According to these standards, the source of supply tends to be
limited to graduates from an accredited school of social work with
specialization in the approved curriculum in psychiatric social work or
in another curriculum with offsetti tig subsequent supervised experience
in psychiatric social work. In 1948, there were about 900 members of
the American Association of Psychiatric Social Workers who were
employed either in this country or abroad and an additional 182 mem­
bers, including 116 married women, who did not report employment.
Possibly there were 500 to 1,000 additional nonmembers of equivalent
training and experience.
That this supply was insufficient was evident from continued reports
of shortages. However, the increasing number of students specializing
in this field offered some hope of narrowing the gap between demand
and supply.
Nearly 500 students were prepared to complete their specialized
training in this field in 1949, according to the American Association of
Psychiatric Social Workers, as compared with 200 in 1944. In 1950,
22 universities and colleges, as compared with 8 before World
War II, offered curricula approved by tire American Association

SOCIAL CASE WORK, PSYCHIATRIC SETTING

25

of Psychiatric Social Workers. But more were needed. Most schools
reported that they usually had more applicants of high caliber than
the number for which they could provide adequate supervised field
training. At least 1,000 trainees in psychiatric social work would be
needed each year for the next few years to produce the 13,000 to 15,000
psychiatric social workers that estimates indicate are needed in the
1950’s to staff programs already planned for in the United States (35).
The National Mental Health Program of the United States Public
Health Service and the Veterans’ Administration supervised field work
program, like the Commonwealth Fund scholarships in earlier years,
have done much to stimulate interest in this field and to encourage
training for it. The use of male psychiatric social workers in the
Army and the Veterans’ Administration, higher salaries, and the pub­
lic interest in the treatment of mental illness have also awakened many
to the possibilities in this field of work. Most schools of social work
report an increased interest on the part of students in psychiatric
social work specialization.

TRAINING
The continued acute demand for social workers in psychiatric set­
tings resulted in lowering the amount of experience required for some
positions. But the training required for positions in this field usually
conforms to educational requirements set by the American Association
of Psychiatric Social Workers and endorsed by the National Advisory
Mental Health Council: Completion of a 2-year graduate course in an
accredited school of social work, including specialization in psychiatric
social work as approved by the American Association of Psychiatric
Social Workers. (See appendix, p. 50, for essential elements in this
specialization.) Those hired in the past who had not completed an
approved course in an accredited school of social work were usually
urged to complete their training following employment.
So great has the emphasis on initial training become that the Group
for the Advancement of Psychiatry has recommended that when per­
sonnel without graduate professional training in a school of social
work with major emphasis in psychiatric social work must be em­
ployed, they should be designated by a completely different title.
Work experience in a social service department even in a psychiatric
setting is not likely to be accepted as a substitute for graduate training
in social case work in the future. On the other hand, such experience
in addition to adequate training is often required for particular
positions (26).
Schools of social work in the United States offering the 2-year
graduate training approved by the American Association of Psychi­
atric Social Workers almost tripled in number from 8 in 1940 to 22 in

26

OUTLOOK FOR WOMEN

1949. (For a list of accredited schools, see appendix, p. 51.) Six of
these schools offer a third-year graduate program. In order to
develop more advanced training facilities, the National Mental Health
Institute of the Public Health Service is encouraging other schools of
social work to arrange a third-year program for outstanding gradu­
ates of the 2-year program who have had at least 3 years of successful
experience in a psychiatric setting. Fellowships of $2,400 are avail­
able to qualified candidates for this type of training.

Figure 13.—A psychiatric social work supervisor in a mental hospital
conferring with a social work student who is obtaining her field ex­
perience at the hospital.

In the second year of the graduate program it is customary for
schools of social, work to arrange for a considerable amount of field
work experience in the type of agency in which the student wishes to
work following graduation. For work in a psychiatric hospital, at
least 9 months or 3 quarters spent in field work in a psychiatric hos­
pital are recommended by the Group for the Advancement of Psychi­
atry (2(j). Some experience in a psychiatric hospital with its exten­
sive and varied problems and facilities is recommended for all, includ­
ing those who intend to work in a child guidance clinic or other non­
hospital setting.

SOCIAL CASE WORK, PSYCHIATRIC SETTING

It

Further training of those already employed is commonly encouraged
and often provided by the employing agency in this rapidly develop­
ing field where it is difficult to keep abreast of new techniques and
methods. Thirty-six States and Territories in 1948 were using Fed­
eral funds for training their psychiatric personnel, including psychi­
atric social workers, for better service in their mental health programs
{20). Recent emphasis in training has been on the use of group
techniques with psychiatric patients. Schools of social work of the
University of Pittsburgh, Western Reserve University, and the Uni­
versity of Minnesota train social group workers for work in psychi­
atric settings. Case workers in psychiatric 'hospitals and clinics also
have been increasingly drawn into group therapy work with patients
under the supervision of a psychiatrist. The Jewish Board of Guai dians in New York City has had a continuous seminar for its workers
in activity group therapy for 10 years, as well as a seminar in inter­
view group treatment. Because in its clinics, contrary to the usual
clinical practice, case workers are expected to engage in psychotherapy,
seminars are also given in clinical orientation, diagnostic categories,
and treatment {31). It is generally recognized by authorities in this
field that if social workers are to engage in psychiatric treatment,
customarily handled by the psychiatrist, they need intensive training
in psychotherapy following the 2-year approved program for psychi­
atric social work and several years of experience in a psychiatric set­
ting {29) {1). The experience of going through a psychoanalysis is
also recommended by some authorities for those who attempt treat­
ment of the emotionally disturbed {1).
Scholarships, Fellowships, and Other Student Aids

The scholarships available under the National Mental Health Act
of 1946 have given financial encouragement to potential students of
psychiatric social work {61). In 1949, 60 women and 2 men were re­
ceiving scholarships under this program, after being chosen from more
than 300 individuals applying for such assistance to schools of social
work cooperating in the program. Fifty-three, including one of the
men, were completing their second year of training in an accredited
school of social work in a curriculum approved by the American
Association of Psychiatric Social Workers. (See appendix, p. 50.)
Each received a stipend of $1,600. Nine others, who had completed
their master’s degree and had at least 3 years of successful experience
in psychiatric social work, were completing a third year of graduate
work to train them for administrative, supervisory, research, or teach­
ing positions in the field. Their stipends were $2,400. Grants for
predoctorate and postdoctorate research fellowships in mental health
are also made by the Division of Research Grants and Fellowships of

28

OUTLOOK FOR WOMEN

the National Institute of Mental Health for work on research projects
approved by the United States Public Health Service. Grants vary
from $1,200 to $3,600 depending on the academic degree possessed by
the researcher and whether or not he has dependents. Scholarships
and fellowships for psychiatric social work training are available
through some State departments of health and mental hygiene,
financed by State and National Mental Health Act funds.
Other scholarships designed specifically for training in psychiatric
social work were available through schools of social work. The Cali­
fornia Congress of Parents and Teachers offered fellowships for
1949-50 at the University of California and at the University of
Southern California for students preparing for psychiatric social
work with children who would agree to work subsequently for 2 years
in public schools or other public agencies in California. Other
scholarships for those who desire to work in the field of mental health
for children were also made available at the University of Southern
California and at Smith College School for Social Work by the George
Davis Bivin Foundation. At the University of Louisville's Raymond
A. Kent School of Social Work, several fellowships were offered in
1949-50 by the Kentucky State Board of Health to students who would
subsequently work in the psychiatric social work program of the
Board. Scholarships for first-year students planning to specialize in
psychiatric social work as well as for second-year students, were of­
fered in cooperation with local agencies at a number of schools, for
instance, the Pennsylvania School of Social Work, Smith College
School of Social Work, and at Western Reserve University’s •'School
of Applied Social Sciences. Some schools like the Pennsylvania
School of Social Work offered special scholarships for training in psy­
chiatric social work for students who have had at least 3 years of
experience in social work. Simmons College School of Social Work
was among those which in 1949-50 offered resident scholarships for
second-year students specializing in psychiatric social work (8).
Resident scholarships in a State hospital were available for 1949-50
for second-year students majoring in psychiatric social work at the
Carnegie Institute of Technology, for instance. Internships cover­
ing all living expenses were also available at certain mental hospitals
and clinics on the list of cooperating field work agencies of Smith
College School for Social Work (5). The dearth of skilled workers
in psychiatric social work, as well as the limited financial remunera­
tion for persons with such training, was given as a reason for failure
to find qualified candidates in 1946 for an annual fellowship in child
therapy at the Washington Institute of Mental Hygiene.
Provision for supervised field work in social service in the Veterans’
Administration hospitals and clinics over the country, either on a
part-time paid field work or an unpaid basis, was also of great help in

SOCIAL CASE WORK, PSYCHIATRIC SETTING

29

increasing tlie total supply of psychiatric social workers as well as
in meeting Veterans’ Administration needs. Under the paid field
work program, begun in 1947, selected students who had completed 1
year in a recognized school of social work and had 1 year of case work
experience in a health or welfare agency of acceptable standard, were
paid for part-time work performed in the Veterans’ Administration.
This placement met the second-year field work requirement of the
school of social work in which the candidate was enrolled for spe­
cialization either in psychiatric or in medical social work. Students

Figure 14.—An experienced case worker in a veterans’ neuropsychiatric
hospital sees patient in her office to discuss plans for his return home
when doctor indicates he is ready for discharge.

worked a minimum of 24 hours a week (66) and -were paid $1.64 an
hour. In December 1948, 232 students from 36 schools were placed
in Veterans’ Administration hospitals and regional offices, 159 of them
in psychiatric settings.
Only male graduate students of social case work enrolled in grad­
uate schools of social work were eligible for selection in 1949 for the
Army’s new program to secure psychiatric social workers for a career
as officers in the Regular Army Medical Service Corps, under which
pay and allowances for the second year of graduate training averaged
$3,800 per student.

30

OUTLOOK FOR WOMEN

EARNINGS, HOURS, AND ADVANCEMENT
Earnings.—The most recent comprehensive study of salaries of psy­
chiatric social workers was that made in December 1942, when 380
members of the American Association of Psychiatric Social Workers
replied to a questionnaire. Almost half, or 46 percent, were in the
$2,000 to $2,900 group; one-fifth (21 percent) received from $3,000
to $3,900; the remaining 23 percent were divided almost equally be­
tween the extremes, those who earned $1,800 to $1,900 and those who
earned $4,000 or more. Nearly three-fourths of those employed in
public mental hospitals received from $2,000 to $2,900. Salaries were
higher, however, in child, guidance clinics where more than half re­
ported salaries of $3,000 or more, and some received $5,000 or more.
Salaries were lowest in nonpublic hospitals and clinics for adults
where almost one-fourth received less than $2,000. More than ninetenths of the members engaged in teaching in schools of social work
received $3,000 or more, and this group had the greatest proportion
(14 percent) in the $5,000 or above group. The report calls attention
to the fact that New York City and Pennsylvania salaries may have
distorted the picture upward (11).
Nation-wide information for 1950 will be available shortly from
the Bureau of Labor Statistics’ current study of the economic status
of social workers. Meanwhile, the following scattered evidence in­
dicates that salaries have increased considerably since the 1942 study.
Salaries offered in 1949 on openings in psychiatric social work were
slightly higher than those offered on other case work openings, ac­
cording to the Social Work Vocational Bureau and reports from scat­
tered employers and schools. Graduates of schools of social work
with specialization in psychiatric social work were starting at $2,400
to $3,000, while requests for alumnae for executive positions offered
$5,000 to $6,000. In Pittsburgh a local report on salaries in 1946 had
recommended that salaries for all case workers range from $2,100 to
$3,000, but commented that the higher salaries offered by the Veterans’
Administration for psychiatric and medical social workers would
handicap local agencies in obtaining experienced workers in these
fields. In 1949, a beginning salary of $3,825 was paid in the Veterans’
Administration. (For requirements for beginning positions in the
Veterans’ Administration see appendix, p. 49.)
On hospital jobs listed with the American Association of Psy­
chiatric Social Workers in a 6-month period in 1948-49, the lowest
minimum offered psychiatric case workers was $2,400; the highest
maximum, that for a director of the social service department, was
$4,848. On many jobs salaries were not quoted, the employer usually
stating in that case that the salaries were flexible and depended on

SOCIAL CASE WORK, PSYCHIATRIC SETTING

31

the experience of the person hired. One. Slate hospital mentioned
that a charge for maintenance was deducted; another offered $2,250
per year with complete maintenance, or $2,490 plus meals and some
laundry if the worker lived off the grounds. Six offered complete
maintenance if desired, ranging in cost from $360 to $810.
On clinical jobs, the lowest salary quoted was $2,400, with one excep­
tion at $2,160; the highest, for directors, was usually $5,000, although
one child guidance clinic offered $6,200. The minimum quoted in
child guidance clinics was $2,700. Salaries in educational work were
in the higher brackets. In mental hygiene educational work, salaries

Figure 15.—A social case worker in a mental hospital interviews patient’s
wife to learn about social and emotional factors related to his illness.

in two openings ranged from $4,000 to $5,652. For a 9-month year,
the lowest salary quoted for a school of social work job was $3,000, the
12-month equivalent of which would be $4,000. Salaries on 1949-50
teaching openings listed with the American Association of Psychiatric
Social Workers ranged front $3,600 to $5,000 for a school year of 9
months.
In California in 1949 one agency paid a consultant in psychiatric
social work $7.50 an hour for 214 hours a week. Salaries on six psy­
chiatric case work jobs, listed with the California Department of
Employment's Social Workers’ Placement Service, in a 8-month period

32

OUTLOOK FOR WOMEN

in the years 1947-48, ranged from $2,580 to $4,260. On supervisory,
consultant, and executive jobs the range was from $3,600 to $5,400. The
State of Wisconsin in 1949 paid $3,240 and a cost-of-living bonus to its
beginning psychiatric social workers, and salaries on psychiatric social
consultant positions in Southern States in late 1946 were reported to
range from $2,100 to $5,000 (32). Beginning case work positions in
more than 100 mental hospitals in 1947, according to the Group for
the Advancement of Psychiatry, offered from $1,530 plus maintenance
to $2,400 without maintenance. Salaries ranged up to $5,000 without
maintenance for chief social workers who headed social service depart­
ments (26).
The median annual salary for social workers providing direct serv­
ices to individuals in Michigan in 1948 was found by the Bureau of
Labor Statistics to be $2,640 for women and $3,320 for men. For so­
cial work executives, the median was $3,680 for women, $4,500 for men.
No special report was made of those working in psychiatric set­
tings (18).
Hours and Working Conditions.—For many years, the hours of work
of social workers in hospitals, which, of course, operate 7 days a week
and 24 hours a day, were longer, more uncertain, and on a less desirable
schedule than those in social agencies. However, in 1949 psychiatric
social workers in mental hospitals, like those who worked in clinics
not connected with them, generally had regular hours. The work­
week seldom exceeded 40-44 hours, and compensatory time off for Sat­
urday, Sunday, evening, or holiday work was customary.
Living in the institution was sometimes required in isolated hospi­
tals or in child study homes, but most psychiatric social workers did not
live at their place of employment. Jobs involving work with patients
residing outside the hospital but still under its supervision, as well
as some regional jobs of the Veterans’ Administration and some State
Consulting jobs, practically required the possession of a car for travel.
More comprehensive and recent information on hours and working
conditions will be available in the Bureau of Labor Statistics’ report
on its 1950 study of the economic status of social workers.
Advancement.—Opportunities for advancement to supervisory or
administrative work within a psychiatric agency depend upon the size
of its staff. In a small clinic employing only one social worker, ad­
vancement for the social worker usually lies only in transfer to a larger
organization where advancement to a case supervisor or possibly to a
position as director of social service is possible. In only a few clinics
has a social worker become director of the entire clinic, a post usually
held by a psychiatrist and less often by a psychologist.
In large psychiatric hospitals and organizations such as the Veterans’
Administration and the American Red Cross, directors of social serv­

SOCIAL CASE WORK, PSYCHIATRIC SETTING

33

ice or chief social workers have an administrative job of some size.
For instance, in large Veterans’ Administration hospitals, the chief
social worker does not engage in direct case supervision or actual case
work. However, a wartime study of members of the American Asso­
ciation of Psychiatric Social Workers indicated that administrative
jobs in this field usually involve direct supervision of case work or
actual case work. About half of all the jobs reported by 277 members
involved administrative responsibility either in a psychiatric or non­
psychiatric agency (77). For the position of director of social sei vice
in a psychiatric hospital, the Group for the Advancement of Psychia­
try has recommended a minimum of 5 years of experience, including
at least 3 in a psychiatric setting and 2 in a supervisory capacity (26).
Many psychiatric social workers prefer to remain in positions where
they are giving service directly to patients. As in other case work
fields, salary increases usually recognize the growing skill and experi­
ence of those who prefer to remain in case work positions.
ORGANIZATIONS
The American Association of Psychiatric Social Workers is the
principal professional organization for case workers who have special­
ized in work with psychiatrists. It stemmed from a club of psychia­
tric social workers which was organized in Boston in 1920 and in 1922
became a section of the American Association of Hospital Social
Workers. In 1926, as more and more of its members were found in
such nonhospital agencies as mental hygiene and child guidance clinics,
ic formed a separate organization under its present name with 99 mem­
bers (M). In 1949 it had 1,150 members who qualified by training
and experience as psychiatric social workers. (See appendix, p. 49,
for minimum requirements.) It publishes a journal, a newsletter, and
a monthly job information service bulletin for members. It is affili­
ated with other social work groups through the National Conference
of Social Work and holds its annual meeting in that connection. Some
of its members who work in hospitals also belong to the American
Association of Medical Social Workers. Many also belong to the
American Association of Social Workers, whose membership is open
to all social workers who meet certain standards of training and experi­
ence, regardless of their specializations.
The American Orthopsychiatric Association is a membership organ­
ization which provides for the professional affiliation of psychiatric
social workers with other members of the psychiatric clinical teampsychiatrists and psychologists. In 1948 members totaled 706, of
whom 332 were psychiatrists, 151 were psychologists, 163 were psychi­
atric social workers, and 60 were in other classifications. In 1949 its
president was a woman psychiatric social worker.

34

OUTLOOK FOR WOMEN

The American Psychiatric Association lias for many years had a
committee on psychiatric social service which concerns itself with
liaison between these two professional fields, and which works toward
the most effective use of social work in the treatment of emotionally
disturbed people.
The Group for the Advancement of Psychiatry, organized in May
1946 and composed of 150 psychiatrists in the United States and
Canada, has a committee on psychiatric social work. Psychiatric
social workers serve as consultants to this committee. The National
Committee for Mental Hygiene, Inc., established in 1909, includes
750 elected members who have rendered distinctive service in the field

figure 16. The president of the American Orthopsychiatric Association
(center) conferring with speakers at the 27th annual convention of the
association.

of mental hygiene, of whom about 10 percent in 1949 were social work­
ers. . State societies for mental hygiene are organizations for the pro­
motion of better mental health through work with the public and are
not professional membership organizations.

SUGGESTIONS TO THOSE CONSIDERING TRAINING
EOR PSYCHIATRIC SOCIAL WORK
Maturity and stability as evidenced by one's own ability to meet
life s problems and to savor its joys are considered essential for suc­
cess in this field. These qualities are considered important in most
social work positions but are more important than ever in work

SOCIAL CASE WORK, PSYCHIATRIC SETTING

35

that is continuously with disturbed people. In addition, therefore,
to the usual qualifications for social work and interest in social service,
which now can be measured to some extent through interest tests, those
who wish to become psychiatric social workers must feel a personal
warmth toward emotionally disturbed people and a deep concern for
their mental health.
Many employers of psychiatric social workers have emphasized the
need for training and experience with badly disturbed patients in
mental hospitals as background for all types of psychiatric social work
including child guidance. Some have also stressed the desirability of

Figure 17.—A psychiatrist in a mental hospital opening conference to dis­
cuss a convalescent patient about to leave the hospital. Participating
(clockwise) are an occupational therapist, the head of the social service
department, a case work supervisor, a case worker, a psychologist, and a
nurse.

case work experience with emotionally well-adjusted or “normal '
people as essential to a perspective on those whose emotional dis­
turbances are great enough to warrant psychiatric help. 1 lie same
range of advice is reflected in the suggestion of those, who train psy­
chiatric social workers.
Some suggest summer jobs as aides in
mental hospitals to test one’s ability to face constantly the personality
deviation in patients; others believe that summer experience as an aide
in a family or children’s agency is preferable. It is well to obtain
both types of experience if possible.
Like the medical social worker, the psychiatric social worker must
also acquire skill in working out. problems in daily cooperation with

36

OUTLOOK FOR WOMEN

other professional persons, in this case the psychiatrist and psycholo­
gist, and often the physical therapist, the occupational therapist, the
teacher, the nurse, the physician, the dietitian, and others. She must
understand the ethics and practice of these related professions in
order to work effectively with those engaged in them for the welfare
of the patient.
Adequate initial training and continuing study are important in
this field in which new theories and practices are constantly challeng­
ing the old. Scholarships are available for well-qualified women to
enable them to complete the 2 years of graduate training usually re­
quired. No rigid undergraduate requirements for entrance have been
set by the member schools of the American Association of Schools of
Social Work. However, a sound foundation in general education, a
concentration in the social sciences and closely related fields, and some
orientation to the field of social work through a course or courses
with social work content have been recommended (7). Individual
schools vary in their requirements, some making no subject specifica­
tion and others requiring 30 semester hours in the social and biological
sciences. Courses in psychology, including abnormal psychology, are
useful both as background and try-out experiences. More attention
is now being given in many colleges to preprofessional preparation,
and counselors and advisors are available on many campuses to work
out suitable programs. 1 hey can also be useful in helping determine
fitness for this field of work.
The first year of training in a graduate school of social work also
serves as a further try-out period, during which fitness and liking for
social case work in a psychiatric setting may be tested both through
courses and practical experience.
The great majority of psychiatric social work jobs are in govern­
ment agencies, such as State and veterans’ hospitals and county and
city clinics, where the advantages and disadvantages of government
work apply. However, the variety of psychiatric work within and
without government agencies, combined with the urgent demand for it,
offers many choices {U). Women who are well-suited and welltrained for this work will find in the future many opportunities to
help in the great task of salvaging for society and for their own
happiness those who are threatened by mental illness.

Section II
EMPLOYMENT BEFORE WORLD WAR II
Social services to patients suffering from mental illness were de­
veloped along with services to other patients in general hospitals in
the early 1900’s. The neurological clinic at Massachusetts General
Hospital in Boston and at Bellevue Hospital and at the Cornell Clinic
in New York City as early as 1905 assigned social workers to assist
physicians by supplying information on the patient’s home environ­
ment and his social problems. A year later, the State Charities Aid
Association of New York introduced social workers into the Manhat­
tan State Hospital on Ward’s Island. They remained undifferen­
tiated from other social workers in hospitals in name or in training
until 1913, when the Boston Psychopathic Hospital developed the
specialty of “psychiatric social workers” (H) ■ World War I gave a
sudden spurt to the growing demand for social workers trained to
work with individuals with nervous or emotional disorders. Pro­
grams of training were begun at Smith College School of Social
Work in 1918 and at the New York School of Social Work in 1919
to meet the need for specially trained workers (86). In March 1919
the American Red Cross was asked to organize social service in
mental hospitals for servicemen similar to that existing in mental
hospitals for civilians. By January 1920, 42 hospitals had social
service departments and the Red Cross offered special scholarships
and cooperated with schools of social work in training programs (H) •
In Psychiatric Hospitals

By 1940 there were at least 503 full-time social workers employed
in mental institutions in the United States, according to the Bureau
of the Census. This number was reported by 209 mental hospitals
and 134 State institutions for mental defectives or epileptics and
represented the bulk of such institutions as well as of the resident
patients in them. Not reported were those employed in county, city,
and private hospitals for mental diseases (which were credited with
about 8 percent of all mental patients) and those in psychiatric wards
of general hospitals and in military hospitals. The largest number,
349, of the social workers were in State hospitals for mental diseases,
where the resident patients numbered approximately 400,000.
Ninety-five were in State institutions for mental defectives and epilep­
tics where the resident patient population exceeded 100,000. Ninety
37

38

OUTLOOK FOR WOMEN

percent of the social workers in the State hospitals were women,
and it may be assumed that this proportion held for the remaining
group for which sex data were not given. Fifty-nine of the 170
State hospitals reporting to the Census employed no social workers,
and in 12 States no social workers at all were reported employed
in mental hospitals. Half of the States employed no social workers
in institutions for the mentally defective or epileptics; the Southern
and Mountain States were most lacking in this type of personnel (56).
Less than 1,000 patients in State mental hospitals were being given
family care outside the institution in a home other than that of a
relative, and only six States had provision for this sort of care, which
requires intensive case work. Most of the social workers worked
with resident patients or with some of the more than 50,000 patients
paroled to their homes in 1910 preceding discharge (56).
In 1941, a 71 percent shortage of social work personnel in State
hospitals for mental disease was reported by the United States Public
Health Service (22). Some of this may have been due to the steadily
growing demand for social workers in mental hospitals and the in­
crease of mental patients, but one writer in 1910 said: “Social work
in mental hospitals has been, for the last 10 years, a field not gen­
erally regarded ' ‘ ' as one offering desirable opportunities.
Reasons given have been lower salaries, isolation from community
contacts, necessity of living within the institution, discouragingly
heavy case loads, demands made upon the time of social workers for
routine duties within the institution.” She concluded, however, that
salaries were improving, that the isolation was breaking down’ and
that mental hospitals would again offer attractive opportunities (&£).
In Psychiatric Clinics

About 60 percent of all psychiatric clinics in the country were
under State auspices in 25 States in 1935, and three-fourths of these
<>7o clinics under State auspices were clinics of mental hospitals.
More than two-thirds had social workers on their staffs, though there
were wide variations in set-up and services (67). Some of the clinics
m mental hospitals in which patients were diagnosed and treated
were early extended to give service to out-patients. As early as 1914,
the Massachusetts State Department of Education in cooperation
with the Department of Mental Health established traveling clinics
out of and by State mental hospitals for examination of school chil­
dren retarded 3 years or more (2). But the most spectacular growth
m psychiatric clinics took place outside mental hospitals The recog­
nition that many of the mental breakdowns that occurred annum
sohhers m World War I were traceable to childhood maladjustments
and the need for reducing juvenile delinquency resulted in emphasis

SOCIAL CASE WORK, PSYCHIATRIC SETTING

39

on psychiatric clinics for children and on “child guidance.” As early
as 1915, a psychiatric social worker had been added to the Juvenile
Psychopathic Institute in Chicago which in 1909 became the first
child guidance clinic in the United States (later known as the Insti­
tute for Juvenile Research of the Illinois Department of Public
Welfare) (16).
In 1921 the National Committee for Mental Hygiene, assisted by
large appropriations from the Commonwealth Fund, embarked on a
program of demonstration clinics and advisory services throughout
the country to prevent juvenile delinquency. Most of the clinics were
set up in urban centers, and there were none in cities under 150,000
population though some had service from t raveling staffs (67). Some
were noninstitutional State clinics operated by the department of
health, department of education, or by a State university hospital.
The boards of education in at least four cities operated clinics with
a full-time psychiatrist, and those in several other cities helped finance
community clinics for children (24). More often, however, the schools
relied on occasional psychiatric help from other agencies. The Edu­
cational Policies Commission of the National Education Association
and the American Association of School Administrators in 1939 re­
ported that only the largest school systems would ordinarily need
a full-time psychiatrist and that use should be made of psychiatric
services available in the community or of traveling clinics (10). A
United States Office of Education bulletin in the same year also said
that most school systems find it impossible to employ the services of a
full-time psychiatrist but recommended that every attempt be made
to locate either within or without the school system a psychiatrist
versed in child guidance whose services could be made a part of the
total program. Other essentials in a clinical organization were the
services of a physician, psychologist , and case worker such as a visit­
ing teacher or social worker (59).
Visiting teachers had been assigned as early as 1906 and 1907 in
Boston, Hartford, and New York to work intensively with families
to better adjustment of pupils in school whose behavior was abnormal.
Later, as many visiting teachers took training in psychiatric social
work and many psychiatric social workers took jobs in school systems,
the distinction between the two in school work, whether in function
or in training, was chiefly that the visiting teacher had more extensive
teaching and educational experience and the psychiatric social worker
in the school had more experience in working with psychiatrists. Both
did case work with students and educational work to promote a better
understanding of mental hygiene. The psychiatric social workers,
fewer in number than the visiting teachers, were more often attached
to a clinic and carried a smaller case load. In 1937, however, only

40

OUTLOOK FOR WOMEN

28 members of the American Association of Psychiatric Social Work­
ers were working in educational institutions or colleges, whereas most
of the members of the American Association of Visiting Teachers
were working in schools ($}£). All types of social workers in schools
will be discussed in a later bulletin in this series.
There were only a few colleges in 1940 in which psychiatric social
workers were employed as part of a clinical staff to service students.
At that time one writer concluded that the use of psychiatry in col­
leges was not clear cut, and the relations of psychiatric staff to other
staff members working with individual students remained to be defined.

Figure 18.—A psychiatric social case worker interviewing a parent at a
child guidance center operated in a public school system by the State
Division of Mental Hygiene.
At the opposite end of the educational scale only a few nursery schools
connected with psychiatric clinics employed psychiatric social workers,
although some had services of psychiatric social workers through board
of education or combined facilities. A few churches had operated
psychiatric clinics and there were a few marriage clinics and life ad­
justment centers in which psychiatric social workers were employed.
But the amount of such employment, like that in private practice,
was negligible. Only occasionally and for short periods were psychi­
atric social workers engaged by psychiatrists in private practice to
give social service to their patients (2If).
In 1940 there were 461 psychiatric clinics serving both children and
adults and 38 for adults only. Most of them were attached to general

SOCIAL CASE WORK, PSYCHIATRIC SETTING

41

or mental hospitals, but some were attached to criminal, family, or
domestic-relations courts, or to local community agencies (&£)• One
authority, in 1940, noted that State hospital clinics, especially in work
with the mentally defective, utilized psychologists more than social
workers {67).
Some traveling clinics were operated by the State. Virginia’s Bu­
reau of Mental Hygiene in 1928, for example, with aid from the Com­
monwealth Fund, employed two psychiatrists, two psychologists, and
one psychiatric social worker to travel through the State working
with public health and private physicians. Regular services were
supplied to all children received at the Department of Public Welfare
and to institutions for the mentally ill and mentally defective, and lim­
ited clinical services were rendered to juvenile courts in the State and
also to schools through local court or welfare services {30). Under
provisions of the Social Security Act, funds for psychiatric and psy­
chological services were available in connection with the extension
of child welfare services to rural areas, and, by 1942, about one-thi rd
of the States had psychiatrists or psychologists on their staffs to aid
local child welfare workers {36). Three States in 1939 had separate
departments of mental hygiene, and nine others had mental health
divisions in their health or welfare departments. A few psychiatric
social workers were known to be employed in State departments in a
consulting capacity before the war, in addition to those employed in
clinics (&£).
In Preventive Work
The prevention of mental illness was spread gradually from the
mental hospital and the clinic to the court, the school, the public
health agency and other settings where young people and others
who showed early symptoms of maladjustment might be reached.
Prominent in spreading this recognition was the National Committee
for Mental Hygiene and State and local mental hygiene societies
which published information on mental health and assisted in the
permeation of principles of mental hygiene in all agencies dealing
with individuals. As early as 1936, 12 out of 400 public health nurs­
ing organizations had mental health supervisors, and 11 members of
the American Association of Psychiatric Social Workers were so
employed at that time, while 9 members were employed by mental
hygiene societies. About one-fourth of the members of the American
Association of Psychiatric Social Workers were working as consult­
ants or case workers in family or child welfare agencies where empha­
sis on psychiatric problems was increasing (&£).
Throughout the history of psychiatric social work, the demand has
exceeded the supply, according to publications of the American Asso­
ciation of Psychiatric Social Workers. Even during the depression of

42

OUTLOOK FOR WOMEN

(lie thirties, all job openings were not filled. Years ago, turn-over
figures for the American Association of Psychiatric Social Workers
revealed that the average member stayed in one position less than 2
years as an array of job choices was presented (&£)■. The only type
of psychiatric agency in which the supply ever closely approached
the demand before World War II was the child guidance clinic.
In State hospitals, mental hygiene organizations, and schools of social
work, there were usually budgeted positions vacant. Reasons given
by various authorities for this undersupply included prejudice against
psychiatric work, low salaries in some centers, and lack of training
facilities.
(

WARTIME CHANGES IN EMPLOYMENT
World War II accentuated the shortage of psychiatric social work­
ers. So critical was the need that the Rockefeller Foundation helped
finance a war service office of the American Association of Psychi­
atric Social Workers, which continued to operate until the close of
(lie war in 1945. Ry 1944, the Red ( toss had expanded its prewar staff
of 94 medical and psychiatric social workers in Army and Navy
hospitals to 1,083 case workers in domestic hospitals, of whom about
270 were psychiatric social workers. Ry 1945, it also had in its over­
seas hospitals 281 social workers, of whom from 70 to 75 were psychi­
atric social workers. One of these overseas workers described her
experiences as unlike anything for which her previous experience had
prepared her. The lack of usual facilities and resources and the short
association with patients under war pressures called for the utmost
in resourcefulness {53).
Meanwhile, the Army itself recognized the need for psychiatric
social work and in the fall of 1943 provided for a special SSN 263
classification for enlisted men under the title “military psychiatric
social worker,” which was later used in many installations (£9). Some
were assigned to neuropsychiatric wards and hospitals, supplement­
ing the Red Cross social work staff; others worked in psychiatric
clinics, called mental hygiene units, or “consultation services” set up
in training and other centers to assist service men with emotional ills.
Generally, they prepared case histories on the patients for use by the
psychiatrist, made referrals to resources of aid in treating the patient,
and assisted in the solution of his social problems. Sometimes, they
participated in treatment involving groups, called “group therapy,”
used increasingly because of the tremendous need for psychiatric
treatment and the lack of available personnel. Minimum qualifica­
tions for the SSN 263 classification were graduation from a recognized
school of social work or 2 years of supervised social work activities
in a public or private agency. Many without these qualifications

SOCIAL CASE WORK, PSYCHIATRIC SETTING

43

were later assigned from related fields such as teaching, public wel­
fare, and employment interviewing.
Extraordinary efforts were made by the War Service Office of the
American Association of Psychiatric Social Workers to inform its
membership and, through flic Wartime Committee on Personnel of
the American Association of Social Workers, other social workers
concerning the Army’s program and to supply the Army periodically
with lists of persons qualified for and interested in the classification.
It reported more than 300 social case workers in the Army who wanted
to use their skills in psychiatric work (40). It issued a bibliography

mam

Figure 19-—A Red Cross psychiatric case worker visits patients in iso­
lation ward of an Army station hospital in Bayreuth, Germany.

on military psychiatric social work which also included references
on the use of social work skill in such military assignments as per­
sonnel consultant and personal service worker (23). Recruitment
for the SSN 263, which came late, was hampered by the lack of
officer status in the social work specialization and the availability of
commissions in the field of psychology, for which a number of social
workers also qualified. Further, many psychiatric social workers on
duty in the Army were already officers in nonclinical assignments,
including combat units. Although the Neuropsychiatry Consultants
Division of the Surgeon General’s Office established a Psychiatric
Social Work Branch in June 1945 under an officer who was a psychi­
atric social worker, it was not until after the close of hostilities in

44

OUTLOOK FOR WOMEN

September 1945 that the Army set up a corresponding classification
for commissioned officers, MOS 3605 (35).
No records are available as to how many of the more than 700
persons classified as military psychiatric social workers in the armed
forces shortly after VJ-day were fully qualified. Due to the lack of
trained persons available and the adjustment of standards to meet
immediate Army needs, probably only 150 to 200 were fully trained
social workers, according to an estimate by the social worker in charge
of the program (43). A considerable number of WAC’s were given
in-service training and assigned to consultation and mental hygiene
units, especially toward the end of the war, and the Women’s Army
Corps actively recruited civilian social workers for this program (68).
Although some psychiatric social workers may have been among
the 93 WAVE officers with social work training or experience assigned
to personnel or welfare jobs in which their social work background
was utilized, no records are available as to their number. At least
2 were known to be members of the American Association of Psychi­
atric Social Workers.
Meanwhile, the pressures of war were felt in civilian programs
(69). A large number of men were rejected for military service
and classified as “psychoneurotic” because their mental or emotional
disturbances made them poor risks. Later the number of men dis­
charged after service for the same reason amounted to nearly onehalf of all medical discharges. These facts aroused public interest
in psychiatric treatment. Some selective service boards employed
psychiatric social workers to assist psychiatrists in screening men
ready for induction. Much of this work, however, as well as the
discussion of their problems with rejected men, was done by social
workers who volunteered their services as a wartime contribution
(37) (4-2). As a number of psychiatrists and psychiatric social
workers left civilian hospitals and clinics for military service, their
places were often left vacant because trained personnel were not avail­
able (41)- By 1945 more than one-fourth of the 550 positions for
social -workers in State mental hospitals were vacant (57). The 30
graduates in psychiatric social work in 1941-42 at one school in­
cluded 16 men and 1 woman who were in the armed forces in the
following spring. Of the remaining 13 graduates, only 4 went into
hospital work. Some civilian clinics closed down, although the need
for psychiatric services increased under the strains and stresses of
war, and later the need for community clinics for service and rejected
men arose. A number of communities provided funds for such
clinics but were unable to secure qualified personnel. In some clinics
already established, psychiatric social workers were left to carry on
service without a psychiatrist.

SOCIAL CASE WORK, PSYCHIATRIC SETTING

45

A new demand for women with psychiatric social work training
came from large industrial plants and government agencies which
inaugurated employee counseling programs to hasten the adjustment
to war work of large numbers of inexperienced and often poorly
qualified employees (40). In some of these psychiatrists were on the
staff, permitting close consultation, but in most the worker was on
her own. The extension in 1943 of the Federal Vocational Rehabili­
tation Act to include mental as well as physical rehabilitation also

Figure 20.—A social case worker and an occupational therapist in a mental
hospital observing a patient working on a jig saw.
created a new demand for psychiatric social workers as consultants
in vocational rehabilitation programs.
With only 600 members at the outbreak of World War II, the
American Association of Psychiatric Social Workers early recognized
the need for utilizing their skills only in positions where less welltrained persons could not be substituted. A statement prepared in
1943 by the War Service Office reported that, on the basis of informa­
tion from more than two-thirds of its 600 members, only one-third
were using their specialized training and experience in a direct work­
ing relation to psychiatry in hospitals or clinics. (See table 3.) An
additional 18 percent were engaged in teaching, administrative, or

46

OUTLOOK FOR WOMEN

consulting positions in psychiatric social work or mental hygiene,
also considered essential wartime positions. Of the remaining half
of the membership, 8 percent were not working, 1 percent were in pri­
vate practice, and the others were in positions where their services
could not lie considered as essential psychiatric social service (11).
In December 1942, the War Service Office reported 251 openings
requiring psychiatric social work training and involving a direct
working relation to psychiatry, excluding the blanket call from the
American Red Cross for 100 social workers. The information pre­
sented suggested that members who voluntarily moved from a non­
essential job to an essential job in mental health service, as agreed upon
by the American Association of Psychiatric Social Work member­
ship, would be conserving their much-needed skills and performing
a useful service (It).
Table

3.—Type

of Employment of 418 Members of the American Association of
Psychiatric Social Workers, December 1942
Type of employment

Percent
100
—

Veterans’ Administration and Army Mental Hygiene Units------------------------------------

13
9
9
2
9
5
4

Miscellaneous, including college teaching, work in nursing organization, etc.____ _____

11
10
7
4
3
5

33

18

1
40

8
Source: American Association of Psychiatric Social Workers

Membership Personnel Inquiry (11).

The American Red Cross in 1942, in an attempt to obtain qualified
staff for military hospitals, announced a scholarship aid program for
students eligible for the second-year course in a school of social work
offering approved curricula in psychiatric or medical social work.
(See appendix, p. 50, for approved curriculum in psychiatric social
work.) Later, grants were made to beginners for graduate social serv­
ice study, and only 1 year of service with the Red Cross following
training was required. From December 1, 1942, to August 1947, 525
scholarships or grants were given lo prepare staff for case work serv­
ice in military hospitals. Of these, 119 were granted to second-year
students specializing in psychiatric social work; 163 to other secondyear students; and 243 to first-year students whose specialty was un­
determined.

SOCIAL CASE WORK, PSYCHIATRIC SETTING

47

In the final year of the war, postwar requirements for psychiatric
social workers were estimated at 12,000 by the National Committee
for Mental Hygiene (4). More men in the field and better distri­
bution through more widespread location of schools were stressed
as needs by one authority. The War Office of the American Associa­
tion of Psychiatric Social Workers and the National Committee for
Mental Hygiene urged men and women in the armed forces to con­
sider training for psychiatric social work, noting that the number of
positions open to men was “large and expanding daily.” This in no
way interfered with the continuing demand for women in the field.
VOLUNTEERS AND PAID AIDES
Volunteers to assist social workers by performing some of their
nonprofessional duties were recruited by the American Red Cross for
wartime service, and some have continued to serve since the war (10).
In 1949 some were used as social welfare aides in military wards
for mental patients, following completion of the required Red Cross
training course and subsequent orientation in the hospital selected
for service. Most mental hospitals, as compared with general and
other hospitals, however, have had relatively little experience with
volunteers. A majority of the 100 psychiatric hospitals represented
by a group of leading psychiatrists in 1948 reported no employment
of lay volunteers (26). Where volunteers were used, their work has
been mainly that of transportation, entertainment, recreation, or
general visiting, rather than assistance in case work.
Encouraged by the Friends Service Committee, and under a pro­
gram worked out by the National Committee for Mental Hygiene,
a number of conscientious objectors gave service in institutions for
mental patients during the war. These psychiatric aides more often
served as attendants to badly disturbed patients than as case work
aides, but some assisted the social workers with routine case work
problems, depending on their own background and interest and on the
extent to which the psychiatric social worker could supply the neces­
sary training. Their observations and reports gave rise to the forma­
tion of the National Mental Health Foundation in 1946, the aim of
which is to work toward the improvement of conditions in mentalinstitutions and to promote mental health.
The continued use of paid “subprofessional” personnel as a tem­
porary expedient to relieve the shortage of psychiatric social work­
ers in hospitals has been deemed feasible if proper training is given
(20) (28). In 1948 the Army was training selected officers with col­
lege degrees and enlisted men for subprofessional work as “case
aides.” A 26-week course for officers and a 20-week course for en­
listed men were given for this purpose at Fort Sam Houston,
Tex. (IS).

APPENDIX
Minimum Requirements for Beginning Position as Psychiatric Social
Worker at St. Elizabeths Hospital in the U. S. Public Health Service
and in the District of Columbia Government1
(As taken from Civil Service Announcement No. 99 (Assembled), issued May 4,
1948, amended September 21, 1948, closed October 5, 1948.)2

Age: Eighteen years of age or over but under 62 (waived for veterans).
Education and Experience:
1. (a) Completion of the following work in a college, university,
or school of social work of recognized standing—2 courses in social
case work theory and principles, 1 course in medical or psychiatric
information, 500 hours of supervised field work in social case work,
and 6 additional courses in one or more of the following fields: Child
welfare, juvenile delinquency, probation and parole, social legislation,
labor problems, social group work, community organization, public
welfare administration, or social research. (A year of study in an
accredited school of social work, including supervised field work, will
be accepted as meeting this requirement.) PLUS
(b) One year of experience in psychiatric social work;
OR
2. Completion of 2 years of study in an accredited school of social
work.
Physical Requirements:
A physical examination is required before appointment. Amputa­
tion of arm, hand, leg, or foot will not disqualify an applicant for
appointment, but loss of foot or leg must be compensated by use of
satisfactory prosthesis. Vision with or without glasses must be suffi­
ciently acute, and near vision, glasses permitted, must be acute enough
for the reading of printed material the size of typewritten characters
without strain. Applicants must be able to hear the conversational
voice, with or without a hearing aid. Applicants must be free from
1 In November 1949, the beginning salary on this position was $3,825. A lower grade
position at $3,100 per year did not carry the psychiatric social worker title; it required
only 1 full year of study in an accredited school of social work or a year of experience
in social case work following college graduation or 5 years of experience in social case
work or equivalent combinations of training and experience.
2 For more recent and complete information consult latest announcements of the Civil
Service Commission in first- and second-class post offices.

48

SOCIAL CASE WORK, PSYCHIATRIC SETTING

49

emotional instability and have no history or presence of serious mental
diseases. Any physical condition which would cause the applicant
to be a hazard to himself or others, or which would prevent efficient
performance of the duties of the position, will disqualify for appoint­
ment.
Minimum Requirements for Beginning Position as Psychiatric Social
Worker for Duty in the U. S. Veterans’ Administration 3
(As taken from Civil Service Announcement No. 60 (Unassembled), issued July
15, 1947- closed August 12, 1947)4

Age: Eighteen years of age or over but under 62 (waived for veterans).
Education and Experience:
One year of training in an accredited school of social work, includ­
ing supervised field work and courses in psychiatric or medical
information.
One year of experience in social case work in a health or welfare
agency or in the armed forces. One year of training completed in an
accredited school of social work, beyond the training used to meet the
above educational requirement, may be substituted for this experience.
Physical Requirements:
A physical examination is required before appointment. Duties
require moderate physical exertion involving prolonged walking.
Arms, hands, legs, and feet must be sufficiently intact and functioning,
and vision sufficiently acute, with or without glasses, to perform the
duties. Applicants must be able to hear ordinary conversation, with
or without a hearing aid. Emotional and mental stability is essen­
tial. Any physical defect which would cause the applicant to be a
hazard to himself or to others, or which would prevent efficient per­
formance of the duties of the position, will disqualify the applicant
for appointment.
Minimum Requirements for Membership in the American Association
of Psychiatric Social Workers

For active membership:
A bachelor’s degree or its equivalent, plus—
1. Graduation from a curriculum in psychiatric social work
approved by the American Association of Psychiatric
Social Workers at a school of social work accredited by
t'he American Association of Schools of Social Work.
3 In November 1949 the beginning salary on this position was $3,825.
4 For more recent and complete information consult latest announcements of the Civil
Service Commission in first- and second-class post offices.

50

OUTLOOK FOR WOMEN

2. One year of subsequent paid continuous employment in
psychiatric social work in positions lasting not less than
6 months each.
Or,
1. Graduation from a curriculum in social case work in a
school accredited by the American Association of Schools
of Social Work.
2. T wo years of subsequent paid continuous employment in
psychiatric social work 6 months of which must have been
under the supervision of a psychiatric social worker, and
at least 1 year of which must have been in a single position.
Bor associate membership (which includes all privileges except the
right to vote, hold office, and serve as an endorser) :
A bachelor’s degree or its equivalent, plus—
1. Graduation from a curriculum in psychiatric social work
approved by the American Association of Psychiatric
Social Work at a school of social work accredited by the
American Association of Schools of Social Work.
Or,

1. Graduation from a curriculum in social case work in a
school accredited by the American Association of Schools
of Social Work, and
2. Six months’ paid experience in psychiatric social work
under the supervision of a psychiatric social worker.
Essential Elements in a Training Program Approved by the American
Association of Psychiatric Social Workers, 1949

A 2-year graduate program leading to a master’s degree in a school
of social work approved by the American Association of Schools of
Social Work, including—
1. Completion of the basic social work curriculum as defined by
the American Association of Schools of Social Work, covering—
(a) Instruction in case work, group work, community or­
ganization, public welfare, medical information, psychi­
atric information, research, and administration.
(b) 400 hours of field work (in the first-year basic curricu­
lum) .
2. A sequence of courses having to do with psychiatric under­
standing of individuals and its application and the practice of
social case work in the various possible psychiatric settings,
including at least the following: Dynamics of personality,
psychopathology, health and disease, mental testing, seminar
in psychiatric social case work.

SOCIAL CASE WORK, PSYCHIATRIC SETTING

51

3. Field work of at least 3 days a week for 2 semesters or 3 quarters
in all are required. This should include not less than 600
clock hours in a psychiatric hospital, a psychiatric department
of a hospital, or a psychiatric clinic, under the direction of a
qualified psychiatric social worker. At least 6 months of con­
secutive field work in any given agency is necessary to count
toward the amount needed.
\
4. Completion of a research project or thesis, preferably relating
to the field of psychiatric social work.
Schools of Social Work in the United States Offering Curricula in
Psychiatric Social Work Approved by the American Association of
Psychiatric Social Workers, January 1950 5
Boston College,
School of Social Work,
Boston, Mass.

Smith College,6
School of Social Work,
Northampton, Mass.

Boston University,
School of Social Work,
Boston, Mass.

Tulane University,
School of Social Work,
New Orleans, La.

Catholic University of America,
The National Catholic School of Social
Service,
Washington, D. C.
College of William and Mary,
School of Social Work,
Richmond, Va.
Fordham University,
Graduate School of Social Work,
New York, N. Y.

University of Buffalo,
School of Social Work,
Buffalo, N. Y.
University of California,
Graduate School of Social Welfare,
Berkeley, Calif.
University of Chicago,"
School of Social Service Administra­
tion,Chicago, 111.

University of Denver,
The New York School of Social Work School of Social Work,
Denver, Colo.
of Columbia University,'1
New York, N. Y.
University of Louisville,
Raymond A. Kent School of Social
Pennsylvania School of Social Work,"
Work,
Philadelphia, Pa.
Louisville, Ky.
Simmons College,
School of Social Work,
Boston 16, Mass.

University of Minnesota,"
School of Social Work,
Minneapolis, Minn.

5 All the member schools of the American Association of Schools of Social Work offer the
first year of the accredited program. A current list of these schools, showing those offering
the second year of the approved specialization in psychiatric social work, is published semi­
annually by the American Association of Schools of Social Work, 1 Park Avenue, New
York 16, N. Y.
a Also offer advanced training beyond the second year.

52

OUTLOOK FOR WOMEN

University of North Carolina,
Washington University,
Division of Public Welfare and Social George Warren Brown School of Social
Work,
Work,
Chapel Hill, N. C.
St. Louis, Mo.
University of Pittsburgh,6
School of Social Work,
Pittsburgh, Pa.
University of Southern California,
Graduate School of Social Work,
Los Angeles, Calif.

Wayne University,
Detroit, Mich.
Western Reserve University,
School of Applied Social Sciences,
Cleveland, Ohio.

6 Also offer advanced training beyond the second year.

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Political and Social Science 212: 202-208, November 1940.
(3) Alt, Herschel. The fusion ol psychiatry and case work in the child guid­
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54

OUTLOOK FOR WOMEN

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- society. New York, N. Y., Commonwealth Fund, 1948. 424 pp.
(46) Report of Chairman of Committee on Membership Qualifications, American
Orthopsychiatric Association, Inc. In Proceedings of the 25th Annual
Meeting of the American Orthopsychiatric Association, Inc., American
Journal of Orthopsychiatry 19:167-175, January 1949. Note: For full
report of this Committee on its study of current trends in the use and
coordination of professional services of psychiatrists, psychologists, and
social workers in mental hygiene clinics and other psychiatric agencies
and institutions see American Journal of Orthopsychiatry 20: 1-62, Jan­
uary 1950.
(47) Robinson, J. Franklin. Resident psychiatric treatment of children. Ameri­
can Journal of Orthopsychiatry 17 : 484-487, July 1947.
(4S) Rockmore, Myron John. Private practice: an exploratory inquiry. Sur­
vey 84: 109-111, Midmonthly, April 1948.
(49) Ross, Elizabeth II. What’s so different about Army psychiatric social
work. The Family 27: 64-71, March 1946.
(50) Sloan, Marion Bradford. Social workers share the job in a veterans’
hospital. Cleveland, Ohio, Western Reserve University, School of Ap­
plied Social Sciences, May 6,194S. 107 pp. Ms. Thesis.
(51) Stevenson, George S. Potentials for mental hygiene activities under publichealth authority. American Journal of Orthopsychiatry 18: 685-690, Oc­
tober 1918.
(52) Tiebout, Harry M. Alcoholism. In Social Work Yearbook 1947. pp. 45-50.
(53) Tobias, Irene. A psychiatric social worker overseas. New York, N. Y.,
Family Welfare Association of America, 122 E. 22nd St.., 1945. 45 pp.
(54) Towle, Charlotte. Social case work. In Social Work Yearbook, 1945.
New York, N. Y., Russell Sage Foundation, 1945. pp. 415-421.
(55) U. S. Department of Commerce, Bureau of the Census. Current population
reports. Population estimates. Series P-25, No. 15. Washington, D. C.,
the Bureau, Oct. 10,1948. 6 pp.
(56) -------- - ---------. Patients in mental institutions, 1940. Washington, D. C.,
U. S. Government printing office, 1943. 184 pp.

56

OUTLOOK FOR WOMEN

(57) U. S. Department of Commerce, Bureau of the Census. Patients in mental
institutions, 1945. Washington, D. C., U. S. Government printing office,
1948. 214 pp.
(58)------------------- . 16th Census of the United States, 1940. Population, Vol­
ume III. The labor force. Part I. Washington, D. C., U. S. Government
printing office, 1943. 301 pp.
(59) (U. S.) Federal Security Agency, Office of Education. Clinical organiza­
tion for child guidance within the schools. Washington, D. C., U. S.
Government printing office, 1939. 78 pp. (Bulletin No. 15.)
(60) -------- ----------- . Education in training schools for delinquent youth. By
Christine P. Ingram in collaboration with Elise PI. Martens and Katherine
M. Cook. Washington, D. C., U. S. Government printing office, 1945. 93 pp

(61) -------- Public Health Service. Training and research opportunities under
the National Mental Health Act. Washington, D. C., U. S. Government
printing office, June 1948. 22 pp. (Mental Health Series No. 2.)
(62)------------- ------ . Mental Hygiene Division. The National mental health
program. Washington, D. C., U. S. Government printing office, June 1948.
7 pp. (Mental Health Series No. 4.)
(63) ■
--------- The National mental health program progress re­
port. Washington, D. C., the Division, Nov. 15, 1948. 4 pp. Multilith.
(64) ---------. Social Security Administration, Bureau of rublic Assistance and
Children’s Bureau. The American family; a factual background. VII.
Income maintenance and social services to families. Washington, D. C.,
National Conference on Family Life, Inc., May 1948. 39 pp. and appen­
dix.
(65) ---------. U. S. Employment Service. Dictionary of occupational titles.
Volume I. Definitions of titles. Washington, D. C„ U. S. Government
printing office, March 1949. pp. 204-205. (Sided.)
(66) (U. S.) Veterans Administration. Supervised field work positions in V. A.
social service. Washington, D. C., the Administration, July 2, 1948. 4 pp.
Multilith. Fact Sheet No. 10-2 (Revised).
(67) Witmer, Helen Leland. Psychiatric clinics for children, with special refer­
ence to State programs. New York, N. Y., the Commonwealth Fund.
London, Humphrey Milford, Oxford University Press, 1940. 437 pp.
(68) WAC recruiting of psychiatric social workers. Social Work Journal 26:25
(formerly The Compass), November 1944.
(69) Woodcock, Mary-Ellen. Local observations by psychiatric social workers
in wartime. The News-letter of the A. A. P. S. W. 13 : 42-45, Autumn, 1943.

CURRENT PUBLICATIONS OF THE WOMEN S BUREAU
FACTS ON WOMEN WORKERS—Issued monthly. 4 pages. (Latest statitsics
on employment of women; earnings; labor laws affecting women ; news items of
interest to women workers; women in the international scene.)
1950 HANDBOOK OF FACTS ON WOMEN WORKERS. Bull. 237.

(In press.)

THE AMERICAN WOMAN—Her Changing Role as Worker, Homemaker, Citizen.
(Women’s Bureau Conference, 1948.) Bull. 224. 210 pp. 1948.
EMPLOYMENT OUTLOOK AND TRAINING FOR WOMEN
The Outlook for Women in Occupations in the Medical and Other Health Services,
Bull. 203:
1. Physical Therapists. 14 pp. 1945. 100.
.
2. Occupational Therapists. 15 pp. 1945. 100.
3. Professional Nurses. 66 pp. 1946. 150.
4. Medical Laboratory Technicians. 10 pp. 1945. 100,
5. Practical Nurses and Hospital Attendants. 20 pp. 1945. 100.
6. Medical Record Librarians. 9 pp. 1945. 100.
7. Women Physicians. 28 pp. 1945. 100.
8. X-ray Technicians. 14 pp. 1945. 100.
9. Women Dentists. 21 pp. 1945. 100.
10. Dental Hygienists. 17 pp. 1945. 100.
11. Physicians’ and Dentists’ Assistants. 15 pp. 1945. 100.
12. Trends and Their Effect Upon the Demand for Women Workers. 55 pp.
1946. 150.
The Outlook for Women in Science. Bull. 223:
1. Science. [General Introduction to the series.] 81pp. 1949. 200.
2. Chemistry. 65 pp. 1948. 200.
3. Biological Sciences. 87 pp. 1948. 250.
4. Mathematics and Statistics. 21 pp. 1948. 100.
5. Architecture and Engineering. 88 pp. 1948. 250.
6. Physics and Astronomy. 32 pp. 1948. 150.
7. Geology, Geography, and Meteorology. 52 pp. 1948. 150.
8. Occupations Related to Science. 33 pp. 1948. 150.
The Outlook for Women in Police Work. Bull. 231. 31 pp. 1949. 150.
Home Economics Occupation Series. Bull. 234. The Outlook for Women in :
1. Dietetics. 80 pp. 1950. 250. (Others in preparation.)
Social Work Series. Bull. 235. The Outlook for Women in:
1. Social Case Work in a Medical Setting. 59 pp. 1950. 250.
2. Social Case Work in a Psychiatric Setting. (Instant publication. Others
in preparation.)
Your Job Future After College. Leaflet. 1947. (Rev. 1948.)
Your Job Future After High School. Leaflet. 1949.
Occupations for Girls and Women—Selected References. Bull. 229. 105 pp.
1949. 300.
Training for Jobs—for Women and Girls. [Under public funds available for
vocational training purposes.] Leaflet 1. 1947.
57

EARNINGS
Earnings of Women in Selected Manufacturing Industries.
14 pp. 1948. 100.

1946.

Bull. 219

LABOR LAWS
Summary of State Labor Laws for Women. 8 pp. 1950. Mimeo.
State Legislation of Special Interest to Women. Mimeos for 1948 and 1949.
Minimum Wage
State Minimum-Wage Laws and Orders, 1942; An Analysis. Bull. 191. 52 pp.
1942. 200. Supplement, July 1, 1942-July 1, 1950. Bull. 227. (Revised.)
(In press.)
State Minimum-Wage Laws. Leaflet 1. 1948.
Model Bill for State minimum-wage law for women. Mimeo.
Map showing States having minimum-wage laws. (Desk size; wall size.)
State Minimum-Wage Orders Becoming Effective Since End of World War II.
1950. Multilith.
Equal Pay
Equal Pay for Women. Leaflet 2. 1947. (Rev. 1949.)
Chart analyzing State equal-pay laws and Model Bill. Mimeo.
Texts of State laws (separates). Mimeo.
Model Bill for State equal-pay law. Mimeo.
Selected References on Equal Pay for Women. 10 pp. 1949. Mimeo.
Movement for Equal-Pay Legislation in the United States. 5 pp. 1949.
lith.

Multi­

Hours of Work and Other Labor Laws
State Labor Laws for Women, with Wartime Modifications, Dec 15 1944
Bull. 202:
I. Analysis of Hour Laws. 110 pp. 1945. 150.
II. Analysis of Plant Facilities Laws. 43 pp. 1945. 100.
III. Analysis of Regulatory Laws, Prohibitory Laws, Maternity Laws. 12 pp.
1945. 50.
IV. Analysis of Industrial Home-Work Laws. 20 pp. 1945. 100.
V. Explanation and Appraisal. 00 pp. 1946. 150.
Working Women and Unemployment Insurance. Leaflet. 1949.
Maps of United States showing State hour laws, daily and weekly. (Desk size;
wall size.)
LEGAL STATUS OF WOMEN
International Documents on the Status of Women. Bull. 217. 110 pp. 1947. 250.
Legal Status of Women in the United States of America, January 1, 1948:
United States Summary. Bull. 157 . (Revised.) In preparation.)
Reports for States, Territories, and Possessions (separates). Bulls. 157-1
through 157-54. (Revised.) 50 and 100 each.
Ihe I olitieal and C ivil Status of Women in the United States of America. Sum­
mary, including Principal Sex Distinctions, as of January 1 1948 Leaflet
1948.
’
'
Women’s Eligibility for Jury Duty. Leaflet. July 1, 1949.

58

Reply of United States Government to Questionnaire of United Nations Economic
and Social Council on the Legal Status and Treatment of Women. Part I.
Public Law. In 6 Sections: A and B, Franchise and Public Office; C, Public
Services and Functions; D, Educational and Professional Opportunities; E,
Fiscal Laws; F, Civil Liberties; and G, Nationality. Mimeo.
HOUSEHOLD EMPLOYMENT
Old-Age Insurance for Household Workers. Bull. 220. 20 pp. 1947. 100.
Community Household Employment Programs. Bull. 221. 70 pp. 1948. 200.
RECOMMENDED STANDARDS—for women’s working conditions, safety, and
health.
Standards of Employment for Women. Leaflet. 1950.
When You Hire Women. Sp. Bull. 14. 10 pp. 1944. 100.
The Industrial Nurse and the Woman Worker. Bull. 228. (Partial revision of
Sp. Bull. 19. 1944.) 48 pp. 1949. 150.
Women's Effective War Work Requires Good Posture. Sp. Bull. 10. 6 pp.
1943. 50.
Washing and Toilet Facilities for Women in Industry. Sp. Bull. 4. 11 pp.
1942. 50.
Lifting and Carrying Weights by Women in Industry. Sp. Bull. 2. (Rev. 1946.)
12 pp. 50.
Safety Clothing for Women in Industry. Sp. Bull. 3. 11 pp. 1941. 100.
Supplements: Safety Caps; Safety Shoes. 4 pp. each. 1944. 50 each.
Poster—Work Clothes for Safety and Efficiency.
WOMEN UNDER UNION CONTRACTS
Maternity-Benefits Under Union-Contract Health Insurance Plans.
19 pp. 1947. 100.
COST OF LIVING BUDGETS
Working Women’s Budgets in Twelve States.

Bull. 226.

Bull. 214.

36 pp. 1948.

150.

EMPLOYMENT
Women's Occupations Through Seven Decades. Bull. 218. 260 pp. 1947. 450.
Popular version, Women’s Jobs: Advance and Growth. Bull. 232, 88 pp.
1949. 300.
Employment of Women in the Early Postwar Period, with Background of Pre­
war and War Data. Bull. 211. 14 pp. 1946. 100.
Women Workers in Ten War Production Areas and Their Postwar Employ­
ment Plans. Bull. 209. 56 pp. 1946. 150.
Women in Higher-Level Positions. Bull. 236. (In press.)
Baltimore Women War Workers in the Postwar Period. 61 pp. 1948. Mimeo.
INDUSTRY
Women Workers in Power Laundries. Bull. 215. 71 pp. 1947. 200.
The Woman Telephone Worker [19441. Bull. 207. 28 pp. 1946. 100.
Typical Women’s Jobs in the Telephone Industry [1944], Bull. 207-A. 52 pp.
1947. 150.
Women in the Federal Service. Part I. Trends in Employment, 1923-1947.
Bull. 230-1. 81 pp. 1949. 250. Part II. Occupational Information. Bull.
230-11. 87 pp. 1950. 250.
Night Work for Women in Hotels and Restaurants. Bull. 233. 59 pp. 1949.
200

.
59

WOMEN IN LATIN AMERICA
Women Workers in Argentina, Chile, and Uruguay. Bull. 195. 15 pp. 1942.
50.
Women Workers in Brazil. Bull. 206. 42 pp. 1946. 100.
Women Workers in Paraguay. Bull. 210. 16 pp. 1946. 100.
Women Workers in Peru. Bull. 213. 41 pp. 1947. 100.
Social and Labor Problems of Peru and Uruguay. 1944. Mimeo.
Women in Latin America: Legal Rights and Restrictions. (Address before the
National Association of Women Lawyers.)
THE WOMEN’S BUREAU—Its Purpose and Functions. Leaflet. 1950.
For complete list of publications available for distribution, twite—
The Women’s Bureau
U. S. Department

of

Labor

Washington 25, D. C.

o

60


Federal Reserve Bank of St. Louis, One Federal Reserve Bank Plaza, St. Louis, MO 63102