Theorising Social Work Research
Researching Social Work as a means of social inclusion 6th March 2000 Edinburgh
Service users' knowledges and social work theory: conflict or collaboration? Peter Beresford Professor of Social Policy, Brunel University
Nothing about us without us The disabled people's movement
This discussion is concerned with two concurrent developments; the increasing significance of service users'* movements in public, political, policy and professional debates and the concern in social work to take forward debate on its theorising. My aim, as someone with a joint interest and affiliation as a service user and researcher, is to connect these two developments, examining their relations and beginning to explore ways of understanding and improving their links for the future.
The seminar series which provides the opportunity for this discussion reflects the broader history of social work theorising. It starts from the position of trying to challenge the wider response to social work as an area of research and theory-building. As the application to the ESRC states, it seeks:
- to put social work 'on the map' as a research-based discipline
- for it to be recognised by the ESRC as a discipline in its own right, by debating the specific contribution it could make to social science research activity. Though many Social Work researchers are involved in ESRC-funded work, Social Work itself is invisible because applications are required always to cite Discipline Codes which do not include it.
Social work discussion of theory
As this suggests, social work has long seemed to need theory more than theory has apparently needed or wanted social work. Conventional social work commentators clearly see its theoretical underpinnings as important. As Joan Orme observed in 1998, in a key standard text for social work students and novice practitioners:
- Social work needs to articulate, celebrate and broadcast the theoretical frameworks which inform, structure and facilitate its operation. (Coulshed and Orme, 1998, p3)
At the same time non-social workers are frequently despising about social work's raiding of the social science cookbook for handy theoretical recipes. (Jones, 1996, p203) The concern to strengthen what might be called social work's theoretical credibility appears to be linked to its professional and intellectual vulnerability, insecurity and low status. There is an understandable defensiveness about many social work discussions of theory. Social work is a practical hands-on activity which has never commanded much official respect. It is a profession predominantly made up of women, which has made determined efforts to include within its ranks black and minority ethnic groups and which operates in some of the most contentious areas of state intervention. As such it is perhaps to be expected that it would come in for regular ideological, political and media attack, particularly given its refusal to accept the 'handmaiden' status imposed upon some comparable human service roles.
Social work discussions about theory have tended to be reactive. There has been a concern to highlight the theoretical credentials of social work. Theory in relation to social work has tended to be presented in terms of legitimation, as if the more social work could demonstrate its theoretical connections, the more credibility would be attached to it.
Theories in social work are still often set out as a list of different approaches, including, for example, person-centred counselling, family therapy, task-centred work, cognitive-behavioural therapy, networking, groupwork, psychoanalytical theory, anti-discriminatory/oppressive practice and feminist theory. (Davies, 1997) or alternatively, crisis intervention, the psychosocial approach, behavioural social work, working with families, etc. (Coulshed and Orme, 1998) The lists vary, but generally what they have in common is that the approaches and associated theories do not originate from and are not specific to social work. Social work has also raised more critical questions about its own theorising, for instance:
- acknowledging that there is no agreement about the nature or meaning of social work theory
- recognising its own limited role in theory-building
- questioning the idea of foundational theory
- appreciating that theorising is a political and social process
- recognising a distinction between postmodernist views of 'theory' and alternatively, modernist, positivist or 'hard science' views of social work 'theory' (Payne, 1997, p27)
All this however has to some extent further confused the meaning of theory in social work. In one sense at least social work is inevitably based on theory. There is an inextricable link between social work and theory - or at least between social work and unevidenced hypotheses - whether these are technical, social or psychological theories or hypotheses. This is true however much adverse criticism is levelled against social work for being atheoretical. Implicitly if not explicitly, it has developed and been undertaken on the basis of certain assumptions and expectations about what it is, what it does, what it is for, what its effects are and what it can achieve. This is true for social work, just like any other human activity.
While postmodern discussion of social work theory has helped connect it with broader contemporary theoretical discussions and highlighted the social production of theory, it hasn't resulted in a radical reassessment of the role of service users in social work theory-building. But now that social work theory is under particular scrutiny, this urgently needs to be reviewed, particularly given the new significance given to the involvement of 'service users' and the emergence of service users' own organisations and movements. A number of interrelated strands in the emergence of participation and service users as prioritised issues for social work and social care need to be reviewed.
The emphasis on 'user involvement'
From the late 1980s discussion if not action on social work and social care has been transformed by the emergence of the idea of 'user involvement'. It has becoming one of the guiding formal principles of social services. Requirements for user involvement are built into both child care and community care government guidance and legislation. This has found expression in a massive increase in market research and consultation initiatives in social work and social care. (Beresford and Croft, 1993) The consumerist commitment of Conservative administrations to user involvement, or at least a variant of it, is now embedded in New Labour's 'third way'. (Giddens, 1998) This is reflected in an interest in new forms of political process and local democracy and 'best value' in local government policies and services. User involvement has become established as a formal component at levels of both collective policy and individual practice. It is embodied as a measure in both official audit and learning 'competencies'.
The emergence of service users and their organisations
While the 1990s emphasis on user involvement can be seen as an expression of changes in political ideology and new 'mixed economy' approaches to public and welfare services, alongside it has run a distinct but interrelated development; the emergence of movements of service users. At its most basic, this development represents a strong collective reaction from people included in social care categories to their negative experiences of welfarist and professional responses to them. It is also related to a number of other broader social and political changes over the same period. (Croft and Beresford, 1996) The disabled people's movement is perhaps the most strongly established and visible of these movements, with the most well worked-out philosophy, (Oliver and Barnes, 1998; Shakespeare, 1999; Barnes, Mercer and Shakespeare, 1999) but this should not divert attention from other movements, for example, of psychiatric system survivors, people with learning difficulties, people living with HIV/AIDS etc. (Beresford, 1999) What distinguishes these movements is that they have been determinedly:
- based on self-identification: for example, as movements of disabled people, mental health service users/psychiatric system survivors or older people;
- self organised and self-run: organised around local, national and international groups and organisations based on their own identities, which they themselves control, developing their own ways of working, philosophies and objectives;
- committed to both parliamentary and direct action: the latter reflected, for example, in the activities of the disabled people's movement's Direct Action Network (DAN) and psychiatric system survivors' Reclaim Bedlam campaign.
These characteristics significantly distinguish such movements from traditional challenges to state social policy and associated social and economic inequalities, reflected still, for example, in anti-poverty and unemployment campaigning. This has come predominantly from organisations and agencies which have not been controlled by the people directly affected by the problem, but which have ostensibly campaigned and advocated on their behalf. This is not to say that the latter have not struggled and sought to be at the heart of such opposition.
Service users' knowledges and theories
There have always been service users' knowledges - from the earliest days of lay and clerical charity and the beginnings of state intervention and the old poor law. What is different now is that there are both formal expressions of interest in and commitments to such knowledges and service users and their organisations have the capacity to place, indeed sometimes to force such knowledges on to political, professional, academic and policymaking agendas. One key quality distinguishes such knowledges from all others involved in social care and social policy provision. They alone are based on direct experience of such policy and provision from the receiving end. Service users' knowledges grow out of their personal and collective experience of policy, practice and services. They are not based solely on an intellectual, occupational or political concern. As in all identity based groupings and movements, they are experientially based. Thus the introduction of service users' knowledges into the discussion, analysis and development of social work and social care brings into the arena a crucially different relationship between experience and knowledge and between direct experience and social work and social care discourses. As we shall see, the importance of this cannot be overstated. It has fundamental implications for social work analysis and theorising.
Service users' knowledges are developing and being shared in a range of formal and informal settings; through the contact that service users have with each other both within and outside the service system; in self-advocacy and user groups; at meetings and in campaigns. There is of course an enormous body of unrecorded and hidden users' knowledge in the form of user wisdom, advice and learning. More recently though such knowledges have increasingly been recorded in the form of service users' accounts, testimonies, critiques and discussions. (Read and Reynolds, 1996; Beresford, Stalker and Wilson, 1997; Campbell and Oliver, 1996) These are to be found in users' newsletters, journals and other publications. There is a tendency for these to be devalued in dominant professional discourses as 'grey literature', as if they did not have the same authority as commercially produced materials, but service users and their organisations have also begun to be included in specialist professional publications and mainstream print and broadcast media. In addition, they are now producing their own histories. (Campbell and Oliver, 1996; Campbell, 1996)
Just as service users' knowledge is inextricable from their experience, so is their theorising, and theory-building has played an important part in the movements of service users. Perhaps the most important single expression of this is the social model of disability developed by the disabled people's movement.
This is a sea change theory. It represents one of the most important theoretical developments in modern social policy, if not the most important, as well as being important in public policy and political thought more broadly. As yet it has not generally been seen as such in mainstream debates. (Abberley, 1998; Barnes, 1998) It provides an effective challenge to hundreds of years of individual interpretations of disability and more than a century of the dominance of medicalised individual interpretations. It has made a fundamental impact on the consciousness of many thousands if not millions of disabled people world wide. It has also impacted significantly on politics, policy and culture in the UK, mainland Europe and North America, even though efforts have been made in policy and practice to subvert it.
Coupled with the idea of independent living, it has provided both a philosophical basis for the disabled people's movement and a touchstone for living for individual disabled people. (Morris, 1993) It has made the crucial coupling between people's human and civil status by reframing disability in terms of rights, anti-discrimination and equal opportunities.
While, for example, psychiatric system survivors have not yet developed an equivalent theoretical basis for their movement, although this is now in progress, theory building, at both micro and macro levels is also an inherent part of this movement, challenging, for example, dominant medicalised categorisations and 'treatments'; reinterpreting the experience, perceptions and behaviour of survivors and reconceiving psychiatrically structured and individualised 'problems' like eating distress and self-harm to make sense of their social relations and role as solutions to personal and social problems. (for example, Pembroke, 1994a and b)
Service users and research
Another expression of service users' theory building and knowledge generation is their involvement in research. This takes two forms; first their development of their own research methodologies and findings and second their involvement in mainstream research. The disabled people's movement has pioneered the development of emancipatory research. Mike Oliver, the disability activist and academic, characterises this as:
- "an alternative, emancipatory approach in order to make disability research both more relevant to the lives of disabled people and more influential in improving their material circumstances. The two key fundamentals on which such an approach must be based are empowerment and reciprocity. These fundamentals can be built in by encouraging self-reflection and a deeper understanding of the research situation by the research subjects themselves as well as enabling researchers to identify with their research subjects" (Oliver, 1996, p141)
The starting point for many service users' view of research is as part of a structure of discrimination and oppression; an activity which is both intrusive and disempowering in its own right and which serves the damaging and oppressive purposes of a service system over which they can exert little or no influence or control. Oliver argues for a different social process for the production of research. (Oliver, 1996) There is now a large and growing body of research and evaluation undertaken by service users and their organisation. This includes both qualitative and quantitative research and it is being undertaken by a wide range of service users, including disabled and older people, people with learning difficulties and psychiatric system survivors. (Barnes and Mercer, 1997) Service user organisations are also now commissioning research. The British Council of Disabled People has its own Disability Research Unit at the University of Leeds. Organisations like the Sainsbury Centre for Mental Health and Mental Health Foundation have also established strategic initiatives to support user research. My own Centre at Brunel University, the Centre for Citizen Participation, is committed to undertaking and developing user led and user controlled research.
The development of their own research by the disabled people's and service user' movements has been coupled with their increasing demands for changed social relations in mainstream research, with a more active and equal role for research participants. This has led to an increasing interest in the degree of control that service users have in research. (Evans and Fisher, 1999) Thus alongside participatory and emancipatory paradigms, discussion has developed about user-led and user-controlled research. This discuss focuses on the degree of user involvement and control in all key aspects of research including:
- the origination of research
- who gains the benefits of research
- the accountability of the research
- who undertakes the research
- research funding
- research design and process
- dissemination of research findings
- action following from research
Service users and social work theorising
There has traditionally been a tendency in social policy to marginalise and invalidate service users' viewpoints and knowledges. (Beresford, 1997; Croft and Beresford, 1998) The knowledge of disabled people has been dismissed on the basis of their perceived incapacity; that of survivors because of the assumed unreliability and irrationality of their perceptions and understandings and those of people with learning difficulties on the basis of their perceived intellectual deficiencies. Discrimination on grounds of ageism, disablism and mentalism have all been at work. It is important to reiterate that these knowledges have always existed. The point is that it is only recently that service users have been able to mount an effective challenge to dominant discourses. Social work and social care are probably at the leading edge in involving the perspectives of service users. They are certainly more advanced than some other related academic disciplines or areas of professional activity. There is, however, still far to go. The involvement of the knowledges of service users in social work analysis and theory building is still at an early stage. This has yet to develop in a systematic, structured and coherent way. In this it reflects other areas of social work and social care activity, like professional education and practice, where there have been numerous individual and local initiatives to involve service users, but as yet this has not resulted in a coherent or strategic approach to policy or practice. As far as the present author knows, this seminar marks the first occasion on which this issue has been explicitly addressed in social work discussions.
What might we expect the relation between professional social work and service user theorising to be? We can expect them to be different. We know that social work was traditionally reliant on dominant individualised medical models of both disability and madness and distress. The two strands of theory building; professional and user, have been different in philosophy, process, focus and objectives. While, for example, service users have deliberately sought to be participatory in their understanding of and approach to intellectual work, social work has much more closely reflected broader academic and professional processes. The coming of 'disability studies' and the emergence of discrete disability movement academics and of 'user researchers' reflects a developing division of labour in intellectual activity within service user movements, but the process of developing knowledge and ideas is still one which self-consciously seeks both to draw in a wide range of service users and activists and to be accountable back to them. Also as Jane Campbell, the disability activist has said of the disabled people's movement:
- "The movement is multi-faceted. There is direct action campaigning on the street. There is letter writing and political work in parliament. There is intellectual work and arts. The movement involves all of these and people cross over. People who write the books are also on the picket line. This has given us a much fuller representation because we have a much more holistic approach and understanding."(Beresford and Campbell, 1994, p321)
Theory building is also not only a written process. As we might expect of movements which highlight speaking for yourself, grassroots involvement and collective action, it also develops through people coming together formally and informally, as part of meetings and the democratic and political process of organisations and groups. While social work theorising has been concerned with advancing the intellectual basis of its practice, policy, teaching and research, the theory building of service user movements has been most directly and explicitly linked with action and making change.
Relating service users and social work theorising
None of this means that social work and service users' approaches to theory and its development are necessarily incompatible or antagonistic. This is particularly so given social work's longstanding professional commitment to social approaches and self-determination. But it does mean that seeking to connect the two will require some understanding of their different histories, cultures and power relations and that these need to be acknowledged and negotiated if the two are to be brought closer together.
This raises the question of what the relation should be between social work theorising and service users and their knowledge. Traditionally in social work as in other social policy areas, the social work profession tended to be the arbiter and interpreter of such knowledge, at theoretical as well as practice levels. In social work, a distinct area of research developed which came to be called 'client studies', pioneered by the book 'The Client Speaks'. (Meyer and Timms, 1970)
Thus while we might expect service user's knowledges to be included in social work theorising routinely to at least some degree, with the development of service users' own powerful and democratically constituted organisations and movements, the longstanding role of social work academics and practitioners as interpreters and mediators of service users' knowledges and perspectives can no longer go unquestioned. Instead the matter of involving service users and their organisations themselves is raised. Thus the issue for social work theorising is not just of including the knowledges of service users. Instead it becomes one of including service users themselves. This involvement must also be more than seeking their responses to social work's own intellectual agendas, priorities and concerns if it is to avoid tokenisation and incorporation. It means including their:
- analyses - including their interpretations, meanings, hypotheses and theories.
1. practical and methods-based;
2. philosophical and methodological;
1. practical and methods-based
Including service users in social work theorising makes it possible to include their insights, understandings and experience and helps fill a key gap that would otherwise be left. Their first hand knowledge and experience offer a unique basis for developing theory as it does policy and practice. Debate about social work theory can only be better informed if those directly affected are part of it. Their involvement makes it possible for the debate to identify, reflect and advance their needs, concerns and interests more accurately and closely and can enable more relevant and participatory research and analysis. It accords with both traditional social science concerns to address all sources of data and the commitment of postmodernist approaches to multiple perspectives and interpretations.
2. philosophical and methodological
The exclusion of service users from social work theorising undermines them both. Including service users is part of the broader issue of addressing rather than reinforcing their restricted rights and citizenship. It signifies respect for them; an acknowledgement that they have something to offer, that their contribution is important, worthwhile and valued, and shows recognition of their expertise in their own experience. It challenges their objectification and has a symbolic as well as practical significance. Service users and their organisations see themselves as having a right to be involved in discussion and action which affect them. Their exclusion is incompatible with values associated with both social work and social inclusion.
Historically, as already indicated, the knowledge base of social work has been derived from social research conducted using traditional methods of inquiry which claim to be 'objective', 'neutral' and 'value free' and to produce knowledge which is independent of the persons carrying out the research. (Stanley and Wise, 1993) Feminist researchers have, for more than two decades, argued that the independence and objectivity of conventional social research is illusory, for example, failing adequately to represent the experiences of women. In her discussion of standpoint theory Sandra Harding highlights the socially situated nature of (all) knowledge claims and the implications this has for generating critical questions about received belief. (Harding 1993, pp54-55 ) Standpoint theory would hold that service users who are on the receiving end of social work theory and practice which directly relates to them are likely to be better placed to generate critical questions and knowledge claims about them than outside academics or practitioners.
Social work theory building which includes service users and their organisations is increasingly likely to be seen as having more credibility and authority than that which doesn't. It is likely to have more political weight in several senses. The service user movements now arguably carry more clout with politicians and policymakers than professional and academic social work and social care discourses. The disabled people's movement, for example, is now a significant intellectual and political force in policy making. Service users' organisations are unlikely to lend their support to a process of theorising which they are excluded from or marginalised by. Service users' involvement provides the basis for stronger and more effective action following from theorising. Social policy and social work discussions and campaigns which have not involved their subjects have tended to have limited success. The lesson of recent politics is that popular discussions and campaigns are the ones which seem to make the most impact. We can see expressions of this new participatory politics and analysis in campaigns for disabled people's rights, the environment and against road building and GM food as well as in the black people's, gay men and lesbians' movements. Such broad-based campaigns and their successes stand in contrast with narrowly based welfare and anti-poverty intellectualising and campaigning.
As social work makes concerted efforts to take forward its theorising, it is also faced with the challenge and opportunity of involving service users and their organisations systematically in the process. It is difficult to see how such a process of theorising can be effective, inclusive or justified otherwise.
The first requirement is for there to be full and equal access to theoretical discussion for service users and organisations. This relates to addressing:
- the support needs of people with physical, intellectual and sensory impairments, people who communicate differently and people experiencing distress;
- the categorisation of individuals and groups included in social care categories in terms of 'deserving' and 'undeserving' and conventional reluctance to include the latter;
- 'the dismissal of service users and their organisations as 'unrepresentative', particularly when their views conflict with the status quo. (Beresford and Campbell, 1994)
To set in train an inclusive process of theory development means working towards equality between service users and other actors in discussion and action in three main areas. These are:
Equality of respect
The same respect should be attached to users of services as to other participants, without any imposition of stigma or assumption of their incapacity or inferiority, challenging rather than reinforcing dominant discriminations;
Equality of validity of contributions
Contributions to theory building from people associated with service use must be accorded the same validity as others. Assumptions about objective, neutral and value free social science cannot be sustained. Recognition should be given to the validity of the subjective knowledges, analyses and perspectives of people included in social care categories;
Equality of ownership and control of the debate and of knowledge
More than a few token users must be included in the process and they should have equal ownership of it. There needs to be a shift in power, in the control of knowledge and what counts as knowledge, with service users having more say in both.
Key requirements for working for inclusive debate include:
- support for people to take part in discussion about social work theory. This includes information, practical support, support for people to increase their confidence and self-esteem, development costs, personal assistance, etc. (Croft and Beresford, 1993, pp51-3);
- support for equal opportunities, to ensure that everyone can take part on equal terms regardless of age, 'race', gender, sexuality, disability, distress, or class;
- open debate which includes service users on equal terms
The involvement of service users in social work theorising needs to be seen as an opportunity for, not an obligation imposed upon them. Some service users and their organisations may not be interested in being involved and not see it as worthwhile or productive. Others are likely to be suspicious, expecting from previous experience that attempts will be made either to coopt or ignore them. Service users and their organisations have limited resources and other priorities, not least maintaining and taking forward their own discussions and objectives.
This highlights the importance not only of supporting the involvement of service users in social work's own process of theory building, but also supporting service users' own debates about social work theory. In this way individuals and organisations who wish to can be helped to get together, explore and develop their own ideas, agendas and discussion on their own, in safety and confidence, prior to, as well as in addition to taking part in social work's own discussions. This will help make it possible to relate their own theoretical discussions to those of social work. It will also further limit the risk of service users being incorporated in professionally initiated, directed and dominated theory development.
The term 'service users' is used in this discussion to describe people who receive or are eligible to receive social work and social care services. This embraces people included in a wide range of categories, including mental health service users/survivors, people living with HIV/AIDS, children and young people in state 'care' or who are fostered or adopted, disabled people, older people, people with learning difficulties, people with addictions to alcohol and proscribed drugs, etc.. People may receive social work and social care services voluntarily or involuntarily. The term 'service users' is problematic, because it conceives of people primarily in terms of their use of services, which may well not be how they would define themselves. However, there is no other umbrella term which can helpfully be used to include all these overlapping groups. For example, some may include themselves as and be included as disabled, but others would not. Therefore the term 'service user' is used as a shorthand to describe the subjects of social work and social care, without seeking to impose any other meanings or interpretations upon it or them.
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