Consumer-Centered Social Work Practice: Restoring Client Self-Determination

By Tower, Kristine D. | Social Work, March 1994 | Go to article overview

Consumer-Centered Social Work Practice: Restoring Client Self-Determination


Tower, Kristine D., Social Work


The social work profession holds the right of self-determination among its highest values. The NASW Code of Ethics states, "The social worker should make every effort to foster maximum self-determination on the part of clients" (National Association of Social Workers, 1993, p. 1). In the real world of human services, the constraints of time and limited funding are exacerbated by the demands of increasing caseloads. As a result, self-determination is frequently the first right to be violated in the name of expediency, protection, or cost containment. Freedberg (1989) suggested that "day-to-day contact with clients involves confronting an inherent dilemma in the philosophy of self-determination". It was her position that agencies and their agents (social workers) must "control" the services delivered, thus controlling the clients. Abramson (1985) referred to the conflict as an "autonomy-paternalism dilemma."

A solution to the discord of paternalism and self-determination is to adopt a consumer-centered approach toward practice. This article presents a new model that emphasizes greater consumer participation in and control over the helping process.

The term "consumer" is commonly used in human services systems, but the essence of the term, with its fundamental rights and responsibilities, is largely overlooked in agency operations. This is unfortunate because when consumers are encouraged to exercise their intrinsic power, positive changes can occur. Progressive social workers that serve the most vulnerable clients (such as mentally ill, frail elderly, and severely disabled clients) are finding that the consumers themselves can be their own greatest resources. Several consumer movements are currently under way and are providing solutions to long-term problems.

Philosophy of Consumerism

At first glance, consumerism when applied to the human services may seem like an absurd idea. How is an elderly person using in-home supportive services a consumer? Is an outpatient clinic for the mentally ill population providing consumer goods and services? What does consumerism have to do with a severely disabled person living independently?

Fundamentally, clients of the human services are consumers in the same way as are customers who acquire the services and products of a grocery store. Their consumption bears an actual cost that consumers pay either directly or through third-party payers, means-tested transfers, or charitable funding. Most providers, however, do not conceptualize their services as consumer products. In addition, consumers often do not understand the rights and responsibilities they bear for the management of their own lives.

The basic doctrine of consumerism within human services systems is that individuals who have direct experience with a particular life condition (for example, aging, disability, mental illness) are more knowledgeable about their own needs and interests than are their professional counterparts. When individuals redefine their role from that of patient, client, or recipient of goods and services to that of consumer, their sense of control over their own lives is elevated.

The consumer rights movement is not a new phenomenon. It grew out of several complementary social movements that began to emerge in the 1960s and 1970s, including

* the civil rights movement and legislation

* the development of self-help organizations

* demedicalization and self-care (as with terminally ill people)

* deinstitutionalization of the mentally ill population

* the independent living movement of physically disabled people.

Ralph Nader, leader of the original consumer movement, tackled large corporations to demand consumer rights and sovereignty. The movement was based on feelings of basic and widespread mistrust of the seller and the service provider (DeJong, 1984). In the early days of the movement, President John F.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Consumer-Centered Social Work Practice: Restoring Client Self-Determination
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.