RPP 18 1 Book Reviews

Research Policy and Planning: The journal of the Social Services Research Group – Vol 18 (1) 2000

Book reviews

Unfinished Business? Local Government Reorganisation And Social Services

Craig, G. and Manthorpe, J, 1999, Bristol: Policy Press, £10. 95, paperback, 486pp.

This clear and readable account asks pertinent questions about the effects of local government reorganisation on social services departments. It draws on two major studies, one in North Humberside and York, the other on the rest of mainland Britain, using three case studies from the former Dorset, Leicestershire and Cleveland County Councils and a fourth considering the unitary status change for Powys. Views on reorganisation were gathered from: social services staff, including directors; the voluntary sector; health authorities or boards, users and carers.As someone who experienced local government reorganisation, it is useful to reflect on the themes emerging here. These include the political experience of reorganisation and its lack of a rational planned basis, as well as clear criticism of the Department of Health for failing to co-ordinate change processes within health and local government. The resulting loss of status and power for smaller social services departments negotiating with larger health trusts or authorities is clearly identified, as is the potential for the ascendancy of the medical model. The report also highlights the difficulties for a range of partners in altering arrangements. These were particularly acute for the voluntary sector, who had little say but had to adapt considerably. The report questions whether the anticipated local feel to planning and services will result in tangible benefits and conveys a very reasonable degree of caution about the extent to which corporateness on its own creates a reality of integrated working within local authorities.A report such as this can only offer a snapshot in time and in some areas this study is already outdated. Central government agendas for modernising local government, such as devolution, new health structures, initiatives on partnership work, plus the results ofJoint reviews, arejust some of the current preoccupations for social services * Reorganisation has now happened. New systems have bedded in and new priorities occupy the attention. The report can only sketch in the legacy of local government reorganisation and its effects. Approaching individuals and groups during a period of change will tend to highlight concerns about loss and the uncertainty of future arrangements. Read today, the worries about lack of specialist expertise and the unfairness of disaggregation are less of an issue. Individuals and organisations have adapted; change has opened up planning processes and service development to review and realignment. One example is that primary care/local health groups are of a size more likely to fit into unitary authority structures.One key ongoing factor is that of cost. The report tries to estimate the overall cost of the reorganisation transition but the figures are difficult to confirm – ranging from £146 million to £720 million in Scotland depending on source and at least £100 million in Wales. The disputes are greater in relation to net costs and savings on service delivery. This aspect of the report is confusing and may reflect the difficulty of getting reliable facts. Apparently 6 ‘ 800 posts were lost in April 1996. Subsequently, difficult budget settlements for social services have resulted in transfer out or closure of a significant proportion of direct service provision. The questions remain unanswered as to whether there is an ongoing revenue cost that has significantly reduced services for users and carers or whether ongoing financing of the reorganisation has been at the expense of those services. Perhaps the new arrangements deliver more local, responsive and targeted services?Performance measurement and management have been tangible recent developments within social services. Information dating back to the period before reorganisation is unlikely to be available, reliable or collected in a comparable format. Consequently, measures of effectiveness and efficiency before and after reorganisation are likely to be inaccurate. The report is, however, helpful in showing how scant the evidence for local government reorganisation and its costs, both human and financial, was.Of particular relevance is the consideration of the status of social services departments. The report argues that the loss of experience, political and professional, the disruption of developed partnerships and the downsizing of many departments has reduced the organisational influence of social services particularly in partnerships with health. It remains to be seen whether increased corporateness and promotion of local agendas will significantly influence health partnerships in the way envisaged by central government initiatives. Or indeed whether social services departments as an entity could cease to exist in any recognisable form. In contrast, the strong current emphasis on consultation and involvement should have improved relationships with both the voluntary sector and users and carers, and can be evidenced through the Joint Review inspections.This report does leave a key unanswered question – does size matter? (And if so, what should that size be?) As environmental and organisational change are givens learning from what worked or not, and using that in developing future structures seems to make sense. Hopefully, next time around, sense will matter.Moyna Wilkinson

Monmouthshire County Council

Privatisation and Social Policy

Drakeford, M, 2000, Harlow Longman, £17.99, paperback, 230pp.

Those working within the local authority sector over the last few years will have witnessed a growing privatisation of services and activities. Colleagues in health and social security have undergone similar changes. This book provides a social history of the implementation of privatisation policies under the Conservatives and offers evidence that the Labour Government will by no means be making a u-turn in this area. As the author observes, the incoming Labour administration had little to say about its policies regarding social services and a rolling back of privatisation has not materialised.Like others in this series, this book is a social policy overview with extracts from a number of relevant documents from official sources. Since the advent of websites it is easy to forget how ephemeral material such as press releases of ministerial speeches might be. In terms of privatisation, there is the added point that much policy took the form of ministerial pronouncements rather than legislation.The book starts with an introduction and a chapter in which Drakeford distinguishes marketisation as a possible outcome of privatisation but argues that the two are not synonymous. He sees privatisation as a shift in decisionmaking, particularly around choice and responsibility. Marketisation may involve a transfer to private providers but may mean an opening up of processes of tendering and dontracting. Unfortunately, this book was evidently written before the new ‘best value’ agendas which extend some of this inquiry and search for efficiency.Drakeford usefully considers the utilities in his examples of privatisation, a subject area currently relatively neglected in social welfare. Concerns over fuel poverty, disconnections and hypothermia were high some years ago amongst social workers and their clients. The problems of heating homes remain but are perhaps less visible. Drakeford argues that poor people are ‘disconnecting themselves’ in effect by being unable to spend money on meters. He also points to the potential public health time-bombs of those who are cut off from water supplies. The utilities have now become an area over which social workers may feel that privatisation has diminished their capacity to exert any moral pressure.Social security is another area which has changed significantly and continues to do so. Drakeford providessome examples of the reviews and reforms, with an interesting excursion into the matter of funeral costs. This is an area which may symbolise the essence of social security changes, with funeral expenses being important to the present older generation and earlier governments’ recognition of this with promises of support from ‘cradle to grave.’ Restrictions introduced in the 1980s on what would be paid and who would be eligible have made a universal grant far more distant. Funeral costs are now a matter for individuals and families. When this is problematic, there is an unseemly tussle between agencies and government organisations over the bill. Drakeford describes an example of an undignified argument between one local authority and a residential home about responsibility for funeral costs, with the local authority referring to responsibility for burial as being similar to an industry’s duty to manage its ‘waste’ material. The notion of a safety net of social security appears pretty threadbare. As Drakeford observes, it has been privatised to an individual level. He might also have added that this has provided opportunities for the marketing of funeral plans: revitalising a Victorian industry.This text then presents an overview of the recent past. it is likely to appeal to curious students and possibly to those wishing to track key debates and policies. It serves as an important reminder that our own activities may one day form the subject of some hapless historian. While larger institutions may be able to build up organised archives and records, smaller providers of welfare may find this difficult. As this book demonstrates, however, one of the legacies of the years of privatisation has been to increase the number and variety of organisations involved in services. It will prove a challenge to document their activities.

Jill Manthorpe

University of Hull

The Changing Role of Social Care

Hudson, B. (Ed), 2000, London.. Jessica Kingsley, £16.95,200pp.

This is a brave and important book. Brave because it attempts and, for the most part, succeeds in tackling the difficult task of writing about change in a sector whose dominant characteristic appears to be that of change itself. Bob Hudson’s strategy of enlisting researchers who are expert in key areas of debate and getting them to review research and policy developments against the background of a change in administration and in millennia, has paid off. The result is a valuable collection of essays each making a significant contribution to knowledge and to social policy analysis.The central and recurring issue which the authors were obviously directed to address is: What, if any, changes can be detected in the move from Conservative to New Labour? There are some broadly similar answers and Hudson’s concluding chapter draws these out. He identifies such determinants as central control of local authority social services, which he calls their ‘nationalisation’ (p. 224). He gives equal weight to an emphasis on efficiency, protection, professionalism and partnership between health and social services. None of this sounds very new, and indeed he points out that what we are experiencing is more in the nature of change not in ‘what is done’ but in ‘the way it is done’ (p. 237), with an emphasis on prescription of forms of intervention rather than diagnosis of problems.To what extent does the evidence presented by the different authors conform to this perspective? John Stewart’s review of local governance assumes a continuing role for local authorities but within rather different structures. He points out the contradictions between a policy which emphasises a role for local government in relation to ‘community leadership’, invoking involvement, new ways of working and partnership and a prescriptive approach which appears to determine the outcomes of any such initiatives.Three chapters, by Nirmala Rao, Brian Hardy and Gerald Wistow and Jererny Kendall, respectively consider change in the statutory,private and voluntary sectors. Each brings together principal research findings and draws out what has been significant as the forces of privatisation and the mixing of the economy brought changes in relation to traditional territories and relative powers. Kendall’s review of the relative costs of types of care provided by the voluntary sector is thought-provoking. With evidence of resistance to collaborative styles of working, legacies of mistrust and continuing inequalities in resourcing, these chapters, as well as those by Murray Hawfin on housing, Geoff Firnister on social security and Melanie Henwood, who reviews tensions between the central and the local, each again illustrate likely points of resistance to policy prescriptions. Identifying housing as the physical expression of a community care policy guarantee of’ordinary living’ and benefit income as the basis of day-to-day survival for many recipients of social care, Hawfin and Firnister separately make a case for more Inexible and better-informed policy-making at local and national levels.Sue Balloch and John Maclean’s work on the social care workforce is similarly well established. Appropriately for this publication, they draw on evidence relating to stress giving specific attention to racism and abuse in work settings. The extent to which such issues are a response to continuing pressure from changing structures and expectations, or lack of change, is one which they leave for debate. Comparative perspectives in social care policy development are provided by Alison Petch, who reviews legislation and policy initiatives in Wales and Scotland, and Michael Hill, whose chapter looks at welfare regimes in Europe, Scandinavia and the Far East.The perspective of the user of social care services is one which is normally at the centre of any debate about policy change and it is here that the book seems strangely out of step. In her contribution to the collection Julia Twigg reviews legislation which has affected the position of service users, including carers. With a clear and well argued appraisal of the impact of theories of normalisation and of the social model of disability on the lives of younger disabled people, she contrasts the situation for older people. A valuable chapter, but perhaps an analysis from a user of care services is also called for. Such a chapter might have considered the contribution which prescribed activities such as consultation, audit and assessment have made to policy development and quality of life for service users.Here we have a solid set of chapters, each in turn summarising key research findings and policy analysis in relation to issues which are central to debates about the future of social care. It is a product of a particular moment, and this is perhaps a weakness. As a text for students at undergraduate and post-graduate level, or for anyone who is interested in making sense of the last twenty years of social care policy developments, the book must be acknowledged as indispensable. However, in seizing the moment of change it has restricted itself to the concerns and limitations of that moment. The prescriptions and predictions waiver as chapter after chapter points to new administrations, emergent policies, forthcoming legislation, guidelines and anticipated reports. It is a book to be read now, but will references to Green and White Papers and to possible policy initiatives of the late 1990s still feel topical in two years’time?

Dr Joanna Bornat

The Open University

Researching Children’s Perspectives

Lewis, A. & Lindsay, G. (Eds), 2000, Buckingham: Open University Press, £16.99, paperback, 256pp.

This book provides the uninitiated reader with a competent introduction to the ethical issues that underpin children’s research. Informed consent, confidentiality and child protection are discussed in a very accessible manner. Indeed, the reader is expertly guided through the legal and moral considerations that apply to such concepts. Specifically, the book is separated into two sections: Theoretical and Conceptual Issues and Practical Applications. The first includes a number of chapters on the theoretical and methodological positions employed in educational sociology and psychology. These are supported by chapters that discuss the legal aspects of children’s research which aim to encourage researchers to afford children the same rights as adult respondents.Various aspects of the UN Convention on the Rights of the Child, the Children’s Act (1989), Children (Scotland) Act (1995) and professional ethical guidelines are unpacked to establish good ethical and methodological practice. For example, Dockrell et al. encourage researchers to question whether they actually understand children’s terminology and Mason explains the dangers of paying children to be respondents or interviewers. Indeed, Nlason’s is the pick of the early chapters, there being little doubt that her comments will warn budding children’s researchers of the variety of legal pitfalls that they may encounter in the field.The second section includes chapters which consider how to do research with: disabled children; children who have different experiences of religion; children in care; children who have experienced bereavement; children about health issues and an adult’s perspective of a ‘difficult’ childhood. Some also demonstrate a keen ‘eye’ for good practice, for example, Detheridge cautions researchers to consider whether a gap in speaking skills automatically means a child also lacks comprehension skills.Yet, many of the authors write as if they are the first to have developed participatory research techniques. Even allowing for the barriers which persist between different paradigms, one wonders how these authors have managed to miss the explosion of articles on child centred research techniques which appeared in the 1990s (for further references see Christensen and James, 2000). Indeed, this lack of engagement means the book as a whole gives little thought to contemporary arguments within the new social studies of childhood concerning issues of structure, culture, agency and identity.Other surprises are that the work of psychologists such as Martin Woodhead (for additional references see Woodhead and Faulkner, 2000) is overlooked and that the chapters concerning research with disabled children show little awareness of emancipatory perspectives in disability studies which criticise both positivist and interpretive approaches (see for further information Davis, 2000) or traditional approaches to researching this group (for example, Priestley, 1998).These criticisms should not, however, deter readers as the book has many saving graces. Chapter 10 by Warren discusses how his research problems enabled him to understand how children can be empowered to become interviewers and Nesbitt’s Chapter 11 on children’s experiences of religion expertly demonstrates the diversity of childhoods which await the reflexive researcher. Both these chapters highlight the need for researchers to demonstrate humility. They promote a holistic approach in which every moment of the research process is analysed for meaning. Neither takes any aspect of their work for granted. Indeed, it is this trait that sets their chapters apart from others in the book.Most of the other chapters tell us how to use interpretive techniques to search for objective positivistic truths. In contrast, these two authors employ reflexivity not to find truths but to understand their own and others’ subjectivities. Unfortunately, this means that the book has the potential to confuse the student reader who compares Warren’s Chapter 10 comments concerning multiple realities and subjectivities to the editors’ final chapter which mostly associates qualitative research with ‘truth’ and ‘validity’.A final surprise is that this book rarely includes children’s voices (verbal or non-verbal). This means that, in contrast to many other works in this field, its editorial tone leaves the somewhat arrogant impression that adults in universities (former lawyers, psychologists, social workers or teachers) or other bodies are the sole arbiters when it comes to defining good research practice and, therefore, that doing research with children is all about choosing the correct, professionally approved ethics and tools.ReferencesChristensen, P. and James, A. (Eds) (2000) Research With Children. London: Falmer.Davis, J. (2000) ‘Disability studies as ethnographic research and text: research strategies and roles for promoting social change?’, Disability & Society, 15(2): 191-206.Priestly, M. (1998) ‘Childhood Disability and Disabled Childhoods: Agendas for Research’, Childhood, 5(2): 207-223.Woodhead, M. and Faulkner, D. (2000) Subjects, Objects or Participants? Dilemmas of psychological research with children, in Christensen, P. And James, A. (Eds) Research with Children. London: Falmer.John M Davis

University of Edinburgh

Parenting Matters: What Works in Parenting Education

Lloyd, E. (Ed), 1999, London.. Barnardo’s, £10, paperback, 168pp.

Parenting education has always been, implicitly or otherwise, at the core of child welfare. In recent years, however, it has become a more prominent feature of practice within a range of agencies and settings. The ‘rebalancing debate’, particularly around children in need, has made parenting capacity a central theme within policy, service assessment and intervention. More recently, government thinking has brought parenting into sharp relief with the introduction of Sure Start. Likewise, concerns over social exclusion, lone parent families and the heated exchanges between opinion-formers over’what to do about’ teenage mothers has brought some parents to centre stage: notably those deemed in need of skills, attributes and moral purpose. Quite what or who is representative of a ‘good parent’ and what might represent a properly reared child remain rarely glimpsed in current policy debate apart from the most general summations and value statements that tell us little about how we construct ourselves as parents and how children experience their relationship with us. Barnardo’s report on parenting education edited by Eva Lloyd, while not intending to address these more sociological and intensely political questions, nonetheless brings together many critical themes and convincing evidence about ‘what works’ in helping people to parent.Lloyd’s introduction recognises the need for more normative studies of parenting and for greater understanding about family formation within the complex interweave of culture, class, gender and race. Such caveats do not diminish what is an important report around the very practical domain of intervention and outcomes. In this, the report is firmly embedded in today’s evidence-led discourse around which Barnardo’s claim the high methodological ground. For, as Lloyd observes in her opening remarks, the text is part of a wider research and development programme by Barnardo’s that has ‘resulted in Barnardo’s being the first major children’s services. agency to commit itself to evidence based practice’ (p13). It might seem churlish to ask where the evidence is for this (global?) claim and one wonders what other children’s service providers will make of the implication that they have all been wallowing adrift in the wake of Bamardo’s empirical vanguard.Free of any epistemological distraction about what might constitute ‘evidence’, the introduction moves swiftly on to set out key exemplars of parent education research. In doing so, important points are made about the interactive effects of community upon parenting, the impact of genetic disposition, the deeply subjective nature of what is ‘good enough’ parenting and the absence of any unequivocal evidence over the long term effectiveness of parenting education. Nonetheless, the case for parenting education is convincingly made and we move quickly into Part Two – ‘assessing effectiveness’ – authored by Tony Newman and Helen Roberts. Here we enjoy an accessible and focused argument around the ideal methods of securing evidence based intervention in child and family services. The section makes the general case for robust research tools fit for purpose – the randomised controlled trial (RCT) – but the contribution of qualitative enquiry is properly regarded too. Perhaps some further reference to the wide range (and debate) of evaluative techniques that lie outside the gold standard of the RCT would have added some ecumenical moderation to the slightly canonical strictures that appear essential for a Barnardo’s seal of methods approval.Part Three of the report, ‘what works in parent education’ by Jane Barlow, offers incisive evidence drawn from a systematic review of the literature on evaluation of parent education in improving the behaviour of pre-adolescent children. Inclusion criteria comprised mainly randomised controlled trials and meta analyses. The search from 1970 to 11996 via electronic databases revealed that group-based parent education is clearly effective, often enduring, though not necessarily generalisable to other settings such as schools. Behaviour modification programmes appeared to produce the best results. However, very few of the studies cited were conducted in the UK and Barlow comments that little information exists about the social and demographic characteristics of participants. While the general picture is very positive, she notes we still have insufficient knowledge about what types of children and families respond best to particular models of behavioural intervention. Overall, Barlow provides an encouraging and persuasive review of the evidence and a valuable resource for those who wish to get to grips quickly with the key issues.This is followed by Carolyn Webster-Stratton’s analysis of parent training techniques for child conduct problems in the US. The author is a leading international figure in this field who provides a compelling overview of training techniques, theory, project examples and evaluation outcomes that leave us in little doubt about the value of such interventions. Of note is the author’s statement that in the US they eschew the term ‘parent education’ which can involve all sorts of programmes, for the more precise ‘parent training’, in which parents are trained to work with children and their conduct problems. Webster-Stratton broadens the debate from a behavioural focus to include relational, affective and ecological issues and takes us through the history of various programmes at the Seattle Parenting Clinic. Evidence is garnered from several studies in the US and more latterly from similar programmes in the UK about the effectiveness of videotape modelling in group based contexts with key participants. The range of programmes and outcomes are impressive and the central lessons on moving away from a parent deficit model to a more inclusive approach to group intervention involving parents, children, teachers and peers are well illustrated with examples.Of course, there are no magic wands: families drop out, many do not achieve lasting improvements and there are no simple predictors of success. Also, parent training cannot remedy social and economic deprivation which will impact on the capacity of families to engage with programmes and implement what they learn. The need for multiple strategies is well put by Eva Lloyd in the final section, as is the need for more research around hitherto neglected variables likely to influence training needs and outcomes (lone and step parenting, age of child/parent, gender, ethnicity, views of children, foster carers, practitioner/therapist attitudes and so forth). There is of course a massive literature around child conduct disorders, parent education, behavioural and psychosocial theories that could not possibly be addressed in a report such as this but the text deals admirably with the key themes and the central message is clear: parent education ‘works’ and thanks to Bamardo’s we have a valuable source of examples, direction and ideas in what will surely be an expanding area of child and family provision across the UK.Andy Pithouse

Cardiff University

Risk

Lupton, D., 1999, London and New York.. Routledge, £10.99, paperback, 184pp.

Although the term ‘risk’ has been around for a long time, its use in the English language can be traced back to the seventeenth century when it seems to have become a key concept in contemporary society. Using the computerised data base of her local daily newspaper, the Sydney Morning Herald, Lupton found that in 1992, risk appeared 2,356 times in the main text and 89 times in the main headline. By 1997, risk appeared 3,488 times in articles and in 118 headlines. It has become such an important concept that Routledge commissioned Lupton, an eminent sociologist, to review’risk’ as part of their’key ideas’ series.Routledge make it clear that they do not see the books in this series as traditional literature reviews, rather they expect them to be original essays, providing lively and original treatments of their subjects- It is therefore hardly surprising that Lupton’s review is based on a strong sociological standpoint. While she provides an overview of contemporary thinking on risk, she evaluates it in terms of her own sociological thinking. She does not have much time for the ‘objective’ representation of risk which underpins much current psychological research, instead she conceptualises it as concerned with issues of power and control. Following some aspects of Foucault’s work, she sees risk in terms of discourses, as a technique for establishing and creating social control. A simple version of this analysis would be that in the eighteenth century governments increasingly saw their populations as a resource that needed to be controlled and ordered. The emerging professions developed forms of knowledge that facilitated this control. Thus ‘threatening’ elements in the population were isolated and ‘reprogrammed’ in the new institutions while the remainder of the population internalised control through ‘responsible’behaviour based on professional advice about safe and hygienic practice.This Foucauldian approach has been influential in the health and welfare services and especially in the ways in which they create and manage risk. Analysts using this approach seek to identify ‘discourses’ through which experts create knowledge and power. Such discourses usually involve some form of binary opposition based on norm al/abnormal, safe/risky and good/bad and may be applied to various areas of human experience, for example, heterosexual/hom o sexual, sane/mad, western/oriental. There is also a psychological dimension as the ‘self seeks to align itself to ‘normal’ and separate itself from ‘other’, but is both attracted to and threatened by the latent ‘other’ which has to be psychologically policed and repressed.Used in a sophisticated manner, discourse analysis can be anti-oppressive and can generate powerful insights. For example, Said’s (1995) study of orientalism, originally published in 1978, is a classic study of the ways in which the academic study of the orient emphasised its ‘otherness’ and underpinned western imperial expansion and domination. Much of the debate about health and welfare that took place at the end of the nineteenth century can be interpreted in this way. For example, the development of IQ testing can be linked to eugenic scares about the immoral, feebleminded underclass.While this type of analysis may generate important insights into developments in the eighteenth and nineteenth century, its utility has been undermined by the economic and social changes of the twentieth century. Modern economies have shifted from agriculture and heavy industry, which needed disciplined but unskilled labour, to hi-tech and service industries. Such industries needed skilled and innovative work forces. While China has a large disciplined work force, the USA has developed a culture which supports and rewards creative risk takers such as Bill Gates or Steve Jobs.Similar developments can be identified in health and welfare. The factories of the welfare system, the asylums which disciplined inmates in the interest of public safety, have been increasingly replaced by more individualised and risky forms of care. While hard-line Foucauldians would see this liberation as a more sophisticated form of repression, a sort of ‘false consciousness’, sociologists such as Giddens (1990) would see it as ‘reflexivity’, the use of knowledge by individuals to achieve control over their situation. Thus GoOman’s insights into the repressive nature of asylums and of stigmatisation can be seen as underpinning the development of social movements such as disability or gay rights which challenge expert definitions of normality and abnormality. They welcome and are happy to live in a complex, uncertain world in which risk-taking is fun, as with, for example, unsafe sex.Lupton’s short book is a challenging read. While readers may be put off by some of the more complex and and theorising, those who persist will be rewarded, especially by the final chapter on risk-taking and living on the edge.ReferencesSaid, E. W. (1995) Orientalism: Western conceptions of the Orient. London: Penguin.Giddens, A. (1990) The Consequences of Modernity. Cambridge: Polity Press.

Andy Alaszewski

University of Hull

One Way Street? Retrospectives on Childhood Prostitution

Melrose, M, Barrett, D. and Brodie, L, 1999, London.. The Children’s Society, £8.95, paperback, 99pp.

The study reported in One Way Street? builds on earlier work undertaken by the Children’s Society to draw attention to the difficult and emotive issue of childhood prostitution. Melrose, Barrett and Brodie note that this has been an under-researched area within which, in particular, the voices of the young people involved are generally missing. Their study specifically addresses that gap and draws on the reported experiences of a group of people with direct knowledge of the phenomenon of child prostitution through their own involvement as child/juvenile prostitutes. It aims to shed light on the circumstances surrounding their entry into prostitution, their reasons for continuing to be involved and, where appropriate, their routes out. The authors also offer a series of recommendations for developing appropriate services.The introductory chapter covers a lot of ground, moving from background information and scene-setting (including brief sections on definitions of child prostitution, prevalence, legal, socio-economic and social policy issues; and professional responses) to the aims, methodology and ethics of the study. The sample is succinctly described, and the authors then go on to reflect – again very briefly ~ on gender issues in prostitution. Given the slimness of the volume overall (only 99 pages), it is clear that this chapter can only offer a summary of the material surveyed and the complexities of setting up research into this sensitive topic. Nonetheless, 1 would have welcomed more discussion, particularly around the difficulties and ethics.The central chapters are devoted to discussion of five key questions: who becomes involved in prostitution; how do they become involved; how do young people experience prostitution; what makes them stay in it and what do they think would help them to get out. Quotes are presented to support or illustrate the points being made. One of the strengths of this book is its inclusion of a ‘user perspective’ and when the interviewees ‘speak for themselves’ the effect on the reader is very direct.Family conflict or breakdown, educational problems, early disruption or termination of school attendance, going missing from home or local authority care, needing money to support drug use and lack of alternative employment options recur in the stories the respondents tell to explain their initial involvement. The study makes clear links between poverty or perceived economic necessity and prostitution, noting that the majority of the interview group became involved before they were old enough to earn money through legal employment channels. Drug use and violence are common features of many of the young people’s lives and can exacerbate feeling of isolation and exclusion from mainstream society.The study suggests that routes into prostitution are rather easier to find than ways out. Economic need can keep young people trapped, whilst fear of detection or arrest make child and juvenile prostitutes a difficult group to track or to target for services. How then can young people be facilitated to leave prostitution? The authors present a number of recommendations under four broad headings: voluntary and statutory services; law and policing; education and labour market and welfare provision. These recommendations are thoughtful and clearly supported by the reported experiences of the interviewees in the study. However, it is doubtful whether they will be met in full – particularly those for the reinstatement of benefit payments to ensure a minimum level of legal economic support to young people and the provision of “realistic opportunities” to compete in the job market. So while some aspects of the problem may be addressed (for example, through the provision of child/young person-centred services at ‘street level’ which offer counselling, support, educational input and so on), the key issue of economic marginalisation or lack of (legal) opportunity may remain, leaving significant groups of young people vulnerable to the abuse and exploitation of juvenile prostitution.The authors make no grand claims about the generalisability of their data, but emphasise the usefulness of qualitative work of this kind. One Way Street2 offers a chance for the voices of some of those involved in childhood prostitution to be heard. It will be relevant to practitioners in a range of fields – for example, social work, education and the police service – who come into contact with juvenile prostitutes, and will provide some insight into the ‘push/pull’ factors affecting these young people.

Danielle Turney

Goldsmiths College, University of London

Institutional Abuse: Perspectives Across the Life Course

Stanley, N, Manthorpe, J. and Penhale, B., 1999, London.. Routledge, £16.99, paperback, 242pp.

Institutional Abuse: Perspectives Across the Life Course comprises eleven edited chapters. Each is written by a different commentator and deals with different aspects and accounts of institutional abuse. The exceptions are the introduction, which deals with the problems of defining institutional abuse and the changing context of institutional care, and the concluding chapter, which attempts to shift the focus from the individual pathologisation of abusers to a users’ rights perspective.What makes this book stand out from other texts on the same subject, is its breadth in terms of settings, client groups and their chronological ages, and its diversity of perspectives and theoretical frameworks. These emanate from researchers and practitioners as well as from users/clients. The four client groups selected, whose experiences are chronicled and analysed, are children living in residential settings, adults with learning disabilities, adults with mental health problems and older people. The book is consequently subdivided into four main sections, each dealing with one of these groups, including a critical overview of the current situation, analysis of relevant research and graphic documentation of users’ perspectives and experiences of abuse.This is a timely, coherent, well-structured and well-written contribution to the literature on institutional abuse. Its main strengths are its ability to demonstrate the often striking similarities of such abuse in different settings and with different client groups, alongside the inevitable but lesser differences; its attention to user perspectives, which have been unjustifiably neglected in many previous texts, and its awareness of the often gendered nature of power differentials.The literature analysed, which ranges from empirical research studies and academic theorising, to inquiry reports and users’ accounts, is both well represented and critically evaluated, with few omissions. Both older and more contemporary research is alluded to and Glendinning’s reference to the ongoing relevance of such seminal texts as Goffinan’s Asylums is commendable, yet simultaneously a sad indictment of how little has changed in the last 40 years. Notable, however, is that in none of the chapters, is Menzies’s ( 1960) key psychoanalytic text on institutionalisation as a defence against staff anxiety mentioned or linked to abuse. In the concluding chapter the link between gender and sexual ity/sexual abuse in institutions is made, but could have been profitably analysed with reference to texts on sexuality in organisations, such as Hearn and Parkin’s (1987) hallmark text, which is referred to by Brown in an earlier chapter.Institutional Abuse is a text which should be read by all researchers, practitioners, managers and policy makers who are researching, working with, or responsible for developing policies for vulnerable children or adults who are living, or temporarily accommodated, in institutional settings. Although analysing only the four client groups, much of what is written is at least partially transferable to others because of the similarities in the way in which abuse is intentionally or unintentionally perpetrated in the full range of residential settings. The attention paid to covert and unintentional abuse is also dealt with well in the book and may alert many of those involved with institutional care to the ways ingrained and long accepted work practices may be psychologically abusive in themselves.Clough’s chapter on older people and the role of management and regulation in institutional settings is particularly good in elucidating the complexities involved in defining and dealing with abuse and exposing its multicausal nature, as well as offering some very clear and concrete guidelines in relation to how incidents of abuse can be minimised.Although dealing with both adults of different ages and children in institutional care, the subtitle of the book ‘Perspectives Across the Life Course ‘could potentially be misconstrued. This is not just because literature other than that relating to abuse and the life course is covered, but also because the impact of institutional abuse over an individual’s or a group of specific individuals’ life/lives is not dealt with. The children abused in residential care are not necessarily the same individuals who become patients in psychiatric wards or residents in homes for older people, although they may be. Equally, the experience of people with learning disabilities in institutional care, at all ages, is likely to be qualitatively different from that of other client groups.Overall, this is an extremely valuable and well-thought out text, which combines analysis and summary of relevant research and literature with poignant and emotive user accounts as well as policy and practice implications and directives. It is also to be commended for being firmly committed to shifting the focus on abuse away from individual deviance and pathologisation to the dynamics and responsibility of the institutions themselves and wider social structures and discourses.ReferencesFlearn, G. and Parkin, W. (1987) ‘Sex at Work’.. The Power and Paradox of Organisation Sexuality. Brighton: Wheatsheaf.Menzies, I.E.P. (1960) ‘A case study in the functioning of social systems as a defence against anxiety’, Human Relations, 13.

Lorraine Green

University of Huddersfield