Marvin B. Sussman

Professional Autonomy and the Revolt of the Client

One of the normative characteristics of a profession is autonomy, the right to determine work activity on the basis of professional judgment. This activity increasingly occurs in a bureaucratic context, with the professional sharing in organizational authority. The public grant of autonomy has presumably been based on recognition of two other characteristics of a profession—store of esoteric knowledge and service orientation. Various publics may be viewed as presently questioning these claims to special knowledge and the humanitarian ethos, and challenging institutional delivery systems, either because they are inadequate or because they exceed appropriate bounds. Among middle-class groups, students deny the pedagogic expertise and good will of their educators, while demanding a redefinition of administration and faculty organizational power. Among poverty groups, clients, claiming to know more about community needs and problems than the professional social workers and to be more concerned, are organizing for a voice in welfare benefits and their distribution. Among blacks, the demand for power confronts the professional teacher, social worker, and public official. The thrust of the client revolt is against the delivery systems for knowledge application, as controlled by the professionals, and against the encroachment of professional authority into areas unrelated to their claimed expertise. Professionals have sought to preserve their institutional power and autonomy by coopting their challengers. The “new careers” movement, poverty programs and other forms of dealing with the revolt of the client are discussed from the perspective of cooptation, and implications for modifications in professional autonomy are reviewed.

The Isolated Nuclear Family: Fact or Fiction

Current family theory postulates that the family in American Society is a relatively isolated social unit. This view of the family stems largely from theories of social differentiation in more complex societies.

Family Interaction, Diabetes, and Sibling Relationships

HE focus of this study is on family interaction and behaviour in situations Twhere one child has diabetes. The questions being asked are: Does a child who has diabetes behave differently from his non-diabetic sibling? Does the relationship between the diabetic child and his mother differ from that between the non-diabetic sibling and his mother? Answers to the questions will determine if a child with a chronic illness has markedly different relationships and interactions with his mother from those of his non-diabetic sibling. Today there is considerable discussion of appropriate therapies for the chronically ill child. Is it necessary to &dquo;treat&dquo; or &dquo;handle&dquo; differently the ill child? One stance is that illness produces or at least accompanies different human interactions and relationships from those of the pre-illness period. Moreover, the ill child has a different pattern of behaviour from the non-ill one. Illness is viewed as a critical intervention which upsets established interpersonal relationships. The consequences are, often, severe emotional upset of the ill child, and confusion among parents over appropriate ways to handle the child. Something different from the usual must be done in order to cope with the emotional and social problems of the chronically ill child. Another position is that illness creates no unusual changes in the interpersonal relationships of the child with members of his family. Illness is similar to other events of life to which the individual adapts. Crisis with its attendant stresses and strains may be provoked as a consequence of the illness, but in time these are handled without marked changes in the life ways of the individual. The focus is upon the normal and usual, and consideration for extraordinary treatment of the ill child of itself may create a situation of &dquo;being different&dquo; for the child which does not actually exist.

Professionalization and Unionism: A Jurisdictional Dispute?.

Unionization and professionalization are two processes by which members of an occupation seek to achieve collective upward mobility. Such combined efforts at job advancement are the analogue, on a group scale, of individual striving for a better job-one with higher pay, pleasanter working conditions, more freedom from supervision, and higher community status. Where individual upward mobility is blocked or hindered, occupational incumbents often turn to collective efforts with the same generalized goals of increased earnings, autonomy, and prestige. In short, individuals unlikely to get better work tend to join with others similarly situated to make their work better. The particular upward mobility route chosen historically has varied with the nature of the tasks, along the manual/nonmanual dimension. Blue-collar workers have formed unions, while white-

Human and Mechanical Error-an Unknown Quantity in Research:

0 Among the various types of non-sampling error discussed in the methodo!ogy literature, there is a residual category often called &dquo;processing error,&dquo; which includes mistakes in coding, punching, tabulating and computing. Although considerable attention is paid to two other main sources of non-sampling error &dquo;lost cases&dquo; and measurement bias processing error usually rates little more than a passing word of warning. This relative neglect is perhaps due to the fact that accu-

THE CALORIE COLLECTORS A STUDY OF SPONTANEOUS GROUP FORMATION, COLLAPSE, AND RECONSTRUCTION*

O N the cold night of January 26, 1953, 162 persons who considered themselves overweight, met at City Hall. in Lightburgh. They came in response to newspaper stories announcing the formation of an organization called The Calorie Collectors whose objective was to help each other lose weight.t Why did so many people from an urban industrialized community of 100,000 turn out on a wintry night to attend the first meeting? After this auspicious beginning, the group rapidly lost members until there were fewer than six actively meeting nine months later. Instead of collapsing, however, The Calorie Collectors made a surprising recovery. How did the group develop its organization and what conditions and circumstances led to its breakdown and eventual reconstitution?

The vicissitudes of change

Abstract A recent study of outpatient care examines the effects of change on patient and staff satisfaction. The significance of the proposed improvements is first examined. Four ‘deviant cases’, clinics which do not change according to official prescriptions, illustrate direct and indirect responses to change, rejection and diffusion respectively.