Welfare recipient views about caseworker performance: Lessons for developing TANF case management practices

Anderson, Steven G

Abstract

As states implement Temporary Assistance for Needy Families (TANF) programs, the importance of public assistance caseworker functioning has been magnified. Based on personal interviews with 60 recipients, this article presents recipient perspectives about caseworker performance in one pre-TANF welfare reform program. While assessments of caseworker performance were mixed, study respondents consistently emphasized three dimensions in evaluating caseworker performance: substantive competence, accessibility, and Interpersonal relations. Respondents rarely mentioned empowerment, strength building, or other casework practices that have been emphasized In social work practice literature. It was concluded that developing caseworker competence along the basic performance dimensions stressed by respondents may be a prerequisite to the establishment of more substantial helping relationships. Discussion includes prospects for infusing empowerment and strength-building perspectives Into TANF case manager roles.

THE PASSAGE OF THE Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) fundamentally transformed the United States welfare system. In addition to devolving program responsibility to the states, the PRWORA legislation mandated time limits on welfare receipt and stricter work and training requirements, and allowed policies denying benefit increases for additional children (Hagen, 1999). In some cases, these requirements have been accompanied by expanded income and support services and emphasis on individual case planning (Center on Hunger and Poverty, 1998). While 40% reductions in caseloads since TANF implementation have fueled optimism about program results (U.S. Department of Health and Human Services, 1999), early research findings indicate patterns of low wages, job instability, high use of sanctions, and underuse of available services (Loprest, 1999).

In this changing program environment, the importance of front-line TANF caseworkers has been magnified. These workers, who traditionally have focused narrowly on determining and monitoring service eligibility, face new responsibilities related to developing individual service plans, arranging work and training activities, and linking clients to support services (Hagen, 1999). Simultaneously, stricter sanctioning policies have granted caseworkers increased power to terminate services that vitally affect family well-being.

The performance of caseworkers therefore will be critical in determining whether TANF helps recipients develop skills and viable work opportunities, as opposed to simply serving as a convenient vehicle for cutting welfare costs. Unfortunately, while new TANF caseworker roles require increased case management skills, their introduction follows a quarter century of welfare caseworker deprofessionalization (Fabricant & Burghardt, 1992). If TANF caseworkers are to serve the interests of their clients effectively, caseworker roles must be carefully re-examined and redesigned. Such a re-examination provides the possibility of infusing TANF caseworker roles with social-work casework insights. In particular, the welfare reform focus on personalized case plan development and linking recipients to income and social service supports could incorporate social work perspectives on client empowerment and strength building (Cohen, 1998; Gutierrez, DeLois, & GlenMaye, 1995; Salleebey, 1997). That is, if skillfully conducted by TANF caseworkers, the personalized case plans could empower recipients to make choices about the education, training, work, and support services that can best improve their economic prospects.

Welfare recipients can provide a unique and generally overlooked perspective in this evolving redefinition of TANF caseworker roles. As the direct recipients of services, their views of caseworker interactions often vary sharply from those of policy analysts and practitioners who develop agency policies (Anderson, 1998). Further, they bring strengths to their encounters with public bureaucracies upon which conceptions of caseworker functioning can usefully build (Chapin, 1995; Salleebey, 1997).

This article presents recipient perceptions about caseworker performance based on personal interviews in one pre-TANF welfare reform program. The findings will suggest that, although the elaboration of new caseworker roles under TANF is critical, the performance of the most basic casework practices must also be carefully assessed. Study respondents commonly evaluated caseworkers according to their availability and interpersonal treatment, and successful interactions along these dimensions may be prerequisites to the establishment of more substantive helping relationships. The implications of these findings for the development of TANF caseworker roles are discussed.

Background

Previous research has found that the administrative practices of welfare agencies can have powerful impacts on client outcomes (Bane and Ellwood, 1994; Brodkin, 1986, 1997; Lipsky, 1980; Weaver & Hasenfeld, 1997). Such effects may be partially random, as caseworkers exercising discretion provide inconsistent messages about welfare system intent, available services, and expectations. However, organizational goals and the related structuring of service functions define the context in which caseworkers operate, and consequently affect outcomes more systematically (Bane & Ellwood, 1994; Weaver & Hasenfeld, 1997).

Concern over systemic organizational biases has been expressed in welfare reform discussions. Perhaps most broadly, researchers have argued that the organizational culture of welfare offices must be transformed so that recipient work efforts are expected, encouraged, and supported (Bane & Ellwood, 1994; Bloom & Butler, 1995; Rangarajan, 1998). Caseworkers are seen as the principal actors for communicating these changing expectations. Consequently, Bane and Ellwood (1994) have argued that the traditional caseworker emphasis on eligibility determination and compliance must be fundamentally altered. New or expanded caseworker tasks that have been suggested include providing clear messages about how working affects welfare benefits; developing personalized case plans; informing recipients about work-related support services and arranging related referrals; and troubleshooting in response to problems once a recipient is working (Bloom & Butler, 1995; Halpern, 1999; Herr, Wagner, & Halpern, 1996; Rangarajan, 1998). Such caseworker functions collectively are viewed as critical to the development of trusting relationships between workers and clients, which in turn are hypothesized to foster improved work outcomes (Hasenfeld, 1998; Weaver & Hasenfeld, 1997).

Social work casework perspectives, which have evolved from extensive experience working with powerless and disenfranchised groups, have lacked prominence in these discussions of TANF case management development. Yet, important social work principles are consistent with the purported welfare reform intent of increasing recipient independence and minimizing dependency. For example, social work perspectives on client empowerment suggest that client choice and decision-making power are critical in maximizing client growth and autonomy (Cohen, 1998; Gutierrez, DeLois, & GlenMaye, 1995; Lee, 1994). Casework scholarship also has demonstrated the importance of carefully identifying and responding to the client perspective in developing interventions (Goldstein, 1983), and of building on client strengths as opposed to emphasizing deficiencies (Saleebey, 1997).

Redefined case management roles have been tested with some success in small demonstration projects, and political rhetoric accompanying welfare reform discussions often envisioned such roles in new state TANF programs. However, transferring the lessons from demonstrations to large public bureaucracies has proven extremely difficult (Hagen & Lurie, 1994). Part of this problem may be transitional, as bureaucracies must reorient and retrain caseworkers and managers. Even with adequate retraining, some analysts have argued that goal conflicts inherent in public welfare bureaucracies undermine implementation of an expanded case manager role. In particular, eligibility monitoring and application of sanctions may limit the development of trusting relationships (Hasenfeld, 1998; Weaver & Hasenfeld, 1997). Other non-client-centered bureaucratic activities, as well as complex and frequently changing rules, also reduce the time needed for effective case management (Halpern, 1999; Myers, Glaser, Dillon, & McDonald, 1996).

Reports on both pre-TANF state waiver programs and initial TANF programs raise serious concerns about caseworker functioning. Myers, et al., (1996) found that California caseworkers typically provided neither personalized case planning nor information on work-related supports. In Wisconsin, sanctions applied for noncompliance frequently have been overturned due to administrative errors (DeParle, 1997). In Illinois, both shortcomings in case management provision and confusion about work-related policies have been documented (Center for Urban Economic Development, 1998; Grumman, 1998; Welfare Reform Information Center, 1999).

Several personal interview studies have examined recipient perceptions of life on welfare, but the recipient perspective on caseworkers and on welfare bureaucracies has received little attention. Edin & Lein (1997) found recipients often fail to report work to caseworkers because they fear their benefits will be reduced. Confusing or poorly structured work incentives also may undercut relationships with caseworkers, as recipients blame caseworkers for systemic problems (Anderson, 1998). Several studies have found that recipients often cite poor caseworker performance as the reason they lack knowledge about welfare benefits and rules (Coalition on Human Needs, 1988; Rank, 1994; Southport Institute for Policy Analysis, 1992). However, no recent studies have more broadly examined how recipients evaluate caseworker performance, or identified aspects of caseworker performance they consider most important. This study does so in a program environment similar to that now facing many TANF recipients.

Methods

To explore recipient perceptions about caseworker performance, I conducted personal interviews in 1995 and 1996 with Aid to Families with Dependent Children (AFDC) recipients in Lansing, Michigan. At that time, Michigan was implementing a welfare reform program often portrayed as a model for the development of state TANF programs. Nearly all Michigan recipients were required to either be working, participating in schooling or a work training program, or volunteering in community service activities for at least 20 hours per week. In addition, the state had implemented "earnings disregard" policies and support services programs designed to encourage work. All public assistance caseworkers had been told to discuss these new program features with recipients in the year preceding study interviews.

The sample consisted of 60 unmarried women who had received AFDC in the month immediately prior to being interviewed. Thirty of these women either were currently working at least part-time in a regular job or had done so within the last 6 months, while the remaining thirty had not worked in the last 6 months. All respondents received services through the same county welfare department.

Because of concerns that recipients might be reluctant to openly share their opinions if the author was associated with the state or the county welfare department, subjects were recruited using two community-based strategies. First, local social service agencies, educational and training programs, and churches were asked to distribute study advertisements to potential participants. Second, study ads were posted on public bulletin boards in grocery stores, check-cashing exchanges, and secondhand stores in low-income areas. To encourage participation, a payment of $25 was offered for completing an interview. Brief telephone screening interviews were used to assure that persons who called in response to these recruitment efforts met the criteria for inclusion.

In addition, anyone who had learned of the study from someone already interviewed was screened out, in order to minimize snowball effects. While the resulting sample is not random, the diversity of referral sources and the screening out of acquaintances appeared successful in minimizing systematic biases. No single type of referral source accounted for over one-fourth of respondents, and the characteristics of respondents were simlar to the broader AFDC population on key demgraphic variables.

The interview schedule included both closed and open-ended questions pertaining to caseworker performance, with the emphasis on qualitatively assessing the opinions of respondents. Subjects were asked to rate the overall performance of their current caseworker, as well as various dimensions of caseworker performance. Openended questions focused on respondent views about caseworker strengths and shortcomings, and on how caseworker performance could be improved. More general open-ended questions about welfare reform also yielded many comments regarding caseworker performance.

In discussing caseworker performance, subjects were asked to think about their current eligibility determination worker. Subjects always referred to this worker as their caseworker, and I will follow that convention. Many subjects were also assisted by other Michigan Department of Social Service workers, including employment and training workers. While these other workers were important in providing information about work-related benefits and requirements, the eligibility determination workers were the only workers common to all recipients. When coupled with the fact that eligibility determination workers were charged with informing recipients about work and training requirements, an analytic focus on these workers seemed most useful.

The interviews generally were conducted in subjects' homes, and all but seven were audiotaped. To encourage trust, subjects were paid $25 in cash at the beginning of the interview, and assurances of disassociation from the state were provided. The interviews generally lasted between 1 1/2 and 2 hours.

Interview responses were transcribed, coded, and entered into an SPSS file for analysis. Respondent comments also were organized according to specific topics for qualitative analysis, and subsequent analysis focused both on similarities and differences in response (Lofland & Lofland, 1984; Strauss & Corbin, 1990). Respondent comments were particularly helpful in gaining a more indepth understanding of the recipient perspective, and thus will be used extensively in the presentation of findings. To maintain the integrity and nuances of recipient comments, quotes are presented verbatim.

Results

Caseworker Importance and Perceptions About Discretionary Power

The overall importance of caseworker performance to welfare recipients was demonstrated most clearly in open-ended responses about welfare system likes and dislikes. Sixty-one percent of respondents mentioned some aspect of caseworker performance in discussing what they liked least about the welfare system, easily the most frequent response category. This is striking given the major systems changes that were occurring during the interview period, and the array of possible concerns such as benefit levels, work and training requirements, and support services availability. It was clear that, while analysts typically assess the welfare system abstractly in terms of the adequacy of hypothetically available services, respondents viewed the system in terms of their concrete experiences with caseworkers.

Respondents typically viewed caseworkers as powerful actors who exerted considerable control over recipients. As one respondent expressed most bluntly: "Generally the caseworker who has your case has your life in their hands and they know they can cut you off for any reason they want to."

The closed question responses presented in Table 1 indicate that the ability to affect client outcomes differentially was seen as a primary source of such caseworker power. Nearly all respondents agreed that recipient treatment varied depending on caseworkers, and high percentages felt that caseworkers could apply rules and dispense benefits in a discretionary manner. Respondents also typically believed that caseworkers were inconsistent in the information they provided to recipients about both benefits and rules. Perhaps most disturbing in this regard was the widespread belief that some caseworkers deliberately do not tell recipients about services or benefits for which they may be eligible.

Many respondents amplified the importance of caseworker discretion in determining client outcomes. These comments pointed to both negative and positive aspects of caseworker discretion. When asked, "Does MDSS provide any help with day care?" the following responses were typical:

If they feel like it. That's one of those discretionary things ... if they do it, they do it. And if they don't, you can't make them. They always say that they've got guidelines, but I feel like they do what they want to do. I've always felt like that. I think it just depends on the attitude of who you get out there.

It really depends on your caseworker. Some of them will bend the rules a little bit.

The judicious use of discretion is important in developing an individual service plan tailored to the unique needs of individual clients. However, what is notable in these recipient responses is the perceived autocratic imposition of discretion, as opposed to more carefully circumscribed discretion based on well-defined rules and assessments of client needs. From the recipient perspective, discretion generally involved an arbitrary quality, and appeared to be based on the attitudes of the caseworker to whom one happened to be assigned. This contrasts sharply with social work research perspectives on shared power in decision-making and careful assessment of individual needs (Cohen, 1998; Goldstein, 1983).

Evaluations of Caseworker Performance

Respondent evaluations of their current caseworker's performance were mixed, with 47% rating performance as excellent or good and 53% as fair or poor. Respondents emphasized three dimensions of caseworker performance when discussing the primary reasons for the evaluations: substantive competence, accessibility or timeliness of response, and interpersonal treatment (Table 2).

Substantive Competence

Comments pertaining to substantive competence focused on caseworkers' knowledge about and provision of information on available services and work supports, or their ability to negotiate the service system in ways that resulted in respondents obtaining needed services. In this sense, the substantive competence dimension most closely captures caseworker performance in carrying out functions typically viewed as important in supporting recipients as they transition off welfare.

Substantive competence was the most frequently offered reason for positive caseworker evaluations, with over 60% of those who positively evaluated their caseworker mentioning this dimension of caseworker performance (Table 2). Two comments are illustrative:

When I need any help, either she helps me or she gives me a place where I could get some help.

She'll find me everything I'm entitled to, she'll let me know it ... she'll go right by the letter of the rules, but she will make sure I know all of the rules.

In contrast, only one-fourth of respondents who evaluated their caseworkers negatively offered substantive competence reasons. These respondents typically focused on caseworkers' failure to provide important information:

I think that they need to make you aware ... if you don't know what you are eligible for, they're not gonna tell you. I think that's their job. If I come in there and I've got a particular problem, and I need some help, they ought to be able to say "well, we'll assist with this, and here's a list of so and so and so and so. "

I feel as though she doesn't offer me as much information as she could ... It's almost as if they're afraid to give you too much in formation-anything that you specifically want you have to specifically ask of them-they're not willing to offer it.

Closed question responses indicated more broadly that most respondents did not believe that caseworkers were very helpful either in informing them about services or in helping them to get off welfare. Only 27% of respondents said that caseworkers told them about services for which they might be eligible, while 37% indicated that their caseworkers had tried to help them get off welfare. Thus, in areas of caseworker performance given particular prominence in welfare reform discussions, caseworkers typically were seen as performing inadequately.

It also is noteworthy that, when respondents evaluated substantive competence positively, they focused rather narrowly on the provision of information on services or assistance with arranging a service. While this is not a trivial concern in a complex social services system, it falls short of more comprehensive visions of case management. For example, none of the respondents mentioned the joint development of a service plan for helping respondents move from welfare to self-sufficiency.

Accessibility or Timeliness of Response

One-half of all respondents provided reasons related to caseworker accessibility or timeliness of response when evaluating caseworker performance, and such reasons were offered about equally by those who evaluated caseworker performance positively and negatively (Table 2). These responses included general statements about the ease or difficulty of contacting caseworkers, as well as more specific comments on how long it took caseworkers to respond to calls or follow through on agreed upon case actions.The prominence of accessibility as a reason for positive evaluations suggests that simply responding to basic requests in a timely manner often may be sufficient to demonstrate solid caseworker performance to recipients. While clearly not adequate from the standpoint of proactive case management, this finding is consistent with low recipient expectations of caseworkers found by Handler and Hollingsworth (1971). The following comment reflects this view:

Like if I need something, like when I get a shutoff notice, all I do is just call her up, and she'll take care of it right away. Or if I have questions to ask her and she is not in her office, I leave my number and she'll get ahold of me right away. And a lot of caseworkers don't do that.

Those who evaluated caseworker performance negatively sometimes suggested that poor caseworker accessibility resulted in delays in receiving needed services. These respondents often interpreted poor accessibility as reflecting lack of caseworker interest in recipients.

When you call in, they could pick up the phone if they're sitting there, because sometimes they'll be eating doughnuts or coffee or whatever, and they don't even answer the phone. They can be sitting right there and you be wanting to ask a question about something, and they would just ignore it.

It seems like since they got their new voicemail system they don't have to answer the phone at all anymore.

While accessibility thus was important in terms of its tangible impact on receiving services, it also involved broader symbolic implications. In particular, caseworker accessibility signaled clients about how their caseworkers and the welfare system valued them, which may have important effects in terms of recipient trust and willingness to participate in government sponsored service interventions.

For example, caseworker inaccessibility may signal clients that workers are not interested in their well-being, which may create resistance or apathy to subsequent interventions.

Interpersonal Relations

One-third of all respondents mentioned interpersonal relations or communications skills when evaluating their caseworkers. These comments reflected respondents' perceptions of how caseworkers generally approached and treated them as individuals, as opposed to the substantive nature of caseworker response. Negative comments on this dimension revolved around two related but distinct themes. First, many respondents indicated that their caseworker looked down on them or lacked respect for them:

They ... make you feel belittled. They're higher up, so they make you feel lower, like you can't accomplish anything.

They talk to you like, "Oh, you're just somebody on welfare," like you're a nobody, really.

They talk to you like you're an imbecile. They talk down to you like you're a secondclass citizen.

Second, some respondents suggested that caseworkers stereotyped recipients, and hence made little effort to learn about their specific needs and capabilities or to engage in individualized case planning.

I do want to work, and they look at me like I don't want to work-like I want to live on it. And I don't want to. I was raised in an uppermiddle-class family, and the money they give me isn't enough for me-I want to work.

[There is a] lack of communication between the caseworkers and the people on assistance. Like they don't know you, they don't know your children, they don't know your background in which you're struggling through and bow hard you're trying to get out. They just know you as another file.

In comparison, positive caseworker evaluations emphasized empathy, interest in the specific circumstances of recipients, and other good communications skills. Quite frequently, these were coupled with positive substantive responses and good accessibility to provide a solid helping relationship.

She treats me like a person, not a file. She works with me. If I call her crying and say "What am I going to do," she says "Well, we can do this, and then we can do this, and we can do that, and we'll do it that way." She explains stuff to me-this is what you got to do. She doesn't just send me papers-- she talks to me.

She doesn't talk down to you. A lot of my caseworkers just treated you terrible ... when you call her, either she calls you right back or else she answers the phone believe it or not. And ... she's just real helpful-she just takes care of whatever problem I have right away.

As with perceptions about accessibility, the interpersonal dimensions stressed by respondents often send signals inconsistent with the development of sound casework relationships. The perception that workers talk down to or demean recipients heightens the already large power differential existing between clients and workers, which diminishes the potential for building shared decision-making relationships. In addition, the tendency for respondents to feel stereotyped departs dramatically from social work practice principles of understanding individual perceptions and needs and then tailoring interventions from these often diverse starting points (Goldstein, 1983).

The emphasis that respondents placed on interpersonal relations, accessibility, and substantive competence often precluded focusing on broader systemic factors that might impinge upon caseworker performance. That is, respondents typically did not look for systemic explanations such as large caseload sizes or caseworker role constraints to explain caseworker performance. Rather, they more often focused narrowly on how they were treated in specific encounters, and then used these experiences to make general inferences both about caseworker motives and skills and about the broader welfare system.

Discussion

The recipient perspectives presented in this study provide several lessons for those interested in strengthening TANF case management performance. For one thing, the findings support Hasenfeld's (1998) contention that developing trusting relationships emphasizing the moral worth of clients is critical if public welfare case managers are to produce meaningful results. Study respondents typically evaluated caseworker performance on basic dimensions such as accessibility and interpersonal treatment. While these functions are not sufficient to fulfill a useful case management role, they may be prerequisites that signal recipients about caseworker interest in them. This, in turn, may increase recipient receptivity to more substantive interventions concerning client needs, perspectives, and service plans.

Unfortunately, establishing such trust and receptivity in public bureaucracies is extremely difficult, particularly given that public welfare agencies typically employ marginally qualified caseworkers trained as eligibility and compliance monitors (Bane and Ellwood, 1994).

Because public welfare agencies generally operate in a political environment unsympathetic to social service orientations (Hasenfeld, 1998), it may be unrealistic to assume that resources for more skilled workers will accompany the demands for more sophisticated case management under TANF. Consequently, an initial challenge is to develop strategies for improving the performance of current case managers along the basic dimensions identified by study respondents.

For example, although the provision of training on interpersonal relations, customer relations, and time management may seem elementary for trained social workers, these may be critical as basic preparation for TANF caseworkers. Developing the knowledge base of workers about the support services and benefits available to those who work also is critical, as is assuring that workers routinely provide this information to clients. Furthermore, given the presence of time limits, timely planning and follow through with all client activities must be emphasized. Collectively, the development of these capabilities would move caseworkers toward a case management systems approach (Bowers, Esmond, & Canales, 1999; Roberts-DeGenarro, 1987).

Without associated organizational routines, performance standards, and supervision, training is unlikely to have more than marginal impacts. Current workers typically have been evaluated based on minimizing errors in eligibility determinations, which while laudable from a public administration standpoint, does not assist clients in achieving successful outcomes (Bane and Ellwood, 1994). Performance standards that reward workers for completing case planning tasks, providing clients with information on services and benefits, and arranging for services are more appropriate in the TANF environment. This is not intended to deprive caseworkers of the discretion required to determine appropriate service plans for TANF clients. However, as study findings suggest, discretion without clear boundaries may result in perceptions that caseworkers exercise power arbitrarily. Therefore, the discretionary authority of workers in case planning and service provision needs to be circumscribed within well-defined boundaries and expectations understandable to both workers and clients.

Cohen (1998) has classified caseworker-client relations as following a continuum ranging from authoritarianism to mentorship to partnership. The suggestions outlined above would help move TANF caseworker-client interactions from what study respondents often considered authoritarian relationships toward mentoring relationships. While doing so would constitute a substantial improvement, a more difficult challenge is to develop TANF caseworker expectations that build upon social work practice research, with the goal of incorporating aspects of shared decision-making or partnerships in these relationships.

Given that TANF clients are a powerless population and that welfare reform debates stressed increased client self-sufficiency, advocating for casework approaches that empower clients in decision-making and that build on client strengths are appropriate. Building empowerment approaches has proven difficult even in small agencies with strong philosophical commitments in that direction, largely due to conflicts with funding bodies and other agency imperatives (Cohen, 1998; Gutierrez, GlenMaye, & DeLois, 1995). Consequently, many may discount the possibility of developing such approaches in much larger and more complex public bureaucracies.

Some steps consistent with these principles of social work practice nonetheless may be supportable. One example is to incorporate client choice into decision-making about the work or training activities in which clients participate, as well as in selecting associated support services. Another is to improve caseworker skills in evaluating and building upon client strengths in developing welfare-to-work plans with clients. Such approaches generally are more time consuming than more autocratic case management styles (Gutierrez, GlenMaye, & DeLois, 1995), or than common TANF approaches that provide clients with few choices in meeting work and training requirements. Empowerment approaches also require that caseworkers share power with clients, which may create difficulties if not accompanied by substantial administrative and caseworker commitment. While not discounting these problems, advocacy on behalf of these more substantive case practice approaches is warranted if more successful client outcomes can be demonstrated.

As states continue to implement TANF programs, the perspectives of TANF recipients deserve more attention. Given the imposition of time limits and stringent work and training requirements, welfare reform is affecting literally millions of poor persons. TANF caseworkers play a critical role in implementing these programs, and in turn in determining how these programs impact TANF clients. The challenge for social service advocates is to help redefine public welfare caseworker roles in a way that provides needed assistance and incorporates client perspectives in service planning and delivery.

Author's note: I would like to thank Mary Corcoran, Sheldon Danziger, and Ann Chih Lin for their ideas and support related to this work. I also benefited from thoughtful, anonymous reviewer comments. An earlier version of this paper was presented at the 45th Annual Program Meetings of the Council on Social Work Education.

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Steven G. Anderson is assistant Professor, School of Social Work, University of Illinois, Urbana, IL 61801. E-mail: sandersn@uiuc.edu

Original manuscript received: April 23, 1999

Revised: May 18, 2000

Accepted: May 24, 2000

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