Thinking about predictability put me in mind of the study undertaken for the Department of Health and Social Security of the practice of field Social services teams. They reported that “for ongoing work definite appointments were rarely made but clients were usually given approximate indications of the date for the next visit”. “Few social workers attributed much significance in visiting on a strict appointment rather than on a causal basis”. “Visiting is often determined for you to really by the way the clients respond when you see them,” was the comment of one of the social workers. This comment is interesting because in one sense, it appears to fit readily with the notion of sensitivity to the client’s signals, and yet in practice, this approach seems equivalent to the caregiver who only responds when the child cries. Another worker is reported thus; “Priority with me is not a conscious thing, it just happens; you get involved with a particular situation….. and you get a series of these situations and so you find yourself visiting maybe half a dozen (clients) regularly and the rest seem to get pushed aside for a time anyway, and it is not really a conscious thing at all”.
Much of this report makes disturbing reading in the light of attachment theory and it certainly reflects the immense difficulties of providing reliable caregiving in the context of local authority social work. The subject prompted me to do a small survey of the caseload of my team. One of the interesting points that arose in discussion was that a small number of cases formed a warm relationship with the secretary of their probation officer. These often seemed to be quite angry young men in their late teens. Their relationship with the secretary considerably extended the accessibility of the Service’s attention, and indeed the secretaries are not infrequently more easily accessible to clients than are the officers whose business takes them away from the office for long periods. This experience points to the creative potential of the general office, which often goes unrecorded.
The other outcome pointed to the contrast with the local authority experience. Out of 140 cases studied, only 16 did not have some kind of pattern of appointments, and in two thirds of the cases, the pattern was made explicitly in negotiation with the client. There seemed to be a tendency for more experienced officers to be less reliable in maintaining patterns of contact, although this was more an impression than something easily demonstrated numerically. It does I think reflect the effort required to keep up a reliable caregiving structure.
This outcome seems to show the advantage for the agency and clients, of the existence of a Court order, which holds both workers and clients to a disciplined pattern of contact. Certainly, in the case of voluntary work with individuals where there was no Court order, there was less likely to be a pattern of contact on which the client could rely.
However, given the existence of a pattern of contact, the frequency of the contact was often every two weeks or every month. What could accessibility mean in this context? An examination of the four dimensions of caregiving together raises the possibility that different dimensions are of different importance in different settings. For example, perhaps the officer who is more able to demonstrate his understanding of the client’s emotional needs to the client, will be felt to be more accessible whatever the frequency of appointments, and thereby be more effective?
 Stevenson, O., and Parsloe, P. (1978) Social Services Team: The Practitioners’ View. HMSO
 Stevenson and Parsloe 1978 pp 79-84