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© 2019 Cengage. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in
PART TWO
GUIDING HUMAN SERVICE PRACTICE
© 2019 Cengage. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in
CHAPTER 3
THE HISTORY OF ADVOCACY IN HUMAN SERVICES
LEARNING OBJECTIVES
After reading this chapter, students will be able to:
3-1 Trace the historical development of helping.
3-2 Summarize how the meeting of human needs has changed since the Middle Ages.
3-3 Summarize the influence of the Elizabethan Poor Laws on human service delivery
3-4 List the individuals in colonial America who influenced human services and their
contributions.
3-5 Summarize the founding of the social work profession.
3-6 Illustrate a contribution of each of the three 19th-century philosophies to human
service delivery.
3-7 Justify the purpose of organizations such as the Charity Organization Society and
3-8 Identify the areas of reform in the delivery of human services that occurred during
the 19th century.
3-9 Summarize the significant legislation that encouraged providing services to those
3-10 Detail the contribution Clifford Beers made to the treatment of the mentally ill.
3-11 Give examples of the advocacy of each of the following presidents: Franklin
Roosevelt; John Kennedy; Lyndon Johnson; Richard Nixon; Gerald Ford; Jimmy
3-12 Summarize the approach to human service advocacy of Presidents George W.
Bush and Barack Obama.
1. Until the Middle Ages, treatment of mental illnesses focused on ridding
2. Hippocrates used the scientific approach to diagnose mental illness.
3. Until the 1500s, the Catholic Church was responsible for providing
4. England’s needy received help from the government; mentally
impaired were categorized “idiots” or “non compos mentis”.
5. Hospitals and insane asylums treated the needy during the Middle
6. The Elizabethan Poor Law of 1601 described the services available and
a. Began the welfare bureaucracy
b. Formally involved the government in human service delivery
1. The following four principles were used to define poor relief:
a. It is a public responsibility.
b. It is based upon legal residency.
2. Almshouses were established in the colonies to meet human needs.
III. The 19th century: A time of change
1. An emphasis on individualism, laissez-faire economics, and Social
Darwinism promoted a limit on human services.
2. Private sector became instrumental in meeting human needs.
1. The concept of “friendly supervision” was an early form of probation.
2. Dr. Benjamin Rush studied mental illness scientifically.
3. Dorothea Dix campaigned to improve the treatment of the mentally ill
and developmentally disabled in jails and almshouses.
4. Children were removed from almshouses and placed in newly created
5. Immigration and migration to urban areas affected services provided
during the latter half of the 19th century. Two responses were as follows:
a. Organized charity movement: developed to eliminate fraud and
© 2019 Cengage. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in
duplication in the provision of services
1. Two significant events for the human service profession were as
follows:
2. Muckrakers forced a reexamination of the causes of poverty.
3. Clifford Beers began his mental health reform efforts, which caused
services to improve and expand.
1. Passage of National Mental Health Act of 1946 created the National
2. Joint Commission on Mental Illness and Health proposed a national
mental health program and a new type of mental health worker.
3. Kennedy and Johnson administrations continued commitment to mental
4. The Community Mental Health Centers Act of 1963 established mental
health centers throughout the United States.
5. Deinstitutionalization moved mentally ill patients from hospitals to
community-based treatment programs.
1. Scheuer Subprofessional Career Act of 1966 developed programs to
2. Professional human service organizations for human service education
are founded.
1. The Great Depression created an economic situation that increased the
number of individuals who needed help.
2. The Social Security Act of 1935 was the cornerstone of the reform of
this era.
a. provided public assistance, social insurance, and health and
1. Both men were advocates for the poor.
2. Johnson established Medicare and Medicaid.
C. Richard Nixon and Gerald Ford
1. Richard Nixon’s administration marked a decline in federal spending
2. Gerald Ford’s administration continued the reduction of federal
involvement in human services.
1. Created the Department of Health and Human Services
2. Established the President’s Commission on Mental Health
1. Reagan decreased federal government involvement in human services.
2. The Americans with Disabilities Act (ADA) passed during the Bush
administration.
1. Committed to domestic reform
2. Passed the Personal Responsibility and Work Opportunity
Reconciliation Act in hopes of reforming the welfare system
1. Medicare Prescription Drug, Improvement, and Modernization Act of
2003 provides outpatient drug benefits on Medicare, Part D.
2. Promoted faith-based initiatives as partners with federal government
1. The Patient Protection and Affordable Care Act expands health care to
millions of uninsured Americans.
2. President Donald Trump campaigned to repeal the Act.
CHAPTER SUMMARY
Chapter 3 presents a history of helping and human services. The history of
helping begins with the early treatment of the mentally ill, the first definitions of mental
Human services were present in colonial America and developed in earnest during
1813. The earliest treatment for the mentally ill was medically based and many of those
with mental illness were housed in asylums. Reform was underway by the mid-19th
century as Dorothea Dix and others educated the public about the poor treatment of the
mentally ill. This chapter also describes the roots of child welfare, the organized charity
movements, and the settlement house movement.
The 20th century was an era of reform for human services. Clifford Beers, Jane
significant contributions to the human service movement and set the stage for
deinstitutionalization. Programs established under the leadership of Presidents John
Kennedy and Lyndon Johnson targeted poverty, civil rights, and health insurance to
improve the lives of all Americans.
Since the 1960s, the human service movement has grown rapidly. New training
programs, a larger mental health delivery system, the development of professional
organizations, and a federal presence in human service administration are evidence of this
mental health/illness, President Carter reorganized the government, resulting in the
creation of the Department of Health and Human Services.
The Republican administrations of Ronald Reagan and George H.W. Bush
emphasized the economy, defense, and foreign policy to the detriment of human services.
The need for welfare reform contributed to the election of Bill Clinton, and the Personal
Responsibility and Work Opportunity Reconciliation Act replaced Aid to Families with
© 2019 Cengage. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in
Affordable Care Act was passed in 2010 and expanded health care coverage to millions
1. To review the history of helping
2. To explore the changing beliefs about who is “less fortunate” and how those
beliefs shaped the definition and treatment of needs throughout history
3. To examine the emergence and growth of the human service movement
4. To review the increase and decline of federal involvement in the 20th and 21st
centuries, as indicated by needs, legislation, and reform
1. Divide the class into five groups. Assign each group a significant historical event in
Middle Eastern history. Ask each group to list the needs that people had during that time
in history. List those needs on the board.
2. The following list of people have made significant contributions to the field of human
services: Dorothea Dix, Ronald Reagan, John Kennedy, Benjamin Rush, Jane Addams,
Mary Richmond, and Hippocrates. Ask individual students to volunteer to study one of
3. Students may have limited historical perspective about social problems and sometimes
are unaware how quickly the problems and proposed solutions change from one decade
to the next. To expand student thinking, divide the class into groups of four. Then ask
1928. During their review, the students should try to answer the following questions:
1. Could you find many articles on the subject?
2. What was the focus of the articles?
© 2019 Cengage. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in
3. Describe the problems at that point in time.
4. Identify the issues.
5. Describe the proposed solutions.
6. What seems to be the predominant human service concerns during this year?
After the students have completed their research, ask them to share it with their
4. One way to learn about the development of human services is to interview a helping
professional who has been involved in human service delivery for five years or more.
1. Ask about the history of the agency.
2. What changes have occurred?
3. How have the job responsibilities of this individual changed?
DISCUSSION QUESTIONS
1. Describe the role of the church in the early history of human services.
2. Discuss the importance of the Elizabethan Poor Law to human services in both
3. How was poor relief defined in colonial America?
4. Explain the forces behind major changes in attitudes toward the role of human
services in 19th-century America.
5. Differentiate between the approaches of the organized charity movement and the
6. Analyze the impact of 20th-century legislation and presidential administrations on
service delivery.
7. Explain the significance of the National Mental Health Act of 1946.
8. Analyze the impact of 21st-century legislation and presidential administrations on
service delivery.
MINDTAP VIDEO IN-CLASS DISCUSSION
HOW SOCIAL PHILOSOPHIES RELATE TO HEALTH CARE REFORM
Reform of the government’s health care policy for those without access to care remains a
1. Identify the philosophy that most closely resembles each speaker’s
position on health care.
2. How did you know which philosophy was used to describe the speaker’s
beliefs about health care reform?
KEY TERMS
emergency services, assistance to the courts, and services for the mental health of
© 2019 Cengage. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in
Social Security: Public assistance to those in need that was provided as part of the
1. Prior to the Middle Ages, what were the causes of and treatments for “evil
spirits”?
2. How did Hippocrates change the approach to mental illness?
3. Identify the early labels of the mentally ill and the questions that were asked to
determine the status of an individual’s mental health?
4. What was the major impact of the Elizabethan Poor Law of 1601?
5. How did the Elizabethan Poor Law of 1601 characterize the needy?
6. What were the four principles of the Elizabethan Poor Laws that influenced
human services in colonial America?
7. Describe the major philosophies of the 19th century.
8. What was Benjamin Rush’s contribution to the treatment of the mentally ill?
9. What two significant events in the early 1900s had a major impact upon the
history of helping?
10. What was important about the development of social work?
11. Describe Clifford Beers’ experience as a mental patient.
© 2019 Cengage. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in
12. List the major components of the Social Security Act. Why was it important to the
support of those in need?
13. What was the focus of the National Mental Health Act of 1946?
14. What two recommendations did the Joint Commission on Mental Illness and
Health make that influenced the growth of the human service movement?
15. What was deinstitutionalization? How did it influence the development of the
human service movement?
16. List three characteristics of the changing role of the federal government during the
17. List the major pieces of mental health legislation since 1960.
18. Identify the major human service challenges as we enter the 21st century.
1. Describe major characteristics of helping those in need prior to the Middle Ages,
during the Middle Ages, and immediately following the Middle Ages.
2. Trace the role of the church and the role of the government during the Middle
3. Describe the Elizabethan Poor Laws and explain how these laws influenced
colonial America’s approach to helping the poor and needy.
4. What role did institutions play in the development of human services?
5. Trace the development of care for the mentally ill and children from the 1850s to
the 1930s. How did the care change? Why did it change?
6. Explain the impact of the Great Depression on helping those in need.
© 2019 Cengage. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in
7. Trace the federal government’s involvement in human services from the 1930s to
the present.
8. In what ways has major legislation influenced the development of human
services?
9. How did the passage of the Patient Protection and Affordable Care Act impact
human services?
The following exercises allow students to apply what they have learned from the
1. Select a problem that your country is facing today (homelessness, poverty, etc.).
Based on your knowledge of Presidents Roosevelt, Kennedy, Johnson, Nixon,
Carter, Ford, Reagan, George H.W. Bush, Clinton, George W. Bush, and Obama,
how do you think each of their administrations would address this issue?
2. Construct a timeline of human service events between 1946 and the present in the
United States. Add the key events in the United States that have contributed to the
3. Divide students into groups. Each group works for an agency or organization that
represents the philosophies of individualism, Social Darwinism, and laissez-faire,
4. Re-create the case of Almeada and baby Anne in Chapter1. Rewrite the case as if
Barb La Rosa worked for a managed care organization. Critique the results.
© 2019 Cengage. May not be scanned, copied or duplicated, or posted to a publicly accessible website, in
LO/STANDARD CORRELATION TABLE
Early Foundations of Advocacy
3-1
3-2
26, 30
11
12
The Elizabethan Poor Laws
3-3
26, 30
11
12
The 19th Century: A Time of
Change
3-5
3-6
3-7
26, 30
11
12
Social Philosophies
3-8
26, 30
11
12
