Eliminate the use of obsolete terms: Stop Calling People Clients

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Date	27.07.2017
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ELIMINATE THE USE OF OBSOLETE TERMS: Stop Calling People Clients
Jim Masters, First published in the NASCSP Newsletter April 2003. Updated today!
“Words count,” as Buddy Ray says. He cites the example of the progression over the past decades from calling people “retarded” to calling them “mentally handicapped” and now calling people “developmentally disabled” or “differently-abled.”
We should stop using words that are counter-productive. This paper was originally precipitated by a discussion about the use of the term “client” in the 2001 CSBG IS report. The CSBG IS policy was changed and the term “client” was removed from the CSBG IS. I hope this paper helped in that discussion. Now, “client” is back.
The term “customers” or almost any other term is better than “client.” Other good terms are “people” or “program participants.” Or, people with low-incomes, citizens, residents, residents of low-income neighborhoods.
In community action, there are four specific problems with the use of the term client.

The Medical Model is the wrong model for most CAA activity.
The flawed early days of social work in the ADC and AFDC programs poisoned the term client.
The civil rights movement focuses attention on the problems in the opportunity structure that need to be changed, not on the people.
Other networks like child protective services and corrections that have caseworkers and that that use “client” have all the power and the client has none. We need to differentiate ourselves from them.

1. The first problem is the “medical model” on which too many human service programs are based. While there are powerful customers and empowered clients in some other professional/client relationships, this is not usually the case in publicly-funded social service programs. In almost all publicly funded programs that use the term client, the system is the focus and it has the power to effect change. The clients pass through it and are changed by it. This is the classic “injection” theory of providing social services through a medical model. The professional has the answers and the client waits for the diagnosis and the prescription of treatment. In their relationship to the professionals, clients wait to be told what to do.
In the “strength-based, family-centered model,” the person is in charge of their life and responsible for producing changes in it. The publicly-financed worker is there as a coach and facilitator. Big difference.
Some CAA’s are still confused about which of these two models they are running. (I come back to this in # 2 and # 3 below.)
2. The second problem is the legacy of the early days of social work, when social service functions were carried out by social workers in the ADC and then the AFDC program. From 1938 to 1967, when AFDC caseworkers were all social workers – and all AFDC recipients were called clients. The social workers were tasked with determining eligibility for income maintenance eligibility, with providing social services, and with enforcing local social norms and mores. These roles got horribly confounded. The caseworkers:

(a) enforced the local social values on which the state/county/city government-run AFDC operations were based (including racial discrimination in hiring and in determining eligibility), and

(b) enforced policies designed to restrict enrollment (apply only on Thursdays between 10 am and Noon), and

(c) pushed people out of the program for allegedly having other sources of income – although this was more about unmarried women being immoral and therefore being classified as being “undeserving” of aid. The caseworkers would do unannounced home visits and search the house and if they found a man’s shoes this was seen as proof there was a ‘man-in-the-house’, and the woman obviously had income she was concealing and so she was declared ineligible.

(d) managed one of the greatest failures ever imposed on program participants and one of the greatest hoaxes ever perpetrated on the public – the Work Incentive Now (WIN) program, which operated from 1967 into the 1970’s.
Until the mid-1960’s the huge majority of the social workers were white. The civil rights movement, the welfare rights movement and the CAA’s attacked the entire AFDC system head-on, with sit-ins and demonstrations. CAA’s literally pushed the doors open. Due largely CAA and Legal Services program efforts, the AFDC rolls grew from about 4 million to about 9 million between 1965 and 1969. Instead of eligibility being awarded only to the “deserving poor,” the CAA’s insisted it be given to all who were eligible for it by statute, who were entitled to it, regardless of their race.
Recall that for several years OEO funded the National Welfare Rights Organization (NWRO). The civil rights movement and the CAA’s exposed the confounded roles the social workers were performing and the power dominance issues and the flawed concepts of social work itself. CAA’s attacked the concept of social work as it was being practiced and they succeeded in driving social workers out of the Income Maintenance program. With active CAA support, in 1967 Congress separated income maintenance and social services. Starting in 1967, IM was turned over to clerks, and the social workers were supposedly “freed up” to provide real social services based on the family’s needs and to get back to community organizing and social change. In most jurisdictions the new role for social workers – doing “real” social work – lasted only a few months or years. By 1973, virtually all the social workers had been transferred into child protective services, foster care or adult protective services.
So, the old AFDC system was based on social workers having all the power, and the term client was used to describe the millions of powerless pawns in a bad system. This history is not forgotten. These memories are in the bones of many IM managers, especially at the state level. So the term client was in disrepute in CAA’s and antipoverty programs and was not used – until it reappeared in the 1980's with the re-arrival of social work concepts at CAA’s in family development programs.
Until about 1975, CAA’s helped a lot of people get a GED and a job at the minimum wage and thus got them out of poverty. As the economy changed this strategy lost effectiveness. And, our civil rights strategy largely succeeded in eliminating the formal aspects of segregation and literally millions of minorities could get jobs, buy houses, ride busses, get an education and vote.

And then, this strategy at the CAA level lost its power as civil rights issues moved “from the streets” to the bureaucracies and the courts. By the late 1970's or early 1980's, many CAA’s no longer had these two powerful program strategies (civil rights and GED/job) as the foundation of their anti-poverty work. We were left with seeking equity in transfer payment programs, i.e. making sure people who were eligible for service or benefits got them, and with service integration, program coordination, and partnerships – the latter being stock items of social services for the past 100 years.

And so in the mid 1980's people said: “Look! Over there! There’s a dead zone where generic case management for anti-poverty purposes has failed in the publicly-funded social service agencies! Let’s take over that territory!” You could say that CAA’s moved into the “failure zone” from which the social workers had been kicked out or had withdrawn in defeat. Starting in the 1980's, social work methods began flowing into community action through the Children’s Bureau grants that were trying to expand preventive services for foster care in local child welfare agencies. They were trying to move the social work diagnoses and interventions “upstream” to prevent child abuse. These ideas came primarily through the University of Iowa School of Social Work. The pioneers at the Mid-Iowa CAA began to apply these same concepts in their family development program, and then Cornell University, the University of North Carolina and other colleges also began offering courses on family development based on social work theory and methods to non-social work students.
The CAA’s began to provide family development services in the hope that their approach would somehow help to reduce poverty. The evaluations over the early years especially in the OCS funded Demonstration Partnership Program showed some success, but only if the agency worked with the participant for 5 years or more until the person gets an Associate of Arts degree and the good job that an AA brings. The hope that this strategy will produce powerful anti-poverty results remains strong. I would argue that family development is an excellent human development strategy – but it is not a very powerful anti-poverty strategy because most CAA’s do not work with the participant long enough to make a difference.
Today, about 50% of CAA family development programs are family-centered and strength-based and use some social work principles with the work being done by people who are not social workers. About 10% of CAA family development programs are medical-model with social workers. About 40% have a wannabe medical model but without the professional social workers, which creates an odd program indeed.
So, one challenge for CAA’s is to assimilate the useful parts of social work principles and methods WITHOUT bringing the historical baggage (clients, mimicking the medical model) along with it. This is kind of a long explanation, but it is one reason to avoid calling people clients.
The family development market niche -- the social work withdrawal zone in publicly funded social service agencies – now has two other competing networks in it. One is the traditional, United Way funded Family Service Agencies (about 400 agencies), who employ M.S.W. and B.A. social workers who use a therapeutic medical model. The other is the “new” family preservation movement and Family Support Network, which employs both social workers and non-social workers, using a strength-based, family-centered model in what is now a billion dollar program. These agencies vary from area to area in their constellation of services and who they seek to help. The Family Support Network agencies are now the trend-setters in terms of practice methodology. CAA’s are living in a place of hope of producing anti-poverty outcomes, but the programs they run are increasingly look like what is happening in these other agencies. How do we differ from them?
3. The third problem with using the term client comes from community action as a part of the civil rights movement. The ideology was/is that people should become empowered, take charge of their own lives and their communities -- and change the social values and institutions that are keeping them in poverty. The people-are-in-charge was central to the mantra of maximum feasible participation. The terms used were: people, low-income people, citizens, residents, residents of low-income neighborhoods, program participants, and others. All these terms imply equal power with the agency/program or are neutral on the issue of power difference. In a social movement you have citizens; in a medical-model social service program you have clients. When I hear the term clients, I hear the ghosts whispering “here are the powerless clients in the program with the professionals-in-charge.” The basic assumption of the civil rights movement is that eighty percent of causes of poverty are “out there” in the opportunity structure, not with the people who want to work.
4. The fourth problem is that other networks that assign case managers such as child protective services, corrections and others call their participants clients, and they mean it -- in the sense of ‘we have the power and you the participant don’t.’ We cannot assume that the clients from these other punitive systems can determine that our label of client means something else. The best way to differentiate ourselves from these other systems is to call people something other than clients.
Today, under our umbrella, only Head Start retains and has institutionalized the idea of equal power between program participants and staff. About 95% of Head Start programs are family-centered. In Head Start you almost never hear parents called clients.
Just to be clear, I enthusiastically support family development and the use of social work theory and methods in the strength-based, family centered approach. Our Summer Institutes in Case Management and Family Development attract hundreds of Head Start workers each summer. These provide college credit through Cal-State East Bay. The Professors and M.S.W. graduates of U.C. Berkeley School of Social Welfare, Cal State Hayward and other Bay Area universities help the Head Start staff adopt and adapt social work methods for use in Head Start.
Social work theory and practice provides excellent human development tools that CAA’s can learn and use. Their use for anti-poverty purposes is much more problematic. In any case, call them people and not clients.

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