SPE 74 - Studies in Political Economy

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listening to clients' problems; suggesting alternative solutions and resources; ... systems exist in social services agencies in Canada, originating at different.
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F O R U M : Q UA N T I TAT I V E I N D I C AT O R S “WHOSE

NEEDS ARE BEING

S E R V E D ? ” Q U A N T I TAT I V E M E T R I C S A N D

THE RESHAPING OF SOCIAL SERVICES Donna Baines

Downsizing, funding cuts, narrowed service mandates, and the introduc-

tion of repeated waves of market-oriented workplace reorganization have been key factors in the restructuring of Canada’s public and non-profit social service sectors. Prior to the mid-1980s, Canadian social service organizations operated on a mandate of providing service to those who could establish need.1 In fact, this approach was guaranteed in funding arrangements such as the Canada Assistance Plan (mid-1960s to mid-1990s). The introduction of neoliberal budgets during the late 1980s at the federal and provincial level, however, meant that social service organizations were required to meet increased social demand with fewer financial resources. Piggybacking on these funding cuts and popular discourses that vilified the poor,2 social service agencies introduced a range of measures that quantified the activities and output of front-line workers in an attempt to reorganize public care to reflect market forms and priorities, provide a modicum of public accountability, justify the use of public funds, and eliminate waste. In tandem with the hegemony of statistical data as the basis for political, social, and economic decisionmaking,3 these accounting-like processes attempted to quantify and apply numbers to a range of emotional, interactive, and relationship-building activities that formed the main substance of social service care work. One consequence of this preoccupation with numbers was the standardization and deskilling of the predominantly female, Studies in Political Economy 77

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professional, and quasi-professional labour force, the displacement of social caring as the central ethical and operating principle within the sector, and the emergence of new forms of social caring-based workplace resistance. While some players in the social services sector actively resisted new accounting-based forms of public sector management, other players wholeheartedly embraced quantitative metrics, such as best practices, competencies, and benchmarking. The impacts these quantitative projects had included the erosion of professional discretion, a decrease in the quality of service, and an expanded reliance on flexible, temporary, part-time, and volunteer workforces. Many social service workers strongly embrace an ethic of social caring.4 Indeed, this is the major reason why they continue to work in a sector in which hours of work are long and demanding, the work is generally very stressful, and wages, particularly in the non-profit sector, are low.5 This ethic of social caring can give rise to strong worker opposition to management schemes that reduce resources to clients or control clients in ways that offend workers’ sense of social fairness. Caring-based resistance to management directives predates the introduction of quantitative metrics,6 but this resistance accelerated and assumed new forms under the current managerial regime. Ironically, rather than reflecting existing or enhanced social work practice, some of the new benchmarks and best practices used within the social services sector reflect the resistance of workers who have consciously lowered their performance in order to leverage more time and resources in order to perform their jobs in ways that reflect social solidarity, rather than narrow quantification and constraint. Thanks, in part, to this resistance, the quantitative metrics have not fully succeeded in boosting “productivity” or “accountability,” even by their own ideologically biased criteria. This article begins with a short synopsis of the methods used to gather the data on which this article is based. This is followed by a brief discussion of some unique aspects of social services work, including the management/worker/client dynamic and the way that the caring content of social service work acts as the major source of social meaning for those whom it employs, as well as a pathway for self- and employer-exploitation and worker resistance. The fourth section involves an overview of the forms of quanti196

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tative measures utilized in the social services, and a discussion of their implications and effects. The article concludes with a look at resistance strategies. Methods The data reported in this article were collected in two sets. Initially, 83 front-line union and nonunion social service workers (roughly 70 percent unionized) and a small number of managers, supervisors, policymakers, and advocates were interviewed in three Canadian provinces: Alberta (28), British Columbia (29), and Nova Scotia (26). Follow-up interviews (22) with research participants occurred two years later in British Columbia, where the election of a strongly neoliberal government resulted in a rapid and massive overhaul in what, up to that point, had been the province with the highest levels of human service funding in English Canada. This brought the total number of interviews to 105. Research participants worked in the public or non-profit sector for an average of 8.5 years. Similar to the broader social services workforce, the sample was roughly 80 percent female. The sample of research participants included roughly equal numbers of those with professional education and credentials (BSW, MSW) and those without. Using an interview guide, interviewees were asked to comment broadly on changes they may have experienced in their paid and unpaid work in the last five years. Data analysis involved fracturing the data into concepts and subsequently labelling, sorting, and resorting7 until a mapping of the interconnections was possible. The Management/Worker/Client Dynamic and Care Work The labour process is generally seen as a two-way dynamic relationship between workplace management and workers. In service work, a third player enters the dynamic in the form of the service user, also known as the customer, client, patient, or consumer.8 Within the classic two-way dynamic of worker and management, workers are presumed to be the main source of waste and error, necessitating a wide range of managerial initiatives and efforts aimed at controlling workers’ behaviour and output. Standardization in its many formats has been the main managerial strategy employed to speed up work, reduce production delays, and increase productivity. In the service work relationship, however, clients are the most likely 197

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source of delay and disruption of production. When they are not pleased with service, they can refuse to leave cashier line-ups, mental health offices, or instant tellers, thus preventing the operation of regular business. They can raise a major disruption in a food bank, in a store, or on a hospital floor, thereby distracting or preventing workers from going about their tasks, as well as instilling doubt in, and potential disruption among, other service users. Finally, in for-profit enterprises, clients can refuse to pay their bills and they can take their business elsewhere. Hence, a great deal of managerial attention has been paid to the question of how to control the service user in order to maintain and increase production.9 Like other kinds of work, standardization and fragmentation of tasks are the primary methods of workplace control in service work,10 although, in order to exert control over customers, standardization also extends to the routinization of the behaviours and emotions of service workers.11 When emotional states are deliberately invoked in workers to extend control over clients, they often become a source of alienation and occupational stress.12 Examples of inappropriate use of emotion in service work include the scripted politeness and subservience of McDonald’s workers; the thrilled cheeriness of Gap clerks, and the maternalistic control of air flight attendants. However, the use of emotion is an appropriate part of service work involving actual care for other people — nursing, social work, childcare — because caring for and about people is generally inseparable within the tasks and goals of this type of work, and is a major source of meaning and job satisfaction.13 Care work is a central concern of most women’s professions. The link to caring often undermines professional claims to status, high wages, and prestige because it is commonly assumed that caring is merely an extension of what women do “naturally,” rather than highly gendered work involving sophisticated skills, knowledge, and creativity.14 Thus, femaledominated professions like social work and quasi professions like social service work continue to be among the low-pay, low-status professions.15 Despite this tenuous grasp on professional power, social workers and social service workers have had a “fair degree of discretion in their work,”16 giving them the sense that they should have significant control over tasks, the order and outcomes of the tasks, and so forth. Prior to neoliberal restruc198

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turing, social service clients were not controlled by lighting, employee scripts, or specially designed physical environments as are customers/clients in much of the broader service sector. Instead, as in other types of care work, control of clients occurred through the establishment of caring relationships and the actual provision of care. Care was presumed to be taking place and caring relationships were assumed to be built when workers undertook activities such as expressing an interest in the clients’ struggles and dilemmas; listening to clients’ problems; suggesting alternative solutions and resources; providing hands-on support, counselling, and active intervention; building long-term case plans and goals, and referring clients elsewhere to obtain services that the workers could not provide. While many workers and clients felt oppressed by the restrictions imposed by bureaucratic life and the welfare state’s construction of gender-, class- and race-blind services prior to the introduction of New Public Management (NPM) and NPM-like managerialism, social service workers’ identity as caring professionals, and the relatively large amount of discretionary power accorded to them, provided this group of workers with unique rewards and identities as social citizens and moral, caring individuals.17 As will be discussed later in this paper, this identity and power formed the basis for direct conflict between this group of workers and new NPM and NPM-like managerial schemes that tightly quantified services and curtailed opportunities for workers to build caring relationships with clients. New Public Management and Other Quantitative Practices in the Social Services NPM is a model of performance management in which public and non-profit social service organizations are encouraged to think of themselves as “business units” and to meet quantitative measures that take the form of performance goals, benchmarks, and ongoing evaluation.18 As noted earlier, prior to the mid-1980s, social services in Canada operated on non-market logics of redistribution and service to those in need.19 The transformation of public and non-profit services into entrepreneur-like business units represents a pivotal way in which social services have become increasingly pro-market, while remaining nominally non-market.20 Public and non-profit social services are pro-market in that they have adopted and 199

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promote the values, practices, legitimacy, and supremacy of the private market. They remain non-market in that they do not generate profits, instead receiving most of their funding from governments and private charity. In 1993, NPM strategies were explicitly adopted in Alberta, a wealthy province and a continental leader in neoliberal experimentation.21 Results-based forms of public management were introduced somewhat later in the other two provinces involved in this study: 1999 in Nova Scotia and 2001 in British Columbia. In part, NPM and other performance-based managerial projects were introduced to respond to several real and manufactured crises in social welfare. For example, child welfare tragedies in Nova Scotia and British Columbia in the 1990s put provincial governments under considerable pressure to improve accountability and client care,22 while public and government discourse deriding and vilifying the poor set the stage for “welfare reform.”23 These much needed social welfare reforms could have taken any number of progressive directions, but governments in all three provinces chose to introduce contemporary, pro-market forms of work organization and NPM or NPM-like schemes that advanced the priorities of budgetcutting and pro-market rationality, and decreased client care and access. A wide range of quantitative performance indicators and management systems exist in social services agencies in Canada, originating at different levels of the management hierarchy. Some provincial governments have experimented with imposing quantitative funding formulae or service standards on publicly funded agencies (including both in-house public agencies and publicly funded independent agencies) through which funding grants to agencies are linked simplistically to the number of clients served. When an agency’s funding depends on a (narrow) measure of documented clients served, the agency’s operations can become skewed in various unintended directions; for example, some of the respondents in this study reported explicit or implicit pressure to screen the types of clients accepted on the basis of the likely speed with which they could be “serviced.” At the level of individual agencies, these quantitative approaches are then made more specific. Individual case workers are given stringent quantitative performance targets (for example, reference and collateral checks on a case file 200

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must be completed in under twenty minutes, regardless of the number of documents that need to be verified; a case worker must file all documentation, risk assessments, and reports on child welfare intake investigations within twenty-four hours of receiving an initial child welfare complaint). Typically, these are applied with little regard to the complexity of individual cases or to the caseload of the workers involved. In some agencies, the fee for service approach trickles down to the level of individual case workers, who may be paid according to the number of appointments completed.This provides individual workers with powerful incentives to screen their clients (screening out more difficult cases to reduce average appointment length and reduce the incidence of “no shows”) in order to enhance their income opportunities. It also transfers the risk and financial burden from agencies to individual case workers associated with missed appointments and other “disruptions” in the normal flow of client interactions. Financial and operational targets of this sort make it especially difficult for agencies or individual workers to address the unique, time-consuming needs of troubled clients who may require additional support outside of normal appointment times. Most of the research participants reported experiencing pressure from management to reduce the average amount of time spent with clients in order to meet unidimensional quantitative standards, which are often monitored electronically (for example, through computer programs which prompt case workers to complete various stages in client intake or other interactions within various prescribed time limits). The overall impact on social service workers of these quantitatively oriented NPM techniques is to reduce professional discretion in their work, and increase the intensity of bureaucratic or electronic supervision. The impact on the quality of care provided by these agencies is similarly destructive. NPM and other results-based management models borrow heavily from private-sector performance management models used in retail and sales work. In private-sector performance management, the practices of retail and sales workers with the highest sales numbers are recorded, and posted publicly and prominently.24 Other staff members are then coached to emulate the “best practices” that led to the high numbers. Similar to the retail world, in order to meet NPM target numbers in the social services managers are 201

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charged with coaching social service workers to emulate practices that generate the lowest cost figures and the highest numbers of processed cases. In order to achieve these targets, management control over the labour process necessarily increases, despite claims of worker participation and empowerment.25 As one manager of a mid-sized non-profit (in Alberta) put it, “empowerment — who has time for that?” Findings from the study analyzed in this article show that in the underfunded, overstretched social services sector, best practices coaching rarely occurs. Managers and workers agree that there is no time for it. Supervisors and managers involved in this study reported that funding cuts have seriously increased their workloads, resulting in a general lack of time in which to complete their regular work. This, in turn, means that irregular tasks such as performance evaluations and targetsetting are conducted at the last minute with little or no discussion with or among staff. Instead, new technologies have been introduced that permit work to be broken down into smaller components, routinized, and completed rapidly, making it more likely that target goals can be achieved or exceeded. Unfortunately, in this manner fragmented and standardized social service work is largely stripped of its caring content, although many workers struggle to carve out small ways to ensure that caring can continue to exist.26 These new technologies include computer-based case management and employee monitoring packages, and computer-based or hard copy check-box client need-assessment forms which dictate service options and the number of service hours clients are entitled to (given the scores they receive on the form). These quantitative tools have replaced face-to-face interaction, relationship-building, and custom-made intervention plans that characterized social work practice prior to restructuring. Face-to-face, supportive, troubleshooting supervision has been replaced by infrequent or e-supervision in which computers monitor and dictate the amount of time per task and the associated documentation, alerting managers when workers fail to meet time targets and other performance goals. Indeed, workers and managers reported that, rather than having best practices focus on the complex actions and emotions that go into providing productive care for clients, most best practices and benchmarks are nothing more than targets 202

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for the numbers of cases to be processed and the dollar figures attached to the time allotted for each case. In order to generate the numbers on which funding allocations are based, documentation and statistics-keeping functions have expanded exponentially under NPM and similar management models. One group of front-line workers in Nova Scotia reported that they were keeping four sets of statistics on every interaction with clients. This obviously leaves far less time to interact helpfully with clients and is the source of serious discontent among social service workers. Increasing their sense of frustration and alienation, the Nova Scotia workers had little or no information on who used the data, or for what purpose. Social service workers in each of the provinces involved in this study reported increased quantitative controls on their work including keystroke counts on computers; the monitoring of telephone calls for length and content; computer packages or flowcharts that dictate timeframes for tasks to be completed, as well as their order and content, and ongoing case audits and statistic keeping. Under optimal operation of NPM, these statistics would be analyzed and workers or programs that required improvement would be coached in best practices, while workers and programs that exceeded performance goals would set the new benchmark for others to emulate. However, there is a perverse incentive in non-profit and public agencies because meeting or exceeding benchmarks will almost inevitably lead to cutbacks and redeployment of resources. One worker with an unusually straightforward caseload was applauded for consistently coming in under her time allotments per case and was told that if this continued, a new benchmark could be established. Encountering a particularly difficult and time-consuming case, the worker was reprimanded for significantly overspending her time allotment. According to her, this veteran worker suddenly realized that her previous efficiency could and likely was being used to justify cuts to funding and services, as well as setting a standard by which she and other workers could be disciplined. It was at that moment that she began to try “to subvert the whole thing and turn benchmarks to our advantage so we can get more, not less, funding and time.” Many front-line workers felt bitter about standardized assessments and quantified care plans. They questioned who they were helping: 203

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There are assessments that need to be done on the computer, but when you look in reality, as a social worker, at what you are doing you say to yourself, “What is this really doing for the client who needs some help right now?” It’s more of a management tracking system ... than any help. It doesn’t speak to people’s needs and how we are going to get to meet them. (Senior welfare worker and union activist, Nova Scotia)

Standardized assessments that quantified care into small units were often compared to assembly line work, with the once-professionalized workers resenting the loss of decisionmaking power and control: The identifying issue might be the same but every person and family is different. We can’t treat them all like little chocolates on an assembly line. Each person needs a different level of care and I, as a social worker, should get to decide that level in conjunction with the client, rather than a stupid form telling me how I have to work with each person. (Community mental health worker, Nova Scotia)

Managers were also cognizant of the ways that the standardization associated with NPM contributed to deskilling. As one young manager noted, standardized risk assessment forms “can be completed by anybody, they don’t need a social worker in this job” (Manager of counselling, Nova Scotia). Or as a British Columbia welfare supervisor put it, “almost anyone who completed high school could walk through that door and do this job.” This has made it easier to transfer social services work to the constantly changing temporary, part-time, and casual workforce that is increasingly displacing full-time workers. It also means that it is easier to transfer the work to volunteers who form an increasingly significant portion of the social services labour force.27 While this is an unintended consequence of NPM and similar models, it is an outstanding achievement (from the perspective of management), as there are few things cheaper than a labour force that works for free. Many workers expressed acute discomfort with the lack of a meaningful voice for clients at any level of performance management or program delivery, questioning “whose needs are being served by this obsession with accountability — it sure isn’t the clients’, and it sure isn’t the workers’ or any of the rest of the average people out there” (Inner city addictions counsellor, British 204

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Columbia). Emphasizing holistic services with full community participation and accountability, research participants favoured the removal of standardized job content, replacing it with collaborative forms of intervention in which the workers’ expertise and resources are mobilized to help service users to meet mutually agreed upon goals. In this context, accountability would shift from “funders and taxpayers to service users and communities” (Housing worker, British Columbia). While NPM is not the focus of my research project, it is interesting to note that, ironically, NPM has not been wholeheartedly adopted within the privatized sections of the social services. Instead, it operates mainly in the remaining public and non-profit social services, such as child welfare agencies. These agencies receive the majority of their funding from government and operate within very restricted and detailed government mandates and standards. Anecdotal evidence suggests that the costs associated with ongoing self-study make NPM too expensive, time-consuming, and cumbersome for the for-profit social services. Most have resisted its implementation, even in cases where private agencies receive most of their funding through government contracts from governments using NPM within their own services. Indeed, the unending requirement for self-study, statistics-keeping, behaviour coaching, and documentation is the main reason that the integration of performance management and other NPM-like models into the public and non-profit sectors has been slow and has assumed a hybrid form that emphasizes standardization and deskilling, rather than the much-touted benefits of worker empowerment, high performance, and multiskilling. Resistance As noted earlier, a perverse incentive exists in public and nonprofit services because increased efficiency and performance does not result in increased profit. Instead, higher benchmarks mean higher caseloads, shorter turnaround times and, often, funding cuts. Hence, as soon as social service workers start to understand the connection between benchmarks, increased caseloads, and decreased funding, they encounter dilemmas regarding their personal and professional ethic of care, as well as professional conflicts regarding job content in which their professional judgement is replaced by standardized scripts, performance targets, and highly detailed, 205

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fractured, step-by-step processes. Performance management cannot work without buy-in or participation from employees. Performance management has had mixed success in retail because it is difficult to coach and engage a constantly changing low-paid, temporary, and part-time workforce. Indeed, a number of retail chains have entirely abandoned or significantly modified performance management strategies. For social service workers, the overlap between caring and professional discretionary power forms the crucible for worker discontent and resistance. The workers involved in my study used two major types of strategies to resist the narrow quantification of care — general and specific. As Abu-Lughod notes, workplace resistance does not always, or even exclusively, result in an increase in worker power; in many cases, it may cause a decrease, reflecting “the ways in which intersecting and often conflicting structures of power work together.”28 The general resistance strategies employed by the workers involved with this study reflect this complexity: their strategies provide a way to renegotiate control and meaning in the workplace29 while simultaneously deepening the exploitation of workers by extending hours of work with no increase in pay or benefits. Reflecting their central focus on caring, many social service workers felt compelled to take on extra unpaid work in the form of overtime or volunteer work, often in their own workplaces, in order to extend the capacity of an increasingly narrow and punitive social service system.30 Recognizing the retreat of social provision and the hardship this creates for many clients, one long-time social service worker regularly undertook unpaid overtime and noted that “people are desperate and need that cheque; they can’t wait until tomorrow or the end of the weekend” (Welfare worker, Nova Scotia). Lamenting the “loss of our vision of what social work is supposed to be and who it is supposed to serve,” another front-line worker performed many hours of unpaid overtime every week in order to add “some decency” to her job (Mental health counsellor, British Columbia). In contrast to the individualism that underlies neoliberalism, another front-line worker explained her unpaid overtime work by arguing that “it’s people’s right to have this service even if the government seems to have forgotten that” (Mental health worker, Nova Scotia). While undertaking unpaid overtime 206

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and volunteer work, many workers felt conflicted about this resistance, wondering whether they were “helping the system stay afloat” when they should be “helping to bring it down” (Child welfare worker, Alberta). In terms of specific resistance strategies, workers used whatever discretionary power they still had to produce the outcome numbers they felt were most advantageous for them and their clients. Research participants reported faking statistics and time/motion studies. They also “forgot” to complete certain forms that strictly dictated service units, and completed other forms in ways that ensured the outcomes desired by the workers, not the performance targets. Workers also deliberately slowed and lowered their performance in order to lower or retain existing benchmarks. In effect, best practices lower the bar on social service workers’ performance, reflecting that which the workers could still achieve through resistance within a standardized, deskilled system instead of the best of what highly skilled, interactive, social caring has been and could be. As noted earlier, many social service workers have tried “to subvert the whole thing” in order to use the quantification of work and service to expand funding and opportunities so that workers can practise social work in less restrictive ways and downplay, in whatever ways possible, the new “performance” of social services work. Conclusion The reality that many benchmarks reflect consciously lowered performance undermines the claim that NPM and similar models increase efficiency or output. Ironically, the direct costs associated with NPM seem to indicate that even private social service agencies are resistant to adopting it. Instead of promoting improved quality and public accountability, quantitative metrics in the social services expand bureaucracy and contribute to the standardization of work and the deskilling of the workforce, thus paving the way for increased reliance on low-wage, temporary, and unpaid workers. With ingenuity and insight, workers can turn, and are turning some of these measures to their own ends. Yet, despite worker resistance, client care and the quality of services decrease under these management models. Instead of saving costs, increasing accountability, or enhancing performance, the introduction of NPM and other quantitatively oriented performance management schemes meets ideological goals. They make it clear that public 207

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and non-profit services are no longer operating on non-market logics of social caring or meeting human needs. Instead, social services are run on narrow, market-compatible management schemes, even if those schemes contradict the ostensible market goals of efficiency and productivity. Notes 1. E. Lightman, Social Policy in Canada (Toronto: Oxford University Press, 2002). 2. D. Martin, “Demonizing Youth, Marketing Fear: The New Politics of Crime,” in J. Hermer and J. Mosher, (eds.), Disorderly People: Law and the Politics of Exclusion in Ontario (Halifax: Fernwood Publishers, 2002), pp. 91–104; J. Mosher, “Managing the Disentitlement of Women: Glorified Markets, the Idealized Family, and the Undeserving Other,” in S.M. Neysmith, (ed.), Restructuring Caring Labour: Discourse, State Practice, and Everyday Life (Toronto: Oxford University Press, 2000), pp. 30–51. 3. J.F. Dent, “Accounting and Organizational Cultures: A Field Study of the Emergence of a New Organizational Reality,” Accounting, Organization and Society 16/8 (1991), pp. 705–32. 4. D. Baines, “Caring for Nothing: Work Organization and Unwaged Labour in Social Services,” Work, Employment and Society 18/2 (2004a), pp. 267–95; B. Mullaly, Challenging Oppression (Toronto: Oxford University Press, 2002); B. Carniol, Case Critical: The Dilemma of Social Work in Canada (Toronto: Between the Lines, 1987). 5. Canadian Policy Research Networks (CPRN), The Non-Profit Sector: Struggling to Make Work Pay (Ottawa: Canadian Policy Research Networks, Inc., 2003); Carniol, Case Critical. 6. B. Mullaly, Structural Social Work: Ideology, Theory and Practice (London: Oxford University Press, 1997); Mullaly, Challenging Oppression; R.A. Cloward and F.F. Piven, “Notes Towards a Radical Social Work,” in M. Bailey and M. Brake, (eds.), Radical Social Work (New York: Pantheon Books, 1975); D. Baines, “Everyday Practices of Race, Class and Gender,” Journal of Progressive Human Services 11/2 (2000), pp. 5–28; Carniol, Case Critical. 7. A.L. Strauss and J. Corbin, Basics of Qualitative Research: Grounded Theory Procedures and Techniques (Newbury Park, CA: Sage Publications, 1990). 8. H.J. McCammon and L.J. Griffin, “Workers and their Customers and Clients,” Work and Occupations 27/3 (2000), pp. 278–93; E. Reiter, “Life in a Fast-Food Factory,” in C. Heron and R. Storey, (eds.), On the Job: Confronting the Labour Process in Canada (Montreal and Kingston: McGill-Queen’s University Press, 1986); R. Leidner, Fast Foods, Fast Talk: Service Work and the Routinization of Everyday Life (Berkeley: University of California Press, 1993); S.H. Lopez, “The Politics of Service Production: Route Sales Work in the Potato-Chip Industry,” in C.L. MacDonald and C. Sirianni, (eds.), Working in the Service Society (Philadelphia: Temple University Press, 1996). 9. McCammon and Griffin, “Workers and their Customers”; MacDonald and Sirianni, Working in the Service Society. 10. Reiter, “Life in a Fast-Food Factory.” 11. A.R. Hochschild, The Managed Heart: Commercialization of Human Feeling (Berkeley: University of California Press, 1983). 12. C. Boyd, “Customer Violence and Employee Health and Safety,” Work, Employment and Society 16/1 (2002), pp. 151–69; Hochschild, The Managed Heart; R.J. Erikson and C. Ritter, “Emotional Labour, Burnout, and Inauthenticity: Does Gender Really Matter?” Social Psychology Quarterly 64/2 (2001), pp. 146–63; D.L. Deadrick and R.B. McAfee, “Service with a Smile: Legal and Emotional Issues,” Journal of Quality Management 6 (2001), pp. 99–110. 13. C. Baines, P.M. Evans, and S.M. Neysmith, Women’s Caring: Feminist Perspectives on Social Welfare (Toronto: Oxford Press, 1998). 14. Baines, Evans, and Neysmith, Women’s Caring; P. Herd and M.H. Meyer, “Care Work: Invisible Civic Engagement,” Gender and Society 16/5 (2002), pp. 665–88; N.Y. Glazer, Women’s Paid

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16. 17. 18.

19. 20. 21. 22. 23. 24. 25.

26. 27. 28. 29. 30.

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