The Cambridge-Somerville Youth Study was built on a speech. In 1940 its director wrote that “many of the ideas expressed by him in his presidential address in 1931 at the National Conference of Social Work have been incorporated in the basic philosophy of the Study,” and the speech survives in the conference’s printed proceedings, twenty-two pages under the title “Treatment in Social Case Work and the Need of Criteria and of Tests of Its Success or Failure.” Richard Cabot gave it at the fifty-eighth annual session, held in Minneapolis from June 14 to 20, 1931, as the conference’s president. What follows is what he said, in his order and largely in his words.

Diagnosis second

He began by quarrelling with the profession’s founding book, Mary Richmond’s Social Diagnosis of 1917, and with the Massachusetts Commissioner of Correction, who had said the year before that “the proper way to handle the problems of human beings is first of all to find out what is the matter with them.” Cabot challenged that. “It is often better, I believe, to find out, first of all, what-is-not-the-matter, what is sound, what the client can build on—his assets.” Even in a hospital, he said, “Many a patient recovers without the luxury of a diagnosis.” He quoted the superintendent of the Norfolk Prison Colony, who in interviewing prisoners “did not always inquire much into their crimes but tried first to make friends and then to find out their strongest and most available interests.” That, Cabot said, was treatment begun at once, “on the very different social hypothesis that the most helpful thing to do is to strengthen, if we can, a man’s strong points and to establish, first of all, a friendly relation with him.” The sentence that the Youth Study would be built on is here: “Not a diagnosis but a friendly relationship is the thing which we try to establish if possible, at the start.”

He then attacked the search for causes. To look for “the cause” of what is most characteristic in a person, he said, “is as much a wild goose chase as to look for perpetual motion. It is also an insult and, therefore, a bad way to start a relationship which is friendly or else a failure.” A client who finds that he is being managed “senses the attempt to ‘manage him,’ to manipulate him and his ideas without his free action,” and resents it as anyone would.

The granite fortress

The fourth section is the one people remembered. Richmond had defined case work as the processes “which develop personality,” and Cabot asked whether the profession had faced how hard that was. “The community still spends money for institutions called ‘reformatories’ which until recently we were induced to believe reformed 80 per cent of the delinquent personalities sent there by the courts, in utter ignorance of whether the delinquents were benefited there or not.” Sheldon and Eleanor Glueck’s Five Hundred Criminal Careers had shown “not 80 per cent of success but 80 per cent of failure” at the Massachusetts Reformatory at Concord, “probably one of the best institutions of its kind in the country.” A study of “one of the best known private case work agencies in Boston,” about to be published, showed 88 per cent of failures.

Was that bad? He did not know. In cancer of the stomach, 12 per cent of cures “would be an unheard of, an unexampled victory over the disease.” Success “depends on the ratio between the resistance of the evil to be attacked and the strength of the methods of attack,” and the methods of attack on delinquency were imprisonment with regular hours and shop work chosen without reference to the man, and then parole under officers “burdened with an impossibly heavy case load.” “What is the pea-shooter?” he asked, and answered with that. Given the pea-shooter, 20 per cent of success “seems to me a surprisingly good showing.” And he was glad the fortress held: “Human society would soon be in a hopeless mess if human character were of such a flabby texture that it could be easily molded by whomever thinks he knows how. When I consider the number and quality of quack remedies now offered for the ‘development of personality,’ I thank God for the relative toughness and slow-yielding quality of most human characters.”

What impressed him was that the Gluecks had applied to five hundred men “the difficult but satisfying test of ‘end results after five years,’” and that almost no case work agency had done anything of the kind for itself. Since 1923, he said, every meeting of the conference had shown “an uncomfortable awareness that we do not know our results, though we tell the public that they are good.”

What can be measured

He conceded at once that “many of the best things in human life cannot be measured”: religion, art, love, friendship, much of education. But an agency that asks the public for money on the strength of what it has accomplished must find, “side by side with the imponderables, something that we can evaluate and, to that extent, can measure.” A footnote said what he meant by the word: “To evaluate successful and unsuccessful cases by some clearly stated tests and to count them is what I mean by ‘measurement.’” The physician’s presence at the bedside cannot be weighed, “but we can weigh the patient.” The surgeon’s satisfaction in a perfect operation cannot be measured, “but we can count how many of these successful operations were followed by post-operative pneumonia or by death.”

His model was the Gluecks’ yardstick. They had said in advance what would count as success in the five years after release: no law-breaking, a steady industrial record, satisfactory family life, satisfactory use of leisure, each defined in words that a reader could argue with but could not mistake. None of it was objective in the sense of a machine timing a sprinter; “especially wholesome” family relations were someone’s judgment. “But the vast majority of all scientific data are obtained in the same way.” “In these statistics, as in all statistics, the important sources of error are not in the calculations themselves but in the individual judgments which precede the statistical calculations.” And then the hope that the Youth Study would try to meet: “My hope is that social agencies will begin to make more of these fallible judgments, to expose themselves more often to the dangers of statistics, to the risks which come to light when we announce and apply the criteria by which we believe that our success or failure should be judged.”

Time

The seventh section is about waiting. Few evaluations, he said, had let “a reasonable period of time” elapse and then judged by “a fresh study of the situations and personalities involved.” Lee and Kenworthy’s child guidance results had been taken a few months after the cases closed, and the authors already regarded some successes as failures. “It is always hard to find ‘successful’ cases that will stay successful until the report is printed!” Medicine had learned the cure-period of its diseases, the three-year cure in cancer, the three months after which typhoid will not return. “But have we learned, by patient follow-up, the cure-period of most social evils in social case work?” For stealing, he guessed, three years was probably as reliable as in cancer. “All these statements lack statistical backing. It can hardly be obtained by a study of records alone. The follow-up of closed cases is called for.”

The dangers of measurement, and of not measuring

He quoted a letter from John M. Glenn of the Russell Sage Foundation: “I really think it is dangerous to try to apply tests in this field.” Cabot took the warning seriously and set it aside. “But that evaluation is dangerous is nothing against it. Non-evaluation is certainly at least as dangerous. We face dangers wherever we turn and especially if we do not turn at all.” A one-sided yardstick could deform the work, as hospital superintendents eager to empty beds hurried patients into relapse; so the goals had to be stated at the start, by the worker herself, “in such a form that the yardsticks cannot deform the work.”

The parallel series

The ninth section answered the objection “that no agency can estimate the degree of its success or failure because no single agency governs the life of a client,” who “is played upon by innumerable influences—climatic, economic, hereditary, domestic, educational, hygienic or unhygienic, recreational, sexual, civic, religious.” Cabot granted the premise and refused the conclusion. Agencies did try to solve problems in individual lives, and did ask the public to pay for it, “and so long as public and private agencies ask for financial support they cannot heed the objection that no one is responsible for good results or bad results because so many causes enter into each.”

Then the sentence. “Pending the much-to-be-desired epoch when we shall control our results by comparison with a parallel series of cases in which we did nothing, we must admit that we may not be responsible either for our successes or our failures. Meantime, it is just as important to record the proportion of supposed successes and our reasons for calling them such.” And: “we can count the failures even if we cannot assign blame for them, and, if the proportion of failures is large, it will still be proper to ask whether the work was worth while.”

Why so few

Why had so few agencies tested their results by following up? Three reasons. Follow-up was expensive: the Gluecks’ five hundred cases had cost $15,000, “or $30 a case,” and finding over 90 per cent of the people you were looking for would always cost that kind of money. The agencies were busy. And “it is very uncomfortable to do so much thinking about our standards and goals as is necessary before we can begin to inquire about results.” Against that he set what testing would bring: confidence and “peace of mind” for the workers, a public better satisfied with its investment, the deserving agencies more easily told from the rest, and, “lastly, and of most importance,” clients “better served by a profession more aware of what it is about.”

He ended with the proper proportion of attainable objectives in a year’s work, and with the warning that an agency should know when it was on a desperate venture, like the morphine habit in the underworld, and, “at the other extreme, when we are ‘curing’ ills that would probably cure themselves about as well without us.”

Four years later the Ella Lyman Cabot Foundation hired the counsellors and the home visitors, and the parallel series of cases in which they did nothing was 325 boys long. The entry tells what it heard.

Sources

• Richard C. Cabot, “Treatment in Social Case Work and the Need of Criteria and of Tests of Its Success or Failure,” presidential address, Proceedings of the National Conference of Social Work at the Fifty-eighth Annual Session Held in Minneapolis, Minnesota, June 14 to 20, 1931, University of Chicago Press, November 1931, pp. 3 to 24. Every quotation above; the “parallel series” passage is on p. 19. archive.org
• P. S. deQ. Cabot, “A Long-Term Study of Children: The Cambridge-Somerville Youth Study,” Child Development 11, no. 2, June 1940, pp. 143 to 151, for the address as the source of the study’s philosophy. archive.org
• Sheldon Glueck and Eleanor T. Glueck, Five Hundred Criminal Careers, Knopf, 1930, the study Cabot was quoting, as he describes it.