Social workers’ construction of “family” in Cuban context: Ideas for a debate

This paper presents preliminary research about the process of the construction of concepts in social work. In this case, it is referred to as a social worker’s construction of “family” as a concept and as a field of practice in a current Cuban context. Based on an exploratory and qualitative research design, the paper presents an analysis that also opens to the discussion about social work with families in Cuba. The findings shows that Cuban social workers think of family as a group with cohabitation and affinity, which is more important than consanguinity, as a dimension for family definitions. They also point at structures of family, special bonds in family network and the social internal and external functions of family in their definitions. Among these functions, the transmission of cultural values, as well as the emotional support and shelter for members, seems relevant. Regarding family as a field of practice, they all share the criteria that is necessary for practice to develop a contextual analysis of each situation that goes from macro-contextual aspects to the micro-reality of family. The importance of structural matters and their impact on family functions is also a common idea, which is nucleated around a multigenerational reality of Cuban families and evaluated as a positive or negative impact depending on the case in question. They consider social work with families, and social work in general, to be in a critical situation in relation to losing professionalization and social recognition. The reasons explaining these ideas have to do with the instability of social work institutionalization and the recent retraction of social services. These variations have obeyed the changes in a Cuban context that affects the entire welfare system and social work’s position in it.


Introduction
The relationship between State, Family and Society has been traditionally "solved" by social policies, and has constituted a fieldwork for Social Work studies and practice.Within this frame, social work has been seen as a mediator and an expression of the general principles of social policies.It also operates under an ethical and ideological conception that gives it support.Based on this, changes in a social and political context affect social work organizationally, institutionally and practically.
In Latin-American societies, the familiarization of welfare promoted by a neoliberal adjustment, both during and after the 1980s, positioned social work with family in a contradictory picture.Familiarization refers to the extension of the family responsibility for solving welfare needs in a specific welfare regime.Juliana Martínez affirms that Latin-American familiarism is represented by a high proportion of families that became productive units and/or social protection networks (Martínez, 2008).The extension of mercantilism in welfare (Esping-Andersen, 1998, pág. 3), in addition to decentralization, and focalization, placed social work in a context of reduced resources for family programs, but with increasing social demands and unsatisfied needs.The tendency towards less State involvement in welfare meant the partial or total transference of State responsibility towards other private actors (enterprises, NGOs and communities); decentralization provoked a reorganization of social and public services, thus increasing the responsibility of local governments and institutions, while focalization implied a change for the aims and targets of social policy, from the citizen as a beneficiary by civic rights, to the family/groups or areas at risk as a strategic goal.
In the Cuban case, today's conditions for development are set in similar circumstances, although moved by different interests than those which motivated the adjustment in the Latin-American region.Both contexts have experienced a retraction of the State's responsibilities with welfare and a tendency to familiarize the social welfare regime (PCC, 2011, págs. 14, 25). 1 Inside the political discourse, the interests that move the recent Cuban reform are connected to the necessity of the economic sustainability of the State and social redistribution.It is also supposed that it will enhance the projection of development toward the next years.However, it is possible to say that the challenges are similar to those the region is still facing regarding the long-term effect of such an adjustment into the social development.
Of course, the intensity of these impacts is not the same for both.But in the same contradictory way for both Latin-American reality and Cuba, the rise of the family role in the access or limitation to welfare also comes together with the lack of family vision in Social Policy designs (Donati, 2008), (Durán, 2010, pág. 81).Although some recent experiences in the region have implemented some programs and policies with a family orientation; still, they have not radically changed the situation described here.
In between, Cuban social workers face multiple pitfalls and challenges, framed by disarticulated institutional mechanisms.Social work is called to transit towards a practice that has to be updated with the reinforcement of family responsibilities.But it creates problems in various dimensions: in the objective possibilities professionals encountered when they developed interventions with families in communitarian levels, and in the subjective representations of their work constructed by practitioners, institutions and society.
Regardless, in relation to the importance of this situation for the development of social work as a profession, and for the Cuban welfare system in general, there is not enough scientific production about what are the positions, opinions and reflections that Cuban social workers have about these problems and their own practice.As formal social work has recently declined in its position in social welfare, some issues such as how social work builds its practice upon the changes and the new situation seem to be neglected.
In the case of social work with the family, it is important to develop an approach to those meanings and experiences that social workers share.Such knowledge could be interpreted as the starting point of their professional performance, as it clarifies the perspectives that social workers implement, or think to be valuable for their practices and interventions in families.At the same time, it would contribute in some way to the discussion about the conditions they face in their daily practice, in today's context of relationship between the State, social services and family.
Following this logic, the current paper will introduce the main results of preliminary research.2whose general objective is: to analyze the construction of "family" as a concept and as a field of practice that a group of Cuban social workers develop in a current context.Due to the nature of social work as a scientific discipline and a practice-oriented profession, the construction of a concept of family brings with it direct bonds with their professional performance.These bonds are bidirectional; this is why it is highlighted in the general aim, with the definition of family as a field of practice being a necessary aspect of the analysis.
The relevance of this inquiry is, first of all, related to an epistemological matter by which a certain type of knowledge in social work is constructed and sustained in specific contexts.In the second place, this study would define the positions from which practitioners in Cuba can actually project a new performance in the mediation between Cuban Social Policy and the family.These arise in a context in progress that has implied changes in the strategies for Cuban development since 2010.From this year, and after a popular consultation, it was launched by the government and the Communist Party as the New Lines for Economic and Social Policy.Its 2011 documentation is legitimated from the political institutions, a set of transformations in the relationship between State/Society and individuals/families.The structure of this paper follows a line from theoretical, methodological and contextual frames to the expositions of the research's main analysis and findings, closing with conclusions and analytical considerations based on the results.

Basis for explaining the construction of family in social work
The construction of concepts is a basic process in the development of scientific knowledge.This procedure takes place by the delimitation of a significant word, and by the definition of its meaning.Definition, or meaning, refers to the isolation of each phenomenon of the reality and its particularities.As a result, concepts only make sense when they are defined, becoming the bricks of theoretical structures sustaining general social and scientific actions in specific contexts (Turner, 1978).
In this case, the analysis of the family concept constructed by a group of social workers focuses on the definitions of the family they build, the dimensions and contents they use to isolate "family" as a part of reality and its relationship with a set of other concepts that provide sense to their knowledge construction.The definition of family as a field of practice has to do with the particularities that social workers conceive for family as an "object" of social work intervention that concerns the ways they use to approach to it, the difficulties and variables they consider to take into account and the influence they think their scenarios bring to practice (scenarios refers to the institutional environment of social services).
Traditional approaches to family define it as an institution or as a social group.The institutional perspective considers family as a subsystem integrated into the general social system.This tradition often conceives family as a nuclear structure (parents and children), and it affirms that family accomplishes social functions for both society and for subsystem members (Parsons & Robert, 1955, pág. 39).The social group approach considers family as being based on the relationships and bonds created and supported by its members' interactions.It opens family conceptions to a communitarian approach centered in relationships rather than in consanguinity as the unique nature of family linkages.
If the contradictions between both perspectives have mostly been overcome in social sciences today, it is still interesting to discuss the perspective professionals defend in their daily practice.Specifically for social work, the integration of these theoretical lines becomes central in the conception of family.Although some assume a more communitarian (social group) perspective (e.g.(Fleck-Henderson, 1998), the use of an institutional perspective is quite significant in social work practice.Along this line, a great number of studies, e.g.(Lietz, 2006 ) and (Blitz, Kida, Gresham, & Bronstein, 2013) use a systemic approach to analyze family functionality, and its relationship with other subsystems in society, especially social services.
Social work has been worried about how to conceive of family.With a rich production in this field of practice and analysis, social work conceives of family as a "wide range of associations, many of which do not fit the traditional two-parent family image.The growth of single-parent families as well as families headed by gay and lesbian partners, as examples, has broadened our understanding of the concept of family" (Shulman, 1992, pág. 209).
Following Shulman (Shulman, 1992, pág. 211), "There are a number of factors to be taken into account when working with families.For example, families have a history that goes back many generations.Family members over many generations, dead and alive, can often have an impact on the nuclear family in the present.(…) There is a power differential between family members."These references highlight the complex dynamics of social work with the family.This is why in recent years, the complex systems analysis has provided social work with a better understanding of family dimensions (Guerrini, 2009).While these analyses seem to have a great tradition in international social work practices, in the Cuban case practitioners do not count on a study that focuses on the ways they construct their perspectives about family.
Addressing these issues, this research attempted to answer a general question: How do Cuban social workers construct "family" as a concept and as a field of practice in the current context?More specifically, it is interesting to know: What are the main characteristics of family that social workers define, and how do they face social work with family?What are the main differences and similarities in the process of defining family as a concept and as a field of practice, and what contradictions appear?As can be seen, the comparison here will be related to the identification of two main lines of social work development.One of them is linked to Health Schools of Social Work, and another developed by Emergent Schools of Social Work born in the Communist Youth Union.
Other questions are: How are scenarios for practice and educational backgrounds taking place in the construction of the family that these social workers develop?How do the analyzed opinions represent the challenges and difficulties for social work with family in a Cuban context?These problems move in the world of ideas and meaningful constructions in relation to the context in which they take place.Some studies (Healy, 2005) have inferred that practice environments shape social work based on a theoretical ground that includes philosophies and ideas, expectations and other factors.
One probable way for approaching these topics could be the internalistic perspective of a sociology of knowledge.It has as a first statement that knowledge is a social fact, which means that it comes from a specific social context and that subjects are concrete and historical.The internalistic perspective focuses on the frames and contents of ideas by keeping the analysis on the intellectual environment of their production and validation (Espinoza, 1994).In this case, the central debate on the level of concept definitions, as a result and base for a specific professional environment, makes this perspective not only useful but necessary.

Methodological approach for understanding the construction of the family concept
Qualitative methodology concentrates the analysis in the narratives and meanings of social workers' attributes to the topic of research.This is why it has been chosen as the analytical way to carry out the study.It allows an approach to the ways in which professionals´ imagination, opinions and common sense are constructed and supported in fieldwork (Carreras-Zamacona, 2002).
For this reason, the methodological strategy of this research was formed by group interviews with social workers, representing different social service programs and institutions.This strategy helped to facilitate the observation at the time of interviewing and the discourse analysis of the transcripts.As introduced, the units of analysis were professionals related to social work with the family in communitarian service systems.
The sampling procedure was intentional, and based on a selection of exemplary individuals combined with a structured sampling (taking into account the two main branches of social work in the country based upon education and institutional scenario for practice).One branch has a health educational background with a trajectory inside the programs of the Health Ministry's social services system in the communities.The second one comes from the Emergent Social Work Program now associated to the Work and Social Security Ministry.Representing these branches, five were interviewed in the first group interview and six in the second one.More specifically, the first group (Health System) was formed completely by five women (thus representing the feminization of the profession in traditional social work), with every social worker having a professional experience of more than 15 years.The educational background in this group was from the Health System Technical Schools, and one of them had finished a bachelor's degree in sociology with a specialization in social work.The ages were between 40 to 50 years old.
Although the majority were women (four out of six), the presence of men in the second group shows their involvement in the Emergent Program, and with this the social objective the program was accomplished.These social workers had approximately seven years of experience in fieldwork at the time of interview.All of them were finishing their bachelor's degree in sociology with a specialization in social work, and they were between 25 to 30 years of age.
Due to the lack of previous studies regarding social workers' construction of concepts and fieldwork "objects" in Cuban social sciences, the selection of just two groups responds to the possibilities of an exploratory qualitative research design.This kind of design is more preoccupied by the analytical relevance of the findings than in its statistical validation (Sautu, Boniolo, Dalle, & Elbert, 2005).
The interviews were semi-structured and adjusted to the scenarios of each group interviewed, looking for the same kind of discussion about the topics of research.In general, group interviews took an entire day of work.In each group, the participants knew each other from before, thus making the interaction between them and the organization of discourses easy.As part of a major comparative research, the instrument used for the interview was actually oriented to the discussion of a vignette regarding one social work case.A number of tasks referring to the case indicated that social workers discuss their own contexts and concepts of social work with family.Example Task 1: The focus group members present to a foreigner how they understand the concept of "family" in their country, and how they usually work with families in social work, and in particular in child welfare work (see (Nygren & Oltedal, 2011).This is why the analysis of data corresponded with a semi-closed code analysis.Based on Patton (Patton, 1990, págs. 40-45), this interpretation of data followed an inductive and holistic perspective.No previous expectations of preconceptions were explicitly a guide for the research, whereas the process under study was conceived in the interconnections with other complex issues.In this process, transcripts of each interview were reviewed, looking for semantic and meaningful constructions of key words such as family, institutions related to interventions in the family, protocols and institutionalized mechanisms for social work with family, among others.All these were done in connection with the various professional backgrounds and areas of practice.
Based on the analysis of a few individuals' narratives, this research is not statistically representative but instead analytically relevant since it is the first approach of this kind made to social workers' concepts of construction in the Cuban case.Because of that, the findings should be understood as being suggestions for future intense research.For a better understanding of the cases and conditions of the study, a brief description of Cuban social work development would be presented in context, in addition to referring to the more recent transformations after 2010.Nevertheless, after 1990, with the debacle of the Communist bloc, Cuba lost more than 85% of its international economic exchange and commercial partners.This situation, together with internal limitations of the national economy, made the country face the biggest economic crisis in the history of Revolution.The main consequence of this crisis, which has yet to be fully overcome, was a fast decrease in the material living conditions of the Cuban population (Ferriol, Alvarez, & Therborn, 2004).This context of economic crisis in the 1990s, and the limited performance of formal welfare institutions, also shined a light on a latent transformation in the relationship between Family and State.It meant that economic growth could not actually sustain the structure of the current welfare system.

A research in its context
After this period, although the universalistic social policy system remains, the tendency to familiarization is becoming not only informal and extended, but also formally induced by the State.The new lines for social and economic policy in Cuba are formalizing the reconfiguration of the relationships between the State and Family, as it was traditionally appointed.It means that family is formally gaining responsibility in the provision of welfare due to the retraction of subsidies and other traditional benefits from the State (Peña, 2014).
The fundamental dilemma of this tendency to familiarization is related to the nonexistent adequate infrastructure that supports the taking over of family responsibilities.Besides, other contradictions have been originated in the increase of inequalities that diminishes the possible achievements of the universalistic model of social policy.

The situation of social work: Education and institutionalization
In the Cuban Revolution, social work has followed an intermittent path.During the 1960s, it disappeared as a profession and remained as just a specialization from the Cuban Women's Federation (FMC), and was developed by volunteers in the To develop communitarian projects in disadvantaged neighborhoods (translation by the authors of a set of lines defined in the Ecured website (Ecured, 2015).
For both cases, a field of action related to family has been formally conceived, but it is still too general in its nature.Actually, these quotations show the prevailing contradiction brought by the new roles that social work and family have been called to play since the 2010 reforms in the social welfare regime.An unresolved question should be the role that social work would have to play in the new situation in order to empower families.However, it is logical to think that because there is an intention of relocating social policy towards a more familiaristic perspective, it would also be necessary to relocate social work practice in the new social demands.
In this complex context, and with so many changes and challenges for family and social welfare, it is important to know the concepts that social workers build of family, in addition to the ways that they imagine and face their daily work with family in their respective institutional frameworks, Health System or Emergent social work.

Social workers definitions of family
As has been previously said, two group discussions were conducted to incite social workers to express and discuss their concept of family and other related topics.
During these sessions, practitioners were asked to define what they consider a "family" to be.
Both groups set the idea of Family as a "basic cellule of society," which tends to revolve a main concept that could be identified as a "professional perspective": "Family is the first or primary social group, where cultural traditions are transmitted from parents to children and so on, during the vital cycle and development of family.
Traditions, beliefs, habits and values are conserved and transmitted through family" (social worker from Emergent Social Work School); "Family is a group of people with consanguineous linkages at different levels.And we may not limit this group only to blood, because we have reconstituted families that have a stepfather, for example, and they function harmonically.But I think the idea of living together is also significant" (social worker from the Health System).These types of definitions were common despite the social work branch they represented.
In analyzing these concepts, it is interesting to pay closer attention to the dimensions they use to construct definitions, as well as what aspects are included, potentiated or eluded in these statements.As can be seen, definitions are pointing to structures of family, special bonds in the family network and the social internal and external functions of the family.Hence, they all are mixing the two lines of understanding family, and they are closer to the general ideas presented by Shulman (1992) and others regarding family in social work.
Consequently, regarding the structure and bonds of family, definitions establish an open structure not limited to consanguinity.In this matter, classic definitions are combined with a more contextualized and contemporary shape, size and configuration of a family.Definitions include but transcend the traditional idea of the family as a nuclear procreation unit, and take into account the reconstitutions of family and the possibility of not being related to descendants, but rather to affinity or cohabitation.They also distinguish the possible differences in family based upon the number of members.Nevertheless, when they speak about unions, this structure continues to be linked to a heterosexual unification.In general, they combine the biological principles of the traditional idea of family with other mechanisms such as social functions that diminish the role of consanguinity: "When they have to solve a problem, they care and they help members to live in society" (social worker from the Emergent Social Work School).
So, beyond structures, it seems more important to social workers to emphasize the functions of family as a strong pillar of definitions.In this sense, the expressions were clear and combined the actions of the family as a socialization group supportive and providing shelter for the members, with the functions family accomplish for society in general (transmission of the basic foundations of culture).
It is possible to appreciate that ideas are very similar among all the interviewees; in fact, there were no important differences found in conceptualizations of the family based on background or scenarios for practice.
In particular, due to the significance of these definitions for social workers performance in society, to relate them to a broader and more operative perspective about family as a field of practice constitutes an important step in the analysis.

Family as a field of practice: What to take into account for family interventions?
The issue of family as a field of practice places aspects for the analysis such as how On the other hand, social workers from the Health System refer to an intervention with families that highlight: 1) the trajectory of the family (history, background, biography, cycle); 2) a familiar and communitarian context; 3) the ways in which the structure of family affects its functionality; 4) the request or necessity that it is expected for social work to solve: "We also have to see the problem that makes the family come to us asking for help." If we compare the main ideas in each group of social workers, just a few differences appear.They share the criteria of a practice oriented to a contextual analysis of the family situation that goes from macro-contextual aspects to the micro-reality of family, while the importance of structural matters and their impact on family functions is also a common idea.
Nonetheless, social workers from the Emergent Program introduced the intention to overcome the traditional separation between professional and common sense knowledge, rearming the importance of "clients' perceptions of their own reality for the social work profession.Another significant disparity is that social workers from Health System programs tend to refer a family that goes asking for help to a designed service in a specific institution: "For us, the explanation of the family environment is critical for understanding the case we receive" (social worker from the Health System), whereas social workers from the Emergent Program refer to a family that has to be identified, a family that has to be addressed, so they have to go to the family and say: "We have to detect the problem" (social worker from the Emergent Social Work School).This specific question is expressing the impacts of practice scenarios, more than backgrounds, in their connections with the abstract and concrete perspectives of the family as a field of practice.

Role of family and professionals in social work with the family
Concretely, social workers interviewed from the Health System consider family as a resource for some attention to the problems that may affect any of the members.
There is a shared perception in this group that family has to be seen as an agent for change, not only to the intra-family level, but also to the community level in a broader sense.They give the family the theoretical capacity to influence society, and not only the condition to be affected by it: "Family is a support network for the patient; we try to raise its functions as a system to such a degree that we involve family in the treatment.With a family collaboration, we have feedback and reassess the results and improve the process of healing." This notion of family as a resource was emphasized more by social workers from the Health System, while social workers from the Emergent Program share a vision that does not deny that notion, emphasizing the family more like a part of the problem that originated the intervention: "For example, in a family with a member in need, very often you will find that other members are also dysfunctional, e.g.alcoholism, no study or work for children or adults, respectively, and so on" (social worker from the Emergent Social Work School).This distinction apparently relates to the impacts of institutional scenarios on the ways that practitioners construct family as a field of practice, operatively and in their imaginations.Social work in the Health System has been more or less stable (in the trajectory of the Health Ministry Social Work Program).It has developed an institutionalized approach to intervention based on policlinics and hospitals environments and programs.This is why social workers refer families to go and ask for help.Social work from the Emergent Program has gone through many changes that made it go closer to community work and to dealing with the family in its own environments.This is why they are referred to as the ones who go to families to help identify social problems.
But regardless of those differences, both groups similarly evaluate their functions toward families in each scenario.They also identify similar challenges because of its impacts in their work with the family.For example, social workers from the Health System declare: "Social work's function is to orientate and implement actions"; "If we are asked about initiatives, we would deliver the case to the health service of their community."While social workers from the Emergent Program argue: "We are, in this sense, mediators between people and the institutions, about all now in the Social Security Ministry.So the solutions and the actions don´t depend on us, but on others above us"; "We have to detect the problem and then, social policies in general or specific programs institutions are in charge for giving the assistance." Based on these quotations, the basic function of both groups of social workers is to intermediate between people (families or individuals) and specific institutions that may vary from scenario and specialization.The authority of social work is limited to these tasks due to institutional protocols they cannot ignore in their daily practice.
Regarding how to accomplish these functions in their contexts, both groups of professionals also share ideas.They consider the development of their practice to be first of all related to the ways in which Cuban families are distinctive, due to very specific structural and cultural conditions.

The particularities of Cuban families
In the case of Emergent social workers when explaining Cuban families' particularities, they used expressions like: "I think that in Cuba, family issues are very complex, because first you have these superfamilies where many people live together.Above all, there are different generational groups inside.This is one of the main issues, the generational complexity, because each generational group requires a different approach as family members (...).The other thing is the social spatial contexts but not in a simple way, because some time in a higher class family, in a central town, to reach the family is more difficult that in a marginal area where sometime people are more cooperative." That type of opinion is recurrent in this group, as the importance they give to the multigenerational families becomes clear, together with the structural limitations for the emancipation of youth.The relevance of this feature of Cuban families could be both a value, but also a problem when they develop their practice.Moreover, this complexity is understood by these social workers as a challenge that they have had to solve.Similar thoughts were expressed by social workers from the Health System.Nevertheless, it is interesting that though they recognize an institutional protocol for social work with family, arguments can also go in the other direction: "In our case, all the health programs that are developed in policlinics have a family perspective, but as programs, for example PAMI, elderly programs and all those ones which have to do with a human being, they involve family ideas"; "The situation is seen in a holistic point of view.For us, the explanation of the family environment for understanding the case we receive is critical.We make a psycho-social history of the family.Our group works with addictions, and we have specialists in family support, so we take our cases and help them to face their problems, their illness, and we cannot forget that in a family people get habits, ways of life, etc." It is possible to see that they declare a social work with a family perspective, but continue referring to this, like a practice toward a sick person or a person in need, who needs family to overcome a certain condition.Once again, family is a resource but not an entity to be addressed.Within this aspect, the difference between the two groups of social workers is strengthened; while those from the Emergent Program are open to an understanding of a family as a totality, the practitioners from the Health System consider fulfilling this approach by "using" family as a support to solve one member case.
Although these approaches are not opposed, they are actually pointing at two different directions in social work with the family: "We have also in our center a group for family support.So we teach them how to take care of the person who is sick, how to deal with the problem from the same family.So we try to make them promoters of mental health.We also bring to the process the perception the family has about the problem they are facing.And from this point, we delineate actions for rehabilitation and the social re-insertion of the patient" (social worker from the Health System).
In the encounter of the specific conditions of Cuban families recognized by professionals, with the functions that each conceive for their practice, there is also a process that shapes their perceptions of the family as a field of practice.As was suggested before, this construction has a strong dialogical link with the institutional environments in which the practice takes place.

Institutional environments and perceptions about family as a field of practice: conflicts and challenges for social workers
Protocols and approaching mechanisms that facilitate or inhibit interventions in social work with family are substantial for a construction of the family as a field of practice.These procedures place an analysis on how social workers think about institutional frames, and the conflicts they perceive, as important sides of their professional exercise.
The primary opinions that complete the construction of family as a field of practice in each group interviewed are concentrated in some relevant aspects: both groups experience a contradiction between what they consider to be a family approach and what their institutional scenarios are projecting as social work with the family.
First of all, in both scenarios family is not visualized as a totality to be addressed.
Contrarily, there is a lack of education/capacities for dealing with family as a whole, as "It has been interesting that for example with children, from the program of underweight,3 we were opening a path for working with abuse, violence in the family and other more delicate topics.But I confess we were not prepared for dealing with all that" (social workers from the Emergent Social Work School); "The structure is thought but it doesn´t work, and we lack from general orientation" (social worker from the Health System).
Based on both groups' reflections, these scenarios (social services from Health Ministry, or from the Work and Social Security Ministry) do not have a fully organized family approach.As a result, they do not provide a training for social workers to deal with family complexities.But if this situation is important for social work with the family, other kinds of conflicts seem more relevant for the perspectives that social workers construct about the family as a field of practice regarding institutional scenarios.
In particular, social workers consider themselves affected in their approach to family by two interrelated issues.One is the transformation that has been carried out in social work in general in the country, while the other one is the lack of authority they think to have in their practice.Within this problem, there are no main differences in both groups of social workers other than the evaluation that each group makes of the other based on the trajectory of each program.

Thinking about institutional transformations and scenarios
About the institutional transformation of social work, social workers from Emergent social work consider that: "Each time there is a new change in the program we expect that we are going to be able to perform real social work.But the change leaves us more distant from this dream"; "critical cases (...) are discussed in the CAM, are treated by MININT and social workers; and we are so many that we are actually splitting up the case into parts.So when the moment arrives you don´t know if you got any improvements or what.But social workers are closest to the family, he/she is the one who has to go to the house, face to face with people.Finally, these institutions treat the case in a very pragmatic way, but the other more emotional, more affective side, which is the part that sometimes needs to be activated for solving cases, this part is not possible to foster from our institutions." In these opinions, it is possible to see two kinds of situations.In the first place, it is the movement that Emergent social work has faced that they consider to negate their aspirations to carry out real social work.They were opening to a family approach due to the conflicts they were experiencing in practice, but as they were moved away from their original foundations in UJC, they have had to again reconfigure this opening.This situation is perceived like a backward movement.
In the second place, these social workers complain in a certain way about the disarticulated protocols used to deal with family problems.The separation of family into individuals in need, made by the manners in which social services are organized, makes it difficult for their growth towards an enriched practice.
Based on different reasons, social workers from the Health System evaluate the situation in similar terms: "The services sometimes exist, while other times there are resources and they don´t get to the patients because of this disorganization we face"; "I don´t want to do the history of social work now, but I think we have gone back in our development, and we have lost a lot of social assistance.What we perform now has nothing to do with the social work I learned to practice a lot of years ago." Here, the arguments go into the organizational direction as well, but in this case they think more of the relationship between the social policies in general and their implementation in local services.Additionally, they consider how the disorganization affects the delivery of resources, the orientation for practitioners for how to solve a case (to deliver cases to other institutions) and the collaboration between the two branches of the profession.With regard to this last matter, they think it is going through many difficulties.
If both groups of opinions are put together, it is possible to see they share a critical perspective about the situation of social work with the family, as well as the ways in which they have to construct family as a field of practice.But maybe more importantly is that they perceive to be losing credibility and authority in their institutional scenarios and in society.

A matter of legitimation of social work with family
A social worker from the Emergent Program affirms: "We have also lost influence, because we started delivering material resources, like beds, refrigerators, TV sets; then people saw us like the one who is delivering things.So when we go to a family they expect we give them something material.And when it doesn´t come, then they don´t want to talk to us again," while a social worker from the Health System expresses: "The social work we met before doesn´t exist anymore.I feel our work has become deprofessionalized, and we have lost credibility as social workers.

Social work created an image of political function in recent years, and we lost the image of social work."
As was said before, there are more similarities than differences in these perceptions.
Regardless of educational backgrounds or scenarios for practice, both groups consider themselves as facing similar problems for constructing the family as a field of practice in a more concrete or applied way.Even so, it does not behave the same when it comes to evaluating how each program relates to the other.While social workers from the Emergent Program think that society and social services in general do not approve of them as qualified professionals, those from the Health System consider that social services tends to privilege the other branch in terms of the availability of resources, due to the specific program in which they were born (UJC).This aspect could seem relatively insignificant, but as these two groups of social workers are now tending to the same local area (communities), this mutual understanding (or misunderstanding) adds conflicts to the way they perceive that they can actually perform social work with the family.Fortunately, there is an idea of the necessity of collaboration in both groups that is starting to be implemented, although very slowly.This last idea is presenting a hopeful environment despite the difficulties each group experiences.If there is criticism regarding institutional contradictions in social work with families, their position is to find possible ways to solve them and to improve their practice proactively toward promotion of welfare: "So in general we were thinking that after some years of the program we have gained expertise and confidence (...) who knows if in a few years we are reborn as the force we were meant to be from the beginning" (social workers from the Emergent Social Work School); "Now, thinking about the family, in our country, a crisis meant to lose not only our economy but also values in our society, so the social worker has to work tightly with the family to rescue these values and style of living.But this, we have to think it, organize it, but also to feel it, to dream it.My impression is that we have been forgotten, not only by young generations, but by the policy makers as well, and I think we all need to learn from experiences" (social worker from the Health System).
After this research, just a few and subtle differences were found between the two groups interviewed regarding the definitions of family as a field of practice.These differences were more significant in the distinctive perception each group develops about the position of the family over a social problem.In this case, social workers from the Health System consider family as a resource for attending to a member who is seen as a patient or sick person.Not necessarily contradictory, social workers from the Emergent Program see family as a part of social problems, cause and environment.
This difference may be pointing to the influence of a high education background in social workers from the Emergent Program (with a strong sociological perspective).
It also blends with the concrete nature of fieldwork that these social workers have been carrying out in communities.While social workers from the Health System are dealing with "patients" to be treated or healed by procedures clinically or medically understood, the other group deals with social problems and multivariable causes that they probably cannot often control.It has opened their minds to the complexity of practice as a social action.To take part in their own family scene and observe their reality in place may have had an impact on their ideas about family problems.This helps to identify another relative difference regarding family problems.Social workers from the Health System speak about a family that goes asking for help to a specific institutional identify by the service it provides, while the other group refers to analyzing cases and distinguishing social problems from the contacts with the family in the community.The nature of practice scenarios again marks the distinction.
The mutual understanding between each branch of social work is also taking part of the disparities that were found.Each group considers the other to be in a better position, although the reasons may actually differ.For social workers from the Health System, the other program has more available resources, whereas the the way mediation is understood here contradicts other principles of intervention in social work such as developing the potential of individuals and families, in addition to their resilience and self-management (Guerrini, 2009, pág. 4) (Palmer-House, 2008).
Based on the constructions and ideas analyzed before, it is possible to raise the hypothesis that in Cuban social work with the family, institutional scenarios for practice are relevant in influencing social workers imaginations about how to approach a family during interventions.This influence in the Cuban case seems very similar for both groups despite the differences between each scenario.The most important issues are not the subtle differences each implies to definitions, but rather the analogies they share with each other in terms of conditions for the development of social work with family in a broader perspective.
These conditions are brought to the discourses with criticism, and point to the institutional visions and programs that segment family in social work practice.They share problems in the institutionalization of social work with family in a Cuban context.Based on the analyzed opinions, institutionalization has created a profession for delivering resources, a practice that can hardly integrate the actions of different and disarticulated programs and institutions, to perform social work with family.It has formed a social work that is not formally oriented to the creation of capabilities in a context of an increasing family role.These ideas and findings highlight an urgent discussion that needs to be undertaken and faced by Cuban professionals and authorities.
: Placing the Cuban case Tradition and recent changes in Cuban welfare structure One of the primary characteristics of the Cuban context throughout more than 50 years of the Revolution has been the vocation of creating social policies centered in broadening human rights and citizenship guarantees.This has been addressed through a universalistic and decommodificated principle of social protection architecture.The impact of this conception and its achievement allows Cuba to be positioned as a country with high level indicators of social development (PNUD-UNDP, 2011).
It emphasized the responsibility of informal social relationships and family networks for the satisfaction of basic needs at the communitarian level.Inequity became a characteristic of Cuban society, shown by a decrease of family consumption possibilities, poverty, family conflicts and social values transformations.Responding to this situation after 10 years of crisis in the period from 1999-2007, a process of reinforcement of State responsibilities took place (almost a decade during which the Emergent Social Work Program was developed).During these years, the social expenses were beyond the real economic possibilities of the State.
communities.It was not until the 1970s that the Health Ministry created the first School of Social Work and graduated technicians (middle-level education).These technicians created the unique social work association in Cuba known as SOCUTRAS.But in general, this line of medical social work established an assistance practice without any real tools for promoting social change.In 1992, the National Group of Social Work was established, unifying workers from the Health Ministry and others with the FMC's professionals.This Group had the mission of creating common plans and concrete actions that helped in integrating social work practice into a single model.In 1995, the first and unique Master Program in Social Work in the country was created in Camaguey.In 1998, a Bachelor in Sociology with a specialization in social work, was opened at the University of Havana (high level of education).This program contributed to the theoretical and reflective growths in the professionalization of social work.It was combined later (in 2000) with the creation of the Emergent Social Work Schools and Social Work Program by the Communist Youth Union (UJC).However, it reinforced the assistance character of the profession that was established in former practices (Urrutia & Muñoz, 2004).As a result, social work entered the new century with two main practical branches; as said before, one was formed by the Health System, and the other by the Emergent schools of social work.The high level (bachelor) education continued as a way of providing the profession with a more integral perspective.Despite difficulties, the institutionalization of social work was enhanced, and the social recognition of the profession increased.But a problem aroused, as social work started to be judged based on the resources that the Social Work Program between Journal of Comparative Social Work 2015/2 14 1999 and 2007 put in their hands; because of that, social work (about all the Emergent branches) became a resources delivery practice.Although social workers from the Health Ministry remain more or less in similarly practical conditions, the context for social work in general has changed in recent years.Recent reforms in the institutional and welfare systems in the country moved Emergent social workers from the UJC's programs to the frame of the Work and Social Security Ministry.It is also closing the bachelor's degree in Sociology with a specialization in Social Work.That movement meant changing ways and protocols, as well as a reduction in the availability of resources and social acceptance.Right now, academic institutions are reorganizing a new social work program that finally unifies the profession into a single root, although these goals seem far away and not accomplished yet, particularly when it comes to social work with family.Social work with families under questionIn the process described, social work with the family has been especially critical.In the first place, it has been difficult to follow due to the lack of an integral family social policy.But at the same time, it has been present since every intervention of social policy and programs have been related to the family to some extent.In this setting, social work has been directly attached to the formal actions of the State in relation to the family.Regarding the two main branches of social work mentioned here, the one from the Health Ministry defines the practice involving the family as follows: "Social work in the health sector, in the different programs and levels of attention, takes part in multidisciplinary teams.These are oriented to socio-medical research, and allow to identify the social needs and privations that interfere in the health-disease process" (translation by the authors)(SOCUTRAS, 2013, pág.3).With this statement, social work addresses family, community and patients as participants in projects and specialized health programs.On the other side, and after changes since 2010, practices toward families were redefined for the Social Work Program in the Work and Social Security Ministry.In this branch, the roles of social work are:To diagnose the situation of more than 70% of the families in the community;To guarantee social attention to vulnerable families in the new context of labor market redefinition and a decrease in social assistance;To prioritize social work with families whose members have taken part in felonies; social workers intervene with family, what they consider important in the process, the function that they consider social work has to perform and what characterize Cuban families.This topic starts with an abstract dimension of constructions.Social workers from the Emergent Social Work School Program made considerations that highlight some interesting questions.First of all, social workers from the Emergent Program relate at least four important aspects in their opinions about social work with family: 1) the importance of the economic and political context in a broader sense, but also in the closer communitarian context of the family; 2) the ways in which the structure of family affects its functionality; 3) the cultural dimension of family; and 4) the vision that families construct about boundaries, structure and concept: "For working with a family, it is also important about the concept it has about its own, not only the structure that we could identify, but also what is the family the person is considered to have.Because  sometimes the persons care more about other relatives like the closest family than those ones who live together with him/her.As a social worker, you have to think in both senses: not only in what the sociological concept is, but also the concept they have.I have to think like that to see what I can do with this family for making it an intervention agency as well."