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SWK 331 Methods of Practice I

Understanding Generalist Practice: Kirst-Ashman & Hull, Jr.
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Rhondda Waddell

on 27 October 2015

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Transcript of SWK 331 Methods of Practice I

Chapter 4
Part I Chapters 1-8
Chapter 5
Chapter 6
Chapter 7
Chapter 8
SWK 331 Methods of Practice I
Saint Leo University

Agenda:
Chapter 1 Review
Prezi Discussion
Active Learning Exercise
SLU core Values: Integrity & Respect
Chapter 1
Chapter 2
Chapter 3
Agenda:
Chapter 2 Review
Prezi Discussion
Active Learning Exercises
SLU Core Values: Integrity & Respect
Agenda:
Chapter 3 Review
Prezi Discussion
Active Learning Exercises
SLU Core Values: Integrity & Respect
Agenda:
Chapter 4 Review
Prezi Discussion
Active Learning Exercises
SLU Core Values: Integrity
& Respect
Agenda:
Chapter 5 Review
Prezi Discussion
Active Learning Exercises
SLU Core Values: Integrity &
Respect
Agenda:
Chapter 6 Review
Prezi Discussion
Active Learning Exercise
SLU Core Values: Integrity & Respect
Agenda:
Chapter 7 Review
Prezi Discussion
Active Learning Exercise
SLU Core Values: Integrity & Respect
Agenda:
Chapter 8 Review
Prezi Discussion
Active Learning Exercises
SLU Core Values: Integrity & Respect
LO: Help Prepare Students to:
1. Define the process of generalist practice
2. Acquire and apply an eclectic knowledge base
3. Acquire professional values and apply professional ethics

LO: Help to prepare students to:
1. Use interviewing skills
2. Demonstrate effective nonverbal behavior when working with clients
3. Maintain a commitment to client self-determination
LO: Help prepare students to:
1. Articulate the functions of treatment & task groups
2. Attend to professional roles in groups
3. Use empathy
LO: Help prepare student to:
1. Utilize a conceptual framework for an organizational context of practice
2. Analyze, formulate, and advocate for interventions and policy planning
3. Explore professional roles as a social worker
LO: Help prepare students to:
1.Employ skills needed for engagement
2. Assess intervention goals
3. Assess clients strengths
LO: Help to prepare students to:
1. Use an 8-step planning process
2. Engage in planning mezzo practice
3. Engage in planning macro practice
LO: Help prepare students to:
1. Recognize child maltreatment
2. Examine child protective services
3. Implement the GIM to CP
LO: Help prepare students to:
1. Identify methods for evaluation
2. Identify methods for program evaluation
3. Identify common evaluation problems
Triple A approach (Ask, Assess, Assert)
“Facts May Not Be True
A Widespread Application of Critical Thinking

LO-12

Defining Generalist Practice: Critical Thinking Skills

LO-10

Defining The Ecological Perspective: Concept of social environment
Intersectionality of Diverse Factors-people can belong to multiple diverse groups.

Dimensions of Diversity- see page 28 list 1.8

The Potential for Discrimination (the act of treating people differently based on some group they belong to) and Oppression (involves putting extreme limitations on members of an identified group)

Cultural Competency- a set of knowledge and skills a social worker must develop to be effective with multicultural clients)

LO-9

Defining Generalist Practice: Appreciate and Stress the Importance of Human Diversity

Micro Skills for Generalist Practice
Mezzo Skills for Generalist Practice
Macro Skills for Generalist Practice

LO-7

Defining Generalist Practice: Recognize a Wide Range of Practice Skills to Work with Individuals, Families, Groups, Organizations, and Communities

Karen K. Kirst-Ashman
Grafton H. Hull, Jr.
Supplements by Chris Simmons

UNDERSTANDING GENERALIST PRACTICE,
7E

LO-2

Planned Change Steps in GIM
Step 1: Engagement-orient yourself to the problem & establish communication
Step 2: Assessment-Identify your client & issues
Step 3: Planning-Prioritize problems & translate into needs
Step 4: Implementation-Involves the doing of the plan
Step 5: Evaluation-Critical for accountability pg. 48
Step 6: Termination-Conclude the plan let client know it is coming to an end
Step 7: Follow-Up- Re-examine the progress made with the situation

LO-14 & 15

The Generalist Intervention Model (GIM)

Counselor Educator Broker
Mobilizer Case manager Mediator
Facilitator Manager Initiator
Integrator/ Negotiator Spokesperson
Coordinator Organizer Consultant
Advocate

LO-11

Defining Generalist Practice: A Wide Range of Professional Roles

National Association of Social Workers Code of Ethics
International Federation of Social Workers/International Association of Schools of Social Work Ethics in Social Work, Statement of Principles

LO-6

Defining Generalist Practice: Acquire Professional Values and Application of Professional Ethics

An Eclectic Knowledge Base: Incorporate Research-Informed Practice and Practice-Informed Research

An Eclectic Knowledge Base: Includes Values and
Principles That Guide Generalist Practice

LO-5

Defining Generalist Practice: Acquire and Apply an Eclectic Knowledge Base to Practice (cont.)

LO-4 & 5

LO-2

Defining Generalist Practice

Chapter 1

Introducing Generalist Practice: The Generalist Intervention Model

The Strengths Perspective
Resiliency: Seeking Strength Amid Adversity

LO-8

Defining Generalist Practice: Emphasize Principles Involving Values That Underlie Generalist Practice

LO 1

Focus on any problem
May target environment for : change
Advocacy
Professional values and ethics
Partnership with clients
Adherence to professional standards

Introducing Generalist Practice
The Uniqueness of Social Work

LO-4

Self-determination- Each individuals right to make his or her own decisions

Empowerment -The process of increasing personal, interpersonal, or political power so that individuals can take action to improve their life.


Client Self-Determination and Empowerment

LO-3

Warmth-Conveying a feeling of interest and concern verbal or non-verbal

Empathy -Invovles not only being in tune with how a client feels, but also conveying to that client that you understand how he or she feels

Genuineness - The hones, natural, and open expression of yourself


Empathy and Other Interpersonal Skills

Chapter 2

Micro Practice Skills: Working with Individuals

LO-9, 10

Silence in the Interview

Client-Initiated Silence-a.) Gain time to organize thoughts b. Attempt to pressure worker to give some responses or solution to a problem c.) Resistance to or rejection of the worker's authority

Negative Worker-Initiated Silence

Focusing on the Client Instead of Yourself
Therapeutic Worker-Initiated Silence-a. Pacing the interview using small periods of silence to all time to think about what is occurring b. silent focusing- Enables the client to focus in on and think more intensively about the issue without having to rush into something else. c. Responding to defenses- Occurs when a client has an emotional outburst directed toward the worker d. Silent caring- Conveys your caring and understanding after a period of intense emotion is expressed



Critical Thinking & Cross-Cultural
Awareness in Interviewing

LO-6


Empowerment: Emphasizing Clients’ Strengths:
5 types of questions to explore client's strengths: a) Survival questions b) Support questions c) Exception questions d) Possibility questions e) Esteem questions (See highlight 2.5 Stressing Client Strengths)

3 basic areas to emphasize a client's strengths: a) Client behaviors and accomplishments b) Personal qualitaies c) Client's resources

Self-Disclosure- A worker's divulgence to a client of personal thoughts, information, feelings, values, or experiences

4 major types of disclosure: 1) Information about your professional role 2) Your feelings and impressions about the client and the client's behavior by giving feedback 3) Feedback about your perceptions concerning your ongoing interaction and relationship with the client 4) Relating aspects about your own life or problems in some way to the client's feelings or situation (Make sure disclosure id beneficial to client, relevant to client, short & simple

Summarization- Restating the main points of an interview or a portion of an interview in a brief and consice manner

Eliciting Information-Use open-ended question and closed-ended questions

The Use of “Why” -can be threatening to clients because it is "intrusive"

Using Sensitivity and Tact



Effective Oral Communication (cont.)

LO-5

Initial Introductions-Be knowledgeable about cultural differences

Alleviating the Client’s Anxiety- "Start where the client is"

Portraying Confidence and Competence-Using Direct or Indirect questions

Beginning Statement of Purpose and Role--1) Clearly explain the interview's purpose to the client 2) Explain the worker's role to the client 3) Ebcourage client feedback on the purpose
4) Convey to the client the usefulness of the interview



Starting the Interview (cont.)


LO-5

The Interview Setting

How to Dress for the Interview and for the Job

Thinking Ahead about an Interview with a Client-1)Gather specific information that will be needed 2) Time frame should be clearly specified 3) Purpose of the interview

Starting the Interview

LO-2

LO-2

Eye Contact-1) Important when establishing rapport with clients 2) Be aware of cultural differences where direct eye contact is considered disrespectful, insincere, or rude

Attentive Listening-1. Listening focuses on comprehending the meaning of what is said a. Three aspect of communication 1) Intent 2) Impact 3) Environmental barriers

Facial Expressions-1. Tense/relaxed 2. Formal/Informal
3) The use of personal space-The European North American expectation distance in interviews are usually a few feet beyond arm's length; The English prefer greater distances than Americans; Many Latin people prefer half the distance of European North Americans; The Middle East people may talk eyeball to eyeball

Body Positioning- Sitting behind a desk implies great formality; speaking with a desk implies great informality and warmth


Verbal and Nonverbal Behavior

LO-2

Engagement- Establish an initial relationship with an individual or group of individuals

Assessment-Must talk and relate to other individuals effectively to solicit enough information about the issue or problem involved to initiate positive change

Plan-Involves working integrally with client to establish plan of action

Implementation- Working with others in environment to achieve goals

Evaluation-Communicate with client and others to validate accomplishments

Termination-Must prepare client for the end of the social work relationship

Follow-Up- Solicit information regarding how planned change goals have been maintained

Skills for Working with Individuals and the Generalist Intervention Model

Karen K. Kirst-Ashman
Grafton H. Hull, Jr.
Supplements by Chris Simmons

UNDERSTANDING GENERALIST PRACTICE,
7E

LO-9, 10

Confronting Clients- Confrontation is the direct expression of one's own view of the conflict and one's feelings about it and at the same time an invitation to the opposition to do the same

Framing Discrepancies in Confrontation-a.) Incongruities in verbal statements b.) between what one says and what one does c.) Between statements and nonverbal behavior d.) Between two or more people or the situation

Suggestions for Using Confrontation-a.) Consider whether the relationship with the client is strong enough to withstand the confrontation b.) Be aware of the client's emotional state c.) Never confront a client to vent your own anger or frustration d.) Use confrontation carefully and only when they will likely be effective


Critical Thinking: Challenges in Interviewing (cont.)

LO-7

Enhancing Cultural Competence: Ethnographic Interviewing-focuses on learning about a client's cultural world including values, behavioral expectations, and language

Global Questions-initial, general inquiries posed to solicit information about the culturally relevant aspects of the client's life

Cover Terms-words that cover a realm of concepts, ideas, and relationships within a cultural context and have significant and special meaning to members of a cultural group

Descriptors-word solicited to explain cover words


Effective Oral Communication (cont.)

LO-6

Verbal Responses to the Client-
Simple Encouragement
Rephrasing
Reflective Responding
Clarification
Interpretation
Providing Information

Empowerment: Emphasizing Clients’ Strengths: a) Reinforces a client's sense of self-respect and self-value b) Provides rays of hope even in "tunnels of darkness" c) Helps identify ways to solve problems by relying on the specified strengths


Effective Oral Communication

Intervention Skills for task and Treatment Groups using the (GIM)

Conflict Resolution-Recognizing conflict

Recognizing Conflict-Ideas suggested by one side may be rejected by another (High light 3.5) pg. 119

Assessing Conflict- Usually requires talking directly to the parties involved (High light 3.6) pg. 119

Choosing a Strategy and Intervening-Win-lose and win-win situations (High light 3.7) pg. 120



LO-5

Use Empathy and Other Interpersonal
Skills with Groups (cont.)

Persuasion by a Minority of the Group-A vocal and persuasive group sways the majority

Nominal Group Technique- Intent is to help group members arrive at a consensus with respect to a pending decision (pg. 112 Stages)

Brainstorming-Group technique used to encourage members to produce a variety of ideas about a specific topic

Parliamentary Procedure-Robert's Rules of Order, Filibuster involving endless speaking to prevent a group from conducting its business, motions used to propose actions for support by the group

LO-4

Problem-Solving and Decision-Making
Approaches with Groups (cont.)

Group Development- 4 stages: Stage 1: Strong reliance on the leader, focus is on trust among members; 2: Group members begin to assert themselves, conflict is common, power and control issues increase, leader encourages open discussion; 3. Group productivity increases, work occurs, trust is developed, worker's role is more of a consultant/adviser; 4. Separation phase goals are reached, often there is a feeling of loss

Group Culture:Tradition, customs, & values/beliefs shared by members

Norms- Unwritten expectations about how individuals will act in situations

Power-Members vie with the leader for power related to issues

Group Size and Composition- Education groups 4-15 members,
Discussion groups 5-8 members, personal growth/support/therapy groups 3-12; decide on heterogeneity or homogeneity of the group, age and gender must be considered

Duration-Highlight 3.4 page 110 Approaches to Decision Making

LO-3

Conceptual Frameworks in Group Assessment,
Intervention, and Evaluation

Differentiating Types of Groups (cont.)
Task Groups (cont.)
Multidisciplinary Teams
Case Conferences and Staffings
Social Action Groups
Participatory Action Research
Achieving Organizational Goals

LO-1

Benefits and Functions of Treatment
and Task Groups (cont.)

Benefits of Groups-

Mutual Assistance-Offer the opportunity to give help and receive help from others.

Connecting with Others-Helps reduce isolation, shares thoughts, and beliefs.

Testing New Behaviors-Allows to test behaviors in a safe environment.

Goal Achievement- Ability to accomplish things is greater.

Decision Making- Allows the capacity to bring the wisdom of many together.

LO-1

Benefits and Functions of Treatment and Task Groups

Chapter 3

Mezzo Practice Skills: Working with Groups

Karen K. Kirst-Ashman
Grafton H. Hull, Jr.
Supplements by Chris Simmons

UNDERSTANDING GENERALIST PRACTICE,
7E

Conceptual Frameworks: Group Functions and Roles-Help to keep a group on task ensure the needs of the members are attended

Table 3.1 pg. 117 See list
Potentially positive roles, negative roles, nonfunctional roles

Task Roles- Designed to help the group achieve goals

Maintenance Roles-Concerned with improving or enhancing group function

Nonfunctional Roles-Behavior that blocks the goals of the group

LO-4

Critical Thinking and Groups

Consensus Decision Making-All members support and accept decision even if not initially inclined

Compromise-Reaches a decision that most, but not all agree

Decision Making by Majority-Over one-half support an idea

Rule by an Individual-Allow one individual to make choices that affect the entire group

Persuasion by a Recognized Expert-Members agree to accede to recognized expert

Averaging of Opinions of Individual Group
Members-Using average to decide on an idea

LO-4

Problem-Solving and Decision-Making
Approaches with Groups page 110

Broker-Helps clients obtain needed resources from community agencies

Mediator- Helps group members resolve conflicts

Educator- Provides members with new information, structures presentations, and uses modeling to help members learn new skills

Facilitator- Guides, eases, or expedites the way for others

LO-2

Professional Roles in Groups

Differentiating Types of Groups (cont.)

Treatment Groups - Primarily focused on member's social & emotional needs

Growth Groups- Designed to encourage support & growth of the members

Therapy Groups- Help clients with identified goals to change behavior

Educational Groups- Designed to provide members with information about themselves or others

Socialization Groups-Assist members in acquiring skills of members to become socialized into community

Self-Help & Support Groups- Groups of members sharing characteristics to provide emotional sustenance, encourage new coping mechanisms, strength-based

Social Networking Groups- Groups with members from social networks that share a common goal and interest, concerns, or problems

LO-1

Benefits and Functions of Treatment
and Task Groups (cont.)

Differentiating Types of Group- Task or Treatment?

Task Groups- Exists to achieve a specific set of objectives

Board of Directors- Administrative groups charged with policy governing

Task Forces-Groups established for special purpose and disbaned after completion of task

Committees and Commissions-Responsible for dealing with specific tasks and matters (standing or ad hoc)

Legislative Bodies-City councils, county boards, state legislatures, congress

Staff Meetings-Composed of agency staff members with a purpose

LO-1

Benefits and Functions of Treatment and
Task Groups (cont.)

Conflict Resolution (cont.)

Modeling and Coaching-Teaching new skills, showing clients alternative methods for problem resolution, coaching involves giving the client information and corrective feedback.

Team Building- The process of creating a group of individuals with expertise & dedication needed to achieve a specific purpose.

Confrontation- The worker engages in nonblaming confrontation by pointing out discrepancies using "I" statements

Consultation- Case and program focus is on client or agency situation

Coordination- Using structure

Using Structure- structure used to plan interventions and program activities, agendas structure time, and enforces the time

LO-5

Use Empathy and Other Interpersonal
Skills with Groups (cont.)

LO-5

Use Empathy and Other Interpersonal Skills with Groups

Negotiating- A process in which at least two individuals participate in a face-to-face interaction in order to reach a mutually acceptable decision

Mediating- Both parties meet with a third party who serves as an impartial referee or peacemaker to resolve disputes between the opposing parties.

Influencing Decision Makers-
Petitioning- Collecting signatures on a document asking an organization or person to act in a particular manner.

Communication Skills: Working with the Media-
Media Releases-Use the five W's: Who, What, When, Where, and Why

LO-4

Macro Skills for Organizational and
Community Change (cont.)

Advancing Social Justice Highlight 4.2

Group Skills for Organizational and Community Change- Mezzo Skills: Conflict resolution; developing win-win outcomes; team building; public speaking; consultation; coordination

LO-3

Use Empathy, Interpersonal Skills, and
Group Skills in Macro Practice

LO-1

Systems Theory- Is a set of elements that are orderly and interrelated to make a whole.

Organization Theory- Concerned with how organizations function, what improves or impairs the ability of an organization to accomplish its mission, and what motivates people to work toward organizational goals.

Community Theory- Two primary components : the nature of communities and social work practice within communities.

a. Community- A combination of social units and systems that perform the major social functions important to the locality
b. Social functions of communities: production, distribution of goods; Socialization the process of knowledge, values, beliefs, behaviors taught by members; Social control the community's effort to make sure members live within norms; Social participation- the involvement of community members in various activities to enhance belonging; Mutual support- involves caring for the sick, helping the poor and vulnerable

Conceptual Framework for Organizational
and Community Change

LO-1

Defining Macro Practice in generalist social work

Engaging with Organizations and Communities

Chapter 4

Macro Practice Skills: Working with Organizations
and Communities

Karen K. Kirst-Ashman
Grafton H. Hull, Jr.
Supplements by Chris Simmons

UNDERSTANDING GENERALIST PRACTICE,
7E

Influencing Decision Makers (cont.)
Educating
Persuading
Confrontation- The act of challenging another, usually in a face-to-face meeting.

Collaborating- Procedure in which two or more persons work together to serve a given client.

Letter Writing- Can be effective in certain situations

See Highlight 4.7: Letter Writing Startegies

LO-4

Macro Skills for Organizational
and Community Change (cont.)

Social Policy/Planning- A technical process of problem solving regarding substantial social problems requiring expertise.

Capacity Development- Involves building the capacity of the group to make large scale change.

Social Advocacy- Is about using pressure to bring about change s that will benefit individuals and groups.

Cause Advocacy-Advocate on behalf of a single case

Case Advocacy-Advocate on behalf of an issue of overriding importance to a group of clients

LO-2

Analyze, Formulate, and Advocate
for Interventions

Evaluating Results- Practice outcomes focus on the effectiveness or results of what individual social workers do. It make be in the form of single-subject designs, task achievement scaling, client satisfaction surveys, or goal attainment.

Fund-raising- Individual donors, corporate donors, foundations, membership dues, benefits.

Budgeting-
Line-Item Budgets- Statement of expenditures for a designated period of time, where each cost item is noted on a separate line.

Program Budgets- Lists expenditures broken down according to programs the agency provides know as functional budgets.

Incremental Budgets- Agency's budget from last year is used as a starting point for this year's budget.

LO-4

Macro Skills for Organizational and Community Change

LO-1

Professional-Organizational Conflicts
Limitations and Risk Assessment

Conceptual Frameworks: The Organizational Context
of Social Work Practice

GIM
Step 1: Engagement
Step 2 Assessment
Step 4 Implementation
Step 3
Planning
Step 5 Evaluation
Step 6 Termination
Step 6 Termination
Step 7 Follow up
Systems Theory: Focus on interactions of various systems in the environment: individuals, groups, families, and organizations.
Focusing on strengths such as client resources, capabilities, knowledge, abilities, motivations, experience, intelligence & positive qualities.
Generalist practice: The application of an eclectic knowledge base, professional vales, and a wide range of skills to target any size for change within the context of four primary processes
System is a set of elements that forms an orderly, interrelated, and functional whole
Social environment: Conditions, circumstances, and human interactions that encompasses human beings.

Person-in environment: People constantly interact with various systems around them

Transactions: Communication with others in the environment

Energy: Natural power of active involvement among people and their environments

Interface: Exact point at which the interaction between an individual and the environment take place

Adaptation: Capacity to adjust to surrounding environmental conditions
Coping: Human adaptation to overcome problems

Interdependence: Mutual reliance of each person on each other person

See page 30 for Definitions
A-Ask questions
A- Assess the established facts & issues involved
A- Assert a concluding opinion
Involuntary Clients
Suggestions to help:
a. Acknowledge the client is involuntary to yourself
b. Try to put yourself in their shoes
c. Label negative feelings and help the client to express them
d. Clarify your role to the client
e. Know the limits of your authority and power over the client
f. Give as many choices as possible
g. Figure out what you can do that the client wants
Use pro-social modeling and positive reinforcement
h. Allow client time to gain trust
i. Accept their right to choose to cooperate or not

Handling Hostility
a. do not get angry or defensive
b. Focus of the hostile behavior not the hostile person
c. Allow client to voice anger
d. Emphasize the client's personal strength
e. Know the facts regarding the client's situation
f. Focus on the present and future
g. Look at various alternative open to client
h. Do not moralize
i. Summarize what has occurred and what recommendations have been made
j. Establish short-term, initial goals with a hostile client
Suspicion of Untruth
a. Evaluate the situation logically
b. Examine the client's pattern of prior behavior
c. Consider not confronting the client if this is the first time the possibility of lying has come up
d. Evaluate the costs of believing or not believing your client
As a leader of a group responsible for making a decision, what would you do to encourage critical thinking in your group?
Groupthink-When groups have the illusion of agreement but have really failed to carefully consider their decision, and go along with the rest of the group
What are some possible options to help evaluate the effectiveness of a group?
pg. 118
Designed to improve or modify some aspect of society

Concerned with developing new resources when none are available

Helping clients get their due rights

Targets the system to determine how changes are made

Requires advocacy

Occurs frequently in organizational context
How would you define Macro Practice?
Highlight 4.1: When the Agency You Work For Is Part of the Problem.
Social work practice in community includes-
Need Assessment
Both a product and process that includes a systematic gathering of data designed to identify the extent and nature of a social problem or condition, the resources available to deal with the problem, and potential obstacles and solutions to an intervention.
Program Evaluation and Review Technique (PERT)
Four Steps:
1) Identify major tasks to be accomplished
2. Place tasks in sequential order
3. Determine probable time needed for completion of each step
Identify those responsible for the completing each task
Workers Roles in Organizational and Community Change

Initiator- The person or persons who call attention to an issue
Negotiator- Represents organization with other groups
Advocate- Speaks out and acts on behalf of client
Spokesperson-Authorized to speak on behalf of others
Organizer- coordinates individuals and groups to pursue functions
Mediator- Neutral person who resolves disagreement among various systems in conflict
Consultant- Provides advice and suggestions for another.

Understanding Generalist Practice, 5e, Kirst-Ashman/Hull

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LO-3-5

Chapter 5

Engagement and Assessment in Generalist Practice

Karen K. Kirst-Ashman
Grafton H. Hull, Jr.
Supplements by Chris Simmons

UNDERSTANDING GENERALIST PRACTICE,
7E

Family Assessment Skills-Eco-map- Provides a graphic representation of the family's ecological system, and depicts family membership and relationships See page 186

Genogram-Provides a means of depicting a family from one generation to the next, and provides a chronological picture of the family noting important events, health issues, losses in the family, communication patterns, occupations.

Other factors to consider in a family assessment:

Family Communication
Family Structure
Life Cycle Adjustments
Impacts of the Social Environment
Key Areas of Family Conflict
Family Relationships


LO-6

Working with Families

Diagnostic and Statistical Manual (DSM)-Five major axes: a. Clinical disorders and conditions not attribuable to mental disorder b. Personality disorders c. Physical conditions d. Environmental and psychosocial problems e. Global assessment of averall level of functioning

4 Reason why DSM is relevant to social workers: 1. Provides a means for a variety of professionals to communicate with each other 2. Helpful in evaluating and treating clients with mental disorders 3. Utility in teaching about mental disorders 4. Provides better opportunities to do research on mental disorders

Reasons why to be wary of using the DSM:
1. It only describes particular conditions
2. There can be some tendency to focus on individual pathology instead of client interactions with the environment 3. Imperfections in its categories 4. it is primarily focused on deficits, and is not strengths based, does not help in identifying s

Assessing Assertiveness (Rathus Assertiveness Schedule)- An instrument composed of 30 items that measure an individual's assertiveness

Assessing Alcohol and Other Drug Abuse
(College -Alcohol Problems Scale-Revised)-The National Institute on Alcohol Abuse and Alcoholism (2000) reports that alcohol related problems include economic losses resulting from time off work owing to alcohol related illness and injury, disruption of familya nd social relationships, emotional problems, impact on perceived health, violence and aggression, and legal problems.

Family Assessment- Family is a primary group whose members assume certain obligations for each other and generally share common residences.
Family assessemnt skills include: a. Family communication b. Family structure-involves the organization of relationships and patterns of interactions within the family Assessment of 5 dimensions: 1. Functioning as a system that is intact with appropriate boundaries and subsytems 2. Family norms 3. Family roles 4. Appropriate balance of power 5. Intergenerational aspects and the impact of family history upon current family functioning

LO-5


Microassessment Tools


Resistance in Assessment- An important concept in assessment is to start where the client is
Critical thinking Question 5.2 page 177.

Which Problem Should You Work On?
1. Client must recognize that the problem exist.
2. Problems should be clearly defined.
3. You and client should realistically be able to do something to remedy the problem.
4. Partialization- Breaking down a problem or series of problems into manageable parts
5. Problems should be ordered in terms of priority

Collecting, Organizing, and Interpreting Client Data- Gathering Information: Sources of Assessment Data a. Agency forms completed by client b. Responses by clients to your questions during interview c. Nonverbal behavior of client d. Client's interactions with other people e. Outside sources F. Psychological or other testing g. Your own interactions with clients

Questions You Can Ask during Assessment pg. 178 Highlight 5.2


LO-4


Assess Client Strengths and Limitations (cont.)

The Difference between Diagnosis and Assessment-pg. 167 Highlight : Assessment differs in at least 4 ways: 1. Environmental surroundings are considered as important when trying to understand any problem. 2. Since problems may exist outside of the client, outside systems can become targets of change. 3. Using the medical model, a client is diagnosed as having a problem; assessment in generalist practice emphasizes that practitioners work with not on clients. 4. Diagnosis focuses on pathology; assessment targets not only the client's problems but also the client's strengths.

From the 1920s to the 1960s most social work programs used a medical model to understand human behavior and human problems.

Attention shifted from individual pathology to problems in the client's environment.

Approaching Assessment- Social workers began to assess problems by viewing clients in their situations instead of diagnosing what was wrong with the clients themselves.



LO-2

Assessment

Greeting the Client-

Demonstrating Effective Attending Skills-. Listen carefully 2. Make eye contact-Be aware of cultural differences 3. Focus on client thoughts and feelings use open-ended questions4. Use silence as necessary 5. Take notes of information you are unlikely to remember

Discussing Agency Services and Client -1. Deciding if the Agency & worker can help 2. Offering service to the client 3. Orienting the client to the helping process

Expectations- (Client needs to know the rules and conditions; negotiate with clients as to the frequency of sessions, time and place, and total number of sessions) Completing paperwork

LO-1

Engagement

Family and Friends
Education and Employment Background
Problem-Solving and Decision-Making Skills
Personal Qualities and Characteristics
Physical and Financial Resources
Attitudes and Perspectives
Religiosity and Spirituality


LO-4

Assess Client Strengths and Limitations

LO-3

Types of Problems (cont.)
Psychological and Behavioral Problems- Emotional upheavals and inappropriate, self-defeating, criminal, or uncontrollable behavior.

Inadequate Resources- Deprivation of basic needs

Problems in Decision Making- Emotional dilemmas may create emotional turmoil and they see no positive solution

Cultural and Religious Conflicts- Involves discrimination and oppression by majority groups

Prioritizing Problems- The number of potential problems may seem overwhelming and they need help in deciding which problem to work on first, second, etc.


Assessment from a Micro Practice Perspective: Defining Problems (cont.)

LO-3

Types of Problems
Interpersonal Conflict-Involves individuals having difficulty relating to each other

Dissatisfaction in Social Relations-involves inability to get as close to others as he or she would like, and/or lack of assertiveness

Problems with Formal Organizations-involves feeling they are not getting the resources they need

Difficulties in Role Performance- Can best be distinguished from interpersonal conflict by the fact that role performance is more one sided: 1. Role- a culturally expected behavior pattern that characterizes people having a particular position and status in society 2. Role performance involves family, student, employee, patient role, etc.

Problems of Social Transition-Difficulty dealing with some major change in their lives


Assessment from a Micro Practice Perspective: Defining Problems

Assessment-Acquiring an understanding of a problem, what causes it, and what can be changed to minimize or resolve it.
Achieving the Goals of Assessment: 1. Articulate a clear statement of the need, problem, or situation 2. Recognize the strengths, assets, skills, and abilities of clients 3. Formulate a clear description of the client's system 4. Understand the client's system's interactions with other systems 5. Identify any missing information that is important 6. Put all the information together
Elephants are like Us
Mid-Term Practice
Word Bank Mid-term Methods of Practice I-Micro
Purpose of Social Work
4 primary process of general practice
Generalist Intervention Model-Steps
Empathy
Interview
Empowerment/Self-determination
Self-Disclosure
Open and Close-ended questions
Norms
Macro
Mezzo
Micro
Advocate/Negotiator/All roles of social work
Negotiator
Genogram
Ecomap
Capacity development
Systems theory
Ecological perspective/Strengths perspective /Resiliency
What traits make social work a profession?
Jane Addams
CSWE
Social Network
Social Action
Flexner
NASW
2 fundamental components of Generalist Practice
Benefit of groups
Know different Types of groups
Advocacy
How to influence decision makers


Immersion Day
Chapter 6

Planning in Generalist Practice

The Complexity of Setting Objectives in Mezzo Practice
Clarifying Goals and Objectives
Input from Both Worker and Clients
Workers’ Perspective
Group Members’ Perspective
Variations in Goals
Categories of Goals-a. Group-centered goals- involve nourishing the group and keeping it going b. Common group goals- arrived at and shared by all group members c. Individual goals- and individual member works to attain some specific goal for him or herself

Contracts in Mezzo Practice-Such as contracts between the sponsoring agency itself or between the worker and the group or between the group an individual group member, or between the worker and a group member or involving two or more members of the group

LO-4

Planning in Mezzo Practice

Step 8: Formalize a Contract- 4 major components a. A contract specifies what will occur during the intervention process b. A contract is established by a worker and client making an agreement together c.A contract generally contains four types of information: 1. goals 2. methods 3. timetables and 4. mutual obligations

The Purpose of a Contract-a. Contracts ensure the consumer's rights, to free the consumer, and to increase consumer control in developing and implementing the plan b. Purchase of service agreement- A fiscal agreement or contract between two or more organizations

Make Contracts With Clients-Not for them.
Culturally Competent Contracts-

LO-3

Use Contracts as Part of the Planning Process

Step 5: Establish goals- Benefits a. Help ensure that clients and workers are in agreement about such matters as problem definition and the changes that must occur to produce a suitable solution b. Validate the client's concerns and definition of the problem and facilitate client empowerment c. Suggest the direction sand nature of the intervention which helps both client and social worker stay on course d. Lend themselves more easily to evaluation, which is a critical component of the planned change process

Step 6: Specify Objectives- a. Objective should be measurable b. Sometimes goal and objectives are confusing objectives should always be clear, specific, and measurable and goals are ofter too complex to be measurable

Setting Objectives in Micro Practice-Objects should meet 3 criteria: a. Specificity- should be explicit enough that anyone can tell that they have or have not been achieved b. Clarity-Involves the conditions or circumstances under which the behaviors involved in achieving the objective are performed c. Standard performances- Involves how ell, how soon, or how often the performance, activity, or behavior should be done.


Step 7: Specify Action Steps-
1. Who will do what by when a. Who-the individual specified for accomplishing a task b. What- the tasks the individual has to complete in order to achieve the goal c. When- sets a time limit so that the task is not lost in some endless eternity

LO-2

Establish Goals and Objectives

Step 1: Work with Your Client(s)

Step 2: Prioritize Problems—Which Problem
Should You Work on First?

LO-1

Steps in the Planning Process

An Approach to Program Planning
Work with the Client
Prioritize Problems

Translate Problems into Needs-a. Get data and information to clarify need b. Specify other agencies already addressing the identified need c. Talk to other professionals involved with clients d. Ask community residents how they perceive the problem and the need e. Consider a more formal needs assessment

Evaluate the Levels of Intervention-
Establish Goals and Specify Objectives and Action Steps
Formalize a Contract

LO-5

Planning in Macro Practice

Step 8: Formalize a Contract (cont.)
The Format of a Contract-Includes:

The Written Contract- a. Advantages should be clear, virtually indisputable record b. Participants sign the contract Disadvantages- a. Takes time to draw up b. Clients may feel uncomfortable or pressured into signing a contract

Advantages:
The Oral Contract-a. Can be done swiftly and easily
b. Can be helpful with resistant clients who refuse to sign a written document

Implicit Contracts- Agreements that are implied or assumed but not actually articulated

LO-3

Use Contracts as Part of the Planning Process (cont.)

Step 3: Translate Problems into Needs
a. Problems- involve any source of perplexity or distress b. Needs typically fall into three categories 1. Items we depend upon for survival 2. Items we require in order to maintain a sense of well-being
3. Items we require to achieve a sense of fulfillment in our lives


Step 4: Evaluate Levels of Intervention—Selecting a Strategy- a. focus on the first need you and client have selected to work on b. Review the need and consider identifying micro, mezzo, and macro alternative strategies to arrive at a solution c. Emphasize your client's strengths when establishing strategies d.Pros and Cons of each strategy e. Select and pursue the strategy that appears to be most efficient and effective

LO-1

Steps in the Planning Process (cont.)

Karen K. Kirst-Ashman
Grafton H. Hull, Jr.
Supplements by Chris Simmons

UNDERSTANDING GENERALIST PRACTICE,
7E

Step 8: Formalize a Contract (cont.)
What to Include in Intervention Contracts-

Identifying Information
Specified Objectives and Action Steps
Signatures
Dates
Formats Vary
Contracts Often Change Over Time

LO-3

Use Contracts as Part of the Planning Process (cont.)

1. Identify with client the range of problems that are most significant to the client
2.Restate each problem using explicit behavioral terms
3. Prioritize the problems in order of their importance to the client
4. Establish an initial agreement with the client regarding the problem you will attend to first
Action Steps to Include:
a. Determine whether the need exists
b. Marshal support for program development-Action group
c. Allocate responsibilities to a board or advisory council
d. Describe the purpose of the proposed program.
e. Formulate clear objectives
f. Implement a feasibility study. Feasibility study- A systematic assessment of the resources needed to accomplish a specified objective and concurrent evaluation of an organization's existing and anticipated capabilities for providing those resources.
g. Solicit financial resources needed to initiate the program
h. Describe how program will provide services
i. Get the program started
j. Establish how service will be provided on an ongoing basis

Finally, formalize the contract
Karen K. Kirst-Ashman
Grafton H. Hull, Jr.
Supplements by Chris Simmons

UNDERSTANDING GENERALIST PRACTICE,
7E

Empowerment at the Mezzo Level

Empowerment at the Macro Level- 1. Adequacy and effectiveness of treatment program 2. Accessibility of alcohol and other substance abusers 3. Prevention of alcohol and other substance abuse


Integration of Policy and Practice: Ethical Dilemmas
in Managed Care an integral aspect of social work practice
Capitation-The managed care organization pays a fixed, per-person amount to its providers for a given period of time, regardless of the number of services rendered.

Two primary principles- Retention of quality and access, and controlling costs.

It reduces utilization rates, but direct costs are not total costs.

Traditional relationships between clients and workers in mental health settings have been transformed.


Ethical issues:1. Potential conflict between the gatekeeping role of managed care organizations and client self-determination. 2. Manage care may destroy informed consent. 3. Potential to violate client confidentiality.

Advocacy is an important role for social workers.
LO-8

Alcohol and Other Substance Abuse (cont.)


The Strengths Perspective on Alcohol Abuse and Dependence Treatment- a. Harm reduction treatment approach emphasizing means to reduce the harm caused by the addiction. b. A more traditional disease model used by AA may experience success with extroverted severely addicted adults seeking structure and people support. c. a harm reduction approach provides more flexibility in terms of treatment planning and goals. A key component is choice. d. The practitioner assists the clients in understanding the costs of drinking and exploring what options they have to gain greater control of their lives if that is what they desire.

Helpful Techniques in the Harm Reduction Approach: Express empathy; Develop discrepancy; Avoid argumentation; Roll with resistance; Support self-efficacy

LO-8

Alcohol and Other Substance Abuse

Treatment Approaches for Alcoholism
A Four-Stage Recovery Model
Stage 1: Abstinence
Stage 2: Confrontation
Stage 3: Growth
Stage 4: Transformation

LO-8

Alcohol and Other Substance Abuse

Generalist Practice, Empowerment, and Older Adults -
An empowerment orientation to practice can assist older people to utilize their strengths, abilities, and competencies in order to mobilize their resources toward problem solving and ultimately toward empowerment. Spirituality and religion are important sources of strengths for older adults.

Essential Concepts in Empowerment-Adaptation- To new experiences, and even losses. Competence-focus on and emphasize what they can do instead of what they cannot do. Relatedness- Strengthen older adults' relationships with others, including friends, family members, and professional caregivers. Autonomy-Helping people to live as independently as possible.


Strategies for Working with Older Adults- a. Identify and face any preconceived notions and stereotypes you might harbor about older adults. b. Appreciate the different life situations experienced by people from different age groups. c. Understand the older adults are individuals with unique characteristics and experiences. d. Learn about how both gender and cultural background influence the aging experience. e. Understand the developmental aspects of later life such as people's physical, mental, living, and socioeconomic conditions.


Empowerment in Micro Practice with Older Adults- Listen carefully to what clients are saying and work to understand the meaning. b. Help clients identify their coping skills and their abilities to implment planned change. c. Show clients videotapes of older adults talking about how they have learned to cope with issues. d. Share social media about older adults who have initiated service activities and taken political action to help others. e. Connect them with mutual support and education. f. Encourage them to help others.


LO-6

Practice Issues with Diverse Groups (cont.)

Empowerment, Child Maltreatment, and Practice
with Families and Groups

Empowerment, Child Maltreatment, and Practice with Organizations and Communities

5 areas for improvement at the Macro level:
a. Focus on providing services aimed at prevention instead of emphasizing the reporting of child maltreatment. b. A more supportive system geared toward improving resources, and services for families in general is essential to maintain family strengths. c. More resources should be directed at treatment instead of case finding. d. Focus on treatment outcomes and improvement rather than on treatment process. e. Locate and develop more community and neighborhood supports.
LO-3

Child Maltreatment and Protective Services (cont.)

The Generalist Intervention Model: Assessment

Family Assessment: Interviewing the Child-
a. Be aware of how a child's perception might differ from that of adults in at least three dimensions: 1. Children often use metaphors or stories representing what they want to say instead of using literal facts as adults do. 2.Time-Specific numbers of days or weeks may have little meaning to children. 3. A child's attention span is usually much more limited. a. Use activities such as role playing, play therapy, or drawing. b. Play therapy- the child can use toys or dolls to act out situations that are difficult to talk about.

Need to pay attention to the interview setting. Select a familiar room where they feel comfortable and where there is some privacy.
Be especially sensitive to the child's emotional perspective in view of the turbulent context of abuse (trust issues and withdrawing behaviors).

Introduce yourself and inform the child about the purpose of the interview and your own role-must be done carefully so as not to freighten the child or imply blame.

Use some initial small talk about the child's favorite toys, TV shows, or what they like to wear.
Help the child anticipate what will happen in the future.

Family Assessment: Understanding the Family

LO-3

Child Maltreatment and Protective Services (cont.)

Definitions and Indicators
Physical and Behavioral Indicators- 1. Bruises, Lacerations, fractures, burns, Head injuries, Internal injuries

Behavioral indicators-Extremely passive, accommodating, submissive behavior aimed at preserving a low profile and avoiding potential conflict with parents that might lead to abuse. Hypervigilence- Avoiding playing because it draws too much attention to themselves.

Notably aggressive behaviors and marked overt hostility toward others caused by rage and frustration at not getting needs met.

Developmental lags- because abused children are forced to direct their attention and energy toward coping with their abusive situation, they will frequently show developmental delays. These may appear in the form of language delays, poorly developed social skills, or lags in motor development.

Child Neglect- A caregiver's failure to meet a child's basic needs that may involve deprivation of physical, emotional, medical, mental health, or educational necessities.
Ex. Physical health care, mental health care, educational neglect, supervision, abandonment and substitute child care, abandonment and substitute child care, housing hazards, household sanitation, personal hygiene, nutrition, nutrition, social and attachment difficulties, cognitive and academic deficits, emotional and behavioral problems

Psychological Neglect- Passive or passive/aggressive inattention to the child's emotional needs, nurturing, or emotional well-being.

Psychological Abuse- More aggressive and negative than emotional neglect. It is belittling, humiliating, rejecting, undermining a child's self-esteem, and generally not creating a positive atmosphere for a child.

Sexual Abuse-Any sexual acitivty with a child where consent is not or cannot be given. This includes sexual contact that is accomplished by force or threat of force, regardless of the age of the participants, and all sexual contact between an adult and a child whether the child is aware of the sexual nature of the contact or not . Ex. Physical indicators, emotional indicators, increased or inappropriate sexual behaviors, difficulties in social relationships.

Incest-sexual intercourse between people too closely related to legally marry (usually interpreted to mean father-daughter, mother-son, or brother-sister combinations)


Incidence of Child Maltreatment- The actual number of child maltreatment cases is difficult to determine and one study found that 63% of reported cases were due to neglect, 20 percent to physical abuse, 10% to sexual abuse, and 8% to psychological abuse or neglect.

Characteristics of Perpetrators- Serious need for support and nurturance that remains unfulfilled from their own childhoods; Social isolation-their own self-confidence is low. They feel that no one will like them, so they isolate themselves.; Communication and relationship difficulties. Relationship abusers do have with family, significant others, and others are often stormy; Not knowing how to raise children in a nurturing family environment. Their own family environment of origin may have been hostile and abusive; Poor general coping skills. Perpertrators may be unable to cope with stress, lashing out at their children instead: Lack anger management skills, inappropriate delineation of responsibility, lack decision making or problem solving skills, lack skills in how to delay their own gratification; Extreme external stress and life crises; Parents who neglect their children appear to have characteristics similar to physically abusive parents, although poverty can also contribute to the potential for neglect; No clear-cut characterizes people who sexually abuse children other that most are male and are known to the victim. Some tend to be shy, lonely, poorly informed about sexuality, and very moralistic or religious.

LO-1

A Profile of Child Maltreatment

Chapter 7

Implementation Applications

Other Issues
Early Screening for Abuse and Dependence
The Problem of Denial

What If Your Client Has a Relapse?1. Remain calm and be empathetic 2. Treat the ordeal in as beneficial a light as possible 3. If the relapse was related to stress, address how to manage stress better in the future

What If Your Client Arrives Drunk? 1. Counseling cannot proceed effectively if a client comes to an interview drunk. 2. The worker's main goal should be to minimize the disruption and send the client safely home.

LO-8

Alcohol and Other Substance Abuse (cont.)

People with Alcohol Problems
Definitions of AODA Terms- 1. Alcohol-Refers to any type of fermented or distilled liquor containing alcohol.
2. Drug-Refers to a wide range of materials that alter the mood or consciousness when ingested. 3. Substances- Is commonly used to refer to mind-altering drugs, including alcohol. 3. Intoxication- Linked to drug abuse and dependence, is the development of a series of symptoms, involving psychological or behavioral changes, directly related to intake of the substance and its influence on the central nervous system. 4. Abuse-Maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances. 5. Substance dependence- A cluster of cognitive, behavioral, and psychological symptoms resulting from continued use of the substance despite significant resulting problems.

Your Role as a Referral Agent-Resources available: Detoxification, Outpatient treatment, Inpatient treatment, therapeutic communities, halfway houses, mutual self-help groups, pharmacological adjuncts.

The Effects of Alcoholic Parents on Their Children-a. anti-social behavior and conduct disorder, school environment problems, emotional issues, adolescence often starting point. Not all children experience negative effects when parents are alcoholics. It is recommended children of alcoholics be involved in their family's treatment process, including individual and group counseling.

Your Role in Intervention with Alcoholics-1. Engagement with the social worker in a trusting relationship. 2. A multiple-system approach should be used. 3. Follow-up care after primary treatment has ceased is critical to maintain progress. 5. Clients need help in developing a social network for support, guidance, and recreation.

LO-8

Alcohol and Other Substance Abuse

Disaster Relief Work versus Individual Crises
Assessment in Disaster Relief
Intervention in Disaster Relief-Welcoming, Framing, Educating, Grieving, Integrating, Reflecting, Empowering, Terminating and revisiting

Provision of Long-Term Help-4 phases: 1. Heroism phase-Helpers rally to respond to the crisis and help those in need.
2. Honeymoon phase- People work together to begin rebuilding their community. 3. disillusionment phase- the burdens of accessing adequate resources and trying to rebuild become extremely difficult and frustrating. 4. Reconstruction phase- Community residents take on the long-term, grueling task of rebuilding the best they can.

Taking Care of Yourself in Disaster Relief

Social Work Role and Disaster Relief-reuires multidisciplinary approach

LO-5

Crisis Intervention at the Macro Level: Disaster
Relief and Trauma Counseling

The Crisis Process-1. An individual is exposed to a heavy amount of stress over some period of time. 2. This stress acts to make the person exceptionally vulnerable to intimidation and assaults from outside. 3. Some precipitating factor acts as a turning point to push the individual into a state of active crisis, marked by disequilibrium, disorganization, and immobility. 4. The person experiences surging anxiety and such accompanying troublesome emotions as depression or grief. At this point, the individual will probably be most receptive to help.

Steps in Crisis Intervention- 1. The primary goal is to help the client return to the pre-crisis level of functioning. 2. Crisis intervention is relatively short term. 3. Specific, current, observable difficulties are the target of the intervention. 4. Crisis intervention strategies generally work better than other approaches when dealing with crises. 5. The practitioner in crisis intervention assumes a more active role which is often more directive than that assumed in other approaches to generalist practice.

Step 1: Engagement-The foundation of crisis intervention is the development of rapport.
Step 2: Assessment-Five specific areas of questioning: 1. Why did the person called or came to you on that particular day? 2. How does your client view the crisis situation and precipitating event? 3. Does your client have access to support from others? 4. What is your client's history in solving similar problems? 5. To what extent is your client either suicidal or homicidal?
Step 3: Planning-evaluate the extent the crisis has interfered with client's ability to function. Review potential alternatives, evaluate pros and cons, and determine course of action to pursue.
Step 4: Implementation-4 suggestions: 1. Help the client look at the crisis situation objectively. 2. Help the client express hidden feelings. 3. Use past coping methods in resolving the crisis. 4. Re-establish old or develop new social support systems.
Step 5: Anticipatory Planning- Anticipatory planning for evaluation, termination, and follow-up.

LO-4

Crisis Intervention-A brief and time-limited therapeutic intervention where a social worker or other mental health professional helps a client system in crisis recognize the precipitating problem and identifying potential coping methods.

Risk Assessment-To determine the degree of risk and the need to further involve the family with social services or law enforcement.

5 forces that can either contribute or dimenish risk in a home:
Maltreatment Force-Involves the type and severity of maltreatment that are occurring in the home.

Child Force- Involves the maltreated child's personal characteristics.

Parent Force-
Entails the characteristics of the parents in the family: How do they feel about themselves; their child management skills; their own upbringing in the past.

Family Force- Concerns 3 elements: What variables characterize the family in terms of demographics; How can family function, interact, and communicate, What overall support and nurturance does the family receive from the surrounding social environment.

Intervention Force- Concerns the workers' anticipation of how well the family will react to intervention.

Assessing the Forces of Risk-8 dimensions upon which goals are frequently based for families in risk management: Self-sufficiency; Communication skills; Parenting knowledge; Stress management; Impulse control; Problem-solving skills; Interactive nurturing; resource enhancement.

LO-3

Child Maltreatment and Protective Services (cont.)

Family Preservation Philosophy: Empowering Families Perspective:Problem is seen as a social issue; Condemning and punishing parents who maltreat their children does no good; Intervention should not interfere with the family's dynamics and ongoing activity any more than is absolutely necessary to endure a partnership role; Concentrate only on working constructively with the families; Coordinate intervention efforts with other professionals; most maltreating child caretakers can improve their conduct with support and assistance; Keep maltreated children within their own families if possible; Clients should always be integrally involved in the intervention.





LO-2 & 3

Child Maltreatment and Protective Services

The Generalist Intervention Model: Implementation

The Generalist Intervention Model: Evaluation,
Termination, and Follow-Up

LO-3

Child Maltreatment and Protective Services (cont.)

Overcoming Hopeless
The Generalist Intervention Model: Engagement
1. Child protective service worker should have a forthright and candid approach, making a clear statement on the agency's behalf that it has learned that the child is in potential danger and that, representing the community, it would like to enlist the aid of the parent in determining what is happening.
2. The worker should emphasize that the process is a joint process where both worker and family are trying to address and resolve the problem.
3. The worker should assume an approach of helper rather than authoritative investigator.
4. The worker should reflect the agency's concern for the well-being of the entire family.
Class Activities:
Exercise 1 Risk Management: You will be presented a case involving alleged child maltreatment, and are asked during a class discussion to assess the five forces of risk involved. See handout.

Exercise 2: What do you do with a drunken sailor (or an alcoholic client? Volunteers role play possible alcoholics. The remainder of the class then responds concerning assessment information, potential referral sources, and addressing the role player's denial. See handout.
Doing the Follow-Up-The act of acquiring information about a client following termination

Possible Tasks- 1. Actively represent the consumer 2. Discuss problems 3. Straighten out difficulties 4. Prepare the consumer

Possible intervention outcomes that may be discovered during follow-up: 1. The client may be functioning at the same level in follow-up as at termination 2. The client may have shown more improvements since termination 3. There may be gradual deterioration that is a result of premature withdrawal of the intervention or of oter unknown factors. 4. Rather than a gradual deterioration, there may be a complete relapse



LO-10

Client Follow-Up

Other Points about Termination
Reactions and Feelings in Termination
Extent and Range of Emotional Reactions
Amount of Contact
Size and Type of System
Mixed Feelings
Worker Reactions to Termination

LO-5 & 6

Termination and Follow-Up (cont.)

Alternative Explanations for Program Outcomes
History
Maturation
Mortality
Creaming
Regression toward the Mean
Reactance
Unanticipated Consequences

LO-4

Issues and Problems in Evaluation (cont.)

LO-3

Evaluation Designs for Programs (cont.)

LO-2

LO-2

Data-Gathering Methods: Surveys or interviews or observations

Independent variable- The factor we think is responsible for causing certain behaviors, reactions, or events

Dependent Variables- The outcome or end product of the helping process (outcome is dependent upon the helping efforts)

Generalizability-The ability of a set of results in one situation to fit another circumstance or instance

Generalization across the Globe

LO-2

The Evaluation Process (cont.)

Formative Evaluation-Focus on the process of providing help instead of the end product of help giving

Summative Evaluations-Provide information about whether or not the outcome we anticipated at the beginning of our planned change process has been achieved

Note: Formative evaluations occur while a planned change process is continuing, and a summative evaluation occur at the conclusion of the planned change process looking backwards.

Baseline-A measure of the frequency, intensity, or duration of a behavior.



LO-2

The Evaluation Process

Definition and Purposes of Evaluation
1. Evaluation- A process of assessing the success or worthwhile
2. Micro level- Determine to what extent our work with a specific client was successful
3. Mezzo level- Determine if the treatment or educational group achieved its purposes
4. Macro level- Determine whether entire programs accomplished their purpose

External Factors in Evaluation- 1. Economic 2. Political 3. Consumer 4. Accountability-In social work it involves being responsible for and answerable to others for the quality and effectiveness of one's efforts.

1. Obstacles to Evaluation- Reasons evaluation has not been an ongoing concern for workers:
a. Leaves practitioner vulnerable b. Workers are often too busy c. Many agencies have not emphasized its importance d. Most social workers lack training in use of evaluation

2. Thrusts of evaluations
a. Monitoring- Looks at the process of giving service b. Evaluation- Looks at the effectiveness of the service provided c. Effectiveness- Involves succeeding at what you set out to accomplish
d. Efficiency- Concerns doing it at a reasonable cost


LO-1

Evaluating Social Work Practice

Chapter 8

Evaluation, Termination, and
Follow-Up in
Generalist Practice

-1. Suggestions are to help clients maintain and generalize changes: a. Help-clients select and appropriate situations to work on b. Help clients build confidence in their own abilities c. Use multiple situations and settings when helping members learn new behaviors d. Use naturally occurring consequences rather than creating artificial ones e. Extend treatment through use of follow-up sessions f. Reduce setbacks in other environments g. Help members confront future problems by teaching them sa problem-solving process

Stabilizing Change in Small Groups a. Vary use of group activities
b . Ceremonies (graduations) help intensify the sense of ending and acknowledge progrss of client.

Stabilizing Change in Large Systems-a. Routinize procedures and processes b. Clarification of policies and procedures c. Reducing the influence of the change agent d.Addressing Ongoing Needs of Clients

LO-9

Stabilization of Change

Planning for Termination- Tasks of Termination 1. Decide when to terminate the professional worker-client relationship 2. Evaluate achievements of objectives 3. Maintain and continue progress 4. Resolve emotional reactions of the worker and client 5. Make appropriate referrals 6. Ultimately, the goal at termination is to empower the client system

Unplanned Terminations 1. may occur because no progress has been made or because problems are getting worse, not better. 2. Client is being referred to another agency 3. Client may simply quit coming without notifying the worker 4. The area being probed is too sensitive and the client cannot tolerate opening the matter up See highlight 8.5 Unplanned Terminations in Groups Listed Reasons for Termination


Addressing Feelings about Termination-

Table 8.7 Factors Affecting Reactions to Terminations 1. Mixed Feelings 2. Worker reactions to termination 3. planning for termination 4. addressing feelings about termination a. Worker should help the client express any feelings associated with termination b. Sometimes sharing the worker's own feelings about the approaching termination can be helpful

Summarizing Progress

LO-7 & 8

Helping Clients at Termination

Ethical Practice and Critical Thinking about Termination
Terminating Professional Relationships
Tasks of Termination
Planned Terminations
Unplanned Terminations

LO-5

Termination and Follow-Up

A. Problems in Generalizability-1. Random sample- One in which all elements in a population have an equal probability of being included in a sample 2. Stratified random sampling-A method of sampling that ensures some important subset or strata of a population is not accidentially left out of a typical random sample

B. Wrong Choices of Evaluation toolsC. Failure to Involve Clients in the Evaluation Process
D. Staff Distrust of Evaluation
E. Evaluation Process Interference with Service-Giving
F. Alternative Explanations for Program Outcomes *





LO-4

Issues and Problems in Evaluation

Needs Assessments- Systematic efforts to help an agency determine whether, and to what extent, a program is needed. A form of front-end analysis

Evaluability Assessments- Methods designed primarily to answer the questions: Can this program be evaluated? and Is the agency evaluation ready?

Process Analysis-Designed to evaluate the way interventions in anagency are carried out (formative evaluations)

Program Outcome Analysis-An evaluation designed to tell us whether or not a program is working

Continuous Quality Assurance Evaluations- Evaluations focused on measuring attainment of previously identified program goals (Usually specific indicators that the agency has accepted evidenced best practices)

Program Monitoring-An ongoing activity designed to provide information to the agency on all aspects of its ooperation

LO-3

Evaluation Designs for Programs

LO-2

Evaluation Designs for Generalist Practice

Validity- Refers to the extent to which you are measuring what you think you are measuring.

Face validity- Professional judgement about whether the measure actually measures what it is suppose to do.

Concurrent validity- Exists when scores on one instrument correlate well with scores on another instrument that is already considered valid.

Predictive validity- Exists when a measure can be used to predict future events.

Reliability- The extent to which an instrument measures the same phenomenon the same way each time it is used.
Single-Subject Designs- Research methods aimed at determining whether or not an intervention was successful, and are frequently used with a single case or client

There are four types: AB design; B Design; ABC Design; and ABAB Design
AB Design- The outcome of the intervention is compared to the state of affairs prior to intervention

a. The A represents the preintervention state, and B the intervention
b. Figure 8.2 Single subject (AB) Design
c. Steps in implementation
1) Identify an easily measured goal
2) Baseline established showing frequency of the behavior prior to intervention (Phase A)
3. Record kept of frequency of behavior during and following intervention
B Design- Used when there is no opportunity to establish a baseline
a. Only the behavior occurring during and at the end of the intervention phase can be measured
b. It is relatively simplistic to consider results that occur in Phase B to be caused by the intervention
c. Figure 8.3: B Design Without a Baseline
ABC Design
a. Phase A: Period prior to intervention
b. Phase B: When social worker begins to provide an intervention
c. Phase C: Additional treatment prescribed
d. Figure 8.4: ABC Design
ABAB Design
a. A: Baseline
b. B: Intervention runs it course and is discontinued
c. A: Base on the measurement level when the last intervention stopped
d. B: Intervention is begun again
e. Figure 8.5: ABAB Design
f. The Rathus Assertiveness Scale is a n Example
Additional Perspectives on Single-Subject Design
BAB-Multiple baselines
Figure 8.6: BAB Design with multiple baselines

Goal-Attainment Scaling- A method used when achievement of the goal is sufficiently important to be used as the primary outcome criterion

Task-Achievement Scaling- A method of evaluating the degree to which an identified set of tasks has been accomplished
1. Typically a five-point scale is used

Client Satisfaction Questionnaires- A series designed to learn the reactions of the client to various aspects of a product
Disadvantage: Potential for misuse

Target -Problem Scaling- A process where a problem is identified, a plan is implemented, and changes in target problems are measured to determine if the problem has changed in severity or seriousness
* Highlight 8.3 Alternative Explanations for Outcomes
a. History-Any event that occurs prior to the end of an intervention
b. Maturation- The process of aging
c. Mortality- The loss that occurs when some of the people in the sample begin to drop out
d. Creaming-The tendency of smoe programs to take only the very best candidates for a program
e. Regression towards the mean- The tendency for extreme scores to move toward the mean over time
f. Reactance-The reaction or change of behavior that occurs simply because of a new situation or environment

Cultural Competence and Evaluation-

1. Ensure that samples chosen for research accurately reflect the diversity and characteristics of the entire population

2. Be sensitive to data gathering than may be less effective with some groups

3. Recognize that language differences and facility with English may place respondents from other
cultures at a disadvantage in terms of understanding either written or oral interview questions

4. Whenever possible, involve members of minority groups, people of color, women, and gay and lesbian people in the planning stages of research that affects them

5. Use culturally sensitive language

6. Use interpreters to ensure understanding

7. Focus on strenghts

8. Avoid generalizing to other groups

9. Look for differences that may help understand differential outcomes

10. Ensure questions are gender-neutral

11. When given choices make certain you have not overlooked options for different ethnic groups or ones that do not apply

Unanticipated Consequences:
1. Side effects-When a program has had consequences or outcomes we did not envision. These may be classified as harmful to clients, netral in their impact, or beneficial.
2. Regressive effects- A situation gets worse as a result of the intervention (e.g., Scared Straight programs)
Termination must be based on clear evidence that the goals and objectives have been achieved.
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