Comp Exam Flashcards
Mission of Social Work
Service Social Justice Dignity and Worth of the Person Importance of Human Relationships Integrity Competence
Ethical Dilemma
A ________ _________ is a predicament when a social worker must decide between two viable solutions that seem to have similar ethical value. Sometimes two viable ethical solutions can conflict with each other. Social workers should be aware of any conflicts between personal and professional values and deal with them responsibly.
Essential Steps in Ethical Problem Solving
- Identify ethical standards, as defined by the professional codes of ethics, that are being compromised (ALWAYS go to the NASW Code of Ethics first – do not rely on supervisor or coworkers).
- Determine whether there is an ethical issue or dilemma.
- Weigh ethical issues in light of key social work values and principles as defined by the NASW Code of Ethics.
- Suggest modifications in light of the prioritized ethical values and principles that are central to the dilemma.
- Implement modifications in light of prioritized ethical values and principles.
- Monitor for new ethical issues or dilemmas.
Ethical Standards
The following _______ _______ are relevant to the professional activities of all social workers. These standards concern (1) social workers’ ethical responsibilities to clients, (2) social workers’ ethical responsibilities to colleagues, (3) social workers’ ethical responsibilities in practice settings, (4) social workers’ ethical responsibilities as professionals, (5) social workers’ ethical responsibilities to the social work profession, and (6) social workers’ ethical responsibilities to the broader society.
CSUSM MSW Foundation and Advanced Practice Behaviors
- Demonstrate Ethical and Professional Behavior.
- Engage Diversity and Difference in Practice.
- Advance Human Rights and Social, Economic, and Environmental Justice.
- Engage in Practice-Informed Research and Research-informed Practice.
- Engage in Policy Practice.
- Engage with Individuals, Families, Groups, Organizations, and Communities.
- Assess Individuals, Families, Groups, Organizations, and Communities.
- Intervene with Individuals, Families, Groups, Organizations, and Communities.
- Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities.
Congress ETHIC Decision Making Model
E - Examine personal, professional, client, agency, societal values.
T - Think about the applicable ethical standards, laws and legal precedents that apply.
H - Hypothesize different decisions, their outcomes and the impact on relevant systems.
I - Identify who will benefit and who will be harmed by these specific decisions keeping in mind the professional values and mission.
C - Consult.
Concept of Boundaries
- A sense of personal identity and self definition that has consistency and cohesion over time.
- This remains constant regardless of emotional ups and downs or external pressures.
- The framework within which the worker-client relationship occurs.
- Provides a system of limit setting.
- The line between the self of client and self of worker.
7 Areas of Concern Dealing with Boundaries
- Over familiarity with clients.
- Personal gain.
- Gift giving and receiving.
- Treatment of family and friends.
- Social contacts.
- Sexual relationships with clients.
- Sexual harassment.
Client Vulnerabilities to Boundary Violations
- Impulsivity
- Borderline personality
- Confused, alone, want sex and caring
- Childhood Trauma
- Low self-esteem
- Needs validation
- Marital problems
- Psychiatric disorders
Danger Zones for Boundaries
- Over-identification with client’s issues
- Strong attraction to client’s personality
- Strong physical attraction to client
- Clients who can potentially reward you with their influence.
- Transference and counter transference
Questions to Ask in Examining Potential Boundary Issues
- Is this in my client’s best interest?
- Whose needs are being served?
- How would I feel telling a colleague about this?
- How would this be viewed by the client’s family or significant other?
- Does the client mean something “special” to me?
- Am I taking advantage of the client?
- Does this action benefit me rather than the client?
Ethical Standards
- Social Workers’ Ethical Responsibilities to Client
- Social Workers’ Ethical Responsibilities to Colleagues
- Social Workers’ Ethical Responsibilities in Practice Settings
- Social Workers’ Ethical Responsibilities as Professionals
- Social Workers’ Ethical Responsibilities to the Social Work Profession
- Social Workers’ Ethical Responsibilities to the Broader Society
The Social Worker’s Role in the Problem-Solving Process
- Consultant
- Advocate
- Case Manager
- Catalyst
- Change Agent
- Counselor
- Broker
- Mediator
- Facilitator
- Instructor
- Mobilizer
- Resource Allocator
Cycle of Violence
Phase I: Tension Building
Phase II: Battering incident – shortest period of the cycle, lasts a brief time
Phase III: “Loving-contrition” (absence of tension or “honeymoon” phase) – batterer offers profuse apologies; assures attacks will never happen again; and declares love and caring.
Impact of Diversity in Styles of Communicating
- Recognize direct and indirect communication styles.
- Demonstrate sensitivity to nonverbal cues.
- Generate a wide variety of verbal and nonverbal responses and strategies.
- Use language that is culturally appropriate.
- Identify his or her own professional style and recognize limitations and strengths.
- Identify and reduce barriers that will inhibit engagement with persons who are culturally different.
ADDRESSING Framework
A - Age and generational differences
D - Disability status (developmental disability)
D - Disability status (acquired physical / cognitive / psychological disabilities)
R - Religion and spiritual orientation
E - Ethnicity
S - Socioeconomic status
S - Sexual orientation
I - Indigenous heritage
N - National origin
G - Gender
Cultural Competency VS. Cultural Humility
The approach of cultural humility goes beyond the concept of cultural competence to encourage individuals to identify their own biases and to acknowledge that those biases must be recognized. Cultural competency implies that one can function with a thorough knowledge of the mores and beliefs of another culture; cultural humility acknowledges that it is impossible to be adequately knowledgeable about cultures other than one’s own.”Humility denotes a willingness to accurately assess oneself and one’s limitations, the ability to acknowledge gaps in one’s knowledge, and an openness to new ideas, contradictory information, and advice.
Why is Cultural Humility Important?
- Cultural humility means not pigeon-holing people. Knowledge of different cultures and their assumptions and practices is indeed important, but it can only go so far,
- Cultural humility is also an important step in helping to “redress the imbalance of power, and
- Approaching each encounter with the knowledge that one’s own perspective is full of assumptions and prejudices can help one to keep an open mind and remain respectful of the person (s) seeking involvement.
Cultural Sensitivity
The ability to be open to learning about and accepting of different cultural groups.
Internalized Oppression
A subconscious belief in negative stereotypes about one’s group that results in an attempt to fulfill those stereotypes and a projection of those stereotypes onto other members of that group.
Heterosexism
A belief in the inherent superiority of one pattern of loving over all and thereby the right to dominance.
Multiculturalism
The recognition and acknowledgment that society is pluralistic. In addition to the dominant culture, there exists many other cultures based around ethnicity, sexual orientation, geography, religion, gender, and class.
Culture
A body of learned beliefs, traditions, principles, and guides for behavior that are shared among members of a particular group.
Ethnocentrism
To judge other cultures by the standards of one’s own, and beyond that, to see one’s own standards as the true universal and the other culture in a negative way.
Primary Dimensions of Diversity
______ ______ are aspects of ourselves that we cannot change They are things people know about us before we even open out mouths because they are physically visible (except sexual orientation). When people feel they are being stereotyped based on primary dimension, they can be very sensitive about it.
Secondary Dimensions
______ ______ are elements we have some power to change. People are less sensitive about ______ ______. We also have the choice of whether to disclose this information or not; we can conceal these characteristics.
Intersectionality
According to an ________ perspective, inequities are never the result of a single, distinct factors. Rather, they re the outcome of intersections of different social locations, power relations and experiences.
Ways to facilitate communication across cultural boundaries
- Recognize differences
- Build your self-awareness
- Describe and Identify, then Interpret
- Don’t assume your interpretation is correct
- Verbalize your own non-verbal signs
- Share your experience honestly
- Acknowledge any discomfort, hesitation, or concern
- Practice politically correct communication
- Give your time and attention when communicating
- Don’t evaluate or judge
Individual’s Path to Cultural Competency
- Ethnocentricity
- Awareness
- Understanding
- Acceptance / Respect
- Appreciation / Value
- Selective Adoption
- Multi-culturation
Community Organizing
______ ______ is focused on harnessing the collective power of communities to tackle issues of shared concern. It challenges government corporations, and other power-holding institutions in an effort to tip the power balance more in favor of communities.
______ ______ enhances participatory skills of local citizens by working with and not for them, thus developing leadership with particular emphasis on the ability to conceptualize and act on problems. It strengthens communities so they can better deal with future problems; community members can develop the capacity to resolve problems.
Social Planning
______ ______ is defined as the process by which a group or community decides its goals and strategies relating to societal issues. It is not an activity limited to government, but includes activities of the private sector, social movements, professions, and other organizations focused specifically on social objectives.
Family
- to control and regulate sexual behavior
- to provide for new members of society
- to provide for the economic and emotional maintenance of individuals
- to provide for primary socialization of children
Religion
- to provide solutions for the unexplained
- to support the normative structure of the society
- to provide a psychological diversion from unwanted life situations
- to sustain the existing class structure
- to promote and prevent social change
Techniques to Inform and Influence Organizational And Social Policy
- knowledge / innovation
- social, political, and economic conditions / resources
- legal issues / laws
- institutional influences
- external influences
Cooptation
______ has many meanings, but may be used as a strategy to influence social policy as leaders will try to quiet dis-sention or disturbances not only by dealing with immediate grievances, but by making efforts to channel the energies and angers of dissenters into more legitimate and less disrupting activities. When ____ing, incentives are offered and other efforts are made aimed at complacency.
What are the three prevention strategies?
- Primary prevention
- Secondary prevention
- Tertiary prevention
Primary Prevention
The goal is to protect people from developing a disease, experiencing an injury, or engaging in a behavior in the first place.
Examples:
- immunizations against disease
- education promoting the use of automobile passenger restraints and bicycle helmets
- screenings for the general public to identify risk factors for illness
- controlling hazards in the workplace and home
- regular exercise and good nutrition
- counseling about the dangers of tobacco and other drugs
Since successful ______ ______ helps avoid the disease, injury, or behavior and its associated suffering, cost, and burden, it is typically considered the most cost-effective.
Secondary Prevention
______ ______ occurs after a disease, injury, or illness has occurred. It aims to slow the progression or limit long-term impacts. It is often implemented when asymptomatic, but risk factors are present. ______ ______ also may focus on preventing rein jury.
Examples:
- telling those with heart conditions to take daily, low-dose aspirin
- screenings for those with risk factors for illness
- modifying work assignments for injured workers
Tertiary Prevention
______ ______ focuses on managing complicated, long-term diseases, injuries, or illnesses. The goal is to prevent further deterioration and maximize quality of life because disease is now established and primary prevention activities have been unsuccessful. However, early detection through secondary prevention may have minimized the impact of the disease.
Examples:
- pain management groups
- rehabilitation programs
- support groups
Filtered resources
- systematic reviews
- critically-appraised topics
- critically-appraised individual articles
Unfiltered Resources
- randomized controlled trials
- cohort studies
- case-controlled studies, case series, and case reports
Levels of Evidence Pyramid
In order of best:
- systematic reviews
- critically-appraised topics
- critically-appraised individual articles
- randomized controlled trials
- cohort studies
- case-controlled studies, case series, and case reports
- background information / expert opinion
F.L.A.I.R.
F - Formulate an answerable question based on a client or organizational need
L - Locating the best available evidence to answer the question
A - Assess the quality of the evidence as well as its applicability
I - Integrate the evidence with client / social context, practitioner experience and judgment
R - Review and evaluate the effectiveness and efficacy of the solution
Evidence-Based Practice (EBP)
______-______ ______ is a process in which the practitioner combines well-researched interventions with clinical experience, ethics, client preferences, and culture to guide and inform the delivery of treatments and services.
Mission Statement
A ______ ______ is a general, concise statement outlining the purpose guiding the practices of an organization.
Goals
______ are broad, general statements of what the program intends to accomplish.
Objectives
______ are brief, clear statements that describe the desired outcomes. They are distinguished from goals by the level of specificity.
Outcomes
______ may be knowledge, abilities (skills), and / or attitudes (values, dispositions) that have been obtained. ______ are achieved results.
Needs Assessment
A ______ ______ is a systematic process for determining and addressing gaps between current and desired conditions.
Perceived Need
______ ______ are defined by what clients think about their needs, with the standard set by each client.
Expressed Need
______ ______ are defined by the number of clients who have sought help, thus taking action to address their problems.
Relative Need
______ ______ are concerned with equity – comparing the needs of clients with the goal of ranking them.
The effects of program evaluation findings on services
One of the most significant benefits that a ______ ______ communicates is the need to make service improvements. Some examples of improvements that may need to be made include:
- eliminating services that do not achieve program outcomes
- adding services that are better designed to achieve outcomes
- acquiring more adequate resources to support effective services
- targeting a different group of participants to receive services
Methods to evaluate agency programs
- cost-benefit analysis
- cost-effectiveness analysis
- outcome assessment
Cost-benefit Analysis
A ______-______ ______ determines the financial costs of operating a program as compared with the fiscal benefits of its outcomes. A ______-______ ratio is generated to determine whether, and the extent to which, the costs exceed the benefits. Program decisions can be made to eliminate or modify the program (by reducing program expenditures) based upon the findings.
Cost-effectiveness Analysis
A ______-______ ______ is similar to a cost-benefit analysis, but distinct. It considers the benefits that are not measured in monetary terms, such as illnesses prevented and / or lives saved. It does not produce a cost-benefit ratio, but may focus on the most financially efficient way to achieve a defined outcome or the cost for producing a specific non-monetary outcome.
Outcome Assessment
An ______ ______ is the process of determining whether a program has achieved its intended goal(s). It involves collecting evidence through assessment, analyzing the data, and then using the findings to make programmatic changes if needed. It is an iterative process with continual feedback loops.
Types of research
- Experimental
- Quasi-experimental
- Pre-experimental
Experimental Research
- Randomized experiments, also called ______, are the most rigorous.
Quasi-Experimental Research
When randomization of subjects or groups is neither practical nor feasible, ______-______ approaches can be used.
Pre-Experimental Research
______-______ studies contain intervention groups only and lack comparison / control groups, making them the weakest.
Single-Subject Research Design
______-______ ______ aims to determine whether an intervention has the intended impact on a client, or on many clients who form a group. The most common ______-______ ______ is pre- and post-test or single-case study (AB) in which there is a comparison of behavior before treatment (baseline; denoted by “A”) and behavior after the start of treatment (intervention; denoted by a “B”). The reversal or multiple baseline (ABA or ABAB) is also commonly used.
In ______-______ ______, a client is used as his or her own control. The focus differs from experimental research, which looks at the average effect of an intervention between groups of people.
______-______ ______ is ideal for studying the behavioral change a client exhibits as a result of some treatment. When done correctly and carefully, single-subject research can show a causal effect between the intervention and the outcome.
Internal Validity
______ ______ addresses the extent to which causal inferences can be made about the intervention and the targeted behavior.
External Validity
______ ______ addresses how generalizable those inferences are to the general population.
Descriptive Statistics
Once entered into the computer, ______ ______ are used to describe the basic features of the data. They provide simple summaries about the sample and the measures. Together, with simple graphics analysis, they form the basis of virtually every quantitative analysis of data. ______ ______ describe what the data shows.
Inferential Statistics
______ ______ used to answer research questions or test models or hypotheses. In many cases, conclusions from ______ ______ extend beyond the immediate data. For instance, ______ ______ determine the probability that an observed difference between groups is a dependable one or not that might have happened by chance.
Reliability
(dependability, stability, consistency, predictability): Can you get the same answer repeatedly?
Validity
(accuracy): Is what is believed to be measured actually being measured or is it something else?
External Validity
Can the results be generalized?
Internal Validity
Is there confidence in cause / effect?
Interrater or Interobserver Reliability
Assesses the degree to which different raters / observers give consistent estimates of the same phenomenon.
Test-Retest Reliability
Assesses the consistency of a measure from one time to another.
Parallel Forms Reliability
Assesses the consistency of the results of two tests constructed in the same way from the same content domain.
Method for evaluation
How will progress be measured?
Schedule for evaluation
When, how often, and on what dates or intervals of time will progress be measured?
Formative Evaluations
______ ______ are ongoing processes that allow for feedback to be implemented during service delivery. These types of evaluations allow social workers to make changes as needed to help achieve program goals. Needs assessments can be viewed as one type of formative evaluation.
Summative Evaluations
______ ______ occur at the end of services and provide an overall description of their effectiveness. ______ ______ examines outcomes to determine whether objectives were met. ______ ______ enable decisions to be made regarding future service directions that cannot be made during implementation. Impact evaluations and cost-benefit analyses are types of ______ ______.
NASW Evaluating Practice
- Obtaining voluntary and written informed consent from clients, when appropriate, without any implied or actual deprivation or penalty for refusal to participate; without undue inducement to participate; and with due regard for participants’ well-being, privacy, and dignity.
- Page 260 in textbook.
Tools for Ethical Decision Making
Ethical Rules Screen
Ethical Principles Screen
Essential Steps for Ethical Problem-Solving
- Determine
- Identify
- Rank
- Develop
- Implement
- Reflect
Strengths Perspective
Everyone has this - this approach allows social workers to identify client ______ and building upon them to increase client functioning. In utilizing this approach, clients may live a more meaningful and satisfying life.
Multiethnic Placement Act
Prohibits states from delaying, or otherwise discriminating against adoption placement based on the prospective adoptive parent’s race, color, or ethnicity.
Cultural Hegemony
The all-concompassing dominance of particular structures in society. Not limited to political control, but includes a way of seeing the world that includes cultural and political dominance.
First Generation Human Rights
Civil and political rights that focus on the prevention and protection of human rights violations. Protecting the rights of political prisoners, deportation of refugees. Social workers work to protect these rights by advocating for their protection.
Second Generation Human Rights
Focus on the protection of Economic, and cultural human rights. Social workers can deliver direct practice and challenge policy and social action in favor of clients.
Multiculturalism
Society is pluralistic. This is important to keep in mind with micro settings, such as, clinical work where the client may have a different understanding of their their presenting symptoms based on their cultural background. On a larger level, it behooves social workers to promote policies and legislation that are tolerant of the various cultures in society.
Environment Theory
Focuses on social function problems, environmental problems, mental health problems, and physical health problems. This theory allows social workers to better understand the unique circumstances of every client without de-contextualizing their lived experiences to inform treatment in collaboration with the client.
Person-Centered Theory
Denotes that all people are inherently good. It asserts that change is possible when the practitioner validates the client. This theory states that the practitioner takes a non-directive approach; by respecting the choices, the client makes and refrains from giving unsolicited advice.
Ecosystems Perspective
Looks at people changing and adapting as a result of an ever-changing environment. Social workers understand that clients exist within a larger system context. However, within this system, there exists sub-systems and a change in one system can trickle to other parts of functioning system.
Ethnic-Sensitive Perspective
People all have different walks of life. This perspective states that ethnicity, culture, religion, and socio-economic class influence client’s thoughts, behaviors, and values. It could influence how problems are defined, or whether a client decides to seek help. Social workers strive to work clients in a way that is tuned to the client’s beliefs, values, traditions, and expectations.
Solution-Focused Model
Allows social workers to work with diverse populations, such as individuals, families, and couples. This model views clients as the true experts in their lives. Clients have all the strengths and resources that can be utilized to solve problems in their lives.
Intersectionality Theory
Recognizes numerous vectors of oppression and privilege, including, but not limited to gender, class, race, global location, sexual orientation and age; recognizes that individuals often hold cross cutting and overlapping memberships in different status groups.
Intersectionality Feminist Theory
States that no single category is sufficient to understand social oppression, and that categories such as gender, race, and class intersect to produce different experiences for women of various races or classes.
Systems Perspective
The relationship between human action and social systems. The interweaving of one’s culture, societal values, customs, expectations, poverty, physical and emotional health, and environment that shape a person. Taking a systems perspective, social workers are more alert of how various systems affect diverse groups of people.
Feminist Theory
Theories that focus on male domination of the major social institutions and present a vision of a just world that aims to redistribute power away from the dominant patriarchy.
Biopsychosocial Approach
Asserts that human behavior is a result of interactions of integrated biological, psychological, and social systems.
Genogram
A visual representation of the multi-generational family system, using squares, circles, and relationship lines. This screening tool allows the social worker to develop understanding of the client’s family system.
Family Ecomap
Visual representation of how a family is connected to other individuals and social systems; uses circles, lines, and arrows to show family relationships and the strength and directional flow of energy and resources to and from the family.
Respectful Model
R - Religious/Spiritual Model
E - Economic Class
S - Sexual identity
P - Psychological development
E - Ethnic/Racial identity
C - Chronological age
T - Trauma and threats to well-being
F - Family
U - Unique physical issues
L - Language and location of residence
Internal Controls
______ ______ are systematic measures instituted by a human service organization to deliver services in an orderly and efficient manner; appropriately manage its assets and resources; deter and detect errors, abuse, fraud, and theft; produce reliable and timely management information; and adhere to established policies and procedures. ______ ______ are put in place to help ensure that human service organizations achieve their objectives.
Preventive Controls
______ ______ are designed to avoid errors or irregularities from occurring, such as having managers approve expense requests to prevent inappropriate expenditures.
Detective Controls
______ ______ are designed to identify an error or irregularity after it has occurred. These controls are performed on a routine basis to identify issues that pose potential risks in a timely manner. A ______ ______ can be having managers review expenditure and other fiscal reports to assure that they accurately reflect the financial transactions of the agency.
Title VI of the Civil Rights Act of 1964
…states that no person shall “on the grounds of race, color, or national origin, be excluded from participation in, denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.” It desegregated all schools and public buildings and required all agencies that receive federal funds to terminate discriminatory hiring practices. Social workers are charged with challenging discriminatory practices and upholding the belief of equal rights for all.
The Older Americans Act (OAA) of 1965
…offers services to older Americans. It established the Administration on Aging, which empowers the federal government to distribute funds to the states for supportive services for individuals over the age of 60. The Administration achieves its aim by awarding grants to states, which pass them along to local Area Agencies on Aging (AAA). Some programs target vulnerable older adults who need help staying in their homes. Other programs provide access services, in-home services, community services, caregiver services, and opportunities for volunteer work.
Child Abuse Prevention and Treatment Act of 1974
…is key legislation for addressing child abuse and neglect. It has been amended several times and provides federal funding to states in support of prevention, assessment, investigation, prosecution, and treatment activities; it also provides grants to public agencies and nonprofit organizations for demonstrating programs and projects.
Family Educational Rights and Privacy Act (FERPA) of 1974
…protects the privacy of educational records. The law applies to all schools that receive funds under an applicable program of the United States Department of Education. ______ gives parents certain rights with respect to their children’s education records. These rights transfer to the student when he or she reaches the age of 18 or attends a school beyond the high school level. Prior to 18, parents have the right to inspect and review a student’s education records maintained by the school. Schools are not required to provide copies of records unless, for reasons such as great distance it is impossible for parents to review the records.
Education for All Handicapped Children Act of 1975
… guarantees a free, appropriate public education to all children with disabilities between the ages of 3 and 21. Children receiving such services should be provided with Individual Educational Programs (IEPs) which are outlined in plans that are revised annually. A team composed of a social worker, teacher, administrator, and other relevant school personnel typically create the IEP.
Indian Child Welfare Act of 1978
…gives American Indian / Native American / Indigenous nations or organizations jurisdiction over child welfare cases that involve an American Indian / Native American / Indigenous child in order to protect the integrity of American Indian / Native American / Indigenous Families. The law specifies a hierarchical procedure for placement of an American Indian / Native American / Indigenous child: (a) verify the ethnic and tribal identity of the child; (b) allow tribal jurisdiction over case; (c) if tribe rejects jurisdiction, placement with family member; or (d) if that is impossible, placement with family of the same tribe. The last resort is placing the child in a home with a family that is not American Indian / Native American / Indigenous.
Adoption Assistance and Child Welfare Act of 1980
…focuses on family preservation efforts to help keep families together and children out of foster care or other out-of-home placements. This law also focuses on family reunification or adoption if a child is removed from a home. The act requires courts to review child welfare cases more regularly and mandates that states make “reasonable efforts” to keep families together via prevention and family reunification services. States are also required to develop reunification and preventative programs for foster care and assure that children in nonpermanent settings are seen at least every 6 months. An adoption subsidy reimbursed by the federal government is also provided through this law for children with complex needs or disabilities.
Americans with Disabilities Act (ADA) of 1990
…is civil-rights legislation that prohibits discrimination on the basis of disability. It has been amended and affords similar protections as the Civil Rights Act of 1964 for discrimination based on race, religion, sex, national origin, and other characteristics. Unlike the Civil Rights Act of 1964, the ADA also requires covered employers to provide reasonable accommodations to employees with disabilities and imposes accessibility requirements on public accommodations. ADA disabilities include both mental and physical conditions. A condition does not need to be severe or permanent to be a disability.
Patient Self-Determination Act (PSDA) of 1991
…introduced a new set of federal requirements intended to implement advance directive policies at all health care facilities that receive federal funding through Medicaid and Medicare programs. The Act specified that these facilities must inform clients of their rights to make decisions concerning their own health care, ask and document whether a client has an advance directive, and provide education for staff and the community.
Family and Medical Leave Act (FMLA) of 1993
…requires covered employers to provide up to 12 weeks of unpaid, job-protected leave to “eligible” employees for certain family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave.
Multiethnic Placement Act (MEPA) of 1994
…prohibits agencies from refusing or delaying foster or adoptive placements because of a child’s or foster / adoptive parent’s race, color, or national origin, and prohibits agencies from considering race, color, or national origin as a basis for denying approval as a foster and / or adoptive parent. It also requires agencies to diligently recruit a diverse base of foster and adoptive parents to better reflect the racial and ethnic makeup of children in out-of-home care.
Violence Against Women Act (VAWA) of 1994
…has improved the criminal justice response to violence against women by strengthening federal penalties for repeat sex offenders and creating a federal “rape shield law”, which is intended to prevent offenders from using victims’ past sexual conduct against them during a rape trial; keeping victims safe by requiring that a victim’s protection order will be recognized and enforced in all state, tribal, and territorial jurisdictions; increasing rates of prosecution, conviction, and sentencing of offenders by helping communities develop dedicated law enforcement and prosecution units and domestic violence dockets; training law enforcement officers, prosecutors, victim advocates, and judges; and ensuring access to the services needed by victims to achieve safety and rebuild they lives.
Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996
…was considered to be a fundamental shift in both the method and goal of federal cash assistance to the poor. It added a workforce development component to welfare legislation, encouraging employment among the poor. PRWORA instituted Temporary Assistance for Needy Families (TANF), which became effective July 1, 1997. TANG replaced the Aid to Families With Dependent Children (AFDC) program, which had been in effect since 1935, and also supplanted the Job Opportunities and Basic Skills (JOBS) Training Program of 1988. It also imposed a lifetime 5-year limit on the receipt of benefits.
Patient Protection and Affordable Care Act (ACA) of 2010
…expands access to insurance, increases protections, emphasizes prevention and wellness, improves quality and system performance, expands the health workforce, and curbs the rising health care costs. Key provisions of the ACA that intend to address rising health costs include providing more oversight of health insurance premiums and practices; emphasizing prevention, primary care, and effective treatments; reducing health care fraud and abuse; reducing uncompensated care to prevent a shift onto insurance premium costs; fostering comparison shopping in insurance exchanges to increase competition and price transparency; implementing Medicare payment reforms; and testing new delivery and payment system models in Medicaid and Medicare.
Workforce Innovation and Opportunity Act (WIOA) of 2014
…reauthorizes the Workforce Investment Act (WIA) of 1998 with several key changes in areas such as Workforce Development Boards; One-Stop Operations; Job-Driven Training for Adults and Dislocated Workers; and Integrated Performance and Youth Services.
Fiscal Management Techniques
- Planning
- Acquisition
- Allocation
- Internal control
- Recording / Reporting
- Evaluating
Formal Power
- Organizations typically have organizational charts that list the relationship and ranks of positions. The charts detail the lines of authority and responsibilities and outline the formal power structures of the organizations. Formal power may refer to position in the organizational hierarchy, corporate structure, or even job function. A chief executive officer, for example, has decision-making power in many areas. Even in small agencies without official organizational charts, employees can easily recognize formal power because of job roles, titles, and functions.
Informal Power
- The most powerful person in an organizational unit is not necessarily a supervisor. Instead, persons with the most influence, who can lead others to achieve goals or accomplish tasks, may have the greatest influence. ______ ______ refers to the ability to lead, direct, or achieve without official authority. It is derived from relationships that are built. Employees with ______ ______ may be the most experienced or knowledgeable or the most respected because of personality traits.
All forms of power within an organization are beneficial when used appropriately. Formal power is necessary to achieve goals. ______ ______ can be equally useful. Workers may be more apt to accept criticism or take direction when they receive guidance from a colleague that is respected and trusted. It is often easier to get employee “buy-in” when suggestions come from those with ______ ______.
Importance of multiple level interventions
- individuals - micro
- families - micro/mezzo
- groups - mezzo
- organizations - mezzo
- communities - macro
*each is viewed as a system within its environment
Generalist Intervention Model (GIM)
- Engagement
- Assessment
- Planning
- Implementation
- Evaluation
- Termination
- Follow-up
Generalist Social Workers
______ ______ ______ must have infinite flexibility, a solid knowledge-base about many things, and a wide range of skills at their disposal:
- select effective strategies
- evaluate results of practice
- professional competence
Knowledge base chosen form a range of theories:
- systems
- ecological
- structural functionalism
- cognitive
- empowerment
- behaviorism
- developmental
- many more
Generalist Core Competencies
- Demonstrate Ethical and Professional Behavior
- Engage Diversity and Difference in Practice Competency
- Advance Human Rights and Social, Economic, and Environmental Justice
- Engage In Practice-Informed Research and Research-Informed Practice
- Engage in Policy Practice
- Engage with Individuals, Families, Groups, Organizations, and Communities
- Assess Individuals, Families, Groups, Organizations, and Communities
- Intervene with Individuals, Families, Groups, Organizations, and Communities
- Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities
Definition of Systems Theory
- System - a set of elements that are orderly and interrelated to make a functional whole.
- Systems theory:
- targets multiple systems of different size
- focus on boundaries WITHIN a system
- system – dynamic
- Interact – homeostasis
- Input – output
- Equifinality
Equifinality
…is the principle that in open systems a given state can be reached by many potential means.
Ecological Theory
- Refers only to living dynamic interactions
- focuses on transactions BETWEEN the individual and environment at the interface point.
- social environment
- person-in-environment
- energy (input/output)
- interface
- adaptation
- coping
- interdependence
Empowerment Model
the “process of increasing personal, interpersonal, and political power so that individuals, families, and communities can take action to improve their situations.”
Strength-Based Perspective
Social Work seeks to focus on individual, family, and community strengths and competency. This is in contrast to other professions which focus on deficits or maladaptive functioning (pathology). Focusing on strengths gives people the power to build on what resources they already possess, what skills and competencies they have already mastered to overcome the obstacles they are faced with.
Client Centered Approach
______ ______ ______ seeks to focus on the needs of clients and to let their needs and abilities guide social work practice. ______ ______ ______ ensures that interventions are collaborative and individualized. ______ ______ ______ seeks to empower the individual to direct the intervention and assess what resources they need.
Person-in-Environment
Social Work seeks to recognize both the client (person), their environment, and the interaction between them. Coined by Florence Hollis (1964) Person-In-Environment (PIE) or “the person-in-the situation” stresses a person’s physical, social, and psychological realities as well as the social realities that both define and limit that person. Social Workers seek to examine both the personal, and the social aspects of all ‘Problems’ be they social problems, or personal ones. Most intervention happens at the individual level, while system approaches to problem solving seek mainly to improve individual functioning.
EcoSystems Approach
Similar to Person-in Environment Ecosystems approach seeks to intervene at a level of systems with humans. Developed in the 1970’s and 1980’s Ecosystems approach seeks to identify and improve ecological conditions and is an offshoot of systems theory. This approach was developed by Meyer, Germain and Gitterman, and Maluccio.
Meyer (1988): The paradigm on ecosystems “considers environmental variables as interrelated and reciprocal with the person variables, and therefore environmental intervention must be included among the treatments of choice.” (p.287)
Germain (1979): “In an ecological view, [social work]practice is directed at improving transactions between people and environments in order to enhance adaptive capacities and improve environments for all who function within them” (pp. 7-8)
Systems Theory
______ ______ describes broad conceptual perspective of the interactions of various elements (not just humans) that are interrelated to make a functional whole (e.g. solar system). It is premised on the idea that an effective system is based on characteristics and attributes of the system. When applied to humans, families, couples, and organization members are directly involved in resolving a problem even if it is an individual issue.
Social Learning Theory
______ ______ ______ is based on Albert Bandura’s idea that learning occurs through observation and imitation. New behavior will continue if it is reinforced. According to this theory, rather than simply hearing a new concept and applying it, the learning process is made more efficient if the new behavior is modeled as well.
Psychosocial Development Theory
______ ______ ______ is an eight-stage theory of identity and psychosocial development articulated by Erik Erikson. Erikson believed everyone must pass through eight stages of development over the life cycle: hope, will, purpose, competence, fidelity, love, care, and wisdom. Each stage is divided into age ranges from infancy to older adults.
Psychodynamic Theory
______ ______ was developed by Freud, and it explains personality in terms of conscious and unconscious forces. This social work theory describes the personality as consisting of the id (responsible for following basic instincts), the superego (attempts to follow rules and behave morally), and the ego (mediates between the id and the ego).
Transpersonal Theory
______ ______ proposes additional stages beyond the adult ego. In healthy individuals, these stages contribute to creativity, wisdom, and altruism. In people lacking healthy ego development, experiences can lead to psychosis.
Rational Choice Theory
______ ______ ______ is based on the idea that all action is fundamentally rational in character, and people calculate the risks and benefits of any action before making decisions.
Social Work Practice Models
- Problem solving
- Task-centered practice
- Cognitive Behavioral Therapy
- Crisis Intervention model
Problem Solving
______ ______ assists people with the problem solving process. Rather than tell clients what to do, social workers teach clients how to apply a problem solving method so they can develop their own solutions, frequently using the planned change process (or Generalist Intervention Model).
Task-Centered Practice
______-______ ______ is a short-term treatment where clients establish specific, measurable goals. Social workers and clients collaborate together and create specific strategies and steps to begin reaching those goals.
Cognitive Behavioral Therapy
______ ______ ______ focuses on the relationship between thoughts, feelings, and behaviors. Social workers assist clients in identifying patterns of irrational and self-destructive thoughts and behaviors that influence emotions.
Crisis Intervention Model
______ ______ ______ is used when someone is dealing with an acute crisis. The model includes seven stages: assess safety and lethality, rapport building, problem identification, address feelings, generate alternatives, develop an action plan, and follow up. This social work practice model is commonly used with clients who are expressing suicidal ideation.
Mental State Examination (MSE)
A ______ ______ ______ is a structured way of observing and describing a client’s current state of mind under the domains of appearance, attitude, behavior, mood and affect, speech, thought process, thought content, perception, cognition, insight, and judgment. A ______ ______ ______ is a necessary part of any client assessment no matter what the presenting problem. It should be documented in the record either in list form or in narrative form. The following client functions should be included:
1) Appearance - facial expression, grooming, dress, and gait.
2) Orientation - awareness of time, place, and events.
3) Speech pattern - slurred, pressured, slow, flat tone, and calm.
4) Affect/Mood - mood as evidenced in both behavior and client’s statements (sad, jittery, manic, and placid)
5) Impulsive/potential for harm - impulse control with special attention to potential suicidality and/or harm to others.
6) Judgment/insight - ability to predict the consequences of his or her behavior, to make “sensible” decisions, to recognize his or her contribution to his or her problem.
7) Thought processes/reality testing - thinking style and ability to know reality, including the difference between stimuli that are coming from outside himself or herself (statements about delusions, hallucinations, and conclusions about whether or not a client is psychotic would appear here).
8) Intellectual functioning/memory - level of intelligence and of recent and remote memory functions.
Delusion
false, fixed belief despite evidence to the contrary (believing something that is not true).
Disorientation
confusion with regard to person, time, or place.
Dissociation
disturbance or change in the usually integrative functions of memory, identity, perception, or consciousness (often seen in clients with a history of trauma).
Hallucinations
hearing, seeing, smelling, or feeling something that is not real (auditory most common).
Hypomanic
elevated, expansive, or irritable mood that is less severe than full-blown manic symptoms (not severe enough to interfere with functioning and not accompanied by psychotic symptoms).
Psychotic
experiencing delusions or hallucinations.
Indicators of Traumatic Stress and Violence
Stress is a typical response to feeling overwhelmed or threatened. Fight, flight, and freeze are survival responses to protect individuals from danger. Individuals react and respond to stress in different ways.
1) addictive behaviors related to drugs, alcohol, sex, shopping, and gambling.
2) an inability to tolerate conflicts with others or intense feelings.
3) a belief of being bad, worthless, without value or importance.
4) dichotomous “all or nothing” thinking.
5) chronic and repeated suicidal thoughts / feelings.
6) poor attachment.
7) dissociation.
8) eating disorders – anorexia, bulimia, and obesity.
9) self-blame.
10) intense anxiety and repeated panic attacks.
11) depression.
12) self-harm, self-mutilation, self-injury, or self-destruction.
13) unexplained, but intense, fears of people, places, or things.
Social Work Interview
- In social work, an interview is always purposeful and involves verbal and nonverbal communication between a social worker and client, during which ideas, attitudes, and feelings are exchanged. The actions of a social worker aim to gather important information and keep a client focused on the achievement of the goal.
- A social work interview is designed to serve the interest of a client; therefore, the actions of a social worker during the interview must be planned and focused. Questions in a social work interview should be tailored to the specifics of a client, not generic, “one size fits all” inquiries. The focus is on the uniqueness of a client and his or her unique situation.
- The purpose of the social work interview can be informational, diagnostic, or therapeutic. The same interview may serve more than one purpose.
In planning, a social worker and client should be…
1) Defining the problem (in a well-defined, clear, and data-driven format).
2) Examining the causes of the problem and how it relates to other positive/negative aspects of a client’s life.
3) Generating possible solutions that will impact on the problem.
4) Identifying the driving and restraining forces related to implementation of each of the solutions.
5) Rating the driving and restraining forces related to consistency and potency.
6. Prioritizing these solutions based on these ratings.
7. Developing SMART objectives – Specific, Measurable, Achievable, Relevant, and Time-specific – related to the chosen solutions.
8. Creating strategies and activities related to the objectives.
Engagement
- A social worker should be actively involved with a client in determining why treatment was sought; what has precipitated the desire to change now; the parameters of the helping relationship, including defining the roles of a social worker and client; and the expectations for treatment (what will occur and when it will happen). Client involvement is essential in determining what is important to a client now and in the future.
Assessment
- A client is the source of providing essential information upon which to define the problem and solutions, as well as, identifying collateral contacts from which gaps in data can be collected.
Planning
- A client and social worker must develop a common understanding of a client’s preferred lifestyle. Goals are developed from this common understanding in order to provide a direction to help a client move toward this lifestyle. Specific action plans are developed and agreed upon in order to specify who will do what, what and how resources will be needed and used, and timelines for implementation and review.
Intervention
- a client must be actively involved in mobilizing his or her support network to realized continued progress and sustainable change. A client must bring to the attention of a social worker issues that arise which may threaten goal attainment. Progress, based upon client reports, must be tracked and plans/timelines adjusted accordingly.
Evaluation
- Subjective reports of a client, in conjunction with objective indicators of progress, should be used to determine when goals or objectives should be set. Client self-monitoring is a good way to involve a client so he or she can see and track progress himself or herself.
Termination
- a client should reflect on what has been achieved and anticipate what supports are in place if problems arise again. Although this is the last step in the problem-solving process, it still requires active involvement by both a social worker and client.
A client’s cultural strengths
- supportive family and community relations
- community and cultural events and activities
- faith and spiritual or religious beliefs
- multilingual capabilities
- healing practices and beliefs
- participation in rituals (religious, cultural, familial, spiritual, community)
- dreams and aspirations
A social worker should consider the following given their cultural appropriateness:
- individual versus group treatment
- alternative treatment approaches (yoga, aromatherapy, music, writing)
- medication (western, traditional, and/or alternative)
- family involvement
- location / duration of intervention
When choosing social work interventions / treatments…
______ ______ ______ must be selected based upon the biopsychosocial-spiritual-cultural assessments of clients, which include the strengths that they possess, as well as, the identification of feasible and desired outcomes within these larger service contexts.
Social Work Contracts with Clients (AKA service agreements/plans, case plans, treatment plans, intervention plans, or individual/family support plans)
- A contract can be a written, oral, or even an implied agreement, although the more specific a contract, the more likely it is to prevent misunderstandings. A contract should delineate the problems or concerns to be addressed, goals and objectives of the intervention, activities that a client will undertake, tasks to be performed by a social worker, expected duration of the intervention, schedule of time and place for meetings, and/or identification of other persons, agencies, or organizations expected to assist with the change process.
NOTE: Except in those cases in which contracts are written into court orders, contracts are not viewed as legally binding.
Psychotherapy
- aims to treat clients with mental disorders or problems by helping them understand their illness or situation. Social workers use verbal techniques to teach clients strategies to deal with stress, unhealthy thoughts, and dysfunctional behaviors. ______ helps clients manage their symptoms better and function optimally in everyday life.
Despite the level of intervention, the steps that a social worker takes are similar:
1) Engagement with client, group, or community.
2) Assessment of strengths and needs.
3) Planning or design of intervention.
4) Intervention aimed at making change.
5) Evaluation of efforts.
6) Termination and anticipation of future needs.
Stages of change
- Pre-contemplation: denial, ignorance of the problem.
- Contemplation: Ambivalence, conflicted emotion.
- Preparation: Experimenting with small changes, collecting information about change.
- Action: Taking direct action toward achieving a goal.
- Maintenance: Maintaining a new behavior, avoiding temptation.
- Relapse: Feelings of frustration and failure.
Methods for helping involuntary clients:
- Acknowledging clients’ circumstances and understanding how they came about given clients’ histories.
- Listening to clients’ experiences in order to try to understand how they feel about intervention.
- Engaging in clear communication because involuntary clients struggle to understand what is happening to them.
- Making clear what the purpose of the intervention is, what clients have control over and what they do not, what is going to happen next, and what the likely consequences will be if they do not participate.
- Assisting at an appropriate pace as progress may be slow.
- Building trust, even on the smallest scale, by consistently being honest and up-front about the situation and why a social worker is involved.
- Giving clients practical assistance when needs to help them fight for their rights.
- Paying attention to what is positive in clients’ behavior and celebrating achievements.
- Showing empathy and viewing clients as more than the problems that brought them into services.
Core Social Work Theories
- Ecological System
- Psychodynamic Theory
- Conflict Theory
- P.I.E.
- Strengths-Based
Common Factors Model
- 40% - client factors
- 30% - relationships
- 15% - model therapies
- 15% hope
Parenting Styles
- Permissive
- Uninvolved
- Authoritative
- Authoritarian
Stages of Change (Transtheorectical Model)
- Pre-contemplation
- Contemplation
- Act
- Maintenance
- Relapse
Maslow’s Hierarchy of Needs (Top to Bottom)
- Self-actualization
- Esteem
- Love/Belonging
- Safety
- Physiological
Developmental Theories
- Erikson – psychosocial
- Freud – psychosexual
- Piaget – cognitive
- Vygotsky – sociocultural
Social Learning Theory
- Pavlov – classical conditioning
- Skinner & Watson – operant
- Bandura – social learning theory
Role Modeling Techniques
- Live Modeling
- Symbolic Modeling
- Participant Modeling
- Covert Modeling
Live Modeling
______ ______ refers to watching a real person perform the desired behavior.
Symbolic Modeling
______ ______ includes filmed or videotaped models demonstrating the desired behavior. Self-modeling is another form of ______ ______ in which clients are videotaped performing the target behavior.
Participant Modeling
In ______ ______, an individual models anxiety-evoking behaviors for a client and then prompts the client to engage in the behavior.
Covert Modeling
In ______ ______, clients are asked to use their imagination, visualizing a particular behavior as another describes the imaginary situation in detail.
Methods to Teach Coping and Other Self-Care Skills to Clients/Client Systems
- How their histories have shaped them
- Needs associated with medical and/or behavioral health conditions
- Developmental issues related to various phases across the lifespan
- The workings of system in which they operate
- Ways of coping in various situations
Methods of Conflict Resolution
- The recognition of an existing or potential conflict
- An assessment of the conflict situation
- The selection of an appropriate strategy
- Intervention
Methods and Approaches to Trauma-Informed Care
- Phase 1: Safety and Stabilization
- Phase 2: Mourning and Remembrance
- Phase 3: Reconnection and Reintegration
Environment of Care
Staff Appearance
Staff Behavior
Organizational Understanding
Treatment Considerations
Anger Management Techniques
- Relaxation Exercises
- Cognitive Techniques
- Communication Skills
- Environmental Change
Cognitive Techniques
- Replacing destructive thoughts, such as “This is the end of the world” with healthy ones like “This is frustrating, but it will pass”
- Focusing on goals as a way of finding solutions to problems
- Using logic to get a more balanced perspective
- Not using an “all or nothing” approach
- Putting situations into perspective
Communication Skills
- Slowing down speech to avoid saying something not meant or that one will regret
- Listening to what others are saying
- Thinking about what to say before speaking
- Avoiding defensiveness
- Using humor to lighten the situation
Environmental Change
- Walking away or leaving situation
- Avoiding people or situations in the future that evoke anger
- Not starting conversations or entering situations that may cause anger when tired or rushed
Stress Management Techniques
- The first step in ______ ______ is for clients to monitor their ______ levels and identify their ______ triggers. These can be major life events, but also those associated with day-to-day life, such as job pressures, relationship problems, or financial difficulties. Positive life events, such as getting a job promotion, getting married, or having children, also can be ______.
- The second step in ______ ______ is to assist clients in identifying what aspects of a situation they can control. Clients can make these changes, as well as, benefit from ______-reduction techniques, such as deep breathing, exercise, massage, tai chi, or yoga, to manage those aspects of a situation that cannot be altered. Maintaining a healthy lifestyle is essential to helping manage ______.
Cognitive and Behavioral Interventions
- ______ ______ ______ is a hands-on, practical approach to problem solving. Its goal is to change patterns of thinking or behavior that are responsible for clients’ difficulties, and so change the way they feel. ______ ______ ______ works by changing clients’ attitudes and their behavior by focusing on the thoughts, images, beliefs, and attitudes that are held (cognitive processes) and hose this relates to behavior, as a way of dealing with emotional problems.
- ______ ______ ______ can be thought of as a combination of psychotherapy and behavioral therapy. Psychotherapy emphasizes the importance of the personal meaning placed on things and how thinking patterns begin in childhood. Behavioral therapy pays close attention to the relationship between problems, behaviors, and thoughts.
- This approach is active, collaborative, structured, time limited, goal oriented, and problem focused. This approach lends itself to the requirements posed by managed care companies, including brief treatment, well-delineated techniques, goal and problem oriented, and empirically supported evidence of its effectiveness.
Steps in Cognitive Restructuring
- Assist clients in:
1. Accepting that their self-statements, assumptions, and beliefs determine or govern their emotional reaction to life’s events.
2. Identifying dysfunctional beliefs and patterns of thoughts that underlie their problems.
3. Identifying situations that evoke dysfunctional cognitions.
4. Substituting functional self-statements in place of self-defeating thoughts.
5. Rewarding themselves for successful coping efforts.
Strengths-Based and Empowerment Strategies and Interventions
- ______ aims to ensure a sense of control over well-being and that change is possible. A social worker can help to ______ individuals, groups, communities, and institutions.
- On an individual level, social workers can engage in a process with a client aimed at ______ his or her self-worth by making a change in life that is based on his or her desires.
- To facilitate ______, a social worker should:
Establish a relationship aimed at meeting a client’s needs and wishes such as access to social services and benefits or other sources of information.
Educate a client to improve his or her skills, thereby increasing the ability for self-help.
Help a client to secure resources, such as those from other organizations or agencies, as well as natural support networks, to meet needs.
Unite a client with others who are experiencing the same issues when needed to enable social and political action.
Change Strategies
- Modify systems: The decision to help a client on a one-to-one basis or in the context of a larger system must take into consideration a client’s preferences and previous experiences, as well as, the degree to which a client’s problem is a response to forces within the larger system and whether change can be readily attained by a change in the larger system.
- Modify individual thoughts: A social worker may teach how to problem solve, alter his or her self-concepts by modifying self-defeating statements, and/or make interpretations to increase a client’s understanding about the relationship between events in his or her life.
- Modify individual actions: A social worker may use behavior modification techniques, such as reinforcement, punishment, modeling, role playing, and/or task assignments. Modeling and role modeling are very effective methods for teaching. They should be used whenever possible.
- Feedback from others: Thoughts can be modified by feedback from others and behaviors can be modified though the actions of others in a system (by altering reinforcements).
- Advocate: A social worker can also advocate for a client and seek to secure a change in a system on his or her behalf.
- Mediator: A social worker can be a mediator by helping a client and another individual or system to negotiate with each other so that each may attain their respective goals.
Partializing Techniques
- During the problem-solving process, a social worker may need to assist a client to break down problems or goals into less overwhelming and more manageable components. This is known as partialization and aims to break down complex issues into simpler ones.
- Partialization is useful because it may assist the social worker and a client to identify the goals that are easier to achieve at first, enabling a client to see results more quickly and gain some success in making harder changes. Partialization can also help individuals to order the problems or goals that need more immediate help from those that can be addressed later. A social worker can use Maslow’s hierarch of needs as one tool to assist in making decisions about more pressing needs. In addition, a client should be asked to prioritize his or her concerns or goals.
The Role of a Social Worker
- The role of a social worker is to create an atmosphere that is conducive to change and to increase a client’s intrinsic motivation so that change arises from within rather than being imposed from without.
5 Stages of the Interview
- Rapport / Structuring
- Defining the problem
- Defining a goal
- Exploration of alternatives & confronting incongruity
- Generalization to daily life
Methods to work w/ Involuntary Clients
- empathizing and validating client’s circumstances and how it is understandable based on their history.
- make clear the purpose of the intervention, what clients have control over and what they do not, what is going to happen next, likely consequences if they choose not to participate.
- emphasizing strengths, any + change, awareness of the client’s stage within the Stages of Change model.
Termination best practices
- Evaluate the degree to which goals were attained.
- Acknowledge and address issues related to the ending of the relationship.
- Plan for subsequent steps and possible follow-up meeting or referral.
3 Phase Model of Trauma-Informed Care
- Safety and Stabilization
Maslow - address basic needs
Develop safety plan
Replace risky coping with non-harmful - Mourning and Remembrance
Psychoeducation
Acknowledge and speak about trauma
Grieve losses - Reconnection & Reintegration
Use trauma for empowerment
Utilize skills to create healthy environment
Engage in new activities and relationships
Principles of Family Therapy
- Understand historical, conceptual, and contextual
- Boundaries and homeostasis
- Diversity in families
- Impact of own family origin/biases
- Treat family as a unified whole, a system of interacting parts
- Social roles and interpersonal interactions are treatment focuses
- Goal to interrupt patterns of unhealthy communication and behaviors and replace them with more healthier ones
- Instrumental (provision of resources) and affective (emotional support) functions
Crisis Intervention Hierarchy
- Plan and conduct crisis and biopsychosocial assessment (including lethality measures)
- Establish rapport and rapidly establish collaborative relationship
- Identify dimensions of presenting problem(s) (including the “last straw” or crisis precipitants)
- Explore feelings and emotions (including active listening and validation)
- Generate and explore alternatives (untapped resources and coping skills)
- Develop and formulate an action plan
* CRISIS RESOLUTION* - Follow-up plan and agreement.
Specific techniques to help change behaviors
- setting priorities
- shaping/partializing - breaking a task into small steps and rewarding small steps
- psychoeducation
- modeling - both as a clinician and help find other models
- behavioral rehearsal - practice desired behaviors in hypothetical situations, role plays, and imaginal rehearsal
- the eventual goal is to try behavior in real life
- reinforcers, from clinician, client environment, and self
- contingency contract - if you do this, you get that
- used frequently in group homes, school settings - Token economy
- Homework - behavioral assignments
O.A.R.S.
- Open-ended questions - more than yes or no answer
- Affirmations - validate the experience
- Reflective Listening - convey a desire to understand
- Summarization - reinforce and link ideas and feelings
Ecological Theory
Transactions between the individual and environment.
- Micro - individual (age, sex, health)
- Mezzo - Church group, school
- Macro - attitudes, ideologies of the society
- Ecosystem - neighbors, legal, or social services
Bio-psycho-social-spiritual
- Biological: role of the biological systems in a person’s body and the impact of environment on those systems.
- Psychological: the role of thoughts, emotions, and behavior on social functioning.
- Social: how individuals relate to others, groups, and systems.
- Spiritual: religious/spiritual beliefs and practices (formal or informal).
Mental Status Exam (MSE)
- the psychological equivalent of a physical exam that describes the mental state and behaviors of the person being seen, objectively and subjectively.
Mental Status Examination (MSE) Common Areas
- Appearance
- Attitude
- Behavior
- Speech
- Affect
- Mood
- Thought processes
- Thought content
- SI
- HI
- Perception
- Orientation
- Memory
- Concentration
- Insight
- Judgment
Dialectical Behavior Therapy (DBT)
- core mindfulness
- interpersonal effectiveness
DEAR MAN - Distress Tolerance
ACCEPTS
Acceptance and Commitment Therapy (ACT)
Psychological Flexibility
- Present moment
- Values
- Committed Action
- Self as context
- Cognitive Delusion
- Acceptance
Generalist Intervention Model (GIM)
- Engagement
- Assessment
- Planning
- Implementation/Intervention
- Evaluation
- Pre-Post
- Rating Scale
- Termination
- Follow-up
Solution Focused Techniques
- Interviewing ideas
- Identifying goals
- Coping questions
- Scaling
- Miracle question
- Develop action plan
- Establish follow-up plan and agreement
Why Evaluate Practice?
Code of Ethics
- “Social workers should critically examine and keep current with emerging knowledge relevant to social work and fully use evaluation and research evidence in their professional practice.”
The Research Process
- Specify research problem
- Review the literature
- Relate research problem to theory
- Formulate hypothesis
- Select research design
- Gather data
- Analyze data
- Interpret results
- Identify implications
- Prepare report
Ethics in Research
- informed consent
- confidentiality
- anonymity
- voluntary participation
- objectivity
- careful research design
- accurate reporting of findings
Single-System Designs
- phases
- baseline (these data can be gathered retrospectively or reconstructed)
- intervention
- alphabetic notation
- treatment goal reviews and formal measures can be a part of the single system design
Types of Single-System Designs
- A = Baseline
- B = intervention
- C = no intervention
- D = reinstitute intervention
- AB design
- B design
- ABCD design
- ABAB design
- BAB design
- Multiple baseline
- multiple clients
- multiple settings
- multiple target problems
AB Design
- includes
- one baseline period (A)
- one intervention period (B) - introduce single independent variable or intervention at the end of the baseline phase
- baseline can be retrospective and based on client report
BAB Design
- Reversal design
- no initial baseline pattern
- immediate introduction of an intervention (Phase B)
- observe and measure changes in data patterns during phases - Ethical issue: planned withdrawal of intervention
Structural Family Therapy
This approach stresses the importance of family organization for the functioning of the group and the well-being of its members. A social worker “joins” (engages) the family in an effort to restructure it. Family structure is defined as the invisible set of functional demands organizing interaction among family members.
Methods to Assess the Availability of Community Resources
Step 1: Clarifying the Need or Purpose for the Referral Step 2: Researching Resources Step 3: Discussing and Selecting Options Step 4: Planning for Initial Contact Step 5: Initial Contact Step 6: Follow-up to See if Need was met
Motivational Interviewing
______ ______ is a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence.
