PROBLEM-SOLVING, BRIEF-SOLUTION FOCUSED, AND CRISIS INTERVENTION THEORIES

Question 1

Problem-Solving Theory

Answer 1

The Generalist Intervention Model (GIM) provides a framework for problem solving. It is a planned change process whereby the social worker and client work collaboratively to attain goal(s) to address a client’s problem(s) or concerns.
It is an approach that “assumes that problems are a naturally occurring part of people’s lives. Social workers then work with clients to develop plans to solve the identified problems” (Kirst-Ashman & Hull, 2018, p. 385).

Question 2

key steps

Answer 2

Identify Problems (Step 2: Assessment)  Find Solutions (Steps 3 & 4, Planning & Implementation)
We are now going to look at a planned change process that focuses more on the desired goal or outcome (versus the problem) and then a problem-solving approach applied to crisis situations.

Question 3

Brief Solution Focused Theory attributed to the work of ____ in the ____

Answer 3

attributed to the work of Steve De Shazer in the 1980s.

Question 4

“Research shows that we normally spend 50 minutes talking about problems and only _____ minutes on solutions” (p. 179); want to shift this ratio.

Answer 4

10 minutes

Question 5

underlying principle:

Answer 5

“people can get preoccupied with their problems and are not able to see past them with any confidence. Workers use this approach to support clients to see beyond the difficulties and reframe their perspective” (p. 180).

Question 6

Typical themes in client sessions, include:

Answer 6

focus on “the outcomes (goals) that the client wants to achieve” (p. 179).
importance of drawing upon the client’s strengths and resources.
“identifying exceptions” (p. 180), where the client has been able to prevent or resolve similar problems.
“discussing changes in the client’s life from session to session and noting successes” (p. 180).
“confirming the strategies that the client finds helpful in achieving the changes” (p. 180).

Question 7

1. Goal setting questions

Answer 7

• questions that ask the client what they hope to achieve and how will they know if their goal is attained.

Question 8

2. The miracle question

Answer 8

• questions that encourage the client “to envision how the future will be different when the problem is no longer present” (p. 180); helps the client “formulate a vision of how life will be when they no longer ‘have’ the problem” (Kirst-Ashman & Hull, 2018, p. 386).

Question 9

3. Scaling questions

Answer 9

• questions that get the client “to score the present on a scale of 1 to 10” and then “what it will take to move one point up the scale” (p. 180); helps the client identify immediate goals.

Question 10

4. Exception finding questions

Answer 10

• questions that help the client identify “the successful strategies they used in the past” (p. 180); helps client build confidence that they can use their own strategies.

Question 11

5. Coping questions

Answer 11

• questions that “help clients to recognize their general strengths and resources”, “to move from an internalized problem-focused narrative to recognition of their capabilities” (p. 180).

Question 12

Crisis Intervention Theory

Answer 12

inevitably, a social worker “will encounter situations where individuals or families are experiencing trauma or crisis within their lives, as opposed to the everyday stresses which we all experience” (Maclean et al., p. 225).
people can experience a range of crisis evoking issues that “can leave them feeling overwhelmed and unable to manage” (Maclean et al., p. 225).

Question 13

definition of a crisis:

Answer 13

“Crisis is a subjective reaction to a stressful life experience, one so affecting the stability of the individual that the ability to cope or function may be seriously compromised” (Maclean et al., p. 225).

Question 14

Kanel (2015) “defines a crisis situation where”

Answer 14

1. “a precipitating event occurs”;
2. “a person has a perception of the event as threatening or damaging”;
3. “this perception leads to emotional distress”; and
4. “the emotional distress leads to impairment in functioning due to failure of an individual’s usual coping methods that previously have prevented a crisis from occurring”.

Question 15

Caplan (1965) outlines three phases to a crisis; and the “time frame from beginning to end is about 6 to 8 weeks”

Answer 15

• impact stage
  -recoil stage
  -adjustment/adaption/end stage

Question 15

Impact stage:

Answer 15

A crisis arises and the client’s “coping skills are overwhelmed by the current crisis and services may become involved. [The client] experienced a series of feelings and emotional responses which make [them] feel low and vulnerable” (Maclean et al., p. 225). This stage has also been referred to as the ‘active crisis’. “The range of emotional responses will vary and depend on the presenting issues that have precipitated the crisis” (Maclean et al., p. 226). [people are often receptive to help during a crisis]

Question 16

Recoil stage:

Answer 16

“This refers to conscious, planned responses by the client. While the client is experiencing a crisis, it is important for the social worker to use a structured approach” (Maclean et al., p. 226). [want client responses to be functional as they work to re-establish balance and homeostasis]

Question 16

Adjustment and adaptation/end stage:

Answer 16

“Emotional responses may still be strongly felt by clients, however, they should be able to function. The need for service intervention should have receded, so the worker can withdraw” (Maclean et al., p. 226).

Question 16

Roberts (2005) identified 7 key areas to intervention

Answer 16

1. “Assessing lethality and safety needs”.
2. “Establishing rapport with the client” (e.g., demonstrate understanding, good communication, being non-judgmental and respectful).
3. “Highlighting the presenting problems and any previous coping mechanisms utilized by the client”
4. “Supporting clients to deal with the anxiety and stress created by the crisis” (e.g., use of active dialogue).
5. Supporting clients “to explore what changes need to be made to enable them to deal with the problem more effectively”.
6. “Developing an action plan. Provide constructive and positive feedback to help the service user deal with the problem” [worker is more active and directive than in most other practice models]
7. “Follow up support or advice on services that could be available in the future”.

Question 17

Step 1: Engagement

Answer 17

• importance of development of rapport, “as the client begins to feel rapport, trust and openness follow, allowing the interview to proceed”

Question 18

Step 2: Assessment

Answer 18

• First, “determine why the person called you or came in to see you on that particular day” (p. 272); identify what precipitating event occurred.
• Second, explore “how your client views the crisis situation and precipitating event” (p. 272).

Question 19

• Third “line of questioning involves whether your client

Answer 19

has access to support from others”

Question 20

• “The fourth area of information to pursue concerns your client’s history in solving similar problems” (p. 272). [perhaps client can draw ________

Answer 20

upon these coping skills in the crisis situation

Question 21

The fifth area to explore is “the extent to which clients are _______

Answer 21

in danger of harming either themselves or others”

Question 22

Step 3: Planning

Answer 22

• need to “evaluate the extent to which the crisis has interfered with your client’s ability to function” (p. 272) (e.g., daily activities they are no longer doing and could be able to resume).
• “review potential alternatives, evaluate the pros and cons, and determine the course of action to pursue” (p. 272).
• remember to draw upon the client’s strengths and supports.

Question 23

Step 4: Implementation;

Answer 23

possible areas to address during this step:
- “Help the client look at the crisis more objectively” (p. 273).
- “Help the client explore and express hidden feelings” (p. 273); people can become immobilized by unacknowledged feelings.
- “Identify and use coping approaches used in the past for resolving crises” (p. 273); may be appropriate to suggest new methods of coping (remember, in crisis intervention the worker is more active and directive).
- “Reestablish old or develop new social support systems”

Question 24

Step 5: Planning for future crises

Answer 24

(includes Evaluation and Termination Steps)
- can focus “on articulating and summarizing what clients have learned during the crisis intervention process” (p. 273).
- help the client identify coping behaviours that they used.
- With crisis intervention, follow-up might not be possible.