Generalist social work practice Ch 5
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Introduction.
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This chapter will discuss engagement and assessment considering potential micro, mezzo, and macro dimensions of each. The text emphasizes on micro skills in GP so the primary focus of this chp will: (on page 146 it lists what the ch will focus on)
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Engagement. What does engagement focus on?
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Establishing a professional relationship between worker-client. The relationship is an absolute requisite to be effective and these relationships should be done as a partnership. Part of the purpose of the engagement phase is to help the client realistically assess whether the swer and the agency can help and sometimes the client has unrealistic expectations.
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Engagement. Professional worker-client relationships are characterized by what?
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1-.a clear purpose, 2-a commitment to meeting client needs 3-ethical standards of practice, 4-worker emphasis on communicating warmth, genuineness and empathy
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Engagement. When does engagement take place?
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...starts from the very first meeting (on phone or in person) and they begin to identify client needs. and this is can be referred to a 'intake'.
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Engagement. GP's must understand the common activities and actions needed to successfully complete the engagement phase. These activities include: pp 147
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1-Greet clients and encourage them to talk with you 2-Demonstrate effective attending skills that communicate your interest in their situation 3-Discuss agency services and the client expectations 4-Decide whether the agency and worker can be of assistance 5-Offer agency and worker servies to the client (this is offering the client treatment from our facility) 6-Orient the client to the helping relationship 7-Complete any required paperwork.
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Engagement. Greeting the Client. This is one of the activities listed in the engagement process, how should a swer greet a client?
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Be careful not to assume a client wants to use their name informally and if they have been discriminating against or adverse treatment from others, they may use their name formally. \"I understand you wanted to talk with me about something\" This allows client to aloborate. \"I asked to see you because your son....\" \"In your phone call you said you wanted to discuss problems you're having with your mother\" \"What brings you in to our agency today?\" \"How can I help you?\" These encourage talking.
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Engagement. Demonstrating Effective Attending Skills. This is one of the activities listed in the engagement process, how should a swer demonstrate effective attending skills?
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Listen, don't be thinking about what your going to say next. Eye contact Leaning forward-to encourage Nodding-expresses interest But, remember these can also cause problems if the 'intent' is miss understood in the 'impact' from the receiver. Always pay attention to see your responses and actions are facilitating or discouraging the client's communications. Attending skills also allow swer to focus on both client thoughts and feelings. The client may not understand what they are feeling. Ask open-ended questions. This is a time to talk, not a time to make decisions. Use Silence as necessary to let clients process your questions or comments.
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Engagement. Demonstrating Effective Attending Skills. What is the goal of this exchange?
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...to communicate ot clients your interst in them and your willingness to explore both feelings and thoughts.
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Engagement. Demonstrating Effective Attending Skills. This is one of the activities listed in the engagement process, Is taking notes okay during this activity?
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Yes, take notes of information you may not remember. Ask the client \"I'd like to take a feew notes while we talk. What you are telling me is important, and I want to be sure I get the key ideas down. Will that be OK?\"
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Engagement. Discussing Agency Services and Client Expectations. This is one of the activities listed in the engagement process, how should a swer demonstrate these skills?
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The swer should describe what they do and the services they offer, andy costs, the length of time. If the services don't match needs make a referral. If they ask you a question you don't know, be honest and say you don't know. this is good role modeling and your trying to empower the client.
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Engagement. Deciding if the Agency and Swer Can Help. This is one of the activities listed in the engagement process, how should a swer demonstrate these skills?
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This is all about making sure the client is aware of the services available. Be sure to give them correct information so they are not mislead, which can cause damage because of their vulnerable situations. If your agency doesn't provide the needed service you can advocate and try to get the services.
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Engagement. Offering Agency and Worker Services to the Client. This is one of the activities listed in the engagement process, how should a swer demonstrate these skills?
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Once a client knows your services they should have the freedom to make a decsion for themselves as to whether or not they want to continue with your agency. If they are court ordered thats different, but you should still provide them some sense of freedom to choose within the agency.
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Engagement. Orient the client to the Helping Process. This is one of the activities listed in the engagement process, how should a swer demonstrate these skills?
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This is about letting the client know how their treatment is going to progress. But remember you should negotiate with them, don't dictate to them. You should negotiate frequency of sessions and the time and place of meeting. Also, you should never tell them they have complete confidentiality. Tell them their communications may be shared with a spervisor, law envorcement, insurance company or other needed agency's. Part of the function of the helping relationship is to explore, locate, or build additional resources for the client to draw upon to resolve their problems.
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Engagement. Completing Required Paperwork. This is one of the activities listed in the engagement process, how should a swer demonstrate these skills?
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Help clients fill out/sign any documents needed. Explain confidentiality and possible supena, but also tell them how rare that is. The book is referring to the engagement process here so it is what ever paperwork that is taking place during this phase of getting the client engaged in your relationship and services with your agency.
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Where does the engagement take place?
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The paper work is done at intake, and intake is part of the engagement process.But the divers enature of GP can affect where this engagement process actually occurs. Sometimes the 1st step of engagment happens over the phone, school, nursing home, hospital, institution etc.
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Assessment. This is the 2nd step in the Planned Change Process. What does this invovle?
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...involves 'acquiring an understanding of a problem, what causes it, and what can be changed to minimize or resolve it.
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Assessment. This is the 2nd step in the Planned Change Process. What perspective does a GP use to evaluate a clients problem?
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Environmental perspective, which is called Person-in-environment. A problem involves the person, the family, the environment, and the system. Ppl are dramatically affected by individuals, groups, and organizations around them.
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Assessment. What are some factors in the environment that can affect a person?
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lack of friends and social support within an offece environment. Whether ppl love or hate their jobs. Taxes, and feedom to enjoy life.
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Assessment. There are 4 perspective an assessment can considered, what are they? pp150-151
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1- Transactions between and among clients, family members, friends, and other systems. in the immediate environment. 2-Focusing on functioning at different points in their life cycle. Meaning that adolescence has diff problems than adulthood. 3- Specific problems can be the focus of the assessment. Such as depression, substance abuse, and behavioral problems of kids or adults. Different approaches and/or instruments are available to assess these areas. 4- The techniques and assessment methods used by swers run the gamut from micro to mezzo to macro situations. Ethnic, racial, and cultural factors may pla a role in the assessment.
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Assessment. How to approach an Assessment. There are 4 considerations involved when doing a GP assessment, what are they?
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Micro, Mezzo, Macro, and Human Diversity. This chapter is covering the first three, and chapter 12 will go into the human diversity.
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Assessment. How to Approach Assessment. Before going into the specific assessment techniqes there are 5 major points, what are they?
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1- is the involvement of the client is absolutely essential. 2- Assessment alwas involves making judgments, sometimes with insufficient or incomplete information. 3- Working with the Clients Strengths (and weaknesses) 4- A single, clear definition of the problem may not exist. 5- Assessment is continuous process
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Assessment. It is important not to make your company sound like they are the magic bullet that can fix all their problems, don't sugar coat what you offer. What are some things you need to be careful with in regards to the assessment phase?
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Assessments need critical thinking, and should reflect the best practice in sw, meaning using methods and tools that aare valid and carefully evaluate information thats gathered about the client. Dont lead the client on to make you sound better than anyone else, and don't leave out the negative consequences that can happen if they do choose your services. Also, if you say or do something the client feels is inaccurate during the assessment, encourage the client to speak up because their response is helpful in seeing the larger picture and that you are faliable as well. pp.153
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Assessment. What are the goals of an assessment? (6 goals) pp154-155
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1- clear understanding of the problem or need that will be the focus of the assessment. 2- strengths/weaknesses that will be used to accomplish goal/solve problem 3- Formulate a clear picture of the clients systems (family, friends, church, groups, etc) 4- Interactions the client will have with systems 5- Identify missing information 6- Put all gathered information together to form an intervention plan (treatment plan)
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Assessment. Assessment from a Micro Practice Perspective. This is referring to the next section that will focus on the assessment of an individual client system (client system is another way of saying the client). What are the areas that will be covered in this section? pp 155-166
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1-Defining the problems and Issues 2-Types of Problems 3-Empowerment: Identifying the strengths of the client 4-Resistance in the Assessment 5-Which problem should you work on 6-Gathering Information: Sources of Assessment Data 7-Assessment Instruments 8-Diagnostic and Statistical Manual (DSM) 9-Assessing Assertiveness 10-Assessing Substance Abuse
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Assessment. Defining problems and Issues, explain. pp 155
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The assessment has to start with the swer recognizing the clients' unmet needs and then swer must identify the barriers, then swer must determine the strengths, resources, and motivations that the environment and/or client has to add to the solution.
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Assessment. Types of Problems. There is a list of 10 Problems that I listed on a separate flash card because of its lenghty answer.
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See other flashcard for the list of problems.
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Assessment. Empowerment: Identifying Clients Strengths. Strengths can include anything a client is good at, all peps in clients life who can provide assistance, and any other identifiable resources. Strengths can be divided into 7 categories, list them.
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1- family and friends 2-education/employment background 3-problem-solving/decision-making skills 4-personal qualities/characteristics 5-physical/financial resources 6-attitudes/perspectives 7-miscellaneous other strengths
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Assessment. Empowerment: Identifying Clients Strengths. Strengths can include anything a client is good at, all peps in clients life who can provide assistance, and any other identifiable resources. Explain how family/friends can be a strength.
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Is thier FF? How motivated are they? Is their help potentially significatn to assit client situation?
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Assessment. Empowerment: Identifying Clients Strengths. Strengths can include anything a client is good at, all peps in clients life who can provide assistance, and any other identifiable resources. Explain how Education/Employment can help to be a strength.
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This is really helpful especially if unemplyment or financial need is the problem. Can prior skills be transferred to help this situation?
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Assessment. Empowerment: Identifying Clients Strengths. Strengths can include anything a client is good at, all peps in clients life who can provide assistance, and any other identifiable resources. Explain how Problem solving Decision making can help to be a strength.
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If they have learned in the past how to make decisions and solve problems, it will be that much easier for them to solve problems at hand and future problems that will arise.
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Assessment. Empowerment: Identifying Clients Strengths. Strengths can include anything a client is good at, all peps in clients life who can provide assistance, and any other identifiable resources. Explain how Personal Qualities and Characteristicscan help to be a strength.
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Is the client articulate and pleasant? Intelligent? Good listener? Dependable and punctual? Labeling and emphasizing positive qualities can educate the client about himself and build self-confidence.
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Assessment. Empowerment: Identifying Clients Strengths. Strengths can include anything a client is good at, all peps in clients life who can provide assistance, and any other identifiable resources. Explain how Physical and Financial Resources can help to be a strength.
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Because clients stress problems, they can overlook strengths. Do they reside in adequate housing? What kind of property do they own? Do they have a car? Savings account? Source to borrow money?These things can provide a sense of security and continuity.
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Assessment. Empowerment: Identifying Clients Strengths. Strengths can include anything a client is good at, all peps in clients life who can provide assistance, and any other identifiable resources. Explain how Attitudes and Perspectives can help to be a strength
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Does client appear motivated? Show a willingness to cooperate? Willing to talk and work with YOu? Motivation and positive attitudes toward change are criticallty important.
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Assessment. Empowerment: Identifying Clients Strengths. Strengths can include anything a client is good at, all peps in clients life who can provide assistance, and any other identifiable resources. Explain how Religiosity and Spirituality can help to be a strength.
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Don't let your own bias overlook the religion of you client as a strength they can pull from.Asking about this area is just as important in an assessment as asking about ethnic identity, client feeling and mental or physical health. Sometimes clients hold on to values that can help them during difficult times, so use this as a strength. There are questions on pp 160 to help swer assess.
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Assessment. Empowerment: Identifying Clients Strengths. Strengths can include anything a client is good at, all peps in clients life who can provide assistance, and any other identifiable resources. Explain Miscellaneos Other Strengths.
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Each person is unique. There are innumerable possibilites regarding strengths that may not occur to your or be readily apparent. Listen carefully to what clients say is invaluable to them. Strengths can develop during the assessment or intervention process. Strengths may include: athletic ability, musical talent, acting ability, or special interests. Interests may range from collecting old beer cans to counted cross-stitch to deer hunting. Any of these may provide potential sources of satisfaction, motivation, and enhanced self esteem.
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Assessment. Resistance in Assessment. pp 160 How should a swer handle resistance?
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Roll with resistance. Don't tell the client he's wrong, instead respond by acknowledging the client has a different perspective. You may say, \"You dont see that your drinking has any effect on your life\". Another response i sto acknowledge \"It is certainly your choice about whether you change your drinking patterns\". You may also tell the client that \"The fact you came into today is a pretty good indication that you have some concerns that we might address\". Start where the client is. This is an important concept in the assessment process.
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Assessment. Which Problem Should You Work On? There are 3 criteria when looking at what problem to start with, what are they?
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1-the client must recognize he has a problem. 2-the problem should be clearly defined in understandable terms. 3-you and the client should realistically be able to do something to remedy the problem
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Assessment. Which Problem Should You Work On? What is 'target problem'?
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This is the problem that will be worked on. Many clients will have a list of problems, but you need to narrow in and target problems by prioritizing the most important ones.
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Assessment. Which Problem Should You Work On? What is \"explicit behavioral terms\"?
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After exploring with the client the range of problems of most concern, each problems is defined in \"explicit behavioral terms\". This means the precise nature of the problem should be clear in your mind. and the problem statement should include descriptions of the behaviors that will ater allow you to measure your progress and determine when you succeed in solving the problem.
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Assessment. Which Problem Should You Work On? What is \"Partialization\"
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This is taking a problem, breaking it down into manageable parts. A swer wants to ultimately teach the client how to do this on his own so when services are gone they can disect their own problems and work them out. Problems should be prioritized.
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Assessment. Gathering Information: Sources of Assessment Data. There are at least 7 basic \"sources of information\" about your clients, what are they?
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1- forms the client fills out during intake 2-responses to the interview questions 3-nonverbal behavior during interview 4-interactions with other ppl 5-outside sources, family friends, other professionals 6-testing instruments 7-your own interactions with the client
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Assessment. Assessment Instruments. What does the book say about this? pp 162
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There is a lot of assessment tools used. They evaluate health, suicide potential, assertiveness, spirituality, self esteem, childs need for protection from abuse, interaction bewteen spouses, availability of resources. Thre are three assessment instruments selected to discuss here. DSM, the Rathus Assertiveness Schedule (RAS), and an Alcoholism Test.
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Assessment. Diagnostic and Statistical Manual (DSM) List the axis and what they cover.
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Axis I - Clinical Disorders Axis II - Personality Disorders Axis III - Physical Conditions AxisIV - Environmental Psychosocial GAF -Global Assessment
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Assessment. Diagnostic and Statistical Manual (DSM) What does Axis I cover?
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Clinical Disorders and conditionas that are not directly attributable to a mental disorder but things that people still seek help for. Mood Disorders like Bipolar/Depression Anxiety Disorders like OCD/PTSD Second part of Axis I covers borderline intellectual functioning, academic or marital problems, and parent-child difficulties, among others.
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Assessment. Diagnostic and Statistical Manual (DSM) What does Axis II cover?
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Personality disorders Paranoid disorders antisocial Borderline Mental retardation
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Assessment. Diagnostic and Statistical Manual (DSM) What does Axis III cover?
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Physical conditions that may influence a person's emotional health AIDS Diabetes Diseases of the nervous system
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Assessment. Diagnostic and Statistical Manual (DSM) What does Axis IV cover?
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environmental and psychosocial problems affecting the mental disorder. Family crises, Stressors Loss of significant other Job loss
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Assessment. Diagnostic and Statistical Manual (DSM) What is the GAF score?
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Global assessment is a score based on the clinicians opinion of the client's overall level of functioning. It is a score between 1-100, and is for the time of assessment or up to 3 months prior.
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Assessment. Diagnostic and Statistical Manual (DSM) There are at least 4 reasons why the DSM is important to swers, what are they?
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1-It provides a means for a variety of professionals to communicate with each other about specific mental, emotional, and behavioral problems. 2- DSM is helpful in evaluating and treating clients with mental disorders. It doesnt say the cause, it just helps specify the disorder in order to set up the intervention. 3-third benefit is the manual's utility in teaching about mental disorders. Classifying a disorder by describing its symptoms enhances our understanding of that disorder 4- the DSM provides better opportunities to do research on mental disorders. It allows to place people into certain categories.
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Assessment. Diagnostic and Statistical Manual (DSM) What are at least 4 reasons to be wary of the DSM IV?
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1-It only describes particular conditions. No interventions and is only for assessment that interventions can be built from. 2-There can be a tendency to focus on pathology or mental illness instead of the clients interaction with environment. DSM does use the term 'client'. But the dsm targets the person instead of intervening. There may be a tendency to 'cure' instead of intervene. 3-concerns imperfections in its categores. Professional opinion is involved in assigning diagnoses. Behaviors/Illnesses do not fit perfectly into tiny little boxes. It can be dangerous to label ppl too. 4-DSM's main focus is on deficits and is not a strength based assessment tool and doesnt help with identifying resources.
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Assessment. Diagnostic and Statistical Manual (DSM) Who uses a DSM?
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Psychiatrist or Physician use them to do their assessments.
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Assessment. Assessing Assertiveness. What is assertiveness?
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Assertiveness involves being able to state your thoughts, wants, and feelings straightforwardly and efffectively. It is the ability to establish an appropriate stance between being too agressive and too timid. This is taking the needs of others, and your needs and finding a balance. Being assertive is valued in our culture, but not in all cultures. In Asian cultures it is not valued to put your needs above your parents or your family.
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Assessment. Assessing Assertiveness. What does it mean to be aggressive in this context?
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Ignoring the needs and rights of others.
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Assessment. Assessing Assertiveness. What does it mean to be timid in this context?
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concerns placing the needs and wishes of others far before your own.
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Assessment. Assessing Assertiveness. What is the RAS-Rathus Assertiveness Schedule?
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Its an instrument composed of 30 items that measure an individual's assertiveness. It can gauge clients' ability to determine how well they can speak on their own behalf assertively without aggression. Figure 5.3 in book.
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Assessment. Assessing Alcohol and Other Drug Abuse pp 165
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Because drug/alcohol abuse is so prevalant, a GP needs to assess the extent the client may have a problem
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Family Assessment. GP sees familys as a special type of system. What does this mean?
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Families are very intimate and the relationships empact one another more intensely. Due to the intensity GP sees working with the family as a micro system and mezzo syste. A GP needs to look at the dynamic of the family in order to help the individual.
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Family Assessment. Choosing to Work with Families. There are some variables to take into account when working with families, what are they? pp 166
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1- ask yourself to what extent the problem affects other family members. 2-do you have the time and resources to work with other family members>? 3-in terms of prioritizing problems, are those aspects of the problem involving other family members among the most critical to be addressed 4-to what extent do you think family intervention is likely to be successful.
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Family Assessment Skills. Families have momentous significance on individual members' physical and emotional well being. Assessing families also poses social challenges for the GP, why?
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All family members can/will have different ideas about the existing problems and the GP needs to address not only the individual but the family interactions as well.
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Family Assessment Skills. When doing a family assessment, what is the GP's task?
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to ensure that all perspectives are valued and that each member feels you are interested in their views. Additional strengths to consider as well. they include individual strengths and strengths characterized by the entire family.
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Family Assessment Skills. What are some of the assessment concepts provided in this chapter?
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Family communication Family structure, Life cycle adjustments Impacts of the social environment
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Family Assessment Skills. Explain what 'Family Communication' consists of when doing a family assessment.
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This involves how well the family conveys feelings and ideas to each others. To what extent does each sender's INTENT match the IMPACT on the receiver. The effectiveness of a family's internal communication is important, not only for assessment but also for planning and undertaking the intervention. Improving communication is frequently a core goal when working with families.
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Family Assessment Skills. Explain what 'Family Structure' consists of when doing a family assessment.
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...involves the organization of relationships and patterns of interaction within the family. There are 5 dimensions when assessing family. 1-functioning as a system-boundaries 2-family norms-rules/behavior 3-family roles 4-balance of power 5-intergenerational aspects-impact family history has on current situation
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Family Assessment Skills. Explain what 'Life Style Adjustments' consists of when doing a family assessment.
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Assess how the family adapts to phases in life like Births, Deaths, Marriages, Children leaving home, and many other important phases. Its their coping abilities.
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Family Assessment Skills. Explain what 'Impacts of the Social Environment' consists of when doing a family assessment.
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How does the family fit with other ppl in the same environment, are they isolated, social misfits, etc? This needs to be assessed because of the interventions that are needed.
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Family Assessment Skills. Explain what 'Key Areas in Family Conflict' consists of when doing a family assessment.
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Ch 9 will address this furture. But they are: Marital Difficulties Parent-Child relationship difficulties Personal problems of individual members External Environmental stresses
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Family Assessment Skills. Family Relationships. When assessing the family its important to understand the entire family system. There are 2 tools to help with this what are they?
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Eco-map, Genogram
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Family Assessment Skills. Family Relationships. When assessing the family its important to understand the entire family system. There are 2 tools to help with this, one is an eco-map, what is this?
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Eco-maps look at the the family's ecological system. I depicts family relationships to help individuals and families recognize their own strengths and areas of weakness. They look at points in time, but can also be used to look at relationships over time.
