Psychotropic drugs work by modifying neuro transmission processes-the chemical and electrical communication systems between nerve cells. Humans are thought to have 50-100 neuro transmitters, but only a few such as dopamine, serotonin, acetylcholine, norepinephrine, gama amenobutyric acid and glutamate are known to have direct relevance to psychotropic medications. the drugs can be roughly classified into 5 categories :
1. antipsychotic medications
2. anti depressant medications
3. mood stabilizing drugs
4. anti anxiety medications
5. psychostimulants
Antipsychotic medications can further be classified into conventional antipsychotics which include chlorpromazine (trade name : thorazine) , haloperidol (haldol), fluphenazine (prolixin) which has higher potency and adverse effects on neuro transmitters. the drugs are considered to have greater impact on positive symptoms like hallucinations, agitation, bizarre behavior than negative symptoms like flat affect, withdrawal and poverty of thoughts. The new type of atypical antipsychotics do not cause adverse effects as the former ones. they block activity of both serotonin and dopamine while the former blocks only dopamine. atypical medications include clozapine (clozaril), risperidone(risperdal), olanzapine(zyprexa) and quetiapine (seroquel). they may have some therapeutic effect on some negative and positive symptoms.
Anti depressant medications are classified into three types, the MAO inhibitors, cyclics and serotonin specific drugs. these drugs must be taken continuously before expecting a positive change since they experience resistance from the site where action takes place. all these drugs also have anti anxiety effects. the notable antidepressant medication includes phenelzine (nardil) and tranylcypropine (parnate) which are not prescribed frequently due to strict diet observation to be followed to avoid adverse effects of drug. common cyclic anti depressant include imipramine (tofranil), amilriptyline (elavil), nortriptyline (pamelor), dexepin (sinequan). the newest anti depressants are the selective serotonin reuptake inhibitors such as fluoxetine (prozac) , citaprolam (celexa), paroxetine (paxil), vanlafaxine (effexor) and sertraline (zoloft). fluvoxamine (luvox) ios predominantly used to treat OCD.
Mood stabilizinf drugs
Lithium carbonate is the primary drug treatment for bipolar disorder. monitoring blood levels is essential in using this drug. lithium has a low therapeutic effect and adverse reactions such as muscle tremor and kidney damage can occur at blood levels slightly higher than the therapeutic levels.
certain antiseizure medication such as valporate (depakote) and carbamazepine (tegretol) also act as effective mood stabilizer.
Anti anxiety medication
benzodiazepines constitute the largest class of anti anxiety drugs. they achieve their therapeutic effect by working on the GABA neurotransmitter. they are quickly absorbed in the gastrointestinal tract and has addictive effects with continuous use. examples of benzodiazepines are chlordiazepoxide (librium), diazepam (valium), alprozolam (xanax),clonazepam (klonopin) and l;orazepam (ativan). Buspirone (buspar) is a widely used anti anxiety drug which takes several weeks to take effect.
Psychostimulants
Stimulants are used to treat ADHD. has higher abuse potential. therefore prescription by phone and writing of refills are not allowed. moderate dosage of the drug improves attention, concentration and improved cognitive functioning while higher dosage has common adverse effects such as agitation and insomnia. methylphenidate (ritalin) is the most widely used psychostimulant, pemoline (cylert) and amphetamine (adderall, desoxyn, dexedrine) is a lesser used medication which has very high potential for abuse.
Reference : Social Workers desk reference
http://socialworksdigitaldivide.blogspot.com/2012/09/pharmacology-and-social-worker.html
Thursday, June 19, 2014
tools of Assessment
Ecomap
The eco map has been used in a variety of situations including marriage and family counselling, adoption and foster care home studies. its a short hand method for recording basic social information.this techniques helps client and workers to gain insight into clients problems by providing a snapshot view of important interactions at a particular point in time.
A typical ecomap consists of a family diagram surrounded by a set of circles and lines used to describe the family within an environmental context. eco map users can create their own abbreviations and symbols.
ref : The practice of SW, Charles Zastrow, pg : 179
http://socialwork.msu.edu/koehler/docs/AboutEcomaps.pdf
Genogram
The Genogram is a graphic way of investigating the origins of a client's or client family's presenting problem by diagramming the family over at least 3 generations. The client and the worker usually jointly construct the family genogram.,which is essentially a family tree.
Murray Bowen is the primary developer of this technique. the genogram helps the worker and the family members examine problematic emotional and behavioral patterns in an inter generational context that tend to repeat themselves. since what happens in one generation often occurs in the next. Genograms help family members identify and understand family relationship problems.
The eco map and genogram has various similarities. with both technique users gain insight into family dynamics. some of the symbols used in the two approaches are identical. there are differences however, the eco map focuses attention on family's interaction with groups , resources, org etc but the genogram focuses attention on inter generational patterns particularly the dysfunctional ones.
Sociogram
while eco map and genogram are used for family assessment , sociogram can be used to understand group dynamics.
Case Management
Case Management is a service for highly vulnerable client populations to ensure that they receive the help they need within the fragmented american service delivery system. Frankel and Gelman state that the goal is service and coordination, which enables community based assistance to enable impeded persons to live their lives in a natural environment, rather than in an encapsulated institutional one. The role of case managers vary from setting to setting . The role of Case managers as defined by helpworth and larson : Case Managers link clients to resources that exist in complex service delivery networks and orchestrate delivery of services in a timely fashion. Case Managers function as brokers, facilitators, linkers, mediators and advocates. A case manager must have extensive knowledge of community resources, rights of clients and policies and procedures of various agencies and must be skillful in mediation and advocacy.
Barker defined case management as follows: A procedure to plan, seek and monitor services from different social agencies and staff on behalf of a client. Usually one agency takes primary responsibility for the client and assigns a case manager, who co ordinates services, advocates for the client and sometimes controls resources and purchases services for the client. The procedure makes it possible for many social workers in the agency or different agencies, to coordinate their efforts to serve a client through professional team work, thus expanding the range of needed services offered. Case Management may involve monitoring the progress of a client whose needs require the services of many different professionals, agencies,health care facilities and human services program.
ref : The practice of Social WOrk by Charles Zastrow, pg:21
1. Access to the agency
2. intake
3.assessment(psychological, social, medical)
4.goal setting
5. intervention planning
6. resource identification
7. formal linkage
8. informal linkage
9. Monitoring
10. reassessment
11. Outcome evaluation
clinical case management is an approach to human service delivery that integrates elements of clinical social work and traditional case management practices. it is used primarily with clients having serious mental illnesses such as schizophrenia, major depression, bipolar, personality and substance abuse disorders. Clinical case management includes following activities within 4 areas of focus:
1. initial phase : engagement , assessment and planning
2. environmental focus : linking with community resources, consulting with families and caregivers, maintaining and expanding social networks, collaboration with physicians, hospitals and advocacy
3. client focus : intermittent individual psychotherapy, independent living skill development, and client psycho education
4. client environment focus : crisis intervention and monitoring
Tasks and activities
Harris and bergman have summarized the therapeutic tasks of clinical case management practice as follows :
1. forging a relationship or making a positive connection with the client
2. modelling healthy behaviors, to facilitate a client's movement from a position of dependancy through one of imitation to an internalization of the case manager's qualities.
3. altering the client's physical environment through process of creation, facilitation and adjustment.
Reference :
Social Workers Desk reference pg 467 covers topics on Case Management in child welfare, psychiatric setting, medical setting, substance abuse, older adults and so on.
https://www.youtube.com/watch?v=9DvBxSM9Gc8&index=7&list=PL8F2DA860458E1786
Barker defined case management as follows: A procedure to plan, seek and monitor services from different social agencies and staff on behalf of a client. Usually one agency takes primary responsibility for the client and assigns a case manager, who co ordinates services, advocates for the client and sometimes controls resources and purchases services for the client. The procedure makes it possible for many social workers in the agency or different agencies, to coordinate their efforts to serve a client through professional team work, thus expanding the range of needed services offered. Case Management may involve monitoring the progress of a client whose needs require the services of many different professionals, agencies,health care facilities and human services program.
ref : The practice of Social WOrk by Charles Zastrow, pg:21
Functions of Case Management
1. Access to the agency
2. intake
3.assessment(psychological, social, medical)
4.goal setting
5. intervention planning
6. resource identification
7. formal linkage
8. informal linkage
9. Monitoring
10. reassessment
11. Outcome evaluation
intermittent functions :
intra agency coordination, counseling, therapy, advocacyClinical Case Management
clinical case management is an approach to human service delivery that integrates elements of clinical social work and traditional case management practices. it is used primarily with clients having serious mental illnesses such as schizophrenia, major depression, bipolar, personality and substance abuse disorders. Clinical case management includes following activities within 4 areas of focus:
1. initial phase : engagement , assessment and planning
2. environmental focus : linking with community resources, consulting with families and caregivers, maintaining and expanding social networks, collaboration with physicians, hospitals and advocacy
3. client focus : intermittent individual psychotherapy, independent living skill development, and client psycho education
4. client environment focus : crisis intervention and monitoring
Tasks and activities
Harris and bergman have summarized the therapeutic tasks of clinical case management practice as follows :
1. forging a relationship or making a positive connection with the client
2. modelling healthy behaviors, to facilitate a client's movement from a position of dependancy through one of imitation to an internalization of the case manager's qualities.
3. altering the client's physical environment through process of creation, facilitation and adjustment.
Reference :
Social Workers Desk reference pg 467 covers topics on Case Management in child welfare, psychiatric setting, medical setting, substance abuse, older adults and so on.
https://www.youtube.com/watch?v=9DvBxSM9Gc8&index=7&list=PL8F2DA860458E1786
Wednesday, June 18, 2014
More on Direct/Micro Practice
Methods used to provide educational services to the client
Educators give information to client to teach them adaptive skills. to be an effective educator the worker must first be knowledgeable. Additionally the worker must be a good communicator so that information is conveyed clearly and is readily understood by the receiver. eg: teaching parenting skills, instructing teenagers in job hunting strategies, teaching anger controlling techniques to individuals with difficulties in these areas.
Ref : The practice of social work, charles zastrow
Strategies for conflict resolution
Ref ; The practice of SW, charles zastrow, pg : 157
SOme techniques of conflict resolution include :
1. role reversal - to allow involved parties see the issue int he opponents view
2. empathy - grasp what the other person is thinking and feeling
3. inquiry - gentle probing to learn more about what the other person is thinking and feeling,
4. i-messages - (using i message rather u-message ...you- message is often divided into solution msg and put 5. down msg. people do not like either of them. I message fosters open communication . the purpose is to . help the other person understand the effect of behavior ,
6. disarming - finding some truth in what the other person says and agreeing to it (though they may be wrong, insulting, obnoxious) and when we disarm the other side they will move towards listening to our feelings.respect more and merit our point of view,
7. stroking - similar to disarming... u say positive about the person in conflict with even during a heated argument. to let them know even in heated difference of opinion and arguments, u have high esteem for them.
8. mediation - intervention of an acceptable, unbiased, neutral third party to settle dispute.
Techniques used to motivate clients
Ref : The practice of Social Work by Charles Zastrow , pg : 97
Motivation is the key elements for clients who are willing to take efforts to make changes regarding their problem. counselors can best motivate discouraged or apathetic people of positive changes they wanted to make or taking efforts to make. certain characteristics which help in client motivation includes the foll:
a. acceptance of person, not the dysfunctional behavior
2. non blaming attitude - so the discouraged person doesn lie, pretend or mask
3. empathy
4. genuine interest in clients progress, which must be expressed as per clients understanding
5. confidence in the capacity of the discouraged client to improve
6. non judgemental listening
7. the ability to notice every small instance of progress
8. the ability to motivate without worker getting discouraged with the client
9. the ability to reinforce the person's efforts
10. skill to look for clinet's uniqueness and strength and communicating the same to client
Tuesday, June 17, 2014
Task centered practice
Overview
Developed by : William j Reid and Laura EpsteinPractice usage : time limited (6-12 interviews over 2-4 month period)
Approach : Problem Solving
Basic Characteristics and principles
1. focus on clients problems, importance to tasks, integrative stance (the model draws from several approaches methods required for problem solving process), planned and short term, collaborative relationship between client and worker, empirical orientation- uses tested methods to work on the problem.
Outline of the Model
Phases : 3 (initial, middle and termination)
Phase 1 : identifying problems and assessment, selecting target problems, prioritizing target problems,problem specification, setting goals and using contracts, development and implementation of initial tasks
Phase II : problem and task review, identification and resolution of obstacles to task accomplishment,task planning and implementation sequence.
Phase III: Termination after review of accomplishment and problem solving skills (review of target problems and overall problem situation, identification of successful problem solving strategies used by clients, discussion of other ways to maintain client gains, discussion of what can be done about remaining problems, making decisions about extensions
Phase 1 : identifying problems and assessment, selecting target problems, prioritizing target problems,problem specification, setting goals and using contracts, development and implementation of initial tasks
Phase II : problem and task review, identification and resolution of obstacles to task accomplishment,task planning and implementation sequence.
Phase III: Termination after review of accomplishment and problem solving skills (review of target problems and overall problem situation, identification of successful problem solving strategies used by clients, discussion of other ways to maintain client gains, discussion of what can be done about remaining problems, making decisions about extensions
Ref : Social Work Practice a generalist approach- Louise c Johnson
The Practice of social work, Charles zastrow
Task centered casework , William j reid and Laura epstein
https://is.muni.cz/el/1423/podzim2012/SPP140/um/Tolson_Generalist_Practice.pdf
http://www.furthereducationlessontrader.co.uk/health%20and%20social%20care%20task%20centered%20model%20of%20social%20work.htm
Social Workers Desk Reference, Albert Roberts ,Gilbert Gerene
Crisis intervention approach
Ref : https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&cad=rja&uact=8&ved=0CEkQFjAE&url=http%3A%2F%2Fwww.raco.cat%2Findex.php%2FQuadernsPsicologia%2Farticle%2Fdownload%2F195789%2F262571&ei=7ZOgU87gCa2isASDiYHwDA&usg=AFQjCNHhcB2hLyOk1qR5cml-tenTxlUAVA&sig2=L8Wa9ey3uLHNAdTbH-Fqkg&bvm=bv.68911936,d.cWc
http://www.sagepub.com/upm-data/14229_Chapter5.pdf
The practice of social work, charles zastrow
Social work practice, a generalist approac-Louise C Johnson
The term crisis derives form the greek word «krisis» which means decision or turning point. This definition of the word as a decisive stage that has important consequences in the future of an individual or a system, has been preserved up to our days and has provided the framework for the development of the theory and practice of crisis intervention. Crisis intervention postulates that in crisis situation, the current or usual levels of functioning are disrupted and previously manageable psychological difficulties stirred up.
Crisis intervention was initially developed as a response to the growing demand for services in situations where immediate assistance was required for large numbers of individuals. Ell notes that there are infinite number of crisis situations in which CI is appropriate. These crisis include serious illness, trauma, death of a loved one, disaster, violent crimes, moving away from home and unplanned pregnancy.
Since people are often in a frozen position when a crisis arises, CI services often have two tasks : to resolve the current crisis and resolve the problems people have been denying previously or ignoring.
Definition of Crisis :
According to Lindemann, persons experiencing acute grief display one or more of the following symptoms:1. somatic distress; 2. preocupation with the image of the deceased; 3. guilt, 4. hostile reactions, and 5. loss of patterns of conduct. Sometimes the person experiencing crisis of bereavement may have distorted or
delayed grief reactions. Lindemann also stated that the grief work includes achieving emancipation from the deceased, readjustment to the environment in which the deceased is missing and formation of new relationships.
Caplan has provided various definitions of crisis (1964, 1974): he considers that a crisis is provoked when a person faces a problem for which he appears not to have an immediate solution and that is for a time insurmountable through the utilization of usual methods of problem solving. A period of upset and tension follows during which the person makes many attemps at the solution of the problem. Eventually, some kind of adaptation and equilibrium is achieved which may leave the person in a better or worse condition than prior to the crisis. Caplan suggests that the essential factor determining the occurrence of a crisis is an imbalance between the perceived difficulty and importance of the threatening situation and the resources immediately available to deal with it; the crisis refers to the person's emotional reaction not to the threatening situation itself.
crisis as defined by Rapoport as «an upset in a steady staten where an individual finds himself in a hazardous situation. The crisis creates a problem that can be perceived as a threat, a loss or a challenge. Rapoport argues that 3 interrelated factors usually produce a state of crisis: a hazardous event, a threat to life goals and the inability to respond with adequate coping mechanisms.
Components of Crisis :
SIFNEOS(1 960) has identified 4 components of an emotional crisis:
1) The hazardous event that starts the chain of reactions that lead to the crisis. Sometimes it is a sudden unexpected event, while other times it can be a developmental change.
2) A vulnerable state of the individual which is essential for the crisis to develop.
3) The precipitating factor that is the final event or circumstance that makes the hazardous event
unbearable and results in the crisis, and
4. The state of active crisis.
SHULBERG& SHELDON(1 968) have developed a probability formula
for a crisis: the probability of a crisis situation occurring because of a hazardous event is a function of the interaction between the hazardous event, the exposure of the individual to the event and the vulnerability
of the individual:
P Crisis = f (hazardous event exposure vulnerability)
Characteristics of Crisis :
time limited
Stages of Crisis :
According to CAPLAN(1 964) most crisis reactions follow 4 distinct phases:
1. In the initial phase the individual is confronted by a problem that poses a threat to his homeostatic state: the person responds to feelings of increased tension by calling forth the habitual problem-solving measures
in an effort to restore his emotional equilibrium.
2. There is a rise in tension due to the failure of habitual problem-solving measures and the persistence of the threat and problem. The person's functioning becames disorganized and the individual senses feelings
of upset and ineffectuality.
3. With the continued failure of the individual's efforts, a further rise in tension acts as a stimuli for the mobilization of emergency and novel problem-solving measures. At this stage, the problem may be
redefined, the individual may resign himself to the problem or he may find a solution to it.
4. If the problem continues, the tension mounts beyond a further threshold or its burden increases over time to a breaking point. The result may be a major breakdown in the individual's mental and social functioning .
Rapoport's (1962) three phases of a crisis reaction overlap with Caplan's stages, with the difference that Rapoport has merged Caplan's phases 1 and 2 and considered them the initial phase of crisis. She also
points out that some type of equilibrium is restored during the end phase of the crisis; yet this equilibrium can be lower, the same or higher than the one previous to the crisis.
Types of Crisis :
According to Erickson ; Maturational/developmental crisis and situational
according to rapoport : developmental crisis which is biopsychosocial in nature, crisis of role transition and accidental crisis
According to Baldwin emotional crisis includes 6 types of crisis situation : problematic situations, life transition crisis, crisis resulting from traumatic stress, developmental crisis in interpersonal situation, crisis reflecting psychopathology, psychiatric emergencies
Identifying the type of crisis that a person is going through is an important step of the crisis intervention process, that facilitates to a great extent the therapist's work with the person in crisis.
Crisis Intervention
EWING (1978) has defined crisis intervention as the informed and planful application of techniques derived from the established principles of crisis theory, by persons qualified through training and experience to
understand these principles, with the intention of assisting individuals or families to modify personal characteristics such as feelings, attitudes and behaviors that are judged to be maladaptive or maladjustive.
HAFER and PETERSON (1982), in a less formal definition, refer to crisis intervention as the kind of psychological first aid that enables to help an individual or group experiencing a temporary loss of ability to cope with a problem or situation.
According to Charles Zastrow Crisis Intervention progresses in the following manner:
1. An attempt is made to alleviate the disabling tension through ventilation and creation of climate of trust and hope
2. Next the worker attempts to understand the dynamics of the event that precipitated the crisis
3. the worker gives his impression and understanding of crisis and checks out these perception with the client
4. client and worker attempt to determine specific remedial measures that can be taken to restore equilibrium
5. new methods of coping may be introduced
6. finally termination occurs
Levels of Crisis Treatment
Levels of Crisis Treatment JACOBSEN,S TRICKLER& MORLEY( 1968) and MORLEY( 1970) have
discussed different levels of crisis treatment:
a) Environmental manipulation. In this case the helper serves as a
referral source, getting the client in touch with a resource person or facility.
b) General support. It consists basically of active listening in a non threatening manner, allowing the person to speak in some detail about is problem without challenging him.
c) Generic manipulation. It is helping the person resolve a crisis by accomplishing certain psychological tasks that are the same for al1 the people experiencing the same crisis regardless of individual differences.
d) Individual approach. It focuses on the specific needs of the person in crisis and emphasizes the assessment of the psychological and psychosocial processes that are influencing the client. It looks at the specific
psychoIogica1 tasks and problem solving activities that each person must accomplish in resolving a particular crisis.
Models of Crisis Intervention
LANGSLEY& KAPLAN(1 968) have classified crisis intervention models according to their main focus:a) Recompensation Model. It is a patient-oriented model, that is, it focuses on the patient exclusively. The main goal of the treatment intervention is to stop the decompensation, get the symptoms under control
and return the patient to his pre-crisis leve1 of functioning. The model does not aim at explaining the failure to cope nor at understanding the past dynamics of the person that led him to the crisis. Moreover, there
is not much concern about the person's future adjustment. The military treatment of the traumatic neuroses is a typical example of the recompensation approach to treatment.
b) Stress-Oriented Model. It takes into account the stress event. The goal of the intervention is to achieve successful resolution of the specific tasks posed by the stress event. It emphasizes the development of problem- solving strategies and coping skills and it is concerned with the future adjustment of the individual to other stressful situations. This model has been developed to great extent by Lindemann and Caplan.
c) System-Oriented Model. It is the one advocated by Langsley and Kaplan; it takes into account the social field in which the person deals with the crisis. It is based on the belief that not only the development
but also the outcome of the crisis depend in part on the social field of the person in crisis, and therefore emphasizes the systems approach to intervention. Family-Oriented crisis treatment is an important development of this model, which is based on the assumption that the symptoms of the family member who seeks treatment are usually an expression of family conflicts.
Process of Crisis Intervention (refer link given above)
Assessment in Crisis Intervention
1. focus on immediate identifiable problem
2. understand the problem from the client's point of view
3. explore the client's coping strategies, strengths and social support
4. if possible get information from client significant others
Goal of the intervention :
to restore social functioning and improve coping capacityDirect Practice / Micro
Client Advocacy
Advocacy is a concept that SW has borrowed from the legal profession. As an advocate the SWr becomes the speaker of the client by presenting and arguing the client's cause when this is necessary to accomplish the objectives of the contract.
According to Michael Sosin and Sharon concepts of advocacy in SW can be defined as " An attempt, having a greater than zero probability of success, y an individual or a group to influence another individual or group to make a decision that would not have been made otherwise and that concerns the welfare or interests of a third party who is in a less powerful status than the decision makers.
The advocate will argue, debate, bargain, negotiate and manipulate the environment on behalf of the client. Advocacy differs from mediation. In mediation, the effort is to secure resolution to a dispute through give and take on both sides. In advocacy the effort is to win for the client, advocacy efforts are frequently directed towards securing benefits to which the client is legally entitled.
reference : pg 625 of Social Work porcesses
Empowerment Process
This is one of the most important aspect of Social Work. Empowerment can be defined as "a process whereby the social worker engages in a set of activities with the client (...) that aim to reduce the powerlessness that has been created by negative valuations based on member-ship in a stigmatised group. It involves identification of the power blocks that contribute to the problem as well as the development and implementation of specific strategies aimed at either the reduction of the effects from indirect power blocks or the reduction of the operations of direct power blocks." (Solomon, B.: Black Empowerment: Social Work in Oppressed Communities, New York 1976.)
Ref : http://www.agef-saar.de/AHOI/Lima/Base/Chapter4.htm
http://www.johnlord.net/web_documents/process_of_empowerment.pdf
Empowerment is a process at individual, group and community level. Rappaport's (1987) concept of empowerment, "conveys both a psychological sense of personal control or influence and a concern with actual social influence, political power and legal rights" (p.121). In this sense, empowerment can exist at three levels: at the personal level, where empowerment is the experience of gaining increasing control
and influence in daily life and community participation (Keiffer, 1984); at the small group level, where empowerment involves the shared experience, analysis, and influence of groups on their own efforts (Presby,Wandersman, Florin, Rich, & Chavis, 1990); and at the community level, where empowerment revolves around the utilization of resources and strategies to enhance community control (Labonte, 1989).
The common theme in the process of empowerment are :
1. Powerlessness (social isolation, unresponsive services and systems, poverty and abuse)
2. Impetus to the Empowerment Process
(being involved in a crisis or "life transition."
• acting on anger or frustration.
• responding to new information.
• building on inherent strengths and capabilities
3. Support from People (practical support, moral support and mentoring) Research and analysis has suggested that "building on people's strengths" is one of the key ways to facilitate personal empowerment
4. Access to Valued Resources ( Parenti (1978) describes power as the ability to control powerful resources in order to get what you want, despite resistance. And since the sense of power and empowerment are closely related, to have the access to the kind of material and immaterial resources does empower people)
5. The Role of Participation in Community Life (Participation significantly advanced the process of empowerment for all of the people involved in the research. In fact, the process of participation itself was
empowering. Participants had noted that their feelings of powerlessness were accompanied by a lack of participation. As people gained in self-confidence, they would seek more avenues for participation; their involvement in community activity would in turn enhance their self-confidence and sense of personal control.
Therefore the elements of empowerment process include the following
experiencing powerlessness, gaining awareness, learning new roles, initiating participation and contribution.
Methods used in working with involuntary clients
Understanding involuntary clients, behaviors they exhibit to express it, steps for dealing with involuntary clients, principles and best practices.
Psychosocial approach
The psychosocial framework is a distinctive practice model that originated early in the profession's history. Its goals are to restore, maintain, and enhance the personal and social functioning of individuals. Drawing on psychological and social theories, it has evolved considerably from its Freudian and ego psychological underpinnings. It has incorporated new knowledge on gender and diversity. Assessment, the client–worker relationship, respect for diversity, and an appreciation of client strengths are fundamental to the psychosocial approach. It uses both individual and environmental interventions and can be applied to a broad range of client populations. There is empirical evidence for the utility of psychosocial intervention but more research on the psychosocial framework is needed. - Encyclopedia of Social Work
This model can be used only with clients who can verbalize their issues and is willing to commit long term involvement and with the desire for self knowledge or insight
underlying theories include psychoanalytic theory, social theories on culture, race, role,communication etc, systems theory.
The Psychosocial approach to Casework, florence hollis
Components of Problem solving process
Ref : Social work practice, a generalist approach , pg 76
social work processes , buelah compton, pg 389
Problem solving is a process by which the social worker examines the concern and need and identifies blocks to need fulfillment leading to problem identification and formulation. It seeks solutions for problems. The knowledge, values, skills of SWr is used in understanding the nature of the problem and in identifying the possible solutions. The stages in problem solving process includes :
1. preliminary statement of the problem
2, nature of problem
3. collection of information
4. analysis of information available
5. development of plan
6. implementation
7. evaluation of plan
Social case work is a process used by human welfare agencies to help individuals to cope more effectively with their problems in social functioning. in this case it is problem solving process with individual. Either with individual, groups, families or community, the components of problem solving process is pretty much same.
Saturday, June 14, 2014
Social Worker Roles and Relationships
This is part III under Professional relationships,values and ethics section which comprises 27% of exam content. Few topics covered as per ASWB study guide
According to Beulah R COmpton in Social Work Processes (important reference material )
1. concern for others
2. commitment and obligation
3. acceptance and expectation
4. empathy
5. genuineness
6. Authority and Power
7. Purpose
To carry out professional relationships with professional skills workers will need to make the following qualities as part of their professional selves :
Maturity , creativity, capacity to observe self, the desire to help, courage, sensitivity and the ability to endure ambiguity.
Ref : https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&cad=rja&uact=8&ved=0CD0QFjAE&url=http%3A%2F%2Fweb.mnstate.edu%2Fclarkt%2FDocs%2FSW420%2520ppts%2FThe%2520Client-Worker%2520Relationship.ppt&ei=b2GbU9fMM8zNsQTSyYLQAg&usg=AFQjCNGBphud4XEHQfSaQUw2Gv28g9hFLA&bvm=bv.68911936,d.cWc
Alan Keith Lucas defines helping relationship as "the medium which is offered to people in trouble through which they are given an opportunity to make choices, both about taking help and the use they will make of it," Qualities of the relationship are mutuality, reality, feeling, knowledge, concern for other person, purpose, takes place in here and now,offers something new and non judgmental. further elements of social worker client relationship apart from one mentioned above would be commitment to the needs of the client system, objectivity and self awareness on the part of the worker.
The purpose of the relationship was described as creating an atmosphere, the development of personality, a better solution of the client's problem, the means for carrying out function, stating and focusing reality and emotional problems, and helping a client to make more acceptable adjustment to a personal problem.
Konopka describes that the relationship between social worker and the small helping group differs from that of a social worker involved with an individual in the following ways :
1. members support each other and are not alone with the authority
2. there is greater informality
3. members are surrounded by others in the same boat and there is a feeling of identification impossible in social casework
4. Members are not bound to accept other members
5. the worker is shared
6. there is lack of confidentiality within the group
Ref (important ) : http://anzasw.org.nz/documents/0000/0000/0613/Principles-for-Engagement_1_.pdf
Engagement is founded on the following main components (Bordin, 1994; Kirsh & Tate, 2006):
• the connection and rapport between the service user
and worker
• the collaborative nature of the work
• agreement on goals
• agreement on tasks.
Self-disclosure can be an invaluable tool when employed ethically and purposefully in establishing a collaborative relationship and engaging the client in further working with the social worker, yet if not employed properly it can cause incredible and irreparable damage to the client.
Ref : http://books.google.com/books?id=1dZTDeLF368C&pg=PA20&lpg=PA20&dq=client+engagement+in+social+work&source=bl&ots=a-7P2MSnFU&sig=0jfFW5XoUTllA4nsvktGBGc-hfw&hl=en&sa=X&ei=4V2XU8TyGNWnsQS46IHoAw&ved=0CG0Q6AEwCTgK#v=onepage&q=client%20engagement%20in%20social%20work&f=falseThe quality of relationship between the client and the helping person is extremely important and should not be underestimated. In direct practice client engagement is comprised of two activities :
1. establishing a beginning relationship of trust between the client and the practitioner
2. establishing the client in the role of a client, willing to mutually identify and work on the identified target problem. establishing rapport and creating a helping alliance are terms that also describe what we refer to as engagement.
Client engagement with voluntary client who come for help is usually refered as "relationship enhancement", whose specific techniques include client structuring, imitation and conformity, helper expertness, credibility, empathy, warmth and self disclosure, helper client matching, physical closeness and posture, negotiation of meaning and overcoming cultural differences. research suggests that practitioner client relationship improves as the quantity and quality of these enhancers increase. these individual enhancers group together to create the three qualities most often attributed to effective practitioners : interpersonal attraction, trustworthiness and perceived expertness.
This differs in great with client worker relationship when it comes to involuntary clients. those which enhance the relationship with voluntary clients may have a negative influence on relationships while working with involuntary clients.
Ref : http://books.google.com/books?id=yKCMAgAAQBAJ&pg=PA150&lpg=PA150&dq=client+engagement+in+social+work&source=bl&ots=oJhRlXYf3o&sig=7N1tVtlRCU4QOvDXFpi87oge-Yk&hl=en&sa=X&ei=o2OXU-nfJuHEsATcooBA&ved=0CD0Q6AEwAzge#v=onepage&q=client%20engagement%20in%20social%20work&f=false
Social worker client relationship in work with community and organizations
according to Pincus and Minahan relationship can be thought of as an affective bond between workers and other systems with which they may be involved and that relationships may involve an atmosphere of collaboration, bargaining or conflicted. A lot of literature has developed around relationship between social worker and client in one to one or one to group setting, but not really in terms of community or larger group.
Social workers engaged in administration, policy planning and organization activities often carry a client relationship with the system in which they are involved, but the responsibilities they assume within this relationship are quite different from those of the direct services helping relationship. In these relationships too they carry no responsibility to help the other system with personal problems or individual member or group as a unit. rather, they are involved in helping the client system to change another system in regard to certain professional policies and programs. either helping individual or group or communities,there are certain elements in relationships which are common to all. The elements of power and authority may be lodged in persons other than social worker especially in situations involving policy making or organizational change. the elements and skills a social worker needs differs in range with respect to client (individual or group or community) and used deferentially.
The problem solving process begins from the clients need. even those individuals, families or groups who were often held by earlier helping systems to be unreachable and beyond help could participate as partners in the problem solving process once they understood that the SWr is listening and, really wanted to know them as people (not as interesting case) and were willing them to pursue their own goals. There is rich information client could give on goals they worked previously on but could not attain due to reasons. and this is the point where problem solving really began. The insight from the side of the client and a clear communication to social worker or the SWr responsibility and skill in understanding the whole concept gives concrete goals to work and bring change. Therefor the process demands clients following:
a. that they be able to share with the worker, information about something they would like to have changed
b. that they achieve something that is of value to them
c. that as the worker is able to demonstrate concern and competence to help with the exploration of this problem, clients are able to trust this concern enough and
d. they allow worker to continue to meet with them around this purpose.
That is all that is demanded from the client system
Ref : social work processes pg: 383-384
Other references :
Social Work practice a generalist approach. Louise C Johnson
books available @ openlibrary.org which is free to borrow and use online.
According to Beulah R COmpton in Social Work Processes (important reference material )
1. Social Worker Client relationship patterns :
The elements of relationship differ in terms of the nature of the role of socia worker (helper, advocate, policy maker,researcher) and the type of system in which the change agent is involved. Common to all include :1. concern for others
2. commitment and obligation
3. acceptance and expectation
4. empathy
5. genuineness
6. Authority and Power
7. Purpose
To carry out professional relationships with professional skills workers will need to make the following qualities as part of their professional selves :
Maturity , creativity, capacity to observe self, the desire to help, courage, sensitivity and the ability to endure ambiguity.
Ref : https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&cad=rja&uact=8&ved=0CD0QFjAE&url=http%3A%2F%2Fweb.mnstate.edu%2Fclarkt%2FDocs%2FSW420%2520ppts%2FThe%2520Client-Worker%2520Relationship.ppt&ei=b2GbU9fMM8zNsQTSyYLQAg&usg=AFQjCNGBphud4XEHQfSaQUw2Gv28g9hFLA&bvm=bv.68911936,d.cWc
Concept of a helping relationship :
Alan Keith Lucas defines helping relationship as "the medium which is offered to people in trouble through which they are given an opportunity to make choices, both about taking help and the use they will make of it," Qualities of the relationship are mutuality, reality, feeling, knowledge, concern for other person, purpose, takes place in here and now,offers something new and non judgmental. further elements of social worker client relationship apart from one mentioned above would be commitment to the needs of the client system, objectivity and self awareness on the part of the worker.
The purpose of the relationship was described as creating an atmosphere, the development of personality, a better solution of the client's problem, the means for carrying out function, stating and focusing reality and emotional problems, and helping a client to make more acceptable adjustment to a personal problem.
Principles of relationship building
1. Purposeful expression of feelings
2. controlled emotional involvement
3. Acceptance
4. individualization
5. non judgemental attitude
6. client self determination
7. confidentiality
Social Worker client relationships in work with small groups
Konopka describes that the relationship between social worker and the small helping group differs from that of a social worker involved with an individual in the following ways :
1. members support each other and are not alone with the authority
2. there is greater informality
3. members are surrounded by others in the same boat and there is a feeling of identification impossible in social casework
4. Members are not bound to accept other members
5. the worker is shared
6. there is lack of confidentiality within the group
Concept of Empathy
Empathy is the necessary quality in a helping relationship. "Empathy is the capacity to enter into the feelings and experiences of another- knowing what the other feels and experiences- without losing oneself in the process. The helping person makes an active effort to enter into the perceptual frame of the other person without losing personal perspective, but, rather, using that understanding to help the other person.
Carl Rogers defines empathy as" the perceiving of the internal frame of reference of another with accuracy, and with the emotional components which pertains thereto, "as if" one were the other person but without losing the "as if" condition."
TO be simple, empathy is the capacity to feel an emotion deeply and yet to remain separate enough from it to be able to use knowledge.
Process of engagement in Social Work practice
Engagement refers to the clients’ willingness to partake in the therapeutic process and is therefore critical to change influenced by social workers. The therapeutic alliance is also known as the collaborative relationship between the client and the social worker, the strength and structure of which is often based on the clients’ level of engagement. ref: http://socialworkersanonymous.wordpress.com/2013/01/29/the-use-of-you-in-client-engagement/Ref (important ) : http://anzasw.org.nz/documents/0000/0000/0613/Principles-for-Engagement_1_.pdf
Engagement is founded on the following main components (Bordin, 1994; Kirsh & Tate, 2006):
• the connection and rapport between the service user
and worker
• the collaborative nature of the work
• agreement on goals
• agreement on tasks.
Self-disclosure can be an invaluable tool when employed ethically and purposefully in establishing a collaborative relationship and engaging the client in further working with the social worker, yet if not employed properly it can cause incredible and irreparable damage to the client.
Ref : http://books.google.com/books?id=1dZTDeLF368C&pg=PA20&lpg=PA20&dq=client+engagement+in+social+work&source=bl&ots=a-7P2MSnFU&sig=0jfFW5XoUTllA4nsvktGBGc-hfw&hl=en&sa=X&ei=4V2XU8TyGNWnsQS46IHoAw&ved=0CG0Q6AEwCTgK#v=onepage&q=client%20engagement%20in%20social%20work&f=falseThe quality of relationship between the client and the helping person is extremely important and should not be underestimated. In direct practice client engagement is comprised of two activities :
1. establishing a beginning relationship of trust between the client and the practitioner
2. establishing the client in the role of a client, willing to mutually identify and work on the identified target problem. establishing rapport and creating a helping alliance are terms that also describe what we refer to as engagement.
Client engagement with voluntary client who come for help is usually refered as "relationship enhancement", whose specific techniques include client structuring, imitation and conformity, helper expertness, credibility, empathy, warmth and self disclosure, helper client matching, physical closeness and posture, negotiation of meaning and overcoming cultural differences. research suggests that practitioner client relationship improves as the quantity and quality of these enhancers increase. these individual enhancers group together to create the three qualities most often attributed to effective practitioners : interpersonal attraction, trustworthiness and perceived expertness.
This differs in great with client worker relationship when it comes to involuntary clients. those which enhance the relationship with voluntary clients may have a negative influence on relationships while working with involuntary clients.
Ref : http://books.google.com/books?id=yKCMAgAAQBAJ&pg=PA150&lpg=PA150&dq=client+engagement+in+social+work&source=bl&ots=oJhRlXYf3o&sig=7N1tVtlRCU4QOvDXFpi87oge-Yk&hl=en&sa=X&ei=o2OXU-nfJuHEsATcooBA&ved=0CD0Q6AEwAzge#v=onepage&q=client%20engagement%20in%20social%20work&f=false
Concepts of Transference and counter transference
Transference is the phenomenon whereby we unconsciously transfer feelings and attitudes from a person or situation in the past on to a person or situation in the present. The process is at least partly inappropriate to the present
Countertransference is the response that is elicited in the recipient (therapist) by the other's (patient's) unconscious transference communications . Countertransference response includes both feelings and associated thoughts. When transference feelings are not an important part of the therapeutic relationship, there can obviously be no countertransference.
Ref : http://mondaynightgroupsupervision.blogspot.com/2010/02/transference-counter-transference.html
http://socialworkexamreview.blogspot.com/2007/06/managing-transference-and.html
http://staciehebert.blogspot.com/2012/07/the-social-work-intervention-model.html
Social worker role in problem solving process
The problem solving process in SW consist of 3 phases
1. contact phase (Problem identification, problem definition, goal identification, preliminary contract on working towards agreed goal, exploration and investigation)
2. contract phase ( assessment and evaluation /diagnosis, formulation of plan of action, prognosis)
3. action phase( carrying out the plan, termination, evaluation)
this might differ slightly in terms of long term or short term intervention.
however the role of social worker would be multiple differing in each phase sometimes clubbing more than one role at a time. Every phase of problem solving involves use of specific skills. The role of the social worker depends upon client system, agency setting/policy and the problem. A social worker is a helper in the initial phase and mostly throughout the problem solving process. helping client or client system to analyse the needs, identify problems and work through it, A social worker also takes up the role of enabler, teacher, broker, advocate, mediator, adviser/guide, facilitator and so on.
Ref : http://allisonmurdach.wordpress.com/2011/05/05/helen-harris-perlman-and-the-problem-solving-model/Social worker client relationship in work with community and organizations
according to Pincus and Minahan relationship can be thought of as an affective bond between workers and other systems with which they may be involved and that relationships may involve an atmosphere of collaboration, bargaining or conflicted. A lot of literature has developed around relationship between social worker and client in one to one or one to group setting, but not really in terms of community or larger group.
Social workers engaged in administration, policy planning and organization activities often carry a client relationship with the system in which they are involved, but the responsibilities they assume within this relationship are quite different from those of the direct services helping relationship. In these relationships too they carry no responsibility to help the other system with personal problems or individual member or group as a unit. rather, they are involved in helping the client system to change another system in regard to certain professional policies and programs. either helping individual or group or communities,there are certain elements in relationships which are common to all. The elements of power and authority may be lodged in persons other than social worker especially in situations involving policy making or organizational change. the elements and skills a social worker needs differs in range with respect to client (individual or group or community) and used deferentially.
Client's role in problem solving process
The problem solving process begins from the clients need. even those individuals, families or groups who were often held by earlier helping systems to be unreachable and beyond help could participate as partners in the problem solving process once they understood that the SWr is listening and, really wanted to know them as people (not as interesting case) and were willing them to pursue their own goals. There is rich information client could give on goals they worked previously on but could not attain due to reasons. and this is the point where problem solving really began. The insight from the side of the client and a clear communication to social worker or the SWr responsibility and skill in understanding the whole concept gives concrete goals to work and bring change. Therefor the process demands clients following:
a. that they be able to share with the worker, information about something they would like to have changed
b. that they achieve something that is of value to them
c. that as the worker is able to demonstrate concern and competence to help with the exploration of this problem, clients are able to trust this concern enough and
d. they allow worker to continue to meet with them around this purpose.
That is all that is demanded from the client system
Ref : social work processes pg: 383-384
Other references :
Social Work practice a generalist approach. Louise C Johnson
books available @ openlibrary.org which is free to borrow and use online.
Thursday, June 12, 2014
Memorare
Wednesday, June 4, 2014
Professional values and Ethics
Professional Values and ethics :
this forms 27% of testing content for ASWB exam. (topics covered according to ASWB study guide)
Values : Service, social justice, dignity and worth of human person, integrity, competence and importance of human relationships
Based on the above professional values, the ethical standards concern
1. responsibility to clients
2. responsibility to colleagues
3. responsibility in practice setting
4. responsibility as professionals
5. responsibility towards profession
6. responsibility towards broader society
a. commitment to clients : SW's primary responsibility is to promote the wellbeing of the client, in general clients interests are primary, however SW's responsibility towards the larger society or specific legal obligation may supersede the loyalty owed to clients and the clients should so be advised.
b. Client Self Determination :Social workers respect the individual’s right to make independent decisions and to participate actively in the helping process. People have a right to freedom as long as they do not infringe on the rights of others. Therefore, transactions with people who are seeking and utilizing resources should enhance their independence and self-determination. Our commitment to client self-determination and empowerment is hollow if clients lack access to the resources necessary to achieve their goals hence Social workers are committed to assisting client systems to obtain needed resources. People should have access to the resources they need to meet life’s challenges and difficulties as well as access to opportunities to realize their potential throughout their lives. Social workers may limit clients’ right to self-determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.
c. Intrinsic worth and value of the individual : Social workers respect the inherent dignity and worth of the person. Social workers treat each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity. Social workers promote clients’ socially responsible self-determination. Social workers seek to enhance clients’ capacity and opportunity to change and to address their own needs. Social workers are cognizant of their dual responsibility to clients’ interests and the broader society’s interests in a socially responsible manner consistent with the values, ethical principles, and ethical standards of the profession.
d. client's right to refuse service : In instances when clients lack the capacity to provide informed consent, social workers should protect clients’ interests by seeking permission from an appropriate third party, informing clients consistent with the clients’ level of understanding. In such instances social workers should seek to ensure that the third party acts in a manner consistent with clients’ wishes and interests. Social workers should take reasonable steps to enhance such clients’ ability to give informed consent.
(d) In instances when clients are receiving services involuntarily, social workers should provide information about the nature and extent of services and about the extent of clients’ right to refuse service.
e. ethical issues regarding termination : 1. terminate when the treatment no longer required or no longer serves the clients needs or interests, 2. when client is still in need of services and under unusual circumstance the client has to be terminated, possible efforts to arrange for the continuation of service must be taken and for no others reasons than SW's disability, relocation or other unusual conditions. When doing so, the risks must be mitigated on possile adverse effects, 3. Social workers should not terminate services to pursue a social, financial, or sexual relationship with a client., 4. Social workers who anticipate the termination or interruption of services to clients should notify clients promptly and seek the transfer, referral, or continuation of services in relation to the clients’ needs and preferences. 5. Social workers who are leaving an employment setting should inform clients of appropriate options for the continuation of services and of the benefits and risks of the options.
f. Identification and resolution of ethical dilemmas & h.applying ethics to practice issues : when attempting to resolve an ethical dilemma in practice, social workers should determine if it is an absolute or approximate dilemma; distinguish between personal and professional dimensions; and identify the ethical, moral, legal, and values considerations in the situation. After conducting this preliminary analysis, an ethical decision-making model can then be appropriately applied. http://www.socialworker.com/feature-articles/ethics-articles/What_Is_an_Ethical_Dilemma%3F/ and https://www.socialworkers.org/pubs/code/oepr/steps.asp and http://www.socialworktoday.com/news/eoe_101402.shtml and http://www.socialworktoday.com/news/eoe_101402.shtml and http://naswil.org/news/chapter-news/featured/ethics-corner-resolving-ethical-dilemmas/ and http://journals.iupui.edu/index.php/advancesinsocialwork/article/viewFile/124/107
g Responsibility to seek supervision :
1. Social workers should provide services in substantive areas or use intervention techniques or approaches that are new to them only after engaging in appropriate study, training, consultation, and supervision from people who are competent in those interventions or techniques.
2. When faced with ethical dilemmas, SW should seek supervision, usually the agency has the ethics committee who are trained to handle such situations
3. http://www.socialworkers.org/practice/naswstandards/socialworksupervision/SUPERVISION%20STANDARDS2%20Public%20Comment%20Draft%20August%2016.pdf
h. Use of professional development to improve practice :
i. Professional boundaries : Social Workers should under no circumstance engage in any sexual activity with current or former clients or to the person close to the client, incase of any such involvement, it is the social workers burden and not the client's to prove that the client has not been exploited, coerced or harmed. Also SWrs should not provide clinical services to clients with whom prior sexual involvement is present. Social Wkrs should not involve in physical contact with client when it has the possibility to harm the client. SWks are responsible for setting clear, appropriate, and culturally sensitive boundaries that govern such physical contact. Sexual harassment of any kind strictly prohibited, Swks cannot use derogatory language, they must be respectful in all their communications with and about the client
b. Confidentiality : ref http://journals.iupui.edu/index.php/advancesinsocialwork/article/viewFile/124/107
legal and ethical issues regarding confidentiality,including electronic communication, use of client records,ethical issues regarding mandatory reporting and obtaining informed consent
1.responsibility to the larger society or specific legal obligations may on limited occasions supersede the loyalty owed clients, and clients should be advised about it
2. client's right to self determination can be limited when the SW r finds threats/imminent risk for client and others or larger society
3. In instances when clients are not literate or have difficulty understanding the primary language used in the practice setting, social workers should take steps to ensure clients’ comprehension. This may include providing clients with a detailed verbal explanation or arranging for a qualified interpreter or translator whenever possible.
(c) In instances when clients lack the capacity to provide informed consent, social workers should protect clients’ interests by seeking permission from an appropriate third party, informing clients consistent with the clients’ level of understanding. In such instances social workers should seek to ensure that the third party acts in a manner consistent with clients’ wishes and interests. Social workers should take reasonable steps to enhance such clients’ ability to give informed consent.
(d) In instances when clients are receiving services involuntarily, social workers should provide information about the nature and extent of services and about the extent of clients’ right to refuse service.
(e) Social workers who provide services via electronic media (such as computer, telephone, radio, television) should inform recipients of the limitations and risks associated with such services.
(f) Social workers should obtain clients’ informed consent before audiotaping or videotaping clients or permitting observation of services to clients by a third party.
disclosing confidences :
1. when there is a harm at stake either at self or others (specific information required to help)
2. sucidality, homicidality , suspected harm to children, decompensation (when client is unable to take care of oneself and thus causes threat to self or others eg: dementia, psychotic (accute), subpoenas .under all these cases confidentiality can be broken, but only required information must be provided according to situation and the client must be informed about it.
3. when AIDS is involved
Ref :
the Jennifer Keeton case at Augusta State University and the Julea Ward case at Eastern Michigan University
NASW code of Ethics
http://quizlet.com/44253454/ethics-confidentiality-flash-cards/
this forms 27% of testing content for ASWB exam. (topics covered according to ASWB study guide)
Values : Service, social justice, dignity and worth of human person, integrity, competence and importance of human relationships
Based on the above professional values, the ethical standards concern
1. responsibility to clients
2. responsibility to colleagues
3. responsibility in practice setting
4. responsibility as professionals
5. responsibility towards profession
6. responsibility towards broader society
a. commitment to clients : SW's primary responsibility is to promote the wellbeing of the client, in general clients interests are primary, however SW's responsibility towards the larger society or specific legal obligation may supersede the loyalty owed to clients and the clients should so be advised.
b. Client Self Determination :Social workers respect the individual’s right to make independent decisions and to participate actively in the helping process. People have a right to freedom as long as they do not infringe on the rights of others. Therefore, transactions with people who are seeking and utilizing resources should enhance their independence and self-determination. Our commitment to client self-determination and empowerment is hollow if clients lack access to the resources necessary to achieve their goals hence Social workers are committed to assisting client systems to obtain needed resources. People should have access to the resources they need to meet life’s challenges and difficulties as well as access to opportunities to realize their potential throughout their lives. Social workers may limit clients’ right to self-determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.
c. Intrinsic worth and value of the individual : Social workers respect the inherent dignity and worth of the person. Social workers treat each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity. Social workers promote clients’ socially responsible self-determination. Social workers seek to enhance clients’ capacity and opportunity to change and to address their own needs. Social workers are cognizant of their dual responsibility to clients’ interests and the broader society’s interests in a socially responsible manner consistent with the values, ethical principles, and ethical standards of the profession.
d. client's right to refuse service : In instances when clients lack the capacity to provide informed consent, social workers should protect clients’ interests by seeking permission from an appropriate third party, informing clients consistent with the clients’ level of understanding. In such instances social workers should seek to ensure that the third party acts in a manner consistent with clients’ wishes and interests. Social workers should take reasonable steps to enhance such clients’ ability to give informed consent.
(d) In instances when clients are receiving services involuntarily, social workers should provide information about the nature and extent of services and about the extent of clients’ right to refuse service.
e. ethical issues regarding termination : 1. terminate when the treatment no longer required or no longer serves the clients needs or interests, 2. when client is still in need of services and under unusual circumstance the client has to be terminated, possible efforts to arrange for the continuation of service must be taken and for no others reasons than SW's disability, relocation or other unusual conditions. When doing so, the risks must be mitigated on possile adverse effects, 3. Social workers should not terminate services to pursue a social, financial, or sexual relationship with a client., 4. Social workers who anticipate the termination or interruption of services to clients should notify clients promptly and seek the transfer, referral, or continuation of services in relation to the clients’ needs and preferences. 5. Social workers who are leaving an employment setting should inform clients of appropriate options for the continuation of services and of the benefits and risks of the options.
f. Identification and resolution of ethical dilemmas & h.applying ethics to practice issues : when attempting to resolve an ethical dilemma in practice, social workers should determine if it is an absolute or approximate dilemma; distinguish between personal and professional dimensions; and identify the ethical, moral, legal, and values considerations in the situation. After conducting this preliminary analysis, an ethical decision-making model can then be appropriately applied. http://www.socialworker.com/feature-articles/ethics-articles/What_Is_an_Ethical_Dilemma%3F/ and https://www.socialworkers.org/pubs/code/oepr/steps.asp and http://www.socialworktoday.com/news/eoe_101402.shtml and http://www.socialworktoday.com/news/eoe_101402.shtml and http://naswil.org/news/chapter-news/featured/ethics-corner-resolving-ethical-dilemmas/ and http://journals.iupui.edu/index.php/advancesinsocialwork/article/viewFile/124/107
g Responsibility to seek supervision :
1. Social workers should provide services in substantive areas or use intervention techniques or approaches that are new to them only after engaging in appropriate study, training, consultation, and supervision from people who are competent in those interventions or techniques.
2. When faced with ethical dilemmas, SW should seek supervision, usually the agency has the ethics committee who are trained to handle such situations
3. http://www.socialworkers.org/practice/naswstandards/socialworksupervision/SUPERVISION%20STANDARDS2%20Public%20Comment%20Draft%20August%2016.pdf
h. Use of professional development to improve practice :
i. Professional boundaries : Social Workers should under no circumstance engage in any sexual activity with current or former clients or to the person close to the client, incase of any such involvement, it is the social workers burden and not the client's to prove that the client has not been exploited, coerced or harmed. Also SWrs should not provide clinical services to clients with whom prior sexual involvement is present. Social Wkrs should not involve in physical contact with client when it has the possibility to harm the client. SWks are responsible for setting clear, appropriate, and culturally sensitive boundaries that govern such physical contact. Sexual harassment of any kind strictly prohibited, Swks cannot use derogatory language, they must be respectful in all their communications with and about the client
b. Confidentiality : ref http://journals.iupui.edu/index.php/advancesinsocialwork/article/viewFile/124/107
legal and ethical issues regarding confidentiality,including electronic communication, use of client records,ethical issues regarding mandatory reporting and obtaining informed consent
1.responsibility to the larger society or specific legal obligations may on limited occasions supersede the loyalty owed clients, and clients should be advised about it
2. client's right to self determination can be limited when the SW r finds threats/imminent risk for client and others or larger society
3. In instances when clients are not literate or have difficulty understanding the primary language used in the practice setting, social workers should take steps to ensure clients’ comprehension. This may include providing clients with a detailed verbal explanation or arranging for a qualified interpreter or translator whenever possible.
(c) In instances when clients lack the capacity to provide informed consent, social workers should protect clients’ interests by seeking permission from an appropriate third party, informing clients consistent with the clients’ level of understanding. In such instances social workers should seek to ensure that the third party acts in a manner consistent with clients’ wishes and interests. Social workers should take reasonable steps to enhance such clients’ ability to give informed consent.
(d) In instances when clients are receiving services involuntarily, social workers should provide information about the nature and extent of services and about the extent of clients’ right to refuse service.
(e) Social workers who provide services via electronic media (such as computer, telephone, radio, television) should inform recipients of the limitations and risks associated with such services.
(f) Social workers should obtain clients’ informed consent before audiotaping or videotaping clients or permitting observation of services to clients by a third party.
disclosing confidences :
1. when there is a harm at stake either at self or others (specific information required to help)
2. sucidality, homicidality , suspected harm to children, decompensation (when client is unable to take care of oneself and thus causes threat to self or others eg: dementia, psychotic (accute), subpoenas .under all these cases confidentiality can be broken, but only required information must be provided according to situation and the client must be informed about it.
3. when AIDS is involved
Ref :
the Jennifer Keeton case at Augusta State University and the Julea Ward case at Eastern Michigan University
NASW code of Ethics
http://quizlet.com/44253454/ethics-confidentiality-flash-cards/
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