Social Casework Processes: Study and Diagnosis
So far we have seen that social casework addresses Since client worker relationship is the medium In the study phase the client presents the problem. The study is an exploratory examination of the relationship between the in relation to the independent variables of treatment phase, casework method, and . Thus, social case work is one to one relationship with the person py which help .. Study phase Social, study is a systematic study of the client and his/her.
The treatment procedures have been defined by the Hollis' typology of casework treatment. The variation in the use of the treatment procedures is also examined in relation to three intervening variables: The clients studied are a well defined group. The sample tends to represent clients who continue in service through at least the ninth assigned service interview.
These are clients who have agreed to partake in a research project and to have their interviews tape recorded. The study has examined eighty-seven tape recorded interviews drawn from thirty-five clients representing twenty-two families. Individual clients are represented by a range of from one to three interviews drawn from a maximum of three phases of treatment. The interviews are representative of assigned service client interview one through fourteen and assigned service case interview one through thirty-nine.
The caseworkers treating the clients assessed the clients' status and functioning on the selected diagnostic variables. The treatment procedures used by that same caseworker with each client were determined through the content analysis of tape recorded interviews with the clients. Each worker statement clause was classified as one of eleven possible treatment procedures. The proportionate use of each procedure was computed for each interview.
Differences in proportions were examined in relation to the independent variables. Variation in the use of the treatment procedures in relation to the independent variables of treatment phase, casework method, and case- worker were examined through a series of multivariate analyses of variance tests.
Objectives set should be specific, realistic and achievable within the time limit. Once this planning is complete, one can move with the case to achieve the desired objectives. This planning should be a continuous process and not a periodical one. In some cases, in India, discussing the planning with the client may not be feasible either for time factor or overall socio-educational level of the client.
In such cases, planning how the problem will be solved should at least be shared with him. This may not be useful if it involves telling the client the process of therapy, i. Telling this to the client may weaken his motivation to seek help. This, to my experience, is quite true of majority of the Indian clients -who do not, by and large, appreciate the invisible therapeutic process.
Implied in these goals are prevention of deterioration in and conserving the strength of the client. The approach to treatment, then, can be said to include either or any combination of the following services: To achieve the desired goals, many practice theories i. This decision of the practitioner will be partly dependent upon: Intervention starts from the first contact with the client who seeks to solve his problems with the help of a social caseworker.
Approach to intervention as described by Hollis is discussed below. The author has chosen this approach because it describes the process in toto and encompasses the usual problems dealt with by the caseworkers. Interviewing skills and techniques are used to achieve the goals. Principles constantly guide the activities of the caseworker. Privacy is important for conducting casework interviews. Knowledge of human behaviour helps in focusing on relevant aspects of behaviour.
While doing so, worker remembers values and assumptions and is guided by principles and knowledge of human behaviour. Hollis describes the processes in her approach as given below. Sustaining Process Initial Contact: We all have experienced anxiety whensoever we had to ask for help from persons unknown or formally known to us. Similarly, questions about self from unknown or formally known persons also create anxiety in us. Sustaining process becomes more useful when anxiety is greater as it quickly reduces his anxiety, makes him comfortable and thus builds his confidence in caseworker.
The worker continues to convey a positive and understanding attitude towards the client. This attitude is not dependent upon the nature of action or behaviour of the client. It is a continued expression of goodwill or positive concern towards the client. The worker extends the required respect, listens to him interestingly and communicates to the client through his facial expression, tone of voice, choice of words and body postures that he likes the client.
The verbal and non-verbal communication of the worker should not be incongruent and contradictory. It should rather be supplementary to communicate acceptance.
Acceptance can be communicated better only when the local norms and traditions for communicating respect are fully understood by the worker. The technique of reassurance brings relief to the client suffering from anxiety and guilt. Relief does not come from understanding but because the caseworker, in whom the client has placed confidence, has said in effect that it is not necessary to be so worried.
Sustaining process may require use of gift, patting and fondling when working with children. Home visits or solving the pressing concrete piece of problem, etc. The process of direct influence deals with the different ways the worker uses to promote a specific kind of behaviour on the part of the client, i. The trust of the client in the worker is used as a vehicle for influencing his behaviour. Hollis classifies the areas where direct influence is more useful: Anxious people till they do not develop self-confidence.
Persons whose sense of reality is weak. The technique of direct influence should be used only when the worker knows that a particular the suggested course of action will be more useful and is perhaps the best in the situation for the client. This process should be used only when the client really needs it, i. According to Hollis the techniques of direct influence are: This involves approving or emphasising a course of action, the client himself is contemplating upon.
Since the worker is not emphatic on this suggestion, the client is free to reject the idea. Physicians advise drugs which should be taken by the client if he wants to get cured.
He does not suggest a drug when the patient is sick rather he advises. Similarly, the caseworker advises actions which should be adopted by the client to solve the problems. This is one step beyond the advice, i. Such situations may be like a mentally disturbed person sticking to the home, a person likely to commit suicide, or running away from home, etc.
In all such situations, advocating becomes more useful because it saves the client from the big loss he may suffer because of his ill-considered action. Here in the caseworker takes action to prevent the client from taking inadequately considered action or sees that he acts in a particular the desirable way. Examples are removing the patient to a hospital, placing the child in a hostel, etc.
Use of these technique demands that the worker be fully convinced that the step is factually justified and necessary community resources and support are available.
His action should be firm and polite without communicating any anxiety to the people around.
Direct influence techniques should be avoided unless it is really justified and it should be, wherever possible, used in conjunction with the procedures for development of understanding. To start with, most gentle form of influence should be used.
The caseworker has to be very cautious and conscious of his own needs while suggesting and offering advice. The process of ventilation catharsis is the process of helping the client to air his feelings freely and to provide him with an atmosphere which makes free expression of the feelings easier. The more intense the feelings, the better result through this process. This is usually used when the client is more tense or eager to come out with his inner feelings.
This technique may be used in certain unpleasant situations which might have arisen in between the interviews. Ventilation is not only therapeutic but also diagnostic. The therapist should explore intently and stimulate the client, by questioning or commenting, to tell more about his situation and its various aspects. Only towards the end of session, the caseworker may use generalisation and logical discussion to lessen his guilt.
Caseworker (social work)
In the initial stages one should not minimise the anxiety lest he stops coming out with relevant materials necessary to help him. The caseworker may choose either to be totally passive or actively participating and directing.
The client must feel that the worker is uncritical, tolerant and is listening to him. One should not permit ventilation when it is used as a defense mechanism to avoid further exploration. In such situations, it is better to divert his attention and help him to discuss the relevant matters concerning his problem.
It should be avoided or used with caution in case of psychotics etc. Ventilation is used sometimes by the client to seek attention and sympathy from the worker or a gratification from talking freely about self.
The caseworker should be conscious in all such situations and direct the interviews accordingly. As stated earlier, the psycho-social therapy views man in his situation and tries to understand the total man, i. The procedure for reflective discussion, according to Hollisdoes not involve use of clarification or interpretation utilised for developing insight.
She has classified the procedure for discussion of current person- situation configuration into four sub-categories: These are described in the paragraphs that follow.
The procedure in this sub-category deals partly with perception and partly with the question of knowledge. Some of the clients see either distorted or only one-sided picture of the real situation around them. The feelings may also blot out important aspects of the reality. The worker may, in such situations, draws the attention of the client to the real facts of the situation which may in many cases correct his distorted perception of the situation.
If this procedure does not work, the client may be helped to perceive the discrepancies between reality and his views of it, without going into the dynamics of his perceiving reality into a distorted way.
When we are angry with our friend or relative, we see his negative points only and interpret his good behaviour also from a negative angle only. His help is interpreted as motivated by selfish ends etc. In some situations the client may be hostile to others just because he is unable to imagine their feelings in the situation, or because of his failure to identify with the feelings of the person.
A husband may not appreciate the difficulties of a university educated housewife, unable to manage household affairs effectively, simply because he fails to imagine the possible responses and feelings of such a housewife in such a situation. Similarly, a wife failing to appreciate the tiredness of her husband after he returns home from his work, may start murmuring the moment he enters the house.
Understanding of the external world can be increased if help guidance is extended in respect of various important life events like family budget, work situation, physical conditions, involvement in some social situation etc.
If proper guidance is extended in these matters, e. Techniques like logical discussion, questioning, etc. Explanation may not be very effective. Informing or use of bibliography can also be tried along-with other techniques in helping the client to reflect upon various aspects of his current situation.
Decisions and Consequences Reactions: In this procedure we consider the decisions and activities of the client and its effects in interaction with his environment. Over and again the worker strives to help the client think about the effect of his decisions and actions on others or its consequences for himself, e.
In any of these instances, the client tries imaginatively with the help of the caseworker to foresee the consequence of the plan for himself and for the other people whose lives are involved in his decision. The decision should be taken after all possible facts have been gathered and the pros and cons of the alternative decisions have been considered.
To quote Hollisa mother may not realise that hitting her son compels him to defy her to maintain his prestige before his peers. If possible, avoid explaining the relationship between behaviour and consequences. It is preferable to lead the client to see sequence himself. Many times the client will draw his own correct conclusion once the two aspects of his behaviour are brought to his attention.
Inner Awareness, Responses and Distortions: This part involves awareness of the so-called hidden feelings or reactions. There are many degree of hiddenness, according to Hollis The client may be perfectly aware of his reactions but afraid to speak of it because he is ashamed of it or fears ridicule or criticism, or has not recognised the significance of his feeling. At times, the client may be truly unaware of his feelings because they are not part of his conscious thoughts.
There are occasions when reading his thoughts is necessary, either because the client, unable to bring out his thoughts into open will feel relieved if the worker does so for him, or, because there is therapeutic justification for bringing them out even though this may make him uncomfortable. Skill lies in finding Ways of enabling the client to bring out the hidden material himself.
Where full awareness is present, this often occurs without any specific prompting as the client becomes more secure with the worker in response to a sustaining approach. At other times, when the worker is fairly sure of what the client is withholding, he may be able to make comments which refer tangentially to the anticipated content, thus inviting the client to talk about it but still not facing him with it directly, e.
Often one can use the procedure of calling the attention of the client to the discrepancies between facts and feelings, to overemphasis, or to inconsistencies or inappropriateness one sees in the feelings. Sometimes this can be done merely by repeating the revealing statement in a questioning tone. Occasionally, a direct unqualified interpretation is helpful, but for this the worker should be very sure of his ground. Reactions to the Worker and Treatment: This procedure is designed for those persons who cannot benefit adequately from the earlier procedure because of intrapsychic forces operating behind their patterns tendencies of behaviour.
Consideration of patterns of personality and behaviour does not involve probing early life experiences. How the libidinal sex urges and aggressive drives are seeking satisfaction? Is their satisfaction creating anxiety in client? In cases where the client is vaguely aware of his unrealistic or inappropriate behaviour, the caseworker may point out and draw his attention to it. If required, reality may be demonstrated along-with discussion of the feelings and thoughts involved in the said inappropriate behaviour.
A student who coerces his classmates to leave the class is indulging in ego-dystonic behaviour though he thinks it to be ego-systonic.
To help such students clients one has to first help him to realise that his behaviour is, in fact, ego-dystonic, therefore, non-congenial to his proper social functioning.
Unconscious matters revealed through dreams etc. Too much of use of defense mechanisms speaks of poor capacity of ego to tolerate frustrations and consequent anxiety.
In such cases, one may first bring these instances to his notice and slowly interpret it in dynamic terms, i. Similarly, he may be helped to recognise his impulsive behaviour to learn to control such behaviours.
Certain clients suffer from excessive guilt because of too strong superego. In such cases too one may first bring the facts to his notice i.
Similarly, his unrealistic beliefs about caste, religion, etc. Insight into the current dynamics interplay and interaction of his feelings, responses, behaviour in his current interaction with others leads him to improvement. To develop insight one should try to understand the emotional process, their origin may be dissatisfaction of drives and defense mechanisms used.
Techniques may be clarification and interpretation, confrontation and logical discussion etc. An attempt is also made in this procedure to understand how a behaviour is continuing to exist in-spite of its being counter-productive. Reinforcing factors behind these counter-productive behaviours have to be located and tackled. Positive reinforcement is required to strengthen the newly learnt behaviour.
Hollis pleads for use of this procedure only when the earlier procedures fail to yield desirable results i. These influences block his efforts to change in the required direction. Therefore, it becomes imperative to help the client to see the links between his present personality characteristics and earlier life experiences. Once the client is able to perceive how his earlier life experiences have shaped his certain current behaviour patterns tendencieshe can be helped to review his earlier life experiences if it can be recalled properly and modify his reactions to these earlier experiences.
These dysfunctional characteristics or tendencies to behave in a particular style cannot be overcome unless he develops insight into how these experiences have shaped his present dysfunctional behaviour patterns or tendencies.
This is based on Freudian concepts, according to which childhood experiences have permanent effect on personality functioning. However, it has been now realised that earlier life experiences get modified and the later experiences are as much valuable as the earlier ones.
In this procedure also, positive reinforcers for a particular behaviour pattern are to be located and handled. Earlier misconceptions or distorted generalisations get confirmed or reinforced by later experiences.
To quote an example, a girl aged 20 years was unwilling to marry a college teacher because according to her, teachers have poor social life and status. On enquiry, it was revealed by her that this was based on her experience of her father. Her distorted generalisation got reinforced from her experiences of her neighbours also.
It may be mentioned that in such cases, clients perceive what they want to perceive and recognise only those experiences which confirm their ideas. As opined earlier, no attempt is made to uncover the unconscious or retrace the infantile experiences, except those which can be easily recalled with normal probing. No technique of psycho-analysis to understand unconscious is used.
The caseworker may draw the attention of the client to the inconsistencies in his behaviour or examine his past experiences in the light of realities prevailing then. In the case of a mother who does not allow her university educated girls for marketing, the caseworker can help to link her this behaviour with her own experience of moving along when unmarried.
Sometimes this behaviour of mother may be because she learnt from her parents to restrict the movement of unmarried girls. In such a case, the link between her present behaviour and her experience of parental restriction can be established and examined and re-evaluated in terms of the realities existing then to develop insight. It may be mentioned that before attempting dynamic or genetic developmental understanding, the caseworkers should use sustaining process and ventilation. Interpretations should always be in tentative terms unless one is dead sure of the meaning of the behaviour.
Dependence of the client on caseworker for self-understanding should be minimised and he should be encouraged to think more on himself. It is always better to lead the client to think on his own than giving him readymade answers or solutions, in other words, caseworker should work with the client and not for the client.
One may work, in the case of an industrial worker, with the immediate supervisor, labour officer, wife, etc. In the case of a school-going child, one may work with the parents and teachers. While arranging these protective services, the caseworker should assess if these services will be helpful to his social functioning, i.
While serving the client, the caseworker can work in the role of a provider, locator, creator, interpreter, mediator and aggressive intervener Hollis, Concepts drawn from various other approaches can be used along-with this approach.
These approaches can be used as supplementary to each other. While working with rural population and tradition-bound families, use of Indian concepts has been found quite useful.
In recent years evaluation has assumed a significant place in our service programmes. It has been realised that no service or project can be effective unless we continuously and intermittently evaluate the outcomes of programmes and effectiveness of the methods used to deliver services. A lot of literature has, in the last decade, emerged on evaluation of welfare services. In social casework practice too, we need to evaluate, at least empirically, the outcome of our efforts.
The purpose of evaluation, as a process of casework, is to see if our efforts are yielding any result or not, if the techniques used are serving the purpose, and if the goals are being achieved.
This is not done from research point of view, because of which we do not use any rating scale etc. Like assessment diagnosisthis too is a continuous process.
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Intermittently, evaluation of the approach and result should be taken up with the client so that the efforts are meaningfully utilised. These evaluations may tell if the problem needs redefinition, if the objectives are to be reassessed and re-determined, and if the intervention approach and techniques need any change.
This will further strengthen the relationship between the helper and helpees and motivate the client to work towards his goal. At the end, i. Follow-up is done to help the client maintain the improvement. During follow-up, the client is helped to discuss the problems he faces in maintaining the improvement. Work is done with the people significant for his improved social functioning. If required, he is referred to the proper source for needed services and help.
An eclectic approach or choosing the most suitable approach according to the nature of the problem is necessary to achieve the desired result. Though literature available on choice of approach in various types of problems is plenty, experience is the only key to choose the right approach in each case.