The Process of Generalist Practice Chapter 4

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The Process of Generalist PracticeChapter 4
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Defining Generalist Practice

• THE APPLICATION OF
• Professional values
• Flexible knowledge base
• Wide range of skills
• TO TARGET ANY SIZE SYSTEM (i.e. micro, mezzo,
  macro systems)
• USING
• A wide range of professional roles
• Use of critical thinking skills
• Emphasizing client empowerment
• Working effectively in an organizational
  structure

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Drawing Upon Theories

• Systems Theories-
• Focus on the dynamics among and interactions of
  people in their environment
• Ecological Perspective
• Social environment-conditions, circumstances and
  interactions of human beings
• Coping-the struggle to adjust to conditions and
  problems

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Levels of Practice

• Micro Systems-is an individual
• Mezzo System-is a group
• Macro System- includes organizations and
  communities
• Families, because of their intimate nature, fall
  somewhere between micro and mezzo systems

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Levels of Practice

• Micro Systems- Examples
• Help a homeless person find shelter, employment,
  economic resources
• Counsel a teen who is addicted to heroine
• Assist an elderly man in hospice in making
  end-of-life decisions

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Levels of Practice

• Mezzo Systems-Examples
• Run a self-esteem group for inner city 3rd grade
  girls
• Lead a support group for parents of children
  diagnosed with cancer
• Lead a meeting involving various agency staff to
  discuss a clients progress

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Levels of Practice

• Macro Systems-Examples
• Initiate cooperation among social services
  agencies to create a list of resources available
  to mentally ill clients
• Contact government officials and advocate for
  increased funding for needy families with a
  special needs child
• Organize a Neighborhood Watch Program to help
  residents fight high crime

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A Wide Range of Roles

• Counselor- providing guidance to clients and
  assisting them in a planned change process
• Educator- Giving information and teaches skills
  to others
• Broker- Linking clients to needed resources
• Case Manager- Coordinates needed services
  provided by a number of agencies

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A Wide Range of Roles

• Mobilizer- Identifying and gathering community
  members to change their environment for the
  better
• Mediator- Helping to resolve conflicts between
  systems
• Facilitator- Guiding a group of individuals with
  similar experiences
• Advocate- Speaking out on behalf of clients to
  gain resources, promote fair treatment

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Use Critical Thinking Skills

• To
• Ask questions about how their clients are served
  and treated
• Investigate how interventions are supposed to
  work and whether they are really effective
• Examine both sides of an issue
• Analyze arguments, keeping eyes open for
  inconsistencies and deviations from truth

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The Planned Change Process

• Planned change or problem solving-involves the
  development and implementation of a strategy for
  improving or altering conditions, behaviors, or
  circumstances to promote positive change
• Intervention-
• Planned effort to bring about specific change

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Case Example

• Ron is a social worker for a large treatment
  center serving children with various disabilities
• This agency is funded primarily by private
  insurance, medical assistance reimbursement,
  voluntary donations, government grants
• Rons job entails providing family counseling,
  educating parents about behavior management
  techniques, and brokering resources

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Case Example

• Ron receives a new case referral, Peyton, a 5
  year old boy with sever speech and behavioral
  problems
• Stutters
• Violent tempers
• Unable to play appropriately with peers
• Familys insurance will not pay for Peytons
  treatment unable to pay for services themselves

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Intervention at the

• Micro level
• Arrange for speech and behavioral assessments
• Examine how Peytons behavior affects his
  interaction with his family, teacher, peers
• Micro/Mezzo level
• Family Counseling
• Educating Peytons parents/teacher about behavior
  management techniques
• Mezzo level
• Improve Peytons peer relationships
• Treatment Group
• Macro level
• Advocate for sliding scale fee within agency or
  special fund/fund raising
• School involvement in Peytons treatment

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Six Primary Steps in Planned Change

• Engagement
• Assessment
• Planning
• Implementation
• Evaluation
• Termination

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PROCESS of Working with Individuals and Families

• Engagement-Intake
• Purpose is to engage the client and help client
  decide whether to enter treatment.
• Emphasis is on the problem as perceived by the
  client (not the worker).
• Emphasis is on the here-and
• -now.

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The Social Worker / Client Relationship

• Self-determination
• Client decides whether to accept or decline
  services.
• Client makes choices between
  treatment
  alternatives.

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The Social Worker / Client Relationship

• Confidentiality
• Individualization and
  acceptance
• Social work assumes the inherent worth and
  importance of the individual and the
  inter-dependence between the individual and
  society.

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The Social Worker / Client Relationship

• Nonjudgmental attitude
• All human beings have strengths and weaknesses.
• Confront behaviors, but dont attack the person.
• Freedom of expression

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PROCESS of Working with Individuals and Families

• Assessment
• Obtain relevant information about the client and
  perceived needs.
• Determine clients current level of functioning.
• Purpose to understand the problem and determine
  how to reduce its impact.

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PROCESS of Working with Individuals and Families

• Assessment (contd)
• Recognize the uniqueness of every situation
• Recognize the importance of treatment planning
• Identify strengths.
• Assessment never really stops.

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Development of Practice Skills

• Interviewing skills
• Focused and goal-directed.
• Communication skills are essential.
• EMPATHY
• Documentation skills

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PROCESS of Working with Individuals and Families

• Planning, Goal-setting and Contracting
• Set short- and long- term goals.
• Goals should be realistic and achievable.
• Prioritize problems so that most critical ones
  are addressed first.

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Development of Practice Skills

• Conceptual skills
• Ability to understand the interrelationships of
  various dimensions of the clients life
  experiences and behaviors, put them into a
  helpful framework, and to arrive at appropriate
  intervention strategies.

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PROCESS of Working with Individuals and Families

• Implementation/Intervention (same as treatment)
• Purpose assist clients toward an acceptable
  resolution of problems and to address their unmet
  needs.
• Starts from the first contact.
• Determined by the clients needs.

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Process of Casework

• Evaluation
• Did it work?
• How do you know?
• Is there a need to change or modify goals?
• Does the client know it worked?

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PROCESSof Social Casework

• Termination and Evaluation
• Shouldnt come as a surprise.
• Avoid making the client dependent on you.
• Review progress an reassure client of their
  ability to function effectively.
• Evaluation is an on-going process.

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Case Example

• Presenting problem
• Alex is a
• 29 year old white female with a history of
  depression presents to a mental health clinic
  with passive suicidal ideations
• Off her anti-depressant for 1 year
• Stressors include recent divorce, economic
  stressors, death of her father, reentering the
  workforce, co-parenting her 4 year old son
  diagnosed with autism

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Engagement

• Use verbal and non-verbal communication to make
  Alex comfortable (i.e. nods, smiles, hand
  gestures, eye contact)
• Introduce myself describing purpose and role
• General Questions What brought you to the
  mental health clinic today?

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Assessment

• Gathering information about Alexs reasons for
  visiting the mental health clinic, current mental
  status, identified stressors/problems
• Gather information about Alexs environment

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Planning

• Create treatment plan with Alex
• Identify strengths
• Alex has obtained a job that offers benefits/room
  to move up tin the company
• Alex has a supportive mother/sister
• Alex wants to alleviate the depression to improve
  her quality of life
• Alex has fairly good relationship with her
  x-spouse
• Develop goals
• Make a referral to a psychiatrist for a med eval
• Locate a grief support group/support group for
  parents with children with developmental
  disabilities
• Locate tangible resources (food pantries,
  clothing, apply for housing/childcare subsidies)
• Establish a contract

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Implementation

• Social Worker
• Investigates the best community resources to help
  Alexs specific needs and refers Alex to these
  agencies
• Contacts psychiatrist and updates him on Alexs
  situation
• Alex
• Makes an appointment with psychiatrist and starts
  medications
• Attends a grief support group
• Uses referrals given to get food and clothing

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Evaluation

• Sw and Alex meet to discuss progress
• Alex reports her depression is now a 2 on a scale
  of 1-10. Before coming to the agency Alex
  reported her depression as an 8.
• Alex does not have thoughts of suicide and feels
  hopeful
• Alex has utilized the resources

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Termination

• Goals have been met. Alex will continue to see
  the psychiatrist for quarterly med evals and
  continue with support groups and tangible
  resources if necessary.