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Three major paradigms in the history of social work knowledge

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Title: Three major paradigms in the history of social work knowledge


1
Three major paradigms in the history of social
work knowledge
  • Pragmatism (1900 1950)
  • Positivism (1950 present)
  • Postpositivism (1980 present)
  • Social constructionism
  • Fallibilistic realism

2
Sources of social work knowledge
  • Practice wisdom transmitted from supervisors to
    supervisees
  • Theory developed from case data
  • Findings from research in other fields that are
    integrated into social work theories (e.g.,
    research about child development or racial
    discrimination)

3
Social Work Code of Ethics
  • Confidentiality
  • Clients right to self-determination
  • Respecting the dignity and worth of every client
    and every cultural group
  • Advocacy for social and economic justice
  • Developing scientific social work knowledge
  • Protection of clients and society from harm
    (abuse, violence)
  • Treating ones colleagues with respect

4
Elements of a theory
  • Concepts
  • Principles
  • Assumptions
  • Ontological
  • Epistemological

5
Types of theories used in social work
  • Theories of human development
  • Theories of the origins of psychopathology
  • Theories of bringing about change
  • Micro-level practice
  • Meso (community level) practice
  • Macro practice (e.g. state and federal policy
    change)
  • Theories about the functioning of large systems
    (e.g., organizations, communities, countries)

6
Non-depth psychologies used in social work
practice
  • Ecological systems approach
  • Empowerment approach
  • Some family systems theories
  • Task-centered treatment
  • Problem-solving models
  • Cognitive behavioral approaches
  • Behavioral approaches
  • Some narrative and social constructionist
    approaches to practice

7
Depth psychologies used in social work practice
  • Contemporary variants of psychoanalytic theory
  • Ego psychology
  • Object relations theory
  • Self psychology
  • Psychoanalytically-based family therapy models
  • Intrapsychic humanism
  • Some forms of client-centered (Rogerian) theory
  • Jungian theory
  • Some narrative and social constructionist
    approaches

8
Social Work Interview Techniques
  • Sustainment (empathy, open-ended questions)
  • Advice (directiveness re choices)
  • Intrapsychic or pattern-dynamic reflection (e.g.,
    aversive reactions, transference interpretations)
  • Person-in-situation reflection
  • Genetic or etiological reflections
  • Education
  • Referrals and resource provision

9
Ego functions
  • Synthetic function
  • Reality testing
  • Secondary process thinking (problem solving)
  • Object relations
  • Defense mechanisms

10
An unconscious motive is indicated by
  • doing something one knows is not good for oneself
  • not doing something that is good for oneself
  • patterned conflict in making and pursuing choices

11
Common defense mechanisms
  • Identification with the aggressor (blaming the
    victim)
  • Projection
  • Displacement
  • Reaction formation
  • Somatization
  • Denial
  • Acting-out

12
Defense mechanisms
  • Operate unconsciously, although they can be
    reflectively experienced with support
  • Are subjectively experienced, when a person
    becomes aware of them, as protective
  • Change a persons experience of internal and/or
    external reality and so impede reality-testing
    and/or insight

13
Transference
  • Psychoanalytic theory The transfer of
    instinctual wishes from a prior relationship
    (usually with family of origin) into the
    relationship with the therapist
  • Self psychology Narcissistic, self-object
    transferences can be of three kinds idealizing,
    mirroring, and twinship
  • Intrapsychic humanism the use of self and
    nonself meanings for personal meaning

14
Countertransference
  • Psychoanalytic theory
  • 1) the therapists transference to the patient
  • 2) the therapists reaction to the patients
    transference to the therapist
  • Intrapsychic humanism negative and other
    unrealistic motives and experiences in the
    relationship with the client are produced by
    personal motives that have (unbeknownst to the
    therapist) perempted the therapists caregiving
    motives

15
Assessment
  • can occur naturally through the therapeutic
    interview process
  • is ongoing and cumulative -- new priorities are
    revealed as treatment proceeds
  • can change as treatment progresses and the
    alliance deepens -- e.g. a clients diagnosis
    will change, transference emerges
  • should incorporate micro, meso, and macro systems
    considerations

16
Basic categories of psychosocial assessment
  • Presenting problem
  • From clients point of view
  • From the point of view of others involved with
    the client
  • From the social workers point of view
  • History of presenting problem
  • Clients psychosocial environment
  • Significant relationships and their history
  • School or employment
  • Community supports (church, support groups, etc.)
  • Medical care
  • Diagnosis and Formulation
  • Treatment plan

17
Diagnostic Formulation
  • Why is this client here now? Based on
  • clients expressed purpose,
  • past relationships and losses,
  • ongoing client functioning and internal psychic
    structure,
  • social support network,
  • current stressors.
  • Mental status exam
  • Diagnosis (DSM-IV if needed)

18
Treatment Planning
  • Goals (optimal and practicable)
  • Short-term goals
  • Long-term goals
  • Treatment modalities to be employed
  • long-term, short-term, crisis-oriented?
  • individual, couples, family, group, a
    combination?
  • Referrals and resources needed?
  • Who will be contacted for coordination? (school,
    physician, pastor, etc.)
  • Agency mandate/capabilities?

19
Central principles in practice with children
  • Consider the impact of adultcentrism on the child
    and your relationship with her/him
  • The child has the right to a confidential
    treatment and to making her/his own treatment
    contract
  • Offer an environment that allows the child to
    communicate naturally
  • There is always a third party influencing the
    treatment relationship the childs parents
  • Keep in mind that any psychosocial diagnosis made
    will have an impact on how those in the childs
    environment perceive the child, as well as on the
    childs entire developmental process

20
Central etiological concepts in family systems
theory
  • Family of origin experiences are repeated in an
    individuals subsequent relationship patterns
  • Individual symptoms reflect an effort to resolve
    a problem in the individuals family system
  • Equifinality the same origin may lead to
    different outcomes, and the same outcome may
    result from different origins. (Walsh, 1983, p.
    468)
  • Family systems theory asserts that the
    influence of initial conditions or events will be
    outweighed by the impact of the family
    organization--its ongoing interactional patterns
    and response to events. (Walsh, 1983, p. 468)

21
Treatment modalities in family therapy
  • Multiple family therapy a procedure devised by
    Bowen, in which several families are treated at
    the same time, in a group therapy modality.
  • Parental counseling
  • Couples counseling
  • Treatment of the family as a whole

22
Crucial assessment concepts in family therapy (I)
  • Homeostatic mechanism the means by which norms
    are delimited and enforced to maintain a steady,
    stable state in the ongoing interactional
    system.
  • adaptive
  • maladaptive
  • Genogram A diagram of the family members and
    relationships that extends back in time for at
    least three generations.
  • Identified patient The family member viewed as
    having the problems according to other family
    members.
  • Metacommunication the implicit, often nonverbal
    message which comments on the intent of a verbal
    statement.
  • Pseudo-hostility superficial bickering that
    blurs issues of intimacy and affection which
    produce anxiety.
  • Pseudo-mutuality pretense of family harmony
    which hides conflicts and deeper affections.

23
Crucial assessment concepts in family therapy (II)
  • Enmeshment limits or sacrifices individual
    differences to maintain a cohesive unity (Walsh,
    p. 468)
  • Disengagement reinforces individual
    difference, separateness, and distance at the
    expense of family cohesion, at the extreme
    fragmenting the family unit and isolating
    individual members. (Walsh, p. 469)
  • Triangle a tendency of two-person systems,
    especially in marital relationships, to draw in a
    third person when tension develops between the
    two. (Walsh, p. 469) (leads to scapegoating,
    coalitions, go-between relationship patterns)
  • Parental child often in single-parent families
    an elder child assumes parent-like caretaking
    responsibilities. (Walsh, p. 469)
  • Scapegoating others in a system project their
    own undesirable qualities onto an individual and
    treat the person negatively

24
Fundamentals of the Treatment Contract in Couples
Counseling
  • The treatment is to help the couple get to know
    each other and themselves better
  • The decision about whether the couple will stay
    together is made by each partner based on whether
    the relationship is good for her/him
  • You can help each partner think through the
    decision even if the couple chooses to separate
    you can help them through that process
  • You will not keep secrets from either partner
  • The couple can decide with you in advance whether
    they will have individual sessions if one partner
    cannot attend

25
Central Elements of Couples Counseling
  • Focus on the interactions you see occurring with
    you and share your observations
  • Aid the couple in bringing conflicts into the
    relationship with you
  • Prevent the increased potential for negative
    transference with increased support
  • Unless there is a clear power differential (e.g.,
    physical strength) be even-handed in interpreting
    each partners contribution to problematic
    patterns

26
Principles for forming treatment alliances across
barriers associated with color, sexual
orientation, age, status of health and
disability, and gender (Boyd-Franklin, Hagen
Davis, Pinderhughes, Spaulding, Padrone)
  • SW recognizes (internally) the history of
    discrimination the client has faced
  • SW recognizes (internally and perhaps in
    relationship with the client) that unless s/he is
    a member of the clients oppressed group, s/he
    cannot know what that discrimination is like and
    thus needs to be available to hear about it from
    the client
  • SW recognizes (internally) her/his own unwanted
    internalization of oppressive prejudices,
    stereotypes, including an assumption that the
    client might resent her/him for her/his power
  • SW prioritizes not repeating in the relationship
    with the client the oppressive patterns that
    exist in the wider society
  • SW actively plans how to assist in redressing
    injustices the client is experiencing in her/his
    daily life
  • SW recognizes that anger, fear, and sadness about
    experiences of discrimination are not
    pathological but are natural and healthy
    responses that need to be heard and respected by
    the SW

27
Fundamental assumptions in the Empowerment models
of social work practice (e.g., Guttierez,
Pinderhughes)
  • "issues of power and powerlessness are
    central...proposes concrete and specific ways in
    which practice can help resolve personal problems
    by increasing power and helping individuals
    improve their life situations (Guttierez, p. 149)
  • Empowerment practice incorporates the macro
    level improve collective political power micro
    level improve personal feeling of power and
    control.
  • "based on a conflict model that assumes that a
    society consists of separate groups possessing
    different levels of power and control over
    resources" (Guttierez, p. 150)
  • "Social problems stem not from individual
    deficits, but rather from the failure of the
    society to meet the needs of all its members.
    The potential for positive change exists in every
    person, and many of the negative symptoms of the
    powerless emerge from their strategies to cope
    with a hostile world." (Guttierez, p. 150)

28
Fundamental goals of the empowerment approach to
social work practice (Guttierez)
  • increasing self-efficacy
  • developing group consciousness (awareness of how
    political structures affect individual and group
    experiences, p. 150)
  • reducing self-blame
  • assuming personal responsibility for change (p.
    150)

29
Specific empowerment treatment techniques
(Guttierez)
  • helping relationship based on collaboration,
    trust, and the sharing of power
  • accept clients definition of the problem
  • identify and build upon existing strengths
  • engage in power analysis of clients situation
    (have students give examples)
  • teach specific skills how to modeling is a
    central way
  • mobilize resources and advocate for clients
  • help client experience a sense of personal power
    within the relationship, e.g., role playing,
    support clients in their efforts to help others,
    let them set the agenda of the treatment and
    research resources
  • support development of alternative structures in
    the community
  • praxis blending of reflection and action

30
Social constructionism
  • What we define as reality, and the meanings we
    attach to it, are socially constructed
    (heuristics)
  • All theories are social constructions
    (heuristics)
  • Examples of concepts that are social
    constructions or heuritics
  • the family
  • disability
  • gender roles

31
Gender in family therapy theories (acc. to
Hare-Mustin)
  • Gender is the basic category by which our
    species, the family and all societies are
    organized. Because gender inequities are
    embedded in the larger social system, they are
    assumed to be part of the natural order. What
    results is the implicit and often unintended
    support of sexism.
  • Women have constituted an underclass
  • Two forms of bias in family therapy theories
  • Alpha bias exaggerates differences between
    groups of people (ex. psychoanalysis)
  • Beta bias ignores differences when they do
    exist (ex. systems theories)

32
Helping multicultural students and families in
complex systems (Ishibashi)
  • Recognize the stress on each person and group of
    people caused by differences in culture
  • Identify sources of the conflict in terms of the
    differing motives of each person and system
  • To aid in conflict resolution, identify the
    constructive motivation in each person and system
  • Motivating people to change is best accomplished
    by eliciting each persons constructive
    motivation and helping people make choices based
    on that self-caretaking motivation

33
Goals of social work practice with disabled
people and their families
  • Help family members to adapt and possibly change
    roles
  • Assist family with reactions to the disability,
    such as shock, anger, grief, and blocking in the
    adaptation process
  • Relief may develop only when a distinction can
    made between the disability, per se, and the
    person with it
  • Avoid encouraging acceptance of the disability,
    because that represents passivity in the face of
    a terrible loss, and leads to client resistance
    and resentment

34
Psychotherapists working with people with
disabilities should consider
  • focus of attention
  • extent and type of disability
  • phase of rehabilitation
  • family relationships
  • stage of life
  • circumstances of onset of disability
  • meaning of disability
  • psychodynamic functioning
  • countertransference

35
Facts about women in families
  • Less than 10 of American households still
    consist of the traditional family with a working
    father, a mother at home, and two school-aged
    children
  • The American mother has the least childcare and
    housework help of any mother in the world
  • Housework is at a preindustrial stage -- it has
    no exchange value in the marketplace.
  • Women's depression is often associated with the
    mindless and unappreciated routines of housework
  • One-fifth of all children live with a single
    parent 25 of all births are now to unwed
    mothers
  • Fifty-six percent of American wives work outside
    the home, the majority in sex-segregated,
    low-paying jobs

36
Goals of Family Treatment
  • Stimulating new interaction patterns
  • Offering new ways of thinking about
    relationships
  • Improvement of family communication opens up the
    system, removes blocks to more healthy
    interactions, so the family can respond to the
    developmental needs of its members
  • Problem-solving
  • Mourning unresolved losses.

37
Common Family Treatment Techniques
  • Paradoxical instructions a type of directive
    that seems to be in opposition to the goals being
    sought but actually serves to move the family
    towards them. (Walsh, 1983, p. 478).
  • Family sculpting
  • Reframing and relabeling the strategic
    redefinition of a problem or situation in order
    to cast it in a new light or perspective ...
    useful in shifting a familys rigid view or
    stereotyped response, in altering an unproductive
    blaming or scapegoating process, and in
    overcoming resistance to change. (Walsh, 1983,
    p. 478)
  • Education instructing parents about
    developmental needs or educating a family about
    severe mental illness.

38
Assessment of Homicidal and Suicidal Risk
  • History of prior violence (avowed, inferred)
  • Substance abuse and other predisposing syndromes
    (e.g., post-traumatic stress disorder)
  • Gender, age, and cultural variances
  • Plan
  • presence of a plan
  • access to means
  • lethality of plan
  • Evaluate imminent harm as opposed to ongoing
    but not imminent

39
Important facts about family violence
  • We do not permit among strangers the violence
    permitted in the family
  • Attacks by boyfriends and husbands on girlfriends
    and wives result in more injuries requiring
    medical treatment than rapes, muggings, and
    automobile accidents combined
  • One-third of all women slain are killed by their
    husbands or boyfriends

40
Types of family violence
  • Partner abuse sexual, physical, emotional
  • Child abuse sexual, physical, emotional
  • Abuse of dependent adults
  • elderly
  • severely mentally ill
  • mentally retarded

41
Evaluating family violence
  • Individual interviews are required
  • Intervention modality to handle denial by
    perpetrator
  • Consider constant factor of secrets and
    intimidation
  • Long-term diagnostic assessment is usually needed
  • Consider History of abusive relationships in
    families of origin ongoing, unexplained serious
    symptoms substance abuse

42
Naturalistic evaluation of practice
  • Will practitioner and evaluator be the same
    person?
  • Draw the environment-system boundary for a)
    practice b) data collection
  • Formulate assessment and treatment goals
  • Develop change indices based on treatment goals
  • Analyze treatment process data to determine
    whether change has occurred, and if so, what kind

43
Termination -- central issues
  • Whose motive is it for treatment to terminate?
  • Is it a planned or unplanned termination? Time
    frame?
  • Termination can be used therapeutically as an
    opportunity to develop the capcity to mourn loss
  • Review the aims and achievements of treatment
  • Ensure the client is linked with appropriate
    resources
  • Say a real good-bye
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