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Social Case Work Celebrating the dignity & worth of every individual Compiled by S.Rengasamy Madurai Institute of Social Sciences Acknowledgements http://christcollegemsw.blogspot.com/ http://Indian Social Study.com http://www.scribd.com/vinitha_sukumar Grace Mathew‟s “Case Work” form Encyclopedia of Social Work in India S.Rengasamy. Social Case Work 2 Contents (Click on each content to go to the relevant page) Social Case Work –Syllabus #UGC / NET /JRF Syllabus Social case work Richmond & Pearlman(Box) Social Case work # Origin of Case work #Mary Richmond's Contribution to Social Case Work #What Social Workers learned from Freudian psychology & Economic depression # Broadening the understanding–From self to interaction with others Causes of Human Problems as conceived by Social Case Workers # Lack of material resources # Misconceptions about situations and relationships and lack of appropriate # Illness or health related handicaps # Emotional distress resulting from stressful situations # Personality features or deficiencies Definitions of Social Case Work Objectives of Social Case Work Nature & Characteristics of Case Work Components/elements of case work: Purpose & concern for the Client system # Expectation at three level # Accuracy of Empathy and clear communication # Non Possessive warmth # Genuineness and acceptance #Authority Principles and Techniques of case work (Box) Principles of Case work # I. Individualization # II. Purposeful expression of feelings #III. Control emotional involvement #IV. Self determination # V. Acceptance #VI. Non-Judgmental attitude #VII. Principle of Confidentiality # More Explanations on the Principles of Social Casework Stages Components of Social Case Work # Social Case History (Box) #Social Diagnosis # Types of diagnosis (Table) # Social Treatment # Objectives of social case work treatment (Box) #Methods of case work treatment Interviewing in Casework Case Work process (Box) # Process of Social Case Work # Intake (First Interview) Rapport Building # Psycho-Social study (Exploration / Investigation) # Psycho - Social diagnosis (Assessment) #Intervention / Treatment (Problem-solving process) # Monitoring and Evaluation # Follow-up and Termination # Social Case Work Process (Box) Components of Case Work #Person # The problem # The place # The process # Transference #Transference and counter transference (Diagram) # Relationship in Social Case Work Similarities and differences between case work and counseling # Similarities between case work and psychotherapy Problem & Strength Perspective Theories of Social Case Work #Psychodynamic theory # Ego psychology # Functional casework # Cognitive theory #Social role theory # Behaviour modification theory # Communication theory# Crisis theory # Family theory and Learning theory. Qualities of Social Case Worker # Knowledge base of Social Case Work Three Roles of the Case Worker # Clinical/behavioural change role Role of the consultant/educator #The advocate/broker role Recording in Social Work # Principles of Case Records Casework Practice in India #Theory Building in Casework Psychosocial Theory and Social Work Practice Imran Ahmad Sajid # Peshawar University # Introduction # Meaning of Psychosocial # Psychosocial theory # Client‟s context # Problem # Aim of Treatment # The Goal of Psychosocial Workers # Historical Origin and Development #Mary Richmond # Knowledge from Psychology and Psychiatry # Ego Psychology #Principles and Assumptions # Assumptions from Ego psychology # The Worker Client Relationship #Obstacles in effective worker-client relationship # Approaches to Intervention # Psycho-social Study # Initial Interviews # Additional Source of Information # Approaches to Intervention # Early Life History # Psychosocial Assessment # Psychosocial Intervention # Recap Behaviour & Behaviour Modification References S.Rengasamy. Social Case Work 3 Syllabus UGC / NET /JRF Syllabus Case work - Concept, Objectives and Principles. Social Case Work Process - Intake, Study, Social Diagnosis, Treatment, Termination and Evaluation. Approaches in Case Work - Psychoanalytical, Psycho-social, Problem Solving, Behaviour Modification, Crisis Intervention and Eclectic Approach. Techniques and skills in Social Case Work - Interviews, Home visit, Resource Mobilization, Referral, Environmental Modification, Case Work Relationship, Communication - Types of Recording in Case Work. Role of Social Case Worker in Various Settings Social Case Work –Syllabus 1. Social Case Work- Definition, Meaning, Concept, Objectives, Principles and history of Social Case work in India and abroad 2. Basic components of social casework. – Problem, Person, Place, Process. Relationship in case work –nature, establishment, maintenance, termination, transference and counter transference 3. Case Work process – Study (Case recording, Interview, Collateral contact etc), Diagnosis, Treatment, (methods & techniques), Follow –up and Termination 4. Approaches in social case work –Functional, Diagnostic, Directive, Non-directive and Eclectic. Recording in case work –Importance and Methods 5. Application of social case work in family, educational institutions, community, industries and in hospitals Social Case Work Hope Opportunity Choice Hope Opportunity Choice S.Rengasamy. Social Case Work 4 Mary Richmond Pearlman SOCIAL CASEWORK Social casework, representing that part of social work which focused more on the individual, had a vital non-poverty populations. Social work's prestige was raised through work in war-related activities such as the Red Cross's Home Service. Caseworkers with the home service, led by Mary Richmond, applied their skills to problems faced by service men and their families. Physicians, psychiatrists and psychologists working with emotionally disturbed soldiers saw the social worker as a natural ally. They began using caseworkers as specialists in social adjustment. Such vital activities were outside the profession's traditional constituency of the poor and indigent and opened up new opportunities for social work. The second major event that marked social casework‟s ascendancy within social work was the publication of Mary Richmond's Social Diagnosis. For several decades, Ms. Richmond had been attempting to turn the practical but rough-hewn techniques and skills commonly known as casework into a more systematic approach. After honing her ideas through workshops, lectures and articles, Ms. Richmond put her ideas into a book which was the first definitive text on casework. Much more than just another book, Social Diagnosis, gave to the new field of social work an anchor in its quest for professionalism. In 1915, noted authority of professional education, Abraham Flexner, had delivered a paper at the National Conference on Charities and Corrections declaring that social work was not yet a profession. In his paper, Dr. Flexner was particularly critical of the new field's lack of a technique which was "communicable through the educational process". Mary Richmond, through Social Diagnosis, gave social work what Dr. Flexner said it was lacking and propelled casework from one of a number of approaches used by charity workers into a major form of practice. Objectives of Social Case Work: “Social Case work may be defined as the art of doing different things for and with different people by cooperating with them to achieve at one and the same time their own and society‟s betterment.” Mary Richmond (1915) Definition S.Rengasamy. Social Case Work 5 Case Work Making Adjustment Meaningful Social Case Work: Social Case Work, a primary method of social work, is concerned with the adjustment and development of individual towards more satisfying human relations. Better family life, improved schools, better housing, more hospitals and medical care facilities, protected economic conditions and better relations between religious groups help the individual in his adjustment and development. But his adjustment and development depend on the use of these resources by him. Sometimes due to certain factors, internal or external, he fails to avail existing facilities. In such situations, social caseworker helps him. Thus, social casework is one to one relationship, which works in helping the individual for his adjustment and development. Every individual reacts differently to his social, economic and physical environments and as such problems of one individual are different from those of another. The practice of casework is a humanistic attempt for helping people who have difficulty in coping with the problems of daily living. It is one of the direct methods of social work which uses the case-by-case approach for dealing with individuals or families as regards their problems of social functioning. Case work, aims at individualized services in the field of social work in order to help the client to adjust with the environments. Origin of Case work By working with the poor Social Workers radically realized that forces within the individual and forces external to him contributed for human suffering. Though casework as a mode of helping people on the basis of a person-to-person relationship was present in every society from ancient times, the professional method of casework originated in U.S.A. in the second decade of this century. One of the earliest organised efforts in U.S.A. to help the poor was the establishment of the American Charity Organization Society (1) in 1877 on the pattern of the Charity Organization of London, which was started seven years earlier. One of the aims of the society was to find out ways and means of helping the poor and needy and thus to organise individualised services geared to this purpose. The society used volunteers, who were called friendly visitors, to visit the homes of the poor for purposes of assessing their need, for rendering material assistance and for giving them guidance and advice. The friendly visitors were subsequently supplemented by 'paid agents'. These paid helpers gradually developed, systematic procedures in performing their tasks. They collected data about the needy individuals and families, and helped them after assessing their need. They also maintained records in which they kept all the information including personal data, as well as the type of help rendered. It was out of the practice of these early workers that casework Josephine Shaw Lowell Founder of New York's Charity organization S.Rengasamy. Social Case Work 6 Century before, even before the declaration of human rights Mary Richmond asserted that poor have their own individuality and they have a right for self determination developed gradually to a professional method in subsequent years. Their collective experience of knowing the poor families and their problems and the concurrent studies of poverty by social scientists broadened the understanding of human behaviour. There was the growing recognition that there were forces within the individual and forces external to him which influenced his behaviour and the nature of his existence in society. In course of time the terms 'paid agents' and 'the poor' were supplanted by caseworkers and clients respectively in the terminology of the help giving organisation and the office of the organisation came to be known as the agency. Mary Richmond's Contribution to Social Case Work Mary Richmond's book, Social Diagnosis, which was published in 1917 may be considered as the first book in casework. It set forth a methodology of helping clients through systematic ways of assessing their problems and handling them. Besides, the book introduced the principle of individualization and also acknowledged the client's right of self-determination. The first training programme for caseworkers was in the form of summer courses. Then the need for more substantial training was found necessary and schools of social work, attached to agencies, came into existence. When these schools attained a certain standing in the community, they were recognized as professional schools under the administrative authority of universities. What Social Workers learned from Freudian psychology & Economic depression Freudian psychology which emerged in the 1920s had a strong impact on casework. The new psychoanalytical knowledge pertaining to human behaviour was eagerly absorbed by caseworkers which was found useful in understanding clients and their problems. During this period of development, caseworkers focused their attention on psychic forces within the individual. During the economic depression of the 1930s casework had to consider the economic factors which were causing distress to clients. There was also the realization that economic distress could lead to emotional distress and breakdown. One major outcome of the depression was the establishment of governmental public assistance programs. It relieved the voluntary agencies from the tasks of providing economic help which enabled the caseworkers to devote more time in dealing with clients' interpersonal problems. Broadening the understanding–From self to interaction with others During the 1940s, caseworkers were exposed to the formulations on ego psychology based on the observations of human beings as regard's their differential coping and adapting abilities in times of stress. The new studies on human behaviour brought to light the potentialities of the human personality for healthy adaptation to life's stresses. During the next two decades, some casework theoreticians began to examine sociological concepts like social role, social system, social class, etc., with reference to their applicability to casework situations. The result was the shifting of the S.Rengasamy. Social Case Work 7 focus from the self of the individual to his continuous interactions with his significant others in social settings. American casework did influence the use of casework in India as the first professional social workers who did casework in the Indian setting were trained in the American schools of social work. Casework was one of the courses taught when the Sir Dorabji Tata Graduate School of Social Work, currently known as the Tata Institute of Social Sciences, was started in Bombay in 1936, and it became a method of practice in helping people with their problems of social functioning. Some social welfare agencies employed caseworkers particularly with the purpose of helping their clients in a one-to-one relationship. Currently, the so-called caseworkers attached to some welfare services are not trained social workers, and those professionally trained social workers who use the method of casework considerably in their work are not given the designation of caseworkers as they are likely to use other methods as well. Causes of Human Problems as conceived by Social Case Workers Problems of social functioning cause distress to the individuals who come voluntarily or involuntarily to a social work agency for help. What is important to note here is that these individuals are not to be considered as one of a mass of people or a unit of a category, but as unique persons. Casework method in social work is an indication of the high value placed on the individual by the profession. Those people who seek social work help for their problems of living do so because their normal coping methods are not effective in dealing with the particular problems. There are reasons why individuals find their normal coping patterns ineffective in the face of some problems. These reasons may be broadly divided into five categories. 1. Lack of material resources: Social work agencies do not have financial resources to give assistance to people who seek material help. But, when, lack of money makes it difficult for an individual to deal with a particular situation effectively, it is likely that he can obtain financial help through the services of a caseworker, depending upon the nature of the situation and the policy of the agency. For example, it is possible for an amputee who is poor and who is a patient in a general hospital to get monetary help through the social work department of the hospital for buying artificial limbs. 2. Misconceptions about situations and relationships and lack of appropriate information: Wrong notions about things prevent people from handling difficult situations effectively. Many people have superstitious beliefs about diseases which prevent them from taking prompt medical treatment which can cure the disease. For example, if a man believes that his child's epileptic fits are caused by the possession of a devil, he is likely to try remedies which will worsen the condition. Sometimes it is ignorance of existing services and resources which delays action. Help is required to correct distorted perceptions and for obtaining essential information. 3. Illness or health related handicaps: Tata Trust S.Rengasamy. Social Case Work 8 Physical and mental illness and health related handicaps of various types make people helpless or irrational in the face of difficulties. For instance, when in a family the father is ill, the mother will have to bear extra burden and face problems alone for which she may require outside help. The patient and his family may need help to accept the illness of the former and to make realistic plans for the present and future. 4. Emotional distress resulting from stressful situations: In certain situations strong feelings are aroused which make a person incapable of acting sensibly. For instance, when a father comes to know of his adolescent son's delinquent activities he may feel so upset and ashamed that he may want to throw the boy out of the house and to sever all his connections with him. In such situations the emotionally upset person needs someone to whom he can verbalize his feelings freely. Verbalization will reduce the need to act out irrationally and set the mind clear for objective thinking. 5. Personality features or deficiencies: Defective features of one's personality not only create problematic situations for oneself and others but also make one incapable of solving problems of life. If a little girl is brought up by her mother in the strong belief that her father who deserted the family was a bad man and that all men are likewise bad, it is probable that the girl will have a difficult relationship with her husband when she later marries. The generalized wrong idea may get deeply implanted in the daughter's personality during childhood and she may not be even aware of it as she grows into adulthood. There are innumerable problems of this type effecting human relationships, caused by unhealthy attitudes and reactions which are deeply embedded in the personality. Here, the remedy lies in helping the persons concerned to develop insight about their own reactions and learn to act consciously and appropriately rather than react automatically to situations. Definitions of Social Case Work Mary Richmond (1915) “Social Case Work may be defined as the Art of doing different things with different people, co-operating with them to achieve some of their own & society‟s betterment.” Mary Richmond (1917) Social case work is the art of bringing about better adjustments in the social relationship of individual men or women or children Mary Richmond (1922) Social case work means, „those processes which develop personality through adjustment consciously affected, individual by individual, between men and their social environment‟ Jarrett (1919) Social case work is “the art of bringing an individual who is in a condition of social disorder into the best possible relation with all parts of his environment‟. Taft (1920) Social case work means “social treatment of a maladjusted individual involving an attempt to understand his personality, behaviour and social relationships and to assist him in working out better social and personal adjustment”. Watson (1922) Social Case Work is the art of untangling and restructuring the twisted personality in such a manner that the individual can adjust himself to his environment S.Rengasamy. Social Case Work 9 Queen (1932) Social case work is the art “of adjusting personal relationship”. Lee (1923) Social case work is the art of changing human attitudes” Taylor (1926) Social case work is a process concerned with the understanding of individuals as whole personalities and with the adjustments of these to socially healthy lives Raynolds (1935) Social case work is the processes of counseling with a client on a problemwhich are essentially his own, involving some difficulty in his social relationship. Raynods (1935) Social case work is that form of social work which assists the individual which he suggests to relate himself to his family, his natural group , his community Klein (1938) Social case work is a technical method in social work…. A way of adjusting to the client to his personal problems. Swift (1939) Social case work is the art of assisting the individual in developing and making use of his personal capacity to deal with problems which he faces in his life. DeSchweiinitz (1939) Case work means those processes involved in giving service, financial assistance, or personal counsel to individuals by the representatives of social agencies, according to polices established and with consideration of individual need. Strode (1948) Social case work is the process of assisting the individual to best possible social adjustment through the use of social case study, social resources and knowledge from relative fields of learning. Towle (1947) Social case work is one method ….by which certain social services are made available in areas of unmet needs. Bowers (1949) Social case work is an art in which knowledge of the sciences of human relations and skill in relationship are used to mobilize capacities in the individual and resources in the community appropriate for better adjustment between the client and all or any part of his total environment. Hollis (1954) “Social Case work is a method employed by social worker to help individuals find solution to problems of social adjustment which they are unable to handle in satisfactory way by their own efforts.” Gordon Hamilton (1956) “Social case work (which is both a tool and area of work) consists of those processes which develop personality through adjustment consciously affected, individual by individual between man and his social environment.” Gordon Hamilton In social case work the client is stimulated to participate in the study of his situation, to share plans, to make an effective effort to solve his problems, using his own resources and whatever community resources are available and appropriate. Perlman (1957) “Social Case work is a process used by certain human welfare agencies to help individuals to cope more effectively with their problems in social functioning.” S.Rengasamy. Social Case Work 10 Going Beyond Prejudice and Fear to Understanding Safrad “Social Case Work is a method employed by a social worker to help individual, find a solution of their problem of social adjustment which they are unable to handle in a satisfactory way by their own effort.” Objectives of Social Case Work To make good rapport with the common people To find-out, understand & solve the internal problems of an individual To strengthen ones ego power To prevent problem To develop internal resources Nature & Characteristics of Case Work Relationship arise out of shared & emotionally charged situation Relationship contains elements of acceptance, expectation, support & stimulation Client & case worker are interdependent Case work relationship may have several therapeutic values Improvement of condition More adjustment within the society Development of personality Capacity building Relationship needs outside help Case worker too has relationship reactions and part of and part of one‟s professional skills in their management Components/elements of case work: Purpose & concern for the client system A purpose to find-out internal problems & try to solve it and a concern to make good rapport, feel ones feelings and aims at individualized service Expectation at three level -Expectation of the case worker from the client, how the case worker feels about the clients ability & what extend client support anybody -Expectation of the client from the Case worker -Positive result in the period of interaction Accuracy of Empathy and clear communication - Think positively in others point of view - What extent you are sympathetic - Ability to perceive & communicate accurately & feel - Case worker should be sensitive to express feelings towards client by voice, posture and good communication Non Possessive warmth Give respect, acceptance, liking, caring and concern for the client in a non- dominating way. Genuineness and acceptance Case worker mist be practical in nature. He must S.Rengasamy. Social Case Work 11 Solving problems by Drawing inner strength Case Work Principles and Techniques of Casework The foundation of the practice of casework is a conceptual framework consisting of certain values or philosophical assumptions. The most basic value is that of the worth and dignity of every human being. The next is the commitment to the goal of human betterment, in terms of both material and emotional wellbeing. Then, there is the value related to the development of human potential to the highest level possible. Since each individual is considered to be important, there is the corollary of the need for every person to participate fully in the direction of his own life. These value orientations are the result of philosophic thought over years of human existence and are to be differentiated from scientific theories which can be tested and proved. Nevertheless, belief in these values is a necessary pre-requisite in order that casework may be effective. There is another set of commitments emerging from these philosophical assumptions and the idea of individualised help. They are concepts of acceptance, non-condemning attitudes, confidentiality and controlled emotional involvement. Though these concepts originally developed from the values mentioned earlier, they were reinforced later by the experience of social workers with the result that they subsequently became casework principles or rules of action. Closely linked with these values and principles is the postulate that human behaviour can change. Human history indicates that sages, philosophers, priests and teachers, since times immemorial, had tried to explain human behaviour and to change it. They were only partially successful. It will be presumptuous to think that by application of behavioural sciences one can change human behaviour easily. One has to be rather modest as regards one's expectations Human dignity Human Potential Human participation Acceptance Non condemning attitude Confidentiality Controlled emotions Human Behaviour can change be a person of genuineness being real, honest in their approach and never go beyond her/his limit. Authority Case worker must have a capacity to handle any situation, being resourceful and helpful Having knowledge, attitude, experience and a position to identify and solve internal problem of client Principles of Case work Individualization Purposeful expression of feelings Control of Emotion Self determination Acceptance Principle of non-judgmental attitude Principle of Confidentiality I. Individualization Individualization means analyze an individual not from a single aspect but from various aspects. Every Individual is different from others & unique in itself. Problem of every individual is different from another & depend S.Rengasamy. Social Case Work 12 upon her/his intelligence, so the mode of helping (Technique) must be according to the Intellectual level, socio-economic situation and ego strength, ones capacity and resource. II. Purposeful expression of feelings Case worker must give the chance to the client to express her/his feelings freely, especially her/his negative feelings because maximum time feelings are negative in nature. The case worker listen purposefully clients feelings neither praising nor condemning. Don‟t point out any one as good or bad because of one‟s psycho-social problems. III. Control emotional involvement Without feeling any one‟s emotion with sensitivity, it‟s impossible to find-out her/his problem & get a solution of that problem. Emotion comes from 3 ways as - Sensitivity -Understanding -Response IV. Self determination Self determination we means let the client to take her/his own decision in own way, give chance her/him to decide, what is right or wrong for them. V. Acceptance A case worker must be accept an individual as a person of “worth & dignity”, not treat as a problem and always accept ones positive feelings and negative feelings VI. Non-Judgmental attitude A case worker mustn‟t have the right to judge any one as guilty or innocent. VII. Principle of Confidentiality Case work relationship has a principle to take the problems of the client in confidence and keep it as secret. More Explanations on the Principles of Social Casework 1. A worker should believe in social reality. Every individual has his own different problems because every personality is unique Problems do exit and there is no stigma attached to a problem and or any maladjusted person and a social worker does not believe in social isolation for the physically, mentally, emotionally and socially sick person. Every problem can, therefore, be solved provided we create conditions for an individual who help to make an adjustment with his social environment. 2. The personality of the client is to be respected. 3. Worker should build up purposeful relationship with the client. 4. Worker should always have belief in the ability of the human beings to change and grow. 5. Worker should not involve himself emotionally with the client. There should not be any over-identification with the client. 6. Worker has to accept and appreciate the individual differences and prejudices of the client. 7. In the process of helping, it should be observed that the client is as active as the worker, since the formers‟ participation in the treatment is very necessary. The client should be helped to help himself. 8. Worker has also to look to the interest of the family, community and the agency and as such he has to help the client to adjust with the family and the community by releasing the immediate resources available in the community, taking family as a primary institution. The worker has to consider the client as part of the family, community and society with mutual responsibility. 9. In order to establish rapport with the client, worker should be sincere and sympathetic S.Rengasamy. Social Case Work 13 Case Study … All the relevant information or material gathered about an individual, family, group, etc., and arranged so as to serve as an organized record and have analytic value for a social worker, student, or the like: used especially in social work, sociology, psychiatry, and medicine. Case Study … A record that shows a person's past illnesses, treatments, and other information for use by doctors, social workers, etc Content of the Case History 1. The picture of the problem 2. Client‟s feelings & Reactions 3. Client‟s efforts to solve problems 4. Social conditions 5. Psycho-social development of the client Tools /Techniques of case study Interview and observation Interview means face to face conservation, or questioning, for the purpose of eliciting information to understand and analyze issues /problems in question Format of interview schedule 1. History of the problem 2. Personal history 3. Habits 4. Occupational history 5. Income 6. Sex experience (if it is needed) 5. Income 6. Sex experience (if it is needed) 7. Family details Diagnosis is an explanation 1.Based on the facts (case study) collected, 2. Based on the theoretical knowledge base, 3. It is subject to change if new facts are collected Types of diagnosis Dynamic Diagnosis Clinical Diagnosis Etiological Diagnosis Dynamic diagnosis gives an understanding of the current problem of the client and the forces currently operating within the client, within social environment and between him/his environment. The nature of such diagnosis is changeable because it is the beginning phase of the social case work practice Clinical diagnosis is an attempt to classify the client by the nature of his/her sickness / problem. It identifies the client‟s personality maladaptation & malfunctioning. It is useful only when it becomes apparent that a disorder of personality accompanies the social disorder, creating & complicating it This diagnosis is concerned with the explanation of the life history of the client‟s problem. When the client‟s responses are not in accordance with the problem, the past history and its appraisal helps to understand the rigid reactions of the client and make appropriate treatment plan towards him and sensitive to the clients‟ feelings and problems. Stages in Case Work Different stages in case work process are: Case study /Social Investigation / Psycho Social Study Social Diagnosis and. Social Treatment Social Case History: The first step in the case work is to collect the social history of the client. This could be done in various ways. These are: 1. Interview with the client 2. Interview with the relatives, employer, teacher and friends of the client. 3. Visiting the neighborhood and environment in which the client lives. All these visits will help the worker to know the client in his environment and collect all the data in respect of the client and his environment i.e. his family, neighborhood, friendship circle, employer, teacher, etc. as a matter of fact it is not possible to separate the three stages of case work service i.e. social history, diagnosis and treatment. During the course of interview, the worker may be able to diagnose and even suggest treatment to the client but where the problem is very acute; it is necessary to consider the diagnosis in relation to his own history. Social Diagnosis Social diagnosis is an attempt to arrive at an exact definition as possible of the social situation and personality of a given client. It is a search for the causes of the problem which brings the client to the worker for help. Diagnosis, is therefore, is concerned with understanding both the psychological or personality factors which bear a casual relationship to the client‟s difficulty and the social or environmental factors which tend to sustain it. S.Rengasamy. Social Case Work 14 Objectives of Case Work Treatment 1. To prevent social breakdown 2. To conserve client‟s strength 3. To restore social functioning 4. To provide positive reinforcements 5. To create opportunities for growth and development 6. To compensate psychological damage 7. To increase capacity of self direction 8. To increase his social contribution Methods of social case work treatment Administration of Practical Services Indirect Treatment (Environmental Manipulation) Direct Treatment Providing help to the client to choose and use the social resources afforded by the community. Money, medical care, legal aid, helping to get job or admission in educational institutions, aged homes, foster homes, recreational facilities are such type of services that any person in problem may need in order to resolve a given problem in his daily living Environmental manipulation means changing the social conditions of the client so that he/she may be relieved from excessive stresses and strains. For example attempts to change the attitude of the parents, teachers, spouse, employer, friends and relatives, training and employment for livelihood, group experience in accordance with the needs of the client. Environmental modification is undertaken by the case worker only when environmental pressures upon the client are beyond the client‟s control but can be modified by the case worker In this the case worker exerts influence directly on the client. It is used when the client needs direction because of his ignorance, anxiety and weakness of his ego strength. Direct treatment is given through counseling, therapeutic interviewing, clarification and interpretation leading to an insight. Social Treatment Social treatment in case work is the sum total of all activities and services directed towards helping the client with a problem. The focus is to relieve the immediate problem and if feasible modify any basic difficulties which precipitated it. Strictly speaking, everything that has been discussed so far is part of treatment. Generally, two types of efforts are required for social adjustment – environmental modification and or change in behaviour modification. Early case work treatment was placed on modification through the environment. Later on the development of ego psychology helped social case workers to use intensive and direct treatment techniques. The interviews in all these process are every important and unless the interviews are conducted properly, it is not possible to expect results. The case worker has, therefore, not only to understand the theory of interview but also have sufficient training and experience in interviewing, if he/she wants to be successful in providing service to the client. Interviewing in Casework By interviewing, we mean a meeting or conference (may be formal or informal) between two or more persons for specific purpose. It is an art which is used in every situation for better understanding and better relationships between the interviewer and the interview. Interviewing is the foundation on which theory and practice of social case work is based because without interview, the worker cannot get all the possible information about the client nor can the client gain any confidence in the worker. The purpose of an interview is, therefore, three-fold 1. To obtain knowledge of the situation. 2. To understand another person. 3. To make the person understand you. Note: the word client used here means any person who is seeking help or is being offered S.Rengasamy. Social Case Work 15 specialized service. Case Work Process Casework process has four different stages, namely, Social study, Social diagnosis, Casework treatment, and Evaluation. Conceptually, they are different and separate stages but they do not make a neat progression always with one stage following the other in sequence. Sometimes, two or more stages proceed simultaneously. Diagnosis may also change with the gathering of more data about the situation or with changes taking place in the situation itself. Casework help cannot be postponed till the completion of the social study or of the formulation of a social diagnosis. Some kind of help may have to be rendered even at the first worker -client contact. The skilful way the caseworker conducts the interview may be of help to the client in terms of the concern, hope, warmth and interest conveyed to the client, which in turn start a process, sooner or later, within him activating him to mobilise his inner resources for problem solving. In casework intervention the individual client is not considered in isolation from the family, but as a part of the family, since the family forms the most important human environment for the client with its network of emotional relationships. Therefore, other members of the family are also involved in the casework process. Also, home visits are made by the caseworker to get an understanding of the environment as for other reasons. S.Rengasamy. Social Case Work 16 Process of Social Case Work I. Intake (First Interview) Rapport Building II. Psycho-Social study exploration/Investigation) III. Psycho - Social diagnosis (Assessment) IV. Intervention / Treatment (Problem-solving process) V. Monitoring and Evaluation: VI. Follow-up and Termination Process of Social Case Work I. Intake (First Interview) Rapport Building Client comes to an agency for professional help through a Case worker. Relationship between two persons of unequal positions and power is developed. Accept client as a person in a stressful situation Respect the client‟s personality and help him resolve. The areas for probing are 1. The stage of the problem at which the person, through whom, and the reasons because of which, comes to this agency. 2. The nature of request and its relation to his problem, and the cause of his problem, as the client see. 3. Does the request relate directly to his needs/ problems? 4. His adjustment to his social functions in job, family, etc. 5. The state of his physical and mental health. 6. His appearance including dress, etc. in his first meeting. 7. His personal and social resources including material and financial position. 8. Appropriateness and intensity of feelings. 9. Nature of defense mechanisms he frequently uses. 10. Level of motivation, how quickly he wants to get rid of his problems. 11. Nature of family, its status, values, relationship pattern within the family, etc. 12. Reactions to the worker and seeking help from the agency and sex of caseworker who will be suitable to help the person. Intake (First Interview) Rapport Building The areas for probing are I II. Psycho-Social study (Exploration / Investigation): * “Psycho – Social study is the initial assessment of client‟s current, relevant past and possible future modes of adaptation to stressful situations and normal living situations.” Perlman has given the following contents of the case work study 1. The nature of the presenting problem 2. The significance of the problem. 3. The cause(s), onset and precipitants of the problem. 4. The efforts made to cope with problem-solving. 5. The nature of the solution or ends sought from the case work agency. 6. The actual nature of the agency and its problem solving means in relation to the client and his problem. Tools of study The tools used by the case worker for collecting the relevant information are: 1. Interview guide and schedule. 2. Life chart. 3. Video recording of family interaction. 4. Tape recorded interview. The Format of Interview Schedule 1. History of the problem.2.Personal history. 3. Family history. 4. Problematic areas. 5. Treatment Plan Psycho-Social study (Exploration / Investigation) II S.Rengasamy. Social Case Work 17 III. Psycho - Social diagnosis (Assessment): Perlman (1957) – “Diagnosis helps in determining the focus of treatment, further collection of facts and deciding the best course of action to solve the problem.” “Social diagnosis is the attempt to arrive at an exact definition as possible of the social situation and personality of a given client.” “Diagnosis is concerned with understanding both the psychological or personality factors which bear a causal relation to the client‟s difficulty and the social or environmental factors which tend to sustain it.” “Diagnosis may be viewed as the fluid, constantly changing assessment of the client, their problems, life situations and important relationships.” Content of the Social Diagnosis 1. The nature of the problem brought and the goals sought by the client, in their relationship to. 2. The nature of the person who bears the problem and who seeks or needs help with the problem, in relation to. 3. The nature and purpose of the agency and the kind of help it can offer and/ or make available. Process of making diagnosis Shifting the relevant from irrelevant data Organizing the facts and getting them into relatedness Grasping the way in which the factors fit together Preparing the meaning as a whole. Data for Diagnosis 1. Interviews 2. Checklist and Inventories 3. Direct Observation Steps in Diagnosis 1. The worker begins to focus on problematic behaviors. Both functional and dysfunctional behaviors in the client‟s environment are surveyed. The client‟s personal strength as well as of his environment are evaluated. 2. He specifies the target behaviors. Break down complex behaviors into clear and precise component parts. 3. Baseline data are collected to specify those events that appear to be currently controlling the problematic behaviors. 4. The collected information is summarized in an attempt to anticipate any major problem in treatment and as a way of beginning to establish objectives for treatment. 5. Selecting priorities for treatment is the final step of the diagnosis Psycho - Social diagnosis (Assessment) III Types of diagnosis 1. Clinical The person is described by the nature of the illness. E.g. schizophrenia, psychopath, typhoid, etc. Used in medical practice. Use is minimum in case work practice. - Importance in medical and psychiatry. 2. Etiological Tries to delineate the causes and development of presenting difficulty. History of the person. Limitation doesn‟t look into present. 3. Dynamic Proper evaluation of the client‟s current problem as he is experiencing it now. Role of psychological, biological, social and environmental factors in the causation of the problem. No attempt to dig life history. Case worker and client engage in appropriate corrective action or treatment. These developments may lead to modifications in the goals for treatment S.Rengasamy. Social Case Work 18 IV. Intervention / Treatment (Problem-solving process): * Hamilton, “Treatment is the sum total of all activities and service directed towards helping an individual with a problem. The focus is relieving of the immediate problem and, if feasible, modifies any basic difficulties which precipitated it.” The objectives of Social case work treatment 1. To prevent social breakdown. 2. To conserve client‟s strength. 3. To restore social functioning. 4. To provide happy experiences to the client. 5. To create opportunities for growth and development. 6. To compensate psychological damage. 7. To increase capacity for self-direction. 8. To increase his social contribution. Methods of Social treatment 1. Administration of concrete and practical services. E.g. money, medical care, scholarships, legal aid, etc. 2. Indirect treatment (modification of environment, both physical and social). E.g. camps, group experience activities, training programmes, etc. 3. Direct treatment: A. Counselling – marriage, occupational, family, school, etc. B. Therapeutic Interviewing – family and marital therapy. C. Clarification D. Interpretation and Insight E. Psychological support. F. Resource utilization G. Environment modification. Intervention / Treatment (Problem-solving process) IV V. Monitoring and Evaluation: * Monitoring provides crucial feedback to case worker and the client regarding 1. Whether the treatment program is succeeding as desired, 2. Whether established goals have been achieved, 3. Whether modifications in the program are necessary and 4. Whether the client is being helped in real sense. Importance of Monitoring and Evaluation The purpose of Evaluation is to see if the efforts of the case worker are yielding any result or not, if the techniques used are serving the purpose, and if the goals are being achieved. Evaluation is the process of attaching a value to the social work practice. It is the method of knowing what the outcomes are. It is a continuous process. Evaluation of the approach used and result should be taken up with the client so that the efforts are meaningfully utilized. Evaluation will further strengthen the relationship between the caseworker and client and motivate the client to work towards his goal. Casework practices need to be evaluated from time to time. The subject needs to be tested and researched and most importantly needs ongoing validation. They need to be proved to the public that they are effective and beneficial to the clients. Casework practice should be subjected to critical review. Workers need to be held accountable for what they do and for their social work competence. Workers need to win approval for their programs. They may sometimes have to be told that their services are overlapping and ineffective. Workers have to enhance their own image and also of the agency to develop public relations. The clients need to give a feedback on the effectiveness of the services. Importance of Monitoring and Evaluation in Case Work V S.Rengasamy. Social Case Work 19 Follow – up & Termination VI. Follow-up and Termination: At the end, i.e. termination, the worker should discuss the original as well as revised goals and objectives, achievements during the helping period, factors helpful or obstructive in achieving the objectives, and the efforts needed to maintain the level of achievement and the feelings aroused by disengagement. It is neither wise nor necessary for the termination to be an abrupt one. It is best to discuss termination and its ramifications (implications) several times before the final interview. The frequency and amount of contacts should be gradually decreased. Termination of the helping process brings up in both the case worker and client(s) many feelings – both positive and negative – which must be verbalized and discussed. Follow-up is done to help 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. The follow-up should be planned on a diminishing basis – after two weeks, then a month, then three months, six months and a year following the termination of the formal program. VI Social Case Work Process Intake (First Interview) Rapport Building Psycho-Social study exploration/ Investigation) Psycho - Social diagnosis (Assessment) Treatment (Problem- solving process) M&E Follow-up and Termination The components of social casework are -The Person -The Problem -The Place -The Process -The worker - client relationship -The Problem solving work S.Rengasamy. Social Case Work 20 Components of Case Work I. Person: The person‟s behaviour has this purpose and meaning: to gain satisfactions, to avoid or dissolve frustration and to maintain his balance-in-movement. Whether a person‟s behaviour is or is not effective in promoting his well-being depends in large part upon the functioning of his personality structure. The structure and functioning of personality are the products of inherited and constitutional equipment in continuous interaction with the physical, psychological and social environment the person experiences. A person at any stage of his life – not only is a product of nature and nurture but is also and always in process of being in the present and becoming in the future. The person‟s „being and becoming‟ behaviour is both shaped and judged by the expectations he and his culture have invested in the social role he carries and the major The person who comes as a client to a social agency is always under stress. To understand human behavior and individual difference, Grace Mathew has given the following propositions: 1. An individual‟s behaviour is conditioned by his/her environment and his/her experiences. Behaviour refers to reacting, feeling, thinking, etc. the conditions and influences surrounding the person constitutes the environment. 2. For human growth and development it is essential that certain basic needs should be met. (Maslow‟s hierarchy of needs) 3. Emotional needs are real and they cannot be met or removed through intellectual reasoning. 4. Behaviour is purposeful and is in response to the individual‟s physical and emotional needs. 5. Other people‟s behaviour can be understood only in terms of ones own emotional and intellectual comprehension. PERSON Person Problem Place Process S.Rengasamy. Social Case Work 21 II. Problem: The problems within the purview of social casework are those which vitally affect or are affected by a person‟s social functioning. The multifaceted and dynamic nature of the client‟s problem makes necessary the selection by caseworker and client some part of it as the unit for work. The choice of problem depends on (1) whether the problem is the client‟s problem (2) leadership given by case worker depends upon the professional knowledge and judgment and (3) agency‟s function e.g. hospital, etc. Problems in any part of a human being‟s living tend to have chain reactions. …..> cause > effect > cause.. Any problem which a person encounters has both an objective and subjective significance – quality and intensity of our feelings. Not only do the external (objective) and internal (subjective) aspects of the problem co-exist, but either may be the cause of the other. Whatever the nature of the problem the person brings to social agency; it is always accompanied and often complicated by the problem of being a client. Problems can be categorized as follows (Grace Mathew): 1. Problems related to illness and disabilities 2. Problems due to lack of material resources. 3. School related problems. 4. Problems related to institutionalization. 5. Behaviour problems. 6. Problems of marital discord. 7. Problem situations needing a follow-up service. 8. Needs related to rehabilitation of people. 9. Clients caught up in social problems like gambling, prostitution, alcoholism, drug addiction and unmarried motherhood. Problem III. Place: The social agency is an organization fashioned to express the will of a society or of some group in that society as to social welfare – community decides the need of the agency. Each social agency develops a program by which to meet the particular areas of need with which it sets out to deal. It depends on factors like money, knowledge and competence of the agency staff, the interest, resources available and support of the community. The social agency has a structure by which it organizes and delegates its responsibilities and tasks, and governing policies and procedures Hierarchy – roles and responsibilities clear, designated and delegated – collaboration procedures and policies, understand the usefulness. by which it stabilizes and systematizes its operations. – among workers – The social agency is a living, adaptable organism susceptible to being understood and changed, much as other living organisms. – Past, present and future – not static and fixed. Every staff member in an agency speaks and acts for some part of the agency‟s function, and the case worker represents the agency in its individualized problem solving help. – Case worker not an independent professional practitioner – case worker speaks and acts for the agency – psychologically identified with its purpose and policies The case worker while representing his agency is first and foremost a representative of his profession. – must know and be committed with feeling to the philosophy that guides the practice of the social work profession. Agency – Private e.g. funding agencies and Public e.g. family welfare orgs. Primary e.g. NGO and Secondary e.g. Hospitals, schools, etc. Based on functions – child welfare, family welfare, education, specialization based. Also differs based on Source of support, Professional authority, Clientele they serve, Services they offer, Goals of the agency, etc. Place S.Rengasamy. Social Case Work 22 IV. Process: * In order to understand what the case work process must include in its problem-solving help, it is necessary to take stock first of the kinds of blockings which occur in people‟s normal problem-solving efforts. The six are: 1. If necessary tangible means and resources are not available to the person. 2. Out of ignorance or misapprehension about the facts of the problem or the facts of existing ways of meeting it. 3. If the person is depleted or drained of emotional or physical energy. 4. Some problems arouse high feelings in a person – emotions so strong that they overpower his reason and defy his conscious controls. 5. Problem may lie within the person; he may have become subject to, or victim of, emotions that chronically, over a long time, have governed his thinking and action. 6. Haven‟t developed systematic habits or orderly method of things and planning. The intent of the case work process is to engage the person himself both in working on and coping with the one or several problems that confront him and to do so by such means as may stand him in good stead as he goes forward in living The means are 1. The provision of a therapeutic relationship 2. The provision of a systematic and flexible way and 3. Provision of such opportunities and aids. All competent problem-solving, as contrasted with trail-and-error method, contains three essential operations. Urgent pressures will often dislodge their sequence, but any conscious effort to move from quandary (difficulty) to solution must involve these modes of action: 1. Study (fact-finding) 2. Diagnosis (thinking about and organizing facts into a meaningful goal-pointed explanation) and 3. Treatment (implementation of conclusions as to what and how of action upon the problem). Finally, for the solution or mitigation of many problems there must exist certain material means or accessible opportunities which are available to the needful person and which he can be helped to use. Kinds of resources that a person may need are money, medical care, nursery schools, scholarships, foster homes, recreation facilities, etc. Process Transference: “Transference is a form of displacement in which the individual Unconsciously displaces onto a current object those drives defenses, attitudes, feelings and responses which were experienced or developed in relationship with earlier objects (mainly persons) in the individual‟s life.” Unconscious attitudes and associated feelings transferred from the past onto the present relationship, usually irrational. For instance, one could mistrust somebody who resembles an ex-spouse in manners, voice, or external appearance; or be overly compliant to someone who resembles a childhood friend. Transference may be positive (love, liking, etc) or negative (irrational, hostile feelings. Can be tackled by clarification (clarifying reality), interpretation, spacing the interview, etc. Counter – transference: - Social worker also has unconscious tendency to transfer on the client. - The job of the case worker to recognize his feelings and must control them. Types of Transference: Positive: E.g. Parents have shown to be friendly and helpful, the client will transfer a desire to help, friendship, guidance, emotional support and interest. Negative: E.g. Parents not shown interest and indifferent, the client will have feelings of unfriendliness, suspicion and distrust. Uses of Transference (3 stages): 1. Understanding the transference – his behaviour, unconscious need of the client. 2. Utilizing the transference – integrate past and present experiences and earlier relationships. 3. Interpreting the transference – careful analysis of his unconscious defenses. Transference & Counter Transference S.Rengasamy. Social Case Work 23 The face to face, ego to ego relationship between case worker & client Transference: The relationship between the client's unconscious and the case worker’s ego. . Counter-transference: The relationship between the case worker's unconscious and the client's ego. The relationship between the case worker’s ego & unconscious & The relationship between the client's ego and unconscious. Transference & Counter-transference. The relationship between the client's unconscious & the case worker's unconscious. Transference & Counter Transference in case work Relationship S.Rengasamy. Social Case Work 24 Conscious and disciplined use of is the means to achieve the purpose of relationship Case Worker‟s Self Relationship in Case Work Client – Case Worker Relationship The term relationship in social case work was used for the first time by Miss. Virginia Robinson in her book “A changing psychology in Social Case Work” in 1939. Relationship is the channel through which the mobilization of the capacities of the client is made possible. Relationship is the medium through which the client is enabled to state his problem and through which attention can be focused on reality problems, which may be as full of internal conflict with emotional problems. Relationship is the professional meeting of two persons for the purpose of assisting one of them, the client, to make a better, a more acceptable adjustment to a personal problem. Professional relationship involves a mutual process of shared responsibilities, recognition, of other‟s rights, acceptance of difference to stimulate growth through interaction by creating socialized attitudes and behaviour. Virginia Robinson Psycho Social S.Rengasamy. Social Case Work 25 Similarities and differences between case work and counseling Similarities 1. Both have the same objective: Both case work and counseling attempt to help those individuals who are in trouble, to solve their psycho-social problems in such a way so that they find themselves capable of dealing with their problem at present and also may solve in future if such problems arise. 2. Both deals with the same type of clients: A client is a person (man, woman, child or anyone) who finds himself or is found to be in need of help in some aspect of his social – emotional living, whether the need be for tangible provisions or counsel. 3. Both deals with the same type of problems: Both case work and counseling attempt to address problems client‟s inner problems that exert pressure over client‟s social functioning. 4. The effectiveness of both depends on relationship: Relationship is the medium through which help is provided to the client 5. Both believe in the worth and dignity of the client 6. Both have common principles: Both accept client as he is and provide opportunities for self expression. Both believe that the client has every right to determine his own path for his own recovery from malfunctioning Differences 1. In counseling help is provided to the client without social services whereas in case work administration of services (concrete help) is a major treatment strategy to solve problems 2. Agency is not essentially required in counseling but social case work is always practiced in agency settings 3. Counseling is concerned most of the time with one type of problem but in case work the client is studied and understood as a whole. 4. In counseling the emphasis is on the problem not on the person concerned, but in social case work the emphasis is basically on client and the type of service is provided 5. Counselor is independent in the counseling practice but the case work services are provided through agency. Similarities between case work and psychotherapy 1. Both social case work and psychotherapy help an individual who comes with emotional problems and painful situations 2. Interview is the technique used by both methods 3. Both attempt to put the client at ease and make it possible for him to express his feelings 4. Both share the value of individuality, worth and respect for the client 5. Both believe in the client‟s self determination 6. Both recognize the role of emotional and unconscious processes in influencing the attitudes and behaviour of the client 7. Both provide emotional support to relieve immediate anxiety of the client 8. Both give importance to the transference S.Rengasamy. Social Case Work 26 Problem & Strength Perspective Problem/Deficit Perspective Strengths Perspective Person is defined as a “case” where symptoms add up to diagnosis Person is defined as unique where traits, talents, resources add up to strengths Problem-focused (history & symptoms) Possibility-focused (hopes & dreams) Personal account aids in diagnosis of deficits, pathology, & problem Personal account is essential means to knowing the whole person fully Knowing the person from outside in Knowing the person from inside out Blames the “victim” for their problems Believes in the individual/family Childhood trauma is a precursor/ predictor of psychopathology Childhood trauma is not predictive; may weaken, strengthen or typically do both Centrepiece of therapeutic work is the treatment plan: goals set by practitioners Centrepiece of collaborative work: the goals and aspirations set by individuals, families and communities Practitioner is the expert on clients‟ problems, needs and lives Individual is the expert on his/her own life (problems, goals, means to solution) Professional designs and carries out the “course of treatment” The design and execution of the helping effort is collaborative and mutual Possibilities for choice, control and personal development are limited by eficits/pathology Possibilities for choice, control, and commitment are always open Resources for work are exclusively the knowledge and skills of professional Resources for work are the strengths, knowledge, skills, abilities and adaptive capacities of the individual Help is centered on reducing the effects of symptoms or the negative personal and social consequences of actions, emotions or thoughts Help is centered on making one‟s life be the best it can be, affirming/developing values/ commitments, making and finding membership in community Theories of Casework Apart from the basic values, principles and techniques of casework discussed earlier, there are several theoretical formulations explaining human behaviour, specifying indicators for intervention and identifying helping procedures. Behavioral sciences have contributed a good deal of knowledge to casework but much of this is on causative factors. Strategies of intervention are rather limited. Consequently, social diagnosis becomes more elaborate than treatment. Since for every causative factor there is no corresponding remedial procedure, devoting undue amount of time for diagnosis does not serve any useful purpose. Besides, for a wide range of problems, help can be rendered without knowing the causes in depth. Some experts in casework, therefore, recommend that instead of the traditional analysis of developmental features of the problem, an assessment of the conditions which currently sustain the problem may be carried out. At present, there are about fifty or more theories in casework many of which are characterised by the limitation mentioned earlier, that they focus more on explanations of behaviour than on procedures of changing behaviour. A few of these theories can be listed here: Psychodynamic theory, Ego psychology, Functional casework, Cognitive theory, Social role theory, Behaviour modification theory, S.Rengasamy. Social Case Work 27 Communication theory, Crisis theory, Family theory, and Learning theory. These are not theories in the strict sense of the word; these are only conceptual frameworks or systems of thought. The exponent of each theory puts forth arguments in favour of his or her particular theory. But there is no evidence in practice that one is more effective than the other. At the same time, none has been proved useless at an empirical level. Though supporters of particular theories are inclined to emphasize the divergence between theories, there are aspects common to many theories. There is no single personality theory which explains all types of human behaviour. Similarly, there is no unitary practice theory in casework, and therefore it is necessary to adopt an eclectic approach. Eclecticism means the use of the best of knowledge gathered from a number of different theoretical orientations. 'Informed eclecticism' entails in-depth knowledge of the theoretical approaches from which one selects principles and procedures of action. Taking bits and pieces from many theories and using them casually without any definite purpose is not informed eclecticism. The utility of a theory or theoretical prescription can be assessed in terms of the kind of problems it is concerned with, the type of clients to whom it can be applied and, most pertinently, in term of its effectiveness in producing results. Professional skill is required on the part of the caseworker to assess every client and to select a suitable procedure based on empirical evidence. The core of eclecticism is that it aims at choosing a procedure suitable for the client rather than fitting the client to a procedure in hand. The choice of a particular conceptual stance is the end product of an intellectual and emotional process and it is likely to be influenced by the particular personality make up of the caseworker. An eclectic approach does make heavy demands on the caseworker in that he needs to have substantial knowledge and practical skills. He should analyze and evaluate. Most importantly, he should have the tolerance and flexibility to have his own attitudes altered to be willing to try new procedures. All these would imply that casework practitioners should involve themselves in an ongoing process of education. Refresher courses, seminars, workshops and such other programs are methods for providing continuing education to social workers. teaching and writing. In her written work, she has tried to integrate relevant concepts from Indian philosophy with casework.8 (iv) A fourth method has been to compile all theories together and to make comparison between theories, (v) There are a few who have built up theory based on research findings. Though this is an important and essential method, this has been used infrequently. Therefore, this mode has to be developed and fostered to strengthen the theoretical base of casework. Qualities of Social Case Worker In this context, it is pertinent to think of the qualities desirable in a caseworker who functions as the change agent. The social worker must be a person who is capable of changing himself and his attitudes to be in keeping with the values and principles of casework. He must be open to new ideas and develop the capacity for self-awareness. Self-awareness is a never ending process, and the ability for self-awareness is an essential quality in order that the social worker may be able to perceive his own biases and shed them to be able to render effective casework service to clients. Related to the belief in the basic assumptions in casework is the necessity for the social caseworker to cultivate appropriate attitudes and qualities necessary for social work. S.Rengasamy. Social Case Work 28 Knowledge base of Social Case Work Besides the values and principles, the body of knowledge in casework consists of scientific concepts, tools and techniques for action. Many of the concepts of casework have been borrowed from the social and behavioural sciences. Some of these important concepts are the influence of environment on the individual's life experience, the importance of the basic physical and emotional needs, consequences of the non-fulfilment of these needs, the purposefulness of behaviour and the impact of social and cultural factors on human lives. The techniques and tools of casework have developed from practical experience and from the knowledge derived from behavioural sciences. Interviewing is an important tool in casework and in interviewing, effective listening becomes an essential component. Many procedures are brought into play in the person-to-person contact between the caseworker and the client. Acceptance of feelings, empathy, encouragement for expression of feelings, assurance, clarification of ideas and situations, and giving of advice and information are some of the techniques used in casework. These techniques of communication may sound to be rather commonplace, but they are called techniques for the specific reason that they have to be applied consciously and deliberately by the social worker for certain objectives. For example, empathising as a technique is to be differentiated from the quality of sympathy. A person‟s distress may evoke feelings of sympathy in an observer without any mental effort on the part of the latter. On the other hand, an imaginative effort and an awareness of one's own feelings are necessary for the exercise of empathy. A social worker cannot always rely on his own feelings of sympathy to be a competent professional helper. Even in situations where sympathy is not evoked, the social worker has to use empathy to be of help to the client. Empathising and related techniques help towards developing a one-to-one relationship. In a positive relationship, marked by an emotionally non-threatening atmosphere, the client feels accepted despite his shortcomings and, as a result, the inner pressure to defend himself is considerably reduced In such an emotional atmosphere the client is inclined to look at himself, at others and at situations more objectively. An objective perception, separated from subjective feelings, is the first step towards change of behaviour. Besides these techniques of communication, there is another procedure, that of environmental change. The caseworker makes efforts to deal with the client's environmental difficulties by securing for him material resources. Social work agencies do not have the financial resources to provide economic assistance to clients; but the social worker, with his knowledge of the S.Rengasamy. Social Case Work 29 larger community, is often able to locate the resources and services available outside the agency and thus put the client in touch with these. Three Roles of the Case Worker The caseworker has three major roles: Clinical/behavioural change role; Role of the consultant/educator; and The broker/ advocate role. Some aspects of these roles have already been referred to in the previous paragraphs. Clinical/behavioural change role In the clinical/behavioural change role, the caseworker focuses his attention on those aspects of the client's behaviour which cause stress to himself or others. As an educator, the caseworker may impart information, transmit knowledge, give advice, correct perception or explain situational factors which are hidden from the client's view. Role of the consultant/educator The caseworker may be required to give consultation to other social workers and professionals from other disciplines and to provide social work practice instruction to students of social work. The advocate/broker role The advocate/broker role is of two types. The first aspect, that is, the caseworker's commitment to the individual client or family as regards locating resources and services for meeting urgent material needs has been mentioned earlier. The second aspect of this role is with reference to groups of clients who have the same kind of problem or handicap. Here the S.Rengasamy. Social Case Work 30 caseworker's task is to help them to organize themselves around their problem and to activate them for collective action to find solutions to their common problem A For example, a caseworker may have a number of mentally retarded children in his case load who do not derive any benefit from the educational and other services provided for normal children. He may help the parents of these retarded children to organize themselves in order to get specialised services for their retarded children. Here the caseworker goes beyond the case-by- case approach to the application of community organization methods for helping clients' groups. Since many of the casework clients are from the lower socio-economic levels who are plagued by problems of poor housing, unemployment, and inadequacy of medical and educational services, the advocacy role becomes important. Traditionally, the caseworker has been delivering the person-centered services. In addition to this task, the caseworker of today has to be involved in system-centered activities or activities related to the impact of various social systems on the lives of many clients. In addition to this task, the caseworker of today has to be involved in system-centered activities or activities related to the impact of various social systems on the lives of many clients. It implies that only a part of casework service is confined to the office and the rest is community-based. The caseworker must know the community he serves, its demographic characteristics, its power structure and problems. He must be able to identify the needs of the community and work with the community to develop resources. One aspect of casework is prevention of problems. The focus in prevention is on the influence of environmental systems in the causation of human problems. This aspect of casework is compatible with the idea of system-oriented activity mentioned earlier arid the major goal is making individuals and families resistant to problems. The family and school are important social systems through which preventive efforts can be carried out. Sex education, particularly for adolescents, premarital counseling and family life education are programs geared to prevention which are within the field of operation of caseworkers. The clientele here are not people characterized by problems for which they seek help but are people who are being helped to prevent the development of certain problems. Programs geared to crisis intervention have secondary benefits in terms of prevention. Even though the primary goal is to provide instant social work services, at the time of a crisis, prompt intervention prevents the problems from deteriorating. Furthermore, casework help is given in such a way that it fosters the development of patterns of coping which will stand the client in good stead in future crises. Recording in Social Work 1. By maintaining records, a worker can improve his professional skills and techniques, can learn by his own errors and can thus make his help more effective and systematic. 2. Records not only help a worker to evaluate his own work, but he can also improve upon his own methods. 3. Records can create interest not only in the worker but also in the client and help in building worker-client relationship. 4. Records add to the body of knowledge of social work and also make this knowledge communicable. 5. Records make supervision and teaching easier and effective. 6. Records can be used for social research and planning. 7. Through records a worker can show his agency what work he has done. 8. Records ensure continuity of work, if another replaces one worker. 9. Records are useful for future references. 10. Records help in providing service on a systematic basis. S.Rengasamy. Social Case Work 31 Principles of Case Records: No hard and fast rules can be laid down for preparing records but the following are some of the most important points, which should be borne in mind: 1. The contents of the records should be kept confidential. 2. Objectivity, accuracy, simplicity and brevity should be the guiding factors in preparing records. 3. Records should be written in very simple language and a simple style. 4. Reaction of the Client/group should be recorded beginning and /or ending in his/their own words 5. Abbreviations should be avoided in records 6. Summary is a good device for organizing and analyzing facts. 7. Narrative is a good style for reporting facts. 8. If possible, notes should be not be noted down before the client but after the interview is over. 9. Client‟s emotions- anger, happiness, irritability, etc., should be suitably recorded. 10. Records should be supplemented with letters, etc. Casework Practice in India Casework is practiced in many settings in India, but only in settings confined to urban areas. Social work agencies which provide casework services to help people in distress are social service departments of hospitals and clinics, family welfare service centers, residential institutions for children and adults, social service departments of schools, child guidance clinics, community centers, correctional institutions and mental health centers. In order to understand the case situations of Indian clients, it is useful to refer to the classification of factors (a classification which has been mentioned earlier) which lie beyond people's abilities for problem solving. Most of the casework clientele belong to the lower socio-economic levels. They bring problems which fall within the five-factor range, and generally they bring more than one problem. Most have the common difficulty, namely, lack of material resources, coupled with other predicaments. Caseworkers are often overwhelmed by the prevalence of large scale poverty among their clientele. Never during the brief span of the history of casework have caseworkers claimed that they had remedies for large scale poverty and economic distress. While working with a poor person what the caseworker can offer is a humane and understanding relationship and advocacy on his behalf to get the necessary materials for the fulfillment of his basic needs. Caseworkers in cities, particularly in Bombay, do succeed in Theory Building in Casework A listing of the different approaches to theory building in social work presented by Turner in one of his books is relevant here with reference to theory building in casework. The approaches are: Some of the earlier books on casework were the results of caseworkers' efforts to formulate and explain the values, axioms, attitudes and techniques of practice. This is referred to as the pre-theory approach, Some caseworkers have based their written work on some specific theory which they have accepted. There have been some casework books written on the framework of psychodynamic theory, some others on functional theory and at least one book each on cognitive theory and role theory, S.Rengasamy. Social Case Work 32 Some authors have used practice base and have presented concepts in their own thinking. G.B. Banerjee, one of the pioneers of professional social work in India, has contributed considerably to Indian social work through her pooling material resources on behalf of individual clients. But when there are many poverty stricken clients, the caseworker's success in finding economic resources diminishes. There is a point of view, therefore that all social work efforts should be geared to system-change rather than to individuals. Such a stance cannot be accepted by the caseworker whose first commitment is to the individual. Caseworkers also deal with situations other than those created by economic needs. Furthermore, efforts by social workers alone cannot bring about changes within the social, political and economic structures of the Indian society. Social workers, nevertheless, have a responsibility as regards the advocacy role and to support the argument and social action in favour of system-change. Indian casework needs to develop indigenous literature. Caseworkers have developed strategies of intervention suited to Indian clientele. If they can abstract these from practice situations, conceptualize and build postulates around them, it will have considerable educational and practice value. Some of the approaches to theory development which were discussed in this article can be used by caseworkers for developing concepts. An eclectic approach provides ample scope for practice-based research. The introduction of doctoral programs in social work in Indian universities is a step which will also help in building up indigenous literature. Casework which is the oldest method in professional social work has been the centre of many controversies. The main controversy has been around the question whether it is an effective way of dealing with human problems. There have been arguments for and against casework, without arriving at any conclusion. Casework is not the method suitable for all human problems, but for certain problems no better method is available. Until a better and more effective way is evolved, this method, embodying a personalized service, is going to stay. Psychosocial Theory and Social Work Practice Imran Ahmad Sajid Peshawar University Introduction All social work practice-historically and currently-has relied on psychosocial concepts. From the very beginning, social work has been dedicated to; The alleviation of sufferings and to the enhancement of human life. Social Workers had been concerned that How to support the well-being of individuals and families How to respond to people‟s need How to restore social functioning and How to better their interpersonal relationships and life situations. In order to answer these questions the psychosocial approach grew up in social work practice. Meaning of Psychosocial The term “Psychosocial,” 1st used in 1899, means, “Pertaining to mind and society”. “Relating Social Conditions to Mental Health”. Merriam Webster Dictionary. The term “psychosocial” is the combination of two words, “psycho” means “psychological” and “social” means “relating to society, or the way in which people in groups behave and S.Rengasamy. Social Case Work 33 interact”. So in this context psychosocial means “interaction of psychological and societal forces / components”. Psychosocial theory Psychosocial theory says that individual and his environment are intertwined. Changes in one system create changes in other systems. In other words individual‟s behaviour is the product of psychological forces and societal factors. His problem triggers not only due to psychological forces or social factors but by the combination of both. Therefore the intervention strategy must address both the factors. Client’s context The client‟s context is made up of many interacting systems-not only one system including psychological, social, family, personality, school, work place etc. Problem Problems are seen as a consequence of disequilibrium between individual and environment. What psychosocial case worker to do to solve the problems is, to help client reduce the disequilibrium between individual and their environment. Aim of Treatment The psychosocial treatment often is not aimed at the so-called “pathological” or “dysfunctional” aspects of the gestalt; rather, interventions are tailored to address those aspects that are most accessible and most capable of change. Ameliorization of the client‟s environment may result in enduring changes in the personality or family system. The Goal of Psychosocial Workers The goal of psychosocial workers is to work collaboratively with clients to find optimal “fits” between people and their social or physical surroundings. Historical Origin and Development Social work has always been profoundly influenced by the conditions and demands of the day. During some periods, socio-economic forces received the greatest attention; at other times, there was keener interest in understanding personality development and functions. As our theory and knowledge base matured, the tendency to neglect either component diminished significantly. Mary Richmond: She set the stage for the development of modern casework theory and practice. When she published her first book, “friendly visiting among the poor: a handbook for charity workers”, in 1899, she began formulating and evaluating practice concepts and techniques. Some of her major ideas and findings are as follows: 1. Focus on the individual alone did not always help. Social relations and environment-past and present-are major forces shaping personality External influence had to be addressed in order to promote a better adjustment between individual and the surrounding. 2. Case workers actual experience should be subjected to critical analysis and their efforts must be measured by best standards available. She outlined specific approaches to collection of “social evidence” from which inferences were to be drawn, leading to “social study, diagnosis, and treatment planning process. 3. Treatment must be individualized. She cautioned against generalization and stereotyping. S.Rengasamy. Social Case Work 34 Each person and each family is unique and must be studied and listened to separately. Knowledge from Psychology and Psychiatry Psychology and psychiatry prevailed over social workers during WW-I up till 1950s. During 1920‟s the sociological basis of social work was partially obscured by new ideas of personality development, and emotional experiences etc. Freud‟s thinking were particularly influencing. Inner “weakness” was too often blamed for miseries or crises that were primarily social in origin. Family and socioeconomic influence was downplayed. Ego Psychology All approaches in ego psychology broaden the psychosocial casework horizon. Particularly defense mechanism of Anna Freud, Erikson‟s psychosocial developmental stages, Client Centered therapy of Roger, and cognitive therapy are more important. Ego Psychology: Principles and Assumptions 1. People of all ages have the capacity to grow, learn, adapt and-at least to some degree- modify their social and physical environment. 2. Psychological systems do not stand alone, but constantly interact with biological and social systems. 3. People‟s behaviour develops within the context of many open systems interacting in mutually causative ways. Change in one system inevitably creates changes in other systems. 4. Family system provides most significant context for personality growth and development. Problems of fit among family members are mutual. 5. Families are also subjected to stresses that come from larger systems, including poverty, racism, etc. the daily lives of many clients are pervaded by these forces. Assumptions from Ego psychology: 1. Significant feelings and thoughts lie outside of awareness. 2. Personality is fluid and dynamic system of forces that influences behaviour; 3. Defenses are constructed that serve bother positive and negative end. 4. Symptoms are adaptive attempts to uncover and resolve internal conflicts. 5. Neurosis is actually social in origin. The Worker Client Relationship Successful treatment depends heavily on the quality of relationship between client and worker. How to promote Positive Relationship? 1) Positive therapeutic relationship stems from the worker‟s demonstration of non- possessive warmth and concern, genuineness, accurate empathy, and non-judgmental acceptance, along with his capacity to communicate optimism and professional competence. 2) For client: he must mobilize some courage, hope and motivation to join the worker, and to trust in his ability to help. Obstacles in effective worker-client relationship: Numerous obstacles stand in the way of effective worker-client relationship; People seeking help feel anxious-with feeling of shame and failure to resolve difficulties. Fear of dependence on another may create apprehension Anticipatory fear- that the worker truly cannot understood their need or circumstances can also hinder effective relationship. S.Rengasamy. Social Case Work 35 When the client is referred by some referring agency e.g. parents, school, court etc-in that case the client‟s willingness to engage in work may be impeded. Approaches to Intervention The approaches to intervention include; Psychosocial Study Psychosocial Assessment Psychosocial Intervention 1. Psycho-social Study Gathering The Facts vs. Interpreting Facts The primary emphasis in psychosocial casework is placed on understanding the client‟s dilemmas and what has contributed to them. This understanding is called psychosocial study. It requires observation and gathering of accurate facts that are arranged in orderly manner. Often the bulk of data is obtained in early interviews. Initial Interviews Facts gathering begins as the worker elicits from clients their perception of problems, what they think led up to it, how they have attempted to remedy it, what they believe might help now, and what other people, agencies or systems are involved. Additional Source of Information Observations of the client‟s nonverbal behaviours and demeanour and the dynamic of the client-worker relationships, usually prove useful. The goal is fact gathering, not interpretation. The psychosocial study of children requires collateral interviews with parents, teachers, and other concerned. Approaches to Intervention Early Life History Many problems in living emerge during the developmental phases of the individual and family life cycle. Therefore early life history is also obtained for psychosocial study. Psychosocial Assessment Psychosocial assessment begins by thinking critically about the facts gather in psychosocial study. The worker‟s task, now, is to conceptualize how the multiple symptoms are interacting. Assessment simultaneously addresses and formulates hypotheses about two major matters; 1. How and why a problem exists, and 2. Who and what is accessible to change. Only after determining where we can enter the constellation of multiple systems, and which system or systems are probably most amenable to change, can effective treatment strategies be designed. Assessment identifies points of access and evaluates the capacity, motivation, and opportunity for change-of individual, the family, the social networks, and communities. Psychosocial Intervention Psychosocial treatment often uses a blend of individual, couple, family and environmental modalities. In work with symptomatic children, family members are often the most important resources for change. S.Rengasamy. Social Case Work 36 Recap Individual and his environment are intertwined. Changes in one bring changes in others. A problem is the disequilibrium between individual and his environment. The worker‟s goal is to work collaboratively with the client and find an optimal fit between individual and his physical and social surroundings. Behaviour & Behaviour Modification What is Behaviour? Behaviour can be defined as the way in which an individual behaves or acts. It is the way an individual conducts herself/himself. Behaviour should be viewed in reference to a phenomenon, an object or person. It can be seen in reference to society norms, or the way in which one treats others or handles objects. Behaviour, therefore, is the way an individual acts towards people, society or objects. It can be either bad or good. It can be normal or abnormal according to society norms. Society will always try to correct bad behaviour and try to bring abnormal behaviour back to normal. Root Causes of Behaviour Differences The following are the root causes of behaviour differences: 1. Individual differences 2. Differences in family patterns 3. impairment/disabilities 4. Environmental factors 5. Psychological factors. What is Behaviour Change or Behaviour Modification? Behaviour change is based on a simple idea of learning. It is based on the idea that behaviour followed by reward is more likely to be repeated, or retained, than not. On the other hand, behaviour which results in an unpleasant outcome tends to be quickly dropped or disappear. Behaviour change is based on the idea that behaviour is, in part, controlled by its consequences. Behaviour Theories You should be acquainted with some behavioral theories which will help you in your work. Three of these theories are mentioned here briefly. You are advised to read more about these theories. References are given at the end of the unit. 1. Respondent Learning This theory was formulated by a Russian psychologist called Ivan Pavlov. It is known as classical conditioning and is based on a stimuli-response formula. (S-----R) 2. Operant Conditioning This theory is based on the work of B. F. Skinner, who drew on the idea of classical conditioning, but thought individuals to be more active in the learning process than that theory allowed. For learning to occur, it is essential that the person be an active participant. In this theory, when learning is rewarded, behaviour is perpetuated or maintained, while punished behaviour is removed. S.Rengasamy. Social Case Work 37 3. Social Modeling: This is based on the work of Albert Bandura, who thinks that most learning is a result of copying or imitating what others do, i.e. vicarious learning. The social modeling theory emphasizes the importance of external reinforcers, and allows learning to occur independently of reinforcement. Fundamental Principles of Behaviour Change The central theoretical positions underlying the professional efforts of behavioral counselors can be summarized in a number of propositions, among which are the following: a) Human behaviour is caused by learning; therefore it is guided by the laws of learning. b) Human behaviour is the product of learning, and can be assumed to be liable to unlearning or correction. c) Human behaviour is influenced by consequences, and is strengthened when followed by rewards, and spoilt when followed by negative consequences. d) Human behaviour is controlled not only by internal factors, but also by external factors, such as the presence of significant role models and other social rewards like praise or prizes. e) Maladjusted behaviour may be changed by changing the circumstances which maintain it. f) Human beings begin life with a clean slate on which nothing has been written. In effect, they inherit good or bad habits at the time when they enter the world. g) Behaviour is learnt in life individually, or by watching others learn, or by training or conditioning. h) Students who need help may show observable negative behaviour they wish to eliminate, or observable positive behaviour they wish to promote. Having gone through these propositions, behavioral modification appears to be different from other approaches, which promote effective mental health by addressing cognitive or emotional problems. Behaviour modification uses all the effective principles of learning which influence behaviour. References 1. M. Richmond, Social Diagnosis, Russell Sage Foundation, New York, 1917. 2. The short history of American Casework presented here is based on an article by H.H. Perlman. M.H. Perlman, "Social Casework" in H.K. Lurie (ed), Encyclopedia of Social Work, National Association of Social Workers, New York, 1965. 3. H. H. Perlman, Social Casework: A Problem-solving Process, The University of Chicago Press, Chicago, 1957. 4. J. Fischer, Effective Casework Practice, an eclectic approach, McGraw-Hill Book Company, New York, 1978. 7. Francis Turner, "Some Considerations on the Place of Theory" in Turner Francis (ed.), Social Work Treatment, The Free Press, New York, 1974. 8. G.B. Banerjee, Papers on Social Work, An Indian Perspective, Tata Institute of Social Sciences, Bombay, 1972. ences in family patterns 3. impairment/disabilities 4. Environmental factors 5. Psychological factors. What is Behaviour Change or Behaviour Modification? Behaviour change is based on a simple idea of learning. It is based on the idea that behaviour followed by reward is more likely to be repeated, or retained, than not. On the other hand, behaviour which results in an unpleasant outcome tends to be quickly dropped or disappear. Behaviour change is based on the idea that behaviour is, in part, controlled by its consequences. Behaviour Theories You should be acquainted with some behavioral theories which will help you in your work. Three of these theories are mentioned here briefly. You are advised to read more about these theories. References are given at the end of the unit. 1. Respondent Learning This theory was formulated by a Russian psychologist called Ivan Pavlov. It is known as classical conditioning and is based on a stimuli-response formula. (S-----R) 2. Operant Conditioning This theory is based on the work of B. F. Skinner, who drew on the idea of classical conditioning, but thought individuals to be more active in the learning process than that theory allowed. For learning to occur, it is essential that the person be an active participant. In this theory, when learning is rewarded, behaviour is perpetuated or maintained, while punished behaviour is removed. S.Rengasamy. Social Case Work 37 3. Social Modeling: This is based on the work of Albert Bandura, who thinks that most learning is a result of copying or imitating what others do, i.e. vicarious learning. The social modeling theory emphasizes the importance of external reinforcers, and allows learning to occur independently of reinforcement. Fundamental Principles of Behaviour Change The central theoretical positions underlying the professional efforts of behavioral counselors can be summarized in a number of propositions, among which are the following: a) Human behaviour is caused by learning; therefore it is guided by the laws of learning. b) Human behaviour is the product of learning, and can be assumed to be liable to unlearning or correction. c) Human behaviour is influenced by consequences, and is strengthened when followed by rewards, and spoilt when followed by negative consequences. d) Human behaviour is controlled not only by internal factors, but also by external factors, such as the presence of significant role models and other social rewards like praise or prizes. e) Maladjusted behaviour may be changed by changing the circumstances which maintain it. f) Human beings begin life with a clean slate on which nothing has been written. In effect, they inherit good or bad habi