Social History Assessment

Arlene B. Andrews

• Publisher: SAGE Publications, Inc
• Year: 2006
• ISBN:
  9781452238524
• Edition: 1
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

"Her book takes us on a journey back to the basics of conducting a thorough and informative social history and is an account of what a real social history involves...I recommend this book not only for the novice but also for all clinicians who want an edge on how to accumulate more pertinent information concerning their patients and to guide their treatment." —PSYCCRITIQUES

In the mental health and human service professions, taking a social history assessment marks the start of most therapeutic interventions. Social History Assessment is the first resource to offer practical guidance about interpreting the social history. Author Arlene Bowers Andrews provides rich resources to assist helping professionals as they gather and–most importantly–interpret information about social relationships in the lives of individuals.

1

The Significance of a Person’s Social History

Most people seem compelled to reflect on their own lives and dabble with exploring their family trees, even their genealogies. People ponder how they came to be uniquely themselves while carrying the innate and acquired traits of those who came before them. They boast of their ancestors, avoid mention of them for shame, or wonder about the mystery of the unknown. In recent years, through the Internet, people have gained easy access to treasure stores of information about past generations, spawning renewed popular interest in family history.

Many people explore their life histories primarily for pleasure or enlightenment, but there comes a time for some people when they need to explore their history to promote personal growth or healing. When people develop personal or social problems or encounter barriers to desired development, their concern is typically with discomfort in the present and immediate future. They will find that when they go to a helping professional, giving at least a brief social history marks the start of most therapeutic interventions. Exploring the client’s origins helps build rapport and lay the foundation for mutual client-professional assessment of the here and now and what can happen in the future. This book focuses on the development of the individual history in the context of the helping relationship so that together, the person and professional can develop a plan for future life enhancement.

The helping professions have a long tradition of reliance on social histories as a tool to promote healing and growth. In this book, “helping professionals” will refer to people from various disciplines who have specialized knowledge, certified skill through advanced education and/or licensure, and a code of ethics that guides interventions aimed at helping another person manage a life problem or make critical decisions. Helping professionals are found in such fields as counseling, education, law, medicine, ministry, nursing, psychiatry, psychology, and social work. Each profession has its own body of knowledge and skills, including traditions regarding the use of social histories. Though independent, the knowledge bases for the professions often overlap and most professionals have worked on interdisciplinary teams, producing transdisciplinary knowledge that crosses over professional boundaries. Taking a personal history is one of the key transdisciplinary practices.

Different theories that guide helping professionals in their practice emphasize the power of history to varying degrees. For example, psychoanalysts and narrative therapists regard personal history as pervasive, while behaviorists essentially look at old habits, without intensive review of how they developed, and focus on forming new habits to replace them. Professionals draw on a variety of theories, tending to emphasize some over others. Regardless of the professional’s theoretical grounding, most people who seek help can communicate comfortably, though perhaps selectively, in the language of personal stories. Many people are fascinated by life histories and eagerly explore their own. The professional will help the person honor the gifts of the past, tenderly confront any agonies that originated there, and learn new ways to heal and grow for the future.

The helping professional’s use of life history can be informed by the growing body of research about life history in the social and behavioral sciences. Researchers in such fields as anthropology, sociology, genetics, criminology, psychology, social work, education, journalism, and, of course, history, are among the many who have advanced knowledge about how to effectively gather, record, describe, and interpret life histories and narratives as a means to understanding human behavior in the broader environmental context (see, e.g., Atkinson, 1998; Bruner, 1986; Hatch & Wisniewski, 1995; Josselson & Lieblich, 1993, 1995). The research methods have included focused studies of individual lives as well as studies of mass populations over multiple generations using life course methods (see, e.g., Giele & Elder, 1998; Mortimer & Shanahan, 2003). The findings from these studies portray the powerful influence that meaning and context have on individual development and behavior. Many of the studies have contributed to the articulation of methods for gathering and interpreting information that ensures fidelity to the narrator’s story. The findings and the methods are useful in professional practice.

Edward Bruner (1984) suggests that a person’s life can be regarded as the “life lived” (what actually happened), the “life experienced” (meanings, images, feelings, thoughts of the person), and the “life as told” (the narrative as influenced by cultural conventions of storytelling, audience, and social context). The “life lived” can be recorded as a life event history that identifies milestones, critical incidents, or key decision points in a person’s life. The “life lived” is based on relatively objective information that can be substantiated by records or consensus by other people who witnessed or observed the events. The event history becomes a chronological list of events with identification of who did what, when, and where.

The latter two ways of knowing the life are based in the subjective impressions of the informant. The “life experienced” gets expressed through the “life as told” as well as the person’s art, behavioral patterns, emotional expressions, and other forms of communication. The life event history can be illustrated with notes about the person’s experience or response to events, such as recalled emotional reactions to or images of key events. The “life as told” is the personal narrative with its unique content and form. The narrative, which tends to express the meaning that a person gives to events that happened, itself offers information about the person’s life history.

People relate their own life narratives through the filter of their memories and interpretive meanings, thereby revealing much about who they are now as well as who they were and what they did. Anthropologists James Peacock and Dorothy Holland (1993) propose using the term life-focused to refer to the history that primarily addresses the factual events and subjective experiences of the subject (i.e., the “life lived” and “life experienced,” using Bruner’s typology). They suggest that alternatively, the “story-focused” approach emphasizes the narrative, with emphasis on how the subject structures the story and the process of telling the story. For example, the narrator may have a coherent story, one that integrates life experiences and reflected meaning, or an incoherent story with scattered themes and reflections. The narrator may emphasize certain themes and minimize others. “Story-focused” approaches assume the subject’s culture affects beliefs, ideas, and traditions about how the narrative is expressed. How the subject tells the story reflects the meaning the subject has made of his or her life experiences. Both approaches, together and separately, have value in different contexts. This book will address how to capture information about life experiences while emphasizing the significance of the narrative and interpretations of the story.

Life stories are contextual. Goodson (1995) maintains that the analysis of a life story in its political and economic context over time makes it a life history. Each part of a story occurs in time, at a place or series of places, and within a culture. In addition, an individual’s life story is linked to the life stories of people close to him or her. A social history can be conducted for an individual, dyad, family, small group, organization, or community.

Life stories are dynamic, emerging over time, even as they are told. The listener (e.g., the caseworker or therapist) becomes a part of the story. Life stories are also developmental, open to reinterpretation as the person gains new knowledge or insight. This is the key to the helping professional’s intervention. Like any good historical research, the meaning of the social history emerges through skilled interpretation of the history, development of a subjective current understanding about the past, and application of this understanding to future action.

Helping professionals listen to people as they tell their stories, add their own interpretations to the story, and often supplement the personal narrative with other sources of information, such as the perspectives of others who know the person or records left by people who have known or interacted with the person. The professional’s interpretations are grounded in knowledge and skill derived from theories, empirical studies, and experiences about how other humans have managed similar circumstances. Together the professional and client share their interpretations as they move through the change process. Skilled professionals carefully reflect on their own interpretations in order to distinguish them from their client’s interpretations. The dual perspectives shed greater light on the patterns and features of a life history.

When people construct their own histories from their own impressions and their interpretations of what others have said to them orally or in records, they are essentially being autobiographical. When outsiders describe a life history, they are biographical, and can construct the history without even consulting the subject of the history, using information from others and records. This formerly happened often, for example, when children or older people with disabilities were assessed and their own perspectives were ignored, before their rights of self-determination and participation were asserted and affirmed by law and professional standards. The autobiographical and biographical perspectives each have value. By bringing them together, the social context of the individual’s life can often be better understood. Given that life histories are socially constructed, they are constantly evolving, changing as the historian, be that self or other, develops fresh perspectives based on new life experiences. In the context of a relationship with a helping professional, the person can develop fresh ways of looking at new life experiences so that future historical constructions promote life enhancement.

The Focus on Social Relations

Humans are complex creatures. Their thoughts, emotions, behaviors, and sensations are affected by their biology, psychology, and social relations. This book particularly addresses the personal social history, ¹ that is, the social relationships that have influenced the development of the person during the life course. The life history also includes the person’s biological development, including normative health, wellness behaviors, and maturation as well as illnesses, disabilities, injuries, or behaviors detrimental to health. It also involves psychological development, including learning and performance ability, emotional and behavioral regulation, communication and information processing, personality and identity development, mental health, and the host of factors that make up the individual as a person. The term biopsychosocial was coined to refer to the holistic assessment of a personal history.

A thorough understanding of the social aspects of a life must be informed to some extent by the biological and psychological aspects of the life. This book therefore briefly addresses essential elements of biological and psychological assessment, but the emphasis is on social history. Social relations involve the association of self with others. All individuals are influenced by and exert influence on the people around them. From a developmental and social ecological perspective, a person’s social relations grow more complex over time. They start in infancy with intimate relations between the infant and primary caregivers and extend to include less familiar people, such as teachers and other caregivers, peers, social acquaintances, neighbors, contacts in the community, and messengers brought by various media from the broader society and culture. Interactions with the social networks become integral to the person’s evolving social history.

Social interactions powerfully influence human development. Each human is born with a unique genetic constitution and innate capacities. The extent to which many of these capacities are realized is elicited, from birth onward, through interactions with the external environment. That environment includes the physical world, with its temperature, light, sounds, smells, images, and other stimuli. It also includes, critically, the social environment, and the other humans who, if they are nurturing, link the infant and young child to food, water, protection, comfort, and modeling of developmentally appropriate human behavior. The infinite variety of external influences sends messages to the baby’s growing brain and helps to shape its development. Even in utero, the developing fetus can be influenced by the mother’s social situation to the extent that it affects her nutritional intake, health, stress level, and other conditions.

Understanding a person’s social history and how the person makes meaning of the history is a key to helping the person relate socially in ways that are healthy and fulfilling.

The Social History: Overview

Social histories take many forms in the helping professions. In a managed care world, when a psychotherapist may have only six 55-minute sessions to assess a client and promote healthy bereavement and coping after a sudden divorce, the history may take only moments. At another extreme, when a person’s life is at stake, as when a defendant faces a possible sentence of death from a court of law, the defense team will scour the earth in search of information and expert opinion about the social history to explain how the history affected the defendant at the time of the crime and mitigates a sentence of death. In either case, the skilled professional will follow a standard that elicits adequate information for the goals of the process with the client.

The social history is a time-honored practice, as reflected in this description by one of the founders of the social work profession, Mary Richmond, in 1917:

Social diagnosis is the attempt to arrive at as exact a definition as possible of the social situation and personality of a given client. The gathering of evidence, or investigation, begins the process, the critical examination and comparison of evidence follows, and last come its interpretation and the definition of the social difficulty. (p. 62)

This series of steps still forms the fundamental process in a social history assessment. The assessment is often followed by a final stage— planning a course of action to change the problem. And, given a century of research and theory development regarding human behavior in the social environment, the process is grounded in theoretical frameworks that guide the professional’s approach to the whole assessment.

This book follows the sequence of steps in a social history assessment, as follows:

The Professional Lens. Chapters 2 and 3 review core theories that guide professional understanding of human behavior in the social environment. Theory provides the interpretive paradigm that professionals can contribute to the relationship with the client as they make meaning of the social history. This step begins with the professional’s training and experience prior to interacting with the client. Scores of theories from multiple disciplines guide various health and human services professionals; only a few core theories are covered here. Chapter 2 address fundamental themes in human social development through the life span: environmental context and social systems theory, the life course, and critical processes in social development. The discussion addresses barriers to and resources for prosocial and healthy development with a focus on the social functions of learning and adaptation, attachment and stability, stress and coping, and deprivation. Chapter 3 summarizes the social environment, including family, social network, and community influences on the development of individual behavior. The chapter closes with an examination of factors in the broad social environment, including culture, class, race-ethnicity, location, spirituality, and government and public policy.

The material in Chapters 2 and 3 is just the tip of an iceberg that is loaded with empirical and conceptual information available to helping professionals. The information will be familiar to people with advanced education in the social or behavioral sciences or professions. They might use the chapters as a ready reference guide or skip them altogether. For relative novices in the field of social history, the two chapters are critical to comprehending the interpretation phase of the social history assessment.

The individual life story becomes a speck in a universe of information about human behavior in the social environment. The life story can be deconstructed from a variety of perspectives. Individuals are the best informants and decision makers about which themes are most salient in their lives. As professionals listen carefully to how individuals express the themes in their social histories, the professional interpretation will enable a fresh perspective that can help the individual gain new insight.

Describing the Social History. Chapter 4 covers the gathering of facts and observations that lead to the description of the history and the recording of meaning that participants in the history have made of the life events. A description is essentially a straightforward reporting of what was detected by the professional and person as they made a record of the life history. The history description is grounded in information from multiple interviews, records and reports, and direct observation. The professional uses tools such as genograms, sociograms, chronology, time lines, and other aids to summarize the information. Chapter 4 essentially addresses how complex human experience can be summarized in ways that promote clarity and manageable focus on critical themes. The descriptive part of the history helps to differentiate effects of past from effects of life events in the here and now.

Making Meaning: Interpreting the Social History. Chapter 5 addresses the blending of theory, facts, and observations as the history is critically examined and interpreted. The social history assessment helps to explain how people function socially and how their histories have influenced the way they think, feel, and behave. The chapter reviews the analytic and synthesizing processes that are applied and presents a case study to illustrate the art of history interpretation in the human services. By achieving deeper understanding, the person or others connected to the person can make decisions about how to move forward into the future—thereby shaping their own history and contri...

Table of contents

• Cover Page
• Dedication
• Title Page
• Copyright
• Contents
• List of Figures
• Preface
• 1. The Significance of a Person’s Social History
• 2. The Professional Lens, Part I: Human Social Development and the Life Course
• 3. The Professional Lens, Part II: Social Ecology of Human Development and Behavior
• 4. Describing the Social History
• 5. Making Meaning: Interpreting the Social History
• 6. Tools to Aid Social History Development
• References
• Index
• About the Author