The Social Workers' Toolbox

Sustainable Multimethod Social Work

Herman de Mönnink

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781317390084
• Edition: 1
• Topic: Medicina
• Subtopic: Atención sanitaria

The Social Workers' Toolbox aims to bring order to the diversity of tools which are so characteristic of social work: assessment tools, practice tools and outcome-measurement tools. The tools described in this Toolbox can be directly put into practice and adapted to the social workers' personalized approach with their individual clients and their environments. The underlying meta-theory for Sustainable Multimethod Social Work is the 'PIE-Empowerment Theory'. This theory defines social work practice in terms of the partnership between social worker and client and is aimed at enhancing quality of life through systematically and sustainably addressing human needs and human rights. The multimethod model promotes the flexible combination of well-written evidence- and practice-based tools.

Packed full of useful checklists, the Toolbox is ideal reading for both inexperienced and more practiced social workers. The book provides a solid basis through the use of practical examples. For the more experienced social worker it offers a substantial resource and the means to legitimize a chosen course of action and social work intervention. Schools of social work will be able to use the book as an easily accessible resource for social work assessments, interventions and quality social work management.

Part I

The social work approach

1

Three-step social work approach

I could see no beginning and no end to it all. Using the imagery of a personal filing cabinet enabled me to see my problem areas as separate entities. It was a bit of a scare; is that me? However, my problem situation was reduced to workable proportions. Unfinished business was subsequently scrutinized and dealt with until complete closure was achieved.

(Maria, age 19)

Questions

This chapter addresses the following questions:

• What is meant by the three-step approach in social work?
• What is meant by PFC, the personal filing cabinet?
• What is meant by PSA, the psychosocial assessment?
• What is meant by PSI, the psychosocial intervention?
• What is meant by multimethod social work?
• What is meant by identifying which differential methods are indicated?

1.1 Introduction

This chapter will explain the three-step social work approach that constitutes the essential practical methods guidelines in social work for optimizing the Quality of Life (QoL). First, the three-step plan is explained, followed by a description of each of the three methodical steps. The theory is illustrated by elements from the case study of Maria.

Case study: Maria

Maria was a social work student who was not able to finish her grief support workshop, which formed part of her programme of studies as a social work student. One of her lecturers referred her to the student advisor (social worker) at her college. It appeared that her unfinished emotional business had been reactivated in the course of the workshop and as a result she found herself unable to concentrate on her studies. For a long time Maria had been struggling with her mother’s unexpected death (by suicide when Maria was 5) and her brother’s death (through an overdose at the age of 14) and with the fact that her father had never been there for her at the time of these life events. Maria remained rebellious and came close to having dealings with the judicial system and the police. During the college social work sessions she wondered ‘Why? Why have such terrible things happened in my life? The social work sessions helped Maria sort out the troubling issues in her life. By sorting through all the problem areas she was able to deal with one specific area at a time and eventually regained her grip on life.

1.2 Sustainable multimethod social work in three steps

In order to work sustainably and in a goal-oriented way it is vital that social workers utilize a stepped plan in their thinking. By working according to a multimethod stepped plan social workers engage in stepwise and goal-oriented mapping and focusing on the pluses and minuses in the client situation.

The multimethod stepped plan in social work comprises the three following steps:

1. 1 PFC, the personal filing cabinet: the social worker is mapping and visualizing the impact factor using keywords – in the client’s language – to identify which minuses and pluses the client is experiencing: how do clients describe their own situation, how do clients experience the impact of life events, for example what is the impact when you suddenly lose your job (impact factor)? Which stressors and strengths do you experience when that happens?
2. 2 PSA, the psychosocial assessment: the social worker determines a plan of action: which practical methods can empower the client situation in meeting clients’ unfulfilled needs, for example how can we help clients to acknowledge the life impact (impact factor)? How can we help clients cope with job loss effectively (enhancing the coping factor)? How can we make the environment more supportive (enhancing the support factor)?
3. 3 PSI, the psychosocial intervention: the social worker and the client work together to actually implement the plan of action to enhance personal and environmental strengths, e.g. by acknowledging the job loss, improving clients’ coping style as well as support from family or friends and public resources and services. Client feedback will be measured on a regular basis to see if the actions taken are effective, if different actions are needed, and social worker and client will work through the three steps again till the Quality of Life of the client is optimal.

Case study: Maria (19)

The college social worker (student advisor) started by asking Maria to tell her own story. Maria did not really expect this to happen considering her past experiences with professionals in support services, who normally commenced by asking her to fill out various checklists and questionnaires. The social worker did not stick to any particular order when interviewing her, instead focusing on facilitating Maria to tell her story instead (non-directive core method; no filling in for the other person). Maria’s first question to the college social worker was to ask how she would normally deal with a case like this. The social worker simply said she would ask: ‘what support do you need to take a step forward in your life?’ Answering this question was meeting Maria’s unfulfilled needs (stress factors) and enhancing her strengths. In addition, they would both deal with each drawer from her ‘personal filing cabinet’ by easing the stress (fulfilling a need) and enhancing her strengths. Maria was encouraged to deal with one file at a time and determine her own needs (needs-centred approach). This actually appealed to Maria, who really longed for something like this after so many years of carrying such a heavy burden (sustainable approach).

This approach by social workers can be typified as client-centred and multimethod. Pluses in Maria’s personal filing cabinet stand for her personal strengths and the support strength of her environment while minuses stand for stumbling blocks for optimal QoL.

Maria’s social worker adopted a needs-centred approach and kept returning to Maria’s needs as her point of reference. In doing so, the social worker’s focus remains on the client’s needs rather than on the social worker’s own preferential method. By adhering to this principle, all methods and techniques can be utilized flexibly. After this overview of the three-step approach, we will now discuss each step.

1.2.1 Step 1: personal filing cabinet (PFC)

The first step for you, as a social worker, is to establish contact during the intake interview, after which you collect information about the client situation and arrange this information in the client’s personal filing cabinet (PFC). In order to obtain reliable information a safe basis of interaction between you and your client is needed. Your starting point for the interview is ‘where your client is’. This is where you start implementing your core method: the non-directive core method (see Chapter 3). This core social work method will be used for the duration of the whole social work interaction trajectory to maintain contact and establish a partnership (see also Chapter 4).

By making contact with your client you are also working on developing a relationship of trust. During the interview you start by mapping the client’s situation. This is a preliminary inventory of the pluses and minuses, as described in the case study of Maria.

Case study: Maria

Maria’s story offered the social worker a range of themes for designing a PFC, which helped her visualize Maria’s story in a succinct and orderly manner, by drawing a diagram and using keywords to identify all the stress factors and empowering factors. Maria’s situation became organized in a workable framework, which could be used to set an agenda and a plan of action (see Figure 1.1). Maria’s PFC presented the following stress factors and empowering factors.

Client as expert

Clients like Maria draw attention to existing unfulfilled needs: a plus or a minus indicates whether the need has been fulfilled or not.

The PFC is used to summarize and reflect areas that will need to be focused on, as indicated by the client. By drawing the client’s filing cabinet each area of attention is pictured as a ‘drawer’ from the person’s filing cabinet (see Figure 1.1). The drawers contain ‘troubled material’, meaning the unfulfilled needs that have not yet been dealt with satisfactorily. You suggest to your client the idea of first organizing the issues in the personal filing cabinet. Your clients’ strengths (pluses) will be encouraged (empowerment) to actively identify and reduce the stress factors (minuses).

Figure 1.1 The personal filing cabinet (PFC) of Maria with strengths (pluses) and stress factors (minuses)

The impact factor

As described earlier, three factors influence the degree of fulfilment of client needs: the impact factor, the coping factor and the support factor. The coping factor and support factor are described in Step 2. One part of the impact factor are life events. Life events cannot be influenced, because life events are part of life: ‘shit happens,’ and you cannot prevent tragedy and vulnerability. But life events can also be positive. You can experience successes and flow. Attention is also focused on the positive effects of these life events. There are also positive life events such as falling in love, getting married, having a child and so on. It is sufficient and essential for both the social worker and the client to first acknowledge the impact of these life events. The PFC reveals the actual and personal consequences of the client’s life events, known as ‘life impact’. Your clients tell their story of their life events, disclosing not only the facts of the life events but also the consequences of these life events such as their emotions and questions.

Reactions resulting from life events such as divorce, death and illness are addressed. Such reactions may be formulated as ‘I feel tense,’ ‘I am so tired,’ ‘No one will help me’ or ‘I feel let down.’ Another component of the impact factor is how the client first manages the situation or ‘I don’t know how to manage.’ The last component of the impact factor is how the environment responds: ‘I (don’t) feel supported by my network.’ Reflecting on these components of the impact factor in the PFC (life events, reaction-styles and support styles) will help the client identify and acknowledge these QoL issues.

The social worker acknowledges the client’s issues by writing down the key words concerning the life events in the PFC. Life impact pertains to the effect that actual life events have on fulfilling human needs. To what extent have the needs for survival, affection and self-determination been fulfilled? Life impact concerns the ‘dead weight’, the unfulfilled needs, and the psychosocial weight that may disrupt a person’s life. The death of a loved one (bereavement), illness (health domain) or job loss (work domain) may result in someone losing their footing in life. On the other hand, the impact might have been less profound if the loss had not taken such a prominent place in the client’s life structure. In conclusion, life impact concerns the extent of disruption to human needs that are experienced as a consequence of one or more life events.

The impact factor: Maria

Maria was 5 when her mother committed suicide, her brother took an overdose at the age of 14 and she had recently gone through a relationship breakup. Another significant setback was the fact that she kept failing to complete the grief support seminar. For years Maria had been in a state of survival (survival needs), longing for love and attention (affection needs) and wanting to give direction to her own life (needs for self-determination). Maria was avoiding these life events and her situation deteriorated when she became confronted with her past during the grief support seminar. She was helped by her study-mentor.

1.2.2 Step 2: psychosocial assessment (PSA)

The first rough draft of the client-centred inventory in the PFC forms the foundation for Step 2, the psychosocial assessment of the client situation (PSA). Once you have mapped the pluses and minuses in the client situation, you and your client try to assess or clarify what kind of support is needed. At the same time you acknowledge and gain an appreciation of what the client discloses about positive self-care and help from inform...