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ASWB LSW Chapter 12-Intervention
Process and Techniques
Defining objectives - Clients and SW both have objectives, that of the SW is to be of assistance. Clarification and definition of these objectives often become important parts of the helping process. Problem solving approach - Based on the belief that an inability to cope with a problem is due to some lack of motivation, capacity, or opportunity to solve problems in an appropriate way. Client's problem solving capacities or resources are maladaptive or impaired. Goal of problem solving process - To enhance client's mental, emotional, and action capacities for coping with problems and/or making accessible the opportunities and resources necessary to generate solutions to problems. Steps of the problem solving process - E-Engaging A- Assessing (t-terming at end) P-Planning I-Intervening E-Evaluating Steps in planning - Define the problem, examine the causes, generating possible solutions, identifying the driving and restraining forces related to implementing each of the possible solutions. Prioritizing solutions based on ratings, devloping SMART objectives, creating strategies and activities related to the objectives. SMART goals - Specific, measurable, Achievable, Relevant, and Time Specific Components of a care plan goal - Criteria, method for evaluation, schedule for evaluation Criteria -
What bx must be exhibited, how often, over what period of time, and under what conditions to demonstrate achievement of the goal Method of evaluation - How will progress be measured? Schedule for evaluation - When, how often, and on what dates or intervals of time will progress be measured? Engagement - This process with a client helps determine why tx was sought, what precipitated desire to change now, parameters of helping relationship, including defining roles of social worker and client, tx expectations Assessment - Ct is source of providing essential information upon which to define problem and solutions, as well as identifying collateral contacts from which data gaps can be collected Planning - Development b/t client and social worker of understanding of client's preferred lifestyle. Goals are developed based on this and specific action plans are created. Intervention - Client must be actively involved in mobilizing his or her support network, to realize continued progress and sustainable change. In this stage the client must bring barriers to achieving goals to the attention of the SW. Progress must be tracked and timelines adjusted accordingly Evaluation - Subjective reports of client, in conjunction with objective indicators of progress, should be used to determine when goals or objectives have been met and if new ones should be set. Client self monitoring is a good way to do this. Termination -
activity and involvement from a social worker. Sets specific goals and tasks in order to increase a client's sense of mastery and control. Goals of crisis intervention -
- relieve impact of stress with emotional and social resources 2) return a client to a previous level of functioning (regain equilibrium) 3) help strengthen coping mechanisms during crisis period,
- develop adaptive coping strategies. Learning theory - Conceptual framework describing how information is absorbed, processed, and retained during learning. Cognitive, emotional, and environmental factors all play a part in how understanding or worldview is acquired or changed, as well as how info is retained. All fit into 1 of 4 categories- behaviorist, cognitive, humanistic, social/situational Behaviorist learning theory - Learning is viewed through change in behavior and the stimuli in the external environment are the locus of learning. Change external environment to bring about change in client. Pioneers are Pavlov and Skinner. Cognitive learning theory - Pioneer-Piaget. Learning is viewed through internal mental processes, including insight, information processing, memory and perception, and the locus of learning is internal cognitive structures. Develop opportunities to foster capacity and skills to learn better. Humanistic learning theory - Pioneer-Maslow. Learning is viewed as a client's activities aimed to fulfill his or her full potential and the locus of learning is to meet cognitive and other needs. Aiming to develop whole person Social/situational learning theory - Pioneer-Bandura. Learning is obtained between clients and their environment, and interactions or observations in social contexts. Social workers establish opportunities where conversation and participation can occur. Cognitive Behavioral theory (CBT) -
hands-on, practical approach to problem solving .Goal is to change patterns of thinking or behavior that are responsible for clients' difficulties, and thereby change the way they feel. Changes client's attitudes and their behavior by focusing on the thoughts, images, beliefs, and attitudes that are held and how these related to behaviors as a way of dealing with emotional problems. Active, collaborative, structured, time limited, goal oriented, and problem focused. Lends itself to requirements set by managed care as it is brief, well delineated, goal oriented, and has empirical evidence. Psychotherapy - Emphasizes the importance of the personal meaning placed on things and how thinking patterns begin in childhood. Behavioral therapy - Pays close attention to the relationship between problems, behaviors, and thoughts. Steps in cognitive restructuring - Assisting clients in: Accepting that their self-statements, assumptions, and beliefs determine or govern their emotional reaction to life's events. Identifying dysfunctional beliefs and patterns of thoughts that underlie their problems. Identifying situations that evoke dysfunctional cognitions. Substituting functional self statements in place of self-defeating thoughts. Rewarding themselves for successful coping efforts Behavioral theories - Suggest that personality is a result of interaction between the individual and the environment. Study observable and measurable behaviors, rejecting theories that take internal thoughts and feelings into account. Represent the systematic application of principles of learning to the analysis and treatment of behaviors. Goal is to modify behavior Observable behaviors - Target symptom, problem behavior, or an environmental condition, rather than the personality of the client. Respondent behavior - Automatically elicited by a certain behavior. Stimulus elicits response Operant behavior -
Extinction - Withholding a reinforcer that normally follows a behavior. Behavior that fails to produce reinforcement will eventually cease Flooding - A treatment procedure in which a client's anxiety is extinguished by prolonged real or imagined exposure to high intensity feared stimuli In vivo desensitization - Pairing and movement through a hierarchy of anxiety from least to most anxiety provoking situations; takes place in "real" setting Modeling - Method of instruction that involves an individual (the model) demonstrating the behavior to be acquired by a client Shaping - Method used to train new behavior by prompting and reinforcing successive approximations of the desired behavior Systematic desensitization - Anxiety inhibiting response cannot occure at the same time as the anxiety response. Anxiety- producing stimulus is paired with relaxation producing response so that eventually an anxiety producing stimulus produces a relaxation response. Rational emotive therapy (RET) - Cognitively oriented therapy where SW seeks to change a client's irrational beliefs by argument, persuasion, and rational reevaluation and by teaching a client to counter self-defeating thinking with new, non distressing self statements. Time out - Removal of something desirable-negative punishment technique
Token economy - Client receives tokens as reinforcement for performing specified behaviors. These tokens function as currency within the environment and can be exchanged for desired goods, services, or privileges Empowerment - Aims to ensure a sense of control over well-being and that change is possible. Can be achieved by establishing a relationship aimed at meeting client's needs and wishes, educate client to improvehis or her skills (increasing ability to self help), help client to secure resources, such as those from other organizations or agencies to meet needs, unite a client with others who are experiencing the same issues when needed to enable social and political action. Self-determination - Client increases self worth by making a change in life that is based on their desires Role playing - Modeling strategy that involves acting out a scenario to become more confident in actually doing it. Usually used to practice having a difficult conversation, being assertive, managing anger, etc. Role modeling - Emphasizes importance of learning thru observation and imitation and helps clients acquire new skills. Live modeling - Involves watching a real person perform desired bx. Symbolic modeling - Filmed or videotaped models demonstrating the desired bx. Self modeling - Client is videotaped doing bx Participant modeling -
Stress management - Peovides tools to deal with threats and minimize impacts of psychological or physical reactions. First step is to monitor stress levels and identify triggers. Second step is to assist clients in identifying what aspects of a situation they can control. For parts they can't, can engage in stress mgmt techniques. Anger management - Relaxation excercises, cognitive techniques, communication skills, environmental change Relaxation exercises - Deep breathing, meditation, guided imagery, yoga, stretching or exercise Cognitive techniques - Replace destructive thoughts, focusing on goals, use logic, not using all or nothing approach, putting situation into perspective. Communication skills in anger mgmt - Slow down speech, listening, think before you speak, avoid defensiveness, using humor. Environmental change in anger mgmt - Walking away or leaving situation, avoiding people or situations in future that evoke anger, not starting conversations that may cause anger when tired or rushed. Group work approaches - Should use the group as major helping agent, and not make decisions for group. Should only intervene when group is becoming dysfunctional Purposes of using group work - achieve personal change, social, environmental, or political change, foster relationships/support, maximize resources, facilitate learning. Group interventions (when needed) - Maintain group's structure, boundary, and purpose, open up new possibilities for exploration, guide direction of the group away from or toward certain themes, interpret the assumptions,
attitude, or bx of the group or its unconscious communication, model a way of dealing with dilemmas Family practice approaches - Focus of assessment and intervention is the interaction of family members Community based approach - Aims to change some aspect of a community, including policy or programs Stages of community approaches - Orientation-members meet for forst time and get to know each other. Conflict- disputes, arguments, conflict. Emergence- seeing and agreeing on course of action. Reinforcement stage- making a decision and justifying why it was correct. Policy analysis - Systematic approach to solving problems through policies. Involves identifying the problem, developing alternatives, selecting the desired option, designing and implementing the policy, and evaluating the outcomes Influences on social policy - Knowledge/innovation: create new opportunities to change and information on current practices. Social, political, economic conditions or resources. legal issues/laws, institutional influences/structure, and external influences such as media and public opinion. Title VI of the Civil Rights Act of 1964 - No person shall be excluded from participation in, denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance on the grounds of race, color, or national origin. The Older Americans Act of 1965 (OAA) - Offers services to older Americans, created the Administration on Aging. This agency is responsible for administring funds to the states for supportive services for people over 60. Child Abuse Prevention and Treatment Act of 1974 -
Advance Directives - Designate a person to make medical decisions on your behalf should you be incapacitated. Without this, no one is able to make decision on your behalf to take you off or put you on life support. Combined with living wills Living WIll - allows individuals to retain some control over what happens at the end of their life even if they aren't competent to make personal choices for terminal care, by specifying wishes while they are still healthy and mentally competent Family and Medical Leave Act (FMLA) of 1993 - Requires covered employers to provide up to 12 weeks of unpaid job protected leave to "eligible" employees for certain family and medical reasons with continuation of group health insurance coverage. Multiethnic Placement Act (MEPA) of 1994 - Prohibits agencies from refusing or delaying foster or adoptive placements because of a child's or foster/adoptive parents race, color, or national origin as a basis for denying approval.Also requires agencies to recruit a diverse base of foster and adoptive parents to better reflect the racial and ethnic makeup of children in out of home care. Violence against women Act (VAWA) of 1994 - Strengthened federal penalties for repeat sex offenders, and creating federal "rape shield law" which is intended to prevent offender's from using a woman's past sexual conduct against them during a rape trial. Keeps victims safe by requiring that victim's protective order be recognized and enforced in all jurisdictions including tribal, increases amount of sentencing, prosecution, and conviction of offenders by training law enforcement and ensuring access to services by victims. Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) - Added workforce development component to welfare legislation. Instituted TANF, which replaced the Aid to Families with Dependent Children, and supplanted the JOBS Training program.Imposed lifetime 5 year limit on receiving TANF. Patient Protection and Affordable Care Act (ACA) 2010 - Expands access to insurance, increases protections, emphasizes prevention and wellness, improves quality and system performance, expands health workforce, and curbs rise in health care
costs. Provides more oversight of healthcare premiums, emphasizes prevention, primary care, and effective treatments, reducing health care fraud and abuse, reducing uncompensated care to prevent a shift onto insurance premium costs, foster comparison shopping , implementing Medicare payment reforms, and testing new delivery and payment systems. Health Insurance Portability and Accountability Act (HIPAA) of 1996 - Provides individuals with ease of access to their medical records and gives more control over how health information is used and disclosed. Federal floor of privacy protection; states can provide higher level if they want. Workforce Innovation and Opportunity Act of 2014 (WIOA) - Reauthorizes Workforce investment act, w/ some changes to Workforce Development Boards structure, One-Stop operations, Job-Driven Training for Adults and Dislocated Workers, and Intergrated Performance and Youth Services Micro level social work - Concentrate on helping individual clients solve their problems. Can include families or partners/spouses. Help clients access needed services from other agencies, as well as provide direct support and counseling. Often focus of clinical practice Mezzo level social work - Applies to larger groups or communities. Attempt to make connections between individual and macro level. Macro level social work - Stresses importance of economic, historical, sociopolitical, and environmental influences on client well-being and functioning. Determination of how these factors can facilitate growth or create problems for clients. Requires systems level change that can lead to opportunities or reduce barriers. Includes creating or changing policies, procedures, regulations, and laws. Aims at not only helping individual client, but others who might be experiencing same difficulties. Classic Organizational Theories - Attempts to explain workings of organizations. Main deficiency with these is that they assume that people's motivation to work is strictly a function of economic reward. Scientific Management Theory (Theory X) -
