The impact of sight loss in social work practice

This article intends to familiarize the social worker with the various definitions of blindness and sight loss, common obstacles faced by persons with sight loss, general therapeutic issues, when and how to use self-disclosure of a disability, and the ways in which the social worker can use his or her disability, specifically sight-loss, as an instrumental therapeutic tool with clients. Case examples will be provided to illustrate effective interventions and the various ways in which a disability may impact a client or clients. In addition, a brief discussion of various theoretical approaches to understanding disabilities is outlined.     

E-technology and Community Participation: Exploring the Ethical Implications for Community-based Social Workers

ABSTRACT

To date, much of the work on social work, ethics and technology has been focused on clinical social work and micromorality—the ethical practices of the worker and their clients in one-on-one or therapeutic group interactions. In contrast, this article foregrounds social workers engaged in community work and the ethical implications at a macromoral level. Central to community-based social work, also known as social development work, is the principle of participation. In observing the ways e-technology is affecting community participation, the focus is upon communicative and social technologies, rather than assistive technologies, or technology enabled assessment. The article explores the intersection of these three themes of community participation, technology, and ethics to examine the implications for social workers located in the complex context of community work.     

Getting Started: Psychodynamics,Racism and Anti-Racism

Abstract

This paper mainly addresses white social workers who want to practise in an anti-racist manner. It aims to clarify common confusions about the relationship between therapeutic and political goals in anti-racist practice, which can lead workers to feel immobilised and unable to get started. Analysis of a case example based on the author's experience is used to unravel the strands of personal distress and experience of racism which a client may bring to a social worker, and the corresponding strands of personal and institutional racism with which the social worker must wrestle. It is proposed that familiar concepts of transference and counter-transference can be helpful in understanding the confusions about racism which white social workers may experience in practice encounters with black clients. The importance of all this is seen to lie in the likelihood of white social workers unwittingly reproducing racism, unless they are clear about the boundaries between the therapeutic and the political domains.     

Responding to children’s ‘emotion talk’: a conversation analysis of a therapeutic encounter between a social worker and two siblings using child-centred play therapy

ABSTRACT

Reflection of feelings is a hallmark strategy of non-directive child-centred play therapy that enhances children’s emotional awareness and equips them with emotionally expressive words. The case presented here describes the application of child-centred play therapy by a social worker with two young children (aged four and six) with sibling rivalry issues. One of the sessions was videotaped, which enabled the use of conversation analysis to dissect the language patterns used by both the clients and the social worker. This in-depth verbal analysis illuminated subtle nuances in the children’s interactions and behaviour while also providing the social worker with the opportunity to reflect on practice. This case discussion presents a snapshot of that session and allows readers to understand how such therapy occurs.     

Responsibilisation,social work and inclusive social security in Finland

ABSTRACT

In this article responsibilisation in social work is studied by analysing two Finnish state-level policy documents (called final report and research report) which concern a current activation initiative called inclusive social security (ISS). It is asked how social workers and clients are constructed as responsible subjects in these documents. Responsibilisation refers to the advanced liberal mode of governmentality, which aims to strengthen citizens’ abilities to self-governance through various techniques that include the intertwined elements of surveillance and empowerment. It is demonstrated that the policy documents construct the social workers’ and the clients’ responsibilities partly in different ways. The final report leads activation to be based on shared responsibility and social work to be more community-based, whereas the research report strengthens more individual-based responsibility of clients and social workers. For the clients, the interpretation of ISS based on shared responsibility would probably be less stigmatising and paternalistic than the one based on individual responsibilities, i.e. approaching long-term unemployed citizens as being personally ‘at risk’ and thus a justified target group of individualised techniques for activation. For social workers and clients, future activation appears to be a wide mix of different techniques, moral expectations and possible ways of being a responsible subject.     

Social Work Roles in Drug Treatment with Youth

ABSTRACT

Social workers working with youth, who are prescribed psychotropic medication, are routinely faced with tasks pertaining to psychopharmacologic treatment. Little is known, however, about how these workers contribute to the medication treatment process or the impact of their contributions. The purpose of this national survey of social workers practicing with youth was to explore three areas: (1) the frequency of medication-related functions with adolescent clients; (2) the worker, client, and contextual factors associated with greater involvement; and (3) social workers' perceptions of the effects of greater involvement on treatment processes and outcomes. Our findings suggested that in relation to medication treatment, social workers more frequently interfaced with clients than physicians, and that various treatment context and individual factors are associated with greater involvement. Social workers also perceived their involvement as associated with some desirable treatment processes/outcomes, especially the inclusion of adolescents in decision-making.     

Nothing to give at all

Abstract

Adlerian psychology has been publicly neglected for many years but has been used covertly in many modern psychologies. Social work theory owes much to Adler's philosophy and many social workers probably unknowingly use it — in whatever guise — as their starting-point. But if Individual Psychology is their spring-board, the casework relationship may be their life-raft — to the detriment of creative and therapeutic work with people. Adler's ideas and social work theory are of value only in so far as they are expressed in the relationship of the worker with the client. For the most part, certainly in statutory agencies, other demands make it difficult for workers to operate from anything other than a defensive position. Therapeutic community practice, in contrast, reflects both Adlerian psychology and the best of social work theory: an egalitarian approach springing from a commitment to self-determination for both clients and workers.     

Beginning Practice with Preoperative Male-to-Female Transgender Clients

Abstract

Preoperative male-to-female transgender clients often present with specific and unique psychological and social issues distinct from gay male and lesbian clients. Therapists must be ready to assess and help diagnose these in preparation for work with gender queer clients. Therapists must also be prepared to face and resolve the various counter-transference dynamics inherent in therapeutic relationships with transgendered individuals. This Practice Note focuses on the author's beginning clinical and social case management experience working with two preoperative male-to-female transgender individuals.     

Survival and change: Social work with angry men

Abstract

This paper discusses the risk elements in encounters with six angry male clients of a social services neighbourhood team. Their preoccupation with basic survival needs produced an identification of the worker with an elusive “stolen object”; this leads to a discussion of how we also felt we had become identified with an image of persecuting parent, rooted in their childhood experience. The key notion of our “struggle” with them is linked to that of “boundary-setting” and the therapeutic value of the characteristic escalation of client/worker conflict is examined. The worker's survival is seen as a confirmation of the client's personal integrity. The process of disengagement is then analysed with particular attention to the material transactions between client and worker that served to mark the end of the engagement. We acknowledge the minimalist nature of our strategy with these men, and attempt to examine outcomes.     

Recognising Strategy and Tactics in Constructing and Working with Involuntary Social Work Clients

ABSTRACT

This paper reports on the author’s academic work on working with involuntary clients, which began with a knowledge exchange project in Scotland. I reflect back on this work and use it as a way to explore subsequent reflections on the field. These move beyond consideration of the skills required to undertake such work through locating the category of involuntary clients within wider, yet contradictory, governmental discourses on client engagement. These are identified as the strategy that sets the context for such work. But the strategy is enacted through the day-to-day tactics of social workers on the ground; such tactics, enacted in everyday encounters, are constitutive of effective but also ineffective engagement with clients. The discussion goes on to problematise the distinction between voluntary and involuntary clients and to suggest that effective social work practice, whatever the nature of that involvement, requires that clients are recognised at an ethical and relational level.

IMPLICATIONS

• The term involuntary client(s) cannot be taken for granted but is constructed and needs to be understood in particular and often contradictory policy and professional contexts.

• Effective but also ineffective ways of working with involuntary clients go beyond the acquisition or demonstration of particular skills but are embodied in the everyday relational practices of social workers.

• Ethical engagement with involuntary clients proceeds from a sense of mutual recognition.

     

Self-care techniques for social workers: Achieving an ethical harmony between work and well-being

ABSTRACT

The prevalence of burnout in the field of social work is a significant challenge to staff retention. This paper addresses the necessity of self-care in the prevention and treatment of burnout amongst social workers. Self-care is important for social workers who wish to maintain healthy, balanced lives. It is also argued that social workers who do not practice self-care are not able to provide the best possible services to their clients. For these reasons, self-care is necessary both from an ethical and personal standpoint. Specific steps for developing an individualized self-care plan are presented. This begins with the creation of a self-inventoryutilizes the Holmes-Rahe Life Stress Inventory. This is followed by a sample of self-care techniques that social workers can use. The techniques are not meant to be an exhaustive list of all self-care practices, but rather a sample of practices from various areas of social worker’s lives to demonstrate the expansive and diverse nature of self-care.     

Exploring emotional aspects of care and control in social work with children and families - a single case analysis of conversation

ABSTRACT

In this article, I explore how emotions are displayed and dealt with on a communicative level in face-to-face encounters between social workers and parents in a child welfare setting. The analysis draws upon detailed analysis of a whole encounter between a social worker and a parental couple who have recently had their new-born daughter placed in foster care. By examining the way emotional stances are expressed and responded to I discuss how orientations toward institutional tasks and goals create constraints for the display, recognition and validation of clients’ emotion displays. I consider the communicative challenges this poses for the parents and the social worker and the implications these may have for the client–worker relationship.     

Challenges,Barriers, and Opportunities: Social Workers With Disabilities and Experiences in Field Education

ABSTRACT

The purpose of this study was to explore the experiences of social work students with disabilities in field education. This qualitative inquiry used semistructured interviews exploring inclusion and accommodations in field education. The 15 participants were graduates of accredited BSW or MSW programs and reported one to five disabilities each. Four themes emerged: different experiences with visible versus invisible disability, confusion about accommodation, field as a learning opportunity regarding disability, and a sense of isolation being a social worker with a disability. This study provides information valuable to social work educators and field instructors regarding strategies for improving opportunities for students with disabilities as future social workers, aligning with the mission and values of the social work profession.     

Applications of a Capability Approach to Disability and the International Classification of Functioning,Disability and Health (ICF) in Social Work Practice

Abstract

As disability rates increase more social workers will require greater preparation to practice effectively with individuals with disabilities. The Capability approach and the International Classification of Functioning, Disability and Health provide helpful tools for social worker training. The capability approach emphasizes the need to assess what individuals are able to do in their real-life environments (capabilities) rather than capacity or functional status. The ICF provides helpful disability-related terminology and an actual classification to assist social workers to develop appropriate interventions that facilitate capability development among individuals with disabilities. Using the capability framework with the ICF will contribute to improved understanding of disability among social work students and practitioners.     

Faith and Religious Delusions in First-Episode Schizophrenia

ABSTRACT

Empirical research has not adequately examined whether social workers and clients discuss sociocultural issues when addressing mental health problems, nor the quality of the interaction when such discussion occurs. This exploratory mixed-method study examined the interactional process associated with discussion of sociocultural issues in the first three counseling sessions with four white social worker/client of color dyads. Findings showed that productive cross-cultural interactions were associated neither with specific sociocultural content nor client-worker composition, but rather with the social worker's perception and skill. Analysis differentiated one worker/client dialogue from the others, highlighting the importance of training practitioners to apply social work knowledge and skills in a synthesized manner.     

Dealing with Resistance: Working with Involuntary Clients in Community-Based Drug Treatment Programs in China

ABSTRACT

This study explores strategies for dealing with client resistance that are commonly used by a group of selected counsellors who work closely with illicit drug users in the community-based compulsory treatment programs in China. Through semistructured in-depth interviews with 16 counsellors, this study finds that different forms of client resistance were experienced in their day-to-day practice, encompassing passive and active behaviours. Five typical strategies are used by Chinese counsellors in this study to deal with client resistance: showing respect and caring and expressing empathy; attending to the needs of the clients; making effective use of peer influence; altering clients’ unwillingness to change; and strategically enhancing clients’ self-determination. Considering these strategies can also be seen as general principles for dealing with involuntary clients in other fields of social work services, the findings of this study may have broader impact.

IMPLICATIONS

• Effective ways that can be used by counsellors for reducing illicit drug users’ resistance during treatment include: showing respect and caring, and expressing empathy; attending to the needs of the clients; making effective use of peer influence; altering clients’ unwillingness to change; and strategically enhancing clients’ self-determination.

• Professional social work training is urgently needed among community-based drug treatment social work practitioners in China, to achieve efficient practices and better outcomes.

     

Social Work and the Treatment of Substance Abuse in Israel

SUMMARY

This paper examines the role of the social worker within the field of substance abuse in Israel at the start of the 21st century, its implications for the profession, and the training of its practitioners. Addiction to psychoactive substances is viewed as a bio-psycho-social phenomenon caused by a wide variety of factors and the respective interactions between them, placing it within the realm of the expertise of the social worker. The social worker plays a central role in providing both administrative and clinical interventions with this population. Additional ways in which the education and training of social workers can prepare them to deal more efficiently and comprehensively with the problem of substance abuse in both practical and academic terms is discussed.     

Who Writes the “Therapeutic Story” of Families in Extreme Distress: Overcoming the Coalition of Despair

ABSTRACT

When families in extreme distress come to social workers, the enormity of their needs often stresses the workers. The problems which these families face often require material and personal resources in excess of what the agency can provide. This places the worker in a position of being under pressure from both sides the clients and the organization. In these situations, the workers and families together can become subject to a coalition of despair. It is characterized by exhaustion and losing hope that therapeutic change is possible. A way to overcome or avoid the coalition is proposed.     

Integrating self-care into clinical practice with trauma clients

ABSTRACT

Self-care is recognized as an important aspect of social work practice. Beginning in educational settings, developing social workers are encouraged to learn about and practice self-care. However, self-care is typically promoted through strategies and approaches outside of the practice context. Social workers are oftentimes encouraged to use individualized self-care plans, which often feature a variety of relaxation and secondary techniques; focus on self-awareness and self-reflection; and have proper use of supervision. Although these strategies are invaluable, they do little to directly benefit the social worker during direct practice or while in session with a client which is a time period when clinicians are particularly vulnerable to distress or burnout. The importance of real-time self-care strategies is particularly critical for clinicians, especially those who engage in trauma work, given the sensitivity of topics that clients may have endured or benefit from assistance in processing. Further, little information has been published on the use of self-care techniques during a session with a client or in a clinical context. The purpose of the present paper is to discuss self-care strategies that can be useful both outside of and within a clinical setting and present a model of such strategies that focus on integrating self-care in clinical practice particularly for those engaging in trauma work. The paper will conclude by discussing the relevancy of the developed model in practice.     

Readers Comment

Abstract

Cardiac patients frequently experience anxiety and depression as major responses to a life-threatening event. Well-timed intervention by the social worker can assist in alleviating these responses and enhance psychological well-being by the use of counselling and other therapeutic techniques. Two case-studies are presented illustrating the range of work undertaken in a comprehensive approach to working with patients in both the acute and rehabilitation phases of cardiac crisis.