Outreach social work: from managing access to practices of accessibility

A recurring feature of outreach work is that outreach tries to reach people who are left without care and not effectively reached by existing services. In this article, we discuss the importance of outreach practices in the context of changes in society. We suggest that the pressure on the managing of access to social services is increasing along with the demand to avoid an unnecessary inflow, and make a distinction between a residual and structural approach to social work and social service delivery. In a residual approach, outreach social work can be seen as a strategy to manage access or as a strategy to link clients with appropriate services. In this sense, they ensure that people meet predefined criteria of social services. From a structural approach, however, the focus lies on how practices possibly contribute to the realization of human dignity in social interactions and might lead to a socio-political analysis of those situations in which social work intervenes. On a conceptual level, outreach practices thus appear as practices of accessibility. From this perspective, existing problem constructions and dynamics of inclusion and exclusion in social services but also more broadly in society might be questioned and ultimately changed.     

Doing Well by Returning to the Origin. Mission Drift,Outreach and Financial Performance of Microfinance Institutions

The majority of studies discussed the existence of a trade-off between financial performance and outreach, pointing out those MFIs that look for higher profits lead to lower outreach. Another stream of research discussed the phenomena of mission drift, which see MFIs leave from their social mission, which is to provide micro financial services to break the cycle of poverty by reducing financial exclusion and move away from the traditional microcredit business model by three different ways. The paper contribute to the debate focussing the impact of mission drift phenomena on both financial performance and outreach of MFIs. This paper uses a dataset of 194 microfinance institutions (MFIs), 788 annual ratings from 2001 to 2010, collected by MicroFinanza Rating, an international MFIs’ rating agency, to study and test three hypotheses on the relationship between mission drift, financial performance and outreach of MFIs. Data analysed with mixed effect regressions shows that a trade-off exist between financial performance and outreach. Results show that mission drift positively impacts on financial performance but it reduces outreach. MFIs should be encouraged to clearly define if their main aim is to assure remuneration of shareholders or if they want to contribute to the outreach of poor.     

Goffman's Interaction Order at the Margins: Stigma,Role, and Normalization in the Outreach Encounter

This article considers Goffman's conceptualization of interaction order at the margins of society in encounters between urban welfare workers and their clients. Observations from these encounters demonstrate practices relating to the situated management of stigma and identity, and the accomplishment of role within these service encounters. A reading of Goffman's theoretical contribution lies in revealing how social actors and social structures are realized in situ within the constraints of the interaction order sui generis. The article discusses three aspects of the outreach encounter, namely, (1) the accomplishment of role and motive, (2) the sequential phases of the outreach encounter, and (3) “the normalization ritual,” and introduces the concept of willful disattention.     

The Outposting Method of Community Services: A Multistaged Field Experience

Outposting is an interorganizational method of service delivery that requires an exchange relationship between an initiating agency and a host setting, for the benefit of third-party clients. This paper reports its experimental adoption as a graduate field training modality at a school of social work. Consideration is given to the contractual relationships among the parties, and to the learning objectives and outcomes. It focuses on problems of dual agency orientation and the integration of outposting with outreach and multiple advocacy. It confirms that outposting is a flexible service modality most appropriate in times of turbulence and social change.     

Outreach approaches in the private domain: an international study

The aim of this article is to present the results of an international study on outreach approaches in the private domain in social work with a focus on moral dilemmas. The reason to start the study was to investigate if a trend in Dutch social work toward outreach approaches can be recognized in other European countries and what can be learned from other outreach practices. First, a definition of outreach approaches in the private domain was discussed. Next, data were collected by interviews with social workers in four different countries, executed by social work students and researchers. Although no evidence was found that outreach approaches in other countries than the Netherlands are increasing, many similarities were found in social workers' interpretation of their outreach work. All the interviewees emphasized that outreach approaches are intended for excluded people who are at risk or a risk and who are not in contact with social services. All workers stress the importance of gaining trust and staying in touch. A dilemma is that workers often find themselves between two fires. They tend to give priority to the relation with the client and accept that this can contradict rules of organizations or society.     

Finding ways to the hard to reach—considerations on the content and concept of outreach work

In this article central elements and characteristics of outreach work are discussed. The empirical basis is documentation from five research circles conducted in Sweden, where outreach workers participated and put their work experiences into words. The findings from the circles are weighed against accounts from detached youth workers and it is argued that there are common methodological key components in outreach work that can be identified throughout the different contexts where the method is applied. The three main tasks of outreach work are contact making, initiating social change processes and providing social support to keep the process going. The efforts are performed in quite different surroundings, typically, however, in settings that the outreach worker does not organize or control. This has effects on how relations are built with target groups. Since outreach workers often meet people in vulnerable positions, engagement and respect are stressed as important professional qualities. Linking people to other resources is common and outreach workers need an extensive network of contacts to other organizations. The processes and situations that outreach workers engage in often have an open and unpredictable character. Managing contingency is therefore a central aspect of the work. Finally, a definition of outreach work is suggested.     

The Modern Poor: On the Sociological Position of Social-Aid Clients

Abstract

The social-aid institution has been analyzed almost exclusively from a social problems approach, aiming at the understanding of social aid clients as a social problem. This article views them from a different angle, as a sociological category occupying a unique position in society. Following Simmel, we deal here with those who are poor in a social sense, i.e., anyone receiving public assistance. It is the acceptance of social assistance which makes clients into a specific sociological stratum. The specific kinds of rules and roles involved in any society's public assistance system are thus seen to produce the sociological position of the clients. With goalmotivated assistance, clients tend to be by-passed. With relationship-motivated assistance, the increasing formalization of modern society has made clients and practioners equal in one important sense—both are subordinated to the same rules and regulations.     

The Convergence Between Outreach and Financial Performance in Mediterranean MFIs: A Panel Data Analysis

There is a long-standing debate on the relationship between outreach and financial performance in the microfinance institutions (MFIs). Although previous researches have reported contradictory results, many of these studies suffer from problems of misspecified model and/or restricted data. In this paper, we employ a static panel data analysis to empirically examine the impact of outreach on financial performance for a sample of 16 Mediterranean MFIs over the 2001–2008 period. Our evidence implies, first that the non-governmental organizations commercial viability increases with average loan size. Second, this commercial viability also increases with the number of outstanding loans per women. Finally, neither targeting the poor nor targeting women affect the repayment default.     

Considerations for the provision of prosthetic services in post-disaster contexts: the Haiti Amputee Coalition

Following the 2010 earthquake, Hôpital Albert Schweitzer and Hanger Prosthetics founded a prosthetics shop in rural Haiti. This research explored barriers to clients’ continued use of their limb, with the goal of improving programming and thus increasing rates of success. Methods used included ethnographic observation, semi-structured interviews and focus groups. The participants included retrospective and prospective prosthetic users as well as in-house clients. Data were collected from over 100 individuals. Despite gratitude for the services, many clients reported they did not utilize their limbs on a daily basis and provided insightful critiques to the programme and suggestions for improvement. Lack of clear communication with the clients was a major problem in the programme. Clients expressed gratitude for the sense of community within the programme but noted the lack of outreach after discharge. Other important concerns were programme sustainability and the provision of more holistic care for individuals with disabilities.     

Medication for Children with Attention-Deficit Hyperactivity Disorder

When making assessments and planning interventions, social workers adopt a biopsychosocial perspective. One important area where biologically based treatments influence psychosocial functioning is the area of psychopharmacology. However, even though many clients take medications, social workers often feel poorly prepared to address a subject that could be very important to their clients; that subject is the meaning of the medication to the client. The meanings that clients ascribe to medication can have a significant impact on medication adherence. Using attention-deficit/hyperactivity disorder (ADHD) to illustrate, I provide an overview of ADHD and common forms of treatment, discuss the possible meanings and acceptability of stimulant treatment for ADHD, provide practice guidelines for helping families reduce ambivalence about medication, present two clinical vignettes, and suggest resources for social workers and families.     

The impact of the economic crisis on the practice of social casework

ABSTRACT

What is the impact of the economic crisis on the practice of social casework? How is the economic crisis reflected in the professional practice, when social services have to cope with depletion as a result of an increasing attendance pressure? This study analyses the way in which social workers in community services face the understanding of the problem situation jointly with their clients. The aim is to uncover the items that professionals prioritize when they formulate and analyse the problem situation together with their clients. Data show that there is a discrepancy between the intervention criteria that have been considered important and their level of accomplishment. This difference points out that the understanding of the problem situation seems superficial, showing a low level of practice of the intervention criteria that assess the meanings which clients give to the incidents, strengths, solutions attempted, and larger systems involved. Data show that the implementation of fundamental analysis instruments is not sufficiently trusted and the use of the professional’s own knowledge is not regarded as important. This situation does not provide a context of intervention that is suitable and consistent with the problem situation and, consequently, the interventions for change will probably not match the clients’ needs.     

Working with African American clients: considering the "homeplace" in marriage and family therapy practices

In this article, we discuss perspectives on the "homeplace" that are important to consider in marriage and family therapy involving African American clients. The homeplace comprises individual and family processes that are anchored in a defined physical space that elicits feelings of empowerment, rootedness, ownership, safety, and renewal. Critical elements of the homeplace include social relationships that shape individuals' and families' sense of social and cultural identity. We draw on our ethnographic and clinical research with African American families in urban and rural settings to describe typical schisms between therapists and African American clients when communicating about the homeplace. We also explore the impact of homeplace disruptions on experiences of "yearning." Recommendations for integrating a homeplace perspective into therapy practices are provided.     

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.     

A trauma-informed social work framework for the abortion seeking experience

ABSTRACT

This purpose of this article is to discuss the abortion seeking experience in relation to stress, trauma, and trauma-informed care. Definitions of stress and trauma are provided, and potential points of stress during the abortion seeking experience will be discussed in the areas of unintended pregnancy, policy barriers, provider access, and the external clinic environment. Abortion stigma will also be discussed in relation to individual stigma, mass media stigma, community stigma, social work practitioner stigma, and the impact of stigma on the abortion seeking experience. Next, we discuss a trauma-informed lens for considering the abortion seeking experience in the United States, and a trauma-informed social work framework for interacting with clients during the abortion experience is presented as a practice approach for reducing and eliminating trauma and trauma triggers. We then present the potential benefits of this approach. The article concludes with some additional recommendations for a trauma-informed approach to aspects of social work advocacy.     

Counselors as Social Advocates

ABSTRACT

The authors discuss the importance of social advocacy and empowerment models in working with lesbian clients. They also explore the multiple contexts that impact lesbian clients and their families. A case illustration involving a lesbian client facing issues of internalized homophobia, heterosexism, sexism, and legal issues is presented. Suggestions for applying a feminist and social advocacy approach are offered.     

Protecting Clients From Harm: The Role of Continuing Professional Education

Abstract

In the absence of professional regulation and in the context of a changing and competitive environment, the Australian Association of Social Workers (AASW) encourages member commitment to self-regulation and continuing professional education (CPE). Continuing professional education is promoted as the platform upon which the credibility of the entire profession of social work and the maintenance of high-quality standards of practice rest. High practice standards are integral to the protection of vulnerable people from potential unethical, inappropriate and harmful practice. The present article asserts that Australia's changing and competitive environment, driven by prevailing ideologies and policies, has an impact on social work practice and is harmful to vulnerable clients. In order to protect vulnerable clients from harm and to maintain high standards of practice, the AASW's CPE programme arguably needs to include topics that enhance professional knowledge of current ideologies and policies and their impact on social work practice and clients.     

Reducing youth's drug abuse through training social workers for cognitive–behavioral integrated treatment

Cognitive–behavioral integrated treatment (CBIT) is an intervention that social workers can learn to treat youth's drug abuse by cognitive restructuring, behavioral modification, and goal setting. A way to enhance the learning is training specifically for CBIT. Evaluation of the effectiveness of such training in raising social workers' CBIT practice and their young service users' illicit-drug-free days is the aim of this experimental study. This study first randomly assigned 14 outreach social workers to receive training for CBIT and 14 outreach social workers not to receive the training. The study also assessed 222 young service users (aged 11–22 years) engaged by 28 outreach social workers before the training and 169 of them after the training in a six-month follow-up. Furthermore, the study identified the reduction in the youth's dysfunctional cognition of playfulness as a means to deter the youth's drug abuse, based on personal interviews with outreach social workers and their young service users before the training. Derived from the statistical analysis of assessment data, results principally showed cascading effects from the social worker's reception of the CBIT training to the young service user's reception of CBIT, reduced playfulness, and lengthened drug-free days. A supplementary finding was that the young service user's time in the outreach social work service prolonged drug-free days and reduced playfulness. These results imply that the outreach social work service, CBIT training, and CBIT are useful for treating youth's illicit drug abuse.     

What Money Cannot Buy: The Distinctive and Multidimensional Impact of Volunteers

Although it is assumed that volunteers make an extremely important contribution to organizations and the community, studies that examine their direct impact are scarce. Using quantitative and qualitative data collected from clients, volunteers and staff at the Philadelphia Ronald McDonald House, examined is the impact of volunteers on the organization, the clients and on themselves. Volunteers had a high direct and indirect impact on recipients, including on their attitudes toward volunteering and their future behavior. Volunteers gained intrinsic and extrinsic benefits and, as expected, their participation had a positive impact on the organization. The study contributes to the body of knowledge on social impact and volunteering.