人本疗法与认知行为疗法相结合的探讨——社会工作介入社交恐惧症的案例报告

社交恐惧心理障碍是青少年群体中较为常见的心理问题,它严重影响青少年的身心健康。本文通过一个典型案例对青少年群体的社交恐惧心理障碍进行社会工作介入：采用人本疗法与认知行为疗法相结合的方法,对案主的认知、行为和情绪等各个方面进行系统、全面的咨询与干预。从而帮助他们克服心理障碍,并取得较为满意的效果。     

Cognitive-Behavioural Social Work with Children

Correspondence to: Dr Tammie Ronen, The Bob Shapell School of Social Work, Tel-Aviv University, Ramat-Aviv, Tel-Aviv 69978, Israel Summary The paper aims to explore the complex and important links betweeninterventions with children, cognitive therapy, and social work.Although children comprise about half of the referrals to socialwork services, they do not generally receive direct treatmentin these settings. Social workers are involved with childrenin the roles of mediator or counsellor and as the supervisorwho is concerned with the placement of the child in appropriatesettings. When the need for direct therapeutic interventionarises, children are usually referred to educational or clinicalpsychologists. Social work as a profession has been foundedupon a psychodynamic approach; however, social workers havealways been concerned with effective treatments, the definitionof clear goals, and the clarification of client needs. Thesefeatures link social work to cognitive-behavioural therapy.Cognitive therapy, although not frequently used with children,is presented in this paper as a means for conducting directinterventions with children which fulfil social work's basictargets and needs.     

The client as learner and the clinician as teacher: Working with an educational lens

This article highlights the social worker's role as educator and how that role relates to clinical practice. The educational component of practice is not grounded in a substantial theoretical, research, or practice literature, and yet teaching is a nascent role for most clinicians. For the most part, the educational aspects of clinical practice have languished, at least from a theoretical perspective, in the shadow of therapy. In this paper we advocate for developing and articulating the clinician/teacher role in order to support effective use of the learning relationship as a dynamic and necessary means for assisting clients in managing life transitions, developmental challenges, and adversity. We propose the use of an educational lens derived from the fields of education, developmental psychology, and cognitive science, to provide perspective from which the client is viewed as learner, and the client‐work relationship is seen as an educational transaction. We highlight the transformative power of educational transactions that we think are as significant as primary caregiving, and also provide a working definition of education as it is used in clinical teaching‐learning relationships. And finally, we elaborate on the range of purposes education may serve in social work practice.     

Paternal domination: Its influence on child guidance results 1

Acknowledging the limitations of adhering to one particular theoretical orientation in helping clients with multiple issues, psychotherapy integration in treatment becomes a prominent trend in clinical practice. However, we have few guidelines for an integrated case formulation. Also, there have been some concerns that available treatment options limit and even pre-determine how clinicians understand and formulate cases. In order to address these concerns, this article first critically reviews the psychotherapy integration movement and highlights social work contributions to this movement. Next, using a clinical case example, we illustrate an integrated case formulation in clinical social work practice, which comprehensively assesses a client-in-context from psychodynamic, behavioral, and cognitive approaches. We also delineate how social workers can directly link this integrated assessment to selecting the integrated treatment options to custom-fit with the idiosyncratic needs of the client. This formulation is then truly client-centered. Thus, formulating a case is developing a theory of a client.     

Utilizing a Required Documentation Course to Improve the Recording Skills of Undergraduate Social Work Students

ABSTRACT

Baccalaureate social workers respond to documentation and record-keeping demands of regulatory organizations that oversee or fund social service agencies. Learning to accurately document client needs, progress, and service delivery outcomes is important in ensuring that clients are receiving effective services. Despite the importance of documentation skills, many undergraduate social work programs do not provide sufficient curriculum content on client record keeping. The authors report the results of a study that examined changes in baccalaureate social work students’ perceptions of their documentation skills after completing a required documentation course. The sample size included 101 students at pretest and 97 students completing the post-test. Statistically significant findings show students perceived an increase in knowledge in three areas of documentation: 1) formats, 2) content, and 3) writing skills. The authors discuss implications for social work education and practice.     

Cognitive Mechanisms of Ingroup/Outgroup Distinction

People use social categories to perceive and interact with the social world. Different categorizations often share similar cognitive, affective and behavioral features. This leads to a hypothesis of the common representational forms of social categorization. Studies in social categorization often use the terms “ingroup” and “outgroup” without clear conceptualization of the terms. I argue that the ingroup/outgroup distinction should be treated as an elementary relational ego‐centric form of social categorization based on specific cognitive mechanisms. Such an abstract relational form should produce specific effects irrespective of the nature of a particular social category. The article discusses theoretical grounds for this hypothesis as well as empirical evidence from behavioral and brain research. It is argued that what is commonly termed as “ingroup” and “outgroup” can be produced by distinct cognitive operations based on similarity assessment and coalitional computation.     

Current practices in intake and service in family welfare organizations 1 : A study of the experience of eight agencies in 1934–35

Autism spectrum disorders include difficulties with social interaction, repetitive behavior, sensory sensitivity, and, often, concomitant language deficits. Psychodynamic theory is a powerful tool in explaining and treating the behavioral symptoms of autism. Specifically, the object relations theories of Melanie Klein and Wilfred Bion explicate the meanings and developmental challenges associated with autism. The epistemology of heuristics, with the use of triangulation, supports psychodynamic theory as one of multiple ways of interpreting phenomena. In this particular situation, the symptoms and presenting issues associated with autism evident in this composite clinical case are drawn from one of the author’s practice. This report illustrates the use of psychodynamic formulations and treatment in the psychotherapeutic work with a 12-year-old boy diagnosed with autism whom we call Austin.     

Effects of the war on marriage relationships 1

Abstract

This article discusses the major themes that emerged from a Smith College School for Social Work student's Master's thesis, “Communication Styles in Wind River Native American Clients and the Therapeutic Responses of their Clinicians”. The project explores differences in communication styles between Wind River native people and Anglo‐Americans. Secondly, it seeks to discover therapeutic approaches and styles that are effective with Wind River native people.

Semi‐structured, exploratory interviews were conducted with ten clinicians who worked with Native American clients on the Wind River Reservation in Wyoming. The participants included mental health care professionals and paraprofessionals from the following professions: psychology, social work, counseling, nursing, and community action.

The findings of the research revealed the importance of understanding cultural differences in human interaction and meaning making as conveyed in communication style. As clinicians, these complex and often subtle differences play a crucial role in our ability to establish a therapeutic alliance and conduct sensitive, effective therapy. Many theoretical models, such as psychodynamic, cognitive and behavioral, family systems, ecological, constructionist, and narrative theories support the successful approaches discussed in the article.     

Modeling Contextual Effects in Developmental Research: Linking Theory and Method in the Study of Social Development

This special section was inspired by the recent increased interest and methodological advances in the assessment of context‐specificity in child and adolescent social development. While the effects of groups, situations, and social relationships on cognitive, affective and behavioral development have long been acknowledged in theoretical discussions of social development, empirical research has largely relied on the assessment of individual differences rather than contextual differences in these processes—perhaps due to the fact that advanced data analytic techniques are required to access contextual dependencies in such data. While still developing, best practice data analytic techniques enable us to access the ‘social’ of social development in more precision today than ever before. In this special section we examine three of these techniques through the work of our invited authors.     

Social Workers' Implementation of Client Participation: What Factors Make the Difference?

ABSTRACT

Client participation is both a value and a strategy in social work, involving clients in decisions influencing their lives. Nevertheless, the factors encouraging its use by social workers in social services have received little research attention. This article reports on a study drawing on Goal Commitment Theory to examine, for the first time, four categories of variables that might predict its implementation: background variables (intervention method, age, experience, education, supervision); personal resources (self-esteem, mastery); organizational variables (superiors' support, organizational commitment); and situational factors (previous client participation, perception of client participation).

A sample of 661 Israeli social workers completed questionnaires. Hierarchical regression analysis and t-tests revealed that intervention method, mastery, superiors' support, and both situational variables contributed significantly to explaining the variance in client participation. Moreover, social workers valued client participation significantly more than they used it. The implications for researchers and professionals in social services are discussed. Proper training could increase social workers' awareness of client participation and provide tools for implementation. Policy makers should set standards for its use and evaluation, and require its inclusion in all interventions. Further research investigating clients and managers of social services could provide a broader picture of the factors impacting client participation.     

The Influence of Client Age on Clinical Judgements of Male and Female Social Workers

Social workers were presented with a clinical vignette in which client age was systematically varied. There were no differences in ratings of older and younger clients on prognosis or pathnology. The older client was not seen as less ideal or more organically impaired, and treatment recommendations did not differ. However, female social workers attached significantly less importance to psychodynamic issues for the older client than the younger.     

Assessing families and other client systems in community-based programmes: development of the CALF

Programmes providing services to children and families often face the challenge of assessing not only the child referred, but also the child’s family system and its individual members. Recognizing that household/family members can cause, contribute to or affect a child’s problems requires that human service agencies utilize assessment tools capable of assessing family members across the lifespan. The literature references many assessment tools used by clinical programmes in mental‐health settings that are not well suited to use in social service agencies with multidisciplinary staff at different skill levels. As a response to this dilemma, the authors have developed the Collaborative Assessment of Life Functioning (CALF), a user‐friendly tool that assesses various areas of life functioning. Based on Maslow’s motivation theory, person‐in‐environment and systems theories, the CALF can be used with various client systems. This paper describes the development of the tool, its purpose and use, the importance of assessment tools in the helping process and considerations for agencies wishing to use an assessment tool like the CALF. The authors also discuss the applicability of the CALF in human services and social service agency settings and with diverse client populations.     

Practices of activation in frontline interactions: Coercion,persuasion, and the role of trust in activation policies in Germany

Following Michael Lipsky's well‐known argument that policy is made in the daily encounters between street‐level bureaucracy and citizens, a growing body of research emphasizes that actors and organizations delivering social and labor‐market policy play a crucial role in welfare‐state politics. Using qualitative data collected at three local employment agencies in Germany, this article explores worker‐client relations as a crucial mechanism through which activation policies are translated into practice. The analysis investigates how caseworkers define their role and their relationships with clients. The findings show that it is essential for caseworkers to achieve client compliance. In such a context, building relationships of trust is a strategic instrument in overcoming possible barriers to co‐operation in the caseworker‐client interaction. Caseworkers develop strategies to create the impression of trustworthiness and to motivate both unemployed clients and employers to become trust‐givers in the caseworker‐client relation. While research has often stressed the dichotomy between disciplining and enabling elements of activation policies, our explorative study shows that persuasion and trust‐building are a further important dimension of the frontline delivery of activation policies. These strategies reflect the importance of emotional aspects of frontline work.     

Client Violence Against Social Workers at Homeless Assistance Organizations in South Korea

This study examined the essence of client violence that social workers encounter at homeless assistance organizations in South Korea. Based on 149 self‐administered questionnaires in 29 homeless assistance organizations in Seoul metropolitan areas, the study verified that client violence against social workers was prevalent. More than 70% of respondents experienced physical violence from their clients; 78.5% reported emotional violence; 53% reported property damage. This study also found that client violence emerged differently according to gender and types of agencies in the field. The results suggested that effective prevention strategies against client violence should be encouraged to maintain valuable human resources and to create a safe workplace in the field of social work.     

Social Workers Talking to Clients: A Comment

Summary I read Baldock and Prior's article with interest in view ofthe shortage of studies examining day-to-day practice in socialwork, but the authors' analysis leaves me reflecting uneasilyupon the state of uncertainty into which social work has fallen.The authors conclude by describing as ‘skilled’,practices which they say resulted in confusion for clients andwhich only apparently reflected social work principles. We arenot told whether the authors checked their analysis with workersor clients and it is possible that the clients were not as confusedas we are led to believe, given their long term contact withthe workers. If, however, the picture is an accurate one, shouldit really be described as representing skilled social work?Baldock and Prior do so but neglect to examine the ends towardswhich interviewing skill should be directed in social work.The result is a strangely ambiguous statement about practice,particularly in the light of research findings on effectivenessand client satisfaction, and one which offers little scope forcomplacency.     

Open Records: The Client's Right to Partnership

Summary Many Social Services Departments have opened their files totheir clients or intend to do so. This reflects the incomingtide of concern about citizens' rights and client participation,but what effect might the opening of records have on the practiceof social work? The paper summarizes the findings of a small scale study inwhich a team of social workers opened their case recording toa selected number of clients. The workers’ and clients‘views of this process are described, along with the implicationsfor practice. The study suggests that a focus on shared recordingcan begin to alter the kind of work done by the social worker,helping to promote a partnership between the worker and theclient. Finally, the paper argues that a policy of client access enforcedonly as a right is prone to sabotage or a fall into disuse.A seven point training programme is outlined in order to helpsocial workers use Open Records as an opportunity to promotea partnership in their work with clients.     

A STUDY OF SOCIAL WORK PRACTICE WITH GROUPS

This paper presents the second stage of a study on group use in social work in Quebec. The first stage had identified 72 practitioners working with 130 client groups, and 60 of these workers participated in the second stage interview. The interview explored characteristics of social work practice with groups, and studied personal and organizational factors which may influence group use. The findings suggest group use in social work is characterized by a diversity of group goals, client populations and service settings. Most groups are small units formed by the worker. and their membership is closed during the duration of the group which is usually from 8 to 15 meetings. Structure varies, but most groups base program on discussion or structured exercises, and most workers assume a facilitator or therapist role. Despite these commonalities, there appear to be several distinct styles of practice which vary according to type of group goal, role of worker, and theoretical influences on the worker. These styles vary especially in the extent to which the worker takes a central leadership position or shares group tasks with members.     

Empowerment in social work practice with the psychiatrically disabled: Model and method

Empowerment of those clients disempowered by society is explored as both a philosophy to inform social work practice and as a continuing method of practice in itself. A three‐part model of empowerment at individual, interpersonal, and group levels is presented and is then illustrated by application to a case study of psychiatric disability. The generalist model of practice is seen as particularly suited to empowerment. New directions in serving mental health consumers are discussed, including participatory action research, the disability paradigm, and consciousness‐raising in relation to economic oppression. Egalitarian partnership between worker and client is seen as the future of social work practice.     

Playing with sound: The therapeutic use of music in direct work with children

Children rarely have the language or the cognitive development to process and convey their experiences solely through words, so spontaneously complement these with symbolic forms of expression and communication, such as play, metaphor and a variety of visual, auditory and kinaesthetic imagery. Consequently, social workers need to supplement verbal methods of assessment and intervention with more symbolic modes of communication and engagement when working directly with children. The play therapy literature has been a key source of guidance and the expressive arts therapies, such as art and drama therapy, are now well represented in the literature and training of social workers in ‘direct work with children’. However, principles and practice from music therapy are under‐represented. The writer, who is a social worker, psychotherapist and musician, shares her reflections on introducing techniques and theoretical approaches from music therapy into her own therapeutically orientated direct work. Suggestions are made as to how other practitioners (both musically trained and not) could develop the use of music as a further ‘tool’ in their direct work with children.