SOCIAL CASE WORK

DEPARTMENT OF SOCIAL WORKMANUU.

MOHAMMAD HABEEBROLL No. A165089

PART A characteristics and definitions of Social Case Work:-

Social Case Work:

Social Case Work, a primary method of social work, is concerned with the adjustment and

development of individual towards more satisfying human relations. Better family life, improved

schools, better housing, more hospitals and medical care facilities, protected economic

conditions and better relations between religious groups help the individual in his adjustment and

development. But his adjustment and development depend on the use of these resources by him.

Sometimes due to certain factors, internal or external, he fails to avail existing facilities. In such

situations, social caseworker helps him. Thus, social casework is one to one relationship, which

works in helping the individual for his adjustment and development. Every individual reacts

differently to his social, economic and physical environments and as such problems of one

individual are different from those of another. The practice of casework is a humanistic attempt

for helping people who have difficulty in coping with the problems of daily living. Its one of the

direct methods of social work which uses the case-by-case approach for dealing with individuals

or families as regards their problems of social functioning. Case work, aims at individualized

services in the field of social work in order to help the client toad just with the environments.

Definitions of Social Case Work:

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Mary Richmond (1915)

“Social Case Work may be defined as the Art of doing different things with different people, co-

operating with them to achieve some of  their own & society’s betterment.” 

Mary Richmond (1917)

Social case work is the art of bringing about better adjustments in the social relationship of

individual men or women or children

Mary Richmond (1922)

Social case work means, „those processes which develop personality through adjustment

consciously affected, individual by individual, between men and their social environment‟Jarrett (1919)

Social case work is “the art of bringing an individual who is in a condition of social disorder into

the best possible relation with all parts of his environment.

Taft (1920)

Social case work means “social treatment of a maladjusted individual involving an attempt to

understand his personality, behavior and social relationships and to assist him in working out

better social and personal adjustment”.

Watson (1922)

Social Case Work is the art of untangling and restructuring the twisted personality in such a

manner that the individual can adjust himself to his environment

Queen (1932)

Social case work is the art “of adjusting personal relationship”.

Lee (1923)

Social case work is the art of changing human attitudes”

Taylor (1926)

Social case work is a process concerned with the understanding of individuals as whole

personalities and with the adjustments of these to socially healthy lives

Reynolds (1935)

Social case work is the processes of counseling with a client on a problem which are essentially

his own, involving some difficulty in his social relationship.

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Reynolds (1935)

Social case work is that form of social work which assists the individual which he suggests to

relate himself to his family, his natural group , his community

Klein (1938)

Social case work is a technical method in social work…. A way of adjusting to the client to his

personal problems.

Swift (1939)

Social case work is the art of assisting the individual in developing and making use of  his

personal capacity to deal with problems which he faces in his life.

DeSchweiinitz (1939)

Case work means those processes involved in giving service, financial assistance, or personal

counsel to individuals by the representatives of social agencies, according to polices established

and with consideration of individual need.

Strode (1948)

Social case work is the process of assisting the individual to best possible social adjustment

through the use of social case study, social resources and knowledge from relative fields of

learning.

Towle (1947)

Social case work is one method ….by which certain social services are made available in areas

of unmet needs.

Objectives of Social Case Work: To make good rapport with the common people 

To find-out, understand & solve the internal problems of an individual

To strengthen ones ego power 

To prevent problem

To develop internal resources

Nature & Characteristics of Case Work:

Relationship arise out of shared & emotionally charged situation

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Relationship contains elements of acceptance, expectation, support & stimulation

Client & case worker are interdependent

Case work relationship may have several therapeutic values

Improvement of condition

More adjustment within the society 

Development of personality

Capacity building

Relationship needs outside help

Case worker too has relationship reactions and part of  one’s professional skills in their

management

Relationship in Case Work Client:

Case Worker Relationship

The term relationship in social case work was used forth first time by Miss. Virgini a Robinson

in her book “A changing psychology in Social Case Work” in 1939.

Relationship is the channel through which the mobilization of the capacities of the client

is madepossible.

Relationship is the medium through which the client is enabled to state his problem and

through which attention can be focused on reality problems, which may be as full of

internal conflict with emotional problems.

Relationship is the professional meeting of two persons for the purpose of assisting one

of them, the client, to make a better, a more acceptable adjustment to personal problem.

Professional relationship involves a mutual process of 

shared responsibilities,

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recognition, of other‟s rights,

acceptance of difference to stimulate growth

interaction by creating socialized attitudes and behavior.

PART B

Components of Case Work  

I- Person:-

The person’s behavior has this purpose and meaning: to gain satisfactions, to avoid or

dissolve frustration and to maintain his balance-in-movement.

Whether a person’s behavior is or is not effective in promoting his well-being depends in

large part upon the functioning of his personality structure.

The structure and functioning of personality are the products of inherited and

constitutional equipment in continuous interaction with the physical, psychological and

social environment the person experiences.

A person at any stage of his life not only is a product of nature and nurture but is also and

always in process of being in the present and becoming in the future.

The person’s being and becoming behavior is both shaped and judged by the expectations

he and his culture have invested in the social role

 The person who comes as a client to a social agency is always under stress. To understand

human behavior and individual difference, Grace Mathew has given the following propositions:

1. An individual’s behavior is conditioned by his/her environment and his/her experiences.

Behavior refers to reacting, feeling, thinking, etc. the conditions and influences surrounding the

person constitutes the environment.

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2. For human growth and development it is essential that certain basic needs should be

met. (Maslow’s hierarchy of needs)

 3. Emotional needs are real and they cannot be met or removed through intellectual reasoning.

4. Behaviour is purposeful and is in response to the individual’s physical and emotional needs.

5. Other people’s behavior can be understood only in terms of ones own emotional and

intellectual comprehension.

PERSON II –Problem:- The problems within the purview of social casework are those which vitally affect or are affected

by a person’s social functioning. The multifaceted and dynamic nature of the client’s problem

makes necessary the selection by caseworker and client some part of it as the unit for work. The

choice of problem depends on

(1) whether the problem is the client’s problem

(2) leadership given by case worker depends upon the professional knowledge and judgment

(3) agency’s function e.g. hospital, etc.

Problems in any part of a human being’s living tend to have chain reactions. ….

cause > effect > cause.

Any problem which a person encounters has both an objective and subjective significance

quality and intensity of our feelings.

Not only do the external (objective) and internal (subjective) aspects of the problem co-

exist, but either may be the cause of the other.

Whatever the nature of the problem the person brings to social agency; it is always

accompanied and often complicated by the problem of being a client.

Problems can be categorized as follows (Grace Mathew):

1. Problems related to illness and disabilities

2. Problems due to lack of material resources.

3. School related problems.

4. Problems related to institutionalization.

5. Behaviour problems.

6. Problems of marital discord.

7. Problem situations needing a follow-up service.

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8. Needs related to rehabilitation of people.

9. Clients caught up in social problems like gambling, prostitution, alcoholism, drug addiction

and unmarried motherhood.

Problem 

III -Place:-

The social agency is an organization fashioned to express the will of a society or of some

group in that society as to social welfare community decides the need of the agency.

Each social agency develops a program by which to meet the particular areas of need

with which it sets out to deal. It depends on factors like money, knowledge and

competence of the agency staff, the interest, resources available and support of the

community.

The social agency has a structure by which it organizes and delegates its responsibilities

and tasks, and governing policies and procedures Hierarchy roles and responsibilities

clear, designated and delegated collaboration procedures and policies, understand the

usefulness. by which it stabilizes and systematizes its operations. among workers.

The social agency is a living, adaptable organism susceptible to being understood and

changed, much as other living organisms.

Past, present and future not static and fixed.

Every staff member in an agency speaks and acts for some part of the agency’s function,

and the case worker represents the agency in its individualized problem solving help.

 Case worker not an independent professional practitioner

case worker speaks and acts for the agency psychologically identified with its purpose

and policies.

The case worker while representing his agency is first and foremost a representative

of his profession must know and be committed with feeling to the philosophy that guides

the practice of the social work profession.

Agency Private e.g. funding agencies and Public e.g. family welfare orgs.

Primary e.g. NGO and Secondary e.g. Hospitals, schools, etc

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Based on functions

child welfare, family welfare, education, specialization based.

Also differs based on Source of support, Professional authority, Clientele they serve,Services

they offer, Goals of the agency, etc.

IV- Process:-In order to understand what the case work process must include in its problem-solving help, it is

necessary to take stock first of the kinds of blockings which occur in people’s normal problem-

solving efforts. The six are:

1. If necessary tangible means and resources are not available to the person.

2. Out of ignorance or misapprehension about the facts of the problem or the facts of existing

ways of meeting it.

3. If the person is depleted or drained of emotional or physical energy.

4. Some problems arouse high feelings in a person emotions so strong that they overpower his

reason and identfy his conscious controls.

5. Problem may lie within the person; he may have become subject to, or victim of, emotions that

chronically, over a long time, have governed his thinking and action.

6. Haven’t developed systematic habits or orderly method of things and planning.

The intent of the case work process is to engage the person himself both in working on and

coping with the one or several problems that confront him and to do so by such means as may

stand him in good stead as he goes forward in living.

The means are

1. The provision of a therapeutic relationship

2. The provision of a systematic and flexible way

3. Provision of such opportunities and aids.

All competent problem-solving, as contrasted with trail-and-error method, contains three

essential operations. Urgent pressures will often dislodge their sequence, botany conscious effort

to move from quandary (difficulty) to solution must involve these modes of action:

1. Study (fact-finding)

2. Diagnosis (thinking about and organizing facts into a meaningful goal-pointed explanation)

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3. Treatment (implementation of conclusions as to what and how of action upon the problem).

 

Finally, for the solution or mitigation of many problems there must exist certain material means

or accessible opportunities which are available to the needful person and which he can be helped

to use. Kinds of resources that a person may need are money, medical care, nursery schools,

scholarships, foster homes, recreation facilities, etc.

PART C

Stages in Case Work:

Different stages in case work process are:

Case study /Social Investigation / Psycho Social Study

Social Diagnosis

Social Treatment

Social Case History: The first step in the case work is to collect the social history of the client. This could be done in

various ways. These are: 

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Interview with the client

Interview with the relatives, employer, teacher and friends of the client.

Visiting the neighborhood and environment in which the client lives.

All these visits will help the worker to know the client in his environment and collect all the data

in respect of the client and his environment i.e. his family, neighborhood, friendship circle,

employer, teacher, etc. as a matter of fact it is not possible to separate the three stages of case

work service i.e. social history, diagnosis and treatment. During the course of interview, the

worker may be able to diagnose and even suggest treatment to the client but where the problem

is very acute; it isnecessary to consider the diagnosis in relation this own history.

Social Diagnosis:- Social diagnosis is an attempt to arrive at an exact definition as possible of the social situation

and personality of a given client. It is a search for theca uses of the problem which brings the

client to the worker for help. Diagnosis, is therefore, is concerned with understanding both the

psychological or personality factors which bear a casual relationship to the client’s difficulty and

the social or environmental factors which tend to sustain it.

Social treatment:-Social treatment in case work is the sum total of all activities and services directed towards

helping the client with a problem. The focus into relieve the immediate problem and if feasible

modify any basic difficulties which precipitated it. Strictly speaking, everything that has been

discussed so far is part of treatment.

 

Generally, two types of efforts are required for social adjustment environmental modification

and or change in behavior modification. Early case work treatment was placed on modification

through the environment. Later on the development of ego psychology helped social case

workers to use intensive and direct treatment technique

Objectives of Case Work Treatment: 

To prevent social breakdown .

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To conserve client’s strength .

To restore social functioning. 

To provide positive reinforcements.

To create opportunities for growth and development. 

To compensate psychological damage. 

To increase capacity of self direction. 

To increase his social contribution.

Methods of social case work treatment. Administration of Practical Services.

Indirect Treatment (Environmental Manipulation)

Direct Treatment

Providing help to the client to choose and use the social resources afforded by the community.

Money, medical care, legal aid, helping to get job or admission in educational institutions, aged

homes, foster homes, recreational facilities are such type of services that any person in problem

may need in order to resolve a given problem in his daily living Environmental manipulation

means changing the social conditions of the client so that he/she may be relieved from excessive

stresses and strains. For example attempts to change the attitude of the parents, teachers, spouse,

employer, friends and relatives, training and employment for livelihood, group experience in

accordance with the needs of the client. Environmental modification is undertaken by the case

worker only when environmental pressures upon the client are beyond the client’s control but

can be modified by the case worker In this the case worker exerts influence directly on the client.

It is used when the client needs direction because of his ignorance, anxiety and weakness of his

ego strength. Direct treatment is given through counseling, therapeutic interviewing, clarification

and interpretation leading to an insight.

 

Social Treatment Social treatment in case work is the sum total of all activities and services directed towards

helping the client with a problem. The focus is to relieve the immediate problem and if

feasiblemodify any basic difficulties which precipitated it. Strictly speaking, everything that has

beendiscussed so far is part of treatment.

 

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Generally, two types of efforts are required for social adjustment environmental modification

and or change in behavior modification. Early case work treatment was placed on modification

through the environment. Later on the development of ego psychology helped social case

workers to use intensive and direct treatment techniques. The interviews in all these process are

every important and unless the interviews are conducted properly, it is not possible to expect

results. The case worker has, therefore, not only to understand the theory of interview but also

have sufficient training and experience in interviewing, if he/she wants to be successful in

providing service to the client.

Interviewing in Casework  

By interviewing, we mean a meeting or conference (may be formal or informal) between two or

more persons for specific purpose. It is an art which is used in every situation for better

understanding and better relationships between the interviewer and the interview. Interviewing is

the foundation on which theory and practice of social case work is based because without

interview, the worker cannot get all the possible information about the client nor can the client

gain any confidence in the worker. The purpose of an interview is, therefore:  

o To obtain knowledge of the situation. 

o To understand another person.

o To make the person understand you.

PART D

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Case Work Process:Casework process has four different stages, namely, 

Social study

Social diagnosis

Casework treatment

Evaluation.

Conceptually, they are different and separate stages but they do not make a neat progression

always with one stage following the other in sequence. Sometimes, two or more stages proceed

simultaneously. Diagnosis may also change with the gathering of more data about the situation

or with change staking place in the situation itself. Casework help can not be postponed till the

completion of the social study or of the formulation of a social diagnosis. Some kind of help may

have to be rendered even at the first worker-client contact. The skilful way the case worker

conducts the interview may be of help to the client in terms of the concern, hope, warmth and

interest conveyed to the client, which in turn start a process, sooner or later, within him

activating him to mobilize his inner resources for problem solving. In casework intervention the

individual client is not considered in isolation from the family, but as a part of the family, since

the family forms the most important human environment for the client with its network of

emotional relationships. Therefore, other members of the family are also involved in the

casework process. Also, home visits are made by the caseworker to get an understanding of the

environment as for other reasons.

Process of Social Case Work:

I. Intake (First Interview) Rapport Building

 

Client comes to an agency for professional help through a Case worker.

Relationship between two persons of unequal positions and power is developed.

Accept client as a person in a stressful situation

Respect the client’s personality and help him resolve.

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The areas for probing are:

 1. The stage of the problem at which the person, through whom, and the reasons becauseof

which, comes to this agency.

2. The nature of request and its relation to his problem, and the cause of his problem, asthe client

see.

3. Does the request relate directly to his needs/ problems?

4. His adjustment to his social functions in job, family, etc.

5. The state of his physical and mental health.

6. His appearance including dress, etc. in his first meeting.

7. His personal and social resources including material and financial position.

8. Appropriateness and intensity of feelings.

9. Nature of defense mechanisms he frequently uses.

10. Level of motivation, how quickly he wants to get rid of his problems.

11. Nature of family, its status, values, relationship pattern within the family, etc.

12. Reactions to the worker and seeking help from the agency and sex of caseworker who will be

suitable to help the person.

II. Psycho-Social study (Exploration / Investigation):

“Psycho –  Social study is the initial assessment of client’s current, relevant past and possible

future modes of adaptation to stressful situations and normal living situations.”

Perlman has given the following contents of the case work study

1. The nature of the presenting problem

2. The significance of the problem.

3. The cause(s), onset and precipitants of the problem.

4. The efforts made to cope with problem-solving.

5. The nature of the solution or ends sought from the case work agency.

6. The actual nature of the agency and its problem solving means in relation to the client and his

problem.

Tools of study

The tools used by the case worker for collecting the relevant information are:

1. Interview guide and schedule.

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2. Life chart.

3. Video recording of family interaction.

4. Tape recorded interview.

The Format of Interview Schedule

1. History of the problem.

2.Personal history.

3. Family history.

4. Problematic areas.

5. Treatment Plan

 IIII. Psycho - Social diagnosis (Assessment):

 According to Perlman (1957)

 

“Diagnosis helps in determining the focus of treatment, further collection of facts and

deciding the best course of action to solve the problem.” 

“Social diagnosis is the attempt to arrive at an exact definition as possible of the social

situation and personality of a given client.” 

“Diagnosis is concerned with understanding both the psychological or personality factors

which bear a causal relation to the client’s difficulty and the social or environmental

factors which tend to sustain it.” 

“Diagnosis may be viewed as the fluid, constantly changing assessment of the client,

theirproblems, life situations and important relationships.” 

 

Content of the Social Diagnosis:

1. The nature of the problem brought and the goals sought by the client, in their relationship to.

2. The nature of the person who bears the problem and who seeks or needs help with the

problem, in relation to.

3. The nature and purpose of the agency and the kind of help it can offer and/ or make available.

Process of making diagnosis 

Shifting the relevant from irrelevant data 

Organizing the facts and getting them into relatedness

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Grasping the way in which the factors fit together

Preparing the meaning as a whole.

Data for Diagnosis

1. Interviews

2. Checklist and Inventories

3. Direct Observation

Steps in Diagnosis

1. The worker begins to focus on problematic behaviors. Both functional and dysfunctional

behaviors in the client’s environment are surveyed. The client’s personal strength as well as of 

his environment are evaluated.

2. He specifies the target behaviors. Break down complex behaviors into clear and precise

component parts.

3. Baseline data are collected to specify those events that appear to be currently controlling the

problematic behaviors.

4. The collected information is summarized in an attempt to anticipate any major problem in

treatment and as a way of beginning to establish objectives for treatment.

5. Selecting priorities for treatment is the final step of the diagnosis. 

III

Types of diagnosis

1. Clinical 

The person is described bythe nature of the illness.E.g. schizophrenia, psychopath,

typhoid, etc.

Used in medical practice.

Use is minimum in casework practice. - Importance in medical and psychiatry.

2. Etiological 

Tries to delineate the causes and development of presenting difficulty. 

History of the person.

3. Dynamic 

Proper evaluation of  the client’s current  problem as he is experiencing it now.

Role of psychological, biological, social and environmental factors in the causation of the

problem.

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No attempt to dig life history.

Case worker and client engage inappropriate corrective action or treatment.

These developments may lead to modifications in the goals for treatment

IV. Intervention / Treatment (Problem-solving process):According to Hamilton-“Treatment is the sum total of all activities and service directed towards helping an individual

with a problem. The focus is relieving of the immediate problem and, if feasible, modifies any

basic difficulties which precipitated it.”

 

The objectives of Social case work treatment

1. To prevent social breakdown.

2. To conserve client’s strength.

 3. To restore social functioning.

4. To provide happy experiences to the client.

5. To create opportunities for growth and development

6. To compensate psychological damage.

7. To increase capacity for self-direction.

8. To increase his social contribution.

Methods of Social treatment

 

1.Administration of concrete and practical services.

E.g. money, medical care, scholarships, legal aid, etc.

2.Indirect treatment (modification of environment, both physical and social).

 E.g. camps, group experience activities, training programmes, etc.

3.Direct treatment

A. Counseling

marriage, occupational, family, school, etc.

B. Therapeutic Interviewing

family and marital therapy.

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C. Clarification

D. Interpretation and Insight

E. Psychological support.

F. Resource utilization

G. Environment modification.

Intervention / Treatment (Problem-solving process)

 V

V. Monitoring and Evaluation:

Monitoring provides crucial feedback to case worker and the client regarding

1. Whether the treatment program is succeeding as desired

2. Whether established goals have been achieved

3. Whether modifications in the program are necessary

4. Whether the client is being helped in real sense.

Importance of  Monitoring and Evaluation

The purpose of Evaluation is to see if the efforts of the case worker are yielding any

result or not, if the techniques used are serving the purpose, and if the goals are being

achieved.

Evaluation is the process of attaching a value to the social work practice. It is the method

of knowing what the outcomes are.

It is a continuous process.

Evaluation of the approach used and result should be taken up with the client so that the

efforts are meaningfully utilized.

Evaluation will further strengthen the relationship between the caseworker and client and

motivate the client to work towards his goal.

Casework practices need to be evaluated from time to time. The subject needs to be tested

and researched and most importantly needs ongoing validation. They need tobe proved to

the public that they are effective and beneficial to the clients.

Casework practice should be subjected to critical review. Workers need to be held

accountable for what they do and for their social work competence. Workers need to win

approval for their programs.

They may sometimes have to be told that their services are overlapping and ineffective.

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Workers have to enhance their own image and also of the agency to develop public

relations. The clients need to give a feedback on the effectiveness of the services.

VI. Follow-up and Termination

At the end, i.e. termination, the worker should discuss the original as well as revised

goals and objectives, achievements during the helping period, factors helpful or

obstructive in achieving the objectives, and the efforts needed to maintain the level of

achievement and the feelings aroused by disengagement.

It is neither wise nor necessary for the termination to be an abrupt one.

It is best to discuss termination and its ramifications (implications) several times before

the final interview.

The frequency and amount of contacts should be gradually decreased.

Termination of the helping process brings up in both the case worker and client(s) many

feelings both positive and negative which must be verbalized and discussed.

Follow-up is done to help client maintain the improvement.

During follow-up, the client is helped to discuss the problems he faces in maintaining the

improvement.

Work is done with the people significant for his improved social functioning.

If required, he is referred to the proper source for needed services and help.

The follow-up should be planned on a diminishing basis after two weeks, then a month,

then three months, six months and a year following the termination of the formal

program.VI

In InSocial Case Work Proce

In short

The case work process consists of:

Intake (FirstInterview)Rapport Building  Psycho-Socialstudy exploration/ Investigation) 

Psycho - Social diagnosis (Assessment)

Treatment (Problem-solving process

Follow-up and Termination 

The components of social casework are:

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The Person

The Problem

The Place

The Process

The worker – client relationship

The Problem solving work

PART Eapproaches in Social Case Work.

Casework: A Psychosocial Therapy

Known in academic circles as the 'bible' for clinical practitioners of social work, Casework: A

Psychosocial Therapy introduces readers to the basic theory and principles in the practice of

psychosocial therapy, along with attention to the historical development of the approach as it

has been enriched and expanded over the years. The authors' approach reflects a balanced focus

on people, their environment, and the ways in which people interact with their environment.

Essential techniques including how to conduct initial interviews with clients, crisis

intervention, arriving at assessments, and choosing appropriate treatment, are thoroughly

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explained, and often clarified with case studies and vignettes, preparing readers to assess social

work clients from a variety of perspectives. The book is designed for the graduate-level student

who needs to master the principles, theories, and approaches of the psychosocial approach to

applied practice, but it may also be used to fit a variety of courses, including the Introduction to

Social Work BSW student who is looking for supplemental information on the basics of

clinical practice. Now in its fifth edition, Casework has been thoroughly revised to keep

discussions clear and up to date. New material has been added throughout, including a greater

variety of case studies, discussions about current topics such as the influence of ethnicity and

diversity in the social work practice, changes in family life roles, changes in ideas and practice

approaches, and a significantly updated bibliography for reference.

Functional Approach

Structural functionalism is a broad perspective in sociology and anthropology which sets out to

interpret society as a structure with interrelated parts. Functionalism addresses society as a whole

in terms of the function of its constituent elements; namely norms, customs, traditions and

institutions. A common analogy, popularized by Herbert Spencer, presents these parts of society

as "organs" that work toward the proper functioning of the "body" as a whole.[1] In the most basic

terms, it simply emphasizes "the effort to impute, as rigorously as possible, to each feature,

custom, or practice, its effect on the functioning of a supposedly stable, cohesive system." For

Talcott Parsons, "structural-functionalism" came to describe a particular stage in the

methodological development of social science, rather than a specific school of thought.[2][3]

Parsons called his own theory for action theory and argued again and again that the term

structural-functionalism was a misleading and inappropriate label to use as a name of his theory.

THEORY

Classical functionalist theories are defined by a tendency towards biological analogy and notions

of social evolutionism:

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Functionalist thought, from Comte onwards, has looked particularly towards biology as the

science providing the closest and most compatible model for social science. Biology has been

taken to provide a guide to conceptualizing the structure and the function of social systems and

to analyzing processes of evolution via mechanisms of adaptation ... functionalism strongly

emphasizes the pre-eminence of the social world over its individual parts (i.e. its constituent

actors, human subjects).

1) Social case work and crisis management?

Social Workers and Case Management: The Key to Crisis Intervention

Every day around the world, people are in crisis. They face problems and situations that they

cannot deal with alone and the caring advocacy of the social workers that help them may be the

difference between their ability to deal with the crisis or to “drown” under the weight of it.

A Day in the Life of a Social Worker

The Social Worker’s day is typically filled with crisis intervention. The diversity of the needs of

the patients assigned to them requires research, strategic planning and provision of

individualized support to each client. In addition, the nature of their work requires confidentiality

and emotional separation to enable them to carry out their case management in a professional

manner.

Team Work as Intervention Strategy

Working closely with a client and his or her family, the social worker must also work as a

member of a team to provide the best outcomes for the client. Depending on the type of work

engaged in, and the type and extent of support required, the types of teams the worker is part of

may change considerably from client to client.

Communication is the Key to Successful Intervention

Case management requires the development of excellent communication skills to enable all

members of the team, and the client to feel that progress is being made and that the client’s most

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pressing needs are being successfully addressed. Social work can be a difficult and sometimes

stressful profession, but ongoing education can provide skills in areas that would otherwise be

potentially draining. Courses in communication, technology, team work and strategic planning

are among the many options that can help provide all health care workers with advanced skills to

assist them in their work.

Best Practice Interventions

When an individual is faced with a crisis, they may in certain circumstances need someone to

make decisions for them. This is particularly true of children requiring protective services

intervention. Their age and vulnerability mean that often they are incapable of making important

life decisions.

But older individuals must be empowered to make their own decisions and this is the role of

social workers working with adult clients. They offer an essential service in the provision of

advocacy and information, ensuring that their client is in a position to be able to make informed

life choices.

If you feel that the field of social workers might be a career for you, why not check into

one of the online training courses that are offered. You won’t just learn a new skill, but

will become a part of a movement that is all about helping othersExplain the important

keys to crisis intervention

PART F

social work recording:-

Case Work Recording

There has been a significant change in the nature of case recording, which in many ways reflects

the wider changes in social work. Staffing levels, increased user involvement and increased

accountability to service users, the organization and profession, are all factors which have

influenced the development of the case record and recording practice

23

The traditional case record reflected the interaction between the practitioner and the service user,

in the context of the service user's history and current situation. At its heart was the relationship

between the practitioner and service user. Traditional case records were 'often written in an

abstract discursive style for a sophisticated professional audience' within the agency.

Practitioners were reluctant to restrict their professional autonomy by establishing 'clear and

specific criteria for the clinical (practice) record'

In the absence of any definition by practitioners, the way in which the case record developed to

meet the changes in legislation and social work practice was led by organizational and

managerial requirements . Whilst, the shift to more structured, focused and evidenced recording

has been both welcome and necessary, concerns have been expressed that using case recording

simply to evidence individual and organizational accountability neglects it's value as a practice

tool .

'The case file is the single most important tool available to social workers and their managers

when making decisions as to how best to safeguard the welfare of children under their care. It

should clearly and accessibly record the available information about the child and the action that

has been taken on the case to date. Reference to the case file should be made at every stage of the

case and before any significant decision is made'.

The case record should be more than a complex diary of the practitioner's actions and the

response of the service user. To use it in such a way is like buying a video recorder and then only

using its clock to tell the time. Practitioners should use case recording to support analysis and

reflection .

Using recording for analysis requires practitioners to assess the weight that should be given to

information gathered. To do this practitioners should draw on their knowledge from research and

practice combined with an understanding of the child's needs within his or her family and/or the

context in which the child lives .

Analysis provides a clear direction to ongoing records and assists practitioners in identifying

what information should be recorded . However analysis often takes place outside day to day

recording and is facilitated by specific formats. Initial and Core Assessments, genograms,

24

ecomaps, social histories and case summaries are all examples of formats that support analysis.

They require practitioners to organize, manipulate and evaluate the information gathered in the

case files. They provide an opportunity to assess the child's needs, monitor progress, evaluate the

effectiveness of interventions, and to identify patterns that would may not immediately be

apparent.

Often case recording can become almost a subconscious activity, like driving a car along a

familiar road. You arrive but can't say exactly how you got there. The regular use of tools for

analysis in the case record keeps recording a proactive activity that supports ongoing assessment,

planning and intervention.

Avoid the pitfall

Do not record simply what is happening, use analysis to move beyond this to hypothesise

and explain why particular situations and events are occurring.

Use genograms, ecomaps, chronologies and assessment records to help you to organise

and to analyse information.

Use case summaries as a way of reviewing progress and evaluating the effectiveness of

interventions.

Use training, journals and articles to keep up to date with developments in research to

inform your practice.

What do we mean by social case work recording?

We mean all the written material contained in the social work files of people using social work

services. Social work files may be wholly or partly electronic or they may be in hard copy.

Recording is a crucial part of day to day social work practice and takes up a substantial amount

of practitioners' time. Recording involves:

25

* writing down the work you do;

* noting the progress people make towards their desired outcomes;

* including the views of the person;

* analysis and assessment; and

* the life history of the person and its interpretation.

Good records are an essential tool for practitioners to reflect on their on going work with people

and plan future work. When shared with the person whose file it is they encourage transparency.

Recording is also part of the code of practice for social services workers 1 published by the

Scottish Social Services Council ( SSSC). The purpose of this code is to set out the conduct

expected of social service workers and to inform people using social work services and the

public about the standards of conduct they can expect from social service workers. Recording

comes under section 6:

'As a social service worker you must be accountable for the quality of your work and take

responsibility for maintaining and improving your knowledge and skills.'

purpose of social work recording

* documenting the involvement with the individual;

* informing assessment and care planning;

* enabling practitioners to review and reflect on their work;

* assisting practitioners to identify any patterns;

* ensuring accountability of staff;

26

* meeting statutory requirements;

* providing evidence for legal proceedings;

* enabling continuity when a new worker takes over the case;

* providing performance information;

* forming a biography - for example, for a looked after child to read at a later date to provide

them with their history;

* providing evidence for inquiries or reviews; and

* assisting partnership working between workers and people using their services.

27

PART Gsocial worker in the medical setting.

Case work in Medical & Psychiatric Setting

Medical and Psychiatric Social Work is a branch or specialisation in professional social work. The

medical and psychiatric social workers are employed in health settings like hospitals, community

health care projects, medical and psychiatric rehabilitation agencies, psychiatric treatment centres

and counselling centres. The role of the medical and psychiatric social worker is to help individuals

with social, economic and psychiatric problems that arise because of ill health, disability and

economic problems. They help to enable the person to lead a productive and satisfied life to the best

of his abilities. The social worker uses his skill in relationship with the client system, and

understands the problems faced by the client. It could be economic problems, attitude towards the

problem faced by the client, the nature of the relationship he has with other support systems like the

family, employers and referral agencies. The social worker gets the cooperation of the family

treatment of the client and uses community resources that are available.

In the medical setting, the worker acts as the link between the doctor and the patient. She acts

as the source of knowledge for the client. In the commullity health care organisations, the worker

understands the social-cultural patterns of the community, the health practices of the community, the

needs of the community and interprets these to the team of other professionals with whom she

works. Her main role in the community is to elicit participation of the community in planning their

health care, provide health education and help them to use preventive services effectively. In the

psychiatric setting, she does the mental status examination of the client, understands the psychosocial

problems of the client and interprets the same to the psychiatric team. Her main role is one of

counselling and education of the family to understand and accept the client. In the drug addiction

centers, she is the link between the psychiatric and medical team, the family and the client. Apart

from counselling the client, she works towards the rehabilitation of the client in the community and

helps him to become a productive member of the community,

History

28

Medical Social Work had its beginning in England and the United States of America. In 1880, a

group of volunteers working for an asylum in England paid friendly visits to the discharged patients

to find how they were adjusting to their home conditions. In 1885 Sir Charles Loch recommended

that the lady almoners should visit the patients at home to prevent the abuse of drugs given freely in

the charity hospitals. The almoner, while investigating the financial problems of the clients, found

other sets of social and psychological problems that needed handling. Hence, apart from the medical

help given, she also tapped other community resources in order to help them overcome social

problems.

In thd "tlmtea Statcs of Ainerica, around 1900, nurses visited the discharged patients in their homes

and showed the importance of understanding the patient in his social situation. In 1902, Dr. Emerson

of John Hopkins University, Baltimore, made the medical students visit the patients in their homes.

This helped the students become aware of the impact of the social and cultural factors in health. In

1905, a –medical social worker was appointed at the Massachusetts General Hospital, with the

establishment of the Social Service Department. In the first thirty years, more social

Psychiatric SettingApart from individual patient care, the social workers were also involved in other activities like

administrative planning, joint teaching and research. They were involved in the planning Bond

implementation of community health care activities. In the west, the medical social workers have

firmly established themselves and work as members of the health team. Their main role revolves

around the treatment of the psychosocial

dimensions of the patient's personality.

Medical and Psychiatric Social Work in India

India has a tradition of voluntary social work. Service to the sick has been a part of 't the Indian

tradition. The scientific orientation to medical social work took a longer time. Further, the medical

social workers had to struggle lo establish their image as professionals. The origin of medical social

work in India could be attributed to the Bhore Committee (1946). The Committee strongly

recommended the appointment of inedical social workers in hospitals. The Bhore Committee made

the following recolnmendations regarding the role of the medical social worker. Discovery and

making available to the medical staff factors in the patient's environment that may have any bearing

on his physical condition, thus supplementing inedical history with social history. Influencing and

29

guiding patients in canying out treatment, making the physician's direction siniple and concrete, and

helping them to carry out the plan of treatment through to completion. Overcoming obstacles to

successful treatment or recovery particularly in the outpatient department and during convalescence

medical and surgical supplies are secured: the social or economic conditions affecting the patient

adversely are corrected. Arranging for the supplementary care of patients. Educating the patient in

regard to his physical condition in order that he may better . cooperate ia the programme laid down

by the physician. Because of the recommendation of the Bhore Commit-tee and the conviction of

some of the doctors who had seen the effective work done by the medical social workers .

.

The Envisaged Tasks of the Medical Social Worker

The medical social worker is involved in the following areas: direct service to the client system,

teamwork, administration, teaching, supervision and self-development, and community health.

Direct Service to the Client System

Soc'ial evaluation of the individual patients in terms of their ability to participate in the treatment

process. Interpretation of the nature of the illness to the patient and his family an individual basis.

Visits to patient's home for assessment of the psychosocial situation. Counseling and helping the

patient and family to deal with the psychological and social problems arising out of the illness and

giving information on the prognosis, treatment process and rehabilitation. Environmental

modification through work with employers, family and others to enable the patient to benefit

maximum from the treatment process. Organizing with patients, volunteers and other agencies,

therapeutic, educational and recreational activities for group of patients and their relatives. Placement

and institutionalization of destitute and other patients, if and when found necessary. Follow up of the

client system to ensure fullest utilization of the services given. Referring patients and their families to

other social welfare agencies.

Team. Work

Interpreting the role of the social worker to the other team members. Interpreting the patient's

psychosocial needs to the other team members. Participating in formulating a diagnosis and planning

the treatment. Consultation to and from other members of the team.

' Work yith various members of the team.

Community Health Work

Involving the community in carrying out a community survey and use of media’ to identify needs

30

social worker in family setting:-

Family

Family-centered casework practice encompasses the range of activities designed to help families

with children strengthen family functioning and address challenges that may threaten family

stability. These activities include family-centered assessment and case planning; case

management; specific interventions with families including counseling, education, and skill

building; advocating for families; and connecting families with the supportive services and

resources they need to improve their parenting abilities and achieve a nurturing and stable family

environment.

Family-centered assessment

Family-centered case planning

Family-centered case management

Working With families and youth

Advocating for families

Working With community resources

Family-Centered Assessment

Assessment forms the foundation of effective practice with children and families. Family-

centered assessment focuses on the whole family, values family participation and experience,

and respects the family's culture and ethnicity. Family-centered assessment helps families

identify their strengths, needs, and resources and develop a service plan that assists them in

achieving and maintaining safety, permanency, and well-being.

There are many phases and types of family-centered assessment, including screening and initial

assessment, safety and risk assessment, and comprehensive family assessment. Assessment in

child welfare is ongoing.

School Settings:

31

Professional social workers play a vital role in helping school children of all ages. Traditionally,

school social workers serve as liaisons between the home, the school, and the community. Since

1907, school social workers have collaborated with teachers and other school personnel in

advancing the purposes of education.

School social workers are an important part of the school team, possessing unique

interdisciplinary knowledge. School social workers contribute to programs designed for students

at-risk due to a variety of factors, including:

emotional problems,

poor self-esteem,

child abuse and domestic violence,

poverty and unemployment,

suicidal behavior, drug and alcohol abuse,

teen pregnancy and parenting,

discrimination, and

Attendance related issues.

 

The School Social Work Program is designed to train school social workers and provide them

with the competencies to practice in a variety of traditional and non-traditional primary and

secondary education settings. Such competencies include assessing the needs of school children,

designing and implementing interventions, and making referrals to other professionals and

agencies as needed.

PART C

32

social case work in community setting

Community setting :

This is another training document in the series of community mobilizing methods for results

other than a physical construction such as a communal water supply, clinic or school.

The product or output is a programme of services for vulnerable members of the community,

many of whom can help themselves if only they are provided with a relatively small amount of

help and encouragement.

What is Social Work?

The profession of Social Work is an odd mixture of many things. It is usually practised by

government civil servants in the west (Europe and North America) while many international

NGOs have social workers on their staff.

The clientele of social work are often called the vulnerable, ie people whose special conditions or

circumstances put them in positions of weakness or vulnerability in comparison with the

mainstream of a society. Generally they include members of society who need some help.

Typically, these include those with physical or mental disabilities, persons who are not able to

work for a living or not able to care for themselves. In special cases, these may include battered

women (those who have been physically or emotionally assaulted – eg by their spouses –and can

not escape dangerous situations on their own), frail elderly persons, children without parents to

support them, or who are being mistreated,

The tasks of a social worker mainly include administration and counselling, along with a little bit

of medical (usually psychological) intervention and advocacy. The social worker provides her or

his clients with little bits of wisdom, advice, information, counselling, as needed. Every case is

different.

33

The government (or NGO) social worker in a western country (Europe and North America)

provides services that are usually provided by elders and family members in other countries.

Social work services are too expensive for governments in the least developed countries.

The word "social" is a bit misleading because, in the west, where it is mainly practised, the social

worker does not work with a whole society, or even with a community or a group in a social

context. The social worker usually handles "cases," and a case is usually about an individual or

lately increasingly, a family.

This is even more ironical because where social work is taught, usually in a university in a

department or a school of social administration or social work, often (where they are small) they

are attached to sociology departments. Such schools or departments, in turn, are then usually also

where community development (like much of the material on this web site) is also taught.

Community development, in contrast, is an activity aimed at social institutions, such as

communities or groups, rather than at individuals. (See Community).

One of the many motivating facts pushing the development of this web site is that the

empowerment of communities is important and highly needed in low income countries. Limiting

the training of community workers to those who are studying in universities, limits the available

number of potentially capable community workers; this should be taught to middle school level

students (after they have been working out in the real world and have some life experience).

.

Where is CBSW Appropriate?

Rich countries can usually provide social work services (on an individual or family basis, not

community based), and poor countries rely on the advice, experience and knowledge of elders

and family members. So where would it be appropriate to place a community based social work

programme? Community based social work services are needed where they can not be provided

by elders and families, but where there is not enough finance available to provide it on an

individual basis.

34

The situation which comes to mind most readily is where there are large displaced or refugee

populations, in camps, in poor countries. Further to that, after the emergency is over, those same

refugees may return home. Their lives will have been interrupted, losing many family members,

including elders and family members, thus the need for social work services remains. So long as

there is enough funding available for a professional social worker to supervise the community

based work, keeping it up to required standards, the community itself can supply the energy, time

and interest in making it work.

Apart from refugee situations, wherever there is a large disaster that results in the removal of

elders and family members, and/or which disrupts the normal and traditional social organization,

are included among situations where it would be appropriate to set up a community based social

work programme. Post disaster situations would be included in these.

Where there are large refugee populations, the basic services, food, water, shelter, elementary

medical, are usually provided, often by UN agencies and international NGOs. Finance is not

unlimited, however, so there may only be a token attempt at providing social work services, if

any at all. This is a good situation in which to consider organizing a community based social

work programme.

Community Perceptions:

When a child is a witness to atrocities that destroy her world, she is affected. To watch your

family members and/or neighbours being shot or bombed produces immense trauma if you are a

child. In many cases, the experience results in the child withdrawing into herself, refusing to talk,

and/or refusing to respond to daily interactions. The child who is traumatized by the same events

which lead to refugee or displaced communities, may display behaviour that is often

misinterpreted by her remaining family or care givers. Sometimes she is deemed as mentally

retarded, and beyond recovery. Sometimes she is seen as affected by evil spirits. Sometimes her

condition is seen as a punishment for previous misdeeds by her family members. In all these

cases, there is much shame and secrecy associated with her behaviour. All too often her care

givers do not understand that she is reacting to the terrible events of the disaster or civil war, and

they do not know that the condition can be reversed by a few simple interventions.

35

Many times such children are hidden (even tied up) in darkened rooms away from public view.

They can not dress or clean themselves, and often are found in their own filth and in poor health,

hungry, dirty, sick, weak and helpless. Public announcements do not get the message across.

Hands on intervention is needed to assess each child.

If they are traumatized by atrocious events, and not retarded or otherwise disabled by other

factors, they can show remarkable changes, learning to dress themselves, clean themselves and

feed themselves. This requires patience, love and care, extended over several weeks and months.

A stimulus or two in the form of a doll, and perhaps later a ball, are effective and useful tools for

the job.

Here is a situation, repeated hundreds of thousand times around the world, where a community

based social work programme is appropriate. This is a typical or classic situation for CBSW.

A single, university educated, professional social worker can appraise the situation, prescribe

appropriate interventions, and monitor. Community mobilizers can work with the community

members to identify hidden and suffering children, recruit community level social workers,

arrange for their training and supervision, organize CBOs to manage and operate the CBSW

programme at community level, and ensure an effective flow of information. Local residents, on

a volunteer basis or with some incentives, can provide the care and stimulation to the children in

need, and keep the mobilizers informed about changing conditions and further needed training.

This is only one of many kinds of situations involving vulnerable refugees or displaced persons

in communities disrupted by (but surviving) disasters caused by natural or human made events.

The PHC Principles:

The "Primary Health Care" (PHC) policy promoted by WHO (UN World Health Organization),

has several basic principles, perhaps the best known one being that prevention is better than cure.

Another, that is particularly applicable here to community based social work, is the idea that

resources should not be spent on expensive cures for a few people.

36

Underlying this is a public health policy in support of the greatest good for the greatest number.

With a limited budget available, that means to concentrate on a few common diseases, to provide

elementary training to persons educated at low levels, and reaching the most rural and remote

patients. This gave rise to the popular (but slightly inaccurate) concept of "The Barefoot Doctor."

(Also see Water and PHC). If the PHC policy is transferred to the need for social services, then

the idea is to give elementary training to persons without university level education,

concentrating on the most common and easily treated conditions, and relying on a referral system

for more complicated diseases or conditions.

The goal in community based social work, then, is to organize a cadre of community members

who can be given low level training (ie not requiring university education) to treat a limited

number of social conditions of vulnerable community members. Their interventions will not be

as flexible or a sophisticated as those of social workers with university level education and

extensive social work training, but they will be able to reach a wider proportion of the population

than if only highly skilled and relatively costly professionals are employed.

"The greater good for the greater number."

Structure:

What is a possible structure for a CBSW programme?

Where you have a population of refugees or others who have had severe disruptions in their

community lives, where they are able to access support for their immediate needs (food, shelter,

water, housing) but no social welfare. Where you may have a professional social worker or two

for a population too large for them to reach everybody. Where you have a situation conducive to

organizing voluntary community groups.

There you have the basis for CBSW.

The professional social workers need to make a needs analysis to determine the limited number

of conditions that can be addressed by community workers with low level training. They then

need to train and to supervise the training of a cadre of community workers who have access to

37

the client community or communities. Both the needs assessments and the training would not be

once-off, but ongoing. They and the community workers (mobilizers) need to identify, recruit,

and train community members, as community leaders of the programme, as practitioners of

social work interventions in their communities, and as monitors of the changing situations in

their respective communities.

Members of the community groups conduct the social work interventions. They need to be

supported with training and guidance by the mobilizers and (more indirectly by) the professional

social workers.

What results in effect is like a social work pyramid, with the professional social worker(s) at the

apex, possible social work trainers (temporary or long term) supervised by the social workers,

mobilizers, community leaders and managers of the community groups (CBOs) and community

and CBO members who conduct most of the interventions.

Training and Support:

In general, community mobilizers should never be trained once-and-for-all, but need regular

support, encouragement, and a forum in which to ask questions that arise in the field (See

Training Methods). In CBSW this is even more a requirement. First, mobilizers without formal

training (the main audience for this web site) need continued support and professional inputs.

Second, the tragedies witnessed in CBSW require field workers to meet with their colleagues to

share experiences and to be re-energised and re-infused with enthusiasm and positive attitudes. A

CBSW programme as described above needs a routine and predictable forum for getting

mobilizers together to share experiences, to ask questions arising from the field, and to obtain

inputs from more highly trained and educated social workers. A training unit could be an answer

to this need. How it is to be set up depends upon available finances and circumstances.

An initial training programme for the mobilizers could use the first six training modules from

this web site. They can be printed and handed out in the training programme. They can be easily

adapted to developing a CBSW programme. The training for social work, in contrast, needs to be

38

defined and generated by the professional social workers, after they make their initial appraisal

of the situations, and will be modified as new information comes in.

Correctional Social Work

With 1.6 million Americans behind bars and the cost of their care rising, NASW believes

preventative services, alternatives to incarceration, and an emphasis on prisoner rehabilitation

must be undertaken. Adequate services both inside and outside of the prison could reduce rates

of incarceration and recidivism for the betterment of individuals and society as a whole.

A number of facts about the prison population, although disturbing, point toward solutions for

stemming the growth in numbers of incarcerated individuals:

People of color are disproportionately represented in the prison population.

Substance abuse and mental illness underlie many offenses committed.

An estimated 200,000 prisoners have severe mental disorders, while others have mental

health problems that are undiagnosed and untreated.

Although the effectiveness of some practices to promote rehabilitation—such as helping

prisoners maintain family ties and responsibilities—are known, the social work profession

should identify others through research (for example, other options for dispute resolution,

alternatives to prison, and effective treatments within correctional settings). In addition, social

workers in correctional settings need specialized training, including the ability to communicate

with prisoners from other cultures. Finally, social workers should participate in national policy

debates, collaborate with other organizations that deal with prisoners, and advocate preventative

efforts, including community-based services to treat addiction and mental illness before these

become criminal justice issues.

Aged Care

Medical (skilled care) versus Non-Medical (social care

39

A distinction is generally made between medical and non-medical care, and the latter is much

less likely to be covered by insurance or public funds. In the US, 86% of the one million or so

residents in assisted living facilities pay for care out of their own funds. The rest get help from

family and friends and from state agencies. Medicare does not pay unless skilled-nursing care is

needed and given in certified skilled nursing facilities or by a skilled nursing agency in the home.

Assisted living facilities usually do not meet Medicare's requirements. However, Medicare does

pay for some skilled care if the elderly person meets the requirements for the Medicare home

health benefit. [12]

Thirty-two U.S. states pay for care in assisted living facilities through their Medicaid waiver

programs. Similarly, in the United Kingdom the National Health Service provides medical care

for the elderly, as for all, free at the point of use, but social care is only paid for by the state in

Scotland, England, Wales and Northern Ireland are yet to introduce any legislation on the matter

so currently social care is only funded by public authorities when a person has exhausted their

private resources, for example by selling their home.

Elderly care emphasizes the social and personal requirements of senior citizens who need some

assistance with daily activities and health care, but who desire to age with dignity. It is an

important distinction, in that the design of housing, services, activities, employee training and

such should be truly customer-centered.

However, elderly care is focused on satisfying the expectations of two tiers of customers: the

resident customer and the purchasing customer, who are often not identical, since relatives or

public authorities rather than the resident may be providing the cost of care. Where residents are

confused or have communication difficulties, it may be very difficult for relatives or other

concerned parties to be sure of the standard of care being given, and the possibility of elder abuse

is a continuing source of concern. The Adult Protective Services Agency — a component of the

human service agency in most states — is typically responsible for investigating reports of

domestic elder abuse and providing families with help and guidance. Other professionals who

may be able to help include doctors or nurses, police officers, lawyers, and social workers.[13]

Improving mobility in the elderly

40

Impaired mobility is a major health concern for older adults, affecting fifty percent of people

over 85 and at least a quarter of those over 75. As adults lose the ability to walk, to climb stairs,

and to rise from a chair, they become completely disabled. The problem cannot be ignored

because people over 65 constitute the fastest growing segment of the U.S. population.

Therapy designed to improve mobility in elderly patients is usually built around diagnosing and

treating specific impairments, such as reduced strength or poor balance. It is appropriate to

compare older adults seeking to improve their mobility to athletes seeking to improve their split

times. People in both groups perform best when they measure their progress and work toward

specific goals related to strength, aerobic capacity, and other physical qualities. Someone

attempting to improve an older adult’s mobility must decide what impairments to focus on, and

in many cases, there is little scientific evidence to justify any of the options. Today, many

caregivers choose to focus on leg strength and balance. New research suggests that limb velocity

and core strength may also be important factors in mobility.[14]

The family is one of the most important providers for the elderly. In fact, the majority of

caregivers for the elderly are often members of their own family, most often a daughter or a

granddaughter. Family and friends can provide a home (i.e. have elderly relatives live with

them), help with money and meet social needs by visiting, taking them out on trips, etc.

One of the major causes of elderly falls is hyponatremia, an electrolyte disturbance when the

level of sodium in a person's serum drops below 135 mEq/L. Hyponatremia is the most common

electrolyte disorder encountered in the elderly patient population. Studies have shown that older

patients are more prone to hyponatremia as a result of multiple factors including physiologic

changes associated with aging such as decreases in glomerular filtration rate, a tendency for

defective sodium conservation, and increased vasopressin activity. Mild hyponatremia ups the

risk of fracture in elderly patients because hyponatremia has been shown to cause subtle

neurologic impairment that affects gait and attention, similar to that of moderate alcohol intake.[15]

41

PART F1) What is CSCW?

A) Computer Supported Cooperative Work

2) What is Ethnography?

A) Ethnography is a method of data capture that works through the immersion of the

researcher within the environment being studied.

3) What is HCI?

A) Human Computer Interaction

PART B

1) List out Problems and limitations and recent trends of Social Case Work practice in

India?

Lack of trained persons

lack of training facilities

42

poor remuneration

Lack of Indian literatures

Recent trends in Social Case Work.

Use of computers

Interview guide and schedule,

Life chart,Video recording of family interaction

Tape recorded interview

.

PART C

1. List out the Use of single case evaluation and ethnography as research methods in

Social Case Work.

Ethnography

Ethnography is a method of data capture that works through the immersion of the researcher

within the environment being studied, collecting detailed material (notes, documentation,

recordings) on the ‘real-time real-world’ activities of those involved. Periods of immersion can

range from intensive periods of a few days to weeks and months (more common in systems

design studies), and even years. A primary product of most ethnographies is the development of

a ‘rich’ description – a detailed narrative – of the work or activity in question, which may then be

further analysed or modelled for various means, taking various approaches. The means may be

for the purposes of answering sociological, psychological or systems design research questions,

with the different approaches for analysis arising from various theoretical and methodological

perspectives within these areas. Ethnographers are interested in studying the work going on in

settings rather than just computer systems in a narrow sense – they are interested in studying

computer systems in operation, being used by people, within an organisational context and

43

therefore shaped by organisational norms, rules, procedures, ethos, culture etc. In this conception

we can think of, for example, a tax office as a complete organizational system – it comprises

various technologies (e.g. computer and paper-based), organizational rules, processes (and

methods for implementing them) and so forth, and staff who draw on their everyday and

specialised social and vocational skills, abilities and knowledge to operate the technologies and

work according to organizational requirements.

Structuring ethnographic data

Ethnographic records are collected opportunistically and, consequently, cannot be planned,

organised and structured during the ethnography itself. However, when the raw data is analysed,

we believe that it is useful to organise and structure this data in such a way that it is more

accessible to system designers. We do this by providing a series of topics that can be used to

guide observations and organise (or structure) fieldwork data. These topics have been developed

in the ethno methodological litera4 ture, particularly through the studies that have been presented

for computing audiences

The topics provide a comprehensive framework for considering features of social systems of

work and how social systems interact with technical systems, rules, plans and procedures and the

spatial arrangement (ecology) of the workplace. We suggest eight different headings that may be

used to structure and organize ethnographic data. However, we are not suggesting that these are

the only ways to impose structure on this data or that the headings proposed are necessarily

relevant to every study and setting. Rather, from extensive experience, we have found that these

structural devices allow a mass of data to be organized so that it becomes more accessible

to system designers who can relate the ethnographic structure to the structure of the requirements

and the design of the computer-based system.

Temporality and sequentially …..

The working division of labor…..

Rules, plans and procedures ……

Routines, rhythms, patterns ……

(Distributed) coordination …….

Awareness of work ……

Ecology and affordances …….

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Skills, knowledge and reasoning in action ……

The Social Structure of Work

In the previous section, we introduced a set of headings under which we believe it is useful to

organize the ethnographic record and, in some cases, they may be effective in focusing

ethnographic studies. These headings are not, of course, arbitrary, but reflect perspectives

through which we believe it is possible to discern the social

structure of work.

The social structure of work can be thought of as the way in which work is organized as a social

process – how organizations perceive how work should be done by their employees and how this

is reflected in actual practice by the people doing the work. Unlike a system architecture, say, it

is a more subjective, dynamic concept and cannot reliably be expressed as a set of static models.

Broadly speaking we suggest that there are three relevant forms of structure which are central to

the social structure of work:

Temporal and sequential structure: how processes and practices unfold – the

relationships between entities, actions, utterances etc. over time in sequence.

Spatial structure: related to the spatial relationships between objects, persons, actions

and so forth.

Conceptual structure: (sometimes also termed ontological, in a particular usage in

computing) what a set of objects, entities, people, actions are, how they can be

individuated

and how they relate to one another conceptually1. Of course, these notions are also applicable to

some extent to the structure of technical systems. The temporal and sequential structure reflects

the assumptions of systems designers as to the sequences of operations that the system will

support and the dependencies between the members of these sequences. The conceptual structure

is, in essence, the system and data architecture and the abstractions used in the system

design. The spatial structure is, perhaps, less significant because of the intangibility of software

but may be reflected in some systems where the physical positioning of hardware is significant

or in the layout and organization of the system’s user interface. Ethno methodological studies of

work are often interested in the temporal and sequential structure of processes in the technical

system (structured as a series of definite steps – ‘workflow without’, and how well these

processes mesh with the ways in which the social practices are structured temporally and

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sequentially from within. Commonly, the temporal structures of the technical system are much

more rigid than the fluid, reactive structures of the social system and this leads to a mismatch

where users are frustrated by the restrictions imposed by the technical system.Dourish states that

questions of ontological or conceptual structure “…address(es) the question of how we can

individuate the world, or distinguish between one entity and another; how we can understand

the relationships between different entities or classes of entity; and so

forth.”

Rules, plans and procedures

We defined the social structure of work in the previous section as a reflection of both how work

is perceived by an organisation and how that work is actually carried out by people. The

organisational view is normally defined in sets of rules, plans and procedures. Rules define

conditions that must be maintained (e.g. credits and debits must balance), plans (or processes)

define workflows (e.g. what steps are followed to close an account) and procedures define the

particular ways in which activities are carried out (e.g. how to validate a customer’s identity).

Practical experience, as well as a wide range of ethnographic studies, tells us that the way in

which work is actually done and the way in which it is set out in the rules, plans and procedures

is often markedly different. Different people interpret the organizational rules, plans and

procedures in different ways depending on their competence, knowledge, status, experience and

the contingencies of each particular situation.

Social structure and system dependability

How do we now approach the dependable design of socio-technical systems given this

understanding of ‘social structure’ in socio-technical systems? The key issue here is to

understand the way in which the structure of technical systems and the structure of rules, plans

and procedures, fit with that of the social system. The relationship cannot be adequately

described in formal structural terms, i.e. it is not possible to produce an accurate model of a

socio-technical system because social practices are structured from within while technical

systems are structured from without (the have a structure that can be specified separately to the

technology they are implemented in). Technical systems can be, and are, modelled, social

practices are emergent, dynamic and are always responsive to the contingencies of this situation,

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this time. Models of social practices abstract, gloss and rationalise these features of them, giving

them a rigid, formulaic structure not found ‘in the wild’. Therefore, while models of social

practices can be made commensurate with those of technical systems, i.e. by encapsulating a user

model in the structure of the GUI, caution needs to be applied when considering how usable the

system will be (how well it will fit in with social practices). The abstractions, glosses and

rationalisations of practice used to construct the idealised user model may have problematic

consequences when implemented in a real, dynamic and contingent situation. Social practices

will have to adapt in a way that enables users to carry out what they need to do, in each case, in

response to the

idealised user model encapsulated in the system. The idealised user model will not match what

they already do, and it may well clash quite badly with certain crucial aspects of everyday

practice. Technical systems, however, need to be built using user models and models of work.

Does this necessarily set up a serious problem? Fortunately the answer to this is no, for two

reasons. Firstly, humans and the social systems they form are necessarily adaptive. They respond

to the contingencies of this situation, this time, and they can also adapt their practices over time

to work successfully with a computer system that initially fitted badly with their work practices.

Secondly, user models can be created through observation ‘in the wild’ rather than theoretically

conceptualised. A user model or model of work based on a faulty or incomplete understanding or

work, or created through imagining what users do, rather than discovering what they do runs

serious risks of misunderstanding the users or misrepresenting their work. A key feature of

system dependability concerns efficient and effective sociotechnical system operation such that

personnel will be able to achieve work with technical systems successfully. This includes the

extent to which technical systems will not have to be worked around, and will not inhibit

important social practices, or getting the job done. Achieving dependability also includes an

assessment of how reliable, safe, secure, resistant to failure these processes and practices are. A

design process therefore involves an assessment of current working, and is often characterized by

a desire to transform things to make them better or more dependable. The desired design is

envisaged to ‘preserve’ certain adaptive, or desirable, patterns of work, while transforming

inefficient, maladaptive or inconsequential practices for organisational gains. Better decision

making in this process should be facilitated by a detailed understanding of current process and

practice.

47

Cultural Factors The social and cultural factors that influence the buying behavior of consumers are inclusive of

culture, social class, reference group, family, demographics and geography. Culture is an

amalgam of tangible factors and intangible traditions that enunciate the lifestyle of a particular

group of people. As for social class, it defines the income group the individual belongs too and

that, in turn, is heavily dependent on the income earned, which is a great factor in determining

buying behavior. The third factor is the reference group. As is obvious from the name it is the

group from whom the consumer seeks reference. It could range from people like one's parents,

members of the family whom the individual feels close to, close friends, celebrities who endorse

the brand etc. People whom we trust, their opinion means a great deal to us and affects many

decisions of ours including buying behavior. Regarding family, this determinant is totally

different from the erstwhile one as this one focuses on the norms and preferences of the family in

which the individual lives and is brought up. Moreover this determinant is on a collective and

unconscious basis as the individual's buying decision is taking effect from the ambience of his

family and the unconscious way he has grasped the values that have been given to him by his

family. Coming to demographics, these are small and specific details about the individual such as

age, gender, education, income, occupation etc. Also the geographical location in which the

consumer resides also determines the buying behavior depending on sub-factors like climatic

conditions, availability of resources, surroundings etc.

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www.answers.com

www. case atduke.org

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