By Fatskills Exam Guides Team — the exam nerds behind 28,500+ quizzes and 2.1M practice questions across 500+ global exams.
Erikson's Psychosocial Stages The Epigenetic Principle in Erikson's Psychosocial Stages of Development is summarized as follows: The individual develops after passing through eight well-defined stages, each of which demonstrates a unique combination of needs and vulnerabilities. Each developmental stage has its focus on some aspect of growth and culminates in an encounter or crisis. The outcome of the encounter or crisis leads to the development of an important human quality. - The impact of the broader environment, society, and its culture on the child's development are taken into consideration. The psychosocial stages are summarized below:
Trust vs. Mistrust - Birth to 1.5 yrs - Infants develop a sense of trust in self and in others. - Psychological dangers include a strong mistrust that later develops and is revealed as withdrawal when the individual is at odds with self and others. - Autonomy vs. Shame and Doubt - 1.5 to 3 yrs—same ages as Freud's Anal Stage - In this phase, rapid growth in muscular maturation, verbalization, and the ability to coordinate highly conflicting action patterns is characterized by tendencies of holding on and letting go. - The child begins experiencing an autonomous will, which contributes to the process of identity building and development of the courage to be an independent individual. - Psychological dangers include immature obsessiveness and procrastination, ritualistic repetitions to gain power, self-insistent stubbornness, compulsive meek compliance or self-restraint, and the fear of a loss of self-control. - Initiative vs. Guilt - 3-6 years (same ages as Freud's Phallic Stage) - Incursion into space by mobility, into the unknown by curiosity, and into others by physical attack and aggressive voice. - This stage frees the child's initiative and sense of purpose for adult tasks. - Psychological dangers include hysterical denial or self-restriction, which impede an individual from actualizing inner capacities. - Industry vs. Inferiority - 6-11 yrs (same as Freud's Latency Stage) - Need of child is to make things well, to be a worker, and a potential provider. - Developmental task is mastery over physical objects, self, social transaction, ideas, and concepts. - School and peer groups are necessary for gaining and testing mastery. - Psychological dangers include a sense of inferiority, incompetence, self-restraint, and conformity. - Identity vs. Identity Diffusion - Adolescence (same age range as Freud's Genital Stage) - Crucial task is to create an identity, reintegration of various components of self into a whole person—a process of ego synthesis. - Peer group is greatly important in providing support, values, a primary reference group, and an arena in which to experiment with various roles. - Psychological dangers include extreme identity confusion, feelings of estrangement, excessive conformity or rebelliousness, and idealism (a denial of reality, neurotic conflict, or delinquency). - Intimacy vs. Isolation - Early adulthood - Task is to enter relationships with others in an involved, reciprocal manner. - Failure to achieve intimacy can lead to highly stereotyped interpersonal relationships and distancing. Can also lead to a willingness to renounce, isolate, and destroy others whose presence seems dangerous. - Generativity vs. Stagnation - Adulthood - Key task is to develop concern for establishing and guiding the next generation, and the capacity for caring, nurturing, and concern for others. - Psychological danger is stagnation. Stagnation includes caring primarily for oneself, an artificial intimacy with others, and self-indulgence. - Integrity vs. Despair - Later adulthood - Task is the acceptance of one's life, achievements, and significant relationships as satisfactory and acceptable. - Psychological danger is despair. Despair is expressed in having the sense that time is too short to start another life or to test alternative roads to integrity. - Despair is accompanied by self-criticism, regret, and fear of impending death.
Piaget's theory The concepts of Action and Operation, Activity in Development, and Adaptation according to Piaget are described below: Action is overt behavior. Operation is a particular type of action; may be internalized thought. Activity in Development: Child is not a passive subject, but an active contributor to the construction of her/his personality and universe. The child acts on her/his environment, modifies it, and is an active participant in the construction of reality. Adaptation: Includes accommodation and assimilation. Accommodation entails adapting to the characteristics of the object. Assimilation is the incorporation of external reality into the existing mental organization.
Piaget's stages of development are summarized as follows:
Sensory-Motor Stage
- Birth-2 yrs - Infant cannot evoke representations of persons or objects when they are absent—symbolic function. - Infant interacts with her/his surroundings and can focus on objects other than self. Infant learns to predict events (door opening signals that someone will appear). Learns that objects continue to exist when out of sight. Learns a beginning sense of causality.
Pre-Operational Stage
- 2-7 yrs - Developing of symbolic thought draws from sensory-motor thinking. Conceptual ability not yet developed.
Concrete Operational Stage
- 7-11 yrs - Child gains capacity to order and relate experience to an organized whole. Child can now explore several possible solutions to a problem without adopting one, as s/he is able to return to her/his original outlook.
Formal Operational Stage
- 11-adolescence - Child/youth can visualize events and concepts beyond the present and is able to form theories. - A systematic approach to problems replaces cognitive random behavior. - Child/youth acquires objectivity and awareness of relative relationships, the ability to reason by hypothesis, and they relate past, present, and future.
Social work values The following are core social work values held across the board by major social work theorists: Worth of the individual Right of individuals to access to services Right of individuals to fulfill potential without regard to class, race, gender, or sexual orientation Self determination Confidentiality
Social work goals The core social work goals held across the board by major social work theorists are to help clients: improve social functioning resolve problems achieve desired change meet self-defined goals
Theoretical approaches used in Clinical Practice approach Theoretical approaches used in Clinical Practice are explained as follows: - Psychosocial - focuses on intrapsychic and interpersonal change. - Problem Solving - seeks to solve distinct problems, based on psychosocial and functional approaches. - Behavior Modification - symptom reduction of problem behaviors, learning alternative positive behaviors. - Cognitive Therapy - symptom reduction of negative thoughts, distorted thinking, and dysfunctional beliefs. - Crisis Intervention - brief treatment of reactions to crisis in order to restore client's equilibrium. - Family Therapy - treats entire family system and sees individual symptom bearer as indicative of a problem in the family as a whole. - Group Therapy - model in which group members help and are helped by others with similar problems, receive validation for their own experiences, and test new social identities and roles. - Narrative Therapy - the stories clients tell about their lives reveal how they construct perceptions of their experiences. Worker helps client construct alternative, more affirming stories. - Ecological or Life Model - focuses on life transitions, environmental pressures, and maladaptation between individual and family/ environment. Focuses on interaction and interdependence of people and environments. - Task Centered - focuses on completing tasks to strengthen self-esteem and restore usual capacity for coping.
Psychosocial approach The theoretical base for the Psychosocial approach to social work practice is discussed below: Psychoanalytic theory (Sigmund Freud) Ego Psychology: psychoanalytic base, with focus on ego functions and adaptation; defense mechanisms (Anna Freud); adaptations to an average 'expected' environment (Hartmann); ego mastery and development through the life cycle (Erikson); separation/individuation (Margaret Mahler) Social Science Theories: role, family and small group, impact of culture, communication theory, systems theory Biological theories: ecological, homeostasis, behavioral genetics, health, illness
Problem-Solving approach The theoretical base for the Problem-Solving approach to social work practice is explained as follows: Psychodynamic, with major influence from Ego psychologists: Erik Erikson (capacity for change throughout life), Robert White (coping, adaptation, mastery of environment), Heinz Hartmann (use of the conflict-free ego). Social science theory: role theory, problem solving theory (John Dewey).
The following are the assumptions that the Problem-Solving approach to social work practice makes about human behavior: Individuals are engaged in life-long problem-solving and adaptation to maintain, rebuild, or achieve stability, even as circumstances change. The individual is viewed as a whole person; the focus, however, is on the person in relation to a problem. Individuals have or can develop the motivation and ability to change. This perspective does not see the individual as sick or deficient, but instead as in need of help to resolve life problems. Each individual has a 'reachable moment' at a time of disequilibrium, at which point s/he can most successfully mobilize motivation and capacity An individual's cognitive processes can be engaged to solve problems, to achieve, and to grow emotionally An individual has both rational/irrational, conscious/unconscious processes, but cognitive strengths can control irrationality.
Crisis Intervention The theoretical base for the Crisis Intervention approach to social work practice is described below: Psychodynamic, particularly ego psychology (Freud, Erikson, Rapoport) and Lindemann's work on loss and grief. Intellectual development (Piaget) Social Science: stress theory, family structure, role theory
The Crisis Intervention approach makes the following assumptions about human behavior: The individual has a tendency to a natural progressive growth that prevails over forces of regression. Stress during a crisis induces disequilibrium and anxiety that allow therapeutic accessibility. Crisis can create opportunities to develop new coping mechanisms and growth or can give rise to dysfunctional behavior. Crisis occurs when established coping skills do not resolve stress adequately. A crisis inflicts an array of affective, cognitive, and behavioral tasks. A crisis can reactivate old problems. An individual in crisis is not ill, but rather is dealing with a challenge that is a part of the human condition. The crisis counselor does not necessarily assume the presence of a pathological condition or DSM disorder. An individual in crisis is affected by the past, but the present situation is more relevant.
Behavior Modification The theoretical base of the Behavior Modification approach to social work practice is described as follows: Early classical conditioning research (Pavlov) Behavior modification theory—operant conditioning (Skinner, Thorndike, Watson, Dollard & Miller, Thomas) Social learning theory—observing, imitating, modeling (Bandura)
The following are the assumptions that the Behavior Modification approach makes about human behavior: One can know a person only through the observable. Behavior can be explained by learning theory. Theory of the unconscious is unnecessary. A person has learned, dysfunctional behaviors rather than emotional illness. No presumptions about psychiatric illness. One expresses dysfunctional behavior in symptoms. Definition of symptoms: observed individual behaviors that are labeled as deviant or problematic. Once the symptoms are removed, there are no remaining underlying problems. High priority goes to research and empirically based knowledge.
Cognitive Therapy The theoretical base for the Cognitive Therapy approach to social work practice is as follows: Albert Ellis' rational-emotive behavior therapy Aaron Beck's cognitive theory
The Cognitive Therapy approach makes the following assumptions about human behavior: Mental distress is caused by the maladaptive and rigid ways we construe events, not by the events themselves. Negative automatic thoughts are generated by dysfunctional beliefs. These beliefs are set in motion by activating events and they trigger emotional consequences. Future events are interpreted through the filter of these belief systems. Negative affect and symptoms of psychological disorders follow negative automatic thoughts, biases, and distortions. Irrational thinking carries the form of systematic distortions.
Task-Centered approach The theoretical base of the Task-Centered approach to social work practice is as follows: Learning theory Cognitive and behavioral theory High priority on research-based practice knowledge
The following are the assumptions that the Task-Centered approach makes about human behavior: - An individual is not influenced solely by internal/unconscious drives, nor controlled solely by environmental forces. - The client usually is able to identify her/his own problems/goals. - The client is the primary agent of change and is a consumer of services. - The worker's role is to help the client achieve the changes that s/he decides upon and is willing to work on.
Systems Theory The theoretical base to the Systems Theory approach to social work practice is as follows: This approach is based on general system theory applied to social work treatment. Systems Theory is a framework that a worker can use with any of the practice approaches in order to help the client establish and maintain a steady state.
Definitions in Systems Theory:Boundary—organizational means by which the parts of a system can be differentiated from their environment and which differentiates subsystemsOpen/Closed system—indicates whether boundary between a system and its environment is open or closed.Subsystem—subset of the entire systemEntropy—randomness, chaos, disorder in a system. Causes a system to lose energy faster than it creates or imports it.Homeostasis—a system will make changes in order to maintain an accustomed balance. The Systems Theory approach makes the following assumptions about human behavior: Individuals have potential for growth and adaptation throughout life. They are active, problem solving and purposeful. Individuals can be understood as open systems which interact with other living systems and the nonliving environment. All systems are interdependent. Change in one system brings about changes in the others. Additionally, change in a subsystem brings about changes in other subsystems.
Ecological or Life Model The theoretical base for the Ecological or Life Model approach to social work practice is as follows: Ecology Systems Theory Stress, coping, and adaptation theory Psychodynamic, behavioral, and cognitive theory
This approach follows a conceptual framework that has its focus on the interaction and interdependence of people and environments. It provides service to individuals, families, and groups within a community, organizational, and cultural environment. The Ecological or Life Model approach to practice makes the following assumptions about human behavior: The individual is active, purposeful, and problem solving. S/he has potential for growth and adaptation throughout life. There are three areas of life experience in which problems occur: life transitions, environmental pressures, and/or maladaptive lack of 'fit' between the individual and a larger entity (the family, the community). Each individual client system depends upon or is interdependent with other systems.
Family Systems theory The Family Systems Theory approach to practice makes the following assumptions about human behavior: Change in one part of the family system brings about change in other parts of the system. The family provides the following to its members: unity, individuation, security, comfort, nurturance, warmth, affection, and reciprocal need satisfaction. Where family pathology is present, the individual is socially and individually disadvantaged. Behavioral problems are a reflection of communication problems in the family system. Treatment focuses on the family unity; changing family interactions is the key to behavioral change.
Murray Bowen's family systems theory Bowen's theory focused on: The role of thinking versus feeling/reactivity in relationship/family systems. Role of emotional triangles. The three-person system or triangle is viewed as the smallest stable relationship system and forms when a two-person system experiences tension. Generationally repeating family issues. Parents transmit emotional problems to a child. (Ex: parents fear something wrong with a child and treat child as if something is wrong, interpret child's behavior as confirmation.) Undifferentiated family ego mass—family's lack of separateness, fixed cluster of egos of individual family members as if all have a common ego boundary Emotional cutoff—way of managing emotional issues with family members (cutting off emotional contact) Consideration of thoughts and feelings of each individual family member as well as seeking to understand the family network.
Contributions to Family System's theory Psychodynamic theory's contributions to Family System's theory, via work of Nathan Ackerman, Don Jackson, Olga Silverstein is summarized below: - Emphasizes multi-generational family history. Earlier family relations and patterns determine current ones. Distorted relations in childhood lead to patterns of miscommunication and behavioral problems. Interpersonal and intrapersonal conflict beneath apparent family unity results in psychopathology. Social role functioning influenced by heredity and environment. - Jackson focuses on power relationships. He developed a theory of 'double-bind' communication in families. Double-bind communication occurs when two conflicting messages communicated simultaneously create/maintain a 'no-win,' pathological symptom. Sal Minuchin's Structural family therapy in relation to its contributions to Family Systems Theory is explained as follows: - This therapy seeks to strengthen boundaries when family subsystems are enmeshed, or seeks to increase flexibility when these systems are overly rigid. - Minuchin emphasizes that the family structure should be hierarchical and that the parents should be at the top of the hierarchy.
Terms The following are terms that are commonly used in Family Systems treatment: - Boundaries: means of organization through which system parts can be differentiated both from their environment and from each other. They protect and improve the differentiation and integrity of the family, subsystem, and individual family members. - Collaborative Therapy: therapy in which separate worker sees each spouse or member of the family - Complementary family interaction: type of family relationship in which members present opposite behaviors that supply needs or lacks in the other family member - Complementarity of needs: circular support system of a family, in which reciprocity is found in meeting needs; can be adaptive or maladaptive - Double-bind communication: communication in which two contradictory messages are conveyed concurrently, leading to a no-win situation - Family of origin: family into which one is born - Family of procreation: the family which one forms with a mate and one's own children - Enmeshment: obscuring of boundaries in which differentiation of family subsystems and individual autonomy are lost. Similar to Bowen's 'undifferentiated family ego mass.' Characterized by 'mind reading' (partners speak for each other, complete each other's sentences) - Homeostasis: state of systemic balance (of relationships, alliances, power, authority) - Identified patient: 'symptom bearer' in the family - Multiple family therapy: Therapy in which three or more families form a group with one or more clinicians to discuss common problems. Group support is given and problems are universalized. - Scapegoating: unconscious, irrational election of one family member for a negative, demeaned, or outsider role
Haley and Madanes' Strategic Family Therapy Haley and Madanes' Strategic Family Therapy is summarized as follows: - This therapy seeks to learn what function the symptom serves in the family, i.e., what 'payoff' is there for the system in allowing the symptom to continue? - Problem-focused behavioral change, emphasis of parental power and hierarchical family relationships, focus on role of symptoms as an attribute of the family's organization. - Helplessness, incompetence, illness all provide power positions within the family; child uses symptoms to change the behavior of parents.
Milan School's systemic family therapy The Milan School makes the assumption that symptoms serve a purpose: to maintain the family structure within dysfunctional families. In this understanding, a family member is sacrificed to maintain the family structure. Virginia Satir and the Esalen Institute's Experiential Family Therapy This perspective draws on sociology, ego concepts, and communication theory to form role theory concepts. Satir examined the roles of 'rescuer' and 'placatory' that constrain relationships and interactions in families. This perspective seeks to increase intimacy in the family and improve self-esteem of family members by using awareness and communication of feelings. Emphasis on individual growth in order to change family members and deal with developmental delays. Particular importance is given to marital partners and on changing verbal and non-verbal communication patterns that lower self-esteem.
Narrative Therapy approach The theoretical base for the Narrative Therapy approach to social work practice is discussed below: - Draws on the work of Michael White of the Dulwich Centre in Australia. - Utilizes a variety of individual and personality theories, as well as social psychological approaches. - Focuses on the stories people tell about their lives. These stories are interpreted through their subjective personal filters. - Interventions are designed to reveal and reframe the way clients structure their perceptions of their experiences. The Narrative Therapy approach to practice makes the following assumptions about human behavior: - Individuals' behaviors come from their interpretations of experiences. - Subjective meanings influence actions. Meanings derived from interpretations of experience determine specifics of action. - Narrative therapy is concerned with the telling and re-telling of the preferred stories of people's lives, as well as the performance and re-performance of these stories.
Treatment of children Children are typically referred to treatment for symptoms or behavioral problems. The child's underlying conflicts reveal themselves through play and verbally in free expression. Play is the child's form of symbolic communication, an emulation of the real world, and the child's psychological reality. The theoretical base for the treatment of children is found in: Normal child development theory Psychosocial development theory (S. Freud, Anna Freud, Erikson) Attachment theory Object relations theory
Group work Advantages The following are some advantages of group work: Members can help others dealing with the same issues and can identify with others in the same situation. Sometimes people can more easily accept help from peers than from professionals. Through consensual validation, members feel less violated and more reassured as they discover that their problems are similar to those of others. Groups give opportunities to members for experimentation and testing new social identities/roles. Group practice is not a replacement for individual treatment. Group work is an essential tool for many workers and can be the method of choice for some problems. Group practice can complement other practice techniques.
Purposes and goals Group practice takes a multiple-goals perspective to solving individual and social problems and is based on the recognition that group experiences have many important functions and can be designed to achieve any or all of the following: Providing restorative, remedial, or rehabilitative experiences. Helping prevent personal and social distress or breakdown. Facilitating normal growth and development, especially during stressful times during the life-cycle. Achieving greater degree of self-fulfillment and personal enhancement. Helping individuals become active, responsible participants in society through group associations.
Social work groups The different types of social work groups are: Educational groups, which focus on helping members learn new information and skills. Growth groups, which provide opportunities for members to develop deeper awareness of their own thoughts, feelings, and behavior as well as develop their individual potentialities (i.e. values clarification, consciousness-raising, etc.) Therapy groups, which are designed to help members change their behavior by learning to cope and improve personal problems and to deal with physical, psychological, or social trauma. Socialization groups, which help members learn social skills and socially accepted behaviors and help members function more effectively in the community. Task groups, which are formed to meet organizational, client, and community needs and functions.
Importance of relationships The importance of relationships in group work methodology is explained below: Establishing meaningful, effective, relationships is essential and its importance cannot be overemphasized. The worker will form multiple and changing relationships with individual group members, with sub-groups, and with the group as a whole. There are multiple other parties who have a stake in members' experiences, such as colleagues of the worker, agency representatives, relatives, friends, and others. The worker will relate differentially to all of these.
Group formation process Key elements of the group formation process are as follows: The worker makes a clear and uncomplicated statement of purpose, of both the members' stakes in coming together and the agency's (and others') stakes in serving them. Describing the worker's part in as simple terms as possible. Reaching for member reaction to worker's statement of purpose. Identifying how the worker's statement connects to the members' expectations. The worker helps members do the work necessary to develop a working consensus about the contract. Recognizing goals and motivations, both manifest and latent, stated and unstated. Re-contracting as needed.
The issues of heterogeneity vs. homogeneity in group formation are explained as follows: A group ought to have sufficient homogeneity to provide stability and generate vitality. Groups that focus on socialization and developmental issues or on learning new tasks are more likely to be homogeneous. Groups that focus on disciplinary issues or deviance are more likely to be heterogeneous. Composition and purposes of groups are ultimately influenced or determined by agency goals.
Group types Closed groups Closed groups are described as follows: Convened by workers. Members begin the experience together, navigate it together, and end it together at a predetermined time (set number of sessions). Closed groups afford better opportunities than open groups for members to identify with each other. Give greater stability to the helping situation; stages of group development progress more powerfully. Greater amount and intensity of commitment due to same participants being counted on for their presence.
Open groups Open groups are described as follows: Open groups allow participants to enter and leave according to their choice. A continuous group can exist, depending on frequency and rate of membership changes. Focus shifts somewhat from the whole group process to individual members' processes. With membership shifts, opportunities to use group social forces to help individuals may be reduced. Group will be less cohesive, less available as a therapeutic instrument. Worker is kept in a highly central position throughout the life of the group, as s/he provides continuity in an open structure.
Short-term groups Short-term groups are described below: Short-term groups are formed around a particular theme or in order to deal with a crisis. Limitations of time preclude working through complex needs or adapting to a variety of themes or issues. The worker is in the central position in a short-term group.
Formed groups Formed groups are described as follows: Deliberately developed to support mutually agreed-upon purposes. Organization of group begins with realization of need for group services. Purpose is established by identification of common needs among individuals in an agency or worker caseload. Worker guided in interventions and timing by understanding of individual and interpersonal behavior related to purpose. It is advisable to have screening, assessment, and preparation of group members. Different practice requirements for voluntary and non-voluntary groups as members will respond differently to each.
Phases of group work Stress that the worker might experience in beginning phases of a group's process is described as follows: Anxiety regarding gaining acceptance by the group. Integrating group self-determination with an active leadership role. Fear of creating dependency and self-consciousness in group members which would deter spontaneity. Difficulty observing and relating to multiple interactions. Uncertainty about worker's own role.
The middle phase of group work is described as follows: Relatively clear agreement of purpose. Members are engaged in group tasks. Members allow worker to facilitate group efforts toward achieving goals.
The following summarizes group members' methods of forestalling or dealing with termination: Simple denial—member may forget ending, act surprised, or feel 'tricked' by termination Clustering—physically drawing together, also called super-cohesion Regression—reaction can be simple-to-complex. Earlier responses reemerge, outbursts of anger, recurrence of previous conflicts, fantasies of wanting to begin again, attempts to coerce the leader to remain, etc. Nihilistic flight—rejecting and rejection-provoking behavior Reenactment and review—recounting or reviewing earlier experiences in detail or actually repeating those experiences Evaluation—assessing meaning and worth of former experiences Positive flight—constructive movement toward self-weaning. Member finds new groups, etc.
System Analysis and Interactional Theory of small groups System Analysis and Interactional Theory of small groups is explained below: This is a broadly used framework for understanding small groups. In this framework, small groups are living systems that consist of interacting elements which function as a whole. In this framework, a social system is a structure of relationships or a set of patterned interactions. System concepts help maintain a focus on the whole group, and explain how a group and its sub-groups relate functionally to larger environments. This framework describes how interaction affects status, roles, group emotions, power and values.
Social System Concepts Boundary maintenance: maintaining group identities and separateness System linkages: two or more elements combine to act as one Equilibrium: maintaining a balance of forces within the group
General Systems Concepts Steady state: tendency of an open system to remain constant but in continuous exchange Equifinality: final state of a system that can be reached from different initial conditions Entropy: tendency of a system to wear down and move toward disorder
Symbolic Interactionism Symbolic Interactionism in small group work is summarized as follows: Emphasizes the symbolic nature of people's relationships with others and with the external world, versus social system analysis that emphasizes form, structures, and functions. Group members play a part in determining their own actions by recognizing symbols and interpreting meaning. Human action is accomplished mainly through the process of defining and interpreting situations in which people act. The worker uses such concepts to explain how individuals interact with others, and to understand the role of the individual as the primary resource in causing change; the significance of social relationships; the importance of self-concept, identification, and role identity in group behavior; and the meanings and symbols attributed to group interactions.
Gestalt orientation and Field Theory Gestalt orientations and Field Theory in regard to small groups are summarized as follows: Gestalt psychology played a major part in development of group dynamics. Contrasting with earlier psychologies that stressed elementary sensations and associations, Gestalt theorists viewed experiences not in isolation, but as perpetually organized and part of a field comprised of a system of co-existing, interdependent factors. Group dynamics produced a plethora of concepts and variables: goal formation, cohesion, group identification and uniformity, mutual dependency, influences and power, cooperation and competition, and productivity. Group dynamics (or group process) provide a helpful framework of carefully defined and operationalized relevant group concepts.
Sociometry The following summarizes Sociometry: Inspired by J. L. Moreno's work. Both a general theory of human relations and a specific set of practice techniques (psychodrama, sociodrama, role playing). Sociometric test are devised to measure the 'affectivity' factor in groups. Quality of interpersonal attraction in groups is a powerful force in rallying group members, creating feelings of belonging, and making groups sensitive to member needs.
Cognitive Consistency Theory and Balance Theory Cognitive Consistency Theory and Balance Theory in relation to small group practice are explained as follows: Basic assumption of cognitive consistency theory is that individuals need to organize their perceptions in ways that are consistent and comfortable. Beliefs and attitudes are not randomly distributed but rather reflect an underlying coherent system within the individual that governs conscious processes and maintains internal and psychosocial consistency. According to balance theory, processes are balanced when they are consistent with the individual's beliefs and perceptions. Inconsistency causes imbalance, tensions, and stress, and leads to changing perceptions and judgments which restore consistency and balance. The group worker incorporates varying ideas from these orientations. Some stress the need for the group to be self-conscious, to study its own processes, emphasizing that cognition is apparent in contracting, building group consciousness, pinpointing or eliminating obstacles, and sharing data.
Social Reinforcement and Exchange theory Below is a summarization of Social Reinforcement and Exchange theory in regard to group work: Social exchange theorists propose that members of groups are motivated to seek profit in their interactions with others, i.e. to maximize rewards and minimize costs. Analysis of interactions within groups is done in terms of a series of exchanges or tradeoffs group members make with each other. The individual member is the primary unit of analysis. Many of the core concepts of this theory are merely transferred to the group situation and do not further understanding of group processes.
Group properties Group properties are attributes that characterize a group at any point in time. They include: Formal vs. informal structure Primary group (tight-knit family, friendship, neighbor) Secondary relationships (task centered) Open vs. closed Duration of membership Autonomy Acceptance-rejection ties Social differentiation and degrees of stratification Morale, conformity, cohesion, contagion, etc.
Analyzing group processes The following are the major categories for analyzing group processes: Communication processes Power and influence Leadership Group norms and values Group emotion Group deliberation and problem solving
Group development Group development is described as follows: Group processes that influence the progress of a group, or any of its sub-groups, over time. Group development typically involves changing structures and group properties that alter the quality of relationships as groups achieve their goals. Understanding group development gives workers a blueprint for interventions that aid the group's progression toward attaining goals. A danger in using development models is in the worker's forcing the group to fit the model, rather than adapting interventions for what is occurring in the group. A complex set of properties, structures, and ongoing processes influence group development. Through processes that are repeated, fused with others, modified and reinforced, movement occurs.
The following are the stages in the different linear stage models of group development: - Tuckman's Five stages: - form - storm - norm - perform - adjourn - Boston Model (Garland, Jones, & Kolodny): - Preaffiliation - Power and Control - Intimacy - Differentiation - Separation - Relational Model (feminist, Schiller): - Preaffiliation - Establishing a Relational Base - Mutuality & Interpersonal Empathy - Challenge & Change - Separation & Termination
Social Goals Model The Social Goals Model of group practice is summarized as follows: Primary focus—to influence a wide range of small group experiences, to facilitate members' identifying and achieving of their own goals, and to increase social consciousness and social responsibility. Assumes a rough unity between involvement in social action and psychological health of the individual. Early group work was concerned with immigrant socialization and emphasized principles of democratic decision making, in addition to tolerance for difference. Methodology—focus on establishing positive relationships with groups and members, using group processes in doing with the group rather than for the group, identification of common needs and group goals, stimulation of democratic group participation, and providing authentic group programs stemming from natural types of 'group living.'
Remedial/Rehabilitative Model The Remedial/Rehabilitative Model of group practice is described below: - Uses a medical model and the worker is focused primarily on individual change. - Structured program activities and exercises. - More commonly found in organizations concerned with socialization, such as schools, and in those concerned with treatment and social control (inpatient mental health treatment, etc.). Practice techniques in this model focus on stages of treatment: Beginning stage—intake, group selection, diagnosis of each member, setting specific goals Middle stage—planned interventions. Worker is central figure and uses direct means to influence group and members. Worker is spokesperson for group values and emotions. Worker motivates and stimulates members to achieve goals. Ending stage—group members have achieved maximum gains. Worker helps clients deal with feeling about ending. Evaluation of work, possible renegotiation of contract.
Reciprocal Interactional or Mediating Model The Reciprocal Interactional or Mediating Model of group practice is explained as follows: - Worker is not called a therapist but a mediator and participates in a network of reciprocal relationships. Goals are developed mutually through contracting process. The interaction and insight of group members is the primary force for change in what is seen as a 'mutual aid' society. - Worker's task—help search for common ground between group members and the social demands they experience, help clients in their relationships with their own social systems, detect and challenge obstacles to clients' work, and contribute data. Phases of intervention: Tuning in/preparation for entry—worker helps the group envision future work, but makes no diagnosis. Worker is sensitive to members' feelings. Beginnings—worker engages group in contracting process; group establishes clear expectations. Middle phase—searching for common ground, discovering/challenging obstacles, data contribution, sharing work visions, defining limits/requirements Endings—worker sensitive to own and members' reactions and helps members evaluate the experience and consider new beginnings
Freudian/Neo-Freudian approach The Freudian/Neo-Freudian approach to group practice is explained as follows: Groups of 8-10 members. Interaction mainly through discussion. Group members explore feelings and behavior and interpret unconscious processes. The worker uses interpretation, dream analysis, free association, transference relations, and working through. This approach aims to help group members re-experience early family relationships, uncover deep-rooted feelings, and gain insight into the origins of faulty psychological development.
Tavistock Group-Centered Model The Tavistock 'Group as a Whole' Group-Centered Model for practice with groups is summarized as follows: This approach derives from Bion's work with Leaderless Groups. Bion developed analytic approaches that focused on the group as a whole. Latent group feelings are represented through the group's prevailing emotional states or 'basic assumption cultures.' Groups are sometimes called S groups (Study groups). Therapist is referred to as a consultant. The consultant does not suggest an agenda, establishes no rules/procedures, but rather acts as an observer. Major role of the consultant is to alert members to ongoing group processes and to encourage study of these processes. Consultant encourages members to explore their experiences as group members through interaction.
Irvin Yalom's 'Here-and-Now' or Process Groups Irvin Yalom's 'Here-and-Now' or Process Groups are described as follows: Yalom stressed using clients' immediate reactions and discussing members' affective experiences in the group. Relatively unstructured and spontaneous sessions. Groups emphasize therapeutic activities, like imparting information, or instilling hope, universality, and altruism. The group can provide a rehabilitative narrative of primary family group development, offer socializing techniques, provide behavior models to imitate, offer interpersonal learning, and offer an example of group cohesiveness and catharsis. Two inpatient group methods based on the interpersonal approach are the Interactional Agenda Group and Focus Groups.
Moreno's Psychodrama group therapy Moreno's Psychodrama group therapy is explained below: Powerful therapy for groups that uses spontaneous drama techniques to aid in the release of pent-up feelings, and to provide insight and catharsis to help participants develop new and more effective behaviors. Five primary instruments used are the stage, the patient or protagonist, the director or therapist, the staff of therapeutic aides or auxiliary egos, and the audience. Can begin with a warm-up. Uses an assortment of techniques such as self-presentations, interviews, interaction in the role of the self and others, soliloquies, role reversals, doubling techniques, auxiliary egos, mirroring, multiple doubles, life rehearsals, and exercises.
Behavioral Group Therapies Behavioral Group Therapies are as follows: Main goals: to help group members eliminate maladaptive behaviors and learn new behaviors that are more effective. Not focused on gaining insight into the past, but rather on current interactions with the environment. Among few research-based approaches. Worker utilizes directive techniques, providing information, and teaching coping skills and methods of changing behavior. Worker arranges structured activities. Primary techniques used—restructuring, systematic desensitization, implosive therapies, assertion training, aversion techniques, operant-conditioning, self-help reinforcement and support, behavioral research, coaching, modeling, feedback, and procedures for challenging and changing conditions.
Group work Seriously mentally ill clients Clearly defined programs that use psychosocial rehabilitation approaches (not psychotherapeutic). Focus on making each group session productive and rewarding to group members. Themes addressed include dealing with stigma, coping with symptoms, adjusting to medication side effects, dealing with problems (family, relationships, housing, employment, education, etc.), real/imagined complaints about mental health treatment organizations. Many groups in community-based settings focus on helping members learn social skills for individuals with limited or ineffective coping strategies. Mandated groups in forensic settings are highly structured and focus on basic topics such as respect for others, responsibility for one's behavior, or staying focused.
Chemical dependency Group work is the treatment of choice for substance abuse. Guidelines for these groups include maintaining confidentiality, using 'I' statements, speaking directly to others, never speaking for others, awareness of one's own thoughts and feelings, honesty about thoughts and feelings, taking responsibility for one's own behavior. Types of groups used include: Orientation groups that give information regarding treatment philosophy/protocols. Spiritual groups that incorporate spirituality into recovery. Relapse prevention groups that focus on understanding and dealing with behaviors and situations that trigger relapse. AA and NA self-help groups utilize the principles and philosophies of 12-step programs. For family and friends, Nar-Anon and Al-Anon groups provide support.
Parent education groups These groups are used in social agencies, hospitals and clinics. Often labeled as Psychoed groups or Parent training groups. Use a cognitive-behavioral approach to improve the parent-child relationship. Often structured to follow manuals or curricula. Focus is helping parents improve parent-child interactions, parent attitudes, and child behaviors.
Abused women's groups Provide warm, accepting, caring environment in which members can feel secure. Structured for consciousness raising, dispelling false perceptions, and resource information. Common themes these groups explore include the use of power which derives from the freedom to choose, the need for safety, the exploration of resources, the right to protection under the law, and the need for mutual aid. Basic principles of these groups: respect for women, active listening and validation of members' stories, insuring self-determination and individualization, and promoting group programs that members can use to demonstrate their own strength and achieve empowerment. For post-group support, groups typically seek to utilize natural supports in the community.
Groups for spouse abusers Work with this population is typified by resistance and denial. Clients have difficulty processing guilt, shame, or abandonment anxiety and tend to convert these feelings into anger. These clients have difficulties with intimacy, trust, mutuality, and struggle with fear of abandonment and diminished self-worth. Mandatory group treatment is structured. It is designed to challenge male bonding that often occurs in such groups. Including spouses/victims in these groups is quite controversial in clinical literature.
Groups for sex offenders Typically, membership in these groups is ordered by the court. No assurance of confidentiality, as workers may have to provide reports to the courts, parole officers, or other officials. Clients typically deny, test workers, and are often resistant. In groups with voluntary membership, confidentiality is extremely important, as group members often express extreme fear of exposure. Prominent themes include denial, victim-blaming, blaming behavior on substances, blaming behavior on uncontrollable sex drives/needs. Treatment emphasizes the importance of conscious control over drives/needs, regardless of their strength or if they are 'natural.' Culture of victimization strongly discouraged.
Groups for children of alcoholic families Individuals who grow up with parents who abuse alcohol and/or drugs often learn to distrust others as a survival strategy. They become used to living with chaos and uncertainty and with shame and hopelessness. These individuals commonly experience denial, secrecy, and embarrassment. They may have a general sense of fearfulness, especially if they faced threats of violence, and tend to have rigid role attachment. Treatment in these groups requires careful planning, programming, and mutual aid in the form of alliances with parental figures and other related parties in order to create a healthy environment that increases the individual's safety and ability to rely on self and others. Groups for sexually abused children Group treatment typically used with child victims of sexual abuse. Worker must pay particular attention to her/his own attitudes toward sexuality and the sexual abuse of children. Important in these groups are contracting, consistent attendance, and clearly defined rules and expectations. Clients may display control issues and may challenge the worker's authority. Confidentiality is not guaranteed. Termination can be a particularly difficult process. Common themes that come up include fear, anger, guilt, depression, anxiety, inability to trust, delayed developmental/socialization skills. Programming can include ice breaking games, art, body drawings, letter writing, and role playing.
Sigmund Freud's Psychoanalytic Theory The Topographical Theory, found within Sigmund Freud's Psychoanalytic Theory, is summarized as follows: - Unconscious - Repressed fantasies and experiences of childhood/adolescence - Primary process functioning—immediate discharge of mental energies - Inaccessibility to consciousness - Wish fulfillment—wishes are the motivation behind dreams - Infantile—guided by pleasure principle - Preconscious - Accessibility to consciousness - Censor which blocks the unconscious - Operates according to reality principle - Consciousness - Sensations from the outer world and from inner events such as thoughts, emotions, memories - Reality principal functioning
The Structural theory is summarized as follows: - Id is the source of all motives, energies, and instincts. Cathexes of the id are mobile, press for immediate and rapid discharge. - Ego is the rational, reality-oriented personality system. - Superego moral and ethical standards, ambitions, and ego ideals (conscience). Seeks to inhibit id impulses. - Personality development—infants are pure id (driven by pleasure principle). Id collides with reality, which leads to ego development. Ego builds practical coping strategies, including capacity to delay gratification. Ego is then governed by reality principle. Reality oriented thinking is referred to as secondary process thought. Finally, the oedipal complex occurs in early childhood. Out of that process develops the superego.
Sigmund Freud's Psychosexual Stages of Development are as follows: - Oral stage: birth to 1.5 yrs, gratification through mouth/upper digestive tract - Anal Stage: 1.5-3 yrs, child gains control over anal sphincter, bowel movements - Phallic Stage: 3-5 yrs, gratification in genital zone and is sought without concern for others. Major task is resolution of oedipal complex and leads to development of superego. This begins about age 4 and the child's phallic striving is directed toward opposite-sex parent and in competition with same-sex parent. Out of fear and love, the child renounces his desire for opposite sex parent and represses her/his sexual desires. Child then identifies with same-sex parent, internalizes their values, etc., which leads to development of superego and ability to experience guilt. - Latency stage: 6-10 yrs, sublimation of oedipal stage, expression of sexual/aggressive drives in socially acceptable forms - Genital stage: 10 yrs-adulthood, acceptance of one's genitalia, concern for others' well-being Adult personality types, according to Sigmund Freud, are summarized below: - Oral Personality: Infantile, demanding, dependent behavior; preoccupation with oral gratification. - Anal Personality: Stinginess, excessive focus on accumulating and collecting. Rigidity in routines and forms, suspiciousness, legalistic thinking. - Phallic Personality: Selfish sexual exploitation of others, without regard to their needs or concerns.
Social-psychological area of community There are several versions of the social-psychological area of community. One is the belief that people of a community are bound together by an existing area of interest. They feel connected based on goals they share, needs, values and activities that makeup the feeling of community. Another is the belief that there is a personal-psychological community within each individual. This is the view from one person that reflects what the community is like. Children and lower-class individuals tend to view community as having more narrow boundaries than the middle and upper class adults do. Another view is the cultural-anthropological view of community, which looks at community as a form of social living that is defined by attitudes, norms, customs, and behaviors of those living in the community.
Learning Theory and Behavior Modification Pavlov Pavlov learned to link experimentally manipulated stimuli (or conditioned stimuli) to existing natural, unconditioned stimuli that elicited a fixed, unconditioned response. Pavlov accomplished this by introducing the conditioned response just prior to the natural, unconditioned stimulus. Just before giving a dog food (an autonomic stimulus for salivation), Pavlov sounded a bell. The bell then became the stimulus for salivation, even in the absence of food being given. Many conditioned responses can be created through continuing reinforcement.
B.F. Skinner Empty Organism Concept—an infant has the capacity for action built into her/his physical makeup. Also has reflexes and motivation that will set this capacity in random motion. The Law of Effect governs development. Behavior of children is shaped largely by adults. Behaviors that result in satisfying consequences are likely to be repeated under similar circumstances. Halting or discontinuing behavior is accomplished by denying satisfying rewards or through punishment. Schedules of Reinforcement—rather than reinforcing every instance of a correct response, one can reinforce a fixed percentage of correct responses, or space reinforcements according some interval of time. Intermittent reinforcement will reinforce the desired behavior. Skinner was an operant theorist.
Operant Behavior and Respondent Behavior Operant Behavior is controlled by consequences of that behavior. Actions preceding or following the behavior need to be changed. Respondent Behavior is behavior which is brought out by a specific stimulus. The individual must be desensitized to the stimuli, for example, in the case of phobias.
Systematic Desensitization and Flooding Systematic desensitization is a therapy used to treat anxiety disorders, typically those caused by a specific stimulus. The patient is progressively exposed to anxiety-inducing objects, images, or situations, or is asked to imagine them, and is then encouraged to practice relaxation or other coping techniques to manage or eliminate the anxiety. Once the client learns to cope with a given level of exposure, the intensity of the exposure is increased and the process is repeated. This continues until the client is successfully desensitized to the stimulus. Flooding is an extreme form of desensitization by exposure. While typical systematic desensitization gradually increases the intensity of the stimulus, flooding jumps directly to the final stage. The client is subjected to the full intensity of the anxiety-inducing stimulus for a prolonged period of time, sometimes several hours. Part of the reasoning for this method is that all of the physiology-based fear responses can only affect the person for limited time, and once the client is no longer affected, they will be better able to train themselves not to fear the stimulus.
Community organization practice Assumptions The following assumptions underlie community organization practice: Members of the community want to improve their situation. Members of the community are able to develop the ability to resolve communal and social problems. Rather than having changes imposed on them, members must participate in change efforts. A systems approach, which considers the total community, is more effective than imposing programs on the community. One goal of participation in community organization initiatives involving social workers is education in democratic decision-making and promoting skills for democratic participation. The organizer enables members to address community problems independently, in part through their learning analytic, strategic, and interpersonal skills.
Models The following are the different models of community organization practice: Locality Development Social Planning Social Action Social Reform
Locality Development model: The Locality Development model of community organization practice is summarized as follows: Working in a neighborhood with the goal of improving the quality of community life through broad-spectrum participation at the local level. Is process-oriented with a purpose of helping diverse elements of the community come together to resolve common problems and improve the community. Tactics used include consensus and capacity building. As the organization resolves smaller problems, it facilitates the solving of more complex and difficult problems. The worker's roles include enabler, coordinator, educator, and broker.
Social Planning model: The Social Planning model of community organization practice is summarized as follows: Involves careful, rational study of a community's social, political, economic, and population characteristics in order to provide a basis for identifying agreed-upon problems and deciding on a range of solutions. Government organizations can be sponsors, participants, and recipients of information from social planners. Focus on problem solving through fact gathering, rational action, and needs assessment. Tactics may be consensus or conflict. The worker's roles include researcher, reporter, data analyst, program planner, program implementer, and facilitator.
Social Action model: The Social Action model of community organization practice is summarized as follows: This model requires an easily identifiable target and relatively clear, explainable goals. Typically, the target is a community institution that controls and allocates funds, community resources, and power and clients are those who lack social and economic power. Assumption in this model is that different groups in the community have interests that are conflicting and are irreconcilable. In many cases, direct action is the only way to convince those with power to relinquish resources and power. Tactics include conflict, confrontation, contest, and direct action. The worker's roles include that of advocate, activist, and negotiator.
Social Reform model: The Social Reform model of community organization practice is summarized as follows: In collaborating with other organizations for the disadvantaged, the worker's role is to develop coalitions of various groups to pressure for change. This model is a mixture of social action and social planning. Strategies include fact gathering, publicity, lobbying, and political pressure. Typically, this approach is pursued by elites on behalf of disadvantaged groups.
Geriatric social work The theoretical base of Geriatric Social Work includes the following: Psychodynamic theory Ego psychology Family systems theory Life-span development theory (Wieck) Continuity theory Normal aging and demographics of the aging population Impact of chronic illness and physical/cognitive limitations
Geriatric Social Work makes the following assumptions about human behavior: Growth occurs throughout the life span, including during old age. Individuals are inherently adaptive and are capable of managing the disruptions, discontinuities, and losses that are characteristic of old age. Our culture demands and values independence. This can present a conflict with accepting the increasing need for help in old age. The younger generation's caring for the older may be seen as role reversal and may be challenging to both generations. Dependency in the aged, however, has a different meaning than dependency in childhood. Supportive services are preferable to institutional care whenever possible. Ageist assumptions or an individual's living in an institutional setting are not reasons to compromise self-determination or confidentiality. Individuals age in different ways.
Challenges of diagnosis and treatment of alcohol abuse Particular challenges of alcohol abuse in the context of diagnosis and treatment are discussed below: Alcohol is the most available and widely used substance. Progression of alcoholism dependence often occurs over an extended period of time, unlike some other substances whose progression can be quite rapid. Because of this slow progression, individuals can deny their dependence and hide it from employers for long periods. Most alcohol dependent individuals have gainful employment, live with families, and are given little attention until their dependence crosses a threshold, at which time the individual fails in their familial, social, or employment roles. Misuse of alcohol represents a difficult diagnostic problem as it is a legal substance. Clients, their families, and even clinicians can claim that the client's alcohol use is normative. After friends, family members, or employers tire of maintaining the fiction that the individual's alcohol use is normative, the alcoholic will be more motivated to begin the process of accepting treatment.
Harm due to method of administration of illegal drugs Harm that may come from the use of illegal drugs due to their method of administration is discussed below: Doses can be unknown, which can lead to drug overdose and death. Using contaminated needles can cause staph infections, Hepatitis, or HIV/AIDS. Inhalants are frequently toxic and can cause brain damage, heart disease, and kidney or liver failure.
Harm from behaviors caused by substance abuse Harm that can result from the behaviors that substance use/abuse can generate is discussed below: Substances that are illegally obtained are often associated with minor crimes, crimes against family members and the community, and prostitution. Alcohol is associated with domestic violence, child abuse, sexual misconduct, and serious auto accidents. All substances promote behavioral problems that may make it difficult for the individual to obtain/retain employment, or to sustain normal family relationships.
Narcotics Narcotics are: Drugs used medicinally to relieve pain. They have a high potential for abuse. They cause relaxation with an immediate rush. Possible effects are restlessness, nausea, euphoria, drowsiness, respiratory depression, constricted pupils.
Symptoms of overdose The following are symptoms of overdose of narcotics: Slow, shallow breathing Clammy skin Convulsions Coma Possible death
Withdrawal syndrome The withdrawal syndrome for narcotics includes the following symptoms: Watery eyes Runny nose Yawning Cramps Loss of appetite Irritability Nausea Tremors Panic Chills Sweating
Depressants Depressants are: Drugs used medicinally to relieve anxiety, irritability, or tension. They have a high potential for abuse and development of tolerance. They produce a state of intoxication similar to that of alcohol. When combined with alcohol, their effects increase and their risks are multiplied.
Withdrawal syndrome Withdrawal syndrome for depressants includes the following symptoms: Anxiety Insomnia Muscle tremors Loss of appetite Abrupt cessation or a greatly reduced dosage may cause convulsions, delirium, or death.
Stimulants Stimulants are drugs used to increase alertness, relieve fatigue, feel stronger and more decisive, for euphoric effects, to counteract the 'down' feeling of depressants or alcohol. Effects The following are the possible effects of stimulants: Increased heart rate Increased respiratory rate Elevated blood pressure Dilated pupils Decreased appetite
With high doses— Rapid or irregular heartbeat Loss of coordination Collapse Perspiration Blurred vision Dizziness Feelings of restlessness, anxiety, delusions
Withdrawal syndrome Withdrawal syndrome for stimulants includes the following symptoms: Apathy Long periods of sleep Irritability Depression Disorientation
Hallucinogens Hallucinogens are: Drugs that cause behavioral changes that are often multiple and dramatic. No known medical use, but some block sensation to pain and their use may result in self-inflicted injuries. 'Designer drugs,' which are made to imitate certain illegal drugs, can be many times stronger than the drugs they imitate.
Effects The possible effects of hallucinogens are as follows: Rapidly changing mood/feelings, immediately and long after use. Hallucinations, illusions, dizziness, confusion, suspicion, anxiety, loss of control. Chronic use—depression, violent behavior, anxiety, distorted perception of time. Large doses—convulsions, coma, heart/lung failure, ruptured blood vessels in the brain. Delayed effects—'flashbacks' occurring long after use. Designer drugs—possible irreversible brain damage.
Cannabis Cannabis is the hemp plant from which marijuana (a tobacco like substance) and hashish (resinous secretions of the cannabis plant) are produced. Effects Euphoria followed by relaxation Impaired memory, concentration, and knowledge retention Loss of coordination Increased sense of taste, sight, smell, hearing Irritation to lungs and respiratory system Cancer With stronger doses: fluctuating emotions, fragmentary thoughts, disoriented behavior
Withdrawal syndrome The withdrawal syndrome for cannabis includes the following symptoms: Insomnia Hyperactivity Sometimes decreased appetite
Alcohol Alcohol is: A liquid distilled product of fermented fruits, grains, and vegetables. Can be used as a solvent, an antiseptic, and a sedative. Has a high potential for abuse. Small to moderate amounts taken over extended periods of time have no negative effects and may have positive health results.
Effects The following are possible effects of alcohol use: Intoxication Sensory alteration Reduction in anxiety
Withdrawal syndrome The withdrawal syndrome for alcohol includes the following symptoms: Sweating Tremors Altered perception Psychosis Fear Auditory hallucinations
Steroids Steroids are synthetic compounds closely related to the male sex hormone, testosterone, and are available legally and illegally. They have a moderate potential for abuse, particularly among young males. Effects The following are the possible effects of steroids: Increase in body weight Increase in muscle mass and strength Improved athletic performance Improved physical endurance.
Withdrawal syndrome The withdrawal syndrome for steroids includes the following symptoms: Considerable weight loss Depression Behavioral changes Trembling
Substance abuse treatment The components of treatment for individuals with substance use disorders are: An assessment phase Treatment of intoxication and withdrawal when necessary Development of a treatment strategy.
Three general treatment strategies used with individuals with substance abuse disorders are: Total abstinence (drug-free) Substitution, or use of alternative medications that inhibit the use of illegal drugs Harm reduction
The goals of substance abuse treatment are: Reducing use and effects of substances Abstinence Reducing the frequency and severity of relapse Improvement in psychological and social functioning
The objectives of clinical management in treatment for clients with substance abuse disorders are as follows: Establish and maintain a therapeutic alliance. Monitor the client's clinical status. Arrange and monitor services/programs for the client and family. Assess the need for continued services, monitor their effectiveness. Provide direct clinical social work services. Remain alert to states of intoxication and withdrawal. Facilitate client's following the treatment plan. Prevent relapse. Provide education about substance use disorders. Ensure availability of medical care.
The following psychosocial treatments have been found to be most effective for clients with substance use disorders: Cognitive behavioral therapies Behavioral therapies Psychodynamic/interpersonal therapies Group and family therapies Participation in self-help groups
Contributing and predicting factors of substance abuse The following are some factors that contribute to and predict substance use: - Early or regular use of 'gateway' drugs (alcohol, marijuana, nicotine) - Early aggressive behavior - Intra-familial disturbances - Associating with substance-using peers
Drug of choice The factors that influence an individual's preference for a 'drug of choice' are: Current fashion Availability Peer influences Individual biological and psychological factors Genetic factors (especially with alcoholism)
Anna Freud's Defense Mechanisms The Nature of Defense Mechanisms according to Anna Freud, are as follows: - Defense mechanisms are an unconscious process in which the ego attempts to expel anxiety-provoking sexual and aggressive impulses from consciousness. - Defense mechanisms are attempts to protect the self from painful anxiety and are used universally. In themselves they are not an indication of pathology, but rather an indication of disturbance when their cost outweighs their protective value. The following are terms as they pertain to Anna Freud's Defense Mechanisms: - Compensation - protection against feelings of inferiority and inadequacy stemming from real or imagined personal defects or weaknesses - Conversion - somatic changes conveyed in symbolic body language; psychic pain is felt in a part of the body - Denial - avoidance of awareness of some painful aspect of reality - Displacement - investing repressed feelings in a substitute object - Association - altruism; acquiring gratification through connection with and helping another person who is satisfying the same instincts - Identification - manner by which one becomes like another person in one or more respects. Is a more elaborate process than introjection. - Introjection - absorbing an idea or image so that it becomes part of oneself. - Inversion (turning against the self) - object of aggressive drive is changed from another to the self, especially in depression and masochism. - Isolation of Affect - Separation of ideas from the feelings originally associated with them. Remaining idea is deprived of motivational force; action is impeded and guilt avoided. - Intellectualization - Psychological binding of instinctual drives in intellectual activities, for example the adolescent's preoccupation with philosophy and religion - Projection - Ascribing a painful idea or impulse to the external world. - Rationalization - effort to give a logical explanation for painful unconscious material to avoid guilt and shame. - Reaction Formation - replacing in conscious awareness a painful idea or feeling with its opposite. - Regression - withdrawal to an earlier phase of psychosexual development - Repression - the act of obliterating material from conscious awareness. Is capable of mastering powerful impulses. - Reversal - Type of reaction formation aimed at protection from painful thoughts/feelings - Splitting - Seeing external objects as either all good or all bad. Feelings may rapidly shift from one category to the other. - Sublimation - redirecting energies of instinctual drives to generally positive goals that are more acceptable to the ego and superego. - Substitution - trading of affect for another, i.e., rage masking fear - Undoing - ritualistically performing the opposite of an act one has recently carried out in order to cancel out or balance the evil that may have been present in the act - Identification with the Aggressor - a child's introjection of some characteristic of an anxiety evoking object and assimilation of an anxiety experience just lived through. In this, the child can transform from the threatened person into the one making the threat.
Trauma-Related social work The following describes the theoretical base of Trauma-Related social work practice with adults: The trauma victim experiences a threat to her/his physical integrity or life. The trauma experience confronts a person with an extreme situation of fear and helplessness. Trauma may be chronic and repeated or may take the form of one event of short duration. Many of the symptoms related to PTSD and domestic violence are self-protective attempts at coping with realistic threats.
Trauma-Related social work practice makes the following assumptions about human behavior: Most individuals experience the world as a basically safe place in which they are worthy participants. Trauma can challenge or reverse these assumptions about the world and oneself. Resilience is defined as an innate capacity to self-regulate after experiencing a stressor so extreme as to be traumatic. Resilience can be derived from both internal and environmental resources. Resilience can be more difficult to achieve or sustain when the trauma is more severe, is chronic, and/or when the perpetrator is someone who should be a caretaker or trusted protector.
Physical and sexual abuse Physical abuse—extreme physical discipline that exceeds normative community standards Physical indicators—bruises or broken bones on an infant without an adequate explanation or that occur in unusual places; lacerations; fractures; burns in odd patterns; head injuries; internal injuries; open sores; untreated wounds or illnesses Behavioral indicators—child may be overly compliant, passive, undemanding; overly aggressive, demanding, hostile; role reversal behavior, extremely dependent behavior re: parental, emotional, physical needs; developmental delays Sexual abuse—inappropriate sexual contact, molestation, rape
Child neglect Child neglect is the failure of a child's parent or caretaker, who has the resources, to provide minimally adequate health care, nutrition, shelter, education, supervision, affection, or attention. Also, insufficient encouragement to attend school with consistency, exploitation by forcing to work too hard or long, or explore to unwholesome or demoralizing circumstances. Indicators of child neglect include abandonment, absence of sufficient adult supervision, inadequate clothing, poor hygiene, lack of sufficient medical/dental care, inadequate education, inadequate supervision, inadequate shelter; consistent failure, unwillingness, or inability to correct these indicators. Treating maltreated/traumatized children Treatment planning in social work practice with maltreated/traumatized children includes the following: Principal goal is protecting child from further harm and halting any further abuse, neglect, or sexual exploitation immediately and conclusively. This may require temporary or permanent removal of an offending caretaker or household member, or removal of the child from the home to a safe place. Secondary goal is creating conditions that insure that abuse or neglect does not recur after supervision/treatment is terminated. May include prosecution/incarceration of offending party. May include evaluation of non-offending parent's long-term capacity and motivation to protect the child. Official agency can and will use legal authority to insure compliance with agency directives when necessary. Worker should be aware that possibility of child's removal may be primary concern of parent and may lead to panic, dissembling, or flight. Treatment's goal is to help parents learn parenting/relational skills that can change parental behavior and child's responses.
Theory of Cultural Relativism The Theory of Cultural Relativism is summarized below: - Values, beliefs, models of behavior, and understandings of the nature of the universe must be understood within the cultural framework in which they appear. - The outlines and limitations of normality and deviance are determined by the dominant culture. - Ethnic/minority behavioral norms and expressions of emotional needs may be defined as abnormal in that they differ from those of the larger, dominant culture. - If understood through a unique cultural context behaviors/attitudes may be perceived differently. It is important for a worker to know whether a client from a particular ethnic group who displays unorthodox behavior is also deviant within her/his own culture, as well as in her/his self-assessment.
Children in poverty The following are some basic facts/statistics dealing with children in poverty in the U.S.: Almost one in four children under age six lives in poverty. Minority children under age six are much more likely than white children of the same age. Many of these children in poverty are homeless or are in the child welfare system. Fewer than one-third of all poor children below age six live solely on welfare. More than half of children in poverty have at least one working parent. Children of single mothers are more likely to live in poverty. Poor children have increased risk of health impairment.
Children in the child welfare system The following are some disabilities that children in the child welfare system face in this country: Children in foster care often go through frequent relocations due to rejection by foster families, changes in the family situation, returning to biological families and later returns to foster care, agency procedures, and decisions of the court. Additionally, many foster children experience sexual and physical abuse within the foster care system. Due to frequent changes in their situation, children in foster care may change schools multiple times, which can have an adverse impact on their academic achievement. Many youth 'age out' of the foster care system at age 18; this can abruptly end the relationships with foster families and other supportive structures. Compared with children raised with their own families, children who have been through the foster care system have a higher incidence of behavioral problems, increased substance abuse, and greater probability of entering the criminal justice system.
Theory of Moral Development Lawrence Kohlberg's Theory of Moral Development is summarized as follows: Build on Piaget's moral development research in which he argues that children's experiences shape their understanding of moral concepts (i.e. justice, rights, equality, human welfare) and that moral development is a process that takes an extended period. Kohlberg distinguishes six stages of moral reasoning, each of which reveals a dramatic change in the moral perspective of the individual. Moral development is linear (no stage can be skipped) and takes place throughout the life span. Progress between stages is contingent upon the availability of a role model offering a model of the principles of the next higher level.
Stage 1 of Kohlberg's Theory of Moral Development is summarized as follows: Stage one is the pre-conventional or primitive level. The individual perspective frames moral judgments, which are concrete. The framework of Stage 1 stresses rule following, because breaking rules may lead to punishment. Reasoning of Stage 1 is ego-centric and is not concerned with others.
Stage 2 of Kohlberg's Theory of Moral Development is summarized as follows: Stage 2 emphasizes moral reciprocity. It has its focus on the pragmatic, instrumental value of an action. Individuals at this stage observe moral standards because it is in their interest, but they are able to justify retaliation as a form of justice. Behavior in this stage is focused on following rules only when it is in the person's immediate interest. Stage 2 has a mutual contractual nature, which makes rule-following instrumental and based on externalities. There is, however, an understanding of conventional morality.
Stage 3 of Kohlberg's Theory of Moral Development is summarized as follows: Individuals in Stage 3 define morality in reference to what is expected by those with whom they have close relationships. Emphasis of this stage is on stereotypic roles (good mother, father, sister). Virtue is achieved through maintaining trusting and loyal relationships.
Stage 4 of Kohlberg's Theory of Moral Development is summarized as follows: This stage shifts from basically narrow local norms and role expectations to a larger social system perspective. Social responsibilities and observance of laws are key aspects of social responsibility. Individuals reflect higher levels of abstraction in understanding laws' significance. Individuals at Stage 4 have a sophisticated understanding of the law and only violate laws when they conflict with social duties. Observance of the law is seen as necessary to maintain the protections that the legal system provides to all.
Stage 5 of Kohlberg's Theory of Moral Development is summarized as follows: Stage 5 is characterized as the beginning of the post-conventional level. Ethical reasoning is shaped on the basis of general principles and is understood in accordance with underlying rules and norms. Stage 5 rejects uniform application of rules and norms. The level of moral judgment is rooted in the ethical fairness principles from which moral laws are created. The person at this level critically evaluates laws and judges whether or not they conform to principles of basic fairness which are agreed upon by a majority. This level values human life and human welfare as the primary principles of existence.
Stage 6 of Kohlberg's Theory of Moral Development is summarized as follows: Stage 6 is the natural progression of Stage 5. This stage has a complete separation of morality from legality; laws may be entirely unjust. The individual uses abstract reasoning based on universal principles to determine his or her model of morality. The person at this level critically evaluates their own actions with respect to their understanding of justice. If they find their actions inconsistent with their belief, they experience guilt.
Morality of Care The following summarizes Carol Gilligan's Morality of Care: Is the feminist response to Kohlberg's moral development theory. Kohlberg's theory based on research on males. Gilligan purports that a morality of care reflects women's experience more accurately than one emphasizing justice and rights. Women's morality reflects caring, responsibility, and nonviolence; morality of justice and rights emphasizes equality. Another perspective is that these two moralities give two distinct charges—to not treat others unfairly (justice/rights) and not to turn away from someone in need (care). Care stresses interconnectedness and nurturing. Emphasizing justice stems from individualism. Differences in moral perspectives are explained by aspects of attachment. Masculine—requires individuation and separation from the parent which leads to awareness of power differences and concern over inequity. Feminine—continuing attachment to parent, less awareness of inequalities, not primarily focused on fairness.
Worldview Worldview is an integral concept in assessment of clients' experience. This can be defined as a way that individuals perceive their relationship to nature, institutions, and other people and objects. This comprises a psychological orientation to life as seen in how individuals think, behave, make decisions, and understand phenomena. It provides crucial information in the assessment of mental health status, assisting in assessment and diagnosis, and in designing treatment programs. Cultural competence Individual practitioner Cultural competence for the individual practitioner is the capability to function with cultural differences. It includes: Awareness and acceptance of differences. Awareness of one's own cultural values. Understanding the dynamics of difference. Development of cultural knowledge. Ability to adapt practice skills to fit the cultural context of the client's structure, values, and service.
It is an ongoing process that requires continuing education, awareness, management of transference/countertransference, and continuous skill development.
Institution Cultural competence for the institution is the practice skills, attitudes, policies, and structures that are united in a system, in an agency, or among professionals and allow that system, agency, or group of professionals to work with cultural differences. It includes: - Values diversity—diverse staff, policies that acknowledge and respect differences, and regular initiation of cultural self-assessment. - Institutionalization—the organization has integrated diversity into its structure, policies, and operations.
Communication Interpersonal communication is shaped by both culture and context. According to Hall's Theory of Communication, high context communication styles are used in Asian, Latino, Black, and Native American cultures in the U.S. In this style, there is a strong reliance on contextual cues and a flexible sense of time. This style is intuitive, and in it social roles shape interactions, communication is more personal and affective, and oral agreements are binding. According to Hall's theory, low context communication styles are used more in Northern European, white groups in the U.S. These styles tend to be formal and have complex codes. They tend to show a disregard for contextual codes and a reliance on verbal communication. In these styles there is an inflexible sense of time. They are highly procedural, relationships are functionally based, and linear logic is used. The clinician should be aware of the potential for cross-cultural misunderstanding and that all cultures exhibit great diversity within themselves.
Limitations Some cultural differences may be damaging or unacceptable. The worker needs to have a balanced approach to assess cultural norms within the context of American practices, norms, and laws. There are illegal and unacceptable cultural practices, such as: Child labor Honor killings Private/family vengeance Slavery Infanticide Female circumcision Clitorectomies Infibulations Wife or servant beating Bigamy Child marriage Denial of medical care Abandonment of malformed or defective children Extreme discipline of children
Language and communication to become culturally competent A worker can use language and communication to become more culturally competent by doing the following: Learn to speak the target language. Use interpreters appropriately. Participate in cultural events of the group(s). Form friendships with members of different cultural groups than one's own. Acquire cultural and historical information about cultural groups. Learn about the institutional barriers that limit access to cultural and economic resources for vulnerable groups. Gain an understanding of the socio-political system in the U.S. and the implications for majority and minority groups.
Characteristics The following are some characteristics of the culturally competent social worker: With regard for individuality and confidentiality, s/he approaches clients in a respectful, warm, accepting, interested manner. S/he understands that opinions and experiences of both worker and client are affected by stereotypes and previous experience. Is able to acknowledge her/his own socialization to beliefs, attitudes, biases, and prejudices that may affect the working relationship. Displays awareness of cross-cultural factors that may affect the relationship. Able to communicate that cultural differences and their expressions are legitimate Is open to help from the client in learning about client's background. Informed about life conditions fostered by poverty, racism, and disenfranchisement. Is aware that client's cultural background may be peripheral to the client's situation and not central to it.
Stages of development in organizations The following are the stages of development of cultural competency in organizations: Cultural destructiveness (devaluing different cultures and viewing them as inferior) Cultural incapacity (aware of need, feels incapable of providing services—immobility) Cultural blindness ('colorblind,' lack of recognition between cultural groups, denial of oppression and institutional racism) Cultural pre-competency (starting to recognize needs of different groups, seeking to recruit diverse staff and include appropriate training) Cultural competency (addresses diversity issues with staff and clients; staff is trained and confident with a range of differences) Cultural proficiency (Ideal; ability to incorporate and respond to new cultural groups)
Measures The measures of cultural competence are as follows: Recognizing effects of cultural differences on the helping process. Fully acknowledging one's own culture and its impact on one's thought and action. Comprehending the dynamics of power differences in social work practice. Comprehending the meaning of a client's behavior in its cultural context. Knowing when, where, and how to obtain necessary cultural information.
Barriers to cross-cultural practice The following are some barriers to cross-cultural practice: Cultural encapsulation (ethnocentrism, color-blindness, false universals) Language barriers (verbal, non-verbal, body language, dialect) Class-bound values (re: treatment, service delivery, power dynamics) Culture-bound values
Immigration Stresses The following are some stresses associated with immigration: Gaining entry into and understanding a foreign culture. Difficulties with language acquisition. Immigrants who are educated often cannot find equivalent employment. Distance from family, friends, and familiar surroundings.
Clinical issues The following are some clinical issues associated with immigration: Symptoms related to stress such as depression, social isolation, etc. Reason for emigrating from home country (i.e. refugee?) How immigrants use social services is greatly impacted by language and worldview.
Considerations when assessing client needs The following are areas that a worker should consider when assessing an immigrant client's needs: Why and how did client immigrate? What social supports does the client have? (community/relatives) Client's education/literacy in language of origin and in English. Economic and housing resources (including number of people in home, availability of utilities) Employment history, ability to find/obtain work. Client's ability to find and use institutional/governmental supports. Health status/resources (pre and post-immigration) Social networks (pre- and post-immigration) Life control—degree to which s/he experiences personal power and the ability to make choices
Racism Racism can be described as follows: - Generalizations, institutionalization, and assignment of values to real or imaginary differences between individuals to justify privilege, aggression, or violence. - Societal patterns that have the cumulative effect of inflicting oppressive or other negative conditions against identifiable groups based on race or ethnicity. - Is pervasive, ubiquitous, and institutionalized. Bias in human service clinical work Health and mental health services express the ideology of the culture at large (dominant culture). This may cause harm to clients or reinforce cultural stereotypes. For example: - Minorities and women often receive more severe diagnoses and some diagnoses are associated with gender. African-Americans are at greater risk for involuntary commitment. Gays and lesbians are sometimes treated with ethically questionable techniques in attempts to reorient their sexuality.
Stereotypes of the elderly The following are some stereotypes of the elderly: Asexual Rigid Impaired psychological functioning Incapable of change
Power Power is the ability to influence others in intended ways. Sources are: Control of recourses Numbers of people Degree of social organization
Important terms Client population – The group served by an agency or all clients served by all fields of social work. Structure – As it pertains to group work, structure is the patterned interactions, network of roles and statuses, communications, leadership, and power relationships that distinguish a group at any point in time. Culture – Integrated patterns of human behaviors that include thought, communication, actions, customs, beliefs, values, and institutions of a racial, ethnic, religious, or social group.
Diversity – This refers to social groups that are not easily subsumed in the larger culture. These groups differ by socioeconomic status, gender, sexual orientation, age, and differential ability. Ethnicity – This is a group classification in which members share a unique social and cultural heritage that is passed on from one generation to the next. Ethnicity is not the same as race, though the two terms are used interchangeably at times. Race – This concept first appeared in the English language just 300 years ago. There is no biological significance to race, but it has great social and political significance. Race can be defined as a subgroup that possesses a definite combination of physical characteristics of a genetic origin. Prejudice – Prejudice is bias or judgment based on value judgment, personal history, inferences about others, and application of normative judgments. Discrimination – Discrimination is the act of expressing prejudice with immediate and serious social and economic consequences. Stereotyping – Amplified distorted belief about an ethnic, gender, or other group in order to justify discriminatory conduct. Oppressed minority – A group differentiated from others in society because of physical or cultural characteristics. The group receives unequal treatment and views itself as an object of collective discrimination. Privilege – Advantages or benefits that the dominant group has. These have been given unintentionally, unconsciously, and automatically. Ageism – An attitude toward the capabilities and experiences of old age which leads to devaluation and disenfranchisement.
Acculturation – The process of learning and adopting the dominant culture through adaptation and assimilation.
Ethnic Identity – A sense of belonging to an identifiable group and having historical continuity, in addition to a sense of common customs and mores transmitted over generations. Social Identity – The dominant culture establishes criteria for categorizing individuals and the normal and ordinary characteristics believed to be natural and ordinary for members of the society. Virtual Social Identity – The attributes ascribed to persons based on appearances, dialect, social setting, and material features. Actual Social Identity – Characteristics the person actually demonstrates Stigma – A characteristic that makes an individual different from the group and is perceived to be an intensely discreditable trait. Normification – An attempt of the stigmatized person to present her/himself as an ordinary person. Normalization – Treating the stigmatized person as if s/he does not have a stigma
Join 4M+ learners. Unlock unlimited quizzes, wrong-answer tracking, flashcards + reminders, study guides, and 1-on-1 challenges.