As a developing social worker, it is crucial to analyse and discuss change in society, understand societal structures disadvantage and marginalise individuals and groups in society as well as an understanding of processes around ageing, social demography, gender and ethnicity amongst others and How theoretical interventions as well as reflect on my own knowledge and skills and the impact is has on individuals power and control over their own lives. In this essay I will be discussing my own understanding of critically reflective practice and how you apply this on placement and how your own framework for practice contributes to a socially inclusive society. As well as analysing my approach to social work practice.
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There are many disadvantaged communities and individuals in history and today. Many of these communities’ access social work services for mental health, counselling, psychosocial intervention and holistic intervention to empower and enhance quality of life. Within my student placement I was part of a service that support majority the middle eastern community providing Social Work intervention and support. Many of the individuals accessing the services presented with underlying challenges such as trauma and self-medicating behaviours. Social Work practise required a healing processes and positive change focussing on family, individuals and organisational structure. Social work practise can be challenging as there is an expectation to fix and resolve all issues. However once clients are faced with adversity individuals seek therapy in order to understand what it is that is causing anxiety and emotional change. “The aim of therapy, very briefly, is to increase the client’s level of differentiation and to decrease emotional reactivity to chronic anxiety in the system. As differentiation increases, so anxiety will decrease” (Gehart, 2010, p. 290). Basically differentiation may be defined as the ability to separate intrapersonal from interpersonal distress. From an intrapersonal perspective, one should be able to separate feelings from thoughts in order to be able to respond rather than react. From an interpersonal angle, it is necessary to be able to know where one ends and another begins without a loss of self (Gehart, 2010, p. 284). Furthermore, therapy does not influence the client if the issue is external so why would one have to change? It creates change for the external world such as a job, friend and family, therefore a Social Work works towards change using approaches such as Cognitive Behaviour Therapy or Dialectal Behaviour Therapy.
During this trimester, I have gained further in-depth knowledge and an introduction to additional major Social Work and psychotherapeutic methodologies, theories, and applications. I have integrated my preferred theory of Social Work and deepen their understanding of the theory and practice of other major Social Work theories and approaches. I have studied the philosophical theories and practical application of a range of approaches to Social Work. Covering other therapeutic modification and contemporary approaches are explored throughout the study of this unit has given me a broader understanding of the Social Work approaches used in today settings.
Within this session I have applied my main focus on an introductory session to gather information about the client based on the presenting issue in this case domestic violence. Reeves (2008) suggests that gaining an understanding of the client’s needs early in the Social Work process is essential, regardless of the Social Work’s theoretical model. “A Social Work assessment is an exploration by the Social Work and client of what has brought the client to Social Work, what the client wants or needs to change and how or if that might be facilitated by Social Work and the Social Work” (Reeves, 2008, p. 63).
I applied solution focussed or motivational interviewing skills, allowing the client to explore positives and focus on the positives. Solution-focused brief therapy is based on the assumption that clients have the ability to solve their own problems. This positive focus is taken further by looking at what already works for the client and finding ways to connect that positive experience to help in the future. A common approach in brief therapy is to ask the client: “Tell me about times when you felt a little better and when things were going your way” (Corey, 2009, p. 379). Throughout the session I used various techniques such as open ended question and closed questions to gather information needed to build a trust and professional rapport with the client. Domestic violence was the core of the client’s issue. I used the motivational interviewing theory/approach to the Social Work session, this is evident as I explored ambivalence and identified hope, I allowed the client to feel empathy throughout the session through my language and body language and exploring the positive supports the client can use in this present time.
I identified the client’s reaction to specific question, therefore I found Gestalt therapy to be appropriate in asking the client about the reaction. Essentially, gestalt therapy aims to integrate various conflicting parts of a client. It does not offer an analysis or attempt to get rid of feelings; it helps clients to re-own parts of themselves that have become lost or disowned along the way. The aim is to experience and then integrate all the factions of one’s personality. Throughout the session I did maintain sensitivity and did not advise the client or make a dramatic scene out of the situation being an abusive situation. In further session I would explore the domestic violence issue in depth if necessary, if not I would continue to focus on strength-based therapy, followed by gestalt therapy. This will enable the client to explore their strengths and work in gestalt therapeutic frame to assist with the clients supressed emotions.
There are many different methods to work with a client to influence change, these methods include: working determinedly against client resistance; interpreting and challenging client defences; encouraging, persuading and cajoling clients to keep persisting at the hard work of changing themselves; and experimenting with a wide variety of methods to find the one that works best with their individual clients.
Client issues in the early age’s social issues were addressed by group therapy. Human problems were addressed by individual or group therapy models based upon intrapsychic process and psychopathology (Barker & Chung, 2013, p. 13). Following in the later ages family and systemic Social Works, argued that it was the interactions between the individual and members of their family and other social systems that counted. For some Social Works, the inclusion of multigenerational and extended family systems was also important this was due to the fact that family systems where needed to be able to explore further issues to identify how each client interacted with the external world.AN effective approach that Social Work used was a systemic approach which concentrated on action and diminished interrupting problematic patterns of behaviour. As stated by Nichols (2014, p. 61) states: Constructivism teaches us to look beyond behaviour to ways we interpret our experience.
Harry Goolishian and Harlene Anderson developed a collaborative approach where Social Works did not adopt the role of expert. The focus of a collaborative approach is on a relational system and process in which a client and a Social Work become conversational partners in the telling, inquiring, interpreting, and shaping of the narratives. The collaborative Social Works did not approach their clients from the perspective of function or structure (Nichols, 2014, p. 61). They did, however, adopt a stance of curiosity and held that concepts like systems, enmeshment and triangles are merely metaphors which do not exist in some objective reality but are merely metaphors or constructions. For example: Nichols (2014, p. 61) gives the example of an adolescent boy who consistently disobeys his parents. He says that constructivists would point out that the boy’s actions are not just as a result of the parent’s efforts to discipline the son but on the boy’s construction of their authority. Social constructionists would add that this construction is not only shaped by the boy in regard to what occurs in the family but also by messages transmitted from the culture at large; from school, at the movies, television and so on. According to constructivists, people have problems because of the way that they interpret the objective conditions of their lives, whereas social constructionists recognise that the meanings given emerge in the process of talking with other people (p. 62).
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Dialectical Behavioural Therapy also known as DBT is an approach that helps clients to accept emotions and emotional experiences. As stated by Corey (2012, p. 367) It is a blend of cognitive behavioural and psychoanalytic techniques as well as Eastern psychological and spiritual practises mainly Zen and including Buddhist mindfulness. Within DBT, mindfulness is the capacity to pay attention non-judgementally to the present moment. Another form of therapy that Social Work use to promote change include Cognitive behavioural therapy. CBT focuses on behavioural change through challenging client thoughts. CBT is used in working with clients diagnosed with a mental health issue. For example: Those diagnosed with borderline personality disorder must enhance and maintain the client’s motivation to change. A Social Work has to realise that progress will be slow. They have to accept that clients have had tragic lives and that they will need to develop an ability to find the valid in the client’s behaviour and validate the valid (as cited in Reid, 2013, p. 24). Social Works and clients work collaboratively but clients are given a clear set of guidelines and boundaries for their behaviour (as cited in Reid, 2013, p. 6). The Social Work is to be seen as an ally rather than an adversary (as cited in Reid, 2013, p. 7). In saying this there are many issues that are faced when Social Work with change and influence such as borderline personality disorder, particularly those who are highly suicidal, is that they have no experience whatsoever of connection to others or to the universe as a whole. Dialectics always emphasizes how everything is connected, how even both sides of opposites are connected. And so there’s an emphasis on that, an emphasis on being comfortable with change. Whereas CBT Social Works don’t try to make everything stay the same so you feel secure. They try to make sure that we program in change and teach you how to be comfortable with it because it is the nature of the world. So dialectics has a lot of characteristics that are very compatible with the behavioural approach, but it expands it.
In equating therapy with change, Social Works themselves have fallen into the trap of emphasizing change for its own sake. In saying this change it is difficult to influence the clients. Taking this stand it can be an issue due to the fact that it imposes limits and constraints on the possibilities of relationship between Social Work and client – limits that may themselves significantly aggravate the elements of power within the therapeutic process and which may, however inadvertently, promote various forms of both overt and subtle abuse. According to Spinelli (1994, p. 58) stressed that “to claim that therapy is itself the means to reducing or removing social problems is both simplistic and potentially dangerous”. In summary his findings regarding therapy and Social Work and change in the following: Therapy, it seems to me, can at best provide the means to explore, better understand and reassess various issues in one’s life so that an individual gains a more adequate means of acting upon, accepting or changing his or her perspectives and behaviours. It is, broadly speaking, a means towards the acceptance and clarification of the possibilities for change rather than the instigator or cause of change. (Spinelli, 1994, p. 59).
One of the distinguishing characteristics of a Social Work relationship is the unequal power differential present. Feminist therapy and narrative models are two ways of working that directly address power in Social Work. These contemporary models recognize that is impossible and indeed unhelpful to separate the client from their social and historical context. An interesting addition to the section are reflections from Social Works themselves on their role and whether influencing clients is something that they aim to do or something they aim to minimize. The research conducted by Spong (2007) highlights the complexity and paradoxes present in the thinking of Social Works around the issue of power and influence in Social Work.
In conclusion, the ability humans have to self-right or self-heal is evidence that clients usually have what they need to heal. Social Work provides an interpersonal relationship and supportive environment that can assist clients to take the time and space they need to focus on their problems (Bohart & Tallman, 2014). Research has demonstrated that the collaboration and active involvement of clients leads to greater success in Social Work. Social Workers can promote collaboration through creating an environment where clients feel safe and comfortable to share of themselves and take risks.
References:
- Corey, G. (2012). Theory & practice of group Social Work. Belmont, CA: Brooks/Cole.
- Dallos, R., & Draper, R. (2000). An introduction to family therapy: Systemic theory and practice. Buckingham, Philadelphia: Open University Press.
- Dryden, W. (1985).Social Works’ dilemmas. London, England; SAGE Publications.
- Duncan, B.L., Miller, S.D., and Sparks, J.A. (2004). Heroic client: A revolutionary way to improve effectiveness through client-directed, outcome-informed therapy. San Francisco, CA: Jossey-Bass.
- Duncan, B.L., Miller, S.D., Wampold, B.E. & Hubble, M.A. (2010). The heart and soul of Change: Delivering what works in therapy. Washington, DC: American Psychological Association.
- Guttman, H.A. (1991). Systems theory, cybernetics and epistemology. In A.S. Gurman & D.P. Kniskern (Eds.), Handbook of Family Therapy Volume II. New York, NY: Brunner/Mazel.
- Spinelli, E. (1994). Demystifying therapy. London, England: Constable.
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