Unit III: Interventions with Clients/Client Systems (24%)

motivational approach: key factor

*empathy* is used to: 1. increase motivation 2. lower resistance 3. foster greater long-term behavioral change

political environment: political advocacy

A SW skill that is considered to be *important/necessary* to engage in social/political action to ensure that all have *equal access* to resources, employment, services, & opportunities to: 1. *meet* basic *human needs*/develop full potential 2. *improve* social conditions by advocating for policy changes/legislation -> meet human needs 3. promote *social justice*

family therapy/interventions/approaches: strategic family therapy: family homeostasis

part of a type of family therapy technique: a term to refer to a situation in families tend to preserve *familiar* organization & communication patterns, being resistant to change.

agencies: quality assurance: formative evaluations

a type of agency assessment: -an ongoing process occurring throughout the number of sessions that *examines the process of delivering services* through implemented feedback. -SW use these types of evaluation to achieve program goals.

political environment: policy making

-*understand*: public policies affect -> individual's personal problem. -*SW*: 1. powerful to impact both policies + individuals: impacting at micro/macro levels -*prevent negative* decisions regarding policies -*promote positive* decisions

mobilizing community participation

-a useful method that SW use to inform others in collaboratively contributing to make needed changes of once effective/appropriate but now has become ineffective policies, programs, & services. -SW assists in creating relationships/partnerships with diverse groups for team work in addressing problematic policies. -Decision-making power partly/wholly rests with community. -Community members who participate in *successful* policy changes are encouraged about collective accomplishments & are willing to take on new challenges & encourage communities to continue changing by informing policymakers/planners about addressing their needs -> enables most important problems to be addressed. -empowerment used to motivate members for policy/socioeconomic change.

intervention: measurable objectives

1. *goals*: -observable + measurable. -containing set objectives [subparts: steps toward goals/desired final outcome] 2. *criteria*: -clearly stating *desired bx* [how many times, during which times, under which conditions--to meet criteria]. 3. *evaluation methods*: -how will progress be measured? 4. *evaluation schedule*: progress measurement when? how often? dates/times? 5. *evaluating progress*: critical in problem-solving process. -discuss target bx: goals/desired final outcome -health-care improvements -psychiatric symptoms: increased/decreased? -qualitative information -helping/hindering factors that impeding progress 6. *modify goals* based on evaluation outcome 7. *celebrate* clients' progress: -explain: why progress occurred -encourage: continued progress

social policy: influencing factors

1. *knowledge/innovation (technology)*: enables -creation of new policies -reformation of current policies 2. *social norms* + *political/economic conditions*: -promote/hinder creation or revision of policies. 3. *legal issues*: new policies may influence/interact with existing laws. 4. *government agencies/private sector organization* 5. *media* coverage/external influences: calls attention to problems + public opinions 6. *negative attitudes* of service personnel 7. *lack of resources* SW: -SW platform: support beneficial policies/create barriers negating/removing undesirable policies.

case records

1. *purpose*: -evaluates through existing data sources: practice, services, supervision. -assesses: clients' views central? -contributing to clients' care & service satisfaction? 2. *clients' consent*: -SW must discuss confidentiality. -voluntary, w/o penalty, written informed consent to use & release records [*cannot release records w/o consent*]. -clients must understand & consent to mandatory *supervisor revision*: supervisors must only review to check SW's *proper*/*unbiased* documentation for *clients' betterment* & *service quality*; if supervisor is consultant, client must consent, unless a compelling need for disclosure exists. 3. *SW*: 1. must include facts: -clear, accurate, unbiased, relevant to delivered services -no value judgements/subjective comments. 2. Decisions. 3. must be finished on time. 4. must store properly according to state's statues, regulations, & contracts: -adults: 5 years -<18 years: 5+ years 5. *proper recording/maintaining records=avoids malpractice, negligence, breach of confidentiality & ensures service quality.* -must not release notes *w/o proper client consent*.

role play

1. This activity emphasizes the following in clients: 1. personal concerns 2. problems 3. behavior 2. SW uses this particular technique & encourages clients to actively participate in one of the learning process activities, which contains the following stages: 1. preparation/explanation of the activity 2. preparation of activity 3. activity occurs 4. discussing/debriefing about what happened during the activity. Benefits: This particular activity teaches clients: 1. *empathy* toward those whom they're imitating, which does the following: 2. *increases* clients' *understanding* of different perspectives 3. embeds concepts -> *increases clarity* of abstract/difficult information 4. *improves interpersonal*/communication *skills*

governance

1. refers to: -structures, functions, process, & outcomes existing within an organization to ensure operations achieve objectives effectively/transparently, as it is an accountability to clients, stakeholders, & wider community. 2. includes the following *characteristics* to add value through performance/organizational improvement, improving outcomes/impacts: -uses efficient management -strategic/equitable resource allocation -service provision 3. *SW's role*: -advocate within/outside agencies -> meet clients' needs -resource allocation procedures ensuring: availability of adequate agency/organizational resources for appropriate staff supervision [according to NASW Code of Ethics] -> meet clients' needs.

family therapy/interventions/approaches: strategic family therapy: relabeling

part of a type of family therapy technique: changing negative labels attached to person or problem to positive ones in order to perceive situation differently hoping that new responses will evolve as a result.

agencies: quality assurance: summative evaluation

a type of agency assessment: -at the end of the service, the overall description of the effectiveness of service and its outcomes of whether objectives/goals were met are examined, which enables decisions to be executed regarding future service directions that can't be made during implementation. -SW use these types of evaluation to achieve program goals.

family therapy/interventions/approaches

In SW: working w/ families is central & assessing their family *interaction* is important. treating family as unified whole with interacting parts of overall system through observation of behaviors & communications affecting current life situations are addressed by interrupting & replacing circular patterns of pathological communication & behaviors to eliminate dysfunction. SW: 1. *understand*: -own family origin & current family structure on family intervention. -client's historical, conceptual, & contextual issues that influence family functioning. 2. *awareness*: -*unique* needs of each family based on their problems [blended families, trauma/loss, adoption, domestic violence]. -Impact of *diversity* on each family [race, class, ethnicity, gender, orientation, aging, disabilities].

crisis intervention approaches

In this particular approach, SW is highly involved: -setting specific goals/tasks -> increases clients' sense of mastery & control. lasting 4-6 weeks, this approach aims to: 1. relieve impact of stress [social/emotional]. 2. return client to equilibrium/previous functioning level. 3. strengthen coping mechanisms/adapt coping strategies during this challenging situation.

family therapy/interventions/approaches: structural family therapy

In this particular type of therapy: SW stresses the importance of family organization *for* the family roles & functioning & family members' well-being through "joining"/engaging family in an effort of restructuring through -> observing & controlling interactions during therapy sessions by acting out situations to increase family's understanding.

trauma-informed care approaches: staff appearance

a type of approach which includes the following features: -professional -easy to identify -modest (not provocative)

Goal-Setting Techniques

SW + clients collaborate, plan, & set an agreement of activities = achieve goals. 1. modify *thoughts*: *feedback* is used to teach clients about adjusting self-defeating statements & accurately interpreting to increase clients' understand about life events. 2. modify *behavior*: *reinforcement* is primary used, along with other behavior modification techniques: -punishment -role play -role modeling -task assignment -modeling in both modifying thoughts/behaviors, negotiation is useful in achieving goals.

trauma-informed care approaches: staff behavior

a type of approach which includes the following features: -proper manner/respectful -pleasant demeanor -minimizing delays -clear, non-threatening communication tone -eye contact -smiling -nodding -flexible

fiscal (gov. income/taxes) management techniques

SW administrators are to be knowledgeable of financial management techniques as they oversee program operations. Financial management occurs through the following techniques: 1. *planning*: short/long-term strategies for fiscal solvency [ability of organization to meet financial obligations]. 2. *acquiring*: human/material/economic resources by fundraising, grant writing [completing application process for financial grant], contractual agreements, fees, merchandise purchases. 3. *allocation*: internal (inside organization)/external (outside organization) distribution of resources. 4. *internal control*: establishing standardized policies/procedures of monetary items. 5. *recording/reporting financial & material resources*: using manual/automated/computerized system to list/classify transactions to create statements & reports. 6. *method evaluation*: periodic review of financial activities -> assess efficiency/effectiveness of meeting financial accountability goals. *human service organizations are accountable for reporting financial transactions*.

involuntary clients: SW's role

SW are to do the following in situations in which clients are forced to attend SW services: 1. *acknowledge*: clients' circumstances 2. *understand*: clients' history 3. *listen* to clients' experiences & *understand* their feelings about SW intervention. 4. show *empathy*: view clients as > more than the problem which forced them to attend SW services. 5. *build rapport*/trust: -communication: be *honest* & up-front about clients' situation & why SW is involved. 6. clearly *communicate*: -what is happening to clients -Intervention purpose: -clients' choices -what happens during sessions 7. reassert *professionalism*: -consequences of lack of participation 8. *assist* w/ appropriate pace & enable clients' to fight for their rights. 9. *pay attention* to clients' behavior 10. *celebrate* clients' achievements. 11. seek *supervision* & *peer support*

motivational approach techniques

SW does the following in this particular approach: 1. clearly identifying problems/risks. 2. explaining why change is important. 3. advocating specific change. 4. identifying barriers to remove them. 5. finding best action course. 6. setting goals. 7. progressing step by step. 8. preventing relapse.

Policies

SW engage in doing the following to minimize risks for clients, colleagues, & practice settings: 1. create _ 2. implement _ 3. evaluate _

Problem-solving approach: problem-solving process

SW is to engage in the following steps when collaborating with clients to solve problems: 1. *engaging* 2. *assessing*: clients' strengths/weaknesses 3. *planning* 4. *intervening* 5. *evaluating* 6. *terminating*

consultation approaches

SW not only seeking but also providing information based on existing knowledge/skills, following all ethical standings to avoid conflict of interests/maintaining boundaries.

Problem-solving approach

SW recognizes: -clients have lack of motivation + opportunity +maladaptive/impaired resources & capacities -> unable to solve problems appropriately -> unable to cope with problems. SW formulates plan/goal: 1. enhance clients' mental, emotional, action capabilities + make accessible opportunities/resources -> cope with & create solutions to problems.

formal documents

SW recording notes must adhere to the following: 1. Include key content + purposeful writing: -accurate -clear -precise description -specific language -to the point 2. Avoid: -over-documentation -excessive words -punctation/spelling mistakes -Irrelevant/inappropriate information -meaningless phrases -Illogical conclusions -acronyms -abbreviations -bias wordings. *know audience: supervisor/other authorities scrutinize notes.* write accordingly.

motivational approach

SW use the following approach to stimulate change in clients: 1. use *empathy* to increase motivation, lower resistance, foster greater & long-term behavioral change. 2. enables clients to *realize what needs to change*. 3. enables clients to *discuss* about daily lives & satisfaction with current situations. 4. enables clients to *recognize consequences of current behavior*/conditions contributing to dissatisfaction. 5. creates atmosphere conducive to change & increases clients' intrinsic motivation (creating a picture of how lives would appear with fewer stresses).

harm reduction techniques

SW uses the following type of approach in addressing substance abuse. -Informal/non-clinical method to -> reduce harmful consumptions & risks associated with consumption. Benefits for individuals & communities: -practical -feasible -effective -safe -cost-effective -easy way to address behavioral problems.

harm reduction techniques: harm reduction model

SW uses the following type of model: Recognizing that many substance users are unwilling or unable to abstain from use, this model refers to any program, policy, or intervention that seeks to reduce or minimize the adverse health and social consequences associated with substance use without requiring a client to discontinue use to reduce harm to themselves, to others, and to the community.

active listening

SW uses this technique by: 1. showing *interest* in clients' communication -If clients notice: SW listens, is *interested*, & *understands* their communication -> feel *comfortable* -> more *honest disclosure* -> establishes: -trust/respect -*builds therapeutic alliance* 2. probe *questions* 3. *paraphrase* *Technique benefits*: 1. SW's are able to identify: -clients' emotional states -interactional patterns

team collaboration: interdisciplinary

SW work together with professionals from other disciplines: -legal/educational professionals in medicine, psychiatry, sociology, education, etc. needful for clients by: 1. seeking peer support 2. gaining/sharing information 3. facilitating decision making process 4. fulfilling biopsychosocial-spiritual-cultural care through daily/periodical meetings for cost effective, increased positive outcomes, & effective services.

trauma-informed care approaches: environment

a type of approach which includes the following features: -soothing colors -quiet/soft music -pleasant/gentle aroma -Individual chairs/bathrooms

leadership/management: management

a positional task characterized by the following: -focused on: efficiency, effectiveness, & planning. -concerned with performance -plan -accountable -monitor -evaluate -cooperate -engage in teamwork -govern resources -oversee tensions among controlling, rationing, & providing needed services.

feedback

This kind of verbal/non-verbal responses reveal effectiveness of treatment/practitioner & are essential in assessing *what works* & *what can be improved*. SW's role: 1. explain to clients why responses are needed (to assess: what works/what could be improved) & how responses would be handled. -respect confidentiality 2. ask for responses during: -difficult/positive circumstances -during key decision making points 3. obtain & document through: -face-to-face interviews -emails -texting -online questionnaires (closed/open-ended questions)

role modeling

This particular technique/activity does the following: -emphasizes learning from observing & imitating -assists clients in acquiring new communication skills: 1. observation 2. imitation 3. assertive communication -more effective when combined with role play + reinforcements = lasting behavioral change. Includes the following types: 1. live modeling 2. symbolic modeling 3. self-modeling 4. participant modeling 5. covert modeling

family therapy/interventions/approaches: Bowenian family therapy

This particular type of therapy: aims to improve the overall family functioning through the intergenerational transmission process leading to a reduction in family member's problematic symptoms or symptomatology through 8 theoretical constructs (i.e., theories/ideas composed of various conceptual elements) .

evidence-based practice

Using the following research methods: 1. *systematic reviews*: lit. review collecting secondary data to critically assess research studies & synthesize findings qualitatively/quantitatively. 2. *meta-analysis*: examining data from independent studies of same subject to determine overall trend. 3. *less rigorous research design* to gain: 1. *research knowledge* [from rigorous, scientific, & empirical studies] to seek, interpret, & evaluate with best available information -> practice: -existing research/evidence to address target problem? -risks/benefits? -practice evidence consistent w/ research? 2. *professional/clinical expertise*: -SW have training/expertise? -goals/desired outcomes be achieved? -comparative cost w/ other options/insurance coverage? -periodical assessment: when/how? 3. *SW values*: promote clients' strengths, capabilities, interests? 4. *clients' preference/circumstances*: -selected by or discussed w/ clients?

policies: ethics audit

a comprehensive examination of risks associated with creating, implementing, & evaluating policies and procedures; this results in preventative strategies in reducing risks in policies, in the following stages: 1. *appoint*: informed & concerned staff/colleagues as committee/task force. 2. *gather pertinent information*: -agency documents -client/staff interviews -accreditation reports -other sources to assess risks associated w/ client rights -confidentiality/privacy -Informed consent -service delivery -boundary issues -conflicts of interest -documentation -client records -supervision -staff development & training -consultation -client referrals -fraud -service terminations -professional impairment -misconduct/incompetence 3. *review* all gathered information. 4. *determine risk* in each area: none, minimal, moderate, or high risk. 5. *prepare action plans*: addressing risks & preventing future risks to -> mitigate/lessen existing risks. 6. *monitor policy implementation/progress*: reduces risks & ensures that procedures adhere to SW's core ethical principles. *risk management*: -ongoing -contains preventative strategies (based on _ results)

family therapy/interventions/approaches: unhealthy/dysfunctional family structure

a family with the characteristics: disengaged & rigid enmeshment.

family therapy/interventions/approaches: healthy family structure

a family with the characteristics: interdependent, yet promoting differentiation & autonomy. permeable boundaries to outside world: social contact & well-functioning open-system.

conflict resolution methods

a method in which the SW: 1. *recognizes*: existing/potential conflicts. 2. *assesses*: conflict situation. 3. *selects*: appropriate strategy. 4. *intervenes* if conflict arises, structuring technique is used to: 1. decrease *contact* between parties, *time* spent between problem-solving sessions, & *formality* in these sessions. 2. *limit* scope of issues. 3. use *3rd party* mediator.

follow-up meetings

a part of therapy in which there is a collaboration of client + family = making decisions based on preference. SW: 1. *reinforces* therapeutic gains. 2. *encourages* continued efforts/maintenance. 3. set *clear boundaries* [to prevent clients from prolonging therapy to avoid termination]. 4. *state goals* clearly & professionally. 5. *disclosing new problems*: assess clients to make them feel comfortable [as they are more comfortable with the same social worker -> easier disclosure].

Problem-solving approach: short-term interventions: short-term psychodynamic approach

a particular type of approach, based on Freud's theory that suggests: root of adult dysfunctions -> childhood experiences

leadership/management: leadership

a positional task characterized by the following: -focused on future: prospectively considering ways in which organizational operations need to change. -manage uncertainties/instabilities -Initiates/sustains/helps in maintaining momentum through change process -attentive & assist in balancing stability & change -Inspire -transform -empower -trust -Innovate -creative

trauma-informed care approaches: organizational understanding

a type of approach which includes the following features: -trauma policy is in place -commitment -all staff, clients, & family members are aware of trauma & its impact -universal trauma screenings for all clients -continually assessed trauma status -clear organization plan for behavioral crises -separate areas for calming/crisis management -feedback: valued

trauma-informed care approaches: treatment considerations

a type of approach which includes the following features: -treatment goals reflect consumer preferences -Integrated treatment across disciplines -offer clients' choice of treatment provider (when possible) -use everyday language -acknowledge & address statements of abuse -consider proximity of seating options -cultural respect for clients -recognize physical boundaries (touch may sometimes trigger trauma) -avoid: trauma-triggering jokes/stories

role modeling: participant modeling

a type of technique, referring to: an individual models anxiety-evoking behaviors for a client and then prompts the client to engage in the behavior.

role modeling: self-modeling

a type of technique, referring to: another form of symbolic modeling in which clients are videotaped performing the target behavior.

role modeling: covert modeling

a type of technique, referring to: clients are asked to use their imagination, visualizing a particular behavior as another describes the imaginary situation in detail.

role modeling: symbolic modeling

a type of technique, referring to: filmed or videotaped models demonstrating the desired behavior. (e.g., cooking videos).

role modeling: live modeling

a type of technique, referring to: watching a real person perform the desired behavior. (e.g., singing live).

anger management techniques

a type of therapeutic technique: *problem*: clients are unable to control anger -> increases risk for physical health problems [headaches, digestive problems, heart disease] & stress-related illnesses [insomnia]. *solution*: SW uses the following developing actions/treatment plans to change behavior & develop coping skills: 1. *relaxation skills*: -deep breathing -meditation -Imagery -exercise/stretching 2. *cognitive skills*: -replacing destructive thoughts with healthy thoughts -focusing on goals/finding solutions -using logic for more balanced perspective -don't use "all-or-nothing" approach -putting situations into perspective 3. *communication skills*: -Slow down speech -Listen to others -Think before speaking -Avoid defensiveness -Use humor to ease the atmosphere 4. *environmental skills*: -Walk away/leave situation -Avoid people/situations who evoke anger -When tired/rushed, don't start anger-provoking conversations or enter into situations.

agencies: quality assurance

agencies develop systems to: 1. gather information -> assess information: for quality 2. based on gathered/assessed information: implement necessary improvements on an ongoing basis through the following processes: 1. continuous quality improvement systems 2. formative assessments 3. summative assessments

empowerment

aims to ensure a sense of control over well-being that change is possible through strengthening one's self-worth based on his/her desires [i.e., self-determination] to enhance overall well-being & potential of clients by emphasizing control over clients' lives to the possible extent. SW uses the following intervention methods to assist clients: 1. *educating* in skills improvement 2. establish *therapeutic relationship*: providing *access* to social service, *secure* resources & informative *resources* to meet clients' needs/wishes. 3. *unite* with other clients w/ mutual experience = enable social/political action.

evaluating SW practice

as there is an ethical mandate to provide most effective/efficient services to: 1. enhance clients' *well-being* (doesn't harm) 2. enhancing *treatment outcomes* & agency *decisions, planning, & accountability*. *Techniques*: 1. obtain voluntary/written informed consent: -SW should regard their well-being, privacy, & dignity -no undue inducement to participate -must inform & allow withdrawal at any time w/o penalty -Avoid conflict of interest/dual-relationships w/ clients. 2. ensure clients have access to *appropriate supportive services*.

agencies: quality assurance: continuous quality improvement systems

attempts to gather & assess information on quality & works to implement necessary improvements on ongoing basis by the following steps: 1. adopting outcomes/standards 2. incorporating quality assurance standards & processes throughout work 3. gathering data & information 4. analyzing data & information 5. using analyses & information to make improvements.

leadership/management

both leaders & managers are reasonably the same individuals, as both of their tasks are interconnected.

SW practice: advocacy

clients have needs & SW make systemic changes to meet/address problems of groups who are *vulnerable/unable to speak for themselves* by persuading locally, in county/state, nationally about *legitimate needs* of clients/society members & obtaining legislative support or by drawing attention to problem via media. SW's role: 1. *educate*: empowering clients by teaching appeal process when they're denied services & ways to change policies & fix/increase services to meet needs. (*don't speak for clients; assist* them to express own opinions/concerns). *goal= assist clients in strengthening own skills by locating/sharing power sources shared to make necessary changes* & *change factors that create/contribute to problems*: 1. *problem*: acknowledge, define, & analyze. 2. create *solution* -> problem. 3. *solution options*: evaluate & implement.

self-monitoring techniques

clients keep log/record thoughts, emotional states, behaviors during difficult times--even subtle shifts in feelings are recorded.

communication techniques: verbal/non-verbal

contains the following characteristics: -active listening -silence -questioning -reflecting/validating -paraphrasing/clarifying -reframing -positive facial expressions/postures/gestures -being genuine: building trust & establishing therapeutic relationship -displaying empathy -positive regard for clients -> caring about them + emphasizing strengths/achievement potential -clearly establishing boundaries -safe environment for clients -clients seek & appreciate consistent boundaries (they haven't gotten such boundaries in any other environments) -congruence: 1. important for relationship vitality 2. facilitates true assistance (part of problem-solving process)

Intervention phases

contains the following steps, in which the SW collaborates with client & establishes therapeutic relationship: 1. *engage* client, group, community 2. *assess* strengths & needs to address in intervention process 3. *plan* & design intervention to address *identified problem* 4. execute *intervention* to make necessary changes -> meeting planned/designed goals or to achieve goals. 5. *evaluate* SW + clients efforts. 6. *terminate* & anticipate future needs.

family therapy/interventions/approaches: strategic family therapy: first order changes

part of a type of family therapy technique: -superficial behavioral changes within a familial system that don't change the structure of the family system--foundation/structure of family remains the same, while only the measurable symptoms [i.e., superficial/noticeable behaviors] are addressed & modified through feedback.

Interviewing principles/techniques: interview

defined as & characterized by the following: -interactive & inter-relational verbal/non-verbal communication exchanging ideas, attitudes, & feelings that is informational, diagnostic, therapeutic between SW & client. -serves clients' best interest -focus: clients' & their situation's uniqueness SW's role: -engages in *non-judgmental active listening while *gathering* important information/*data* -keeps clients *focused on goal achievement* when using interpreters (*interpreter cannot be a family member* due to conflict of interest): -*face & speak directly to client* not interpreter

involuntary clients

defined as: -clients who did not choose & are forced to attend SW services due to: 1. law mandate 2. criminal justice system 3. child protective services (CPS) -because of being forced: clients attempt to *test* & *exhibit anger* at SW.

coalition building

group of individuals and/or organizations with a common interest who agree to work together toward a common goal.

educational components of supervision: supervisors

have various roles to ensure that clients are completely served: teachers, coaches, consultants, mentors, evaluators, administrators.

couples interventions/treatment approaches: couples therapy

in a particular type of therapy: SW uses: 1. behavior modification 2. insight-oriented psychotherapy 3. Gottman therapy to: -validate each one's experience & explore reservations about engaging in therapy, while reframing individual problems in relationship terms & supporting each one's sense of self as part of a unit & as an individual.

family therapy/interventions/approaches: strategic family therapy: paradoxical directive/instruction

part of a type of family therapy technique: SW uses the very symptomatic/problematic behavior in order to enable the client to realize that he or she can control it, while using the strength of the resistance to change the problem & moving a client toward desired goals.

cognitive restructuring

in this particular intervention technique: client = self-monitors: negative thoughts, emotions, behaviors. 1. *accept* that self-statements, assumptions, beliefs -> determine & govern emotional reaction to life's events. 2. *identify* thought pattern + dysfunctional beliefs = underly problems. 3. *identify* particular situations bring out-> dysfunctional cognition. 4. *substitute* self-defeating thoughts -> functional self-statements. 5. clients *reward* self: successful coping efforts.

family therapy/interventions/approaches: strategic family therapy: second-order changes

part of a type of family therapy technique: -aims to change the familial systematic interaction pattern to reorganize the family system so that it functions more effectively.

family therapy/interventions/approaches: strategic family therapy: pretend technique

part of a type of family therapy technique: -encouraging family members to pretend & encourages voluntary behavioral control.

involuntary displacement

refers to clients' hospitalization, incarceration due to needed safety or long-term care needs: can be traumatizing -> health issues, financial concerns, safety problems.

service delivery

refers to private/public organizations: -government -schools -hospitals -correctional facilities -private non-profit agencies -organizations are to uphold the following: 1. (supervision, workload management, & continuing professional development reinforce) agency policies/procedures: -ethical practice/standards -> good quality services, values, & principles -protects SW & clients against danger, discrimination, & exploitive behavior. -confidential treatment -record storage 2. adopts & implements policies/procedures: -workload/caseload management -> add to service quality. 3. organizations: -SW must be qualified, possess necessary skills & experience -> ensure quality service/affordability to clients. 4. SW: regularly inform clients & public: -agency policies/procedures -know how to raise concerns/complaints.

team collaboration

refers to: working with other professionals to develop new & innovative approaches to deal with problems for the betterment of clients & improved services. Goal: *improve services & clients' betterment/welfare*. 1. includes both: -intradisciplinary [within SW practice] -interdisciplinary [other professions]. 2. Required skills improves upon practice: -*strong interpersonal communication* -group skills -understanding others' perspective -treating colleagues kindly & respectfully -*pre-meeting work* -ignoring minor irritations -> facilitates *cohesion* to meet goal. SW's role: 1. focus: own behavior, not changing others'. 2. clarify: own SW role. 3. *understand*: others' disciplinary roles [acknowledge differences within own field & others' -> *establish/maintain* common ground & collegiate relationship]. 4. *participate/contribute*: decisions affecting clients' well-being. 5. *address*: team conflicts & *resolve* disagreements [if not able to resolve, pursue other avenues].

mobilizing community participation: orientation stage

the 1st stage in the community-based decision making process in which community members meet for the 1st time & become familiar with each other.

mobilizing community participation: conflict stage

the 2nd stage in the community-based decision making process in which disputes, little fights, arguments occur; however, these are eventually worked out.

mobilizing community participation: emergence stage

the 3rd stage in the community-based decision making process in which community members begin to see & agree on a course of action.

mobilizing community participation: reinforcement stage

the 4th/last stage in the community-based decision making process in which community members finally make a decision & justify why it was correct.

family therapy/interventions/approaches: Bowenian family therapy theoretical construct: differentiation

the core concept of the one of the family therapy approach, which suggests that the more differentiated a client is, the more he/she can be an individual & think through a situation with emotional contact with family but without being drawn through internal/external emotional pressures to act.

couples interventions/treatment approaches: problems of couples

the following causes friction in relationships: 1. re-triggering emotional trauma without repair. 2. unable to bond/reconnect after hurting/damaging the other. 3. lack of knowledge/skills.

Treatment phases

the following stages occur in sequentially: 1. *precontemplation*: clients *deny/ignore* problem. 2. *contemplation*: clients are *ambivalent/emotionally conflicted* about behavioral change. 3. *preparation*: clients *experiment* w/ small changes while investigating whether the small changes are *rewarding/not*. 4. *action*: clients take *direct action* toward goal achievement. 5. *maintenance*: clients *maintain* new behavior & avoid relapse. 6. *relapse*: clients feel *frustration/failure*

couples interventions/treatment approaches: couples therapy: insight-oriented psychotherapy

the following technique is used in a particular type of therapy: SW studies interactions between individuals to develop hypothesis on what caused individuals to react to each other the way they do.

couples interventions/treatment approaches: couples therapy: behavior modification

the following technique is used in a particular type of therapy: addressing & modifying dysfunctional behavior to change the way couples behave with each other.

couples interventions/treatment approaches: couples therapy: gottman method

the following technique is used in a particular type of therapy: based on the idea that healthy relationships know each other's stresses/worries, shares fondness & admiration, maintains positivity, manages conflicts, trusts one another, & committed to one another; so, it focuses on conflicting verbal communication to: 1. increase intimacy, respect, & affection while, 2. removing barriers creating stagnant feelings in conflicting situations 3. creating heightened empathy & relational understanding.

family therapy/interventions/approaches: Bowenian family therapy theoretical construct: sibling position

the following technique is used in one of the family therapy approaches: client's birth order can influence how he/she relates to parents & siblings through determining the triangles that clients develop in; tends to be a factor in determining personality.

family therapy/interventions/approaches: Bowenian family therapy theoretical construct: societal regression

the following technique is used in one of the family therapy approaches: manifested by problems based on societal anxieties/problems [e.g., depletion of natural resources], as Bowen viewed the society as a family as an emotional system with its own multigenerational transmission, chronic anxiety, emotional triangles, cutoffs, projection processes, and fusion/differentiation struggles.

family therapy/interventions/approaches: Bowenian family therapy theoretical construct: family projection process

the following technique is used in one of the family therapy approaches: refers to parental transmission of their emotional problems to children leaving child functioning impaired & increasing children's vulnerability to clinical symptoms.

family therapy/interventions/approaches: Bowenian family therapy theoretical construct: emotional triangle/triangulation

the following technique is used in one of the family therapy approaches: relationship network among three individuals; a 3rd party is introduced into a dyad to reduce anxiety, as it is seen as almost improbable for two individuals to interact without triangulation. process that occurs when a third person is introduced into a dyadic relationship to balance either excessive intimacy, conflict, or distance and provide stability in the system. E.g.: parents fight constantly; child (3rd party) acts out in school, their fighting subsides as the focus is redirected to the child = __ has occurred.

family therapy/interventions/approaches: Bowenian family therapy theoretical construct: emotional fusion

the following technique is used in one of the family therapy approaches: tendency for family members to share emotional response due to poor interpersonal boundaries between members in a fused family in which there is little room for emotional autonomy; so, if a member moves toward autonomy, it is experienced as abandonment by other members; the counterpart of differentiation.

family therapy/interventions/approaches: Bowenian family therapy theoretical construct: multigenerational transmission

the following technique is used in one of the family therapy approaches: the concept that stresses the connection of the current generations to past generations as a natural process by giving the present a context in history; focuses a SW on differentiation in family system & on the transmission process.

family therapy/interventions/approaches: Bowenian family therapy theoretical construct: nuclear family

the following technique is used in one of the family therapy approaches: the most basic unit in society in which clients form relationship outside this type of family tend to pick mates with the same level of differentiation.

family therapy/interventions/approaches: family structure

the invisible set of functional demands organizing interaction among family members through boundaries & rules that determine who does what, where, & when.

stress management techniques

this particular technique includes the following steps: *1st step*: 1. identify triggers [major life events or everyday life events -> job pressures & relationship/financial problems] 2. monitor stress levels. *2nd step*: 1. assist clients in what they could control 2. use stress-reduction techniques [health lifestyle: deep breathing, exercise, massage, etc.]. *primary goal: reduce stress*

Problem-solving approach: short-term interventions

this particular type of method is characterized by the following: -*time*/treatment *duration* focused (occurs due to: organizational/financial constraints) -E.g.: -crisis intervention model -cognitive behavioral model -short-term psychodynamic approach

family therapy/interventions/approaches: strategic family therapy

this type of therapy includes the following characteristics: 1. built on communication theory & rooted in structural family therapy 2. active, brief, directive, & task-centered therapy in which SW initiates therapy process through a specific approach for each one's problems [seen as symptoms of current dysfunction] in a flexible/adjustable family & behavior changes through feedback alterations to change dysfunction in family. 3. Uses strategy to address problematic/symptomatic behaviors. 4. Uses feedback to move family from dysfunction to better functioning family. Uses *6 techniques*: 1. pretend technique 2. 1st order changes 3. 2nd order changes 4. family homeostasis 5. relabeling 6. paradoxical directive/instruction.

out-of-home displacement: impacts

understand background: -homes: clients' place of self-definition, likes/dislikes, interests, reminder of past experiences, future actions, familiarity, safety; a physical environment that cues behavior. contributes to the following problems: 1. *emotional reactions*: change in roles can contribute to the following -depression -anxiety -confusion -negative self-image -guilt (b/c of spending money on self) -fear (b/c of running out of funds for housing/care) 2. *loss of possessions*: -losing precious items representing lifetime memories b/c of: natural disasters & selling/donating items. -draining assets 3. *loss of relationships*: -lack of visitation from family/friends b/c of: inconvenience/lack of privacy in hospitals, jails, or nursing homes. 4. *lack of freedom/choice/control*: schedules (some of the following may be consequently overseen), numerous rules, policies, & procedures -meals -activities -room cleaning -bathing

team collaboration: intradisciplinary

unidisciplinary group: composed of SW within profession which can be useful in professional development, mentorship, & supervision provision; although this can facilitate agreement & cohesion within the group by sharing the same professional orientation & values, it can reduce alternative solutions to problems from various perspectives.

community resources: referral process

used for (goal:) -*clients' best interest & betterment*, so client is free to use variety of resources. -discuss: *self-determination*, which should *only* be limited when client is danger to self/others: *clients have right to refuse services [its consequences]/right to be referred*. -SW is to *assist* in accessing available resources or create new avenues. this particular intervention method contains 4 steps. prior to proceeding, SW must choose a provider who is competent, specialized, or an expert in meeting client's target problem/needs. 1. *clarify referral need/purpose*: -SW is no longer effective or making reasonable progress w/ client -> additional services needed to address clients' needs. -referral: competent professional w/ specialized knowledge/expertise -> meeting clients' needs. 2. *discuss & select options* w/ clients: -SW cannot give/receive payments for referring-unethical b/c no actual service was provided. -If a provider is available in same agency, maintain it, based on clients' preference: *self-determination is essential*. 3. *plan: initial contact* of client with referred provider: 1. discuss what client is to *expect* & review needs/progress made: inform that this info. can be discussed with new provider. 2. *with clients' consent: take appropriate steps in facilitating & transferring responsibility to new provider by disclosing *all* pertinent info. ___ 4. *follow-up*: must ensure new provider is meeting clients' needs. when following-up, SW attempts to support & increase client's chances of success.

consultation

using the advice of the informal authority of an "expert" [based on demonstrated knowledge, expertise, & competence of the subject. e.g., colleagues] in a specific area to help with developing a solution to an issue in a time-limited fashion by: 1. defining consolation purpose 2. specifying consultant's role 3. clarifying problem nature 4. outlining consultation process & disclosing only what's absolutely needed; although SW is not *required* to follow such recommendations, it's for the best interest of clients.