Transformative Social Work Practice

Erik M.P. Schott, Eugenia L. Weiss

• Publisher: SAGE Publications, Inc
• Year: 2015
• ISBN:
  9781483359625
• Edition: 1
• Topic: Scienze sociali
• Subtopic: Sociologia

Transformative Social Work Practice presents an innovative and integrative approach towards critically reflective practice with an interweaving of micro, mezzo, and macroapplications to realworlddemands. The authorsexploreissues commonly addressedby social workers, including health, mental health, addictions, schools, and family and community violence, while challenging assumptions and promoting ethically-driven, evidence-based practice perspectives to advocate for social justice and reduce disparities. The bookis aboutredefiningsocial work practice to meet the current and complex needsofdiverse andvulnerable individuals, families, and communities in order to enhance their strengths in an era ofunprecedented technological growth, globalization, and change.

Chapter 1 Introduction

Eugenia L. Weiss

Erik M. P. Schott

Our aim in editing this book was to address an evolving health care landscape with the Patient Protection and Affordable Care Act (ACA) of 2010 and all of its iterations and to explore the myriad ways that we can redefine or retool ourselves as social workers in an era of unprecedented technological growth, globalization, and change. Our profession is being propelled into uncharted territories that have the potential for transformative processes and outcomes—for instance, developing interdisciplinary partnerships that we may not have imagined as bedfellows, such as social workers collaborating with engineers. The book adheres to the conventional ecological (Bronfenbrenner, 1989) and systemic roots (von Bertalanffy, 1969) applied in social work practice plus the infusion of current scientific research and innovative practice models that encompass the multidimensionality of the human experience both in terms of understanding hardship and of fostering resilience through evidence-based practice (EBP) process and empirically supported treatments (EST). Social work practice knowledge and skills with diverse populations in the areas of health, mental wellness, recovery, addictions, schools, family, and community are necessary ingredients to meet the complexity of contextual demands along with fulfilling our professional responsibility to ethical, evidence-informed practices and the promotion of client- or system-level advocacy and social justice (the pillars of our profession, as delineated by the National Association of Social Workers, 2008). Thus a combination of tradition with innovation within a matrix of multiple realities (and complexities) is what we hope to render the reader, whether a beginning social worker or a seasoned one, and whether practicing in the United States or abroad. Through the crossing of technological boundaries, global access, and mobility, social workers need to not only be versed in what impacts and helps to empower local communities, but also take into account national and international influences (both strengths and crises) and apply this knowledge in realistic, resourceful, and culturally responsive ways in their immediate practice domains. Borrowing from the field of public health, we consider multiple determinants of health (e.g., social, cultural, economic, occupational, and environmental), the impact of those factors on health care outcomes (Institute of Medicine [IOM], 2002), and the reciprocal effects of health on those social determinants. This allows us to take a person-in-environment perspective (Germain, 1981; Perlman, 1957), which is seminal to social work practice. The book provides many examples of health inequities within racial and ethnic minority populations and how to intervene in addressing these disparities. As we know, racial and ethnic minority populations in the United States have disproportionately higher rates of preventable chronic illnesses and shorter life spans than whites (Thomas, Quinn, Butler, Fyer, & Garza, 2011). We are also incorporating integrative practices to represent not only integrated delivery systems (IOM, 2001), where we work in interdisciplinary teams that serve to treat the “whole” person (e.g., integration of mental health and health), but also a broader conceptualization of combining elements and systems in terms of a gestalt, or holistic approach, as in the biopsychosocial-spiritual orientation that we espouse in our profession (Woods & Hollis, 2000).

We have several main goals in this text. First, in the true social work tradition, we offer an ecological or systemic perspective to understanding and intervening with clients and/or systems within a contextual frame of reference (Guadalupe & Lum, 2014). We also adhere to assessment and intervention through the current lens of EBP and provide real-world case scenarios from a multilevel contextual and integrative approach to practice. Rubin and Bellamy (2012) remind us that EBP is a cyclical process involving several steps as we approach client care:

(1) Question formulation, (2) Searching for the best evidence to answer the question, (3) Critically appraising the evidence, (4) Selecting an intervention based on critical appraisal of the evidence and integrating that appraisal with practitioner expertise and awareness of the client’s preferences and clinical state and circumstances, and (5) monitoring client progress. Depending on the outcome observed in the fifth step, the cycle may need to go back to an earlier step to seek an intervention that might work better for the particular client, perhaps one that has less evidence to support it but which might nevertheless prove to be more effective for the particular client in light of the client’s needs, strengths, values and circumstances. (p. 14)

Additionally, we consider EBP from the perspective of our colleagues Soydan and Palinkas (2014), as professional competence in an “imperfect world in which real life conditions change in terms of time and space and our methods of capturing reality of that social and behavioral world have shortcomings. EBP prescribes use of the best available evidence, recognizing that this evidence is not the ultimate truth but only a temporary estimate of causal relations in real-life situations” (p. 1).

We also adhere to a meta-framework theoretical approach from Breunlin, Schwartz, and Kunne-Karrer (1992), who proposed a systemic therapy orientation based on interactional patterns, a blueprint for an explanatory theory based on a distillation of multiple theories. Thus, the book is an amalgamation of practice issues along with varied theoretical and evidence-based approaches within contextual frameworks that account for complex systems and practice orientations. (Due to space limitations here, please see Sanger and Giddings (2012) for a more complete explanation of complexity theory as applied to social work practice.)

Our second goal with the book to is to further support collegial and interdisciplinary connections and transactions. The Council on Social Work Education (CSWE, 2008) has set guidelines for educational programs based on competencies, the Educational Policy and Accreditation Standards (EPAS). The EPAS are currently undergoing revisions and adaptations, which have not been released at the time of this writing. It is our hope that this book will contribute to the discussion of cultivating a new generation of social workers who are prepared to translate and implement social work research into practice and policy and who can communicate theory-driven evidence-based interventions in the language of the re-engineering of our profession as the present and future demands and needs of humankind continue to evolve and our methods of providing social work interventions are being revolutionized through innovations and unprecedented cross-collaborative efforts in order to meet the profession’s Grand Challenges as proposed by the American Academy of Social Work and Social Welfare (see Chapter 25).

Last, the term transformative in the title of the book not only alludes to change but also borrows from Witkin’s (2014) approach to social work education and his argument that transformation “enables and requires learners (including teachers) to maintain an ongoing critical stance towards their own and others’ ideologies, theories, beliefs, assumptions, and practices” (p. 569). Thus, it is a method of learning that then informs how social workers practice. In our interpretation of Witkin’s work, based on Mezirow’s (2003, p. 58) “critical-dialectical discourse” that allows for “democratic citizenship,” therefore, a questioning of dominant social discourses must occur in order to examine oppression and privilege, as a philosophical and applied approach to “transform” realities given the complex world that we live in, utilizing “imagination, creativity and innovation” (Witkin, 2014, p. 594). While even if we seemingly contradict ourselves in taking a positivistic stance where we apply an EBP process to intervention, we believe, like others in the field, that it is possible to examine existing empirical knowledge and be able to imagine future possibilities and alternatives to practice and to incorporate both into the practice decision-making process with the clients that we serve without furthering oppressive practices. Thyer and Pignotti (2011) eloquently noted, as others have as well, that “EBP asks the practitioner to locate the best available evidence, to evaluate its findings and potential applicability” (p. 330) along with considering the practitioner’s clinical expertise and the client’s values as well as preferences—which is different from merely applying empirically supported treatments. While Zayas, Drake, and Jonson-Reid (2011) inform us that the roots of EBP, as defined by Sackett and colleagues (1996), are founded on evidence along with the use of clinical judgement and consideration of client values, we need to be careful to not become too narrow in our focus, only emphasizing the evidentiary aspect and not the other two components of practice. Brekke (2014) summarizes that professional social work today is “an integrative science that allows for the blending of values and scientific rigor that are crucial to maintaining the identity of social work and for increasing its relevance and capacity for solving critical problems in living” (p. 522). Thus, at the risk of oversimplification, it is not an “either/or” proposition (i.e., science or social work values) nor is it micro (clinical practice) versus macro, but instead it is about embracing an integrative perspective, with all of its complexity, without having to make binary choices between opposites, as Robins (2015) and others suggest.

Overview of Contents

This transformative social work practice text consists of 36 chapters organized into three sections (with the caveat that the sections are, in a sense, arbitrary and artificial because there are no true divisions in real life or in social work practice, except for the demarcations that we create for the convenience of organizing our world and ultimately our curricula). Additionally, we were inspired by the efforts of our School of Social Work at the University of Southern California in re-envisioning our curricula with the hopes of developing a generation of social workers who would be better equipped and versatile in their helping roles to meet the needs of their respective agencies, organizations, and communities regardless of which emphasis they choose to study in professional social work education. Thus, we are taking the perspective of the advanced generalist as proposed by Dran (2014), as a professional social worker who “works patiently in multiple dimensions at once, alert to new patterns that emerge. In a complex situation that may overwhelm the generalist, the advanced generalist creatively responds by discover...