Social Work Intervention

Trevor Lindsay, Trevor Lindsay, SAGE Publications Ltd

• Publisher: Learning Matters
• Year: 2013
• Print ISBN: 9781446266656, 9781446266649
• eBook ISBN: 9781446281338
• Edition: 2
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

Since launching in 2003, Transforming Social Work Practice has become the market-leading series for social work students. These books use activities and case studies to build critical thinking and reflection skills and will help social work students to develop good practice through learning.

Social workers need to have a sound working knowledge of intervention as they are often balancing complex and sometime stressful circumstances with the individual needs of the service users. Also, as there are a wide range of social work interventions in current practice, students will benefit from knowing the advantages and disadvantages of each model and approach.

This book on effective social work intervention will help students apply and integrate this knowledge in practice, to critically evaluate different methods and to choose the most effective in any particular set of circumstances.

Fully-revised to include new material on value-based practice and direct links to the new Professional Capabilities Framework for Social Work, this second edition is essential reading for all social work students.

Chapter 1 Psychosocial Approaches

Trevor Lindsay

Achieving a Social Work Degree

This chapter will help you to develop the following capabilities from the Professional Capabilities Framework:

• Professionalism
  Identify and behave as a professional social worker committed to professional development.
• Knowledge
  Apply knowledge of social sciences, law and social work practice theory.
• Intervention and skills
  Use judgement and authority to intervene with individuals, families and communities to promote independence, provide support and prevent harm, neglect and abuse.

It will also introduce you to the following standards as set out in the 2008 social work subject benchmark statement.

5.1.1 Social work services and clients.

5.1.4 The nature of social work practice.

5.5.1 Managing problem solving activities.

5.5.3 Analysis and synthesis.

5.5.4 Intervention and evaluation.

Introduction

While, in this book, we will be discussing social work interventions, many of the approaches also feature prominently in counselling methods. There is some confusion around the differences and similarities between social work and counselling. Feltham and Dryden (1993) identify a number of areas of overlap and Brearley (1995) argues that counselling and social work are not two separate entities; they have much in common (p1). Although, as McLeod (2003) argues, it is not particularly helpful to draw strict lines of demarcation between the professions, such as suggesting that social workers never engage in counselling, it is important to be aware of what distinguishes one from the other. The British Association of Counselling and Psychotherapy provides this definition of counselling on their website (BACP 2008):

Counselling takes place when a counsellor sees a client in a private and confidential setting to explore a difficulty the client is having, distress they may be experiencing or perhaps their dissatisfaction with life, or loss of a sense of direction and purpose. It is always at the request of the client as no one can properly be ‘sent’ for counselling.

By listening attentively and patiently the counsellor can begin to perceive the difficulties from the client's point of view and can help them to see things more clearly, possibly from a different perspective. Counselling is a way of enabling choice or change or of reducing confusion. It does not involve giving advice or directing a client to take a particular course of action. Counsellors do not judge or exploit their clients in any way.

Counsellors are not social workers and social workers are not counsellors. Although, as we shall see, counselling and social work have a common history and share many values, skills and areas of knowledge, they are quite distinctive professions. Looking at the BACP definition, we can identify the following areas of difference.

• First, we see that counselling takes place in a private and confidential setting. This is not always the case for social work. Social work occurs in a variety of places that are not always either private or confidential, for example the courts, hospitals, day centres and so on.
• It is always at the request of the client as no one can properly be ‘sent’ for counselling. Social work is not always at the request of the client. Many people become involved with social workers, in child protection, compulsory admission to mental health care, at the order of the criminal courts, for example, when really they would rather not. This points to a major difference. Social work always takes place, voluntary or statutory, fieldwork or group care, within a legal framework, and the boundaries of the work are governed by legal mandate. These can and do frequently change and so social workers need to be aware of the current statutes, regulations, policies and procedures that apply to the area of work.
• It does not involve giving advice or directing a client to take a particular course of action. The legal responsibilities of social work mean that at times, for example where we encounter risk, we may have a responsibility to direct. Social work also does involve giving advice, for example about the law, rights and resources. Social workers have a body of knowledge which it may, at times, be appropriate to share, for example in terms of stages of child development. Of course, we need to be very careful that the advice we give is accurate and also that it is desired and timely.

There are some other differences of which we need to be aware.

• Generally speaking, counsellors are employed only to provide counselling. Social workers, on the other hand, engage in a greater range of tasks, from finding resources to taking legal action, sometimes in relation to the same person.
• Social workers have different qualifying education and training, and practise under a different set of professional standards.

Nevertheless, social work and counselling share very similar roots (Brearley 1995) and it is not therefore surprising that there is a large number of similarities. Most importantly, they have in common a considerable body of knowledge, values and skills. The quote above provides some evidence of this. Both deal with personal difficulties, distress and dissatisfaction. The communication skills used in social work are the same skills as are used in counselling. Both involve listening attentively and patiently and both involve seeing things from the client's point of view and helping them to see things more clearly. Both aim to enable choice, positive change and reduction of confusion. They share principles of being non-judgemental and non-exploitative. However, does it go further than this? As Brearley (1995) argues, the extent to which counselling influences social work practice depends very largely on the practice context. Some areas of practice depend only on the skills of counselling, while in others counselling methods form a significant part of the work. McLeod (2003) makes a useful distinction between being a counsellor, in which there is a formal counselling contract and the counsellor has no other role in relation to the client and counselling, where this is offered in the context of a relationship that is primarily focused on other, non-counselling concerns (p9).

McLeod (1993) cites Karasu (1986) as having identified more than 400 distinct models of counselling and psychotherapy, most of which have developed in the last half century. In spite of the large number of different models of counselling and psychotherapy, most owe their origins to one or more of three approaches – psychodynamic; person-centred; and cognitive behavioural therapy (CBT). In this chapter, we will discuss the first of these, introducing psychodynamic counselling generally and following this with a discussion of social casework, which was its first manifestation in social work practice.

Psychosocial Approaches

In order to understand the psychosocial model we first need to be familiar with psychodynamic theory, from which psychosocial social work originates. Psychodynamic theory is primarily concerned with the inner person – their thoughts and feelings – and considers external factors only from the client's view. The psychosocial approach borrows from both psychodynamic theory and ego psychology but adds social, economic and practical considerations, hence psychosocial. Within social work, a purely psychodynamic approach is rare. However, it forms the basis of psychosocial work and is the starting place for a number of other interventions that we will discuss later in this book. It is important, therefore, that it should also be our starting point in this book. Psychodynamic approaches have been highly influential in social work practice generally, providing essential understanding of:

• the unconscious and how it affects our behaviour and relationships;
• the influence of past experiences on the present;
• defence mechanisms;
• transference and counter-transference.

Psychodynamic Theory

The psychodynamic approach encompasses all the theories in psychology that understand human behaviour in terms of the interaction of an individual's drives and urges. Freud's theory of psychoanalysis was the original theory but this has been built upon by a number of others, for example Jung (1963), Adler (1927), Erikson (1965), Klein (1932) and Freud's daughter Anna Freud (1966). The origins of psychodynamic counselling lie in Freud's ideas of the unconscious and his theory of the construction of the personality.

Freud believed that the human mind was divided into the conscious and the unconscious. The conscious is the part of which we are aware. It may involve our thoughts, emotions, perceptions, sensations, moods, dreams, and our self-awareness. The unconscious, on the other hand, represents those areas of which we have no awareness. It contains our instinctual desires and needs. Imagine the human mind as a personal computer. You may think you have deleted data entirely but it can remain on the machine for a long time without your being aware of it and perhaps causing problems and conflicts. So, too, with some of our memories and past thoughts; we may think that they have gone for ever, insofar as they are no longer in our conscious, but they may in fact live on in our unconscious without our awareness. The unconscious can act as a sort of warehouse for our memories, some of which may be very painful. In this way it protects our conscious mind from more emotional pain than is bearable. But these memories can be so strong that they refuse to remain in the unconscious for ever and can come so close to the surface that they affect our emotions and behaviour in the present.

The idea of the unconscious is an important one for social work practice. Firstly because we need to be able to understand where strong emotions in our clients are coming from or what is causing what can seem to be very irrational behaviour. We also need to be able to understand how past painful experiences, such as the withdrawal of affection by a parent, are affecting present behaviour. We also need to be open to and understand the origins of our own emotions, especially those that threaten to overpower us as we react to the experiences and pain of our clients.

Freud understood the personality as being constructed of the ego, the id and the superego. In brief, the id represents the basic, animal drives – the drive to reproduce, to survive, but also attraction and desire, rage and hatred. It is self-centred, without morality and is ruled by the pleasure–pain principle. It has no use for logic but is primarily sexual and emotionally childlike. The super-ego acts as the conscience. It represents our moral sense. It develops in childhood as the child internalises the values, rules and prohibitions of the parents and later teachers and other authority figures. The ego is the thinking, deciding, planning part of the personality, the part that relates to reality. The ego is the ‘self’, I, Me. The ego has a big job to do as it mediates between the id, the superego, and the outside world. Constantly it is protecting itself from external dangers – threats to personal safety, competition, aggression from others – at the same time as controlling the instinctive drives and satisfying the exacting standards of the superego. This internal struggle is reflected in the term ‘psychodynamic’. Childhood experiences determine the development of these parts of the personality and this can result in underdeveloped or overdeveloped ego, superego or id. An overdeveloped superego might result in an extreme prudishness or excessive guilt while an underdeveloped one could lead to anti-social behaviour, insensitivity to others, etc. A weak ego can result in an uncertain or inconsistent idea of ‘self’, low self-esteem and poor self-efficacy, poor self-control or overwhelming feelings of anger, guilt, inadequacy and so on. A large part of the mind operates at the level of the unconscious. While the greater part of the ego, but not all, can be conscious, most of the superego and id are unconscious. The child whose parents have failed to provide affection may not have any conscious memory of this but it may have had a large impact on its unconscious, where as an adult they feel that they are unlovable. A child who has witnessed violent arguments between their parents may, as an adult, unconsciously fear close relationships. This, therefore, is an important concept for social workers to bear in mind.

The inner tensions, inherent in the struggle between the ego, superego, id and reality, cause anxiety, which threatens the ego further. The ego deals with anxiety by employing a number of defence mechanisms. The function of the defence mechanisms is to keep emotional reality safely at bay. However, these can lead to psychological disturbance (Smith 1996). A major contribution to Freudian psychology was the itemisation of these mechanisms by Anna Freud (1966), some of which have found their way into common parlance. We list the most important.

• Denial is the blocking of unwelcome or threatening information from awareness. Consequently, it is possible to refuse to acknowledge that a situation exists. The person behaves as if this were, indeed, the case. A teenager refuses to accept that she is pregnant, in spite of all the evidence to the contrary. A person who is recently bereaved cannot accept that the loved one is dead.
• Rationalisation is when we find a logical explanation for behaviour for which we have feelings of guilt or regret. For example, a person buys an expensive car and explains that the purchase was necessary because of more advanced safety features.
• Repression is the blocking of unwelcome thoughts, ideas or memories from awareness. A person who was sexually abused as a child has no conscious recollection of it happening.
• Reaction formation is turning unacceptable thoughts into the opposite. A four-year-old demonstrates great affection for a younger sibling o...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• About the Editor and Contributors
• Acknowledgements
• Preface to the Second Edition
• Introduction
• Chapter 1 Psychosocial Approaches
• Chapter 2 Person-Centred Approaches
• Chapter 3 Crisis Intervention
• Chapter 4 Advocacy
• Chapter 5 Task-Centred Work
• Chapter 6 Cognitive Behavioural Approaches
• Chapter 7 Groupwork
• Chapter 8 Motivational Interviewing
• Chapter 9 Family Therapy and Systemic Approaches
• Chapter 10 Brief Solution-Focused Therapy
• Chapter 11 Life Story Work and Life Review
• Chapter 12 Mediation Approaches
• Chapter 13 Bringing it All Together – Integrative and Eclectic Models
• Appendix 1: Professional Capabilities Framework
• Appendix 2: Subject Benchmark for Social Work
• References
• Index