Case Studies in Social Work Practice

Craig W. LeCroy, Craig W. LeCroy

• Publisher: Wiley
• Year: 2014
• ISBN:
  9781118416228
• Edition: 3
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

A practical approach to understanding social work concepts in action that integrates theory and practice

In this updated edition of the classic social work text, students and instructors have access to real-world demonstrations of how social work theories and concepts can be applied in practice. The case studies in this book bridge the gap between the classroom and the field by allowing students to discover the when, why, and how of social work principles. Brief but comprehensive topic overviews are brought to life by case studies that apply general theories to the work of social work.

• Each of the book's nine sections cover an essential area of social work, encompassing the micro, mezzo, and macro levels
• Highly readable explanations are followed by 3-5 case studies relating theory to the living practice of real social workers
• Topics include Generalist Practice; Family Therapy, Treatment of Adults; and Diversity

Approaching each topic from a variety of different theoretical bases, this essential text allow students to learn by concrete example, experiencing social work concepts as they are applied in the profession today.

PART I
Case Studies in Generalist Practice

The idea of generalist practice is an old one. The origins of the generalist concept are as deep as the social work profession itself. Social work pioneers such as Mary Richmond and Jane Addams have stressed the importance of understanding people in relation to their environment. The social workers’ long-standing commitment of a dual focus on the individual and on the society supports the fundamental notions of generalist practice.

Although the notions of generalist practice are old, the emphasis of a generalist perspective in social work reemerged as social work programs began to offer Baccalaureate of Social Work (BSW) degrees. The BSW programs, as stipulated by the Council on Social Work Education, required education from a generalist perspective. Currently, most BSW programs focus their curricula on generalist practice, and MSW programs use the first year, or foundation year, for education on the generalist approach to practice. As Landon (1995, p. 1102) concludes, “in the quest for a theory for this broad practice base, social work education adopted notions from general and social systems theories and ecological thinking to undergird the foundation for all practice.”

Generalist practice has reemerged as central to social work education. But what exactly is generalist practice? How is it defined? Not surprisingly, there is no one definition of generalist practice. However, important themes emerge in the various definitions.

Several generalist social work practice books describe generalist practice as beginning with a decision as to what the unit of attention should be—an individual, a family, a small group, an agency or organization, or a community (Johnson & Yanca, 2009; Krist-Ashman & Hull, 2008). The generalist model promotes a multimethod and multilevel approach, an eclectic theory base, and the dual perspective of social work. Schatz, Jenkins, and Sheafor (1990) generated a three-level model of generalist practice:

1. 1. The generic or foundation level of knowledge necessary for all social workers, regardless of later specialization, includes the purposes, values, focus, and knowledge base of the profession.
2. 2. The initial generalist level includes competency in direct and indirect practice based on multilevel assessment and the capacity to intervene on multiple levels, perform various practice roles, and evaluate practice ability.
3. 3. Generalist practice at the advanced level delineates knowledge needed for practice in greater depth and in relation to more complex and technical issues.

Lastly, any discussion of the generalist perspective would be remiss to omit a discussion of the ecological perspective. The underlying theory of social work is rooted in social systems theory, particularly ecological-systems theory. Gitterman and Germain (2008, p. 20) describe the theoretical underpinnings of an ecological perspective, or what they refer to as the life model:

Ecology is a science concerned with the relations between living organisms—in this case, human beings and all the elements of their environments. It is concerned with how organisms and environments achieve a goodness-of-fit or adaptive balance and equally important, how and why they sometimes fail to do so.

Ecological-systems theory provides an understanding of the person-in-environment perspective, stressing how critical interactions occur between individuals and their environments. This model directs social work practice at the interface of these systems and helps social work practice maintain a dual emphasis. Social workers assess an individual in relation to the opportunities and obstacles that exist in one'S environment.

In this chapter you will read three case studies that explicitly address a generalist perspective in social work practice. The first case study by Patterson, Jess, and LeCroy describes an ecological perspective and shows why it is considered the cornerstone of good generalist practice. It takes the fundamental concepts from ecological theory and illustrates how they can be used in direct social work practice. The case study demonstrates how the notions of ecological theory are tantamount to generalist social work practice.

The case study by Lortie presents a complex situation for a social worker in a hospital setting. It elucidates how generalist practice with a person-in-environment perspective must consider the resources available to a person. It is an excellent example of how critical good case management can be and shows that case management services represent social work at the interface of the person and the environment. A lot of social work practice revolves around helping individuals cope with a difficult environment. In addition to helping them cope on an individual basis, we must help bring services to bear on their problems.

The last case by Chapelle extends the generalist model to community-based work. Too often, social work is focused narrowly on the individual. As this case demonstrates, good social work practice can take place at the community level. Using basic concepts of community practice, this case shows how a social worker can approach large-scale change in a community.

Together these cases represent a sample of how direct-line practitioners view generalist practice. It should give you a good, practical feeling for what it means to do generalist practice. Also, it should alert you to the difficulties and complexities of doing good social work. When our attention is focused on personal problems and social concerns, multilevel methods, and ecological understandings, we are faced with drawing on a broad range of skills and abilities. Social work practice offers a challenge for those who want to tackle social problems but need a large toolkit.

REFERENCES

Gitterman, A., & Germain, C. B. (2008). The life model of social work practice: Advances in theory and practice (3rd ed.). New York, NY: Columbia University Press.

Johnson, L. C., & Yanca, S. J. (2009). Social work practice: A generalist approach (10th ed.). New York, NY: Pearson.

Krist-Ashman, K. K., & Hull, G. H. (2008). Understanding generalist practice. Pacific Grove, CA: Brooks Cole.

Landon, P. S. (1995). Generalist and advanced generalist practice. In R. L. Edwards (Ed.), Encyclopedia of social work (19th ed., pp. 1101–1108). Washington, DC: National Association of Social Workers.

Schatz, M., Jenkins, L., & Sheafor, B. (1990). Milford redefined: A model of initial and advanced generalist social work. Journal of Social Work Education, 26, 217–231.

Case Study 1-1
Using the Ecological Model in Generalist Practice: Life Transitions in Late Adulthood

SHIRLEY PATTERSON, JAN JESS, AND CRAIG WINSTON LECROY

This case uses the ecological perspective as a guide to generalist practice. This perspective offers a framework for how the social worker organizes her work and helps the client cope with a serious life transition.

Questions

1. 1. Why is the ecological perspective considered a good framework for generalist practice?
2. 2. What were the essential skills and abilities the social worker used in this approach?
3. 3. How were ecological concepts used to help the social worker?
4. 4. How was the concept of person and environmental fit used in this case?

I met Mrs. Lilly Goodman at the medical center in Kansas City on the long-term care unit where I work. She is a 77-year-old woman who is thin, small in stature, with straggly gray hair, who peers at you above her glasses, which keep slipping down her nose. When I met her for the first time, I was struck by her sad demeanor. However, as I got to know her, I came to love her wry sense of humor that is often masked to those who do not know her well.

Mrs. Lilly Goodman has been a hard-working laborer all of her life. She grew up in poverty—living in apartments and moving frequently as her father sought new work opportunities. She was not encouraged to go to school and, in fact, quit school after completing a fifth-grade education. Despite this, she is a well-spoken woman who is articulate, well-read, and has seized new learning opportunities all of her life.

Mrs. Lilly Goodman began work as a “cleaning lady” at 12 years old and has been doing it ever since, until she became too frail to continue. She recounts the very day she could not work anymore: “It was about half past noon when I bent over to put fresh sheets on the bed. As I tried to straighten up, my back experienced sharp shooting pains and I knew that I could not work any longer.” As she tells me about her life, I can sense the confident, proud woman that she is. As she talks, you quickly get to know that one of her greatest achievements and joys is her home. She bought and paid for her own home, and she is very proud of having accomplished this goal. Also, her home is a central source of comfort: “I have lived in my home now for 30 years. I have one of the neighborhood'S best gardens. My neighbors stop by to see me on a regular basis.”

I try to think back to what life must have been like for her prior to landing in the hospital. I can see her getting up early in the morning to tend to her flowers, sitting and reading in an old overstuffed chair, and having a few old friends over for afternoon tea. Everything is different now. Her independence has come to an end, and she has not had much time to prepare for it. After suffering two strokes, one right after the other, and developing crippling and painful arthritis, I know that her life must have changed dramatically.

She, however, has not accepted these changes. Mrs. Goodman has consistently told the hospital staff that she plans to return home to live as soon as she gets out of the hospital. Because staff were unsure about the possibility of her returning to home, I was brought in as the long-term care social worker. Mrs. Lilly Goodman did not directly ask for help, but she willingly accepted my offer for help, proffered help—I was reaching out to her.

An ecological perspective was used in thinking about and guiding my approach to practice (Gitterman, 2009; Gitterman & Germain, 2008). From an ecological perspective, Mrs. Lilly Goodman is best understood as someone who is in a life transition. She is at a place in her life where she is facing a major transition—from an independent person who took care of herself to a person who is dependent and needs some assistance. There are three aspects of her life transition that help in thinking about how to offer her help:

1. Her developmental stage
2. Her change in status and roles
3. The crises she faces

Mrs. Lilly Goodman is in the final stages of growth. The developmental stage that confronts her has a biological base, and the associated tasks of this stage of development arise out of biological pressures and the social and physical environment. In other words, her residency in long-term care is not of her own choosing; rather, it is a result of illness, limited resources, and lack of family support.

Mrs. Lilly Goodman is also being thrust into some very new statuses, none of which she is particularly happy about. These include being:

1. resident of a nursing home
2. displaced homeowner
3. dependent person
4. An older adult with fairly limiting health problems, which are difficult for her to accept

In addition to new statuses, Mrs. Lilly Goodman has new roles that she must adapt to, including being:

1. lucid, ambulatory resident among many residents who are neither
2. protected mother (and mother-in-law) in a sheltered environment
3. welfare recipient, who receives Medicaid to supplement her social security that pays for her care in the long-term care unit

These roles are a striking contrast to the Mrs. Lilly Goodman of only a few months ago—someone who lived independently, tended her garden, cared for her home, and shared tea in the afternoon with friends.

As the team of workers at the hospital staffed this case, they recognized that Mrs. Lilly Goodman faces severa...