How Contemporary Social Work Is Organised and Practiced - Literature review Example

Running Head: Critically analyse the theories that underpin or influence how contemporary social work is organised and practiced. Introduction Postmodernism and change Postmodernism is described as referring to changes in the way in we think about our societies and the way we create and understand knowledge. As the modern view emphasises objective knowledge and an external reality, it fails to recognize differences; and the views of a specific class of people (white males) are the basis of ideas and theories presented as knowledge and absolute truths. (Nigel Parton). On the other hand postmodernists are of the view that there is no universal truth and all perspectives are equal. Payne (1997) suggested that a postmodern stance aids social practitioners in criticizing, analyzing and developing theories to meet clients’ needs. Post-modernist theories have led to concerns regarding social progress and social justice. Critics of post modernism claim that the emphasis on the conflicted and fragmented nature of society as well as the relativist nature of knowledge leads to abdication of political responsibility to welfare. Peter Leonard (1997) addressed these issues by examining the modernist ideal of the welfare state to be morally progressive. The shift from the conception of social work as a generic activity in a centralized organization with a focus on casework to one of fragmented, multiple service provision, co-ordination between agencies and case management is a result of post modernization of welfare institutions and services. Changes in social work and practices are a result of the emergence of more fragmented and diverse societies. Post modern perspectives help in opening constructive approaches to practice especially through truth-redefinition. Instead of relying on science to obtain answers it prioritizes dialogue and receptivity. (Nigel Parton) The 1970’s saw more efforts undertaken in organising social work as a profession. In 1971, the first issue of Social Work Today was published and the British Association of Social Workers (BASW) was set up. In 1972, the British Journal of Social Work (BJSW) was published. The setting up of BASW combined with the establishment of social service departments by the Seebhom Committee of 1968, consolidated social work with the aim of decreasing inefficiency by bringing together all activities under one department (Payne, 2002). According to (Stream, 1971), social casework was developed when the nation turned away from reform. Social casework represented a part of social work which focused more on the individual; its influence started to increase shortly before the 19th century (Payne, 2000).. The NHS and Community Care Act 1990 recommended that social workers working with adults should be identified as care managers. This proposed a new role for social workers as ‘case managers’ with considerable autonomy and flexibility about the way in which they responded to the clients’ needs. But this was largely in reference to procedural and managerial requirements instead of flexible professional practice (Carey, 2008) Case Management is an individualised service delivery approach based on comprehensive assessment that is used to develop a case or service plan. The Case Management approach believes that clients with complex and multiple needs will access services from a range of service providers and will require different responses from within organisations and across organisational boundaries. Case management is described as a boundary spanning strategy to ensure service provision is client driven instead of being organisational driven. Social work case managers use their social work skills to carry out case management activities at all levels of service. A feature of social work case management is that it is a clinical social work approach for dealing with emotional problems. In most scenarios case managers need to be therapists as well. The extent to which the case manager’s role varies from broker to therapist depends on the situation. It is imperative for the case manager to establish an interactive process which includes clinical skills such as relationship formation, ego support, assessment and diagnosis. But it is also vital that a sound delivery system is maintained. Case management requires a smart blend of broker and therapist. Lamb (1980) argued that good therapists are good managers; he is of the view that it is impossible to separate the provision of resources from the psychotherapeutic aspects of service. Most of casework practice at present is short term and focused on goals, both the service user and the caseworker are aware of this. Some of it is carried on a crisis framework, where there is an inability to cope up with the present situation as well as openness to changing for example when the client is suicidal or the client’s husband is threatening to run off with their child. Case workers need the skill to develop trusting relationships with clients in a short time. Social work case management also targets clients in need of a range of community-based services or individuals in long term care specifically those who have disabilities but can manage without an institution. The matching of needs and resources in this scenario is a long term consideration. A disabled child or mentally ill patient will require an array of services including economic, medical, social, and personal care needs. (Betsy S. Vourlekis) Case management is difficult to evaluate because contextual factors play a major role in the effectiveness of program operations. These programs do not function in isolation. A key component of successful case management is establishing connections with other agencies in a service network. The environment in which case management functions may be more important that the functions themselves. Case management research in the mental health field has led to mixed results. They reveal the need to develop programs specific to particular populations. The Assertive Community Treatment (ACT) model includes a team of case managers who work with clients to address problems of everyday life and have a commitment to providing services to clients for as long as they are required. The model seems to be successful in decreasing psychiatric hospitalization, but there is little evidence that it improves the quality of life of the client. (Harvey A. Siegal) In a study on the effectiveness of case management, results of 82 patients in a rehabilitation-oriented case management program six months and two years after they were released from an inpatient setting to join the program were compared with those of 82 control patients discharged from the same inpatient settings before the case management program was established. At the two-year follow-up, the patients in the case management program were more likely than the control patients to have better occupational functioning, to live in a more independent residence than at the six-month follow-up, and to be more socially integrated; In contrast, at the six-month follow-up only their occupational functioning was better than the control group’s functioning. (Paula N. Goering R.N.) According to research on case management regarding HIV several challenges were faced. The most commonly stated challenge by case managers was the complex population of clients within the case management system. The next most often mentioned challenge was time constraints; they had enough time to either case manage clients or do the paperwork. Several case managers felt their many responsibilities prevented them from being involved in their HIV case management job and were not as accessible to clients as they felt the clients deserved. Several case managers mentioned the challenge of not being able to meet the needs of the client. According to them, this happens when the services the client needs are not available because of a lack of resources or funding from the State. Some case managers referred to “the paperwork,” as a challenge; while others specifically stated that the required annual assessments were too time consuming and should be streamlined. A handful of minor themes emerged, as well. On the positive side many case managers felt case management had an effect on the clients’ lives. “Almost half of the respondents specifically stated they felt it was “positive”, “helpful” or “beneficial.” Majority of the case managers felt case management helped clients because it provided them with social support. Case management was a human connection for clients that did not exist otherwise. ’There were many other specific ways in which respondents indicated case management improved their clients’ lives, including: case management stabilizes clients and maintains their health, educates them about reduces their stress’ (Susan Van’t Hof) An anti-oppressive practice (AOP) framework stresses on the issues of power and oppression among social work services as well as within the lives of clients who have been oppressed. AOP seeks to de-individualize clients’ problems in order to view them in the wider social context of their lives. It moves away from an ‘expert’ model of service delivery towards one that is more inclusive of clients’ experiences and that incorporates coping and resistance to oppression. Anti-discriminatory practice and anti-oppressive practice are relatively new terms in social work practice. They fundamentally change the context in which the clients’ problems are viewed. A social worker should not have preconceived notions about the clients’ and their background as this will affect the way they view the issues and their treatment of the client. The provision of services to clients should not be based on gender or race. An individual is affected by his surroundings such as: institutions, family, race, culture, local community, economy and country. The social worker should first identify this complexity by placing the person in the context of their social and physical environments even when interventions involve actions primarily at the local, individual or family level. The individual may be aware of the impact of only some of these factors, or may choose to deliberately focus on a few of its dimensions, that is, those that seem more relevant in particular circumstances. ADP and AOP theories have existed since time-immemorial. Amidst these theories which have existed since forever, attachment theory stands out. The theory throws light on social work with children and families. Psycho dynamic theories were very popular amongst specialists. Psychodynamic theories are still actively used in both statutory and voluntary agencies. A good understanding of theories such as the attachment theories, underpins the assessment done when working with children and families; Moreover, psychodynamic therapy has influenced social work’s permissive, open, listening style of relationship against a directive and controlling style (Lowenstein, 1985). This gives a good flow to the assessment for children in need, children needing protection or children with disabilities. Modern day or contemporary social work is underpinned by a theory base which explains it practices and service provision. Theories located within the functionalist paradigm have two things in common; they are interested in the orderly relationships that exist between people and they prefer to explore this interest in the style of the natural sciences .The characteristics of the fixers are that they are often problem-oriented in approach and are concerned about providing practical solutions to practical problem. The functionalist is also described as an empiricist, someone who takes the view that human activity is best approached as observable behavior, behavior that can be seen and described. simplistic However, they recognize that different parts of a whole functioning entity, such as society, the family or an individual body, are interrelated and interdependent (Human, 1980). The psychoanalytical style of fixers matches that of medical practice in that it tends to diagnose a problem and treat the client. This approach may work in a medical arena where sometime the problem is apparent and they used medication to directly deal with the problem and sort out. Social workers and other health professionals deal with wide range of diversity in people and therefore can develop an awareness of their own identity and a sense of who they are. This affects their sense of the world, their place within it, and their relationship with others. Unless social workers locate themselves within the context of a working relationship, they are more likely to engage in stereotypical behavior that can damage the work they do with clients. Working together-with and not against people’s social location, goes a long way to remove barriers for those who are disadvantaged. Psychosocial problems are sometimes innate and therefore the social worker may not be able to understand the problems of an individual unless they have narrated their story. It is bad and oppressive practice for a social worker to have pre-conceived ideas before going to visit a service user. The practitioner should be listening to the service user and find out from them how they may need help. Polemic. Because of the financial problems, social workers are obliged to go out and carry out short term resource based interventions. Methods that tend to be commonly practiced in social services local authority are the task centered method and brief solution based focus. This is so that no cost is experienced by the agency and no time is ‘wasted ‘in ongoing visits. However, the downfall is that many people then suffer in silence or just give up hope and this does not help them in anyway. Only voluntary agencies still use therapeutic methods of intervention. Those who cannot afford to purchase their own service will continue struggling individually whilst those with sound financial backgrounds will go and buy themselves the best possible service. This encourages the societal class division making a big gap between the rich and the poor. Task centered case management is a relatively new concept which deals with coordination problems that are faced when a case involves multiple service providers. The social worker is one of many practitioners serving the client. In such cases a task-centered case management structure is useful for coordinating among different practitioners. In task-centered case management, the social worker is a case manager or coordinator. There has been a lot of research on task centered case management and most of it has yielded positive results. The reduction in problems does not however mean that the problem has been eradicated. The long term effects of this approach have been not as effective as the short term results. Task centered treatment is a system of brief, time-constrained practice that focuses on clients with specific problems. There are limits on its range of application but it is usually offered to majority of clients who deal with clinical social workers. (Turner) In conclusion, social work has developed over a number of centuries. Even though there might be new policies and methods of delivering a service, the ethics and values of social work remain the same with the vision of helping the disadvantaged. Case management has had a positive impact in individualizing clients; needs but there is a need for looking at these needs in a broader social environmental context. Bibliography Betsy S. Vourlekis, Roberta Rubin Greene. Social work case management. n.d. Davies, Martin. The Blackwell encyclopaedia of social work . n.d. Harvey A. 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(2005) Use of Critical Consciousness in Anti‐Oppressive Social Work Practice: Disentangling Power Dynamics and Structural Levels, British Journal of Social Work, Vol 35,pp. 435‐452. Stepney, P. and Ford, D. (eds) (2000) Social Work Models, Methods and Theories: A Framework for Practice, Lyne Regis: Russell House Publishing. Read More