The videotape shows the preliminary session with Joy, a young single mother of a six-year-old boy. She is also a full-time worker of the U.S. armed forces and a student. During the initial discussion, Joy mentioned feeling overwhelmed with the responsibilities and unable to cope with the number of tasks at hand. Joy is also feeling powerless to influence her son: for instance, despite her efforts to put him to bed by eight p.m., he constantly stays up late, causing her to postpone her schoolwork. Joy is also concerned about communicating her feelings and needs to others. She mentioned that due to being the oldest one of her mother’s six children she has always seemed to be a strong and independent woman, and thus she feels that asking others for help undermines that image. From the introductory session, it has been concluded that using a seven-step generalist intervention model would be the best strategy in Joy’s case.
Engagement
The first step of the intervention, engagement, involves building a professional relationship between the social worker and the client (Kirst-Ashman & Hull, 2011, p. 159). This professional relationship is needed as it provides a clear purpose, ensures commitment both of the worker and the client to the change process, and determines the ethical standards applied to practice; moreover, professionalism emphasizes building a warm and empathetic relationship with the client (Kirst-Ashman & Hull, 2011, p. 159). All of these factors facilitate the client’s progress and aid in the counselor’s work.
Part of the engagement process, therefore, is to greet the client in a welcoming manner and to introduce the client to the agency’s confidentiality policy by stating that the information shared with the counselor will remain confidential unless there is a threat to life or wellbeing of the client, his or her family, or other people. After the introduction, it is necessary to determine whether the agency can be of any help to the client by gathering information about the client and his or her issues. This can be done both by asking the client directly (e.g. “How can I help you?”) and by looking at the overall patterns in the client’s story. For example, Joy’s situation cannot be solved solely by counseling because one of the issues that put great pressure on her is the behavior of her son: she claims that he has been “acting up” ever since the family split. Besides counseling, Joy could benefit from going to parenting therapy groups, which was suggested at the end of the meeting.
Assessment
The assessment stage is crucial in preparation for the planning process, as it helps to evaluate the primary issues and their impact on the person’s current situation. However, there are many challenges and features to the assessment process that has to be taken into account. For instance, Kirst-Ashman and Hull (2011) note that a lack of valuable information on the issues or the client’s background can lead to a false judgment, which will harm the assessment process (p. 164). Furthermore, it is important to understand that assessment is a continual process (Kirst-Ashman & Hull, 2011, p. 159). This means that the social worker will have to evaluate factors like the client’s mood, progress, struggles, and attitude to therapy during every session and to alter the approach accordingly.
However, one of the goals of the preliminary discussion is to identify a primary issue that brought the client to the social worker. To find out about the issue, the social worker should ask questions like “Can you explain some of the pressure you are feeling?” or “How does [the situation] make you feel?”. It is necessary to listen to the client’s responses carefully, as they might indicate a larger underlying issue that is the key to a successful change process. For instance, despite all the smaller issues Joy has talked about, there was evidence that the main problem is not her inability to cope with the pressure, as she stated at the beginning, but rather her difficulty in asking for help due to the image of a strong woman imposed on her by her mother. Helping Joy to erase this stereotype would improve the situation dramatically in all the areas of concern.
Planning
Nevertheless, before the larger issue is addressed, it is crucial to follow through with the planning process. The process aims to prioritize issues, establish the primary goals of the therapy, and to develop a plan for achieving these goals. To ensure the cooperation of the patient and to avoid tackling undesirable topics at the beginning of the treatment, it is necessary to consult the client as to which topics are the most important for him or her at the moment. For instance, when asked to outline the main concern, Joy chose to focus on her education.
She stated that to balance her schoolwork and her full-time job it is necessary for her to put her son to bed early, which does not happen because he does not see her often and therefore wants to stay up late to spend more time with his mother. The main goal of the therapy would thus be to achieve a balance between parenting, education, and work. Smaller objectives would include employing new parenting techniques to minimize the child’s anxiety and to achieve effective communication, as well as to improve time-management skills and to learn to ask for the help of other people to delegate some of the tasks to alleviate some of the pressure.
Evaluation
The next stage is not fully applicable to the present videotape, as it involves the evaluation of the effectiveness of the social work practice at the end of working with a client (Kirst-Ashman & Hull, 2011, p. 288). Various evaluation techniques could be used depending on the client’s issues and the focus of work. In the case with Joy, goal-attainment scaling would be used to evaluate the effect of the work. Goal-attainment scaling is applicable here as it focuses on the achievement of one clear goal (e.g. finding balance in life), which is crucial to the solution of the person’s problems.
Termination and Follow-Up
The last two stages of the generalist intervention model need to be built around the client’s progress as opposed to the theoretical models of social work. The worker should also agree with the client on the terms of termination. For example, during the preliminary session, Joy was offered a sequence of six sessions under the condition that the necessity of further sessions will be determined by her progress. Follow-up meetings were not discussed, but it would be desirable to check Joy’s progress one month after the termination of work.
Evaluation of the Session
Questions
Both open and close-ended questions were asked during the session. The open-ended questions were primarily used to find out more about Joy’s issues and feelings (e.g. “How are you and your son’s father? Does he come to visit?” and “How does that make you feel?”), whereas the closed questions, were used for clarification purposes (e.g. “So you are the oldest one of six children?” and “[Staying up late] makes you late for work in the morning?”). This strategy is effective as it avoids suggesting answers to the fundamental questions about feelings and emotions that could impact the person’s responses and thus the assessment. One of the weaknesses of the questioning strategy employed was the overuse of clarifying questions, which promoted re-statement. For instance, the question “So you are the oldest one of six children?” could have been changed to “How did it make you feel to be the oldest of six children?”. This change would allow exploring the client’s background in more detail.
Areas for Improvement
Given the short length of the preliminary meeting, few areas for improvement could be identified. For instance, it would be useful to find out more about Joy’s experience as the oldest child, as this might be the factor that had a profound effect on the issues she experiences now: being used to helping rather than to asking for help, she takes on too much responsibility and avoids delegating some of the tasks so as not to appear weak. Decreasing the amount of close-ended questions would also help to save extra time, which could be spent on exploring Joy’s story further. Moreover, there could have been more engagement of the client in the planning process. Allowing Joy to evaluate her contribution to completing the objectives could have a positive impact on the further change process.
Summarization
There was no clear summary at the end of the session that would draw together all the points of Joy’s story and direct her attention towards the various issues outlined by it. A summary of the session would be beneficial as it would help to prepare Joy for participation in the change process.
Conclusion
Overall, the introductory session provided a stable basis for further work with Joy. The application of the generalist intervention model allows splitting the change process into distinct stages, ensuring both the client’s involvement in the change process and the social worker’s ease in developing and following a plan of action. There were some minor drawbacks to the strategies used, but it is highly unlikely that they will have a significant effect on further progress. Joy’s case is not an easy one – indeed, the most challenging cases in social worker’s practice are the ones where clients experience a range of problems in various aspects of life (Boyle, Smith, Farley, Hull, & Mather, 2009, p. 6). However, with a thorough plan of change that touches all the problems, both overt and underlying, there is a great potential for progress that would enable Joy to achieve the level of balance in life that she aims to have.
References
Boyle, S. W., Smith, L. L., Farley, O. W., Hull, G. H., & Mather, J. H. (2009). Direct practice in social work. Boston, MA: Allyn & Bacon.
Kirst-Ashman, K. K., & Hull, G. H. (2011). Understanding generalist practice (6th ed.). Boston, MA: Cengage Learning.