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SOCIAL CASE WORK
DEPARTMENT OF SOCIAL WORK
MANUU.
MOHAMMAD HABEEB
ROLL No. A165089
PART A
characteristics and definitions of Social Case Work:-
Social Case Work:
Social Case Work, a primary method of social work, is concerned with the adjustment and
development of individual towards more satisfying human relations. Better family life, improved
schools, better housing, more hospitals and medical care facilities, protected economic
conditions and better relations between religious groups help the individual in his adjustment and
development. But his adjustment and development depend on the use of these resources by him.
Sometimes due to certain factors, internal or external, he fails to avail existing facilities. In such
situations, social caseworker helps him. Thus, social casework is one to one relationship, which
works in helping the individual for his adjustment and development. Every individual reacts
differently to his social, economic and physical environments and as such problems of one
individual are different from those of another. The practice of casework is a humanistic attempt
for helping people who have difficulty in coping with the problems of daily living. Its one of the
direct methods of social work which uses the case-by-case approach for dealing with individuals
or families as regards their problems of social functioning. Case work, aims at individualized
services in the field of social work in order to help the client toad just with the environments.
Definitions of Social Case Work:
1
Mary Richmond (1915)
“Social Case Work may be defined as the Art of doing different things with different people, co-
operating with them to achieve some of their own & society’s betterment.”
Mary Richmond (1917)
Social case work is the art of bringing about better adjustments in the social relationship of
individual men or women or children
Mary Richmond (1922)
Social case work means, „those processes which develop personality through adjustment
consciously affected, individual by individual, between men and their social environment‟
Jarrett (1919)
Social case work is “the art of bringing an individual who is in a condition of social disorder into
the best possible relation with all parts of his environment.
Taft (1920)
Social case work means “social treatment of a maladjusted individual involving an attempt to
understand his personality, behavior and social relationships and to assist him in working out
better social and personal adjustment”.
Watson (1922)
Social Case Work is the art of untangling and restructuring the twisted personality in such a
manner that the individual can adjust himself to his environment
2
Queen (1932)
Social case work is the art “of adjusting personal relationship”.
Lee (1923)
Social case work is the art of changing human attitudes”
Taylor (1926)
Social case work is a process concerned with the understanding of individuals as whole
personalities and with the adjustments of these to socially healthy lives
Reynolds (1935)
Social case work is the processes of counseling with a client on a problem which are essentially
his own, involving some difficulty in his social relationship.
Reynolds (1935)
Social case work is that form of social work which assists the individual which he suggests to
relate himself to his family, his natural group , his community
Klein (1938)
Social case work is a technical method in social work…. A way of adjusting to the client to his
personal problems.
Swift (1939)
Social case work is the art of assisting the individual in developing and making use of his
personal capacity to deal with problems which he faces in his life.
DeSchweiinitz (1939)
Case work means those processes involved in giving service, financial assistance, or personal
counsel to individuals by the representatives of social agencies, according to polices established
and with consideration of individual need.
Strode (1948)
Social case work is the process of assisting the individual to best possible social adjustment
through the use of social case study, social resources and knowledge from relative fields of
learning.
Towle (1947)
Social case work is one method ….by which certain social services are made available in areas
of unmet needs.
3
Objectives of Social Case Work:
 To make good rapport with the common people
 To find-out, understand & solve the internal problems of an individual
 To strengthen ones ego power
 To prevent problem
 To develop internal resources
Nature & Characteristics of Case Work:
 Relationship arise out of shared & emotionally charged situation
 Relationship contains elements of acceptance, expectation, support & stimulation
 Client & case worker are interdependent
 Case work relationship may have several therapeutic values
 Improvement of condition
 More adjustment within the society
 Development of personality
 Capacity building
 Relationship needs outside help
 Case worker too has relationship reactions and part of one’s professional skills in their
management
Relationship in Case Work Client:
Case Worker Relationship
The term relationship in social case work was used forth first time by Miss. Virgini a Robinson
in her book “A changing psychology in Social Case Work” in 1939.
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• Relationship is the channel through which the mobilization of the capacities of the client
is madepossible.
• Relationship is the medium through which the client is enabled to state his problem and
through which attention can be focused on reality problems, which may be as full of
internal conflict with emotional problems.
• Relationship is the professional meeting of two persons for the purpose of assisting one
of them, the client, to make a better, a more acceptable adjustment to personal problem.
• Professional relationship involves a mutual process of
 shared responsibilities,
 recognition, of other‟s rights,
 acceptance of difference to stimulate growth
 interaction by creating socialized attitudes and behavior.
PART B
Components of Case Work
I- Person:-
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 The person’s behavior has this purpose and meaning: to gain satisfactions, to avoid or
dissolve frustration and to maintain his balance-in-movement.
 Whether a person’s behavior is or is not effective in promoting his well-being depends in
large part upon the functioning of his personality structure.
 The structure and functioning of personality are the products of inherited and
constitutional equipment in continuous interaction with the physical, psychological and
social environment the person experiences.
 A person at any stage of his life not only is a product of nature and nurture but is also and
always in process of being in the present and becoming in the future.
 The person’s being and becoming behavior is both shaped and judged by the expectations
he and his culture have invested in the social role
The person who comes as a client to a social agency is always under stress. To understand
human behavior and individual difference, Grace Mathew has given the following propositions:
1. An individual’s behavior is conditioned by his/her environment and his/her experiences.
Behavior refers to reacting, feeling, thinking, etc. the conditions and influences surrounding the
person constitutes the environment.
2. For human growth and development it is essential that certain basic needs should be
6
met. (Maslow’s hierarchy of needs)
3. Emotional needs are real and they cannot be met or removed through intellectual reasoning.
4. Behaviour is purposeful and is in response to the individual’s physical and emotional needs.
5. Other people’s behavior can be understood only in terms of ones own emotional and
intellectual comprehension.
PERSON
II –Problem:-
The problems within the purview of social casework are those which vitally affect or are affected
by a person’s social functioning. The multifaceted and dynamic nature of the client’s problem
makes necessary the selection by caseworker and client some part of it as the unit for work. The
choice of problem depends on
(1) whether the problem is the client’s problem
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(2) leadership given by case worker depends upon the professional knowledge and judgment
(3) agency’s function e.g. hospital, etc.
 Problems in any part of a human being’s living tend to have chain reactions. ….
cause > effect > cause.
 Any problem which a person encounters has both an objective and subjective significance
quality and intensity of our feelings.
 Not only do the external (objective) and internal (subjective) aspects of the problem co-
exist, but either may be the cause of the other.
 Whatever the nature of the problem the person brings to social agency; it is always
accompanied and often complicated by the problem of being a client.
Problems can be categorized as follows (Grace Mathew):
1. Problems related to illness and disabilities
2. Problems due to lack of material resources.
3. School related problems.
4. Problems related to institutionalization.
5. Behaviour problems.
6. Problems of marital discord.
7. Problem situations needing a follow-up service.
8. Needs related to rehabilitation of people.
9. Clients caught up in social problems like gambling, prostitution, alcoholism, drug addiction
and unmarried motherhood.
Problem
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III -Place:-
 The social agency is an organization fashioned to express the will of a society or of some
group in that society as to social welfare community decides the need of the agency.
 Each social agency develops a program by which to meet the particular areas of need
with which it sets out to deal. It depends on factors like money, knowledge and
competence of the agency staff, the interest, resources available and support of the
community.
 The social agency has a structure by which it organizes and delegates its responsibilities
and tasks, and governing policies and procedures Hierarchy roles and responsibilities
clear, designated and delegated collaboration procedures and policies, understand the
usefulness. by which it stabilizes and systematizes its operations. among workers.
 The social agency is a living, adaptable organism susceptible to being understood and
changed, much as other living organisms.
 Past, present and future not static and fixed.
 Every staff member in an agency speaks and acts for some part of the agency’s function,
and the case worker represents the agency in its individualized problem solving help.
 Case worker not an independent professional practitioner
 case worker speaks and acts for the agency psychologically identified with its purpose
and policies.
 The case worker while representing his agency is first and foremost a representative
of his profession must know and be committed with feeling to the philosophy that guides
the practice of the social work profession.
 Agency Private e.g. funding agencies and Public e.g. family welfare orgs.
 Primary e.g. NGO and Secondary e.g. Hospitals, schools, etc
Based on functions
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child welfare, family welfare, education, specialization based.
Also differs based on Source of support, Professional authority, Clientele they serve,Services
they offer, Goals of the agency, etc.
IV- Process:-
In order to understand what the case work process must include in its problem-solving help, it is
necessary to take stock first of the kinds of blockings which occur in people’s normal problem-
solving efforts. The six are:
1. If necessary tangible means and resources are not available to the person.
2. Out of ignorance or misapprehension about the facts of the problem or the facts of existing
ways of meeting it.
3. If the person is depleted or drained of emotional or physical energy.
4. Some problems arouse high feelings in a person emotions so strong that they overpower his
reason and identfy his conscious controls.
5. Problem may lie within the person; he may have become subject to, or victim of, emotions that
chronically, over a long time, have governed his thinking and action.
6. Haven’t developed systematic habits or orderly method of things and planning.
The intent of the case work process is to engage the person himself both in working on and
coping with the one or several problems that confront him and to do so by such means as may
stand him in good stead as he goes forward in living.
The means are
1. The provision of a therapeutic relationship
2. The provision of a systematic and flexible way
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3. Provision of such opportunities and aids.
All competent problem-solving, as contrasted with trail-and-error method, contains three
essential operations. Urgent pressures will often dislodge their sequence, botany conscious effort
to move from quandary (difficulty) to solution must involve these modes of action:
1. Study (fact-finding)
2. Diagnosis (thinking about and organizing facts into a meaningful goal-pointed explanation)
3. Treatment (implementation of conclusions as to what and how of action upon the problem).
Finally, for the solution or mitigation of many problems there must exist certain material means
or accessible opportunities which are available to the needful person and which he can be helped
to use. Kinds of resources that a person may need are money, medical care, nursery schools,
scholarships, foster homes, recreation facilities, etc.
PART C
Stages in Case Work:
Different stages in case work process are:
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 Case study /Social Investigation / Psycho Social Study
 Social Diagnosis
 Social Treatment
Social Case History:
The first step in the case work is to collect the social history of the client. This could be done in
various ways. These are:
 Interview with the client
 Interview with the relatives, employer, teacher and friends of the client.
 Visiting the neighborhood and environment in which the client lives.
All these visits will help the worker to know the client in his environment and collect all the data
in respect of the client and his environment i.e. his family, neighborhood, friendship circle,
employer, teacher, etc. as a matter of fact it is not possible to separate the three stages of case
work service i.e. social history, diagnosis and treatment. During the course of interview, the
worker may be able to diagnose and even suggest treatment to the client but where the problem
is very acute; it isnecessary to consider the diagnosis in relation this own history.
Social Diagnosis:-
Social diagnosis is an attempt to arrive at an exact definition as possible of the social situation
and personality of a given client. It is a search for theca uses of the problem which brings the
client to the worker for help. Diagnosis, is therefore, is concerned with understanding both the
psychological or personality factors which bear a casual relationship to the client’s difficulty and
the social or environmental factors which tend to sustain it.
Social treatment:-
Social treatment in case work is the sum total of all activities and services directed towards
helping the client with a problem. The focus into relieve the immediate problem and if feasible
12
modify any basic difficulties which precipitated it. Strictly speaking, everything that has been
discussed so far is part of treatment.
Generally, two types of efforts are required for social adjustment environmental modification
and or change in behavior modification. Early case work treatment was placed on modification
through the environment. Later on the development of ego psychology helped social case
workers to use intensive and direct treatment technique
Objectives of Case Work Treatment:
 To prevent social breakdown .
 To conserve client’s strength .
 To restore social functioning.
 To provide positive reinforcements.
 To create opportunities for growth and development.
 To compensate psychological damage.
 To increase capacity of self direction.
 To increase his social contribution.
Methods of social case work treatment.
 Administration of Practical Services.
 Indirect Treatment (Environmental Manipulation)
 Direct Treatment
Providing help to the client to choose and use the social resources afforded by the community.
Money, medical care, legal aid, helping to get job or admission in educational institutions, aged
homes, foster homes, recreational facilities are such type of services that any person in problem
may need in order to resolve a given problem in his daily living Environmental manipulation
13
means changing the social conditions of the client so that he/she may be relieved from excessive
stresses and strains. For example attempts to change the attitude of the parents, teachers, spouse,
employer, friends and relatives, training and employment for livelihood, group experience in
accordance with the needs of the client. Environmental modification is undertaken by the case
worker only when environmental pressures upon the client are beyond the client’s control but can
be modified by the case worker In this the case worker exerts influence directly on the client. It
is used when the client needs direction because of his ignorance, anxiety and weakness of his ego
strength. Direct treatment is given through counseling, therapeutic interviewing, clarification and
interpretation leading to an insight.
Social Treatment
Social treatment in case work is the sum total of all activities and services directed towards
helping the client with a problem. The focus is to relieve the immediate problem and if
feasiblemodify any basic difficulties which precipitated it. Strictly speaking, everything that has
beendiscussed so far is part of treatment.
Generally, two types of efforts are required for social adjustment environmental modification
and or change in behavior modification. Early case work treatment was placed on modification
through the environment. Later on the development of ego psychology helped social case
workers to use intensive and direct treatment techniques. The interviews in all these process are
every important and unless the interviews are conducted properly, it is not possible to expect
results. The case worker has, therefore, not only to understand the theory of interview but also
have sufficient training and experience in interviewing, if he/she wants to be successful in
providing service to the client.
Interviewing in Casework
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By interviewing, we mean a meeting or conference (may be formal or informal) between two or
more persons for specific purpose. It is an art which is used in every situation for better
understanding and better relationships between the interviewer and the interview. Interviewing is
the foundation on which theory and practice of social case work is based because without
interview, the worker cannot get all the possible information about the client nor can the client
gain any confidence in the worker. The purpose of an interview is, therefore:
o To obtain knowledge of the situation.
o To understand another person.
o To make the person understand you.
PART D
Case Work Process:
Casework process has four different stages, namely,
• Social study
• Social diagnosis
• Casework treatment
• Evaluation.
Conceptually, they are different and separate stages but they do not make a neat progression
always with one stage following the other in sequence. Sometimes, two or more stages proceed
simultaneously. Diagnosis may also change with the gathering of more data about the situation
15
or with change staking place in the situation itself. Casework help can not be postponed till the
completion of the social study or of the formulation of a social diagnosis. Some kind of help may
have to be rendered even at the first worker-client contact. The skilful way the case worker
conducts the interview may be of help to the client in terms of the concern, hope, warmth and
interest conveyed to the client, which in turn start a process, sooner or later, within him
activating him to mobilize his inner resources for problem solving. In casework intervention the
individual client is not considered in isolation from the family, but as a part of the family, since
the family forms the most important human environment for the client with its network of
emotional relationships. Therefore, other members of the family are also involved in the
casework process. Also, home visits are made by the caseworker to get an understanding of the
environment as for other reasons.
Process of Social Case Work:
I. Intake (First Interview) Rapport Building
 Client comes to an agency for professional help through a Case worker.
 Relationship between two persons of unequal positions and power is developed.
 Accept client as a person in a stressful situation
 Respect the client’s personality and help him resolve.
The areas for probing are:
1. The stage of the problem at which the person, through whom, and the reasons becauseof
which, comes to this agency.
2. The nature of request and its relation to his problem, and the cause of his problem, asthe client
see.
3. Does the request relate directly to his needs/ problems?
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4. His adjustment to his social functions in job, family, etc.
5. The state of his physical and mental health.
6. His appearance including dress, etc. in his first meeting.
7. His personal and social resources including material and financial position.
8. Appropriateness and intensity of feelings.
9. Nature of defense mechanisms he frequently uses.
10. Level of motivation, how quickly he wants to get rid of his problems.
11. Nature of family, its status, values, relationship pattern within the family, etc.
12. Reactions to the worker and seeking help from the agency and sex of caseworker who will be
suitable to help the person.
II. Psycho-Social study (Exploration / Investigation):
“Psycho – Social study is the initial assessment of client’s current, relevant past and possible
future modes of adaptation to stressful situations and normal living situations.”
Perlman has given the following contents of the case work study
1. The nature of the presenting problem
2. The significance of the problem.
3. The cause(s), onset and precipitants of the problem.
4. The efforts made to cope with problem-solving.
5. The nature of the solution or ends sought from the case work agency.
6. The actual nature of the agency and its problem solving means in relation to the client and his
problem.
Tools of study
The tools used by the case worker for collecting the relevant information are:
1. Interview guide and schedule.
2. Life chart.
3. Video recording of family interaction.
4. Tape recorded interview.
The Format of Interview Schedule
1. History of the problem.
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2.Personal history.
3. Family history.
4. Problematic areas.
5. Treatment Plan
IIII. Psycho - Social diagnosis (Assessment):
According to Perlman (1957)
 “Diagnosis helps in determining the focus of treatment, further collection of facts and
deciding the best course of action to solve the problem.”
 “Social diagnosis is the attempt to arrive at an exact definition as possible of the social
situation and personality of a given client.”
 “Diagnosis is concerned with understanding both the psychological or personality factors
which bear a causal relation to the client’s difficulty and the social or environmental
factors which tend to sustain it.”
 “Diagnosis may be viewed as the fluid, constantly changing assessment of the client,
theirproblems, life situations and important relationships.”
Content of the Social Diagnosis:
1. The nature of the problem brought and the goals sought by the client, in their relationship to.
2. The nature of the person who bears the problem and who seeks or needs help with the
problem, in relation to.
3. The nature and purpose of the agency and the kind of help it can offer and/ or make available.
Process of making diagnosis
 Shifting the relevant from irrelevant data
 Organizing the facts and getting them into relatedness
 Grasping the way in which the factors fit together
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 Preparing the meaning as a whole.
Data for Diagnosis
1. Interviews
2. Checklist and Inventories
3. Direct Observation
Steps in Diagnosis
1. The worker begins to focus on problematic behaviors. Both functional and dysfunctional
behaviors in the client’s environment are surveyed. The client’s personal strength as well as of
his environment are evaluated.
2. He specifies the target behaviors. Break down complex behaviors into clear and precise
component parts.
3. Baseline data are collected to specify those events that appear to be currently controlling the
problematic behaviors.
4. The collected information is summarized in an attempt to anticipate any major problem in
treatment and as a way of beginning to establish objectives for treatment.
5. Selecting priorities for treatment is the final step of the diagnosis.
III
Types of diagnosis
1. Clinical
 The person is described bythe nature of the illness.E.g. schizophrenia, psychopath,
typhoid, etc.
 Used in medical practice.
 Use is minimum in casework practice. - Importance in medical and psychiatry.
2. Etiological
 Tries to delineate the causes and development of presenting difficulty.
 History of the person.
3. Dynamic
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 Proper evaluation of the client’s current problem as he is experiencing it now.
 Role of psychological, biological, social and environmental factors in the causation of the
problem.
 No attempt to dig life history.
 Case worker and client engage inappropriate corrective action or treatment.
 These developments may lead to modifications in the goals for treatment
IV. Intervention / Treatment (Problem-solving process):
According to Hamilton-
“Treatment is the sum total of all activities and service directed towards helping an individual
with a problem. The focus is relieving of the immediate problem and, if feasible, modifies any
basic difficulties which precipitated it.”
The objectives of Social case work treatment
1. To prevent social breakdown.
2. To conserve client’s strength.
3. To restore social functioning.
4. To provide happy experiences to the client.
5. To create opportunities for growth and development
6. To compensate psychological damage.
7. To increase capacity for self-direction.
8. To increase his social contribution.
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Methods of Social treatment
1.Administration of concrete and practical services.
E.g. money, medical care, scholarships, legal aid, etc.
2.Indirect treatment (modification of environment, both physical and social).
E.g. camps, group experience activities, training programmes, etc.
3.Direct treatment
A. Counseling
marriage, occupational, family, school, etc.
B. Therapeutic Interviewing
family and marital therapy.
C. Clarification
D. Interpretation and Insight
E. Psychological support.
F. Resource utilization
G. Environment modification.
Intervention / Treatment (Problem-solving process)
V
V. Monitoring and Evaluation:
Monitoring provides crucial feedback to case worker and the client regarding
1. Whether the treatment program is succeeding as desired
2. Whether established goals have been achieved
3. Whether modifications in the program are necessary
4. Whether the client is being helped in real sense.
Importance of Monitoring and Evaluation
• The purpose of Evaluation is to see if the efforts of the case worker are yielding any
result or not, if the techniques used are serving the purpose, and if the goals are being
achieved.
• Evaluation is the process of attaching a value to the social work practice. It is the method
of knowing what the outcomes are.
• It is a continuous process.
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• Evaluation of the approach used and result should be taken up with the client so that the
efforts are meaningfully utilized.
• Evaluation will further strengthen the relationship between the caseworker and client and
motivate the client to work towards his goal.
• Casework practices need to be evaluated from time to time. The subject needs to be tested
and researched and most importantly needs ongoing validation. They need tobe proved to
the public that they are effective and beneficial to the clients.
• Casework practice should be subjected to critical review. Workers need to be held
accountable for what they do and for their social work competence. Workers need to win
approval for their programs.
• They may sometimes have to be told that their services are overlapping and ineffective.
• Workers have to enhance their own image and also of the agency to develop public
relations. The clients need to give a feedback on the effectiveness of the services.
VI. Follow-up and Termination
 At the end, i.e. termination, the worker should discuss the original as well as revised
goals and objectives, achievements during the helping period, factors helpful or
obstructive in achieving the objectives, and the efforts needed to maintain the level of
achievement and the feelings aroused by disengagement.
 It is neither wise nor necessary for the termination to be an abrupt one.
 It is best to discuss termination and its ramifications (implications) several times before
the final interview.
 The frequency and amount of contacts should be gradually decreased.
 Termination of the helping process brings up in both the case worker and client(s) many
feelings both positive and negative which must be verbalized and discussed.
 Follow-up is done to help client maintain the improvement.
 During follow-up, the client is helped to discuss the problems he faces in maintaining the
improvement.
 Work is done with the people significant for his improved social functioning.
22
 If required, he is referred to the proper source for needed services and help.
 The follow-up should be planned on a diminishing basis after two weeks, then a month,
then three months, six months and a year following the termination of the formal
program.VI
In InSocial Case Work Proce
In short
The case work process consists of:
 Intake (FirstInterview)Rapport Building Psycho-Socialstudy exploration/ Investigation)
 Psycho - Social diagnosis (Assessment)
 Treatment (Problem-solving process
 Follow-up and Termination
The components of social casework are:
 The Person
 The Problem
 The Place
 The Process
 The worker – client relationship
 The Problem solving work
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PART E
approaches in Social Case Work.
Casework: A Psychosocial Therapy
Known in academic circles as the 'bible' for clinical practitioners of social work, Casework: A
Psychosocial Therapy introduces readers to the basic theory and principles in the practice of
psychosocial therapy, along with attention to the historical development of the approach as it has
been enriched and expanded over the years. The authors' approach reflects a balanced focus on
people, their environment, and the ways in which people interact with their environment.
Essential techniques including how to conduct initial interviews with clients, crisis intervention,
arriving at assessments, and choosing appropriate treatment, are thoroughly explained, and often
clarified with case studies and vignettes, preparing readers to assess social work clients from a
variety of perspectives. The book is designed for the graduate-level student who needs to master
the principles, theories, and approaches of the psychosocial approach to applied practice, but it
may also be used to fit a variety of courses, including the Introduction to Social Work BSW
student who is looking for supplemental information on the basics of clinical practice. Now in its
fifth edition, Casework has been thoroughly revised to keep discussions clear and up to date.
New material has been added throughout, including a greater variety of case studies, discussions
about current topics such as the influence of ethnicity and diversity in the social work practice,
changes in family life roles, changes in ideas and practice approaches, and a significantly
updated bibliography for reference.
Functional Approach
Structural functionalism is a broad perspective in sociology and anthropology which sets out to
interpret society as a structure with interrelated parts. Functionalism addresses society as a whole
in terms of the function of its constituent elements; namely norms, customs, traditions and
institutions. A common analogy, popularized by Herbert Spencer, presents these parts of society
as "organs" that work toward the proper functioning of the "body" as a whole.[1]
In the most basic
24
terms, it simply emphasizes "the effort to impute, as rigorously as possible, to each feature,
custom, or practice, its effect on the functioning of a supposedly stable, cohesive system." For
Talcott Parsons, "structural-functionalism" came to describe a particular stage in the
methodological development of social science, rather than a specific school of thought.[2][3]
Parsons called his own theory for action theory and argued again and again that the term
structural-functionalism was a misleading and inappropriate label to use as a name of his theory.
 THEORY
Classical functionalist theories are defined by a tendency towards biological analogy and notions
of social evolutionism:
Functionalist thought, from Comte onwards, has looked particularly towards biology as the
science providing the closest and most compatible model for social science. Biology has been
taken to provide a guide to conceptualizing the structure and the function of social systems and
to analyzing processes of evolution via mechanisms of adaptation ... functionalism strongly
emphasizes the pre-eminence of the social world over its individual parts (i.e. its constituent
actors, human subjects).
1) Social case work and crisis management?
Social Workers and Case Management: The Key to Crisis Intervention
Every day around the world, people are in crisis. They face problems and situations that they
cannot deal with alone and the caring advocacy of the social workers that help them may be the
difference between their ability to deal with the crisis or to “drown” under the weight of it.
A Day in the Life of a Social Worker
The Social Worker’s day is typically filled with crisis intervention. The diversity of the needs of
the patients assigned to them requires research, strategic planning and provision of
individualized support to each client. In addition, the nature of their work requires confidentiality
25
and emotional separation to enable them to carry out their case management in a professional
manner.
Team Work as Intervention Strategy
Working closely with a client and his or her family, the social worker must also work as a
member of a team to provide the best outcomes for the client. Depending on the type of work
engaged in, and the type and extent of support required, the types of teams the worker is part of
may change considerably from client to client.
Communication is the Key to Successful Intervention
Case management requires the development of excellent communication skills to enable all
members of the team, and the client to feel that progress is being made and that the client’s most
pressing needs are being successfully addressed. Social work can be a difficult and sometimes
stressful profession, but ongoing education can provide skills in areas that would otherwise be
potentially draining. Courses in communication, technology, team work and strategic planning
are among the many options that can help provide all health care workers with advanced skills to
assist them in their work.
Best Practice Interventions
When an individual is faced with a crisis, they may in certain circumstances need someone to
make decisions for them. This is particularly true of children requiring protective services
intervention. Their age and vulnerability mean that often they are incapable of making important
life decisions.
But older individuals must be empowered to make their own decisions and this is the role of
social workers working with adult clients. They offer an essential service in the provision of
advocacy and information, ensuring that their client is in a position to be able to make informed
life choices.
If you feel that the field of social workers might be a career for you, why not check into
one of the online training courses that are offered. You won’t just learn a new skill, but
will become a part of a movement that is all about helping othersExplain the important
keys to crisis intervention
PART F
26
social work recording:-
Case Work Recording
There has been a significant change in the nature of case recording, which in many ways reflects
the wider changes in social work. Staffing levels, increased user involvement and increased
accountability to service users, the organization and profession, are all factors which have
influenced the development of the case record and recording practice
The traditional case record reflected the interaction between the practitioner and the service user,
in the context of the service user's history and current situation. At its heart was the relationship
between the practitioner and service user. Traditional case records were 'often written in an
abstract discursive style for a sophisticated professional audience' within the agency.
Practitioners were reluctant to restrict their professional autonomy by establishing 'clear and
specific criteria for the clinical (practice) record'
In the absence of any definition by practitioners, the way in which the case record developed to
meet the changes in legislation and social work practice was led by organizational and
managerial requirements . Whilst, the shift to more structured, focused and evidenced recording
has been both welcome and necessary, concerns have been expressed that using case recording
simply to evidence individual and organizational accountability neglects it's value as a practice
tool .
'The case file is the single most important tool available to social workers and their managers
when making decisions as to how best to safeguard the welfare of children under their care. It
should clearly and accessibly record the available information about the child and the action that
has been taken on the case to date. Reference to the case file should be made at every stage of the
case and before any significant decision is made'.
The case record should be more than a complex diary of the practitioner's actions and the
response of the service user. To use it in such a way is like buying a video recorder and then only
27
using its clock to tell the time. Practitioners should use case recording to support analysis and
reflection .
Using recording for analysis requires practitioners to assess the weight that should be given to
information gathered. To do this practitioners should draw on their knowledge from research and
practice combined with an understanding of the child's needs within his or her family and/or the
context in which the child lives .
Analysis provides a clear direction to ongoing records and assists practitioners in identifying
what information should be recorded . However analysis often takes place outside day to day
recording and is facilitated by specific formats. Initial and Core Assessments, genograms,
ecomaps, social histories and case summaries are all examples of formats that support analysis.
They require practitioners to organize, manipulate and evaluate the information gathered in the
case files. They provide an opportunity to assess the child's needs, monitor progress, evaluate the
effectiveness of interventions, and to identify patterns that would may not immediately be
apparent.
Often case recording can become almost a subconscious activity, like driving a car along a
familiar road. You arrive but can't say exactly how you got there. The regular use of tools for
analysis in the case record keeps recording a proactive activity that supports ongoing assessment,
planning and intervention.
Avoid the pitfall
• Do not record simply what is happening, use analysis to move beyond this to hypothesise
and explain why particular situations and events are occurring.
• Use genograms, ecomaps, chronologies and assessment records to help you to organise
and to analyse information.
• Use case summaries as a way of reviewing progress and evaluating the effectiveness of
interventions.
• Use training, journals and articles to keep up to date with developments in research to
inform your practice.
28
 What do we mean by social case work recording?
We mean all the written material contained in the social work files of people using social work
services. Social work files may be wholly or partly electronic or they may be in hard copy.
Recording is a crucial part of day to day social work practice and takes up a substantial amount
of practitioners' time. Recording involves:
* writing down the work you do;
* noting the progress people make towards their desired outcomes;
* including the views of the person;
* analysis and assessment; and
* the life history of the person and its interpretation.
Good records are an essential tool for practitioners to reflect on their on going work with people
and plan future work. When shared with the person whose file it is they encourage transparency.
Recording is also part of the code of practice for social services workers 1 published by the
Scottish Social Services Council ( SSSC). The purpose of this code is to set out the conduct
expected of social service workers and to inform people using social work services and the
public about the standards of conduct they can expect from social service workers. Recording
comes under section 6:
'As a social service worker you must be accountable for the quality of your work and take
responsibility for maintaining and improving your knowledge and skills.'
29
purpose of social work recording
* documenting the involvement with the individual;
* informing assessment and care planning;
* enabling practitioners to review and reflect on their work;
* assisting practitioners to identify any patterns;
* ensuring accountability of staff;
* meeting statutory requirements;
* providing evidence for legal proceedings;
* enabling continuity when a new worker takes over the case;
* providing performance information;
* forming a biography - for example, for a looked after child to read at a later date to provide
them with their history;
* providing evidence for inquiries or reviews; and
* assisting partnership working between workers and people using their services.
30
PART G
social worker in the medical setting.
Case work in Medical & Psychiatric Setting
Medical and Psychiatric Social Work is a branch or specialisation in professional social work. The
medical and psychiatric social workers are employed in health settings like hospitals, community
health care projects, medical and psychiatric rehabilitation agencies, psychiatric treatment centres
and counselling centres. The role of the medical and psychiatric social worker is to help individuals
with social, economic and psychiatric problems that arise because of ill health, disability and
economic problems. They help to enable the person to lead a productive and satisfied life to the best
of his abilities. The social worker uses his skill in relationship with the client system, and
understands the problems faced by the client. It could be economic problems, attitude towards the
problem faced by the client, the nature of the relationship he has with other support systems like the
family, employers and referral agencies. The social worker gets the cooperation of the family
treatment of the client and uses community resources that are available.
In the medical setting, the worker acts as the link between the doctor and the patient. She acts
as the source of knowledge for the client. In the commullity health care organisations, the worker
understands the social-cultural patterns of the community, the health practices of the community, the
31
needs of the community and interprets these to the team of other professionals with whom she
works. Her main role in the community is to elicit participation of the community in planning their
health care, provide health education and help them to use preventive services effectively. In the
psychiatric setting, she does the mental status examination of the client, understands the psychosocial
problems of the client and interprets the same to the psychiatric team. Her main role is one of
counselling and education of the family to understand and accept the client. In the drug addiction
centers, she is the link between the psychiatric and medical team, the family and the client. Apart
from counselling the client, she works towards the rehabilitation of the client in the community and
helps him to become a productive member of the community,
History
Medical Social Work had its beginning in England and the United States of America. In 1880, a
group of volunteers working for an asylum in England paid friendly visits to the discharged patients
to find how they were adjusting to their home conditions. In 1885 Sir Charles Loch recommended
that the lady almoners should visit the patients at home to prevent the abuse of drugs given freely in
the charity hospitals. The almoner, while investigating the financial problems of the clients, found
other sets of social and psychological problems that needed handling. Hence, apart from the medical
help given, she also tapped other community resources in order to help them overcome social
problems.
In thd "tlmtea Statcs of Ainerica, around 1900, nurses visited the discharged patients in their homes
and showed the importance of understanding the patient in his social situation. In 1902, Dr. Emerson
of John Hopkins University, Baltimore, made the medical students visit the patients in their homes.
This helped the students become aware of the impact of the social and cultural factors in health. In
1905, a –medical social worker was appointed at the Massachusetts General Hospital, with the
establishment of the Social Service Department. In the first thirty years, more social
Psychiatric Setting
Apart from individual patient care, the social workers were also involved in other activities like
administrative planning, joint teaching and research. They were involved in the planning Bond
implementation of community health care activities. In the west, the medical social workers have
firmly established themselves and work as members of the health team. Their main role revolves
around the treatment of the psychosocial
32
dimensions of the patient's personality.
Medical and Psychiatric Social Work in India
India has a tradition of voluntary social work. Service to the sick has been a part of 't the Indian
tradition. The scientific orientation to medical social work took a longer time. Further, the medical
social workers had to struggle lo establish their image as professionals. The origin of medical social
work in India could be attributed to the Bhore Committee (1946). The Committee strongly
recommended the appointment of inedical social workers in hospitals. The Bhore Committee made
the following recolnmendations regarding the role of the medical social worker. Discovery and
making available to the medical staff factors in the patient's environment that may have any bearing
on his physical condition, thus supplementing inedical history with social history. Influencing and
guiding patients in canying out treatment, making the physician's direction siniple and concrete, and
helping them to carry out the plan of treatment through to completion. Overcoming obstacles to
successful treatment or recovery particularly in the outpatient department and during convalescence
medical and surgical supplies are secured: the social or economic conditions affecting the patient
adversely are corrected. Arranging for the supplementary care of patients. Educating the patient in
regard to his physical condition in order that he may better . cooperate ia the programme laid down
by the physician. Because of the recommendation of the Bhore Commit-tee and the conviction of
some of the doctors who had seen the effective work done by the medical social workers .
.
The Envisaged Tasks of the Medical Social Worker
The medical social worker is involved in the following areas: direct service to the client system,
teamwork, administration, teaching, supervision and self-development, and community health.
Direct Service to the Client System
Soc'ial evaluation of the individual patients in terms of their ability to participate in the treatment
process. Interpretation of the nature of the illness to the patient and his family an individual basis.
Visits to patient's home for assessment of the psychosocial situation. Counseling and helping the
patient and family to deal with the psychological and social problems arising out of the illness and
giving information on the prognosis, treatment process and rehabilitation. Environmental
modification through work with employers, family and others to enable the patient to benefit
maximum from the treatment process. Organizing with patients, volunteers and other agencies,
therapeutic, educational and recreational activities for group of patients and their relatives. Placement
33
and institutionalization of destitute and other patients, if and when found necessary. Follow up of the
client system to ensure fullest utilization of the services given. Referring patients and their families to
other social welfare agencies.
Team. Work
Interpreting the role of the social worker to the other team members. Interpreting the patient's
psychosocial needs to the other team members. Participating in formulating a diagnosis and planning
the treatment. Consultation to and from other members of the team.
' Work yith various members of the team.
Community Health Work
Involving the community in carrying out a community survey and use of media’ to identify needs
social worker in family setting:-
Family
Family-centered casework practice encompasses the range of activities designed to help families
with children strengthen family functioning and address challenges that may threaten family
stability. These activities include family-centered assessment and case planning; case
management; specific interventions with families including counseling, education, and skill
building; advocating for families; and connecting families with the supportive services and
resources they need to improve their parenting abilities and achieve a nurturing and stable family
environment.
• Family-centered assessment
• Family-centered case planning
• Family-centered case management
• Working With families and youth
• Advocating for families
• Working With community resources
34
Family-Centered Assessment
Assessment forms the foundation of effective practice with children and families. Family-
centered assessment focuses on the whole family, values family participation and experience,
and respects the family's culture and ethnicity. Family-centered assessment helps families
identify their strengths, needs, and resources and develop a service plan that assists them in
achieving and maintaining safety, permanency, and well-being.
There are many phases and types of family-centered assessment, including screening and initial
assessment, safety and risk assessment, and comprehensive family assessment. Assessment in
child welfare is ongoing.
School Settings:
Professional social workers play a vital role in helping school children of all ages. Traditionally,
school social workers serve as liaisons between the home, the school, and the community. Since
1907, school social workers have collaborated with teachers and other school personnel in
advancing the purposes of education.
School social workers are an important part of the school team, possessing unique
interdisciplinary knowledge. School social workers contribute to programs designed for students
at-risk due to a variety of factors, including:
• emotional problems,
• poor self-esteem,
• child abuse and domestic violence,
• poverty and unemployment,
• suicidal behavior, drug and alcohol abuse,
• teen pregnancy and parenting,
• discrimination, and
• Attendance related issues.
35
The School Social Work Program is designed to train school social workers and provide them
with the competencies to practice in a variety of traditional and non-traditional primary and
secondary education settings. Such competencies include assessing the needs of school children,
designing and implementing interventions, and making referrals to other professionals and
agencies as needed.
PART C
social case work in community setting
Community setting :
This is another training document in the series of community mobilizing methods for results
other than a physical construction such as a communal water supply, clinic or school.
The product or output is a programme of services for vulnerable members of the community,
many of whom can help themselves if only they are provided with a relatively small amount of
help and encouragement.
What is Social Work?
The profession of Social Work is an odd mixture of many things. It is usually practised by
government civil servants in the west (Europe and North America) while many international
NGOs have social workers on their staff.
The clientele of social work are often called the vulnerable, ie people whose special conditions or
circumstances put them in positions of weakness or vulnerability in comparison with the
mainstream of a society. Generally they include members of society who need some help.
36
Typically, these include those with physical or mental disabilities, persons who are not able to
work for a living or not able to care for themselves. In special cases, these may include battered
women (those who have been physically or emotionally assaulted – eg by their spouses –and can
not escape dangerous situations on their own), frail elderly persons, children without parents to
support them, or who are being mistreated,
The tasks of a social worker mainly include administration and counselling, along with a little bit
of medical (usually psychological) intervention and advocacy. The social worker provides her or
his clients with little bits of wisdom, advice, information, counselling, as needed. Every case is
different.
The government (or NGO) social worker in a western country (Europe and North America)
provides services that are usually provided by elders and family members in other countries.
Social work services are too expensive for governments in the least developed countries.
The word "social" is a bit misleading because, in the west, where it is mainly practised, the social
worker does not work with a whole society, or even with a community or a group in a social
context. The social worker usually handles "cases," and a case is usually about an individual or
lately increasingly, a family.
This is even more ironical because where social work is taught, usually in a university in a
department or a school of social administration or social work, often (where they are small) they
are attached to sociology departments. Such schools or departments, in turn, are then usually also
where community development (like much of the material on this web site) is also taught.
Community development, in contrast, is an activity aimed at social institutions, such as
communities or groups, rather than at individuals. (See Community).
One of the many motivating facts pushing the development of this web site is that the
empowerment of communities is important and highly needed in low income countries. Limiting
the training of community workers to those who are studying in universities, limits the available
number of potentially capable community workers; this should be taught to middle school level
students (after they have been working out in the real world and have some life experience).
37
.
Where is CBSW Appropriate?
Rich countries can usually provide social work services (on an individual or family basis, not
community based), and poor countries rely on the advice, experience and knowledge of elders
and family members. So where would it be appropriate to place a community based social work
programme? Community based social work services are needed where they can not be provided
by elders and families, but where there is not enough finance available to provide it on an
individual basis.
The situation which comes to mind most readily is where there are large displaced or refugee
populations, in camps, in poor countries. Further to that, after the emergency is over, those same
refugees may return home. Their lives will have been interrupted, losing many family members,
including elders and family members, thus the need for social work services remains. So long as
there is enough funding available for a professional social worker to supervise the community
based work, keeping it up to required standards, the community itself can supply the energy, time
and interest in making it work.
Apart from refugee situations, wherever there is a large disaster that results in the removal of
elders and family members, and/or which disrupts the normal and traditional social organization,
are included among situations where it would be appropriate to set up a community based social
work programme. Post disaster situations would be included in these.
Where there are large refugee populations, the basic services, food, water, shelter, elementary
medical, are usually provided, often by UN agencies and international NGOs. Finance is not
unlimited, however, so there may only be a token attempt at providing social work services, if
any at all. This is a good situation in which to consider organizing a community based social
work programme.
Community Perceptions:
38
When a child is a witness to atrocities that destroy her world, she is affected. To watch your
family members and/or neighbours being shot or bombed produces immense trauma if you are a
child. In many cases, the experience results in the child withdrawing into herself, refusing to talk,
and/or refusing to respond to daily interactions. The child who is traumatized by the same events
which lead to refugee or displaced communities, may display behaviour that is often
misinterpreted by her remaining family or care givers. Sometimes she is deemed as mentally
retarded, and beyond recovery. Sometimes she is seen as affected by evil spirits. Sometimes her
condition is seen as a punishment for previous misdeeds by her family members. In all these
cases, there is much shame and secrecy associated with her behaviour. All too often her care
givers do not understand that she is reacting to the terrible events of the disaster or civil war, and
they do not know that the condition can be reversed by a few simple interventions.
Many times such children are hidden (even tied up) in darkened rooms away from public view.
They can not dress or clean themselves, and often are found in their own filth and in poor health,
hungry, dirty, sick, weak and helpless. Public announcements do not get the message across.
Hands on intervention is needed to assess each child.
If they are traumatized by atrocious events, and not retarded or otherwise disabled by other
factors, they can show remarkable changes, learning to dress themselves, clean themselves and
feed themselves. This requires patience, love and care, extended over several weeks and months.
A stimulus or two in the form of a doll, and perhaps later a ball, are effective and useful tools for
the job.
Here is a situation, repeated hundreds of thousand times around the world, where a community
based social work programme is appropriate. This is a typical or classic situation for CBSW.
A single, university educated, professional social worker can appraise the situation, prescribe
appropriate interventions, and monitor. Community mobilizers can work with the community
members to identify hidden and suffering children, recruit community level social workers,
arrange for their training and supervision, organize CBOs to manage and operate the CBSW
programme at community level, and ensure an effective flow of information. Local residents, on
a volunteer basis or with some incentives, can provide the care and stimulation to the children in
39
need, and keep the mobilizers informed about changing conditions and further needed training.
This is only one of many kinds of situations involving vulnerable refugees or displaced persons
in communities disrupted by (but surviving) disasters caused by natural or human made events.
The PHC Principles:
The "Primary Health Care" (PHC) policy promoted by WHO (UN World Health Organization),
has several basic principles, perhaps the best known one being that prevention is better than cure.
Another, that is particularly applicable here to community based social work, is the idea that
resources should not be spent on expensive cures for a few people.
Underlying this is a public health policy in support of the greatest good for the greatest number.
With a limited budget available, that means to concentrate on a few common diseases, to provide
elementary training to persons educated at low levels, and reaching the most rural and remote
patients. This gave rise to the popular (but slightly inaccurate) concept of "The Barefoot Doctor."
(Also see Water and PHC). If the PHC policy is transferred to the need for social services, then
the idea is to give elementary training to persons without university level education,
concentrating on the most common and easily treated conditions, and relying on a referral system
for more complicated diseases or conditions.
The goal in community based social work, then, is to organize a cadre of community members
who can be given low level training (ie not requiring university education) to treat a limited
number of social conditions of vulnerable community members. Their interventions will not be
as flexible or a sophisticated as those of social workers with university level education and
extensive social work training, but they will be able to reach a wider proportion of the population
than if only highly skilled and relatively costly professionals are employed.
"The greater good for the greater number."
Structure:
What is a possible structure for a CBSW programme?
40
Where you have a population of refugees or others who have had severe disruptions in their
community lives, where they are able to access support for their immediate needs (food, shelter,
water, housing) but no social welfare. Where you may have a professional social worker or two
for a population too large for them to reach everybody. Where you have a situation conducive to
organizing voluntary community groups.
There you have the basis for CBSW.
The professional social workers need to make a needs analysis to determine the limited number
of conditions that can be addressed by community workers with low level training. They then
need to train and to supervise the training of a cadre of community workers who have access to
the client community or communities. Both the needs assessments and the training would not be
once-off, but ongoing. They and the community workers (mobilizers) need to identify, recruit,
and train community members, as community leaders of the programme, as practitioners of
social work interventions in their communities, and as monitors of the changing situations in
their respective communities.
Members of the community groups conduct the social work interventions. They need to be
supported with training and guidance by the mobilizers and (more indirectly by) the professional
social workers.
What results in effect is like a social work pyramid, with the professional social worker(s) at the
apex, possible social work trainers (temporary or long term) supervised by the social workers,
mobilizers, community leaders and managers of the community groups (CBOs) and community
and CBO members who conduct most of the interventions.
Training and Support:
In general, community mobilizers should never be trained once-and-for-all, but need regular
support, encouragement, and a forum in which to ask questions that arise in the field (See
Training Methods). In CBSW this is even more a requirement. First, mobilizers without formal
training (the main audience for this web site) need continued support and professional inputs.
41
Second, the tragedies witnessed in CBSW require field workers to meet with their colleagues to
share experiences and to be re-energised and re-infused with enthusiasm and positive attitudes. A
CBSW programme as described above needs a routine and predictable forum for getting
mobilizers together to share experiences, to ask questions arising from the field, and to obtain
inputs from more highly trained and educated social workers. A training unit could be an answer
to this need. How it is to be set up depends upon available finances and circumstances.
An initial training programme for the mobilizers could use the first six training modules from
this web site. They can be printed and handed out in the training programme. They can be easily
adapted to developing a CBSW programme. The training for social work, in contrast, needs to be
defined and generated by the professional social workers, after they make their initial appraisal
of the situations, and will be modified as new information comes in.
Correctional Social Work
With 1.6 million Americans behind bars and the cost of their care rising, NASW believes
preventative services, alternatives to incarceration, and an emphasis on prisoner rehabilitation
must be undertaken. Adequate services both inside and outside of the prison could reduce rates
of incarceration and recidivism for the betterment of individuals and society as a whole.
A number of facts about the prison population, although disturbing, point toward solutions for
stemming the growth in numbers of incarcerated individuals:
• People of color are disproportionately represented in the prison population.
• Substance abuse and mental illness underlie many offenses committed.
• An estimated 200,000 prisoners have severe mental disorders, while others have mental
health problems that are undiagnosed and untreated.
Although the effectiveness of some practices to promote rehabilitation—such as helping
prisoners maintain family ties and responsibilities—are known, the social work profession
should identify others through research (for example, other options for dispute resolution,
alternatives to prison, and effective treatments within correctional settings). In addition, social
workers in correctional settings need specialized training, including the ability to communicate
42
with prisoners from other cultures. Finally, social workers should participate in national policy
debates, collaborate with other organizations that deal with prisoners, and advocate preventative
efforts, including community-based services to treat addiction and mental illness before these
become criminal justice issues.
Aged Care
Medical (skilled care) versus Non-Medical (social care
A distinction is generally made between medical and non-medical care, and the latter is much
less likely to be covered by insurance or public funds. In the US, 86% of the one million or so
residents in assisted living facilities pay for care out of their own funds. The rest get help from
family and friends and from state agencies. Medicare does not pay unless skilled-nursing care is
needed and given in certified skilled nursing facilities or by a skilled nursing agency in the home.
Assisted living facilities usually do not meet Medicare's requirements. However, Medicare does
pay for some skilled care if the elderly person meets the requirements for the Medicare home
health benefit. [12]
Thirty-two U.S. states pay for care in assisted living facilities through their Medicaid waiver
programs. Similarly, in the United Kingdom the National Health Service provides medical care
for the elderly, as for all, free at the point of use, but social care is only paid for by the state in
Scotland, England, Wales and Northern Ireland are yet to introduce any legislation on the matter
so currently social care is only funded by public authorities when a person has exhausted their
private resources, for example by selling their home.
Elderly care emphasizes the social and personal requirements of senior citizens who need some
assistance with daily activities and health care, but who desire to age with dignity. It is an
important distinction, in that the design of housing, services, activities, employee training and
such should be truly customer-centered.
However, elderly care is focused on satisfying the expectations of two tiers of customers: the
resident customer and the purchasing customer, who are often not identical, since relatives or
43
public authorities rather than the resident may be providing the cost of care. Where residents are
confused or have communication difficulties, it may be very difficult for relatives or other
concerned parties to be sure of the standard of care being given, and the possibility of elder abuse
is a continuing source of concern. The Adult Protective Services Agency — a component of the
human service agency in most states — is typically responsible for investigating reports of
domestic elder abuse and providing families with help and guidance. Other professionals who
may be able to help include doctors or nurses, police officers, lawyers, and social workers.[13]
Improving mobility in the elderly
Impaired mobility is a major health concern for older adults, affecting fifty percent of people
over 85 and at least a quarter of those over 75. As adults lose the ability to walk, to climb stairs,
and to rise from a chair, they become completely disabled. The problem cannot be ignored
because people over 65 constitute the fastest growing segment of the U.S. population.
Therapy designed to improve mobility in elderly patients is usually built around diagnosing and
treating specific impairments, such as reduced strength or poor balance. It is appropriate to
compare older adults seeking to improve their mobility to athletes seeking to improve their split
times. People in both groups perform best when they measure their progress and work toward
specific goals related to strength, aerobic capacity, and other physical qualities. Someone
attempting to improve an older adult’s mobility must decide what impairments to focus on, and
in many cases, there is little scientific evidence to justify any of the options. Today, many
caregivers choose to focus on leg strength and balance. New research suggests that limb velocity
and core strength may also be important factors in mobility.[14]
The family is one of the most important providers for the elderly. In fact, the majority of
caregivers for the elderly are often members of their own family, most often a daughter or a
granddaughter. Family and friends can provide a home (i.e. have elderly relatives live with
them), help with money and meet social needs by visiting, taking them out on trips, etc.
One of the major causes of elderly falls is hyponatremia, an electrolyte disturbance when the
level of sodium in a person's serum drops below 135 mEq/L. Hyponatremia is the most common
electrolyte disorder encountered in the elderly patient population. Studies have shown that older
44
patients are more prone to hyponatremia as a result of multiple factors including physiologic
changes associated with aging such as decreases in glomerular filtration rate, a tendency for
defective sodium conservation, and increased vasopressin activity. Mild hyponatremia ups the
risk of fracture in elderly patients because hyponatremia has been shown to cause subtle
neurologic impairment that affects gait and attention, similar to that of moderate alcohol intake.
[15]
PART F
1) What is CSCW?
A) Computer Supported Cooperative Work
2) What is Ethnography?
A) Ethnography is a method of data capture that works through the immersion of the
researcher within the environment being studied.
3) What is HCI?
A) Human Computer Interaction
45
PART B
1) List out Problems and limitations and recent trends of Social Case Work practice in
India?
 Lack of trained persons
 lack of training facilities
 poor remuneration
 Lack of Indian literatures
Recent trends in Social Case Work.
 Use of computers
 Interview guide and schedule,
 Life chart,Video recording of family interaction
 Tape recorded interview
.
PART C
1. List out the Use of single case evaluation and ethnography as research methods in
Social Case Work.
Ethnography
Ethnography is a method of data capture that works through the immersion of the researcher
within the environment being studied, collecting detailed material (notes, documentation,
recordings) on the ‘real-time real-world’ activities of those involved. Periods of immersion can
46
range from intensive periods of a few days to weeks and months (more common in systems
design studies), and even years. A primary product of most ethnographies is the development of
a ‘rich’ description – a detailed narrative – of the work or activity in question, which may then be
further analysed or modelled for various means, taking various approaches. The means may be
for the purposes of answering sociological, psychological or systems design research questions,
with the different approaches for analysis arising from various theoretical and methodological
perspectives within these areas. Ethnographers are interested in studying the work going on in
settings rather than just computer systems in a narrow sense – they are interested in studying
computer systems in operation, being used by people, within an organisational context and
therefore shaped by organisational norms, rules, procedures, ethos, culture etc. In this conception
we can think of, for example, a tax office as a complete organizational system – it comprises
various technologies (e.g. computer and paper-based), organizational rules, processes (and
methods for implementing them) and so forth, and staff who draw on their everyday and
specialised social and vocational skills, abilities and knowledge to operate the technologies and
work according to organizational requirements.
 Structuring ethnographic data
Ethnographic records are collected opportunistically and, consequently, cannot be planned,
organised and structured during the ethnography itself. However, when the raw data is analysed,
we believe that it is useful to organise and structure this data in such a way that it is more
accessible to system designers. We do this by providing a series of topics that can be used to
guide observations and organise (or structure) fieldwork data. These topics have been developed
in the ethno methodological litera4 ture, particularly through the studies that have been presented
for computing audiences
The topics provide a comprehensive framework for considering features of social systems of
work and how social systems interact with technical systems, rules, plans and procedures and the
spatial arrangement (ecology) of the workplace. We suggest eight different headings that may be
used to structure and organize ethnographic data. However, we are not suggesting that these are
the only ways to impose structure on this data or that the headings proposed are necessarily
relevant to every study and setting. Rather, from extensive experience, we have found that these
structural devices allow a mass of data to be organized so that it becomes more accessible
47
to system designers who can relate the ethnographic structure to the structure of the requirements
and the design of the computer-based system.
Temporality and sequentially …..
The working division of labor…..
Rules, plans and procedures ……
Routines, rhythms, patterns ……
(Distributed) coordination …….
Awareness of work ……
Ecology and affordances …….
Skills, knowledge and reasoning in action ……
 The Social Structure of Work
In the previous section, we introduced a set of headings under which we believe it is useful to
organize the ethnographic record and, in some cases, they may be effective in focusing
ethnographic studies. These headings are not, of course, arbitrary, but reflect perspectives
through which we believe it is possible to discern the social
 structure of work.
The social structure of work can be thought of as the way in which work is organized as a social
process – how organizations perceive how work should be done by their employees and how this
is reflected in actual practice by the people doing the work. Unlike a system architecture, say, it
is a more subjective, dynamic concept and cannot reliably be expressed as a set of static models.
Broadly speaking we suggest that there are three relevant forms of structure which are central to
the social structure of work:
 Temporal and sequential structure: how processes and practices unfold – the
relationships between entities, actions, utterances etc. over time in sequence.
 Spatial structure: related to the spatial relationships between objects, persons, actions
and so forth.
 Conceptual structure: (sometimes also termed ontological, in a particular usage in
computing) what a set of objects, entities, people, actions are, how they can be
individuated
and how they relate to one another conceptually1. Of course, these notions are also applicable to
some extent to the structure of technical systems. The temporal and sequential structure reflects
48
the assumptions of systems designers as to the sequences of operations that the system will
support and the dependencies between the members of these sequences. The conceptual structure
is, in essence, the system and data architecture and the abstractions used in the system
design. The spatial structure is, perhaps, less significant because of the intangibility of software
but may be reflected in some systems where the physical positioning of hardware is significant
or in the layout and organization of the system’s user interface. Ethno methodological studies of
work are often interested in the temporal and sequential structure of processes in the technical
system (structured as a series of definite steps – ‘workflow without’, and how well these
processes mesh with the ways in which the social practices are structured temporally and
sequentially from within. Commonly, the temporal structures of the technical system are much
more rigid than the fluid, reactive structures of the social system and this leads to a mismatch
where users are frustrated by the restrictions imposed by the technical system.Dourish states that
questions of ontological or conceptual structure “…address(es) the question of how we can
individuate the world, or distinguish between one entity and another; how we can understand
the relationships between different entities or classes of entity; and so
forth.”
 Rules, plans and procedures
We defined the social structure of work in the previous section as a reflection of both how work
is perceived by an organisation and how that work is actually carried out by people. The
organisational view is normally defined in sets of rules, plans and procedures. Rules define
conditions that must be maintained (e.g. credits and debits must balance), plans (or processes)
define workflows (e.g. what steps are followed to close an account) and procedures define the
particular ways in which activities are carried out (e.g. how to validate a customer’s identity).
Practical experience, as well as a wide range of ethnographic studies, tells us that the way in
which work is actually done and the way in which it is set out in the rules, plans and procedures
is often markedly different. Different people interpret the organizational rules, plans and
procedures in different ways depending on their competence, knowledge, status, experience and
the contingencies of each particular situation.
 Social structure and system dependability
49
How do we now approach the dependable design of socio-technical systems given this
understanding of ‘social structure’ in socio-technical systems? The key issue here is to
understand the way in which the structure of technical systems and the structure of rules, plans
and procedures, fit with that of the social system. The relationship cannot be adequately
described in formal structural terms, i.e. it is not possible to produce an accurate model of a
socio-technical system because social practices are structured from within while technical
systems are structured from without (the have a structure that can be specified separately to the
technology they are implemented in). Technical systems can be, and are, modelled, social
practices are emergent, dynamic and are always responsive to the contingencies of this situation,
this time. Models of social practices abstract, gloss and rationalise these features of them, giving
them a rigid, formulaic structure not found ‘in the wild’. Therefore, while models of social
practices can be made commensurate with those of technical systems, i.e. by encapsulating a user
model in the structure of the GUI, caution needs to be applied when considering how usable the
system will be (how well it will fit in with social practices). The abstractions, glosses and
rationalisations of practice used to construct the idealised user model may have problematic
consequences when implemented in a real, dynamic and contingent situation. Social practices
will have to adapt in a way that enables users to carry out what they need to do, in each case, in
response to the
idealised user model encapsulated in the system. The idealised user model will not match what
they already do, and it may well clash quite badly with certain crucial aspects of everyday
practice. Technical systems, however, need to be built using user models and models of work.
Does this necessarily set up a serious problem? Fortunately the answer to this is no, for two
reasons. Firstly, humans and the social systems they form are necessarily adaptive. They respond
to the contingencies of this situation, this time, and they can also adapt their practices over time
to work successfully with a computer system that initially fitted badly with their work practices.
Secondly, user models can be created through observation ‘in the wild’ rather than theoretically
conceptualised. A user model or model of work based on a faulty or incomplete understanding or
work, or created through imagining what users do, rather than discovering what they do runs
serious risks of misunderstanding the users or misrepresenting their work. A key feature of
system dependability concerns efficient and effective sociotechnical system operation such that
personnel will be able to achieve work with technical systems successfully. This includes the
50
extent to which technical systems will not have to be worked around, and will not inhibit
important social practices, or getting the job done. Achieving dependability also includes an
assessment of how reliable, safe, secure, resistant to failure these processes and practices are. A
design process therefore involves an assessment of current working, and is often characterized by
a desire to transform things to make them better or more dependable. The desired design is
envisaged to ‘preserve’ certain adaptive, or desirable, patterns of work, while transforming
inefficient, maladaptive or inconsequential practices for organisational gains. Better decision
making in this process should be facilitated by a detailed understanding of current process and
practice.
 Cultural Factors
The social and cultural factors that influence the buying behavior of consumers are inclusive of
culture, social class, reference group, family, demographics and geography. Culture is an
amalgam of tangible factors and intangible traditions that enunciate the lifestyle of a particular
group of people. As for social class, it defines the income group the individual belongs too and
that, in turn, is heavily dependent on the income earned, which is a great factor in determining
buying behavior. The third factor is the reference group. As is obvious from the name it is the
group from whom the consumer seeks reference. It could range from people like one's parents,
members of the family whom the individual feels close to, close friends, celebrities who endorse
the brand etc. People whom we trust, their opinion means a great deal to us and affects many
decisions of ours including buying behavior. Regarding family, this determinant is totally
different from the erstwhile one as this one focuses on the norms and preferences of the family in
which the individual lives and is brought up. Moreover this determinant is on a collective and
unconscious basis as the individual's buying decision is taking effect from the ambience of his
family and the unconscious way he has grasped the values that have been given to him by his
family. Coming to demographics, these are small and specific details about the individual such as
age, gender, education, income, occupation etc. Also the geographical location in which the
consumer resides also determines the buying behavior depending on sub-factors like climatic
conditions, availability of resources, surroundings etc.
51
REFERENCES
Banerjee G.R. Selected Papers in Social Work Education, Tata Institute of Social
Sciences, Bombay, 1968.
Bernstein, S Group Supervision in Social Work Field Instruction, Unpublished Paper,
Loyola University, Chicago, 1968.
Bessie, Kent Social Work Supervision in Practice, Perga~non Press, Oxford, 1969.
Desai, A.S. Field Instruction in Social Work Education, Undated and Unpublished
Manuscript.
Pathak, S Medical Social Work. In History and Philosophy of Social Work in India,
Allied Publications, Bombay, 1968.
Pathak, S.H. Medical Social .Work, In Gore (Ed.) Encyclopaedia of Social Work in
India, ~ h Pkla nning Commission of India, Delhi, 1968.
Shah Gita A Study of Medical Social Workers in the City of Bombay, Unpublished
Ph.D. Thesis, Tata Institute of Social Sciences, Bonlbay, 1988.
Morton, T.D. Educational Supervision: A Learning Theory Approach, Social Case
Work, Journal of Contemporary Social Work, 1980.
Sheafor et al. Quality Field Instruction in Social Work, Programme Development and
Maintenance, Longman, N.York, 1982.
Singh, R.R. Seminar on Field Education in Social Work: An exploration, Unpublished
paper, 2005.
UGC Second Review Committee of Social Work Education: Retrospect and Prospect,
1978.
Websites
52
www.wikipedia.org
www.answers.com
www.caseatduke.org
53
54

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Social case work

  • 1. SOCIAL CASE WORK DEPARTMENT OF SOCIAL WORK MANUU. MOHAMMAD HABEEB ROLL No. A165089 PART A characteristics and definitions of Social Case Work:- Social Case Work: Social Case Work, a primary method of social work, is concerned with the adjustment and development of individual towards more satisfying human relations. Better family life, improved schools, better housing, more hospitals and medical care facilities, protected economic conditions and better relations between religious groups help the individual in his adjustment and development. But his adjustment and development depend on the use of these resources by him. Sometimes due to certain factors, internal or external, he fails to avail existing facilities. In such situations, social caseworker helps him. Thus, social casework is one to one relationship, which works in helping the individual for his adjustment and development. Every individual reacts differently to his social, economic and physical environments and as such problems of one individual are different from those of another. The practice of casework is a humanistic attempt for helping people who have difficulty in coping with the problems of daily living. Its one of the direct methods of social work which uses the case-by-case approach for dealing with individuals or families as regards their problems of social functioning. Case work, aims at individualized services in the field of social work in order to help the client toad just with the environments. Definitions of Social Case Work: 1
  • 2. Mary Richmond (1915) “Social Case Work may be defined as the Art of doing different things with different people, co- operating with them to achieve some of their own & society’s betterment.” Mary Richmond (1917) Social case work is the art of bringing about better adjustments in the social relationship of individual men or women or children Mary Richmond (1922) Social case work means, „those processes which develop personality through adjustment consciously affected, individual by individual, between men and their social environment‟ Jarrett (1919) Social case work is “the art of bringing an individual who is in a condition of social disorder into the best possible relation with all parts of his environment. Taft (1920) Social case work means “social treatment of a maladjusted individual involving an attempt to understand his personality, behavior and social relationships and to assist him in working out better social and personal adjustment”. Watson (1922) Social Case Work is the art of untangling and restructuring the twisted personality in such a manner that the individual can adjust himself to his environment 2
  • 3. Queen (1932) Social case work is the art “of adjusting personal relationship”. Lee (1923) Social case work is the art of changing human attitudes” Taylor (1926) Social case work is a process concerned with the understanding of individuals as whole personalities and with the adjustments of these to socially healthy lives Reynolds (1935) Social case work is the processes of counseling with a client on a problem which are essentially his own, involving some difficulty in his social relationship. Reynolds (1935) Social case work is that form of social work which assists the individual which he suggests to relate himself to his family, his natural group , his community Klein (1938) Social case work is a technical method in social work…. A way of adjusting to the client to his personal problems. Swift (1939) Social case work is the art of assisting the individual in developing and making use of his personal capacity to deal with problems which he faces in his life. DeSchweiinitz (1939) Case work means those processes involved in giving service, financial assistance, or personal counsel to individuals by the representatives of social agencies, according to polices established and with consideration of individual need. Strode (1948) Social case work is the process of assisting the individual to best possible social adjustment through the use of social case study, social resources and knowledge from relative fields of learning. Towle (1947) Social case work is one method ….by which certain social services are made available in areas of unmet needs. 3
  • 4. Objectives of Social Case Work:  To make good rapport with the common people  To find-out, understand & solve the internal problems of an individual  To strengthen ones ego power  To prevent problem  To develop internal resources Nature & Characteristics of Case Work:  Relationship arise out of shared & emotionally charged situation  Relationship contains elements of acceptance, expectation, support & stimulation  Client & case worker are interdependent  Case work relationship may have several therapeutic values  Improvement of condition  More adjustment within the society  Development of personality  Capacity building  Relationship needs outside help  Case worker too has relationship reactions and part of one’s professional skills in their management Relationship in Case Work Client: Case Worker Relationship The term relationship in social case work was used forth first time by Miss. Virgini a Robinson in her book “A changing psychology in Social Case Work” in 1939. 4
  • 5. • Relationship is the channel through which the mobilization of the capacities of the client is madepossible. • Relationship is the medium through which the client is enabled to state his problem and through which attention can be focused on reality problems, which may be as full of internal conflict with emotional problems. • Relationship is the professional meeting of two persons for the purpose of assisting one of them, the client, to make a better, a more acceptable adjustment to personal problem. • Professional relationship involves a mutual process of  shared responsibilities,  recognition, of other‟s rights,  acceptance of difference to stimulate growth  interaction by creating socialized attitudes and behavior. PART B Components of Case Work I- Person:- 5
  • 6.  The person’s behavior has this purpose and meaning: to gain satisfactions, to avoid or dissolve frustration and to maintain his balance-in-movement.  Whether a person’s behavior is or is not effective in promoting his well-being depends in large part upon the functioning of his personality structure.  The structure and functioning of personality are the products of inherited and constitutional equipment in continuous interaction with the physical, psychological and social environment the person experiences.  A person at any stage of his life not only is a product of nature and nurture but is also and always in process of being in the present and becoming in the future.  The person’s being and becoming behavior is both shaped and judged by the expectations he and his culture have invested in the social role The person who comes as a client to a social agency is always under stress. To understand human behavior and individual difference, Grace Mathew has given the following propositions: 1. An individual’s behavior is conditioned by his/her environment and his/her experiences. Behavior refers to reacting, feeling, thinking, etc. the conditions and influences surrounding the person constitutes the environment. 2. For human growth and development it is essential that certain basic needs should be 6
  • 7. met. (Maslow’s hierarchy of needs) 3. Emotional needs are real and they cannot be met or removed through intellectual reasoning. 4. Behaviour is purposeful and is in response to the individual’s physical and emotional needs. 5. Other people’s behavior can be understood only in terms of ones own emotional and intellectual comprehension. PERSON II –Problem:- The problems within the purview of social casework are those which vitally affect or are affected by a person’s social functioning. The multifaceted and dynamic nature of the client’s problem makes necessary the selection by caseworker and client some part of it as the unit for work. The choice of problem depends on (1) whether the problem is the client’s problem 7
  • 8. (2) leadership given by case worker depends upon the professional knowledge and judgment (3) agency’s function e.g. hospital, etc.  Problems in any part of a human being’s living tend to have chain reactions. …. cause > effect > cause.  Any problem which a person encounters has both an objective and subjective significance quality and intensity of our feelings.  Not only do the external (objective) and internal (subjective) aspects of the problem co- exist, but either may be the cause of the other.  Whatever the nature of the problem the person brings to social agency; it is always accompanied and often complicated by the problem of being a client. Problems can be categorized as follows (Grace Mathew): 1. Problems related to illness and disabilities 2. Problems due to lack of material resources. 3. School related problems. 4. Problems related to institutionalization. 5. Behaviour problems. 6. Problems of marital discord. 7. Problem situations needing a follow-up service. 8. Needs related to rehabilitation of people. 9. Clients caught up in social problems like gambling, prostitution, alcoholism, drug addiction and unmarried motherhood. Problem 8
  • 9. III -Place:-  The social agency is an organization fashioned to express the will of a society or of some group in that society as to social welfare community decides the need of the agency.  Each social agency develops a program by which to meet the particular areas of need with which it sets out to deal. It depends on factors like money, knowledge and competence of the agency staff, the interest, resources available and support of the community.  The social agency has a structure by which it organizes and delegates its responsibilities and tasks, and governing policies and procedures Hierarchy roles and responsibilities clear, designated and delegated collaboration procedures and policies, understand the usefulness. by which it stabilizes and systematizes its operations. among workers.  The social agency is a living, adaptable organism susceptible to being understood and changed, much as other living organisms.  Past, present and future not static and fixed.  Every staff member in an agency speaks and acts for some part of the agency’s function, and the case worker represents the agency in its individualized problem solving help.  Case worker not an independent professional practitioner  case worker speaks and acts for the agency psychologically identified with its purpose and policies.  The case worker while representing his agency is first and foremost a representative of his profession must know and be committed with feeling to the philosophy that guides the practice of the social work profession.  Agency Private e.g. funding agencies and Public e.g. family welfare orgs.  Primary e.g. NGO and Secondary e.g. Hospitals, schools, etc Based on functions 9
  • 10. child welfare, family welfare, education, specialization based. Also differs based on Source of support, Professional authority, Clientele they serve,Services they offer, Goals of the agency, etc. IV- Process:- In order to understand what the case work process must include in its problem-solving help, it is necessary to take stock first of the kinds of blockings which occur in people’s normal problem- solving efforts. The six are: 1. If necessary tangible means and resources are not available to the person. 2. Out of ignorance or misapprehension about the facts of the problem or the facts of existing ways of meeting it. 3. If the person is depleted or drained of emotional or physical energy. 4. Some problems arouse high feelings in a person emotions so strong that they overpower his reason and identfy his conscious controls. 5. Problem may lie within the person; he may have become subject to, or victim of, emotions that chronically, over a long time, have governed his thinking and action. 6. Haven’t developed systematic habits or orderly method of things and planning. The intent of the case work process is to engage the person himself both in working on and coping with the one or several problems that confront him and to do so by such means as may stand him in good stead as he goes forward in living. The means are 1. The provision of a therapeutic relationship 2. The provision of a systematic and flexible way 10
  • 11. 3. Provision of such opportunities and aids. All competent problem-solving, as contrasted with trail-and-error method, contains three essential operations. Urgent pressures will often dislodge their sequence, botany conscious effort to move from quandary (difficulty) to solution must involve these modes of action: 1. Study (fact-finding) 2. Diagnosis (thinking about and organizing facts into a meaningful goal-pointed explanation) 3. Treatment (implementation of conclusions as to what and how of action upon the problem). Finally, for the solution or mitigation of many problems there must exist certain material means or accessible opportunities which are available to the needful person and which he can be helped to use. Kinds of resources that a person may need are money, medical care, nursery schools, scholarships, foster homes, recreation facilities, etc. PART C Stages in Case Work: Different stages in case work process are: 11
  • 12.  Case study /Social Investigation / Psycho Social Study  Social Diagnosis  Social Treatment Social Case History: The first step in the case work is to collect the social history of the client. This could be done in various ways. These are:  Interview with the client  Interview with the relatives, employer, teacher and friends of the client.  Visiting the neighborhood and environment in which the client lives. All these visits will help the worker to know the client in his environment and collect all the data in respect of the client and his environment i.e. his family, neighborhood, friendship circle, employer, teacher, etc. as a matter of fact it is not possible to separate the three stages of case work service i.e. social history, diagnosis and treatment. During the course of interview, the worker may be able to diagnose and even suggest treatment to the client but where the problem is very acute; it isnecessary to consider the diagnosis in relation this own history. Social Diagnosis:- Social diagnosis is an attempt to arrive at an exact definition as possible of the social situation and personality of a given client. It is a search for theca uses of the problem which brings the client to the worker for help. Diagnosis, is therefore, is concerned with understanding both the psychological or personality factors which bear a casual relationship to the client’s difficulty and the social or environmental factors which tend to sustain it. Social treatment:- Social treatment in case work is the sum total of all activities and services directed towards helping the client with a problem. The focus into relieve the immediate problem and if feasible 12
  • 13. modify any basic difficulties which precipitated it. Strictly speaking, everything that has been discussed so far is part of treatment. Generally, two types of efforts are required for social adjustment environmental modification and or change in behavior modification. Early case work treatment was placed on modification through the environment. Later on the development of ego psychology helped social case workers to use intensive and direct treatment technique Objectives of Case Work Treatment:  To prevent social breakdown .  To conserve client’s strength .  To restore social functioning.  To provide positive reinforcements.  To create opportunities for growth and development.  To compensate psychological damage.  To increase capacity of self direction.  To increase his social contribution. Methods of social case work treatment.  Administration of Practical Services.  Indirect Treatment (Environmental Manipulation)  Direct Treatment Providing help to the client to choose and use the social resources afforded by the community. Money, medical care, legal aid, helping to get job or admission in educational institutions, aged homes, foster homes, recreational facilities are such type of services that any person in problem may need in order to resolve a given problem in his daily living Environmental manipulation 13
  • 14. means changing the social conditions of the client so that he/she may be relieved from excessive stresses and strains. For example attempts to change the attitude of the parents, teachers, spouse, employer, friends and relatives, training and employment for livelihood, group experience in accordance with the needs of the client. Environmental modification is undertaken by the case worker only when environmental pressures upon the client are beyond the client’s control but can be modified by the case worker In this the case worker exerts influence directly on the client. It is used when the client needs direction because of his ignorance, anxiety and weakness of his ego strength. Direct treatment is given through counseling, therapeutic interviewing, clarification and interpretation leading to an insight. Social Treatment Social treatment in case work is the sum total of all activities and services directed towards helping the client with a problem. The focus is to relieve the immediate problem and if feasiblemodify any basic difficulties which precipitated it. Strictly speaking, everything that has beendiscussed so far is part of treatment. Generally, two types of efforts are required for social adjustment environmental modification and or change in behavior modification. Early case work treatment was placed on modification through the environment. Later on the development of ego psychology helped social case workers to use intensive and direct treatment techniques. The interviews in all these process are every important and unless the interviews are conducted properly, it is not possible to expect results. The case worker has, therefore, not only to understand the theory of interview but also have sufficient training and experience in interviewing, if he/she wants to be successful in providing service to the client. Interviewing in Casework 14
  • 15. By interviewing, we mean a meeting or conference (may be formal or informal) between two or more persons for specific purpose. It is an art which is used in every situation for better understanding and better relationships between the interviewer and the interview. Interviewing is the foundation on which theory and practice of social case work is based because without interview, the worker cannot get all the possible information about the client nor can the client gain any confidence in the worker. The purpose of an interview is, therefore: o To obtain knowledge of the situation. o To understand another person. o To make the person understand you. PART D Case Work Process: Casework process has four different stages, namely, • Social study • Social diagnosis • Casework treatment • Evaluation. Conceptually, they are different and separate stages but they do not make a neat progression always with one stage following the other in sequence. Sometimes, two or more stages proceed simultaneously. Diagnosis may also change with the gathering of more data about the situation 15
  • 16. or with change staking place in the situation itself. Casework help can not be postponed till the completion of the social study or of the formulation of a social diagnosis. Some kind of help may have to be rendered even at the first worker-client contact. The skilful way the case worker conducts the interview may be of help to the client in terms of the concern, hope, warmth and interest conveyed to the client, which in turn start a process, sooner or later, within him activating him to mobilize his inner resources for problem solving. In casework intervention the individual client is not considered in isolation from the family, but as a part of the family, since the family forms the most important human environment for the client with its network of emotional relationships. Therefore, other members of the family are also involved in the casework process. Also, home visits are made by the caseworker to get an understanding of the environment as for other reasons. Process of Social Case Work: I. Intake (First Interview) Rapport Building  Client comes to an agency for professional help through a Case worker.  Relationship between two persons of unequal positions and power is developed.  Accept client as a person in a stressful situation  Respect the client’s personality and help him resolve. The areas for probing are: 1. The stage of the problem at which the person, through whom, and the reasons becauseof which, comes to this agency. 2. The nature of request and its relation to his problem, and the cause of his problem, asthe client see. 3. Does the request relate directly to his needs/ problems? 16
  • 17. 4. His adjustment to his social functions in job, family, etc. 5. The state of his physical and mental health. 6. His appearance including dress, etc. in his first meeting. 7. His personal and social resources including material and financial position. 8. Appropriateness and intensity of feelings. 9. Nature of defense mechanisms he frequently uses. 10. Level of motivation, how quickly he wants to get rid of his problems. 11. Nature of family, its status, values, relationship pattern within the family, etc. 12. Reactions to the worker and seeking help from the agency and sex of caseworker who will be suitable to help the person. II. Psycho-Social study (Exploration / Investigation): “Psycho – Social study is the initial assessment of client’s current, relevant past and possible future modes of adaptation to stressful situations and normal living situations.” Perlman has given the following contents of the case work study 1. The nature of the presenting problem 2. The significance of the problem. 3. The cause(s), onset and precipitants of the problem. 4. The efforts made to cope with problem-solving. 5. The nature of the solution or ends sought from the case work agency. 6. The actual nature of the agency and its problem solving means in relation to the client and his problem. Tools of study The tools used by the case worker for collecting the relevant information are: 1. Interview guide and schedule. 2. Life chart. 3. Video recording of family interaction. 4. Tape recorded interview. The Format of Interview Schedule 1. History of the problem. 17
  • 18. 2.Personal history. 3. Family history. 4. Problematic areas. 5. Treatment Plan IIII. Psycho - Social diagnosis (Assessment): According to Perlman (1957)  “Diagnosis helps in determining the focus of treatment, further collection of facts and deciding the best course of action to solve the problem.”  “Social diagnosis is the attempt to arrive at an exact definition as possible of the social situation and personality of a given client.”  “Diagnosis is concerned with understanding both the psychological or personality factors which bear a causal relation to the client’s difficulty and the social or environmental factors which tend to sustain it.”  “Diagnosis may be viewed as the fluid, constantly changing assessment of the client, theirproblems, life situations and important relationships.” Content of the Social Diagnosis: 1. The nature of the problem brought and the goals sought by the client, in their relationship to. 2. The nature of the person who bears the problem and who seeks or needs help with the problem, in relation to. 3. The nature and purpose of the agency and the kind of help it can offer and/ or make available. Process of making diagnosis  Shifting the relevant from irrelevant data  Organizing the facts and getting them into relatedness  Grasping the way in which the factors fit together 18
  • 19.  Preparing the meaning as a whole. Data for Diagnosis 1. Interviews 2. Checklist and Inventories 3. Direct Observation Steps in Diagnosis 1. The worker begins to focus on problematic behaviors. Both functional and dysfunctional behaviors in the client’s environment are surveyed. The client’s personal strength as well as of his environment are evaluated. 2. He specifies the target behaviors. Break down complex behaviors into clear and precise component parts. 3. Baseline data are collected to specify those events that appear to be currently controlling the problematic behaviors. 4. The collected information is summarized in an attempt to anticipate any major problem in treatment and as a way of beginning to establish objectives for treatment. 5. Selecting priorities for treatment is the final step of the diagnosis. III Types of diagnosis 1. Clinical  The person is described bythe nature of the illness.E.g. schizophrenia, psychopath, typhoid, etc.  Used in medical practice.  Use is minimum in casework practice. - Importance in medical and psychiatry. 2. Etiological  Tries to delineate the causes and development of presenting difficulty.  History of the person. 3. Dynamic 19
  • 20.  Proper evaluation of the client’s current problem as he is experiencing it now.  Role of psychological, biological, social and environmental factors in the causation of the problem.  No attempt to dig life history.  Case worker and client engage inappropriate corrective action or treatment.  These developments may lead to modifications in the goals for treatment IV. Intervention / Treatment (Problem-solving process): According to Hamilton- “Treatment is the sum total of all activities and service directed towards helping an individual with a problem. The focus is relieving of the immediate problem and, if feasible, modifies any basic difficulties which precipitated it.” The objectives of Social case work treatment 1. To prevent social breakdown. 2. To conserve client’s strength. 3. To restore social functioning. 4. To provide happy experiences to the client. 5. To create opportunities for growth and development 6. To compensate psychological damage. 7. To increase capacity for self-direction. 8. To increase his social contribution. 20
  • 21. Methods of Social treatment 1.Administration of concrete and practical services. E.g. money, medical care, scholarships, legal aid, etc. 2.Indirect treatment (modification of environment, both physical and social). E.g. camps, group experience activities, training programmes, etc. 3.Direct treatment A. Counseling marriage, occupational, family, school, etc. B. Therapeutic Interviewing family and marital therapy. C. Clarification D. Interpretation and Insight E. Psychological support. F. Resource utilization G. Environment modification. Intervention / Treatment (Problem-solving process) V V. Monitoring and Evaluation: Monitoring provides crucial feedback to case worker and the client regarding 1. Whether the treatment program is succeeding as desired 2. Whether established goals have been achieved 3. Whether modifications in the program are necessary 4. Whether the client is being helped in real sense. Importance of Monitoring and Evaluation • The purpose of Evaluation is to see if the efforts of the case worker are yielding any result or not, if the techniques used are serving the purpose, and if the goals are being achieved. • Evaluation is the process of attaching a value to the social work practice. It is the method of knowing what the outcomes are. • It is a continuous process. 21
  • 22. • Evaluation of the approach used and result should be taken up with the client so that the efforts are meaningfully utilized. • Evaluation will further strengthen the relationship between the caseworker and client and motivate the client to work towards his goal. • Casework practices need to be evaluated from time to time. The subject needs to be tested and researched and most importantly needs ongoing validation. They need tobe proved to the public that they are effective and beneficial to the clients. • Casework practice should be subjected to critical review. Workers need to be held accountable for what they do and for their social work competence. Workers need to win approval for their programs. • They may sometimes have to be told that their services are overlapping and ineffective. • Workers have to enhance their own image and also of the agency to develop public relations. The clients need to give a feedback on the effectiveness of the services. VI. Follow-up and Termination  At the end, i.e. termination, the worker should discuss the original as well as revised goals and objectives, achievements during the helping period, factors helpful or obstructive in achieving the objectives, and the efforts needed to maintain the level of achievement and the feelings aroused by disengagement.  It is neither wise nor necessary for the termination to be an abrupt one.  It is best to discuss termination and its ramifications (implications) several times before the final interview.  The frequency and amount of contacts should be gradually decreased.  Termination of the helping process brings up in both the case worker and client(s) many feelings both positive and negative which must be verbalized and discussed.  Follow-up is done to help client maintain the improvement.  During follow-up, the client is helped to discuss the problems he faces in maintaining the improvement.  Work is done with the people significant for his improved social functioning. 22
  • 23.  If required, he is referred to the proper source for needed services and help.  The follow-up should be planned on a diminishing basis after two weeks, then a month, then three months, six months and a year following the termination of the formal program.VI In InSocial Case Work Proce In short The case work process consists of:  Intake (FirstInterview)Rapport Building Psycho-Socialstudy exploration/ Investigation)  Psycho - Social diagnosis (Assessment)  Treatment (Problem-solving process  Follow-up and Termination The components of social casework are:  The Person  The Problem  The Place  The Process  The worker – client relationship  The Problem solving work 23
  • 24. PART E approaches in Social Case Work. Casework: A Psychosocial Therapy Known in academic circles as the 'bible' for clinical practitioners of social work, Casework: A Psychosocial Therapy introduces readers to the basic theory and principles in the practice of psychosocial therapy, along with attention to the historical development of the approach as it has been enriched and expanded over the years. The authors' approach reflects a balanced focus on people, their environment, and the ways in which people interact with their environment. Essential techniques including how to conduct initial interviews with clients, crisis intervention, arriving at assessments, and choosing appropriate treatment, are thoroughly explained, and often clarified with case studies and vignettes, preparing readers to assess social work clients from a variety of perspectives. The book is designed for the graduate-level student who needs to master the principles, theories, and approaches of the psychosocial approach to applied practice, but it may also be used to fit a variety of courses, including the Introduction to Social Work BSW student who is looking for supplemental information on the basics of clinical practice. Now in its fifth edition, Casework has been thoroughly revised to keep discussions clear and up to date. New material has been added throughout, including a greater variety of case studies, discussions about current topics such as the influence of ethnicity and diversity in the social work practice, changes in family life roles, changes in ideas and practice approaches, and a significantly updated bibliography for reference. Functional Approach Structural functionalism is a broad perspective in sociology and anthropology which sets out to interpret society as a structure with interrelated parts. Functionalism addresses society as a whole in terms of the function of its constituent elements; namely norms, customs, traditions and institutions. A common analogy, popularized by Herbert Spencer, presents these parts of society as "organs" that work toward the proper functioning of the "body" as a whole.[1] In the most basic 24
  • 25. terms, it simply emphasizes "the effort to impute, as rigorously as possible, to each feature, custom, or practice, its effect on the functioning of a supposedly stable, cohesive system." For Talcott Parsons, "structural-functionalism" came to describe a particular stage in the methodological development of social science, rather than a specific school of thought.[2][3] Parsons called his own theory for action theory and argued again and again that the term structural-functionalism was a misleading and inappropriate label to use as a name of his theory.  THEORY Classical functionalist theories are defined by a tendency towards biological analogy and notions of social evolutionism: Functionalist thought, from Comte onwards, has looked particularly towards biology as the science providing the closest and most compatible model for social science. Biology has been taken to provide a guide to conceptualizing the structure and the function of social systems and to analyzing processes of evolution via mechanisms of adaptation ... functionalism strongly emphasizes the pre-eminence of the social world over its individual parts (i.e. its constituent actors, human subjects). 1) Social case work and crisis management? Social Workers and Case Management: The Key to Crisis Intervention Every day around the world, people are in crisis. They face problems and situations that they cannot deal with alone and the caring advocacy of the social workers that help them may be the difference between their ability to deal with the crisis or to “drown” under the weight of it. A Day in the Life of a Social Worker The Social Worker’s day is typically filled with crisis intervention. The diversity of the needs of the patients assigned to them requires research, strategic planning and provision of individualized support to each client. In addition, the nature of their work requires confidentiality 25
  • 26. and emotional separation to enable them to carry out their case management in a professional manner. Team Work as Intervention Strategy Working closely with a client and his or her family, the social worker must also work as a member of a team to provide the best outcomes for the client. Depending on the type of work engaged in, and the type and extent of support required, the types of teams the worker is part of may change considerably from client to client. Communication is the Key to Successful Intervention Case management requires the development of excellent communication skills to enable all members of the team, and the client to feel that progress is being made and that the client’s most pressing needs are being successfully addressed. Social work can be a difficult and sometimes stressful profession, but ongoing education can provide skills in areas that would otherwise be potentially draining. Courses in communication, technology, team work and strategic planning are among the many options that can help provide all health care workers with advanced skills to assist them in their work. Best Practice Interventions When an individual is faced with a crisis, they may in certain circumstances need someone to make decisions for them. This is particularly true of children requiring protective services intervention. Their age and vulnerability mean that often they are incapable of making important life decisions. But older individuals must be empowered to make their own decisions and this is the role of social workers working with adult clients. They offer an essential service in the provision of advocacy and information, ensuring that their client is in a position to be able to make informed life choices. If you feel that the field of social workers might be a career for you, why not check into one of the online training courses that are offered. You won’t just learn a new skill, but will become a part of a movement that is all about helping othersExplain the important keys to crisis intervention PART F 26
  • 27. social work recording:- Case Work Recording There has been a significant change in the nature of case recording, which in many ways reflects the wider changes in social work. Staffing levels, increased user involvement and increased accountability to service users, the organization and profession, are all factors which have influenced the development of the case record and recording practice The traditional case record reflected the interaction between the practitioner and the service user, in the context of the service user's history and current situation. At its heart was the relationship between the practitioner and service user. Traditional case records were 'often written in an abstract discursive style for a sophisticated professional audience' within the agency. Practitioners were reluctant to restrict their professional autonomy by establishing 'clear and specific criteria for the clinical (practice) record' In the absence of any definition by practitioners, the way in which the case record developed to meet the changes in legislation and social work practice was led by organizational and managerial requirements . Whilst, the shift to more structured, focused and evidenced recording has been both welcome and necessary, concerns have been expressed that using case recording simply to evidence individual and organizational accountability neglects it's value as a practice tool . 'The case file is the single most important tool available to social workers and their managers when making decisions as to how best to safeguard the welfare of children under their care. It should clearly and accessibly record the available information about the child and the action that has been taken on the case to date. Reference to the case file should be made at every stage of the case and before any significant decision is made'. The case record should be more than a complex diary of the practitioner's actions and the response of the service user. To use it in such a way is like buying a video recorder and then only 27
  • 28. using its clock to tell the time. Practitioners should use case recording to support analysis and reflection . Using recording for analysis requires practitioners to assess the weight that should be given to information gathered. To do this practitioners should draw on their knowledge from research and practice combined with an understanding of the child's needs within his or her family and/or the context in which the child lives . Analysis provides a clear direction to ongoing records and assists practitioners in identifying what information should be recorded . However analysis often takes place outside day to day recording and is facilitated by specific formats. Initial and Core Assessments, genograms, ecomaps, social histories and case summaries are all examples of formats that support analysis. They require practitioners to organize, manipulate and evaluate the information gathered in the case files. They provide an opportunity to assess the child's needs, monitor progress, evaluate the effectiveness of interventions, and to identify patterns that would may not immediately be apparent. Often case recording can become almost a subconscious activity, like driving a car along a familiar road. You arrive but can't say exactly how you got there. The regular use of tools for analysis in the case record keeps recording a proactive activity that supports ongoing assessment, planning and intervention. Avoid the pitfall • Do not record simply what is happening, use analysis to move beyond this to hypothesise and explain why particular situations and events are occurring. • Use genograms, ecomaps, chronologies and assessment records to help you to organise and to analyse information. • Use case summaries as a way of reviewing progress and evaluating the effectiveness of interventions. • Use training, journals and articles to keep up to date with developments in research to inform your practice. 28
  • 29.  What do we mean by social case work recording? We mean all the written material contained in the social work files of people using social work services. Social work files may be wholly or partly electronic or they may be in hard copy. Recording is a crucial part of day to day social work practice and takes up a substantial amount of practitioners' time. Recording involves: * writing down the work you do; * noting the progress people make towards their desired outcomes; * including the views of the person; * analysis and assessment; and * the life history of the person and its interpretation. Good records are an essential tool for practitioners to reflect on their on going work with people and plan future work. When shared with the person whose file it is they encourage transparency. Recording is also part of the code of practice for social services workers 1 published by the Scottish Social Services Council ( SSSC). The purpose of this code is to set out the conduct expected of social service workers and to inform people using social work services and the public about the standards of conduct they can expect from social service workers. Recording comes under section 6: 'As a social service worker you must be accountable for the quality of your work and take responsibility for maintaining and improving your knowledge and skills.' 29
  • 30. purpose of social work recording * documenting the involvement with the individual; * informing assessment and care planning; * enabling practitioners to review and reflect on their work; * assisting practitioners to identify any patterns; * ensuring accountability of staff; * meeting statutory requirements; * providing evidence for legal proceedings; * enabling continuity when a new worker takes over the case; * providing performance information; * forming a biography - for example, for a looked after child to read at a later date to provide them with their history; * providing evidence for inquiries or reviews; and * assisting partnership working between workers and people using their services. 30
  • 31. PART G social worker in the medical setting. Case work in Medical & Psychiatric Setting Medical and Psychiatric Social Work is a branch or specialisation in professional social work. The medical and psychiatric social workers are employed in health settings like hospitals, community health care projects, medical and psychiatric rehabilitation agencies, psychiatric treatment centres and counselling centres. The role of the medical and psychiatric social worker is to help individuals with social, economic and psychiatric problems that arise because of ill health, disability and economic problems. They help to enable the person to lead a productive and satisfied life to the best of his abilities. The social worker uses his skill in relationship with the client system, and understands the problems faced by the client. It could be economic problems, attitude towards the problem faced by the client, the nature of the relationship he has with other support systems like the family, employers and referral agencies. The social worker gets the cooperation of the family treatment of the client and uses community resources that are available. In the medical setting, the worker acts as the link between the doctor and the patient. She acts as the source of knowledge for the client. In the commullity health care organisations, the worker understands the social-cultural patterns of the community, the health practices of the community, the 31
  • 32. needs of the community and interprets these to the team of other professionals with whom she works. Her main role in the community is to elicit participation of the community in planning their health care, provide health education and help them to use preventive services effectively. In the psychiatric setting, she does the mental status examination of the client, understands the psychosocial problems of the client and interprets the same to the psychiatric team. Her main role is one of counselling and education of the family to understand and accept the client. In the drug addiction centers, she is the link between the psychiatric and medical team, the family and the client. Apart from counselling the client, she works towards the rehabilitation of the client in the community and helps him to become a productive member of the community, History Medical Social Work had its beginning in England and the United States of America. In 1880, a group of volunteers working for an asylum in England paid friendly visits to the discharged patients to find how they were adjusting to their home conditions. In 1885 Sir Charles Loch recommended that the lady almoners should visit the patients at home to prevent the abuse of drugs given freely in the charity hospitals. The almoner, while investigating the financial problems of the clients, found other sets of social and psychological problems that needed handling. Hence, apart from the medical help given, she also tapped other community resources in order to help them overcome social problems. In thd "tlmtea Statcs of Ainerica, around 1900, nurses visited the discharged patients in their homes and showed the importance of understanding the patient in his social situation. In 1902, Dr. Emerson of John Hopkins University, Baltimore, made the medical students visit the patients in their homes. This helped the students become aware of the impact of the social and cultural factors in health. In 1905, a –medical social worker was appointed at the Massachusetts General Hospital, with the establishment of the Social Service Department. In the first thirty years, more social Psychiatric Setting Apart from individual patient care, the social workers were also involved in other activities like administrative planning, joint teaching and research. They were involved in the planning Bond implementation of community health care activities. In the west, the medical social workers have firmly established themselves and work as members of the health team. Their main role revolves around the treatment of the psychosocial 32
  • 33. dimensions of the patient's personality. Medical and Psychiatric Social Work in India India has a tradition of voluntary social work. Service to the sick has been a part of 't the Indian tradition. The scientific orientation to medical social work took a longer time. Further, the medical social workers had to struggle lo establish their image as professionals. The origin of medical social work in India could be attributed to the Bhore Committee (1946). The Committee strongly recommended the appointment of inedical social workers in hospitals. The Bhore Committee made the following recolnmendations regarding the role of the medical social worker. Discovery and making available to the medical staff factors in the patient's environment that may have any bearing on his physical condition, thus supplementing inedical history with social history. Influencing and guiding patients in canying out treatment, making the physician's direction siniple and concrete, and helping them to carry out the plan of treatment through to completion. Overcoming obstacles to successful treatment or recovery particularly in the outpatient department and during convalescence medical and surgical supplies are secured: the social or economic conditions affecting the patient adversely are corrected. Arranging for the supplementary care of patients. Educating the patient in regard to his physical condition in order that he may better . cooperate ia the programme laid down by the physician. Because of the recommendation of the Bhore Commit-tee and the conviction of some of the doctors who had seen the effective work done by the medical social workers . . The Envisaged Tasks of the Medical Social Worker The medical social worker is involved in the following areas: direct service to the client system, teamwork, administration, teaching, supervision and self-development, and community health. Direct Service to the Client System Soc'ial evaluation of the individual patients in terms of their ability to participate in the treatment process. Interpretation of the nature of the illness to the patient and his family an individual basis. Visits to patient's home for assessment of the psychosocial situation. Counseling and helping the patient and family to deal with the psychological and social problems arising out of the illness and giving information on the prognosis, treatment process and rehabilitation. Environmental modification through work with employers, family and others to enable the patient to benefit maximum from the treatment process. Organizing with patients, volunteers and other agencies, therapeutic, educational and recreational activities for group of patients and their relatives. Placement 33
  • 34. and institutionalization of destitute and other patients, if and when found necessary. Follow up of the client system to ensure fullest utilization of the services given. Referring patients and their families to other social welfare agencies. Team. Work Interpreting the role of the social worker to the other team members. Interpreting the patient's psychosocial needs to the other team members. Participating in formulating a diagnosis and planning the treatment. Consultation to and from other members of the team. ' Work yith various members of the team. Community Health Work Involving the community in carrying out a community survey and use of media’ to identify needs social worker in family setting:- Family Family-centered casework practice encompasses the range of activities designed to help families with children strengthen family functioning and address challenges that may threaten family stability. These activities include family-centered assessment and case planning; case management; specific interventions with families including counseling, education, and skill building; advocating for families; and connecting families with the supportive services and resources they need to improve their parenting abilities and achieve a nurturing and stable family environment. • Family-centered assessment • Family-centered case planning • Family-centered case management • Working With families and youth • Advocating for families • Working With community resources 34
  • 35. Family-Centered Assessment Assessment forms the foundation of effective practice with children and families. Family- centered assessment focuses on the whole family, values family participation and experience, and respects the family's culture and ethnicity. Family-centered assessment helps families identify their strengths, needs, and resources and develop a service plan that assists them in achieving and maintaining safety, permanency, and well-being. There are many phases and types of family-centered assessment, including screening and initial assessment, safety and risk assessment, and comprehensive family assessment. Assessment in child welfare is ongoing. School Settings: Professional social workers play a vital role in helping school children of all ages. Traditionally, school social workers serve as liaisons between the home, the school, and the community. Since 1907, school social workers have collaborated with teachers and other school personnel in advancing the purposes of education. School social workers are an important part of the school team, possessing unique interdisciplinary knowledge. School social workers contribute to programs designed for students at-risk due to a variety of factors, including: • emotional problems, • poor self-esteem, • child abuse and domestic violence, • poverty and unemployment, • suicidal behavior, drug and alcohol abuse, • teen pregnancy and parenting, • discrimination, and • Attendance related issues. 35
  • 36. The School Social Work Program is designed to train school social workers and provide them with the competencies to practice in a variety of traditional and non-traditional primary and secondary education settings. Such competencies include assessing the needs of school children, designing and implementing interventions, and making referrals to other professionals and agencies as needed. PART C social case work in community setting Community setting : This is another training document in the series of community mobilizing methods for results other than a physical construction such as a communal water supply, clinic or school. The product or output is a programme of services for vulnerable members of the community, many of whom can help themselves if only they are provided with a relatively small amount of help and encouragement. What is Social Work? The profession of Social Work is an odd mixture of many things. It is usually practised by government civil servants in the west (Europe and North America) while many international NGOs have social workers on their staff. The clientele of social work are often called the vulnerable, ie people whose special conditions or circumstances put them in positions of weakness or vulnerability in comparison with the mainstream of a society. Generally they include members of society who need some help. 36
  • 37. Typically, these include those with physical or mental disabilities, persons who are not able to work for a living or not able to care for themselves. In special cases, these may include battered women (those who have been physically or emotionally assaulted – eg by their spouses –and can not escape dangerous situations on their own), frail elderly persons, children without parents to support them, or who are being mistreated, The tasks of a social worker mainly include administration and counselling, along with a little bit of medical (usually psychological) intervention and advocacy. The social worker provides her or his clients with little bits of wisdom, advice, information, counselling, as needed. Every case is different. The government (or NGO) social worker in a western country (Europe and North America) provides services that are usually provided by elders and family members in other countries. Social work services are too expensive for governments in the least developed countries. The word "social" is a bit misleading because, in the west, where it is mainly practised, the social worker does not work with a whole society, or even with a community or a group in a social context. The social worker usually handles "cases," and a case is usually about an individual or lately increasingly, a family. This is even more ironical because where social work is taught, usually in a university in a department or a school of social administration or social work, often (where they are small) they are attached to sociology departments. Such schools or departments, in turn, are then usually also where community development (like much of the material on this web site) is also taught. Community development, in contrast, is an activity aimed at social institutions, such as communities or groups, rather than at individuals. (See Community). One of the many motivating facts pushing the development of this web site is that the empowerment of communities is important and highly needed in low income countries. Limiting the training of community workers to those who are studying in universities, limits the available number of potentially capable community workers; this should be taught to middle school level students (after they have been working out in the real world and have some life experience). 37
  • 38. . Where is CBSW Appropriate? Rich countries can usually provide social work services (on an individual or family basis, not community based), and poor countries rely on the advice, experience and knowledge of elders and family members. So where would it be appropriate to place a community based social work programme? Community based social work services are needed where they can not be provided by elders and families, but where there is not enough finance available to provide it on an individual basis. The situation which comes to mind most readily is where there are large displaced or refugee populations, in camps, in poor countries. Further to that, after the emergency is over, those same refugees may return home. Their lives will have been interrupted, losing many family members, including elders and family members, thus the need for social work services remains. So long as there is enough funding available for a professional social worker to supervise the community based work, keeping it up to required standards, the community itself can supply the energy, time and interest in making it work. Apart from refugee situations, wherever there is a large disaster that results in the removal of elders and family members, and/or which disrupts the normal and traditional social organization, are included among situations where it would be appropriate to set up a community based social work programme. Post disaster situations would be included in these. Where there are large refugee populations, the basic services, food, water, shelter, elementary medical, are usually provided, often by UN agencies and international NGOs. Finance is not unlimited, however, so there may only be a token attempt at providing social work services, if any at all. This is a good situation in which to consider organizing a community based social work programme. Community Perceptions: 38
  • 39. When a child is a witness to atrocities that destroy her world, she is affected. To watch your family members and/or neighbours being shot or bombed produces immense trauma if you are a child. In many cases, the experience results in the child withdrawing into herself, refusing to talk, and/or refusing to respond to daily interactions. The child who is traumatized by the same events which lead to refugee or displaced communities, may display behaviour that is often misinterpreted by her remaining family or care givers. Sometimes she is deemed as mentally retarded, and beyond recovery. Sometimes she is seen as affected by evil spirits. Sometimes her condition is seen as a punishment for previous misdeeds by her family members. In all these cases, there is much shame and secrecy associated with her behaviour. All too often her care givers do not understand that she is reacting to the terrible events of the disaster or civil war, and they do not know that the condition can be reversed by a few simple interventions. Many times such children are hidden (even tied up) in darkened rooms away from public view. They can not dress or clean themselves, and often are found in their own filth and in poor health, hungry, dirty, sick, weak and helpless. Public announcements do not get the message across. Hands on intervention is needed to assess each child. If they are traumatized by atrocious events, and not retarded or otherwise disabled by other factors, they can show remarkable changes, learning to dress themselves, clean themselves and feed themselves. This requires patience, love and care, extended over several weeks and months. A stimulus or two in the form of a doll, and perhaps later a ball, are effective and useful tools for the job. Here is a situation, repeated hundreds of thousand times around the world, where a community based social work programme is appropriate. This is a typical or classic situation for CBSW. A single, university educated, professional social worker can appraise the situation, prescribe appropriate interventions, and monitor. Community mobilizers can work with the community members to identify hidden and suffering children, recruit community level social workers, arrange for their training and supervision, organize CBOs to manage and operate the CBSW programme at community level, and ensure an effective flow of information. Local residents, on a volunteer basis or with some incentives, can provide the care and stimulation to the children in 39
  • 40. need, and keep the mobilizers informed about changing conditions and further needed training. This is only one of many kinds of situations involving vulnerable refugees or displaced persons in communities disrupted by (but surviving) disasters caused by natural or human made events. The PHC Principles: The "Primary Health Care" (PHC) policy promoted by WHO (UN World Health Organization), has several basic principles, perhaps the best known one being that prevention is better than cure. Another, that is particularly applicable here to community based social work, is the idea that resources should not be spent on expensive cures for a few people. Underlying this is a public health policy in support of the greatest good for the greatest number. With a limited budget available, that means to concentrate on a few common diseases, to provide elementary training to persons educated at low levels, and reaching the most rural and remote patients. This gave rise to the popular (but slightly inaccurate) concept of "The Barefoot Doctor." (Also see Water and PHC). If the PHC policy is transferred to the need for social services, then the idea is to give elementary training to persons without university level education, concentrating on the most common and easily treated conditions, and relying on a referral system for more complicated diseases or conditions. The goal in community based social work, then, is to organize a cadre of community members who can be given low level training (ie not requiring university education) to treat a limited number of social conditions of vulnerable community members. Their interventions will not be as flexible or a sophisticated as those of social workers with university level education and extensive social work training, but they will be able to reach a wider proportion of the population than if only highly skilled and relatively costly professionals are employed. "The greater good for the greater number." Structure: What is a possible structure for a CBSW programme? 40
  • 41. Where you have a population of refugees or others who have had severe disruptions in their community lives, where they are able to access support for their immediate needs (food, shelter, water, housing) but no social welfare. Where you may have a professional social worker or two for a population too large for them to reach everybody. Where you have a situation conducive to organizing voluntary community groups. There you have the basis for CBSW. The professional social workers need to make a needs analysis to determine the limited number of conditions that can be addressed by community workers with low level training. They then need to train and to supervise the training of a cadre of community workers who have access to the client community or communities. Both the needs assessments and the training would not be once-off, but ongoing. They and the community workers (mobilizers) need to identify, recruit, and train community members, as community leaders of the programme, as practitioners of social work interventions in their communities, and as monitors of the changing situations in their respective communities. Members of the community groups conduct the social work interventions. They need to be supported with training and guidance by the mobilizers and (more indirectly by) the professional social workers. What results in effect is like a social work pyramid, with the professional social worker(s) at the apex, possible social work trainers (temporary or long term) supervised by the social workers, mobilizers, community leaders and managers of the community groups (CBOs) and community and CBO members who conduct most of the interventions. Training and Support: In general, community mobilizers should never be trained once-and-for-all, but need regular support, encouragement, and a forum in which to ask questions that arise in the field (See Training Methods). In CBSW this is even more a requirement. First, mobilizers without formal training (the main audience for this web site) need continued support and professional inputs. 41
  • 42. Second, the tragedies witnessed in CBSW require field workers to meet with their colleagues to share experiences and to be re-energised and re-infused with enthusiasm and positive attitudes. A CBSW programme as described above needs a routine and predictable forum for getting mobilizers together to share experiences, to ask questions arising from the field, and to obtain inputs from more highly trained and educated social workers. A training unit could be an answer to this need. How it is to be set up depends upon available finances and circumstances. An initial training programme for the mobilizers could use the first six training modules from this web site. They can be printed and handed out in the training programme. They can be easily adapted to developing a CBSW programme. The training for social work, in contrast, needs to be defined and generated by the professional social workers, after they make their initial appraisal of the situations, and will be modified as new information comes in. Correctional Social Work With 1.6 million Americans behind bars and the cost of their care rising, NASW believes preventative services, alternatives to incarceration, and an emphasis on prisoner rehabilitation must be undertaken. Adequate services both inside and outside of the prison could reduce rates of incarceration and recidivism for the betterment of individuals and society as a whole. A number of facts about the prison population, although disturbing, point toward solutions for stemming the growth in numbers of incarcerated individuals: • People of color are disproportionately represented in the prison population. • Substance abuse and mental illness underlie many offenses committed. • An estimated 200,000 prisoners have severe mental disorders, while others have mental health problems that are undiagnosed and untreated. Although the effectiveness of some practices to promote rehabilitation—such as helping prisoners maintain family ties and responsibilities—are known, the social work profession should identify others through research (for example, other options for dispute resolution, alternatives to prison, and effective treatments within correctional settings). In addition, social workers in correctional settings need specialized training, including the ability to communicate 42
  • 43. with prisoners from other cultures. Finally, social workers should participate in national policy debates, collaborate with other organizations that deal with prisoners, and advocate preventative efforts, including community-based services to treat addiction and mental illness before these become criminal justice issues. Aged Care Medical (skilled care) versus Non-Medical (social care A distinction is generally made between medical and non-medical care, and the latter is much less likely to be covered by insurance or public funds. In the US, 86% of the one million or so residents in assisted living facilities pay for care out of their own funds. The rest get help from family and friends and from state agencies. Medicare does not pay unless skilled-nursing care is needed and given in certified skilled nursing facilities or by a skilled nursing agency in the home. Assisted living facilities usually do not meet Medicare's requirements. However, Medicare does pay for some skilled care if the elderly person meets the requirements for the Medicare home health benefit. [12] Thirty-two U.S. states pay for care in assisted living facilities through their Medicaid waiver programs. Similarly, in the United Kingdom the National Health Service provides medical care for the elderly, as for all, free at the point of use, but social care is only paid for by the state in Scotland, England, Wales and Northern Ireland are yet to introduce any legislation on the matter so currently social care is only funded by public authorities when a person has exhausted their private resources, for example by selling their home. Elderly care emphasizes the social and personal requirements of senior citizens who need some assistance with daily activities and health care, but who desire to age with dignity. It is an important distinction, in that the design of housing, services, activities, employee training and such should be truly customer-centered. However, elderly care is focused on satisfying the expectations of two tiers of customers: the resident customer and the purchasing customer, who are often not identical, since relatives or 43
  • 44. public authorities rather than the resident may be providing the cost of care. Where residents are confused or have communication difficulties, it may be very difficult for relatives or other concerned parties to be sure of the standard of care being given, and the possibility of elder abuse is a continuing source of concern. The Adult Protective Services Agency — a component of the human service agency in most states — is typically responsible for investigating reports of domestic elder abuse and providing families with help and guidance. Other professionals who may be able to help include doctors or nurses, police officers, lawyers, and social workers.[13] Improving mobility in the elderly Impaired mobility is a major health concern for older adults, affecting fifty percent of people over 85 and at least a quarter of those over 75. As adults lose the ability to walk, to climb stairs, and to rise from a chair, they become completely disabled. The problem cannot be ignored because people over 65 constitute the fastest growing segment of the U.S. population. Therapy designed to improve mobility in elderly patients is usually built around diagnosing and treating specific impairments, such as reduced strength or poor balance. It is appropriate to compare older adults seeking to improve their mobility to athletes seeking to improve their split times. People in both groups perform best when they measure their progress and work toward specific goals related to strength, aerobic capacity, and other physical qualities. Someone attempting to improve an older adult’s mobility must decide what impairments to focus on, and in many cases, there is little scientific evidence to justify any of the options. Today, many caregivers choose to focus on leg strength and balance. New research suggests that limb velocity and core strength may also be important factors in mobility.[14] The family is one of the most important providers for the elderly. In fact, the majority of caregivers for the elderly are often members of their own family, most often a daughter or a granddaughter. Family and friends can provide a home (i.e. have elderly relatives live with them), help with money and meet social needs by visiting, taking them out on trips, etc. One of the major causes of elderly falls is hyponatremia, an electrolyte disturbance when the level of sodium in a person's serum drops below 135 mEq/L. Hyponatremia is the most common electrolyte disorder encountered in the elderly patient population. Studies have shown that older 44
  • 45. patients are more prone to hyponatremia as a result of multiple factors including physiologic changes associated with aging such as decreases in glomerular filtration rate, a tendency for defective sodium conservation, and increased vasopressin activity. Mild hyponatremia ups the risk of fracture in elderly patients because hyponatremia has been shown to cause subtle neurologic impairment that affects gait and attention, similar to that of moderate alcohol intake. [15] PART F 1) What is CSCW? A) Computer Supported Cooperative Work 2) What is Ethnography? A) Ethnography is a method of data capture that works through the immersion of the researcher within the environment being studied. 3) What is HCI? A) Human Computer Interaction 45
  • 46. PART B 1) List out Problems and limitations and recent trends of Social Case Work practice in India?  Lack of trained persons  lack of training facilities  poor remuneration  Lack of Indian literatures Recent trends in Social Case Work.  Use of computers  Interview guide and schedule,  Life chart,Video recording of family interaction  Tape recorded interview . PART C 1. List out the Use of single case evaluation and ethnography as research methods in Social Case Work. Ethnography Ethnography is a method of data capture that works through the immersion of the researcher within the environment being studied, collecting detailed material (notes, documentation, recordings) on the ‘real-time real-world’ activities of those involved. Periods of immersion can 46
  • 47. range from intensive periods of a few days to weeks and months (more common in systems design studies), and even years. A primary product of most ethnographies is the development of a ‘rich’ description – a detailed narrative – of the work or activity in question, which may then be further analysed or modelled for various means, taking various approaches. The means may be for the purposes of answering sociological, psychological or systems design research questions, with the different approaches for analysis arising from various theoretical and methodological perspectives within these areas. Ethnographers are interested in studying the work going on in settings rather than just computer systems in a narrow sense – they are interested in studying computer systems in operation, being used by people, within an organisational context and therefore shaped by organisational norms, rules, procedures, ethos, culture etc. In this conception we can think of, for example, a tax office as a complete organizational system – it comprises various technologies (e.g. computer and paper-based), organizational rules, processes (and methods for implementing them) and so forth, and staff who draw on their everyday and specialised social and vocational skills, abilities and knowledge to operate the technologies and work according to organizational requirements.  Structuring ethnographic data Ethnographic records are collected opportunistically and, consequently, cannot be planned, organised and structured during the ethnography itself. However, when the raw data is analysed, we believe that it is useful to organise and structure this data in such a way that it is more accessible to system designers. We do this by providing a series of topics that can be used to guide observations and organise (or structure) fieldwork data. These topics have been developed in the ethno methodological litera4 ture, particularly through the studies that have been presented for computing audiences The topics provide a comprehensive framework for considering features of social systems of work and how social systems interact with technical systems, rules, plans and procedures and the spatial arrangement (ecology) of the workplace. We suggest eight different headings that may be used to structure and organize ethnographic data. However, we are not suggesting that these are the only ways to impose structure on this data or that the headings proposed are necessarily relevant to every study and setting. Rather, from extensive experience, we have found that these structural devices allow a mass of data to be organized so that it becomes more accessible 47
  • 48. to system designers who can relate the ethnographic structure to the structure of the requirements and the design of the computer-based system. Temporality and sequentially ….. The working division of labor….. Rules, plans and procedures …… Routines, rhythms, patterns …… (Distributed) coordination ……. Awareness of work …… Ecology and affordances ……. Skills, knowledge and reasoning in action ……  The Social Structure of Work In the previous section, we introduced a set of headings under which we believe it is useful to organize the ethnographic record and, in some cases, they may be effective in focusing ethnographic studies. These headings are not, of course, arbitrary, but reflect perspectives through which we believe it is possible to discern the social  structure of work. The social structure of work can be thought of as the way in which work is organized as a social process – how organizations perceive how work should be done by their employees and how this is reflected in actual practice by the people doing the work. Unlike a system architecture, say, it is a more subjective, dynamic concept and cannot reliably be expressed as a set of static models. Broadly speaking we suggest that there are three relevant forms of structure which are central to the social structure of work:  Temporal and sequential structure: how processes and practices unfold – the relationships between entities, actions, utterances etc. over time in sequence.  Spatial structure: related to the spatial relationships between objects, persons, actions and so forth.  Conceptual structure: (sometimes also termed ontological, in a particular usage in computing) what a set of objects, entities, people, actions are, how they can be individuated and how they relate to one another conceptually1. Of course, these notions are also applicable to some extent to the structure of technical systems. The temporal and sequential structure reflects 48
  • 49. the assumptions of systems designers as to the sequences of operations that the system will support and the dependencies between the members of these sequences. The conceptual structure is, in essence, the system and data architecture and the abstractions used in the system design. The spatial structure is, perhaps, less significant because of the intangibility of software but may be reflected in some systems where the physical positioning of hardware is significant or in the layout and organization of the system’s user interface. Ethno methodological studies of work are often interested in the temporal and sequential structure of processes in the technical system (structured as a series of definite steps – ‘workflow without’, and how well these processes mesh with the ways in which the social practices are structured temporally and sequentially from within. Commonly, the temporal structures of the technical system are much more rigid than the fluid, reactive structures of the social system and this leads to a mismatch where users are frustrated by the restrictions imposed by the technical system.Dourish states that questions of ontological or conceptual structure “…address(es) the question of how we can individuate the world, or distinguish between one entity and another; how we can understand the relationships between different entities or classes of entity; and so forth.”  Rules, plans and procedures We defined the social structure of work in the previous section as a reflection of both how work is perceived by an organisation and how that work is actually carried out by people. The organisational view is normally defined in sets of rules, plans and procedures. Rules define conditions that must be maintained (e.g. credits and debits must balance), plans (or processes) define workflows (e.g. what steps are followed to close an account) and procedures define the particular ways in which activities are carried out (e.g. how to validate a customer’s identity). Practical experience, as well as a wide range of ethnographic studies, tells us that the way in which work is actually done and the way in which it is set out in the rules, plans and procedures is often markedly different. Different people interpret the organizational rules, plans and procedures in different ways depending on their competence, knowledge, status, experience and the contingencies of each particular situation.  Social structure and system dependability 49
  • 50. How do we now approach the dependable design of socio-technical systems given this understanding of ‘social structure’ in socio-technical systems? The key issue here is to understand the way in which the structure of technical systems and the structure of rules, plans and procedures, fit with that of the social system. The relationship cannot be adequately described in formal structural terms, i.e. it is not possible to produce an accurate model of a socio-technical system because social practices are structured from within while technical systems are structured from without (the have a structure that can be specified separately to the technology they are implemented in). Technical systems can be, and are, modelled, social practices are emergent, dynamic and are always responsive to the contingencies of this situation, this time. Models of social practices abstract, gloss and rationalise these features of them, giving them a rigid, formulaic structure not found ‘in the wild’. Therefore, while models of social practices can be made commensurate with those of technical systems, i.e. by encapsulating a user model in the structure of the GUI, caution needs to be applied when considering how usable the system will be (how well it will fit in with social practices). The abstractions, glosses and rationalisations of practice used to construct the idealised user model may have problematic consequences when implemented in a real, dynamic and contingent situation. Social practices will have to adapt in a way that enables users to carry out what they need to do, in each case, in response to the idealised user model encapsulated in the system. The idealised user model will not match what they already do, and it may well clash quite badly with certain crucial aspects of everyday practice. Technical systems, however, need to be built using user models and models of work. Does this necessarily set up a serious problem? Fortunately the answer to this is no, for two reasons. Firstly, humans and the social systems they form are necessarily adaptive. They respond to the contingencies of this situation, this time, and they can also adapt their practices over time to work successfully with a computer system that initially fitted badly with their work practices. Secondly, user models can be created through observation ‘in the wild’ rather than theoretically conceptualised. A user model or model of work based on a faulty or incomplete understanding or work, or created through imagining what users do, rather than discovering what they do runs serious risks of misunderstanding the users or misrepresenting their work. A key feature of system dependability concerns efficient and effective sociotechnical system operation such that personnel will be able to achieve work with technical systems successfully. This includes the 50
  • 51. extent to which technical systems will not have to be worked around, and will not inhibit important social practices, or getting the job done. Achieving dependability also includes an assessment of how reliable, safe, secure, resistant to failure these processes and practices are. A design process therefore involves an assessment of current working, and is often characterized by a desire to transform things to make them better or more dependable. The desired design is envisaged to ‘preserve’ certain adaptive, or desirable, patterns of work, while transforming inefficient, maladaptive or inconsequential practices for organisational gains. Better decision making in this process should be facilitated by a detailed understanding of current process and practice.  Cultural Factors The social and cultural factors that influence the buying behavior of consumers are inclusive of culture, social class, reference group, family, demographics and geography. Culture is an amalgam of tangible factors and intangible traditions that enunciate the lifestyle of a particular group of people. As for social class, it defines the income group the individual belongs too and that, in turn, is heavily dependent on the income earned, which is a great factor in determining buying behavior. The third factor is the reference group. As is obvious from the name it is the group from whom the consumer seeks reference. It could range from people like one's parents, members of the family whom the individual feels close to, close friends, celebrities who endorse the brand etc. People whom we trust, their opinion means a great deal to us and affects many decisions of ours including buying behavior. Regarding family, this determinant is totally different from the erstwhile one as this one focuses on the norms and preferences of the family in which the individual lives and is brought up. Moreover this determinant is on a collective and unconscious basis as the individual's buying decision is taking effect from the ambience of his family and the unconscious way he has grasped the values that have been given to him by his family. Coming to demographics, these are small and specific details about the individual such as age, gender, education, income, occupation etc. Also the geographical location in which the consumer resides also determines the buying behavior depending on sub-factors like climatic conditions, availability of resources, surroundings etc. 51
  • 52. REFERENCES Banerjee G.R. Selected Papers in Social Work Education, Tata Institute of Social Sciences, Bombay, 1968. Bernstein, S Group Supervision in Social Work Field Instruction, Unpublished Paper, Loyola University, Chicago, 1968. Bessie, Kent Social Work Supervision in Practice, Perga~non Press, Oxford, 1969. Desai, A.S. Field Instruction in Social Work Education, Undated and Unpublished Manuscript. Pathak, S Medical Social Work. In History and Philosophy of Social Work in India, Allied Publications, Bombay, 1968. Pathak, S.H. Medical Social .Work, In Gore (Ed.) Encyclopaedia of Social Work in India, ~ h Pkla nning Commission of India, Delhi, 1968. Shah Gita A Study of Medical Social Workers in the City of Bombay, Unpublished Ph.D. Thesis, Tata Institute of Social Sciences, Bonlbay, 1988. Morton, T.D. Educational Supervision: A Learning Theory Approach, Social Case Work, Journal of Contemporary Social Work, 1980. Sheafor et al. Quality Field Instruction in Social Work, Programme Development and Maintenance, Longman, N.York, 1982. Singh, R.R. Seminar on Field Education in Social Work: An exploration, Unpublished paper, 2005. UGC Second Review Committee of Social Work Education: Retrospect and Prospect, 1978. Websites 52
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