Casework – A Psychological Therapy

By Woods and Hollis

Chapter 4: Classification of Casework Treatment, pages 95-101

Client-Worker Communications

Or in other words, procedures that take place directly between worker and client. Direct treatment.

The Six Categories of Client-Worker Techniques:

1. Sustainment
   1. Activities by the worker that demonstrate interest, desire to help, understanding, expressions of confidence in the client’s abilities or competence, and reassurance concerning matters about which the client has anxiety and guilt
   2. Much of this type of communication takes place through nonverbal or paraverbal means, such as nods, smiles, attentive posture, and murmurings
   3. This technique lessens the client’s anxiety and gives the client the feeling that he or she is in a place where help will be forthcoming
   4. Examples: “You are looking well today” or “I can understand how difficult that must have been” or “Such feelings are natural”
2. Direct Influence
   1. The expression of the worker’s opinion about the kind of action a client should take
   2. The effectiveness of this technique depends to a large extent on the existence of a strong positive relationship between client and worker, which is promoted by sustaining procedures
   3. Examples: “It might be better to do so-and-so,” or “I think that you ought to…” or “No, I do not think that will work; you had better…”
3. Exploration, Description, and Ventilation
   1. Communications designed to draw out descriptive and explanatory material from the client and to encourage the pouring out of pent-up feelings and descriptions of emotionally charged events
   2. This helps the worker understand the person and his or her problems
   3. It also gives the client considerable relief to release all these pent-up emotions
   4. This technique, supported by the sustaining procedures, further reduces accompanying anxiety or guilt
   5. This technique also promotes reflective consideration
4. Person-Situation Reflection
   1. Communications designed to encourage reflective consideration of the person-situation configuration
   2. Reflection upon current and relatively recent events
   3. Attention is directed…
      1. Outward
         1. Perception of understanding of others, of one’s own health, or of any aspect of the outside world ** “Can you think of anything else that might be making your wife so nervous lately?”
      2. Partly Inward and Partly Outward
         1. Understanding of one’s own behavior in terms of its actual or potential outcome or its effect on others or on the self ** “When you say things like that, how does it work? What happens?”
      3. Inward for self-understanding
         1. Awareness of the nature of one’s own behavior ** “You sound as though you were very angry”
         2. Awareness of the causative aspects of one’s own behavior when these lie in the interaction between the person and others ** “What actually happened that could have made you so angry? What do you think it was?”
         3. Evaluation of some aspect of the client’s own behavior, in the sense of self-image, concepts of right and wrong, principles, values, or preferences ** “Somehow you sound as though you feel very uncomfortable about doing that”
         4. Awareness and understanding of feelings about the worker and the treatment process ** “Do you still think I am siding with Jon?”
   1. The type of problem brought by the client is one of the important determinants of where the emphasis will be
      1. The more realistic and external the problem is ** interviews will emphasize procedures from the first two subdivisions
      2. The more subjective involvement in the problem ** draw upon the third, fourth, and fifth subdivisions
5. Pattern-Dynamic Reflection
   1. Encourage the client to think about the psychological patterns involved in his or her behavior and he dynamics of these patterns and tendencies
   2. Reflect upon some of the internal reasons for responses and actions, and encourage the client to look at the dynamics of his or her behavior by studying the relationship between one aspect of this behavior and another
   3. Examples: “Have you noticed how often that happened? You take it out on Mary when you’re really mad at your wife.”
6. Developmental Reflection
   1. Think about the development of his or her psychological patterns or tendencies
   2. A subjective area
   3. The client is helped to deal with early life experiences that are important because, although they occurred in the past, they have been internalized to such a degree that they are now part of his or her responses to current situations
   4. Treatment revolves around consideration of the relationship of one facet of behavior, one reaction, to another – this time, however, in historical terms

Person-in-Situation or Environmental Interventions

Or in other words, procedures that take place between the client and the environment. Indirect intervention.

From the years following the great depression of the ‘30s until the development of poverty programs in the ‘60s, social work did not give the same quality of attention to “indirect” treatment of the environment, as it did to “direct” treatment of individuals.

Indirect treatment does involve psychological means, used to elicit the clients’ needs and desires, as well as the clients’ reflections about hat kinds of changes they are seeking in their lives.

It is the social worker’s purpose to assist in providing the best possible “fit” or adaptation between person and situation. The complexities of both sides of the match must therefore be evaluated.

Treatment can be done THROUGH the environment and MODIFICATION OF the environment.

• Through = social worker makes use of resources or opportunities that exist, are potentially available, or can be developed for the benefit of the client in the total situation (enlisting help)
• Modification of = deals with modifications that are needed in a situation in order to lessen pressures or increase opportunities and gratifications (intervening to bring change in a situation)

Hollis: An additional way of classifying environmental work:

1. Type of resource
   1. The employing social agency itself
   2. The employing agency or institution in which social work is not the sponsoring profession, but one of several services offered
   3. The social agency of which the worker is not a staff member
   4. A non-social work organization of which the worker is not a staff member
   5. Individuals
      1. Those who have an “instrumental” or task-oriented relationship to the client, such as employers and landlords
      2. Those who have an “expressive” or feeling-oriented relationship, such as relatives, friends, and neighbors
2. Type of communications (between worker and client, as well as worker and collateral, or individuals who are not the client)
   1. Sustainment
   2. Direct intervention
   3. Exploration, description, and ventilation
   4. Person-situation reflection
3. Type of role (that the worker will assume when working with a collateral individual or an agency)
   1. Provider of a resource
      1. This occurs when one is the vehicle through which one’s own agency’s services are given
   2. Locator of a resource
      1. When one seeks and finds a resource that gives promise of meeting the client’s need
   3. Interpreter of the client’s needs to a collateral
   4. A mediator for the client with an unresponsive or poorly functioning collateral
   5. Aggressive intervention-er when an agency is clearly failing to carry out its responsibilities or an individual is violating the client’s rights

Advocacy = Activities through which the worker strives to secure for clients services to which they are entitles, but which they are unjustly denied or unable to secure by their own efforts.

The treatment of any case as a whole is seen as constantly changing blend of some or all of these treatment procedures.