1. Vice Chancellor’s Fellow Melbourne Law School, University of Melbourne
CLINICAL ASSESSMENT IN SOCIAL WORK. UNIVERSITY OF HUMANITIES AND SOCIAL SCIENCES, HANOI, AUGUST LECTURE ONE
Peter Norden, A.O.
Vice Chancellor’s Fellow
Melbourne Law School, University of Melbourne

2. CLINICAL ASSESSMENT IN SOCIAL WORK
Primary Goal of this course: to help social work practitioners provide more effective treatment to their clients.
Focus on the therapeutic process
How to make a good diagnosis and assessment that leads to an effective intervention?

3. CLINICAL ASSESSMENT IN SOCIAL WORK
History of Diagnosis and Assessment in Social Work:
1917: Mary Richmond, Social Diagnosis
1968: Francis Turner, Differential Diagnosis and Treatment in Social Work
Mary Richmond’s work was developed as a new idea at the time, that the social worker, like the physician, must think diagnostically, to understand the nature of the disorder so as to know how to alleviate it.
This book remained a key text book for many years, and the attention focused solely on problems of treatment methodology.
Even with the development of psychoanalytic thinking in the 1930’s, there was little development of new approaches around diagnostic groupings, but simply around general principles of treatment.
The development of clinical diagnosis only developed in the 1940’s, with a greater concentration on the psychological component of diagnosis.
Turner’s work in the 1960’s summed up these developments, looking at elements in personality which characterise a group of individuals, who might respond in common ways to certain forms of treatment.
Yet Turner’s compilation of diagnostic approaches tended to focus on individuals rather than groups, but he pointed to the growing need of the social work practitioner to be a multi-skilled person, comfortable in individual, joint, and group treatment, as well as being able to engage in educative and collaborative activities.

4. CLINICAL ASSESSMENT IN SOCIAL WORK
More recent writings on Diagnosis and Assessment:
2005: Eileen Gambrill, Critical Thinking in Clinical Practice, Uni. Of California, Berkeley
2006, Corcoran and Walsh, Clinical Assessment and Diagnosis in Social Work Practice
Gambrill’s work was more alert to the dynamic nature of social work intervention. She suggested that her contribution was to help clinicians think more clearly about the decisions they make and the context in which they make them.
She recognised clinical practice as “an uncertain enterprise” and that much remains unknown about what works best.
But she suggested that some decisions can clearly be seen as better than others, and that the success rate can be improved by avoiding common sources of error.
Corcoran and Walsh focused more on the Diagnostic and Statistical Manual of Mental Disorders (commonly known as DSM) which is the pre-eminent diagnostic classification system among clinical practitioners.
They acknowledged the the DSM’s lack of emphasis on environmental influences on human behaviour.
Social Work considers much more than psychology the reciprocal impact of people and their environments in assessing human behaviour.

5. CLINICAL ASSESSMENT IN SOCIAL WORK
More recent writings continued:
2004: Sally Holland, Child and Family Assessment in Social Work Practice
1995: Jordan and Franklin, Clinical Assessment for Social Workers
Holland focuses more on the child care and child protection areas, in the context of intervention at the family level.
She presents an assessment framework that incorporates three features:
The child’s developmental needs
Parenting capacity, and
Family and environmental factors
Jordan and Franklin on the other hand focus their work on clinical assessment for social workers by combining both quantitative and qualitative methods.

6. CLINICAL ASSESSMENT IN SOCIAL WORK
An Important Perspective on Clinical Assessment:
Much clinical assessment can focus on deficits, disease and dysfunction.
Focus on diagnosing abnormal and pathological conditions.
It is also critical important to focus on the strengths of the client in order to bring about greater client empowerment.
Assessment in clinical practice can be an oppressive activity when seen in a more political or social analytical framework.
Assessments that focus on deficits provide obstacles to client exercise of personal and social power, leading to a victimisation of those seeking help.
A focus of assessment of clients’ strengths can increase the potential for client empowerment and greater independence and self-actualisation and growth.

7. CLINICAL ASSESSMENT IN SOCIAL WORK
Charles Cowger (Social Work Journal, 1994) Assessing Client Strengths: Clinical Assessment for Client Empowerment.
12 practice guidelines that foster a strengths perspective.
Based on the understanding that the primary purpose of social work is to assist people in their relationships with one another and with social institutions in such a way as to promote social and economic justice.
The focus on a strengths perspective is particularly important for mandated or involuntary clients because of the powerlessness implicit in the involuntary nature of the client-worker relationship.
This social empowerment dynamic recognises that client definitions and characteristics cannot be separated from their context and that personal empowerment is related to opportunity.
The person with social empowerment is a person who has the resources and opportunity to play an important role in his or her environment and in the shaping of that environment.

8. CLINICAL ASSESSMENT IN SOCIAL WORK
Give pre-eminence to the client’s understanding of the facts
Believe in the client
Discover what the client wants
Move the assessment towards personal and environmental strengths

9. CLINICAL ASSESSMENT IN SOCIAL WORK
Make assessment of strengths multidimensional
Use the assessment to discover uniqueness
Use language the client can understand
Make assessment a joint activity between worker and client

10. CLINICAL ASSESSMENT IN SOCIAL WORK
Reach a mutual agreement on the assessment
Avoid blame and blamings
Avoid cause and effect thinking
Assess: do not diagnose

11. CLINICAL ASSESSMENT IN SOCIAL WORK
CASESTUDIES AND ROLE PLAY:
FOCUS ON DEFICITS
FOCUS ON STRENGTHS

12. CLINICAL ASSESSMENT IN SOCIAL WORK
Review questions:
How has social work developed in its understanding of diagnosis and assessment over the last one hundred years?

13. CLINICAL ASSESSMENT IN SOCIAL WORK
Review questions:
What are the critical questions that you bring to this course from your knowledge or your practice experience?

14. CLINICAL ASSESSMENT IN SOCIAL WORK
Review questions:
What skills do you hope to take from this course on clinical assessment and diagnosis in social work practice?

15. © Copyright The University of Melbourne 2008