Data Collection and Assessment Part II

Assessing a Client’s Social Functioning Assessing a client’s social functioning involves the client and social worker examining various facets of the client’s need-meeting activities and role performance and then drawing conclusions about his or her current level of functioning. Depending on the client’s presenting problem or concerns, some areas are examined in more depth than others.

Assessing a Client’s Social Functioning Adult tasks to be assessed: Fundamentals of independent living. Citizenship and legal concerns. Use of community resources. Family life. Friendships and social supports. Spirituality and religious activities. Interaction with community. Personal appearance and hygiene.

Assessing a Client’s Social Functioning Adult Tasks (continue): Education and training. Employment and job performance. Money management and consumer awareness. Recreational and leisure activity. Housing and housekeeping. Nutrition and health care

Assessing a Client’s Social Functioning Adult tasks (continue): Coping with ordinary problems of living. Coping with mental health problems or addiction. Adjustments of physical disabilities. This list can also provide a starting point for the social worker who is writing goals and objectives to be included in a service agreement or treatment plan.

Assessing a Client’s Social Functioning Children and Adolescent tasks to assess: School performance. Relationship to Parents, siblings, and family. Child or adolescent sexuality. Ordinary problems of childhood and adolescence.

Assessing a Client’s Mental Status A mental status exam consists of conducting a careful observation and asking a set of simple questions that attempt to gauge the client’s orientation to time and place, short- and long-term memory, accuracy of perceptions, judgment, and appropriateness of affect. These questions should be worked into the ordinary flow of conversation.

Assessing a Client’s Mental Status 11 categories of information that should be considered in assessing mental status: General appearance and attitude. Behavior. Orientation to time and place. Memory (immediate, short-term, recent, remote). Sensorium (ability to utilize data from their sense organs; hearing, vision, touch, smelling, and taste).

Assessing a Client’s Mental Status Categories of assessment (continue): Intellectual functioning. Mood and affect. Perceptual distortions. Thought content. Insight. Judgment.

Identifying Developmental Delays in Young Children Early warning signs of sensory problems and developmental delays could include the following: Vision problems. Hearing problems. Delays in speech development. Delays in motor development. Delays in social and mental development.

The Person-In-Environment System The PIE system is designed for use by social workers and is built around two key social work concepts: social functioning and the person-in-environment construct. The PIE provides social workers with the following: Common language to describe their clients’ problems is social functioning.

The Person-In-Environment System PIE provides (continue): A common capsulated description of social phenomena that could facilitate treatment or amelioration of the problems presented. A basis for gathering data required to measure the need for services and to design human services programs and evaluate effectiveness.

The Person-In-Environment System PIE (continue): A mechanism for clearer communication among social work practitioners and between practitioners and administrators and researchers. A basis for clarifying the domain of social work in the human services field. PIE groups client problems into four factors (social functioning, environmental, mental health, and physical health).

The Person-In-Environment System PIE factor I: Social Functioning Social role (familial, other interpersonal, occupational, special life situation) Type of problem in social role (power, ambivalence, responsibility, dependency, loss, isolation, victimization, mixed) Severity of problem (rated on a 6 point scale) Duration of problem (six categories) Ability of client to cope with problem (six levels)

The Person-In-Environment System PIE factor II: Environmental Social system (economic/basic needs; education and training; judicial and legal; health, safety, and social services; voluntary association; affectional support system). Specific type of problem within each social system (71 subcategories) Severity of problem (rated on a 6-point scale) Duration of problem (six categories)

Referral for Psychological Testing A psychological test can provide valuable information on which to base a decision, but one should not rely exclusively on test results, especially if based on a single test instrument. Before referring, be very clear about why you are seeking a psychological evaluation of your client.

Referral for Psychological Testing Explain how and why you and your agency are involved in providing service to the client, the case management decisions you face, and the type of information that would be helpful. List questions you would like the psychologist to answer. Provide information concerning the client’s age, sex, education, occupation and employment history, ethnicity, and any special disabilities. Provide previous testing, including dates and names of tests used.

Referral for Psychological Testing Prepare the client by giving them basic information on what to expect, where the testing will be done, and about how long it will take. The results of testing will confirm the conclusions already reached by people who have observed the client for a matter of weeks or months.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) The social worker should be familiar with the DSM in order to better communicate accurately with other professionals about a client’s mental disorder and to understand reports. Over 200 disorders are classified within 17 broad categories. Each disorder is described in terms of symptoms, diagnostic criteria, age of onset, prevalence, level of impairment.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) The DSM is a classification of mental disorders not people. A term such as schizophrenic should be avoided in favor of an expression such as an individual with schizophrenia. The American Psychiatric Association warns users of the DSM about the inherent difficulties of assessing the behavior of a person from an ethnic or cultural group different from that of the clinician.

Assessing a Child’s Need for Protection State laws require social workers to report cases of suspected abuse or neglect. The observation of several physical and behavioral indicators suggest the possible existence of child abuse or neglect. In the United States, about 50% of all cases of child maltreatment are cases of neglect. About one-half of all child maltreatment-related fatalities are caused by neglect.

Assessing a Child’s Need for Protection A high percentage of the neglect cases occur in families where the parents are abusing alcohol or addicted to drugs. The social worker must be able to differentiate physical abuse from ordinary spanking or corporal punishment. That decision will be tied to the definition of physical abuse found in a states legal code.

Assessing a Child’s Need for Protection Three criteria for making that distinction: In corporal punishment, the child experiences some pain and discomfort. In abuse, there is injury to body tissue. In using corporal punishment, the parent maintains self-control and is aware of where and how hard the child is being hit. In an abusive situation, the parent loses control over their emotions and strikes the child with excessive force.

Assessing a Child’s Need for Protection Criteria (continue) Nonabusive parents using corporal punishment may occasionally get carried away and hit too hard but they quickly realize what has happened and are able to make changes in how they discipline the child so this does not happen again. In situations of abuse, there are repeated episodes of excessive corporal punishment and injury because the parents are unable to gain control of their anger and make changes.

Assessing a Child’s Need for Protection Most children who are sexually abused do not tell anyone because they are either afraid or feel great shame. Most cases of child sexual abuse involve fondling and masturbation but not penetration. It is also important to understand that the majority of sexually abused children do not exhibit unusual sexual behavior.

Assessing a Child’s Need for Protection Sexually abused children are more likely than non-abused children to display adult-like sexual behavior. False allegations by a child are relatively rare but the rate increases if the child’s accusation is being encouraged by a parent and the rate becomes even higher in cases involving child custody fights between parents.

Assessing a Child’s Need for Protection Once a case of abuse or neglect has been identified, the question of risk must be addressed. Factors that should be considered in the assessment of risk are: Child-related factors Parent/caregiver-related factors Environmental factors

Assessing a Child’s Need for Protection In some cases, the removal of the child from their home is necessary. The separation of parent and child is so traumatic to the child and disruptive to the family, an out-of-home placement should be used only in those cases where the child is at high risk of serious harm and there is no less drastic method of protecting the child.

Assessing a Child’s Need for Protection The following principles should guide placement decisions: If a child must be placed into foster care, it is to be done for one reason only: to protect the child from harm. A child should be placed in the least restrictive alternative. Efforts to assure protection for child are to be those that are least intrusive and least disruptive for both child and family.

Assessing Agency Structure The organizational structure of an agency has a significant impact on the ability of the social worker to provide effective services. In human services agencies, a variety of structures exist that range from highly bureaucratized operations to those that permit considerable worker autonomy.

Assessing Agency Structure It is useful to recognize that various degrees of bureaucratization can exist and that adaptations can be made that create a balance between management and worker in order to facilitate the provision of high-quality services. Workers must advocate for structural changes when they find that the agency’s structure interferes with service to clients.

Assessing Agency Structure Bureaucratic Model: an elaborate division of labor in which work activities are clearly defined and assigned to specialized workers. They are stable and consistent, yet slow to change. Adhocracy Model: ad hoc groups have considerable authority and operate with few agency-wide rules and regulations. These groups are weak on both structure and stability, but are able to respond to new issues and undergo change rapidly.

Assessing Agency Structure Functional Model: a second-level administrative layer reports to the director and also leads a program unit or supervises a group of workers. Project-team approach: This model provides for groups of staff to be organized around specific tasks for limited periods of time.

Assessing Human Services Needs Needs assessment refer to the process of identifying the incidence, prevalence, and nature of certain conditions within a community or target group. Purpose is to assess the adequacy of existing services and resources in addressing those conditions. Two judgments must be made: What constitutes a need; a willingness to take action if an unmet need is identified.

Assessing Human Services Needs Guidelines for conducting a needs assessment: What problems do the decision makers hope to solve through the use of a needs assessment? Goals and objectives must be clear before it is possible to select appropriate methods of data collection and analysis. It is helpful to know how other communities or agencies have approached the task.

Assessing Human Services Needs Guidelines (continue): It is important to anticipate possible reasons why situations of unmet need might exist. The assessment should not only identify unmet service needs but also shed light on the quantity, quality, and direction of existing services. Do not attempt a needs assessment until there is evidence that the agency and community possess the administrative and political readiness to use the data once it is gathered.

Focus Groups A focus group is a small group of people who have had a common experience or share common knowledge and are led through a one to two hour discussion of a particular topic. Four essentials of a successful focus group meeting: The participants should be selected carefully. They should represent a broad range of people who are willing to speak their minds.

Focus Groups Four Essentials (continue): The moderator should be well prepared. Their responsibility is to introduce the topic without suggesting a bias and to facilitate an open discussion. There should be a carefully developed plan for the group meeting that includes the preparation of a series of open-ended questions or statements that stimulate discussion. Information provided by the group members must be recorded and accurately interpreted.

Force Field Analysis Force field analysis is a technique that helps to identify and assess significant factors that may promote or inhibit change in an organization or community. Five steps involved: Clearly specify the desired objective. Identify the forces that will determine if the objective will be achieved. Assess the strengths of each driving and restraining force. Identify the actors that might attempt to influence the outcome. Select a strategy for change.

Community Decision-Making Analysis As social workers seek to influence decisions that affect the quality of human services in a community, they must develop a strategy for convincing the person or persons in authority that a particular course of action is the best choice among the possible options.

Community Decision-Making Analysis Variables that affect community decision-making: Size of a city Population diversity (class and ethnic) Economic diversity Structure of local government Communities in the U.S. have a pluralistic type of decision-making structure, and only small rural communities tend to maintain elite power structures.

Community Decision-Making Analysis The worker should be aware that the task of influencing decisions requires a careful assessment of the people who are authorized to make the decisions. One task of the social worker is to assess the various factors that may affect a decision maker’s choice.

Social Policy Analysis When a social worker engages in activity to change an existing social policy or to introduce a new one, it is important that they conduct a careful analysis of that policy. The worker must be prepared to compromise in most policy change efforts. Every social worker should be prepared to analyze the major elements of a policy proposal to assure that compromise does not negate the central goal of the change.

Social Policy Analysis The first step in the analysis of a social policy or program is to have a clear understanding of the problems that created the situation requiring such a policy. Identify how the problem is defined and locate estimates of its magnitude. Determine the causes and consequences of the problem. Identify the ideological beliefs embedded in the description of the problem. Identify the gainers and losers in relation to the problem.

Social Policy Analysis The second step is to assess the social policy being considered as a means of addressing the problem or offering relief to the victims of the problem. Search out the relevant program /policy history. Identify the key elements of the proposed policy. Draw conclusions.