Theories for Direct Social Work Practice Joseph Walsh

Theories for Direct Social Work Practice Joseph Walsh 3 rd edition 1 MSW 521 Spring 2016

2 Walsh, Chapter 1 A theory is a set of statements about relationships between variables A theory is a set of propositions that predict or explain relationships between entities. A theory is an attempt to explain something that is beyond factual understanding A theory is a person’s idea of how things are That said, what is your theory about how the world is? MSW 521 Spring 2016

3 What are Practice Theories? A practice theory is a coherent set of ideas about human nature, nature including concepts of health, illness, normalcy and deviance, which provide verifiable or established explanations for behavior and rationales for intervention (Frank & Frank, 1993) A practice theory is a paradigm of thought about how to help others built on knowledge and understanding about the human condition. That said, what is your theory about helping others? MSW 521 Spring 2016

The Relationship of Theory to Practice 4 Remember, there is a lot of overlap among intervention strategies suggested by different theories. Also, authors and practitioners can use different terms for what are confusingly similar concepts; e. g. , “theory” – “model” – “framework” – “perspective” – “paradigm” – “method” – “modality” Remember, theories are not interventions (though some have the same name – which is also very confusing; e. g. , behavior theory vs. behavior therapy)! Practice theory informs practice technique. MSW 521 Spring 2016

A Good Theory Is. . . 5 Supported by the evidence (Evidence-Based) Coherent and internally consistent Useful with your clients Comprehensive across a range of clients Parsimonious – relatively uncomplicated to use Testable and able to withstand scrutiny MSW 521 Spring 2016

6 Critical Thinking and Evidence-Based Practice MSW 521 Spring 2016

Critical Thinking 7 Critical thinking means thinking in a purposeful, reasonable, goal-directed and evaluative manner (Gambrill & Gibbs, 2009). Critical thinking is useful and beneficial, but it can cost you as well. Critical thinking takes TIME and EFFORT and requires a tolerance for doubt and ambiguity. Critical thinking requires COURAGE – we need to be willing and open to self -examination as well as examination of others’ use of theory and intervention strategies. MSW 521 Spring 2016

8 Evidence-Based Practice To be accountable to others and increase the knowledge base of social work, we seek to use empirically-validated interventions. Six levels of knowledge range from systematic reviews through experiments to the opinions of experts. Does the intervention work? Has it been tested and found to work, and if so, is it better than others? That said, discuss the difference between evidence-based practice and practicebased evidence. MSW 521 Spring 2016

9 Evaluating Your Practice Single-subject or single-system design Pre-experimental design Establish a baseline measure, and measure change over time. Did the client improve? Above all, DO NO HARM!!! MSW 521 Spring 2016

10 A Social Work Perspective on Theory and Practice MSW 521 Spring 2016

11 Walsh Chapter 2 Most of theory used in social work comes from complementary disciplines (sociology, anthropology, psychology, biology). Strengths-Based Practice (Saleebey, 2008) sets social work apart from the other helping professions, as does the Person-In-Environment perspective. Social work practice functions within diversity and multiculturalism; we strive to learn all we can about different groups, knowing we can never be totally competent – we can never really KNOW another culture from our own completely and accurately. MSW 521 Spring 2016

12 Empowerment & Spirituality Social workers help people develop the skills to become independent problem solvers! Some people may not succeed, even with our help! We empower through substantive interpersonal and community connections! Spiritual issues are NOT appropriate to address with clients in ALL situations. We must stay aware of our own issues and their impact on our practice. We must take good care of ourselves – in whatever ways add value and a sense of meaning to our lives. MSW 521 Spring 2016

Ch. 3 Practice Theories & Approaches 13 Client-Centered Theory Human beings have an actualizing tendency. Human beings develop a self-concept. Human beings need congruence to be fully functioning. Person-Centered Approach The use of empathy The use of unconditional positive regard The use of genuineness (or congruence) The use of authentic reflection to open the client to realistic experience A ‘philosophy of living’ existential in nature Works well with social justice and advocacy work MSW 521 Spring 2016

14 Ch. 4 Practice Theories & Approaches Ego Psychology The ego is a mental structure that negotiates between the human’s internal needs and the outside world. The unconscious is an important area of concern. The past is also of importance. MSW 521 Spring 2016 Approach Focus first on conscious, then on unconscious. Developmental reflection is an active component. “Use of Self” is encouraged in exploration, description, and ventilation.

15 Ch. 5 Practice Theories & Approaches Object Relations Theory How humans perceive themselves, including their relationships Early relationships hold the keys to understanding certain beliefs and behaviors Current relationship and interaction patterns can be changed once early relationships are understood MSW 521 Spring 2016 Object Relations Approach Test the “here-and-now” of the client’s reality. Set limits on problematic behaviors. Interpret relationships in new ways. Confronting defenses Bring structure to the client’s life.

16 Ch. 6 Practice Theories & Approaches Family Emotional Systems Theory Humans are influenced by their nuclear family relationships throughout their lifetimes. Family Emotional Systems Approach Draft and review a Genogram. Discuss behaviors in terms of family themes, roles, and traditions. Humans must deal with these relationships. De-triangulate in conversations. Conflict and power in relationships is vital to understanding them. Increase insight through developmental reflection. MSW 521 Spring 2016

17 Ch. 7 Practice Theories & Approaches Behavior Theory Human behavior can be changed. Humans learn from both positive and negative reinforcement. Humans respond to different forms of conditioning. Behavioral Approaches Problems are stated in measurable, behavioral terms. Clear objectives are established. Steps toward problem resolution are assigned. Identify possible obstacles up front. MSW 521 Spring 2016

18 Ch. 8 Practice Theories & Approaches Cognitive Theory How humans think and process information is key to change. How thoughts are structured and organized is important. Beliefs, values and attitudes play key roles in how human’s think. MSW 521 Spring 2016 Cognitive Approaches Use Socratic questioning and reframing. Social worker uses positive regard and rolemodeling. Cognitive restructuring, problem-solving, and the development of communication skills are highlighted.

19 Ch. 9 Practice Theories & Approaches Structural Family Theory Organized patterns in family dynamics are responsible for problems and concerns. How the family functions in daily interaction are explored. The “executive authority” in the family unit is identified. MSW 521 Spring 2016 Structural Family Approach Create structural change in the family. Change or alter boundaries – strengthen some, weaken others. Realign subsystems in the family (power and control). Resolve short-term symptoms. Increase/preserve mutual support.

20 Ch. 10 Practice Theories & Approaches Solution-Focused Theory Solution-Focused Approach Doesn’t represent a single theoretical perspective. Focus is on solutions (or exceptions) to problems, not the problems themselves. Draws from psychology, social work, and sociology. Highlight client strengths and resources. Oriented toward the future, not the past. Rapid change is possible. MSW 521 Spring 2016

21 Ch. 11 Practice Theories & Approaches Motivational Interviewing Theory Does not represent a single theoretical perspective. Uses concepts from a variety of sources: person -centered, cognitive dissonance theory, transtheoretical stages of change. MSW 521 Spring 2016 Motivational Interviewing Approach Help the client resolve ambivalence and enhance motivation regarding a certain goal, wish, or want. Use collaboration, empathy, reflective listening. Client must be willing, able, and ready to change.

22 Ch. 12 Practice Theories & Approaches Narrative Theory Through one’s personal narrative, one understands the self and the world. Originated in existentialism, postmodernism, social constructivism, and multiculturalism. Narrative Approach Awaken the client from a problematic way of living. Free the client from externally-imposed constraints. Personal experience is fundamentally ambiguous. Help the client become the author of a ‘new’ story. Human beings find meaning through their stories. Recruit supportive others for the client’s new life story. MSW 521 Spring 2016

23 Ch. 13 Practice Theories & Approaches Crisis Theory Recognizing the nature and types of crises experienced by human beings. Understanding the effects of stress and trauma. Awareness of the link between trauma and neurological functioning. MSW 521 Spring 2016 Crisis Intervention Approach Restoration of the client to pre-crisis level of functioning. Enhancing the client’s precrisis coping skills. Assess the client’s current emotional, cognitive, and behavioral functioning. Assess and access social support networks.