The Social Workers' Toolbox: Systematically Addressing Human Needs .
The Social Workers’ Toolbox: systematically addressing Human Needs & Human Rights IFSW Edinburgh Sept. 2015 Herman de Mönnink, Netherlands Ph: 0031 647 376 928 www.mmsocialwork.com monnink@home.nl
SW-statue symbolizes: ‘In your life you must adress your needs yourself but not alone!’ So, SW not only strengthens: Personal Skills, but also Social Support & Practising Human Rights! www.mmsocialwork.com
Herman de Mönnink - Social Work Educator (39 yrs) 1999 Dutch SWers’ Toolbox 2016 English SWers’ Toolbox Private Practice: Social & Clinical Work Grief therapist & Trauma psychologist & Trainer Specialties:Toolbox,UBS &Photoview Disasters www.mmsocialwork.com
Overview presentation SWT Big questions and answers in SW Casestudy Mrs. Multiplex (39) What do SW’ers have in common? The Human Needs & Human Rights Approach Feedback from Europe?
Goal of this presentation Describing a comprehensive, workable and sustainable SWers’ Toolbox out of the rich but puzzling SW-models/methods/theories
Three big questions about ‘What is SW?’ 1) How about assessment-tools in SW? 2) How about practice-tools in SW? 3) How about outcome-tools in SW? Answering these big questions with a comprehensive SWers’ Toolbox
Social Work Strengths 1) Ethical Strength: Justice, Dignity 2) Instrumental Strength: Toolbox 3) Personal Strength: Attitudes & Skills Focus in this workshop on 2) Toolbox
Social Work Toolbox: Adressing Human Needs & Human Rights Impact Life events Birth/death, Love/separation, Health/illness, Work/worklessness, Home/homelessness, Inclusion/exclusion etc. etc. Impact Environment Social Work Assessment Social Support & Human Rights Social Work Goals Strengthening Supportive Resources Individual SWmethods Social Work Toolbox Systemic methods & Macro-methods Personal Strength Social Work Outcome Social Strength & Human Justice Person Human Needs Strengthening Individual Skills
Social Worker’s Practice Tools 4 Macromethods 20. Multimethodresearch 17.Signalling method 6 Systemic methods 9 Individual methods 14. Social netwerk method 11.Relation -ship method 18. Prevention method 15. Group work 12. Mediation method 19. Collective Advocacy 16. Case management 13. Family method Self-determination 10. 8. 9. Cognitive Narrative Behavioral method method method 4. Traumaworkmethod Survival 3. 2. Practical Bodywork materialistic method method Affection 5. 6. Catharctic7. Ritual Expressive method method method 1. Non-directive Basic Social Work-method
Mrs. Multiplex-case and the three big questions 1) Assessment-level: human needs&rights? 2) Practice-level: plan of SW-action? 3) Outcome-level: measurement SW-results? 5 min. to write down your first impressions following your SW-approach as asual
I am physically healthy -Serious debts - Help: I lose my house, cut off from electra Supported by general doctor did not help effectively - I close myself up Client story Mrs. Multiplex (39) - I have anger attacks Supported by one friend - Psychologist - Refuses to accept rules of Social Service: ‘at war’ with SS - My son (19) died 3 years ago I feel a strong woman -Side effects Antidepressants Copyright De Mönnink 20015 www.verlieskunde.nl - Care for my spouse is a burden (Chronic disease) Would like to have help from SW - I miss my son -Not sharing my grief 1. SW- Assessment? 2. SW-Methods? 3. SW-Outcome measurement?
Please join me on my journey as we go along developing the SWT
3 Quality measures in Social Work Tools must be . 1) Client centred: Start, follow & end where the client is 2) Multimethod: Flexibly matching with complexity with various tools 3) Sustainable: enduring outcomes So, SW clientcentred, multimethod, sustainable SW!!
Client centred Social Work heart, respect, relationship Based on Outcome research in Psychotherapy Lambert (1992) Common-factors in social work Non-specific, non-directive method
“All have won, all must have prizes." Dodo Bird Verdict 1st evidence: The common factor All therapies have in common: non-specific client- centredness Chapter 3 of Lewis Carroll's Alice's Adventures in Wonderland
Non-directive method basic clientcentred SW-method Humanistic skills guarantee clientcentredness: – – – – Unconditional positive regard Caring, respect Being genuine Work alliance
But: “All have won, all must have prizes." 1st Conclusion: Common factor Nondirective basic SW-method 2nd Conclusion: Specific factors Multimethod-SW: all specific methods deserve a price! Dodo Bird Verdict Chapter 3 of Lewis Carroll's Alice's Adventures in Wonderland
Sustainable SW: systematically adressing human needs and rights ‘Meeting our own needs without compromising the ability of future generations to meet their needs.’ UNESCO (1997) By individual, systemic and macro-practice in SW!
Mrs Multiplex, casestudy Multi Problem
Mrs Multiplex: social workapproach in 3 steps: 1. PAC (Personal Archive Cabinet) 2. PSA (PsychoSocial Assessment) 3. PSI (PsychoSocial Intervention)
Step1 PAC: Personal Archive Cabinet Start, follow & end where the client is!!!!!! Making contact and hearing clients’ story Summarize and visualise clients’ story Enhance awareness of her life situation Non-directive Basic SW-Method
Step 1: How to engage & enhance awareness of Mrs Multiplex needs & rights? Not keep on burying her head in the sand
I am physically healthy -Serious debts - Help: I loose my house, cut off from electra Supported by general doctor - I have anger attacks Supported by one friend - Psychologist - Refuses to accept rules of Social Service: ‘at war’ with SS - My son (19) died 3 years ago Client story Mrs. Multiplex (39) I feel myself a strong woman -Side effects Antidepressants did not help effectively - I close myself up - Care for my spouse is a burden (Chronic disease) Would like to have help from SW - I miss my son -Not sharing my grief How social work with Mrs. Multiplex?
Personal Archive Cabinet (PAC)-tool Mrs. /Mr.
PAC Mrs. Multiplex (39): summarize & visualize Mrs. Multiplex - Help: I loose my house, cut off from electra - Serious debts - Refuses to accept rules of Social Service: ‘at war’ with SS - I close myself Would like to have help from SW - I support my spouse (Chronic disease) - Psychologist did not help effectively I feel a strong woman - I miss my son - I have anger attacks - Side effects Antidepressants - Not share my grief I am physically healthy Supported by one friend - My son (19) died 3 years ago Supported by general doctor
2. PSA: psychosocial assessment unhealthy balance of Mrs. Multiplex Individual Strengths Physically healthy Intelligent woman Looks for SW-help Social Strengths Support by daughter friend Effective refer-system from general doctors to social work Macro Strengths National Ombudsman Human Rights Commission Jurisdiction in similar cases strengths Individual & Social/ Macro Stressors -Son died -Depths stressors -No income -Threath of eviction -No energy -Depressed - Grief and anger -Exhausted by informal care for spouse, -No family-support and network -Strict rules and conditions social service dpt.
Five Quality of Life-factors addressing Human Needs and Human Rights 2. Impact of Life Events: positive or negative? 1. Human Needs & Rights: Stressor or Strength? 3. Quality of Personal Coping How do you cope with your Human Needs & Rights? 5. Quality of Local & National Resources how do they address Human Needs/Rights? 4. Quality of Social Support How are Human Needs/Rights addressed by Social Network?
Mrs Multiplex: five Quality of Life-factors adressing her Human Needs and Human Rights 2. Life Events: eviction, informal carer of spouse, son died in aircraftcrash, ss-cuts. 1. Needs & Rights: Stressor/ Strength? 4. Social Support: family is leaving her alone 3. Personal Coping: aggressive, isolating herself 5. Local & National Resources: access to SS barred, side effects antidepressant
3. PSI: Psycho Social Intervention working together for a healthy balance Reduce Stressors at individual & social & macro levels stressors strenghts Empower Strenghts Individual & Social & Macro
Psycho Social Intervention Order & Clear Stressors & Enhance strengths
PSI Non-directive basic method Strengthening coping skills (awareness) Don’t know what to do with my life . Need for respect and dignity Help to enhance awareness
PSI Narrative method They are against me so I will let them know . start a war against . Need for meaning making, a healing narrative Help to develop a healing narrative
PSI Cognitive method I will not share my grief, because they will not listen Need for realistic thinking Help to strengthen coping skills: realistic thinking
PSI Practical material & Behavioral methods Mrs. Multiplex is not obeying the rules Mrs M. reacts with anger to officials who threaten her with homelessness, with cutting off her electricity Need for solutions and skills, assertive behavior Help to strengthen copingskills: practical problem solving and assertive skills
PSI Couple- and family-methods Mrs. M. is very unhappy and angry after losing her son. Need for sharing her grief with spouse and others Help to strengthen social support in peer/family sessions
PSI Macro-methods Collective advocacy Rules of social service dpt are too strict for crisis clients Depression labels for bereaved clients: abnormalizing, medicalization Need for due respect Help strengthen human rights support: social rights, collective rights
SW-scaling: stress-scaling 10 I experience maximum of stress 10 9 x x 8 x 7 x 6 5 x x 4 x 3 x 2 x x 9 10 1 0 1 2 0 I feel totally relaxed 3 4 5 6 7 8 Monitoring in SW-sessions
Scaling: self-management 10 I can manage 10 9 8 x 7 6 x 8 9 x 5 x 4 x x 3 2 x x x x 1 0 1 2 3 0 I cannot manage myself 4 5 6 7 Monitoring in SW-sessions 10
SW-scaling: social support scale 10 I feel supported very well 10 9 8 x 7 6 x 8 9 x 5 x 4 x x 3 2 x x x x 1 2 1 0 3 0 I do not feel supported at all 4 5 6 7 Monitoring in SW-sessions 10
SW-scaling: human rights support scale 10 I was given my rights very well 10 9 8 x 7 6 x 8 9 x 5 x 4 x x 3 2 x x x x 1 2 1 0 3 4 0 I was not given my rights at all 5 6 7 Monitoring in SW-sessions 10
SW-scaling: quality of life scale 10 I optimally enjoy the possibilities in my life 10 9 8 x 7 6 x 8 9 x 5 x 4 x x 3 2 x x x x 1 2 1 0 0 I feel bad about my life now and here 3 4 5 6 7 Monitoring in SW-sessions 10
The SWers’ Toolbox: some backgrounds 1) Outcome-tools: 10 scalingtools 2) Assessment-tools: 10 checklists 3) Practice-tools: 20 methods, 150 techniques
Outcome-tools: How to measure results? 1) Scaling tools 2) Registration-data
Electronic Supportsystem SWers’ Toolbox
Assessment/Practice-Tools Mary Richmond 1917 (!): ‘What do social workers have in common?’
Family Community Therapy Work Taskcentred casework Grief Counseling Crisisintervention Social casework Traumadebriefing Casemanagement Capability Approach Narrative Therapy Mindfullness Groupwork So many Practicemethods in Social Work Motivational Interviewing Radical & activist perspectives Psychodynamic SW RET Rational Emotive Therapy AntiOppressive practice Strength approach Casemanagement Behavioral Practice Personcentred approaches Emotionally focussed Therapy Macropractice Copyright De Mönnink 20015 www.mmsocialwork.nl ACT Acceptance Commitment Therapy Blended Therapy Ecological approach Solution focused Therapy Feministic Social Work
So many theories .
This rich chaos in assessment/ practice-methods is puzzling 1) Social work students 2) Other disciplines 3) SW-assessors, authorities But how to order our own SW-house?!
SWers’ Toolbox (2006-Dutch & 2016-English)
SWers’ Toolbox: 20 practice methods 1 Non-directive basic method 19 Directive methods 9 Individual SW-methods 1 Relationship based SW-method: client centred engaging, relationship SW’erclient, assessing 6 Systemic SW-methods 4 Macro SW-methods
Social Worker’s Practice Tools 4 Macromethods 17.Signalling method 6 Systemic methods 9 Individual methods 14. Social netwerk method 11.Relation -ship method 20. Multimethodresearch 18. 19. Prevention Collective method Advocacy 15. Group work 12. Mediation method 16. Case management 13. Family method Self-determination 10. 8. 9. Cognitive Narrative Behavioral method method method 4. Traumaworkmethod Survival 3. 2. Practical Bodywork materialistic method method 7. Ritual method 5. 6. Catharctic Expressive method Affection method 1. Non-directive Basic Social Work-method
Every tool systematically defined 1) 2) 3) 4) 5) 6) 7) 8) 9) Introduction of the method History Goals (Contra-)indications Techniques Results Pitfalls Evidence Literature
SWers’ Toolbox: some backgrounds 1) Historical evidence: person-environmentconfiguration, qualified SW-concepts 2) Outcome research: DODO-bird verdict 3) Neuroscientific research: Triune brain 4) Practical evidence: trained Dutch SW’er
Historical Evidence 1) Person-In-Environment 2) Direct Practice – Indirect Practice 3) Micro-Mezzo-Macro 4) Bio-Psycho-Social 5) Human Needs & Human Rights 6) Individual-Systemic-Macro Methods
Overview Human Needs & Human Rights ‘ The SW-focus on meeting basic human needs creates a natural affinity or bond to the concepts of human rights.’ (Reichert 2001)
Classification of Human Needs & Human Rights SURVIVAL NEEDS SAFETY RIGHTS Right to physical security, basic health care, adequate food, protection from battering Cooperation with institutes Right to social security, standard of living, Social safety: money, housing, debts etc adequate shelter, work Mental safety: traumatic experiences, violence Right to psych. security, basic psychological care, protection to inhumane treatment, to slavery Body safety: oxygen, food, sleep, rest, health AFFECTION NEEDS Affection in relations Creative expression, playing Grief and mourning AUTONOMY NEEDS Insights, information, rationality Identity, meaning making Skills, behavior SOCIAL INCLUSION RIGHTS Right to protection in family, social network, etc Right to culture, expression, play Right to grief and mourn SELF-DETERMINATION RIGHTS Right to information, education, development Right to narratives In debts-arrangement Right to education, excercize Copyright De Mönnink 20015 www.mmsocialwork.nl
The need for a unifying framework, our own SW-classification? If you don’t create your own professional classification, others will define a classification you must obey. For example: DSM? Medical?
Classification of Assessment & Practice Methods The Challenge of Developing SW classifications that will support but not restrict the social worker!
Psychotherapy DSM Nursing NIC Neighbours of Social Work Medicine ICD & ICF
Looking at professional neighbours . 1) Nursing 2) Psychotherapy 3) Doctors 1) Nurse DiagnosisNurse Interventions 2) Psychiatric Diagnoses Therapeutic Treatment 3) Medical Diagnosis/ MedicalTreatments
Classifying Assessment-/Practice Tools in Social Work SW-assessment SW-practice Social Work Human Needs & Human Rights Classification Social Work Multi-Method Classification
Classifications of practice methods addressing human needs Non-directive basic method start where the client is! Basic need: need for respectful help Specific needs: survival needs Practical-material work method (Material safety) Body work method (Physical safety) Trauma work method (Psychological safety) Money, housing, etc Oxygen, food, sleep, rest, health, etc Relief from traumas, violence, etc Specific needs: affection needs Emotionally cathartic work method Expressive work method Ritual work method Emotional release in relations, etc Creative expression, playing, etc Grief and mourning, etc Specific needs: self-determination Cognitive work method Insights, information, rationality, etc Narrative work method Identity, meaningmaking, etc Behavioral work method Skills, behavior, etc Adressing Social Support by 6 Systemic-Methods and Human Rights Support by 4 Macro-Methods: ‘scaling-up from an individual level to systemic and macro level when addressing human needs’
Needs classification based on the Human Brain Evolution Survival brain Survival needs Affection brain Affection needs Neocortex Self determination needs Copyright De Mönnink 20015 www.mmsocialwork.nl
Tools-classifications in SW client centred & multimethod Not restrict SW in classification But creating opportunities by classification
Human Rights Classification based on the UND of Human Rights
Bringing Human Rights Home “Where, after all do universal rights begin? The neighborhood he lives in; the school or college he attends; the factory, farm or office where he works. Such are the places where every man, woman, and child seeks equal justice, equal opportunity, equal dignity without discrimination.” (Eleanor Roosevelt, 1958) Practising Rights: Human Rights-based approaches in Social Work in Social Work (Androff 2015)
Outcome of this presentation Hope you see the benefits of a comprehensive workable SWers’Toolbox
The end of the presentation is near .
Could the Human Needs & Human Rights-SWers’ Toolbox be useful for your SW?
SW-Scaling-tools 1. Energy scaling 2. Condition scaling 3. Stress scaling 4. Self-management scaling 5. Progress scaling 6. Empowerment scaling 7. Quality of Life scaling etc
Energy scaling Mrs. Multiplex Please name a number that reflects how much energy you have at this moment. 0 is no energy: I feel totally exhausted, 10 is maximum energy; I feel full of energy .
Results stress scaling Mrs. Multiplex improves in the stresslevel from high stress (8) to low stress level (2).
Social Workers’ Toolbox PAB PSA PSI PAC clientstory PSA Psychosocial Assessment PSI PsychoSocial Intervention Making Contact Exploring Stresses & Strengths ? Humanistic clientcentred method (HCM) Copingskills effective in adressing human needs? 9 Individual methods (IM) HCM Social support effective in adressing human needs? 6 Systemic methods (SM) IM HCM Local/national resources effective in adressing human rights? End of intervention Copyright De Mönnink 2007 Clientsystem self-supporting 4 Macromethods SM IM HCM
3 Quality measures in Social Work Tools must be . 1) Client centred: Start, follow & end where the client is 2) Multimethod: Flexibly matching with . Non-directive Basic Social Work-method 2. Practical materialistic method 3. Bodywork method 4. Trauma-work-method 5. Catharctic method 6. Expressive method 7. Ritual method 8. Cognitive
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