Monday, November 17, 2008
Adolescent Suicide
According to King's article, "Practical Strategies for Preventing Adolescent Suicide", there are three steps to suicide prevention. The first step is "prevention". In this step, a social worker would need to gain awareness of suicide warning signs, risk factors, and take referral steps for the client. Warning signs can be behavioral, verbal, or environmental. The most common suicide warning signs are relationship loss, substance abuse, helplessness, isolation, weight fluctuation, financial loss, feelings of shame, family history of suicide, impulsivity, and depression lasting for more than two weeks. If warning signs are present, step two is "intervention". A social worker should show the client that they care about them, and should ask directly about their thoughts, feelings, plans, and means regarding suicide. If a client is suicidal, it is of utmost importance to provide them with a secure surrounding and maintain their safety. The worker should never leave a suicidal client alone. Direct questions and expression of feelings is extremely important in this step. If a client attempts suicide, the next step would be "postvention". During this step, a social worker should strive to build positive connections for the client and work toward set goals. Deglorification of suicide is key here. The worker should help the client learn new and effective coping skills, develop positive peer groups, and build conflict resolution skills. It is important to focus on strengths and build self-esteem and academic achievement, and to increase the client's involvement in activities that meet their interests.
Monday, November 3, 2008
Groups
A group is defined in this chapter as a small number of people who share similar interests or common problems and convene regularly and engage in activities to achieve objectives. There are two types of social work groups: treatment groups and task groups. The subtypes of treatment groups are support groups, educational groups, growth groups, therapy groups, and socialization groups. The subtypes of task groups are client needs, organizational needs, and community needs.
Because I have never been involved in a treatment group setting, this week's reading is the most exposure I have had to the concept. Unfortunately, my internship does not have these types of opportunities for me to shadow. However, because I work at a foster care agency, the youths in our program each have their own treatment team, or task group, which meets as a task group once per month. These treatment teams often consist of the county social worker, the case manager, the foster parents, any family members who are specified and allowed to participate, possibly a school board member, and the child. Task groups are organized to meet client, organizational, and community needs. Instead of focusing on member growth and achievement, these types of groups focus on developing policies and making decisions. The treatment team meets once per month for the purpose of coordinating ideas and efforts to benefit a particular client, in this case, the child. Task groups begin much like treatment groups, as they start with introductions of the members, identifying the purpose, discussing rules and decision making methods, setting goals, and identifying possible obstacles.
Although I have yet to be included in a group meeting of any kind, this reading taught me what to expect when the time comes. I feel prepared and eager to try engaging in group work at my internship and in my future as a social worker. After reading the different options, I believe that I would prefer to participate in leading a treatment group, specifically a support or growth group.
Because I have never been involved in a treatment group setting, this week's reading is the most exposure I have had to the concept. Unfortunately, my internship does not have these types of opportunities for me to shadow. However, because I work at a foster care agency, the youths in our program each have their own treatment team, or task group, which meets as a task group once per month. These treatment teams often consist of the county social worker, the case manager, the foster parents, any family members who are specified and allowed to participate, possibly a school board member, and the child. Task groups are organized to meet client, organizational, and community needs. Instead of focusing on member growth and achievement, these types of groups focus on developing policies and making decisions. The treatment team meets once per month for the purpose of coordinating ideas and efforts to benefit a particular client, in this case, the child. Task groups begin much like treatment groups, as they start with introductions of the members, identifying the purpose, discussing rules and decision making methods, setting goals, and identifying possible obstacles.
Although I have yet to be included in a group meeting of any kind, this reading taught me what to expect when the time comes. I feel prepared and eager to try engaging in group work at my internship and in my future as a social worker. After reading the different options, I believe that I would prefer to participate in leading a treatment group, specifically a support or growth group.
Wednesday, October 29, 2008
Family Functioning
When assessing the functions of a family, a social worker must consider many things. After reading chapter 10 of the textbook, I believe that looking at the content and process of family interactions is one of the best ways to gain insight into how a family functions on a regular basis. Often in dysfunctional family settings, communication is the major problem. Because of this, it is important that after the social worker observes the interactions between family members, they must identify the barriers to communication that are causing the struggling relationships.
At my internship, I have not had many opportunities to observe the family as a whole. So far, I have mostly dealt with individuals, with one exception. Last week, I sat in on a family visit between one of the children in our program and his grandmother. This child is in foster care and is in the process of being adopted. The grandmother attempted to gain custody of the child, but she was denied. She is now allowed to visit with him once per month. I observed the interactions between the youth and his grandmother, and now that I have read this chapter on family interaction, I am able to better define what occurred during this meeting. During this visit, the child wanted to play a game with his grandmother. She denied this request, and instead wanted to "teach him the word of God". The child was irritated, but went along with this activity. The child paid attention, but did not engage or show interest. The grandmother preached to him for almost their entire visit together, and then allowed the child to play his game with me (she did not want to join in). When it was time to say goodbye and hug his grandmother, the child got angry that his game was interrupted and quickly dismissed his grandmother.
CONTENT AND PROCESS- After reading on the subject, I realize that the child and his grandmother lack effective communication skills. The child explained to me that his grandmother preaches for the entirety of every visit they have together. The grandmother explained that it is "all she knows how to do". The CONTENT of their interactions does not seem to show any personal conversation. The PROCESS of their interactions is always the same. The grandmother preaches and the child politely listeners, but is obviously not interested in what she is saying. Although this type of interaction is ineffective, each visit continues to follow this pattern. BARRIERS TO COMMUNICATION- The grandmother tends to dominate the relationship and does not allow room for the child's interests or feelings. The conversations focus entirely on her interests. The child, on the other hand, tends to avoid the topic being discussed and focuses on his wants as opposed to the interaction at hand. RECEIVER skills- the child lacks the skills of physical attending, true listening, or elaboration, as is evidenced by his lack of engagement in the interactions. SENDER skills- The grandmother is able to express herself well, but only on one particular topic (religion). She lacks the ability to interact in any other way. Also, considering of the nature of the topic, the interactions are often preachy and there are a lot of "shoulds" and "oughts" used.
Currently, the interactions in this family are ineffective and the communication skills are lacking. There is much work that needs to be done to teach these skills to both the child and the grandmother in this family.
At my internship, I have not had many opportunities to observe the family as a whole. So far, I have mostly dealt with individuals, with one exception. Last week, I sat in on a family visit between one of the children in our program and his grandmother. This child is in foster care and is in the process of being adopted. The grandmother attempted to gain custody of the child, but she was denied. She is now allowed to visit with him once per month. I observed the interactions between the youth and his grandmother, and now that I have read this chapter on family interaction, I am able to better define what occurred during this meeting. During this visit, the child wanted to play a game with his grandmother. She denied this request, and instead wanted to "teach him the word of God". The child was irritated, but went along with this activity. The child paid attention, but did not engage or show interest. The grandmother preached to him for almost their entire visit together, and then allowed the child to play his game with me (she did not want to join in). When it was time to say goodbye and hug his grandmother, the child got angry that his game was interrupted and quickly dismissed his grandmother.
CONTENT AND PROCESS- After reading on the subject, I realize that the child and his grandmother lack effective communication skills. The child explained to me that his grandmother preaches for the entirety of every visit they have together. The grandmother explained that it is "all she knows how to do". The CONTENT of their interactions does not seem to show any personal conversation. The PROCESS of their interactions is always the same. The grandmother preaches and the child politely listeners, but is obviously not interested in what she is saying. Although this type of interaction is ineffective, each visit continues to follow this pattern. BARRIERS TO COMMUNICATION- The grandmother tends to dominate the relationship and does not allow room for the child's interests or feelings. The conversations focus entirely on her interests. The child, on the other hand, tends to avoid the topic being discussed and focuses on his wants as opposed to the interaction at hand. RECEIVER skills- the child lacks the skills of physical attending, true listening, or elaboration, as is evidenced by his lack of engagement in the interactions. SENDER skills- The grandmother is able to express herself well, but only on one particular topic (religion). She lacks the ability to interact in any other way. Also, considering of the nature of the topic, the interactions are often preachy and there are a lot of "shoulds" and "oughts" used.
Currently, the interactions in this family are ineffective and the communication skills are lacking. There is much work that needs to be done to teach these skills to both the child and the grandmother in this family.
Tuesday, October 21, 2008
"Voices of African American Families"
This article focuses on the differences in the perception of residential treatment centers in both African American families and non-African American families. Both African American and non-African American families agreed that they would like to be more involved in the planning, decision making, and evaluation processes designated for their children. They all wanted more involvement, more initial and ongoing contact with their children, more respect, more flexible visitation and scheduling policies, and more financial support for contacts.
According to the article, African Americans only make up 12% of the population in the US, however they make up 26% of children placed in residential treatment facilities. They are grossly overrepresented, which is a huge cause for concern. African Americans had more and different concerns regarding residential treatment than did non-African Americans. They were concerned with separation of the child, including feelings of abandonment and of being discarded. They felt that children cannot be well served in residential treatment and that our society needs to redirect resources so that children can function better from their own homes. They also had concerns about medications, because of overreliance on medicines and the lack of research has been done about the effects on blacks. Another concern was the practice of cultural competence, the lack of ethnic diversity among workers, and incongruity between worker and child. Lastly, their concerns included possible stereotyping, which may lead to mistreatment and misdiagnosis.
This week at my internship, I sat in on a treatment team meeting regarding a 12-year-old African American boy. This particular youth has ongoing problems with stealing and with dishonesty, which is why the meeting was called. Many methods have been tried with this youth and nothing, including consequences, is getting through to him enough for him to change his behavior. The purpose of this meeting was to discuss any new possible courses of action that might help improve this youth's behaviors. The child's social worker, brother, foster parents, and case manager were all present at this meeting. All were African American. Possible plans that were brought up were finding a therapist for the child to talk through emotions and other issues that could possibly be the cause of these behaviors. The social worker decided that the therapist assigned to the case should be African American as well, because she thought that cultural and racial dissimilarity could hinder the child's progress. Also, having a therapist of the same race could ensure that there was no negative stereotyping based on race, and would most likely avoid issues of misdiagnosis and discriminatory treatment. A second idea that was brought up for this child, if he did not improve even after therapeutic intervention, was residential treatment. When the social worker mentioned this possibility, both the brother and the foster parents interjected saying that they completely disagreed with that idea. The brother said, "that would only provide him a further disservice, and I really don't want it to get to that point". I did not think anything of this response at the time because I agreed with him that residential treatment should be used as a very last resort. After reading this article, however, I further understand his objection. As an African American, he likely has similar concerns to the issues raised in this article, including separation from family, medications, cultural dissimilarities, and stereotyping. Although this was not delved into in our meeting, his extreme concern with the idea of residential treatment fits perfectly into the point this reading was trying to make. It would be very beneficial to do a similar study with a larger sample so that these ideas could be generalized across the population.
According to the article, African Americans only make up 12% of the population in the US, however they make up 26% of children placed in residential treatment facilities. They are grossly overrepresented, which is a huge cause for concern. African Americans had more and different concerns regarding residential treatment than did non-African Americans. They were concerned with separation of the child, including feelings of abandonment and of being discarded. They felt that children cannot be well served in residential treatment and that our society needs to redirect resources so that children can function better from their own homes. They also had concerns about medications, because of overreliance on medicines and the lack of research has been done about the effects on blacks. Another concern was the practice of cultural competence, the lack of ethnic diversity among workers, and incongruity between worker and child. Lastly, their concerns included possible stereotyping, which may lead to mistreatment and misdiagnosis.
This week at my internship, I sat in on a treatment team meeting regarding a 12-year-old African American boy. This particular youth has ongoing problems with stealing and with dishonesty, which is why the meeting was called. Many methods have been tried with this youth and nothing, including consequences, is getting through to him enough for him to change his behavior. The purpose of this meeting was to discuss any new possible courses of action that might help improve this youth's behaviors. The child's social worker, brother, foster parents, and case manager were all present at this meeting. All were African American. Possible plans that were brought up were finding a therapist for the child to talk through emotions and other issues that could possibly be the cause of these behaviors. The social worker decided that the therapist assigned to the case should be African American as well, because she thought that cultural and racial dissimilarity could hinder the child's progress. Also, having a therapist of the same race could ensure that there was no negative stereotyping based on race, and would most likely avoid issues of misdiagnosis and discriminatory treatment. A second idea that was brought up for this child, if he did not improve even after therapeutic intervention, was residential treatment. When the social worker mentioned this possibility, both the brother and the foster parents interjected saying that they completely disagreed with that idea. The brother said, "that would only provide him a further disservice, and I really don't want it to get to that point". I did not think anything of this response at the time because I agreed with him that residential treatment should be used as a very last resort. After reading this article, however, I further understand his objection. As an African American, he likely has similar concerns to the issues raised in this article, including separation from family, medications, cultural dissimilarities, and stereotyping. Although this was not delved into in our meeting, his extreme concern with the idea of residential treatment fits perfectly into the point this reading was trying to make. It would be very beneficial to do a similar study with a larger sample so that these ideas could be generalized across the population.
Monday, October 20, 2008
The Paradoxes of "Help" as Anti-Oppression and Discipline
Weinberg's Article "Pregnant with Possibility" focuses on the methods used by a social worker "Partricia" with her young single-mother client "Tanesha". Patricia used a framework called "The Wrong Society" which focuses on the social background, family instability, and academic problems of clients. This framework assumes inequality and advocates for the transformation of social conditions. Patricia claimed that her clients had dreams that could be easily attained if only "we had a better government". Patricia's client, Tanesha, used lying as a defense mechanism. While others saw the lying as a sign of bad parenting, Patricia kept in mind that it could be a way of coping with having a sick child and the possibility of loss. The reading mentions an encounter where Tanesha lied about having no money to pay for transportation. When the social worker caught her in her lie, she confronted her with humor and personalization instead of a moralistic attack. This enabled Tanesha to trust Patricia and form a bond with her, because she treated her like a normal person instead of a patient.
When we look at a client, we must note their strengths and avoid characterizing them right away. We must treat them like a human being and not as a business or patient. Clients need to be understood as good and decent people, despite their issues and behaviors. Negative behaviors are often a tool that people use to overcome hurtful feelings and poor life circumstances. For example, today at my internship, I sat in on a treatment team meeting for a young boy in our foster care program. He was removed from his home because of his ongoing negative behaviors, including stealing. His current foster parents are experiencing the same problems, and today's meeting was to decide what steps to take to help the child in terms of this problem. No consequences or other methods have worked for this child, and he continuously lies about what he is doing until he is caught and the evidence is shown to him. In the session, it was decided that this youth needs to see a therapist to deal with this issue, as he may just need someone fresh to talk to about what feelings may be underlying these behaviors. PIt seemed from both the foster parents and the social worker that this child has been confronted over and over in the same way. This method has obviously been ineffective. It seems to me that he has been attacked morally and then been given consequences. It would be best for this child to be treated as a person and not as someone with low morals. I hope that this new therapeutic relationship will provide him a fresh and positive relationship, in which this problem is dealt with in a new way.
When we look at a client, we must note their strengths and avoid characterizing them right away. We must treat them like a human being and not as a business or patient. Clients need to be understood as good and decent people, despite their issues and behaviors. Negative behaviors are often a tool that people use to overcome hurtful feelings and poor life circumstances. For example, today at my internship, I sat in on a treatment team meeting for a young boy in our foster care program. He was removed from his home because of his ongoing negative behaviors, including stealing. His current foster parents are experiencing the same problems, and today's meeting was to decide what steps to take to help the child in terms of this problem. No consequences or other methods have worked for this child, and he continuously lies about what he is doing until he is caught and the evidence is shown to him. In the session, it was decided that this youth needs to see a therapist to deal with this issue, as he may just need someone fresh to talk to about what feelings may be underlying these behaviors. PIt seemed from both the foster parents and the social worker that this child has been confronted over and over in the same way. This method has obviously been ineffective. It seems to me that he has been attacked morally and then been given consequences. It would be best for this child to be treated as a person and not as someone with low morals. I hope that this new therapeutic relationship will provide him a fresh and positive relationship, in which this problem is dealt with in a new way.
Monday, October 13, 2008
Authenticity
I finally met my first client last week. He is a 10 year old boy who has been in our foster program for about 3 years. He has been living with a family for about half of that time, and they are about to begin the adoption process with him. This is always really exciting for my agency, as we do not do many adoptions. My supervisor is the direct case manager for this client, and my role will be to attend all meetings with the family, as well as to work on a lifebook with the child. Lifebooks are similar to scrapbooks, and they focus on biological family, foster family, and school information.
Prior to meeting the client, my supervisor explained to me that the child is not easy to warm up to. She told me it took him a full month to even really begin talking to her. I was expecting to meet a very shy, shielded person. My supervisor also "warned" me that this child is African-American and his foster parents are Caucasian, so that I didn't "freak out" when I saw them. These were her words- I wish I was kidding. I couldn't believe that she thought that would bother me, nor could I believe that was even an issue needing discussion in her mind. I immediately thought it was unprofessional, and that it questioned the social work values of cultural understanding and acceptance.
Once we arrived at the client's home, we sat down around the table with the child and his foster mother. I introduced myself to the child and smiled at him, and he proceeded to smile back and get out of his seat to shake my hand. While we were discussing medications and school issues, he sat there playing with a toy and flipping pages of a book. I decided that since this was my first time with him, I would try to talk to him a bit more instead of focusing only on the discussion. I turned to him and asked him a little bit about the book he was flipping through, about band (which he plays in), and other school things. He was so open and excited that someone was talking to him as another person instead of a strictly business relationship. He opened up immediately to me and was excited to talk to me, contrary to what my supervisor said he would do. We quickly built a rapport that I am excited to build upon next time we meet.
I think the reason he was so open was that I asked him about himself, and then I told him about myself, too. This made me think a lot about authenticity. I think authenticity is important with any client it applies to, but I think it is of utmost importance with children. I do not see how a helping relationship would be beneficial to a child if that child does not feel a sense of comfort, personal connection, care, and realness with their worker. Children do not care about business practices- they want a friendly person to help them through their issues. I am wondering if the same practice standards that apply to adults also apply to children. If so, I do not know that this is valid. We read this week that adjusting for intellectual capacity is important in assessment. Often times, children do not have the same mental capacity as adults, nor do they have the same life experiences. If this is the case, shouldn't we change how we as social workers define the helping process when it comes to children? My supervisor treats children just as she treats adults. While it is important to stay professional and deal with the issues for all clients, it is obvious that her methods did not allow for a strong rapport or relationship with this particular child.
What are the rules about authenticity as it pertains to a child? What are the limits to it? The readings do not specify for age, but I think it is important to consider.
Prior to meeting the client, my supervisor explained to me that the child is not easy to warm up to. She told me it took him a full month to even really begin talking to her. I was expecting to meet a very shy, shielded person. My supervisor also "warned" me that this child is African-American and his foster parents are Caucasian, so that I didn't "freak out" when I saw them. These were her words- I wish I was kidding. I couldn't believe that she thought that would bother me, nor could I believe that was even an issue needing discussion in her mind. I immediately thought it was unprofessional, and that it questioned the social work values of cultural understanding and acceptance.
Once we arrived at the client's home, we sat down around the table with the child and his foster mother. I introduced myself to the child and smiled at him, and he proceeded to smile back and get out of his seat to shake my hand. While we were discussing medications and school issues, he sat there playing with a toy and flipping pages of a book. I decided that since this was my first time with him, I would try to talk to him a bit more instead of focusing only on the discussion. I turned to him and asked him a little bit about the book he was flipping through, about band (which he plays in), and other school things. He was so open and excited that someone was talking to him as another person instead of a strictly business relationship. He opened up immediately to me and was excited to talk to me, contrary to what my supervisor said he would do. We quickly built a rapport that I am excited to build upon next time we meet.
I think the reason he was so open was that I asked him about himself, and then I told him about myself, too. This made me think a lot about authenticity. I think authenticity is important with any client it applies to, but I think it is of utmost importance with children. I do not see how a helping relationship would be beneficial to a child if that child does not feel a sense of comfort, personal connection, care, and realness with their worker. Children do not care about business practices- they want a friendly person to help them through their issues. I am wondering if the same practice standards that apply to adults also apply to children. If so, I do not know that this is valid. We read this week that adjusting for intellectual capacity is important in assessment. Often times, children do not have the same mental capacity as adults, nor do they have the same life experiences. If this is the case, shouldn't we change how we as social workers define the helping process when it comes to children? My supervisor treats children just as she treats adults. While it is important to stay professional and deal with the issues for all clients, it is obvious that her methods did not allow for a strong rapport or relationship with this particular child.
What are the rules about authenticity as it pertains to a child? What are the limits to it? The readings do not specify for age, but I think it is important to consider.
Sunday, October 5, 2008
Assessment
For class this week, the reading was about assessments. This reading corresponded well with my internship, as I had read it just in time to apply it while I sat in on my first intake interview. While an intake interview is not at all the same as a counseling session, assessment still applies. At an intake interview for foster care, the agency meets with the child for the first time and asks them about their background, concerns, and expectations/hopes/fears in relation to the foster care system. The 3 primary issues assessed in all situations, as outlined in the readings, are: 1) primary problems and concerns, 2) legal mandates, 3) health/safety concerns that may require attention. The intake interview I shadowed dealt with a 16 year old girls who was entering foster care for the first time. I will go through the 3 primary issues of assessment as it pertains to this case:
1) PRIMARY CONCERNS- When discussing her concerns, the client explained that she was scared and that she didn't know what to expect from a foster placement. We delved further into these concerns, and by doing so we discovered that she had been interviewed in the past by potential foster parents who decided not to accept her as a placement. She was scared of this happening again. It made her feel unwanted and that these particular people were "lying to [her] face" and giving her false hope. This is a huge issue in foster care, as many times the biological parents are unreliable and make the child feel unwanted by giving them up or not caring for them properly. Foster care is supposed to relieve these types of feelings, however, in this particular case it did the opposite and added to them. This was the child's primary concern as assessed by the intake interview.
2) LEGAL MANDATES- All children referred to Phillips Programs (my internship agency) are referred by the Department of Social Services. All clients in my agency are sent by the decision of the court. Children are taken away from their parents by the courts because of abuse, neglect, unfit living conditions, improper example, behavioral issues, mental health, and sexual abuse, among other reasons. In foster care, many times the court will have terminated the biological parental rights. Other times the goal is to eventually return the child to the biological parents after meeting certain goals that deem it appropriate to do so. The latter was the case for this particular 16 year old girl from the intake interview. She is to be reunited with her parents in the future, and was referred to foster care for the time being by the court.
3) HEALTH/SAFETY- Part of the intake interview covered issues of past self-harming behaviors, as well as violent and socially dangerous behaviors. This information came from reports from the child's social worker, group home case manager, and therapist, who were also in attendance at the interview. The client was also asked about it. She did not report any suicidal tendencies or violent behaviors. She explained that in the past, she did not know how to handle her feelings of anger properly, but living in a group home has helped her to channel her rage effectively without harming herself or others. The client's case manager confirmed these reports. From this information, it was decided that this 16 year old girl had no health or safety issues that will require special attention from our agency or from her future foster placements.
1) PRIMARY CONCERNS- When discussing her concerns, the client explained that she was scared and that she didn't know what to expect from a foster placement. We delved further into these concerns, and by doing so we discovered that she had been interviewed in the past by potential foster parents who decided not to accept her as a placement. She was scared of this happening again. It made her feel unwanted and that these particular people were "lying to [her] face" and giving her false hope. This is a huge issue in foster care, as many times the biological parents are unreliable and make the child feel unwanted by giving them up or not caring for them properly. Foster care is supposed to relieve these types of feelings, however, in this particular case it did the opposite and added to them. This was the child's primary concern as assessed by the intake interview.
2) LEGAL MANDATES- All children referred to Phillips Programs (my internship agency) are referred by the Department of Social Services. All clients in my agency are sent by the decision of the court. Children are taken away from their parents by the courts because of abuse, neglect, unfit living conditions, improper example, behavioral issues, mental health, and sexual abuse, among other reasons. In foster care, many times the court will have terminated the biological parental rights. Other times the goal is to eventually return the child to the biological parents after meeting certain goals that deem it appropriate to do so. The latter was the case for this particular 16 year old girl from the intake interview. She is to be reunited with her parents in the future, and was referred to foster care for the time being by the court.
3) HEALTH/SAFETY- Part of the intake interview covered issues of past self-harming behaviors, as well as violent and socially dangerous behaviors. This information came from reports from the child's social worker, group home case manager, and therapist, who were also in attendance at the interview. The client was also asked about it. She did not report any suicidal tendencies or violent behaviors. She explained that in the past, she did not know how to handle her feelings of anger properly, but living in a group home has helped her to channel her rage effectively without harming herself or others. The client's case manager confirmed these reports. From this information, it was decided that this 16 year old girl had no health or safety issues that will require special attention from our agency or from her future foster placements.
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