Tuesday, December 16, 2014

Impact of Life Stressors on Systems

Impact of Life Stressors on Systems

Life stressors can impact any human system, physical, mental, emotional, social or spiritual. Life stressors generally fall under one of six categories, including relationship issues (conflicted marriages, parent-child relationships, strained friendships), health status issues (coping with disease itself, impact of illness on relationships and budget, impact on ability to cope), career status or events (emotionally abusive environment, unrealistic demands, job that is a bad match, concern about layoffs), finances, personal safety (for self and family) and home life issues (chores, childrearing, home improvements). Any one of these issues can wreak havoc on an individual’s biopsychosocial systems. Conversely, life stressors can also provide the impetus for increased productivity, allowing one to perform at his/her optimal peak.

The stress response is a biological function, often referred to as the “fight or flight” response. The Autonomic Nervous System (ANS) is the control system, operating largely without consciousness, controlling visceral functioning necessary for “fight or flight” activities, acting to increase heart rate, blood pressure, muscle tone, breathing, reading the gastro-intestinal tract for survival by expelling unneeded waste (bowel/bladder functioning is part of this), increased pupil size and other functions related to increasing survival awareness and ability to adapt and overcome a perceived threatening situation. When the body perceives a stressful situation, such as being in the path of an oncoming car, the Sympathetic Nervous System (SNS), a component of the ANS, engages to provide the necessary functions for survival. As a note, breathing may be controlled by both conscious awareness and control in addition to being a part of the ANS, making it a component for use in relaxation and stress response training.
The ANS has a second portion to complement the SNS called the Parasympathetic Nervous System (PNS). The PNS engages after the perceived danger has passed. As the name “para” implies, the PNS works alongside the SNS as a balance, bringing the ANS back into balance once the perceived stressor is neutralized by reducing the heart rate and blood pressure, increasing tone and flexibility of muscles, decreasing respirations, returning full control of bowel and bladder functioning, returning pupils to normal size and countering any other systems that were altered to deal with the situation. Stress can be a positive. For example, having the ability to get out of the way of a moving car or having additional stress when preparing for and delivering a presentation can create optimal performance rather than coming across as listless or apathetic.

When the individual encounters multiple life stressors, the body’s SNS works in the same way, dropping stress hormones, such as cortisol and norepinephrine, and altering glucose levels in the body, and triggering the same reactions in varying levels to prepare for survival. Under chronic conditions, these hormones and alterations in body chemistry, which trigger the SNS to create a situation of chronic stress, depleting the body’s ability to fight physical illness and impairing the biological system.

Stress does not stop at the biological system. When life stressors are present, cognitive capacities are also compromised. The SNS reaction is reallocation of the body’s resources for survival. Higher level reasoning and other frontal lobe activity is not necessary for basic survival, so if you have ever wondered why you were forgetful when you were under stress, this is why. Your body was allocating needed resources for survival elsewhere.


Monday, December 15, 2014

Evolution of Social Work Supervision Model

Evolution of Social Work Supervision Model

Social work supervision was originally based upon the medical model, with physicians teaching in early social work training programs and serving on boards and in charitable organizations with input on how such organizations operated and were structured. The concept of supervision in the organizational setting dates back to early social work educational programs. In agency-based apprenticeships, a new worker shadowed an experienced worker who modeled skills, behaviors and attitudes required to be an agency social worker.

Primary education of social workers transitioned into the university and other educational settings at the turn of the 20th century. While theory and basic skills training and teaching shifted to educational institutions, primary field training continued in a variety of agency and organizational-based settings. Subsequently, different forms of supervision developed over time.

The Clinical Supervisor has the authority and is under assignment to assist and direct the practice of a social worker in the areas of teaching, supporting and administration. Models that may be observed are varied, each with different elements of focus. The Task-Centered Model contains the three basic elements of education, administration and support. The Discrimination Model centers on the elements of process, conceptualization and personalization. The Developmental Model centers on three levels (beginning, intermediate and advanced), each with varying degrees of awareness, autonomy and motivation, and eight identified growth areas for each supervisee. The Contemporary Field Instruction Model of supervision is characterized by the supervisee's case needs, focusing on case planning and problem solving as a primary area of work. The Articulated Approach to supervision focuses on systematic integration of information from the classroom and field placement. The Andragogical Approach to supervision is characterized by learner-directed goals and objectives, has a focus on addressing immediate challenges, as opposed to subject-centered learning and is built around an egalitarian supervisor-supervisee relationship.

Regardless of the format of supervision chosen, certain elements remain crucial for effective supervision to maximize results and minimize liability. The five most important characteristics or elements of effective supervision are that it is structured, regular, consistent, case oriented and evaluated. Using a "structured" approach to supervision, the supervisor has clarified the format in which supervision is conducted, such as group supervision or individual supervision, or a combination thereof. The term "regular" in this context means that supervision is formalized into a schedule and conducted on a standard basis, such as weekly, to avoid infringing on or skipping supervision altogether. The term "consistent" in this context is the approach and style of the supervisor is constant, with a logical connection between the pattern and style of the decision making process, thereby setting up a means to consider approaching a given situation while not being distracted by how the supervisor may or may not react. The term "case oriented" in this context refers to the need for extraneous matters to be limited and the focus maintained on the case material, and all discussion of administrative, personal and learning issues should related to the case, either a specific case or a general case discussion. As a characteristic of effective supervision, "evaluated" refers to formal or informal evaluation of the supervision provided and supervisory process itself.

In any given setting, any number of approaches may be effective in serving both the supervisee and the client. The style is less important than the need for consistency and professional protocols.

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Monday, December 8, 2014

Five Major Channels of Resistance

Gestalt Therapy

Five Major Channels of Resistance
o Tendency to uncritically accept other’s beliefs and standards without assimilating them to make them congruent with who one is
o Passively incorporate what the environment provides, spending little time on becoming clear about what we need or want.

o Disown aspects of self by assigning them o the environment
o Trouble distinguishing between inside and outside world
o Disown attributes of self that are inconsistent with self image and put onto other people
o Avoid taking responsibly of feelings and person one really is
o Keeps self powerless to initiate change

o Process of distraction
o Keeps difficult to sustain sense of contact with reality
o Overuse of humor, abstract generalization, and questions rather than statements, resulting in emotional depletion
o Diminished emotional experience by seeking through and for others

o Do things to self rather than others

o Blurring differentiation between self and environment
o Fitting in, absence of conflict, belief all people feel and think the same way
o High need for acceptance and approval
o Stay safe, never express own feelings
o Therapist uses W’s questions to get client to open up

Other Forms of Resistance
■ Control of environment
o Resistance to contact
o Boundary disturbance

■ Blocks to energy manifested by
o Tension in part of body
o By posture
o Keeping body tight and closed
o Not breathing deeply
o Looking away from people when speaking
o Numbing feelings
o Speaking with restricted voice

SocialWorkExam.com offers online prep for NASW. Unlimited access to practice exams, case studies, simulations, video, audio, and flash cards 24/7.

Saturday, December 6, 2014

Effects of the Environment on Client System Behavior

Effects of the Environment on Client System Behavior

The impact of client behavior can be partly understood via the examination of the environment in which the client exists. This is often referred to as the ‘person-in-environment’ or PIE concept. In this model, the individual is considered to be in constant interaction with any number of systems within their environment at any given time. Systems include family, friends, religion, politics, educational systems, workplace, marketplace, internet/social networking, social services, the legal system and more. The person is conceived as having dynamic involvement with each system. With this framework, addressing the various systems in which a client interacts can then impact the person’s behavior.

Eco-systemic Theory, also referred to as Bronfenbrenner’s Ecological Theory, puts forth the belief that human development is reflective of environmental systems. Five of such systems are defined, including the micro-system, meso-system, exo-system, macro-system and chrono-system.

The micro-system is the setting where the person lives. This context includes the family, school, friends, peers and the neighborhood. In this setting, the individual has the most direct forms of social interactions, such as with parents, partners or teachers. The person is not a passive element in the environment but rather, an active participant, shaping the events and the reality.

The meso-system is the relationship between micro-systems or link between contexts. This is played out in the relationship between the family experiences to school experiences, school experiences to sports experiences, sports experiences to church experiences, and church experiences to peer experiences. In this context, a child who has been rejected by his father may have trouble developing a positive relationship with the teacher in the classroom or difficulty with a teacher may disrupt development of trust with a coach.

The exo-system involves connections between the person’s immediate context and someone in a setting where the person does not have an active role. An example is when a spouse is impacted by his/her partner’s experiences in the workplace. In such a case, a departmental expansion may require more travel or longer work hours leading to greater stress, which in turn, may increase conflict in the home or alter patterns of communication or cherished routines.

The macro-system is the context of the person’s culture where they live. This includes such things as relative poverty or wealth, socioeconomic status, ethnicity, religion, political system and developing and industrialized countries.

The chrono-system involves the pattern of environmental transitions and events over the individual’s life, including socio-historical events and circumstances. An example of an environmental transition is divorce. The impact of divorce disrupts the environment, usually detrimentally for children when considering emotional and economic issues. This impact lessens over time with a decrease in chaos and an increase in stability. A socio-historical circumstance is the recent opportunity for homosexual individuals to marry in some states, and another example is how over the past 30-40 years there have been increased opportunities for women and minorities in the workplace.

Much of the impact on the client system is determined by the client’s ability to adapt to their surrounding environmental conditions, specifically how they adapt or change to new conditions and circumstances in order to continue functioning and surviving at a desired level. Additionally, people are not just affected by their environments; they impact and change their environments, often to increase their ability to cope more effectively. Coping is a part of adaptation involving the ability to identify and then alter behavior, attitude or circumstances to overcome a problem.

SocialWorkExam.com offers online prep for NASW. Unlimited access to practice exams, case studies, simulations, video, audio, and flash cards 24/7.

Monday, December 1, 2014

Attachment Theory

Attachment theory explores the relationships between humans using psychological, ethological and evolutional theory. John Bowlby, a British psychoanalyst and psychiatrist who lived from 1907 to 1990, created the original theory. The central tenet is the belief an infant needs to develop a relationship with one or more primary caregivers for normal emotional and social development to occur.

Bowlby believed in four basic, distinguishable characteristics in attachment. First is Proximity Maintenance. This is the desire to be close to the people to which we are attached. Second is Safe Haven. This is safety or comfort seeking with the attachment figure when feeling threatened or fearful. Third is Secure Base. Secure Base implies the attachment figure is a place the child can use and return to when exploring the surrounding environment, comforted that there is a place of security that acts as a touchstone, if needed, in which to return. Fourth is Separation Distress. This is the occurrence of anxiety when the attachment figure is not present.

Bowlby associated infant behavior with seeking proximity to an attachment figure (trusted caregiver) in situations of stress. The trusted caregivers establish Proximity Maintenance. Infants then become attached to caregivers who respond to them and are constant in their lives, especially from ages six months to two years, because they create a Safe Haven. As children approach the age of two, the child uses the attachment figures (caregivers familiar to them) as a Secure Base. The infant who is attached has an adaptive response of Separation Distress or Separation Anxiety when the attachment figure departs. This mechanism is an apparent survival mechanism for the child.

Initial criticism of Bowlby’s research came from the psychoanalytic community because of the departure from the predominant theory of the time. Later criticism came out of other disciplines after extensive empirical research surrounding the development of infant/child close relationships. However, the basis concepts associated with the theory have remained and serve as the foundation of theory, as well as the formulation of policy and practice in the arenas of social policy as it relates to children and childcare to enhance the attachments in early childhood.

Mary Salter Ainsworth, an American Developmental Psychologist who lived from 1913 to 1999, focused her work on emotional attachment. Through her research, she developed attachment patterns observed in infants: secure attachment, anxious/avoidant attachment and anxious/resistant attachment. She observed infants who experienced distress when their mother departed and sought comfort upon her return, referring to this as Secure Attachment. Ainsworth observed a lack of distress upon a mother’s departure from her infant and avoidance at her return, called Anxious/Avoidant Attachment. Ainsworth’s third category of observations involved a pattern of proximity to the mother in the initial minutes alone, followed by high levels of distress at mother’s departure, seeking comfort upon her return, followed by rejection at the closeness. She referred to this third category as Anxious/Resistant Attachment.

A fourth category was later theorized, called Disorganized Attachment, theorized by Mary Main and Judith Solomon. Disorganized Attachment resembles the Anxious/Avoidant infants/children, but had significant ambivalence upon reunion with the caretaker, both approaching and avoiding. Bowlby described this as pulling away with anger while seeking to be close.

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