Monday, January 19, 2015

Staff Development

III. Staff Development
 A. Purposes of Staff Development
        1. Employee development and proficiency
    • Stress Reduction
    • Augment skills and resources
        2. Organizational Culture
  • Creating
  • Maintaining
  • Shaping
  • Impact on performance
3. Organization performance
  • Executing mission, goals and objectives
  • Facilitating change
4. Short and Long-range planning



B.        Elements of Staff Development Training
1. Formats
  • In-service training
  • Workshops and Lectures
  • Informational brochures
  • Discussion groups
        2. Teaching Styles
  • Task-oriented teaching style
  • The cooperative planner teaching style
  • The learner-centered teaching style
  • The subject-centered teaching style
        3. Training Validity
  • Interorganizational validity
  • Intraorganizational validity
  • Transfer validity
        4. Measurement Designs for Training Effectiveness
  • Participant Action Plan Approach
  • Pre- and Post-Test Design
  • Kirkpatrick Framework
  • Outcome Evaluation Design using Experimental and Control Groups
        5. Measurement Design Flaws
  • History
  • Maturation
  • Instrumentation
  • Statistical Regression
  • Differential selection
  • Attrition
C. Five Concepts of Learning Theory
1. Motivation
2. Conceptualization
3. Practice
4. Reinforcement
5. Feedback

IV. Consultation
A. Provide specific expertise and/or case review
B. Consultant makes recommendations about cases or issues
C. No responsibility or accountability to compel the recipient to comply
D. NASW Ethics
1. Requires receipt of appropriate consultation when indicated
2. Encourages mentorship and sharing of experience

V. Interdisciplinary Collaboration       
A. Approach
1. Multi-faceted with divergent knowledge bases
2. Team setting
B. Strengths
1. Provides a check-and-balance unavailable to any one profession
2. Multiple resources and viewpoints for holistic care
3 Effectively address complex needs
C. Limitations
  • Disputes over who has primary jurisdiction
  • Tendency to defer to one profession over another
  • Potential for fragmented care




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Monday, January 12, 2015

Educational Functions of Supervision

Mary Richmond, the early pioneer of social work, directed the first coursework related to fieldwork supervision in 1911 at the Russel Sage Foundation Charity Organization Department, establishing the first formal social work supervision training. By the 1920, the pivotal shift was made from human service organizations having the explicit purview of educating social workers to colleges and universities doing the primary training. The educational component of supervision allows for the instilling of values, core principles, knowledge and skills of the social work profession. The three primary functions of effective social work supervision are educational, administrative and supportive. Education is, by far, the most important functional element of supervision.

The educational function of supervision seeks to contribute training and knowledge to enhance theoretical understanding, aid in shifting attitudes when and where needed, and to advance methods of work, enabling social workers to set and achieve worthwhile goals. This process lends itself to instilling social work core values and principles throughout, allowing for professional development on multiple levels. Supervisors are charged with ethical practice, which includes having the full professional knowledge and skills required to provide technical expertise, as well as to role model social work values and ethics.

Prior to initiating supervision services, a good supervisor will conduct a thorough and compete educational assessment. While the completed coursework and use of nomenclature may be useful in determining the needs of a supervisee, a full understanding of what the supervisee has experienced may be a better indication of what he or she has actually internalized in the context of experience, practice style, strengths and weaknesses. The effective supervisor will then focus on areas of strength, using positive feedback and positive reinforcement, and begin to build upon existing skills to address deficit areas. Unskilled supervisors may make the mistake of beginning with deficit or weakness areas. This technique may destroy confidence and decrease the establishment of trust, especially early in the supervisor-supervisee relationship. Specific goals should be set to measure progress.

Supervisees can better learn when they have a specific structure in which to organize their learning about the treatment process. One way clinical supervisors may structure the supervisory process is by breaking down the learning process into three components, specifically (1) treatment structure, (2) treatment content and (3) intervention process. Each of these components may be further dissected and be an area of focus in building upon social work skills.

In working with a supervisee on treatment structure, the supervisor may focus supervisory sessions on specific structural techniques to best organize treatment, such as session length, specific type of therapy, location of sessions or the use of contracting. In working with supervisees on treatment content, the supervisor may focus on elements specific to the client case, helping the supervisee ferret out the most meaningful content provided by the client or discover what the client has omitted or minimized in disclosure. During the intervention process, the supervisor may focus with the supervisee on any number of intervention processes, helping the supervisee determine which is best based on the client needs, client development level, treatment setting, available time or other factors.

The function of educational supervision is vital. It is crucial to remain relevant and effective to the population served, to developing the social work profession, and to raising the next generation of social workers.





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Monday, January 5, 2015

General Assessment Issues

General Assessment Issues



The basis for any effective social work action is effective assessment of the problem or situation. A solid understanding of assessment issues is important to the success of case work, crisis management, clinical treatment, psycho education, community organizing, new parent support, child protection services, advocacy, policy development and any other issues that may be defined. It is the key to beginning an effective relationship with a client, or starting any element of mezzo or macro practice.

The first part of the process in assessment is to determine why the client is present. The psychosocial summary should include a statement about what brought the client to the session, specifically the basis for the assessment. When the reason for the assessment is discovered, it drives who should be present for the initial meeting. For example, if parents call about a "problem child," age 7, who is "out of control," who should attend the first session? Should the entire family be present, or some subset thereof? Further, what is observed in the waiting room prior to the initial session? Is the parent engaged with the child, dismissive, agitated, pacing, on the phone? Which member of the family seems eager to be present? Who seems anxious, angry or scared?

Confidentiality must be addressed prior to the start of assessment. If notes are taken during session, be open with the client about what you are doing, such as saying "I need to have some specific information because some things may be hard for me to recall, like dates, names or events." The full parameters of what information can and cannot be kept confidential are important to provide. If insurance is being filed, it is important to make sure the client(s) understand what the insurance company can access and review or what is submitted to the company. If the client is involuntary (i.e. court ordered), make sure the client knows what is expected of them and how confidentiality relates to their status.

Often clients have curiosity about their social worker. After all, the worker is often actively engaged in the client's life and knows extensive information about the client. As a social worker, one must decide how personal questions will be addressed. This should be based on several considerations. One is agency policy. Does the agency have a policy about the disclosure of personal information with clients. Theory often drives how much information is disclosed and the meaning of the question asked by the client. Generally, it is important to understand the meaning of the question to the client. Some clients may ask a personal question because they want to know if the worker has experience in something going on in the client's life. Cultural issues may drive the client's question, perhaps wanting to learn about how a social worker from the dominant culture may relate to a client from a minority background. Other clients have a sincere curiosity about the person who is becoming a part of their life. Some clients have significant boundary issues. Most important is to understand the significance of the client's question and put the client's interests first. This does not suggest the client needs intimate details of a social worker's life, but interpersonal sharing can begin healthy role-modeling for the client. If the worker is uncomfortable sharing any personal information, the worker must negotiate that, as well. The worker can still set the tone for a positive relationship by setting a boundary that does not include sharing personal information by responding honestly, such as "I am not comfortable sharing about my personal life with you, but I want to understand what that question means to you or if you feel I can help without answering personal questions."

The timeframe for assessment may very across settings. Requirements present in a governmental agency may be different than in a non-profit agency setting or an independent practitioner's office. An inpatient unit may require assessment to go very quickly because the turn-around time for the client is fast, while a residential program may allow for assessment to be done over two or three sessions, resulting in a more in-depth assessment. The payer (i.e. insurance, private, self-pay) often dictates the limits or flexibility allowed in the assessment process.





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Monday, December 29, 2014

Indicators of Abuse and Neglect

Indicators of Abuse and Neglect



Abuse and neglect can be defined as acts of commission or omission by a parent, guardian or caretaker that results in physical, emotional or sexual abuse, exploitation or imminent risk of serious harm. Child abuse laws are present in all 50 states, with mandatory reporting laws designed to protect individuals less than 18 years of age. The four categories of abuse discussed are neglect, physical abuse, emotional abuse and sexual abuse.

Neglect is an act of omission, or failure to act on the part of a parent or guardian that results in substandard support of the child. The act may be the result of insufficient resources or information, indicating the caregivers is in need of services or support. Generally, neglect falls into one of three categories, including physical, emotional and educational. Physical neglect is the failure to meet the child's basic requirements for physical development, such as medical attention, nutrition, supervision, clothing and shelter. Emotional neglect is the failure to meet the child's needs for psychological and social development through appropriate affection and support. Educational neglect is the failure to meet the child's special educational needs or simply to educate the child. Behavioral and physical indicators neglect may be present include: chronic hunger or lethargy, begging or collecting leftovers, untreated injuries or illnesses, height and weight significantly below standards for the child's age, clothing unsuitable (no coat in winter, no shoes, too small), poor hygiene (lice), chronic uncleanliness, infestation (roaches, rodents) in the home from chronic uncleanliness, rash that goes untreated, sporadic school attendance, chronic lateness, taking on adult roles/responsibilities or arriving to school early and/or leaving school late.

Abuse is an act of commission against a child and generally falls into one of three categories, including physical abuse, sexual abuse and emotional abuse. Physical abuse is non-accidental injury committed against a child. Physical and behavioral indicators include: unexplained, chronic or repeated bruising, burns or other injuries; withdrawal, regression (acting younger than their age, a return to an outgrown behavior such as thumb-sucking), aggression, attempts to hide injuries, depression or excessive tearfulness and crying; discomfort with physical contact; age inappropriate shyness; excessive fear of a parent, guardian or care-giver; defiant or antisocial behavior, such as chronic truancy, use of alcohol or other drugs, running away or fighting.

Sexual abuse is any act of a sexual nature committed on or with a child, or in the presence of a child for the purposes of sexual gratification. The action may be for sexual gratification of the perpetrator or of a third party. By this definition, the act includes anyone who actively participates in the activity, as well as anyone who allows it to occur. The action may include involvement in pornography, touching, fondling, kissing, oral sex or intercourse. Intercourse can be vaginally, anally or orally, must involve penetration and includes penetration with a variety of body parts or objects (commonly occurs with fingers, tongue or penis). Common indicators of sexual abuse include: complaints of pain in and around the genitals; sexually transmitted disease or pregnancy; difficulty walking or sitting; unusual or offensive body odors; poor bladder or bowel control; severe psychosomatic complaints; bruises or bleeding from external genitals, anus or vagina; genital discharge; eating disorders; frequent, unexplained yeast infections, sore throats or urinary tract infections; torn, bloody or stained underclothing; regressive behaviors (bedwetting, thumb-sucking); sudden changes in behavior or mood; poor peer relationships or inability to related to peers; promiscuity; sexualized behavior inappropriate for the child's age; nightmares, disturbed sleep patterns or fear of the dark; or sudden decline in school performance.

Emotional abuse involves chronic or consistent acts or attitudes that interfere with the social or psychological development of a child, with behaviors such as rejection, withholding love, insults and criticizing. Indicators of emotional abuse include such things as: eating disorders, stuttering; weight or height significantly below expected developmental milestones; hives, stomachaches, facial tics; nail biting; regressive behaviors; poor relationships with peers; isolating from others; cruel behavior to animals or other children; substance abuse; suicide attempts or excessive risk taking; fire setting and other delinquent behaviors.

The presence of any particular indicator is not a causal link to abuse or neglect. Indicators are simply that, indicators. However, the presence of an indicator or cluster of indicators is worthy of attending to the child, their environment and safety needs.





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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.

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