Social Work Theory and Methods of Intervention

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This piece of work will attempt to look at how a chosen Social Work method can be useful in case work intervention with an individual. It will look at the theory in detail with regards to its application in the client/worker relationship, taking into consideration issues of anti-discriminatory practice and the limitations which the method may have in delivering a holistic service. It will then consider the benefits of using another method in conjunction with the first in order to compliment this and provide more robust ministrations.

The individual chosen from the case study is Michael. He is 15 years old and has recently been arrested along with two friends. This is not his first offence and he has intimated that he feels confused and has no-one to talk to. Additionally his relationship with family members is tentative at the present time and he has been blamed for the arrest by his friends.

The method chosen in this instance is Cognitive Behavioural.This approach is concerned with the way we think. It makes the assumption that behaviour is directed by thoughts. Unlike many other concepts, which concentrate more on unconcious drives, feelings or internal conflict. Cigno and Bourne 1998, believe that 'most of what makes us individuals rather than clones, what shapes our personalities, including behaviour, emotion and cognition, is a result of what we have learned'.

This paradigm is rooted in behaviourist theory. Pavlov introduced 'classical conditioning' after his work on physiological processes of digestion. This was a specifically centred around work with laboratory animals, which when observed in experiments began to develop associations and anticipations about food. Pavlov named this stimulus association learning. Operant conditioning is also part of this model, introduced by B.F Skinner 1953, it interposed the concepts of positive and negative reinforcment as a result of stimulus. He believed that ' almost any set of stimuli can aquire reinforcing or punishing associations through the consequences they bring' Cigno and Bourne1998.

'Cognitive and behavioural theories are principles from two related streams of psychological writing', Payne 1997. Social learning theory (Bandura), focuses the fact that most behaviour is learned. However it goes further than behavioural theory by implying that people's perceptions and thinking about their experiences and modelling what they see around them are vital to the process and interdependent to the feelings that they have regarding this. Basically Bandura believed that how we think has an affect on our behaviour and that both of these are open to change. The way we think about a situation mediates between the outside world and our inner self, Harrison and Butler 2004.

People have the capacity to change and behaviour is assimilated by goals, Sheldon 1995.

Cognitive behavioural programmes are based on the application of both social learning theory and cognitive theory to inform therapeutic methods, Cigno and Bourne 1998.

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This particular method would be used with Michael to help address both his offending behaviour and his issues with his family. Sheldon's assessment model (1995) would be useful in this case. This helps us to measure what is happening and assess to Michael's motivation for change:

Focus on the behaviour causing problems - ...

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People have the capacity to change and behaviour is assimilated by goals, Sheldon 1995.

Cognitive behavioural programmes are based on the application of both social learning theory and cognitive theory to inform therapeutic methods, Cigno and Bourne 1998.

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Focus on the behaviour causing problems - Offending behaviour - second offence
Attributions of meaning to stimuli - family have no time for him, Michael feels confused
Present behaviour and thoughts - confusion, no one to talk to. isolated
Target sequences of behaviour - offending behaviour needs to be decreased. Could use ABC technique. Anticedent - problems with the family, Behaviour - offending, Consequence - arrest.

This assessment would be done with the intention of helping Michael to see where he is at present with his own thought processes (hopes, fears,values) and to progress from these to try to make Michael's behaviour goal orientated, e.g getting Michael to think about offending in a different way and 'continuous reinforcment' of a desired behaviour will work quickly to decrease in the behaviour which leads to offending, this promotes change in the thinking behind offending behaviour. Shaping can also be used, reinforcing small steps made toward a required behaviour. The worker also needs to challenge negative thought processes. Feedback needs to be encouraged so that Michael can see what he has achieved oustide sessions, Harrison and Butler 2004. Once the desired behaviour is achieved 'fading' would be used to reduce the amount or type of reinforcement. This enables Michael to transfer his behaviour to other settings, Payne1997.

The principle of self-talk can be tried out with Michael also. Cigno and Bourne 1998 indicate that children gain self-control over their actions as their 'inner' speech develops. Using this formula in the form of self-talk can help with self-appraisal and self-support. Self-Instructional Training (SIT -Goldstein and Keller 1987) was developed with this as a central concept. This intervention can help to establish self control in young offenders, thus helping to decrease the arousal which may lead to offending behaviour.

Beck et al 1985 followed on from Bowlby's (1977) work on attachment and loss and may take the stance that Michael has a 'sociotropic' personality. This means that he values closeness and the loss of a relationship, a rejection or an experience of 'social deprivation' could affect his mood and leave him feeling confused and isolated, Dryden1996. Hence the abnormal thought which lead to offending.

Another use of cognitve techniques could be offered to Michael and his family in the form of Functional Family Therapy if his family were willing to participate.This focuses on family interaction. It uses 'contingency contracting' as a means of changing family interaction in the case of young offenders. It can help to reduce recidivism and have a beneficial effect on the interactions between families. It has become increasingly evident

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that working in partnership with families is important when trying to reduce the risk of re-offending in young people, Cigno and Bourne 1998.

The Cognitive Behavioual approach does have limitations. The nature of the work and the theories that undrepin this can come accross as 'jargonistic' and the system for assessing and evaluating results can be over addressed. This could possibly add to the subjects negative feelings as it errs toward the necessity of gathering empirical evidence as opposed to the importance of the client/worker relationship.

This technique can also have implications for anti-oppressive practice. The worker to all intents and purposes engineers the behaviour of the client. In an arena such as the youth justice system the client has no control over the process which can be deemed as oppressive.

If a worker makes assuptions about the cultural, social or religious influences on the client having implications for negative behaviour, this too can be oppressive. This can lead to questioning who actually wants the change in behaviour? Is it the client? Or is it professionals and wider society who are endeavouring to fit behaviours in to it's system of 'norms'. Payne 1998 believes that 'there is a risk that therapy which seeks to change behaviour so that it adapts to an environment undervalues minority forms of behaviour and less dominant aspects of culture'.

Although behavioural and Cognitive approaches are valid and effective because of their explicit structure and guidence, can good results be maintained over a period of time? When the intervention ceases can the client keep up with the techniques taught, without support? Additionally it is questionable that some of the individualistic therapies, such as Sheldon (1995) can be easily transferred to general social work settings, Payne 1998.

Another problem is that Behavioural programmes require supervision by a person who is expert in the field, as they are complex and require skills to construct. This can be very difficult to provide if their is no existing group of practitioners, Payne 1998.

Additionally client resistance could also be a factor depending on how motivated the client is to change their behaviour.

Lastly Cognitive approaches only take into consideration the person concerned, (behaviour and cognition). Not much thought is given to the societal aspect of the persons life, e.g. environment, family, education. These are factors which are beyond a persons control. This approach tends to work toward making the person 'fit in' as opposed to working to help them realise their place in society, Harrison and Butler 2004.

One method which could be used to address some of the limitations of the Cognitive Behavioural method is Solution Focused Therapy. It has an emphasis on positive rather than problem solving work. It focuses on behaviours which may not be typical of the problems identified and uses these as a base for change. Change is assumed to be continual, with small changes leading to bigger ones.

This is based on de Shazer (1985,1988,1991) and Insoo Kim Berg's (1988,1990) model. It is focused on the

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same idea as family therapy (interactional). However it is very different in a number of ways. It views the process of change as inevitable.

Taking this view it pays close attention to exeptions to problems, e.g when there is a change to the stability of the problem. It sees this as the key to finding solutions, Kim Berg 1999.

If we can find a way to repeat the behaviour which surround the exeption the problematic situation can become less overwhelming and more manageable, it can eventually disappear.

Change occurs in different ways, emotional, perceptual and behavioural. If feelings toward a situation change, a perceptual shift is possible, and in turn a different behaviour. When a problem is seen as positive, we can make behavioural changes in respect of the problem which lead to the client feeling differently about it. If we can create a different emational reaction to the same problem change can occur,Kim Berg 1999.

This type of therapy is about constructing solutions, not focusing on problems. In the case of Michael it would be an idea to focus on education as a pre-session change. Even after being isolated from friends and beaten up by a group of youths, he has not stopped attending school. This may lead us to think that there is something about school which has positive conotations for Michael. Whether it is that he is doing well with subjects, he has someone to support him there (teacher), he feels safe there or he looks on it as the area where he is doing well. This is an area where there is an exeption to his problems. Therefore it could be used as the key to finding a solution in his problems. We would start by creating a small goal which would be set by Michael. After establishing where he wants to be in his life at the present time, we would try to find the quickest way to get him there. Constructing solutions and helping him to focus and discover his own resolution are also part of the therapist role.

Scaling can help in this type of therapy in order to get the pitch of the problem right, e.g. how does Michael feel before he commits an offence on a scale of 1-10? Then by setting acheivable goals and feeding back as to whether things are working for the client, we can help to bring about changes. Once we know what works as practitioners we can repeat the exercises in order to keep supporting change.

These techniques could also be applied to Michael's family as a whole, if they were willing to take part. It could focus on the strengths of the family as a whole and set goals for them, which are achievable. Reframing and focusing on a preferred future rather than the unsatisfactory present helps the family to shift from the negative to the positive interms of relationships, behaviours and emotions. The interventions are short and would suit a family dynamic.

Using Solution Focused Therapy along with Cognitive Behavioural methods would help to improve service delivery for the client because it would give a more robust performance. Michael along with all service users

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needs a wide range of interventions available to him in order to give a holistic overview of the support given.

Although certain methods give very good results in working with groups of clients. These methods should not be used in isolation as this makes the practice very single-minded. Methods should be used to compliment each other for different individual needs.This is not to say that a worker should use all of the theories at one time with a person, as this could become confusing for both worker and client.However factors such as family, environment, education, health and peer relationships all need to be considered when dealing with people in the caring professions. All people are individuals and deserve the right to be treated as such. To do anything less would be seen as an act of oppressive practice. Social workers need to draw on many different paradigms available to them in order to truly meet clients needs.

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