Mezzo and Micro practice
interventions geared towards benefitting family, small groups and individuals.
practice is performed in a case by case basis, generally in clinical settings and is used to solve psychosocial problems of families, individuals and groups
takes place with small groups and families and focuses on communicating, educating and bringing people together.
clients perception of the issue or difficulties he has been experiencing which has caused him to seek help.
exploring factors that maybe relevant to the clients problem, concern or request including legal mandates, health, safety, signs, sypmtoms duration, duration frequency individuals, systems and consequences.
guidelines for conducting a competent assessment
narrow your focus by emphasizing information that is relevant to the clients problem, concern or request and to the type of help you can offer the client. Address top priorties, (legal mandates, health, safety)) Gather information froma variety of sources, Recognize the uniqueness of the client, Adopt strenghts perspective,Be aware of factors that can affect a clients responses (malingering, defensiveness, view assessment as both a product and process.
Independent assessment and clinical team approaches
in some setting, social worker makes an independent assessment ,this is generally completed in one to three sessions. In other settings the social worker is part of a clinical team that makes an assessment. In the team approach the social workers role is to complete the social history of client and assessment may take several weeks.
Interviewing skills for eliciting presenting problems
start where the client is. respond empathically, use reflective opening, make statements that allow client to choose her own direction, aske open ended questions and close ended questions, seek clarification
additional clues for eliciting the presenting problem
problem checklist: a list of problems,concerns commonly reported by a group of clients
problem search: is an agreement between you and a client to spend up to three sessions exploring situation in more depth.
factors that my affect disclosure
clients may test you before disclosing the real problem. This may stem from experiences with discrimination. A voluntary client may exagerate the complexity of the problem. an involuntary client may withhold information and/or minimize the presenting problem.
clients problems usually \stem from a poor fit between those needs and resources in the environment. This includes lack of access to available resources. Sometimes resources are Non existent or unresponsivetto the clients needs. S.W most respond promptly to address a clients basic needs.
are often related to a person's developmental stage an the tasks and transitions associated with it; it is critical to take into account a persons developmental stage when identifying their needs.
Presenting Problems and Needs
the presenting problem often reveal only surface needs.careful exploration is required in order to identify needs that the client may be unaware of.
Planning intervention based upon needs
a clients unmet needs or wants can be translated into goals when you plan the intervention.
History of the problem
clarify's the magnitude of the problem, identies factors contributing to the problem and identifies the clients current level of functioning and motivation for change.
components of the problem history
onset, progression and severity of the client's problem, its precipitants, its environmental antecedents and consequences, factors maintaining the problem, its effects on the clients functioning, clients ideas about its causes, whats been been done to try to solve the problem, whats works and what hasnt worked.
Onset, progression and severity
addresses when the problem began, under what circumstances, was there a specific precipitating event or change in the clients life. how long has it been going on. Is the problem chronic, or episodic, how often does it occur, how intense if the problem or symptom.
Stressor Affecting the Problem
a current/recent psychosocial stressor may have precipitated the clients problem or may be exacerbating the problem to understand the role you should explor how the psychosocial stressor is affecting the client and family. what is the duration of the stressor. what coping skills have the client used.
Degree of Impairment in functioning
How much has the problem affected the clients functioning. Has it affected the clients personal relationships, is it interfering with work, school, home and in what ways. Does client have problems perfomr activities of daily living. Has an interest in pleasuralbe activities changed.
clients belief about the problem
a clients belief or assumption about what causes a behavior can sometimes serve to maintain a behavior.also identifying the clients emotional reaction to the problem is important as emotions can have a potent effect on behavior. emotions can cause behavior that intensifies a problem.