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Week4ConductinganAssessment.pptxSOWK915: Social Work Practice with Individuals and Families Conducting an Assessment
University of Wollongong
Faculty the Arts, Social Sciences and Humanities
School of Health & Society
Master of Social Work Qualifying
Acknowledgement of Country
We acknowledge that Country for Aboriginal peoples is an interconnected set of ancient and sophisticated relationships. The University of Wollongong spreads across many interrelated Aboriginal Countries that are bound by this sacred landscape, and intimate relationship with that landscape since creation. From Sydney to the Southern Highlands, to the South Coast. From fresh water to bitter water to salt. From City to Urban to Rural. The University of Wollongong Acknowledges the Custodianship of the Aboriginal peoples of this place and space that has kept alive the relationships between all living things. The University Acknowledges the devastating impact of colonisation on our campuses' footprint and commit ourselves to truth-telling, healing, and education.
Schedule
Recap the first workshop
What is social work assessment
Conducting an assessment: helpful tool
The role of knowledge and theory in assessment
Role-play practice
Review from Workshop 1: First Session with a Client
Introduce yourself and ask the client for his/her name and how he/she would like to be referred to
Build rapport
Explain your role and ask for a permission to talk
Explain confidentiality and its limits
Invite the client to discuss their situation
Explore the issue - assessment
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What do we mean by social work assessment?
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Social Work Assessment
“A process occurring between a social worker and a client in which information is gathered, analyzed, and synthesized to provide a concise picture of the client and his or her needs and strengths” (Hepworth et al., 2017, p. 188).
Assessment is an ongoing process as it involves the receiving, analysing and synthesising of new information as it emerges during the entire course of a case. Clients often provide new or additional information as a case goes on which changes the focus or emphasis of the presenting and emerging problems.
Without an accurate assessment the following interventions will also be inaccurate.
In any assessment type the focus is reliant on three factors: the role of the social worker, the setting in which the social worker works, and the needs presented by the client.
Assessment is not the same as diagnosis. What is the difference?
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Social Work Assessment cont.
When doing an assessment, social workers consider the whole of the client and his/her physical environment.
This is based on the notion that individuals exist within an environment and that these environments should be included in assessments – that a social work assessment is holistic.
Be alert to any subjectivity you might be bringing to the assessment process including your own history, values, biases or behaviour. These can all affect the outcome.
Always treat client information respectfully and purposefully.
Collect only relevant information, avoid curiosity or gossiping.
Always think about who will see or use the information, now or in the future.
Why do we ask questions of service users?
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The Intent in Every Question
“Every question may be assumed to embody some intent. Whether consciously or not, the therapist has some purpose in asking. This intent or purpose arises from the conceptual posture of strategizing that guides the therapist's moment-to-moment decision making during the conversation. The most common intention behind the questions asked by a therapists to find out something about the clients or their situation. With the use of questions, the therapist invites clients to share their problems, experiences, histories, hopes, expectations, and so on. The immediate intent in the asking is to develop the therapist's understanding” (Tomm, 1987).
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When developing assessment questions, keep in mind…..
Use a mixture of open and closed questions
Keep question structure simple
Ask one question at a time
Avoid double barreled questions, e.g. “How well do you get along with your managers and coworkers?”
Avoid double negative questions: “So you believe that this relationship won't do you no good?”
Avoid leading questions, e.g. In general, how healthy are you? Instead ask: In general, how would you rate/describe your health?
Use of appropriate language
Cultural sensitivity
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Overarching areas to consider within an assessment
Identifying the problems and how they are expressed
The interaction between the client and their surrounding systems
The expressed needs and wants of the client
Stresses associated with life transitions
Cultural, societal and social class factors
Severity of the problem
Meanings that clients ascribe to problems
Locations, context and frequency of problematic behaviours
Duration of the problems
Other issues that may affect daily functioning
Emotional reactions
Risk of aggression
Coping efforts and needed skills and resources
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Further elements of a comprehensive assessment
The personal choices and decisions that the client makes about their life
The client's ideas, knowledge and beliefs about the world and their ability to form judgements and make decisions
The client's beliefs about the meaning of life, religious identity and spiritual practices
The client's values, standards and beliefs about right and wrong
The client's mood and feelings and their ability to express them
The client's physical health, illnesses, energy or disability
Relationships with immediate and extended family
Peer and friendship networks, leisure and recreational activities
The client's sexual orientation, attraction and relationships, or reproductive issues
Involvement with the local area and use of formal and informal networks and community
The nature of their work and source of income
Financial security and resources
Legal rights, responsibilities and entitlements
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Bio-Psychosocial Spiritual Assessment
Often referred to as a BPSS assessment
Bio-Psychosocial Spiritual Assessments include:
Identifying information
History of the present circumstances
Past psychiatric and medical history
Social history
Current mental status testing or reference to multi-disciplinary teams who are involved in that aspect
The aspect of the person that searches for meaning and purpose in life
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Reflective Activity
Reflect and write down your answer:
Why do you think asking about spirituality and/or religion may be important in social work assessment?
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Why is Spirituality and/or Religious Faith Important in Social Work Assessment?
“Hundreds of studies pertaining to health and mental health show that a strong sense of life meaning and purpose as well as participation in religious communities and use of spiritually based healing activities, such as prayer and meditation, tend to be associated with higher levels of self-reported well-being; lower levels of depression and anxiety; lower frequency of suicide, substance abuse, and family violence; faster recovery from illness or surgery; better mental health recovery; and greater longevity” (Canda, 2009).
Difference between Spirituality and Religion:
Spirituality – search for purpose, meaning, and connection between oneself and other people, the universe and the ultimate reality. Engaging a sense of transcendence.
Religion – institutionalized set of beliefs, practices, and traditions experienced within a specific social institution over time. Involves spirituality, community of adherents, transmission of traditions over time, and community support functions.
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Assessment of Spiritual and/or Religious Attitudes and Beliefs
Social workers gain very little real understanding of a person by simply knowing his or her primary religious affiliation.
A better way to assess the spiritual dimension may be: “Does religion or spirituality play an important role in your life?” [If yes] “Can you describe to me in what way?”
Assessing spiritual development and interests is just as important as assessing biopsychosocial factors.
This type of assessment explores positive and negative aspects of religious or spiritual beliefs in ways that go deeper than religious affiliation.
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Emphasizing Strengths in Assessments
Strengths perspective
Search for assets, strengths, attributes and resources the client possesses,
Emphasise the client’s perspectives and understandings
Maintain hope for the future and focus on what the client desires
Reflective Activity
Write down 5 strengths you have
Write down your family’s strengths
Write down the strengths of your community
What did it feel like to reflect on these various strengths?
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What types of questions should we ask during a social work assessment?
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Group Activity – Developing Assessment Questions
In small groups, develop a list of potential questions for one of the assessment areas listed below.
Share your questions with the rest of the class.
Group 1: Personal History (Education, employment, housing & finances)
Group 2: Cultural/Ethnic Background (identity, language, religious affiliation, migration history, experiences of racism, xenophobia, homophobia)
Group 3: Social History (Family, friends, groups, community support, legal problems)
Group 4: Mental health and physical health history and current status
Group 5: Drug and Alcohol History and current status
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Break
Genograms and Ecomaps
Genogram - is a type of family tree to provide an immediate visual representation of the individual and family being assessed. It reveals patterns across generations of which even the client may not have been aware.
Ecomap - a visual representation that locates the family and/or individual members within a spatial context.
Helpful tools that can be used during the assessment process.
Genograms
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Genograms
Genograms
Genograms
Ecomaps
Individual Activity
Develop a genogram of your family
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Review of Existing Assessment Guides
In groups of three, spend 15 min reviewing and discussing one of the five examples of social work assessment guides/tools posted under Weekly Content, Week 4:
Guide for a Psychosocial Assessment from the Western Sydney Local Health District
Narrative Therapy Tree of Life Assessment
Transcultural Assessment Checklist from NSW health
Kessler Psychological Distress Scale (K10)
Suicide Assessment Screener
As a class, discuss the things that stood out to the students about these assessment guides/tools.
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The role of knowledge and theory in assessment
“What you see depends on what
you are looking for.”
What do you think about this statement. How does this impact the assessment process?
“Theories are human inventions, nets, that are designed to catch the world” (Karl Popper, Philosopher, 1988).
Examples of how theory/practice model guides assessment
Anti-racist theory
Maiter, S. (2009). Using an anti-racist framework for assessment and intervention in clinical practice with families from diverse ethno-racial backgrounds. Clinical Social Work Journal, 37(4), 267-276.
What have your experiences in school and with your friends been with respect to your race?
Have you been called derogatory names at school? How have you handled this name-calling?
How have your teachers been reacting to the denigrating name-calling at school? Do you feel supported by your teachers and by the school system?
Solution-focused brief therapy (SFBT)
Can you talk about a situation when [insert problem] does not occur?
How severe would you say [insert problem] is from 1 (very minor) to 10 (very severe)
How committed are you to work on [insert problem] on a scale of 1 to 10?
THE MIRACLE QUESTION: “If, while you were asleep, a miracle occurred and your problem were solved, how would things be different when you woke up?” (Child version: If you had a magic wand, what changes would you make?”)
Context of Assessment
Assessment is conducted in the context of agency requirements and current knowledge including legislation and policy
Remember that some agencies will have topic areas that are specific to their type of work.
Your agency policies will determine who your client is, but this is not always immediately clear
Family members or significant others may also be your clients, but the purpose for work with them is guided by the agency purpose
Different members of the family are likely to have different views
If there is a primary client, then permission for contact with other members in the family must be negotiated throughout the assessment and following interventions.
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Context of Assessment cont.
Assessments are not always limited to only one session. This is determined by the organisational context and the nature of the client needs.
Assessments often require the consultation of other colleagues in the agency e.g. a multi-disciplinary team where different professionals are contributing to a holistic assessment. In these settings often it is the social history and the interpersonal and family dynamics that are the social work contribution to the assessment.
Assessments are an opportunity to determine whether the agency, social worker and the clients' needs are the best fit.
Written Assessment
Assessment is also the written product that results from the process of understanding the client.
Written assessments can include common comprehensive biopsychosocial assessments or can be brief about a singular issue (e.g. mental status, drug use, capacity for self-care or suicidal risk).
Read carefully the examples of a written assessment on pp. 243-248 in Hepworth et al., (2017)
Foundation for Assessment 3
break
Keep in minds…
Don’t forget to sign up for assessment 2:Please put your name+ case number +email address on role play sign up sheet on Moodle under assessment 2 before 24t March
Common question:
‘I don’t have the access for sign up sheet’- Please press request access button
‘Where can I find case study?’ go to Moodle-Assessment 2 Tab –case studies for role play
‘Why do I need to choose a case scenario and what for?’- The case scenario describes who you are when you act AS A CLIENT in your role play. Try to avoid the clash with your partner .
Remember come to sim lab in Week 5 for your role play.
Where is sim lab: B29.110 in Wollongong campus. R110 in Liverpool campus (for student enrolled in Liverpool campus only)
Practice, practice and practice
Quiz 2 is due in Week 5- it will assess your understanding of ALL your learning materials from W4-W5
Please post all assessment related questions on discussion forum and subject coordinator will answer the questions on a daily basis to ensure everyone can view assessment related information
Active Learning
Role Plays - Conducting an Assessment
In groups of 3, role play the following case studies (provided in class). One student should be the service user, one the social worker, and the 3rd should observe.
Swap roles every 10 min so that all members have a turn of being in each role.
The observer will fill out the Role Plays Feedback Sheet (posted on Moodle) to document what the student who plays the social worker is doing well and where the areas of improvement are.
Remember to address all the required steps of an initial meeting with a client (covered in Workshop 1).
Next move on to conducing an assessment (covered in Workshop 2). Based on the questions developed earlier in class and the provided examples, ask questions which you believe are most needed and appropriate to learn about your client. Remember, you are just learning about the client. Do not provide any advices or jump into solutions.
Take 5 min after each role play to discuss the performance of the social worker – both the observer and the service user should provider constructive feedback
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Cases for Classroom Role Plays
CASE 1
Client: Frank is an 85 year old man. Frank plays bowls regularly at the local lawn bowls club but last week when he was there, he had a fall. The club called an ambulance and Frank is now in hospital recovering from a minor fracture in his arm. The doctors have asked the social worker to assess Frank for discharge home.
Social Worker: You are a hospital social worker conducting discharges for clients referred to you by the doctor. You will not be providing long-term counselling or case management services to Frank but you can link him to the services he may need.
CASE 2
Client: Sasha is a 23-year-old Uni student who also works two part time jobs. Sasha experiences anxiety which has become worse this semester. She has contemplated leaving her degree as a result.
Social Worker: You are a social worker at the student counselling service on campus where Sasha presents for help.
CASE 3
Client: Ana is 32 years old and has recently had her baby daughter removed by child protective services. Ana went out with her friends for two hours, and left the baby unattended. The neighbours called the police. Ana has seen a child protection caseworker regularly over the last two months and she hopes to get her parental rights back. She struggles with securing a job, anxiety, and maintaining positive relationships with her family.
Social Worker: You are a social worker where Ana has been referred for counselling services.
Reflective Activity: Impact of Your Worldview on Client’s Assessment
Reflect and write down your answers:
How do you understand selfhood?
How do you view people in general?
How do you view human relationships?
What is your view of the relationship between people and nature?
Are you a here-and-now person or do you think more about the past or the future?
What do you think about the nature of human activity? Are all people engaged in a similar range of activities? Are there differences between people’s daily activities? If yes, then why?
Consider how your preferred view in each category might affect your assessment activity (O’Hara & Pockett, 2011, p. 170).
Discuss your answers in small groups
