Social Work Live Social Work Live Theory and Practice in Social Work Using Videos By Carol Dorr, Ph.D. 1 1 Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offices in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trademark of Oxford University Press in the UK and certain other countries. Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016 © Oxford University Press 2014 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by license, or under terms agreed with the appropriate reproduction rights organization. Inquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above. You must not circulate this work in any other form and you must impose this same condition on any acquirer. Library of Congress Cataloging-in-Publication Data Dorr, Carol. Social work live : theory and practice in social work using videos / by Carol Dorr Ph.D. pages cm ISBN 978–0–19–936893–8 1. Social service. 2. Social case work. I. Title. HV40.D677 2014 361.3—dc23 2014022086 9 8 7 6 5 4 3 2 1 Printed in the United States of America on acid-free paper Contents Preface xv Acknowledgments xvii Introduction xix 1. Overview of Practice in Social Work 1 What Is Direct Practice? 1 Direct Practice, Generalist Practice, and Clinical Practice 2 Qualities of Worker–Client Relationship 3 Clinical Wisdom 4 Paying Attention to Content and Process in the Interview 5 Intersubjectivity 6 Process Recordings 6 Communication Skills 9 Strengths Perspective 14 Empowerment 15 Diversity 16 Values and Ethics 17 Use of Self, Self-Reflection, and Self-Awareness 19 Evidence-Based Practice 20 Assessment 22 Ecological Model 23 Diagnosis versus Assessment 23 Problem-Solving Method 24 Psychosocial Assessment and Intervention Strategy 25 Bio/Psycho/Social/Spiritual Assessment 26 What Is Spirituality? 28 How I Use Spirituality in My Practice 29 References 32 vi | Contents 2. Overview of Theories 34 Use of Videotaped Recordings, Transcripts, and Process Recordings to Identify Theories 34 Use of Multiple Theories and Advantages of Combining Theories 36 Warning About Techniques and Eclecticism 37 Approach to Using Theories in Case Studies 38 Psychodynamic Theories 38 Ego Psychology 40 Object Relations 42 Narrative Theory 44 Cognitive Theory 47 Positive Psychology 50 Behavioral Theory 50 Systems Theory 54 Family Systems Theory 54 Family Emotional Systems Theory or Multigenerational Family Theory 55 Structural Family Theory 59 References 62 3. Practice with Serious and Life-Threatening Illness 64 Allen: “I’m not a heart on my sleeve kind of guy.” 64 Description of Practice Area 64 Loss and Meaning-Making 64 Listening to Patients’ Stories 65 Meditative and Mind–Body Practices 66 Individual and Family Life Cycle Assessment 67 Setting: Social Work in a Hospital Setting 69 How Context Shapes Practice 69 Diagnosis and Intervention: Diagnosis of Panic Attack 71 Panic Attack and Panic Disorder 71 DSM-V Criteria for Panic Disorder 71 Evidence-Based Intervention for Panic Disorder 72 Medical Terminology 72 Case Description 73 History 73 Precipitating Event for Social Work Crisis Intervention 73 First Excerpt from Transcript and Process Recording 74 Reflection of First Process Recording and Discussion of Practice Skills and Theories Used in Intervention 80 Communication Skills 80 Other Practice Skills Used 83 Theories Used in Intervention 83 Narrative Theory 84 Contents | vii Cognitive and Behavioral Theories 85 Psychodynamic Theories 86 Family Systems Theory 86 Second Excerpt from Transcript and Process Recording 87 Reflection of Second Process Recording and Discussion of Practice Skills and Theories Used in Intervention 88 Communication Skills 88 Other Practice Skills Used 89 Theories Used in Intervention 89 Family Systems Theory 89 Cognitive Theory 90 Psychodynamic Theory 90 Narrative Theory 90 Behavioral Theory 91 Third Excerpt from Transcript and Process Recording 91 Reflection of Third Process Recording and Discussion of Practice Skills and Theories Used in Interventions 95 Communication Skills 95 Other Practice Skills Used 97 Theories Used in Intervention 98 Psychodynamic Theory 98 Behavioral Theory Using Mindfulness 99 Cognitive-Behavioral Theories 99 Summary of Third Excerpt and Conclusion: Significance of Social Work Interventions 99 Summary of the Remainder of the Interview with Allen 100 Preparing for Surgery 100 Endings 100 Assessment 101 Problem-Solving Method 101 Bio/Psycho/Social/Spiritual Assessment 104 Psychosocial Assessment and Intervention Strategy 105 End of Chapter Resources 107 Questions for Students 107 Interviewing Skills Used in the Case of Allen 113 Medical Terms and Definitions for Cardiac Patients 116 References 120 4. Practice with At-Risk Populations: The Elderly and Public Assistance 122 Betty: “If i don’t get money here, I’ll be out on the street.” 122 Description of Practice Area 122 The Role of Individualism in American Society 123 Poverty and Social Welfare Policies 124 viii | Contents History of Public Assistance Programs 125 Criminalization of Poverty 126 Poverty and Healthcare Policy 127 Age Discrimination in the Workplace 129 Setting: Public Assistance Office 130 Case Description 130 Situation 130 Precipitating Event for Social Work Intervention 131 First Excerpt from Transcript and Process Recording 131 Reflection of First Process Recording and Discussion of Practice Skills and Theories Used in Intervention 134 Communication Skills 134 Other Practice Skills Used 135 Theories Used in Intervention 136 Psychodynamic Theory 136 Narrative Theory 137 Second Excerpt from Transcript and Process Recording 137 Reflection of Second Process Recording and Discussion of Practice Skills and Theories Used in Intervention 141 Communication Skills 141 Other Practice Skills Used 143 Theories Used in Intervention 144 Psychodynamic Theory 144 Cognitive Theory 144 Narrative Theory 145 Third Excerpt from Transcript and Process Recording 145 Reflection of Third Process Recording and Discussion of Practice Skills and Theories Used in Intervention 148 Communication Skills 148 Other Practice Skills Used 149 Theories Used in Intervention 150 Psychodynamic Theory 150 Narrative Theory 151 Cognitive Theory 151 Fourth Excerpt from Transcript and Process Recording 151 Reflection of Fourth Process Recording and Discussion of Practice Skills and Theories Used in Intervention 157 Communication Skills 157 Other Practice Skills Used 158 Theories Used in Intervention 159 Psychodynamic Theory 159 Narrative Theory 160 Cognitive Theory 161 Contents | ix Fifth Excerpt from Transcript and Process Recording 162 Reflection of Fifth Process Recording and Discussion of Practice Skills and Theories Used in Intervention 165 Communication Skills 165 Other Practice Skills Used 167 Theories Used in Intervention 169 Cognitive Theory Using Coaching and Cognitive Restructuring 169 Psychodynamic Theory 169 Narrative Theory 170 Summary of Excerpt 5 and Conclusion: Significance of Social Work Interventions in Public Assistance 170 Assessment 170 Problem-Solving Method 170 Psychosocial Assessment and Intervention Strategy 172 Bio/Psycho/Social/Spiritual Assessment 175 End of Chapter Resources 176 Questions for Students 176 Interviewing Skills Used in the Case of Betty 182 Terms and Definitions for a Public Assistance Client 184 References 187 5. Practice with Children: Issues of Childhood Leukemia and Divorce 190 Emily: “Will they be scared of me, thinking they might catch it?” 190 Description of Practice Area 190 Practice with Children 190 Developmental Theory 191 Resiliency 193 Play and Expressive Therapies with Children 194 Divorce and Children 196 Practice with Leukemia and Childhood Cancer 197 Setting: Social Work in an Outpatient Hospital Clinic 198 Diagnosis and Intervention: Diagnosis of Childhood Leukemia 200 Case Description 202 Medical History 202 First Excerpt from Transcript and Process Recording 203 Reflection of First Process Recording and Discussion of Practice Skills and Theories Used in Intervention 205 Communication Skills 206 Other Practice Skills Used 208 Theories Used in Intervention 208 Narrative Theory 208 Psychodynamic Theory 209 Cognitive Theory 209