Download Social Worker as Broker - Case management - Lecture Notes and more Study notes Business Management and Analysis in PDF only on Docsity!
Case Management
The Social Worker as Broker
Purpose. To link clients to appropriate human services and other resources.
Description. Social work’s particular emphasis among the helping professions is to assist people in relating to their social environment. That places the social worker in the position of being the professional person most likely to facilitate linkage between client and community resources (i.e., to bring together a person needing a service and a provider of that service). To carry out the broker role, the social worker identifies clients’ needs, assesses their motivation and capacity to use various resources, and helps them gain access to the most appropriate resources.
As a broker of human services, the social worker must be knowledgeable about the various services and programs available, maintain an up-to-date assessment of each one’s strengths and limitations, and understand the procedures for accessing those resources. These resources may include social provisions (e.g., money, food, clothing, and housing) and/or social services (e.g., counseling, therapy, group interaction experiences, and rehabilitative services).
Functions Client Situation Assessment. The first step in brokering is to understand thoroughly and accurately the needs and abilities of the client or clients. An effective broker should be skilled at assessing such factors as the client’s vulnerability, culture, resources, verbal ability, emotional stability, intelligence, and commitment to change.
Resource Assessment. The social worker must assess the various resources available to meet client needs. For his or her own agency, as well as for other community agencies, the social worker must be familiar with what is offered, the quality of staff, the general eligibility requirements, and the costs of those services. Additionally, the social worker must know the best way to help clients gain access to those resources.
Referral. The process of connecting the client to a resource requires that the social worker make a judgment regarding the motivation and ability of the client to follow through and the likelihood that the resource will accept the client for service. Depending on these judgments, the social worker will be more or less active in the referral process. A proper referral also entails a follow-up activity wherein the worker checks to assure the client-resource connection is working to meet the client’s needs. If there has been a breakdown, further service may be warranted.
Service System Linkage. Brokering requires that the social worker facilitate continuing interaction between various segments of the service delivery system. To strengthen the linkage among agencies, programs, and professionals, the social worker may engage in networking to establish communication channels, negotiating resource sharing, and/or participating in interagency planning, information exchange, and coordination activities.
Information Giving. Brokering often requires the transmittal of information to clients, community groups, and legislators or other community decision makers. As a repository of knowledge about the service delivery system, the social worker helps others by sharing this knowledge. Also, the social worker may make the general public aware of gaps between available services and needs.
The Social Worker as Advocate
Purpose. To assist clients in upholding their rights to receive resources and services or to actively support causes intended to change programs and policies that have a negative effect on individual clients or client groups.
Description. At the heart of social work is advocacy. This role is fundamental to social work’s mission and is clearly embodied in the Code ofEthics (NASW 1996). For example, Section 3.07 of the Code calls for social workers to advocate “within and outside their agencies for adequate resources to meet clients’ needs” and to assure that the resource allocation procedures are open and fair for all clients (p. 20).At the macro level, Section 6.04 indicates that social workers are expected to “advocate for changes in policy and legislation to improve social conditions in order to meet human needs and promote social justice” (p. 27). Mickelson (1995) defines social work advocacy as “the act of directly representing, defending, intervening, Supporting, or recommending a course of action on behalf of one or more individuals, groups, or communities with the goal of securing or retaining social justice” (p. 95). Social workers must balance their methods of advocacy with the principles of maximizing client self-determination and client participation in the change process. To the extent possible, advocacy should take the form of assisting clients to be their own advocates.
Needless to say, advocacy is not usually popular within one’s own agency or with the community service system. Nevertheless, advocacy is a necessary function performed by social workers. What is right is not always popular. The social worker should be prepared for negative responses to advocacy activities.
interviews or in more structured educational activities such as presentations and workshops. The teaching method selected is based on an assessment of the readiness and ability of the clients to learn.
The teaching role also has a macro-level application. Social workers should be prepared to engage in activities that educate the public about the availability and quality of needed human services and the adequacy of social policies and programs for meeting client needs. This public education activity lays the foundation for the social worker’s efforts as a change agent.
Functions Teach Social and Daily Living Skills. Teaching skills in conflict resolution, money management, use of public transportation, adjusting to new living arrangements, personal care and hygiene, and effective communication are examples of activities regularly engaged in by some social workers.
Facilitate Behavior Change. The social worker may use intervention approaches such as role modeling, values clarification, and behavior modification in teaching clients more effective interpersonal behaviors. When dealing with larger social systems, the social worker may, for example, educate a board of directors about an emerging social issue or teach a client advocacy group how to redesign a change strategy that is failing.
Primary Prevention. Throughout its history, the social work profession has been mostly concerned with addressing and modifying serious human problems and conditions. In recent years, social workers have given greater attention to primary prevention (i.e., preventing the development of problems). Many such prevention efforts place the social worker in the role of a teacher or even a public educator. Examples include such activities as providing premarital counseling, teaching parenting skills, offering information on family planning, and informing the public of ways to address a social problem or issue.
The Social Worker as Counselor/Clinician
Purpose. To help clients improve their social functioning by helping them better understand their feelings, modify their behaviors, and learn to cope with problematic situations.
Description. Perhaps the most visible and frequently performed social work role is that of counselor or clinician. According to the National Association of Social Workers (1984):
Clinical social work shares with all social work practice the goal of enhancement and maintenance of psychosocial functioning of individuals, families, and small groups. Clinical social work practice is the professional application of social work theory and methods to the treatment and prevention of psychosocial dysfunction, disability, or impairment, including emotional and mental disorders Clinical social work includes interventions directed to interpersonal interactions, intrapsychic dynamics, and life- support and management issues. (p. 4)
In order to perform this role, the social worker needs a knowledge of human behavior and an understanding of how the social environment impacts on people, an ability to assess client needs and functioning and to make judgments about what interventions can help clients deal with these stresses, skill in applying intervention techniques, and the ability to guide clients through the change process.
Functions Psychosocial Assessment and Diagnosis. The clients’ situations must be thoroughly understood and their motivation, capacities, and opportunities for change assessed. This involves selecting conceptual frameworks to organize the information in ways that promote an understanding of both the client and the social environment in order to produce a workable action plan. The labeling and categorizing process inherent in diagnosis is necessary in some settings for purposes of interprofessional communication, research, program planning, and obtaining payment for services provided.
Ongoing Stabilizing Care. The counselor/clinician role does not always involve efforts to change the client or social situation. Sometimes it consists of providing support or care on an extended basis. For example counseling people who are severely disabled or terminally ill—or working with their families—may involve efforts to increase their choices and help them to more comfortably deal with difficult but unchangeable situations or conditions.
Social Treatment. This function involves such activities as helping clients understand the relationships among relevant persons and social groups supporting client efforts to modify social relationships, engaging clients in the problemsolving or interpersonal change efforts, and mediating differences or conflicts between individuals and/or between individuals and social institutions. ittaker and Tracy (1989 9) define social treatment as “interpersonal helping that utilizes direct and indirect strategies to aid individuals, families and small groups in improving social functioning and coping with social problems.” Direct strategies might include face-to-face meetings with the client, whereas indirect strategies often involve helping the client negotiate the human services system by using such tools as advocacy, referral, and the provision of concrete services.
Practice Evaluation. At the direct-Service level, practice evaluation takes two forms. First, the social worker examines his or her own performance to assess the effectiveness of the interventions utilized. In this way, the social worker can be accountable to clients, the employing agency, the general public, and the profession. Second, the social worker
- Obtaining access to services for clients who may “fall through the cracks” of a categorical service delivery system, or for clients who may not fit into existing categories because of multiple problems. (p. 16)
Modern case management practice strives to establish for the client wrap-around services—a package of services selected or created to address the client’s unique Situation and often paid for with funds drawn from several sources. This is in contrast to an expectation that the client’s concerns and situation will fit a preexisting service or funding category. When funds are earmarked for only one type of service, the ability to creatively address the client’s concerns is severely limited.
Functions. Drawing on the work of Rothman (1992), Rose (1992), and Moxley (1989), several core functions of case managers can be identified.
Client Identification and Orientation. This involves directly identifying and selecting those individuals for whom service outcomes, quality of life, or the cost of care and service could be positively affected by case management.
Client Assessment. This function refers to gathering information and formulating an assessment of the client’s needs, life situation, and resources. It may also involve reaching out to potential clients who have not requested services.
Service/Treatment Planning. In concert with the clients and other relevant actors, the social worker identifies the various services that can be accessed to meet client needs. Bertsche and Horejsi (1980, 96) describe these tasks as the work necessary to “assemble and guide group discussions and decision-making sessions among relevant professionals and program representatives, the client and his or her family, and significant others to formulate goals and design an integrated intervention plan.”
Linkage and Service Coordination. As in the broker role, the ease manager must connect clients with the appropriate resources. The case manager role differs, however, in that the social worker remains an active participant in the delivery of services to the individual or family. The case manager places emphasis on coordinating the clients’ use of resources by becoming a channel and a focal point for inter-agency communication.
Followup and Monitoring Service Delivery. The case manager makes regular and frequent follow-up contacts with both the client and the service provider to ensure that
the needed services are actually received and properly utilized by the client. If not, action is taken to correct the situation or modify the service plan. Typically, it is the case manager that completes the necessary paperwork to document client progress, service delivery, and adherence to the plan.
Client Support. During the time the services are being provided by the various resources, the case manager assists the client and his or her family as they confront the inevitable problems in obtaining the desired services. This activity includes resolving personality conflicts, counseling, providing information, giving emotional support, and, when appropriate, advocating on behalf of clients to assure that they receive the services to which they are entitled.
The Social Worker as Social Change Agent
Purpose. To participate in the identification of community problems and/or areas where the quality of life can be enhanced, and to mobilize interest groups to advocate for change or new resources.
Description. Social work’s dual focus on both the person and environment requires that the social worker facilitate needed change in neighborhoods, communities, or larger social systems. The role of social change agent has been a part of social work since its beginnings. Its inclusion in the social worker’s repertoire of practice roles distinguishes social work from the many other helping professions.
When working directly with clients, social workers are in an excellent position to recognize conditions that are contributing to people’s distress and the need for human services. The social worker must take responsibility for assuring that resources are available to meet those needs and/or stimulating action by others to address those problems. Social change typically does not occur rapidly or easily, and the authority to make the political decisions to achieve change is rarely held by social workers. Rather, change requires skill in stimulating action by influential groups and decision-making bodies that have the power to address the problems.
Functions Social Problem orPolicy Analysis. A first requirement for social change is to under- stand the nature of the problem. Trends must be analyzed, data collected and synthesized, and findings reported in ways that are understandable to decision makers. Without this
Functions Self-Assessment. The autonomy required for professional decision making carries with it the responsibility for ongoing self-assessment. In their national task analysis of social work practice, Teare and Sheafor (1995) found that social workers serving virtually every type of client, working in virtually every type of human services organization (including private practice), and performing virtually every social work role devote a substantial amount of effort to self-assessment and their own professional development based on that assessment.
Personal/Professional Development. The corollary to self-assessment is further developing one’s abilities and addressing any performance problems that have been identified. In their job-analysis study, Teare and Sheafor (1995) found that most social workers regularly read articles in professional and scientific journals, news- papers, and magazines related to their job responsibilities; seek critique of their practice from colleagues; and periodically attend workshops, seminars, and other programs intended to improve their job knowledge and skills for practice.
Enhancement of the Social Work Profession. Social workers should contribute to the growth and development of the profession and the expansion of its knowledge base. Maintaining membership in the National Association of Social Workers and contributing time and energy to the efforts of NASW to strengthen the quality of professional practice and support legislative initiatives are obligations of each social worker. In addition, social workers should contribute knowledge gained from their practice or research to colleagues through presentations at conferences and by contributing to the professional literature.
