Social Work Intervention: A Guide to Diagnosis and Family Therapy

Posted on Sep 16, 2024 in Other subjects

Main Elements of Diagnosis: The Person, the Institution, and Demand

The Person

A social worker should be aware of the psychological and social aspects necessary to analyze, mainly related to ability, behavior, life events, and motivation. Do not fall into the fallacy of complete knowledge of the individual. In developing a diagnosis, there is no such approach to a reality as complex as a person. The practitioner has to extrapolate this dynamic reality and adapt to the specific situation of change. In the diagnosis, look for motives, causes, and factors that increase or mitigate the imbalance. The needs and unresolved problems are due to diagrams and patterns of inappropriate behavior, which shape the user’s personality, a descendant of their genetic material and experiences. The social worker should read the user’s personality, looking at the structure and operation, constantly shaping reality.

The person will be embedded in a peculiar social context, which will provide privileges and responsibilities but, in turn, can narrow or coerce their development, leading to a crisis or disequilibrium, which is called social maladjustment. The practitioner will consider the nature of the user’s maladjusted situation, trying to clarify the reasons for and solutions to it.

The Institution

The institution will be the agency responsible for providing adequate support necessary for personal development and achieving the resolution of the demand raised. This entity (public or private) shall be governed by a set of rules and different financial constraints. Intervention factors are previously established by the agencies and authorities, the people that will determine which services are to be provided, who will run them, and under what conditions. The institution will be the main tool for distributing services, designed to promote and ensure the population’s welfare.

It will consist of a specific organization, establishing the order and disposition of the staff at the agency. For the social worker to be qualified in their practice, they must know and respect the structural policy of the institution where they work, but in turn, should not override their criticality and professionalism. This organizational disposition should be clearly indicated in the procedures to be followed by every member of the institution; this work will be systematized and a differential characteristic indicative of the social work activity of the institution. Another feature is that the institution is governed by rules and laws but changes with the constant evolution and development of social needs, where the figure of the social worker is the critical link and the connecting piece between user demand and services provided by the institution.

Demand: The Problem in Itself

The person, like any living organism, needs to see a range of needs covered to survive and adapt to their environment. Necessary means “lack of something.” This gap will have a motivational profile because the lack of that something will mobilize a response from the user, who will try to resolve it. Usually, the person is capable of solving their needs (of any kind). When they cannot eliminate a gap or when resources are not enough, we turn to a professional, in our case, the social worker.

It is important for the practitioner to define the demand precisely because a good and proper intervention will depend on it. As professionals, we should clarify the priorities, what to treat first and what aspects later. Establish a methodology of intervention that would be marked as a professional social worker. The choice of focus of the problem will be marked by three important factors: what the user wants and needs, what the social worker considers possible solutions, and what the institution can provide. The ultimate goal of social work with cases will be to meet the needs, giving the person back to a balanced position, satisfaction, and consensus, avoiding discomfort and discontent.

At the time of making the definition of demand, the professional should be aware that the problems, among others):

  • Are peculiar and unique to each person.
  • They have a cascading effect. Some impact on others and vice versa.
  • Have an objective, explicit in the application.
  • They also have a subjective character, which refers to the interpretation of the subject.
  • Every problem has a solution, and every solution depends on each user.
  • They evoke a sense of imbalance and loss of homeostasis.
  • This involves a motivation to change.

Initial Interview: Start the Process Diagnosis

The initial interview is the first contact with the user, and it is important to develop nuances for intervention. In the initial interview, we will not only explain the problem and try to mobilize resources but also seek the involvement and active participation of the user. The claim of this initial phase is understanding the problem and establishing a relationship or agreement that allows us to work in the future with a more complex design. It will be helpful to try to create a climate of trust and warmth. It works with two things: the beginning of the analysis of the situation and the preparation of a proper interpersonal relationship.

At the beginning of the first encounter, the user’s behavior can be quite peculiar (anxious, nervous, quiet, locked, aggressive, angry…), so the social worker should be cautious when setting assumptions and conclusions. Apart from the initial user behavior, you should consider another important phenomenon: the induction of demand. Usually, the demand is not expressed properly. The user, either because of the crisis or anxiety provoked by the intervention, will not raise the issue properly. For shame/distrust, the person does not expose the whole truth and tells everything you need for a proper diagnosis. It is, therefore, an initial moment of confusion and chaos, where the social worker should provide an accurate analysis and assessment of the situation, i.e., a social diagnosis.

Diagnostic Application of User: Synthesis, Interpretation, and Evaluation of Data. Contents of Diagnosis: Significance of the Problem, Causes, Means, and Solution

Paragraphs of diagnosis could be classified into four main topics: one referring to the person, another demand/need/problem, the following institutional resources available, and finally, the referral to the community. These, in turn, fall into two paragraphs, which is in itself a diagnosis:

  1. Study of social reality.
  2. Forecasting intervention.

2. Data Demand-User Needs

During your visit, the user poses a need or problem, which may or may not correspond with demand. It should delineate the specific user demand and the needs that underlie it. This should deepen the knowledge of:

  • Need-problem.
  • Schedule of need.
  • Cause-effect relationship.
  • History solutions.
  • Expectations of solution.
  • Reasons why you come to the institution.

3. Available Institutional Resources

  • List of available resources.
  • Analysis of the requirements.
  • Frequency.
  • Institutional coordination.

Diagnostic Application of the Family: Analysis of the Family

The family is an element of the first magnitude in the social reality of the user. The practitioner must keep it always in mind but really focus on intervention with the person individually. The social worker will try to facilitate family relationships. An important requirement will be to know and study the family members through successive interviews, although the claim has been made by only one of its members. In the initial diagnosis and family study must necessarily include the following sections:

  1. The family structure. Description of the components that make up the family and its features, specification of roles…
  2. Family Interactions. How members interact to meet the needs of each.
  3. Functions of the family. Activities undertaken by members and their purpose within the family system.
  4. Cycle in which the family is. Spouses, school youth with young children, an elderly couple who lives alone in their home…
  5. Integration outside the house. Consideration of informal networks that impact the family system.

Through subsequent interviews, the social worker will collect all this material. During the first interviews, the practitioner should pay special attention to creating a proper working environment, specifying objectives to guide the intervention, and demarcating roles and functions that the members and the professional will take. During the initial intervention, it is important to analyze the needs of family members, skills, and potential support and resources.

The Family as an Open System

1. Conceptualization

The family is the basic coexistence of the individual. This nucleus could lead to the user a context of:

  • Reference and membership. The feeling of belonging is an indication of our own social nature.
  • Security. Because it allows the user to cover a range of basic emotional needs, economic, psychological and social, among others.
  • Development. This section is added the notion of family life cycle, in constant evolution and change because it passes through different stages:
    • The formation of a steady partner, defining the new context of marriage.
    • He follows the family with children: the system becomes more complex because the rules are changed.
    • Then the family with adolescents: preparing for the gradual disengagement of the children.
    • The family trampoline. It again redefining the roles of the family.
    • The family in later life: are obstacles to overcome (illness, retirement, and death).

Every part of this cycle will have its own needs and difficulties. The social worker must discuss the situation in which there is the family system so you can better understand their structure, their alliances, and their interaction.

  • Training. The family will give the person an education, not only as a teaching duty but as a complicated process that requires years of learning. This is the learning of behavior patterns, roles, values, ways of thinking, ethical and moral principles… This learning facilitates adaptation, which involves the formation of personality. Will be precisely in the family where all this material to develop adaptive.

As professionals, it is essential to know the whys of a problematic situation, and in many cases, they are in the analysis of the family. Faced with a crisis situation, the family can influence directly or indirectly. The straight is formed when the family itself is the main problem. The indirect family develops when the user has provided maladaptive behavior patterns, as a family inheritance (e.g., cases of alcoholism). The family also could be considered an active and dynamic communication mechanism. The person who found a space to express their individuality. Depending on the degree of family involvement, this expression will be higher or lower. Analyze the structure and ways of interacting is another objective of the social worker. The crisis and family conflict can result from deficient family communication.

2. Evolution of the Psychodynamic Perspective to the Systemic

Both perspectives are an interesting reference in family therapy. Although there are differences between these two perspectives (It is quite clear the influence of psychoanalysis, that has prevailed in the first stage of social work. But with the heyday of the systemic model is a change of direction. The systemic approach will mark a new direction work of primarily circular causality, i.e., the feedback from each of the constituent parts of the system. Some parts will influence others, and these, in turn, by these. They will be in constant contact and influence. In short, we study the family as an open, dynamic, and constantly changing business.

3. Unit of Analysis

For family diagnosis should focus the study on the following aspects which are called units of analysis. These units will allow establishing working hypotheses to guide the intervention.

  • Perceptions. By analyzing how perceptions are perceived each other, how they intertwine and coexist these systems, and how they influence family dynamics.
  • Feelings. These may be adaptive and facilitate the balance or otherwise be counterproductive and disrupt the family structure. It should ask family members how they feel at home, how they interrelate, and how they live coexistence. This will have the satisfaction index of the family and find out what the most troubled members are.
  • Stocks. Irrefutable proof for establishing the family structure relationships. The facts speak for themselves. It is here that the observation will be crucial.
  • Partnerships. The ties often reflect affinities and interests. Be aware of the reason for the alliance is as important as knowing among whom are established.

This brief dialogue could be established and the initial findings of work. For development should consider the following elements within the systemic concept of intervention:

  • The hipotetización. Would be the initial explanations or reasons to contrast with reality. Your order will be the explanation of why and a wherefore. The hypothesis is circular, nonlinear functional. In a system has functionality any explanation. This is not the guilt of the members is what to investigate.
  • The circularity. All members influence each other and integrate their linkages, constantly interacting, dynamically changing communication.
  • The neutrality. The family relationships are often not neutral. In response to a particular time or location, partnerships are created or modified.