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"Assessment is the foundation of the social work process with service users" (Walker and Beckett, 2003:6). Why is assessment a crucial aspect of the social work process and what makes an effective social work assessment? What might be some of the barriers to an affective assessment and how can the worker overcome these? In your answer, you will be expected to refer to relevant research regarding social work assessment.
Social workers are expected to carry out an initial assessment of situations they encounter before taking action. These are important because they provide the foundation for any plans to support, protect, manage or provide aid for a client. In a nutshell, an assessment is simply gathering information about people, their situation, factors deemed relative to that situation, and integrating this into a formal report, which will be used to look back on when carrying out a review. This will not only provide a helpful way for the social worker to quickly reacquaint themselves when looking back on a family, but it will also allow other work staff to get a gist of the situation if they are coming into it for the first time.
For an effective assessment it takes someone with an organised, rational and open minded knowledge base, using these to compliment a number of unique skills they will hold, enabling them to come to grasps with the varied number of situations they will face and an ability to be sensitive to those involved.
It is expected of social work graduates to understand all the legal documentations issued by work bodies (such as the Department of Health), for these will include necessary guidelines on assessment and how and when to act. However, simply knowing these will not cut it, and those who are inexperienced will simply be able to regurgitate back what they have learnt without knowing the true art of carrying out their work.
An assessment is more than simply making notes on ones observations, for it includes the worker's opinions, beliefs and ideas, which will be essential when carrying out interventions. They are not to be confused with evaluations, although they do contain evaluative sectors, for example determining a client's needs. Unlike evaluations however, assessments are open to more probing and study, which make them more effective tools for making a decision.
For the social worker to be able to make their assessment successful, they will need to ensure they can fully appreciate a) all factors that affect the client and b) which of the client's needs are not being met. To do this they will need to establish the type of person their client is, for example how they communicate with others, how they react to stress, how they deal with problems etc.
It is important for the social worker to know which bits of information are relevant, and rather than find out everything they can (scatter gun method) they pick out those bits which will serve to help them later. If they ask too many questions it will lead to general misinterpretations, often a common mistake in those just starting social work practice.
One must understand that views will be different, and that other work forces, agencies or even individuals will draw out their own conclusions for a case. This makes it difficult to assume any kind of truth in an assessment, since "what one sees depends on where one looks". (Jones 1983)
Another problem assessor's face is that there is often the case of clients scapegoating or stigmatising based on a negative assessment. Social workers are aware that they are held accountable for any action they make, and so if they make an error in the assessment that could prove costly to a families support, then they may be faced with court proceedings.
In actuality, assessments are by no means a quick process. It is often the case that work staff are met with the stress of having to cope with busy offices, numerous phone calls and masses of paper work. Stress can affect workers in any number of ways, but the biggest concern is that it can lead to negligence such as making quick, inaccurate assessments because there is no time to meet the demands of the office.
There is, however, a way of preventing these difficulties and that is to employ a method referred to as triangulation. This is done by drawing comparisons from other groups to find similarities between information gathered. In addition to this, it may prove helpful to discuss the assessment with clients themselves, for this will not only improve the accuracy of the assessment but will also create a sense of trust and warmth between client and worker.
In spite of triangulation mistakes are still inevitable. Possibly the most common mistake would be to apply a one sided attitude towards people and/or situations. An example would be of a social worker looking at an argumentative couple; seeing things only from either the controlling wife point of view, or the unfaithful husband point of view. For this reason it is essential for the social worker to bring in other colleagues so as to form a multidisciplinary assessment. Rather than relying on one man's opinion, by working as a team, members may gain further insight into the task at hand and observations may be brought to the table that otherwise would have gone unnoticed. However, the use of multiple assessments is problematic in that the social worker will have to deal with multiple theories. This may lead to conflicts and confusions over the correct path to follow.
Because of the time constraints on social work practice, alternative methods have been introduced to take away some of the pressures. Self assessments for example are often carried out when dealing with younger children. It is seen as a fun learning experience and will tell staff workers much about that child. Self assessments will compose of numerous exercises, such as multiple choice questionnaires, rating scales, producing stories, drawings of themselves, and/or their families. Adults often prefer this method as it allows them to use their own words rather than being misinterpreted.
Another alternative is computer aided assessments. These have long been used in other fields such as medicine in order to make quick diagnoses. They are helpful in that they save time, and unlike humans do not forget or make errors. It is as simple as loading in all the variables, and allowing the computer to calculate the most likely outcome and therefore the best form of action. However, computers are unable to process social, emotional, or psychological factors and so can often fail to spot key issues. The use of computers is therefore limited.
Recently, there have been movements in practice theory, the most important of which is a larger emphasis on the influences of powerlessness, prejudicial views, discriminatory acts and oppression. In addition, workers are starting to develop a more constructionist way of thinking. This includes seeing beliefs and ideas not as relying on the influence of the environment around those who hold said beliefs and ideas, rather them being "constructed" by individual people whilst they converse and respond to one another's presence.
It is this constructionist way of thinking where many theories on assessment begin.
In the past 3 years it was found, through reviews from service users, that many were unsatisfied with the assessment process. One rising concern was that a large number of social workers were failing to conduct reassessments. It seems that they only look at certain information in order to confirm their theories and therefore neglect many important items. This is a critical point because assessments are the basis for all further work. An error here would be damaging for the whole investigation.
Even when a reassessment is made, there still remains the problem of prioritising key areas of importance. If this is done shoddily then there is risk of the assessment giving off misrepresentations when conducting an evaluation. To prevent this, there are three areas that it is suggested the social worker start by looking at. These are:
"Starting where the client is", focussing on meeting the client's needs; "legal considerations", which should be made known to the client; and "health or safety concerns", for if there are any risks to the client then they must be informed. (Hepworth and Dean 2006)
Another important issue relates to the production of a culturally competent assessment. The social worker must therefore demonstrate knowledge of "cultural norms, acculturation, and language differences, the ability to differentiate between individual and culturally linked attributes, the initiative to seek out needed information so that evaluations are not biased and services are culturally appropriate; and an understanding of the ways that cultural differences may reveal themselves in the assessment process." (Hepworth and Dean 2006)
There are numerous differences between cultures when it comes to forms of, for example; disciplining younger family members, selecting the most dominant group member, aiding those unable to manage for themselves, how to address one another, and many others. And because of these differences, the social worker must be wary when considering things such as; what is seen as normal behaviour in children with autism? What is seen as a healthy amount of sex in afro Caribbean tribe members? At what age is a child believed to reach maturity in China, Africa, Asia etc? The list is endless. Patterns of behaviour which may appear dysfunctional in one culture may be considered normal to another. It is important that social workers have knowledge of their client's background and if not then research it. For an error made may aggravate or offend them.
It can be hard to define exactly what an assessment is, who it is intended for, and the reason it needs to be carried out. Pincus and Minaham (1973) therefore developed a model framework with the specific aim being to help social workers recognise; the reasons for their involvement, the expected goals and outcomes, which persons fit the role of agent and which fit the role of client, what needs to be maintained and what needs to be managed.
"Pincus and Minaham labelled three kinds of resource system which people will have contact with during their lives and four mapping systems which summarise what is occurring".
The advantages of a systems approach are many. Firstly, it helps the social worker to understand a situation in such a way it gives clear definitions of those involved and how they are linked to one another. Secondly, aims and goals are clearly established early on, which helps them create a formal plan with their client and also helps both parties follow any progress made. Thirdly, it removes some of the burden of work off of the social worker's back, knowing that not everything depends on their selves. It also helps them to see which areas may take the most work, and which may be met with more conflict. This will help them plan their time and resources irrespectively, know when and where they should be, and how much of their attention is required at any time. By doing this, the social worker is less likely to exclude important responsibilities, or focus too much on only one aspect. Upon evaluation of the system, if for any reason another worker sees something they wish to add, remove or change, then this can be easily done with little time consumption. It is not unlikely that things may change at a later date, for example new clients may need to be added to the system, or new targets to be met. People's needs are not immutable and are always changing. The social worker must recognise this and be able to identify any changes, and adjust so as to fit them into the system.
There are also certain disadvantages of a systems approach. Firstly, although it helps to maintain the flow of activities, it will not provide enough understanding of a person's life without the addition of other approaches. Alone, the model is too general, and does not include a great deal of information about the relevant difficulties being assessed. Secondly, despite all its hype about ordering data, the systems approach does not maintain that data should be collected to begin with. Furthermore, it fails to recognise the importance of existing beliefs about human behaviour, so is basically starting from scratch each time. Thirdly, the natural urge to focus primarily on the client's illness, with little attention being paid on their wellness can often lower their sprits and remove their hopes of ever finding a solution to their problem.
As a social worker making an assessment, it helps to understand that, "since external problems become internal, and the internal affects the external, looking at just the social aspects will prove inadequate, just as looking at just the psychological aspects is inadequate".(Milner and O'Byrne 1998) We need to look at both, and use various approaches to complement one another.
Assessments need to draw in help from psychiatrists and psychologists, those skilled at exploring the unconscious. For it may be the case that the client has certain unresolved issues that may be of relevance. A problem workers face is that the id is like a cavern, in that it is made up of large numbers of interrelated passages. Some will affect others, while others will come to a dead end. And everything inside that cavern is hidden away from the outside world and is immune to any happenings beyond its entrance.
Applying a psychodynamic approach as it were is advantageous because it is able to explain away what appears to be irrational behaviour. As I explained, many of a person's difficulties may not be explicit and observable. Many individuals use defence mechanisms as a way of hiding their emotions. And so by combining aspects of psychology (cognitive, psychoanalytic, humanistic etc.) it will allow the worker to delve deep into their client's personality and learn more about their associations with the world around them.
This approach has imposed a caring, considering, communicative attitude amongst assessment workers and gets them to gain more of an emphatic relationship with their clients. Rather than applying a tick box assessment and using the same set of questions for each person, the worker now has a set of guideline questions allowing them to go off on a tangent basing each new question on the previous answer.
The psychodynamic approach does indeed contribute greatly to the advances in social work assessment; however it has a number of issues of concern. First and foremost, the main interest is on the individual and so social factors are often neglected or disregarded. Secondly, abnormal human behaviour or behaviour that does not fit with the norms of society is grounds for a referral. Homosexuality for example is put down to Oedipal conflicts, homosexuals are not treated as a typical male and this causes much oppression and discrimination. Furthermore, the guidelines for communication are based on a middle class Caucasian male. Although certain groups will see equal gain from this method of practice there are many from other cultures that will react differently. And so to make an effective assessment the social worker must be able to relate their skills across cultures.
Thirdly, when dealing with children, psychoanalysis may prove ineffective or even destructive. For example in cases of child abuse the sexual wants of an adult are transferred into the child's want for their parents. The child becomes the culprit and the blame is put towards the mother for being neglectful.
When it comes to the ideas of Freud, the population of workers is split, half of them opposing entirely and half of them supporting entirely. As with all other approaches, the psychodynamic approach works best when in conjunction with others.
An assessment which includes a descriptive evaluation of client behaviours will prove more effective than one without because the worker is then able to look at how those behaviours have come to be part of their client's being and why they continue to exist. Behavioural assessments see behaviours as being learned, and therefore can be unlearnt through training. All behaviours have an underlying cause; the point of the assessment is to therefore find the route of the problem and find ways to negate its effects. There are often however misinterpretations. For example, what is a negative reinforcer? (strengthening a particular behaviour by removal of something undesirable). Punishment is not a negative reinforcer although it is associated with something undesirable. But rather than extinguish the problematic behaviour, it is often the case that it causes resistance. And so the behaviour has become strengthened.
The problem is that there are no clear definitions of positive and negative reinforcers, seeing as what is considered desirable or aversive will vary between people. What may be pain to one man may be seen as a challenge to another who will welcome it. To work around this social workers must ensure they work with their client to determine what they perceive as basically good or bad. It is important the worker be consistent when making visits (reassessments), for example if they always turn up at a foster home when they get a call the child is misbehaving, yet they rarely turn up when the child is behaving reasonably they may inadvertently be making their misbehaviour more appealing.
Many behaviours, be they positive or negative, helpful or hindering, are learned during the course of life and are influenced by our life experiences. Behaviourists believe that when conducting an assessment it is important for the worker to understand where problem behaviours have come from and what reasons there are for their manifestation. Once the underlying routes have been established the worker then helps the client to unlearn those behaviours and get back on track to healthy living. An effective assessment is therefore one that considers the ABCs; the antecedents, behaviours and the consequences. Anything that causes the unwanted behaviour should be removed, whereas anything that promotes desired behaviours should be encouraged. The client should then learn to associate these positive behaviours with pleasant experiences; this way they will want to repeat them. Assessments should look at a client's history thoroughly. It is easy to miss parts out, yet everything needs to be examined for even something seemingly irrelevant may hold the key to a person's problem. Of course it is unrealistic to look at absolutely every aspect of a person's life, especially the elderly who have an extremely long history to cover. And so it has been argued that behavioural approaches lack validity and are unattainable.
This aside the behavioural approach is still useful because it provides clear definitions of; the aims, goals and the plans for intervention. Furthermore, the approach, more so than other approaches motivates the client to have a say in the overall structure of the assessment. Sheldon (1982) believes there is the advantage that it does not manipulate the data in any way so that the client can be placed in a particular category or theory. People are seen as individuals, individual factors are considered, and client perspectives are used to shape the approach.
Task centred theory makes a good starting point for new workers because it is possibly the simplest approach. Assessments can at times be overcomplicated and so it may do workers good to sometimes go back to basics and look at the most obvious action to take. Actions should depend upon one's values rather than any policy one is obligated to follow. Previous experience should be used to improve practice, even the negative ones. Difficulties are inevitable but they will only get worse if the worker continues to make the same mistakes again and again. When there is time pressure to get a job done, rather than crumble the worker should use the pressure as motivation to get things done efficiently. That way they will have to make fewer reassessments.
The first task is to determine their client's needs (what it is they want). The next step is convincing the client to accept ones help, firstly recognising they have needs and secondly wanting to do something about it. Epstein (1988) calls this the "Start up phase", as it gets the ball rolling so to speak. Next, the wants require their own assessment, to determine what should to be done to meet them, how long it will take and who should be involved. The assessment process is a time to give order to the person's needs, generally up to three of them. It would be helpful to consider not only what changes need to be made, but also what might get in the way of these and what further changes could be done to make the initial changes possible. It would also be helpful to find out how individual problems relate to one another, if at all. If they are then able to tackle the main problem, others may follow suit accordingly with little/no effort on the social workers account. A useful strategy for social workers is to get their clients to firstly write down their problems and secondly assign them a score ranging from no problem at all to highly serious. It is vital that needs are set out from the start and fully understood by both worker and client. Failure at this stage will lead to difficulties come the evaluation. When conducting an assessment on two or more people (such as two partners in a relationship) the worker would be advised to look toward the Want Sheet for support (Masson and O'Byrne 1984). This gives detailed descriptions of different wants and can be used to help service users explain what they feel. So far, no approach has come up with a solution to this problem, making the task centred approach unique. The Want Sheet can be administered to couples/groups and this way can be used to compare different ideas. Through this stage alone, it is possible for a group to resolve any issues without any need for an intervention scheme. This is most unlike other approaches, which see the social worker as an agent coming in to help the needy, an approach not unlike the medical model of mental health.
It is important when assessing individuals, not to mistake the clients as abnormal people just because their behaviour may suggest so, or because they appear difficult or un-cooperative. Doel and Marsh (1992) call this "shooting the reflective parrot" for what they are doing is making false judgements based on observation, without getting down deep to the underlying issue.
Before any interventions, it is important for any decisions to be met together, all other options have been considered, and the client is satisfied with how things are being dealt with. Once a decision is reached, there is still time for one final review. This is a useful step because at this late stage, it is still possible to change one's mind; nothing is yet set in stone. If no changes need be made, the review is still beneficial as it helps to reduce any doubts or anxieties before progression.
The task centred approach to assessment seems full proof. Reid (1978) commented that it holds particular value in situations whereby the service user is able to contribute to a moderate degree. It holds the advantage over other approaches because it considers not only the client, but their interactions with the outside world. They get a fair hearing, and communication between them and the social worker is mutual, leading towards a more accurate evaluation.
There have been arguments that giving too much leeway can leave the worker vulnerable to misinformation. More so with children, there are cases where the client is not responsible or trustworthy enough to be given a shared role in the assessment.
In conclusion, there are numerous positives and negatives of any approach to assessment. Every worker will have a preference on how they will deal with a situation; however it need be emphasised that no two situations are alike. And so workers must be able to "think on their feet" if they are to become competent social workers. Those who are open minded will reap the most success, for the key lies within managing all the different approaches, integrating them into a whole. Care should still be taken, for within the approaches lie numerous contradictions. There will always be a degree of uncertainty, but what makes the difference between good and average work, is the confidence to give an opinion, whilst at the same time welcoming the views of others.
In conclusion, why is the assessment process vital? Because it forms the foundation for understanding one's client, and gets the ball rolling when planning actions for change. It forms a record which can be referred to when evaluating said changes, and can also be used as evidence in court.
What makes an effective assessment? One which investigates all relevant factors rather than stick to anything specific, which matches with individual's aims and goals, which is centred on the tasks at hand, which draws from multidisciplinary agencies, which forms a partnership between agent and client, and which is anti oppressive or discriminatory.
What barriers do workers face? They can be time consuming, workers are under pressure to get through their work load and may be unable to spend time getting to know their client, groups who are often the target of oppression may seem uncooperative and resistant to change, and all assessments are in some part vulnerable to bias.
How can these be overcome? It is imperative that when conducting an assessment one shares thoughts and ideas with not only other workers, other agencies and welfare authorities, but also with the client themselves, thus spreading out the work load, and reducing the likelihood of any errors going unnoticed. Furthermore it helps to be self aware. This way one picks up on any fool hardy assumptions they may be making. One should not be afraid to challenge higher authorities and understand that personal values and the law will often conflict. And finally, every assessment should be instigated with care and precision, frequently asking "why" one has come to that conclusion and "what" other alternatives are there.
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