Examining The Theories For Effective Practice
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My choice to apply these two theories to the case scenario of Ms Joanna is based on the structure of these methods. Payne (2005, p 97) cites that Both crisis intervention and task-centred practice reflect a contemporary trend towards brief, focused and structured theories that deal with immediate, practical problems". Because of the recent diagnosis of breast cancer, Joanna is faced with some difficult decisions concerning her sons future. She wants to be sure that she would make the best decision available. Therefore task-centred approach would be the best way for her to achieving this and any other problems that might arise during the exploration process.
Task-centred approach tends to be very structured and person-centred and it can be oriented to ease the most pressing problems. Task-centred practice has been developed within SW itself and tested in a wide variety of circumstances. The procedural aspect of task-centred practice has clearly been shaped by community care policy and care management. Time-limits, plan and contract based are key features of care management practice (Ford and Postle, 2000).
The method is informed by a theoretical framework, which includes elements of systems theory, ego psychology, behaviourism, and empowerment theory. Hence the precise form it may take will be influenced by one or more of these theoretical traditions. Task-centred practice draws heavily from other problem solving methodology such as positive reframing from family therapy (Payne, 1997) and is in direct contrast to the more paternalistic professional practice traditionally employed. The values of self-determination and empowerment are central, as the service user, in this case Joanna, is seen as the best authority on her problems. Task-centred work fits closely with concepts of partnership and participation, in that Joanna should be fully informed and as fully involved as possible through out this process. 'Its principle stance on open, collaborative and accountable practice is clearly compatible with the values of AOP (Doel and Marsh, 1992).
Ford and Postle (2000, p 53) 'the approach is focused on problem-solving, and is short-term and time-limited'. The principle aim of task-centred work is to resolve problems presented by the service user. Hence the starting point of this practice is the problem. Task-centred practice is characterised by mutual clarity and therefore should only be carried out under the following three conditions. The service user must acknowledge the problem and be willing to work on it, they should be in a position to take action to reduce the problem and the problem must be specific and limited in nature. In this scenario Joanna has presented herself to the social worker, she has asked for help in decision making.
Firstly the SW has to identify the main components and problems. For the SW this would be a task which would need careful consideration, planning and analysis.
The recent diagnosis of an advanced breast cancer requires Joanna to explore different options for planning her sons future. Therefore the initial phase of task-centred practice is problem exploration. During this phrase key problems are identified, and then prioritised. There should be a maximum of three problems where the SW would be working on with Joanna. Too 'many selected problems will probably lead to confusion and dissipated effort' Doel and Marsh (1992, p 31).
Having identified the problem(s) the SW would then find out what Joanna wants are. Once the basis for work is established, the SW and Joanna precede in a series of incremental steps towards the goal(s). According to Doel and Marsh (1992) 'the journey from agreeing the objective to achieving it is measured in small steps called tasks. These are put into place by Joanna and the SW. As a result this would help Joanna in achieving her objective and the alleviation of the problem.
Methods or techniques for achieving the task(s) should be negotiated with Joanna. Task-centred practice is designed to enhance the problem solving skills of participants. Therefore it is important that tasks undertaken by clients involve elements of decision making and self-direction.
The task-centred approach would enable fast and effective support to Joanna. 'The time-limit is a brief statement about the likely length of time needed to reach the goal' Doel & Marsh (1992, p 51). A time limit is important for a number of reasons. 'It guards against drift, allows time for a review and encourages accountability. It also acts as an indicator of progress (Adams, Dominelli and Payne, 2002). The task stage is made up of a series of developments and reviews. The execution of reviews is important as it allows for an assessment of the success of the steps taken. The ending of the process of task-centred work will have been anticipated at the initial phrase. The concluding session should include a review of the work that has been accomplished by Joanna in order to alleviate the target problem.
The main advantage of the task-centred practice are that it does not mean simply assigning tasks but it is a very well researched, feasible, and cost-effective method of working. The source of the problem is not presumed to reside in only the service-user. Attention is paid to external factors such as welfare rights and housing, and where there is scope to supply 'power' it is taken in the form of information and knowledge giving. It also addresses the strengths of people and their networks. Task-centred attempts to put worker and client on the same level Coulshed &Orme (1998, p 123).
Althought the advantages to task-centred practice can be easily identified, the disadvantages and drawbacks are not as easy, as they are based on research. Therefore, it is not only looking at the approach widely and hypothesising disadvantages, but putting the approach into practice and gathering relevant information to analyse any negative conclusions. Some of these disadvantages would be that underlying problems requiring longer term approaches may go unnoticed, it requires sustained efforts from service user who may sometimes be unable to do this due to physical or emotional strengths. Clients may be overwhelmed by problems and unable to deal with them in a structured way. However the SW would still have a positive gain by improving their capacity for clearer thinking and forward planning, which in turn brings on successful intervention Coulshed & Orme (1998, p 119).
Moving on to Crisis intervention, which can be quite diverse with the models that uses. Payne (199, p 101) states that 'crisis intervention uses elements of ego-psychology from psychodynamic perspective. It focuses on the service-users emotional responses or reactions to external events and how to control them. Strategies of crisis intervention are based on psychological theory However, these are adapted and modified to fit the demands of the crisis situation.
Crisis is a universal concept which affects people from all cultures. James and Gilliland define a crisis as 'a perception or experiencing of an event or situation as an intolerable difficulty that exceeds the persons current resources and coping mechanisms (2001, p 3). People in crisis situations may overlook or ignore important details and distinctions that occur in their environment and might have trouble relating ideas, events, and actions in a logical way.
Crisis intervention, therefore, is an action plan to help people cope with immediate acute stressful demands. Hence, as crisis intervention focuses on resolving immediate problems and emotional conflicts through a minimum number of contacts. The first stage would be to enable the service-user to make sense of what has happened to them and to begin to feel in control. Drawing on Joannas situation, one can easily see that this type of approach would benefit her in many ways. Joannas cancer is advanced and the life-time left may not be very long. She is aware of her health situation and would need help with her emotional situation as well as Jacobs.
Joanna sees herself in a state of emotional disequilibrium and is struggling to adjust and find a new sense of balance of all her problems, her emotional situation might seem insuperable at the time. Joana does not feel in control of her life anymore but still is trying to manage.
Crisis intervention, intervenes when people have reached a situation in their lives they can no longer cope with. Thompson (2005, p 69) describes it as a 'turning point in peoples lives which creates a lot of energy that can be used positively to tackle problems, resolve difficulties and move beyond previous barriers to progress. This would empower and help Joanna to identify her major problems and find better coping mechanisms. By providing support such as home visits this would help with the breakdown of care for her son and family as well as offer Joanna time for herself to come to terms with her illness.
The methods I would use are the Roberts (1995, p 18) seven stage model. The first stage would be by assessing lethality. Although Joanna presented herself to the SW she might not be the only person most at risk: it might be that Jacob is facing emotional reaction that can even lead to self harm. Therefore the SW should plan and conduct a crisis assessment as well as lethality measures. 'James and Gilliland emphasise that assessment should be a constant part of crisis intervention, because of rapidly changing emotions Payne (2005, p 105).
The second stage of this model would be establishing a rapport and effective communication skills. This can be easily achieved by genuinely respecting and accepting Joanna and her family and sometimes reassuring that behaviour is not unreasonable or unexpected, this may help to achieve the rapport building.
In the third stage the SW has to Identify what Joanna sees as her major problems. 'Myers (2001) distinction between affective, cognitive and behavioural aspects of the reaction to the crisis are also relevant here (Payne, 2005: 107). In the fourth stage the social worker would be actively working on Joannas feelings and emotions, as when dealing with an immediate problem, it can be easy to miss out or avoid to focus on feelings. The fifth stage involves looking at the past coping mechanisms. In Joanas situation, the death of her partner can be seen as a success. 'Success should be highlighted and reinforced Payne (2005, p 108).
In stage six Joana would be working with her SW to understand why the crisis situation was so distressing. Finding a way to manage the situation and formulating an action plan that works for her, so that she can reach her goals and would feel empowered. In the final stage the SW has to make sure that Joanna would feel able to return if further problems arise and establish an action plan for Joanna and family, to help them indentify likely stressful points in the future.
During this process, the SW should remain self aware of own biases and vulnerabilities and recognize how these could have an impact on her own judgment and actions. Payne, (1996, p 43) quotes that 'the term intervention is oppressive. It indicates the moral and political authority of the social worker to invade the social territories of service users. Even though Joanna presented herself for help, she could still see this intervention as being intrusive; this may oppress her and make her feel powerless. She has had the main role of the parent and house keeper in the family and may feel that these have been taken away from her.
Joanna may feel detached from her family and internalize the problem, and may not focus on the situation; instead she may focus on the intrusion. So the SW may not get a true picture of her feelings and may interpret things wrongly and make assumptions. Crisis intervention can be seen as oppressive at times as it demands quick answers in a short time frame. Therefore not taking into consideration different culture background which may see this as questioning and make them feel discriminated against.
In conclusion both try to improve peoples capacity to deal with life problems. Crisis intervention uses practical tasks to help people readjust; they place great importance in the emotional response to the crises and the chances of peoples capacity to manage their everyday problems in the future. Task-centred work focuses on performances in practical tasks which will resolve particular problems. Success in achieving tasks helps emotional problems. Crisis intervention has a theory of origin of life difficulties. Task-centred work takes problems as given, to be resolved pragmatically. Payne (2005)
In summary, I have discussed task-centred and crisis intervention approaches and identified that despite their different origins and differing emphasis, both these approaches have a role to play in promoting the anti-oppressive approach in SW practice by restoring as much control as possible and validating and celebrating strengths. They both reject the long term intervention of psychodynamic work which makes the service-user more dependent on the worker. Both theories promote the time limited and more focused way of working with service-users. Although the approaches have limitations, they provide frameworks for SW to engage with the service-users in the most effective way.
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