Applying a Common Conceptual Framework to the Practicum

Experience: Assessment and Intervention

 

By

 

Skye MacCuish

 

For

 

Richard  Ramsay

SOWK 479

Faculty Social Work, University of Calgary

December 13, 2002

Note: The hard copy of this paper was scanned and digitalized. Hopefully, all related errors have been corrected. Minor editing was carried out.

 

The purpose of this paper is to use the tetrahedral structure of the common conceptual social work framework to prepare a comprehensive assessment and intervention plan. The framework will be divided into four components and each component will be applied to one specific client situation from this writer’s fourth year practicum experience. The strength approach and problem solving approach will be considered as possible intervention strategies within the method component of the common conceptual model. Strengths and weaknesses of the approaches will be examined. The potential strengths and limitations and practical usage of the tetrahedral structured model within the field placement agency will also be explored.

My subject for this paper is an individual client at the Calgary Drop In Center (CDIC) where I am doing my fourth year practicum as a social work student. I will be assessing the client situation by applying the common conceptual framework for Social Work practice as developed by Richard Ramsay (Ramsay, 2001).  I have had a number of lengthy counseling sessions with the client and feel I can confidently discuss the common framework in relation to the specifics of this case.

The client I have chosen will be referred to as Don; his name has been changed for confidentiality purposes. I will begin by assessing Don holistically through the Domain of Practice portion of the assessment. The Domain of Practice component within the common whole framework refers to the one “person” element (could be an individual, a family unit or even a community group) that is interconnected with three environmental “otherness” elements. These are referred to as personal otherness, resource otherness and validator otherness (Ramsay and Karls, 1999).

The person element (P) in the Domain of Practice is used to assess Don himself. This P assessment can be approached from the person-in-environment (PIE) model. The PIE assessment tool consists of four factors: social functioning (mainly familial roles); environmental factors (like social services and other institutions that provide assistance); mental health; and physical health (Knight, 2000).

Don is a twenty-five year old white male. He is currently homeless and living at the Calgary Drop In Center Homeless Shelter. He is an employee at a low wage manual labor job. He is actually quite happy about the job and is very worried about keeping it. Don has been living in Calgary for about 3 months. He moved from Montreal to get away from negative influences. Don appears to be physically sound. He has no illness that has been disclosed and he presents as healthy. Don does not have any substance addictions though he does admit to drinking and to using marijuana on occasion. He has never come in to the counseling office under the influence.

Mentally, Don is also sound in that he does not appear to have any serious diagnosable mental illness. However, Don does present as very angry and hostile. He seems to have very poor impulse control and can be verbally very intimidating. He seems to derive much of his self-definition from his bad temper and violence. Don is fairly small in stature and this seems to have a lot to do with his verbal aggressiveness. He has a street name of Irish and makes a lot of the fact that he has the Irish temper. On the street he feels he has to maintain the role of protector of his friends and the underdog and he does this through displays of violence. He has commented that he no longer wishes to be in that role and is trying to separate himself from the street life and the friends he has there. He states that he does not want to be sucked back into the life and is trying to get his life to a more stable place.

The next stage of the domain of practice is the environmental “Personal Otherness” (PO). This represents the personal support networks. It can refer to the intimate or significant others but also to groups and communities that offer support to the client. (Ramsay and Karls, 1999)  In Don’s case he has a sister in Calgary that he turns to when he needs support. He lived with her for some time but the arrangement did not work out. He still has frequent contact with her and goes to stay with her on occasion. Don feels his sister understands his issues better than anyone because they shared the experience of growing up in an unstable environment. However, he does feel that she is not as supportive as she could be regarding the place he is at in his life right now. He also says he does not like to worry her with his problems and that she can’t deal with his temper.

Don has some contact with his father who resides in Montreal. Don has claimed that his father is a high-ranking member of the motorcycle gang The Hells Angels. He was recently released from prison having served 20 years for manslaughter. This connection to the Hells Angels is very important to Don. He feels it gives him a lot of power and credibility on the streets. Don’s father is both a source of pride and a source of anger to him. He feels that his father is someone to emulate and yet blames him for instilling the violence in him that has been the root of so many of his issues. He seems conflicted over his feelings for his father. He has sent money to his father when he had very little to send and felt that he owed it to his father to take care of him when needed. Yet he harbors tremendous resentments against him because he was not present when Don and his siblings were growing up.

Don has a 4-year-old daughter living in Montreal with the baby’s mother and her new husband. Don was never married to the child’s mother and has had very little contact with her over the last 2 years. This is a source of anger and frustration for Don. He claims to want very much to have custody or at least visitation rights with his daughter yet he moved to Calgary from Montreal making visitation impossible. He is very angry about another man raising his daughter and talks about how he has his father ‘keeping and eye on them” in Montreal. He has made conflicting statements regarding his future plans regarding his daughter. He has said that he is trying to get his life stabilized and separate from the street life and violence of his past so that he can have a chance to reunite with her. However, he has also stated that he realizes that there is no possibility that he is going to get custody or joint custody because of his past. Don is working very hard to make a stable environment for himself. His daughter is the motivator behind that effort so it is very discouraging to hear him speak negatively about his future with her.

Don has recently obtained employment and has made some friends there that are a possible positive influence. They are outside of the street environment that Don feels so threatened and tempted by. While they have not yet become close supports he feels he can trust his boss and has successfully negotiated shift changes a few times at work. This was very positive as it exposed Don to a way of dealing with people that did not require resorting to anger or violence. He does take a lot of pride in having this job and working towards getting out of the CDIC and into his own place. He has been able to keep his focus and is not discouraged by the low wage of the job and the slow progress of the accommodation search.

Don makes extensive use of the counseling services offered at the CDIC. He has seen almost all the counselors at least once and tends to spend at least an hour with each visit. He comes into the counseling offices voluntarily and has expressed his appreciation that there is a place he can go and say what ever he is feeling without being judged or told what to do. It appears that Don uses the counseling offices as a free zone to escape from the outside stresses and take a breather. He usually comes in when he is on the edge of exploding in frustration and rage. He has been able to assess when he needs to calm himself down and he feels unable to do so on his own. He uses the counseling staff as a method to vent and relax. It seems to be effective for him. He has also stated he goes to the counseling staff at the Salvation Army as well for assistance.

 

The next element in the Domain of Practice is the Resource Otherness (RO). As Ramsay and Karls (1999) state this element consists of all the “other resources, goods and services that help to sustain, enhance or impede the social functioning of a person in relation to others in there life” (p. 21). This usually includes social institutions such as health, welfare, education, employment, transportation and the judicial system. (Ramsay and Karls, 1999). Don heavily utilizes the CDIC’s services. The Center has been providing most of his shelter, his food and hygiene needs over the last 2 months. The Salvation Army Center of Hope program has also been providing for some of Don’s needs as well. The CDIC’s services are all provided free of charge. The counseling staff is available all on a voluntary basis. No client is required has to come to see a councilor. There are very few reasons why an individual would be refused services at the Drop In. Violent behavior especially towards a staff member is one offence that would result in a bar from service. This is a constant concern for Don. He has a problem dealing effectively with authority figures. He becomes defensive when feeling threatened and he feels threatened by authority in general. Don has come in to the counseling office on more than a few occasions because of encounters with staff. He has been afraid that he will react violently and lose privileges at the CDIC.

Don’s employment situation is very positive. He has a position in the warehouse of a large grocery chain. The job is unionized and while currently low paying there is possibility for advancement and the position is very stable. He is constantly worried that he will do something to get himself fired, as this has been the pattern in the past. He has begun to understand that the import factor is how he reacts to the pressures and problems in the work environment and not the problems themselves. He is beginning to take responsibility for what transpires. Don takes a lot of pride in the fact that he is working and being responsible for himself.

On of the most pressing concerns for Don is the lack of affordable housing available in Calgary. There is little that a low wage single income person or family can afford in this city. The vacancy rate in Calgary is at about 1.4, which is unacceptable and insufficient given the influx of people moving into the city because of the availability of work. Even if one can find a job they still end up living in a homeless shelter because there are no rental properties available. When there are rentals available the landlords are unlikely to rent to someone who does not have a current address or is using the CDIC as an address. The perception is that if someone is living in a homeless shelter they are not employed and / or they are drug addicts or alcoholics. It’s not always the case but it makes it difficult for an employed single male without addition issues who is currently staying at the CDIC to find a landlord willing to rent to them. The owners have so many other people looking for places to choose from.

Another major issue for Don is the lack of transportation available to him. Don is not able to afford a personal vehicle to get around so he relies on public transportation. The problem is that he is working nights and the buses stop running before he gets off. So often he has a very difficult time getting home. This is a constant source of frustration for him as it is for many people who rely on the public transportation in Calgary. Don had to negotiate with his employer to have his hours moved around so he could get back to the shelter at night. Don did have the foresight to purchase a monthly bus pass when he had the money so he is able to get around without worrying about having the change.

 

Don has refused to accept any assistance from the welfare system. He perceives accepting that kind of help to be the ultimate failure. He has little respect for anyone who does receive benefits even though he would likely be able to find a place to live more quickly if he used the welfare services. Don is also trying to deal with the Family court systems here in Calgary and in Quebec in order regain custody of his daughter. He feels he has been given the run around by all involved. There seems there is little that Don can do from here in Calgary as the case is rooted in Quebec. He has been trying to do some investigation long distance with a lawyer in Quebec but feels he is not getting anywhere. He is torn between moving back home and potentially being sucked back into the street life and sticking it out here, getting settled and then worry about the custody issues.

The final section of the domain of practice is the Validator Otherness (VO). This element is referred by Ramsay and Karls (1999) as identifying “proper and relative norms- expressed as beliefs, ideals, customs, traditions, laws, policies, sometimes collectively defined as culture- used by individuals and other societal groupings to govern their interconnected relationships with others.”(p. 21). The validators can refer to the beliefs that the individual hold to be important and those that the society in general does. These may or may not be one and the same. If there is incongruence between the individuals validators and those of the society or parts of the society there will likely be friction in the interaction between the two.

Don holds the concept of respect in the highest regard. However his definition of how respect is shown and how one gains respect clash with that of the general society. It does however, fit with the notions held within the client population at the CDIC. He has very little tolerance for perceived lack of respect to himself or his associates. He feels it is acceptable to react with violence to any perceived slight. Don has come in to the counseling offices on many occasions because he was “this close” to hurting some one badly for what most would consider a minor slight (like bumping into him and not apologizing). He has little ability to gauge the appropriate response to the situation and overreacts to almost everything. The fact that responding quickly with violence is a way to gain and maintain respect is also very important to Don. Don has made statements of regret for causing physical harm to people who may not have deserved it but maintains that there was nothing wrong with hurting those who did deserve it and that he would have no trouble doing it again if he had to.

Don sees himself as something of a protector to his street family and to the underdogs (maybe because he sees himself as an underdog). He is proud of this title and feels important when others come to him to help with problems. He is aware that when he gets involved with other people’s issues he winds up causing trouble for himself. This is a dilemma for him. He wants to have people rely on him and respect him yet he wants to move into a more stable less dangerous life. This is causing his a lot of anxiety and doubt. He wants to think of the future and his family yet he needs to feel important and gains much of his self-esteem from his role in the street. Without that, who is he?

The next area of the common framework is the Domain of Practitioner. This element has the identical elements as the Domain of Practice but is used to explore the Social worker and his or her environment. (Ramsay and Karls, 1999) For this section I will be assessing my own Domain elements. The Person element will be examined first. I am a 26-year-old student in my fourth year of the bachelor of social work degree at the University of Calgary.  I am in a practicum placement at the Calgary Drop in Center, a homeless shelter in the downtown area of Calgary. I am working in the role as general counselor at the Center for 32 hours a week. I attend classes at the University once a week and am getting above average grades in all my classes. I have developed friendships with many of my school peers especially those in which I am also working with at the practicum setting.

 I am living with my mother and my 20-year-old sister in a small townhouse. I also have a 24-year-old brother who lives on his own in Calgary. My mother and father are divorced and I have not seen my father for over a year. I am very close to my mother and siblings. I have lived in Calgary for 5 years. I moved to Calgary from Vancouver to attend school leaving behind a serious romantic relationship, my own apartment and a good paying job.  I am currently employed for low wages at a retail store in a mall. I work there about 20 hours a week. As I don’t pay rent or any bills at my home I work mostly for tuition and spending money. I enjoy working there as I have many friends there and I find the work stress free. I am currently debt free, having accumulated no student loans.

Physically I am healthy. I have no serious medical concerns. I am a very occasional social drinker and an addicted smoker who is attempting to quit. Mentally I am also healthy. I have the expected stress level of someone with my schedule and school pressures but feel I am handling it in a healthy way. I am currently unable to pursue any of my outside interests because my time is so limited.

The next component of the Domain of Practitioner is the Personal Others (PO). I rely heavily on my immediate family for support. My mother, brother and sister are always there for me and I don’t know what I would do without them. I also have friends at schools that are supportive in regards to academic related issues and a few who can be personally supportive as well. At the CDIC the other students there with me have been a source of strength, as have the other councilors and the field supervisor. My co-workers at the retail store a source of release of stress. I find the environment fun and relaxing and I get a lot of fun and humor from them.

The Validator Other (VO) component is the next element to be discussed. I feel I regard responsibility and accountability most highly. Honest and integrity are also very important to me. I have a very strong work ethic and feel that I can be relied on when I am needed. The closeness of my family is very important to me and I try very hard to be there for them when I am needed. The concept of total acceptance and open mindedness is what I strive for but I realize that I am not at that point and can be internally judgmental of people who seem to disregard the values that I hold so highly. I think in a very logical orderly way and find it can be very efficient but that often limits my imagination. I admire the ability to be less linear and more creative and I strive for a balance between the two.

My resource others include the school that I attend the University of Calgary and the department I belong to, the Faculty of Social Work. I am currently a councilor at the Calgary Drop In Center. I am an employee at a retail store. I am affected by a number of government and city programs. I utilize the public transportation system and that affects me daily. The financial climate in Calgary and the cost of living here affects my decision-making choices and me. The potential job market in the social work field and how it relates to political climates through out the country also affects my decision-making and will continue to do so. The judicial system has affected me recently as it related to my parent’s divorce and the outcome of the property division.

The next component of the Common Framework is the Paradigm of Profession. The interconnected elements of this component identifies four possible practice options available to a social worker and are generally divided into micro or macro levels of practice. (Ramsay and Karls, 1999)  One option is for the practitioner to focus on the Client System (CS), which is a decision to work directly with the client to address a social functioning need. In the case study the worker would chose to work directly with Don in a councilor role mostly in the area of crisis intervention. This would be the role most prescribed to at the practicum agency. Don generally comes in to the offices when in crisis and needs immediate assistance to get him through the stress he is experiencing at that moment.

Another possible practice option would be the Target System (TS). This identifies the option of working with a part of the person in environment domain that needs to be influenced to provide assistance to the Client System. (Ramsay and Karls, 1999) In Don’s case the potential target system could be the rental owner who is reluctant to rent to someone who is living at the CDIC. A worker could take action to convince the owner that it is discriminatory to refuse to rent based on the client’s current address. The worker would probably advocate on behalf of the client to convince the owner that the client would make a good renter. Of course, the worker would not likely put herself in that position unless there was a strong belief that Don would be a good tenant.

The next potential practice option is the Action System (AS). This is the option of working with a part of the person–in-environment domain that is a willing cooperator in providing services to the client system. (Ramsay and Karls, 1999) This can include other affiliated agencies, colleagues and services that can and will provide assistance to the client. In Don’s case a possible Action System is the Salvation Army’s Center of Hope program. This is another shelter service that is able to provide clients who work nights a comfortable place to sleep during the day. At the CDIC the clients are unable to access sleeping areas other than the intoxicated area (mats on the floor) after nine at night. All clients have to be up and out of the sleeping areas by six am. The Center cannot provide the sleep that Don needs but with the Salvation Army’s program he would be able to sleep through from when he arrived from work at 3am to noon. This would be able to accommodate him more effectively.

The final element of the Paradigm of Profession is the Change Agent System (CAS). This element identifies the employer or self-employment system used by the social worker. The agency missions, philosophies and function constraints need to be taken into consideration. Sometimes the change agent system needs to be the focus of one of the other practice options. (Ramsay and Karls, 1999). In Don’s case the CDIC is the agency used by the social worker in question. The mission statement in the CDIC Policy Manual (2002) reads “to compassionately and confidently provide non-political, non-sectarian services, by way of day and night shelter, food, recreation, counseling, and job placement to those in need, including referrals to the various support services available in the community with the ultimate purpose of reintegrating clients into the mainstream of society” (p.1). The agency philosophy is stated in the CDIC Policy Manual (2002) as:

“Based on client directed service in which adherence to policies, procedure and regulations is less important than the needs of the people who are being served. What is kept in mind is that clients of the CDIC are affected by a variety of factors including programs, staff, environment, policies and procedures. The servant leadership philosophy will be evident in the personnel as well as the institution itself” (p. 6).

Basically, the CDIC is concerned with creating a friendly, non-invasive and supportive environment where personal growth can take place. The services are provided for the under privileged and under or unemployed. The services are all cost free to the consumer. It is open 24 hours a day 365 days a year. The services provided include health and hygiene services, including nurses that do outreach at the center. There is a casual labor program to assist in finding temp work. The shelter services consist of showers and laundry mat service as well as the three meals a day plus 2 snacks (CDIC manual, 2002).

Counseling services are provided as well. This is a very essential service for many of the clients but not the focus of much of the funding and attention. If one is to believe the concept behind the hierarchy of needs, it is understood that the mental and emotional issues cannot be addressed until the pressing physical needs are meet. The first priority of the CDIC is providing for the physical needs to prevent needless suffering and possible death. The environment and clientele is such that crisis counseling is the majority of what the social workers in this environment do. Often a counselor will see a client who needs serious crisis intervention and will spend hours in one session and often the counselor will never see the client again. There is no way of assessing whether there is potential for long term work and no way to ensure that a client will return. Within the agency there are a number of programs offered to clients that a counselor can utilize to assist the client system. In Don’s case the CDIC offers an anger management course, which could possibly help Don in to get control over his anger and violence. Don could be referred to the course and it would be his choice to utilize the service or not. This would be an example of using the CAS as the Action System.

The final component of the tetrahedral common conceptual framework is the Methods of Practice component. This section takes into consideration all the other components and their interconnectedness to determine the appropriate intervention method or methods to be implemented at the intervention stage. (Ramsay and Karls, 1999) The first method selected to apply to Don’s situation is the Strengths perspective. Due to the nature of the sessions and the crisis component of the interactions it is important to be able to make an impact early on in the session. Don has issues with low self-esteem and gains his self-confidence in somewhat destructive ways. A strengths approach will help to focus Don on the positive aspects of his life and the tools he has used to make positive choices in his life.

The strengths intervention works well with Don. He is often in the counseling office because he has experienced a set back or a trigger to his frustration and anger. He often feels on the verge of exploding and expresses the desire to act out in violence. The very fact that he has come in to see a counselor is a very positive sign. Emphasizing how far he has come and that he has a desire to do things differently than in his past is sufficient to calm him down significantly. When exploring what Don does have going for himself outside of his street life he can acknowledge many resources and possible options that he is unable to see when he feels overcome with rage. The role of the social worker in this environment is to encourage and support inner strengths of clients so they can take control and responsibility for their own lives and facilitate empowerment of the marginalized (Heinonen, 2001).

The strengths approach also fits in with the holistic view proposed in the common conceptual framework. It can take into consideration how the worker and client relationship is shared and reciprocal, as most rewarding relationships are. In a reciprocal relationship both parties benefit and learn from the experience and take something away with them that can be useful in their futures (Heinonen, 2001). In this way, a familiarity with the inquiry method of learning may be beneficial to a worker interested in using this approach (Postman, 1969). The Strengths perspective promotes growth and development through engaging clients to take charge of their own lives, which includes problem-solving skills. The process of the strengths approach is empowerment and the goal is growth and development (Heinonen, 2001).

The problem solving approach is the second intervention strategy that was utilized when working with Don. The problem solving method usual implies a more direct intervention strategy. This process was generally integrated into the strengths approach and applied after the crisis intervention was applied. The steps of a problem solving approach include articulating the problem, conducting the assessment setting goals deciding on interventions, evaluating the process and ending the process (Johnson, 2000).

One particular problem was articulated as a difficulty controlling his anger. The goal that Don stated was being able to express his anger in a non-violent and non-destructive way. The intervention that was decided on between the worker and Don was Don attending an anger management class offered through the CDIC. Don thought this was something he was willing to really put some effort into. The evaluation process was sporadic but Don would come back to see the worker roughly once a week and discussed some of the strategies he had learned. Don discussed what worked for him and what didn’t. Progress was noted and the new tools evaluated for effectiveness and Don expressed some satisfaction with his new skills. The process is on going but as the anger management classes came to an end Don stated he felt he got something useful out of them. There did appear to be some real progress made by Don in his ability to express his anger in more appropriate ways and to be able to calm himself down when got really angry.

The problem solving and the strengths approach intervention methods chosen were effective when used in conjunction. They may appear on the surface to contradict one another but if applied appropriately they can be very complimentary. While the problem solving approach can give focus and direction to both the client and the social worker the strengths perspective can keep the attention to the positive. The Strengths perspective can help to discover resources that might be otherwise overlooked in the rush to a solution to the problem (Heinonen, 2001).

The problem solving method is often an approach that must be used if the service is to be consumer driven. According to Johnson (2000) “problem solving has been defined as finding- by stages over time- a way of feeling, thinking, and acting that will satisfy some need or remove some obstacle to achieve some goal”. Often the clients have very specific needs and obstacles. The process involved in working from a strictly strengths perspective is not going to get the client the assistance they need in a timely fashion. They will often get fed up with a long process and leave in search of someone who will help them with their immediate issue. This can be frustrating to a social worker interested in doing further work using a person in environment and strengths approach but that is not always immediately possible in this environment.

Within the CDIC the tetrahedral structure of the common conceptual framework can be used effectively as an assessment tool. The importance of all the environmental factors can not be underestimated, especially with the disenfranchised populations that often have little direct control over there own immediate environment. Understanding all the parts that effect the client system and how they are interconnected can be beneficial in choosing an intervention method. It can be essential in choosing a domain of practice. Often when the causes of a client’s disempowerment can be articulated, it is clear that the client is not the element in need of intervention. Moving from a micro focus to a macro focus can be facilitated with the use of the common framework as the interconnectedness becomes so apparent.

The major problem with applying the tetrahedral common framework into counseling practice at the CDIC is being able to get the information needed to make the comprehensive assessment. Often a counselor will only see a client once and get very little information outside of the immediate problem. While the services are all voluntary the clients are often still hesitant to reveal much if any thing about themselves. It is also next to impossible to determine whether what is being revealed is the truth. Often the specifics are not as important as where the client is at right now. Again, crisis intervention often becomes the most important strategy. It could be detrimental to put off taking action until all the data required to complete the comprehensive assessment is gathered.

The agency itself is very open to the use of a common conceptual framework. Any tool that can assist a counselor and is ethical is welcomed. There are so many different styles in counseling being utilized in the agency. The administrations concern is for the process rather that the product as there is very little quantitative way to evaluate the interventions with in this environment (Postman, 1969). The tetrahedral common conceptual framework is a model that can in theory be applied to all the counseling work done at the Calgary Drop In Center and could assist in assessment and intervention strategies. The use of self and evaluating the social workers role in the client’s environment is a big step in the integration of the inquiry method of learning into a more holistic way of practicing social work.

References

Calgary Drop in Center Society (2002). Policy and Procedures Manual.

Heinonen T, Spearman L (2001). Social work Practice: Problem Solving and Beyond. Toronto: Irving Publishing

Johnson L, McClelland R, Austin C (2000). Social Work Practice: A Generalist Approach. Ontario: Allyn and Bacon.

Knight S (2000). Comprehensive Framework Assessment and Planning Paper. Faculty of Social Work: University of Calgary.

Postman N, Weingartner C (1969). Teaching as a Subversive Activity. New York: Delta Book Publishing.

Ramsay RF, Karls JM (1999). Person in Environment Classification System: Adding CD ROM options to the Social Work learning Menu. NTHS, 12, 17-28.

Ramsay RF (February 2001). Revisiting the Working Definition: The time is Right to Identify a Common Conceptual Framework for Social Work. Paper presented to Kentucky conference. University of Kentucky: Lexington, Kentucky.