Generalist Practice 1 & 2

countertransference

A phenomenon occurring when a therapist projects their own emotional responses onto a client, often due to unresolved feelings or conflicts from the therapist's past. May impede treatment.

two types:

1. a reaction to the transference (ex: “becoming mom”)

2. the client material elicits a reaction within the therapist, related to the therapist’s history/inner world

helps us embody the situation, see what the client may be doing to contribute to the problem, offer insight

it is important to be aware of type 2 and not mistake it for type 1

with type 2 we learn about ourselves and our “baggage”

idiot compassion

Giving a client what they want, not need, because you “can’t bear to see them suffering.” Doing it to make yourself feel better, not for their benefit.

adverse childhood experiences (ACES) inventory

A tool used to assess the impact of traumatic experiences during childhood, including abuse, neglect, and household dysfunction, on an individual's long-term health and well-being.

ecological theory

A framework for understanding the complex interplay between individuals and their environments, focusing on multiple levels of influence, such as family, community, and societal factors. Where the phrase “person-in-environment” comes from.

Phase 1 of the Life Model approach - Prepatory

Practitioners prepare for engagement and assessment with clients, focusing on establishing rapport and understanding their needs. Gather information about the client, environment and culture.

Phase 2 of the Life Model approach - Initial

Practitioners engage with clients to conduct assessments and develop an initial understanding of their situations, problems, and strengths. Decide an area of focus and begin to identify goals.

Phase 3 of the Life Model approach - Ongoing

Practitioners continuously engage with clients, monitor progress, adapt interventions as necessary, and support clients in achieving their goals. This phase emphasizes collaboration and adjustment based on client feedback.

Phase 4 of the Life Model approach - Ending

Practitioners conclude their work with clients by summarizing progress, discussing outcomes, and facilitating a transition to independence or further support as needed. This phase also allows for reflection on the overall process and impact of the interventions.

Praxis

The process of putting theoretical knowledge into practice, emphasizing the connection between theory and action in interventions.

Goals of Practice Models

a. Predict & explain client behavior
b. Generalize among clients & problem areas

c. Bring order to intervention activities

d. Identify knowledge gaps about practice situations

Modality

A specific method or technique used in social work interventions, tailored to meet the needs of clients.

Deficit approach

Traditional psychology/psychiatry (DSM) perspective that focuses on clients' weaknesses or problems rather than their strengths and resources, often leading to a narrow understanding of their potential and capabilities.

Strengths-based approach

A perspective that emphasizes the inherent strengths and resources of clients, encouraging them to leverage their abilities and resilience in overcoming challenges. Practitioners can never know the “upper limits” of client growth potential.

“default” strength all clients share

they are here in front of us and actively participating in the process

reason to validate strengths and reflect them back to the client

they may be used to only hearing the negatives or what’s “wrong” with them

Cultural Humility

A commitment to understanding and respecting different cultural identities while acknowledging one's own biases and limitations in knowledge. Yielding who you are to learn about/appreciate the culture of someone else.

Theory of Chaos

A theoretical framework that emphasizes unpredictability and complex interdependence in systems, where small changes can lead to significant impacts, often used to understand social dynamics and human behavior. Interventions may not magically cure everything, but may alleviate some issues and enhance overall functioning.

Cross-Cultural Competence

The ability to think, feel and act in ways that acknowledge, respect, and build upon ethnic, socio-cultural and linguistic diversity.

Implicit Bias

The unconscious attitudes or stereotypes that influence our understanding, actions, and decisions, often affecting how we perceive and interact with individuals from different backgrounds. Increased mindfulness may allow clinicians to recognize and manage these biases in their practice to ensure equitable treatment and improve patient outcomes.

Modernism

Approach to social work that emphasizes empowerment, rationality, and progress through scientific understanding and critical thinking. Focused on following the scientific method and discovering the one and only Truth. This perspective often seeks to address social issues through structured, evidence-based practices, prioritizing objective analysis over subjective experiences.

Post-Modernism

A perspective in social work that challenges the notion of a singular truth, emphasizing the importance of multiple narratives and the subjective experience of individuals. It encourages critical reflection on power dynamics and cultural contexts. Believes there is no real Truth, that things can be nuanced. Ex: Stealing is wrong, BUT if a person is stealing to feed their family, that action may be justified.

Critical Theory

A framework in social work that analyzes how power structures and societal inequalities influence social problems. It seeks to challenge and change oppressive systems, emphasizing the importance of social justice and advocacy. It takes what we think we know and asks “Is that really true?” and encourages us to critically examine societal norms and values in order to promote equity and empowerment (who makes these norms?) Critiquing power and re-centering the narratives of the minoritized.

Feminist Theory

A theoretical perspective in social work that examines gender inequalities and advocates for women's rights. It highlights the role of patriarchy in social structures and aims to empower women by addressing societal norms that perpetuate gender-based oppression. Emphasizes the analysis of gender disparities and systemic structures that affect women's rights. It seeks to promote equality and social justice by challenging patriarchal norms and practices.

Critical Race Theory

A framework in social work, based in legal theory, that examines the relationship between race, racism, and social structures. It highlights how systemic racism impacts individuals and communities and seeks to challenge and dismantle racial inequalities. It emphasizes the lived experiences of people of color, explores how race intersects with other identities, and advocates for social justice through an anti-racist lens.

Intersectionality

A concept that explores how various social identities, such as race, gender, and class, intersect to create unique modes of discrimination and privilege. It emphasizes that individuals experience oppression differently based on their interconnected identities. Formed from the idea that laws designed against racial discrimination assumed MALE, and laws designed against gender discrimination assumed WHITE, leaving Black women overlooked at this intersection of race and gender. Coined by Kimberle Crenshaw.

Queer Theory

A theoretical framework in social work that explores and critiques the social constructions of gender and sexuality. It challenges normative definitions of sexuality and advocates for the rights and acceptance of LGBTQ+ individuals, emphasizing the fluidity of identities. Adds to intersectionality by considering the perspective of different sexual orientations and gender identities, highlighting how these interactions shape experiences of oppression and privilege.

Post-Colonialism

A critical framework that examines the lasting impact of colonialism on cultures and societies. It analyzes power dynamics, identity formation, and the consequences of colonial histories on contemporary social relations.

Oppression

A systemic and pervasive social phenomenon where individuals or groups are unjustly subjected to harsh treatment, discrimination, and subordination based on their identities. It manifests through various forms, including institutional, structural, and interpersonal levels, affecting access to resources and opportunities.

DAC Note

A model used in social work that organizes information into three components: the client's description of their situation, the assessment of their needs, and the contract that outlines the agreement for services.

Best Practice

A set of guidelines or recommendations derived from experience and evidence, used in social work to ensure effective and ethical service delivery. May vary between agencies.

Case Theories

Frameworks used to guide social work practice through understanding individual client situations and interventions.

Mid-Range Theories

Theories that are applicable to specific social work contexts, bridging the gap between grand theories and practical applications. They focus on particular aspects of social behavior and intervention strategies.

Grand Theories

Comprehensive conceptual frameworks that explain broad aspects of social work practice, offering insights into human behavior and societal structures. They provide foundational perspectives for understanding complex social issues.

Ex: Freud, Piaget, Skinner

(less popular today due to being so broad)

Practice Models

Coherent set of ideas about human nature (health, illness, normalcy, deviance) which provide verifiable explanations for behavior and rationale for interventions. Ex: CBT

Risk of rigid adherence to a particular theory

May lead to oversimplification of the client’s situation, which can be reductionist and dehumanizing.

Why some intervention strategies overlap in different theories

Theories may propose similar techniques with a different rationale or purpose.

Reasons a social worker may choose a theory

a. evidence of effectiveness (research support)

b. belief that it produces positive results

c. provides useful intervention techniques

d. consistent with social worker values

e. personal habit

f. used by co-workers, supervisor, or agency

Technical Eclecticism

An approach that combines elements from various theories and techniques to address client needs, allowing for flexibility and individualized interventions. Not into theory, but applies certain interventions to certain problems based on prior demonstrated efficacy (evidence-based). This approach allows practitioners to select and utilize the most effective strategies from different theoretical frameworks, focusing on practical application rather than strict adherence to a single theory.

Common Factors Approach

A perspective that emphasizes the shared elements across different therapeutic approaches that contribute to client improvement, such as the therapeutic alliance, empathy, and client motivation.

Theoretical Integration

An approach that merges different theories to create a cohesive understanding and application of therapeutic practices, enhancing treatment effectiveness through comprehensive frameworks. It may be challenging to obtain mastery when working with 4+ theories, but it allows for a more holistic perspective on client outcomes.

positive arguments for electicism

clients may benefit from a range of ideas

theories contain common elements

some theories do not work for all practice situations

negative arguments against eclecticism

“jack of all trades, master of none” - may lead to a superficial understanding of various approaches

loss of common core of practice may lead the client to suffer or experience inconsistency in treatment, hindering overall progress.

Evidence-Based Practice (EBP) in social work

Stemming from the medical model of care, a systematic approach that integrates the best available research evidence with practitioner expertise and client preferences to inform decision-making in social work interventions. Aims to improve client outcomes and ensure that services provided are effective and reliable.

Heavily biased towards cognitive & behavioral strategies that are easy to quantify.

Tendency to treat all patients/clients the same if they have the same diagnosis, avoiding or discounting other factors.

Values

Principles and beliefs that guide social work practice, influencing decision-making and interactions with clients. They shape the ethical framework within which practitioners operate, promoting respect, integrity, and social justice.

Principles concerning what is right and good.

Ethics

The moral principles that govern a person's behavior or conducting an activity, guiding social work practice to ensure professional conduct and advocacy for clients' rights.

Principles concerning what is right and correct.

6 core values of social workers

service

social justice

dignity and worth of the person

importance of human relationships

integrity

competence

Strengths-Oriented Practice

An approach that emphasizes human resilience and the skills, abilities, knowledge, and insight people accumulate over time as they struggle to surmount adversity and meet life’s challenges.

Major principles include:

a. problems can be a source of challenge & opportunity

b. practitioners can never know the “upper levels” of client’s growth potential

c. collaboration between SW & client (not traditional hierarchy)

d. every environment contains resources (some informal) that can be mobilized to help clients change

Risks

Hazards in the individual or environment that increase the likelihood of a problem occurring. They do not guarantee a negative outcome, but increase the odds of one happening. Seem to have (non-linear) compounding effects, and they are not all created equal.

Presence of one may lead to others ex: lax parenting increases the likelihood of a child socializing with “bad influences”

Protective Factors

Personal, social & institutional resources that foster competence and promote successful development. These decrease the likelihood of problems occurring and increase the likelihood of rebound if a problem does occur.

Presence of one may lead to others ex: parents who provide structure may socialize them with similar peers.

Resilience

The ability to recover from difficulties and adapt positively to challenges. It encompasses both personal traits and external support systems that help individuals withstand adversity.

Absence of significant developmental delays or serious learning/behavioral problems plus the mastery of developmental tasks that are appropriate for one’s age & culture, in spite of exposure to adversity.

Ways social workers can empower clients on a personal level

Changing patterns of thinking, feeling & behaving

Social workers can empower clients by helping them identify strengths and resources, promoting self-advocacy, fostering skills for decision-making, and supporting personal goal-setting. This process encourages individuals to take control of their lives and enhances their overall well-being.

Ways social workers can empower clients on an interpersonal level

Managing their relationships more effectively

Involves fostering supportive relationships, enhancing communication skills, and encouraging collaboration with others. Social workers can help clients build networks of support and connect with community resources, promoting shared experiences and mutual assistance among individuals.

Ways social workers can empower clients on an environmental level

Changing how they interact with larger systems

Involves changing circumstances surrounding clients' lives, such as advocacy for systemic change. Social workers support clients in navigating external systems, accessing resources, and influencing policy to create a supportive environment that fosters individual and community well-being.

Empowerment

The process of enhancing individuals' capacity to make choices and transform those choices into desired outcomes, promoting self-determination and personal agency. It is:

a. a developmental process

b. a psychological state

c. liberation from oppression

Limitations to empowerment

a. some clients view SW as the expert & rely on guidance

b. SW may struggle with suggesting goals/activities

c. SW cannot empower their clients if they themselves are not empowered

d. values of empowerment may conflict

e. some empowerment techniques may be coercive

importance of keeping notes

Maintaining accurate records is essential in social work for tracking client progress, ensuring continuity of care, promoting accountability, and facilitating communication among professionals involved in a client's case. Even if notes are not required at an agency, keeping them is a good way to CYA and keep documentation that can support client advocacy and provide evidence of services provided.

duty to warn

A legal and ethical obligation of social workers to inform authorities or intended victims when a client poses a serious risk of harm to themselves or others.

meta-cognition

The awareness and understanding of one's own thinking processes, which can enhance learning and self-regulation.

Carl Rogers

Pioneer of Person-Centered Theory and a key figure in humanistic psychology, emphasizing empathy, unconditional positive regard, and the therapeutic relationship.

unconditional positive regard

A foundational concept in Person-Centered Therapy, referring to an attitude of total acceptance and support towards a client regardless of what they say or do. The clinician accepts the client for who they are.

mirroring the client

A technique in therapy where the clinician reflects or restates the client's thoughts and feelings, enhancing understanding and empathy in the therapeutic relationship. Involves matching, not mimicking.

ex: if the client is sitting casual, you can sit more casually too

by embodying the client a little it can make you both more comfortable and fosters a deeper connection through nonverbal and verbal cues, leading to a more supportive environment.

Person-Centered Therapy

A therapeutic approach developed by Carl Rogers that emphasizes a non-directive, empathetic framework where the therapist provides unconditional positive regard, allowing clients to explore their thoughts and feelings freely. This methodology fosters personal growth and self-understanding.

Very American/Western style of therapy. Very individualized, focused on ego-agency.

Useful for most populations as long as the client is capable of relating/connecting to the clinician (may be difficult for an antisocial/sociopathic client, or lower-functioning people on the autism spectrum, severe cognitive disabilities etc.)

While it is a good foundational theory, it is very broad and ignores the systems/structures that affect a person’s agency.

importance of ecomaps and genograms

Tools for visualizing family dynamics and social relationships, helping clinicians understand the systems impacting a client's life. These tools are valuable for mapping out connections, family issues, and social networks.

Specific techniques do not matter as long as the client understands the symbols. Should be made together with the client to identify their relationships and resources. They help you get to know your client and visualize their strengths.

Ecomaps

Visual tools that depict social networks and relationships, illustrating how clients interact with their environment and support systems. The client or their community is typically drawn in the center, and different connections and relationships are represented by lines and symbols, helping clinicians assess support and identify areas for intervention.

Genograms

Diagrams that map family relationships and histories, illustrating patterns, dynamics, and potential issues across generations. They are useful for understanding familial influence on a client's current situation and can highlight areas of strength or concern.

Not a diagnostic tool, but can lead to discussion. The client decides what information is relevant.

Dual Relationships

Situations where a clinician has multiple roles or relationships with a client, such as being both a therapist and a friend. This can complicate the therapeutic process and create ethical dilemmas. This includes not engaging in sexual/romantic relationships, not accepting things in lieu of payment, and not writing professional references for clients.

Transference

The phenomenon where clients project feelings, desires, and expectations from past relationships onto the therapist, often mirroring dynamics from significant figures in their lives. It can provide insights into the client's emotional world and facilitate therapeutic growth. ex: the client is yelling at you because you remind them of their mom

in psychodynamic therapy this is the goal, gives us an opportunity to view the relational pattern in real time

SOAP Note

A structured format for documenting client interactions, consisting of Subjective observations, Objective data, Assessment of the situation, and Plan for treatment. It helps ensure a systematic approach to client care and communication among professionals.

Motivational Interviewing

A client-centered counseling approach that aims to enhance intrinsic motivation to change by exploring and resolving ambivalence. This refers to a technique for talking with clients.

Used to engage clients who are reluctant/unmotivated to address problems that are considered serious by significant others, if not the client themselves

initially developed for substance abuse, now used for eating disorders, behaviors, general health care, physical inactivity, smoking, etc.

developed by William Miller

The focus is on helping the client perceive the disadvantages of the problem behavior outweighing its advantages - that gives them reason for change. It involves open-ended questions, reflective listening, and affirmations to encourage client engagement and self-discovery.

Cognitive Dissonance Theory

The idea that people cannot hold 2 incompatible beliefs as true at the same time, leading to discomfort. This theory suggests that to alleviate this discomfort, individuals may change their beliefs or rationalize their behavior.

Ambivalence

In motivational interviewing, refers to the mixed feelings clients may have about change, highlighting the conflict between their current behaviors and their desires for improvement. The clinician can point out this conflict to help resolve it and encourage action toward change.

Trans-Theoretical Stages of Change (TSOC)

A model that describes the stages individuals go through when changing behavior, including precontemplation, contemplation, preparation, action, maintenance, and relapse. It illustrates how people move through various phases when modifying habits or behaviors, taking into account their readiness to change. A dynamic, non-linear process that helps understand and support individuals in making lasting behavioral changes.

TSOC and Motivational Interviewing

Precontemplation, contemplation & preparation

TSOC and Motivational Enhancement Therapy

Action, maintenance & relapse

Motivational Enhancement Therapy

A client-centered, directive approach that enhances motivation to change by exploring and resolving ambivalence. It involves using specific strategies to support clients in achieving their goals and making lasting behavioral changes. This is a complete set of interventions for moving toward a specific goal.

Believes that motivation must come from within, the client must be willing, able, and ready to change.

MI Intervention

a. meet the client where they’re at, begin there

b. explore client’s problem behaviors & accept their perceptions as valid

c. reinforce client statements about wanting to change

d. affirm client’s statements about their ability to change

Reactance

A motivational response where individuals resist persuasion or change due to perceived threats to their freedom of choice or autonomy.

not “resistant client”

May look like: arguing, interrupting, negating & ignoring

This behavior often arises when clients feel pressured or coerced, leading them to assert their independence by rejecting the proposed changes. The clinician needs to adjust their interviewing strategies.

Direct Practice

Engaging directly with clients to address issues.

Risk and Resilience Framework

Understanding the factors that mitigate or exacerbate challenges in a person’s life

spirituality in practice

Involves belief systems, social concerns, creative pursuits, and hope. May be incorporated into therapeutic processes to enhance well-being and recovery. May be particularly helpful for clients struggling with anxiety, guilt, and shame. Spirituality in practice encompasses a holistic approach to well-being, integrating individuals' belief systems and social concerns to facilitate healing and personal growth.

Self-Actualization

The realization or fulfillment of one's talents and potential, often considered as the ultimate goal in personal development and psychological well-being. The core tendency of all people is to actualize their inherent potentials, but the tendency is not consciously known until the self-concept emerges. A major concept in person-centered therapy, though it is part of other theories as well.

conditions of worth

Standards used by an individual to measure self-acceptance and self-esteem, often based on the expectations of others. In person-centered therapy, these conditions can negatively impact a person's self-actualization and well-being.

congruence

The state of a “fully functioning person”, is experienced when the self-concept embraces all of one’s potentials. In this state, people respect and value all manifestations of themselves, are conscious of all there is to know about themselves, and are flexible and open to new experiences. Considered the “ideal lifestyle” in person-centered theory.

incongruence

A state where there is a discrepancy between a person's self-concept and their experiences, leading to feelings of discomfort and disconnection. Characterized by defensiveness, living according to a preconceived plan, disregarding one’s physical and psychological self, feeling manipulated, settling for conforming to the expectations of others, and living with conditions of worth. Considered the “non-ideal lifestyle” in person-centered theory.

empathy

The ability to understand and share the feelings of another person, which is a core principle in person-centered therapy (PCT). Involves actively listening and responding to others' emotional experiences, fostering a supportive therapeutic environment that promotes self-exploration and personal growth.

criticisms of person-centered theory

Criticisms of person-centered theory include its perceived lack of structure, potential overemphasis on subjective experience, and critiques regarding its applicability to severe mental health issues. Some argue that it may not adequately address the complexities of human behavior and the need for more directive approaches in certain therapeutic contexts.

Ego Psychology

Psychodynamic theory that is concerned with the individual in the context of their psychosocial environment. It emphasizes the role of the ego in developing healthy functioning and adapting to life's challenges, focusing on the individual's capacity for self-regulation and personal growth.

Id

One of the three components of Freud's structural model of personality, representing basic instinctual drives and desires, which operates on the pleasure principle and seeks immediate gratification.

Ego

The central part of Freud's structural model of personality that mediates between the id's desires, the superego's moral standards, and reality, facilitating rational thought and decision-making. It is mostly one’s conception of “who you are".” It is the “you” who thinks, feels, and acts in a reasonably consistent manner. It is everything you do to reflect, plan, and act in a way that allows you to “fit in” more or less adequately with the environments in which you live. It is also where cognition occurs, though unconscious processes also influence conscious thinking.

Defense (Coping) Mechanisms

Unconscious psychological strategies used by the ego to protect itself from anxiety and to cope with emotional conflicts. They can distort reality and affect behavior in various ways. They frequently come into play as we attempt to manage our interpersonal and other conflicts.

Can be adaptive (healthy) or maladaptive (unhealthy). They are used appropriately when they promote our adaptive functioning and goal achievement and minimize internal and interpersonal conflicts.

3 Innate Drives according to Ego Psychology

The three innate drives in ego psychology are the pursuit of pleasure, the inclination towards aggression (when threatened), and the desire for mastery and competence.

awareness of the external environment (ego function)

refers to an accurate perception of the external world, including orientation to time, place, and person, and the absence of hallucinations, delusions, and loose associations.

judgment (ego function)

our capacity to choose behaviors that are likely to promote our movement toward goals.

sense of identity (ego function)

a reasonably coherent physical and psychological sense of self. This includes our ability to maintain appropriate psychological boundaries from others.

impulse control (ego function)

our ability to distinguish between primary (drives or impulses) and secondary (planned) mental processes, to control actions in accordance with social norms, and to maintain control of behavior or emotions to a degree that prevents significant problems in functioning.

thought process regulation (ego function)

related to impulse control; our ability to remember, concentrate, and assess situations so as to initiate appropriate action.

interpersonal (object) relations (ego function)

refers to two related functions:

a. the ability to manage relationships appropriately toward personal goal attainment

b. the ability to see other people as unique rather than replications of significant others from our past

People can often manage some types of relationships (such as work or social) more successfully than others (family or intimate ties).

stimulus regulation (ego function)

our ability to screen and select external stimuli to maintain a focus on our relevant life concerns. When ineffective, we may become either overwhelmed or underwhelmed in situations.

autonomous functions (ego function)

the capacity to maintain attention, concentration, memory, or learning. Any impairment of these functions must be assessed for possible biological origin.

denial (defense mechanism)

A defense mechanism by which a person refuses to accept reality or facts, thus protecting themselves from uncomfortable truths or emotions.

Ex: a woman with anorexia acknowledges her actual weight and dieting practices, but believes she is maintaining good self-care by doing so.

Can be adaptive or maladaptive:

Ex: denial about having cancer so that you forgo medical care - may lead to death

acknowledging you have cancer, getting care, but in denial about your impending mortality - may be adaptive, stave off depression