Levels of Human Measure Notes

Levels of Human Measure

Everything starts with the individual. Self-care, healing, self-assessment, and self-awareness are crucial before entering therapeutic relationships.

The Individual

  • Focus on individual counseling and therapy.

  • Address problems and concerns at the individual level

The Family

  • The next ring out from the self.

  • Includes family therapy and counseling because everyone is connected to a family of some form.

The Community

  • Friends make up the community.

  • Community advocacy and activism are important at this level.

The World/Society

  • Encompasses society at large.

  • Involves changing policy and looking at social justice.

  • Major social structures impacting institutions: class, race, sex, and law.

  • All systems are impacted by class, race, sex, and law; the impact differs from person to person.

Important Considerations

  • No one's experience is the same, but experiences can be similar; find common ground, but recognize individual differences.

  • Need to discover how individuals experience and define their experiences to problem solve effectively.

  • Only individuals can explain their lived experiences.

  • Assess people, listen, and understand their experiences to intervene effectively.

  • Intervention is a power position because the person believes the helper has knowledge they need.

Human Capacity and Empowerment

  • Empowerment is based on the concept that everyone has some power, whether they know it or not.

  • Empowering people involves increasing their capacities at individual, family, group, organizational, and community levels.

  • Advocate around issues important to people, rather than speaking for them.

Social Work Core Values and Competencies

  • Core values (NSAW code of ethics): service, social justice, dignity and worth of a person, importance of human relationships, integrity, competence.

  • Social work competencies: nine in total (to be discussed).

  • Social workers are involved in case work, case management, group work, family therapy, community organizing, activism, and advocacy.

  • They work at individual, family, and community levels to improve circumstances and address social justice issues.

Casework vs. Case Management

  • Casework: episodic, short-term intervention (e.g., crisis intervention).

  • Case management: long-term, following a person over time (e.g., corrections, medical social work).

  • Casework can occur within case management.

Example of Casework

  • Emergency room social worker dealing with a car wreck victim:

    • Check if the person is conscious and can provide family contact information.

    • If unconscious, use investigative skills to find the person's identity (wallet, ID).

    • Contact the police in the person's county to visit the address and find family members.

    • Once family contact is made, direct them to the hospital.

    • Casework is complete once the person leaves the ER.

Medical Social Work

  • Social workers are assigned throughout the hospital (cancer units, transplant, general floors) for discharge planning.

  • Clinics usually do not have social workers due to their smaller size and acute care focus.

Group Work vs. Group Therapy

  • Group work: can be psychoeducational, teaching skills (e.g., recovery group).

  • Group therapy: uses specific modalities like cognitive behavioral therapy and involves deeper therapeutic interventions.

Counseling vs. Therapy

  • Counseling: deals with acute, immediate problems; skills-based.

  • Therapy: deals with personality development, trauma, and how it impacts personality; clinically based.

Licensure

  • LMSW (Licensed Master Social Worker) can do therapy under supervision.

  • LCSW (Licensed Clinical Social Worker) does not require supervision to do therapy.

  • LMSW requires 3000 hours of supervision plus a test to become an LCSW.

Scope of Practice

  • LMSW can do immediate work with people experiencing loss, job loss, or new diagnoses.

  • Therapy addresses personality development, traumatic events, and mental health issues.

  • Example: If someone is struggling with depressive symptoms and has a history of sexual assault, recommend therapy to address the trauma.

Grief and Loss

  • Multiple losses in a short period can lead to complex grief, requiring risk assessment for suicidality.

  • Loss can include loss of a job, relationship, or aging.

  • The nature of the loss (murder, sudden death, chronic illness) impacts the grieving process.

Trauma Therapy and Competency

  • It's important to be competent in the therapies you practice.

  • Training in a therapy like EMDR is different from practicing it.

  • Referrals are necessary if you are not competent in a particular therapy.

Continuity of Care and Boundaries

  • Therapeutic relationships are longer-term than crisis intervention counseling.

  • Competency is an ethical principle of social work.

Medication and Mental Health

  • Social workers cannot prescribe medication; only physicians, psychiatrists, and nurse practitioners can.

  • Assess clients' past experiences with medication and encourage them to consult with their primary care physician or psychiatrist.

  • Avoid asking "why" someone stopped taking medication; instead, ask if the medication was working for them.

  • Educate clients about the time frame for medications to build up in their system.

  • Help people explore medication options without pushing them to take it.

Understanding Depression

  • Address the core components of depression: helplessness and hopelessness.

  • Discuss the differences between sadness and depression, emphasizing that depression is more than just sadness.

  • Help people cope with and problem-solve around their depression.

Assessment and Critical Thinking

  • Assumption is not assessment; critical thinking is essential.

  • If someone says they feel sad, ask how long they have been feeling sad and how they define sad.

  • Use open-ended questions to gather information about the person's life and stressors.

Coping Skills

  • Find out how people have been coping with their experiences.

  • Use the same language they use.

  • Assess what is considered "extra" by them, for example extra drinking, eating etc.

  • Ensure assessment includes building rapport, being non-judgmental, and maintaining a comfortable environment.

Building Rapport

  • Ask the right questions at the right time in the right way.

  • Be genuine and kind.

  • Lower your tone and voice if the person is upset.

  • Address basic needs and extend compassion.

  • Build a connection by offering genuine kindness and showing interest in their well-being.

  • Understand reasons why people may avoid shelters (unsafe, belongings may be stolen) and consider mental health and trauma.

Networking and Collaboration

  • Network with other professionals and social workers to gather resource information.

Empathy vs. Sympathy

  • Give sympathy for a loss but apply empathy to a person's life story.

  • Consider how a person's experiences have impacted their capacity.

Self-Care for Helpers

  • Acknowledge that helping professions can be taxing and emotionally draining.

  • Recognize personal limits and boundaries.

  • Good therapists have therapists for self-care and to avoid working out their issues on clients.

Boundaries and Communication

  • Set boundaries on connections with people.

  • Communicate openly and genuinely.

  • Movies often misrepresent social work practices and boundaries.

Private Practice Considerations

  • Set business hours and establish contact procedures for emergencies.

  • Provide a portfolio of resources for outside of business hours.

Social Work Training and Self-Care

  • Social work training is increasingly focusing on the well-being of the professional.

  • Helpers need support and self-care to avoid burnout and secondary trauma.

  • Trauma-informed care should be offered to both clients and the workforce.

Mental Health Awareness and Stigma

  • Increased awareness of mental health since 2020, but stigma still exists.

  • Need to change societal perspectives on mental health and acknowledge its connection to physical health.

  • Adopt a holistic approach to mental health, considering the whole person and their environment.

Assessment Models

  • Medical model: focuses on symptomology.

  • Social work models: strength-based perspective, person and environment, and bio-psycho-social model.

  • Consider social environment, physical environment, and relationships.

Systems Perspective

  • Recognize that individuals are connected to various systems (family, social, political, employment, religious).

  • Assess all these areas to provide comprehensive support.

Generalist Social Work Practice

  • Involves problem-solving, providing shelter or safety, and offering follow-up and evaluation.

  • Focus on crisis intervention across various settings.

Initial Interactions with Clients

  • Avoid assumptions and prioritize assessment.

  • Start by asking how they are doing and what brings them in.

  • Address basic human needs (food, water) before moving to other issues.

Building Rapport with Homeless Individuals

  • Create a welcoming and non-judgmental environment.

  • Offer immediate assistance with basic needs (food, drink).

  • Provide information about available services.

  • Problem-solve together, such as helping them obtain an ID.

Addressing Illiteracy

  • Be mindful of potential literacy issues and offer assistance with forms.

  • Use agency addresses for ID processing.

  • Apologize and reiterate you can work together throughout the process.

Asking Sensitive Questions

  • Frame questions carefully to avoid causing discomfort.

  • Be observant of nonverbal cues and adjust your approach accordingly.

  • Maintain a non-judgmental attitude and focus on building trust..