SOCIAL WORK PRACTICE I

WITH FIELD INSTRUCTION

I

Prepared by: Ms. Joselle G. Salas, RSW

WHAT IS SOCIAL CASEWORK?

1
 It is a process used by human welfare agencies to help
individuals cope more effectively with their problems of
social functioning. It encompasses the four essential
elements or components of social work practice, namely,
the person, the problem, the place and the process.
(Helen Harris Perlman)

1
 “Social case work may be defined as the art of doing
different things for and with different people by
cooperating with them to achieve at one and the same
time their own and society’s betterment”.
MARY RICHMOND (1917)

1
 a helping process which consists of variety of activities that
may include the giving of material assistance; referrals to
other community facilities; rendering emotional and
psychological support through sensitive listening;
expressions of acceptance and reassurance; making
suggestions; appropriately advising and setting limits,
encouraging him to effect his plans; assisting the individual
to narrate and examine his situation; and/or working out with
him a consideration and better understanding of casual
connections between his present attitudes and mode of
adjustment with past experiences. 1
-(Viloria, Esther C.)
 Social casework is a method employed by social worker to
help individuals find solution to problems of social
adjustment which they are unable to handle in satisfactory
way by their own efforts.
(Florence Hollis)

1
• Social casework is an individualized form of helping
people cope with personal problems, essentially on a
one-to-one basis.

• These problems usually involve a deficiency, an

impairment, or a breakdown in psychosocial
functioning.
1
 The over-all goal of social casework is
to achieve some improvement in the
person’s social functioning by bringing
about change in his economic and
social living or environment.
1
SOCIAL WORK METHODS OF INTERVENTION

1
 PRIMARY OR DIRECT METHOD

● The social worker is engaged in direct work with individuals,

groups, and community.

● Often referred to as micro practice

● Terms direct practice and clinical practice are often used

interchangeably

● (Casework, Groupwork, Community Organizing)

1
 SECONDARY OR INDIRECT METHOD

Involves activities by professionals that focus on the structure

through which services are provided such as planning, policy
analysis, program development, administration, and program
evaluation. (Connoway et al, 1998)

● Do not deal directly with clients but require the performance of

certain tasks and activities which facilitate an agency operation
and service and are required to enhance social work practice.

● Often referred to as macro practice 1

HISTORICAL DEVELOPMENT OF CASEWORK

1
 CASEWORK IN THE UNITED STATES

CHARITY ORGANIZATION SOCIETY

-employed the “Friendly Visitor”
• Friendly visitors provide counseling to the individual to do his/her best, to
work very hard to earn enough for himself and his family’s needs.
-FORERUNNER OF SOCIAL WORKERS
-One period of social work development, the years 1880-1990 can be
identified as the era of friendly visiting
Focus of work: poor
Belief: a person’s poverty was the result of defects in his character
Findings: cause of distress is the external economic and
social conditions
-HISTORICAL DEVELOPMENT OF CASEWORK
 CASEWORK IN THE UNITED STATES

1877- American Charity Organization Society was established

(Employed friendly visitors and “paid agents”)

1920's - Freudian Psychology emerged; caseworkers focused their attention on psychic

forces.
-Friendly visitors, the forerunner of the social worker, helped those early settlers who were
unable to adjust to the new culture.

1930's -Economic depression (Economic factors as the cause of distress)

·Poverty and deviance were seen in a different light – these are not the product of personal
deficiency only but are also greatly influenced by the persons situation.
·Functional approach was developed by the faculty of the school of social work of the
university of Pennsylvania.
Groupwork and community organization emerged as the other two methods of social work.
-HISTORICAL DEVELOPMENT OF CASEWORK
 CASEWORK IN THE UNITED STATES

1940's - 1960's
·Ego psychology (coping and adapting abilities)
·Shift of focus from the self to the interaction with significant
others.
·The period that social work functioning as the focus of social
work emerged.
·Felix Biestek identified the seven principles casework.
Helen Perlman came up with the book “Social Casework a
Problem-Solving Process” – marked the end of the diagnostic
functional controversy.
-HISTORICAL DEVELOPMENT OF CASEWORK
 CASEWORK IN THE UNITED STATES

1877- American Charity Organization Society was established

(Employed friendly visitors and “paid agents”)

1920's - Freudian Psychology emerged; caseworkers focused their attention on psychic

forces.
-Friendly visitors, the forerunner of the social worker, helped those early settlers who were
unable to adjust to the new culture.

1930's -Economic depression (Economic factors as the cause of distress)

·Poverty and deviance were seen in a different light – these are not the product of personal
deficiency only but are also greatly influenced by the persons situation.
·Functional approach was developed by the faculty of the school of social work of the
university of Pennsylvania.
Groupwork and community organization emerged as the other two methods of social work.
-HISTORICAL DEVELOPMENT OF CASEWORK
 CASEWORK IN THE UNITED STATES

1877- American Charity Organization Society was established

(Employed friendly visitors and “paid agents”)

1920's - Freudian Psychology emerged; caseworkers focused their attention on psychic

forces.
-Friendly visitors, the forerunner of the social worker, helped those early settlers who were
unable to adjust to the new culture.

1930's -Economic depression (Economic factors as the cause of distress)

·Poverty and deviance were seen in a different light – these are not the product of personal
deficiency only but are also greatly influenced by the persons situation.
·Functional approach was developed by the faculty of the school of social work of the
university of Pennsylvania.
Groupwork and community organization emerged as the other two methods of social work.
-HISTORICAL DEVELOPMENT OF CASEWORK
 CASEWORK IN THE UNITED STATES

1877- American Charity Organization Society was established

(Employed friendly visitors and “paid agents”)

1920's - Freudian Psychology emerged; caseworkers focused their attention on psychic

forces.
-Friendly visitors, the forerunner of the social worker, helped those early settlers who were
unable to adjust to the new culture.

1930's -Economic depression (Economic factors as the cause of distress)

·Poverty and deviance were seen in a different light – these are not the product of personal
deficiency only but are also greatly influenced by the persons situation.
·Functional approach was developed by the faculty of the school of social work of the
university of Pennsylvania.
Groupwork and community organization emerged as the other two methods of social work.
-HISTORICAL DEVELOPMENT OF CASEWORK
 CASEWORK IN THE UNITED STATES

1970's
• Generalist practice was developed for unified social work
profession.
• Authors contributed to the development of Generalist practice
• Carol Meyer’s (Social Work Practice: A Response to the Urban
Crisis)
• Harriet Bartlett (Common base of Social Work Practice)
• Allen Pincus & Anne Minahan (Social Work Practice: Model and
Method)

-HISTORICAL DEVELOPMENT OF CASEWORK

 CASEWORK IN THE PHILIPPINES

1917 - Associated Charities of Manila – family welfare agency pattern with COS which
employed “home visitors”

1920's - Psychiatric Social Work in Welfare Ville

·Victoria cited an unpublished thesis reporting the first social service unit organized in
1915 at the Philippines General Hospital Josefa Jara Martinez pioneered Social
Casework

1940's - Dr. Jose Vergara of ACM adapted the US practice and employed social
workers to work with children and youth (functioned as caseworkers)
The department of Health Circular No. 146 issued in 1954 provided and item for at
least one medical social worker at the national, provincial, city and emergency
hospitals.
-HISTORICAL DEVELOPMENT OF CASEWORK
 CASEWORK IN THE PHILIPPINES

1960's - The three national workshops on social work

education recommended the revision of the social
work curriculum
1980's - Emotional and psychological functioning of
individuals because of addiction, marital conflict,
broken homes, growing numbers of mentally ill
patients, etc.
1
-HISTORICAL DEVELOPMENT OF CASEWORK
SOCIAL CASEWORK PRINCIPLES
(Felix Beistek)

1
 SOCIAL CASEWORK PRINCIPLES

A. PURPOSEFUL EXPRESSION OF FEELINGS

·The recognition of the client’s needs to express his feelings, freely, his
pent-up feeling, especially his negative feelings.

B. CONTROLLED EMOTIONAL INVOLVEMENT

·The workers sensitivity to the clients’ feelings, an understanding of
the meaning of these feelings, and a purposeful, appropriate response.
·Professional noninvolvement, professional detachment
·(Sensitivity) ability to perceive or respond to the clients expressed
feeling, attitudes, or behavior.
1
 SOCIAL CASEWORK PRINCIPLES

C. ACCEPTANCE
·The worker perceives and deals with the client as he is,
including his strengths and weaknesses, his positive and
negative feelings, his constructive and destructive behavior,
while maintaining and communicating a sense of the client’s
innate dignity and personal worth.

D. INDIVIDUALIZATION
·The recognition of each client as a unique individual.
·The worker must be skilled in differential diagnosis
 SOCIAL CASEWORK PRINCIPLES

KLUCKHOLM & MURRAY

A. Like all other men
B. Like some men
C. Like no other men

1
 SOCIAL CASEWORK PRINCIPLES

E.NON-JUDGEMENTAL ATTITUDE
·Based on the belief that social work does not assigning guilt or
innocence.
F.CLIENT SELF DETERMINATION
·The recognition of the right and need of the client to have freedom
in making his own choices and decisions in the social work process.
G.CONFIDENTIALITY
·Is the preservation of the private information concerning the client,
which is disclosed within the professional relationship, or is received
from other sources while working with a client.
The most violated principle 1
 SOCIAL CASEWORK PRINCIPLES

H.WORKER SELF AWARENESS

·Social worker is always conscious that her role is to
make use of her professional relationship with her
client in a way that will enhance primarily the clients
developmental; rather than her own.
I.CLIENT WORKER RELATIONSHIP
·Means for carrying out the social workers functions.
1
THREE MAJOR VALUES

1
 THREE MAJOR VALUES

A. HUMAN RIGHTS
·Man possesses basic human rights endowed on him by
God which are natural, inalienable, and universal.
Civil rights and liberties:
a.Right to life
b.Right to liberty
c.Right to security
d.Right to freedom
e.Right of conscience and religion
f.Right to peaceful assembly and association
g.Right to equal protection
1
 THREE MAJOR VALUES

B. SOCIAL JUSTICE
·The equitable distribution of the national wealth and
income and the equality of access to opportunities for
the full development of every citizen.

·involves the principle of equality of opportunities,

equality before the law, and the equitable distribution
of the fruits of production.
1
 THREE MAJOR VALUES

A. PEOPLE PARTICIPATION
·Refers to voluntary involvement in self determined change.

Levels of Participation
o Direct participation in policy making and program
development usually at local level
o Participation through representation usually at the national
level
o Participation in mutual self-help programs at the
neighborhood level.
1
BASIC CONCEPT IN SOCIAL WORK

1
 BASIC CONCEPT IN SOCIAL WORK

RELATIONSHIP
·Involves self-discipline and self-awareness
·Compassion, mutuality, humility, etc.
·Warmth, caring, and congruence have been identified as
essential qualities.

1
 RELATIONSHIP
SELF-AWARENESS
· Workers value clash with the client’s values.
· Is called for when there is a difference between the problems and
priorities as the worker sees them and as her client sees them.
AUTHORITY AND POWER
·Her position and corresponding functions in the agency and her
possession of knowledge and experience.
COMMITMENT AND OBLIGATION
·To commit is to bind oneself to a relationship
·To obligate is to perform the moral responsibility.
·Helping contract 1
COMPONENTS OF CASEWORK
RELATIONSHIP

1
 COMPONENTS OF CASEWORK RELATIONSHIP

1.REALITY
oAn objective assessment of the client’s situation. Its starts from the
purpose of the client-worker relationship, that is to help the client in some
are of his social functioning.
oA clear direction of where the relationship between the worker and client
should move to achieve its purpose.
2.TRANSFERENCE
o It takes place when the client unconsciously transfers to the social worker
attributes or characteristics of some important or powerful persons in his
past life.
3.COUNTER TRANSFERENCE
This is the workers ounconscious response to the client’s transference.
FOUR MAJOR CASEWORK TECHNIQUES
(FLORENCE HOLLIS)

1
 FOUR MAJOR SOCIAL WORK TECHNIQUES

A. PSYCHOLOGICAL SUPPORT
·Encouraging the client to talk freely and express his
feelings.
B. ENVIRONMENTAL MODIFICATION
·The steps taken by caseworker to change the
environment in the clients favor by the worker direct
action.
1
 FOUR MAJOR SOCIAL WORK TECHNIQUES

C. CLARIFICATION
·Understanding by the client of himself, his environment,
and or people with whom he is associated.
·Technique may be combined with, or it is usually
accompanying psychological support.
·Directed toward increasing the client’s ability to see
external realities more clearly
1
 FOUR MAJOR SOCIAL WORK TECHNIQUES

D. INSIGHT DEVELOPMENT
·Current and past emotions must be relived in a
therapeutic atmosphere.
·The process can help the client see his inner realities and
develop an understanding of how these affects his
behavior and actions.
1
SOCIAL WORK TECHNIQUES

1
 SOCIAL WORK TECHNIQUES

1. Interviewing
·a set of verbal and non-verbal interactions between two
or more people. Focused on gathering information.

Types of Interviews
1. Informational/social history
2. Assessment/decision making
3. Intervention Interview 1
 SOCIAL WORK TECHNIQUES

2. Small talk
- refers to inconsequential conversation.

3. Home Visits
·The process by which a professional or paraprofessional provides
help to a family in their own help.

4. Collateral Contact
·A source of information that is knowledgeable about the client's
situation and serves to support or corroborate information
provided by a client. 1
 SOCIAL WORK TECHNIQUES
5.Support
·To encourage, to uphold, to sustain some aspect of the client’s functioning – his
strength, his attitude, his eagerness to do something about his problem.

A.Ventilation – involves bringing to the surface the feelings and attitudes that
need to be brought out because these are affecting the psychosocial functioning
of the person harboring them – the client.
B.Reassurance – assuring the client that the situation with which he is struggling
has an attainable solution and that he has the capacity to deal with his own
problem.
C.Instillation of Hope – support is given when the worker demonstrates interest
in client’s effort and progress, encouraging his efforts, offering realistic 1
assurance, and expressing hope that things will be better.
 SOCIAL WORK TECHNIQUES

6.Exploration
-Used to elicit necessary information; to bring out details about
experiences and relationships as the client perceives them; and
to examine the feelings connected to the relationships and
experiences.
7.Clarification
-Connected with exploration. When worker explores, he must
make his client clearly understand his questions which in turn
makes him clearly understand the information that his client is
conveying.
 SOCIAL WORK TECHNIQUES

8.Education and Advice

-The social worker is tasked to contribute data, ideas, facts, and
value concepts which are not available to the client, and which may
prove useful to him attempting to cope with that part of social
reality which is involved in the problem with which he is working.
9.Universalization
- The utilization of a commonality of human experiences and the
strengths of others to cope with situations like those which are
troubling the client.
 SOCIAL WORK TECHNIQUES

10.Reward and punishment

- Used when there is a better understanding of the
causes and greater ability to anticipate and control
consequences.
11.Confrontation
-To come face to face with the hard facts of the situation –
with reality, to bring a person face to face with something.
1
 SOCIAL WORK TECHNIQUES

12.Conflict
- A type of stress produced when a person is
motivated by two or more needs in such a manner that
the satisfaction of one need may mean the
dissatisfaction of another one.
13. Manipulation
-Means skillful management of events (e.g.,
environmental manipulation).
1
 SOCIAL WORK TECHNIQUES

14.Conscientization
-Means the arousing of man’s positive self-concept in
relation to the environment and society through a
liberating education which treat learners as active agents
rather than passive recipients of learning.

1
ESSENTIAL ELEMENTS OF SOCIAL WORK
PRACTICE

1
ESSENTIAL ELEMENTS OF SOCIAL WORK
PRACTICE

CLIENT
Individuals, groups and communities
WORKER
Professional change agent
PROBLEM
Reason for entry of a change agent.
PROCESS
Development of helping relationship
1
Casework is a problem-solving process that is
set in motion when a Person with a Problem
comes to a Place where a professional social
worker helps him by a given Process.

1
 PERSON

-In casework, helping efforts are focused on the

individuals, who is the principal client.

-To enable the worker to know the person to be able to

help him, he must understand that person’s behavior to
be able to correct or improve his social functioning.
1
 PERSON
Social Roles
• The sum of the cultural patterns associated with a
specific behavior and attitudes which a person assumes
in a specific situation in his relationship with others.

Aspects which affect the actual performance of role:

PRESCRIBED ROLE
-It is that which is expected by the norms and
expectations of society.
 PERSON

SUBJECTIVE ROLE
- It is that which the person ascribes (assigns) to himself in
a specific role.

ENACTED ROLE
- It is that which the person performs as that’s what he
thinks the role entails
1
 PERSON

STRESS
-Any kind of pressure that affects a person in his daily life,
most especially when he is facing a problem which he
cannot handle by himself.
-Produces a physical or psychological strain disruptive
influence on the person making him unable to function
normally.

1
 PERSON
3 major sources of stress
oEnvironment
oSituation
oEvents

Reactions to stress
·Proactive
-Self-directing, takes responsibility, adjust
·Reactive
-Blaming, feeling victim, helpless 1
 CLIENTY’S MOTIVATION AND CAPACITY

MOTIVATION
-Refers to a person’s taking action based on his thoughts and
feelings.
-What prompt him to act, stimulates him to action,
manifesting interest, and willingness to be involved.
CAPACITY
-Emotional Capacity
-Social Intelligence Capacity
-Physical Capacity 1
 PROBLEM

Problem may be:

-Some unmet needs- economic, medical, educational, etc.
-One of stress which cause the person to be ineffective or
disturbed in carrying out his social roles

1
 PROBLEM
Reasons why individuals are unable to solve their problem:
1. Due to tangible means and resources, he needs are
not available to him
2. Ignorant or lacks information
3. Drained or depleted of emotional and physical energy
that he can hardly lift a finger to help himself
4. Emotions may be so strong that they overpower his
reason and defy his conscious control
1
 PROBLEM TYPOLOGY
A. INTERPERSONAL CONFLICT
-involves individuals having difficulty relating to each other, interpersonal conflict
may also involve both communication and behavior- problem may exist regarding
on how information is conveyed and received between two people
B. DISSATISFACTION IN SOCIAL RELATIONS
-one may feel unable to get close to others as she would like or one may feel tha
lack of assertiveness prevents his needs from being met
C. INADEQUATE RESOURCES
-reflects a deprivation of basic needs be due to poverty, may also refer to lack of
resources or services available to client.
D. DIFFICULTIES IN ROLE PERFORMANCE
-a difficulty in role performance can best be distinguished from interpersonal
comnflict by the fact that role performance is more one-sided
 PROBLEM TYPOLOGY
E. PROBLEMS OF SOCIAL TRANSITION
-clients may experience difficulty dealing with some major changes in
their lives
F. PSYCHOLOGICAL AND BEHAVIORAL PROBLEMS
-these involve a broad gamut of emotional upheavals and inappropriate
self defeating, deviant/ criminal or uncontrollable behavior.
G. PROBLEM WITH FORMAL ORGANIZATION
-difficulty in dealing with rules and regulations in formal organization
H. PROBLEM IN DECISION MAKING
-may manifest in the form of emotional dilemma, loss of objectivity,
irrational choices due to some crisis situation that the client is unable to
control
 PLACE

- It is this organization which

employs social workers to help the
client.

1
 PROCESS
-It is the means through which the agency purpose is
achieved.
-It is a progressive transaction between the professional
helper and the client.

It aims to achieve two things.

1.To help client to meet his needs or solve a problem
2.To provide him with fruitful coping experiences which
he may use later as he goes through life. 1
SOCIAL WORK HELPING PROCESS

1
HELPING PROCESS

•ASSESSMENT
•PLANNING
•INTERVENTION
•EVALUATION
•TERMINATION
1
 ASSESSMENT
·It is “a process and a product of understanding on
which action is based.” (Max Siporin)

·The ultimate purpose is to provide understanding

necessary for appropriate planning.

·The process involves the collection of necessary

information and its analysis and interpretation to
reach an understanding of the client, the problem,
and the social context in which it exists.
 ASSESSMENT
PSYCHO-SOCIAL ASSESSMENT – is used to denote a more holistic,
inclusive and comprehensive view of the inter relationship of the multiple
facets of the client’s life and understanding of the person in context.

BIO-PSYCHO-SOCIAL ASSESSMENT
A.Biological Context – it includes current & past physical conditions, genetic
factors & health, physical functioning, state of health, focus on the presence
of illnesses, injuries, disability, and genetic abnormalities that produces stress
on the body

B.Social Context – encompasses an understanding of interpersonal

relationships as part of the client’s life (family and other significant
relationships and the culture permeating client’s life)
 ASSESSMENT
C.Psychological Dimension – better grasped using psychological
theories as well as the dexterity in their application to specific client
problem situation

D.Other Social Support – other additional interpersonal relationships

that provide us with support

E.Social Environment Resources/Stressors – environmental contexts

that may either present opportunities or limitations

F.Culture – client may belong to ethnic communities that has direct

influence on his identity
 ASSESSMENT
MAJOR TASKS
• information or data-gathering
• problem definition or simply (problem-for-work)
• These tasks culminate in the worker’s writing of an
Assessment Statement or a Problem Definition.
• However, Assessment Statement appears in most
social work literature and seems to also be the
preferred term in the field of practice today.
1
 SOURCES OF INFORMATION
PRIMARY SOURCE
-Client or the community
-The condition and behavior is the main concern
SECONDARY SOURCES
The “significant others” in the life of the client whom
he/she has personal relationship
EXISTING DATA
Data or information previously collected by others
WORKERS OWN OBSERVATIONS
Direct observation of the client, or his/her interaction with
others.
 PRINCIPLES IN DATA GATHERING

1. Client is the main source

2. Data should relate to problem
3. Informed consent from client about the source of data
4. Data collection is a continuous process
5. The type of client and general nature of the problem
can be of guide

1
 PRINCIPLES IN DATA GATHERING

PARSIMONY
- Social Worker collects only that data/information that has
relevance to the situation at hand and is essential to the
formulation of valid working judgments.

- It is gathering important information that are useful for

the client’s case.
1
INITIAL CONTACTS WITH THE CLIENT

1
 INITIAL CONTACTS WITH THE CLIENT

1. CLIENT INITIATES THE CONTACT (Voluntary)

Ex. A client seeks burial assistance from the CSWDO

2.CLIENT IS REFERRED TO THE WORKER OR AGENCY.

·merely forced to secure help.
·called “involuntary clients.”
·Mentally disturbed and severely handicapped persons are two examples.
Sometimes, persons referred by others are merely forced to secure help.
Ex. Drug dependents, children in conflict with the law.

3. AGENCY REACHES OUT TO THE (POTENTIAL) CLIENT

-The “baranganic approach,” used by the Department of Social Welfare and
Development, is one example of an agency outreach program.
Ex. Rescue of victims of human trafficking
TOOLS FOR ASSESSMENT

1
 ECOMAP
-eco-map or ecogram
-A simple paper- and-pencil simulation that presents
the individual or family and the major systems in the
life space, as well as the nature of the individual’s or
family’s relationships with these various systems
-It is a diagram that shows the social and personal
relationships of an individual with his or her
environment.
 GENOGRAM
• a graphic representation of a family tree that displays
detailed data on relationships among individuals. It
goes beyond a traditional family tree by allowing the
user to analyze hereditary patterns and psychological
factors that punctuate relationships.

1
1
INTAKE

1
 INTAKE

• the process by which a potential client achieves the

status of a client. It marks the official start of the
helping relationship and may be accomplished in one
or more session with client.

• ·A good intake interview should provide the client

with adequate understanding of the agency and its
policy and program in relation to the need or
problem, as well as the responsibilities and
obligations from both client and worker. 1
CATEGORIES OF PROBLEMS

1
 CATEGORIES OF PROBLEMS

THE PRESENTING PROBLEM

• It is a problem that is a threat to the client’s or

others’ welfare, and usually stated or presented as
it is being perceived or experienced by the client.
“Start where the client is” and “begin with the felt
need”

1
 CATEGORIES OF PROBLEMS

THE PRESENTING PROBLEM

can be:
a) Symptoms (anxiety, lack of motivation)
b) Behavioral configurations (marital discord, poor school
performance, unemployment)
c) Needs (housing, money, etc.).
• The client’s problem may be such that it requires immediate
action.
• The client’s “presenting problem,” if it is the problem or part of
the problem that the client system feels is most important, may
serve as the problem-for-work.
 CATEGORIES OF PROBLEMS

THE PROBLEM FOR WORK

the place of beginning together.

• Client feels most important

• Worker’s judgement is most critical
• Worker’s judgement can most readily yield to
help
• Falls within the action parameters of the
helping system 1
 CATEGORIES OF PROBLEMS

THE PROBLEM FOR WORK

the place of beginning together.

• Client feels most important

• Worker’s judgement is most critical
• Worker’s judgement can most readily yield to
help
• Falls within the action parameters of the
helping system 1
 CATEGORIES OF PROBLEMS

THE PROBLEM FOR WORK

the place of beginning together.

• Client feels most important

• Worker’s judgement is most critical
• Worker’s judgement can most readily yield to
help
• Falls within the action parameters of the
helping system 1
 UNDERLYING PROBLEM

- The overall situation that is created and

tends to perpetuate the immediate
problem.

1
 1. Partialization – process of separating from so many
problems identified by the client and/or worker the specific
problems or problems which are to be addressed first.

2. Prioritization – taking precedence over other problems

because of its importance.
COMPONENTS OF AN ASSESSMENT STATEMENT
(Mcmahon Maria,1990)

1
 COMPONENTS OF AN ASSESSMENT STATEMENT
(Mcmahon Maria,1990)

1. Opening causal statement.

Who has the problem, why the problem exists

2. Change potential” statement.

Person, Problem, Environment
1
 COMPONENTS OF AN ASSESSMENT STATEMENT
(Mcmahon Maria,1990)
PERSON
• assess the strengths and weaknesses of the person or persons having the problem. An appraisal of the change
potential of a problem in so far as the person factor is concerned should answer questions like.
a. what is his/her/their motivation and capacity for change?
b. Are they able to cope with it alone or accept help from others?
c. What is their change potential?

PROBLEM
• The worker and the contact system (client or some significant others) consider the nature of the problem and
its change potential by answering the following questions:
a. Can this problem be resolved?
b. Is the nature of the problem irreversible (e.g., terminal illness)?
c. How long has the problem been going on
d. who are involved and to what extent?

ENVIRONMENT
In considering the environment in which the problem is located the worker should know the following:
a. What formal or informal resources are available in the environment that can promote the necessary changes?
b. What restraining forces are there that are stronger than supportive resources?
c. With optimum use of available resources, what is the expected outcome?
 COMPONENTS OF AN ASSESSMENT STATEMENT
(Mcmahon Maria,1990)

3. Judgment about the seriousness or urgency of the

problem.
Based on available data, the worker should be able to
answer this question:
d. To what extent is this a life-or-death-matter for the
person(s) concerned? Life-endangering situations require
the worker’s immediate attention even if in her judgment
the change potential for the problem is very low.
CHARACTERISTIC OF ASSESSMENT

1. It is ongoing.
2. It focuses on understanding the client in the situation and in
providing a base for planning and action.
3. It is a mutual process involving both client and worker.
4. There is movement within the assessment process.
5. Both horizontal and vertical explorations are important.
6. Assessment identifies needs in life situations, defines problems
and explains their meanings and patterns.
7. Assessment is individualized.
8. Judgment is important in assessment because many decisions
must be made.
9. No assessment is ever complete.
PLANNING

1
 PLANNING
-link between Assessment and Intervention.
-translates the content of assessment into a goal
statement
-The end goal of planning is planned change.
-Planning allows the worker, with the client’s
participation to move from problem definition to
problem solution.
 PLANNING

TWO MAJOR TASK

1. Goal setting - formulating goals that directly
relate to the client’s need or problem, and
2. Planning interventions - defining the specific
actions or interventions that are necessary in
order to achieve the goals.
 PLANNING
GOALS
- Goals are ends
- Desired and expected outcomes of an
endeavour
- Optimate/general/optimal
- Interim/intermediate/objectives

Characteristics: SMART
 PLAN
- Means or specific actions to achieve goals

UNIT OF ATTENTION
- System that are the focus of the change activity

STRATEGY
- An overall approach to change a situation
- Battle plan
- Orchestrated action
1
INTERVENTION

1
 INTERVENTION
-Is concerned with the action that would solve the client’s
problems
-Rendering of all the specific and interrelated services
appropriate to the given problem situation in the light of the
assessment and planning.
-it is during intervention that the worker is faced with the
challenge of putting into operation her professional
knowledge, values and the skills to help the client reach
their mutually defined goals.
1
 INTERVENTIVE ROLES

refers to the composite of activities or tasks

that we are expected to undertake to
accomplish the goals agreed upon with the
client
1
 INTERVENTIVE ROLES (DIRECT
PRACTICE)
1. Resource provider – direct provision of material aid and
other concrete resources

2. Social broker – negotiating the “service jungle” for clients.

a. Referral is considered as basic activity that involves
connecting the client to needed resources.
b. Networking refers to efforts at establishing and maintaining
relationship with other community entities which have
resources that can support and supplement her own agency’s
resources
 INTERVENTIVE ROLES (DIRECT
PRACTICE)
1. Mediator – the worker must engage in efforts that will resolve
disputes between the client system and other parties.

2. Advocate– the worker has to take a partisan interest in the client

and his cause. She cannot remain neutral.

3. Enabler – help clients find the coping strengths and resources

within themselves to solve problems they are experiencing.

4. Counselor/Therapist – restoration, maintenance, or enhancement

of the client’s capacity to adapt or adjust to his current activity.
 INTERVENTIVE ROLES (INDIRECT
PRACTICE)
1. MOBILIZER OF COMMUNITY ELITE
-informing and interpreting to certain sectors of the community, welfare
programs and services, as well as needs and problems, enlisting their
support and/or involvement in them.
2. DOCUMENTER OR SOCIAL CRITIQUE
-documents the need for more adequate social welfare policies and
programs based on her knowledge (gained from actual experience) about
the inadequacies or deficiencies in these existing welfare policies and
programs
3. POLICY PROGRAM CHANGE ADVOCATE
-involved in efforts to change policies and programs on behalf of sectors of
the population based on the values of the profession; to take a stand
EVALUATION

1
 EVALUATION
-Collection of data about outcomes of a program of action relative
to goals and objectives set in advance of the implementation of
that program.

-Impact refers to the difference between the pre-intervention

situation and/or behavior, and the post-intervention situation
and/or behavior.

-Ongoing vs terminal

1
-Professional accountability; Effectiveness and efficiency
 ESSENTIALS FOR EVALUATION

1. A clear definition of the goals and objectives to

be attained
2. A clear definition of the intervention and change
activities to be undertaken
3. Documentation of the activities undertaken to
achieve the goals defined
1
TERMINATION

1
 REASONS FOR TERMINATION
1. When the goals set by worker and the client have
been reached
2. When, after a reasonable period, there has been very
little movement toward the attainment of the goals
formulated, and the prospect for any change in the
situation is held unlikely
3. When the client thinks that the worker has provided
sufficient help so that it is now possible for the client to
pursue problem-solving on his own
 REASONS FOR TERMINATION
4. When an agency does not have the resources needed
by the client or the worker does not get her agency’s
approval to provide services needed by the client
5. When the systems outside the client make it difficult for
the client to continue with the helping relationship or when
these systems influence the client to discontinue the
relationship
6. When for one reason or another, the worker must leave
the agency
 COMPONENTS OF TERMINATION
( DISENGAGEMENT, STABILIZATION OF CHANGE and
TERMINAL EVALUATION)

1
 DISENGAGEMENT
a)Denial – a defense mechanism that is employed to avoid painful
feelings
b)Emotional reactions – fear of loss or fear of the unknown can give
rise to feelings of sadness or of grief
c)Bargaining – some clients try to negotiate an extension of time or a
modified schedule which can mean fewer contacts over a longer
period with the worker
d)Depression – listlessness, little energy, withdrawal, sadness,
helplessness, despair, absence of motivation to go on.
e)Acceptance – increase energy, and is able to talk about the good
and the bad times and to think about the future
 DISENGAGEMENT

Factors which influence client’s reactions:

1. Length of service
2. Attainment of client goals
3. Client-worker relationship
4. Modality of intervention
1
 STABILIZATION OF CHANGE

- The main test of a change agent’s help is the

stability and permanence of the client system’s
changed behavior when the change agent is no
longer actively working with the client.

1
 TERMINAL EVALUATION

- It is the time for the worker and the client – but

particularly the worker who has been the helping
person, to appraise what have transpired, to focus
on the goal formulated during Planning phase and
on the problem that was identified during the
Assessment Phase.
CASEWORK PRACTICE MODELS AND
APPROACHES

1
 FUNCTIONAL APPROACH

·University of Pennsylvania, 1930s

·Jessie Taft, Virginia Robinson and Ruth Smalley.

·It is a social casework method for engaging the client through

a one-to-one relationship in the use of a social service toward
his own and the general social welfare.

·The focus of the intervention is the delivery of service(s) to the

client (common approach used in the Philippines).
 FUNCTIONAL APPROACH
Characteristics:
Principles:
1. psychology of growth – 1. understanding of the
sees human being as capable phenomenon served
of modifying both himself and (diagnosis)
his environment 2. use of time phases –
2. purpose of the agency
process
guides the social worker’s
over-all purpose. 3. use of agency function
3. social work is viewed as a 4. use of structure – time,
helping process through place, agency policy and
which an agency’s service is procedures
made available
 PROBLEM SOLVING
APPROACH
-Identified with the work of Helen Perlman at the Chicago
school in l957.
- It assumes that the person’s problem-solving
capabilities or resources have been broken down or been
impaired or are maladaptive.
-The focus of treatment is in helping the person go
through the scientific problem-solving process so that he
will act and resolve his problem with only minimum help.
 PROBLEM SOLVING
APPROACH
The person – product of inherited and constitutional makeup in
continuous transaction with potent persons forces in life experiences
The problem – a problem in the current life situation of the help-seeker
which disturbs or hurts the latter in some way.
The place – particular organization, agency or social institutions.
The process – study, diagnosis and treatment

Two factors: (1) relationship and (2) involvement of significant others.

Problem-solving means: (1) motivation, (2) capacity and (3)

 PROBLEM SOLVING
PROCESS
I. Contact Phase (Engagement)
a. Problem Identification
b. Goal Identification
c. Preliminary contract/Emergence of commitment
d. Exploration and investigation
II. Contract Phase
a. Assessment and evaluation
b. Formulation of a Plan of Action
c. Prognosis
III. Action Phase
IV. Evaluation and Termination
 PSYCHOSOCIAL APPROACH

- Freudian theory of personality

- Organismic approach
- Diagnostic school of thought
- Systems theory approach
- Gestalt theory
- Differential treatment
 PSYCHOSOCIAL APPROACH
·One of the first models employed developed by Gordon Hamilton
and her associates from the Columbia School of Social Work.

·It is concerned with inner realities of the person, his emotional,

mental and social processes, and the social context in which he
lives.
·Used with clients affected by traumatic incidents.
·According to Gordon Hamilton, treatment here is focused on the
individual and his functionality.
·Cause and effect relationships are identified between the
individual and environment.
PSYCHOSOCIAL APPROACH

A. INITIAL PHASE
1.Understanding The Reasons for The
Contact
2.Establishing Relationship
3.Engaging The Client in Treatment
4.Beginning Treatment Itself
5.Psychosocial Study
 PSYCHOSOCIAL APPROACH
B. ASSESSMENT OF THE CLIENT AND HIS SITUATION
Types of diagnosis:
a. Dynamic
- examination of how different aspects of the client’s
personality interact to produce his total functioning
b. Etiological
- cause or origin of the difficulty
c. Classificatory
- to classify various aspects of the client’s functioning
and his place in the world
 PSYCHOSOCIAL APPROACH

C. TREATMENT
- to alleviate the client’s distress and decrease the
malfunctioning in the person-situation system.

Treatment Process:
a. Indirect Treatment – intervenes directly in the
environment of the client
b. Direct Treatment – involves direct work with the
client himself. “The influence of mind upon mind”.
 PSYCHOSOCIAL APPROACH

I.Sustaining
II.direct influence
III.catharsis or ventilation
IV.reflective consideration of the current person-situation
configuration
V.encouragement of client to reflect on dynamics of his
response patterns and tendencies
VI.encouragement of client to think about the
development of response patterns or tendencies
 TASK CENTERED APPROACH

·University of Chicago, 1970s

·Laura Epstein and William J. Reid
·Technology for alleviating specific target
problems perceived by clients, that is,
particular problems clients recognize,
understand, acknowledge, and want to
attend to.
 TASK CENTERED APPROACH

·Task – what the client is to do to alleviate the

problem
·Treatment concentrates on helping individual clients
to achieve specific or limited goals of their own
choice within brief and bounded periods of service.
·Designed to solve specific psychosocial problems of
individuals or families in a short-term, time-limited
form of practice.
 TASK CENTERED APPROACH

·It is similar to crisis intervention, but it

focuses on a task to be achieved by the
client.
It may focus on a specific behavior or
social environment that needs to be
changed.
 TASK CENTERED APPROACH
Characteristics:
Brief and time-limited
Concentrated on alleviating specific problems
Tasks are carried out

Targets:
Family and interpersonal relations
Social role performance
Effecting social transitions
Securing resources
Emotional distress reactive to situation factors
 TASK CENTERED APPROACH

FEATURES OF THE MODEL

Assessment – consists of finding out the problem
and classifying and specifying the problem.
Case planning – the practitioner constructs a
program by making judgements about what
changes can be expected to reduce the problem.
Implementation – tasks carried out
Tasks – state what the client is to do.
TASK CENTERED APPROACH
 CRISIS INTERVENTION
APPROACH
There is no such things as a “problem-free” state and life
is a series of recurring developmental crisis.

Crisis – upset in a steady state, an emotional reaction and

temporary disturbance.

Crisis intervention – process of actively influencing the

psychosocial functioning of individuals and groups, during
a period of disequilibrium.
 CRISIS INTERVENTION
APPROACH
• 2-6 weeks in duration
• Available within 24-72 hours
• Hospitals, hotlines, women’s desk, etc.
• “search and find approach”
• “here and now”
• Always voluntary
• Worker’s stance as active, purposive, and
committed.
 CRISIS INTERVENTION
APPROACH
GOALS:
• To reduce the immediate harmful effects of
the stressful events.
• To help mobilize the latent capacities and
capabilities of the person directly affected
so that he can cope more effectively with
the effects of the crisis.
 CRISIS INTERVENTION
APPROACH

TARGET POPULATION:
• Individual in crisis
• Those associated with persons in
crisis
Those in collective crisis
 HELPING PROCESS IN CRISIS
A. ASSESSMENT OF THE SITUATION
I. The hazardous event – specific and stress-producing
occurrence:
a.Anticipated and predictable
- normal developmental critical periods and transitional
stages
a. Unanticipated and accidental events
II.The vulnerable or upset state – subjective reaction of the
individual or family to the initial blow, both at the time it
occurs and subsequently
 HELPING PROCESS IN CRISIS

I.The precipitating factor or event – link in the chain of

stress

II.The state of active crisis – subjective condition once

tension has stopped.

III.The state of reintegration or reorganization – is the

adjustment either adaptive and integrative or
maladaptive and destructive
 HELPING PROCESS IN CRISIS
B. IMPLEMENTATION OF TREATMENT
- middle phase that is about setting up and working out
specific tasks.

Two categories of tasks:

1.Material-arrangement tasks – concerned with the provision
of concrete assistance and services

2.Psychosocial tasks – concerned with dealing with client’s

feelings, doubts, ambivalence, etc.
 HELPING PROCESS IN CRISIS
Treatment techniques:
1. Sustaining techniques – with reassurance and encouragement
predominant,
to lower anxiety, guilt, and tension, and to provide emotional support
2. Direct influence – like giving advice; advocating a particular course
of action,
etc.
3. Direct intervention – in extreme situations such as threats of or
attempts
at suicide or where the client is deteriorating rapidly.
4. Reflective discussion techniques – as the client becomes integrated
 HELPING PROCESS IN CRISIS

A. TERMINATION
worker review their progress, focusing
on key themes and basic issues
 SIX-STEP MODEL OF CRISIS INTERVENTION
(JAMES, 2008)
1. Define the problem
-using core listening skill of empathy, genuineness, and acceptance.
2. Ensuring client safety
3.Providing support
-The support given may be emotional as well as instrumental and
informational
4.Examining alternatives
(1) support system
(2) client’s coping mechanisms
(3) client’s thinking patterns
5. Making plans
 FAMILY INTERVENTION

• 1950s – development of family therapy

• Family therapy – relies heavily on psychoanalytic

personality and systems theory.

• Family-focused treatment – “family casework” focuses

on the individual family member, with the family
members being involved in the helping process.

• Process: Assessment, Planning, Implementation and

Review and Evaluation
• Tools: Genogram and eco-map
 STRENGTHS BASED APPROACH

- Focus on client strengths, resources, coping abilities

that make them capable of change and active
participants in the change process.

- Put clients in charge of the helping process.

- Worker and client continually evaluate client’s progress,
i.e., whether the issues or concerns for which help was
sought have improved
 GENERALIST PRACTICE MODEL

-Based on a problem-solving model from a

systems or person-in-environment
perspective.
-This model is applied with the unique
qualities, values, and ethics espoused by
social work.
 ECOLOGICAL OR LIFE PRACTICED MODEL

- The Ecological or Life Model of Practice

espouses the view that transactions take
place between people and the environment-
meaning there is a consistent striving in
people to achieve goodness-of-fit with their
environment.
 FEMINIST APPROACH

- Gender inequality is the focus of

this approach.
- Racial, social and class issues
shape one’s identity & experiences.
 ANTI OPRESSIVE APPROACH

- Focus: Oppressive systems that needs

to be drastically changes.
- Aim: Minimize power difference in
society and to maximize the rights to
which all people are entitle.
- Advocates human-rights based social
work.
 EMPOWERMENT APPROACH

- Process of increasing the capacities of

individuals to make choices leading to desirable
outcomes.
- Focus: Restoring the power of clients
especially power in decision making process,
creating positive self-image, enhancing one’s
ability to sort what is right and wrong.
 COGNITIVE BEHAVIORAL APPROACH

- Focuses on the present and aims to modify or

replace distorted cognition such as phobia, anxiety
disorder, depression sexual dysfunction and habit
disorder.
- Ultimate goal is the generalization of new skill as
well as development of relapse prevention
strategies (Fanger, 1995).
 STRATEGIC OR SOLUTION MODEL

- Developed by Milton Erickson.

- Focus is on what is happening now and
how it should be changed.
- Emphasis on better ways of dealing with
relationship
 CASE MANAGEMENT

- Introduced in 1970s in recognition of the comprehensive

need for resources from a variety of service sectors.
- This model is indicated for people with HIV/AIDS,
developmental disabilities and those requiring long-term
care.
- Ensures timely and adequate delivery of services.
 COGNITIVE TREATMENT

- Focused on a specific problem (that may be cognitive,

emotional, behavioral, physical-psychological, social
environmental or a combination of these areas) jointly
defined by the worker and the client as the target of
change.
- Worker seeks collaboration with the client but takes
ultimate responsibility for the conduct of treatment.
 TRANSACTIONAL ANALYSIS

- A treatment approach and a personality development theory

formulated in the early 1950s by Eric Berne.
- Personality is made up of three ego states:
a. Parent (right and wrong)
b. Adult (rational, logical and reality-based)
c. Child (functions naturally or ruled by parental directives)
- A transaction is a social intercourse that occurs between two
persons ego states.
- Treatment contract: Adult-to-adult agreement
 MULTI-SYSTEMS APPROACH

- One of the newer approaches to social work.

- Affirms the interrelationships of the individual to
an interlocking network of systems each
influencing the other.
- Takes into consideration the importance of the
systems impacting and being impacted by each
other.
OTHER RELATED CONCEPTS
COUNSELING
 COUNSELING

• the professional application of social work methods and

values in advising and providing guidance to individuals,
families, or groups for the purpose of enhancing, protecting
, or restoring the capacity for coping with the social
environment

• primary concern of counseling is the psychological well-

being and development of clients so counselors assist their
clients with psychological disturbances and guide them
toward peace and stability.
 COUNSELING

Approaches to Counseling:
1. Directive or counselor-centered– the focus of counseling is
the problem rather than the person.
2. Non-Directive/Permissive Counseling
or Permissive/Client-oriented– the client and not the
counselor takes the lead and active role in the counseling
process.
3. Eclectic Counseling– the counselor and counselee jointly
work to solve the problem; the counselor uses mixed method
 COUNSELING

Counseling Principles:
1. Acceptance
2. Individualization
3. Confidentiality
4. Self-determination
5. Controlled emotional involvement
6. Non-judgmental attitude
 COUNSELING SKILLS

1. Attending skills
2. Reflecting and paraphrasing
3. Clarifying and use of
questions
4. Focusing
5. Building rapport
6. Summarizing
 COUNSELING SKILLS

1.ATTENDING
Being attentive means the
counsellor is giving the client their
full focus, paying attention to
what the client is saying, doing,
the tone of voice used and body
language.
 COUNSELING SKILLS

2. REFLECTING AND PARAPHRASING

-repeating back your understanding of the material that

has been brought by the client, using your own words

-can contribute to more diverse and effective

communication in counselling sessions, as it allows the
client's words to be restated in a way that clarifies and
validates their experiences
 COUNSELING SKILLS

CLARIFYING AND USE OF QUESTIONS

• Clarification is used so the counsellor
does not misunderstand the client's
frame of reference.
• Questions during the counselling session can help to
open up new areas for discussion. They can assist to
pinpoint an issue and they can assist to clarify
information that at first may seem ambiguous to the
counsellor
 COUNSELING SKILLS

4. FOCUSING

It involves actively listening to what the

client is bringing, and then choosing an
area to focus down on. Focusing is like
zooming into a detail in a photograph.
 COUNSELING SKILLS

5. BUILDING RAPPORT

To work well with a client, we need to establish rapport

with them. Rapport is important, whatever model of
counselling the counsellor is working with.

Rapport means a sense of having connection with the

person.
 COUNSELING SKILLS

6. SUMMARIZING

the counsellor is 'reflecting back' the main points of

the session so that the client has the opportunity to
recap, and to 'correct' the counsellor if any parts of
the summary feel inaccurate. Summaries are
therefore useful for: clarifying emotions for both the
counsellor and the client.
 COUNSELING SKILLS

7. IMMEDIACY

is the ability of the counsellor/helper to use

the immediate situation to invite the client to
look at what is going on between them in the
relationship.
ACTIVE LISTENING
 ACTIVE LISTENING

• A way of listening and responding to another

person that improves mutual understanding.
• Away of paying attention to other people
that
can make them feel that you are hearing
them.
• This type of listening is called active
EMPHATIC LISTENING
 EMPHATIC LISTENING

Reflection of content and feeling at a

deeper level. Its purpose is to try and get
an
understanding of what may be deeper
feelings
SOLER TECHNIQUE
 SOLER TECHNIQUE IN COMMUNICATION

Sit attentively at an angle

• It is important to sit attentively at an angle to the
person who uses the service. This means that you
can
look at the person directly and shows that you are
listening to the person seated beside you and that
you
are conveying interest
 SOLER TECHNIQUE IN COMMUNICATION

Open Posture
It is important for a practitioner to have an open
posture.
This means not sitting or standing with your arms folded
across your chest as this can sometimes signal that you
are defensive or that you are anxious. If a practitioner
has an open posture the person may be more inclined to
elaborate on their concerns
 SOLER TECHNIQUE IN COMMUNICATION

Lean Forward
• It important that practitioners lean forward towards
the person using the service. This shows that you are
interested in what the person is talking about. It is also
possible that the person may be talking about personal
issues and so may speak in lower or quieter tone of
voice. In addition you may want to convey a message
in a lower or quieter tone of voice if you ar seated in a
public environment
 SOLER TECHNIQUE IN COMMUNICATION

Sit attentively at an angle

• It is important to sit attentively at an angle to the
person who uses the service. This means that you
can
look at the person directly and shows that you are
listening to the person seated beside you and that
you
are conveying interest
 SOLER TECHNIQUE IN COMMUNICATION

Eye Contact
 Eye contact is important as this demonstrates that
practitioners are interested and focused on the message
that the person using the service is conveying. You can
also develop a sense of the person’s emotional state by
making eye contact, therefore, enabling you to judge the
extent to which the person may be experiencing difficulty
 SOLER TECHNIQUE IN COMMUNICATION

Relaxed Body Language

 It is important to have a relaxed body language as this
conveys to the person using the service that you are not
in a rush. This will enable the person to develop their
response to questions in their own time
COMMONLY USED TERMS
Neglect is the ongoing failure to meet a child's basic needs and the most
common form of child abuse

TYPES OF NEGLECT
Physical neglect
• A child's basic needs, such as food, clothing or shelter, are not met or
they aren't properly supervised or kept safe.
Educational neglect
• A parent doesn't ensure their child is given an education.
Emotional neglect
• A child doesn't get the nurture and stimulation they need. This could be
through ignoring, humiliating, intimidating or isolating them.
Medical neglect
• A child isn't given proper health care. This includes dental care and
refusing or ignoring medical recommendations.
Abuse is when someone causes us harm or distress. It can take many forms
ranging from disrespect to causing someone physical or mental pain. It can
occur in someone's home, a care home, a hospital or a public place.
TYPES
• Physical abuse
• Domestic violence or abuse
• Sexual abuse
• Psychological or emotional abuse
• Financial or material abuse
• Modern slavery
• Discriminatory abuse
• Organisational or institutional abuse
• Neglect or acts of omission
• Self-neglect