The case study, followed by a discussion of

The aim of this assignment
is to critically discuss two social work methods and apply them to the above
case study. It will start by identifying the problems in the case study. Each
method will be explained in terms of its history and key principles, before
being applied to the case study, followed by a discussion of the strengths and
limitations. It will conclude with a summary of the interventions and an
explanation of what I will apply during my placement.

Although the case study includes
all of the Jones’s family, the focus of this assignment will be on Diane and
more importantly on her issues with substance misuse. The methods that have
been chosen to be applied to this case study are Solution Focused Practice
(SFP) and Task Centred Practice (TCP). 

Diane is a single mother of
three children and is being monitored by social services due to concerns raised
by several agencies. Several different neighbours have reported about Diane’s
lack of supervision of her children and allegations of her dealing cannabis and
frequently falling asleep during the day after using it. Neighbours have also
reported shouting and fighting following late night parties. Diane has been
warned by the Housing Department that if she gets another warning from them she
will be evicted. Diane has failed to comply a Court Order for supervised
contact every fortnight for her youngest child.

I have chosen Solution
Focused Practice because it is strengths based approach and primarily focuses
on finding a solution for dealing with problems. It concentrates on the skills,
strengths and resources that the Service users possess (O’Connell, 2001).                                                                                                                          I have chosen Task Centred Practice as my
second method of intervention. TCP is a clear and practical method designed to
help in the resolution of difficulties that people experience in their social
situations (Parker & Bradley, 2014).

I hope that using these
methods of intervention with Diane will help her to realise there is a problem
and the impact this is having on her and her children. 

SFP originates from the
Brief Family Therapy Centre in Milwaukee, USA. 
It was developed in the 1980’s by Steve de Shazer, Insoo Kim Berg and colleagues.
The team spent many thousands of hours observing life therapy sessions from
behind a screen and having lengthy discussions (O’Connell, 2012). They found
that clients made progress talking about their preferred futures, without
analysing their problematic histories and they felt empowered describing what
they wanted to happen in their lives (O’Connell, 2012).   

SFP is a short-term model of
practice.  It concentrates on creating
solutions rather than examining problems. 
Therefore, it does not go over the past; rather it focuses on the future
of the service user (Harris & White, 2013). It is based on the assumption
that every person has some idea of what would make his or her life better. The
aim is then to amplify, sustain and develop the person’s own strengths and
resources that they have not noticed (Lee et al., 2003). SF therapists believe
it is behaviour that causes malfunction and not the natural qualities of the
person (Lee et al., 2003).                                                                                      
                            There are seven key assumptions underpinning
SFP; Focus is on solution, change and future, creating exceptions to every
situation, change is occurring all the time, small changes lead to larger
changes, service users are always co operating, people have strengths and resources
they need to solve a problem and the service user is the expert in the lives
(O’Connell, 2012).                         
                                            SFP
is a form of specialized conversation, directed towards developing and
achieving the service user’s vision of solutions (Macdonald, 2011). The
techniques used by SF practitioners are; the miracle question, exception
questions, complimenting the service user on accomplishments, scaling questions
and coping questions (O’Connell, 2012).                                                                                    SFP is used with a wide range of service
users and in many different settings, such as mental illness, substance misuse,
Asperger syndrome to name a few (Shennan, 2014). However, the model will need
to be adapted to the context in which it is being applied, and accordingly to agency
goals and ethics (Shennan, 2014).

Having discussed the
process of SFP I will now move onto applying the method to the case study. Macdonald
(2011) states that the first interview in SFP is the most important, because
this is when the majority of the work is done for most service users. During
this first session, the social worker will aim to make a contract around the
best hopes of the service user, form a collaborative relationship, create an
atmosphere for change, clarify goals, highlight resources and negotiate tasks
(O’Connell, 2012).

However, it is
important to note that this will depend on the service user’s engagement with
the social worker. Diane has already stated that the CAFCASS officer who
prepared the report on contact did not listen to her concern about the
difficulty of getting a bus to the centre. It is important to establish here
whether Diane is a voluntary or involuntary service user. Smith et al (2012)
describes involuntary service users as those who come to treatment under
pressure from significant others such family members. Mandated services users
those who are forced to comply by legal institutions, such as courts. Shennan
(2014) states that strong relationships and rapport are built on respectful and
attentive listening, reflective silences, empathy, genuineness, immediacy and
acceptance. These techniques will make the service user comfortable with the
social worker and willing to collaborate. Milner & O’Byrne (2009) discuss
how at the start of the session the practitioner needs to briefly explain the
model to the service user and what they can expect to happen in the session,
doing so in a calm, confident, positive and friendly way. This will enable the
service user to be an active, informed and consenting service user. Research
repeatedly highlights the importance of social workers explaining clearly to the
service user what they are going to do and why at every stage of social work
intervention (O’Connell, 2012).  This is
also stated in HCPC’s Code of Conduct, ‘You must give service users and carers
the information they want or need, in a way they can understand’ (HCPC, 2016
p.6).

Language is of great
significance in SFP, it includes non-verbal behaviour, such as tone of voice,
cues, and posture. It is important for practitioners to use the words and
language used by the service user and avoid expert jargon.  (O’Connell, 2012).

At
stage one of the assessment Diane was asked to talk about her problem but not
the root cause. Information gained at this stage will also be useful in the
conversation for goal setting and exceptions (Macdonald, 2011). Questions such
as, ‘how often does it happen’, how long has it been going on for?’ can help
prompt the service user for a deeper explanation of the problem (Milner &
O’Byrne, 2009).  However the word ‘Why’
should be avoided. ‘Why’ leads to speculative and general answers that do not
usually clarify goals or behaviour (De Shazer, 1991). During this stage, the
social worker can get an insight into how and when Diane started to use cannabis
and how often.  

Scaling questions
used at this stage will give the social worker the opportunity to ask a series
of questions that can enable the service user to develop their descriptions of
instances and hoped for future (Shennan, 2014). “Scaling questions are the most
versatile and adaptable tools available to the solution focused practitioner”
(Shennan 2014, p.97). Using the scaling questions with Diane, will aim to help
her identify instances when she is not using cannabis and how she feels then and
explore what outcomes she hopes for. Diane describes she has a clear head when
she has not smoked cannabis. As a professional
worker, it is important to note that the main concern here is Diane’s drugs problem;
it would be unethical and judgmental to perceive Diane as the problem
(Thompson, 2009).

 

Diane is already on
the contemplation stage of the Cycle of Change, because she has admitted she doesn’t
like using cannabis because it knocks her out during the day.  In the contemplation stage, the service user starts to see their issue as a
problem and begins to consider the advantages and disadvantages of addressing
it (Trivethick, 2012). The Cycle of Change was developed by Prochaska
and DiClemente. It describes a number of stages that individuals pass through
in the course of changing a problem (Littell & Girvin, 2002). 

 

Stage two of the
process is to develop well formulated goals. This can be achieved through
scaling questions and miracle questions. Milner & O’Byrne (2009) state, the
miracle question is a helpful tool to use with people who are not sure what
their goals are or people who find it difficult to believe in a better future. Diane’s
answer to the miracle question was, ‘not having cannabis in my life and feeling
fresh and full of energy’. The next step is to develop small achievable goals
that are salient to the service user. The goals must be described in concrete
behavioural terms and be achievable within the context of the service user’s
life (De Shazer, 1991).

Stage three of SFP is
exploring exceptions. Macdonald (2011) states asking about exceptions is
particularly useful with goals that are normally viewed as resistant to change,
such as alcohol and drug misuse. Diane spoke of a time when she went to stay to
with her mum who lives 40 miles away and was not able to access drugs there.
She described how she enjoyed spending time with her children and not just
being in the same house as them.

Stage four is the end of
session feedback. A structured format of the feedback is useful to both service
users and the practitioners (Macdonald, 2011). The
feedback should summarise the session and include acknowledgment of the
problem. This shows the service user that the social worker is not ignoring or
underestimating the seriousness of the problem. It should also include genuine
compliments. For example, in this case, Diane’s feedback would say, ‘you have
already taken the first step towards your goal by agreeing to engage in this
session’.  O’Connell (2012) states,
genuine compliments help to motivate individuals and giving non-patronising
compliments help to decrease the power gap between the service user and social
worker.                                                                                                                           Stage
five of SFT is evaluating the service user’s progress and bringing the
intervention to an end (O’Connell (2012). The social worker will identify with
Diane what goals she has accomplished and whether she needs further sessions.

SFP has many advantages;
most importantly, it perceives the service user as the expert and seeks
solutions within the service user’s life (Shennan, 2014). It is an optimistic approach,
which assumes change is possible. It develops the service user’s strengths and
coping strategies. It is time limited, goal orientated and promotes
collaborative working (Shennan, 2014).  The
primary emphasis of SFP is on empowerment, respectful uncertainty and minimum
intervention, therefore making it anti oppressive practice Milner & O’Byrne
(2009).

 

Interestingly
the time limited brief nature of the therapy is also criticised as a weakness.
Howe (1996) cited by Walsh (2010) believes that in short term and time limited
practice little attention is paid to the construction and understanding of the
service users narrative. Therefore understanding the solution without
understanding problem could be misunderstood and potentially dangerous (Walsh,
2010). Another criticism is that strengths based approaches such as the SFBT
fail to correctly assess risk. For example in the case of baby P concerns were
highlighted that the model might have caused the social worker to lose focus on
risk (Davies & Jones, 2015).  Fook
(2002) argues that SFP assumes an ideal of ‘strength’ towards which the healthy
personality works, therefore it is not effective people with low self-esteem
who may not accept that they have strengths and skills. Feminists criticise the
lack of attention paid to gender and power issues (Walsh, 2010).  Other criticisms are that SFP is not holistic
and that praising the service user can be patronising.

 

Having
discussed Solution focused Practice, I will now move onto Task Centred
Practice. Task Centred Practice is a short term,
problem-solving approach. It was developed by Reid and Shyne in 1969 and
appeared as a response to the criticism that the existing open ended and long
term ways of working were time consuming and not very successful in a
significant number of clients (Wilson, 2008). TCP has been developed and refined through numerous empirical
studies over the years. It is influenced by the behavioural model
but is mainly a cognitive approach (Wilson, 2008).  

 

TCP
is a time-limited approach, usually with 12 interviews over a three or four
month period (Okitikpi & Aymer, 2010). The focus is on the tasks that the
service user and practitioner carry out to resolve the problems that the
service user has agreed on. Okitikpi & Aymer (2010) state, the uniqueness
of TCP is that it breaks down the problems faced by service users into small
and manageable components. Milner & O’Byrne (2009) describe TCP as a progressive and goal-orientated social work method
designed to help service users and practitioners collaborate on specific,
measurable, and achievable goals. It can be used with individuals, couples,
families, and groups in a wide variety of social work practice contexts
(Wilson, 2008).

The
key principles of TCP are; it is time limited, work is systematic, based on a
contract, partnership work between service user and social worker, user
involvement, building upon service user strengths (Milner
& O’Byrne, 2009).

 

There are five phases
in the TCP. The first phase is the problem exploration. “Problems are defined
by Reid (1978) as unmet or unsatisfied wants as perceived by the service user”
(Milner & O’Byrne, 2009 p.126).  However, unwilling people referred to social
services by other agencies such as schools, courts etc may say they have no
unmet wants. According to Milner & O’Byrne (2009) task centred work cannot
move forward until some want is acknowledged.  There may also be the issue of mistrust, where
Diane feels worried that the involvement of social services could mean her
children are taken into care. At this stage, the social worker will identify
with Diane the reasons for the intervention in the first place. If the social worker appears abrupt, defensive or
portrays signs of power then the service user may also be reluctant to part
take (Coulshed & Orme, 1998). As stated in the PCF ‘social workers
should recognise the impact of their own values and attitudes can have on
relationships with others (BASW, 2015). Adam et
al (2002) state that in order to empower, it is necessary to respect the
individual, enhance their strengths and coping abilities by conducting key
worker sessions with a non-judgmental attitude.

Coulshed
& Orme (1998) state the problem must be recognised by the service user in
order for the social worker to work in collaboration with them. The
social worker will explain how long the process will take, assess Diane’s
ability to understand her problems and the extent of them. Establish whether
she accepts she has a problem and is willing to do something about it. The
process of problem exploration entails asking questions about where, when and
with whom these problems arise (Coulshed & Orme, 1998). The social worker
will explore with Diane the consequences of her behaviour. Coulshed & Orme (1998) explain, the
exploration of problems helps to bring to the surface under lying problems that
are a direct consequence of one problem. Diane has a number of problems that
are a direct result of one problem, which is using cannabis.

The second phase is
selecting and prioritising the problems. This is where the problems are broken
down into smaller components and prioritized (Maclean & Harrison, 2015).

Phase three is the development
of the contract/ written agreement. Once agreed by both the service user and
social worker these problems will form the basis of the goals and a written
agreement is produced (Coulshed & Orme, 1998). Milner & O’Byrne (2009)
state goals must be specific and achievable, and take into account how much
time they will take. For example, Diane’s goals are to stop using cannabis,
provide better care and a safe living environment for her children, avoid being
evicted and obtain a part time job.  

Phase four is the
implementation of tasks. In this stage the social worker and service user work
collaboratively to assess which task would be the most useful, which are in the
service user’s range, how much help they require to carry out the tasks and whether
outside resources are required (Milner & O’Byrne, 2009). The social workers
tasks will be make referrals to a substance misuse programme and parenting
programme to improve parenting and relationship skills. Coulshed & Orme (2012) state the attainment of each goal promotes
self-confidence and further motivation in the service user. 

Phase five is the
termination stage, at this stage, the tasks are reviewed, problem solving
skills acquired are identified and accomplishments are praised. If the service
user needs further sessions then these will be agreed (Milner & O’Byrne,
2009).

 

TCP
is a well-researched method of intervention and is clear and straightforward (Parker & Bradley 2007. (Doel & Marsh 1995) also agree on the simplicity
of the model adding further that it is easy to understand and apply and enables
the service user to use it for future problem solving. It promotes clarity of
action and accountability between the social worker and the service user. It is
time limited, according to Doel & Marsh (1995) this reduces the risk of
dependency and creates motivation in service users. Coulshed & Orme (2006)
agree that time limited makes people feel more committed, further adding that
because TCP is a time and cost effective intervention. It also saves on
future resources by building service users to solve their own problems in the
future. Furthermore, Milner & O’Byrne (2009) state it is an empowering
approach because it recognises and builds upon the
service users strengths, it considers the personal resources they have to solve
their problems with limited support.

However TCP does have some limitations. Maclean & Harrison
(2015) state that it does not address the service user’s emotional issues and
that it is oppressive and
ineffective if used with service users with limited cognitive functioning. Gambrill
(1994) argues that it relies heavily on the behaviourist
perspective, therefore over simplifying complex problems. Adam et al (2009) argue that boundaries are set due to financial constraints, policies and the practitioner’s value which prevent the
possibilities of real power-sharing. Additionally, it may
not consider structural oppression such as class, poverty etc. according to
(Trevithick 2005) service users need to be willing to participate for the model
to be effective.  Teater (2010) argues
that a signed contract may encourage a power imbalance between social worker
and service user, placing the social worker as the expert.

 

It is evident that
both the SFP and TCP are generally, successful methods of practice and both can
be applied to a variety of situations. They are both structured interventions
and both use specific contracts between the social worker and service user and
both aim to improve the individuals capacity to deal with their problems in a
clear and more focused approach. In addition, both methods promote empowerment
and place the service user as the expert in their lives.

Nevertheless,
there are certain limitations to both methods, for example both are not effective where there are longer-term
psychological issues.

However, Task Centred
Practice appears to be a more popular intervention of the two. It has a history of more than 40 years of research
development and is well rooted in social work practice.

I feel that both
these approaches will be suitable to apply during my placement depending on the
situation. Because they both provide vital frameworks social workers can use to
implement best practice and can be adapted to the workplaces rules. I will also
apply work accordingly to HCPC’s code of conduct and the Professional
Capabilities Framework.