direct practice

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Context of Practice
Chapter Three
Policy, Program and Administrative
Structure of Direct Practice
Importance of Context of
Practice
• What a direct social work practitioner can
or cannot do to meet client needs is
constrained by the context within
which the practitioner works
• A context of practice has eight elements
Elements of Context of Practice
1. Desired end goals: Contained in Mission
Statements that articulate agency purpose and
values (Social Justice)
2. Field of practice –An area of specialized
practice i.e.Child and Family Welfare; Health
and Mental Health; Each field has specific
knowledge and terminology
3. Setting i.e. a place where services are offered
i.e. social service agency, schools, hospitals,
club houses
Elements of Context-Continued
4. Program i.e. TANF; Medicaid-Medicare
5. Programs have procedures for determining
eligibility and benefits
6. Policy regulates the program (TANF) and its
procedures i.e. the Personal Responsibility and
Work Opportunity Reconciliation Act
(PRWORA, 1996) is a policy enacted into law
that regulates TANF
Elements of Context-Continued
7. An Organizational and Administrative
Structure i.e. the Department of Family
and Child Welfare administers the TANF
program in a manner consistent with
PRWORA policy and procedures
8. A client population i.e. Impoverished
children and families
Overview of Social Policy as a
Context of Practice
• In the Western world, Nation-states (i.e. Canada,
the United States, the United Kingdom etc) enact
certain policies to support two macro institutions:
the economy (capitalism) and the government
(democracy). These policies are often referred to
as social (or welfare) policies.
• There are two major social policy models:
Keynesian and Schumpeterian.
Keynesian Model of Social
Welfare Policy
• Holds that profitable growth and full employment
are possible in a closed national economy; Belief
in Capitalism and Democracy
• Citizenship enables individuals to access a range
of welfare benefits which may be universal (social
security) or residual and need-based (TANF)
• Model rectifies market failures but does not
eradicate the market system
Schumpeterian Workfare Model
of Social Welfare Policy
• Replaced Keynesian model
• Model reflects government tendency to reduce
social expenditures and curtail social spending
• Imposes more demanding eligibility requirements
and requires recipients of benefits to engage in
paid employment
• Places a CAP on benefits that may be received
within a given time period; no longer universal
entitlement to minimum economic support
Comparison of Keynesian and
Schumpeterian Models
• Both models assume that an individual can attain a
decent standard of living despite the unequal
distribution of market-based incomes
• Both models provide universal and selectiveresidual welfare services; safety net philosophy
• In both models, local and regional state
governments are relays for policies framed at the
national level
• Both rely on non-profit and private faith-based
charities to augment services
Ideology and Social Welfare
• Values and ideology determine the desired endgoals of social policy
• Science and evidence can document need (what is
the prevalence and incidence of an identified
social problem i.e. domestic violence?) and
evaluate outcome (does a policy or program
work?) but cannot determine policy goals.
• Policy goals are value-based, normative, and
prescriptive (desired good, what should be)
Concept of Social Welfare
• Because of competing ideologies, social welfare is
a complex concept that carries certain tensions and
contradictions; both stigmatizing and nonstigmatizing
• It is a concept that reflects the end result of policyadvocacy aimed at reforming social institutions in
order to respond to populations in need
• It is a concept that acts as a function of social
control and/or mechanism to maintain the status
quo
Desired End Goals
Competing Ideologies
• Radical Ideology: Structural change of major
societal institutions (management/labor, health
care, capitalism, education etc.)
• Liberal Ideology: Reform of major societal
institutions. Creation of a universal safety net i.e.
Universal Health Care
• Conservative Ideology: Residual, means-tested,
temporary, safety-net. Individual and family
responsibility. Faith-based and charitable
initiatives.
Welfare
Social Justice and Social Control
• Social Justice: Through welfare, social work
policy advocates seek to reform institutions to
build a humane and just society
• Social Control: Through the norm of reciprocity
(linked to work) and emphasis on individualism
(linked to personal responsibility), welfare also
functions as a means of social control designed to
maintain the status quo
Two Methods and Two Skill Sets
• The ability to analyze, propose, advocate,
implement (political/legislative social work ) and
administer policy-based programs in social
welfare requires skills in the methods of indirect
practice.
• The ability to deliver policy-based concrete
services in face–to-face contact with individuals
and families in an agency setting requires skills in
the methods of direct practice
Regulatory Context of Practice
• CSWE Curriculum Standards- Degrees
-BSW (Entry level)
-MSW (Terminal practice degree)
-PHD (Teaching and Research degree)
• NASW Code of Ethics
• Legal Regulation- Licensing
Bachelor of Social Work
• The BSW Degree is an undergraduate, entry level
degree. Some students will graduate with a BA
with a concentration or major in social work
• If eligible, BSW graduates may apply for
advanced standing in a Master of Social Work
program
• To practice, BSW graduates must pass an entry
level licensing exam administered by the
Association of Social Work Board
Master of Social Work Degree
• A two-year graduate degree
• Is considered the terminal practice degree
• First year provides a generic curriculum
established by CSWE curriculum standards
• Second year allows students to specialize in
methods of practice: Clinical or social
policy, advocacy, management or
community practice.
Field Internships
• Both degrees, the BSW/BA and the MSW require
course progression and experiential learning.
• Experiential learning is provided by assignment to
a field of practice in an agency setting i.e. field
practicum or internship
• On-site, licensed, MSW field instructors supervise
students in their placements
Association of Social Work
Board
• State legislatures or their equivalent enact
enabling legislation to establish and
empower a board to regulate the profession
of social work
• For social work this is the Association of
Social Work Board
• See: www.aswbdata.powerlynxhosting.
Minimum Requirements for
Licensure or Certification
• Degree (BSW or MSW) from an CSWE
accredited undergraduate or graduate
program of social work
• Experience and supervision
• Successful completion of a competency
exam
Who Needs to be Licensed
• Anyone who wishes to engage in direct
practice with clients; clinical social workers
• Those who practice strictly in policy, class
advocacy, administrative, or community
practice do not need to be licensed.
• Regardless of concentration, all students in
graduate schools of social work receive a
Master of Social Work Degree.
Four Types of Contracts
The Profession is based on four contractual
relationships:
1 Between society and the profession
2 Between the profession and the professional
3 Between the employer and employee
4 Between the worker and client
Auspices
Social workers practice under these auspices:
(1) Public auspices - Family and Child Welfare
(2) Not-for profit - Catholic, Jewish, and Lutheran
social services
(3) For-profit – Privatized behavioral managed
care; EAP’s, private practice
Social workers practice in primary (social service
agencies) and host (hospitals, schools) settings
Organizational Context
of Practice
• Social workers in direct practice work within an
agency structure or in private practice.
• All agencies have an administrative structure
which is both formal and informal
• All organizations have: a chain of command, a
professional and support staff, a geographical
catchement area that serves a particular client
population, a prescribed route to service, intake
and eligibility procedures and defined resources.
Agency Mission Statements
• Articulates agency purpose i.e. desired end goals
• Are value-based
-provide normative prescriptions
-reflect theories of social justice
-are ideological – “shoulds”
• Adjust public resources through policies and
programs to meet the need of client populations
Direct Practice: Two Functions
1. Provision of concrete services associated
with policy-based social welfare programs
Uses case management (chapter 10) to
serve highly vulnerable client populations
2 Provision of therapy or counseling to
both highly vulnerable client populations
and traditional clients. (Chapters 10, 12
and 13)
Highly Vulnerable Clients
• Those dependent on the State because of their age,
their status as dependent, neglected, and abused
children or their status as juvenile or adult
offenders
• Included are the homeless, those with chronic
mental illness or mental disabilities.
• Need long term concrete services from multiple
providers - Step three of the decision tree.
Context of Practice: Managed
Behavioral Health Care
• A “set of health care systems and technologies
aimed at organizing and managing both the
clinical and financial costs of service provision to
a given population of customers” – Popple and
Leighninger, 2002
• Treatment decisions rest with a third party, the
insurer. Cost is a variable in treatment decisions.
• Those in direct practice have a stake in the fiscal
parameters governing the delivery of services
Managed Care and Case
Management
• These are separate and distinct concepts
• Managed care is a cost-containing system
designed to regulate access to health and mental
health services. A third party entity (HMO -the
insurer) authorizes or denies treatment
• Case management is a social work model of
practice in direct practice that coordinates multiple
fragmented services needed by highly vulnerable
clients.
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