Abstract: In direct social work the social worker must be very aware of his interactions with his client in the interview. In the interview the social worker must learn of the client’s presenting problem and then explore the presenting problem by asking neutral, open-ended questions, maintain focus on the presenting problem, and a few other things.
Opening thought: The first phase of treatment lays a foundation for selecting and implementing interventions. This is aimed at resolving a client’s problems and promoting the client’s problem solving skills. Here, we will speak of the first step in the first phase of treatment: exploring the client’s problem.
Factual paragraph #1: The primary objective in first meeting is to elicit the client’s presenting problem, which is his understanding of why he has come into therapy and what he thinks his problem is. As a social worker I have to remember that my view of the client’s problem may be different from his view because most clients are not aware of all of the factors influencing their problem. In some cases there are additional priorities. If the client is legally mandated to come to the interview, the social worker must assess the legal concerns as well as the client’s concerns. Sometimes the social worker may need to address serious health and safety concerns that require immediate attention and thus take precedence over exploring the client’s presenting problem. Sometimes the social worker’s first priority is to assess and then properly manage the client’s clinical risk (suicidality, child or spousal abuse, a medical condition, substance addiction, or may pose a threat to others).
Factual paragraph #2: How does the social worker explore the client’s problem? As soon as the client indicates he is ready to talk about the problem, the social worker begins exploration of the client’s problem by asking neutral, open-ended questions, which then invites the client to tell why he has come in. When the client speaks, as the social worker I must assess the significance of pieces of information and observe the client’s interactions with me and with others who may be present in the interview. The social worker’s judgments about the significance of what he observes at this time will guide him in deciding which aspects of the problem warrant deeper information and if the client is ready.
Factual paragraph #3: In exploring the client’s problem a social worker must encourage the client to continue talking. He must also elicit detailed information from the client, and maintain a focus on the problem until he has attained all of the data he needs. Because most clients begin in general terms, the social worker’s task is to move the client’s description of the problem from general to specific (so that he can attain information needed to understand all facets of the problem- such as those the client is not aware of and identify the systems and factors that contribute to it as well).
Factual paragraph #4: There are certain ways that social workers should conduct themselves in interviews in order to receive the desired outcome in an interview. Social workers should respond in such a way that shows that he understands what his client is saying. One way that a social worker can do this is by paraphrasing his client’s responses. This encourages the client to continue speaking. The social worker can also summarize his client’s responses. A summary ties information together and highlights the important aspects of a problem, which is needed before moving on to other issues. A social worker also needs to be able to use different and specific skills to probe for specific details required to understand the problem. (Ones designed to elicit specific parts of information missing from client’s report) Examples of these are close-ended questions[1] and responses that seek concreteness.[2]
Factual paragraph #5: A social worker must also be aware of his client’s expectations for coming in. As stated before, a client’s view of his problems may be different than a social worker’s view of his problems. Often times social workers encounter clients who come in with unrealistic expectations. When a client expresses unrealistic expectations, the social worker must respond in a direct and sensitive manner. In order to do this the social worker should acknowledge and empathize with the client’s unrealistic expectation (including his sense of urgency), express his helpful intent, explain why the client’s expectations cannot be fulfilled, and explain the helping process and the nature of the helping relationship.
Factual paragraph #6: Last, in exploring a client’s presenting problem it is important to assess certain factors that can affect the client’s presenting problem. These factors include things like: abuse of alcohol or other drugs, exposure to abuse or violence, presence of physical or mental health problems, and the use of prescription medications. Questions about these areas should be a routine part of the interview and should be asked in a straight forward and non-judgmental manner.
What is most interesting about this podcast? The most interesting fact on this podcast was the practical instructions for social workers in direct social work practice.
What can you share with other students about this podcast? I would tell other students to be aware that in all interviews there are possible influencing factors that must be assessed. Factors such as abuse of alcohol or other drugs, exposure to abuse or violence, presence of physical or mental health problems, and the use of prescription medications all can influence the client’s presenting problem.
Concluding Sentence: In order to explore a client’s presenting problem the social worker should be very cognizant of the way he conducts himself
References:
The First Phase of Treatment in Direct Social Work. Association of Social Work Boards, Audio.
[1] close ended questions used to find missing information
[2] seeking concreteness- clarifying meaning of client’s vague term, exploring the basis of the client’s conclusion and eliciting specific feelings or details about his experiences
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