Indian Journal of Health Social Work
ROLE OF CLINICAL SOCIAL WORK
Narendra Kumar Singh
Social Work as a profession came into existence with realization of the fact that simply material supplies cannot and shall not mitigate the sufferings of the recipients of the aids, unless they are helped personally and socially to learn to cope up with their problems. The first major effort to formulate social work practice in a systematic fashion made by Mary Richmond in her book “Social Diagnosis”, and “What is Social Work” (1922), which is appreciated as landmark in Social Work education.
Social work as “The professional activity of helping individuals, families, groups or communities enhance or restore their capacity for social functioning or creating societal conditions favorable to that goal” (NASW,2008).
PURPOSE OF SOCIAL WORK
- To assist individual and groups to identify and resolve or minimize problems arising out to equilibrium between themselves and their environment.
- To identify potentials areas of disequilibrium between individuals or groups and the environment in order to prevent the occurrence of disequilibrium.
- Aims to identify and strengthen the maximum potentials in the individual, groups and communities.
CLINICAL SOCIAL WORK
The National Association of Social Workers (NASW) defines Clinical Social Work as follows: “Clinical social work shares with all social work practice the goal of enhancement and maintenance of psychosocial functioning of individuals, families and small groups”. Clinical social work practice is the professional application of social work theory and methods to the treatment and prevention of psychosocial dysfunction, disability, or impairment, including emotional and mental disorder. It is based on knowledge of one or more theories of human development within a psychosocial context. Clinical social work services consist of assessment; diagnosis; treatment, including psychotherapy and counseling; client-centered advocacy; consultation; and evaluation. The process of clinical social work is undertaken within the objectives of social work and the principles and values contained in the NASW Code of Ethics” (NASW, 2012).
Clinical Social Work integrates significant social work concept with knowledge of human behavior and needs within an environmental context. The Clinical Social work is a health care provider for individual alone, in families and in groups where there is a problem in bio psychosocial functioning. The objectives of clinical social work is both preventive and remedial and methods used are varied, including combination of clinical psychotherapy, family therapy, group therapy and concrete services and interventions on behalf of the client with social system and the environment.
Clinical social workers’ professional scope of practice ranges from assessment and diagnosis to interventions and collaborative case management; their knowledge base encompasses the following: normal and abnormal human development and behavior; disorders and addictions; consequences of trauma, illness, or injury; intrapersonal, interpersonal, and family dynamics; the impacts of the physical, social, and cultural environment; and other bio-psychosocial issues. Here professional competence plays a vital role in forming a better understanding of problem and problem related interventions. Professional use of self, use of the “person in environment” perspective, continuing clinical education, a disciplined approach to the practice environment, and use of best practices in initiating change and ameliorating complex problems are expected of all advanced practitioners. In their interventions, they create a therapeutic alliance with client consumers and they place a high value on cultural, ethnic, and environmental factors. (Paul H. Stuart – 1933).
ROLE OF CLINICAL SOCIAL WORKERS
1. In-patient and out-patient services
The services rendered by clinical social workers to the patients in the clinical, de-addiction, neurological and neurosurgical wards and their respective out-patient departments are a meaningful mixture of independent psycho-social therapeutic activities at individual, family and group levels and programmes of interdisciplinary nature. The activities focus on the psycho-social study of the patients and their families, formulation of a social diagnosis and providing appropriate social treatment. This takes the form of systematic gathering of information, recording of case histories, making home visits, collateral contacts, explaining and educating distressed family members, and group interaction with patients. Depending on the problems, family-centered casework services are offered. In such service activities, clinical social workers make special efforts to involve the ‘significant others’ in the helping process. Mobilisation and utilisation of resources in the family and the community for the welfare of the patient have been the guiding principles of clinical social work services.
2. Child guidance clinics
Clinical social work and child psychiatry have a long history of cooperation. Considering the nature of clinical manifestations in children, the focus on psycho-social situations has been well emphasised in working with disturbed children and adolescents as well as their family members. Therapeutic group activities with children and parents, individual counselling sessions with siblings, interpretation of the problem to the school authorities and liaison with child welfare agencies are the important components of clinical social work intervention in clinics. These services have been offered both at out-patient and in-patient levels. In addition to such services, the clinical social workers collaborate with psychiatrists and clinical psychologists in organising different welfare-oriented therapeutic programmes for the children and their families. Social work services in the child and adolescent unit have immense potential for being models to their counterparts in India and other developing countries
3. Family clinical centres
The clinical social work services focus on the marital problems, family pathology and other interpersonal adjustment difficulties in the family. These are handled at individual as well as family levels. All the family members admitted to the centre are guided to participate in group sessions in order to explore the possible solutions to their problems. Family therapeutic programmes which are applicable to our socio-economic and cultural milieu have been extended to the families, through the staff and students of clinical social work. On the basis of the services rendered in this unit, clinical social workers have been developing indigenous models for understanding marriage and family related problems as well as preventive/promotive and therapeutic intervention models for them.
4. Services in rehabilitation and aftercare
Rehabilitation is one of the core activities of clinical social work. Disability assessment, employability, integration into the community and re-socialisation are the important areas where services of clinical social workers have been extended. Some of the rehabilitative services extended to patients include aftercare and resettlement for long-stay patients, jobs for the mentally and neurologically disabled, social skills development programmes, sponsorship programmes and self-help groups.
5. Neurological and neurosurgery services
Patients with neurological illness and disabilities are offered clinical social work services. This help is in the form of educating the patients and their family members, the use of case work and group work services to the disturbed family and providing specific rehabilitation services. Particular attention has been given to chronic disabled patients. Families have been counselled and guided with regard to future activities and are informed about the social security services and other resources of help. Regular home visits, agency contacts and social and vocational rehabilitative measures have been undertaken whenever necessary.
6. Community mental health programmes
The method of community organisation and social action have been the main models of delivering mental health services in rural and urban communities. Community participation and mental health education have been the important domains of clinical social work services. Clinical social workers actively participated in community care programmes and training programmes for the medical and non-medical personnel. Local leaders have also been involved in mental health programmes.
National Association of Social Workers (NASW). (2008). NASW code of ethics. Retrieved May 2, 2013, from http:/www.socialworkers. org/pubs/code/code.asp.
National Association of Social Workers (NASW). (2012). Standards for school social work services. Washington, DC:
Paul H. Stuart – 1933; Public welfare activities. In Recent social trends in the UnitedStates: Report of the president’s research committee on social trends (Vol. 2, pp. 1224–1273). New York: McGraw-Hill