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CASE STUDIES IN SOCIAL WORK PRACTICE

Third Edition

Craig Winston LeCroy

Title Page

To Kerry B. Milligan and the social workers of the world

Educational Policy and Accreditation Standards (EPAS) and Case Studies Crosswalk

The Council on Social Work Education’s EPAS has set forth recommendations for students of social work to master 10 competencies. Within each competency are practice behaviors that further define the core competencies. Case Studies in Social Work Practice addresses the 10 competencies within the various case studies presented in the book. The following table lists the competencies and the case studies that reflect the competency most directly. This may be helpful to both instructor and student in relating the educational material in the book to the core competencies for effective social work practice.

Educational Policy 2.1.1: Identify as a professional social worker and conduct oneself accordingly.

Educational Policy 2.1.2: Apply social work ethical principles to guide professional practice.

Educational Policy 2.1.3: Apply critical thinking to inform and communicate professional judgments.

Educational Policy 2.1.4: Engage diversity and difference in practice.

Educational Policy 2.1.5: Advance human rights and social and economic justice.

Educational Policy 2.1.6: Engage in research-informed practice and practice-informed research.

Educational Policy 2.1.7: Apply knowledge of human behavior and the social environment.

Educational Policy 2.1.8: Engage in policy practice to advance social and economic well-being and to deliver effective social work services.

Educational Policy 2.1.9: Respond to contexts that shape practice.

Educational Policy 2.1.10: Engage, assess, intervene, and evaluate with individuals, families, groups, organizations, and communities.

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Case Study Topic Areas Matrix

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Preface

This book provides a different format to learn about social work practice than is currently available in traditional social work textbooks. My intent is to provide students with an accordingly different educational experience, which results from reading and thinking about case studies.

Case studies are an action-oriented educational tool because they provide students with an opportunity to vicariously participate in the process of doing social work practice. It is critical to provide an interesting educational atmosphere for effective adult education.

In order to achieve this goal, I have asked many different people, primarily teachers and social workers, to write case studies that reflect their experiences. More than 45 people helped contribute to this book. The people chosen to write case studies reflect the diversity of social work practice. As a result, each case study is unique in approach, content, and writing style.

I have always told my students that doing social work is much more exciting and gratifying than reading about social work practice. Because the case study method of teaching allows students to participate in social work, there is a corresponding increase in interest and motivation for learning.

The objective of Case Studies in Social Work Practice is teaching students about the process of doing social work. The book is appropriate to many classes at the undergraduate and graduate levels. At the undergraduate level, it may be used to teach students about the range and diversity of the social work profession. In this context, the emphasis is on the various fields of practice, the organizational setting, and the variety of roles that social workers embrace. At the graduate level, it may be used as the primary text or as a supplement to a more theoretical textbook, with the emphasis on understanding the complex variables involved in delivering social work services.

Case Studies in Social Work Practice is also designed to be useful as a textbook for field seminars. Here the focus is to help students learn to discuss cases within a social work frame of reference. The instructor can use the case material and emphasize the practice principles relevant for the particular class and level of the student.

FOR STUDENTS

This book was designed to make learning about social work interesting and exciting. In it you will find fascinating experiences that social work practitioners have shared about their work. The focus is on what social workers actually do as professionals—a picture of their day-to-day lives. As you read these case studies, think about being confronted with each situation yourself. How would you feel? What do you notice? What would you do? By doing this, you can vicariously participate in social work practice. This will give you important clues about whether this is the profession for you and where your interests are in the various fields of practice.

The purpose of this book is to help you learn to integrate theory and practice by studying how practitioners have applied general social work principles to real-world case situations. In order to facilitate learning, each case study begins with a series of questions. These questions are designed to stimulate critical thinking and promote class discussion.

Classroom discussions about the case studies will investigate judgments made by the practitioners, answer questions you have about social work practice, and reveal the limitations of textbook generalizations. In many instances, information in the case studies may be incomplete, and students’ opinions may be divided about the manner in which to intervene.

FOR INSTRUCTORS—HOW TO USE THIS BOOK

This book can be used in a variety of ways to teach students about social work practice. The book is designed to be used in a flexible manner, depending on your needs and the objectives of the particular course. Some suggestions for how this book might be used include:

With this kind of book, it is important for you to decide how you can best use the case material. In my experience, I have found some of the following ways of using case studies helpful:

THE THIRD EDITION

It is very exciting to have a third edition of the Case Studies in Social Work Practice book! The overall organization of the text remains consistent with the first edition. The major changes include updating the case material and adding new cases. In particular, new material has been added that reflects newer changes in the field. For example, case studies have been added in areas such as mindfulness treatment, family systems approach, family drug courts, the use of supervision, multisensory interventions, geriatric depression, and the use of evidence-based practice. These changes, in addition to changes from the second edition, should have a broader appeal to social work students: undergraduates, foundation MSW students, and advanced MSW students. The book still maintains case material that represents both generalist practice and more specialized practice, both of which are needed in social work education. The goal of Case Studies in Social Work Practice continues to be the provision of case study material that is interesting and enlightening about the day-to-day practice of social work—material that is too often ignored in social work textbooks.

Acknowledgments

This book is the result of the many authors who agreed to graciously contribute a case study. Without them there would be no book, and I sincerely appreciate their efforts. Many people helped to make this a successful project. Emily Furrier and Molly Madeline Gebler were my research assistants, and they provided critical support in organizing and managing this project. Arizona State University, School of Social Work, provided the needed institutional support. The staff and editors at Wiley are to be thanked for their persistence in helping me get this material into the format of a publishable book. My longtime association with Peggy Alexander provided the impetus for this project, Rachel Livsey worked with me as the acquisition editor for this book, and Amanda Orenstein made sure the project was brought to completion. Lisa Gebo, now deceased, was responsible for making the second edition become a reality. Her vision and confidence in the case study approach to teaching social work is greatly appreciated.

About the Editor

CRAIG WINSTON LECROY is a professor in the School of Social Work at Arizona State University. He also holds appointments at the University of Arizona in the John & Doris Norton School of Family and Consumer Sciences, Family Studies and Human Development division, and the University of Arizona College of Medicine, Department of Pediatrics. He has been a visiting professor at the University of Canterbury, New Zealand; the Zellerbach Visiting Professor at the University of California at Berkeley; and a senior Fulbright specialist.

Professor LeCroy has published 10 books previously, including Parenting Mentally Ill Children: Faith, Hope, Support, and Surviving the System; First Person Accounts of Mental Illness and Recovery, Handbook of Evidence-Based Treatment Manuals for Children and Adolescents; Handbook of Prevention and Intervention Program for Adolescent Girls; The Call to Social Work: Life Stories, Case Studies in Child, Adolescent, and Family Treatment; Case Studies in Social Work Practice; Empowering Adolescent Girls: Examining the Present and Building Skills for the Future with the “Go Grrrls” Program; Go Grrrls Workbook; Human Behavior and the Social Environment; and Social Skills Training for Children and Adolescents.

Professor LeCroy has published more than 100 articles and book chapters on a wide range of topics, including mental health, the social work profession, home visitation, and research methodology. He is the recipient of numerous grants, including (as principal investigator or co-principal investigator) interventions for risk reduction and avoidance in youth (NIH), Go Grrrls Teen Pregnancy Prevention Program, evaluation of Healthy Families (a child abuse prevention program), a mental health training grant for improving service delivery to severely emotionally disturbed children and adolescents (NIMH), and Youth Plus: Positive Socialization for Youth (CSAP).

Contributors


Danie Beaulieu, PhD

Author of Impact Techniques

for Psychotherapists (Routledge)

and Eye Movement Integration

Therapy (EMI) (Crown House

Publishing)


Jennifer L. Bellamy, PhD

Assistant Professor

School of Social Service Administration

University of Chicago

Chicago, IL


Larry Bennett, PhD, LCSW

Professor

Jane Addams College of Social Work

University of Illinois at Chicago

Chicago, IL


Kia J. Bentley, PhD

Professor

School of Social Work

Virginia Commonwealth University

Richmond, VA


Betty Blythe, PhD

Professor

Graduate School of Social Work

Boston College

Chestnut Hill, MA


Charlotte Booth, MSW

Executive Director

Institute for Family Development Federal Way, WA


Yesenia Campos

Recovery Support Specialist

Pima County Family Drug Court

Tucson, AZ


Jeannine K. Chapelle, MAA

Associate Director of Community Initiatives

La Frontera Arizona, Inc.

Tucson, AZ


Kevin Corcoran, PhD

Professor

School of Social Work

Portland State University

Portland, OR


Martha Morrison Dore, PhD

Director of Research and Evaluation

Division of Child and Family Services

The Guidance Center/Riverside Community Care

and

Research Associate

Cambridge Health Alliance

Department of Psychiatry

Harvard University School of Medicine

Cambridge, MA


David R. Eddy, PhD

Clinical Director

Family Therapy Associates

Rockville, MD


Eric Garland, PhD, LCSW

Assistant Professor, College of Social Work

Assistant Director, Trinity Institute for the Addictions

Florida State University

Tallahassee, FL


Brent B. Geary, PhD

Director of Training

The Milton H. Erickson Foundation

Private Practice

Phoenix, AZ


Alex Gitterman, EdD, MSW

Zachs Professor of Social Work

Director of Doctoral Program

School of Social Work

University of Connecticut

Storrs, CT


Nancy Gladow, MA

Social Worker

Public Health

Seattle & King County

Seattle, WA


Kristen A. Gustavson, LCSW, PhD

Assistant Professor

School of Social Work

College of Public Programs, Arizona State University

Phoenix, AZ


Jan Jess, MSW

University of Kansas

School of Social Welfare

Lawrence, KS


Amber Kelly, LCSW

Private Practice

Gainesville, FL


Steven Krugman, PhD

Psychotherapy, Consultation,

and Coaching

Boston and Newton, MA


Jay Lappin, MSW, LCSW

Family Therapy Director

Centra PC

Marlton, NJ


Craig W. LeCroy, PhD, LCSW

Professor

School of Social Work

Arizona State University

Tucson, AZ


Cynthia A. Lietz, PhD, LCSW

Associate Professor

School of Social Work

Arizona State University

Tucson, AZ


Kathie Lortie, MSW

School Social Worker

Tucson Unified School District

Tucson, AZ


Randy H. Magen, PhD

Associate Dean, College of Health

Professor, School of Social Work

University of Alaska

Anchorage, AK


Deana F. Morrow, PhD, LPC, LCSW, LISW-CP, ACSW

Department Chair and Professor

Department of Social Work

Winthrop University

Rock Hill, SC


Paula S. Nurius, PhD

Grace Beals-Ferguson Scholar and Professor

Director, Prevention Research Training Program

School of Social Work

University of Washington

Seattle, WA


Carl Oekerman, MS

Instructor, Psychology/Communications

Bellingham Technical College

Bellingham, WA


Myrtle Parnell, MSW

Warwick, NY


Susan K. Parnell, LCSW

Court Mediator

Pima County Juvenile Court Center

Tucson, AZ


Shirley L. Patterson, PhD

Emeritus Professor

School of Social Work

Arizona State University

Tempe, AZ


Peter J. Pecora, PhD

Managing Director of Research Services,

Casey Family Programs

Professor, School of Social Work

University of Washington

Seattle, WA


Catherine Sammons, LCSW, PhD

Private Practice

Los Angeles, CA


Lawrence Shulman, MSW, EdD

Emeritus Professor and Dean

School of Social Work

University at Buffalo

Buffalo, NY


Christine Swenson-Smith, MSW

Division Director

Pima County Juvenile Court

Tucson, AZ


Frances E. Tack, MS, LPC, LCAS, CCS

Program Chair

Substance Abuse Program

Central Piedmont Community College

Charlotte, NC


Barbra Teater, PhD

Senior Lecturer in Social Work

University of Bristol, UK


Bruce A. Thyer, PhD, LCSW

Professor of Social Work

Florida State University

Tallahassee, FL


Richard M. Tolman, PhD

Professor

School of Social Work

University of Michigan

Ann Arbor, MI


Jo Vanderkloot, LCSW

Private Practice

Warwick, NY


Joseph Walsh, PhD, LCSW

Professor of Social Work

School of Social Work

Virginia Commonwealth University

Richmond, VA

PART I
Case Studies in Generalist Practice

The idea of generalist practice is an old one. The origins of the generalist concept are as deep as the social work profession itself. Social work pioneers such as Mary Richmond and Jane Addams have stressed the importance of understanding people in relation to their environment. The social workers’ long-standing commitment of a dual focus on the individual and on the society supports the fundamental notions of generalist practice.

Although the notions of generalist practice are old, the emphasis of a generalist perspective in social work reemerged as social work programs began to offer Baccalaureate of Social Work (BSW) degrees. The BSW programs, as stipulated by the Council on Social Work Education, required education from a generalist perspective. Currently, most BSW programs focus their curricula on generalist practice, and MSW programs use the first year, or foundation year, for education on the generalist approach to practice. As Landon (1995, p. 1102) concludes, “in the quest for a theory for this broad practice base, social work education adopted notions from general and social systems theories and ecological thinking to undergird the foundation for all practice.”

Generalist practice has reemerged as central to social work education. But what exactly is generalist practice? How is it defined? Not surprisingly, there is no one definition of generalist practice. However, important themes emerge in the various definitions.

Several generalist social work practice books describe generalist practice as beginning with a decision as to what the unit of attention should be—an individual, a family, a small group, an agency or organization, or a community (Johnson & Yanca, 2009; Krist-Ashman & Hull, 2008). The generalist model promotes a multimethod and multilevel approach, an eclectic theory base, and the dual perspective of social work. Schatz, Jenkins, and Sheafor (1990) generated a three-level model of generalist practice:

  1. 1. The generic or foundation level of knowledge necessary for all social workers, regardless of later specialization, includes the purposes, values, focus, and knowledge base of the profession.
  2. 2. The initial generalist level includes competency in direct and indirect practice based on multilevel assessment and the capacity to intervene on multiple levels, perform various practice roles, and evaluate practice ability.
  3. 3. Generalist practice at the advanced level delineates knowledge needed for practice in greater depth and in relation to more complex and technical issues.

Lastly, any discussion of the generalist perspective would be remiss to omit a discussion of the ecological perspective. The underlying theory of social work is rooted in social systems theory, particularly ecological-systems theory. Gitterman and Germain (2008, p. 20) describe the theoretical underpinnings of an ecological perspective, or what they refer to as the life model:

Ecology is a science concerned with the relations between living organisms—in this case, human beings and all the elements of their environments. It is concerned with how organisms and environments achieve a goodness-of-fit or adaptive balance and equally important, how and why they sometimes fail to do so.

Ecological-systems theory provides an understanding of the person-in-environment perspective, stressing how critical interactions occur between individuals and their environments. This model directs social work practice at the interface of these systems and helps social work practice maintain a dual emphasis. Social workers assess an individual in relation to the opportunities and obstacles that exist in one'S environment.

In this chapter you will read three case studies that explicitly address a generalist perspective in social work practice. The first case study by Patterson, Jess, and LeCroy describes an ecological perspective and shows why it is considered the cornerstone of good generalist practice. It takes the fundamental concepts from ecological theory and illustrates how they can be used in direct social work practice. The case study demonstrates how the notions of ecological theory are tantamount to generalist social work practice.

The case study by Lortie presents a complex situation for a social worker in a hospital setting. It elucidates how generalist practice with a person-in-environment perspective must consider the resources available to a person. It is an excellent example of how critical good case management can be and shows that case management services represent social work at the interface of the person and the environment. A lot of social work practice revolves around helping individuals cope with a difficult environment. In addition to helping them cope on an individual basis, we must help bring services to bear on their problems.

The last case by Chapelle extends the generalist model to community-based work. Too often, social work is focused narrowly on the individual. As this case demonstrates, good social work practice can take place at the community level. Using basic concepts of community practice, this case shows how a social worker can approach large-scale change in a community.

Together these cases represent a sample of how direct-line practitioners view generalist practice. It should give you a good, practical feeling for what it means to do generalist practice. Also, it should alert you to the difficulties and complexities of doing good social work. When our attention is focused on personal problems and social concerns, multilevel methods, and ecological understandings, we are faced with drawing on a broad range of skills and abilities. Social work practice offers a challenge for those who want to tackle social problems but need a large toolkit.

REFERENCES

Gitterman, A., & Germain, C. B. (2008). The life model of social work practice: Advances in theory and practice (3rd ed.). New York, NY: Columbia University Press.

Johnson, L. C., & Yanca, S. J. (2009). Social work practice: A generalist approach (10th ed.). New York, NY: Pearson.

Krist-Ashman, K. K., & Hull, G. H. (2008). Understanding generalist practice. Pacific Grove, CA: Brooks Cole.

Landon, P. S. (1995). Generalist and advanced generalist practice. In R. L. Edwards (Ed.), Encyclopedia of social work (19th ed., pp. 1101–1108). Washington, DC: National Association of Social Workers.

Schatz, M., Jenkins, L., & Sheafor, B. (1990). Milford redefined: A model of initial and advanced generalist social work. Journal of Social Work Education, 26, 217–231.